Risky Business with Nate Silver and Maria KonnikovaWhy did COVID Decision-Making Go So Wrong? (with David Zweig)
Early in the COVID pandemic, the US closed schools and sent kids home. And then, the schools stayed closed—even as they began to reopen in other parts of the world. Experts and officials claimed that these measures sprang from “an abundance of caution.” But what was the evidence on the necessity of keeping kids home? And, looking back, did the benefits of prolonged school closures outweigh the costs?
This week, Nate interviews author and journalist David Zweig about his book examining COVID policies and school closure decisions during the pandemic. They get into why we tend to find cost-benefit analysis so difficult, how political polarization shaped decision-making during the pandemic, and how the COVID models failed.
Further Reading:
David Zweig’s book is An Abundance of Caution: American Schools, the Virus, and a Story of Bad Decisions
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Pushkin.
Welcome back to Risky Business, a show about making better decisions. I'm Nate Silver. My co host Maria Khannikova is off today, but we do have a special guest. David Swag is a journalist and author, most recently of the book An Abundance of Caution, American Schools, The Virus and the Story of Bad Decisions. He also writes a substack newsletter, Silent Lunch. So welcome David. There are two reasons we're having you on today. Why is I really like your book, In fact, I endorse it. I blurred the back cover. And the other is that it is Risky Business. It is a show about making better decisions. That's our tagline, and this is the case where a lot of really bad, high stakes decisions were made. So welcome, Welcome to the show, David, Thanks Nate, and to help you and the audience navigate, we are covering quite a bit of territory today. I want to kind of situate us at the start of the pandemic, which may be a traumatic time frankly for a lot of people. I want to talk through the notion of cost benefit analysis and go through some terminology there, talk about politics, and psychology talk about the model. So there's a lot to get to. But I want to first just ask, Okay, sometimes you'll hear this more often from liberals who may be at made a Interesteff, we didn't have the best possible COVID response, But why is it important to talk about this? I mean, it's been more than more than five years. What's your response to that.
Well, I'd say I have two responses. One is that this was, to my mind, possibly the most important event in some regards, you know, as far as infringing on personal liberties of American citizens that we've seen in a generation or more. And you know, when you compare it to other events like I don't know nine to eleven or the Iraq War, the amount of analysis and books written and scholarly study of those events to me seems like there should be that but times ten for this, I mean, like the actual impact on every single person in the country, and of particular interest to me children, to my mind, has not remotely been adequately studied or reckoned with one of the prime reasons I wrote my book. And the second answer to your question is that, ultimately, you know, I think, like any good books should be my book is not really about the pandemic. That's the backdrop, but hopefully what it's about is indeed to the topic of your podcast. It's really, to use a medical word, it's an anatomy of decision making, and my whole book is interested in how do individuals, how do policymakers, and how do we as a society make decisions, particularly when we have limited information and in a time of crisis. I use the pandemic as a case study or is a back to kind of explore these these dynamics in our country, where the reader hopefully comes away from the book with an understanding about these kind of decision making dynamics that can be applied really to any time that's happening, not just a sort of retrospective.
Look, do you think there's some scar tissue where people find it traumatizing it because, like so, we just had two big books come out about Joe Biden, which is a case that in certain ways is parallel where things maybe people on the left kind of got wrong right directionally speaking, do you think people are traumatized by this experience and don't like talking about it?
Well, I don't just think and I know it because many people have told me so. But you know, a reaction I've heard many times to the book is someone said they wanted to put their fist through a wall while they were reading it. Someone else said they cried, people are cringing. Someone said they had to read it in stages. But with all that said, to my mind, this is something that is both a difficult but necessary read. So Scar Tiss would be damned.
So I do want to take us back now five plus years roughly. You know, for me, it was kind of a crazy time. This is just the climax of the Democratic primary campaign. So I'm like flying around like New Hampshire and South Carolina and various events, big conference in Boston. Increasingly you see every flight, every flight, it's a little bit emptier every time. You get a little bit more worried about, you know, maybe we shouldn't be gathering all these people together. You are in Westchester County, correct, which is if people don't know, it's the immediate northern suburbs of New York City, stereotypically nice, leafy houses, liberal, kind of pro democratic politics, middle class, upper middle class depending on the precise community. Right, And you're a dat of too Yep, everything you said sounds accurate. I live part time in Weschester County two. My mom grew up in a town called Crotons, so I can visualize this and like, so one might say, it's like not the worst place to be in a pandemic, right, It's kind of medium density. There tend to be parks and places to go jogging. So what's your sense at the very start of the pandemic when do you start to worry this is going to be severe? How are you behaving?
Like most people in my area when when things kicked off, I listened to the experts. We locked down. I'm a little embarrassed to admit we even wiped our groceries when they came in. So I did not start out as a contrarian on this. I had no political motivations in this at all, and I had no reason to disregard what we were being told simultaneously. However, within like day one of so called remote learning, it was very obvious to me that this was not going to work over a long period of time. It seemed a reasonable trade off initially based on the information we were given, so I wasn't disregarding that, but Nevertheless, this still seemed like, whoa, how is this going to play out? Because this is not working. I had a third grader and a fifth grader at the time, and it was just obvious this was going to be a disaster, and that really led me to start digging into this.
So when did you have these moments, David where you felt like, oh my god, there's not a lot of trustworthy information. What were those those inflections?
