Monday 3 January 2022

Redefining the Floor....Down

I was scrolling through some YouTube clips the other day and came across the great Seinfeld episode in which Frank Costanza invites Seinfeld and Co. to a celebration of Festivus; a made-up, emblematically dysfunctional, substitute for Christmas. 
  
An important part of the Festivus tradition is the "airing of grievances" over dinner. Depending on where you were in the world, the state made such an airing rather difficult for the second straight year. I've already seen Queen Elizabeth, the Pope Francis, and a bunch of world leaders offer year-end messages of hope, renewal, world peace, and good health for 2022. I suppose it's part of the job. 

2021 undercut my optimism about a lot of things. Indeed, as I ponder the past two years, my cynicism and despair about our collective trajectory has only grown. A different "Pope," the English poet Alexander Pope originated the phrase "Hope Springs Eternal," as a way of saying that humans have a way of looking forward to brighter days despite any current gloom. Sure. But as we close in on the second full year of what strikes me as an increasingly futile effort to manage a pandemic, I've decided that most of what I have is actually a list of grievances. There's a good chance you won't agree with me on many of these. I long ago concluded I was on an island by myself; neither MAGA-hat wearing, anti-vaxx conspirator, nor member of the cowering herd.

The Tyranny of Experts

Before I heading into the rabbit hole, I want to say something about "experts." I hear a lot about them these days, mostly that we should "trust" them. After all, they are the experts. The scientists and medical professionals are "experts" and are providing us with advice we should follow. This sort of appeal to expertise sends my Spidey Senses off the charts. I'm all for experts and expertise. But, history tells us that experts ought to be subject to a bit of scrutiny since a lot of "expert" ideas have turned out rather badly. 

A lot of people might read what I have to say below and respond by telling me to "stay in my own lane," "you're not a doctor, an epidemiologist, or an infectious disease 'expert'". True. I'm none of those things. But I do read a lot of what they have to say. And some, I would submit, have been outside their particular lane for a long time; two years, actually. Indeed, the political economy impacts of their decisions ARE my lane. Moreover, I think a lot of our public health "experts" could use input from a more diverse set of.... experts.

A Litany of Grievances

Walk and Chew Gum?

In so many ways, we've forgotten how to walk and chew gum at the same time. In the process of turning our societies upside down to fight SARS-CoV-2 for the past two years, we've taken our eye off the ball in lots of other areas. I see a lot of dark shadows ahead in our geopolitics that many people seem unaware of while they incessantly focus on all things Covid. While western leaders complain about the threat of the unvaccinated and contemplate ineffectual travel bans from countries from whom we've hoarded vaccines, Vladimir Putin and Xi Jinping are having good pandemics amassing troops near Ukraine, putting the boots to Hong Kong, Xinjiang, or salivating over Taiwan. 

Meanwhile, we've been promoting booster shots for the fully vaccinated while large parts of the developing world are still waiting for their first; an approach to Covid-19 that Seth Berkley, the CEO of COVAX, the global vaccine initiative, is calling a dangerous mistake.

While vaccine nationalism impedes progress on fighting the pandemic itself, a different kind of Covid-induced economic nationalism is also solidifying its grip. At the same time public health measures drove people toward e-commerce, many of those involved in producing those products were also at home, rendering them unable to meet demand. A different set of problems have emerged in many port facilities, where workers have been isolating at home while dozens of container ships full of goods wait off-shore. Many of these supply-chain issues initially connected to debates about economic nationalism in hoarding personal protective equipment have since been extended to a host of other product areas. 


Most troubling about it all is the way in which it has accelerated talk of unraveling many of the efficiencies of an integrated global economy. Rather than engage in the hard work of trying to solve some of these problems, we've been reaching for nationalist solutions like "reshoring" or moved to further "decouple" our supply chains from dependence on others, especially China. This should raise alarm bells for students of the economic nationalism of the interwar years. Indeed, we seem to have forgotten the postwar rationales for economic integration, including the European project. None were just about prosperity and efficiency. All were also about linking us to each other politically and socially through positive-sum commercial activities. 

