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Can we look again at progress towards vaccines? - Printable Version

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Can we look again at progress towards vaccines? - oregontim - 07-10-2020

Damn. Damn. Damn. Browsing the thread about the 82 kids infected in a summer camp, and of course all the numbers going up. Pretty dreary prospects. What is the likelihood of generalized behaviors to make it slow? What is the likelihood of national resolve, from leaders at the top, to hunker down to make it slow? Chances are pretty slim, at least through November, IMO.

Seems like this will go on until we have a vaccine.  For my part, my wife and I, both 65+, think we're going to have to avoid human contact as long and as much as possible, probably well into next year — if we're lucky.

It's been a couple of months since we've had a good discussion here on the Cardboard on realistic hopes for vaccine. I've been seeing Stanford prof Seema Yasmin in interviews, usually with the Stanford Quad as a background, an expert on vaccines. She pointed to Pfizer saying they could have 3 million doses by December, but then she paused, sighed, and added that in the history of vaccines, the quickest one done took four years. But this is now, 2020, and a bigger deal than anything in our lifetimes. So maybe we can really get one in less time?

We — especially the older we — have a long road ahead of us.

RE: Can we look again at progress towards vaccines? - OutsiderFan - 07-11-2020

Not to make you feel worse, but it seems to me putting all our eggs in the vaccine basket is a bad idea. Americans in particular are usually looking for the “magic pill” solution. Too many don’t want to put in the work and make the sacrifices needed to effectively solve problems.

The odds a vaccine will work are extremely low, IMO. First, it has to work over an extended period of time. Given we see strong evidence antibodies don’t last long, this is my number one reason for skepticism. But let’s assume a vaccine works for one year before needing another dose. Then, you need it produced at scale. Then you need people willing to get it. Then you need to pay for it. Look how many people won’t wear a damn mask, and I’m suppose to believe enough will take a vaccine to get herd immunity from something they don’t see as a big deal?

The only way out of this disaster is federal intervention. Mass testing on a scale we haven’t seen. Federal mask requirement. Setting up quarantine centers to isolate all infections. A National app for people to check in to any place they go, so contact tracing and effective quarantining can be done. The dirty little secret is if you do these things, only probably bars need to remain closed until infection rates drop and everything can re-open much sooner than if these steps aren’t taken.

The net of this is we all have to be New Zealand and China. The way you stop the virus is drive it to extinction by reducing its spread, preventing spread, and knowing where it is. When community spread is under control, require all travelers on international entry to get tested when they arrive, and require them to use the app for checking in too. The solutions are not easy, but they are absolutely doable if we stop being stupid and use the power of the United States to its potential. If we don’t eradicate the virus by changing our behavior, we might face living with it forever.

It’s frankly outrageous that we have 10 nuclear Air Craft Carriers, dozens of subs, ICBMs, hundreds of fighters and bombers, tanks, artillery pieces, shells, bombs, electronic warfare, and thousands of soldiers and commanders to protect us, but we can’t stop a minuscule strand of RNA.

RE: Can we look again at progress towards vaccines? - oregontim - 07-11-2020

(07-11-2020, 06:19 AM)OutsiderFan Wrote:  Not to make you feel worse, but it seems to me putting all our eggs in the vaccine basket is a bad idea. ...



The odds a vaccine will work are extremely low, IMO. ...



The only way out of this disaster is federal intervention. ...



...The solutions are not easy, but they are absolutely doable if we stop being stupid and use the power of the United States to its potential. If we don’t eradicate the virus by changing our behavior, we might face living with it forever.

Thanks OF for this answer. Not what I wanted to read, obviously, but I asked because I wanted your thoughts and there it is. I'd like to disagree but none of this is my expertise. Particularly chilling is that conditional: "if we stop being stupid." Gulp.

(07-11-2020, 06:19 AM)OutsiderFan Wrote:  It’s frankly outrageous that we have 10 nuclear Air Craft Carriers, dozens of subs, ICBMs, hundreds of fighters and bombers, tanks, artillery pieces, shells, bombs, electronic warfare, and thousands of soldiers and commanders to protect us, but we can’t stop a minuscule strand of RNA.

