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Comment by dereg | Hacker News Reader

If COVID taught us anything, the government is going to let these drugs expire useless, incinerate them, refuse to replenish them, and import loads of fakes when an actual crisis hits.

Snark aside, this may not be the case this time around. Relevant snippet:

> 2004 Project Bioshield Act and $290 million in Project BioShield designated funding to purchase this supply of the drug. Amgen will maintain this supply in vendor-managed inventory. This approach decreases life-cycle management costs for taxpayers because doses that near expiration can be rotated into the commercial market for rapid use prior to expiry and new doses can be added to the government supply.

I'm guessing $290M covers both the cost of the drugs as well as storage for some number of years. Would be nice to know for how long.

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> If COVID taught us anything, the government is going to let these drugs expire useless, incinerate them, refuse to replenish them, and import loads of fakes when an actual crisis hits.

That’s a very weird take on this. So what should the government do in your opinion? Launch some nukes preemptively just so people could say “oh, at least we didn’t waste those anti-radiation medicines! we caused nuclear conflict, but who cares, drugs didn’t expire”?

Considering that the adversary is shifting their strategic bombers, sent their biggest sub with nuclear torpedoes into the sea, and the nuclear train is on the move towards Ukraine, this sounds like a good idea, no?

Governments often have a tendency to think of stockpiles as indefinite items without a lifetime. But everything has a lifetime, as any good engineer would know.

"Let's stockpile nuclear emergency meds" is a good opportunity to forget about expirations and, 50 years from now, say "we're covered because in 2022 we stockpiled them and nothing happened since". Thankfully, as GP points out, this appears not to be the case... this time. But it did happen with Covid (and not just to the US! Many governments were guilty of this thinking)

Yes but that’s not a good argument against buying them now, instead it’s an argument in favour of setting up a replenishment programme for some fraction of the reserve every year after some initial delay.

I'm not reading anyone arguing against buying anything now?

> But it did happen with Covid

what do you mean? We did not have stockpiles of drugs because the drugs were not known and it took quite a bit of research to figure out what works and what does not.

It happened with PPE (which has expiration dates).

Masks and Respirators. We had stockpiles of expired equipment.

Mask don't have expiry dates unless you use them

They do. N95 masks have a 10 year shelf life. You can argue about the usefulness of that shelf life (it's been done to death), but it's there, and when the pandemic hit loads of governments were faced with expired masks.

https://multimedia.3m.com/mws/media/869238O/3m-health-care-p...

Among other issues, the elastic wears out over time even if they're in storage.

yeah they do. the elastic bands and adhesives used to make them will break down.

It wasn't the drugs that were the problem, but, instead, timely boneheadedness:

      May 2018 The Trump Administration disbands the White House pandemic response team.

      July 2019 The Centers for Disease Control (CDC) epidemiologist embedded in China’s disease control agency left the post, and the Trump Administration eliminated the role.

      Oct. 2019 “Currently, there are insufficient funding sources designated for the federal government to use in response to a severe influenza pandemic.”

      Jan. 22, 2020 “We have it totally under control. It’s one person coming in from China. It’s going to be just fine.”

Please don't start. It happened, we learned from it, we're moving on...

>May 2018 The Trump Administration disbands the White House pandemic response team.

Ah yes, yet another person who a) uses Snopes to "fact check" and b) looked at the Snopes piece's headline and nothing else. One would think reading only that, or the Twitter thread (!) the piece is based on, that to save money (or because the Trump administration hated science, or something) the entire "US Pandemic Response Team" agency was eliminated and everyone in a large DC office building was fired.

Actually reading the contemporary NBC News https://www.nbcnews.com/politics/politics-news/tom-bossert-t... and Washington Post https://www.washingtonpost.com/news/to-your-health/wp/2018/0... articles the Snopes piece cites in the body, they seem to have been a handful of people in one team in the National Security Council hierarchy, that the new National Security Advisor reassigned to related agencies, as part of a desire to have his own hierarchical structure. Ziemer resigned because he wanted to keep his team the way it was.

