Michal Lewis’ new book “The Premonition” couldn’t be more newsworthy. Through the stories of three individuals who worked in the public health system, Lewis makes plain just how we ended up with a dysfunctional CDC at a time of a global pandemic.
In an interview with Nicolle Wallace of MSNBC (5/12/21) Lewis notes that we should question whether any of our government is best run by political appointees. The CDC went from an institution run by experts to a home for those who needed to be politically rewarded.
Lewis also notes that there are characteristics of our economic system that made us unable to respond adequately to a crisis, in this case the pandemic, but the problems would be there in any crisis.
Lewis notes that the for-profit system is so entrenched in the society that we are unable to avail ourselves of solutions even when they present themselves unless they exist within the for-profit world.
He tells a story of a non-profit testing lab. When the owners of the lab saw that the CDC was not going to be able to adequately test people for COVID, it developed its own test and tried to give it away for free. But, accepting a free testing service was problematic for some. In one case, the agency approached could not use the free testing because its computer system could not accept any entry that had a $0 for the price.
The testing lab went to San Quentin prison and warned them that if no testing was done in such a confined institution, the result was likely to be a disaster. Those in charge initially accepted the testing but then quickly backed out. When asked why, those in charge explained that they already had established contracts with big testing labs and they were afraid that accepting another test would infringe on their contracts or at the very least, make the big testing firms angry.
The testing provided by the big labs was more cumbersome and took more time. The result, prisoners were transferred into the facility with COVID and twenty people died. Twenty people died needlessly because the big labs needed to make money off their monopoly control over testing at San Quentin.
As Lewis points out there are risks in the social environment that only the government can manage. If we hollow out the ability of the state to manage these risks we do so at our own peril. People like Ted Cruz may be able to fly off to another country and stay in a sealed community, but the rest of us can’t.
Lewis also notes that the entire structure of incentives for health care is defective. There are, for example, no incentives for preventive medicine.
Christina Amanpour interviews author Michael Lewis May 6, 2021 about his new book “The Premonition.”
In his book, Michael Lewis followed three characters involved in the public health system and tells their stories. The stories carry lessons for pandemic response in the past and the future.
As Amanpour notes, Lewis had already written about the hollowing out of creative professionals in the ranks of government. This hollowing out left a bureaucracy afraid of creativity and afraid of risk. When COVID hit, the CDC which should have been the leader, was afraid to act.
As Ezra Klein noted in his article about Lewis’ book in the New York Times (May 2021), the CDC was “too passive, too unwilling to act on uncertain information, too afraid of making mistakes, too interested in its public image.”
According to Lewis, the hollowing out of the CDC, the loss of their reputation, happened long before Trump. I was interested to hear this since during the COVID crisis I kept wondering how Trump could eviscerate the CDC so rapidly. Turns out he didn’t.
According to Lewis, by 2012 the CDC had become an academic institution reluctant to take on any action aside from studying problems. It had, according to Lewis, become a “disease observation and reporting” institution, not a disease control center.
Lewis tells the stories of several people involved in the public health system and their experiences dealing with the CDC. One, Charity Dean, was a public health official on the ground, locally. When she tried to get assistance from the CDC for public health problems, she found none. In fact, she found active hostility. When she called on the CDC to help her they actually obstructed her investigations.
Lewis commented that if the three people whose stories he told were asked whether the CDC would act as the battlefield commander in the event of a pandemic, they would have answer no. The Centers for Disease Control had ceased to function to control disease.
It was obvious to some people, people who were actively trying to develop strategies for a future pandemic, that a battlefield commander was going to be needed. But, the CDC wasn’t listening.
As Lewis tells tells the story, after 9/11 and Katrina, George Bush was primed to be concerned about any unexpected threat. Sometime in 2005, he was handed the book “The Great Influenza.” He supposedly read it and asked about the plan for dealing with a future pandemic. The answer was that there wasn’t any.
Surprisingly, the Bush administration acted quickly and within weeks had Congress appropriate money to study the issue and devise a strategy. Lewis notes how this back story illustrates just what can be done quickly when the President focuses on an issue and decides to get something done.
And, also surprisingly, the individuals brought in from various federal agencies were nominated because of their reputation for creative thinking. That in-and-of itself is extraordinary. In a country that spends untold amounts of money creating commissions and investigations filled with dignitaries and political donors, this body was staffed by people who were creative. Go figure.