Yeah, I agree with that sentiment too. Sigh...

RE: Can we look again at progress towards vaccines? - Snorlax94 - 07-11-2020

(07-11-2020, 06:19 AM)OutsiderFan Wrote:  The odds a vaccine will work are extremely low, IMO. First, it has to work over an extended period of time. Given we see strong evidence antibodies don’t last long, this is my number one reason for skepticism. But let’s assume a vaccine works for one year before needing another dose. Then, you need it produced at scale. Then you need people willing to get it. Then you need to pay for it. Look how many people won’t wear a damn mask, and I’m suppose to believe enough will take a vaccine to get herd immunity from something they don’t see as a big deal?

The only way out of this disaster is federal intervention. Mass testing on a scale we haven’t seen. Federal mask requirement. Setting up quarantine centers to isolate all infections. A National app for people to check in to any place they go, so contact tracing and effective quarantining can be done. The dirty little secret is if you do these things, only probably bars need to remain closed until infection rates drop and everything can re-open much sooner than if these steps aren’t taken.
OF, I agree that we should be able to beat this without a vaccine and should do more to do that, though, I would certainly be happy if a safe, effective vaccine emerged soon.

I recently read the article about Iceland that I believe has been mentioned before, and one remarkable, and kind of depressing, thing that emerges is that there are multiple ways to beat Covid.

All of them seem to include contact tracing, but many of the other details vary. In South Korea,they're cited most for testing and contact tracing, and they were able to tamp down a widespread breakout in Daegu. But in Japan, they never had much of a strict shutdown -- coupled with contact tracing and masks, they were able to keep counts down with social compliance with distancing. No authoritarian government required, and they haven't even tested that widely. Taiwan has been cited for a whole list of steps. Iceland accomplished a lot with its early actions and small size, but reading the article, it's also impressive to see how their involved government can play such a powerful role -- people cooperate with their contact tracers and are grateful because they feel like the contact tracers' primary role is making sure the *infected* are OK, and they've kept mortality rates low by checking up on people and getting all people -- rich and poor -- to hospitals promptly. Do Americans feel that way about the government when a contact tracer calls them?

Every approach -- including vaccines -- will require a competent government but also I'd say at this point -- more significantly -- a cooperative population -- whether agreeing to wear masks, or working with contact tracers, or following distancing guidelines (and not going to bars), or being community minded and not going to a family reunion when you're symptomatic, or taking a vaccine that helps your whole country achieve "herd immunity", or not taking up your assault rifles to protest masks or a Shelter-In-Place. Earlier on, I felt like the greatest failure in America was the government response, but now, it is more and more the lack of the ability of the people to cooperate for the better interest of the entire community and country. And if we don't fix that problem, even a vaccine won't magically solve it, because come on, we already know a lot of people at this time won't take it -- even when it's proven safe and effective. Fauci has warned "the fact that many Americans say they won't get a coronavirus vaccine, makes it "unlikely" that the US will achieve sufficient levels of immunity to quell the outbreak."

To OF's point -- if Americans were cooperative enough to take a safe, effective vaccine if and when it becomes available, we could beat Covid now even without a vaccine. But if America is dysfunctional and Americans refuse to work together even when proven solutions are available, even a vaccine will not solve things.

RE: Can we look again at progress towards vaccines? - lex24 - 07-11-2020

(07-11-2020, 11:58 AM)Snorlax94 Wrote:  
(07-11-2020, 06:19 AM)OutsiderFan Wrote:  The odds a vaccine will work are extremely low, IMO. First, it has to work over an extended period of time. Given we see strong evidence antibodies don’t last long, this is my number one reason for skepticism. But let’s assume a vaccine works for one year before needing another dose. Then, you need it produced at scale. Then you need people willing to get it. Then you need to pay for it. Look how many people won’t wear a damn mask, and I’m suppose to believe enough will take a vaccine to get herd immunity from something they don’t see as a big deal?

The only way out of this disaster is federal intervention. Mass testing on a scale we haven’t seen. Federal mask requirement. Setting up quarantine centers to isolate all infections. A National app for people to check in to any place they go, so contact tracing and effective quarantining can be done. The dirty little secret is if you do these things, only probably bars need to remain closed until infection rates drop and everything can re-open much sooner than if these steps aren’t taken.
OF, I agree that we should be able to beat this without a vaccine and should do more to do that, though, I would certainly be happy if a safe, effective vaccine emerged soon.

