The Big Fail

Starred review from September 11, 2023
In this withering account, The Free Press columnist Nocera and journalist McLean, who previously collaborated on 2010’s All the Devils Are Here, survey the policy decisions, made in some cases decades before 2020, that hampered America’s ability to combat the Covid-19 pandemic. The authors highlight the effects of NAFTA, suggesting that it fueled the globalization of supply chains so that by the time the virus hit the U.S., most hospitals bought PPE on an as-needed basis from China and had few domestic alternatives. The industrialization of American hospitals also proved disastrous, they contend, chronicling how the efforts of Nashville internist Tommy Frist Sr. to privatize and franchise hospitals in the late 1960s heralded a noxious trend of prioritizing profits over patient care, leading hospitals to cut costs by reducing the number of available beds and all but assuring medical facilities didn’t have the capacity to handle waves of patients as Covid swept the country in 2020. Nocera and McLean excel at teasing out how political polarization, private equity’s takeover of nursing homes, and other factors intersected in disastrous fashion during the pandemic, combining first-rate reportage with astute big-picture analysis. It’s among the best reports to date on America’s botched pandemic response.

September 15, 2023
The authors of All the Devils Are Here examine how plutocratic government agencies and self-serving politicians critically mismanaged the Covid-19 pandemic. In their latest eye-opening collaboration, Nocera and McLean document countless mistakes and their consequences in a "series of cascading dominoes." In the early months of the pandemic, Donald Trump's Coronavirus Task Force's obsession with repatriating Americans abroad in China, combined with a marked lack of urgency and transparency from Chinese government officials, delayed deployment of much-needed testing and quarantines. Since then, with death tolls reaching more than 1 million (and counting), supply-chain shortages, hospital overflow, and black-market equipment fraud have persisted. Conveyed in cogent prose, with an impeccably researched timeline, the authors' analysis includes scathing profiles of a host of characters, particularly Ron DeSantis and Andrew Cuomo, who both bungled with rollout of lockdowns and masking. It became a scenario with innumerable variables related to health and illness outcome disparities determined by race, insurance level, income, and age. As the authors show, nursing homes were particularly vulnerable, with many facing lethal staffing shortages. Exacerbated by a reckless, indifferent Trump, masking choices became "a symbol of one's politics," like social distancing and vaccination, while slanderous personal attacks prevented scientists from sharing professional insights. Nocera and McLean also fairmindedly highlight a successful enterprise embedded beneath the pandemic-year failures: Operation Warp Speed, an initiative aimed at accelerating vaccine distribution. This endeavor demonstrated the governmental capacity to work cooperatively with the biomedical industry and develop firm leadership roles and real solutions. At the same time, the hotly debated mistakes were epic, and the authors' text emphasizes how deep and damaging they became. Interestingly, though their report is very much about America's failure in a crisis, it also frighteningly addresses how "the mores of capitalism have encroached upon the morals of society, most notably in caring for the sick and the elderly." A damning report card presenting a distressingly exhaustive array of pandemic fumbles.

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