Where do we go from here?

Last update: Friday 10/30/20

In the spring of 2020, when media pundits chanted over and over again that we were all in this together, skeptics like me bit our tongues.

EXECUTIVE SUMMARY -- TLDR

The U.S. has failed and failed badly to manage the COVID-19 pandemic. Most media pundits lay most of the blame for our failure on President Trump's irresponsible mismanagement. However, after a thorough examination of the facts as reported in the major U.S. media and in publicly accessible databases, I have reluctantly concluded that the White House task force and the CDC committed so many large unforced errors that our nation's efforts to manage the pandemic were doomed to fail, regardless of the president's lies and misdeeds. 

INTRODUCTION

As we come to the end of a hot pandemic summer, it's clear that the U.S. has failed and failed badly to manage the COVID-19 pandemic. Our epic failure stands in stark and surprising contrast to the success achieved not just by authoritarian China, but by a long and growing list of democratic countries whose financial resources are orders of magnitude smaller than our own; think South Korea, New Zealand, Japan, Australia, Iceland, Canada, Vietnam, Singapore, Germany, Denmark, Italy, Spain, France, Israel, etc, etc, etc.  So how did this happen? And where do we go from here?

Most pundits lay most of the blame for our failure on President Trump's irresponsible mismanagement. While I take no issue with their identification of our self-serving president as the most important factor, I have reluctantly concluded that the White House task force and the CDC committed so many large unforced errors that our nation's efforts to manage the pandemic were doomed to fail, regardless of the president's lies and misdeeds. 

President Trump has thrived by exploiting pre-existing divisions in our society. This time his pressure on Republican congressmen, senators, and governors to reopen the economy asap in May exacerbated the nation's deep division over its economic health vs its public health. This conflict pitted the old against the young, and it is the most important division with regards to the spreading of the virus. Conflicts between the different interests of different generations have usually been muted in our society. But I will argue that the manner in which the White House task force presented its recommendations fanned the low burning embers of this division into roaring flames of distrust. 

I will argue that the main causes of our epic failure to manage the coronavirus were two strategic blunders: wrong messengers and wrong messages:

• Wrong messengers, specifically, Dr. Fauci, the other members of the White House task force, and the CDC
  
  
• Wrong messages, for example, "We're all in this together" ... Yes, but not at the same time. Nevertheless the task force recommended that we lock the whole country down at the same time in March, from continental coast to continental coast and all points in between.

Wrong Messengers

The coronavirus kills old people and turns most young people into carriers, often asymptomatic. Therefore the success of any plan to substantially mitigate its spread would depend heavily on our success in persuading younger generations to make extraordinary personal and financial sacrifices from which the vast majority of them will not derive any personal health benefits.  By contrast, older people, the primary victims of the virus, have far more wealth, e.g., stocks, bonds, savings, property, and pensions; so they are better positioned to survive a lockdown's furloughs and layoffs than younger people. 

The primary messengers who would convey mitigation messages to the younger segments of out society would obviously have to be well known personalities who had already established their ability to exert substantial influence over the behavior of young folk, e.g., celebrity athletes on local sports teams; music, movie, TV, and social media stars; and other kinds of influential local celebrities. They would also have to deliver their advocations of monkish/nunnish lifestyles via the media that was most frequently accessed by their young audiences, e.g., TikTok, Instagram, and YouTube.

So why did anyone believe that the un-young Dr. Fauci and the other un-young members of the White House task force, rigidly standing shoulder to shoulder on daytime TV shows, would be persuasive purveyors of "Just say no" messages about the virus. How could anyone over forty have been surprised when the under forty crowd exploded out of lockdown onto the nation's beaches and bars -- without masks -- on the Memorial Day and July Fourth weekends? Disappointed? Yes. But surprised? Let's stop kidding ourselves. 

Wrong Messages

The members of the task force were not only the wrong messengers; they often delivered the wrong messages. Let's start with a couple of easy examples:

• During the daily White House Task Force TV shows in March, its members recommended social distancing, specifically, getting no closer than six feet from other people in public places. They made these recommendations while standing shoulder to shoulder.
  
  
• In April, the task force and the CDC strongly recommended that we all wear masks in public places. They did so while standing within six feet from President Trump who refused to wear a mask  (Recommendation reported in "C.D.C. says all Americans should wear masks. Trump says the rule is voluntary.", NY Times, 4/3/20)

I suggest that it is unarguable that the failure of the task force to follow its own recommendations undermined the credibility of its recommendations. Should the crucial younger generations have believed what the members of the task force said or what they actually did? 

