As a deadly pandemic made its way to American shores, our government was mummified in its own red tape.
U.S. President Donald Trump listens to FDA Commissioner Stephen Hahn (R) speak on the latest developments of the coronavirus outbreak, in the James Brady Press Briefing Room at the White House March 19, 2020 in Washington, DC.(Photo by Chip Somodevilla/Getty Images)
The truth is always less glamorous than the perception. And the truth about 9/11 is that it was first and foremost a failure of bureaucracy.
As early as spring 2000, the CIA had learned that two of the future hijackers had traveled to Malaysia for an al-Qaeda summit. Both men had U.S. visas yet the information was never acted on. In California, the pair roomed with an undercover FBI agent. In Oklahoma, one of them was pulled over for speeding. Mere days before the attacks, they were hunkered down in Laurel, Maryland, not far from the National Security Agency’s headquarters.
They were never stopped, nor were several of the other soon-to-be hijackers who were cited for traffic violations and raised eyebrows at flight schools, more Rocky and Mugsy than SPECTRE. After 9/11, a congressional investigation found that the attacks could have been prevented were it not for FBI and CIA ineptitude. According to that and subsequent reports, the agencies had failed to share information with each other, gotten bogged down in turf wars, and lacked outside-the-box thinking.
They did this because this is how bureaucracies work. The state isn’t some enchanted repository of our national priorities; it’s a sprawling network of individuals, who, like the rest of us, tend to place their own interests before the common good, show reluctance in the face of innovation, cling to rote procedure even under extraordinary circumstances, abuse their power. And just as the predictable failures of the security bureaucracy allowed 9/11 to happen, so too are the predictable failures of the medical bureaucracy enabling the coronavirus to spread.
Start with the feds’ delayed reaction to the virus’s outbreak in Washington State. There, the first case of COVID-19 in America was confirmed all the way back in January, and an infectious disease expert in Seattle, Dr. Helen Chu, had an idea. According to the New York Times, her lab had been using nasal swabs to research the flu; were they to repurpose the tests, they could check for the coronavirus. The team quickly sought the approval of the CDC, which kicked them over to the FDA. The FDA then denied their request, citing both privacy concerns over the swab results and the fact that the labs were not certified for clinical purposes. After weeks of the agency refusing to budge, the team decided to do that most American of things: ignore the government. They tested for coronavirus and found a positive. The bureaucrats promptly told the team to stop; they later relented but only in part.
Those FDA rules may be in place for good reason—patient privacy must be protected, labs must be classified correctly—but such rationales should quickly fall to the floor when an epidemic is raging. Because they didn’t, Chu’s team was forced to waste valuable time. And even those laboratories approved for clinical work were having a tough go of it. They still had to apply with the feds for emergency approval to develop their own tests, and were being stymied. “This virus is faster than the FDA,” grumbled one researcher to the Times. So are turtles with polio. It’s worth pointing out that all this transpired well after the government had declared the coronavirus a public health emergency.
The root of the problem seems to be that the bureaucracy underestimated just how widely the coronavirus would spread. Initial tests were limited to those who had just returned from China. Warnings from local officials that the virus was proliferating were ignored. The CDC, meanwhile, developed its own test, but the kits were quickly determined to be faulty and retracted. Precious weeks slipped by. Had measures been implemented, had people started social distancing earlier and the infected been identified and quarantined faster, the coronavirus could have been better contained. Instead the FDA tried to control the process, only to find that it couldn’t. Private labs were brought in too late and struggled to meet demand, forcing them to ration tests. It wasn’t until last week that the FDA started permitting companies to market tests without federal blessing, though they still must get the agency’s approval within two weeks.
The process remains hamstrung by that most bureaucratic of problems: lack of coordination. Only whereas prior to 9/11 it was agencies failing to coordinate with each other, now it’s the government failing to coordinate the supply chain. The labs, the medical providers, the supply manufacturers—all need to be in harmony in order to develop tests and distribute badly needed equipment. Instead hospitals warn of ventilator shortages. Masks are running dangerously low, with Vice President Mike Pence announcing only last weekend that the government had at last placed an order for hundreds of millions more. A run on supplies following the FDA’s belated easing of restrictions on private labs caused shortages, according to the Wall Street Journal. Tom Rogan at the Washington Examiner reports that pallets of medical equipment are sitting unused in warehouses because the FDA hasn’t loosened its inspection protocols.
Contrast all this with South Korea, which streamlined its medical bureaucracy following the MERS outbreak in 2015. There, officials sounded the alarm in January and one week later a private lab had developed a test. Today, about 10,000 South Koreans are tested daily, many of them at drive-through diagnosis centers, compared to just a small fraction of that number in the United States.
Yes, the fish rots from the head down. Donald Trump’s complacent reaction to the virus set a terrible example. His pronouncement that the outbreak was “like a miracle, it will disappear” now sounds insane. Yet the president can also only reach so far down into the bureaucracy; some of those gears need to align on their own. And they clearly failed to do so. This also can’t be blamed on a lack of funding, given that Trump’s supposed cuts to the medical bureaucracy never actually happened. Amid a massive federal budget and trillion-dollar deficits, we’re paying more than enough to expect the government to do better than this.
I know we’ve convinced ourselves that the country would run better if only the damned libertarians would get out of the way, but it may be that the real problems are less trite than that. And one of them is clearly that the government has mummified itself in its own red tape. This happened despite the bright minds running its departments, human genome pioneer Francis Collins at the NIH and the oncologist Stephen Hahn at the FDA. So now the bureaucracy is taking a more deregulatory approach, lifting roadblocks to private labs, easing restrictions on trucking, lifting barriers to telehealth. They’re about two months too late. Those early weeks were critical and the feds spent them methodically tripping over their own banana peels.
After 9/11, the nation consoled itself by establishing a new government agency with a fancy name, the Department of Homeland Security. Anyone who’s ever talked to a DHS employee knows the confusion and bureaucratic jostling that reigned there for years. Instead of doing the same, once the coronavirus has passed, Congress should take a cue from another post-September 11 authority: the 9/11 Commission. Establish a body to investigate the government’s blunders. Mimic South Korea and clear away the clutter. Because this time the costs of bureaucracy aren’t just abstract notions of productivity and GDP; they’re human lives.