Most people consider the creation of the COVID vaccines an example of incredible competence, and many doctors and others did an amazing job during the pandemic. Many in the public consider government officials to have also done a good job when handed a bad situation.
According to the WHO, COVID has caused almost 7 million deaths worldwide. To put this in perspective, the BBC reported on April 21, 2020 that the world risked ‘biblical’ famines due to the pandemic, according to the UN. The head of the UN’s World Food Programme said that he feared that 30 million people, or more, could die in a matter of months if the UN did not secure more funding and food. The actual numbers may have turned out differently, but there were voices raising concerns over potential vast global negative consequences early in the pandemic when decisions were being made.
Unfortunately, the language used to discuss such things often attributed them to the ‘pandemic’ rather than making the crucial distinction that they were mainly due to the ‘pandemic response’. The response chosen by governments may have cost more lives than it saved already, not to mention the risk of indirectly costing even more lives over the next few decades due to unintended consequences that were not publicly debated.
Were the right choices indeed made based on what was known at the time, and of course how many did die due to the pandemic response and was there a different way to handle it?
Even if you think the government did a great job handling the pandemic and never change your mind about that, the public needs to examine why the policymakers made the decisions they did on a case-by-case basis. Elementary school students need to “show their work” on math problems to help the teacher decide if they got it right, or perhaps copied it from someone else or asked an Artificial Intelligence, or accidentally got a question right when it was a yes or no answer and they had a 50% chance of being right.
Making the right decisions for the wrong reasons is a concern since they may not be so lucky next time (obviously those who think they made the wrong decisions already see a problem). A close look at the information the public is aware of regarding the crisis suggests most, if not all, government officials in this country made policy choices using an obviously flawed process. If this is the case, they shouldn’t be trusted to have a role in making future choices on behalf of the public. If there is information the public hasn’t been given that would lead to a different conclusion, they need to provide it.
This essay will consider some of the basics of how major decisions should be made, which shouldn’t be controversial. That process needs to include considering the downsides of policies and not merely their benefits. Governments in other countries like the UK have at least begun to explore the potential unintended consequences of their covid policy choices. Were there different approaches that may have saved more lives? Were lives saved in the short run, without even considering whether that was done with a risk of indirectly costing even more lives over the next few decades due to unintended consequences that weren’t publicly debated? This is a very rough first draft overview of these issues, not all statements are linked to sources yet while it's a work in progress.
It is important to examine decisions with the luxury of hindsight after any crisis subsides. Even if you continue to think the government did a great job, the public needs to evaluate whether the decisions were justifiably right based on what was known at the time, accidentally right, accidentally wrong, or unjustifiably wrong since they should have been able to do better even in a time crunch. The starting point needs to be at the very beginning: what was the process used to make covid policy decisions, what was their reasoning and the evidence supporting them?
However, disagreements about how US governments handled covid are still a major source of frustration for a large minority of our society. Those differences should be explored now, rather than waiting until they can’t be ignored during some future crisis when added stress and time pressure will make it even more difficult to cooperate as a society, or to even peacefully coexist.
It seems necessary to ease tensions by assessing whether the process used to make decisions was an acceptable one. Even if you think they did a great job: obviously they haven’t done a good job of making their case to a large minority of the public who distrust that process. Perhaps it’s impossible to get unanimous agreement, but at a minimum it seems far more transparency is required regarding how decisions were made.
Evaluating How They Decided, Before Evaluating What They Decided
Most people made their evaluation of how well the government did based on their subjective sense of whether they trusted the actions of government and whether they seem to make sense at first glance, rather than having taken the time to explore data or logic in depth. Each faction isn’t going to merely trust the gut instincts of the other: data and logic need to be provided to even attempt to change anyone’s mind.
During the Cold War era, neither military superpower trusted the other, yet they found ways to co-exist. The famous phrase “Trust but Verify” described the reality that they needed verification from the opposite side rather than merely a claim of “trust us!”. Many now simply don’t trust how the government handles things when they just rely on asserting “trust us, we are the government!”.
