Can We If We May?

America has lost engineering capabilities China now demonstrates.

My mother was always a stickler for the difference between "can" and "may."  If I'd ask, "Can I climb the porch and jump off the roof?" she'd say, "You can, in that you're able to do it, but you may not."

We've written about the thicket of government regulations which, among countless other things: cost the New York Stock Exchange so much that it had to be sold; require air bags which saved few lives at great cost; wipe out low-skilled jobs; hugely increase the cost of automobiles; put people in jail for violating incomprehensible laws; retard cancer research; and many other examples where our government says "You may not do that even if you can, not even if sensible people think you should."

Although Mr. Trump's tax cut understandably receives the lion's share of credit for the current economic boom, his taking an ax to as many regulations as he can also deserves major kudos.  The leftist media "fact checkers" like to cast his claims of red-tape-slashing as a lie; perhaps he hasn't actually eliminated 22 regulations for every new one created, but there's no doubt he's killed off far more than he originated.  It's interesting that the media chooses to castigate him for under-destroying regulations, when they generally believe more regulation is always an unmixed Good Thing.

In fact, the opposite is more generally true as regulations rapidly reach the point of diminishing returns.  Taxes are more or less predictable.  Even though tax rules are made insanely complicated to offer maximum opportunity for politicians to help their friends escape paying their "fair share," taxes on a business venture change seldom and are more or less predictable.

Regulations, however, are not predictable and can change at any time.  We've explained how a politician abused the regulatory agencies to keep a new restaurant from opening even after the would-be entrepreneur had followed all the rules.  Regulations cause uncertainty which quashes innovation as well as entrepreneurship.  That's why we believe that Mr. Trump's whacking back regulatory kudzu deserves equal credit for his boom if not more.

Having dealt at length with the "May not" effect of regulations and knowing that many of our readers have noticed that Mr. Trump's chopping back red tape has had good economic effect, we thought we should switch to the "Can" question of whether we're able to make timely investments that will boost growth or enhance public safety.

Can We?

Part of our ranting against regulations was because we had seen that it now takes decades to do anything constructive, where in time past mere months sufficed.  The planning process to rebuild Highway 30 in Colorado took 14 years.  It took longer to build the 9-11 victim monument - basically a hole in the ground with a roof - than it took to build the entire towering World Trade Center in the first place.

We reported that back in the early 1970s, the head of power generation at Consolidated Edison, the PG&E of New York, estimated that he could build a power generation plant in 9 months if everyone got out of the way, whereas he couldn't built it at all under the then-current regulatory regime.

We remember that when an earthquake destroyed a number of California highway overpasses, the governor told the bureaucrats to get out of the way and the highway was fixed in 1/10 the time expected.  We have always assumed that Americans could get things done if the regulations were cut back.

Recent events, however, have led us to re-think that.

They Can!

When the seriousness of the current coronavirus outbreak in Wuhan was recognized, the Chinese threw up a 1,000 bed hospital in 6 days.  This beat the previous 10-day record, set by a 1,000 bed Beijing hospital erected during the SARS epidemic of 2003.  YouTube has any number of videos showing how it was done from a height, but the details are even more impressing.

Both of these hospitals were built using prefabricated units which were trucked to the site and dropped in place.  Turning prefab shells into a hospital sounds easy, but is actually anything but simple, considering that this is intended as a top-flight isolation hospital for highly contageous plagues.  For example, Siemens China boasted that their team wired up the entire hospital in 38 hours, a project which, they said, would normally take three weeks.

Hospital wiring is complicated, requiring many carefully-separated ground circuits so that stray voltage doesn't get into ICU probes where a small amount of extra current can kill a sick patient.  Wiring normally comes after air ducts and after plumbing, because wiring conduits are easiest to bend in case some other installer put something in the wrong place.

Unless the drawings are done extremely carefully and followed with equal care, these tasks can't be done in parallel because something will interfere with something else and gum up the schedule.  Getting all this done in such a short time indicates organizational and construction skills of an extremely high order - the sort of thing Germans were once famous for, and which Americans used to do routinely, but which we rarely if ever see nowadays.

Electricity Isn't The Trickiest Problem

Difficult as hospital wiring is, the real problem is the air handling system given that the purpose of the hospital is to treat up to 1,000 patients suffering from a virus that spreads easily through the air.

To start with, patients have to be kept in rooms where the air pressure is slightly below outside air pressure so that the virus doesn't escape.  But that alone isn't enough, because you don't want the victims catching things from each other.  So each room must be kept separate from every other room - not to mention the hallways, access spaces, and so on.

Naturally, any air pulled out of isolation wards must be exhausted to the outside through filters that trap viruses, which are very small.  Doing this for 1,000 rooms requires world-class air management on a grand scale.

We know how critical air handling is from the saga of the Diamond Princess, a cruise ship that's been in quarantine in Yokohama harbor in Japan since Feb. 3.  One 80-year-old Chinese passenger from Hong Kong had boarded the ship in Yokohama at the start of the voyage.  The ship called at Hong Kong and passengers went ashore, mixing with the general population of that very crowded city.

