Michael A. Dennis and Anand Toprani
We knew it was serious in early 2020 when Captain James T. Kirk addressed the nation through his sleep apnea ad. Rather than hawk a machine to clean CPAP machines, he asked sleep apnea sufferers to donate their old or unused devices to their local hospital to help patients suffering from COVID-19. William Shatner’s transformed infomercial was simply the most-visible aspect of a nationwide mobilization that echoed that of World War II. While the novel coronavirus was neither Imperial Japan nor Nazi Germany, it threatened to kill a Pearl Harbor or more of Americans every day. The war metaphor colonized public discourse so effectively that protestation proved worthless except for a handful on the lunatic fringe still warning of budget deficits and inflation. Rather than fight the metaphor, policymakers in the administration chose to lean into it.
Plenty of historians brought up the analogy of World War II mobilization when the crisis first began. Their work paid familiar obeisance to the image of B-24s rolling off the Willow Run assembly line; yet, their analyses also left unmentioned two indispensable ingredients of the U.S. production miracle, the artificial intelligence of its day: alliances and infrastructure.
Looking up one of the assembly lines at Ford's big Willow Run plant, where B-24E (Liberator) bombers were made in great numbers. (Howard R. Hollem/Wikimedia)
The Allies’ victory in 1945 was an allied victory. Americans never forgot the contribution of their allies. Britain, France, and their empires had first confronted the Nazi advance and lifted the U.S. economy out of the Depression through arms purchases starting in 1938 until Franklin Roosevelt—and the Japanese—could convince the American people to enter the war. Once it became a belligerent, the United States also served as the arsenal of democracy for the entire Grand Alliance, supplying both GIs and allies. The United States even bankrolled the war effort through Lend-Lease, which it virtually wrote off at war’s end. And even the on-going animosity with Russia could not entirely obscure the fact that the Soviets had paid the blood tax against the Wehrmacht—the Red Army suffering almost as many casualties during the fight for Berlin as the United States did during the entire war.
Just as important as the contributions of the United States’ allies was the existence of a state-of-the art industrial infrastructure, staffed with skilled labor, and using techniques honed during the lean years of the Great Depression. It was this infrastructure, with its high total-factor-productivity, impressive stock of high-tech machinery such as machine tools, and cadre of skilled labor, managers, and even economists that made the production miracle possible.
Historians understood the mobilization was imperfect, involving a gamble that capped the U.S. Army at 90 divisions to maximize production. Equally important, the United States of 2020 was not the United States of 1945—fifty years of offshoring production and supply chains to exploit cheaper sources of labor saw to that. The absence of a massive industrial base demanded a different version of wartime mobilization.
First, recognizing that the virus, rather than the People’s Republic of China, was the enemy—much as Roosevelt and Winston Churchill leaped to help Joseph Stalin following Germany’s invasion of the Soviet Union—the United States reached out to China with two questions: What can we provide that will help you contain the virus? Failing that, what can we do to help both our nations and the world prepare to cope with the coming pandemic?
Chinese President Xi Jinping visiting a Wuhan hospital. (DPA)
It was clear to the authorities in both nations; if anything escaped Wuhan, it would move quickly across East and Southeast Asia to the United States and Europe. The creation of the Chimerica Virus Control Board in January 2020 marked the beginning of unprecedented cooperation between the United States and PRC—mirroring on-going cooperation among the world’s central banks—extended by engaging the World Health Organization and the European Union as a new Grand Alliance.
Americans still had the problem of how to build weapons to challenge the virus. Conventional military power was worthless under these circumstances. The nation’s national-security establishment—the only well-resourced part of its federal government for the last forty years—could contribute little to this struggle or similar challenges in future.
Game plans derived from the H1N1 scare and the Ebola Crisis provided only partial solutions for the respiratory illness the virus generated in humans. U.S. manufacturers began the time- and capital-intensive effort of retooling their limited production capability to make masks and essential protective garb. They were at a profound disadvantage compared to their World War II forebearers due to the de-industrialization and financialization of the U.S. economy since the 1970s. Additionally, U.S. industry had over two years to prepare before commencing all-out production following Pearl Harbor. The sudden outbreak of the virus and its quick spread deprived the United States of time to prepare, presaging a repeat of the disastrous experience of World War I, when U.S. production only started as the war ended.
Another problem was the convoluted supply chains upon which U.S. firms relied upon for their just-in-time business model. For example, DuPont manufactured Tyvek, a material from which medical bunny suits were made, in the United States but sent it to Vietnam for transformation into outerwear. Invoking the often-used Defense Production Act, the federal government used shuttered mills to provide a base for the tailoring of the garb within the United States. Taking advantage of the nation’s aging population, the government hired former seamstresses and tailors to craft the new suits on production lines designed to slow the spread of the virus. Retired clothiers instructed high school seniors and underemployed millennials in the methods of assembly, as manufacturing experts from China and Vietnam reimagined production lines for those with only minimal skills. By mid-February, the new factories began alleviating shortages as the first cases appeared in east and west coast emergency rooms.
Mask Production (Synced)
Bowing to pressure from hardliners and the example of other nations, the president implemented a travel ban on flights from China on 2 February 2020, but it was a symbolic move—over 430,000 people arrived in the United States between New Year’s and early April, and there were no facilities to quarantine people who had travelled to China or been exposed to such people. An earlier travel ban might have made a difference, but the 40,000 people who traveled from China after the travel ban revealed how interconnected the two nations had become. When researchers discovered a COVID-19 California death in early February, it proved that community spread had begun in January or earlier.
