Tuesday, April 21, 2020

Lowry: Trump Team's Ventilator Home Run

To repeat myself: there are lots of reasons to criticize Trump. Most of them have to do with his ridiculous, chaotic rhetoric. But substantively, he's been surprisingly good.
If this account is right, the Trump team's solution to the ventilator crisis was brilliant. The media, as is its wont, relentlessly criticized their response, fanning the flames of hysteria, exaggerating problems, refusing ever to give credit, just plain making stuff up.
   At a coronavirus-task-force briefing at the beginning of April, White House adviser Jared Kushner explained the approach that would -- as events proved -- get the country through its ventilator crisis.
   The media relentlessly pilloried and mocked him, distorting his words in the process.
   Kushner said at one point that states shouldn't be drawing on the federal stockpile just to hold ventilators in their own reserves (the administration was worried about ventilators sent to New York state not making it to hard-pressed hospitals in the Big Apple).
   This led to a flurry of media criticism alleging that Kushner wanted to hoard the federal ventilator stockpile. In a piece for The New Yorker, Susan Glasser predicted that the briefing would "surely go down as one of the administration's most callous Performances."
   Actually, the emphasis on data and shrewd allocation that Kushner discussed at the April 2 briefing has clearly worked.
   At the outset, the country was looking at a daunting, perhaps impossible challenge. A chilling briefing at the Federal Emergency Management Agency early on posited that the United States could be short 130,000 ventilators by April 1.
   The federal government had about 16,000 ventilators on hand in its stockpile and several thousand more from Veterans Affairs and the Department of Defense.
   A couple of insights drove the administration's effort to get its arms around the problem.
   Officials realized, as one White House adviser puts it, that there was "too much guesstimating" going on. Many governors didn't know how many ventilators their states had and were acting on the normal impulse to have more than enough, just in case.
   The administration created a data team. It used hospital billings to estimate how many ventilators were in each state and how many were being utilized, so it didn't have to depend on perhaps panicky, poorly informed requests from states.
   Another important realization was that FEMA could pull off just-in-time delivery. This created a lot of flexibility. The administration could wait to see how things really played out rather than making decisions based on projections weeks in the future.
   The media portrayed it as a failure every time the administration gave a state a fraction of its request, but this was a key element of the strategy.
   If the administration had tried to meet New York's initial estimated need for 40,000 additional ventilators, for instance, everything would have gone out the door --- and for no good reason. Another insight was that most ventilators out in the country weren't being used, since virus hotspots are geographically limited. That meant there was a tremendous capacity to be tapped. This led to the Dynamic Ventilator Reserve. States and hospitals with a safe margin of ventilators not in use could lend them to places that needed them.
   Seems to me that this is basically the sort of thing we get all the time. Nobody knows anything at all about the problem--including the press. You probably know what I know about ventilators and the medical supply chain. Nothing. So the media can make up some more-or-less vaguely plausible account that more-or-less vaguely fits some of the prominent facts, declare Trump an evil dictator + brainless incompetent + owner of stock in a coffin company, and his policies total failures. When it turns out that we didn't come even close to the hysterical predictions of disaster, there's no mention of success. They just move on to the next hysterical criticism. It's the PPE crisis that they're currently flogging him for. Of course we don't know anything about that stuff, either. Nor what a smart response would be likely to accomplish. Nor what a dumb one would. So we have no framework for realistically evaluating the administration's response. All we know is that the media will represent everything in the most Trump-unfriendly way possible. We're not even in an information vacuum, we're in a disinformation pressure chamber. Trump could be failing spectacularly, but we can't know whether he is or not because we don't have a reliable news media. This is what people might have felt like in the USSR. Maybe capitalism is failing in the USA...but even if it were, we couldn't know it. Because Pravda is going to run the same headlines about it whether it's happening or not.
   Blah blah blah.


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