But let's suppose that President Trump insisted that they huddle together in March and excused himself from wearing a mask in April? If so, I suggest that the members of the task force should have shown the same courage as the whistle blowers. They should have notified the president that they would not participate in presentations that violated the life saving procedures they had recommended. And if he refused to conduct the presentations in accordance with their recommendations, they should have submitted their resignations and issued public declarations as to why they were resigning.

COVID-19 is like the flu

In February 2020, President Trump assured the public that the 15 known cases of COVID-19 at that time would disappear, so there was nothing to worry about. However in private telephone interviews with the Washington Post's Bob Woodward, President Trump admitted that he had been warned in a late January intelligence briefing that the COVID-19 virus was far more deadly than the ordinary flu, that it would be like the 1918 Spanish flu pandemic that killed 675,000 Americans, and that it would pose the biggest national security threat that he would face in his presidency. Nevertheless, President Trump publicly asserted that COVID-19 was like the regular flu, and that we had it under control. In another telephone call a few weeks later he told Woodward that he "played it down" because he didn't "want to create a panic".  

Given that Dr. Fauci is supposed to be the "nation's leading expert on infectious diseases", he too should have known that COVID19 was far more dangerous than the flu. Nevertheless he played along with President Trump's feel-good happy talk that we had the coronavirus under control. In a mid-February interview, he declared that the seasonal flu was a bigger risk to the U.S. than COVID-19.

• "Inside Donald Trump's 18 recorded interviews with Bob Woodward for his book 'Rage'", CBS News 60 Minutes, 9/13/20
• "Woodward book: Trump says he knew coronavirus was ‘deadly’ and worse than the flu while intentionally misleading Americans", Robert Costa and Philip Rucker, Washington Post, 9/9/20
• "Disease Expert: Flu a Bigger Risk in the US Than Coronavirus", Taurean Small abd Christie Zizo, Spectrum News 12, 2/15/20 ... features video recording of Dr. Fauci answering questions.

Flattened curve

Another damaging message was delivered by the task force over and over again: the fable of the flattened curve, no, THE flattened curve. The members of the task force referenced this tale every day, with emphasis on changes in the national counts. 

I suggest that curves that show nation-wide increases or decreases of infections, hospitalizations, and deaths are as useless as nationwide weather reports, useful for transcontinental jet setters, but of no practical value for the vast majority us who don't travel more than a hundred miles or so from our homes from one week to the next. Like local weather reports, the news we could really use were the curves that described the impact of the virus on the specific states, counties, cities, towns, and villages in which we lived. 

Weekly national reports from the White House task force might have provided useful context; but daily presentations were a distraction. By contrast, daily 15 to 30 minute local reports from the task forces of our governors and mayors that were delivered to our smart phones via YouTube and other media would have provided us with information that was more useful and more credible. These reports should also have included public service endorsements from the kinds of proven local influencers that I referenced in my earlier comments about the most persuasive purveyors of mitigation messages to the younger generations.

"The science"

From time to time Dr. Fauci, other members of the task force, and their pundit fans in the media have characterized the opinions of the task force as adhering to "the science" as opposed to the opinions of people who disagreed with them. Those who disagreed were branded as "anti-science". 

In my opinion, the task force has yet to show sufficient appreciation of the breath-taking scope of the changes that their recommendations were imposing on our daily lives, but particularly on the lives of younger Americans. Indeed, our total war against the virus has demanded far greater changes in the daily lives of a much larger percentage of America's young civilians than were demanded by our total war against the Axis Powers in World War II. 

It must be noted that no members of the task force had any prior experience managing a disease as contagious as COVID-19 in a country as large as ours, with a population as large as ours, and with political divisions that ran as deeply as ours when they were first introduced to the public. So none of them had track records of prior success at the level of the challenges that we were facing. Nevertheless they asked us to trust them, i.e., to believe their repeated assertions that appropriate supporting data for their recommendations existed and that their interpretations of this data were the only legitimate interpretations that were consistent with "the science."  

