US Medical Supply Chain Failures Caused Coronavirus Deaths

FRONTLINE investigation to be broadcast

on PBS and online Oct. 6 at 10 p.m. EST/9 p.m. CST

A major ongoing months-long investigation by The Associated Press (AP), the PBS series “FRONTLINE,” and the Global Reporting Centre is analyzing the failures of the medical supply chain to respond to the pandemic. The bottom line is that warnings by experts and manufacturers for years have been ignored by both congress and presidents. The consequence is tens of thousands of needless deaths in the coronavirus pandemic. The AP writes:

“Medical supply chains that span oceans and continents are the fragile lifelines between raw materials and manufacturers overseas, and health care workers on COVID-19 front lines in the U.S. As link after link broke, the system fell apart.

This catastrophic collapse was one of the country’s most consequential failures to control the virus. And it wasn’t unexpected: For decades, politicians and corporate officials ignored warnings about the risks associated with America’s overdependence on foreign manufacturing, and a lack of adequate preparation at home, the AP and “FRONTLINE” found.

As the pandemic rolled into the U.S., Asian factories shut down, halting exports of medical supplies to the U.S. Meanwhile, government stockpiles were depleted from a flu outbreak a decade earlier, and there was no way to rapidly restock. The federal government dangerously advised people not to wear masks, looking to preserve the supply for health care workers. Counterfeits flooded the market.

Although it will take years for researchers to understand why the pandemic was disproportionately worse in the U.S., early studies that compare different countries’ responses are finding that shortages of masks, gloves, gowns, shields, testing kits and other medical supplies indeed cost lives.

Meanwhile, studies in nursing homes -- in China, Washington state and across the U.S. -- found that COVID-19 cases were significantly higher in places with shortages of personal protective equipment, or PPE. Harvard Medical School professor Dr. Andrew T. Chan and colleagues found health care workers who didn’t have adequate PPE had a 30% greater chance of infection than colleagues with enough supplies. Black, Hispanic and Asian staffers had the highest risk of catching COVID-19, they found.

“And these are unacceptable deaths, each of which could have been prevented if we had had adequate supply chains in place in advance of the pandemic,” said UC Berkeley Professor William Dow.

Dow and his colleagues say there would be massive savings, in lives and tax dollars, if the government invested more in buying and storing stockpiles of supplies. 

‘This is a case where no individual health care organization is large enough to move the market and induce suppliers to invest in those types of supply chains,’ said Dow. ‘So the government needs to be able to go in and guarantee a certain amount of purchases so that it will be in the self-interest of each one of these manufacturers to be willing to put in the investments into that supply chain.’  

Despite early warnings from inside the White House, the federal government failed to substantially mobilize domestic manufacturers until April, three months after the virus began spreading exponentially across the U.S.  

The impact of the virus varies greatly from country to country. But it is now clear that those with well-managed, diverse and flexible supply chains were able to protect against the deadly spread in ways the U.S. failed.  

The warnings of looming and potentially deadly supply shortages from the White House began confidentially in February when White House trade adviser Peter Navarro wrote to the COVID-19 task force, urging the administration to halt exports and ramp up production of N95 masks. The U.S. “faces the real prospect of a severe mask shortage!” he wrote on Feb. 9.  

In addition to halting exports and prohibiting the sale of N95 factory equipment to China, Navarro pleaded that the U.S. government must provide ‘immediate purchase guarantees for all U.S. supplies at maximum production capacity.’ 

And according to health care workers, the Government Accountability Office and even the FDA, N95 masks continue to be in short supply. The White House denies this.”

 

The AP article goes on to point out that people responsible for pandemic preparedness in the Clinton, Bush, Obama and Trump administrations all said they warned about inadequate supply chains. Neither congress nor the White House made this a priority due to the cost of maintaining a US supply chain. 

In the wake of the 2014-21016 Ebola virus outbreak, an Obama advisor recommended that the US government needed to stockpile protective equipment during an emergency. The problem with that is that foreign suppliers may not be able to keep up with demand if their output was needed domestically. That is what happened.

A 2019 Trump administration pandemic simulation exercise concluded that the U.S. would not have stockpiled enough antiviral medications, needles, syringes, N95 respirators, ventilators, and other needed medical supplies to adequately respond. That is what happened less than a year after that exercise. In the wake of that exercise, the Trump administration made no move to prepare.

As time passed, American manufacturers of supplies either went bankrupt or shut down manufacturing due to limited demand for US supplies that were more expensive than foreign-made supplies. This failure may have saved billions of tax dollars, but that savings has now cost the US trillions in economic losses and thousands of lives. That was penny wise, but pound stupid.

