Tuesday, March 31, 2020

How Techies Ignored the Bureaucrats and Helped the COVID-19 Response

By Andrea O'Sullivan - March 31, 2020 at 08:30AM

Thank God for the tech scene. When our established institutions fail in the face of existential threats, at least we have the quick thinking and resourcefulness of America's computer jockeys to help us muddle through.

Silicon Valley was among the first to sound the alarm about a strange new virus emanating from China. While public health agencies and their media water-bearers were downplaying the growing COVID-19 threat by fluposting and pooh-poohing facemasks, onlookers in tech noted a geometric trend and started preparing accordingly.

People acted like they were crazy. One infamous Recode article chortled at the tech industry's early and prudent substitution of virus-transmitting handshakes for other less-germy forms of greeting. There go the nutty techies, trying to stem the tide of pestilence! If only more people had followed those California weirdos' leads. Of course, outlets that had been spreading COVID-19 denialism and shaming preppers in February are now demanding indefinite shutdowns without skipping a beat.

Meanwhile, because the Centers for Disease Control and Prevention (CDC) had botched the SARS-CoV-2 test rollout, it was officially recommending that only symptomatic patients with known exposure get tested, even though this would miss many infected people. Did government leaders come clean with a mea culpa? No, they downplayed the severity of the problem, discouraged Americans from preparing, and encouraged people to go out into crowds.

The problem with an exponential trend is that by the time it's obvious that we should change our behavior, it's already too late. This is why it was so easy to mock the early adapters to the developing pandemic scenario. But they weren't insane; they were prescient. Their whole job is to study and get ahead of emerging trends in business and technology. More people should have taken them seriously.

Either way, after being among the first to identify and communicate the problem, the tech community is now forging ahead with targeted COVID-19 responses.

There is no master plan. A global grab-bag of coders, designers, DIYers, tinkerers, makers, and bioengineers have simply decided to turn their talents to where they think they're most needed. And they're not asking for permission, either. There's no time to pretend like our many dumb regulations are worth worrying about right now. The technologically-inclined are just doing what they feel they have to do, whether Uncle Sam likes it or not—although in this case, the feds seem relieved that someone is taking up the slack.

Examples abound. Consider the debacle with the CDC-created tests. Infectious disease experts in the early hotspot of Seattle grew impatient with federal dithering. Rather than waiting for the CDC to get its diagnostic act together, a group of doctors with the Seattle Flu Study developed and started running their own test without CDC approval. Their act of civil disobedience resulted in a major, but tragic, breakthrough in public health surveillance: they learned through their testing that the virus had already been circulating in Seattle for several weeks. Might they have learned earlier and been able to prepare if not for such public incompetence?

The CDC and Food and Drug Administration (FDA) eventually started relaxing testing regulations as the human cost of these blunders became clearer. There's still room for improvement. Startups like Everylywell, Carbon Health, and Nurx developed tests that people can take at home so they don't have to risk getting infected at a test site. Awesome! But the FDA said "nein!" and made these startups stop their tests and destroy their samples. Well, maybe there's a DIY solution: researchers are crowdsourcing an accessible open source test that more people can use on their own.

The maker scene has also been quick to hack together low cost alternatives to badly needed medical supplies. Volunteers in six continents enlist in a public Google doc extolling their talents, locations, and how they'd like to help. A couple in New York is printing face shields for testing clinics. Italian hospitals received cheap new ventilator valves that would otherwise cost $11,000. Teams of tinkerers brainstorm together on low cost ventilator schematics so that more healthcare workers can assemble functioning equipment with whatever supplies they've got around them.

Many of these endeavors are on shaky regulatory grounds. Surgical masks, for example, are usually subject to FDA regulation. The modern day Betsey Rosses weaving CAD files for personal protective equipment can follow regulatory best practices, but they're probably not asking permission first.

Even regulators seem to realize that their actions can cause more harm than good. Interestingly, except in a few cases, the government has largely decided to turn a blind eye or loosen up regulations. Now is not the time to nitpick about, like, how many masks are allowed to be sterilized each day.

The official response to the COVID-19 pandemic has been profoundly disappointing, if not entirely unexpected. But a nation with such a wealth of technical talent should be able to coordinate an early and effective public-private response to existential threats. The U.S. failure to prepare for COVID-19 reveals a deep lack of state capacity.

Imagine how much more effective this outpouring of American inventiveness would have been with a competent state partner from the start. After heeding early analyses of a troubling trend, planners could quickly look to identify what we need and how to get it. Sources of regulatory friction could be pruned at the outset. And public health experts could provide counsel on the trade-offs between experimentation and safety, providing some ground rules for the rapid innovation that would come.

It's too late for that now. Thankfully, after unfortunate weeks of dithering, the U.S. establishment has finally started leveraging our strategic corporate and technological resources to better address the COVID-19 pandemic. Some official organs are still spreading misinformation about the effectiveness of mass mask-wearing, but it's a start.

This kind of primal national crisis is precisely when official institutions should shine. It is revealing that our odds of success have hinged mostly on an ad hoc collective of virushackers being able to ignore or override the institutions founded explicitly for this kind of crisis. For now, they work together to tamp down an invisible enemy. But once that is vanquished, many will have lost even more faith in the establishment. When such an appealing alternative presents itself, why bother with the outdated, overpriced, and ineffective model?

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