Covid and Bureaucratic Autonomy

The Covid pandemic has raised in an acute way the question of how much autonomy the political authorities in our government should grant to the bureaucratic experts that work for them. A simple-minded principal-agent model would say that in a democracy, the people are the principals who elect representatives—the president and Congress—as first-level agents, who then appoint bureaucrats as second-level agents to implement the policies that the people desire. It is the job of these agents to carry out the politicians’ wishes; they get into trouble when they have their own agendas or pursue their own interests instead of those of the people.

Herbert Simon, the great theorist of public administration, understood what anyone who has worked within a real government knows well, namely, that this model is highly over-simplified. In practice, the bureaucratic agents have a great deal more expertise and knowledge than their political principals. Authority as a result frequently flows in the opposite direction: it is the agents who dictate policies to the principals. Even if the politicians necessarily set broad mandates for desired policies, their implementation requires complex judgments that only the bureaucratic agents are able to make. If the politicians try to manage implementation too closely, either by specifying overly detailed procedural rules, or by arbitrarily interfering in bureaucratic decisions, government will be inefficient, arbitrary, or chaotic.
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All of these problems were manifest in the Trump administration’s response to the Covid pandemic. The United States had a large public health bureaucracy at both federal and state levels, whose advice on combatting the disease was often at odds with the political preferences of the president and many Republican governors. The country’s political polarization was manifest in alternate views of, on the one hand, an incompetent president pushing quack remedies like hydroxychloroquine and bleach over the advice of medical professionals, and on the other an arrogant and out-of-control bureaucracy undermining basic freedoms and motivated by political hostility to the president.

Now that the immediate crisis is abating, we can look back on what happened and try to draw lessons from it. The picture painted by Trump’s critics of noble public health professionals struggling against ignorant and self-interested politicians has a great deal of truth to it, but the full story is actually much more complicated than this. A more nuanced account is laid out in Michael Lewis’ most recent book, The Premonition, that contains a stinging critique of the Centers for Disease Control, but not on the grounds promoted by conservatives. Their fault was excessive risk-aversion, and not their issuing of disliked mandates. And the political intervention that led to bad outcomes in 2020 had its origins all the way back in the 1970s during the Ford administration.

Lewis’ book recounts the story of an informal group of public health officials nicknamed The Wolverines, who in the early 2000s developed new modeling techniques and health responses to pandemic diseases like Covid. Prior to this point, health authorities believed that the only possible response was development and rapid roll-out of a vaccine. The Wolverines’ models told them that while vaccines were the ultimate solution, spread of an infectious disease could be slowed dramatically through measures like closing schools and social distancing. What was critical was the speed with which these measure were undertaken: if political leaders waited until there was unambiguous evidence of a pandemic, it would already be too late to act given the exponential rate at which infections spread. During the 1918 Spanish Flu pandemic, St. Louis fared a lot better than Philadelphia, precisely because it reacted more quickly in imposing city-wide quarantines.

The central struggle described in The Premonition was over getting the CDC to accept the necessity for rapid shutdowns and prolonged social distancing. We have become so used to these ideas since the onset of Covid that we forget they had never been tried before on a large scale—indeed, social distancing probably couldn’t have been done effectively prior to the rise of the internet and the ability of many people to work online. The CDC made other mistakes during the pandemic, like failing to come up with an effective Covid test early on, but its biggest failure was not to recommend a quick shutdown and social distancing on a national scale sometime in early March 2020. This eventually happened, but where it took place it was at the recommendation of state-level officials who were on board with the Wolverines’ approach. Senior officials at the CDC are portrayed as arrogant, rigid, unopen to new ideas, and excessively risk-averse.

This risk aversion did not necessarily come from fear of crossing Donald Trump. Lewis points to the experience of David Sencer, who back in 1976 was the highly respected head of the CDC.

When swine flu was first detected, he and his agency recommended rapid mass vaccination of the whole US population. The vaccine, it turned out, had serious side effects, and the swine flu pandemic never materialized. Sencer was fired by the incoming Carter administration, and the CDC widely castigated for its mistake; Sencer himself suffered a long and humiliating personal deterioration. Lewis notes, however, that in retrospect, many historians believe that he made the right choice. The problem was uncertainty: had a massive swine flue epidemic broken out, the results would have been far more costly than the effects of the vaccination campaign, but no one could have predicted the ultimate course of the disease at the time. But the agency drew a different lesson. According to Lewis, these were the distant origins of the CDC’s risk aversion in 2020.

So what does this complex story tell us about the appropriate relationship between political principals and bureaucratic agents? I would draw several equally complex conclusions.

First, politicians need to rely on and often defer to professional expertise. The Covid pandemic has given us many examples of political leaders failing to take expert advice with tragic results—not just Trump, but Bolsonaro, López Obrador, Modi, and others. Bureaucratic autonomy and respect for expertise is critical to effective government.

On the other hand, they need to treat that advice with some skepticism. The issue is not necessarily the political agendas of bureaucrats, but the fact that experts oftentimes get things wrong, or change their judgments, within their field of expertise. They are neither gods or oracles, and should not be treated as such.

Furthermore, no expert can ultimately be responsible for setting national policy; that is something that has to remain within the purview of political leaders. An epidemiologist or public health official is going to seek to maximize public health, but that is one good that needs to be traded off against other social goods like economic and social well-being. It was common for people to assert in the depths of the pandemic that public health was the route to economic recovery. That sentiment may have been largely true, but to say that there was no trade-off between health and economic well-being is wrong. It is only an elected politician—hopefully one who is well-informed and oriented towards public good—who can ultimately balance these social goods. So there are ultimately clear limits to bureaucratic autonomy.

(There is the interesting case of Anders Tegnell, the head of the Swedish equivalent of the CDC, who opted for a much lighter touch in responding to Covid than the rest of Europe. The Swedish constitution gives final authority in these matters not to the cabinet but to independent agencies like his, guaranteeing a high degree of bureaucratic autonomy in a society that largely trusts government. Tegnell's policy however does not seem to have been based on public health judgments alone, but on his own sense of how to balance health against economic and social goods. He was in effect usurping the role of an elected leader. Swedes continue to debate whether that judgment was right or wrong; the rest of us can ask whether this kind of institutional design was appropriate or not.)

Finally, the CDC case shows why governments are systematically prone to failure. As in the 1976 swine flu case, they are oftentimes blamed for having taken justifiable and even necessary risks. They are never given credit for pandemics averted or wars that don’t break out. This asymmetry in risks and rewards creates a permanent bias towards risk-aversion. Had the US federal government followed the Wolverines’ advice and shut the country down early on before Covid took off and successfully averted a pandemic, it may well have been blamed for alarmism and the undermining of the economy. Whether it will perform better in a future crisis is an open question.