I recently read the article about Iceland that I believe has been mentioned before, and one remarkable, and kind of depressing, thing that emerges is that there are multiple ways to beat Covid.

All of them seem to include contact tracing, but many of the other details vary. In South Korea,they're cited most for testing and contact tracing, and they were able to tamp down a widespread breakout in Daegu. But in Japan, they never had much of a strict shutdown -- coupled with contact tracing and masks, they were able to keep counts down with social compliance with distancing. No authoritarian government required, and they haven't even tested that widely. Taiwan has been cited for a whole list of steps. Iceland accomplished a lot with its early actions and small size, but reading the article, it's also impressive to see how their involved government can play such a powerful role -- people cooperate with their contact tracers and are grateful because they feel like the contact tracers' primary role is making sure the *infected* are OK, and they've kept mortality rates low by checking up on people and getting all people -- rich and poor -- to hospitals promptly. Do Americans feel that way about the government when a contact tracer calls them?

Every approach -- including vaccines -- will require a competent government but also I'd say at this point -- more significantly -- a cooperative population -- whether agreeing to wear masks, or working with contact tracers, or following distancing guidelines (and not going to bars), or being community minded and not going to a family reunion when you're symptomatic, or taking a vaccine that helps your whole country achieve "herd immunity", or not taking up your assault rifles to protest masks or a Shelter-In-Place. Earlier on, I felt like the greatest failure in America was the government response, but now, it is more and more the lack of the ability of the people to cooperate for the better interest of the entire community and country. And if we don't fix that problem, even a vaccine won't magically solve it, because come on, we already know a lot of people at this time won't take it -- even when it's proven safe and effective. Fauci has warned "the fact that many Americans say they won't get a coronavirus vaccine, makes it "unlikely" that the US will achieve sufficient levels of immunity to quell the outbreak."

To OF's point -- if Americans were cooperative enough to take a safe, effective vaccine if and when it becomes available, we could beat Covid now even without a vaccine. But if America is dysfunctional and Americans refuse to work together even when proven solutions are available, even a vaccine will not solve things.

America is not dysfunctional.   We have a different cultural mindset towards government than Iceland, South Korea, Japan etc. A very different view towards “authority”. It has served us well for most of our history. But there are consequences and this is one of them. Over and over again I see people talking about Iceland, South Korea, pick your small country of choice and I come back to the same thought:  their stories simply aren’t applicable. I’m not suggesting that there are things to learn from these countries from what their governments did are doing etc. But I’m sorry,  you are not going to change a country‘s culture overnight no matter what’s happening. It simply doesn’t work that way. And with the US - given its regional differences it’s ideological differences etc. etc. etc. makes it that much more difficult.

 None of this is to suggest the administration gets a pass. Far from it. That’s not my point. And I’m not inclined to give the administration a pass anyway. But I also think it’s erroneous to suggest that a simple change of administration would’ve made everything different. It certainly could have and should have been handled better and perhaps we would’ve had a significantly better result. Of course we will never actually know that. But saying that Iceland did that or South Korea did this and we didn’t to me is a nonstarter. We simply are very different animals in the way we relate to our government, our heterogeneity and geography.

Edit: I wanted to add a “non-Trump related example”. In NY with it’s near 20,000,000 people, Gov Cuomo was criticized for waiting too long to invoke SIP. His response was along the lines of - at the time you were suggesting I should have ordered a shut down there were something like five reported cases in New York the people would have thought I was nuts and not supported it. He’s right.

RE: Can we look again at progress towards vaccines? - OutsiderFan - 07-11-2020

I read an article today about Germany’s response to the virus. Several factors struck me:

- Serious government response from the jump, based on having a plan and executing it
- An acceptance of science in part due to fact Chancellor has a Ph.D in quantum chemistry
- All 16 German states followed national government guidelines
- People trust the government
- An aversion to catastrophe based on WWII experience

One of the main tactical NPIs Germany instituted was no gatherings of more than 2 people for several weeks unless part of your household. They didn’t do a SIP. They didn’t have curfews. I believe they required masks and had crowd control at stores. They also did thorough contact tracing and the isolation stuff. This includes a two voluntary government sponsored mobile apps, one for reporting your symptoms and one for tracing purposes. Both voluntary and both anonymous. And they ramped up their testing very fast. Germany reported about 200 new infections today.

