Why did COVID Decision-Making Go So Wrong? (with David Zweig)

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Pushkin.

Welcome back to Risky Business, a show about making better decisions.

I'm Nate Silver.

My co-host, Maria Kanikova, is off today, but we do have a special guest, David Zweig, 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 the Substack newsletter, Silent Lunch.

So

welcome, David.

There are two reasons we're having you on today.

One is I really like your book.

In fact, I endorse it.

I blurred the back cover.

The other is that it is risky business.

It is a show about making better decisions.

That's our tagline.

And this is a case where a lot of really bad, high-stakes decisions were made.

So welcome, welcome to this 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 models.

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 maybe admit or mention stuff 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 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, 9-11 or the Iraq War, the amount of analysis and books written and scholarly study of those events

to me seems like like there should be that, but times 10 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 book 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 as a backdrop to kind of explore 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?

And 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 it.

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 fists 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 tissue 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 gets 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 to upper middle class, depending on the precise community, right?

And

you're a dad of two.

Yep.

Everything you said sounds accurate.

And I should say, I live part-time in Westchester County, too.

My mom grew up in a town called Croton, 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, how are you behaving?

Like most people in my area, 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 inflection points?

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 like need to feel informed about what was going on.

And what changed for me was I started to realize the information I 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 like high school track here in my town.

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 50%.

And

as you'll recall, and everyone else will, you know, we were told, and the official slogan was 15 days to slow the spread.

That began in March.

And then they tacked another 30 days onto that.

And, you know, and there was seemingly, to my mind, like, There was no real debate or pushback.

It was just like, oh, yeah, remember how we told you 15 days?

Now we're adding another 30.

And so the thing is, the reasoning behind the 15 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 50%.

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, well, what are you talking about?

I'm like, well, we did it.

We flattened the curve, man.

We had a very specific goal that we were told we needed to achieve.

We achieved it.

We flattened like literally.

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 it in the book, the hairs on the back of my neck still stand up.

Cause that to me was one of the, 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 achieve that goal,

but then they just kept going anyway.

Yeah, no, 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 care.

So,

you know, to be in an environment like that in a kind of rural Missouri hospital at a time when this disease is beginning 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 called the Department of Health in Missouri and 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 end game here, right?

I remember we had

friends over, like you, at first, I was very cautious.

I remember like yelling at a stranger for not wearing a mask on an elevator and some Karen-ish behavior there, right?

But gradually there was kind of this thing where you start to eye roll and group chat and you're like, we can't really not do, 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 forward 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 record scratch moment in the book is when at the end of April and beginning of May, 22 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.

22 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 had 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 uh arguments about oh well europe did that because they no 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 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 mask mandates across the board.

They weren't doing distancing across the board of six feet.

They didn't have HEPA 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, it 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, um you know by the end of april dropped something like 50

another key moment was an article that had come out on NPR

of all places where they talked about the 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 their 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 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 my anecdotal experience of this.

And we can get into it.

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 on the 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 of these, you know, most experts in any field 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 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 Bhattacharya, who now works for the White House, right?

Perfectly well-credentialed expert, but he was going against the consensus.

So therefore, it was kind of blackballed's too strong a phrase.

He had a strong voice in 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 threads of 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.

I know that's like a mouthful, but in plain English, he's not an expert on what happens to children 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 2020.

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 to me, and then to make matters worse, Nate, there were were other people who sort of fashioned themselves as these like COVID pundits 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, is 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 trade-offs are, what are the consequences of closing schools.

And then it's society's job to, in our flawed democratic system, weigh that expert evidence and

make what are 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 a decision to focus so much on

schools, right?

Why that, 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 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 a mask mandate.

I think it was age six and up.

So the fact that just one of a zillion examples, the fact that it was like required for two-year-olds in America to wear masks

was, you know, was quite unusual and worthy of comment.

