CoH, is it the size of the problem or the type of the problem which can best be addressed at a global, national, state, or local level...or a combination of levels?
Good question. In the typical disaster, the event lasts usually less than a day. All efforts are then focused on immediate emergencies and then longer term recovery. This is my experience in the Big Thompson flood and the focus of the few programs I attended about disasters. (FWIW, the Tennessee tornadoes are old news, but I know that the FEMA and many in local government are still working full time on that).
A pandemic is different, the event drags on, and will drag on, for months. The recovery won't be carried out in terms of rebuilding physical and business in confined damaged areas, but in terms of community, state, and national economic recovery.
I guess my answer to your question is no matter what the disaster, or how long it lasts, the front line response has to be local and state government. This is where the legal and governmental infrastructure is found to issue the appropriate orders and directives on short notice. State and local government always will have funding issues because those governments are required to have balanced budgets and borrowing authority is severely restricted. On the other hand, as we know, the feds can make money out of thin air. Obviously for something with the scope of this pandemic, the roles of national, state and local government become more blended. But overall, I think Trump was exactly right when he, for example, directed state agencies to procure needed supplies while making it clear the Feds were there for backup and financial assistance. Except for the VA, the feds don't routinely run health care facilities or procurement and distribution of medical equipment and supplies. It makes no sense for the feds to take on that responsibility during a crisis. Obviously the DOD has emergency health care capability which is now in full deployment.
I keep flashing back to the comment made by a FEMA official during a program I attended about pandemic being his biggest worry and why FEMA didn't instruct about that. Part of the post Katrina congressional response and driven by the shortcomings of state and local government with that disaster, was a requirement for FEMA to embark on a program to educate state and local government about disasters. That's how I attended those programs. The feds required local designated emergency officials, emergency plans, and other kinds of advance planning. Our designated official was a sheriff's captain. Conspicuously absent from this training was, of course, pandemic training. That will obviously change now. I envision similar programs involving state and local public health departments and hospitals for planning and training.
As awful as this pandemic is, one favorable outcome hopefully will to clean the bullshit out of our governmental infrastructure and bring more attention to efficiently carrying out core missions.
Sorry, this turned out to be more long winded than I intended.