States brace for massive budget gaps in coronavirus recession | TheHill

State governments have spent a decade stockpiling billions of dollars in reserve funds for the next economic downturn, scarred by the steep cuts they were forced to make in the midst of the last recession.

Now, with the coronavirus grinding the global economy to a virtual halt, those billions could be gone in a matter of months.

State and local experts say the coming months will be a bloodbath for governments that are required by law to maintain balanced budgets. They will be forced to choose between steep and painful cuts to social programs that are already underfunded or tax hikes at a time when millions of people will be unemployed.

Source: States brace for massive budget gaps in coronavirus recession | TheHill

How Coronavirus Made Andrew Cuomo America’s Governor | US News

The daily morning briefings, carried live on several networks, have a common template, a routine that is in itself reassuring. He starts with an update on the coronavirus numbers, followed by a PowerPoint illustrated account of what his government is doing to address the crisis. He moves on to new directives to control the spread of the virus and heal those infected with it. Then – appropriately seated two arms-length away from everyone else at the briefing – he gets personal, talking about how emotionally draining and frightening the coronavirus is, how it has affected his own family, and how he knows Americans will get through it together.

These are exactly the sort of events many Americans expect from President Donald Trump and his administration during the global public health crisis that has scared individuals and spooked the financial markets. But they are coming from New York Gov. Andrew Cuomo, whom associates say is rising to the unhappy occasion with a take-charge attitude they had expected and a comforting manner that has come as a surprise.

Source: How Coronavirus Made Andrew Cuomo America’s Governor | Health News | US News

With Coronavirus Political Leaders Battle Over Shutdowns, Policies | US News

Mississippi is far from the current coronavirus hot spots, but mayors there wanted to get ahead of the spread of the pandemic as much as they could, imposing citywide curfews and closures of non-essential businesses to limit their residents’ exposure.

Gov. Tate Reeves, who had been reluctant to impose such restrictions, issued an executive order this week that appeared to undermine those city rules, defining “essential” businesses in a very broad manner and allowing restaurants to stay open as long as there were no more than 10 people in a dining room.

The Magnolia State is “rejecting dictator models like China,” Reeves wrote on his social media accounts after issuing the order. “We’re following our experts and I’ve spent many sleepless nights praying for wisdom in this unprecedented time.”

Source: With Coronavirus Political Leaders Battle Over Shutdowns, Policies | The Report | US News

Canada can ignore drug, device patents during outbreak under new law | Reuters

Canada’s emergency legislation on the coronavirus crisis gives the health minister powers to circumvent patent law and ensure medical supplies, medication or vaccines can be produced locally.

The measures could be used if demand exceeds supply or when a patent holder cannot produce for Canada, said Innovation, Science and Economic Development Canada in a statement on Thursday.

Patent holders would receive “adequate remuneration.”

Source: Canada can ignore drug, device patents during outbreak under new law – Reuters

The Multilateral System Still Cannot Get Its Act Together on COVID-19 | Council on Foreign Relations

This week was supposed to offer a reprieve, with the Group of Seven (G7), Group of Twenty (G20), and the United Nations announcing important international initiatives. Instead, it underscored just how divided and unprepared the world remains as it confronts the greatest threat to global public health since the Great Influenza of 1918.

The biggest disappointment has been U.S. President Donald J. Trump, who has been more preoccupied with countering Chinese propaganda than exercising global leadership.

Source: The Multilateral System Still Cannot Get Its Act Together on COVID-19 | Council on Foreign Relations

Support for Hong Kong protesters’ demands rises even as coronavirus halts rallies: poll | Reuters

Demands for the resignation of Hong Kong’s leader, Carrie Lam, were supported by 63% of respondents in the poll, conducted by the Hong Kong Public Opinion Research Institute between March 17-20, versus 57% in a poll it conducted in December.

Supporters of the protests outnumbered opponents by a ratio of roughly two to one, with 28% against them compared with 30% in a poll in December, and 58% supporting them, versus 59% previously.

Source: Exclusive: Support for Hong Kong protesters’ demands rises even as coronavirus halts rallies: poll – Reuters

G20 leaders to inject $5 trillion into global economy in fight against coronavirus | Reuters

Leaders of the Group of 20 major economies pledged on Thursday to inject over $5 trillion into the global economy to limit job and income losses from the coronavirus and “do whatever it takes to overcome the pandemic.”

Showing more unity than at any time since the G20 was created during the 2008-2009 financial crisis, the leaders said they committed during a videoconference summit to implement and fund all necessary health measures needed to stop the virus’ spread.

