WEBVTT - Bethany McLean on the Pandemic's Big Fail 0:00:02.040 --> 0:00:07.760 This is Master's in Business with Barry Ridholds on Bloomberg Radio. 0:00:09.160 --> 0:00:12.319 This week. On the podcast, returning for her third time, 0:00:12.920 --> 0:00:17.760 Bethany MacLean, author of such amazing books as The Smartest 0:00:17.840 --> 0:00:22.160 Guys in the Room about the incredible saga of Enron 0:00:22.239 --> 0:00:25.880 and how it became one of the most respected companies 0:00:25.880 --> 0:00:28.400 in the world, and then blew up her new book, 0:00:28.440 --> 0:00:32.520 The Big Fail What the Pandemic Revealed about who America 0:00:32.720 --> 0:00:36.720 protects and who it leads behind with her co author Jonasara. 0:00:37.159 --> 0:00:39.120 First of all, I know Bethany for a long time, 0:00:39.120 --> 0:00:43.040 and I felt very comfortable really pushing back on some 0:00:43.159 --> 0:00:46.040 of the things she says in the book, but you know, 0:00:46.159 --> 0:00:50.280 to be honest, I couldn't really damage her thesis very much. 0:00:50.360 --> 0:00:54.280 The book is deeply researched and relies to a large 0:00:54.280 --> 0:00:58.000 degree on some nuance and a lot of science and 0:00:58.560 --> 0:01:02.400 a lot of the tropes that we all think about 0:01:02.640 --> 0:01:07.000 the pandemic. She's and Joe have thought deeply about and 0:01:07.080 --> 0:01:11.000 their approach is, Hey, this is not black and white. 0:01:11.000 --> 0:01:14.720 This is very complex. There were mistakes made at every level, 0:01:14.760 --> 0:01:17.800 from the White House to the CDC, and a lot 0:01:17.880 --> 0:01:24.800 of what went wrong during the pandemic predated COVID by decades, 0:01:25.120 --> 0:01:28.000 So a lot of nuance, a lot of subtlety, really 0:01:28.120 --> 0:01:30.640 very fascinating. She takes me to school time and again 0:01:31.200 --> 0:01:34.560 I found our conversation about the book fascinating, and I 0:01:34.640 --> 0:01:38.040 think you will do as well with no further ado. 0:01:38.440 --> 0:01:42.240 My discussion on COVID nineteen with Bethany MacLean. 0:01:42.600 --> 0:01:44.320 Thank you for having me on, Barry. 0:01:44.280 --> 0:01:48.200 My pleasure. So those books they're all about I guess 0:01:48.320 --> 0:01:51.880 giant mistakes, blunders seems to be your stock in trade, 0:01:52.080 --> 0:01:56.640 Enron Fracking, GFC, Fanny and Freddy, and now COVID nineteen. 0:01:56.920 --> 0:01:59.520 Where does this passion for disasters come from? 0:02:00.360 --> 0:02:03.440 Porn right? I don't know. I swear I'm a happy person. 0:02:04.400 --> 0:02:08.160 Maybe this is my way of unleashing my enter demons. No, seriously, 0:02:08.200 --> 0:02:10.800 I always think when something goes wrong, there's always a 0:02:10.880 --> 0:02:13.760 story about how and why it went wrong, And it's 0:02:13.760 --> 0:02:17.000 a story that is so much more than numbers. It's people, 0:02:17.560 --> 0:02:21.560 it's history, it's predilections, it's all these things. And I 0:02:21.600 --> 0:02:24.720 think trying to figure out what that mix is and 0:02:24.720 --> 0:02:27.080 what has happened is just a fascinating puzzle. 0:02:27.440 --> 0:02:31.120 So let's talk about the COVID nineteen puzzle. I found 0:02:31.120 --> 0:02:37.240 the book infuriating, just one unforced error after another. When 0:02:37.320 --> 0:02:39.960 you first sat down to write this, did you have 0:02:40.000 --> 0:02:42.560 any idea what you and Joe wanted to say? Or 0:02:42.600 --> 0:02:45.079 did it kind of develop as you progress? 0:02:45.639 --> 0:02:49.760 We had some loose ideas that ended up becoming part 0:02:49.800 --> 0:02:52.280 of the book. But I'd be lying if I said 0:02:52.280 --> 0:02:54.840 that it all hung together from moment one. I mean, 0:02:54.960 --> 0:02:57.720 I was passionately interested in the spring of twenty twenty, 0:02:57.880 --> 0:03:00.760 in the healthcare system and the effect of private equity 0:03:00.840 --> 0:03:04.320 and healthcare. I was interested in the Federal Reserve and 0:03:04.360 --> 0:03:08.760 how we thought about the Fed's response, And we were 0:03:08.880 --> 0:03:12.600 both interested in globalization and supply chains and what that 0:03:12.680 --> 0:03:15.440 had done to Ppe. So we had these loose ideas, 0:03:15.800 --> 0:03:18.840 but as to how they were going to come together 0:03:18.919 --> 0:03:21.440 into a coherent book, which which I hope we've produced. 