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The Upside of Crisis

What Happens When the Government Throws Away the Rulebook

March 2021

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Here’s a sentence that’s going to sound a little nuts: Someday, 2020 may be remembered as a great year in American history.

(Really. We’re being serious. There’s not a gas leak in our offices or something.)

Yes, those of us who lived through 2020 think about it primarily in terms of the misery of the COVID pandemic. But from the perspective of the future, it’s possible that the most notable thing about 2020 might not be COVID itself — but rather the scientific breakthroughs it gave rise to.

And when future generations study those breakthroughs, they’ll discover something interesting ... they couldn’t have happened without the government throwing away the rulebook.

The COVID pandemic has been the source of so much misery. The fear of contracting the disease. The anxiety of lockdowns. The couple of days at the start where it looked like there was a serious chance Tom Hanks could become a zombie.

But it’s easy now to forget that there was once another serious worry in that mix: some of the smartest people in the world were telling us that it might take years until scientists were able to develop a vaccine.

How did so many brilliant people get something so important so wrong?

Well, in their defense, they had never seen anything remotely like what was about to happen. Pre-COVID, the average time it took to develop a vaccine was over 10 years.i It had never been done in less than four. ii

So how did we get a COVID vaccine so quickly?

Vaccines go through three phases of clinical trials — experiments to test everything from safety to effectiveness to whether the inoculations have different effects on different parts of the population.

The COVID vaccines went through all those safeguards. But here’s where we made amazing progress: where normal vaccines have to move through one phase at a time, the government allowed the companies working on COVID vaccines to move through multiple phases at once. This one procedural change dramatically accelerated the timeframe on which we could get an effective vaccine. And it did so without compromising the science — or our safety.iii

We did something else, too. The government committed money in advance to mass produce the vaccines in development, even though it knew some of them might not get approval. We were willing to risk wasting some of that cash to ensure that we could get a vaccine to the public as quickly as possible.

The result: the FDA approved the first COVID vaccine for use in the United States only nine months to the day that the World Health Organization declared the disease a global pandemic. By that point, the death toll in the United States was already nearing 300,000. Imagine how high those numbers would have climbed if we had to wait years for a vaccine.

Achieving that goal so quickly was an extraordinary accomplishment, and it was also pretty revealing. It demonstrated how much more effective government could be if it cut through the red tape.

We’ve seen this once before in a public health crisis. In the 1980s, at the height of the AIDS epidemic, the FDA began creating loopholes to allow the sickest patients — the ones whose lives were quite literally on the line — to use treatments as soon as they showed promise, even if they hadn’t yet been officially approved. Advocates for those suffering from the disease had forced government leaders to shift their focus. The goal couldn’t be following bureaucratic procedures; the goal had to be to relieve as much human suffering as possible.iv

And this approach can work in areas that go far beyond health care. In 1994, the devastating Northridge Earthquake hit Southern California and destroyed part of the Santa Monica Freeway — the most heavily trafficked stretch of road in the world.

The state’s governor, Pete Wilson, responded by suspending regulations that would have slowed reconstruction — and by striking a deal with the contractors charged with rebuilding: if they completed the work before the government’s deadline, they’d get a bonus of $200,000 for every day it came in ahead of schedule. If they were late, they’d face a penalty of $200,000 per day it was behind.

The result: the reconstruction of the Santa Monica Freeway, which California’s Department of Transportation estimated could have taken up to two years ... was completed in 66 days.v California ended up paying out a $14.5 million bonus — but it’s estimated that by reopening businesses and getting people back to work it saved the economy of Los Angeles as much as $34 million. vi

On the day that the freeway was reopened, the mayor of Los Angeles, Richard Riordan, said, “This is the way government should be carried out all the time, not just in emergencies.”vii

He’s got a point. Not every government program will be as epic as the race for a COVID vaccine. But shouldn’t they all be animated by that same conviction? That the only goal that matters is getting the job done? If 2020 taught us anything, it’s that the results of that mindset ... can look something like a miracle.

Sources

Shownotes

SOUND: ARTLIST (IAN POST, ANBR, C.K. MARTIN) // MATTHEW DENICOLA // ZEN TECH 

FOOTAGE: CNN // THE SUN // TODAY SHOW // THE HILL // NBC // ABC // CBS // MSNBC // CNBC // 60 MINUTES AUSTRALIA // C-SPAN // THE EARTHQUAKE CHANNEL // U.S. FOOD AND DRUG ADMINISTRATION // GLOBAL NEWS // LIBRARY OF CONGRESS // RICKY FLORES // FEMA // SERGIO OLMOS // GETTY (JOE RAEDLELUIS ALVAREZ, MAXIM KALITVINTSEV, VOSHADHI, GORODENKOFF, STOCKELEMENTS, ALISTAIR BERG, CINDY ORD, MARIO TAMA / 1283038997, 155063680, BLOOMBERG CREATIVE, KARL SPENCER, HANDOUT, SPENCER PLATT, POOL, JOE RAEDLE, XAVIERARNAU, BRYAN THOMAS / STRINGERCHIP SOMODEVILLA, STEVE EASON) // STORYBLOCKS (EDUARD_M, FLEXX, STOCKBUSTERS, ILEXX) // SPLASH NEWS // VIDEVO // CITED SOURCES AND NEWS OUTLETS ARE NOT AFFILIATED WITH THIS PRODUCTION. 

Sources

  1. PLOS One
    Risk in Vaccine Research and Development Quantified” (Esther S. Pronker, et al.) 
  2. STAT
    "Operation Warp Speed Promised to do the Impossible. How Far Has it Come?" (Helen Branswell, et al.) 
  3. Johns Hopkins University School of Medicine
    Vaccine Research and Development”
  4. The Cure in the Code: How 20th Century Law is Undermining 21st Century Medicine
    Book by Peter Huber 
  5. Los Angeles Times
    “Santa Monica Freeway to Reopen on Tuesday" Nora Zamichow and Virginia Ellis) 
  6. Economic Policy Institute
    Lessons for Post-Katrina Reconstruction (Peter Philips) 

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