We're doing this all wrong. We've been doing it all wrong from day 1. Social distancing and face covering were never meant to be a strategy by themselves. They were always intended to be combined with large-scale testing & tracing.
Social distancing is meant to reduce the overall number of non-household contacts in the general public to levels that allow ramped-up public health infrastructure for #TestTraceIsolate to get outbreaks under control. That's how other countries achieved suppression & containment.
In March, state & local govts did their part. They used the blunt instrument of widespread business closures to buy time. But the federal govt - as the only actor w/ the resources & interstate authority to ramp up testing - failed to use that time.
By April and May, it was clear federal support for a modern public health response wasn't coming any time soon. States had to shift to a more sustainable approach to social distancing they could keep in place for the several months-years we'll be coping with covid.
But when cautious governors moved slowly, following WH criteria that would've had them wait longer (maybe a very long time given federal failures) to reopen high-risk settings like theaters, bowling alleys, gyms, bars & indoor dining, the president urged them to "liberate."
When death-wish governors moved quickly, throwing caution to the wind and reopening high-risk settings - now pushing for schools to reopen - even as outbreaks began to surge, the president cheered them on.
Meanwhile, Congress provided hundreds of billions for big-industry bailouts. Including for hospitals. Plus ventilators and field hospitals for rescue care. But virtually nothing for testing & tracing even though nearly every expert said it was the key to suppressing the pandemic.
As someone said back in April when Kushner claimed the Strategic National Stockpile program for coordinating the purchase & distribution of critical supplies (including for testing) "wasn't for the states" - it's like the federal government has seceded from the union.
So here we are. States still hold the reins on old-school, 1918-style, "flattening the curve" w/ business & school closures and face masks. But only the federal government has the resources & interstate supply-chain authority that are necessary to crush the curve.
Without federal support, states can flatten the curve to preserve hospital capacity & protect health workers from devastating crisis conditions. But many, many lives will be lost and we'll continue to live with fear and massive economic, social, & educational disruption.
So here we are. Watching other countries return to some semblance of normalcy while keeping things under control b/c their governments implemented a modern response. We're left behind. I can only imagine the effects this will have for our country's future.
Apologies for feeling extra hopeless today. It's not too late. Contact your senators. Demand funding for testing & tracing. That's the starting point.
Funding from Congress + targeted removal of FDA barriers + supply chain coordination through (threat of) DPA + federal procurement & need-based distribution of supplies + federally guided/state implemented strategy for who to prioritize for testing/tracing would be ideal.
If the administration can't be trusted (it can't), then funding from Congress + statutory mandate to release it directly to states/locals + a mandate that administration remove FDA barriers + interstate compacts by governors to coordinate procurement & need-based distribution.
For a long-term solution, @doritmi & I are working on a proposal for Congress to save CDC by creating an independent agency to issue disease control & prevention guidelines (including guidelines for who should be prioritized for testing/tracing), modeled on the Federal Reserve.
And another thing: these problems with our lack of a nationally funded & coordinated testing strategy? These are the *exact* same problems we'll be facing with the lack of a nationally funded & coordinated vaccination strategy.
Getting to the point where a safe & effective vaccine *exists* won't make much difference in daily life for most of us w/o a well-coordinated strategy for ensuring vaccines are available to (& trusted by) the folks whose vaccination will have the biggest impact on the epidemic.