0:03:21.880 --> 0:03:25.400 No, Oh, no, it's coherent. It's too coherent. And the 0:03:25.480 --> 0:03:29.520 coherence is pretty much everybody is grossly incompetent in an emergency. 0:03:30.040 --> 0:03:33.080 Kind of makes you nervous if, like what goes down 0:03:33.080 --> 0:03:37.560 when there's a really terrible earthquake or other disaster, lots 0:03:37.600 --> 0:03:40.520 of people seem to not have their act together. 0:03:40.800 --> 0:03:44.320 Yes, and no. I think the book probably does convey that. 0:03:44.400 --> 0:03:46.520 But then I think there are people that very much 0:03:46.560 --> 0:03:49.440 have their act together. I happen to think in the book, 0:03:49.520 --> 0:03:53.280 I think expresses that Operation Warp Speed is a tremendous 0:03:53.320 --> 0:03:55.520 success and a tremendous act of competence. 0:03:55.800 --> 0:04:00.480 So let me rephrase my criticism. Lots of people rose 0:04:00.520 --> 0:04:03.240 to the occasion, Yes, but it seemed like lots of 0:04:03.280 --> 0:04:04.600 institutions failed. 0:04:04.920 --> 0:04:07.800 I think lots of institutions did fail, and I think 0:04:07.840 --> 0:04:11.480 there are multiple reasons for that. I think one part 0:04:11.520 --> 0:04:15.320 of it is that pandemics had largely bypassed the US 0:04:15.400 --> 0:04:18.800 in the past, and we just simply weren't thinking that way. 0:04:18.880 --> 0:04:21.599 But I think a lot of our structures were also 0:04:21.720 --> 0:04:25.719 breaking even before the pandemic hit, such as our healthcare system, 0:04:26.480 --> 0:04:28.960 such as the way inequality has taken a toll on 0:04:29.000 --> 0:04:32.320 people's health and left people with pre existing conditions that 0:04:32.400 --> 0:04:35.799 made them more vulnerable and then made us all more vulnerable. 0:04:35.800 --> 0:04:38.320 And I think before the pandemic you could say that's 0:04:38.400 --> 0:04:41.599 them and this is us, and the pandemic made you realize. 0:04:41.600 --> 0:04:44.839 There's this great, great quote from Lyndon Johnson when he 0:04:45.000 --> 0:04:48.120 enacted Medicare and Medicaid, and it was basically, the health 0:04:48.160 --> 0:04:51.120 of our country is everything, because without a healthy population, 0:04:51.240 --> 0:04:53.720 what can we hope to achieve? And I'm butchering it 0:04:53.960 --> 0:04:56.000 a little bit, but that's the idea that if we 0:04:56.040 --> 0:04:58.800 aren't all healthy, we don't all have access to health, 0:04:59.000 --> 0:05:01.279 then what can we hope to achieve as a country. 0:05:01.600 --> 0:05:04.039 You spend a bit of time talking about our two 0:05:04.200 --> 0:05:06.599 tiered healthcare system. We'll get to that in a bit. 0:05:07.240 --> 0:05:10.880 Let's sort of flash back to the pre pandemic period 0:05:11.200 --> 0:05:15.960 and you talk about previous pandemics where we did pretty well. 0:05:16.120 --> 0:05:20.400 But it raises the question why were we so unprepared 0:05:20.640 --> 0:05:23.960 and why does it seem like nobody but Bill Gates 0:05:24.080 --> 0:05:25.200 really saw this coming. 0:05:26.160 --> 0:05:30.279 I think because it is beyond the human capacity to 0:05:30.600 --> 0:05:34.760 imagine that these things could actually happen. And I was 0:05:34.800 --> 0:05:37.400 thinking about this because I've said in the context of 0:05:37.480 --> 0:05:41.760 business disasters in the past that the old lesson from kindergarten, 0:05:41.839 --> 0:05:44.839 use your imagination is one of the most important lessons 0:05:44.839 --> 0:05:47.800 you can possibly learn, because if anybody ever says to you, oh, 0:05:47.839 --> 0:05:51.440 that can't happen, well, actually it can. And just look 0:05:51.480 --> 