So the reason I mentioned this 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, Nate, 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 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 I'm really interested in is 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 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-CoV-2, which causes COVID, you know, the novel coronavirus, that it behaved very similarly to way other coronaviruses had behaved.

And I had interviewed this gentleman who's a specialist in infectious 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 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 four hooves, think of a horse.

Don't think of a zebra.

I mean, everyone, and I talk 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 in how they were employed.

But let me start with the 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, 22 countries reopened 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, it's 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 protecting you from bears or

snakes or who knows what, right?

And that's, I think, a more coherent version of the precautionary principle where 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 dovetail with your point there, in medicine, everyone knows the cliche of first do no harm.

Yeah.

And

we reversed that in the pandemic, that typically what you're supposed to do ethically is you don't act first and then then try to figure out things.

You first, you know, there's a reason why the FDA's, you know, motto, 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 a 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 10th of April 2020.

But once there was an enormous amount of empirical evidence that

millions of kids in school was not having a catamaclysmic 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 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 mean, there's like, there's no absolute proof, right?

When there's lots of evidence, right?

There might be preliminary studies.

There are also, you know, to use a 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 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 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 tend 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 like personality type that

got to the level of success where they are.

So all of 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 with 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 kind of had a different type of improvador, you know, attached to it that people could accept it.

I started getting emails from people around the country, including a lot of doctors and including some former CDC and former NIH people.

And they would say, most of them would start off 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 it would say, but all of this is off the record.

And then the second part of that is some of these people were told explicitly by their bosses, you know, and 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 NICU, that's like the pediatric or PICU, 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 PICU,

we've had more kids, more patients here from myocarditis 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 motivations 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 may be 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, Nate, are 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 500 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 will be the last one.

I'm going to give you 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 mind, 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 tape measures and rulers 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 the people from the AAP discussed this in an interview.

He had said, look, if you can do six feet, great, but if you can, 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 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 ritualistic, right?

I think I heard friends in Mexico that like using ultraviolet 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 stand in a crowded restaurant, right?

And then go eat in a room full of people, everyone's mouths open, right?

So you're reducing their risk by 0.01%.

But like, I do want to,

you know, I do want to get into a little bit more of the evidence.

Well, let me, how strong is the evidence on the effect of school closures?

So you'll see some studies saying it's really bad.

See another study saying, oh, only sort of bad, right?

But 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 early on, who would think, well, of course, school closures 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, it intuitively makes sense.

Other people similarly, well, of course, having like a cloth in front of your face strapped on, of course, it'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, of course, if kids were seeing a spike in peanut allergies, of course, we should dial back exposure to peanuts in little kids, because that's exactly what the American Academy of 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,

Dr.

Spagha, 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 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 mention all 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 talk about in the book, even well before they started easing restrictions, people started moving around.

That closing schools could have a benefit

for a week or a couple of weeks if done in conjunction with everything else being closed.

But there 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 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 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 12 months.

It made no sense epidemiologically or ethically.

Yeah, casinos were open, as I experienced a couple of times.

I only went after I 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 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

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, or 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 an e it's just easier it's less cognitive load on you then you everyone was just kind of externalizing a complex at least you know moral and and and logistical decision making they were just sort of um farming it out to someone else.

Let them decide for me.

It's kind of amazing, Nate, 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 Kahneman, the late now Daniel Kahneman's thinking fast and slow, there's like.

System one, fast thinking, which is more kind of intuitive and system two, 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 to first principles and think through things, you know, to the extent people had intuitions,

they were often very wrong intuitions, right?

I remember Mary de Blasio in New York told people, we're going to shut the bars down for a while, right?

So you 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, 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 pointed out like a lot of people's intuitions were based on it being an influenza pandemic and not a coronavirus pandemic, which has dramatically different

effects on how transmissible 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 the 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 in, 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 do X, Y, and Z actions, this will lead to such and such results.

That's what the models were showing.

They 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 do 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 the endnotes.

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 model is based on another model.