The passage of time makes it seem like those days were easier. A big frustration of mine is the way in which Joe Biden has presided over an accelerating slide toward economic nationalism. The "adults in charge" seem to have just accepted that China will anchor one part of the global economy and the US the other. Yet, Biden's disinterest in rejoining the Trans Pacific Partnership (CPTPP) and in fixing the WTO (Appellate Body) suggests he isn't interested in America anchoring much of anything. To those who would say "wait a minute, don't forget about the AUKUS Pact. Surely this is a sign the Team Biden is serious." Well, perhaps, except that Team Biden wasn't aware that Australia and France already had a submarine deal.... And then there's Afghanistan, of course. 

Floor of American power is being redefined downward...

Regressive Public Health

Among the many frustrations I feel toward our public health officials is the regressiveness of their interventions, especially lockdowns. From the jump in March/April 2020, I was struck by how inequitably the blanket lockdowns were being felt by different socio-economic strata. Large box stores were deemed essential and allowed to stay open while small businesses were forced to close. The white collar laptop class was able to comfortably work from home while those far lower on the socio-economic scale were deemed "essential" and continued to work. While the laptop class Zoomed from the comfort and security of their homes, "essential" workers donned hazmat suits and worked from behind plexiglass. There were countless others, particularly in the service sector, who lost their jobs entirely. Indeed, an entire generation of young people, many already discouraged by data showing they'll enjoy a lower standard of living than their parents, have been set back even further. 

While rich country governments implemented a host of emergency employment programs designed to keep people whole while they waited out the pandemic, those programs (like the pandemic itself) were supposed to be temporary. As we approach year three of the "emergency," the various public health restrictions have become rather more permanent than some of the programs aimed at compensating people. 

If this were still March or April 2020, I would be more forgiving of our public health officials for their lack of creative response. There were no vaccines. No real therapeutics. And no real sense of how a novel respiratory virus was going to behave. All of that has changed. In early 2022, we have a host of vaccines that are pretty good at keeping people out of the hospital. There are several therapeutics, and more on the way. And we have consistent data patterns showing who is most at risk. 

Nevertheless, our public health officials continue turning to the only instrument they seem to have in their toolbox; different forms of lockdown. It's as if public health only has hammers so everything they see looks like a nail. Most galling to me are the ways in which public health officials say they understand the collateral damage their measures are causing, but do hardly anything about it. More galling still is that they blame SARS-Cov-2 rather than the measures they've put in place. The evidence that the impact of pandemic restrictions are falling hardest on those who can least afford them is overwhelming and depressing (World Bank, World Economic Forum, American Psychological Association).

I think our educational system (at all levels) has badly failed younger generations. Leadership in higher education (too often a contradiction in terms)  routinely amazes me. Cornell University's response to the Omicron variant is emblematic of the risk-averse nature of higher education. During the summer of 2021, Cornell went to great lengths to push for a return to campus, more or less turning the entire college town of Ithaca, NY into a fully vaccinated bubble. On top of vaccination rates for students and staff approaching 100%, a host of on-campus restrictions were put in place "out of an abundance of caution." Nevertheless, Omicron sent everyone into a panic and everyone was sent back online again in early December. Not to be outdone, dozens of other universities soon thereafter parroted Cornell, putting the remainder of Fall 2021 online and delaying the start of Winter/Spring 2022 until the end of January.... "out of an abundance of caution." 

I'm simply not sure where we think the goal posts ought to be? Vaccination was supposed to be our ticket out of some of this, but it increasingly looks to me like no level of vaccination is good enough to ease various restrictions and allow people to be normal. Long-term consequences for the young, be damned.

I suppose university students are adults and can take their tuition dollars elsewhere once they feel a third-rate online experience isn't cutting it. Primary and secondary students are a different matter entirely and the situation there is even more depressing. The educational and developmental impacts of school closures has already been profound, and we've done so without any compelling evidence of closure's necessity. 