I question some of the task force recommendations, so I am offended by any implication that I am anti-science. My undergraduate degree was in engineering physics, a program designed to give certain kinds of engineering students a thorough grounding in physics because physics was their discipline's most important underlying science. Here are two of the broader insights that I derived from my undergraduate education. 

• First, large engineering projects are usually multidisciplinary activities that involved professionals having expertise in areas outside of engineering and physics.
  
  
• Second, large engineering projects usually entail trade-offs between incompatible goals, as in, if you get more of this, you will get less of that, and vice versa. 

These insights lead me to doubt that the successful management of a national pandemic can occur without the substantial involvement of experts from fields outside of "the science". And it also raises doubts that success in the management of a national pandemic can avoid painful trade-offs between incompatible values, e.g., economic health vs. public health. Trade-offs are inherent features of all large scale human endeavors because our most ambitious pursuits tend to involve incompatible goals.

Given my educational background, I am troubled by three task force recommendations that were supposedly based on "the science" 

• Social distancing -- This should have been an easy one, but it wasn't. Having no expertise with regards to infectious diseases, I would have accepted without question whatever standard the task force proposed, e.g., six feet ... until I discovered that the World Health Organization (WHO) supports a one meter limit -- a little more than three feet -- and that Europe and most of the rest of the world have adopted this standard.
  
  Most European nations have been far more successful than the U.S. in managing the pandemic; so they don't seem to have suffered any significant penalties for maintaining a social distance that is only half as long as ours. Conversely, given our abject failure, we have yet to derive any tangible benefits from our adherence to a social distance that's twice as long as theirs. "The science" underlying the European efforts cannot be different from "the science" that underpins our efforts.
  
  A three foot standard makes it twice as easy to restart economies as a six foot standard, e.g., by fitting twice as many students in classrooms, twice as many customers in restaurants, and twice as many passengers on airplanes. So what kinds of trade-offs were involved in our adoption of a six foot standard? And when will we get more of whatever we were supposed to gain from our larger distance?
  
  
• Face masks -- Here's another task force recommendation that should have been a no-brainer because the value of masks should have been determinable solely by "the science". Unfortunately, as I noted earlier, the task force flip-flopped. Readers may recall that in early March the members of the task force, especially Dr. Deborah Birx (task force response coordinator) and Dr. Jerome Adams (U.S. Surgeon General), discouraged the wearing of face masks by anyone who was not a healthcare professional.
  
  According to the task force, "the science" demonstrated that the only masks that had any protective value against the virus were the N95 masks that were in woefully short supply. They told the public not to buy N95 masks so that more healthcare professionals could buy them ... AND they said that wearing non-N95 masks was worse than useless because wearing them might give the public a false sense of security which might cause some people to be less careful about distancing, washing their hands frequently, and not touching their faces. 
  
  In April the task force suddenly reversed course. Now they proclaimed that they had just learned that "the science" demonstrated that non-N95 masks were incredibly effective in preventing their wearers from infecting other people. So everybody should wear non-N95 masks.
  
  Obviously one of those two recommendations was wrong. If non-N95 masks really were effective, how come the task force, including Dr. Fauci -- "the nation's leading expert on infectious diseases"-- didn't know their value in March. Masks are ubiquitous in most Asian countries and by March 2020 most Asian countries had already demonstrated that they were far more effective in managing the virus than European countries where masks were not worn. 
  
  So why hadn't the task force read publications by Asian experts about the value of non-N95 masks before proclaiming in early March that "the science" demonstrated that non-N95 masks had no value? Evidently they did not understand "the science" as well as they claimed. Their ignorance confused millions of people and probably cost thousands of lives.
  
  Interested readers are referred to a recent article "At the heart of dismal U.S. coronavirus response, a fraught relationship with masks", Griff Witte, Ariana Eunjung Cha and Josh Dawsey, Washington Post, 7/28/20. it provides a broader, more detailed discussion of the contribution of the task force's confusing flip-flop to the substantial resistance to wearing masks in various parts of the country. The article also discusses the contributions of our cultural/political divisions to this resistance.

• Lockstep lockdown -- This is my biggest concern. I will discuss it in a subsequent section of this note (below).