Although we hadn’t faced a worldwide pandemic in our lifetimes before covid, governments and academics have been researching their history for a long time, and discussing how to handle future outbreaks. The CDC and the WHO drafted plans for how to handle major pandemic flu outbreaks. It’s likely that differences between covid and the flu required modifying their plans for how society should handle a pandemic. Yet, it still seems such plans would have provided at least a rough first draft of how to handle covid.
It's important for the public to be provided with a full understanding of why those plans were not followed, what changed. Most people aren’t aware those plans were rather different than how covid was handled, they overall argued against using lockdowns. Maybe something about covid justified it: but the government didn’t bother to explain to the public in depth why that was the case. They merely ignored the existence of the most relevant science-based plans, rather than ensuring the public were informed if changes were made fully rationally, rather than due to reasoning that was clouded by a crisis
A High-Level Overview of Some of the Questions to Consider.
Major government decisions involve unavoidable tradeoffs: just as individual decisions do. Money spent on one thing can’t be spent on another. When a problem arises: often there is no perfect solution and you need to examine the pros and cons of each possible alternative carefully.
Imagine a city develops a problem with rats, and it asks an early primitive Artificial Intelligence program: “What can be done to get rid of a vast quantity of rats infesting several square miles of the city?”. Its answer is to dropping a nuclear bomb; obviously that does indeed solve the problem it was asked to solve, it got rid of the rats.
While the problems with that answer are absurdly obvious to us, the indirect unintended costs associated with solving some real-world problems are not always so obvious. Humans sometimes find themselves in situations where a problem seems so urgent that it may seem necessary to focus on solving it at all costs.
Whether or not it's possible to consider all options in the heat of the moment when time is of the essence: at very least it can be worth afterwards exploring in hindsight what alternatives should have been considered. It's important to decide whether the decisions were justifiably right based on what was known at the time, accidentally right, accidentally wrong, or unjustifiably wrong since they should have been able to do better even in a time crunch.
Although major governments may have been in a rush, they were not like individual humans needing to make a decision in a moment of crisis about something they know nothing about. The governments employed large staffs, and had documents prepared in advance based on lots of research and planning for potential crises. That preparation included considering potential unintended consequences of well-meaning policies. The existing federal flu pandemic plan had concluded the potential harms of lockdowns outweighed any benefit in most cases.
The UK government has at least acknowledged the existence of harms due to lockdowns and made some preliminary estimates of how many people may have died as an unintended consequence of them. Of course, no one could predict in advance exactly how many people would die from lockdowns, but they also couldn’t predict exactly how many would die of covid. It is necessary to make such estimates since even imperfect estimates are better than nothing. Major decisions need to be based on all the available evidence for each option.
When they make any major policy decision with major downsides, government officials need to provide their full reasoning, including their estimates of the costs and benefits for each alternative. If they don’t have time during a crisis, they need to disclose the process in detail afterwards, to improve it in the future. Did any American politicians provide estimates of the negative consequences of their policies? If they did not consider them, do they deserve any more trust than the AI that wanted to nuke a city to kill rats?
They never gave us such estimates, even with enough time to generate them. Even if the estimates were low, the public should be told this, to show that they were considered. They should have had some tools for estimating before the pandemic started, to plug in what they knew about a new pandemic, and choose options quickly. Those options should have been publicly debated in advance, which was not done. Even if the numbers would have weighed heavily in favor of lockdowns, if they made the right decision by accident, that does not excuse the lack of consideration: or the public’s lack of information about it.
Any government official who makes major policy decisions without examining all the upsides and downsides of policies can't be trusted to make any serious decision on behalf of the public. Even if they were right in hindsight, their lack of consideration for tradeoffs means they were only lucky, not competent.
