A little over a year ago, Rochelle Walensky—then a professor of medicine at Harvard Medical School, now the director of the Centers for Disease Control and Prevention (CDC)—gave an interview to WBUR in which she noted the purported successes of lockdown policies in authoritarian countries.
“To give you a sense of what lockdowns were able to do in other countries—and, I mean, really strict lockdowns—in China, their death rate is three per million,” she said,It was sad that death rates in the comparatively relaxed countries of Sweden and the U.S. were so much higher.
Whether China’s “really strict” lockdowns can truly be deemed a success largely depends on whether that government’s reported COVID-19 cases and death totals are accurate—an important question, given how much the Chinese Communist Party has already lied about the pandemic—and whether it will ever be possible to relax them. One year ago, Walensky made an admirable note. China’s pandemic autoritarianism continues to be in full swing despite occasional shutdowns of whole cities. There are dozens of cases being reported each day, making it difficult to determine if these numbers reflect undercounts. Chinese officials mislead citizens about the virus throughout the whole pandemic.
Even if China has COVID-19 under control it is still a costly way to mitigate pandemics. The government recently entrapped a Chinese village bordering Myanmar, which was followed by brutal repression. NPR says:
People were left hungry in makeshift centers made from shipping containers. Businesses forbidden from selling goods – even online. A baby reportedly tested for COVID 74 times.
His wife was forced to relocate to another place for quarantine. The quarantine period was 45 days after her husband went to work. The police rounded her up, and she was told that she would be staying in shelter until the authorities release her. She also received no food or regular supplies. Wang said that Wang was finally able get her out after asking a trusted friend to transport her to hospital. She then spent two more weeks in quarantine at a hotel before she was permitted to return to her home.
Yet despite the anger in Ruili, most people in China support the country’s strict pandemic prevention policies, despite their huge economic cost and the risk of being suddenly quarantined or tested during frequent contact-tracing investigations. Officials who fail to protect the population are publicly shamed, and often fired. Local government officials are subjected to enormous pressure.
People unlucky enough to test positive or — more commonly — cross paths with a close contact can find themselves ensnared in successive and expensive quarantines. Some others have been stuck in limbo and are unable or prohibited from leaving cities, Ruili included.
As ReasonEric Boehm of the International Institute for Democracy and Electoral Assistance noted that China is not an exception to this trend. Many countries have been driven down the road of oppression and illiberalism by their quest for COVID zero. Boehm cited a report by the International Institute for Democracy and Electoral Assistance that stated “more than 20% of countries have used military force to enforce COVID control.” “According to the report, 69 countries have made violating COVID restrictions an imprisonable offense, with two-thirds of those countries being ones the group considers to be democracies. Mexico and Albania have some of the harshest laws in place, with sentences of up to 15 and 12 years respectively for violations pandemic-related protocols.
Walensky is one of the many health officials who fantasize about their potential if the U.S. government were not so constrained by civil rights protections.
But tellingly, this kind of fantasizing only ever seems to run in one direction—toward bigger and more powerful government. Is Walensky aware of any fantasies about improving the U.S. Coronavirus response by having a smaller government with fewer resources? There’s good reason to believe that We offer less COVID-19 would be less likely to kill Americans if there was more central control and authoritarianism.
The failure by FDA to quickly approve Paxlovid, Pfizer’s COVID-19 therapeutic, in pill form, illustrates the point more clearly than anything else. This drug, which can reduce one’s chances of dying from COVID, may be approved by Food and Drug Administration (FDA). Scott Alexander, Substack’s writer, notes that the FDA approval of the drug is expected to be in January or March according to prediction markets. For the FDA, this is remarkably fast—but it still means that thousands of people will die needlessly between now and the date that the drug is approved. The FDA could get rid of this obstacle and people would be able to take the drug earlier, saving their lives.
“It’s pretty weird that the FDA agrees Paxlovid is so great that it’s unethical to study it further because it would be unconscionable to design a study with a no-Paxlovid control group—but also, the FDA has not approved Paxlovid, it remains illegal, and nobody is allowed to use it,” wrote Alexander. The FDA is expected to approve Paxlovid within the next few days. But the prediction market expects it to take six weeks— during which time we expect about 50,000 more Americans to die of COVID.”
This delay is costly and not unexpected. The FDA has failed repeatedly to approve COVID-19 testing that could potentially save lives.
Eric Umansky and Lydia DePillis, respectively, wrote in their article, “Companies who are trying to get approval by the Food and Drug Administration rapid COVID-19 test” ProPublica.
But it gets worse
This May, the FDA revieweder quit and described the internal causes of the delays. He was able to quickly evaluate hundreds of pages within an application, thanks to his background in virology. However, something was strange: After evaluating the hundreds of pages in an application within a few days, he found that they would not be accepted by higher-ups because they were unable to make a decision.
While I could handle dozens, only one or two of them remained in my queue. “They would be there forever,” said he. I had lots of time.”
His experience is reflected in an outside review of the EUA process conducted by the consulting firm Booz Allen Hamilton, which found that the median number of days it took the FDA to issue a decision on original applications rose to 99 in November 2020 from 29 the previous April, with denials taking substantially longer than authorizations. This assessment revealed that there was “limited knowledge in the testing community about how to validate diagnostic tests.”
We should not wax philosophical about the possibilities if the U.S. Government was less restricted. It would be great if federal bureaucrats in the field of health admitted that the ideal scenario, which is the most realistic, was one where their authority was. Continue reading It is better to be limited than it is to make things worse. Walensky and her associates should dream of smaller government.