Eric Kramer is an economist and lawyer who is interested in classical liberalism and libertarian approaches to political economy. Welcome!
Two of the authors of the Great Barrington Declaration, Martin Kulldorff and Jayanta Bhattacharya, have a piece up at the Brownstone Institute that claims Anthony Fauci, the Director of NIAID, got major epidemiology and public health questions wrong.
As part of an effort to learn from our experience with the present epidemic, Dr. Fauci's policy positions and public statements should be examined and criticized. The Kulldorff and Bhattacharya piece is mostly libertarian misdirection and bluster, and it presents little reasoned discussion of the merits of Fauci's decision making. I review their charges and their supporting arguments.
Natural immunity undermines the case for vaccine mandates.
They claim that Dr. Fauci ignores naturally acquired immunity by pushing vaccine mandates.
The fact that your immune system can be generated by a virus or a vaccine does not show that vaccine mandates are unwarranted. Natural immunity might justify an exemption from vaccine mandates for those who have recovered from COVID-19. There are some plausible arguments against the exemptions. If vaccines increase immunity for those who have recovered from COVID-19, then vaccination may be justified on standard utilitarian grounds. If the question is whether those with natural immunity should get vaccine, then this comparison is irrelevant. This is easy to grasp. It is easier to design and implement a universal mandate than a mandate with an exemption for those with natural immunity.
I'm not saying that these considerations are decisive. There are reasons to support an exemption for those with natural immunity. Fauci has denied the existence of natural immunity, but it is not an obvious error. Kulldorff has claimed before about vaccine mandates and natural immunity.
Vaccine mandates for health care workers can harm patients.
It gets worse. Kulldorff and Bhattacharya made this claim.
Hospitals are firing heroic nurses who recovered from chronic bronchitis they contracted while caring for patients. They can care for the oldest and frailest patients with less risk of transmission than the vaccine.
The Foundation for Economic Education is a libertarian organization if you follow the link about firing heroic nurses. There is a story about a nurse who was fired from Houston Methodist hospital for not complying with the hospital's vaccine mandate. There is no indication that she has immunity. If you click through to the source that FEE cites, you discover this:
The Houston Methodist employees who filed the lawsuit likened their situation to medical experiments performed on unwilling victims in Nazi concentration camps during World War II. District Judge Lynn Hughes said the comparison was "reprehensible" and that the claims made in the lawsuit that the vaccines are experimental and dangerous are false.
That is heroism. Bridges claims to have recovered from Covid-19 in 2020 and that she has natural immunity, but she does not cite this as her reason for rejecting the vaccine. She believes that the vaccines are being used by elites to dismantle global democracy.
Furthermore:
Bridges said Tuesday was her first day at her new job at a company that sends nurses into people's homes.
The health care worker is going into the homes of people with serious medical problems. She might have natural immunity. One imagines her patients would be safer if she were vaccine free, but as we have seen Kulldorff and Bhattacharya fail to consider this possibility, they focus on the irrelevant claim that natural immunity is stronger than vaccine-induced immunity, rather than on the relevant issue.
Labor markets and hospitals are damaged by vaccine mandates.
Bridges is still working as a nurse, which casts doubt on the claim by Kulldorff and Bhattacharya that the mandate is causing tremendous disruption to labor markets and hampered the operation of many hospitals. Since Bridges is currently employed as a nurse in Texas, the fact that she is not employed at Houston Methodist does not show that the overall supply of nurses in Texas has decreased.
News reports have not suggested that vaccine mandates are causing major problems in labor markets. Most employees choose to get vaccinations. Many people who quit the labor market are close to retirement, so a reduction in the workforce's size will be temporary as well as small. Mandates may cause difficulties for some employers. It's telling that opponents of mandates are using hysterical claims about labor market disruption to bolster their case. The main cause of staffing difficulties at hospitals appears to be the COVID-19 epidemic, and vaccine mandates are a plausible response to this problem.
Fauci's position on school closings was indefensible.
According to Kulldorff and Bhattacharya, Dr. Fauci may be the biggest mistake of his career.
