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Re:How did the U.S. end up with nurses wearing garbage bags? by jl6 on Friday April 10, 2020 @05:11AM (#22831263)
Remember that our generals will always fight the last battle. We will be well prepared for the next pandemic. But the next big thing probably won’t be a pandemic.
Re:How did the U.S. end up with nurses wearing garbage bags? by marvin on Friday April 10, 2020 @06:49AM (#22831719)
It's not just about fighting the last war, though. It's also about having competent leadership that's able to adapt to a new reality, quickly discover which of their current heuristics are wrong, and then reason from first principles about what needs to be done for a good outcome in the current situation.

There has been a spectacular difference in various nations' performance during this crisis. As a Scandinavian I'm a bit skewed in my judgement, but I'm especially in awe at Denmark and Norway's actions, given their lack of recent history with infectious disease:

Quickly discover from external evidence what the new reality is, that it's much worse than anything seen during the lifetimes of current leaders, that it requires extreme measures normally only deployed during times of war, and then use science-based leadership and a broad array of expertise to choose what measures to apply. Then apply them with vigor and competently deal with the fallout.

This is not trivial - crucially, it requires that the central leadership avoids dogmatic and heuristic reasoning adapted to conditions that no longer apply. Because even if you have such top leadership, there will be leaders on the second tier of this hierarchy that are not used to reasoning on a war footing. They will act or give advice that's normally sound, but counterproductive in the new and extreme reality. Top leadership needs to catch onto this fast, and strike down or disregard advice that's not applicable to the crisis at hand.

You can see these phenomena in a plethora of fields. Scientists grasping for N=100,000 double-blind randomized peer-reviewed studies for a novel phenomenon, rather than make the best educated guess from reasoning and available evidence. National leadership trying to solve a health-induced economic crisis by printing money and nothing else. Politicians infighting and posturing by old routine, as if the enemy army isn't already banging down the gates. Reasoning by analogy, let's do the same as we do in a bad flu season. Blame the other party, has always worked before.

Or a subtle insidious variant that's currently responsible for Sweden's problems: let the experts handle it, and dictate public policy without regard for what happens outside of their field of expertise. Turns out an expert in a narrow field with an IQ of 120 and a track record of success is a very dangerous leader. They often aren't aware of their blind spots.

Re:How did the U.S. end up with nurses wearing garbage bags? by geomark on Friday April 10, 2020 @09:08AM (#22832623)
Yes, competent leadership. Doing things in the way you described. I have a real conundrum, however, when I compare countries that are held up as good examples and the place where I live, Thailand, which is largely ignored in all the multi-country charts.

You see, as of today we have 2,473 confirmed cases and 33 deaths in Thailand. Denmark, on the other had 5,819 confirmed cases and 247 deaths as of a couple of days ago. I am sure the data is noisy and that testing here is not nearly widespread enough. But the bodies are not piling up and we don't really have the kind of censorship here that would keep it hidden if there were a lot of deaths from Covid-19. And most importantly, the words "competent government leadership" and "Thailand" should never be uttered in the same sentence.

So I guess leaders have done some things right by listening to the right experts (a form of competence I suppose). Or maybe it's the weather (popular theory that seems to have been dismissed). Or cultural habits have saved Thailand. Because I look to more advanced countries, especially in Scandinavia, and don't understand why they are doing so much worse than where I live.

Re:How did the U.S. end up with nurses wearing garbage bags? by lostphilosopher on Friday April 10, 2020 @10:08AM (#22833139)
> So I guess leaders have done some things right by listening to the right experts (a form of competence I suppose).

This is the most important form of competence for a leader of government. There is no chance any leader would have adequate expertise in every subject they would need to be versed in in order to lead their nation. They _must_ bring in and rely on SMEs to make informed choices. (Of course they still have to make the choice.)

Re:How did the U.S. end up with nurses wearing garbage bags? by marvin on Friday April 10, 2020 @11:01AM (#22833695)
Are you sure that the proportions (confirmed cases) / (actual cases) and (confirmed deaths) / (actual deaths) are the same in these countries? That's my biggest concern whenever I see dramatically (i.e. 2x or more) different death rates between countries.