COVID19 was not a surprise; that is, it was known to exist in China some time before the first cases appeared in the US. It is not unreasonable for a government to assemble a team to respond to something like a pandemic as needed, as opposed to having people dedicated solely to the purpose and nothing else. And that's exactly what the US did, implementing the ban on non-American travelers who'd been to China in late January 2020, among other things.

You may or may not agree with this. But please don't claim that this is somehow prima facie proof of the Trump administration's malfeasance/evilness.

PS - No, Trump did not "cut the CDC budget" either. https://apnews.com/d36d6c4de29f4d04beda3db00cb46104

I got this from a dishonest liberal rag known as Reuters, not Snopes.

The Trump administration indeed eliminated the Global Health Security and Biodefense unit, known as the “pandemic response” team. Some of its members were reassigned to roles that included pandemic response, but the change had only one single honest purpose, which was to placate Trump's obsession with undoing whatever President Obama's administration set up. There was no other purpose than that, and the government lost some experts in so doing. It was a pretty stupid thing to do, though the Trump Administration later claimed they were "streamlining," to cover up for what can only be described as tribal boneheadedness.

I mean...literally nothing you just said contradicted the post you replied to, so I'm not sure what your point is.

Something something MAGA something something

Don't forget the Tea Party that blocked replenishment funding of the stockpile: https://www.propublica.org/article/us-emergency-medical-stoc...

Emergency management people think about stuff like this and plan for it.

Not sure what the COVID reference is, but vaccination storage and management was initially very complex (requiring ultra cold temperatures and special handling) and given the insanity of the media environment, it was essential that vaccine be available for people who showed up, which meant wasting unused vaccines.

It's an especially stupid thing to point out when that's not the case here, as OP points out. Like, why even mention it then? There is enough negativity/pessimism around, no reason to add to it.

I am not trying to be negative. I mean, what’s brewing is not a subject to throw jokes around. It’s a genuine question, considering current geopolitical issues, when is the right time to prepare for a crisis if not now?

I'm not clear on why you have such a negative take on the response to the pandemic in general. I thought the speed of development and delivery of the mRNA vaccines was nothing short of unprecedented. A lot of things went wrong, but drug development and delivery wasn't one of them IMO.

Where did I mention anything related to the pandemic?

To maybe help defuse: it looks to me like dntrkv was actually agreeing with you (and talking about dereg's post), but it seems like you misunderstood, and then alex_young probably misread you as being dereg given your reply.

Just my take, obv.

Indeed that is the case. Apologies for the confusion.

> I'm not clear on why you have such a negative take on the response to the pandemic in general

You must've been living under a rock then.

Here's a few articles to jog your memory.

- https://www.npr.org/2020/11/06/929078678/cdc-report-official...

- https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.01269

- https://www.nytimes.com/2020/03/19/health/coronavirus-masks-...

> speed of development and delivery of the mRNA vaccines was nothing short of unprecedented

That was the only thing that was better than expected.

We were flying completely blind at the start of the pandemic (when there was a chance of containment) because the CDC had a completely flawed test and banned every other alternative.

I'd ask which country wasn't? We were dealing with a novel virus. Even China which has dealt with new viral outbreaks before (I'm ignoring any insinuation of their foreknowledge of covid), is STILL struggling.

Literally every country in Southeast Asia had far, far fewer deaths because they were able to contain the spread far better than the US. Just spend 2 minutes looking at the statistics.

Australia had 15,000 total deaths compared to the US's 1 million.

> Even China which has dealt with new viral outbreaks before (I'm ignoring any insinuation of their foreknowledge of covid), is STILL struggling.

Struggling is a relative term. China has reported 5k deaths from COVID. Even if you don't believe numbers from the CCP, even 10x that (50k deaths) is far, far better than the US.