Yeah? So, like I said, I sort of had no reason initially to disregard what we were being told. But my nature, just my disposition is to always be somewhat skeptical, and initially I wasn't pursuing this professionally at all. It was just sort of my own need to feel informed about what was going on. And what changed for me was I started realizing the information was getting I started emailing infectious disease experts and epidemiologists and others, almost all of them in Europe because the ones in the States weren't responding or didn't have the information. But I started reaching out to people in Europe trying to get more information, and I very quickly had this strange feeling. I'm like, holy shit, like none of this stuff is really being printed in the Times or I'm not seeing this elsewhere. And then that's when I was like, all right, maybe I need to do something about this. I'm in the media. You know, it's like the media is disappointing me. Well, okay, then I guess it falls on my shoulders. And I was writing another book at the time, obviously totally unrelated to the topic. I just couldn't concentrate on anything. All I could think about was this insane, you know, circumstance that we were in. And then just more specifically, Nate, toward the end of April, I was walking with a friend of mine on the high school track here in my town and we were dutifully separated on like lanes one and four, wearing masks most likely. And by the end of April, I think it was new cases in New York had dropped by something like fifty percent. And as you'll recall and everyone else will, you know, we were told and the official slogan was fifteen days to slow the spread that began in March, and then they tacked another thirty days onto that, and you know, and there was seemingly, to my mind like there was no real debate or pushbackers, just like, oh yeah, I remember how we told you fifteen days. Now we're adding another thirty. And so the thing is, the reasoning behind the fifteen days to slow the spread was we had to prevent hospitals from being overwhelmed. And you know how, we were shown this this graph of you know, if everyone just follows instructions, you'll have this gentle slope, and if you don't follow instructions, we'll have this spike and the hospitals will be overwhelmed. So by the end of April, cases had fallen, new cases had fallen something like fifty percent. And I said to my friend, I'm like, oh, well, do you think schools are going to open next week? You know, I assume, And he's like, what are you talking about. I'm like, well, we did it. We flattened the curve, man. We we had a very specific goal that we were told we needed to achieve. We achieved it. We flattened like literally, and and then he was like, dude, they're not going back. They're not going back to school, and like, still, even though I've retold this story a million times and talk about in the book The Hairs on the back of my neck still stand up, because that, to me was one of the in was like the initial moment where I'm like, oh, like, so that's really weird that we're in a country where the government told us like, here's the thing you need to do, here's the goal that we're trying to achieve. Then we achieved that goal, but but then they just kept going anyway.
Yeah, I know, people forget how much goodwill there was, right, Like, so when shit hit the fan, like kind of Rudy Gobert Tom Hanks day, Right, I was flying to Kansas City, where my partner's father was in hospice cares. So, you know, to be in an environment like that, in a kind of rural Missouri hospital at a time when this disease is getting to spread around the country was I think scary for everybody involved. Right, But we wound up staying in Kansas City for a month because there's a giant red circle around New York City. Of course, there's no way to ascertain cases in Kansas City. I call the Department of Health in Missouri. They're like, have you been to Wuhan, China, Well, then you can't get a COVID test kind of thing, right, But then it was that question of like, what is the endgame here?
Right?
I remember we had friends over like you. At first I was very cautious, remember, like yelling at a stranger for not wearing a mask on an elevator and some carini ish behavior there, right, But gradually there was kind of this thing where you start to I roll and group chat and you're like, we can't really not do and we don't even have kids, you do, right, we can't really stay cooped up for the definite future, right, because you could project fotward that like there was no there was no plan at all.
So one of the things that was really important to me, and you know what I call like a record scratch moment in the book is when at the end of April and beginning of May, twenty two countries in Europe began reopening their lower schools. So this is not like one tiny schoolhouse in the you know, in the countryside of you know, Denmark, twenty two countries and this includes massive cities like Paris and you know and elsewhere. And toward the end of April, the education ministers of the EU met or met you know, at least online and they said, we've observed no negative consequences of this. They met a second time in June and they hade the same reaction and that for me, I remember watching the video of this and like I just it was like a sense of unreality because that is the type of thing that should have been splashed across the front pages of every newspaper. This should have been you know, crawling on the screen on every cable news network. This was the news. Ostensibly we were waiting for Europe looked at all the same information we had and came to a very different conclusion about what was wise, and for them was we should open the schools. And it is not because Europe controlled the virus, which is like one of the false arguments about oh well Europe did that, because they know they didn't. I give an analysis within my book. You know, maybe on a country level when you look at it, but if you look at different you can match up city to city, small town to small town, and go on and on and on and see that in Europe they had cases that were above, that were below, and that were around the same. It was all over the map, you know, literally and figuratively. So they didn't quote control the virus. I think that you know, they weren't doing mass mandates across the board, they weren't doing distancing across the board of six feet. They didn't have have the filters, they didn't have barriers across the board, none of this stuff that we were told, and nevertheless they said we haven't observed any negative impact. That is an extraordinary moment that this was ignored and then if it was ever mentioned, was waved away. I ultimately wrote about it in June I think that meeting, and you know, and I talk about it in my book, but this was not covered. Essentially, this was just memory hold. So that was one key point, key moment. Another one was when the cases had fallen in New York City, as I mentioned, you know, by the end of April dropped something like fifty percent. Another key moment was an article that had come out on NPR. Of all places where they talked about the where they talked about the daycares and the YMCAs, tens of thousands of kids were in these programs early on and they observed no real outbreaks or no kind of like overt negative impacts of this. And then lastly there was the study out of Sweden where they never closed the lower schools. And by the way, Stockholm is, you know, that's a major city. We had like empirical evidence just kind of like screaming at us in the face, and it just kept being waved away. So those were kind of like three or four really important moments quite early in the pandemic when it was clear that schools were not driving the pandemic, and indeed, tons of studies later on showed how schools by and large tended to mirror at most or or be below the community rates of infection.
Do you want to talk a little bit, So, first of all, it is an election year. Do you think the polarity of this was inevitable? What if Hillary Clinton had gotten a few more thousand votes in Wisconsin, Michigan, Pennsylvania and Hillary Clinton had been president, do you think this would have polarized in reverse?