Maybe this experience will result in a meaningful change. At the August Republican National Convention the president stated that “over the next four years, .... we will .... bring home our medical supply chains, and we will end our reliance on China once and for all.” Joe Biden announced a plan to invest $700 billion to support U.S. manufacturing by purchasing domestically made medical supplies and other goods.

Where does responsibility lie?

In the past, the president has blamed sitting presidents for the bad things that occurred while they were in office. He blamed Bush for the Iraq war and said he should have been impeached for it. If one applies the same standard of responsibility to Trump, he should be impeached for his failures. How one apportions responsibility to members of congress will depend factors such as on who failed to act and who opposed action.

American Christian Nationalism

“Christian nationalism seeks to merge Christian and American identities, distorting both the Christian faith and America’s constitutional democracy. Christian nationalism demands Christianity be privileged by the State and implies that to be a good American, one must be Christian. It often overlaps with and provides cover for white supremacy and racial subjugation. We reject this damaging political ideology and invite our Christian brothers and sisters to join us in opposing this threat to our faith and to our nation. We believe that:

• People of all faiths and none have the right and responsibility to engage constructively in the public square. 
• Patriotism does not require us to minimize our religious convictions.”  

-- Christians Against Christian Nationalism 

“‘Let’s run the race marked out for us. Let’s fix our eyes on Old Glory and all she represents. Let’s fix our eyes on this land of heroes and let their courage inspire. And let’s fix our eyes on the author and perfecter of our faith and freedom and never forget that where the spirit of the Lord is there is freedom — and that means freedom always wins.’ .... But Pence, who accepted his party’s nomination for vice president during the speech, sparked outcry in some Christian circles as he closed out his remarks when he combined at least two Bible verses — and replaced references to Jesus with patriotic imagery.” -- Mike Pence, August 2020, dog whistling to Christian Nationalists by conflating Jesus with the US flag based on 2 Corinthians 3:17 and Hebrews 12:1-2

“‘I should have seen this coming,’ writes John Fea in his new book, Believe Me. The toxic mixture of fear, nostalgia, and desire for power so vividly on display in 2016 was not an aberration, Fea tells us. Instead, it’s part of a long white evangelical tradition. The alliance with Trump may have come as a shock to some, but the roots of this strange embrace run deep into the white evangelical past. .... These deep roots are best seen in the most effective chapter of the book, a ‘short history of evangelical fear’. Fea describes Puritan narratives of moral decline and social decay–narratives begun almost before there was time for decline to occur!–as perhaps ‘the first American evangelical fear.’” -- Colorblind Christians, discussing Trump’s 2016 election and the role that Evangelical Christians played in it

A program, God Bless, produced by the NPR program On the Media discusses the phenomenon of Christian Nationalism (CN) in America. Most of the following comments summarize the first ~20 minutes of the broadcast, which also discusses the historical origin of the mostly mythical belief in severe persecution of Christians by various hostile influences throughout history.

This is of some interest because this group is one of the president’s core supporters. The president and vice president both play on mythical fears that CN ideology is partly based on. They pander to this group in ways that are opaque to most Americans but quite clear to people who believe in CN. 

About 75% of Evangelical Christians are Christian Nationalists (CNs), but the emphasis is more on nationalism than on a specific brand of Christianity. The core ideal is to see “people like us.” American-born white people are people like us and that is the focus of power and privilege. Religion is secondary to the in-group and people in the in-group do not need to be religious hardly at all. More than half the American electorate is CN and about 20% of those (~11% of the total electorate?) fiercely endorse the CN ideology, while about 32% are not strident but still hold these beliefs.

For this ideology, being Christian “like us” and an American citizen translates into social beliefs and symbolic boundaries that tend to exclude others from political parties, political offices, social services and even who is a citizen or qualified to vote. The religious component holds that because these God-willed beliefs are sacred, adherents should be willing to do anything to insure that this vision of America comes to pass. Basically, CNs want to see Christianity play a role at the center of American life, with less influence from other religious faiths, secularism and probably racial minorities. 

Christian Nationalism myths include the idea that America was founded as a Christian nation and that Christians are being persecuted in the form of infringements on their religious freedoms. Although the idea of persecution is false in modern America, it is a central complaint that CNs frequently raise. The idea of persecution of Christians dates back to the early days of Christianity and has been raised even at various times when there is no significant persecution. The modern fear is that Christianity is under attack by hostile forces such as secularism, moral relativism and feminism with much of the threat coming from Jews.