Right now, China is "struggling" because they're still clinging to zero-covid policies. They'll lock an entire neighborhood down over a few cases.

As you probably know, these things grow exponentially, so containing the spread at the very start is really, really crucial.

We were completely blind during the start of the pandemic due almost entirely to failures by the CDC.

> able to contain the spread far better than the US

In my opinion a good deal of this was due to the fact that this entire event turned political from the very start. I am not being dramatic when I say that politicians, due to party and ideological loyalty, quite literally, killed people. It's hard to estimate how many. The number certainly has to be between tens of thousands to hundreds of thousands.

> We were completely blind during the start of the pandemic due almost entirely to failures by the CDC.

No, we were not. The instant Trump closed the door to travel from China I knew we were in for an event that was several standard deviations away from the norm. Ideology aside, a POTUS does not make a move like that in isolation. The data had to be absolutely overwhelming.

As an informed observer I was paying attention. The instant I thought "this is several standard deviations from the norm" I took action. I ordered a supply of food and other necessary items (and yes, masks) to last several months. I covered my immediate and extended family (because nobody listens and everyone who gets their information from mainstream media is living in a fantasy made-up of lies).

If I remember correctly, that was mid January 2020. All of my supplies arrived and were put away before the panic started. We barely had to go to the market for a year.

Regarding politicians killing people. A lot of those videos have been deleted from YouTube and other places. They can be hard to find. Here's a few that are still up. All after Trump's travel ban (again a "tilt" event in terms of SD from the mean).

"There is no reason not to take the subway,..."

https://www.youtube.com/watch?v=UbPPGrZH3VY

"About 60% of new cases coming out of the NY metropolitan area"

https://www.youtube.com/watch?v=cdKLx5MhTpk

"Everything is fine" "Precautions have been taken" "Fear is racially motivated" "Coronavirus is under control in the US"

https://www.youtube.com/watch?v=CmllqkU6j2k

This is a big one:

    Just like the normal flu
    We should relax
    We don't think it's going to be as bad as it is in other places
    We have been ahead of this from day one
    Go about your lives
    Go about your business
    There has to be prolonged exposure
    Just wash your hands
    No need to do anything special
    We want New Yorkers to go about their daily lives
    Ride the subway, ride the bus, go see your neighbors
    We have the equipment
    It's not like we are dealing with something we haven't dealt with before
    We have the ability to address this
    We have the capacity to keep this contained
    Like the normal flu

https://www.youtube.com/watch?v=NEhLOp7UGNM

    The local risk is low
    Our preparedness is high
    Go about your lives
    No indication to be using masks
    We have measures
    We have screening
    No indication that going through the subway is a risk factor
    No indications to be using masks
    False sense of security
    The risk is low

https://www.youtube.com/watch?v=rMkBW9ewPz8

These are just some of the links I kept as I chronicled this historical event. A lot of the links I recorded have been deleted.

If you do watch these, pay attention to the dates. Keep in mind that Trump and his team sounded the alarm in early January and the Chinese travel ban went into effect at the end of January.

These people, in very real terms, caused hundreds of thousands of people to become infected. When panic ensued, masses of people left the NY area, carrying the virus everywhere in the country. Yes, these politicians likely killed hundreds of thousands of people. I think that much is without dispute. Nobody talks about it, of course. Because ideology and party are more important than lives. As a classical liberal/libertarian I find this kind of thing to be in a range between revolting and criminal.

Statistics flatten reality. Masking is much more appropriate (and followed) in Asia. Australia had less movement.

The reality is that precautions were not followed in the US for the sake of "liberty" and that had consequences

I really don't see how we could be less "blind". What were we supposed to see? You haven't outlined anything that these other countries "saw" that we didn't.

Clearly they were not talking to you.

In my defense, it was late. Thank you for pointing that out.

Thank you, this is why I value HN so much.

Collecting potassium iodine is not going to save Americans, that’s for sure. The amount of preparation for the American people to survive would be next to extraordinary. Most people these days do not have what it takes, and certainly our government does not, either.