Source: G20 leaders to inject $5 trillion into global economy in fight against coronavirus – Reuters

Coronavirus Threatens Catastrophe in India

This week, the novel coronavirus pandemic, which has affected nearly 200 countries, will begin to ravage one of the biggest, most vulnerable nations in the world. India, home to more than 1.3 billion people, is bracing for a surge in COVID-19 cases. The country already has the largest cohort of people in the world living with respiratory disease, thanks primarily to its chronic air pollution and high rates of tuberculosis. Such conditions make this densely populated country the perfect fodder for a virus that attacks the lungs of its victims.

India reported its first case of COVID-19 on January 30. Over the last few weeks, cases of the disease have grown exponentially, with 519 people infected and ten deaths as of March 24. According to the World Health Organization’s Situation Reports, the virus is spreading in India through local transmission and not simply through the arrival of people who contracted the virus abroad. But until March 21, the Indian government had set fairly restrictive criteria for testing, providing tests only for international travelers and their immediate contacts. On March 24, the government imposed a three-week lockdown to slow the spread of the disease.

India’s indecisive approach to testing has obscured the extent of undetected infections within the country, making the future magnitude of the outbreak hard to predict. India is already an unhealthy nation: it has the dubious distinction of being the “diabetes capital” and “cardiac capital” of the world with 50 million people living with diabetes and 54 million living with cardiovascular disease. Its threadbare public health system and exclusionary private health system don’t provide adequate care for all Indians. The country now finds itself preparing for an uphill battle against a virus that has already overwhelmed some of the most developed health-care systems in the world.

The pandemic will be especially dangerous in India. The country’s health infrastructure is woefully underfunded and unprepared for the eventual crush of COVID-19 patients. The distinctive misfortune of India’s geography—the Himalaya Mountains curtail the movement of winds across the subcontinent in a manner that worsens smog in northern India—has led to growing rates of respiratory disease. In 2018, nearly a third of the cases of chronic respiratory disease around the world were in India. The country already bears the burden of being home to the world’s largest number of people with tuberculosis (2.8 million of the global total of 10.2 million patients); those with tuberculosis are especially at risk of COVID-19. The virus may very well spark a humanitarian crisis.

One estimate, using the same mathematical models applied in the United Kingdom and the United States, suggests that India could face in the area of 300 million cases before the end of July, of which about four million to five million could be severe, leading potentially to one million to two million deaths.

Panic and chaos have already set in across the country. A man hospitalized in New Delhi with COVID-19 symptoms committed suicide. A mob beat up another man in the western state of Maharashstra for sneezing in public. In the northwestern state of Punjab, officials in the town of Ludhiana have lost track of 167 people who may have contracted the virus. Quarantined people have begun running away from the unsanitary isolation wards hastily put up by authorities.

Many Indians don’t feel that they can rely upon the country’s medical establishment. Since independence in 1947, India has failed to invest sufficiently in health infrastructure, effectively handing over the responsibility for health care to private hospitals, which now control 74 percent of the health-care market and hold 40 percent of the nation’s hospital-bed capacity. Only about a tenth of the poorest one-fifth of Indians have access to any kind of government or private health insurance. The Indian government spends a little over one percent of GDP on health care, among the lowest rates in the world.

Given relatively free rein to charge as they wish, India’s private hospitals have become notorious for priortizing profits over patients, overdiagnosing, overtreating, and overcharging those who have insurance. At underfunded government hospitals, doctors tend to underdiagnose the uninsured and offer them meager treatment.

That disparity is accentuated by a scarcity of resources. One of India’s most populous states, Maharashtra, has only 450 ventilators and 502 intensive care unit (ICU) beds in its public hospitals to meet the demands of 126 million people. Chhattisgarh, a state with a population of 32 million people, has 150 ventilators in government hospitals and perhaps only 25 specialists who know how to ventilate cases of acute respiratory distress syndrome, the kind of respiratory failure caused by COVID-19.

The country lacks testing kits, protective gear for health-care workers, ventilators, and hospital beds. These deficits helped create India’s preventable epidemic of tuberculosis in recent decades, which continues to claim 1,400 lives every day, and now pave the way for a devastating coronavirus epidemic in the country. Of all the nations seriously affected so far, India is the least prepared to handle an explosion in cases.

Singapore is now the oft-invoked example of a country that properly contained its COVID-19 outbreak. The measures that worked in Singapore were to aggressively test people for the virus, identify and isolate cases, carefully trace the prior contacts of patients, and strictly quarantine people with suspicious symptoms.

