Friday, February 3, 2023

It's not about preferences. It's about responsible science.

An Opinion piece in Newsweek by an advanced medical student.  From It's Time for the Scientific Community to Admit We Were Wrong About COVID and It Cost Lives by Kevin Bass.  

In one regard, this is the most forthright acknowledgement that the public health experts almost consistently made every wrong decision possible during the pandemic.  The more this message is acknowledged the better.  If we got it so wrong this time, just imagine the consequences if and when we are hit with a virus that is actually materially lethal and contagious.

On the other hand, there is something just a bit off to the whole piece as well.  I want to take the win with the acknowledgement and hate to carp but the bit that is off is concerning.

Part of the issue is that Bass repeatedly tugs at social justice themes throughout the piece.  Quite possibly this purely a sensible defensive tactic given that his core message is so at odds with the belief system of the authoritarian social justice people.  

But it leads to rather horrific statements such as:

Most of us did not speak up in support of alternative views, and many of us tried to suppress them. When strong scientific voices like world-renowned Stanford professors John Ioannidis, Jay Bhattacharya, and Scott Atlas, or University of California San Francisco professors Vinay Prasad and Monica Gandhi, sounded the alarm on behalf of vulnerable communities, they faced severe censure by relentless mobs of critics and detractors in the scientific community—often not on the basis of fact but solely on the basis of differences in scientific opinion.

A healthy mea culpa.  But . . . the tragedy was not because it affected vulnerable communities.  The tragedy is because the chosen policies did little to improve outcomes and at immense cost and despite alternative policies which would have been better and cheaper.  

The elderly were the overwhelming majority of deaths.  I believe in the US the average age of death for a Covid victim was something like 78.  The elderly are physically vulnerable and they were the primary victims.  

But as a political influence, the elderly are not powerless.  Indeed, they are among the most influential communities on the political spectrum.  Why the vulnerable communities language?  This is just social justice signaling and it is evil and a symptom of the public health decision making catastrophe.  We needed to make decisions based on facts and knowledge and experience and instead the decision-making was driven by ideological beliefs and desires.  

Bass has another instance of this ideology signaling in an otherwise robust statement of failure.

Instead, we have witnessed a massive and ongoing loss of life in America due to distrust of vaccines and the healthcare system; a massive concentration in wealth by already wealthy elites; a rise in suicides and gun violence especially among the poor; a near-doubling of the rate of depression and anxiety disorders especially among the young; a catastrophic loss of educational attainment among already disadvantaged children; and among those most vulnerable, a massive loss of trust in healthcare, science, scientific authorities, and political leaders more broadly.

Why is there a concern about wealth concentration in this public health critique?  That is still the same lame ideological obsession which clouded decision making in the first place.  And again, concern for vulnerable communities.  We were all vulnerable to bad decision making by the ideologically inspired but incompetent public health authorities.  The only vulnerable communities were the very aged and the very sick (multiple co-morbidities).  To try and make this about class or race or anything else is the same idée fixe which caused the catastrophe in the first place.  

And it is tightly tied to the other concern with the opinion piece.  

Bass acknowledges the catastrophe but seems to be laying the primary blame on a political equation.

But perhaps more important than any individual error was how inherently flawed the overall approach of the scientific community was, and continues to be. It was flawed in a way that undermined its efficacy and resulted in thousands if not millions of preventable deaths.

What we did not properly appreciate is that preferences determine how scientific expertise is used, and that our preferences might be—indeed, our preferences were—very different from many of the people that we serve. We created policy based on our preferences, then justified it using data. And then we portrayed those opposing our efforts as misguided, ignorant, selfish, and evil.

Maybe.

But surely the ultimate issue is not about what their preferences were.  Surely the issue is that they made bad decisions knowingly.  

I can see now that the scientific community from the CDC to the WHO to the FDA and their representatives, repeatedly overstated the evidence and misled the public about its own views and policies, including on natural vs. artificial immunity, school closures and disease transmission, aerosol spread, mask mandates, and vaccine effectiveness and safety, especially among the young. All of these were scientific mistakes at the time, not in hindsight. 

They weren't mistakes.  They were a conscious decision to ignore 1) past experience, 2) established current protocols, and 3) all the available data that was being accumulated as the tragedy unfolded.

We knew then that there was an alternate and more reasonable approach (England started out down this path but then lost courage; the Swedes followed it through.)

This was not an accidental tragedy arising from ignorance or preferences.  This was a choice made against past experience, established protocols and the data which existed then.  

I hate to nitpick an otherwise forthright confession of failure.  But to ignore that the public health community consciously chose to inflict these ideological policies despite the empirical data against them means that we have not understood the tragedy.

It's not about preferences.  It's about responsible science.  Something that the public health authorities deliberately chose not to do.

No comments:

Post a Comment