Our epidemic is so out of control it’s too late for the U.S. to do any of these things in time to prevent the disaster we are careening toward. I mean do any of y’all know of any apps developed by CDC that are about to be released? The reason Germany got its outbreak under control starts with the fact the country had a plan and followed it from the time the first case was reported. The series of steps it followed and everyone adhered to allowed it to bend down the curve.

Yes, I get we are different culturally than Germany, but even given that, if the U.S. had a national plan and all elected governments took the virus seriously from the beginning, I fully believe our citizens would have largely bought in and followed directions. We’d have our epidemic under control too. Maybe the scale of our COVID-19 Epidemic and the damage it causes becomes for the U.S. what WWII was for Germany in terms of never wanting to experience such a catastrophe again, and changing to make sure we don’t.

RE: Can we look again at progress towards vaccines? - Genuine Realist - 07-11-2020

(07-11-2020, 06:19 PM)OutsiderFan Wrote:  I read an article today about Germany’s response to the virus. Several factors struck me:

- Serious government response from the jump, based on having a plan and executing it
- An acceptance of science in part due to fact Chancellor has a Ph.D in quantum chemistry
- All 16 German states followed national government guidelines
- People trust the government
- An aversion to catastrophe based on WWII experience

One of the main tactical NPIs Germany instituted was no gatherings of more than 2 people for several weeks unless part of your household. They didn’t do a SIP. They didn’t have curfews. I believe they required masks and had crowd control at stores. They also did thorough contact tracing and the isolation stuff. This includes a two voluntary government sponsored mobile apps, one for reporting your symptoms and one for tracing purposes. Both voluntary and both anonymous. And they ramped up their testing very fast. Germany reported about 200 new infections today.

Our epidemic is so out of control it’s too late for the U.S. to do any of these things in time to prevent the disaster we are careening toward. I mean do any of y’all know of any apps developed by CDC that are about to be released? The reason Germany got its outbreak under control starts with the fact the country had a plan and followed it from the time the first case was reported. The series of steps it followed and everyone adhered to allowed it to bend down the curve.

Yes, I get we are different culturally than Germany, but even given that, if the U.S. had a national plan and all elected governments took the virus seriously from the beginning, I fully believe our citizens would have largely bought in and followed directions. We’d have our epidemic under control too. Maybe the scale of our COVID-19 Epidemic and the damage it causes becomes for the U.S. what WWII was for Germany in terms of never wanting to experience such a catastrophe again, and changing to make sure we don’t.
I don't think we had the national consensus you b suggest ever during the wars of national survival (the Civil War and WW II). Whatever policy should be adopted has to be based on the society as sit is, not as one would wish it to be (and most of us would NOT wish it to be in that form in any other circumstances but these). 

My own thought remains strict regulation of the major institutions that are regulable, hopefully trickling down in the proverbial manner.

RE: Can we look again at progress towards vaccines? - akiddoc - 07-11-2020

(07-11-2020, 06:19 AM)OutsiderFan Wrote:  The odds a vaccine will work are extremely low, IMO. First, it has to work over an extended period of time. Given we see strong evidence antibodies don’t last long, this is my number one reason for skepticism. But let’s assume a vaccine works for one year before needing another dose. Then, you need it produced at scale. Then you need people willing to get it. Then you need to pay for it. Look how many people won’t wear a damn mask, and I’m suppose to believe enough will take a vaccine to get herd immunity from something they don’t see as a big deal?

Actually, the odds are that a vaccine will work. The ability to create immunity to this type of virus is more likely than not. The issues are going to be safety, availability and utilization. And yes, we'll probably need booster doses. 

As far as individuals are concerned, you'll likely be able to get reasonable immunity. No vaccine gives 100% coverage but I suspect that we'll also have an antibody test you can take to assure that your vaccine "took." If you are over 40 you probably want to check. When our antibody levels are high, we get pretty good protection from viruses. 

