(In case you missed it, I just published COVID part 1 last Thursday, feel free to check that out if you are interested in more!)
In my last post, I ruminated on some of the reasons that we as a society have been so ineffectual in fighting COVID. But all of my reasons felt very micro: What I wanted to do is try to pull together some thoughts on the Meta-Level reasons that we as a society have failed to fight this disease? Why is it that we have often failed to manage the trade-offs in a way that gets us to an optimum point on the graph?
State Capacity
The first failure I would describe as “State Capacity.” What does this mean? Basically, how well is a government able to execute the stuff that it needs to get done? Libertarian economist and intellectual Tyler Cowen, I think, explains well the problems inherent in the United State capacity when he said:
Many of the failures of today’s America are failures of excess regulation, but many others are failures of state capacity. Our governments cannot address climate change, much improve K-12 education, fix traffic congestion, or improve the quality of their discretionary spending. Much of our physical infrastructure is stagnant or declining in quality. I favor much more immigration, nonetheless I think our government needs clear standards for who cannot get in, who will be forced to leave, and a workable court system to back all that up and today we do not have that either.
I find Cowen’s thoughts on this compelling because he comes out of the libertarian philosophical tradition of wanting the state to do only the tasks it is really suited to do well. Traditionally in American political life, this means a strategy of “starving the beast,” where the size state is reduced as much as possible. But there is increasing recognition that this strategy does not work as intended. Instead of creating a small and efficient government, we largely have a government which has been well described by Steve Teles as a “Kludgeocracy:”
A "kludge" is defined by the Oxford English Dictionary as "an ill-assorted collection of parts assembled to fulfill a particular purpose...a clumsy but temporarily effective solution to a particular fault or problem." The term comes out of the world of computer programming, where a kludge is an inelegant patch put in place to solve an unexpected problem and designed to be backward-compatible with the rest of an existing system. When you add up enough kludges, you get a very complicated program that has no clear organizing principle, is exceedingly difficult to understand, and is subject to crashes. Any user of Microsoft Windows will immediately grasp the concept.
"Clumsy but temporarily effective" also describes much of American public policy today. To see policy kludges in action, one need look no further than the mind-numbing complexity of the health-care system (which even Obamacare's champions must admit has only grown more complicated under the new law, even if in their view the system is now also more just), or our byzantine system of funding higher education, or our bewildering federal-state system of governing everything from welfare to education to environmental regulation. America has chosen to govern itself through more indirect and incoherent policy mechanisms than can be found in any comparable country.
In the face of existential risks, this has deadly consequences:
In a 2007 paper published in Public Administration Review, Martha Derthick showed that the tangled joint administration of the flood-protection system in New Orleans played a key role in the system's failure during Hurricane Katrina. Derthick quotes Maine senator Susan Collins as having found that there was "confusion about the basic question of who is in charge of the levees" — the type of problem that is common as a consequence of our pervasive, kludgey interweaving of federal and state responsibilities. Because administering programs through inter-governmental cooperation introduces pervasive coordination problems into even rather simple governmental functions, the odds are high that programs involving shared responsibility will suffer from sluggish administration, blame-shifting, and unintended consequences.
This does not necessarily mean we should have the largest possible government. Often it just means better prioritization: governments should identify the capacities they can best serve in, and make sure it is really good at those. After all, Cowen aims to maximize the things he really cares about as a libertarian: human freedom and the potential economic growth to lift people out of poverty. As Cowen writes elsewhere in the same piece, his vision for a state is quite different than the current Democratic Party in the US:
State Capacity Libertarians are more likely to have positive views of infrastructure, science subsidies, nuclear power (requires state support!), and space programs than are mainstream libertarians or modern Democrats. Modern Democrats often claim to favor those items, and sincerely in my view, but de facto they are very willing to sacrifice them for redistribution, egalitarian and fairness concerns, mood affiliation, and serving traditional Democratic interest groups. For instance, modern Democrats have run New York for some time now, and they’ve done a terrible job building and fixing things. Nor are Democrats doing much to boost nuclear power as a partial solution to climate change, if anything the contrary.
As a California resident, I can attest to the fact that having a progressive instinct towards bigger government does not guarantee that the bigger government. Despite the numerous pieces of literature showing that state investment in housing, public education, transportation infrastructure, and clean energy generation can pay numerous dividends to society, we in California have generally been bad at all three. Part of this can be explained by rent-seeking (building and trade lobbyists exert enormous power in California politics, which really drives up the cost of building), and some of it can be explained by bad lawmaking (California environmental impact review is structured in such a way that actually harms the environment in the long run).