CDC shortfalls

I am also troubled by evidence of underfunding and mismanagement within the CDC. Mind you, I was not looking for perfection so was I not disturbed, at first, when some of the CDC's efforts went off the rails. Every engineer knows that no matter how carefully you plan your projects, sooner or later you will confirm that the best laid plans of mice and men are often demolished by Murphy's Law -- "Anything that can go wrong will go wrong" ... which is why good engineers always have backup plans ... and backups to their backups ... :-)  

Since the onset of the pandemic, the CDC has evidenced a number of significant deficiencies; but here are the two that I found most troubling:

1. The CDC failed to produce valid test kits for the Coronavirus 
The kits they sent out in January were contaminated. Weeks were lost as the CDC tried and failed to correct its error. Eventually a contractor produced valid kits.

As it happens, the World Health Organization (WHO) had offered their own test kits to the CDC before the CDC released its defective kits, but the CDC turned them down. A prudent engineer would have initially positioned the CDC's planned kits as the backups to the WHO's working kits, then reversed the roles once the CDC's kits became available.

Subsequent inquiries determined that the CDC produced contaminated kits because it had failed to maintain adequate quality control in its production facilities. Murphy's Law was not involved. 

2. The CDC uses antiquated data technologies 
No, that's pithy, but misleading. A more precise statement should read: The CDC and its underfunded public health affiliates at the state and local levels still make extensive use of antiquated, time consuming, error prone data collection technologies including fax, email, and paper. These glaring tech deficiencies reflect chronic underfunding that predates the coronavirus by at least 20 years.

Given their central positions in our total war against the coronavirus, one would have expected that the CDC and its affiliates were deploying state-of-the-art cloud-based technologies to collect and disseminate up-to-the-minute data about tests, infections, hospitalizations, and deaths.  How else could the task force, our governors, and our mayors make timely and effective decisions about imposing or lifting restrictions on our employment and leisure activities?  Remember the old GIGO principle -- garbage in, garbage out? It still applies.  

Readers interested in more detailed discussions of these and other CDC shortfalls are referred to the following reports in major media:

• "C.D.C. Labs Were Contaminated, Delaying Coronavirus Testing, Officials Say", Sheila Kaplan, NY Times, Sunday 4/19/20 ... This story also covered by the Washington Post, Sunday 4/19/20
  
  
• "Virus hunters rely on faxes, paper records as more states reopen", Darius Tahir, Pollitico, 5/10/20
  
  
• "‘How Could the CDC Make That Mistake?’", Alexis C. Madrigal and Robinson Meyer, The Atlantic, 5/21/20
  
  
• "The CDC Waited 'Its Entire Existence for this Moment.' What Went Wrong", Eric Lipton, Abby Goodnough, Michael D. Shear, Megan Twohey, Apoorva Mandavilli, Sheri Fink and Mark Walker, NY Times, 6/3/20
  
  
• "C.D.C. Now Says People Without Covid-19 Symptoms Do Not Need Testing",  Katherine J. Wu, NY Times, 8/25/20 
  
  
• "The nation’s public health agencies are failing when they’re needed most", Chelsea Janes and William Wan, Washington Post, 8/31/20
  
  
• "C.D.C. Testing Guidance Was Published Against Scientists’ Objections", Apoorva Mandavilli, NY Times, 9/17/20
  
  
• "C.D.C. Reverses Testing Guidelines for People Without Covid-19 Symptoms", Apoorva Mandavilli, NY Times, 9/18/20
  
  
• "Advice on Airborne Virus Transmission Vanishes From C.D.C. Website", Apoorva Mandavilli, NY Times, 9/21/20
  
  
• "No matter what the CDC says, here’s why many scientists think the coronavirus is airborne", Ben Guarino, Chris Mooney and Tim Elfrink, Washington Post, 9/21/20
  
  
• "Can Colleges Rely on the CDC?", Elizabeth Redden, Inside Higher Ed, 9/23/20
  
  
• "Inside the Fall of the CDC",  James Bandler, Patricia Callahan, Sebastian Rotella and Kirsten Berg, ProPublica, 10/15/20

Lockstep Lockdown 

I suggest that the most damaging message the task force delivered was its recommendation that the entire country be locked down at the same time in mid-March, from continental coast to continental coast and all points in between. President Trump issued a proclamation that declared that the coronavirus outbreak was a national emergency on March 13, 2020, then posted Coronavirus Guidelines for America. Here are some of the key points in the text and footnotes of his guidelines:

• "If someone in your household has tested positive for the coronavirus, keep the entire household at home."
• "Work or engage in schooling from home whenever possible."
• "Avoid drinking at bars, restaurants and food courts -- Use drive-thru, pickup, or delivery options."
• "Avoid discretionary travel, shopping trips, and social visits."
• "... Governors of states with evidence of community transmission should close schools in affected or surrounding areas ..."
• "In states with evidence of community transmission, bars, restaurants, food courts, gyms, and other indoor and outdoor venues where groups of people congregate should be closed."