Most of what I've observed being done with schools in the name of public health leans much closer to child abuse than public health. The research on the imposition mask-wearing and social distancing on child development makes for depressing reading; brain and speech development, basic socialization, and of course mental health. There is debate about the extent of these setbacks, but the mere fact we're debating the extent rather than its fact tells me there's a problem.

Finally, those who say that kids are adaptable and will get used to all of this never acknowledge that kids have no power in these discussions. Sadly, adults claiming to be acting in the interests of kids are too often just thinking about themselves. 

The floor in regressive public policy now has a big hole in it...

Irrationality Prevails

It's hard to rank my list of gripes here, but my basic belief in the rationality of people has taken a big hit in the last two years. I used to buy the old adage incorrectly attributed to Abraham Lincoln that "You can fool all the people some of the time and some of the people all the time, but you cannot fool all the people all the time." I'm not so sure anymore. 

I've spent some time studying the psychological research examining how well humans reason (more below). The punchline there is "not well." But even with this background, I have been amazed at how uncritically highly educated people have been frightened into submission. Throughout much of 2020, I could understand and forgive the uncertainty about SARS-CoV-2 that would prompt people to hoard toilet paper, disinfect their Amazon boxes, or look at each other in grocery store aisles with fear. But as the pandemic has worn on, I am surprised by the slow pace at which really smart people I know have begun to question their frames of reference for Covid or the strategies by which our public officials have been combating it. After two years of repeatedly doing the same thing to little effect, you'd think there'd be some broader push-back from those who typically think of themselves as speaking truth to power.

One of the (still) very few humanist critiques of some of what we've been doing was David Cayley's "The Prognosis"  which appeared in the Literary Review of Canada all the way back in October 2020. Among the issues Cayley worries about is the abuse of "science" by those in power and the ways in which phrases like "follow the science" quickly become fraught appeals to select groups of credentialed "experts" who happen to be influential. Political prescriptions anchored in "the science" have become unassailable objective facts in the public eye. Cayley writes:

Science, in other words, has become a political myth — a myth quite at odds with the messy, contingent work of actual scientists. What suffers is political judgment. Politicians abdicate their duty to make the rough and ready determinations that are the stuff of politics; citizens are discouraged from thinking for themselves. With science at the helm, the role of the citizen is to stand on the sidelines and cheer, as most have done during the present crisis.

For several years, I have read PhD candidacy exams engage in serial abuse of people like Thomas Kuhn to attack the tenets of a scientific method I am not sure they ever fully understand. Science to many students is just contingent, but a social construct driven almost entirely by subjective circumstance. They misread the hard sciences as devoid of subjective professional judgement, fierce debate about the application of their shared methodological approaches, or the conclusions that flow from them. Interesting to me is the degree to which so many of those who readily critique the hard sciences as socially constructed now worship at the alter of a singular form of science that doesn't exist either. 
Putting the Squeeze on the Charmin


Rational choice is another area of attack popular with students. Unfortunately, most of our students have not read the mountains of psychological work focused on rationality and reasoning, starting with Amos Tversky and Daniel Kahneman. Our students dislike rational choice modelling because it leans to heavily into the cold methodologies deployed by economists. It turns out humans don't reason well, even when presented with new or better information. Indeed, people like Herbert Simon have coined the term "bounded rationality" to describe some of the outer limits of our capacities for reasoned decision-making. Rather than constantly revising our decision heuristics as new information arrives, we instead engage in a lot of satisficing behaviour in which we selectively plug new information into our existing heuristics; seeking a pragmatic rather than idealistic outcome. 

Moreover, there's a lot of interesting research by psychologists like Eldar Shafir focusing on the psychology of scarcity; the ways in which deprivation can lead to a life absorbed by preoccupations.  One  conclusion is that we are easily overwhelmed by the immediacy of problems in front of us, particularly when we do not have a cushion of resources to help us. In other words, we tend to zero in on what seem to be our most proximate problems to the detriment of longer-term strategy.