These folks Bush appointed to the commission, created a testing, tracking and social distancing strategy and convinced the rest of the world that it could be effective. This strategy was designed to decrease mortality during the period between the onset of a pandemic and the development of vaccines.
The kicker was that after convincing a skeptical world that this public health strategy could work, the country that developed it failed to adequately put it into effect when a read pandemic occurred.
Lewis noted that this was because the strategy was widely considered to be a theoretical idea not an implementable public health measure. Similarly, a pandemic was considered to be a theoretical threat, not a real possibility.
But, people on the ground, people like Charity Dean, one of the people in Lewis’ book, were looking at factors like the increasing worldwide transmission of viruses from animals to humans. What they were looking at wasn’t a theoretical possibility. When they looked at the evidence, the outbreak of a dangerous pandemic was a matter of when not if.
But, as Charity Dean told Lewis, people like her felt like Moses, building the ark. Everyone around them accused them of lunacy. So, there were people who knew a dangerous pandemic was coming. When Trump went on national TV and claimed that the COVID virus outbreak was a total shock to the world, he was (as usual) lying.
By 2011 people like Charity Dean, people on the local level of public health, knew not only that a pandemic was coming, but that the country was unprepared. The population, however, (as usual) was being told that we were the most prepared country in the world.
Studies ranking preparedness, listed the U.K. an the U.S. as the most prepared countries in the world. They were wrong. They made people feel good. They made people complacent, but they were wrong.
As Lewis noted, the U.S. with 4% of population would up with 20% of the deaths. Somehow, sometime, Americans are going to have to stop creating and repeating and believing their own propaganda.
Crisis response is not about having the most resources or the most labs or the most prestigious boards at the CDC. Lewis detailed some of the problems that are part of the structure of the society, features that make crisis response (whether it’s to a war or a pandemic) almost impossible.
Lewis and doctors at the WHO, talked about the endemic fear of failure. As one of the doctors at the WHO put it, in March of 2020, fear of failure, fear of making a mistake has become paralyzing. “If you need to be right before you move, you will never win.”
Lewis noted that the culture has been primed to punish viciously crimes of commission, but to forget crimes of omission. It doesn’t take much to predict which crimes will be the most prevalent.
Many of the researchers who understood and warned about the coming pandemic believe that this is not the serious pandemic they are concerned about. They believe that this is only a dry run. The real pandemic has yet to happen. We all need to put that in our pipes and smoke.
TOMORROW: How the For-Profit Health Care System Crippled the pandemic Response.
The New York Times (Marshal, 5/9/21) reported an increasing number of potentially fatal fungal infections affecting people who have COVID or who have recently recovered from COVID. The condition affects people who have compromised immune systems especially those with diabetes.
This is a respiratory mold that was present in India before the pandemic. It erodes the facial structure and harms the brain. Doctors posit that the increase in the incidence could be from self medicating, or the widespread use of steroids to treat the virus.
Marshal (5/9/21) “A potentially fatal fungal…” New York Times
After reporters in India attempted to alert the world to the severity of the problems in the country experiencing a devastating second wave of COVID, right-wing social media started attacking the journalists. In what has been called “an orchestrated move” the right is trying to discredit journalists, especially those wiring for foreign publications like the Washington Post.
They have been slammed as “vultures” for posting photographs and video of crematoriums. Indian journalist Barkha Dutt was criticized as taking “a macabre ghoulish delight at our misery.” She was called a disgrace to India. Dutt has said in interviews that many journalists are being asked not to share photographs of the situation in India on the ground.
In the past two days I have listened to three interviews with Indian journalist Barkha Dutt about the stunning second wave of COVID deaths in India. Dutt lost her own father to COVID within the past week. She comes from what she describes as a privileged family in India, but even so, she was not able to get the medical attention that could have kept her father alive. The desperation in her reporting and in her voice are inescapable.
After it became apparent that a second wave of COVID was out of control in India, a number of journalists posted photographs of vastly overburdened crematoriums operating all over the country. There was also video footage of hospitals that are so over run patients are laying on the ground, or on flattened paper boxes with IV feeds hanging from the limbs of trees. Family members are desperately running from hospital to hospital seeking medical attention for loved ones, and individually searching for oxygen and taking it to those lucky enough to be in hospitals.