I'm pretty certain most states will make it mandatory for school attendance and many companies will make it mandatory for work. The medical industry will definitely make it mandatory. 

The main stumbling block will be vaccine safety.

RE: Can we look again at progress towards vaccines? - OutsiderFan - 07-12-2020

(07-11-2020, 08:01 PM)akiddoc Wrote:  
(07-11-2020, 06:19 AM)OutsiderFan Wrote:  The odds a vaccine will work are extremely low, IMO. First, it has to work over an extended period of time. Given we see strong evidence antibodies don’t last long, this is my number one reason for skepticism. But let’s assume a vaccine works for one year before needing another dose. Then, you need it produced at scale. Then you need people willing to get it. Then you need to pay for it. Look how many people won’t wear a damn mask, and I’m suppose to believe enough will take a vaccine to get herd immunity from something they don’t see as a big deal?

Actually, the odds are that a vaccine will work. The ability to create immunity to this type of virus is more likely than not. The issues are going to be safety, availability and utilization. And yes, we'll probably need booster doses. 

As far as individuals are concerned, you'll likely be able to get reasonable immunity. No vaccine gives 100% coverage but I suspect that we'll also have an antibody test you can take to assure that your vaccine "took." If you are over 40 you probably want to check. When our antibody levels are high, we get pretty good protection from viruses. 

I'm pretty certain most states will make it mandatory for school attendance and many companies will make it mandatory for work. The medical industry will definitely make it mandatory. 

The main stumbling block will be vaccine safety.

There is no AiDS vaccine. There is no vaccine for flu and many other pathogens. I’m curious why so confident a SARS-CoV-2 one will arrive?

Just 50% of Americans say they will take such a vaccine, and a lot of that skepticism lies in the speed at which one is being pursued. It seems many people understand it takes years to develop safe and successful vaccines. Resistance to a vaccine will ebb as a function of time passing with it being safe and working. This is a large part of why I feel waiting for a vaccine instead of seriously changing our approach to getting the outbreak under control, is a bad idea.

RE: Can we look again at progress towards vaccines? - g1313 - 07-12-2020

I agree with your larger point that if we can make a big difference without a vaccine (which many other countries around the world are demonstrating is possible) then we should. However, I humbly suggest that you can be a little more precise with your words. You originally said "The odds a vaccine will work are extremely low" and then listed a number of reasons that, assuming a vaccine is developed, it would not be effective. Akiddoc refuted many of those points, and then you appear to change your argument to "well the vaccine is unlikely to ever be developed anyway." That might also be true, although contrary to your statement there is a seasonal flu vaccine, it just doesn't protect against all flu mutations. 


(07-12-2020, 03:36 AM)OutsiderFan Wrote:  
(07-11-2020, 08:01 PM)akiddoc Wrote:  
(07-11-2020, 06:19 AM)OutsiderFan Wrote:  The odds a vaccine will work are extremely low, IMO. First, it has to work over an extended period of time. Given we see strong evidence antibodies don’t last long, this is my number one reason for skepticism. But let’s assume a vaccine works for one year before needing another dose. Then, you need it produced at scale. Then you need people willing to get it. Then you need to pay for it. Look how many people won’t wear a damn mask, and I’m suppose to believe enough will take a vaccine to get herd immunity from something they don’t see as a big deal?

Actually, the odds are that a vaccine will work. The ability to create immunity to this type of virus is more likely than not. The issues are going to be safety, availability and utilization. And yes, we'll probably need booster doses. 

As far as individuals are concerned, you'll likely be able to get reasonable immunity. No vaccine gives 100% coverage but I suspect that we'll also have an antibody test you can take to assure that your vaccine "took." If you are over 40 you probably want to check. When our antibody levels are high, we get pretty good protection from viruses. 

I'm pretty certain most states will make it mandatory for school attendance and many companies will make it mandatory for work. The medical industry will definitely make it mandatory. 

The main stumbling block will be vaccine safety.

There is no AiDS vaccine. There is no vaccine for flu and many other pathogens. I’m curious why so confident a SARS-CoV-2 one will arrive?