You know, it's a counterfactual, so who's to say. But I do think, based on all the evidence that I describe in my book, it seems impossible to not see it that way. That and I you know, and I believe, and you can tell me if you disagree, But I think I make a pretty strong, like lawyerly persuasive case that much of the response in America from the public health establishment, from the legacy media, from the broader sort of like left wing you know, elites, so to speak, was reactionary against Trump and against Republicans. And you know that's not just sort of like an opinion. There's all sorts of like interesting data on this, and also you know, my anecdotal experience of this, you know, and we can get into it. You know, there's the countless numbers of doctors and others who reached out to me saying that they agreed with the stuff I was writing, but they were afraid to say so publicly, or they were explicitly told they couldn't say so. I don't make this statement lightly about the left being reactionary. I think a lot of people and left weren't even aware that they were being reactionary. I don't even know how much they were thinking about it. This is what the people from on high were telling them. So, you know, we could get into it. But it's like most these you know, most experts in anyfield have a relatively narrow range of expertise. But yet somehow this is slightly tangential to your question. But somehow anyone who was a quote epidemiologist, anyone who had MD after the name, they all of a sudden became experts in like an entire way of living your life, an entire sort of societal response.
I can't I can't resist the bait about the way that experts were thrown around and they I mean, first of all, sometimes it was just like blatantly exclusionary, where if you're you know, like Jay Boicharia who now works to the White House, right perfectly what credential expert, but he was going against the consensus, so therefore was kind of black balls too strong a phrase. He had a strong voice and social media and so forth right, but like who is an expert when it comes to COVID policy?
So that's an awesome question, and it's one of the to my mind, I think key threads in my book where I discussed the idea that only certain people were allowed really within the public conversation and within the media to weigh in on what we should be doing. There's sort of two problems with that. One is that someone like Anthony Fauci has a particular at least ostensibly a particular expertise within infectious diseases and perhaps how to manage them. He does not have an expertise in the values of society and in second order effects of non pharmaceutical interventions and mitigations that I know, that's like a mouthful, but in plain English, he's not an expert on what happens to children who when schools are closed and they won't be able to graduate, you have kids stuck at home with an abusive parent. Because child abuse cases had skyrocketed, and by the way, we knew this data as early as April of twenty twenty. They already had indications that very very bad things were happening to a lot of really vulnerable kids. So Anthony Fauci, you know, and others sort of like within that lane, have a very specific range of knowledge and expertise, and yet they were given this mandate really on being the overall sort of director of society. And then to make matters worse, Nate, there were other people who sort of fashioned themselves as these like COVID pundics, who really for much of the population dictated how they were supposed to think about what was prudent and what was critical or not critical about various interventions that we had to be subject to.
Yeah, my model of this right, as you have kind of one group of experts that might attempt to predict how bad the disease will be, both in terms of number of cases and mortality under certain scenarios. You might have another group of experts, maybe more economists, who talk about what the what the trade offs are, what are the consequences of closing schools, And then it's a society's job to, in our flawed democratic system way that expert evidence and make what our ultimately political decisions. But I want to set one thing up, and maybe it's kind of an inside baseball question about the reporting of the book, But so, why the decision to focus so much on schools right? Why that focus?
I mean, I use schools right as a launch point into this sort of larger Obviously I get into a lot of mask mandate stuff and all these other interventions imposed I would say schools and children in tandem, because I'm really concerned about not just the school closures, but the broader sort of view of children in society during in America and the positioning of them as these sort of like silent super spreaders and the interventions that were imposed on them in our country in a sort of somewhat uniquely aggressive medical culture that we have here, you know, where it's like two year olds had to be masked in America, whereas in Europe, the ECDC, that's their version of the CDC, they didn't even recommend that kids in primary school wear masks at all. And you know, the World Health Organization they had mask mandate. I think it was age six and up. So the fact that just just one of the zillion examples, the fact that it was like required for two year olds in America to wear masks was you know, it was quite unusual and worthy of comment. So the reason I mentioned this is is to me, the kind of like biggest unforced error in America was the long term closure of schools, and then secondarily the impositions imposed on children when schools were open. Finally, that of all the harms that happened, to my mind, this one is, you know, and it's hard to quantify this stuff, mate, but this was perhaps the most consequential, and if not the most consequential, certainly the most unnecessarily harmful of all the interventions that were imposed.
Yeah, I want to get one. So I guess I'm going to ask you an epidemiological question, right. So one of the first things that was there very early on that this disease was hitting older people exponentially harder than younger people, which is not true for all pandemics. So can you explain why that was true for this particular coronavirus.
One of the things that that I'm really interested in his narrative formation and you know, and I talk about that a lot in the book is like how these certain narratives and ideas were formed and then how they were enforced. And one of them is even when you think about the term novel coronavirus, even the word novel adds on an immediate type of association for people. This is new, and often with a disease, something that's new is going to be particularly scary. Think about the word COVID. It's written in all caps. It's different than just like the flu, you know, in lowercase. These things, these things matter, I think to some extent. And the reality is that coronaviruses have been with us for a zillion years. Much of the common colds that we get are from coronaviruses. There's a lot of literature that shows that SARS Kobe two, which causes COVID, you know, the novel coronavirus, that it behaved very similarly to way other coronaviruses had behaved. And I interviewed this gentleman who's a specialist in actious diseases and looking historically from an ethical perspective about how we respond to these things, and he kind of went into a whole thing with me saying like, look this, He's like, this was positioned from the beginning as something that was quote unprecedented. He's like, if I can tell you one thing, please don't use the word unprecedented. It's not our reaction was unprecedented. But having a highly contagious respiratory virus, that's old news. And we shouldn't have been surprised that this was particularly dangerous to old people. There are old people who die every year from just common cold coronaviruses in you know, long term care homes. It's very typical, and children are largely unscathed. It's like a common cold. So unless we were given evidence or shown a reason why to think that this should be performing or acting differently, we should have gone with what to expect. You know, in medicine, there's that expression, if you hear or hoods, think of a horse, don't think of a zebra. I mean everyone and I talked about this in the book. Everyone thought of the zebra, but we should have thought of the horse. Whether this came from a lab or not, it's still a coronavirus and still largely behaved similarly to other coronaviruses, if perhaps more virulent for older people. Though, of course.