According to Dutta, India was incredibly complacent after the first wave of COVID. Most people thought the worst was behind them. The Indian government failed to buy adequate supplies of vaccines to cope with a possible second wave, rejected the idea of buying vaccines that weren’t completely made in India and even gave vaccine away after the first wave. Politicians continued to have enormous rallies without any social distancing or masking and the government allowed masses to gather for religious services.
Now, a second wave has hit India and even the official statistics of deaths are stunning. And, as Dutt reports, the official statistics, alarming as they are, are grossly underreporting the number of deaths. Dutt has talked to crematorium workers who report burning over 120 bodies a day. This is one crematorium in one location. Government statistics for that region, report something like 47 deaths for the entire city.
Dutt has said that she can’t even estimate how extensive the underreporting is. She said that she has seen instances where there is as much as a four-fold difference between the official statistics and those she estimates for a city.
To add to the problem, some testing facilities have been asked to decrease the amount of testing so that there will not be so many cases reported. This is reminiscent of actions taken by the Trump administration when COVID case counts became politically embarrassing.
Dutt argues that the Indian government was outrageously complacent and did not adequately prepare for the possibility of a second wave of COVID. She also reports that people in India while initially forgiving of the mistakes of the government, are now angry.
Some people are blaming health care workers for the lack of vaccines and infrastructure, but in fact, it is the fault of the government. Citizens, she says, have been left to fend for themselves. Whether you survive this pandemic depends on who you know and how strong you are. It is survival of the richest and the most connected. People feel that they are out there all alone, she says. There is no state apparatus to turn to for help at the hospitals or the crematoriums. It is just every person on their own fighting for resources. You can hear the fear and desperation and anger in her voice.
This is what the social configuration looks like when the state breaks down in a complex society. This is exactly what the Republicans have in mind for this country. They have worked for decades to destroy the faith people had in the government. They have worked tirelessly to block any policy that would have allowed government to improve their lives of the citizenry. They have blocked any policies which would have even allowed the government to function. Republicans are against effective programs to deal with COVID because successful state intervention in a crisis might have caused people to start understanding and valuing the role of government in a complex society. An effective government response to COVID might cause people to question whether the state is the enemy.
Numerous corporate journalists (who are like parrots) are now having a field day talking about how the Republicans have ceased to be ideological. Nothing could be further from the truth. They have been and are now conducting an ideological fight for a world where life is each against all, where the wealthy and the powerful can secure access to health and clean food and clean water and the rest of us fight it out on the street as did Dutt’s family when they went to have her father cremated.
This is the world Republicans are ushering in. The reality is staring us in the face every day, with every news report, but the reality is so disturbing Americans cannot and will not look at it. They would prefer to watch corporate news hosts make celebrities out of the hundreds of thousands of people who needlessly died because of a refusal to allow the government to act. They would rather watch hosts quote rap lyrics as if they were great literature, follow the soap opera of the royal family, or interview each other about their books (which all say that the institutions are holding and everything’s fine). The American people would, in other words, prefer to do anything, anything but look at the stark reality of the world the Republicans are preparing us for.
And, we should remember that many of these Republicans have no investment in this world. They truly believe that this is the “end times,” and that in a very short time they are going to be leaving the rest of us behind while they ascend to heaven. So, far from being free of ideology, they have the most destructive ideology on the planet. They believe that the worse things get the better because that brings us nearer to the end of the world.
If you want to know what that world is going to look like, just take a look close look at India.
Dutt was interviewed on Christine Amanpour’s nightly news program and by Ian Bremmer on his podcast, Gzero World (5/8/21)
• There are violent riots in Colombia brought about partly because of a proposed tax hike.
• It is estimated that 45% of the people in the country are living in poverty. There are high levels of unemployment.
• Due to the protests, the proposed tax hike has been withdrawn, but that hasn’t been enough to calm the situation where other grievances are fueling the protests.
• Political parties have been weakened in Colombia and in effect, ceased to function. The streets are the only viable political vehicle.
• “Latin America is going through hell.” Says Moises Naim, Carnegie Endowment for International Peace.
• The consequences of the pandemic have been dire. Latin America has 8% of the world’s population, but 35% of total Covid deaths.