Climate, general health, age distribution and other unknown factors certainly play into it, and could easily affect the rate of deaths by such a factor. But I smell a rat when I hear that Norway get 5% positives and NYC gets 25% when they test. Also, Italy makes it clear that even with a relatively consistent approach to hunting down the corpses, a big factor can get lost in the noise. Way above 2x.

So it's not trivial to compare this between countries, but it seems feasible to (by critical judgement) at least distinguish between a wildly incompetent and a good response.

Re:How did the U.S. end up with nurses wearing garbage bags? by geomark on Friday April 10, 2020 @09:43PM (#22839076)
Not sure, of course, because testing is insufficient and the data is noisy. But it seems pretty clear that there are not a lot of dead bodies piling up. That would be all over social media even if it wasn't reported by local MSM. All of the reported deaths here had serious comorbidities. Are Thais really that much healthier on average? I wouldn't think so, but I'm not sure. Climate? If hot humid weather is the answer then we are safe because we are into hot season now and the weather is miserably hot and humid.
Re:How did the U.S. end up with nurses wearing garbage bags? by pasabagi on Friday April 10, 2020 @07:36AM (#22831960)
I think competent leadership is one of those unsolved problems, that has the added malus of being, insofar as we have some ideas, a tough pill to swallow for any given current leadership.

Granted, most problems are manageable with excellent leadership, but the whole point about a good system is it works fine with mediocre leaders - and there's a corollary - if your organization requires talented leadership to function, it's a bad organization.

Re:How did the U.S. end up with nurses wearing garbage bags? by antibland on Friday April 10, 2020 @05:52AM (#22831450)
I would argue that the last battle was what the US saw occur in China and Italy. We knew the virus would reach us within weeks of those countries being hit, knew the risk potential of it, but did little to adequately prepare.
Re:How did the U.S. end up with nurses wearing garbage bags? by assblaster on Friday April 10, 2020 @07:57AM (#22832098)
The virus was circulating in the United States undetected, by January. As one of the largest, most heavily traveled countries in the world, there was little hope that they would be able to shut their borders early enough to stave off any infections.
Re:How did the U.S. end up with nurses wearing garbage bags? by zuminator on Friday April 10, 2020 @08:20AM (#22832282)
All that is saying is that shutting borders is not by itself an effective method of limiting the virus. We also needed extensive testing/tracking, early aggressive self-isolation, adequate protective gear and other medical equipment, consistent messaging on how to limit exposure. Along with universal screening of returning travelers. All things that we failed at.
Re:How did the U.S. end up with nurses wearing garbage bags? by assblaster on Friday April 10, 2020 @11:22AM (#22833923)
A high percentage of COVID-19 infected people are asymptomatic.

How would temperature and subjective screening prevent these asymptomatic patients from infecting many others?

Re:How did the U.S. end up with nurses wearing garbage bags? by zuminator on Friday April 10, 2020 @11:36AM (#22834099)
In terms of screening people returning from abroad to the US, if we had immediately established a regime of either testing or mandatory self-quarantine, that would have greatly reduced the rate of transmission.

Doing widespread spot testing across the country would've identified the communities where the virus was extant. From there we would've known where to focus the brunt of universal testing, tracking and quarantining.

Just the fact that we are still fiddling with estimates of what percentage of CV infected people are asymptomatic is a travesty. We should have long ago conducted enough statistical sampling to have a very clear picture what was happening in our communities.

Re:How did the U.S. end up with nurses wearing garbage bags? by specialist on Friday April 10, 2020 @11:44AM (#22834175)
But we were prepared for this pandemic.

Then all those programs were eliminated.

That "deescalation" is separate from all the missteps which have happened since.

Re:How did the U.S. end up with nurses wearing garbage bags? by Nightshaxx on Friday April 10, 2020 @06:54AM (#22831744)
Not arguing that we shouldn't have anticipated this more, but to be fair the "next big things" that we were prepared for, you might not have noticed.

For instance I'm sure there are tons of serious terrorist threats that the government has prevented, but when one acctually happens, everyone complains how the government doesn't know what to do about terrorists. I'm definitely not saying they shouldnt have prevented it....just be aware of the bias.