Thread by @JeremyKonyndyk

5 months of this. With COVID again spreading widely, schools closing, college football collapsing, businesses going under, I've been asked by a few reporters lately - "what should the US do?"

My answer: that's the wrong question. The question is, can we find the will to do it?

https://twitter.com/NPRinskeep/status/1293205947696001024

We basically know what needs to happen. It's the same game plan experts have called for since March. It's the same game plan wealthy peer countries have followed.

The problem is that our political and social systems aren't choosing to do it.

Yes, literally since March. Trump's own former FDA chief @ScottGottliebMD put out a plan, co-developed with rock stars like @cmyeaton and @C_R_Watson, that laid out the broad strokes way back then.

aei.org/research-produ…

May others have laid out similar visions - @ashishkjha, @DrTomFrieden, a team convened by @dsallentess, many many others.

My favorite (I'm biased) is the tool that I worked with @RebeccaKatz5 @BethCameron_DC @EllieGraeden to develop: covidlocal.org/metrics/

All of these plans laid out a consistent vision: reopen in a cautious, iterative, data-driven way. Scale up testing, tracing, isolation, surveillance capacity along the way. Ensure a strong lead federal role and a consistent national approach rather than 50-state patchwork.

THAT'S STILL WHAT WE NEED TO DO (plus masks). THAT'S STILL THE "WHAT."

But it hasn't happened in the past 5 months and isn't on track to happen in the next 5.

This is not a failure of science or medicine, it's a failure of political will and consequent failure of public buy-in.

So the question we should all (still) be asking is: can our country generate the political will and public support to truly control this pandemic?

On that front, I'm discouraged. This point that @cmyeaton made in her recent testimony is spot-on.

https://twitter.com/cmyeaton/status/1291532049745051653?s=20

Controlling the pandemic will require fundamental change in three areas:

- True federal ownership of the crisis and a fully engaged federal response
- Consistency and rigor at state and local levels
- Public buy-in driven by clear and consistent communication & dialog

Hard to be optimistic at the federal level.

Trump's inclination is still to claim great success, downplay the crisis, push hard decisions onto the states, and curtail federal involvement.

He'll attack anyone who acknowledges a different reality. thedailybeast.com/trump-attacks-…

Fed leadership disarray is an Achilles heel because it is hard to fix our testing debacle, improve surveillance, produce enough PPE, etc etc etc if the feds refuse to own those problems. The states can't fill those gaps single-handed.

Which gets to the next set of problems.

At the state level, the US response is a peeing-section-of-the-swimming-pool scenario.

Each state gets to make its own choice about whether to pee in the pool, but all the states suffer if even a few states choose to do that.

(This analogy also works for masks, BTW. Wearing a mask is no more a "personal choice" than peeing in a pool)

Perfect example of this dynamic is testing. Each state has had to develop its own testing infrastructure, in absence of federal leadership. And most states have ended up heavily dependent on private commercial labs.

So when a few states reopen recklessly, all states suffer.

As @Nonstopdoc and @BethCameron_DC wrote, testing overloads driven by the Sun Belt surge are slowing test results around the country.

In effect, Florida et al's reopening policies undermined others states' tracing efforts (which hinge on rapid results). nytimes.com/2020/07/16/opi…

So a 50-state patchwork doesn't work. Duh.

But will these governors learn from their overly-aggressive reopening decisions? Judging by their approach to the next big test - schools - I'm not optimistic. politico.com/states/florida…
texastribune.org/2020/08/07/tex…
npr.org/sections/coron…

So as long as the feds cede leadership to the states, and the states are each doing their own thing, the whole country's ability to control the virus hinges upon the least responsible governors.

Now in theory, the public could do quite a lot to curtail this outbreak as well (and many are, voluntarily). Masking, voluntary distancing, avoiding large gatherings, etc all make an impact.

People can choose to do these things, regardless of the president or their governor.

But many people aren't being supported to follow distancing guidelines - low-income essential workers particularly.

And many other are mirroring the President's cavalier disregard for the virus.

https://twitter.com/justinbaragona/status/1293267651591012352?s=20

So here too, poor decisions made by some people will undermine the good choices being made by others.

We need unity of effort; politicization of health measures is a massive liability. It will be hard to unwind the COVID culture wars as long as the President keeps fueling them.

I would love to be wrong!

I would love to see Trump decide to go all-in on testing and PPE the way he's gone all-in on vaccines.

I would love to see GOP and DEM governors coalesce around a common approach.

I would love to see people decide that masks don't undermine freedom.

But it's really hard to envision any of those things happening in the near term.

They all could! It's within our grasp! But the political and public will just...is...not...there.

I had hoped that something might shift the narrative. Perhaps surges in red states would foster more alignment on strategy and standards (so far, nope).

Perhaps school closure sinking in would refocus public buy-in toward control measures (still perhaps possible).

So I fear we're facing another five months of slogging through like this. Burning down US business, harming US children, suffering countless needless deaths, making ourselves a global embarrassment.

I wish I had something more uplifting to say...

But the blockages now are fundamentally about politics - as, frankly, has been the case from the outset.

Like I wrote 4 months ago, the politically-driven inability to admit errors, rectify, and change course means repeating the same mistakes.

https://twitter.com/JeremyKonyndyk/status/1247033544263729158?s=20

That's the root problem. That's what needs fixing. That's (still) what we should be talking and writing about.

I have no more energy for producing warmed-over versions of a strategy our leaders have no will to implement. The political failure is the problem.

Or in summary, this:

https://twitter.com/edyong209/status/1293271292016287744?s=20