By the time the ship got back to Yokohama, the Hong Kong passenger was suffering from what looked like a severe flu.  Japanese authorities knew about the virus and wouldn't let anyone off the ship.  There were 61 cases by Feb. 7, showing either that the Hong Kong sufferer was a "super spreader" or that many passengers had been exposed when they went ashore in Hong Kong or when gathering in communal spaces on the ship.

Among the 3,711 passengers and crew there have been at least 542 confirmed cases, giving the ship the highest infection rate in the world at 14% of the available population.  If that infection rate holds in crowded places like Wuhan or Hong Kong, the epidemic will be serious indeed.

Although quarantining people on the ship seemed like a good idea at the time, we now know that the virus spreads well through a ship's air circulation system.  Just about all of the crew and many low-budget passengers were in rooms without portholes, so they depended on air circulated through the ship's ducts - which, of course, were never designed for virus-rated filters.

We've expressed skepticism of plague statistics coming out of China, but as the number of cases and reported deaths have climbed, fatalities have always come out at around 2%, either by accident or by design.  If 14% of a general population get the disease and 2% of those infected die, .028% of the population will die.

On the basis of past experience with SARS, the British health service estimates that 60% will get the disease.  If they're right and the 2% fatality rate holds, that means 1.2% of the British population will die.  What's worse, it's not clear that recovering from this flu gives immunity - there are reports that a patient recovered, caught the flue, or a slight mutation, again, and died.

Since "only" 14% of the Diamond Princess population have tested positive, we can expect a lot more illness among that group if British estimates are correct.  In that case, the incubation period is a lot longer than the current two week guesstimate.  Many people who were released from quarantine after two weeks will have been spreading the virus and it won't be possible to keep it out of the general population.

In any case, we hope that the air handler engineers in Wuhan did a truly world-class job in their new hospital.  We'll find out!  But the fact that the hospital even appears to be up and running in 6 days is awe-inspiring indeed.

Suppose it Really Mattered?

We've noted that trivia such as environmental impact statements and property rights are non-issues in China.  The Party says "Put it there," and that's where it goes.  Complainers go to jail or disappear.

It's impossible to do that in America.  When Mr. Trump declared a national emergency so that our military could build a wall on our southern border, people who didn't want the wall went to court and blocked part of it.  No Chinese would be so unpatriotic, or foolish, as to question a national emergency decreed from On High.

Suppose, as a thought experiment, that somehow we really got everybody out of the way - environmental, legal, financial, safety, NIMBY, every other obstacle - and told some organization like the Army Engineers to Get It Done Yesterday!  Could we build a hospital to the standards needed to contain this disease in that short a time?

A truly motivating emergency isn't that hard to imagine - nobody wants to die from the plague, and the military owns vast tracts of empty land subject to nothing but federal law and the Commander-in-Chief.  If the coronavirus were to take hold here as in Wuhan, we fully expect The Donald to sign just such an executive order, to the massed applause of worried voters.

Unfortunately, that wouldn't be enough to actually get the hospital built in 6 days, or even 6 months.

Unlike the Chinese, we don't have standard hospital plans - have you ever seen two American hospitals that looked even remotely alike?  We certainly have no factories churning out prefabricated units that could be assembled into a hospital.

The British can't do it either, which is why they're saying people will have to self-quarantine if the virus breaks out.

Could our engineers work out designs to knock together hospitals like Legos?  Sure... eventually, by which time it would be far too late.

Let's look at something simpler, like making 10-cent disposable masks used to stop the virus from spreading through the air.

The South China Morning Post describes mask production in China:

China, which accounts for about half of the world's mask production, is scrambling to snap excess supply from overseas, both through official diplomatic channels, and buyers like Cai [who travels to pharmacies and buys up all the masks he can find].

Demand for masks has surged in recent weeks, exhausting not just China's stockpile, but emptying shelves from Bangkok to Boston. In China, it is now mandatory to wear facial masks in public areas in many cities.

Chinese mask makers are currently operating at 76 per cent capacity, which puts daily production at 15.2 million masks based on the industry's reported capacity to produce 20 million pieces a day, Cong Liang, an NDRC official, said at a press conference in Beijing on Tuesday.

Daily demand, however, is estimated to be between 50 and 60 million units during the outbreak, according to Chinese media reports citing mainland mask manufacturers.  [emphasis added]

Daily demand in China is now 2 or 3 times their maximum production capacity.  They won't be able to make it up by grabbing the rest of the world's mask production because any nation that can make masks will keep them.  Could they make more?  Not to worry: they're slapping together a new mask factory in under a week.

They clearly know how to make machines to make masks and they can raid their garment industry to assemble armies of seamstresses to make them by hand.  How many masks could one sweatshop employee sew in a 12-hour day when motivated by a credible threat of very unpleasant deaths for all their friends and relatives?

In a way, this is even more impressive than the 6-day hospital.  China is home to around 1.5 billion people, and up until very recently they had very few modern hospitals if any at all.  Even without the coronavirus, they had every reason to expect tens of thousands of new hospitals to be needed in the coming years.