0:05:53.920 at the last couple of decades for instruction and to 0:05:54.000 --> 0:05:57.080 this idea that yeah, it can happen. And so I 0:05:57.080 --> 0:05:59.920 think we all have a failure to use our imagine 0:06:00.279 --> 0:06:02.800 and I think we're not good in this country at 0:06:02.839 --> 0:06:06.920 any kind of long term anything. And so we used 0:06:06.920 --> 0:06:09.280 to be, we used to be, and we exist from 0:06:09.360 --> 0:06:13.360 day to day driven by politics and polarization, and it 0:06:13.400 --> 0:06:17.320 makes it very difficult to have anything that involves the 0:06:17.360 --> 0:06:20.080 long term. And I think that's broadly true, not just 0:06:20.120 --> 0:06:22.520 about pandemics, but we saw that come home to roost 0:06:22.520 --> 0:06:23.240 in the pandemic. 0:06:23.480 --> 0:06:28.360 So you mentioned Operation warp Speed, arguably the greatest success 0:06:28.360 --> 0:06:31.919 of the Trump administration. It seems like he was almost 0:06:31.960 --> 0:06:38.320 embarrassed to be associated with a giant medical win. 0:06:38.560 --> 0:06:41.239 Well, I think it's I think it's it's more nuanced 0:06:41.279 --> 0:06:44.480 than that. I think Trump did support warp Speed, but 0:06:45.040 --> 0:06:47.360 somebody who was close to it said to me that 0:06:47.440 --> 0:06:51.279 Warpsbeed could never have succeeded in any administration but under Trump, 0:06:51.480 --> 0:06:54.240 precisely because Trump was so hands off and he just 0:06:54.360 --> 0:06:57.840 left it to run itself. And warp Speed wasn't really 0:06:57.920 --> 0:07:00.160 I mean, it was the Trump administration, but it was 0:07:00.200 --> 0:07:02.599 run by people who had either been marginalized in the 0:07:02.600 --> 0:07:06.800 Trump administration or really were not Trump supporters in any way, 0:07:06.800 --> 0:07:09.680 shape or form. So to see this as somehow a product, 0:07:09.720 --> 0:07:12.800 a Trumpian product, it wasn't, although it might have been 0:07:12.920 --> 0:07:15.280 enabled by some of the things that made Trump such 0:07:15.280 --> 0:07:18.360 a problematic president during during the pandemic, which I think 0:07:18.400 --> 0:07:21.240 is a fascinating a fascinating thing. You also have to remember, 0:07:21.240 --> 0:07:23.720 though Trump was supportive of the vaccines when they first 0:07:23.800 --> 0:07:26.760 came out, he was. It was as he started to 0:07:26.800 --> 0:07:29.920 realize that his constituents had become not supportive of the 0:07:30.000 --> 0:07:33.480 vaccines that was when he flipped. Even Trump got booed 0:07:33.480 --> 0:07:35.520 at a rally where he talked up the vaccines, and 0:07:35.560 --> 0:07:38.120 after that he never talked them up again. Really, yeah, 0:07:38.280 --> 0:07:41.960 So he followed the polarization in the country around the 0:07:42.040 --> 0:07:46.600 vaccines rather than necessarily driving it. Leadership leadership, right. 0:07:46.760 --> 0:07:49.600 You know, it's funny you said, I can't picture another 0:07:49.640 --> 0:07:53.840 administration doing it. Think about what Kennedy did with landing 0:07:53.840 --> 0:07:57.400 on the moon and setting up NASA and promoting it 0:07:57.720 --> 0:08:02.560 on a relentless and ongoing base. I can imagine a 0:08:03.080 --> 0:08:08.400 president of a different character and a I don't know, 0:08:08.600 --> 0:08:11.480 I don't know what the right word is. More serious maybe, 0:08:11.480 --> 0:08:13.280 but you more institutional I think. 0:08:13.360 --> 0:08:16.800 I think that The only counterpoint in it's so difficult, 0:08:16.840 --> 0:08:18.680 you can't go back and hit rewind and see how 0:08:18.760 --> 0:08:21.520 things could play out differently. The only counterpoint to that 0:08:21.640 --> 0:08:23.880 is that a different president might have been all over 0:08:23.960 --> 0:08:26.360 warp Speed from the beginning and might have made it 0:08:26.480 --> 0:08:29.520 very difficult for warp Speed to function because politics might 0:08:29.560 --> 0:08:32.240 have been injected in it. And Trump, because he was 0:08:32.320 --> 0:08:35.200 so hands off, actually allowed warp Speed to be run 0:08:35.240 --> 0:08:38.440 by monsef Slowie in general perna and that it worked. 