• Protest in Latin America is met with arguments of 1) conspiracy – protest is the effect of outside forces (the old “outside agitator” argument; 2) copy cats – this is people copying Hong Kong and other protests; 3) combustion – people are fed up because of other issues and they take to the streets.
• There is a covid-enhanced erosion of democratic forms. There is a concern about decreasing rather than increasing democracy in Latin America.
See the interview with Moises Naim on Amanpour and Company.
Gaetz is certainly a subject of the investigation.
A target means that the prosecutor intends to indict.
Being a subject is not something you should feel good about. It means they’re trying to develop enough information to charge you.
The defense attorney can ask if his/her client is a subject or a target.
Sex trafficking statute. Drugs potentially can go to the coercion part of the law.
Drugs are at the very least a thing of value you can be exchanging for sex.
Mariotti is talking about the decisions that go into charging, whether there is enough evidence to win in court on a specific count.
Mariotti maintains that he would want to have the 17-year-old count. Juries will look at the defendant as such a sleaze they won’t be able to think of anything else.
The Mann Act is a “strange act.” Enacted over a century ago. Weird language in it.
It had been used to prosecute people for sex among adults. People questioned the use. Mariotti maintains that it is not a normal act for the federal government to charge under.
When there are federal Mann act cases, they usually involve child sex trafficking.
My note: Why was Bill Barr so determined to stay away from this case and Matt Gaetz? Why didn’t he quash the case?
There is the speculation that this case is larger than the underage girl question?
Mariotti argues that he would want a slam dunk charge like identity fraud or bank fraud. Then, he would introduce the other sex acts as context. The idea is to convict Gaetz on the fraud charges (the “slam-dunk”) and then tell the judge that the fraud was committed in the context of the sexual behavior which the judge would consider in sentencing.
My note: I don’t really understand this but it sounds sleazy as hell.
My note: Why is Mariotti even talking about Gaetz being charged for political reasons? Is he arguing that they should charge the “slam-dunk” instead of the sex charges because it can be argued that the sex charges are politically motivated? Why? What difference does that even make? Why are people so afraid of what some Republican might say about criminal behavior? If Gaetz has violated the law, he has violated the law.
My note: Mariotti is maintaining that one of the considerations in charging is: “How will this cause people to view the Justice Department differently?” So, what’s Mariotti’s actually saying is that the Justice Department itself is making political decisions (the politics of their own image) in charging.
My note: This is the type of attitude that led Comey to make some of the decisions he made that were so disastrous for the Democrats. He made decisions partly on the basis of what he thought was good for the Justice Department and its image, not on what DOJ policy was and had been when he announced they were not charging Clinton, but probably should have.
My Note: Gaetz was showing photographs of naked women to other men on the floor of the House and bragging that they were his conquests. I would like to know who he showed these photographs to and why they didn’t report him and have him censured? Who were they?
My Note: Matt Gaetz, a Republican, and his behavior with underage girls speaks to the repeated projection by the Republican party. They have spent years accusing Democrats of running a pedophile ring. Now that they have a pedophile in their midst and they are fine with it. It’s all projection. So, I keep thinking about the “baby eating” charge.
The interviewer asks, as a prosecutor would you bring in the fact that Gaetz showed these photos on the House floor? Mariotti says that if he were the judge he would not allow this evidence in because it would be too prejudicial. My note: Jesus Christ.
Mariotti argues that it would be too prejudicial because “Jurors would judge him (Gaetz).” My note: Well, hell yeah. Quite rightly.
Mariotti is talking about “streamlining” cases, what prosecutors do to “streamline” cases. My note: this is part of what’s wrong with the system.
My note: In what universe is Gaetz’s showing nude photos of women on the floor of the House not evidence of a pattern of exploitive behavior towards women?
Gaetz has chosen Mark Mukasey as his attorney. Mukasey’s father was at the Justice Department after Alberto Gonzalez. Mukasey’s a very good trial lawyer, according to Mariotti. He is very closely tied to Giuliani. Perhaps also representing the Trump Organization.
My note: So now we know that Mukasey is part of the club.
Gaetz still thinks he’s living in a world where Trump is president and can shield him.
My note: these men wouldn’t be behaving like this, like they were above the law, if they hadn’t been for their entire lives. The world Mariotti lives in has shielded these elite criminals for decades.