India’s approach stands in sharp contrast. Answering criticism for its limited testing of suspected COVID-19 cases, the government broadened its testing criteria on March 21. But it insists that aggressive testing at the Singaporean scale is not realistic because of the size of India’s population. Testing aside, officials have struggled to trace the contacts of infected patients and to prevent people from fleeing isolation centers. Such measures as self-quarantine and social distancing will not be easily applied in a country where one-third of the population lives in dense, overcrowded cities.

The cultural orientation of the government of Prime Minister Narendra Modi exacerbates these problems. His Hindu nationalist administration has encouraged unscientific thinking since coming to power in 2014. Modi and his ministers hold intellectuals and experts in disdain and have set up a ministry for promoting traditional medicine, such as Ayurveda and yoga. This ministry has endorsed dubious homeopathic prophylactic treatments and undermined the efforts of the health ministry to fight misinformation and superstition.

The COVID-19 pandemic hits India as it is led by ideologues who have urged the use of cow dung and urine to prevent the spread of the virus. One activist belonging to Modi’s Bharatiya Janata Party was arrested after people fell sick at a party he held in March where guests were encouraged to drink cow urine.

Although the prime minister has not himself extolled the virtues of cow urine as a defense against the virus, his approach to the crisis has been high on rhetoric and low on specifics. During televised remarks on March 19, Modi compared the battle against the COVID-19 pandemic to the world wars and warned of the likelihood of an exponential growth of infections in the absence of proper social distancing. But his address to the nation did not explain his government’s strategy to tackle the virus. Instead, he put the onus on citizens, calling on Indians to enter a self-imposed curfew on Sunday, March 22.

Although social distancing is necessary to contain the virus, this curfew has done little to break the chains of transmission that Modi’s government has allowed to spread unchecked since the beginning of March. Some Indians treated the curfew as the occasion to gather in festive crowds, obviating its intended purpose. Modi’s speech on March 19 ended with a request for Indians to thank their doctors, nurses, and emergency responders by imitating the singing now common in locked-down Italy and by gathering on rooftops and balconies to clap in unison.

Many health workers took to Twitter to express dismay at the vagueness of Modi’s speech. One doctor, Afreen Usman, whose husband is caring for COVID-19 patients, tweeted, “As a doctor myself and as [the] wife of a doctor who is working with coronavirus patients, let me assure you that we don’t want people clapping for us, what we really need is more testing kits, better quarantine facilities, hazmat suits, and more awareness.” Belatedly, Modi and his government swung into action, ordering a nation-wide lockdown for 21 days on March 24.

A number of local state governments have already acted decisively. The slow planning of the central government in New Delhi stands in stark contrast to the swift steps taken by state governments, especially those of the southern state of Kerala. As Modi was calling upon Indians to bang utensils and clap from their balconies, Pinarayi Vijayan, Kerala’s chief minister, announced a 200 billion rupee ($2.6 billion) financial package that includes loan waivers, free rations, pensions, and the setting up of low-cost eateries to help residents of the state endure the crisis.

According to some estimates, India has only between 70,000 and 100,000 ICU beds in the entire country across both the public and the private sectors. Health experts insist that India has until about April 10 to better prepare its hospitals, convert a few stadiums into isolation centers, and procure as many ventilators as possible. So far, Modi’s administration has not done any of these things. It has merely asked private hospitals to provide an inventory of ICU beds and ventilators, cancel nonessential surgeries, and make sure they don’t turn suspected COVID-19 patients away. The administration has, however, been quick to invoke the draconian British-era Epidemics Act of 1897, imposed during an outbreak of bubonic plague. The act gives the government sweeping powers to fine, detain, and imprison people for breaking quarantine rules, a nebulous power that could easily be misused. Historically, pandemics—and efforts to control them—have often led to measures that curtail civil liberties. Public health experts and pro-democracy activists in India are worried that the government might use the pandemic as an excuse to crack down further on dissent, which surged when protests against a controversial citizenship law erupted in December.

The epidemic curve in India is likely to follow a trajectory similar to that in Italy. A spike in cases will saturate and overwhelm India’s health system. Failing to contain the pandemic in India has global implications, as is evident in the spread of tuberculosis from the country. In 2015, U.S. health authorities confirmed that an Indian patient with a drug-resistant version of tuberculosis carried the infection to Chicago. The patient drove from there to visit relatives in Tennessee and Missouri. With diasporic Indians in nearly every part of the world, what ails India could easily become a grave threat to global health.