0:08:38.760 --> 0:08:41.280 And so there, Oh, you don't see. 0:08:41.360 --> 0:08:44.800 You don't see either George Bush or Obama handing it 0:08:44.840 --> 0:08:47.800 off and saying do you They were both pretty good delegators. 0:08:48.040 --> 0:08:51.880 They might be unfairly respectful of the institution of government, 0:08:51.920 --> 0:08:53.520 at least outside of. 0:08:53.640 --> 0:08:55.920 I hope, so, I hope. 0:08:55.960 --> 0:08:59.920 So it just looks like I mentioned unforced eras Hey, 0:09:00.480 --> 0:09:03.680 the US had all these excess deaths. When you look 0:09:03.720 --> 0:09:11.520 at US on a per capita basis against comparable economies Germany, Switzerland, Japan, France, 0:09:11.679 --> 0:09:13.880 I mean they all did much better than US, obviously 0:09:14.200 --> 0:09:17.319 through countries like Italy that did poorly and China didn't 0:09:17.320 --> 0:09:19.960 do so great. We'll talk more about China later, but 0:09:20.160 --> 0:09:24.040 it seems like we were at the bottom of the 0:09:24.080 --> 0:09:28.800 Western industrialized democracies on a per capita death basis. 0:09:29.000 --> 0:09:32.839 We were. The economist has done a very good log 0:09:33.240 --> 0:09:36.160 of keeping track of excess deaths, and I think a 0:09:36.200 --> 0:09:37.920 couple of things account for that. I think our two 0:09:37.960 --> 0:09:40.720 tiered healthcare system, and I think some of what happened 0:09:40.760 --> 0:09:43.720 in COVID was that coming home to roost in the 0:09:43.760 --> 0:09:47.599 sense that COVID preyed upon people with pre existing health conditions, 0:09:47.920 --> 0:09:51.120 and pre existing health conditions are in some ways a 0:09:51.160 --> 0:09:53.960 byproduct of a healthcare system that doesn't take care of 0:09:54.040 --> 0:09:54.800 a lot of people. 0:09:54.960 --> 0:09:58.320 You mentioned diabetes and high blood pressure in particular. Yeah, 0:09:58.360 --> 0:10:01.520 and you know, a bad diet tends to be associated 0:10:01.520 --> 0:10:04.240 with lower economic strata. And if you don't have good 0:10:04.280 --> 0:10:08.040 healthcare and you have diabetes and you get COVID, not 0:10:08.120 --> 0:10:08.800 great outcome. 0:10:08.920 --> 0:10:12.400 Yep. It's also excess death captures things other than deaths 0:10:12.400 --> 0:10:15.800 from COVID too, And the deaths of despair in this country, 0:10:15.840 --> 0:10:18.280 and the desk from opioid to overdoses and lack of 0:10:18.320 --> 0:10:23.240 access to healthcare for other conditions not COVID are some 0:10:23.360 --> 0:10:25.800 portion of that too, we are a sicker country. 0:10:26.360 --> 0:10:30.400 So one of the more fascinating little tidbits you drop 0:10:30.440 --> 0:10:33.920 in the book, Most California cities end up pretty much 0:10:33.960 --> 0:10:37.160 in line in terms of per capita deaths with the 0:10:37.200 --> 0:10:40.599 rest of other large urban areas, the exception being the 0:10:40.679 --> 0:10:44.800 San Francisco. When you point to all the infrastructure put 0:10:44.800 --> 0:10:48.439 in place during the AIDS crisis that led San Francisco 0:10:48.520 --> 0:10:50.760 to a much better outcome, tell us a little bit 0:10:50.760 --> 0:10:51.160 about that. 0:10:51.440 --> 0:10:54.520 Yeah, it was fascinating, and this was highlighted our first 0:10:54.559 --> 0:10:57.160 written about in a really good New Yorker piece about 0:10:57.160 --> 0:11:00.360 what San Francisco was doing and why it's numbers were 0:11:00.400 --> 0:11:03.760 so low. And the idea was, you can't just lock 0:11:03.840 --> 0:11:07.079 down and leave the most defenseless parts of our population 0:11:07.200 --> 0:11:10.760 defend for themselves under a lockdown, meaning essential workers who 0:11:10.800 --> 0:11:12.800 still have to go out and do their jobs and 0:11:12.840 --> 0:11:16.400 then potentially bring the illness home to their communities. And 0:11:16.440 --> 0:11:19.800 