Americans Are Rightly Proud of Their Independence. But That’s Worsening the Pandemic. (Letter to the Editor)

To the Editor:

Yesterday I wrote a response to Sean Gibbons’s op-ed column (“A Simple, Low-Cost Way for Nonprofits and Foundations to Curb the Coronavirus Crisis,” March 31).

Today I want to add a perspective from splendid isolation on the southern coast of Norway, my wife’s home country.

We retired here from the United States last summer. Like so many others in different kinds of isolation these days, I’ve got a lot of time, probably too much, to think. My Norwegian language classes have moved online and, except for the few hours a week my student colleagues — mostly refugees from the Middle East and Africa — and teachers meet via Google Classroom, we’re learning on our own, at our own pace.

While we can lay most of the responsibility for the severity and chaotic communications about the pandemic on Individual 1, there’s plenty of blame to go around. The underlying system of federalism that results in multiple and often competing, even conflicting trusted sources of information and guidance can exacerbate the chaos. Pluralism in democratic governance has been key to the strength and endurance of the American republic, but in the pandemic that we now face, might we even begin to ask whether federalism can also kill?

Let me provide some personal and professional context. My first job out of college, in 1974, was working as a “shoe-leather” epidemiologist for the New York State Department of Health, investigating potential source(s) of an unusually large cluster of angiosarcoma, a rare cancer, in the population near Buffalo.

Each week, my unit reported new data to what would be renamed as the Centers for Disease Control and Prevention that was aggregated into its weekly “Morbidity and Mortality Report,” which pinpoints the location and extent of specific diseases throughout the United States, in what was then considered real time. I’m a data nerd, so I loved reading the MMR, down to the details about an extended family in Kentucky that was poisoned by botulism from eating home-canned marinated beaver tail. The report wasn’t and isn’t perfect; state and county health departments’ reporting was inconsistent, often late, and sometimes never. But for that time, it was authoritative and far better than having no early-warning system at all.

Fast-forward 45 years through a career in politics and policy (working for a species of Republican that doesn’t exist anymore), academia, and philanthropy.

Despite Trump’s claim that the United States is doing so much better than other countries (it isn’t), one of the reasons Norway seems to be managing to contain the pandemic is that there are only two trusted, official sources of data and guidance: One, the FHI (Folkehelseinstituttet — Norway’s CDC) is a subunit of the other, the HD (Helsedirektoratet). These agencies respectively collect daily infection and location data: how many tested, how many infected (FHI), how many in the hospital, how many in intensive care/on respirators, how many deaths (HD).

That there are so many “official” sources — federal agencies, states, cities, counties, multiplied by unofficial sources and media — is why the data from the United States is so incomplete and inaccurate and why the United States can’t get a handle on the magnitude or spread of infection. Yes, as South Korea’s experience attests, testing matters a lot, but good reporting and competent management and leadership matter more. Until last week, Norway was on a trajectory that was steeper than the United States, with a higher infection rate and more deaths per capita here than in the United States. Yesterday, the government announced Norway was on the downward slope of the curve and a timetable for a limited return to “normalcy.” Before the end of this week, the U.S. will have surpassed Norway, China, Italy, and Spain combined, a No. 1 ranking even Trump shouldn’t want.

You might say that it’s all easier to do in a small, homogeneous nation and that Norway is a socialist country. It’s not; it’s a decidedly capitalist social democracy with a center-right coalition minority government. Over 15 percent of those residing in our township are immigrants; that’s typical Norway-wide. There’s a much higher percentage of people of color (and women) in government here than in the United States.

Rather, it’s the system and its management, not size or ideology, that determine effectiveness in responding and that thus inspires public confidence and compliance. We don’t have different counties/states/cities and media all reporting different data, giving different advice, and taking different and sometimes contradictory, even competing or opposing, actions. Or no action at all.

It’s a travesty that when you see Johns Hopkins’ Center for Systems Sciences and Engineering’s otherwise authoritative, real-time reporting, for example, you don’t see accurate aggregate U.S. data; the data Hopkins reports is at once both an undercount and duplicate reporting. And when you can’t completely rely on the CDC’s data, even if you’re supposed to rely on the CDC’s changing advice for mitigation.

There’s another big cultural difference between Norway and the United States. Norwegians are far more trusting of expertise than Americans; as a result, they’re more willing to follow expert guidance. And while I don’t generally align with the Norwegian government’s ideology, it has done a magnificent job of leadership in communication and execution, inspiring almost universal trust, confidence, and thus, compliance.

Yes, in a pandemic of this magnitude, the fierce independence and rugged individualism on which Americans pride themselves can kill. And so can the federalist system on which government in the United States is based, which itself undermines that government’s own ability to inform, prevent, protect, and treat. If it’s to contain and survive the next pandemic, the United States must address that paradox head-on.

David Morse

Stavern, Norway

Morse is a former chief communications officer at the Pew Charitable Trusts, Robert Wood Johnson Foundation, and Atlantic Philanthropies. He also worked as an aide to Sens. Jacob Javits of New York and Robert Stafford of Vermont and as director of President Ronald Reagan’s 1981 Task Force on the Arts and Humanities.