Note that President Trump's guidelines were merely guidelines; they were not regulations whose violations would result in fines and/or jail sentences. However, the last two points quoted above directed the governors to issue regulations that would put legal teeth into some of these guidelines by closing schools, bars, restaurants, gyms, etc wherever they found "evidence of community transmission." Given the acute shortage of test kits at the time, contact tracing was all but impossible; so most cases of infection had to be regarded as "evidence of community transmission." 

Also note that the guidelines did not suggest any statistical measures of the spread of the infection. Statistical measures would have shown that some states were hot spots, e.g., California and New York; but some states had very few infections, hospitalizations, and deaths , e.g., Vermont, New Hampshire, and Maine; while most states fell somewhere in between these two extremes. Nevertheless, the president's proclamation of a "national emergency" implied that the problem was substantial in all states. This notion was amplified by media pundits who chanted over and over again that we were all in this together; so obviously we all needed the same remedy: shut down asap.

This notion was highly questionable given the huge scale and diversity of the U.S. The coronavirus is transmitted through face-to-face social and workplace networks. Americans and foreign residents are clustered in thousands of distinct face-to-face networks unevenly spread across America's 3.8 million square miles. Therefore it is almost inconceivable that a new virus that first entered the U.S. in January 2020 could have become more or less equally prevalent in all of the social and workplace networks in all 50 states by mid-March. 

However, given the somber tones of the president's proclamation and the repeated urgings of the task force during their TV presentations for everyone to shelter at home, it came as no surprise that most households and most non-essential businesses in all 50 states shut down right away -- most, but by no means all. As consequence, by the end of April thousands of businesses large and small had closed; the stock market had collapsed; and over 30 million applications for unemployment compensation had been filed. In other words, our economy tanked.

But what about the virus? First the good news. The governors of New York and its sister states (New Jersey and Connecticut) in the super hot spot tristate epicenter of the virus issued regulations that mandated full lockdowns, similar to the lockdowns in Europe, lockdowns that were comprehensive and legally binding. The governor of California, the nation's other large hotspot at the time, also imposed a comprehensive legally binding lockdown. Both lockdowns succeeded in flattening the hospitalization curves in their states. Unfortunately, the task force's one-size-fits-all policy had negative effects downstream, i.e., after the lockdown ended, in some states and substate regions wherein the virus had barely appeared. 

The next section of this note briefly reviews the task force's flexible strategy for restarting the states' economies. It will be easier to discuss the negative downstream effects generated by the one-size-fits-all lockdown in the context of the flexible restart.  

Restart

In mid-April the task force recommended that states exit lockdown and restart their economies in three phases. (See "Opening Up America Again", White House Task Force. 4/16/20). 

The task force offered guidelines as to the specific restrictions that each state should impose while in lockdown, in Phase One, in Phase Two, and in Phase Three. The restrictions were less demanding in each succeeding phase. Phase Three was, therefore, akin to a new normal, i.e., as close to the old normal as states could get before the widespread availability of effective vaccines.

The task force specified three criteria for determining whether a state should move out of lockdown into Phase One:

• Symptoms: "Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period ... AND ... Downward trajectory of covid-like syndromic cases reported within a 14-day period"
  
  
• Cases: "Downward trajectory of documented cases within a 14-day period ... OR ... Downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests)"
  
  
• Hospitals: "Treat all patients without crisis care ... AND ... Robust testing program in place for at-risk healthcare workers, including emerging antibody testing"

The task force then specified that these same three criteria be applied a second time to determine whether a state should move from Phase One into Phase Two. And it specified that the criteria be applied a third time to determine whether a state should move from Phase Two into Phase Three

In other words, the task force made a rigid one-size-fits-all recommendation in March that all states lockdown at the same time, regardless of the actual status of the virus in each state; but in April it recommended a flexible restart strategy that allowed different states to restart their economies at different times, depending on the status of the virus in each state. Moreover, the restart document explicitly stated that its strategy was "implementable on statewide or county-by-county basis at governors' discretion", thereby affording the governors even more flexibility.

