> It's not like every central institution can marshal expertise on every local issue.
True, but maybe we disagree on how easy it is for every locality to acquire expertise. Plenty of local governments in the United States are already stretched thin fulfilling the simpler functions of policing, schooling, and basic infrastructure. Adding a staff epidemiologist seems very hard for such places. The same proviso applies to many poorer states and nations. That is why I think it makes most sense to direct effort toward having a competent central authority.
> By decentralizing the process of decision making, you mitigate the risks, since you are allowing entities to tackle a problem in parallel, and if one of them turns out to be wrong, the fallout is localized. Whereas in a centralized system, one bad decision can spell trouble for everyone.
On the flip side, decentralizing makes coordination harder. In coarse terms, there are game-theoretic considerations in an epidemic. For example, if localities are purely self-interested, an unaffected region may attempt to quarantine and keep all of its medical infrastructure ready for itself rather than lend it to nearby affected regions. In such cases a coordinating mechanism can be extremely helpful.
I'm not arguing that one kind of organization is always better or worse. To me it just seems complicated.