It is possible to argue that some school closings in the United States were unwarranted. If you follow the link, you will see that Fauci approved of school closings for the first three months of the Pandemic because of the unclear risk to children. You can argue that this was not the best advice, but it was still not insane. Fauci began to argue that it was important to keep schools open and that bars should be closed when transmission is high.
Fauci's advice was vague, or that schools should be kept open even when prevalence is high. The anti-Fauci post that Kulldorff and Bhattacharya cite is wrong in suggesting that Fauci was an advocate of school closings. It is not clear if Fauci, a federal health official, bears much responsibility for school closings.
Fauci oversold masks.
Fauci overstated the case for masks and overstated the case for improved ventilation in schools, according to Kulldorff and Bhattacharya.
The gold standard of medical research is randomized trials. There is no evidence that masks work for children. There was no statistically significant difference between masking and not masking when it came to coronaviruses. The 95 percent confidence interval showed that masks reduced transmission between 0 and 18 percent. There are either zero or limited benefits to masks. Dr. Fauci could have emphasized more critical measures, such as better ventilation in schools and hiring nursing home staff with natural immunity.
There are two issues, one of which is the effectiveness of masking, and the other is whether Fauci put too much emphasis on masking relative to other possible responses.
Even though the two studies Kulldorff and Bhattacharya cite are RCTs, there is no reason for them to only focus on the effectiveness of masking. When evaluating a practice like masking, RCTs have limitations. The main public health benefit of masks is that they help protect other people. The study did not measure that. The Bangladesh study has methodological problems. There is no justification for relying solely on these RCTs and ignoring other forms of evidence on the value of masking because of their clear limitations.
Fauci put a lot of emphasis on masking in his public communications. Should he have focused more on improving the air quality in the schools?
Kulldorff and Bhattacharya support their claim that Fauci should have emphasized the benefits of improved air quality in schools instead of the COVID-19 prevention benefits. The main study cited in the article is not an RCT, it reaches a result that appears to be implausible, and it has been subject to serious criticism. The link between the studies mentioned in the article and the double cognitive test scores in advanced green buildings seems even more implausible. Yes.
I'm open to the idea that the federal government should have done more to help schools reopen safely. Kulldorff and Bhattacharya seem to evaluate evidence according to whether it helps them reach their desired conclusion, not by carefully considering how much weight to assign to different studies and forms of evidence. A flawed observational study that claims to show large cognitive benefits of ventilation is accepted as evidence for the value of ventilation against COVID-19, even though it was flawed.
For the sake of argument, let us assume that the federal government should have done more to help schools reopen safely, and that Fauci spent more time advocating for masking than for improved ventilation in schools. It seems plausible and perhaps it is true, but no evidence has been presented for this.
Fauci was wrong to support masking. Fauci emphasizes things that all Americans can do to slow the spread of COVID-19 in his media appearances. Fauci may have advocated for better school air quality in conversations with policymakers. This could have been a good approach.
If Fauci had spent more time talking about school air quality in public, schools would have reopened sooner. This is not true. If Fauci had stressed the importance of improved air quality in public, some schools might stay closed if they didn't have the resources to install new systems. We can argue about this, but Kulldorff and Bhattacharya didn't make a convincing argument for the conclusion that Fauci seriously and clearly messed up by focusing too much on masks and not enough on ventilation.
They are using ideas to further a libertarian agenda, not to get at truth or find common ground.
It is perfectly reasonable to criticize and evaluate major policy decisions by public officials. Kulldorff and Bhattacharya seem more interested in reaching libertarian conclusions than in learning lessons for the future or finding areas of common ground with people who do not share their libertarian values. They make incoherent arguments. They make it appear that the evidence is different. They share links that don't support their argument.
This has been a common occurrence on the libertarian right. The essays published by the Brownstone Institute encourage vaccine hesitancy and distrust of public officials. Some of the essays it publishes are crazy. Many academics are unwilling to admit their support for Kulldorff and Bhattacharya's ideas because they are afraid of being stigmatized. I don't have a basis for evaluating this claim, but I think that even academics with some sympathy for policy ideas would be hesitant to be associated with their tendentious arguments.
All Rights Reserved © 2024
