The End

Final exam is Wednesday, in this classroom, 

9-noon.

 Back to the Future

COVID (Johnson 437-439) as a case study

Issue-Attention Cycle:  1918 Flu epidemic and subsequent epidemics.  

Books: Bush 43 develops a playbook after reading The Great Influenza.  Also World War Z

Path dependency

• Revival of early-20th-century public-health playbooks (masking & distancing): U.S. officials drew heavily on historical precedents from the 1918 influenza pandemic—particularly NPIs (non-pharmaceutical interventions) Responses were familiar, legally defensible, and embedded in existing federal and state guidance.
• Reliance on decentralized federalism: Long-standing U.S. public-health federalism—where states control health powers and the federal government plays a coordinating role—predetermined widely uneven state policies, replicating previous fragmented responses to polio, H1N1, and earlier outbreaks.
• Existing CDC guidance structures: Pre-COVID emergency-preparedness frameworks (from SARS, H5N1, and post-9/11 bioterror planning) channeled the federal response into established “pandemic phases,” guidance documents, and communication patterns—even when COVID-19’s characteristics differed.
• Legacy surveillance systems (e.g., patchworked state reporting, outdated data pipelines, hospital-centric metrics) limited real-time situational awareness because upgrading systems mid-crisis was institutionally difficult.
• Operation Warp Speed built on prior mRNA research, BARDA’s existing contracting mechanisms, and the FDA’s Emergency Use Authorization framework—all created before 2020—making them the default pathways for vaccine approval and distribution.

Unanticipated consequences: 

• Shifting, inconsistent health advice undermined trust
• COVID and inequality

Warp Speed: parallel processing of vaccines

Global inflation hurts incumbent parties all over the world