Public health experts are not experts in healthcare delivery systems. They are not experts in supply chains or logistics. And most importantly, they are not experts in any economic matters. In fact, many of them seem to bristle when economic tradeoffs are discussed in response to their policy recommendations.It's worse than that, the experts on contagion are advising government officials on how to respond based on their own extrapolations of incomplete information. At least we ought be grateful that the people doing so are noting that with better information (more tests, more knowledge of who is sick and who has antibodies and where they are) their extrapolations will get better. (Are the environmental alarmists paying attention?)
Our media have apparently decided to place all their trust in these public health experts. However, as both a hospital administration professional and a student of economics, I have concerns about handing complete control over to “the experts” due to the constrained nature of their expertise.
That might not be the best course of action in the middle of an emergency, notes National Review's Daniel Tenreiro.
For one, a monolithic expert opinion on the present pandemic does not exist. SARS-CoV-2, the virus that causes COVID-19, emerged only three months ago; scientists haven’t had nearly enough time to conduct conclusive research into it. And constraints on testing, compounded by uncertainty as to the number of asymptomatic cases, make the current medical data largely unreliable.That's probably not satisfactory to the people who make policy, and in the case of uncertainty, they might understandably take what they understand the safe course to be, and shut down most commercial activity. The problem is, the people who make policy are themselves making policy under conditions of relative ignorance: no Platonic or Stiglitzian omniscience here.
While some epidemiologists have used previous flu pandemics to inform their thinking, that approach requires rough estimates of factors such as reproduction and fatality rates, leading to wide variance in projections. To take one example, Oxford University researchers found that as much as 40 percent of the U.K. might be immune to the novel coronavirus, while a team from Imperial College London projected more than 250,000 domestic deaths, even under strict social-distancing measures.
Thus, decidedly unscientific factors — lived experience, cultural mores — have trumped technical prowess in the fight against this pandemic.Science is a process, and even scientists at the World Health Organization, assuming there are any who don't put third-world wokeness ahead of principle, can only act on the basis of the information they have. It probably didn't help in the United States that Our President was treating the Kung Flu as an improv act. But perhaps, he, too, was fighting the same past pandemics that the Wise Experts understood.
In the West, overreliance on expertise accelerated the outbreak. The World Health Organization, which in a matter of weeks has brought itself permanent disgrace, assured the public in January that there was “no clear evidence of human-to-human transmission of the novel coronavirus.” Later on, the WHO incorrectly advised against the use of face masks by the general public. Because we’ve been trained to see science as a monolith that delivers incontrovertible dictates, many of us believed these falsehoods, which drove public messaging for weeks and almost certainly affected ordinary citizens’ decision-making.
Prior experiences with SARS, Ebola, and swine flu indicated that the U.S. was resilient in the face of pandemics. In retrospect, it’s easy to identify why that wasn’t the case with the novel coronavirus, but it wasn’t at all clear at the time. The hard sciences are empirical, requiring careful observation of phenomena over long periods of time. Unlike “experts,” political leaders must act preemptively in the face of uncertainty. If policy is “data driven,” without data, there’s no one at the wheel.Or, put another way, there's analysis paralysis, and doing nothing until one has that state of Stiglitzian omniscience will quickly be overtaken by events.
Trump himself is hardly an intellectual, but policy responses across the West — from the U.S. to the U.K. to France — have arguably been too academic. Waiting on precise data and expert judgment, the White House and state governors were caught flat-footed. Scientific researchers operate in the friendly environment of the lab, proving and disproving hypotheses definitively, and social scientists painstakingly superimpose scientific methods onto the humanities. The name “political science” implies that, like biology or physics, the question of human flourishing has fixed answers to be found by sifting through data. This empirical modality now dominates policymaking, leaving us defenseless against novel threats.Let me caution again: science is a process, the whole point being that there is no final answer. Past experience: helpful. Extrapolations: possibly helpful, but respect the margin of error. Fresh data: pray that we will make it through in such a way as to be able to second-guess at leisure.
When a super-spreader is boarding a flight from Wuhan to New York, there’s no time to run a regression. As Clausewitz said of war, “in the course of action, circumstances press for immediate decision, and allow no time to look about for fresh data.”
At the moment, significantly many people are fearful or worried and generally going along with the shelter-in-place requirements. But Noah Feldman correctly identifies the conditions under which I might be fearful of widespread civil disobedience to extensions of those orders.
When epidemiologists say that there is no trade-off to be had between health and the economy, because if people keep getting sick and dying it will leave the economy worse off, lots of economists just shake their heads. "There is always a trade-off," you can hear them thinking. The consequences are measurable. People dying is unfortunate, but it's still a cost that can be compared to the costs of shutdown.That part of the debate will take place using the usual academic conventions, including but not limited to begging to differ or acting shocked and appalled.
Meanwhile, when the economists talk the trade-off talk, lots of epidemiologists (and others) find it morally reprehensible when people are dying.
The conflict between these two approaches is going to come to a head if and when the rate of new infections and deaths in the United States starts to go down as a result of social isolation. That's when economists will say it's time to start getting people back to work. And it's when epidemiologists will say we are courting the disaster of a recurring outbreak.
What will really matter is whether sufficiently many people come to the conclusion that continuing to do nothing, when the epidemiologists have still not offered an exit strategy, is a less bad option than, oh, having the kids go to the playground, or getting a beach volleyball game going, or opening the taverns, governors' orders or not.
There are people writing about those tradeoffs. Perhaps more along those lines in a few days. There's rain in the forecast later this week. It's still not forbidden to do yard work.

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