State Capacity and Vaccine Distribution
I detailed in my last post many ways in which our state capacity has not been up to the task of COVID-19, but one additional one that I have seen in the news in recent days is how our vaccine distribution is quickly moving towards failure.
Up to this point, Vaccines are one of the few bright spots of our COVID response in the US, partially because the private sector saw incredible technological breakthroughs and partially because of state mobilization to subsidize and create pre-purchase agreements with the biotech companies. But that said, in the middle of the pandemic, you need the state the ration vaccines vis-a-vis the state: no one would be happy if the market sold vaccines to the highest bidder.
But as many are increasingly pointing out, the CDC has created a prioritization recommendation that is so complex that it is unclear if we will actually get vaccines to the right people at the right time. Once you go beyond frontline healthcare and nursing home employees (who everyone agrees should be prioritized), the CDC seems to have given about equal weight to three categories of people:
The Elderly
Essential Workers
People with Pre-existing conditions
Based on everything I can tell, this is a big mistake. As Zeynep Tufekci points out, age is WAY more of a risk factor than the others.:
The risk profile of this disease is strikingly exponential: The risk of death for those ages 65 to 69 is a staggering two and a half times that of those just a decade younger. Those just a few years older, ages 75 to 79, face six times the risk of death compared with that same age group (ages 55 to 59). The steepness of this age curve really matters, because it means that protecting the most vulnerable groups with a highly efficacious vaccine will both quickly change our experience of the pandemic and relieve the strain on our hospitals.
If this were a mathematical relationship, age would have an exponential relationship to risk: each year past 65 makes your risk go up significantly. It would seem a no brainer then to prioritize age over the other factors in getting a vaccination, as the UK is doing. Adding complexity into the equation really starts to muddle the priories. Nate Silver points out that the category “essential workers” is so big, it is basically HALF US's of the working pop the US.
The same goes for pre-existing conditions:
Ideally, there are some cases where we would want this complexity to allow common sense among decision-makers to play a role. I can see strong cases for vaccinating teachers early. I can also see a strong case for vaccinating people with severe asthma. However, the problem is that with our low state capacity, these categories will almost certainly get gamed by lobbyists, not data and reason. As Nate Silver points out, the LA Times is already documenting how vaccine lobbyists are popping up for industries and wealthy individuals.
Part of this also seems to be driven by the desire to show that the US government is doing something about the racial inequities of COVID, and Black and Latinos are more overrepresented in essential workers than in older Americans. But Matt Yglesias points out that this actually gets the concept of racial equity wrong by not actually driving at who is the most vulnerable:
We know the people who’ve been dying the most from Covid are Black senior citizens. The decision here is to not prioritize vaccinating them, but to instead vaccinate a different, less vulnerable group of people and then assert that this creates some kind of abstract collective racial benefit.
This may seem like nitpicking, but it is worth pointing out that all models show that we will average 3,000 deaths a day for the next two months. Since 300,00 already have died, this means we might hit 500-600k deaths before we reach herd immunity this summer. Sadly, many of those deaths are locked in due to our current surge, but this vaccine's competent government could prevent many. Our state capacity is literally killing people.
Individualism and Social Trust
All of that said, the fact remains, though, that even if our government was competent, a powerful state is (and should be) limited. Individual people have agency, and we rely on individuals making decisions to “do the right thing.” This leads us to a common refrain during COVID that we have failed as a society because we are “too individualistic." There is almost certainly some truth to this: most objective measures of cultural attributes put the US near the top for “individualism.” By definition, that means people will resist having decision-making taken away from them, even amid a pandemic, and many of the nations atop the list for individualism (Belgium, UK, France) have also not had stellar COVID responses. Likewise, many of the best-performing nations (Taiwan, Singapore, Thailand, Vietnam, and South Korea) are East Asian countries that rank very low on cultural individualism.
But I don’t think individualism can explain as much as is commonly thought. Individualism also means self-reliance and personal responsibility, which would, on its face, be key qualities to draw on in the middle of a pandemic. But we are not by any means unique as being individualistic: New Zealand, Australia, and Denmark are very individualistic societies yet have done well in their COVID responses. If you compare numbers, we see the US has done much worse than these other nations (as of Dec 16th):
The US has a death rate of 1 in ~1,085 people.
Denmark is about 1 in ~6,057 people.
Australia is about 1 in ~27,933 people.
New Zealand is 1 in ~200,000 people.
So individualism alone cannot explain everything. Instead, I want to propose another factor, which has been largely not discussed: social trust. Social Trust is the glue that holds society together, making everyday interactions smoother and easier. This is usually measured on two levels: do people trust the government? And do they trust one another? It is the factor that ties together the successful countries, whether they are East Asian collective cultures like Singapore or individualistic cultures like New Zealand or Denmark. New Zealand actually has seen trust go up over the course of the pandemic, something which we have certainly not experienced in the US!
