Wednesday, July 7, 2021

Lessons learned? Review of a great review.

After great events, will the US government and political system learn from mistakes? Or will we raise the bridges and enshrine whatever was done last time as holy writ, to be repeated again? Reputations of people in power push for the latter. But learning from mistakes is the only way to get ahead. 

Bailouts and stimulus from 2008 seem to have followed the latter possibility. Will the lesson from covid look skeptically on the disastrous performance of CDC and FDA, evaluate whether lockdowns did good commensurate with cost, question the need to spread trillions of newly printed money around, measure the  effectiveness of masks that have now become political symbols? Or will this simply be enshrined as the playbook? Do we twist every event to push our partisan narratives, facts be damned? A blame-Trump-for-everything camp offers some hope, but they're not clear what they would do differently as most of the world's response was the same or less effective than our own. 

This big question frames a must-read Alex Tabarrok Marginal Revolution review of Andy Slavitt’s Preventable. The review doesn't just destroy an otherwise forgettable book, but it really raises these larger questions whether we are so politically polarized that we can no longer learn from mistakes. 

In contemporary discussion, people can just say things that are blatantly untrue, and it all washes over us. 

The standard narrative ... leads Slavitt to make blanket assertions—the kind that everyone of a certain type knows to be true–but in fact are false. He writes, for example:

In comparison to most of these other countries, the American public was impatient, untrusting, and unaccustomed to sacrificing individual rights for the public good. (p. 65)

Data from the Oxford Coronavirus Government Response Tracker (OxCGRT) show that the US “sacrifice” as measured by the stringency of the COVID policy response–school closures; workplace closures; restrictions on public gatherings; restrictions on internal movements; mask requirements; testing requirements and so forth–was well within the European and Canadian average.

The pandemic and the lockdowns split Americans from their friends and families. Birthdays, anniversaries, even funerals were relegated to Zoom. Jobs and businesses were lost in the millions. Children couldn’t see their friends or even play in the park. Churches and bars were shuttered. Music was silenced. Americans sacrificed plenty.

... Some of Slavitt’s assertions are absurd.

The U.S. response to the pandemic differed from the response in other parts of the world largely in the degree to which the government was reluctant to interfere with our system of laissez-faire capitalism…

Laissez-faire capitalism??! Political hyperbole paired with lazy writing. It would be laughable except for the fact that such hyperbole biases our thinking. 

I think the problem is deeper. It's not that this is "hyperbole." It's that this is the sort of mushy sentiment that one can pass around at Washington cocktail parties as easily as write on the front pages of all major media these days, and everyone says yes, sure, without batting an eyelash. It's not hyperbole, it is the unquestioned narrative, it's an inshallah people can add to any statement without question. That's the true danger. 

Laissez-faire capitalism??! The US hasn't had laissez-faire capitalism since, well Wickard v. Filburn 1942 (you can’t grow wheat on your own land to make your own bread if the federal government does t like it.) 

If you read Slavitt uncritically you’d assume–as Slavitt does–that when the pandemic hit, US workers were cast aside to fend for themselves. In fact, the US fiscal response to the pandemic was among the largest and most generous in the world. An unemployed minimum wage worker in the United States, for example, was paid a much larger share of their income during the pandemic than a similar worker in Canada, France, or Germany

To say nothing of a year and counting of eviction moratoriums and more. 

Perhaps because Slavitt believes his own hyperbole about a laissez-faire economy he can’t quite bring himself to say that Operation Warp Speed, a big government program of early investment to accelerate vaccines, was a tremendous success. Instead he winds up complaining that “even with $1 billion worth of funding for research and development, Moderna ended up selling its vaccine at about twice the cost of an influenza vaccine.” (p. 190). Can you believe it? A life-saving, economy-boosting, pandemic ending, incredibly-cheap vaccine, cost twice as much as the flu vaccine! The horror. 

As Alex has said previously, all you need to know about cost-benefit analysis is that Trillions > Billions. I remember the scandal. Pharmaceutical companies are making billions! Yes. And given that the budgetary cost has been $5 trillion in one year, in the US alone, plus the GDP cost, the human suffering and death, we should send the vaccine companies a nice $100 billion check along with flowers, chocolates, a thank you card, and a "I hope you'll be there next time" note. But that would not fit the narrative. 