We'll be right back after this message. I'm going to give you some phrases and you can kind of use these as jumping off points. I think these are all phrases where there was some degree of ambiguity or maybe strategy and how they were employed. But let me start with precautionary principle. It's kind of related to the title of your book. What does that mean? What should it mean?
Yeah, I spend a lot of time talking about the precautionary principle. I think it's fascinating. I interviewed this scholar named Eric Winsburg, who's a philosopher of medicine and particularly of ethics in modeling, and we talked a lot about the precautionary principle. And one thing I learned from him, and that I talk about in the book, is that a lot of philosophers don't even believe there's such a thing as the precautionary principle, because it's based on an assumption that you know how much harm may come to you from doing one thing and how much harm you'll avoid by doing this other thing that already within the beginning of the precautionary principle. It's based on certain assumptions. Now, the precautionary principle, as we conventionally understand it, is a prudent and reasonable course of action in certain circumstances. But those circumstances require a real kind of specific set of data or information that you can be certain about, and very very quickly within the pandemic, we no longer met that specific criteria for the precautionary principle. Certainly so Nate. By the end of April beginning of May, if particular, if we're thinking about schools, millions of kids twenty two countries reopen their schools. At that point, you can no longer say that we are keeping schools closed. Here quote out of an abundance of caution, you just can't so. But this was the sort of like mic drop, It's like, well, I'm just being cautious. It became very hard for most regular people to push back against something when they're like, who wouldn't want to be cautious?
Yeah. There's kind of this effective altruist slash rationalist adjacent phrase called Chesterton's fence, which is the idea that if you see a fence out in the middle of the wilderness, then you probably shouldn't remove it, right, Maybe it's preting you from bears or snakes or who knows what, right, And that's I think a more coherent version of the precautionary principle, or like be wary of uprooting society if there might be unknown consequences. But it seemed like, if anything, that might be the reverse of it, right.
Just to kind of dontail with your point there. In medicine, everyone knows the cliche of first, do no harm, yea, and we reversed that in the pandemic that typically what you're supposed to do ethically is you don't act first and then try to figure out things you first. You know there's a reason why the FDA's you know modo, you know, or their mandate is first you have to find out if something is safe and effective, then it gets approved by the FDA. Yet we did the opposite in the pandemic. We had all these interventions because the school closure is an intervention. That's not the norm. The norm is for kids to be in school, that's the default. But we flipped the default. And again there could be some argument made for that in you know, March tenth of April twenty twenty. But once there was an enormous amount of empirical evidence that millions of kids in school was not having a catamoclysmic effect. The precautionary principle or this quote acting out of an abundance of caution, like I titled my book, this was just a complete bastardization of what that actual sort of principle is about and how it can or should be used.
The two word phrase quote no evidence. I came to be very wary of, right, because you'd read things like, oh, there's there's no evidence that children transmit the disease less effectively than adults, right when like though the way that we used to me, there's like there's no absolute proof, right, when there's lots of evidence, right, there might be pulminary studies. They're also you know, to use term that our listeners will know there are Bayesian priors, right, you know, we probably had strong priors to believe that, yes, if you got this disease, like almost every other disease, you would get some degree of immune protection from that. I mean, how did a certain faction manage to wrangle the default toward being on their side? How did that become the default?
I think a lot of it has to do with that. We have a very very large degree of homogeneity of uniformity within certain very influential institutions in our country, and in particular to the pandemic. We think about public health and within the legacy media. And the uniformity, there's two aspects to it. One is sort of political uniformity that both of these kind of institutions tend to lean left the people within them. And number two, they also to self select for a certain type of person. So you have this kind of thing where you had almost everyone there on the left in these important institutions in our country during the pandemic. And not only were they all kind of largely of the same political persuasion, but they were also most of them, not all, but most of them are of the same type of personality type that got to the level of success where they are so all that merged together, Nate is it leads to a situation where when Donald Trump tweeted in July, schools should open in the fall or schools must open in all caps or a bunch of exclamation points. That was immediately radioactive to a lot of these people, and to whomever else it wasn't radioactive. They got the message quickly that you cannot agree with Donald Trump on anything. And there was such a sort of enforced uniformity within these institutions, within public health, and within the media that that's how you get to a circumstance where something manifestly crazy is accepted by a very large portion of society. Yeah.
The next phrase I wanted to ask you about, which I think a quite complicated phrase actually, is scientific consensus. What does that mean? What should it mean?
Yeah, this was bandied about all the time, and this you know, what's nice is your questions here. Everything kind of threads together because the idea of a scientific consensus was to a large extent, or at least to some extent manufactured. Once I started writing some articles that were challenging to some of the establishment views, but I was writing them in largely kind of legacy media outlets, so it's kind of had a different type of impromoter, you know, attached to it that people could accept it. I started getting emails from people around the country, including a lot of doc and including some former CDC and former NIH people, and they would say most of them would start off something like, thank you so much for this, you know, for writing this article. I agree with the points you're making in here. This just doesn't seem like it's beneficial for schools to be closed. I think it's really harmful. I don't see the value in mask mandates on these little kids, or barriers on their desks, on and on whatever it may be. And then they would say, but all of this is off the record.
Yeah.
