The Financial Times has a multi-part series on the pandemic, "Coronavirus: Could the world have been spared?"
You can argue it's related to the discussion about what Alon Levy calls "state capacity" or what we might call "state competence." Levy writes about transit and the increasingly inability of local and regional governments to be successful at expanding it.
In "One thing that Portland doesn't get accolades for: Getting S***/Stuff Done when it comes to sustainable mobility infrastructure," I discuss how Portland is an outlier (and Oklahoma City too, but for different kinds of projects) in its 50 year history of taking on transportation projects successfully, including adding and integrating multiple transit modes into one network.
There are some gaps in the FT series. For example, I'd have included a piece on Asian countries other than China, specifically Taiwan, South Korea, Hong Kong, and Singapore, and their success mostly and failures (a couple) at responding to the coronavirus, which would have furthered the lessons.
Another important article to include would have been on the massive failures by the CDC and the FDA, not just because of control by the President's office and the HHS higher ups, but because of execution failures and ossification and an unwillingness to act outside of traditional regulatory processes in terms of speed. As well as control of the data ("Why Can’t We See All of the Government’s Virus Data?," New York Times) etc.
Note that the
Wall Street Journal has also been running an ongoing series on response to the coronavirus which is excellent as well: "
The Covid Storm;" and they've focused more on the US and have some of the articles that I wished would have also been in the
FT series, such as on the failure of the FDA to authorize tests and expanded testing by various types of laboratories ("
What Derailed America’s Covid Testing: Three Lost Weeks").
The pieces address China, Europe, New York ("How New York’s missteps let Covid-19 overwhelm the US") and Africa, as well as reader responses.
I'd summarize the lessons as:
1. Many countries, not just authoritarian countries like China, at the outset were more concerned about controlling information and the narrative, than responding.
2. China's authoritarian focus on control and top-down decision making impeded their response.
3. But once they hammered out a position on what to do, because they are an authoritarian country, they could respond decisively with great control focused on stamping out the virus.
4. Most Western countries, because they have limited direct experience with pandemics, but with "run of the mill" flu epidemics, didn't take the threat of the potential of a highly infectious disease seriously. Hundreds of thousands of people have died as a result.
5. Asian countries had experience with SARS and therefore developed the systems to respond. They understand the asymmetric position they are in vis a vis China and monitor disease-related events there closely.
6. Africa, despite its lack of resources, is highly experienced with epidemics and takes them seriously. It responded more quickly than most Western countries, even though at the time it had almost no cases.
Interesting too is image over substance.
7. While people like New York State Governor Andrew Cuomo got lots of accolades for high quality communication and action on the coronavirus, the reality is that his failure to respond with alacrity cost up to 20,000 lives.
From the article on the response in New York:
Mr Cuomo has been hailed for how he fought the ensuing fire, calmly informing the public and marshalling resources. His new book contrasts his crisis management skills with an incompetent national response. But a closer examination of those crucial early weeks tells a less flattering story, of divisions between New York and Washington; the governor and the mayor; the mayor and his health department; and the city’s richest and poorest hospitals.
Many of those divisions persist, raising questions about how many lessons have been learnt from New York’s fraught spring as it enters the winter with cases climbing once more. ...
Our understanding of coronavirus has improved since March, but interviews with dozens of the people at the centre of New York’s response show that its leaders were warned of the threat and could have acted faster.
... New York’s leaders were trying to quell fears, not rouse them. ...
Scares over previous epidemics hitting New York had proved unfounded, and the mayor and governor were treating the disease like Ebola — preparing for isolated cases, not a rampant outbreak. But Michael Osterholm, a University of Minnesota epidemiology professor, believes the public health community “lost six weeks” because they saw coronavirus as less of a threat than a flu pandemic. It was “more than a fog”, he says. “It was like Jell-O.”
This particular piece of mine is good on linking more closely public health and health care systems, albeit not just for pandemics but for chronic health conditions:
-- "More communities need to integrate health care and public health programming: Prince George's County, DC, etc."
In the comments thread on that entry, I add links to new relevant information and concepts as I come across them.
American exceptionalism. While yes, there is the trope of American exceptionalism, the pandemic shows that plenty of countries, not just the United States, have a form of exceptionalistic thinking which means that much of the time they aren't particularly interested in scanning other places for examples of better practice.
(One counter to this, although it's a trend in academia and the information gathered and knowledge created probably tends to stay within academia despite the attempts at dissemination are the think tanks created that have "Observatory" in their name, such as the Observatory on Latin America at the New School.)
Fareed Zakaria had a column on this topic a couple months ago ("What sets apart countries that successfully handled the pandemic? Failure," Washington Post). I disagree with his conclusion--that previous failures better prepared the countries that best responded to the coronavirus, but then, I've always been oriented to gathering best practice ideas from "elsewhere," be it another university, a journal, different academic disciplines, other states, and later, different countries.
I'd say not failure, but having to respond because they had no other choice, was the "secret" to their success.
When I first got involved in urban revitalization, I paid a lot of attention to best practice in other cities, especially cities more economically challenged than Washington, DC, like Pittsburgh--at the time, or Baltimore.
My line about them was that they had "a desperate willingness to be innovative, because they had no other choice."
Economic success too often breeds complacency. And complacency is the biggest problem in governance in the US, at all levels.
It's why many cities and states are doing a bad job expanding transit and taking care of infrastructure. It's why the federal government is failing at responding to disasters like Hurricane Katrina or Hurricane Maria, which devastated Puerto Rico.
The WMATA train crash at Fort Totten in Washington, DC, in 2009 killed 9 and is a perfect of complacency and governance and operational failure. The problem with signal communication had come up previously, but train crashes had been avoided. Rather than accepting that these incidents were indicators of deeper, systemic problems, the managers of the subway operations focused on system uptime. Photo: US Transport Society.Complacency is built upon disinvestment in government--people, capacity, material, etc. The US has been able to muddle through for a long time since Reagan ushered in neoliberalism and a continued disinvestment in government capacity and tax receipts, because of the high level of investment in government and infrastructure before then.
Photo: Emergency crews work at the scene after the Interstate 35W bridge over the Mississippi River in Minneapolis collapsed on Aug. 1, 2007. Photo: Scott Takushi / St. Paul Pioneer Press, "The day a bridge collapsed in Minneapolis and lives changed forever."
The bridge collapsed because of faulty maintenance and inspection. Thirteen people died and 145 were injured.
But finally, that previous level of "over" investment has been exhausted, tapped out, and failure is now much more frequent. As long as the Republicans control significant swathes of government, disinvestment will intensify ("
Stunning' Executive Order Would Politicize Civil Service,"
Government Executive; "
Trump’s historic assault on the civil service was four years in the making,"
Washington Post).
Labels: change-innovation-transformation, decision-making, pandemic/public health, provision of public services, public administration
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