Slavitt’s simple narrative–Trump bad, Biden good, Follow the Science, Be Kind–can’t help us as we try to improve future policy. Slavitt ignores most of the big questions. Why did the CDC fail in its primary mission? Indeed, why did the CDC often slow our response? Why did the NIH not quickly fund COVID research giving us better insight on the virus and its spread? Why were the states so moribund and listless? Why did the United States fail to adopt first doses first, even though that policy successfully saved lives by speeding up vaccinations in Great Britain and Canada?

To the extent that Slavitt does offer policy recommendations they aren’t about reforming the CDC, FDA or NIH. Instead he offers us a tired laundry list; a living wage, affordable housing, voting reform, lobbying reform, national broadband, and reduction of income inequality.

I'm surprised that tackle climate isn't in there too. After all you can make some connection between climate and spread of bugs.. 

Surprise! The pandemic justified everything you believed all along! But many countries with these reforms performed poorly during the pandemic and many without, such as authoritarian China, performed relatively well. All good things do not correlate.

Trump’s mishandling of the pandemic make it easy to blame him and call it a day. But the rot is deep. If we do not get to the core of our problems we will not be ready for the next emergency. If we are lucky, we might face the next emergency with better leadership but a great country does not rely on luck. 

Even here Alex pulls a punch. There are a lot of countries not headed by Donald J. Trump that did the same or a lot worse than the US -- most of Europe.  

A great country relies on an honest discussion, not censored by tech companies or guided by narrative-preserving partisan media, on what worked and what did not, to assemble actual knowledge, embodied in the procedures of a ready bureaucracy, not on the wisdom of whomever happens to be in the Oval Office to dream up on the spot. 

 

16 comments:

  1. I would love to see a deeper discussion at some point of the issues with data on the pandemic. People love to do comparisons of how different interventions effect the deaths/hospitalizations/infections. In all of these it is assumed that everyone is measuring these effects in the same way or close enough to the same way that such comparisons might be informative. I am skeptical of that.

    Putting aside the simplistic nature of such two variable comparisons, I suspect we will find that differences in how these effects are measured in different jurisdictions (e.g. countries and states) have huge effect on the numbers themselves.

    An analog to the issue I am thinking of is the story of how US industrial output has increased despite employing far fewer workers. It turns out, this is not a story of robots in factories, bur rather of GDP adjustments for computers getting getting more powerful at the rate of Moore's law. Until someone looked into what comprised the dollar amount of US industrial output, that number was effectively misleading its users. It would not surprise me if the same were true for many COVID statistics.

    Perhaps my skepticism will prove unwarranted, but until someone does a deeper dive into this question, we just won't know.

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    1. Here you go: https://astralcodexten.substack.com/p/lockdown-effectiveness-much-more

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  2. I would go further and say:

    Stimulus is now the defacto policy response for any and all recessions. Be it pandemics, financial crisis, or whatever - a stimulus check is the answer. Close your eyes and fork it over.

    Budgetary constraints are paid no mind until a soverign default is imminent. Then just hope and pray we don't turn into Venezuela.

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  3. In a 1796 letter from French Royal Naval officer Charles Louis Etienne, Chevalier de Panat to anti-revolutionary journalist Mallet du Pan:

    Personne n'est corrigé; personne n'a su ni rien oublier ni rien appendre.

    Nobody has been corrected; no one has forgotten anything, nor have they learned anything.

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  4. Great post, John!

    "Moderna ended up selling its vaccine at about twice the cost of an influenza vaccine."

    The comparison isn't even close to valid. This was Moderna's first vaccine. They have development costs to pay for and also the regulatory hurdles were steeper than the annual rubber stamp approval for flu vaccines where they swap out the new antigen target for last year's target.

    I agree with Alex's sentiment as well and find it funny that politicians are quick to throw hundreds of dollars per dose to deliver the vaccine and thousands per American on all the policy interventions but complain about the cost of vaccine.

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  5. The criticisms of the left seem obvious and clear. Slavitt is bashing the companies involved in vaccine production for making a profit relative to a far larger benefit they provide to society. Tabarrok's repeated criticisms of Trump seem much less substantial and valid. Trump risked infecting his secret service staff while he was infected? That's quite the petty gripe in the big scheme of things.

    Are we so politically polarized that we can't learn from mistakes? No, we are so politically polarized that leaders like Slavitt care far more about hurting their domestic political adversaries than serving the public interest.

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  6. It’s not a big deal till it’s your big deal!