And then the second part of that is some of these people were told explicitly by their bosses, you know, when we're talking like at you know, some of our top university hospitals in the country. There was a particular physician who I spoke with who worked in the nick you, that's like the the pediatric or pick you pediatric intensive care unit. And she had said to this was like a small kind of like niche media outlet, so it didn't have a big readership. But she had done an interview after the vaccine had come out and was available then for adolescents, and she said, look in our pick you we've had more kids, more patients here from Meyer Kurt Artists following the vaccine than we had COVID patients in an entire year. Now this was someone I just know, this shouldn't matter. She was like very much like a lefty democrat, like she had no motivation behind this. She was just telling the truth. This is just simply what happened in the intensive care unit for pediatrics in her hospital. This is what happened. Her boss told her, you are never to speak to the media again about this. So people need to understand when we are told there's a scientific consensus on something, that consensus very much maybe manufactured, it's an illusion. So I had people, you know, contacting me, you know, because they self censored, or you had people like this physician who I just talked about, where they were explicitly told not to say things. And then the third category, mate, aren't all the experts outside the United States. It's quite remarkable when you think about in the modern era it was. And I had some sort of joke about this in the book. It was as if we had, you know, rewound the clock like five hundred years and the message from the continent hadn't reached us yet, you know, across the Atlantic that like, there were plenty of public health experts throughout Europe who viewed what was happening very very differently from what was happening here, yet that somehow was not included in the consensus. So the idea of a consensus is almost always BS, or certainly was during the pandemic.
For the next phrase, this would be the last one. I'm gonna give your pick between two, either flatten the curve or social distancing.
Oh god, I'll pick social distancing. You know, I discuss it at length in the book. I make a really to my find valiant effort to try to track down the origin of six feet of distancing. You know, as everyone now knows, this was made up. And I would just say on that point that I actually don't think it's unreasonable to have benchmarks for like behavior, because we need something to aim for. It's a bit too vague, particularly if you're talking about like schools for example, or it's like do your best. You know that's going to be interpreted differently and it could lead to a contentious and chaotic kind of environment. However, the way that these interventions were presented to the public, they were presented with such a degree of certainty about like their effectiveness and a degree of certainty about the evidence behind them, that it led to this perverse situation where you had people, you know, I likened it to sort of like a master carpenter, you know, the precision you had you know, teachers and school janitors with with tape measures of r up this is five feet and three quarters. Nope, this isn't going to work, and they're measuring down to this was madness. There was never anything particular about somewhere between five feet and seven feet that made something magical. So if they want to create a benchmark, that's okay, But then you have to say, look, we don't have strong evidence for this being a particularly magical distance, but try to aim for it if you can. Here's why we think it might be helpful. But you know, the American Academy of Pediatrics, early on their initial guidance said, and you know that one of the people from the AP discussed this in an interview. He had said, look, if you can do six feet, great, but if you can't, don't worry about it. It's far more important to get the kids in school. We don't think there's any real good evidence that the benefit of an extra couple of feet is going to matter in the scheme of things. That, of course, was reversed after Donald Trump's tweet. So we had inklings of a reasonable sort of idea about social distancing, but those sadly kind of evaporated relatively quickly, and then it became this very militant type of idea.
No, well, some of it is kind of is ritualistic, right. I think I heard friends in Mexico that like, using ultra violet technologies was kind of this ritual they used, right. I mean, in New York City, we would put our mask on to walk past the hostess sand in a crowded restaurant, right, and then go eating a room full of people. Everyone's mouths open, right, So you're reducing their risk by zero point on one percent, But like I do want to you know, I do want to get into a little bit more of the evidence. Well, how strong is the evidence on the effect of school closures. So you'll see some studies saying it's really bad. See another city is saying only sort of bad. Right, But what's what's your best review of the evidence.
Our intuitions, and particularly our intuitions with medical matters are often wrong. And I'm sympathetic to the idea of anyone which included me in early on, who would think, well, of course school closers are going to have some sort of benefit. It's a bunch of snotty kids running around or teenagers gathering. Of course, that you know intuitively makes sense. Other people similarly, well, of course, having like a cloth in front of your face strapped on, of course that's going to have some sort of benefit. There's this intuitive sense. But what I show in the book there's a zillion examples throughout history, including recent history, where things that seem really obvious, where it's like, well, if course, if kids are we're seeing a spike in peanut allergies, well, of course we should dial back exposure to peanuts in in little kids because that's exactly what the American Academy the Pediatrics told us to do, and that was the exact wrong advice. It was literally the opposite of what they should have done. You know, they said, uh, doctor Spaga, you said, you know, put a baby on their stomach, that'll prevent sids because they could choke. Wrong, bad advice. We should actually do the opposite. There's a zillion things, I'm sure you know of of many examples where things that seem obvious that they will be beneficial once you actually use science, once you actually look at the evidence, it turns out, oh my god, this thing that seemed to be one way is not so. So the reason I mentioned all of this is that you or people listening might think, well, of course they had some benefit. The reality is they had no benefit any intervention. There's this phrase called voltage drop within medicine, which is like that they expect when you do something that its impact is going to wane over time. People don't comply with things that are uncomfortable. Wearing a mask, human beings, you tug at them, even if even unconsciously you're pulling on it. You do things and also people, even the introverts among us were social creatures, and there's cellular phone data that I talked about in the book. Even well before they started easing restrictions, people started moving around that closing schools could have a benefit need for a week or a couple of weeks, if done in conjunction with everything else being closed. But there is zero evidence that over time, having them close over a long period of time was going to have any benefit at all, because everyone was mixing anyway. And that includes, by the way, not just voluntarily. As we know, a significant portion of the country were never locked down. These were the people you know in the in the slaughterhouses, the cashier in a store, the people fixing the electrical lines and so on, and the healthcare workers. So a significant portion of our country were never even allowed to be locked down. So for all of those reasons, it should make sense now to anyone listening why extended school closures were never going to be beneficial. When you had everyone moving about, and you had adults going to restaurants and grabbing a drink at a bar, while at the same time you have a healthy kid locked in their bedroom for six months or for twelve months, it made no sense epidemiologically or ethically.