because San Francisco had this infrastructure that was put in place, 0:11:19.960 --> 0:11:23.120 they knew how to reach all these marginalized populations. And 0:11:23.160 --> 0:11:24.920 because they knew how to reach them all, they were 0:11:24.960 --> 0:11:28.199 able to keep them healthier. And I think what that 0:11:28.280 --> 0:11:32.120 pointed at to us was you. Lockdowns were in many 0:11:32.200 --> 0:11:36.760 ways both an example of inequality and of furtherance of it, 0:11:36.800 --> 0:11:40.000 and that the very people who could lock down were 0:11:40.040 --> 0:11:40.600 the well off. 0:11:41.240 --> 0:11:48.120 So you throw pretty much everybody under the bus. Trump, Cuomo, Desanti's, Deblasio, 0:11:48.360 --> 0:11:52.360 cushn or Pence, even Fauci and lots of others. Will 0:11:52.440 --> 0:11:56.120 get into personalities later. But who came out of the 0:11:56.160 --> 0:11:59.080 pandemic with their reputation intact. 0:11:59.480 --> 0:12:01.760 Well, I think I don't think anybody intended to do 0:12:02.480 --> 0:12:07.079 a bad job, and people were placed into a difficult situation. 0:12:07.280 --> 0:12:09.840 It was hard when you look back at the terrible 0:12:09.880 --> 0:12:12.720 beginning of this in January and February of twenty twenty. 0:12:13.000 --> 0:12:15.920 If anybody had told you up until it happened that 0:12:16.000 --> 0:12:17.800 this was going to be a global pandemic and we 0:12:17.840 --> 0:12:20.400 would be living with this for years, you would have said, no, no, no, 0:12:20.440 --> 0:12:23.079 that can't happen, that can't possibly be true. We'll figure 0:12:23.080 --> 0:12:25.280 out a way around this. The United States always figures 0:12:25.480 --> 0:12:28.160 out a way around this. I think a lot of 0:12:28.200 --> 0:12:31.640 unheralded people came through this with their reputations intact, a 0:12:31.640 --> 0:12:35.520 lot of doctors and nurses who made things so much better. 0:12:35.320 --> 0:12:37.080 Than private citizens doing their. 0:12:37.160 --> 0:12:42.280 Private, private citizens doing job, but that official. But that 0:12:42.320 --> 0:12:44.680 whole list is all public officials. And I think some 0:12:44.840 --> 0:12:47.360 part of it is just a failure of leadership, a 0:12:47.360 --> 0:12:49.880 failure of anybody to really want to be accountable and 0:12:49.920 --> 0:12:52.319 to say the buck stops here in the way that 0:12:52.640 --> 0:12:56.480 General Perna actually did during Operation Warp Speed. And it's 0:12:56.520 --> 0:12:59.360 why I love the story of Operation Warp Speed so much, 0:12:59.400 --> 0:13:02.800 because I think it stands as a contrast to so 0:13:02.960 --> 0:13:06.280 much that happened elsewhere. It's an example of competence. It's 0:13:06.280 --> 0:13:08.760 an example of people saying the buck stops here, this 0:13:08.840 --> 0:13:11.560 is it, this is me, I'm the one responsible for this, 0:13:11.640 --> 0:13:13.880 and I'm going to make it happen. And when you 0:13:14.040 --> 0:13:16.760 look at so many other people, it wasn't that. It 0:13:17.320 --> 0:13:20.640 was deferral of responsibility, pushing things off on other people, 0:13:21.160 --> 0:13:24.160 or a failure to putting out there of rules and 0:13:24.160 --> 0:13:25.920 then a failure to live by them yourself. 0:13:26.400 --> 0:13:30.480 Let's talk about another giant fail China, not exactly the 0:13:30.480 --> 0:13:34.720 world's most responsible member of the global community. Tell us 0:13:34.760 --> 0:13:39.280 about some of the things China did that range from 0:13:40.120 --> 0:13:42.960 merely irresponsible to utterly reckless. 