Awareness of all the estimates for different options is only the beginning of a debate, not the end of it. Differences of opinion on policies may reflect different values and priorities, not just disagreement over the data. There are many who feel that no number, or almost none, could justify many covid policies. They may not care about the numbers that politicians have or use, because they already opposed lockdowns. They should care though. If government officials estimate the downsides of their policies, they may reconsider enacting lockdowns or other policies in some cases, if not always. The current article does not address how to make choices once the data is available.
A High-Level Look at the "Debate" Over Alternatives.
The original CDC flu pandemic plan focused on isolating the sick and protecting those at highest risk, rather than the whole public. Options like that should have been debated in detail, to show that the government considered all possible options based on the data and science, and did not let politics override scientific approaches.
One of the most prominent groups criticizing government policies, were the scientists and others behind the Great Barrington Declaration, a lockdown alternative. Many scientists also called for the collection of better data to make decisions from the start. A full debate over the topics might not have changed any policies. Even if that was the case, the lack of serious debate was a problem.
They faced silencing through emotional attacks more than reasoned disputes. Some of those who defended government policy offered some logical disputes, but the back-and-forth consideration of ideas that science usually operates on was undermined. The current Wikipedia edit of the entry on the topic , apparently done by someone who isn't very knowledgeable about the topic but merely active in editing Wikipedia, describes their approach as a "fringe notion of "focused protection".
Even if people didn’t agree with the approach, it was not a “fringe notion”, as it was based on prior government pandemic plans before covid hit. The entry continues that sentence with a straw man distortion of their views, which shows how they were dismissed without due consideration, and makes it not worth reading further. Emotions often silence productive public debate.
All sides should consider how they might have done better during the pandemic crisis. Whether the Great Barrington approach was a better choice or not, they seemed to skip some steps before engaging in a debate. Before attempting to get the public to consider a different policy approach, they needed to get the government and media to acknowledge that major government decisions should be subject to debate in the first place. Otherwise, any proposed alternative could be dismissed out of hand regardless of its merits. Government policies that rely on science should not be treated as unquestionable dogma, contrary to the basic principles of scientific inquiry. Even policy matters unrelated to science should be open to critique in the way credible science is.
The public often tends to think “if it ain’t broke, don’t fix it” and to fear rocking the boat during a crisis when there is no need. Another step that most lockdown critics skipped over was educating the public about the need to rock the boat. They needed to argue the lockdown approach was broken in concrete terms rather than merely abstract ones. They needed to show that the lockdown approach was flawed in concrete terms, not just abstract ones. Some people assumed that lockdowns were a problem in a free country and preached to the choir who agreed with them, without realizing the need to find different ways to persuade the rest of the public.
They also neglected to persuade others enough that even if they accepted lockdowns, they might not be the best option. They needed to make a stronger public case about the level of lockdown harms, starting with insisting that the government estimate them. It's likely the harms need to be acknowledged by the government before the public will be ready to seriously consider debate over how to reduce those harms.
Just as there were estimates for potential covid deaths, there should have been more discussion of the potential negative consequences of lockdowns. The problem again is that the government never acknowledged any harm or offered any public analysis of competing options.
A High-Level Look at Downsides and Alternatives
Negative consequences of policies weren't used to open pandemic policies up to debate but were merely portrayed as if they were an unavoidable consequence of the virus itself. The particular pandemic response chosen was viewed as if it were set in stone and unquestionable.
The lockdowns also had negative impacts on health care systems and outcomes. Some experts warned early in the pandemic that the lockdown measures could lead to more deaths from other causes, such as lack of vaccination, delayed medical treatment, and disrupted clinical trials. The lockdowns halted vaccination programs and clinical trials for other diseases in many countries, including the US, which could result in more deaths from preventable or treatable illnesses. Moreover, some people avoided getting medical treatment for other conditions due to fear of infection or lack of access, which could have long-term consequences for their health and survival. The lockdowns also affected education and economic outcomes, which could have indirect effects on health and life expectancy. Many students received poorer quality education due to school closures or online learning, which could lower their future income and access to health care. The lockdowns also reduced the GDP of many countries, which could limit their ability to invest in health care systems and research in the future.