Our societal reaction to Covid-19 has demonstrated all of this in spades. The daily barrage of panic porn in the press, some of it contradictory, all of it presented as grim, has pushed many people to the brink. Many have simply hunkered down, barricading themselves in their homes, surrounded by buckets of sanitizer, rubber gloves, and respirators whatever their actual efficacy; a sort of practical satisficing behaviour in the face of sorting through volumes of information.

In all of this, we've become an increasingly infantilized society, breathlessly waiting for daily pressers from public health in the hope that some new measure or tactic will deliver us from the grip of the pandemic. Instead of reasoning through what we now know about SARS-CoV-2 in terms of risk, we compliantly wait for an "all clear" that will never come. For some, the "nanny state" has become their last line of defense; keeping you and your family safe from all conceivable risk. 

One area in which that's become especially true is with respect to "vaccine efficacy," a term many had never heard of until late 2020. One of the biggest mistakes our public health establishment has made is in overselling what SARS-CoV-2 vaccines could actually do. They were only ever designed to keep your butt out of the hospital. That's it. And, they're still doing a really good job of it. 

Yet, early data that suggested they might also be good at preventing infection has contributed to our obsession with case numbers and a de facto, but hopelessly flawed, strategy of zero-covid. In the past several weeks, this obsession with simple infection has resulted in a new wave of irrational activity around rapid testing; long lines at pharmacies and hoarding rapid tests that don't tell you anything about how infectious you might be and experts caution frequently give false positives. 

Rationality be damned.

Worshiping at the NPI Alter
  
Not unrelated to my gloom about rationality is the degree to which a range of so-called non-pharmaceutical interventions (NPIs) introduced to combat the spread of SARS-CoV-2 have become a kind of secular religion. None of the public health advice prior to March 2020 recommended things like masks, social distancing, or other forms of lockdown. Indeed, the research challenging the effectiveness of lockdowns is considerable.  
Yet, there's a considerable constituency that continues to believe they work and routinely call for tougher restrictions.

However, perhaps my biggest gripe with NPIs is the religious piety around masking. It is my conclusion that most of those who faithfully don them are doing so for a host of reasons; virtue signalling, have some faint sense of control of their situation, establish the political tribe you belong to. However, any fair reading of "the science" over the past several years ought to have immediately generated doubts about the efficacy of masks as an intervention. One of the largest mask studies was published in September 2021 out of  Bangladesh and involved randomized interventions with over 300,000 adults. To the media, the study was definitive proof that masks were useful interventions. An actual read of the paper reveals a much more nuanced set of conclusions; effectiveness varied considerably by age group and type of mask used.

Yet, for most of the last two years public health officials everywhere continued to tout the efficacy of masks of any kind. Mask mandates were instituted, many which included doing so outdoors. Yet, the evidence that mask mandates have done much to slow the spread is hard to find.  There are lots of people presenting data on Twitter, but one I like, @ianmSC, has multiple charts showing how badly mask mandates seem to have failed in slowing the spread.
       
In July 2021, evidence of widespread post-vaccination infection at a Gay Pride event in Provincetown, Massachusetts had our public officials reinforcing their views on masking. The vaccinated could also spread, so masking became mandatory regardless of vaccination status. Cloth masks still worked, they said. 

Shifty Guidance

Then, in November, after South Africa reported Omicron to the world, public health officials suddenly began singing another tune about masks. TV doctors began telling us that anything short of an N95 or respirator-style mask was mere decoration in the face of Omicron. 

Really? Apparently Omicron has transformed its molecular structure to become smaller than the Alpha or Delta variants we've been told cloth masks had been so effective against? 

I've never believed masks did much. Moreover, the byzantine and nonsensical rules around mask wearing in the context of entering buildings and restaurants using various vaccine passport schemes are patently absurd. Put on your mask long enough to show you've be vaccinated. Okay. Once inside or at your table you can remove it because... well,... you're safe amongst the vaccinated? Err,... not so much. Okay. I get it. 