The president is aware of the CN ideology and its large following. In his rhetoric anyone who is not a CN is anti-Christian. He has attacked Joe Biden, incoherently and falsely claiming that he “will take away your guns, destroy your second amendment, no religion, no anything, hurt the Bible, hurt God, he's against God.” An ad the president has run shows Biden worshipping with a black congregation with a voice over saying that people will not be safe in America if Biden is elected. Apparently, this kind of incoherence appeals to some or most CNs. 

One can presume that believers in the CN ideology are among the president’s most loyal supporters. Since he is doing what God commands, presumably the ends mostly or completely justify the means. That may even be true if, in the name of CN ideology, the president murders someone in broad daylight with dozens of witnesses seeing it. Most of these people are not going to change their support for the president, no matter what.

In the CN ideology, one can see why so many religious conservatives have no qualms about ongoing widespread voter suppression by the GOP. They do not want minorities or democrats to vote because those people are not “like us.”  

The Origin of the Punisher God Concept: A Cultural Evolutionary Hypothesis

Muslim women praying 

Istiqlal mosque, Jakarta, Indonesia

The NPR Hidden Brain program, Creating God, focuses on the biological and social origins and utility of the concept of God. Social psychology professor Azim Shariff at the Center for Applied Moral Psychology at the University of British Columbia has studied this question in detail. He argues that about 12,000 years ago, as humans invented agriculture, settled down and began to live in groups of more than about 150 people, an urgent need to protect people from cheaters and liars arose. Humans are not adept at knowing more than about 150 people well. Cooperation required knowing people well. 

As groups living in villages of hundreds or thousands of people arose, there had to be a way to insure good, cooperative behavior for civilization to progress. In small groups where everyone knew everyone else, you would get punished if you told a lie, stole someone's dinner, failed to defend the group against enemies or otherwise acted in an immoral way. Cheats and liars could not get away with cheating and lying very well. There was no way to disappear into a crowd. 

To deal with cheats and liars God was invented and the God was envisioned to be a supernatural punisher of bad deeds. People unknown to each other who held a common religion had a basis to trust and cooperate. They knew their God would punish the one who lies or cheats. In essence, a punitive God was invented to deter immoral behavior. 

 

Empirical evidence

Shariff tested the hypothesis that belief in a punisher God would be at least correlated with less cheating behavior and maybe even caused by the religious belief. He wrote this in a 2011 research paper: 

“Fear of supernatural punishment may serve as a deterrent to counternormative behavior, even in anonymous situations free from human social monitoring. The authors conducted two studies to test this hypothesis, examining the relationship between cheating behavior in an anonymous setting and views of God as loving and compassionate, or as an angry and punishing agent. Overall levels of religious devotion or belief in God did not directly predict cheating. However, viewing God as a more punishing, less loving figure was reliably associated with lower levels of cheating. This relationship remained after controlling for relevant personality dimensions, ethnicity, religious affiliation, and gender.”

The historical record indicates that the punishing God concept arose when societies were struggling with increasing social size, complexity or resource scarcity. Under conditions of such stress, Shariff argues that the need for moral cooperation was more urgent. Other research suggests that belief in a punishing God at least correlates with less bad behavior. 

Modern applications

People hostile to religion for various reasons tend to be hostile to the concept that belief in a punisher God could be beneficial to a society or individuals. The hostility is postulated to stem from discomfort with the idea that religion can have any beneficial effects. Unfortunately for those folks, there is a large body of empirical evidence showing that various beneficial effects attach to religious belief regardless of whether the God(s) is a punisher or loving and forgiving.

On the other hand, some devout religious people resent this kind of cultural evolutionary research because in essence, it provides a competing narrative for the origin of God that is entirely secular and human. That thought is discomforting to at least some devoutly religious people, probably most.

Social scientists see progress of human civilization as necessarily a dual inheritance phenomenon. It is both a cultural evolutionary inheritance phenomenon and a Darwinian inheritance phenomenon. Modern religions are cultural structures that arose from millennia of trial and error about what beliefs and rituals served society reasonably well and what did not. The big modern religions arose from cultural evolutionary inheritance. When seen this way, religion served practical functions to help civilization advance.

Some questions that arise from this line of research center on whether modern religions still mostly serve or mostly hinder complex, technological societies with tens of millions of people in them. Have religions adapted to new circumstances? If they have not, are they now more damaging than helpful in the US or any other country? What are the impacts of religious beliefs in a punisher God that hold people should have as many children as they can, while refraining from using birth control?

