Thanks for highlighting this great interview! I'm curious what you think about Matt Yglesias's recent covid-19 retrospective ("What happened with Covid NPIs?", 11/1/23). It is a paid Substack article, but his thesis essentially goes like this:
Contrary to popular wisdom, there was not much covid mortality difference between "red" and "blue" states pre-vaccines not because NPIs were universally ineffective, but precisely BECAUSE NPIs were actually *quite* successfully implemented across the country, flattening the curve, and preventing a Lombardy or NYC-style horror anywhere else in the US. Obviously there were pronounced differences from 2021 on that trace directly to political rhetoric about vaccines. There was a lot of goalpost-shifting about what the objective was for NPIs. We initially told people it was to "flatten the curve" to buy time to learn more about the disease, ramp up PPE and treatments, prevent hospital overrun etc, and we did that! But then it shifted into a long-term strategy with people claiming we could somehow just prevent infections if everyone just followed NPIs forever with seemingly no time limit. When Delta (and later Omicron) hit and people who were formerly cautious and compliant with restrictions started getting covid a lot of trust and credibility eroded.
Yglesias also argues we could not have done much better than we did, not for any particularly nihilistic reasons, but because the pandemic playbook written by the Bush and Obama administrations in the 2000s in the shadow of bioterrorism directly looked to the Great Influenza of 1918 and we followed the precedent as well or better than a century ago. If you look at the data from that era, most NPIs were in place an average of only 4 weeks across the country, which was a little shorter than even the most aggressive red states were in re-opening; the longest 1918 influenza NPIs were in place for 10 continuous weeks, which was *FAR* shorter than many locations in the US with covid.
In the end, Yglesias argues that the lesson we should take from the pandemic is not "NPIs don't work" but that we should re-think which ones we pick, how they are implemented, and how they're enforced, or not. Masks (high-quality ones worn correctly) clearly DO reduce spread of respiratory viruses. However, the evidence the various mask MANDATES worked is less clear and provoked significant backlash, arguably making masks less effective in aggregate (less people wearing them because of politicization). Closing schools in spring 2020 made a ton of sense and was clearly the right move in the beginning when we didn't know anything. But keeping them closed a year after we opened bars and salons and gyms under lobbying from business interest groups isn't coherent policy and clearly upset a lot of people due to learning loss and mental health concerns to say nothing of the economic disruption. We need to remember that public health is not just the specific policy prescription, but also communication, trust, and real world implementation. Trade-offs and conflicting human behaviors abound. People don't exist as dots in a statistical model.
Maybe we could have improved results on the margins, but I do think coronaviruses are inherently much more contagious and difficult to control than something like the flu (speaking as a vet where many significant and deadly coronaviruses impact animals), and some of what we were up against was biology. The US is definitely different culturally than China/Singapore/Taiwan, etc and I don't think there was ever a world in which we could have made our citizens accept covid zero (outside of maybe a couple coastal cities). The biggest improvements we made was from converting an immunologically naive population to an immunocompetent one through vaccines, and sadly for many, natural infection.
“Yes! If writers are going to publish a book based on flawed reasoning on a topic which literally concerns the lives of millions of people, they should have to answer for their sloppiness.”
A theme that have been repeated throughout the history of pandemics. Even during the plague, they were holding parties. We never learn from history, we just repeat it.
My reaction to the following exchange between the book author/columnist (Nocera) and the journalist (Wells) interviewing him was the same as yours (i.e., "Yes!"):
"Nocera: Do we really want to argue about this for the next 20 minutes? I feel like I’m on the witness stand.
Wallace Wells: Well, you did write a book on the subject."
As you rightly say, this isn't a case of "gotcha" journalism; it's a matter of correcting the record regarding a complex issue of longterm national importance.
I had stopped reading NYT Covid coverage when the Morning/David Leonardt made large factual errors in interpreting data and refused to retract.
