The Volokh Conspiracy
Mostly law professors | Sometimes contrarian | Often libertarian | Always independent
It is generally accepted that widespread testing will be key to successful control of Covid-19. Identifying where the virus has (and has not) spread, who is infected, and who may be immune are all important. The tracing and isolation of infected and potentially infected individuals is essential if quarantine and containment efforts are to be targeted. Yet as ProPublica reports:
The lack of testing continues to be a source of deep frustration across the country, with worried patients unable to find out whether they have the ordinary flu, the coronavirus or something else entirely. The availability of testing in regions that aren't hot spots still faces an array of bottlenecks, from shortages of cotton swabs to the capacity of the labs processing the tests.
Why isn't there more testing? And why haven't we been able to ensure testing occurs where necessary? Among other things, the Centers for Disease Control & Prevention (CDC) focused on the development of its own test and discouraged the development of alternatives by others. This turned out to be a particularly bad misstep because the CDC's test was not particularly accurate.
A new investigative report from USA Today paints an even more damning picture of a CDC that simultaneously sought to monopolize testing while deceiving state officials about its capacity, As a consequence, parallel efforts to develop and produce tests in private labs were set back, placing the United States well behind the curve of where we needed to be.
From its biggest cities to its smallest towns, America's chance to contain the coronavirus crisis came and went in the seven weeks since U.S. health officials botched the testing rollout and then misled scientists in state laboratories about this critical early failure. Federal regulators failed to recognize the spiraling disaster and were slow to relax the rules that prevented labs and major hospitals from advancing a backup.
Scientists around the country found themselves shackled as the disease spread.
"We were watching a tsunami and standing there frozen," said Dr. Debra Wadford, director of the public viral disease laboratory in California, where some of the country's earliest patients were identified.
The nation's public health pillars — the Centers for Disease Control and Prevention and the Food and Drug Administration — shirked their responsibility to protect Americans in an emergency like this new coronavirus, USA TODAY found in interviews with dozens of scientists, public health experts and community leaders, as well as email communications between laboratories and hospitals across the country.
The result was a cascading series of failures now costing lives.
As they say, read the whole thing.
The reality is that if it were not for some of the actions taken by the CDC, and the Food and Drug Administration, the United States would have had a greater number of more reliable coronavirus tests available for use far more quickly. We might have even been ahead of the curve.
Another report from ProPublica further supplements the picture of a CDC that fumbled some of its key responsibilities, revealing some of the problems of trying to quarterback the nation's entire response from within a few expert offices.
These stories highlight that scientific and technical expertise does not necessarily translate into administrative expertise. Centralized bureaucratic structures face inherent limitations that make them brittle and magnify the costs of failure. No amount of medical expertise can overcome the Hayekian knowledge problem, and the more centralized the government response, the greater the downside risk if someone makes a mistake, such as by underestimating a threat or distributing a botched test.
Institutions such as the CDC and FDA are important, but they also have their limitations. One of the lessons from the Covid-19 outbreak thus far is that giving them to much power and responsibility can have serious negative consequences.