A window into military affairs - yes, the process was followed to a T in the DoD, as it always is, and very similar to the process at CDC but with less visibility because DHA (Defense Health Agency) is part of the DoD. Data calls are a regular feature in DoD, followed by organizations asking for clarifications, delaying, ducking, trying to figure out what will keep them off the red lists which are discussed in private at higher levels. A call will come out from one organization to its subordinates, but there will be a cross-cutting call from another organization with a related purpose asking for things in a slightly different format, maybe for a slightly different purpose. Perhaps Public Affairs wants to show how well things are going, but Defense Logistics needs to anticipate class 8 (medical materiel) requirements, and the MTFs (treatment facilities) need to gauge patient load...
Anyway, this is all pretty similar to the way CDC and HHS squabbled over COVID data calls going out to states, localities, hospitals, clinics, physicians... the question of what is a reportable illness, what the timelines are, what the diagnostic standards are, who gets to set them, the format of the reports, whether personal information can be included - or whether including it means a sudden-death report to Civil Rights as a HIPAA violation and an investigation - it's all about dynamics inside very large organizations, so large that they have ceased being a single organization, in many ways.
The DoD components and agencies try hard to keep their sights aligned, but a large fraction of COVID related orders for quite a while were about data reporting requirements, subtle and not so subtle shifts in what got reported, to whom, how and when. This also dogged public health and was additionally made a political hot football in the context of the press. In the DoD, the same data is sometimes weaponized as an intra-organizational tool, and so people are similarly cautious and feisty about the data calls.
Three cheers to Emily Oster. Data quality is always terrible in any large organization. What boggles me is that people keep trying to use terrible data and make meaningful arguments around "it is the best data available" as though the answer to having bad, spoiled ingredients for a cake is to just go ahead and make the cake.
Can any number of government agencies at various levels across fifty states and federal organizations, sitting on top of city and county level organizations, actually collect coherent data and make it available in a consistent and meaningful format? I am not optimistic; businesses have trouble doing that at a much smaller scale, for a more focused audience, with a more limited scope, and a profit motive behind it. I think that in many cases we need to get used to the uncertainty and vagaries of what we can know, and at least acknowledge we are mostly blind at the large scale.
On the shot clock concept, I know Brisbane (Australia) has something like this. Don't know the details, but I have a friend who is an architect/developer and had a development proposal automatically approved because the planning department didn't object in time. And yet it remains a very livable city. Who'd a thunk?
That last point is already the law in California. Permits that don’t require environmental review are supposed to be automatically approved in 90 days after submission if no determination has been made before then. The city of San Francisco has admitted to be out of compliance with this law for 20 years. Who’s going to enforce it? https://sfbos.org/permit-streamlining-act
A window into military affairs - yes, the process was followed to a T in the DoD, as it always is, and very similar to the process at CDC but with less visibility because DHA (Defense Health Agency) is part of the DoD. Data calls are a regular feature in DoD, followed by organizations asking for clarifications, delaying, ducking, trying to figure out what will keep them off the red lists which are discussed in private at higher levels. A call will come out from one organization to its subordinates, but there will be a cross-cutting call from another organization with a related purpose asking for things in a slightly different format, maybe for a slightly different purpose. Perhaps Public Affairs wants to show how well things are going, but Defense Logistics needs to anticipate class 8 (medical materiel) requirements, and the MTFs (treatment facilities) need to gauge patient load...
Anyway, this is all pretty similar to the way CDC and HHS squabbled over COVID data calls going out to states, localities, hospitals, clinics, physicians... the question of what is a reportable illness, what the timelines are, what the diagnostic standards are, who gets to set them, the format of the reports, whether personal information can be included - or whether including it means a sudden-death report to Civil Rights as a HIPAA violation and an investigation - it's all about dynamics inside very large organizations, so large that they have ceased being a single organization, in many ways.
The DoD components and agencies try hard to keep their sights aligned, but a large fraction of COVID related orders for quite a while were about data reporting requirements, subtle and not so subtle shifts in what got reported, to whom, how and when. This also dogged public health and was additionally made a political hot football in the context of the press. In the DoD, the same data is sometimes weaponized as an intra-organizational tool, and so people are similarly cautious and feisty about the data calls.
Three cheers to Emily Oster. Data quality is always terrible in any large organization. What boggles me is that people keep trying to use terrible data and make meaningful arguments around "it is the best data available" as though the answer to having bad, spoiled ingredients for a cake is to just go ahead and make the cake.
Can any number of government agencies at various levels across fifty states and federal organizations, sitting on top of city and county level organizations, actually collect coherent data and make it available in a consistent and meaningful format? I am not optimistic; businesses have trouble doing that at a much smaller scale, for a more focused audience, with a more limited scope, and a profit motive behind it. I think that in many cases we need to get used to the uncertainty and vagaries of what we can know, and at least acknowledge we are mostly blind at the large scale.
On the shot clock concept, I know Brisbane (Australia) has something like this. Don't know the details, but I have a friend who is an architect/developer and had a development proposal automatically approved because the planning department didn't object in time. And yet it remains a very livable city. Who'd a thunk?
That last point is already the law in California. Permits that don’t require environmental review are supposed to be automatically approved in 90 days after submission if no determination has been made before then. The city of San Francisco has admitted to be out of compliance with this law for 20 years. Who’s going to enforce it? https://sfbos.org/permit-streamlining-act