Reconsidering religion

This research and the cultural evolution concept casts modern religion in a very different light than I had previously was aware even existed in the science literature. The endless contest between people who want their religion to stay frozen in time and those who want to modernize it is an important source of modern cultural conflict. In that lies a deep reservoir of potential conflict that propagandists and social dividers can tap into for their own ends. In this regard, it seems clear to me that this is a rich vein of mental resource to mine for demagogues, tyrants, kleptocrats and other immoral people who use dark free speech (epistemic terrorism) to deceive, divide, distract, irrationally emotionally manipulate (foment fear, anger, bigotry, distrust, etc.) and bamboozle with self-serving bogus reasoning (motivated reasoning). 

For me, this is another of those significant mind-opening experiences that will take some time to consider in my thinking about people doing politics.

Book Review: Dime’s Worth of Difference

“There's not a dime's worth of difference between the Democrat and Republican parties.” -- white racist and former Alabama governor George Wallace, 1968 American Independent Party candidate for president (before he died, Wallace recanted his virulent racism and apologized for it)

“Integration, therefore, at this turn of the century, has become another promise, not exactly broken, but finagled to mean whatever does not cross the borders of white comfort. Perhaps separate can be equalized after all.” -- Greg Moses, Chapter 19, Civil Rights Down Through the Presidencies

“In the Clinton-Bush years, the number of incarcerated people per 100,000 US residents increased from 163 to 231. We hold the record in this category. The two parties do not differ on the issue of prisons, because both are wedded to corporate power, and the prisons, for that power, provide a vital service.” -- Vijay Prashad, Chapter 20, Capitalism’s Warehouses

“The Big Greens, all democrats, get defeated on forests every time and every time, it’s by a wider margin. Is it mere ineptness? Or, is something darker going on here? Is losing a reflex? Or are they throwing the game and blaming Bush and Republican ultras for their own political purposes?” -- Michael Donnelly, Chapter 11, One Wyden, Many Masters

The 2004 book, Dime’s Worth of Difference: Beyond the Lesser of Two Evils, is an extended attack on the democratic party and politicians, especially Bill Clinton. The book’s central thesis is that the republican party is awful but the democratic party is not much better. The book consists of 23 essays by various authors and was edited by Alexander Cockburn and Jeffrey St. Clair. The book was published by CounterPunch, a left wing political website and magazine (mostly factual fact rating). 

The authors build a case that economic, military and trade policy overlaps much more than it diverges. The books argues that the main difference between the parties is that the Republican party is open about its pro-corporate, homophobic and racist objectives, while the Democratic party deceives its constituents with lip service about human rights and and equality. The essay authors argue that progressive activists need to concentrate on building grassroots, participatory movements without reliance on party elites or leaders. 

One example of the criticisms centers on how Clinton’s sex scandal accidentally wound up saving social security from privatization and subsequent private sector looting. Chapter 3, How Monica Lewinsky Saved Social Security, starts with this blast: 

“Had it not been for Monica’s captivating smile and the first inviting snap of that famous thong, President Bill Clinton would have consummated the politics of triangulation, heeding the counsel of a secret White House team and deputy treasury secretary Larry Summers. Late in 1998, or in the State of the Union of 1999 a solemn Clinton would have told the congress and nation that, just like welfare, Social Security was near broke, and had to be ‘reformed’ and its immense pool of capital tendered in part to the mutual funds industry. .... But in 1998 the Lewinsky scandal burst upon the president .... [and] Clinton’s polls told him that his only hope was to nourish the widespread popular dislike for the hoity-toity elites intoning Clinton’s death warrant. In an instant Clinton spun on the dime and became Social Security’s mighty champion, coining the slogan ‘Save Social Security First.’”

Well, when one puts it that way, maybe Clinton was a bit too much like the republicans, deceitfully self-serving and callously laissez-faire capitalist. 

From what I can tell, this book probably reflects the frustration of most true liberals with the democratic party. From this point of view, it is easier to understand why some people will not vote for Biden no matter what. The betrayals and lies the democrats have relied on are hard to take. For people who really do not believe that there are no meaningful major differences between the two parties, this book tries its very best to demolish that belief. And, it does a pretty good demolition job. 

This book does make it harder to get past the lesser of evils argument to justify a Biden vote, but nonetheless 16 years later and under 2020 conditions, the lesser evil is still justifiable and a sound act. 

What is the Fundamental Basis of Democracy?