Just 50% of Americans say they will take such a vaccine, and a lot of that skepticism lies in the speed at which one is being pursued. It seems many people understand it takes years to develop safe and successful vaccines. Resistance to a vaccine will ebb as a function of time passing with it being safe and working. This is a large part of why I feel waiting for a vaccine instead of seriously changing our approach to getting the outbreak under control, is a bad idea.


RE: Can we look again at progress towards vaccines? - BostonCard - 07-12-2020

(07-12-2020, 03:36 AM)OutsiderFan Wrote:  There is no AiDS vaccine. There is no vaccine for flu and many other pathogens. I’m curious why so confident a SARS-CoV-2 one will arrive?



Just 50% of Americans say they will take such a vaccine, and a lot of that skepticism lies in the speed at which one is being pursued. It seems many people understand it takes years to develop safe and successful vaccines. Resistance to a vaccine will ebb as a function of time passing with it being safe and working. This is a large part of why I feel waiting for a vaccine instead of seriously changing our approach to getting the outbreak under control, is a bad idea.

Huh?  There is an influenza vaccine.

I generally share akiddoc's optimism.  There are currently almost 200 vaccines in development, and over a dozen that have started testing in humans.    While the chances of any given vaccine working are not great (especially the ones pursuing novel technologies), the chances that at least one of them will be safe and effective are pretty decent.

I would not be surprised if there is waning immunity and people will have to get booster shots.  Hopefully over time vaccines will be developed with longer-lasting immunogenic response, but for the moment, I think even the modest goals set by the FDA (>50% efficacy) will make a very big difference in terms of helping control the pandemic.

BC

RE: Can we look again at progress towards vaccines? - oregontim - 07-12-2020

(07-11-2020, 06:19 PM)OutsiderFan Wrote:  Yes, I get we are different culturally than Germany, but even given that, if the U.S. had a national plan and all elected governments took the virus seriously from the beginning, I fully believe our citizens would have largely bought in and followed directions. We’d have our epidemic under control too. Maybe the scale of our COVID-19 Epidemic and the damage it causes becomes for the U.S. what WWII was for Germany in terms of never wanting to experience such a catastrophe again, and changing to make sure we don’t.

Agreed. Well said.

RE: Can we look again at progress towards vaccines? - Snorlax94 - 07-12-2020

(07-12-2020, 11:49 AM)oregontim Wrote:  
(07-11-2020, 06:19 PM)OutsiderFan Wrote:  Yes, I get we are different culturally than Germany, but even given that, if the U.S. had a national plan and all elected governments took the virus seriously from the beginning, I fully believe our citizens would have largely bought in and followed directions. We’d have our epidemic under control too. Maybe the scale of our COVID-19 Epidemic and the damage it causes becomes for the U.S. what WWII was for Germany in terms of never wanting to experience such a catastrophe again, and changing to make sure we don’t.

Agreed. Well said.
+1.
I don't buy the nonsense that there is a "unique" component to American "culture" that makes us unable to wear masks and work together for the common good. So only Brazil, Russia and Americans  are free-thinking individuals and Australians, Germans, Koreans, Taiwanese, New Zealanders, Canadians and Icelanders are somehow robots, failures as entrepreneurs and artists, and incapable of making unique contributions to civilization?

Where in de Tocqueville's Democracy in America did he observe that Americans were uniquely incapable of listening to scientific facts or adapting to a crisis situation to do what is necessary to survive?

What do all soldiers do? They adapt to survive. Does this mean only American soldiers wouldn't wear gas masks in a chemical war because they are so independent and free-thinking and because it would make them look weak?

It is nonsense to say American culture means we cannot change what clothing we wear on our faces. Americans have changed its attire and accessories many times in its history and they managed this without losing our identity or culture.

RE: Can we look again at progress towards vaccines? - BostonCard - 07-12-2020

Four men board a bus.  The bus driver tells the men to wear a mask, which is required on public transport.  The men beat up the bus driver, who subsequently dies.  This happened in France, not Florida.

https://www.cnn.com/2020/07/11/europe/france-philippe-monguillot-bus-driver-dies-coronavirus-intl/index.html

There are sh*t people everywhere.

