The Bay Area also nailed it with the first and second waves of the flu in 1918. Really good track record on public health.
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(Sorry, deleted to rephrase:) There's another story in the tension between SF's good public health culture of outreach & harm reduction, and a harsh two-tier COVID policy that's still confining many poor people in congregate shelters, locking others outdoors, & delaying testing.
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Weird thing about that story is it takes credit away from Mayor Breed, who ultimately put herself on the line and made / supported the very tough call. Great to learn about the machine, but the machine serves the policy maker.
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True. But institutional competence is a thing. Regions with experience (SARS, MERS, Ebola, apparently AIDS) have just done better during this crisis. Institutional competence matters, even if it still requires courage from individual leaders! (And I LOVE Mayor Breed!)
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Great article. As the epidemic and disruption creeped closer and closer to home, I chose to stay partly because of the history of how Bay Area institutions dealt with the AIDS epidemic. Still, I was not aware of the impressive authority level of county health officials!
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There is an important lesson in governance here. Specialized institutions can be authorized to act, interrupting and taking control under certain conditions. It isn't possible to constantly have specialized information and experience where the active exec authority is.
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Just as a disease can confer future immunity on individuals, an epidemic can lead institutions to improve their responses to future outbreaks. This was the advantage that S Korea used to full advantage, and one hopes, it will be one of the outcomes of coronavirus here in the US.
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Ahh Kate and I were curious about exactly this
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