COVID-19: Armchair Quarterbacking

There’s a ton of anger toward Donald Trump for his mishandling of the present outbreak.  I understand it; at present, I myself am quite disappointed.  There’s a few things that ought to have been done much sooner, and we should examine them.

We have too few doctors, nurses, nurse’s aides, people trained in hazmat disposal, and people trained in the use of protective gear.  We have too few hospital beds and, at the same time, several rural facilities that have recently closed.  The news is focused on the story that we have too few ventilators, and we’re also low on surgical and quarantine masks.  And some of these, we could have changed with some early decisive action from the Oval.

Going forward, it’s my hope that we learn from this, so I’m going to ask you to suspend your rage and consider what precisely it is that failed us.  That way, next time, we’ll at least make different mistakes.  Eventually, if we survive long enough, we’ll get it right.

(Yes, I can hear you in the back:  “Don’t vote Trump” is a little vague compared to what I have in mind.)

To begin, here’s some things we simply couldn’t have done without changing our society at a fundamental level — constitutional amendments, that sort of thing.  We’ll knock these off the list, or we’ll look at them in a different light.

  1. Closing Borders:  This is a pandemic that spreads asymptomatically.  There’s no way we could have stopped it from coming to this country even by locking down every overseas flight and sealing the borders.  We’ve already demonstrated we lack the political will to seal the borders, so there’s no sense complaining about this now.

    For the next pandemic, if we want to change this, we’ll need to be able to secure our borders absolutely.  In order to remove the profit motive from our border crossings, legalizing most common illegal drugs — those that can’t be cooked up in a kitchen — is absolutely vital (so they stop digging tunnels).  Additionally, we also would need fortified border reservations for refugees, both physically and from a legal standpoint.  Remember, borders also include airports — and the entire coastline of Puerto Rico, which sees half a million illegal immigrants per year.  Again, I’m fairly certain we lack the political will to do any of this.
  2. More Doctors, Nurses, and Hospital Beds:  We run on a for-profit healthcare model.  Trained healthcare professionals are well paid (and for good reason), but there’s only as many jobs open as the customers need during normal operations.  That’s far too few for even a local crisis, much less the present situation.  As well, it’s worth noting that most of our doctors are specialists; many lack the expertise we need at present, and precious few are well-practiced at the necessary techniques.

    There are some simple ways for us to increase patient capacity.  One would be to create publicly funded rural hospitals in areas that right now can’t maintain them (and might have recently closed them).  During normal life they could be maintained and supplied but only lightly staffed outside of emergency rooms; this would serve the public interest and save lives even then.  In order to maintain reserve personnel, the establishment of a National Medical Corps just makes sense — particularly if it overlapped with both active military and V.A. jurisdictions; rotation between posts could broaden training and licensing while providing needed down time.  Training, of course, would be at the public expense, just like how we train our combat medics now.
    (Nationalizing the entire healthcare system might be simpler, to be honest.  But I’m not convinced our country can agree to do it.  Even this moderate proposal may be too much for us.)
  3. Fully Fund The C.D.C.:  While it’s not true that Trump defunded the C.D.C. or crippled our nation’s pandemic response team, at least a part of that isn’t for lack of trying.  The “show budgets” issued by the White House since 2017 all contain massive cuts to these programs, and if the House weren’t controlled by the opposing party at least some of them would have gone through.  The international observer programs have been downsized; that’s for geopolitical reasons, and until we have world peace we probably can’t fix those.

    But the C.D.C.’s budget can be made apolitical, or at least largely so.  If it’s set up on a long-term and automatically-renewing appropriations system, Congress won’t have the ability to make cuts without taking extraordinary action.  That can’t be done under the public eye.  In order to make it completely independent, we’d need something massive, similar to Social Security but with greater protections built in.
  4. Get Reliable Tests For Everyone:  If this could be done, we’d be doing it, even in the present system:  There’s massive profits on the line, and drug companies just love massive profits.  The biggest hurdle is trying to develop a reliable antibody test that can be cheaply mass-produced, distributed, and used by people with little training.

    The biggest delay in our national response this time was the production of faulty kits by the C.D.C. team (note that the article has been partially debunked).  That, combined with a reluctance to use the W.H.O. recommended protocol (possibly justified over time constraints), led to a bureaucratic mess.  Excessively burdensome regulation and red tape prevented local hospitals and labs from relying on their own tests.Honestly, the only thing I can think of to fix this is to streamline the C.D.C. and associated red tape.  And that’s not going to be easy — or popular.

So much for what we can’t easily fix.  Now let’s look at a few things we can:

  1. Improve Hospital Ships:  The USNS Comfort and USNS Mercy are in the headlines right now, but all you probably know about them is that they’re seagoing hospitals with a thousand beds each.  So far so good — and very useful in the present emergency.  But what you don’t know is, they’re forty-year-old converted oil tankers in need of upgrades, and there’s only two of them in the whole fleet.  Right now we could use three dozen — and, comparatively speaking, they’re not all that expensive.
  2. Improve The National Supply Stockpile:  People have been saying for years that we need more ventilators.  Well, we’re about to have them; Tesla has donated thousands, and converted manufacturing plants are making thousands more.  So that’s about to be taken care of going forward; doubtless there’ll be some quality issues and maintenance problems, but we’ll get there.  We’re also about to have enough manufacturing capacity to generate masks and PPE sufficient to our need.  We’ll need to maintain that post-crisis, but that’s far easier than building it on the fly, which is what we’re doing now.
  3. Practice:  We’re right in the middle of the present trouble, and it’s difficult to conceive of a time when it’s over.  But when it is, we’ll have a natural tendency to forget.  Some people will complain loudly about overreaction; others will claim that this is an extremely rare occurrence.  Nevertheless, it would be wise for us to continue certain things going forward:  Keep spare preserved foods and dry goods at home, and be ready for a disaster at a moment’s notice.

In “Walden”, Thoreau’s theme was based on the supposition that people rarely take the time to examine their lives and their selves, and that if they do they fail to do so honestly.  “…It appears as if men had deliberately chosen the common mode of living because they preferred it to any other.  Yet they honestly think there is no choice left.”

Right now we have the chance to examine why we live our lives the way we do, and how we can improve on them.  It’s rare that an entire society gets this chance; we would be remiss if we failed to take advantage of it.

Things look grim right now, sure.  But if we behave with wisdom and informed intelligence, tomorrow will be a better day because of what we now do.

One thing we might consider is envisioning a world in which I don’t need to ask for donations to keep this going. Until we live in such a world, however, your money is most welcome — the more so because, like an honest politician, it’s so rarely seen.

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