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  7. John: it's on NBER so you've perhaps you've seen this study ( https://www.nber.org/papers/w28930) by Agrawal et al? Consistent to your ex ante thoughts on the relative merits of stay in place mandates versus personal behavioral changes (e.g., your post "Reopening the economy -- and the aftermath" of May 20, 2020) they find "To understand the net effects of SIP policies, we measure the change in excess deaths following the implementation of SIP policies in 43 countries and all U.S. states. We use an event study framework to quantify changes in the number of excess deaths after the implementation of a SIP policy. We find that following the implementation of SIP policies, excess mortality increases."

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  8. Great quote: "It's not hyperbole, it is the unquestioned narrative, it's an inshallah people can add to any statement without question. That's the true danger."

    I suppose we should reduce this by ridicule: Let us all declare, "It is Trump's fault" at the end of each comment or suggestion. Being so absurd and out-of-context will clarify how stupid the social prejudice demanding "cool, politically correct" opinions will look, more like something absurd to all ears makes the speakers look foolish.

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  9. Follow the science? a basic difference between and among various areas of scientific inquiry is whether or not scientific study is amenable to repeatable independent experiments that are similar. Newtonian physics of gravitation is, and economics often is not. Follow the science might also mean engage in further investigation.

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  10. You are right on with this opinion. I would add that we now have laissez-faire free speech. So much of it that commentators are allowed to simply spout old, useless, or even baseless ideas without the criticism of editors and fact checkers. Maybe we have unlimited supply against decreasing demand?

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    1. You think free speech is more prevalent today vs in the past? Wokeism is such that the wrong tweet or the wrong phrase might get you fired or publicly shamed. A white man commenting on anything to do with race related issues might get you fired.

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  11. I haven't read Tabarrok's full review or Slavitt's book, but based on this excerpt Tabarrok seems to make a pretty significant reading error.

    " The standard narrative ... leads Slavitt to make blanket assertions—the kind that everyone of a certain type knows to be true–but in fact are false. He writes, for example:

    In comparison to most of these other countries, the American public was impatient, untrusting, and unaccustomed to sacrificing individual rights for the public good. (p. 65)

    Data from the Oxford Coronavirus Government Response Tracker (OxCGRT) show that the US “sacrifice” as measured by the stringency of the COVID policy response–school closures; workplace closures; restrictions on public gatherings; restrictions on internal movements; mask requirements; testing requirements and so forth–was well within the European and Canadian average.

    The pandemic and the lockdowns split Americans from their friends and families. Birthdays, anniversaries, even funerals were relegated to Zoom. Jobs and businesses were lost in the millions. Children couldn’t see their friends or even play in the park. Churches and bars were shuttered. Music was silenced. Americans sacrificed plenty."

    The Slavik quote emphasizes how Americans were "unaccustomed" to sacrificing individual rights for the public good, but makes no assertion whatsoever that they didn't make significant sacrifices, or even that they made fewer sacrifices. If the writer made that claim, this quote sure doesn't show it. It simply says they made a big stink about them and weren't sure they were necessary.

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  12. Excellent, as always, thank you, John! Indeed, the simple narrative "Trump bad, Biden good" is so deeply enshrined, that it has become impossible to have earnest discussions of what worked and what did not during the Trump administration, and how things compare. Go with the flow and always dump on Trump, lest you want to become an outcast. Do I dare then to agree with your statement at the end that "There are a lot of countries not headed by Donald J. Trump that did the same or a lot worse than the US -- most of Europe"? I do. Most seem to not know it or blissfully ignore it. Here is a comparison of the grim covid death statistics, US vs Europe, as of October last year,
    https://twitter.com/haralduhlig/status/1319329795793178625?s=20 . Europe did somewhat better, but it wasn't exactly a shining nirvana. That comparison did not include Eastern Europe --- which did remarkably well back then, but have become leading trouble countries since. But, for all my woke friends out there, let me quickly add, that, of course, everything is entirely Trumps fault, always, no doubt!

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  13. I've been following Canadian politics more extensively. The "experts" there I read (Paul Wells of MacLean's and The Boys in Short Pants podcast which exclusively follows Canadian politics from Ottawa getting into the nitty gritty of how government works) has pointed out that the Canadian federal government cannot do logistics and substitute throwing money at a problem to solve logistics, the current political elite are incapable of making a hard decision today when it is easier to delay the hard decision until tomorrow, the same problems of federal vs. provincial responsibility when it came to health, and also goes into the how they just muddled through most of the Covid response.

    I think you can write these kinds of mea culpas for almost every government worldwide of "where should we have performed better?" The problem is governments and politicians unlike every private business I've ever worked for never do that and just blame the other side.

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