Lockstep Lockdown ... (continued)

Unfortunately, there was a glaring inconsistency in the April restart strategy, a flaw that stemmed from the March recommendation to lockdown all states at the same time, regardless of wide differences in the status of the pandemic among the 50 states. 

• States that entered lockdown with high rates of new infections might achieve downward trajectories, but still have high rates. Nevertheless, they would still be eligible to leave lockdown and enter Phase One.
  
  
• On the other hand, states that entered lockdown with relatively low rates of new infections but merely maintained the same low rates or incurred small increases in these rates would not be eligible to leave lockdown.

I suggest that the task force should have defined lockdown in absolute terms, e.g., X new infections per 1,000 tests within a two week period. Only the small number of states whose viral measures were equal or above the X lockdown thresh hold should have been encouraged to lockdown. These states should only have been encouraged to leave lockdown if their downward trajectories moved them below the lockdown thresh hold. On the other hand, most states should have been encouraged to regard themselves as being in Phase 1, Phase 2, or Phase 3, depending on their infection rates.

In other words, the categories should have been characterized as levels, not as sequential phases, e.g., as Levels Zero, One, Two, and Three. Lockdown would have been Level Zero wherein the infections per 1,000 tests would have been highest; Level One would have been specified by a lower thresh hold of infections per 1,000 tests; Levels Two and Three by two even lower thresh holds of infections per 1,000.  

Negative downstream effect #1 ... Reopening "too soon"
Some governors in mostly red states reopened their economies in May before they achieved downward trajectories. Readers are referred to the following overview for details: "Most States That Are Reopening Fail to Meet White House Guidelines", Keith Collins and Lauren Leatherby, NY Times, 5/7/20 

Most media reported that GOP governors restarted "too soon" because of pressure from President Trump. Perhaps, but maybe some of the GOP governors also recognized the flaw in the task force recommendation that sentenced their states to the same stringent lockdown restrictions as New York and California, despite the fact that new infections per 1,000 tests in their states were much lower than in those Democratic strong holds. 

Indeed, before the Memorial Day weekend, the pandemic was worst in the East and West coast states governed by Democrats. Readers are referred to the following overview for details, "The Coronavirus Is Deadliest Where Democrats Live", Jennifer Medina and Robert Gebeloff, Washington Post, 5/25/20. 

The efforts of the GOP governors to jump start their economies by rapidly reducing social and workplace restrictions might have succeeded were it not for the collision of their efforts with another negative downstream effect of the lockstep lockdown.

Negative downstream effect #2 ... Doubt, hostility, and rebellion

The New York Times map at the top of the first page of this note shows the location of the 17,935 known cases of the coronavirus on March 21, 2020, about a week after President Trump posted the guidelines recommended by the task force. The red dots indicate the hot spots, i.e., the locations where the virus was highly prevalent. The biggest dots mark the locations with the most cases.  

For the purposes of this discussion, the most significant features of the map are the spaces unmarked by dots, i.e., the communities wherein the virus had not yet had significant impact -- few if any cases, few if any hospitalizations, and few if any deaths. As the reader will see, most of the map is unmarked by dots which means that most U.S.communities had not yet felt the impact of the virus by mid-March. Indeed, some communities would not experience significant presence of the virus until weeks later, some until months later, and others have yet to register significant presence six months later.

By contrast, most U.S. communities felt acute economic pain from the closed businesses and high unemployment that followed within weeks of the task force's recommendations. This disconnect is well described by a NY Times article posted in early June, "A Striking Disconnect on the Virus: Economic Pain With Little Illness", Michael H. Keller, Steve Eder and Karl Russell, NY Times, 6/6/20

When people asked their friends and associates if any of them knew anyone who had been hospitalized or died from the virus, or if their friends and associates had friends and associates who knew anyone who had been hospitalized or died from the virus, they received negative answers. But when they tuned into the daily task force TV presentations that featured national data, they invariably learned that the situation was getting worse and worse. It was like tuning into weather reports and learning about hurricanes and tornados, then looking out the windows and always seeing cloudless skies and sunshine. 