0:13:43.400 --> 0:13:46.080 Well, I think China, I don't think there's much question 0:13:46.160 --> 0:13:49.080 now that China understood what was happening and did not 0:13:49.160 --> 0:13:52.559 want to let the rest of the world know. And 0:13:53.800 --> 0:13:58.280 it's really frightening because the whole system relies on countries 0:13:58.320 --> 0:14:00.720 being honest when they've discovered some so that the rest 0:14:00.720 --> 0:14:03.280 of the world has a chance of protecting itself. But 0:14:03.360 --> 0:14:06.679 particularly I think the part that was the most devastating 0:14:06.720 --> 0:14:08.960 to me was the idea that China had a pretty 0:14:09.000 --> 0:14:10.959 good idea from the beginning that there was human to 0:14:11.040 --> 0:14:15.839 human transmission taking place, and even the who because China 0:14:15.920 --> 0:14:18.520 told them that it wasn't happening or there wasn't evidence, 0:14:18.760 --> 0:14:21.560 and so it took us a much longer than it 0:14:21.720 --> 0:14:25.720 then was necessary to understand that human to human transmission 0:14:25.800 --> 0:14:26.320 was happening. 0:14:26.520 --> 0:14:29.360 We figured out pretty quickly when someone came home from 0:14:29.360 --> 0:14:33.320 abroad and then their husband who hadn't traveled. God, it's like, oh, 0:14:33.440 --> 0:14:36.440 obviously it's human to human. Why the delay? It seems 0:14:36.480 --> 0:14:40.600 like the whole US National Institute of Health is designed 0:14:41.040 --> 0:14:43.400 for this information to bubble up to the top for 0:14:43.440 --> 0:14:47.520 a little commandment, control and communication. That didn't seem to happen. 0:14:47.840 --> 0:14:50.840 No, and the doctor and Wuhan, who was on the 0:14:50.840 --> 0:14:53.400 front lines of this alerted her superiors, and I think 0:14:53.480 --> 0:14:57.200 late December that she thought human to human transmission was happening. 0:14:57.240 --> 0:14:59.040 And so you think about that and how the whole 0:14:59.040 --> 0:15:01.880 course of the pandemic have been different if that knowledge 0:15:01.920 --> 0:15:04.320 had been out there from the very beginning. 0:15:05.200 --> 0:15:09.800 So let's talk about some of the broad policies that 0:15:10.120 --> 0:15:13.600 could have been in place on a timely basis but 0:15:13.800 --> 0:15:20.560 seemed to be mishandled. Testing, lockdowns, vaccines, personal protection equipment, 0:15:20.600 --> 0:15:25.960 PPE masking, social distancing. What in that list wasn't mishandled. 0:15:26.000 --> 0:15:29.480 It seems like across the board nothing was done right anywhere. 0:15:29.800 --> 0:15:33.440 So I think testing is a top the list of 0:15:33.480 --> 0:15:36.640 the things that were mishandled, and there was the CDC 0:15:36.840 --> 0:15:39.920 took control of the test and could not design a 0:15:39.960 --> 0:15:40.720 test that worked. 0:15:41.080 --> 0:15:43.800 You write in the book that they tried to manufacture 0:15:43.800 --> 0:15:48.400 this themselves. They have zero manufacturing expertise. What the hell 0:15:48.440 --> 0:15:49.000 were they thinking? 0:15:49.440 --> 0:15:53.120 I think the CDC has a culture that is arrogant 0:15:53.200 --> 0:15:56.200 and perfectionist and believes that they should be in charge. 0:15:56.440 --> 0:15:58.800 But even more broadly than that, even if the CDC 0:15:59.000 --> 0:16:01.600 test had worked, that should never have been the sun 0:16:01.640 --> 0:16:04.440 and moon and stars upon which America is testing strategy 0:16:04.600 --> 0:16:08.360 hung because we needed tests to be broadly available everywhere. 0:16:08.760 --> 0:16:11.920 And I think there's an intersection of interesting things there 0:16:12.240 --> 0:16:15.280 that we turn to the private market in a situation 0:16:15.480 --> 0:16:17.160 like this, and so part of one of the deeper 0:16:17.200 --> 0:16:19.800 themes of the book to me is when the private 0:16:19.840 --> 0:16:22.360 market works and when it doesn't. And we turned the 0:16:22.360 --> 0:16:24.520 private market in a situation like this and say, well, 0:16:24.560 --> 0:16:27.200 aren't companies going to manufacture test because they can sell 0:16:27.240 --> 0:16:30.160 them without any awareness of a couple of factors, which 0:16:30.160 --> 0:16:32.600 are the times in the past where companies have rushed 0:16:32.600 --> 0:16:35.760 a manufacture test only to have demand not materialize, and 0:16:35.800 --> 0:16:38.080 then they have to explain to their shareholders, oh, we 0:16:38.160 --> 0:16:41.120 invested all this money in this and it didn't actually happen. 