government takes control of monoclonal antibody distribution

this is going to be a debacle even it it does not get politicized. (and it will get politicized)

while most of the attention from the recent biden speech has focused on the bitter, impotent granddad threatening to “turn this car around if you kids don’t stop screwing around back there, i mean it it!” there was another facet beyond the vaccine mandates that warrants consideration:

biden ordered the federal government increase control and supervision of the distribution of monoclonal antibodies, a highly effective form of covid treatment currently in widespread use, especially in florida and texas.

nothing strikes fear into the heart of right-thinking, effective humans everywhere like the words “i’m from the government and i’m here to help.”

these words are all the more pernicious when they are applied to a market that’s already working because only government is so stupid and venal as to try to fix something that is not broken to try to take credit for what was happening anyway.

and, inevitably, you get a total fail because there is nothing government is better at providing or distributing than the private sector is. if you need to get bottled water to a hurricane zone, who would you trust? FEMA or walmart? it’s not even close. and this is why the government assuming control of distribution of antibody infusions is going to be so dangerous: the best you can expect is incompetence and inability to read or respond to market signals.

government will ALWAYS do the wrong thing even when acting with the best of intentions because they have no way to know what they are doing. they do not face real price signals, real market data, or real market discipline. the literal point of government intervention is to break pareto optimality and force inefficient choices and allocations. the free market would have already handled the efficient ones and making mABS “free” when they are also scarce is a recipe for a tragedy of the commons. layer onto that the fact that rather than being steered by the efficiency and accuracy constraints of competition, government serves only talking points, optics, and entrenched bureaucracy, and you get this:

and this is literally the best case scenario.

what you really get is something altogether worse and more politicized.

remember HCO? (hydroxychloroquine) maybe it helped, maybe it didn’t (the evidence looks ambiguous to me) but what surely did not help was NY state taking control of all distribution, making it impossible to get, planning to run a big trial using it, then totally failing in its attempts to do so. supply went to zero, pharmacies could not get it, and the trial never really happened in any useful way turning into a 6 month morass of muppetry and incompetence.

remember ventilators? same thing. the government pushed allocation, let a few states (like NY) hoard them, pushed for massive production, then learned too late that the “vent early vent hard” polices (used mostly to protect HCW’s) were killing patients in droves. they were subsequently abandoned, proning more akin to TB treatment adopted, and warehouses full of surge-produced equipment are gathering dust.

remember the debacles of government disrupting distributions of masks as soon as they waded into that market?

it’s been one after another, total failures and epic disruptions, on and on, world without end.

but this time will be different?

well, maybe. this time looks to be worse because this time looks to have STARTED with an overtly political agenda.

texas and especially florida were having a great deal of success with this treatment. desantis in particular had hung his hat on it pushing centers and treatment in schools and this success seems to have been intolerable for a president determined to “put these governors in their place.”

so, stunningly, the very same fellah falsely hectoring the unvaccinated for “using up all the medical care and deny it to others” put in place a set of programs to ensure that those who need this potentially lifesaving treatment cannot get it in a timely fashion.

and the effects are already showing up.

same doctor, sept 11:

“Still no antibodies today. It seems that they won't be sending more. I've referred several patients elsewhere but it's very frustrating not being able to offer the most effective COVID treatment to them. I reached out to the distributor but haven't gotten a response.”

and then we land here:

HHS has jumped into the middle of the supply chain, because, what every sick patient needs is a delay injected into getting their potentially life saving medication so a federal agency literally synonymous with slow, bungling, politicized bureaucracy can shuffle some paper around, review things, and leave you in harm’s way so they can pretend they helped.

the HHS, from 1000’s of miles away is now taking control of choices doctors make for their patients and can deny access to care at whim (and based on god knows what criteria).

“let’s take choice away from medical professionals with personal knowledge of each situation and hand it to a bureaucrat with a degree in accounting system design in DC!” really?

can this possibly look like a sound basis for public health to any sane human?

(anyone reminded of the obamacare death panels?)

and i’m sure it’s just a coincidence that the states refusing to accept the outlandish overreach of vaccine mandates are the first ones feeling the pinch, right? this combined with the wholesale firing of doctors and nurses over forcing them to take a vaccine against their own medical judgement will start setting up some truly nasty medical crises and shortages.

but this is not a virus’s effects. it’s not a market failure. this is a failure of government whose determination to wreck that which was functioning and play politics with lives while accusing and othering their enemies for doing so has led us here. they are literally creating a disaster so they can accuse their enemies of it.

this has no place in medicine, public health, or even basic morality. these are the actions of a tyrant turned monster.

meanwhile, as ever, the veterinarians seem to be getting all the good drugs.

perhaps if the gorillas are clever, they might even trade some mABS to the zebras for some ivermectin…

my possibly reliable sources are telling me that this is going to be the hot fashion accessory for the fall hospital season.