This disconnect gave rise to doubts. (Indeed, some doubters began to believe that the pandemic was a hoax.) Then doubts gave rise to hostility as economic pain increased. This hostility, in turn, provided fertile ground, especially among the youngest cohorts, for the rebellions that exploded all over the country on the Memorial Day weekend and continue to fuel the ever widening surges of the virus since then. Readers who doubt the continuing resistance among younger cohorts to the task force recommendations are referred to the following reports in major media:

•  "As Virus Surges, Younger People Account for ‘Disturbing’ Number of Cases", Julie Bosman and Sarah Mervosh, NY Times, 6/25/20 
  
  
• "Young Americans Are Partying Hard and Spreading Covid-19 Quickly", Rachel Adams-Heard, Washington Post, 7/1/20 
  
  
• "Covid-19 Cases Soar in Young Adults Bored of Social Distancing", Bloomberg, 7/26/20
  
  
• "WHO warns young people are emerging as main spreaders of the coronavirus", William Wan and Moriah Balingit, Washington Post, 8/18/20

New York smart, New York tough

Full Disclosure: I was born and raised in New York City. In an earlier section I noted the influence of my undergraduate education on the content of my mind; prior to that, growing up in the city framed my values. Although it's been decades since I've lived there, I still think of myself as a New Yorker.

This section offers a New Yorker's prideful celebration of Governor Andrew Cuomo's stunning achievement in managing a complex response process that brought the coronavirus under control, despite President Trump's shenanigans. With his steady hand guiding the process, the governor didn't just flatten New York's infections, hospitalizations, and fatality curves; he crushed them.

Being in a "New York state of mind", I offer the following explanation as to why Governor Cuomo succeeded where so many other governors failed. It's written in the brash vernacular of my youth in the South Bronx that is most appropriate for this topic. Readers who might take offense at this kind of rough language are advised to skip to the following section, OK? ... :-)

Most non-New Yorkers know that New Yorkers, especially those from New York City, think New York is not just the biggest city in the U.S.; it's the greatest city in the U.S., the greatest city in the world, and that New Yorkers are the smartest and toughest people in the world. But non-New Yorkers may be surprised to learn that one of any real New Yorker's worst nightmares is being conned by a bullshit artist, a bullshit artist being a conman who really doesn't know much about anything; bullshit artists just have an ability to spout an endless stream of almost plausible, self-serving bullshit when given the slightest opportunity. 

Therefore, New Yorkers, more than anyone else, were stunned by candidate Donald J. Trump's election victory in 2016 because New Yorkers knew that The Donald was just another New York bullshit artist. When his daily TV talk show with the task force first aired in the spring, New Yorkers didn't need Dr. Fauci's carefully worded "corrections" to the president's riffs; we knew that the Donald was just doing what he's always done, spouting whatever bullshit that came into his head, including endless praise about how well he was doing everything. 

But when the governor began his TV presentations, we sat up and took notice. No bullshit here; just the facts, even the embarrassing facts, like the governor's admission that he should have called for lockdown a week or so earlier than he did. Whereas the president spouted pie-in-the-sky about how things were just going to work themselves out, "like magic"; the governor reminded us what every New Yorker knows deep in his or her bones: life is tough in New York, so New Yorkers have to be smart and tough in order to survive. 

In other words, the governor overcame the young vs. old and all other divides by appealing to the self-images that all New Yorkers shared, shared self-images that formed the basis for a collective action like social mitigation. "We are New York smart; we are New York tough" he repeated over and over again like a coach's last encouraging grunts before the game begins. The yokels and ass holes out there in Kansas or down in Texas might fail to beat the virus; but we will beat it. We will beat it because we are New York smart, New York tough, so we will do whatever it takes to succeed ...The governor's low key, but impassioned coaching worked. Here's a link to a short video that features the governor's mantras; and here's another link

Unfortunately, Governor Cuomo has proven to be in a class by himself, the exception that proves the rule. Nowadays the vast majority of our political leaders only know how to get elected. They don't have the political skill or the political will to expand their electoral majorities into the super majorities required to lead the successful management of a pandemic.

Where Do We Go from Here?

In this note I have argued that there were two major causes of the U.S. failure to manage the coronavirus ==> presidential irresponsibility and blunders by the White House task force and the CDC. 

As i see things, if President Trump is reelected in November, our efforts to manage the pandemic will continue to fail until we achieve herd immunity via the development and widespread dissemination of effective vaccines.