It wasn’t just supply chains that mattered, but families and the flow of individuals and knowledge that produced a profound set of relations not easily disentangled. The People’s Republic of China might have been the source of the problem, but it was also part of any solution, since the United States could not manufacture necessary pharmaceuticals.
To its credit, the American public did not engage in hoarding or panic buying. Instead, transparent communication from public-health officials made clear what was necessary to “flatten the curve”––primarily, to stay home. That meant lost paychecks, and Americans lived such precarious financial existences that few had the savings necessary to weather the storm. To direct money into individuals, Congress appropriated funds to pay businesses to keep their employees on the payroll at either their regular salary, or a new minimum wage of $15 an hour. Arrangements for gig workers and those receiving 1099s made it so that few people were left out.
Such unparalleled measures pursued a single goal—to put the economy on ice to slow the spread of the virus. Workers at essential services, especially those related to food distribution and production, received a modest bonus, plus access to protective equipment. In Midwestern meat and poultry factories, government inspectors and agricultural engineers transformed production processes to reduce labor intensity and concentration. Protein production, like aircraft and missile production in the Cold War, benefitted from the remnants of the U.S. entrepreneurial state.
Such unparalleled measures pursued a single goal—to put the economy on ice to slow the spread of the virus.
Crisis circumstances made it necessary to embrace staggered shifts, a forced rethinking of production, and a willingness to learn or—if necessary—copy from others. For inspiration, historians pointed to the fiasco during World War II, when U.S. Navy submariners labored with torpedoes that rarely worked. When the Naval Torpedo Station in Newport, Rhode Island refused to believe reports and blamed the submariners, the Navy hired Westinghouse to copy a new electric torpedo stolen from the Germans.
American hospitals rather than the high seas were the battlefield in this conflict, and the government soon found out what critics already knew: a for-profit healthcare system cared more about big equipment and administrative processes than hiring skilled nurses, respiratory therapists, and maintaining an adequate stockpile of ventilators. During World War II, Secretary of War Stimson declared, “You have got to let business make money out of the process [of production] or business won’t work.” The U.S. Government could not rely on businessmen’s altruism.
In 2020, the issue was somewhat different—healthcare is not a plane or a truck. The government decided to do for hospitals what it had done during World War II for academic research: a policy of no profit, no loss. Hospitals would receive funds to cover their expenses, their payrolls, and their overhead. Hospitals could also recruit workers from other regions and the government would assist in creating a registry to facilitate movement to hotspots, just as the nation’s ventilator stockpile allowed for the transfer of machines between regions.
Shatner’s call for CPAP machines harvested a fair number of devices that, with modifications, kept some COVID-19 patients alive without intubation. Surge capacity, built by military contractors, provided extra space for those patients for whom intensive care unit admittance was unnecessary but for whom staying at home might spread the infection. The new spaces, including arenas and specially constructed shelters also functioned as fever hospitals, an idea imported from China and Europe. Here the sick, separated from their families, received palliative care. Simply putting patients on their stomachs kept some intensive care units from being overrun, and the use of cheap pulse oximeters revealed that many asymptomatic patients were ill.
In a display of social distancing, people sit far apart while waiting to be tested for COVID-19 at a makeshift medical testing center in Kuwait. (Xinhua)
The United States now discovered another problem: many of its overworked doctors, nurses and other front-line workers were immigrants and not easily replaced. As in the factories, skilled labor was the key variable. Fortunately, health care workers from states not yet suffering from overwhelming cases fortified those in hot spots, just as Chinese physicians from outside Wuhan went there to help their fellow physicians. Retirees, fresh graduates, and students from the nation’s medical and nursing schools also supplemented those in hospital emergency rooms.
Social distancing and putting the economy on ice ended up buying the U.S. some time, as did the efforts of American allies. Americans rediscovered that they were stronger with their friends than alone. Pooling resources and distributing tasks allowed for larger supplies of personal protective equipment where they were needed. Most importantly, the U.S. biomedical research system, suffering from reduced funding, demonstrated tremendous resilience as teachers and their foreign students, back in their home countries, collaborated to generate therapies and work towards potential vaccines. Scientific internationalism, plus networked communication, meant that researchers could work continuously on problems, transferring research ideas and quickly finding out what practices did and did not work in both the clinic and the laboratory. But despite their efforts, a vaccine was not immediately available, and it was unclear if one was even possible for COVID-19.
Still, in our alternate history, Americans and their leaders learned important lessons. First, the cost of letting finance dictate the structure of the U.S. economy was too great, especially for a nation that aspired to play a role of global leadership. Allowing firms to offshore production to exploit low wages provided for cheaper goods, but unfettered capital mobility was a crippling handicap for a nation beset by a pandemic. Second, skilled labor, particularly in manufacturing and in other industries, takes time to develop—it is not a resource that one can reconstitute with a finger snap or a problem at which one can throw money. Services are important, as is consumption, but the pandemic showed that Americans must find a way to reconcile consumption and growth with security—a challenge they cannot afford to ignore if they want to deal with other wicked international problems such as climate change.
Michael A. Dennis and Anand Toprani are professors of strategy and policy at the U.S. Naval War College and visiting professors of public and international affairs at Brown University. They were also among the first recipients of the Applied History Course Development Grant from the Stanton Foundation in 2018-2019. The views they are expressing are their own and not those of the Naval War College, the U.S. Navy, the Department of Defense, or the U.S. Government.
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Header Image: The USNS Comfort medical ship moves up the Hudson River past the Statue of Liberty as it arrives on Monday in New York. (AFP)