One of the advantages of an all-powerful central government is that it can easily standardize things.  Clearly, some Communist Party official led a team designing "Standard Hospital Models A-F," distributed the plans, and set up "The People's Hospital Factory" to crank them out.  They're just turning the crank harder these days, is all.

Nobody would have anticipated the need for a factory that mass-produces mask factories, yet they've managed to wave the wand and create those too.  How long will it be before they meet their needs and are willing to resume mask exports?

Our population is about 1/4 of China's.  Could we make 15 million masks per day to supply our needs if daily masking was required for a similar fraction of our population?

Google believes that Americans manufacture 27.4 billion disposable diapers per year.  Masks take less material, but leaks and hidden defects are fatal as opposed to merely inconvenient.

We'd need on the order of 7 billion masks per year.  The experts at Procter and Gamble could probably retool a diaper machine to make masks, but how long would it take?  How many masks could one re-purposed diaper machine make in a day?  Could they rebuild a machine or make a custom mask maker in 10 days?  Probably not - and then we'd have a diaper shortage, which isn't a good idea if half the country is sick with the flu.

What if everybody in America needed one every day?  350 million masks per day is nearly 130 billion masks per year, far more than our 27 billion diapers.  Not a chance.

There Was a Time

There was a time when we could grind things out.  Every one of our soldiers who fought in WW II remembered the Great Depression, during which everyone had to make do with whatever they had.  They had to learn to tinker, to "Use it up.  Wear it out.  Make it do, or do without."

Google wasn't around during WW II, so it doesn't remember the story of an Air Force general demanding that Douglas aircraft install a radar on a bomber in 90 days.  The boss tried to stall, "We'll need a plane,"  "My guys just landed one at your field," the general said.  "They'll leave you the keys."  The job got done.

We've lost that ethos.  We no longer have a well-developed culture of tinkering.  Instead of learning to tweak cars as the previous generation of teenagers did, kids play video games.

We aren't really prepared for the mass mobilization of building hospitals and making all the medical bunny suits that will be needed to replace shipments from China if the virus breaks out into our population.  We don't live that way, we don't think that way, and we certainly don't work that way - because over the decades, bureaucracy has made sure we can't.

The Chinese are better positioned to crank out whatever they need to fight the virus.  This is one of the few situations in which an undemocratic central government can be enormously more effective than a sclerotic democracy answerable to whichever people are screaming loudest.

What's more, the Chinese can lose a lot more people without their civilization falling apart, if for no other reason than that they have a lot more people to start with.  Within living memory, their government intentionally murdered a huge fraction of the Chinese people, far more than the virus is on track to do - and yet their government and civilization, such as it was, soldiered on.

So from the standpoint of societal resiliency, China has already been tried and passed the test of surviving a plague of death-dealing human beings.  No virus could possibly match that.

Will Offensicht is a staff writer for and an internationally published author by a different name.  Read other articles by Will Offensicht or other articles on Foreign Affairs.
Reader Comments

I think you are underestimating the ‘can do’ capabilities of the American manufacturing engine. There are still plenty of tinkerers in businesses all across this country who use their experience and skills to squeeze a profit under very difficult circumstances.

In fact, the coming need for a response to the Corona Virus once it reaches the US shores in force might even inspire a few millennials to put down their phones and get to work solving the problem.

February 20, 2020 1:41 PM

@Stan - We sincerely hope that all the tinkerers haven't retired. As for teh virus, there are now 600 cases on the ship for an infection rate of 16% and counting.

Forbes tels us that it transfers through the air and also through feces.

The agency recommends strengthening sanitation and hygiene measures to prevent fecal-oral transmission in epidemic area. These include drinking boiled water, avoiding eating raw food, implementing separate meal systems, frequent hand-washing, disinfecting toilets, and preventing water and food contamination from patients’ stool.

“The virus can also be transmitted through the potential fecal-oral route,” the Chinese CDC said. “This means that stool samples may contaminate hands, food, water” and cause infection when the microbes enter the mouth or eyes, or are inhaled, they said.

Rectal swabs can detect the pneumonia-causing virus in patients even when conventional oral tests are negative, doctors at the Wuhan Pulmonary Hospital in central China said in a study.

The novel SARS-like coronavirus was found in oral and anal swabs, and blood -- indicating that infected patients may shed the pathogen through respiratory, fecal-oral or body fluid routes, the authors said.

They showed that the current strategy for detecting viral RNA in oral swabs used to diagnose Covid-19 cases “is not perfect,” the researchers said. They noted that patients may harbor the virus in the intestine at the early or late stage of disease, and that a blood test for antibodies against the virus should be considered to better understand patterns of infection.

February 20, 2020 8:35 PM

@WO- Thanks for the additional info on the Covid-19 Virus. Sounds like masks alone won’t do the trick. However, frequent hand washing with isopropyl alcohol, especially after using the bathroom or being exposed by touching suspect surfaces, will likely reduce one’s chance of infection. This advise is good for protection against all viruses including flu and the common cold.

It will not take long for entrepreneurs in the US to be producing and distributing masks and alcohol hand wipes. The siren call of profits will energize this activity.

February 20, 2020 9:33 PM
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