Source: Coronavirus Threatens Catastrophe in India

The Coronavirus Exposed America’s Authoritarian Turn

The U.S. government’s response to the novel coronavirus pandemic has been confusing, inconsistent, and counterproductive. Since February, the data from China, South Korea, and Italy have clearly shown that the virus spreads rapidly in areas that do not practice social distancing—and that simple measures to keep people apart can significantly slow the rate of new infections. But the administration of U.S. President Donald Trump did not coordinate any social distancing. And even as acute cases overwhelmed Italy’s hospitals, the administration made few efforts to shore up the U.S. health-care system, increase the number of ventilators in hospitals, or make testing widely available.

Many blame these failures on the president, who initially downplayed the severity of the crisis. As recently as March 4, Trump insisted that COVID-19, the disease caused by the new coronavirus, was no worse than the flu. A week later, he claimed that the U.S. health-care system was well prepared for the outbreak. For encouraging the nation to sleepwalk into a crisis, Trump does indeed deserve blame. But even more blameworthy has been the president’s assault on U.S. institutions, which began long before the novel coronavirus appeared and will be felt long after it is gone.

By relentlessly attacking the norms of professionalism, independence, and technocratic expertise, and prioritizing political loyalty above all else, Trump has weakened the federal bureaucracy to such an extent that it is now beginning to resemble a “Paper Leviathan,” the term the political economist James Robinson and I use to describe autocratic states that offer little room for democratic input or criticism of government—and exhibit paper-thin policymaking competence as a result. Bureaucrats in these countries get accustomed to praising, agreeing with, and taking orders from the top rather than using their expertise to solve problems. The more American bureaucrats come to resemble autocratic yes men, the less society will trust them and the less effective they will be in moments of crisis like this one.

In just a little more than three years in office, Trump has upended many of the political norms that previously made the U.S. political system function—including the expectations that the president would not tell outright lies; would not interfere in court cases; would not obstruct law enforcement investigations; would not condone, let alone encourage, mob violence; would not materially benefit—or allow his family to benefit—from executive power and privilege; and would not discriminate against citizens on the basis of their race, ethnicity, or religion.

In eviscerating these norms, Trump has accelerated the polarization of U.S. politics—a corrosive trend that predated him but that has intensified on his watch. The costs of polarization are evident not only in the acrimony of political discourse but in the inability of politicians to compromise to solve basic problems such as lack of health care for millions, the precarious situation of the undocumented, and decaying public infrastructure—or even to prevent the government from periodically shutting down.

Trump’s tenure has been even more calamitous for one of the most important institutional pillars that for the last two centuries has constrained executive power: the civil service. To be sure, by granting the president sweeping powers to make senior appointments, U.S. political institutions don’t make it easy for nonpartisan professionalism to take root in the executive agencies. But even under administrations with very different priorities and policy agendas, most departments have managed to function effectively and pursue sound policies in fields as diverse as education, environment, commerce, aeronautics, space, and, of course, disease control.

By upholding nonpartisan rules and procedures and relying on technocratic expertise, professional bureaucrats who serve under political appointees function as a kind of guardrail for administrations, preventing their more extreme or nakedly partisan policies from being implemented. A professional civil service has also been the last, most powerful defense against natural disasters and health emergencies.

The Trump administration not only has failed to maintain the critical health infrastructure that protects the nation from contagious diseases—for example, he disbanded the pandemic preparedness unit that was part of the National Security Council until 2018—but has actively weakened the civil service. The president’s hostility to impartial expertise has forced many of the most capable and experienced federal employees to quit, only to be replaced by Trump loyalists. His persistent attacks against those who contradict his untruths or point out problems with his administration’s policies have created an atmosphere of fear that impedes bureaucrats from speaking up.

This reticence partly explains the slow, muted, and ineffective initial response to the coronavirus outbreak from federal health agencies such as the Centers for Disease Control and Prevention. The president has shown that he is willing to publicly assail individual civil servants who anger him, as he did Lieutenant Colonel Alexander Vindman, the former National Security Council staffer who testified in the impeachment investigation, and so the incentive to hew to his narrative—or at least not to contradict it publicly—is overwhelming.

Some officials, such as Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have sounded the alarm anyway. But even Fauci has admitted that “you don’t want to go to war with a president. . . . But you got to walk the fine balance of making sure you continue to tell the truth.”

Some officials, such as Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have sounded the alarm anyway. But even Fauci has admitted that “you don’t want to go to war with a president. . . . But you got to walk the fine balance of making sure you continue to tell the truth.