Compounding the stupidities of nonsensical mask rules are the dehumanizing qualities of forcing everyone to wear them if they are of such limited efficacy. The default in public health ought to be do no harm. Harm is being done, to all of us, by forcing us to cover two thirds of our faces as we interact with each other. There is a big human cost to this that public health isn't considering.
Effective Public Health


We all know the function that forcible face and head coverings serve in some societies. Yes, I am for religious and cultural acceptance... but let's be clear.... the function of head and facial coverings being reimposed by the Taliban upon Afghanistan's women is not about religious interpretation. If it were, the majority of the world's nearly 2 billion Muslims would be doing the same. 

The purpose in Afghanistan (and a few others) is to erase women from society.

Those who say to me that masks are no big deal need to prove they work. Otherwise, all we are doing is atomizing ourselves from one another, placing between us a needless barrier to social interaction that signals I should be afraid of getting close. 

After two years of using masks to combat SARS-CoV-2, we ought to have better, more definitive evidence for mask efficacy than we do. Omicron has forced public health to admit their masking advice to now has been rubbish. I'm not sure trying to save face by making us cover our faces with even thicker masking is going to make things any better.

Panic Porn

If it wasn't for Covid-19, I'm not sure what the press would have to sensationalize for us? Car wrecks, murders, and the depressing surge in drug overdoses in the last two years are not enough. The media landscape is depressing. As the business model for the entire newspaper and television business shifts below their feet, we are being more and more poorly served by it. Cost pressures have resulted in the elimination of thousands of local newspapers, an unwillingness to pay for serious investigative journalism, and the hiring of young, inexperienced reporters who (in my view, at least) are too reliant on governments for the information they report. In many ways, newspapers especially have become arms of state public affairs divisions. In others, the newspapers themselves focus on the most simplistic of metrics to animate only the most sensational of headlines. No one wants to hear details about how government actually funds and staffs ICU beds. We just want to know how many of the unvaccinated are clogging up the ones we
have. 

It's embarrassing to read so much uncritical local journalism. 

But it's not just local papers that are a problem. We are confronting SARS-CoV-2 at a time of increasing polarization in our media landscape. Cable news has descended even more deeply into clickbait disguised as learned commentary. I can hardly watch. 

And then there's the issue of social media increasingly being pressured to monitor and censor speech on behalf of the state. I'm deeply uncomfortable with the likes of Twitter and Facebook deciding what acceptable speech is. There's a lot of crap online. But it's our responsibility to read some of it and evaluate it against contending viewpoints. Pressuring Twitter and Facebook to shield us from speech we don't like sends us deeper into the arms of the Nanny State to be protected from every conceivable harm or offence. 

Speech out there you don't like? Suck it up, princess. Perhaps try engaging in some speech of your own.

Big Brother

A major consequence of all the fear that's been sown among us over SARS-CoV-2 is that the state has become ever-more present. The broad swaths of open-ended emergency powers assumed by governments everywhere are eye-popping. It reminds me too much of the debates over the War Powers and other forms of sweeping "emergency" powers given/taken after 9/11. As a reminder, the 2001 Authorization for the Use of Military Force (AUMF), originally intended for the pursuit of Al Qaeda in Afghanistan, has been the basic legal justification for every US military action since then. 

Freedom 2019-style
Emergency conditions have a stubborn tendency to remain in place. Public fear and anxiety breeds acquiescence to "emergency" measures. Governments, of course, are like drug addicts where power is concerned. The emergence authority makes every executive branch agency part of sweeping policy powers unchecked by any pesky naysayers in the legislature. 

A couple of weeks ago, the Cato Institute in Washington, D.C. put out its annual report of Human Freedom Index. A who's who of liberal democracies are among the top twenty. Interestingly, the 2021 report only includes data through 2019. I'll bet the farm this list will look a bit different when the next report is published. 

