Economists aren’t doctors and doctors aren’t economists. At least most of the time.
If I had to choose between the two types of “experts” to advise policy makers on how best to respond to a pandemic, I would choose the economists.
First things first: in an ideal world nobody would be making society-wide rules for how individuals behave; in the real world tough choices have to be made in an environment of imperfect information. That’s why most of us are very forgiving regarding some of the decisions made during the initial days and weeks of the COVID pandemic. Without good information it made some sense to consider a worst-case scenario and act to prevent it.
But as real-world data came in from places other than China the excuses for poor decisions become thinner, and the ceding of public policy choices to public health officials becomes unforgivable. I say this not only based upon the poor quality of the medical decisions they made–and they made many–but upon my belief that public health officials should never have the last word on any public policy.
That may seem odd to many people; after all, when talking about medical issues shouldn’t we listen to the doctors? Public health officials surely know public health far better than politicians or, God forbid, economists!
True enough. But even assuming that the public health officials knew exactly what they were doing–an assumption clearly not borne out by experience–arranging the affairs of an entire society is not simply a matter of public health. Every decision has costs as well as benefits, and not weighing both can easily mean that decisions made can impose costs far higher than the benefits derived.
This is a basic truth that informs all decisions in our society. It, theoretically at least, is embedded into all our regulations, our medical decisions, our purchases, everything. Nothing is cost free, and sad to say but we don’t value life at an infinite number of dollars and without considering costs to everybody involved.
We could avoid every automobile death at the expense of getting rid of automobiles. Every risk reduction tends to also cost a reward reduction as well. We balance everything as best we can and life moves on.
Public health officials, at least when it came to avoiding COVID deaths, didn’t think this way. If you look at the decisions made over the past 3 years there was precious little weighing of costs and benefits. Not just in terms of dollars, but in some of the most basic ways imaginable. Learning loss, loved ones dying alone, social friction, supply chain disruptions, economic losses including business closures. Everything imaginable was put on the chopping block in the name of COVID mortality and morbidity reduction.
We don’t do that with anything else, including other medical issues. It was insane. It still is.
Economists are trained to look at balancing costs and benefits, and while relatively few were initially educated enough in the potential costs and benefits, some were. Such as Dr. Dr. Jay Bhattacharya of Stanford. He is a Professor of Health Policy at Stanford University and a research associate at the National Bureau of Economics Research. He directs Stanford’s Center for Demography and Economics of Health and Aging.
The Wall Street Journal featured a column on the deplatforming of Dr. Bhattacharya which makes for good reading. The good doctor only joined Twitter in 2021, although by then he was an incredibly polarizing figure. He shouldn’t have been–as an MD and economist who works with the National Bureau for Economic Research he is quite mainstream. But his views differed with the powers that be:
Jay Bhattacharya, a professor of medicine at Stanford University, was a latecomer to Twitter, joining in the summer of 2021. In his first tweet, he linked to a recent article he had written that discussed age-based mortality risks and natural immunity, among other topics. His main message was powerful and contrary to Covid policies enacted across the country. “Mass testing is an insidious form of lockdown by stealth,” he wrote. Many Americans, especially parents of school-age children, would agree. But it’s possible that many on Twitter didn’t see his message.
This week Twitter released a set of internal emails and documents from before Elon Musk’s takeover of the company in October. One of the revelations was that Dr. Bhattacharya, among many others, had been censored and shadow-banned (tweets hidden in various ways) by Twitter.
Screenshots from an internal Twitter content-moderation system showed that his account was tagged with a label of “Trends Blacklist,” which ensured that his tweets would never make it to the algorithmic trending topics on Twitter’s front page.
How many people endured weekslong quarantine because Dr. Bhattacharya’s message was suppressed? How many students would have been spared the education death knell of remote learning had schools heeded his advice, or even known about it?
That means that before Dr. Bhattacharya tweeted a single thing he was suppressed on Twitter. He had violated no rules. He had spread no “misinformation.” He was effectively silenced for disagreeing with Dr. Fauci and his minions. Not a single person who worked at Twitter could hold a candle to him intellectually or in terms of expertise; but they knew he was to be silenced.
Bhattacharya was one of the authors of the Great Barrington Declaration, which argued for a “focused protection” approach to infection reduction. Put simply, COVID is largely dangerous to a relatively small proportion of the population, avoiding widespread COVID infection is ultimately impossible, so the greatest effort should be in protecting people most at risk. This maximizes the benefits of societal expenditures, avoids causing unnecessary collateral damage, and ensures that the fewest number of people die unnecessarily.
In the Great Barrington Declaration, co-signed now by many thousand medical scientists and practitioners, we laid out such a middle-ground alternative, with greatly improved focused protection of older people and other high-risk groups.[2] The aim of focused protection is to minimize overall mortality from both COVID-19 and other diseases by balancing the need to protect high-risk individuals from COVID-19 while reducing the harm that lockdowns have had on other aspects of medical care and public health. It recognizes that public health is concerned with the health and well-being of populations in a broader way than just infection control.[3]
This may surprise some readers given the unfortunate caricature of the Declaration, where some media outlets and scientists have falsely characterized it as a “herd immunity strategy” that aims to maximize infections among the young or as a laissez-faire approach to let the virus rip through society. On the contrary, we believe that everyone should take basic precautions to avoid spreading the disease and that no one should intentionally expose themselves to COVID-19 infection. Since zero COVID is impossible, herd immunity is the endpoint of this epidemic regardless of whether we choose lockdowns or focused protection to address it.
You may recall the original argument for slowing the spread was to prepare the medical system for the coming surge–to “slow the spread.” At the beginning of the pandemic the messaging was clear and consonant with reality: most would get COVID and we have to keep the medical system going.
But once people complied with the initial lockdowns the public health establishment moved the goalposts: something like zero-COVID became the policy, and it was always an impossible dream. Look around: most people have had COVID, whether they know it or not. In China, which went aggressively toward zero-COVID, the policy has collapsed after enormous social and economic costs to both the Chinese and the world.
An economist could have told you this would happen, even with only the most modest education in epidemiology. It doesn’t take much research to learn that airborne viruses are impossible to stop once they have begun spreading. They will burn through a population; you can only effect the rate at which they do so, and only then within limits.
The public health establishment has utterly destroyed its credibility by ignoring both the cost/benefit analysis and by promoting an unattainable goal. Slow the spread; stop the spread; vaccines will stop COVID; two shots will stop COVID; a winter of severe illness and death if you are unvaccinated…. Masks don’t work; bandannas work; only N95s work.
No randomized trials; hostility to dissent; constantly changing stories.
You know the drill. It was all BS.
The tragedy of the Great Barrington Declaration was not that it was ignored; it wasn’t. It was actively attacked; its authors censored; academic careers were harmed. All for being right when everybody else was wrong.
America’s undoing is coming due to the hubris of our Elites. They not only lack humility–that is a common human failing–but they now have to power to silence their critics.
A decade ago Dr Bhattacharya’s arguments would have been conventional wisdom, but his willingness to challenge the prevailing narrative–which was wholly unsupported by the facts or by logic–made him a pariah.
Unless and until the power to suppress dissent and to impose mandates is stripped from the Establishment nothing will change. Little has. Mask mandates are back in schools, and the tyrants remain in charge.
It’s dispiriting.
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