However, the government did not provide any estimates for these impacts, nor did it disclose the process of decision-making based on the available data. This lack of transparency and accountability undermines the public trust and prevents a meaningful debate over the alternatives. Decisions should be made using the best available information, while factoring in the uncertainty in those estimates.
Spending money on one thing takes away the ability to spend it on something else, so tradeoffs need to be considered. The government should have compared the costs and benefits of different policy options before imposing lockdowns. For example, the federal GAO reported that as of January 31, 2023 that $4.6 trillion had been spent on COVID response and recovery). This figure does not include state and local funds and may be an underestimate. Moreover, the lockdowns also reduced the GDP of the US, which could limit its ability to invest in health care systems and research in the future. The Washington Post reported on June 1, 2020 that the CBO estimated $8 trillion in reduced GDP over the following decade due to the pandemic response. This report suggested that even early in the pandemic, the government was aware of the massive impact on GDP and could have taken it into account when considering tradeoffs.
If society had stepped back and said, “it’s going to cost us $8 trillion to try to save lives, rather than that, what if we spend the money and don’t lock down, how many lives can we save?”. Yes: perhaps if we hadn’t locked down there would have been some impact to GDP from the disease, but the $8 trillion is just a rough figure to think about other ways we might have aided society for that large a cost. There was also the $4.6 trillion we spent on covid, so $8 trillion is likely an underestimate of the cost society paid for lockdowns.
Would this have been the best use of the funds to save lives if we had stepped back to think about it? Just consider one option to illustrate the point. Even if a simple estimate may be flawed, it suggests the possibility that if we looked further, alternatives might exist to save more lives than what was done without much public debate over alternatives. Or we might have saved the same number of lives at lower cost. The covid problem was attacked as if it had to be handled in the first way that came to mind no matter what the cost, the same way the AI suggested nuking a city to kill rats.
One alternative approach option to save lives would have been to spend the money on developing new pharmaceuticals. One study on 66 diseases in 27 countries explored how many lives were saved from new pharmaceuticals, and the amount of money spent developing them. They estimated that each $2,837 in pharmaceutical industry spending on average saved one year of life. This may or may not have been a viable approach when further examined closely, but it illustrates the importance of considering trade-offs in case a better option may exist.
Imagine we had spent $8 trillion on drugs instead of locking down and losing that $8 trillion in lost GDP. Based on this estimate, this figure implies a potential 2.8 billion years of life saved. The average American is around 38 years old and has about 41 more years of life left. So those years of life could correspond to saving the remaining lives of about 69 million people. If we round life expectancy to 80, that many years of life would be around 35 million full lives worth of years saved.
For perspective, estimates vary, but one study estimated 9.7 million years of life were lost during the first two years of the pandemic. The CDC reports that there have been about 1.1 million deaths due to COVID-19 as of May 2023. We don’t know how many, if any, were saved by the lockdown approach but it’s doubtful it would match the potential lives that would have been saved by the pharmaceutical spending option. Even worst-case projections for the United States weren’t anywhere close to that number of lives.
Spending $800 billion over a decade on pharmaceuticals could have saved as many lives as lockdowns for a lower cost, or perhaps far less. We need better estimates of how many lives, if any, the lockdowns saved compared to how many they took.
Of course, we may not have chosen to spend $8 trillion on other healthcare options instead of locking down and losing that $8 trillion in lost GDP if we had considered this option. Some people (including the author) might have objected to the government spending such a large amount of money on drugs or other interventions, arguing that it would increase the national debt, interfere with the free market, or have unintended consequences. However, others might have supported this option as at least a better approach than expending that much of our GDP on lockdowns, claiming that it would save more lives, improve public health, or stimulate innovation.
The point is, even if this wasn’t a realistic option, there may be other alternatives that may have been invented if there had been debate over alternatives to lockdowns, which was largely absent in the public discourse. Unfortunately, such a complex debate can’t occur rapidly during a crisis, so it needs to occur now before future crises. We need far more data and estimates regarding the impact of the pandemic and its handling to consider what to do in the future.
