I have a new paper out today! Co-written with my colleagues @PatrickSaez2 and @rswrdn. And it's (mostly) not about COVID! :)

We explore the shortcomings of the heavily siloed humanitarian coordination architecture, and propose a new approach.
If you're sticking with me to the second tweet, chances are you know that the "cluster approach" has been in place for 15 years now, and orients humanitarian coordination, planning, and operations around the major technical sectors.

It's got problems.
As we, and many before us, have found, the sector-driven logic of the clusters is increasingly at odds with what the system needs from humanitarian coordination.

Humanitarian ops need to be demand driven, integrated across sectors, and devolve power/resources toward the field.
The cluster approach has instead evolved to be supply driven (the whole logic is about what flavor of support is being supplied!), persistently fragmented across sectors, and to concentrate power and resources in powerful cluster lead agencies.
And the clusters have reinforced the funding dominance of big multilateral agencies. We measured how much more $$ the cluster appeals request for the cluster lead agencies than for their largest national NGOs.

It's eye-popping. National actors remain a budgetary afterthought.
But - the clusters do a lot good in spite of that. They have proven strong on promoting technical quality and learning, and improving in-sector operational accountability.

So: how to square the circle? Keep the good, evolve past the bad?
We propose a new hybrid coord model, inspired by area-based programs.

Area-based ops share three core principles:
- Organize around geography, rather than sector
- Implement in an explicitly multi-sector/multi-disciplinary approach
- Put affected communities at the center
This would mean a coordination system that:
- Organizes around sub-national geography, not sector
- Shifts program cycle responsibilities from the clusters to integrated sub-national hubs
- Delinks cluster leadership from fundraising influence
- Explicitly integrates nat'l actors
Clusters would continue to provide technical leadership and quality assurance. But the rest of the program cycle - the process of needs assessment, priority-setting, determining appeal budgets, etc - would reside with integrated geographic hubs with heavy local influence.
One example of why this is important: this great UNICEF research showing how heterogeneous people's needs and priorities are from place to place, even in a single country.

I could go into much more detail, but this is twitter. So I'd urge you to read the paper itself! cgdev.org/publication/in…
And for a more in-depth discussion with some great examples of why this all matters, check out the event we held earlier today:

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More from @JeremyKonyndyk

15 Oct
Here's the thing about a "shield the vulnerable" strategy: it would have to actually try to identify and shield the vulnerable.

Like mass-producing N95s for anyone 65+ or with other risk factors.

Or programs to support them as they sequester.

There's been nothing of the kind.
I don't support a shielding strategy in any case.

But let's be clear that the administration isn't pursuing it either, at least in practice.

All they're doing is using it as a rhetorical device to excuse their other failures.
The administration is not seeking to identify and support the vulnerable.

It's not trying to scale up real support for them.

It's not laying out a plan for how this would all work.

It is simply pointing to "shielding" to rationalize its failure to actually control the virus.
Read 6 tweets
13 Oct
This is helpful update to that chart. Takeaway is much the same. (HT @CT_Bergstrom)

I do think there is a reasonable rationale for looking at the March/April phase a little differently than May/June onward. In early phase we were fighting this much blinder than from summer on.
The states that got hit in the first crest in March/April were largely places with major travel hubs to Europe/China, and dense populations. And due to federal failings they had little preparedness, little support, and a lot less knowledge on how to fight it.
Other states would likely have followed suit if not for the shutdowns that spread across the country from mid-March, and held in place into late April/May.

The shutdowns spared the rest of the country from NYC-like outcomes.
Read 6 tweets
9 Oct
I would very much like this to be true!

But I'm not entirely persuaded that the data referenced in this article is robust enough to support the headline.
theatlantic.com/ideas/archive/…
The key element that doesn't seem present in this data - is how the level of transmission in schools relates to level of transmission in the surrounding community. Existing CDC guidelines focus on that as a principal driver of in-school risk.
So if the data are telling us that school transmission is consistently low irrespective of localized transmission levels, that's a super relevant finding - but isn't addressed in this data set (only school-based mitigation measures are captured).
Read 11 tweets
7 Oct
To expand on this:

What the administration is doing here is politics, not science.

And what these academics are doing is likewise politics, not science.
The three academics lay out their case here. It's pretty brief and easy to read.

Interestingly, it does not cite or reference a single piece of research to support their arguments, nor does the linked website containing their sign-on "declaration." unherd.com/2020/10/covid-…
The basic argument:
- COVID poses little risk of death beyond specific vulnerable groups
- Non-vulnerables face little risk so should just go ahead and get the disease
- Vulnerables should be sheltered while non-vulnerables get naturally infected
- Ta-da, natural herd immunity
Read 19 tweets
6 Oct
Douthat's column and the powerful @AlecMacGillis piece it references both argue without much evidence that the resistance to school reopening is largely a reaction to Trump pushing schools to open.

I don't think that's quite right.
Trump's push to open schools regardless of local conditions and in-school adaptation, and his failure to provide any meaningful support, didn't help.

But I think the more significant factor was what was happening with the country's outbreak at the same time.
To reopen in-person in August/early September, schools needed to decide which way to go in July.

And July was a catastrophe. The highest recorded peaks of the outbreak and the highest deaths since the worst days of spring.
Read 11 tweets
6 Oct
COVID-19 is 10x as deadly as flu.

Let's be explicitly clear: "learning to live with it" means needlessly accepting hundreds of thousands more preventable deaths and letting our hospitals get nuked yet again.

Why would the President call for that?
"Close the country" vs "learn to live with it" is a false choice, and one that exists only because of Trump's mishandling of the pandemic.

Peer countries have had shorter closures than we have precisely because they chose not to live with it but to control it.
There is an option besides indefinite closure vs let-it-rip: evidence-driven reopening + aggressive public health interventions centered around mass testing and tracing.

Trump's whole game since back in April/May is to make you forget that option exists.
Read 4 tweets

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