Hanlon’s razor advises us “never attribute to malice that which is adequately explained by stupidity.”
At the beginning of the pandemic, Hanlon’s razor appeared to be a sufficient explanation for the poor CDC decision-making that hampered our response to contain SARS-CoV-2.
When the pandemic first made its way to American shores, the United States Centers for Disease Control (CDC) bungled COVID-19 testing in a handful of important ways:
In January and February, the CDC initially distributed faulty COVID-19 testing kits. Bad tests = unreliable results.
The CDC declined to approve testing kits developed by the World Health Organization
Hospital labs were discouraged from developing their own in house tests (technically under FDA purview, but reinforced by the CDC according to WaPo reporting)
The CDC tightly restricted access to tests with stringent criteria for who could get tested. Restricted access = rationing
They were also very slow to adopt community based surveillance, making contact tracing and thus containment of small outbreaks impossible at the beginning
At the beginning of the pandemic, when countries with similar sized outbreaks were performing tens of thousands of tests per day, we were performing less than 100 daily tests here.
When I was working in the ICU at the height of the pandemic, it could take as long as 72 hours to get test results back on our suspected COVID patients. And this was the lag for the sickest patients! People who weren’t so sick just couldn’t get tested.
Slow and inaccurate testing with limited availability + a virus easily spread by asymptomatic people = recipe for rapid community spread that quickly outstrips our ability for containment.
The original sin of our floundering pandemic response is our shitty testing
These testing failures are attributable to errors made by the CDC during our “lost month.”
You can argue that this was a forgivable sin!
At the very least, it was certainly reasonable to attribute these initial errors to incompetence rather than malevolence.
This was a new virus that we didn’t know much about. Things were moving really fast with a lot of uncertain information about spread, symptoms, and fatality rates. It wasn’t clear how reliable the information coming out of Wuhan was at the time and it wasn’t certain that the tests deployed elsewhere in the world were all that accurate.
I can understand the thought that centralized test development by experts from the CDC makes sense as an initial strategy to create a national standard for testing.
The problem is that the CDC failed at their job here! The tests didn’t work and we didn’t have enough of them.
In other words, the food here is terrible and the portions are too small.
Why are we still running in circles?
We’ve never gotten to a point where we had anything close to a national strategy on testing, contact tracing, and isolation.
It is embarrassing. We’re more than half a year into the pandemic and there’s little strategic coherence on testing.
It is tragic. The USA is a country that has 4% of the world’s population and 25% of its COVID cases.
It was completely avoidable. We’ve known about these failures for months and haven’t done anything to fix them.
It’s been clear for some time that the solution is inexpensive, fast, easy, frequent, but less sensitive testing that is widely deployed.
But the CDC is going in the opposite direction, changing guidelines to reduce rather than expand the pool of people who can get tested. The CDC is telling us to slow the testing down, please.
I don’t think Hanlon’s razor can explain our current situation any longer
Now, you could argue that Robert Redfield, the director of the CDC, is simply a textbook example of the Peter principle. After all, Dr. Redfield doesn’t have any experience running a big government agency and this hasn’t exactly been the easiest time to get up to speed.
But I think that gives him a bit too much credit.
The head of the CDC should know that less testing is going to make the pandemic harder to control.
If Dr. Redfield doesn’t know this, he’s unqualified for his job. But even someone wildly unqualified for his job should understand the basics of testing in a pandemic.
And if he does know even a tiny amount about testing, he’s making a deliberately wrong decision that will make the pandemic worse.
Our public health leaders are failing us over and over again and it’s making the pandemic worse.
I wrote earlier this week about how deliberate misrepresentation about the research on COVID treatments has led to the FDA losing its credibility.
The same thing is happening to the CDC. An organization that is supposed to be trustworthy and reliable has completely abandoned a decision making structure that we can feel confident in.
The message that public health officials spread makes a difference for millions of people.
If there is political pressure to make the wrong decision and send the wrong message, then these doctors should resign their posts and tell us all in plain English what they were asked to do.
It’s the ultimate expression of both hubris and cowardice to stay in their roles and try to influence things from the inside when they’ve already done so much damage - both to public health and to the credibility of the organizations that they’re leading.
Why bother being in such an important role during a pandemic if you won’t abide by the oath that you took to do no harm?
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