Yeah, Castinos were open, as I experienced a couple of times. I only went after it got vaccinated. I was a good boy on that. But I want to kind of back up to something we've been kind of dancing around a little bit. Why is it so difficult for people to accept the notion that we need to do some form of cost benefit analysis?
I mean, this is perhaps, you know, a jaundiced view of things, but people like to be told what to do. Some portion of people in a certain way, and what we saw are at least some people in our country. What we saw was this very paternalistic, almost like infantilization of the public. You had the equivalent of like a mom wagging her finger at a three year old saying because I told you so, you know, when they didn't provide evidence for something. And that's how much of the response was conducted and how people reacted. And most people, at least in Blue America went along with this, this sort of argument from authority. That they went along And I can only surmise that that is because it's just a it's just easier, it's less cognitive load on you. Then everyone was just kind of externalizing a complex at least you know, moral and logistical decision making. They were just sort of farming it out to someone else, let them decide for me. It's kind of amazing, mate, how few people actually dug into the data, actually looked at and it didn't even require much digging. This was an extraordinary kind of like default to the experts, don't ask any questions.
Yeah. Look, there are a lot of books about kind of when. I mean, if you read Daniel Kneman and late now Dan Conman is sticking fast and slow. There's like so someone fast sticking, which is more kind of intuitive in the system too, thinking that requires more deliberation, right, And if any problem required more deliberation, I think it would be Covid right, that you have to kind of go back almost the first principles and thing through things. You know, to the extent people's had intuitions, they were often very wrong intuitions, right. I remember Mary de Blasio in New York told people we're gonna shut the bars down for a while, right, so go out and have a big night tonight, right, which is an intuition you might have in New York if there's a hurricane coming which we've had a couple of hurricanes, right, because there's zero threat from the hurricane at one point in time, then there's a window where it's threatening, and then hopefully it's not too bad. Right. But that's probably the most time of most transmission in New York, right. Or I think you point out like a lot of people's intuitions were based on it being an influenza pandemic and not a coronavirus pandemic, which is dramatically different. Effects on how transmisfold is in children, for example. And we'll be right back after this break. Okay. The models. So I've built models in the past. Sometimes I think skepticism of models is unwarranted. I think people also have very difficult, very difficult time telling from the outside what's a good model and what's a bad model. When is a model reliable and when is it just garbage in? Garbage out? But these COVID bells were not very good, David, Can you tell me kind of more about what you learned about them?
Yeah? Well, you know, as you know, one of my chapters is titled Geigo for Garbage and Garbage Out. And the models were built upon an enormous kind of pile of assumptions, and I started digging into them because I'm curious. It was like, how did they come up with this model? You know, showing that if you you do X, Y and z actions, this will lead to such and such results. That's what the models were showing. You said, if you follow instructions, then we'll have this amount of case rates or this amount of you know, transmission, and if you are bad and you don't follow instructions, then it's going to be this big spike. And they would show these visualizations. It's like, well, how did they figure this stuff out? And I started reading some of the papers that went along with the models and the methodology, and what I always do is, because I'm a crazy person, I always look at the citations. I'm like, well, where did they get that from? So you see there's like a little superscript citation. I see it there, you know, in that notes, and I click on it. I'm like, okay, where did they get this from? And then it leads me to another model. I'm like what, so wait, this models based another model. Okay, well where did they get that from? So then I'm leading the second model, and then I'm looking through and there's claims in there, and then I say, oh, that's based on yet more models, And then I likened it to this of like a never ending Russian Dolls type of thing. It was just models upon models upon models and one of them. Ultimately I get to like the bottom and I'm reading in like the supplement buried in the supplement of a paper where they had a claim about transmission in schools as a certain portion of overall kind of transmission activity and it was something like thirty seven percent, and you go deep in, you know, in my mind sort of metaphorically, it's in like six point five it says this figure was chosen arbitrarily. Now that's like you just are peeling back model upon model upon model until finally in the supplement you get to like actual data and then you find out that it was made up. That's kind of wild.
What's so tricky about building models is like, yeah, they are kind of a definition simplifications, right, and sometimes if a point in a model, a data point, is non central to the thesis of the model, then it's totally fine to estimate, right. It's like, Okay, we could do a more rigorous job with this, but it's probably not very important. The model is like robust to different specifications of this parameter. I'm using technical language here, right, there are other times when like it just becomes littally garbage in garbage out, where you know, you're just taking that arbitrary back of the envelope number, feeding it through a bunch of loops, right, and then spinning it back out and pretending that you've done like real real science there. I mean, you know, I mean there's the other big problem with these models too, is so I call it like the kind of like tyranny of the measurable. So cases are easy to measure, actually not as easy as they might be, because it was hard to find enough tests and a lot of cases are you know, asymptomatic and things like that, right, but you know, and you can always try to make the red arrow on CNN go down. Conversely, things like psychological harms of being isolated from other people for months at a time are harder to measure, you know, I know in baseball analysis, offense is much easier to measure than defense in baseball, Right, So some of these teams would build teams that hit a lot of home runs but were terrible defensively because we couldn't measure it well. It turns out as you study it more carefully, it is important. So what are the psychological harms to people of social isolation?
