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How did the pandemic response capability go bankrupt? Slowly at first, then all at once. This is CA but I imagine same story elsewhere. States had a decade of cuts after 2007. Nationwide public health jobs were cut 2008-17.
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“...many of the health workers who deployed to combat the [H1N1] flu crisis [in 2009] did so shortly after they were given pink slips notifying them that they would soon lose their jobs.” H1N1 also targeted young rather than old because 65+ it seems
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Apparently Trump tried to cut more than he did, but there wasn’t actually much more left to cut by the time he got his turn. It’s not actually easy to reconstruct the exact profile of this slow-then-fast bankruptcy.
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Everybody is trying to shift blame around here: state vs federal, Trump vs Obama vs Bush, but I’m not actually sure there’s a way to solve for anything that would seem like adequate preparedness from inside the peak of a crisis. During normal times it would look like waste.
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Public health is basically a form of insurance embodied in jobs and infrastructure that are necessarily very low utilization during healthy years. Especially in large democracies with market-based economies.
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Planned non-market economies are worse. They just hide the gut-in-peace-underreact-in-crisis model. There’s no purely political economy way out of this. Public health needs *heavy* automation coupled with democratized access to personal health management.
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Most people don’t even own a thermometer. Next time this happens, everybody will likely own masks but really, everybody needs a comprehensive quantified self tech force shield around themselves, anchored to phone.
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From paper “How Complex (Human) Systems Fail”
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All practitioners balance 2 roles: produce / defend. When the system works, we complain that they waste production resources on defense. When the system fails, we complain that they ignored defense because they were greedy for production.
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