0:16:41.520 --> 0:16:45.480 And then in modern day capitalism, the ongoing need for 0:16:45.560 --> 0:16:48.880 sustainable earnings such that if you do rush to develop 0:16:48.920 --> 0:16:51.040 tests and you sell them, but then demand goes away 0:16:51.080 --> 0:16:53.320 in two years, you don't get rewarded for that. And 0:16:53.400 --> 0:16:55.520 so I think a lot about where I thought a 0:16:55.520 --> 0:16:57.440 lot in the process of writing this book about where 0:16:57.440 --> 0:17:00.440 capitalism works and where it doesn't work. I'm a little 0:17:00.480 --> 0:17:05.560 more nuanced than maybe the book conveys about whether lockdowns 0:17:05.600 --> 0:17:08.720 could have been done anymore swiftly or the extent to 0:17:08.760 --> 0:17:10.480 which they should have been done. And I think the 0:17:10.520 --> 0:17:14.120 book conveys that second point very very well. I'm not 0:17:14.200 --> 0:17:19.280 sure if you had told Americans in February in January, 0:17:19.359 --> 0:17:21.720 we need to stay at home, nobody would have listened 0:17:21.760 --> 0:17:25.520 to you. Nobody would have believed you. Lockdowns can only 0:17:25.600 --> 0:17:27.879 be effective if you locked down before the virus is 0:17:27.920 --> 0:17:31.359 widely seated, right, That's the only way it works. But 0:17:31.440 --> 0:17:34.640 yet locking down before people know that the virus is 0:17:34.840 --> 0:17:37.159 how do you possibly pull that off, especially in a 0:17:37.160 --> 0:17:39.800 country like the United States. And so while that may 0:17:39.880 --> 0:17:43.320 seem like a failure, I'm not really sure it could 0:17:43.480 --> 0:17:46.040 that could have been done any differently. I think the 0:17:46.080 --> 0:17:49.600 bigger problem was the ongoing use of lockdowns, even without 0:17:49.680 --> 0:17:52.520 a clearly defined endpoint and without a clearly defined what 0:17:52.560 --> 0:17:53.560 are we doing this far start? 0:17:53.600 --> 0:17:55.400 So I'm going to come back to lockdowns in a minute. 0:17:55.480 --> 0:17:59.480 Let's stick with testing and masking, which I thought was 0:17:59.520 --> 0:18:03.719 kind of fat. We hadn't even rolled out tests, and 0:18:03.760 --> 0:18:07.720 you mentioned South Korea was doing some ungodly number of 0:18:07.760 --> 0:18:10.560 tests a day, one hundred thousand tests a day. They 0:18:10.720 --> 0:18:13.160 very quickly were able to figure out who to quarantine 0:18:13.160 --> 0:18:15.960 and who not to and had a much better outcome 0:18:16.000 --> 0:18:21.320 than we did. Various state institutions had the ability to 0:18:21.400 --> 0:18:24.960 create a test and have it outsourced and manufactured, but 0:18:25.080 --> 0:18:28.159 the CDC would not allow it. It seems like they 0:18:28.200 --> 0:18:32.680 were just the dumbest turf battles going on while the 0:18:32.680 --> 0:18:35.800 pandemic ramped up exponentially. 0:18:36.080 --> 0:18:37.919 I think that's a very good way of putting it, 0:18:37.960 --> 0:18:40.320 and I think there was also a failure to realize 0:18:40.359 --> 0:18:43.480 that things that we had put in place then made 0:18:43.480 --> 0:18:46.719 it difficult to roll out testing. So once an emergency 0:18:46.840 --> 0:18:50.960 was declared, then the FDA has to approve test. It 0:18:51.040 --> 0:18:53.000 is put in place so that you don't have shoddy 0:18:53.040 --> 0:18:56.800 test manufacturers running around selling tests that don't actually work. 0:18:57.119 --> 0:18:59.560 But when you need to get tests out the door quickly, 0:18:59.800 --> 0:19:02.000 the things that are put in place to protect people 0:19:02.080 --> 0:19:02.800 can backfire. 0:19:03.119 --> 0:19:07.160 So let's talk about PPE and MASK. Speaking of shoddy 0:19:07.320 --> 0:19:12.160 the government could have used one of the defense accent 0:19:12.720 --> 0:19:16.880 right to ramp that up. Instead, the White House led 0:19:17.080 --> 0:19:24.160 the states all compete with each other, absolute disaster profiteering, fraud. 