The thing is that even if the missile defense system works 100% successfully for a nuke approaching the United States, the electromagnetic pulse above is enough to disable all electronic devices in the US. Like the trajectory of the plume covers the vast majority of the US, no matter what direction the nuke comes from.

At the altitudes they would typically be intercepted at (for ICBMs amyways), it would likely be dispersed over most of a hemisphere and likely somewhat weak... until there are multiples.

what electromagnetic pulse? intercepting a nuke doesn't detonate it early like a conventional explosive; it most likely turns it into a dud.

The EMP blasts - likely multiple - that are precursor strikes for the city bombing.

My point is that the political imperative leads politicians on both ends to take on many unfunded liabilities without planning for continuity or completion. I'm hoping that the extended storage for this is well accounted for and immunized against the whims of the next administration.

> and the nuclear train is on the move towards Ukraine

This was debunked by the US Gov.

Good thing the US government does not have an incentive to lie in this case. Oh, wait. Maybe they want to avoid having taxpayers start panicking and rioting in the streets.

We are in the fog of war. The ground truth of such matters will be elusive until that fog lifts. In the meantime, no one should believe the propaganda spouted by their government without extraordinary proof.

Ok, more evidence then: https://mobile.twitter.com/ArmsControlWonk/status/1577093488...

You quoted the important part. Specifically, this paragraph negates your post.

Read it carefully. Doses that approach expiration will be rotated into the commercial market and replenished with fresh doses.

There is very little cost to the supplier in doing that. They get to sell a healthy dose of medication for full retail value and the government always has a fresh, healthy supply. FIFO (First in, first out).

Most companies try to reduce the value of the products they have on hand to save in taxes and keep their operation lean. The government is basically stepping in and saying "We will make it worth your while to keep a bunch of this on hand. Just guarantee me X number of fresh doses and we're happy."

Yup. Here the government is not really maintaining a stockpile as conventionally imagined, but paying industry to rotate inventory through a buffer which is the size of the desired stockpile. Seems like this strategy would have avoided the 'expired PPE' problem we faced at the beginning of the pandemic.

To be fair, California's government required companies to have n95s to deal with wildfire smoke. Those masks were readily available and deployed during covid. It's not always doom and gloom.

https://www.cnbc.com/2020/03/25/apple-and-facebook-face-mask...

Next time your preferred party (whichever one it may be) is looking to cut spending, just remember that everything looks necessary. Then someone gets appointed "to make the tough choices", and we're back at square one.

Drugs in pill form don't really expire, they just lose efficacy. And if stored well it takes a long time. I cant find it right now but someone found some pills that had been stored like 50 years in sealed containers and testing for the activr ingredient showed they were still like 80% or more good.

Shifting priorities upon leadership change is usually the reason for those types of issues. But two party systems have advantages in other ways.

> If COVID taught us anything, the government is going to let these drugs expire useless, incinerate them, refuse to replenish them, and import loads of fakes when an actual crisis hits.

What are you referring to? The US vaccine development, production, and distribution went quite well, all things considered. I remember the loudest complaint being that we weren’t giving away enough of our supply to other countries.

Tens of thousands of people died at the beginning of the pandemic due to lack of medical and PPE supplies. Nurses were wrapping themselves in garbage bags and searching out construction masks.

Yes, this is what I was talking about. It was an avoidable tragedy.

That is literally the opposite of what is happening in TFA. If anything, you are arguing we're overpreparing.

I did not miss that in my comment.

Yeah, lots of reactionary blasting of your comment from people who didn't realise your point was that in future, if the stocks aren't used, some smartass politician is going to be "see!?! we didn't need it! why should we replace the expired stuff?" and leave the stocks at a state where the usefulness for an emergency is nil.

Unfortunately, there's no incentive when spending taxpayer money for the person who "buys" insurance for tail risk events.