Gitmo-lite @Howard Springs
To see what the erosion of human freedom looks like in liberal states, and how "emergency" measures can be used to justify it all, look no further than New Zealand and Australia. For much of 2020, the rest of the world idealized New Zealand and Australia as they pursued a zero-covid strategy; closing their borders, stranding thousands of their own citizens abroad, stamping out covid outbreaks with means the Chinese could envy. Consider Melbourne, Australia where Victoria State authorities promised that short, circuit-breaker lockdowns would do the trick, after which the city would return to normal life. Through October of 2021, those short lockdowns (some that included stay-at-home orders), totalled 246 days. And then there's Howard Springs quarantine facility outside Darwin. I find this utterly shocking and far out of proportion to the threat. Yet here we are.
So, I'm going to take a victory lap here. In part because of my inner-luddite, I have been complaining about the introduction of vaccine passports since the idea was first floated in the spring of 2020. I still think they were a terrible idea. This past September, I cast doubt about their utility as a public health measure in light of what we learned about the Provincetown, Massachusetts "breakthrough" infections. 

I was right! Vaccine passports did not, and will not, slow the spread of SARS-CoV-2. I could understand why the private sector, especially the service sector, wanted them. Vaccine passports serve no public health purpose, but do open the door a kind of bio-surveillance state. 

The introduction of marginalizing rhetoric blaming the continuation of the pandemic on the "unvaccinated" has not aged well. Omicron has undercut public health messaging around masks and vaccination as a means of slowing the spread. It's been rather comical to watch as the most pious, triple-masked, triple-vaccinated, and most socially distanced enter the 5 stages of grief upon receiving a positive Covid test.      
I am hardly anti-vaxx. Indeed, I got one for something non-covid over the holidays. However, my skepticism about vaccine mandates is growing. The point of vaccines is to keep you off a respirator. They're doing a pretty good job of that. And, as part of my critique of passports in September, I suggested governments just mandate vaccines. I'm much less certain about the merits of mandates than I was. Marginalizing the unvaccinated in the name of slowing the spread no longer makes any logical sense; not in restaurants, not in gyms, not at big public events, not on airplanes. And stop telling me boosters are just like the annual flu shot.... my ability to do my job has never depended on getting a flu shot. Not the same. 

Omicron has complicated (undermined) efforts to "slow the spread." Omicron will hardly be the last variant of SARS-CoV-2 or the last virus we confront. Perhaps we ought to think a bit more (finally), about how we make ur healthcare system a bit more resilient instead?

The Pharma-Industrial Complex?

My last gripe in the litany concerns what seems like an inexorable slide into dependence on Big Pharma to bail us out of this mess. Moreover, it also strikes me that in a very short time we've a single firm, Pfizer, elevated above all others. 

I'm the first to defend Big Pharma to my students. Indeed, I often come across to them as a capitalist
stooge when I defend them; prices, the R&D they do, the corporate welfare they seem to get. But my Spidey Sense are up of late as I've watched 3 of the 4 promising Covid-19 vaccines be systematically marginalized in media coverage and public consciousness. In late 2020 and early 2021, the world was buzzing over vaccine efficacy data being published by Pfizer, Moderna, AstraZeneca, and Johnson and Johnson. Pfizer rightly got the most initial attention because they were first out of the gate. Yet, over the course of the next several months, AstraZeneca and 
Johnson and Johnson had some production problems that set them back. Rather bizarrely, Moderna is in a patent dispute with the Biden Administration over its vaccine. AstraZeneca is being used all over the world, but has still not been approved for use in the US by the FDA. Johnson and Johnson's single dose vaccine is for some reason seen as inferior to others.

WTF? Now all we talk about is Pfizer's boosters and approval of their therapeutic treatment pill (the FDA did approve an antiviral pill from Merek). The other firms' products have become these "also-rans" searching for arms-- in the developed world at least. 

Fin

Well, that's my airing of grievances. I hope you had a Happy Festivus. You're welcome to take me to task. And I welcome data and evidence suggesting I am wrong about all of this. Hope springs eternal and I hope I am wrong about at a lot of this. We'll be in a much better place if I am....Until then, you'll likely appreciate a little Two Minutes Hate with Big Brother followed by a nice Soma Holiday.




   

No comments:

Post a Comment

Redefining the Floor....Down

I was scrolling through some YouTube clips the other day and came across the great Seinfeld episode in which Frank Costanza invites Seinfeld...