In the US, there has been a constant decline in trust in the government since Watergate in the early 70s. Likewise, we have seen a decline in the trust Americans have for one another. These trends have held during different presidencies for both parties and every demographic group. The decline has been especially steep among certain groups, though:
It used to be that what Edelman labels the “informed public”—those aged 25 to 64 who have a college degree, regularly consume news, and are in the top 25 percent of household income for their age group—placed far greater trust in institutions than the U.S. public as a whole. This year, however, the gap all but vanished, with trust in government in particular plummeting 30 percentage points among the informed public. America is now home to the least-trusting informed public of the 28 countries that the firm surveyed, right below South Africa. Distrust is growing most among younger, high-income Americans.
Social Trust has taken many of the most effective pandemic responses off the table. Many countries with very effective responses have done so by limiting the movement of people, both with travel restrictions or forced centralized quarantine. Reading that, you probably recoiled as an American Individualist. But consider those principled defenders of individual liberty have traditionally recognized that free movement during a pandemic does not really safeguard individual rights. As recently as 2014, Libertarian Reason Magazine held a panel that endorsed centralize quarantine for Ebola outbreaks. The rugged individualists of Australia imposed a 3-mile travel radius during the Victoria outbreak over the summer.
I would argue what makes this unpalatable in the US is not some kind of principled individualism. There would be a widespread belief that the government would implement this unfairly. We live in a society with a history of racially disparate treatment, with a high partisanship level. Everyone has a reason to think that they would be the one with the short end of the stick (and not without good reason)!
Likewise, even moderately intrusive protocols will be disobeyed if people either think that:
The government issuing them does not know what they are talking about,
or
Everyone else is going to break the rules anyway.
Even the moderately intrusive intervention have suffered from this. Many do not wear masks because they don’t trust the government protocols or see many other people not wearing masks. Likewise, New Jersey has documented how, when recent outbreaks have happened, a huge number of people refuse to talk to contract tracers to identify people they came in contact with:
Megan Avallone, director of the Westfield Regional Health Department, said Friday that of her last 20 cases — most of whom were young people — nearly half declined to share any close contacts. Others simply don’t return their calls, or refuse to quarantine…Lasher said it may come down to embarrassment or stigma, or just a reluctance to admit they had a barbecue or rented a Shore house with friends.
All of this speaks to the problem of trust: without trust, it is impossible to execute a fight that requires social cohesion.
State Capacity and Social Trust: The Doom Loop
Now you may have noticed that these two ideas are linked together. Lack of state capacity erodes social trust, and vice versa, lack of social trust makes it harder for governments to do their job.
To see the evidence of this, look no further than our leaders both on a national level and state level. have often not been up to the task. Blaming Trump exclusively for our poor COVID response has been a talking point of Democrats and is not really fair. Still, his erratic and unfocused administrative style has certainly done great harm. This is not primarily a partisan issue: I thoroughly believe that a more competent Republican with fewer character-defects (i.e., Mitt Romney or Jeb Bush) would have a much, much better track record on COVID. But Trump’s inability to be a competent manager, and a unifying message, has made national cohesion impossible in this time.
At the same time, many Democratic have also made grave errors. In California, Gavin Newsom was hypocritical enough to enjoy indoor dining and put his kids in an in-person school. At the same time, he called on many Californians to forgo both of these privileges. Andrew Cuomo’s decision making on nursing homes led to thousands of needless deaths, which he conveniently ignored in his press conferences. At the same time, he was quick to turn attention toward the federal incompetence. Even beloved Anthony Fauci failed to recognize quickly that encouraging widespread mask-usage, even if unproven in efficacy at the start of the pandemic, had little to no downside once the market responded to the incentive. Why should Americans put power in the hands of a government it trusts so little?
But the government doesn’t disappear in the face of the loss of trust. In fact, in many ways, they tend to expand in counter-productive ways:
When people perceive that their world is out of control and unpredictable, Shleifer says, they want order to be restored—the faster the better. "They want regulation. They want a dictator who will bring back order." Often, he adds, the rules and restrictions create a negative feedback loop. In response to loss of trust, governments set up new regulations that make it harder to start businesses. Those policies tend to lead to fewer businesses and less employment, which in turn leads to slower economic growth, which leads to calls for more redistribution and yet more regulation.
Where do we go from here?
Unfortunately, that will require another post :). But what I will say here is that it requires a large-scale re-framing of how we see our politics, which centers on our social institutions' importance. Keep an eye out for that, and stay safe y’all!