China Must Stop Hiding Its Vaccine Data
Beijing Is Undermining Confidence in a Vaccine the World Desperately Needs
When the novel coronavirus arrived in the United States, it hit an economy, a society, and a constitutional democracy that were fundamentally unprepared. As the extent of the challenge became clear, the country simply could not deliver what was needed to confront it: a large-scale program of testing and contact tracing, which would have suppressed the virus and allowed the economy to remain open. Just as the 2008 financial crisis exposed blind spots in how countries thought about integrated markets, within the first three months of 2020, the spread of COVID-19, the disease caused by the virus—with the massive spike in deaths and the economic damage resulting from the shutdown—revealed that the United States was vulnerable to a more literal type of globalization-enabled contagion. What went wrong?
Many have blamed the United States’ federal system, arguing that a decentralized government that devolves significant power to 50 states is no match for a fast-acting virus. Those who hold this view have pointed to China’s prompt response to the outbreak as a model for decision-making under crisis, arguing that only a centralized, authoritarian state can act quickly and ruthlessly enough.
Yet federalism was not what held the United States back from a quick and effective response; the problem was governance. President Donald Trump deserves blame for failing at his central task of educating the public, but he wasn’t acting in a vacuum. The virus has exposed that American democracy, although well equipped structurally, has lost its way in terms of its capacity to find a common purpose.
When the framers wrote the U.S. Constitution, they consciously chose a federal system of government. Recognizing that different functions should be handled at different levels, they assigned some responsibilities to the national level and others lower down, while charging the national government with maintaining harmony among the states. In the context of the coronavirus, this system of federalism should be an asset, not a liability. It provides flexibility and the ability to tailor responses to the context—just what the United States needed. Rural areas with no COVID-19 cases did not require the same response as cities with thousands.
In other parts of the world, the pandemic has been controlled most easily in population units smaller than a massive country like the United States. The Chinese contained the virus by specifically locking down Wuhan, the epicenter of the epidemic, and nearby cities. Island states with relatively small populations, such as Hong Kong, New Zealand, Singapore, and Taiwan, have fended off the virus especially well. Iceland has also fared well: by April 11, it had managed to test ten percent of its 350,000 people. The town of Vò, Italy, tested every single one of its 3,000 residents, eradicating COVID-19 in less than two weeks. The smaller the administrative unit, the easier it is to roll out testing.
Why is this so? A big reason is that viruses spread through social networks. Efforts to control them that take into account existing social structures perform better than those that do not. Consider the difference in how Singapore and South Korea responded. Because Singapore was blind to the social networks of migrant communities, the government failed to test and trace the virus’s spread adequately among them, and the country experienced an explosion of COVID-19 cases, starting in its migrant worker population. In South Korea, by contrast, when a member of a large church tested positive, the government moved swiftly to test the entire congregation to control the spread. The lesson for the United States is that authority for key public health decisions should be lodged with state and local authorities. After all, they are the ones who best understand the dynamics of community spread.
Authority for key public health decisions should be lodged with local authorities.
At the same time, however, the federal government needs to create the conditions for success. Small island nations have it much easier: they can both make policy at levels close to the ground and coordinate a national economy to support those policies. In the United States, city governments have no ability to, say, change monetary policy to support their budgets. Nor are states, for their part, in a position to activate a wartime-style reorientation of the economy and force private companies to produce ventilators, masks, and test kits. Only the federal government, empowered by the Defense Production Act of 1950, can do this. But Trump was slow to invoke the act, losing precious weeks.
The United States is blessed with a tiered structure of government, with the authority for responding to an outbreak residing in officials from the president all the way down to the lowly county health officer. This setup is valuable because it makes it possible to implement custom-tailored policy on smaller scales. As public health authorities discovered during the HIV/AIDS crisis, contact-tracing programs work best when they are run by people who are trusted in the communities where they operate. Although Americans’ distrust of the federal government has risen continuously over the last few decades, trust in local government remains high. In a 2018 Gallup poll, 72 percent of respondents said they have a “great deal” or a “fair amount” of confidence in their local government.
That’s why, for example, a contact-tracing program that protects privacy is best introduced at the local level. If sensitive data about everyone a person has interacted with were funneled into a centralized national database, the potential for abuse would be high. No database is foolproof, but compared with a single national database, small pockets of data are a far less tempting target for hackers or profiteers. Although the federal government should surely help design the digital infrastructure used by local health officials, for the sake of benefiting from scale, it’s reasonable to leave the use of that infrastructure in the hands of local authorities, with oversight from state governments.
More broadly, Americans should expect the federal government to focus on the big picture: setting overarching goals and identifying promising practices for how best to respond to the pandemic in ways that save both lives and livelihoods. They should expect their state, county, metropolitan, and municipal governments to get into the nitty-gritty: contact tracing, testing, treating the ill, and supporting those who are self-isolating. That differentiated setup existed long before the coronavirus arrived. The United States’ federal system, in other words, had all the elements needed to respond to such a crisis. What went wrong was a failure of governance.
In times of crisis, a government’s duty is to lead the public through a process of diagnosing the problem and identifying a shared plan for solving it. This is fundamentally an act of public education. The presidency is the foremost teaching platform in the country. To implement the plan, leaders will need to activate the machinery of government and do the nuts-and-bolts work of setting policies and directing resources. But the machinery of government is greased by public acceptance. When the pandemic hit, none of this happened. Trump, the person with the greatest power to educate the public and motivate the whole country behind a common purpose, declined to use that power.