Yeah, just before I get to that, just to your point about the models is the modelers decide what goes in and they can turn those dials whichever way they want if the model doesn't put out what they want to put it out. And I interviewed some really interesting philosophers, Eric Winsburg, who I mentioned before, and a colleague of his, Stephanie Harvard, who they study how models are made, in the sort of ethical implications of models, and what does it say about a society about what goes into the models that they do, and what does it say about the people who build the models. And it's quite astonishing when you think about it that the people who built the models are also the people who tended to fare really well in the pandemic relative to the rest of the country. That's not an accident. So we had models dictating how we responded in America, and the models only took into account certain factors that were of the most interest to the people who are in this kind of white collar profession if they were living If the people who designed the models for IHME and Imperial College were living in a studio apartment in the Bronx with no air conditioning and you know, six children in there, maybe they would have had an input on there. For school closures, you know, maybe they would if they were running a little mom and pop business, et cetera, et cetera. So all these things that are really important in society now. Of course, if anyone's listening, really well, it's not as important as death. But that's a false binary to draw, and for a whole variety of reasons. We tolerate death in a whole variety of ways in our country. For because you know, on the highway we can make the speed limits thirty five, but we don't because we want to get places faster. There's all sorts of things going on that they chose not to put these things in the models, and one of them. So just kind of getting now to your question, there's all sorts of evidence, and this is quite obvious. We know this just as people that isolation is incredibly damaging. It's also it's physically damaging to people. We had people in hospitals, particularly the elderly people who were not allowed to see their family. We had children. The rates of depression and anxiety and of eating disorders both B and I going up, and also anorexia going up and bolimia going up. All these things were directly tied to isolation and school closures. There were people who've said, no, it's just because of the pandemic overall, and they were upset. It's just simply not true. There was a lot of evidence and I cited in my book that directly ties these effects to isolation to school closures. It had nothing to do with the broader kind of like experience of the pandemic.
There's this thing called the value of a cistical life, which is like from empirical data on how many trade offs people are willing to make, and like people have well established trade offs for how much they're willing to trade off length of life in essence for quality of life. It gets complicated when like when I was, you know, a pretty dutiful mascuer and indoor crowd avoid before I got vaccinated, and I wasn't doing it for me. I was doing it for because I would feel guilty as fuck if I transmitted COVID right, but at some point people it just people's tolerance for it lags. And anyway, do you think the models were trying or the modelers were trying to scare people?
Yes, yeah, I mean it's unequivocal, and we know there's more broadly, there are statements, you know, from Fauci saying, if you think you're doing too much, that's probably the right thing. There's some internal documents in the UK government that I cite my book where they talk about specifically like exaggerating and scaring people in order to get them to comply. There are articles in the New York Times that talked about this where they were fairly explicit about having people be frightened in order to get them to behave in a certain way. Ultimately, people people's experience of reality was so divergent from what we were told was the risk ratio and what we were told we needed to do. At a certain point people just called bullshit.
I agree. At the same time, I do think COVID was in this kind of like messy middle ground, where like if it were an order of magnitude more deadly, then people would comply on their own and then very harsh protocols I think would be rational and justified and passed most cost benefit tests. Right. If it were ten times less deadly, then it would be you know, the seasonal flu basically, and people would just kind of let.
It pass through.
We're kind of stuck in the middle, and then there's kind of so much data to cherry pick, and you kind of are forced to kind of figure things out on your own. I think the problem at its core, as I describe it in the book, is that it's really kind of epistemological, isn't it. And it comes down to, like, how do we know it is true? How do we think about evidence? And what frustrated me, just endlessly and enraged me and fascinated me was and still is the fact that the idea of like anyone can cherry pick stuff and you can have dueling studies. If I were to debate someone tomorrow about school.
Closures, they could cite twenty studies if they want, then I could cite twenty studies that you know, have an opposite conclusion. And I spoke to a guy who an oncologist who's but he's I don't think he's practicing anymore, but he talks to patients about how to think through like their treatment and what to do or not and how to think about evidence. And I was talking with him and I said, you know, I talked about you know, the millions of kids in school in Europe and stuff, and I'm like, so does that not count though, because it's you know, in the hierarchy of evidence, it's not a randomized trial. And he was like, David, He's like, that's better than a study. He's like, that's just reality. Studies always have chosen parameters. And it like was really an incredible like moment for me where it was like, right, like empirical reality trumps everything. So the idea, like you know, you mentioned like, oh, in five years from now, you don't want to get into an argument with some and again about like what the outcomes are this that or the other thing. But it's like, I feel like we don't have to. You don't have to look at tons of studies. We can, but studies to just by their nature, have some degree of subjective parameters, you know, put around them, the timing that they run from X day to Y day, you know, the inputs, et cetera. But when you just look at reality, empirical reality. If millions of kids are in school, nothing really happened that, you know. When I spoke to this on college is, he's like, that's better. That's actually above a randomized trial. We're just observing empirical, empirically, something that's true. But instead of looking at that, we favored theory, you know, and all of these things well we well they didn't say we think, They said we know. But implicit in this idea, remember the Swiss cheese model, ny where of course, right, So they told us each of these interventions was like a slice of Swiss cheese, and if you do all of them, hopefully the holes won't line up and the little very ons won't get you know, won't make it through. But what's the implicit message in that? It's that they don't know what works. They were already admitting they didn't know which intervention worked. Therefore we have to do all of them. But yet no evidence was actually accrued to support them, and and we had evidence to the opposite that in reality. So that to me is the thing that I just find endlessly fascinating, you know, and I know you do a lot of work on kind of like human nature and decision making and stuff like that, like on why and how our country, by and large, or at least half of it went along with favoring a sort of like epistelological model of life that favored theory over evidence.
What did the contrarians get wrong?
It's a good question. Well, it depends who you define, you know, as a contrarian, and what that means. I think some of them overstated harms from the vaccine distills. I haven't seen that evidence yet. Maybe it exists and it just had have been uncovered. I have not seen strong evidence that that they caused the mass harm. You know that some people purport them to be causing. I think the contrarians. I think people on both sides, but including the contraints, perhaps misjudged how to effectively argue for their position. I don't know, tell me, maybe I'm missing something.
