4 ideas
In early February 2020 the CDC shipped its own COVID-19 diagnostic kits to state public-health labs. Many kits gave false or inconclusive results because one component was flawed, likely from contamination at the Atlanta lab that made it. Because regulatory rules and institutional habit kept outside labs from quickly deploying their own tests, the U.S. lost weeks of testing while the virus spread undetected.
In late 2019 the Global Health Security Index ranked the United States the country best prepared for a pandemic, yet it went on to suffer among the worst outcomes in the world. The book's explanation is that preparedness scores measure capacities on paper, such as labs, stockpiles, agencies and plans. They do not measure whether political leaders will use those capacities, coordinate them, or tell the public the truth.
Deputy National Security Adviser Matt Pottinger, a former Wall Street Journal reporter in China, used his own contacts there in January 2020 to learn that the outbreak was far worse than Beijing admitted. He pushed early for restricting travel from China and later for public masking. He met resistance inside an administration that wanted to protect the economy and its relationship with China.
Look at a pandemic as a test that exposes weaknesses already built into a society rather than creating new ones. The virus flowed along existing lines of failure: partisan distrust of experts, fragmented federal–state authority, and inequalities in health, work and housing. These determined who got sick and died. So the death toll works as a measure of a society's prior condition, not just of the pathogen.