However, if the president is not reelected, 

• I would strongly advise the newly elected President to appoint a new task force asap that does not include any of its current members. The reorganized task force should include experts from "the science" as well as experts from other relevant disciplines, e.g., economics, management, data science, and sociology.
  
  
• I would strongly advise the new president to replace the current leadership of the CDC asap. The president should also provide the new CDC leadership with whatever additional increases in the CDC's budget that are required to upgrade and maintain the CDC's information infrastructure so as to enable it to deploy state-of-the-art procedures in its collection and dissemination of data related to its core disease control and prevention functions. Additional federal funding should also be provided to the CDC's state and local public health affiliates for similar purposes
  
  
• I would strongly advise the new president to require the task force and the CDC to be ever mindful of the disproportionate impact that the coronavirus will continue to have on poor and working class Whites, Blacks, Hispanics, and other minorities in their recommendations related to the widespread dissemination of effective vaccines.

Until effective vaccines are developed and widely disseminated, I suggest that media pundits encourage the American public to accept the likelihood of spikes and surges in infections within states and sub-state areas that had previously attained a substantial measure of control. None of us should ever become complacent. As noted in the following articles, these kinds of relapses have occurred in countries that have been far more successful than the U.S. in flattening their initial infection, hospitalization, and fatality curves: 

• Hong Kong, "Once a Model City, Hong Kong Grapples With a New Coronavirus Wave", Javier C. Hernández and Tiffany May, NY Times, 7/20/20
  
  
• China, "China Reports Biggest Virus Spike Since End of Wuhan Outbreak", Bloomberg, 7/26/20
  
  
• Spain, "‘Here We Go Again’: A Second Virus Wave Grips Spain", Patrick Kingsley and José Bautista, NY Times, 8/31/20
  
  
• Great Britain, "Britain’s New Measures to Control Virus Inflame North-South Tensions", Mark Landler and Stephen Castle, NY Times, 10/12/20 ... Note: Rather than impose another lockstep lockdown on the entire country, Britain is now assigning regions of the country to one of three tiers based on their virus activity, much like the four level system discussed in this report
  
  
• Europe, "Europe, Which Thought It Had the Virus Tamed, Faces a Resurgence", Mark Landler, NY Times, 10/15/20
  
  
• Asia, "Covid-19’s Global Divide: As West Reels, Asia Keeps Virus at Bay", Margherita Stancati and Dasl Yoon, Wall Street Journal, 10/20/20
  
  
• Great Britain, "Britain’s Health Workers Face 2nd Virus Wave, but This Time With Less Support", Benjamin Mueller, NY Times, 10/27/20
  
  
• France & Germany, "France and Germany Lock Down as Second Coronavirus Wave Grows", Matina Stevis-Gridneff, NY Times, 10/28/20
  
  
• Netherlands, "As Coronavirus Surges, Chastened Dutch Wonder, ‘What Happened to Us?’", Thomas Erdbrink, NY Times, 10/29/20

Indeed, in the cooler months of early Fall, a third wave has hit the United States:

• "Coronavirus cases are rising in U.S., sparking worries the next big wave has begun", William Wan and Jacqueline Dupree, Washington Post, 10/13/20
  
  
• "New York State Tops 1,000 New Daily Coronavirus Cases for First Time Since Early June", Corinne Ramey and Natasha Khan, Wall Street Journal, 9/26/20
  
  
• "As the Coronavirus Surges, a New Culprit Emerges: Pandemic Fatigue", Julie Bosman, Sarah Mervosh and Marc Santora, NY Times, 10/17/20
  
  
• "U.S. Sets Coronavirus Case Record Amid New Surge", Campbell Robertson, Edgar Sandoval, Lucy Tompkins and Simon Romero, NY Times, 10/24/20
  
  
• "Hospitals Are Reeling Under a 46 Percent Spike in Covid-19 Patients", Giulia McDonnell Nieto del Rio, Simon Romero and Mike Baker, NY Times, 10/27/20

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Editor's note to readers

I would greatly appreciate any comments, modifications, or changes you might suggest with regards to the issues raised in this report. Please enter your ideas into the "Post a Comment" form at the bottom of this page ... or send me a direct message via Twitter -- @neoskeptics.

Thank you,
Roy L Beasley, PhD

Certificates in data science from Johns Hopkins University and DataCamp
Editor, Neoskeptics blog and Twitter account 

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Related notes on this blog:

• Coronavirus Guide