Thanks for highlighting this great interview! I'm curious what you think about Matt Yglesias's recent covid-19 retrospective ("What happened with Covid NPIs?", 11/1/23). It is a paid Substack article, but his thesis essentially goes like this:
Contrary to popular wisdom, there was not much covid mortality difference between "red" and "blue" states pre-vaccines not because NPIs were universally ineffective, but precisely BECAUSE NPIs were actually *quite* successfully implemented across the country, flattening the curve, and preventing a Lombardy or NYC-style horror anywhere else in the US. Obviously there were pronounced differences from 2021 on that trace directly to political rhetoric about vaccines. There was a lot of goalpost-shifting about what the objective was for NPIs. We initially told people it was to "flatten the curve" to buy time to learn more about the disease, ramp up PPE and treatments, prevent hospital overrun etc, and we did that! But then it shifted into a long-term strategy with people claiming we could somehow just prevent infections if everyone just followed NPIs forever with seemingly no time limit. When Delta (and later Omicron) hit and people who were formerly cautious and compliant with restrictions started getting covid a lot of trust and credibility eroded.
Yglesias also argues we could not have done much better than we did, not for any particularly nihilistic reasons, but because the pandemic playbook written by the Bush and Obama administrations in the 2000s in the shadow of bioterrorism directly looked to the Great Influenza of 1918 and we followed the precedent as well or better than a century ago. If you look at the data from that era, most NPIs were in place an average of only 4 weeks across the country, which was a little shorter than even the most aggressive red states were in re-opening; the longest 1918 influenza NPIs were in place for 10 continuous weeks, which was *FAR* shorter than many locations in the US with covid.
In the end, Yglesias argues that the lesson we should take from the pandemic is not "NPIs don't work" but that we should re-think which ones we pick, how they are implemented, and how they're enforced, or not. Masks (high-quality ones worn correctly) clearly DO reduce spread of respiratory viruses. However, the evidence the various mask MANDATES worked is less clear and provoked significant backlash, arguably making masks less effective in aggregate (less people wearing them because of politicization). Closing schools in spring 2020 made a ton of sense and was clearly the right move in the beginning when we didn't know anything. But keeping them closed a year after we opened bars and salons and gyms under lobbying from business interest groups isn't coherent policy and clearly upset a lot of people due to learning loss and mental health concerns to say nothing of the economic disruption. We need to remember that public health is not just the specific policy prescription, but also communication, trust, and real world implementation. Trade-offs and conflicting human behaviors abound. People don't exist as dots in a statistical model.
Maybe we could have improved results on the margins, but I do think coronaviruses are inherently much more contagious and difficult to control than something like the flu (speaking as a vet where many significant and deadly coronaviruses impact animals), and some of what we were up against was biology. The US is definitely different culturally than China/Singapore/Taiwan, etc and I don't think there was ever a world in which we could have made our citizens accept covid zero (outside of maybe a couple coastal cities). The biggest improvements we made was from converting an immunologically naive population to an immunocompetent one through vaccines, and sadly for many, natural infection.
“Yes! If writers are going to publish a book based on flawed reasoning on a topic which literally concerns the lives of millions of people, they should have to answer for their sloppiness.”
PERFECT!!
A theme that have been repeated throughout the history of pandemics. Even during the plague, they were holding parties. We never learn from history, we just repeat it.
My reaction to the following exchange between the book author/columnist (Nocera) and the journalist (Wells) interviewing him was the same as yours (i.e., "Yes!"):
"Nocera: Do we really want to argue about this for the next 20 minutes? I feel like I’m on the witness stand.
Wallace Wells: Well, you did write a book on the subject."
As you rightly say, this isn't a case of "gotcha" journalism; it's a matter of correcting the record regarding a complex issue of longterm national importance.
Thanks for sharing this!
Thank you Dr Faust. I would like tosee a graph of the New York City "Variants of Concern" from start to Thanksgiving 2023.
Happy Thanksgiving to the Author & all Readers.
Sorry, I haven’t read the book, but did the authors have anything to say about the -- it pains me to write this -- Great Barrington Declaration?
Paywall/Login bypass for the Times pieces linked (posting for my own notes to come back to these):
YLE:
https://archive.li/oymzW
Transcript of her conversation with DWW in place of Ezra Klein:
https://www.nytimes.com/2023/08/29/podcasts/transcript-david-wallace-wells-interviews-katelyn-jetelina.html
https://archive.li/4QD0y
Mina article from NYT:
https://archive.li/p9y57
So I read David Wallace Wells regularly and found his interview compelling. This rehash, not so much.