The next several days had the quality of a nightmare, as images of unrelieved suffering filled the news. The crisis, it turned out, was unprecedented — not just a massive hurricane but a citywide flood. When it came to providing relief and maintaining order, the normal procedure was to defer to state and local authorities. They quickly proved incapable or incompetent. Many Americans assumed that the main federal component of the response — the Federal Emergency Management Agency — could do emergency response and logistics on a large scale. But FEMA wasn’t (and isn’t) an elite corps of emergency responders. It was (and is) a skeletal organization that expands by hiring contractors in time of need. And the need is usually defined as putting up trailers while a relatively thin strip of destroyed coastal homes is rebuilt.
As the scale of Katrina’s destruction became evident, some at the White House proposed to preempt state and local roles and send in the military. Defense Secretary Donald H. Rumsfeld offered legal objections to conducting operations on U.S. soil. Others made the case that if we took action, we would “own” the situation — creating the impression we could replace the institutions that had primary responsibility.
We found, of course, that the president owns every crisis that can be solved only on a national scale.
So why the flashbacks? Because the United States again faces a circumstance in which the problem may be larger than the institutions that normally deal with it. Public health is mainly the responsibility of states and localities. Americans may think the Centers for Disease Control and Prevention is leading a national response to the coronavirus. It isn’t. The CDC has a weak role in setting and implementing policy, and it is not sufficiently staffed to do the job people think it is doing. The working group headed by Vice President Pence — while needed and helpful — only has the power of cajoling. In a public health emergency, there is no national coordinating function.
In normal circumstances, I am all for federalism. But some problems have a scope — say, fighting a war or constructing a national highway system — that overwhelms the theory of local control.
Coronavirus is likely to be this kind of problem. As America moves to the mitigation stage of the outbreak, social distancing measures — such as closing schools, ending mass gatherings and restricting travel — are the next line of defense. But the problem with such measures is that they tend to be imposed too late and/or lifted too early. And the current implementation of social distancing by states and localities can best be called spotty.
All the elements now exist for a swiftly unfolding emergency, on a scale that dwarfs Katrina. Because of the early absence of adequate tests, we have very little idea how prevalent the disease is in the country and little idea of how fast it is spreading. Dangerously and absurdly, political leaders have been using the low number of confirmed cases as the evidence of success when it is actually a measure of our blindness.
While administration officials were speaking the word “contained,” the virus was spreading unhindered in some places for weeks. And if sickness begins to come in a sudden rush, it will swamp the health-care system, leading to shortages of masks, hospital beds, ventilators and personnel (as it has in northern Italy).
“The glaring risk today,” as J. Stephen Morrison of the Center for Strategic and International Studies told me, “is that the elderly and those with fragile health suffer extreme illness but are unable to access life-sustaining care and die in large numbers.”
In just 18 days, Italy went from three confirmed cases of coronavirus to imposing nationwide internal travel restrictions. In a similar circumstance, the United States would need an assertive, active, early federal role in encouraging mitigation, readying the health-care system and helping states and localities bear the cost of the crisis. Agencies would have to aggressively use their power to influence, because there is no time for Congress to give them the real power to act. Some logistical role for the military may even be helpful.
I can imagine the objections. Some may argue that this would trample on the authority of states and localities, and that the administration would own whatever follows.
But an unprecedented emergency may require going beyond traditional thinking and traditional roles. And the administration owns the situation already.