0:19:24.840 --> 0:19:28.960 It was just again I'm reading this and just getting 0:19:29.000 --> 0:19:32.479 infuriated because all you needed was some leadership at the 0:19:32.520 --> 0:19:34.720 top to say, Okay, we're going to make sure that 0:19:34.760 --> 0:19:38.280 there's personal protection equipment for every doctor, every nurse, and 0:19:38.359 --> 0:19:41.760 every patient to help slow the spread of this that 0:19:41.840 --> 0:19:43.040 never happened was a free for. 0:19:43.040 --> 0:19:46.600 All, Yes, And to be clear, I'm not sure. So 0:19:46.720 --> 0:19:48.320 part of the theme of the book is that a 0:19:48.359 --> 0:19:50.359 lot of the problems were put in place before the 0:19:50.400 --> 0:19:56.280 pandemic even hit. Even if you had had that incredibly coordinated, sophisticated, 0:19:56.359 --> 0:20:00.000 competent response, we had outsourced so much of the manufacturing 0:20:00.000 --> 0:20:03.440 sharing of these critical things to China and elsewhere that 0:20:03.720 --> 0:20:07.600 we were left defenseless. And so I think the pandemic, 0:20:07.920 --> 0:20:11.719 as it has in many aspects, from semiconductors to PPE, 0:20:11.800 --> 0:20:14.960 it has to raise a question about what competence needs 0:20:15.000 --> 0:20:19.119 to remain in America and how much globalization, what the 0:20:19.160 --> 0:20:22.120 limits of globalization really should be, because it turns out 0:20:22.160 --> 0:20:25.560 when a global supply chain is stressed, it breaks down 0:20:25.680 --> 0:20:29.360 really really quickly, as we all know now. That said, yes, 0:20:29.440 --> 0:20:34.479 the stories about doctors and hospitals individually and states just 0:20:34.560 --> 0:20:37.119 scrambling to try to get PPE, and the number of 0:20:37.160 --> 0:20:39.920 frauds that so quickly sprung up, and these people trying 0:20:40.080 --> 0:20:42.919 desperately to get their hands on ppe and finding that, 0:20:42.960 --> 0:20:44.879 you know, paying this money and finding a box of 0:20:44.920 --> 0:20:48.679 dirty gloves would arrive and that was it. Just the 0:20:48.720 --> 0:20:51.440 profiteering really was utterly insane. 0:20:51.080 --> 0:20:53.639 Right, life and death at stake, And people like I 0:20:53.640 --> 0:20:56.880 can make a book on this. Yes, interesting story within 0:20:56.920 --> 0:21:00.439 the book about a small mask company that tried to 0:21:00.440 --> 0:21:04.080 set up in the United States and in the past 0:21:04.720 --> 0:21:08.800 had every time there's a potential pandemic by American even 0:21:08.840 --> 0:21:11.639 though it's a little more expensive, it doesn't go anywhere, 0:21:11.760 --> 0:21:15.120 and then starts ramping up fifty one hundred, one hundred 0:21:15.160 --> 0:21:18.880 and fifty million masks. But if you bought from this company, 0:21:18.920 --> 0:21:21.280 you had to sign a seven year contract. You figured out, 0:21:22.080 --> 0:21:25.080 you know the company I'm decrying too. And so now 0:21:25.119 --> 0:21:29.159 we actually have capacity to make masks in the United States, 0:21:29.200 --> 0:21:32.320 which really we didn't have pre pandemic. 0:21:31.960 --> 0:21:34.800 Right, And you just hope that there's a lesson taken 0:21:34.840 --> 0:21:37.280 from that. And again it's something that we just don't 0:21:37.280 --> 0:21:40.360 do well because I think we have this blind belief 0:21:40.440 --> 0:21:42.800 in the market and that the market forces are going 0:21:42.840 --> 0:21:45.440 to take care of issues like this without the recognition 0:21:45.960 --> 0:21:47.720 that there are a couple things that can go wrong 0:21:47.800 --> 0:21:50.920 in modern day capitalism, that the focus on profits, on 0:21:51.040 --> 0:21:54.960 pleasing shareholders, and on profits that can be sustainable, means 0:21:55.000 --> 0:21:57.719 that the response in a pandemic isn't going to be 0:21:57.840 --> 0:22:00.439 what you think. And then, because of this need to 0:22:00.520 --> 0:22:03.720 minimize costs in order to boost profits, this ongoing pressure 0:22:03.760 --> 0:22:07.360