I do think there was over optimism among the speed with which HERD immunity would be reached. Right. Look, a lot of transmission was not being picked up. It was asymptomatic, and you'd have these waves and there are complicated patterns that you know that every time you feel like you kind of got the hang of modeling, them. Then they wouldn't quite hold up, right, But like I thought, they're you know, there are people that thought, okay, well, actually sixty percent of people have already been infected, we think, and therefore there's heard immunity, you know, notwithstanding evidence about reinfections. You know, kind of I was in, I think the little denial about that. Clearly these reinfections were a problem. So I need to start wrapping up here. So let me kind of let me ask this. Let's say that there is a COVID twenty five pandemic, and let's say that we know this is going to be have roughly the same characteristics as COVID nineteen. For some reason, any immunity you had from previous COVID nineteen infections or vaccines provide no protection. So we're starting from scratch. How do you think the United States would react today?
It'll be it'll be a nightmare, right, I mean, it was just I think the one area where there has been a softening though, is certainly on kids in schools. That's like the one kind of like the narrative initially was we have to do this, we got to protect the kids. Then the narrative shifted to well, the kids are OK, but we need to protect teachers. And then once it became obvious that like that, didn't you know that teachers were not at any greater risk than other professionals, which, by the way, Sweden had a study on this very early that showed this that teachers there were not at higher risk than the average professional, and on and on. Once once like all that's established, it's like then the narrative shifted to which like a year or two into the pandemic, it then shifted to, well, this was a regrettable decision, but they were building the plane as they fly it, you know, as a fog of war. But the key part, just to answer your question, is though, but the narrative did shift, at least to the extent that there was an acknowledgment that this was a mistake. They then come up with some you know, very kind of like exculpatory reasons for why it was a mistake that I think are are convenient and untrue. But the fact that this is now acknowledged that it's like even in like normy kind of liberal circles, most people I think today say like, yeah, that was a mistake. I think that suggests that if there's some you know, virus that behaves in exactly the same way, that there's going to be far far less tolerance for these kind of like long term closures and other interventions on kids. Like people just aren't going to tolerate it.
You know. Look, I'm gonna be honest. I think they are like a certain number of people who uh might be more introverted, right, which is normal, But it felt like it felt like people weren't able to extrapolate from their situation. Where if you have like a nice home in the suburbs and you're someone who loves nothing more than like snuggling on the couch with your partner and your kids or whatever, right and watching movies, and you don't like going out, then maybe this seems good. You don't have any more fomo or guilt for like not worse, you know, Whereas other people I know where like they're like, this is not gonna work for even a week the social distancing thing, and are already going to like illicit parties in New York, and people vary along those dimensions. I'm not even sure what my point.
Was, but my point is, so I know we're bouncing around here but just one more thing, you know, but much of this also has to do with class and and you know, social and economic class. That regardless of whether you're an introvert or not, if you had the means of living in a comfortable home and doing your work from home and not losing your income, that you were just going to experience the pandemic very differently from someone who had to leave their home to work, from someone who lives in a dump somewhere and you know, and their kids are jammed in some tiny apartment with them. It's just so it's like it wasn't just about an introversion. It's also about class. And this was a remarkably class based policies that were put in place during the pandemic that dramatically favored those who were comfortable and dramatically escalated the harms to the people who to not have those same means. I want to talk or close by talking about the United States and kind of social solidarity in the United States, because look, I am certainly like a libertarian leading person by acknowledge that pure libertarianism becomes problematic in a pandemic, right, So you could say, for example, okay, well if it is a time of high transmission.
I want to go to a restaurant. The owner wants to keep the restaurant open. The waiter and the servers want to make money noon tomic income for their families, And so what's so bad about that we're all assuming the own risk. However, we are also creating a negative externality for like people in our community. More broadly, right, and these questions become easier to solve when the countries are more united, right. I mean, you have a quote in the book that you kind of flight at the top. All of this is not a book about COVID, It's about a country ill equipped to ac sensibly under duress. How much of this is about the United States? And has that made you more pessimistic about the United States's leadership abilities? State capacity is a fancy term for it going forward.
I'm very pessimistic. I'm hoping my vook will act as some sort of corrective for people and serve as a record and also as a means of thinking through how these things happen, which will hopefully act as some degree of like a countermeasure. But the reality is, you know, when you have this kind of like constellation of all these different influential institutions, and through both political and kind of like personality inclinations, it created a very bad environment with bad incentives for people to be afraid to either think critically, or if they were thinking critically, then be afraid or told explicitly that they were not allowed to go against the purported consensus. Well, it certainly certainly permanently shifted my priors as far as kind of how wrong the expert consensus can be, and how wrong motivated by I think somewhat banal and obvious political motives, how how unsubtle the effort to maintain the consensus was. And you absolutely would get screamed at if you expressed views that were very centrist a and later proved to be mostly correct B. But they were very careful about how they are drawing, drawing the lines between what was acceptable and what and what was not. And I will never forget it, but I'm glad we're not going through it anymore.
So, thank you so much for joining us, David.
Thanks for having me, Nate, it's good to chat with you.
That's all for this week. Premium subscribers can seek around for our answer to one of your burning listener questions after the credits, and if you're not subscribing yet, consider signing up for just six ninety nine a month. You've got access to premium content from us every week and if you're listening across Pushkin's entire network of shows. Steve Business is hosted by me Nate Silver along with Maria Kanakova. The show is a co production of Pushkin Industries and iHeartMedia. This episode was produced by Isabelle Carter. Our associate producer is Sonya Gerwit Sally helm As our editor, and our executive producer is Jacob Goldstein. Mixing by Sarah Bruguer. If you like the show, please rate and review us. You know we like we take a four or five. We take the five, rate and review us to other people. Thank you for listening.