Okay, well, where did they get that from?

So then I'm reading the second model and then I'm looking through and there's claims in there.

And then I see, oh, that's based on yet more models.

And then I likened it to the sort 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 the 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 37%.

And you go deep in, you know, in my mind, sort of metaphorically, it's in like six-point font.

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 by 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 could do a more rigorous job with this, but it's probably not very important.

And 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 literal 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 um it was hard to find enough tests and a lot of uh 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.

And it turns out that 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 and 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 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 of these things that are really important in society.

Now, of course, if anyone's listening, you're like, 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 death in a whole variety of ways in our country for because, you know, on the highway, we can make the speed limits 35, 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 elderly people, who were not allowed to see their family.

We had children, the rates of depression and anxiety and of eating disorders, both BMI going up and also anorexia going up and bulimia going up.

All of these things were directly tied.

to isolation and school closures.

There are people who've said, no, it's just because of the pandemic overall and they were upset.

It's just simply not true.

There is a lot of evidence, and I cite it in my book, that 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 ciscal 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 masker and indoor crowd avoider before i got vaccinated and i wasn't doing it for me i was doing it for because i would feel guilty as if i transmitted covid right but at some point people it just people's tolerance for it lags and and anyway um 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, just more broadly, there are statements, you know, from Fauci saying, if you're 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 in 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'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 10 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 20 studies if they want.

Then I could cite 20 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 and I was talking with him and I said you know and 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 it's like that's better than a study he's like that's just reality studies always have chosen parameters and and it 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 someone 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,

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,

the inputs, et cetera.

But when you just look at reality, empirical reality of millions of kids are in school, nothing really happened, that,

when I spoke to the psychologist, he's like, that's better.

That's actually above a randomized trial.

We're just observing

empirically something that's true.

But instead of looking at that, we favored theory, you know, and all of these things where we, well, they didn't say we think, they said we know.

But implicit in this idea, remember the Swiss cheese model, Nate?

Where?

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 virions 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

we had evidence to the opposite, that in reality.

So that to me is the thing that I just find endlessly fascinating.

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 epistemological 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 as a contrarian and

what that means.

I think some of them overstated harms from the vaccine.

I haven't seen that evidence yet.

Maybe it exists and it just hasn't been uncovered.

I have not seen strong evidence that they've caused the mass harm that some people um purport them to to be causing um

i think the contrarians

i think people on both sides but including the contrarians perhaps misjudged

how to effectively argue for their position um i don't know tell me maybe i'm missing something i 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 there, you know, there are people that thought, okay, well, actually

60% of people have already been infected, we think, and therefore there's herd immunity, you know, notwithstanding evidence about re-infections, you know, kind of I was in, I think, a 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-25 pandemic.

And let's say that we know this is going to be, have roughly the same characteristics as COVID-19.

For some reason, any immunity you had from previous COVID-19 infections or vaccines provide no protection, So we're starting from scratch.

How do you think the United States would react today?

It would be a nightmare, right?

I mean, it would just, I think the one area where there has been a softening though is certainly on kids and 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 okay, but we need to protect teachers.

And then once it became obvious that like that, 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 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 um well this was a regrettable decision but they were building the plane as they fly it.

You know, it was 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 acknowledgement 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

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 going to be honest, I think there are like a certain number of people who

might be more introverted, right?

Which is normal, but it felt like, it felt like people weren't able to like 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 um

then maybe this seems good you don't have any more fomo or guilt for like not working you know whereas other people i know are like they're like this is not going to 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 is here but my point is that like well 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, 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 um policies that were put in place during the pandemic that dramatically favored those who were comfortable and dramatically escalated the the harms to the people who did 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-leaning person, but I 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, want to make 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 flagged at the top.

Ultimately, this is not a book about COVID, it's about a country ill-equipped to act 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 book 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 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 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 were drawing the lines between what was acceptable 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 was great to chat with you.

That's all for this week.

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