I’ve spent the last couple days writing posts I’ve then set aside about what we’ve learned in two years about the CDC and FDA and whether they are, institutionally, up to the challenge of managing the crisis of pandemic response. To paraphrase Sonny Corleone, during a pandemic we need a wartime CDC. And it’s clear we don’t have one. The institutional apparatus designed for managing ‘ordinary’ infectious diseases, researching and improving care for chronic maladies simply isn’t designed for what we’ve confronted in the last two years.

Back in 2016 there was a knowing social media go-to about how 2016 was the year from hell – one that would come to an end when Trump was defeated in November. Of course, that didn’t happen. It was followed by 2017, the beginning of Trump’s dismal and destructive presidency. Then there was 2020, a year of historic disruption, mortality, economic displacement and social chaos and unrest, which was to be followed by renewal in 2021. And well, here we are. We’ve run through a succession of ‘hell years’ beneath which rumbles a growing trepidation or assumption that maybe none of this stuff is the exception. Maybe this is just a downward trajectory with no snapback to something more normal, something more on a progress toward betterment.

On the eve of a new year where do we fall on this terrain of doomism?