This was a personal failing, but it was not just that. For decades now, the American public’s understanding of the demands and requirements of governance has atrophied. That point hit home after Trump was elected in 2016, when disgruntled Americans of all ages from around the country wrote to me asking how they could play a civic role and protect the values they cared about. (Evidently, being a historian of American constitutional democracy and a political philosopher of democracy was enough to mark me as a civics “Dear Abby.”) What astonished me was how few people knew where to start. They did not know how to call a meeting, how to engage their fellow Americans in a conversation about diagnosing their circumstances and finding some sort of shared purpose. All that constitutional democracy is, is a set of institutions that give people the chance to do these things and, if they do them well, to shape their communities. Yet Americans no longer understood how to use the machinery sitting all around them.
Americans need to shake off the shackles of obeisance to technocrats.
As the pandemic grew, instead of endlessly debating Trump, more Americans should have asked, What questions need to be answered here? Had they done so, they might have realized that neither public health experts nor economists have a monopoly on how to respond. The former know how to fight diseases, but they know little about how to get supply chains to deliver a testing infrastructure on an unprecedented scale. The latter know how to revive a flagging economy, but they know little about which alternatives to stay-at-home orders are effective at controlling a disease. At a time when there was a need to take in advice from two silos of experts and make an integrated judgment, Americans settled into camps, defending the monofocal perspective of one category of expertise or another. Americans needed to shake off the shackles of obeisance to technocrats. Their elected leaders should have led them through the process of asking the right questions and then making judgment calls, taking into account the best advice experts could give.
There was a spark of such a moment in late March, when Trump tweeted about collective stay-at-home orders, “WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF.” He was right. That moment should have been greeted as a call for coming up with alternative ways of addressing the health problem that would not kill the economy. But most of the country did not hear his remark that way. Instead, they interpreted it as a refusal to reckon with the challenge of the disease itself.
A common purpose is not some airy-fairy thing. It is a practical tool that allows people to achieve something together. In effect, it is a map marked with a destination, a guide that permits collaborative navigation. A common purpose is perhaps the most powerful tool in the democratic toolkit, particularly in a crisis, because it can yield the solidarity that induces people to do hard things voluntarily rather than through authoritarian compulsion. Yet the tool is disintegrating from disuse.
Why has Americans’ understanding of constitutional democracy and of individuals’ roles within it deteriorated? The answer probably goes back to another crisis. When the United States entered World War II, it mobilized behind the common purpose of defeating the Axis threat. As part of that effort, the U.S. military, intent on beating Germany to developing an atomic bomb, activated the scientific community through the Manhattan Project. That was the beginning of the scientification of American society.
After the Cold War began, and especially after the launch of Sputnik by the Soviet Union in 1957, the United States increasingly invested in scientific research and in education in the STEM fields (science, technology, engineering, and math). The goal was to remain globally competitive in both economic and military terms. Americans were inspired afresh in 1983 by A Nation at Risk, a federal report that found that the United States’ “once unchallenged preeminence in commerce, industry, science, and technological innovation is being overtaken by competitors throughout the world.” More recently, the National Academy of Sciences’ 2007 report Rising Above the Gathering Storm worried that “the scientific and technological building blocks critical to [the United States’] economic leadership are eroding at a time when many other nations are gathering strength.”
The United States needs science. It needs technological innovation, and it needs scientists to advise elected leaders. But that is not all the country needs. It also needs people who can interpret the science and make judgment calls that take broader factors into account. The U.S. government’s growing investments in scientific education have been accompanied by reductions in funding for civics education.
In the 1950s, most high schools offered students three separate civics courses; today, they usually offer only one, and 15 percent of students don’t even get that. Eleven states have no civics education requirements whatsoever. The federal government spends $54 per student per year on the STEM fields. The figure for civics education: five cents. No wonder, then, that in 2018, the National Assessment of Educational Progress, a set of exams administered by the U.S. Department of Education, found that only 24 percent of eighth graders were proficient in civics.
In the United States, the art of governance is on life support.
What’s more, science education is negatively correlated with political participation: researchers have discovered that the more hours of science courses college students take, the less likely they are to vote or partake in other aspects of civic life. Over the course of nearly eight decades of investing in scientific competitiveness, the United States neglected the civic side of the equation.
And the country is paying for it now. In the United States today, the art of governance is, at best, on life support. Paradoxically, Trump has delivered the best civics lesson in generations. Thanks to his impeachment trial, Americans have had to think about the proper bounds of executive power, the checks offered by the legislative and judicial branches, and precepts of the Constitution. Thanks to his failure to govern through this crisis, many have learned for the first time just how the United States’ federal system is supposed to work.
If the country’s constitutional democracy is to have a healthy future, Americans should finish this crisis intending not only to invest in health infrastructure but also to revive civics education. Schools need more time for history, civics, and social studies. What should go to make room? Sports, for one thing. Compared with other countries, the United States invests a disproportionate amount of time and money in sports. Americans appear to prefer football to democracy. It’s time to cut back—and I say this as someone whose first professional ambition in life was to be a running back. The United States has made such sacrifices before. World War II saw the suspension of football and soccer seasons the world over. Sporting events may be the last things Americans get back as they reopen their economy. They should use the extra time to double down on civics education.
This crisis has laid bare just how fragile and unsteady the United States’ constitutional democracy is. Now, the country must get its house in order and prioritize its farthest-reaching hopes and aspirations. Americans had all the tools needed to respond to this crisis, except for the very thing that would have given them reason to use them: a common purpose. Let the search for one begin.
Learning From the COVID-19 Failure—Before the Next Outbreak Arrives