Vietnam war - we all know exactly what this is

This was part of the evil too

The fundamental basis of democracy is facts, true truths and sound reasoning; 

Lying to and manipulating the public usurps democracy and advances tyranny

In her 1999 book, Lying: Moral Choice in Public and Private Life, moral philosopher, Sisella Bok wrote this in chapter 12, Lies for the Public Good, about the presidential election before America launched into America’s tragically unjustified, disastrous and profoundly immoral, actually evil, Vietnam War:

“[Johnson repeatedly told the American people] ‘the first responsibility, the only real issue in this campaign, the only thing you ought to be concerned about at all, is: Who can best keep the peace?’ The stratagem succeeded; the election was won; the war escalated. .... President Johnson thus denied the electorate of any chance to give or refuse consent to the escalation of the war in Vietnam. Believing they had voted for the candidate of peace, American citizens were, within months, deeply embroiled in one of the cruelest wars in their history. Deception of this kind strikes at the very essence of democratic government.” 

Note the argument that deception strikes at the very essence of democratic government. That is the main point.

As Bok pointed out, Johnson fully intended to escalate the war while at the same time lying to the American people in his campaign for president. He lied to Americans by telling them that he would de-escalate the war. In essence, Bok argued that when people in a democracy form beliefs and make decisions on the basis of lies and deceit, that deprives citizens of their right to make a choice on the basis of truth. The source of the lies and deceit do not matter.[1]

The moral reasoning is straightforward: Citizens who base their decisions on political, special interest or ideologue dark free speech** deprive those citizens of their right to make a choice to consent or dissent on the basis of truth. It really is that simple.

** Dark free speech: lies, deceit, unjustifiable, irrational emotional manipulation, unjustifiable, irrational motivated reasoning, unwarranted character assassination, race baiting, irrational homophobia, irrational xenophobia, etc.

Moral courage requires an ability to face and accept inconvenient facts, truths and reasoning. Moral cowardice lies in ignoring, denying or distorting such inconvenience. Inconvenience is replaced by lies, deceit, manipulation and motivated reasoning. It isn't just politicians and partisan ideologues who are bereft of moral courage. Much of the private sector relies on moral cowardice to make money, just like political moral cowards use it to gain power or influence. The coward oil and plastic industry intentionally deceived and still deceives the American people into a false belief that plastics are mostly recyclable. The coward oil industry tries hard, often quietly with lobbyists and money, to deny anthropogenic climate change.

What shields moral cowards is a combination of ignorance and dark free speech among the public. Significant ignorance is understandable because moral cowards are lying, deceiving and hiding truths as hard as they can.

As I define the concept, all dark free speech is legal. The courts protect dark free speech every bit as much as they protect honest speech. There is no legal difference. 

It isn't dark free speech, it is epistemic terrorism

One of my common interlocutors here has repeatedly criticized my use of "dark free speech" as too wuss. His argument is basically that the label dark free speech is unacceptable because the concept is much more toxic than merely dark. He calls it epistemic terrorism. The google definition of epistemic is "relating to knowledge or to the degree of its validation." Is that label too vague for most people to understand? 

Regardless, maybe deceiving and irrationally manipulating people to win hearts and minds is a form of terrorism. 

Is it? Or, is this too wonky to pay much attention to, e.g., splitting hairs and whatnot?

Footnote: 

1. In a real tyranny, the people have no meaningful voice. It does not matter much if their decisions are based on truth or lies. The tyrant decides, not the people. 

Vietnam

We were deceived

They were innocent

The President is Infected With Coronavirus

The New York Times writes:

“President Trump revealed early Friday morning that he and the first lady, Melania Trump, had tested positive for the coronavirus, throwing the nation’s leadership into uncertainty and escalating the crisis posed by a pandemic that has already killed more than 207,000 Americans and devastated the economy. 

The dramatic disclosure came in a Twitter message just before 1 a.m. after a suspenseful evening following reports that Mr. Trump’s close adviser Hope Hicks had tested positive. In her own tweet about 30 minutes later, Mrs. Trump wrote that the first couple were “feeling good,” but the White House did not say whether they were experiencing symptoms. The president’s physician said he could carry out his duties “without disruption” from the Executive Mansion.”

Whether the president is feeling good or not is an open question. Since he lies about his health, and most everything else, there is no way to know what his health status is. Presumably it is early in the infection, so he probably is feeling good.

Maybe if he had taken this seriously and made the people around him wear masks this would not have happened. But he didn't and it did. 

This is nothing to gloat or be happy about. It reflects how poorly the US, and the president in particular, have dealt with the pandemic.