It is not too late to reverse the damage that Trump has done to U.S. institutions and to the federal bureaucracy. A first step toward doing so would be to give up the dangerous myth that the Constitution, designed masterfully by the Founding Fathers, can protect U.S. democracy even from a narcissistic, unpredictable, polarizing, and authoritarian president. James Madison proclaimed in Federalist No. 57 that “the aim of every political constitution is, or ought to be, first to obtain for rulers men who possess most wisdom to discern, and most virtue to pursue, the common good of the society; and in the next place, to take the most effectual precautions for keeping them virtuous whilst they continue to hold their public trust.” The U.S. Constitution has utterly failed on the first count. Why, then, should anyone trust it to succeed on the second?

No amount of constitutional checks or balances can rein in this president or another like him. The separation of powers hasn’t restrained Trump. To the extent that he has been contained, this has been thanks to the media, civil society, and the electorate. True, the House of Representatives has stood against many of Trump’s worst policies, going so far as to impeach him, but voters were the ones who forced the House to act by making their preferences clear in the midterms. Likewise, when the judiciary has acted—for example by staying Trump’s travel ban targeting majority-Muslim nations—it has often done so because of lawsuits and actions brought by organizations such as the American Civil Liberties Union.

With the Constitution failing to restrain the president, and the civil service under attack by him, it will take societal involvement in politics as well as leadership from state and local governments and private corporations to revitalize U.S. institutions. It won’t be enough to elect a new president in November 2020. The hard work must involve civil society and private enterprises working together with the state to tackle major institutional and economic problems.

With the administration and the federal bureaucracy failing to step up, civil society, the media, and experts outside of government must put additional pressure on the administration while at the same time picking up some of the slack themselves. It is a tall order, but Taiwan offers a model of how society can help develop solutions that complement government efforts to slow the spread of the virus and limit the death toll. The United States will have to do even more to strengthen its failing health-care system and, in the process, rebuild trust in state institutions.

Source: The Coronavirus Exposed America’s Authoritarian Turn

Civic Technology Can Help Stop a Pandemic

The spread of the novel coronavirus and the resulting COVID-19 pandemic have provided a powerful test of social and governance systems. Neither of the world’s two leading powers, China and the United States, has been particularly distinguished in responding. In China, an initial bout of political denial allowed the virus to spread for weeks, first domestically and then globally, before a set of forceful measures proved reasonably effective. (The Chinese government also should have been better prepared, given that viruses have jumped from animal hosts to humans within its territory on multiple occasions in the past.) The United States underwent its own bout of political denial before adopting social-distancing policies; even now, its lack of investment in public health leaves it ill-equipped for this sort of emergency.

The response of the bureaucratic and often technophobic European Union may prove even worse: Italy, although far from the epicenter of the outbreak, has four times the per capita rate of cases as China does, and even famously orderly Germany is already at half China’s rate. Nations in other parts of the world, such as information-manipulating Iran, provide worse examples yet.

Focusing on the countries that have done worst, however, may be less useful at this point than considering which country has so far done best: Taiwan. Despite being treated by the World Health Organization as part of China, and despite having done far broader testing than the United States (meaning the true rate of infection is far less hidden), Taiwan has only one-fifth the rate of known cases in the United States and less than one-tenth the rate in widely praised Singapore. Infections could yet spike again, especially with the global spread making visitors from around the world vectors of the virus. Yet the story of Taiwan’s initial success is worth sharing not just because of its lessons for containing the present pandemic but also because of its broader lessons about navigating pressing challenges around technology and democracy.

Taiwan’s success has rested on a fusion of technology, activism, and civic participation. A small but technologically cutting-edge democracy, living in the shadow of the superpower across the strait, Taiwan has in recent years developed one of the world’s most vibrant political cultures by making technology work to democracy’s advantage rather than detriment. This culture of civic technology has proved to be the country’s strongest immune response to the new coronavirus.

The value of Taiwan’s tech-enabled civic culture has become abundantly clear in the current crisis. Bottom-up information sharing, public-private partnerships, “hacktivism” (activism through the building of quick-and-dirty but effective proofs of concept for online public services), and participatory collective action have been central to the country’s success in coordinating a consensual and transparent set of responses to the coronavirus. A recent report from the Stanford University School of Medicine documents 124 distinct interventions that Taiwan implemented with remarkable speed. Many of these interventions bubbled into the public sector through community initiatives, hackathons, and digital deliberation on the vTaiwan digital democracy platform, on which almost half the country’s population participates.

(The platform enables large-scale hacktivism, civic deliberation, and scaling up of initiatives in an orderly and largely consensual manner.) A decentralized community of participants used tools such as Slack and HackMD to refine successful projects. (Much of our analysis is based on open interviews through these tools with leaders in the g0v community of civic hackers.)

Source: Civic Technology Can Help Stop a Pandemic