Centralized state response is almost universally considered as the first best option for managing pandemics. This paper argues that in reality, states fall short of this ideal. Knowledge problems hinder the government's disease acknowledgement, resource allocation and feedback, while compulsion, political predation, and corruption exacerbate the situation further. On the other hand, a decentralized, voluntary response may overcome knowledge problems and opportunism through effective signals such as prices, better incentives, local knowledge, and internalization of disease-related externalities. This results in a speedier, more effective, and responsive pandemic management, which also accounts for differences in risk preferences, and becomes a feasible second-best option. I then apply these insights to Russia and its history of disease management. I focus on three diseases: plague, cholera, and COVID-19, which results in a historical analysis that spans multiple centuries and different institutional settings. I show that government-led pandemic response in Russia has been riddled with knowledge problems, abuse, political predation, and violence. On the other hand, a decentralized response was quicker and more effective at managing the disease, often emerging even in the most unfavorable circumstances.

中文翻译：

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去中心化应对大流行病是第二好的：俄罗斯的例子

集中的国家应对措施几乎被普遍认为是管理流行病的最佳选择。本文认为，在现实中，国家达不到这一理想。知识问题阻碍了政府对疾病的认识、资源配置和反馈，而强迫、政治掠夺和腐败则进一步加剧了这种情况。另一方面，分散的、自愿的应对措施可以通过价格、更好的激励措施、当地知识以及疾病相关外部性的内部化等有效信号来克服知识问题和机会主义。这导致了更快、更有效、反应更灵敏的流行病管理，这也考虑到了风险偏好的差异，成为可行的第二佳选择。然后，我将这些见解应用于俄罗斯及其疾病管理的历史。我重点关注三种疾病：鼠疫、霍乱和 COVID-19，这导致了跨越多个世纪和不同机构环境的历史分析。我表明，俄罗斯政府主导的流行病应对措施充满了知识问题、滥用职权、政治掠夺和暴力。另一方面，分散的应对措施在控制疾病方面更快、更有效，即使在最不利的情况下也常常出现。