BC

RE: Can we look again at progress towards vaccines? - Goose - 07-12-2020

(07-11-2020, 06:19 PM)OutsiderFan Wrote:  I read an article today about Germany’s response to the virus. Several factors struck me:



- Serious government response from the jump, based on having a plan and executing it

- An acceptance of science in part due to fact Chancellor has a Ph.D in quantum chemistry

- All 16 German states followed national government guidelines

- People trust the government

- An aversion to catastrophe based on WWII experience



One of the main tactical NPIs Germany instituted was no gatherings of more than 2 people for several weeks unless part of your household. They didn’t do a SIP. They didn’t have curfews. I believe they required masks and had crowd control at stores. They also did thorough contact tracing and the isolation stuff. This includes a two voluntary government sponsored mobile apps, one for reporting your symptoms and one for tracing purposes. Both voluntary and both anonymous. And they ramped up their testing very fast. Germany reported about 200 new infections today.



Our epidemic is so out of control it’s too late for the U.S. to do any of these things in time to prevent the disaster we are careening toward. I mean do any of y’all know of any apps developed by CDC that are about to be released? The reason Germany got its outbreak under control starts with the fact the country had a plan and followed it from the time the first case was reported. The series of steps it followed and everyone adhered to allowed it to bend down the curve.



Yes, I get we are different culturally than Germany, but even given that, if the U.S. had a national plan and all elected governments took the virus seriously from the beginning, I fully believe our citizens would have largely bought in and followed directions. We’d have our epidemic under control too. Maybe the scale of our COVID-19 Epidemic and the damage it causes becomes for the U.S. what WWII was for Germany in terms of never wanting to experience such a catastrophe again, and changing to make sure we don’t.

OF, while I agree with the idea that Germany did a much better job of responding than the US, some of what you present here is factually incorrect. First, Germany most certainly did have curfews. https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Germany states that "By 22 March, curfews were imposed in six German states while other states prohibited physical contact with more than one person from outside one's household."  Second, the State of Bavaria was the major player in the beginning, not the national government. In  point of fact, Bavaria wanted to impose a curfew 10 days before it actually was done. They don't need permission to do so from the national level, but Merkel exerted significant political pressure on them to hold off (Which they did. Same political party). She understands science but she is also a politician and has other priorities. Somewhat shades of Cuomo and de Blasio. So all was not in Gute Bestellung all the time.



It is also important to be aware of the fact that the German epidemic response plan is collaborative in nature. Many of the National functions are advisory, not controlling. Take a look at https://www.ncbi.nlm.nih.gov/books/NBK507327/ You are absolutely correct that Germany had a national pandemic plan and they executed it very well. The National, State, and Municipal health authorities worked very well together to do what they had mutually planned to do. It was a "distributed" response, and each part of the response was custom delivered by the local agencies. It is real easy to trust a government that exhibits this level of competence, because they merit that trust. So when one says they "followed the national plan" it is important to remember that plan was written by the various stakeholders to allow them to do things their way. The State and municipal health departments are the contact tracers. This is a very good example of the German inclination to trust the experts and to include all the experts.



For me, the takeaway is that the US had all the right pieces for a good response, but those pieces were just way too weak to do what was needed. We had neglected our Federal, State, and local health departments to the point they had no hope of performing their jobs. We also had a president who couldn't/wouldn't balance the requirements of the experts against his own ego/political needs. That would always have been an issue. However, if the State of California could have responded like the State of Bavaria did things would have been a whole lot better here in California. It didn't have the ability to do so. Ditto whole lots of other jurisdictions. So, if we wanted to emulate Germany, we first needed to have the forces. We didn't, so that was off the table. While we are different culturally in many ways from the Germans, I think Americans (like most everyone else) will trust a government that impresses them as competent. Ours sure failed that test.

New data point: https://www.yahoo.com/news/bavarian-governor-emerges-front-runner-170319198.html No way of knowing at this time if it will "stick", but the public views the Bavarian response more favorably than that of any other State or the role played by Berlin. Not totally fair, because it was the technical level response that mattered, but the politicians sometimes get the credit. Very much not who Merkel wants.