Prior Preparations for Pandemics
Another important issue is how past money and planning was done to prepare for pandemics before this covid hit. The federal government funds many $billions a year in healthcare research. However, some of those who have overseen those funds have stated to be concerned for a long time about the risk of a major pandemic.
Yet when a major pandemic happened, amateurs or people doing this on the side felt a need to step in. They addressed many obvious aspects of science and computer modeling of pandemics that hadn’t been done well enough by large governments with vast resources. Small labs around the world needed to research things like air flow related to viruses, masks, and other issues. While some characteristics of this virus may be different than prior ones, it seems like vast $billions should have prepared better evidence on masks, and explored how better to quickly determine the transmission methods of a new virus and prevent them, etc. They should have had processes in place to quickly determine the relevant characteristics of how a new disease spreads and have solid evidence already regarding protection gear. Yet the topic is still under debate due to questions about the type and quality of evidence.
A few years ago, a television program in the UK called Contagion! The BBC Four Pandemic explored how to model the spread of viruses. The show collected data on the movements of citizens that neither their government nor our government had done a good job of collecting. Such data is crucial for understanding how viruses transmit and how to prevent or contain outbreaks. However, such data may vary depending on the location, population, and behavior of different countries or regions, so one project like that likely wasn’t enough to prepare for a global pandemic. Many computer scientists during the pandemic explored ways to make computer models more realistic that hadn’t been pursued before the pandemic happened, despite the vast amount of funds government spent each year to deal with healthcare related research.
There are several possible ways that some of those $billions of dollars a year over a few decades could have been spent to leave us far better prepared for a pandemic. For example, the government could have invested more in data collection, computer modeling, virus detection, mask production, and public education. Instead, it seems that the government relied on outdated or incomplete information, flawed or simplistic models, slow or inaccurate testing, scarce or ineffective masks, and confusing or contradictory communication. There is a risk of indirectly costing more lives over the next few decades due to unintended consequences that were not publicly debated. We need far more data and estimates regarding the impact of the pandemic and its handling to consider what to do in the future. Because of this, we need outsiders who weren’t involved in the prior work to question the decisions and actions of the government and its experts.
Many independent researchers have argued from the start about the poor quality of the data gathering process. For instance, many diseases are spread predominantly through infection within hospitals, but such data wasn’t being gathered. This data could have implications for the infection rate, the mortality rate, and the effectiveness of the lockdown measures. With covid, however, a case wasn’t considered hospital acquired until a couple of weeks or so after admission to the hospital. While earlier cases might be ambiguous as to when it was caught, many infections might have been acquired during those first two weeks. Data should have been collected to allow that possibility to be investigated.
A common assumption is that the government did a good job of something since they have nothing to compare it to. However, this assumption can be misleading and dangerous, especially when it comes to matters of life and death. By analogy, consider those in the former Soviet Union who knew nothing of the outside world and may have been persuaded that the poor-quality goods their government provided were great since they had no point of comparison. Our government may or may not have done a good job with covid, but we should not take it for granted or accept it without scrutiny. We need to examine it more closely and compare it with other possible approaches, even if we can’t know for certain if things might have gone better.
Of course in many cases officials weren't the primary ones making the decisions. They merely copied those of others. In the case of government actions, sometimes it’s appropriate for policymakers to copy the policy choices of others who have more expertise or resources to make a judgement call quickly. Even so: we still need to consider for each official whether their choice to “cheat” was made with appropriate due diligence or if they should have asked more questions on the public’s behalf.
It is essential for some of the public to explore these concerns in more depth. These issues are not the author’s primary area of interest. However, it is possible that they might be explored further in this newsletter depending on the author’s time (paid supporters will help time be found for more writing in general) and other topics to work on. This is just a quick rough draft preliminary analysis of the topic one Sunday, looking back on what’s happened.
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