I think the question is whether this surge of investment will lead to future complacency or whether the stockpile will be managed and maintained at this level into the future. The US trashed a bunch of masks without replacing them a few years before the pandemic - presumably because someone decided we were spending 'too much' on it.

I hope this is just paranoid anxiety, but never underestimate the power of the federal government's ability to disappoint via reckless reactionism.

Not back-filling all in all was probably a reasonable decision at the time. On the other hand, a lack of on-shore manufacturing capacity to address any on-demand needs is less forgivable. How could we not have a scenario that would have exposed that?

That was the alarming part I saw at the beginning of the pandemic. I had no idea that medical mask/PPE manufacturing had been moved offshore to the extent that it had. It would seem to me to be a capability that any country should have as part of their national biodefense strategy.

What manufacturing hasn't been moved offshore? The majority of it to a country we're told is an enemy? Could the pro-globalization global elites be any less accountable?

You were doing fine until "global elites". There's no organized cabal driving this outcome, just greedy humans solving for local optima that are globally suboptimal

Perhaps. From my vantage point, global elites and greedy humans are synonyms. That is, the greedy who - for their own benefit - pushed the globalization agenda, cleaned up financially, and now are too busy counting their booty to own their role in our current sideways-ness. That latter disconnect is common of elites of any sort.

We're on the same page.

p.s. It doesn't have to be "organized". When there's a common goal, and finite paths to that ends, human behavior automagically begins to synchronize and optimize. Another way to envision it is starlings. No conspiracy, yet highly (enough) organized and "in sync."

https://www.youtube.com/watch?v=UVko9jyAkQg

I hate to break it to you but all humans are greedy. It's a feature, not a bug, and it is in our DNA. Some just don't have an avenue to manifest said greed but would very likely do so if given the opportunity.

Just like you can't expect a woodchuck to not chuck wood, don't expect humans to not be greedy. That will only result in disappointment and resentment.

Rather than trying to fix greed, embrace its inevitability and modify your goals so that you create systems which channel that greed into positive externalities.

We're getting off-topic. I never said it was a bug. What it is, it is. Regardless, some obviously lack self-control to a fault. And regardless of the feature, that doesn't give anyone a free pass on accountability.

I have no problem with greed per se. I also have no problem with those who want to lead. But with those decisions comes responsibility and accountability. Bug? Feature? Not my concern. I'm simply not willing to give out free passes either way.

Not sure if they meant Monkeypox? There was a story in Aug about a substantial stock (20 million doses) of monkeypox vaccine that expired.

https://www.nytimes.com/2022/08/01/nyregion/monkeypox-vaccin...

If it would be much better for these drugs to expire useless than to be used.

> If COVID taught us anything, when an actual crisis hits.

To be fair, nuclear crisis is not at all like COVID. It's one of those things that you can kinda see coming on the horizon. It's increasingly unlikely that, aside from a small scale nuclear attack, nuclear war will spring up without tons of advanced warning; for example, in the forms of degenerating relations between nuclear powers, and saber-rattling. Spending money on up-keep for these drugs isn't the best use of funds, and should only be done during periods of high tension.

And yes, as a society, our preparation for a COVID-like event was weak (in the US, in no small part due to Trump's efforts to reverse Obama-era preparations).

Except there are cases where nuclear emergencies do just pop up, take the Sendai earthquake in Japan for instance. Having some of the drugs ready to go seems like a small price to pay in the grand scheme of things.

do you think the obama administration depleting the stockpile of N95 masks from 2009-2016 made any difference?

see section 3 “The Atrophy of Vigilance in the Strategic National Stockpile”

https://ethics.harvard.edu/files/center-for-ethics/files/23p...

I suppose I made a mistake in getting political, but there's a difference between atrophying something, and sweeping the whole thing into the trash.

Negligence vs Incompetence? From leadership? Different means. Same ends. The difference is semantic.

Until the next batch of Amgen execs needs some more options to exercise for new summer or ski homes.

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