A former Food and Drug Administration commissioner surveys what went wrong with America’s response to the Covid pandemic

See ‘Uncontrolled Spread’ Review: Tested and Found Wanting by Alex Tabarrok. Excerpts:

"the Centers for Disease Control and Prevention failed utterly. It’s now well known that the CDC didn’t follow standard operating procedures in its own labs, resulting in contamination and a complete botch of its original SARS-CoV-2 test. The agency’s failure put us weeks behind and took the South Korea option of suppressing the virus off the table. But the blunder was much deeper and more systematic than a botched test. The CDC never had a plan for widespread testing, which in any scenario could only be achieved by bringing in the big, private labs.

Instead of working with the commercial labs, the CDC went out of its way to impede them from developing and deploying their own tests. The CDC wouldn’t share its virus samples with commercial labs, slowing down test development. “The agency didn’t view it as a part of its mission to assist these labs.” Dr. Gottlieb writes. As a result, “It would be weeks before commercial manufacturers could get access to the samples they needed, and they’d mostly have to go around the CDC. One large commercial lab would obtain samples from a subsidiary in South Korea.”  

At times the CDC seemed more interested in its own “intellectual property” than in saving lives. In a jaw-dropping section, Dr. Gottlieb writes that “companies seeking to make the test kits described extended negotiations with the CDC that stretched for weeks as the agency made sure that the contracts protected its inventions.” When every day of delay could mean thousands of lives lost down the line, the CDC was dickering over test royalties.

In the early months of the pandemic the CDC impeded private firms from developing their own tests and demanded that all testing be run through its labs even as its own test failed miserably and its own labs had no hope of scaling up to deal with the levels of testing needed. Moreover, the author notes, because its own labs couldn’t scale, the CDC played down the necessity of widespread testing and took “deliberate steps to enforce guidelines that would make sure it didn’t receive more samples than its single lab could handle.”"

"On Jan. 28, 2020, one month before the United States recorded its first Covid death, he [Dr. Gottlieb] and a co-author warned in these pages that we must “Act Now to Prevent an American Epidemic.” Correctly predicting that testing would be a bottleneck, he urged the CDC to bring in private test suppliers as quickly as possible. One wonders how many deaths might have been averted had Dr. Gottlieb’s advice been followed."

"The CDC failed. What worked? The American model worked. Namely, private incentive and ingenuity backed by a supportive federal government. Operation Warp Speed, the Trump administration’s effort to produce vaccines, was the shining jewel of the American model. The federal government promised to buy hundreds of millions of doses of vaccine from private manufacturers (so long as the vaccines worked but regardless of whether they would be needed). It also supported very large and expensive clinical trials, and it lifted burdensome rules and regulations. The advance market-commitment model is very powerful in an emergency. We should have used a similar model for masks and tests."

Uncontrolled Spread: Why Covid-19 Crushed Us and How We Can Defeat the Next Pandemic by Scott Gottlieb