Coronavirus: five reasons public health experts have lost credibility

[C C]

Coronavirus: five reasons public health experts have lost credibility
https://www.acsh.org/news/2020/07/16/cor...lity-14915

EXCERPT: Of all the things we have lost this year due to the COVID-19 pandemic – from the people we love to the jobs that put food on the table – one of the more pernicious is the loss of faith and confidence that Americans have in their public health institutions. How did it happen? It’s not simply a matter of being wrong. It’s okay to be wrong [...] A loss of credibility, therefore, happens for other reasons. In the case of coronavirus, we believe there are five reasons: Incompetence, waffling, moving the goalposts, disregarding unintended consequences, and being political... (MORE - details)

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Coronavirus: why it’s dangerous to blindly ‘follow the science’ when there’s no consensus yet
https://theconversation.com/coronavirus-...yet-140980

INTRO: The Lancet and the New England Journal of Medicine are among the most influential scientific journals in the world. Both have recently had to retract studies on the effectiveness of COVID-19 treatments after doubts were raised about the underlying data. The scandal reveals the dangers of “fast science”.

In the face of the virus emergency, research standards have been relaxed to encourage faster publication and mistakes become inevitable. This is risky. Ultimately, if expert advice on the pandemic turns out to be wrong, it will have dire consequences for how reliable scientific evidence is treated in other policy areas, such as climate change.

The pandemic has become politicised, pitting smug liberals versus reckless conservatives. There’s also a move towards thinking about options in terms of science versus common sense. If we accept this framing, we risk causing people to believe that experts are no better than the rest of us at making predictions and providing explanations that can guide policy... (MORE)

[Yazata]

Coronavirus: five reasons public health experts have lost credibility
https://www.acsh.org/news/2020/07/16/cor...lity-14915

EXCERPT: Of all the things we have lost this year due to the COVID-19 pandemic – from the people we love to the jobs that put food on the table – one of the more pernicious is the loss of faith and confidence that Americans have in their public health institutions.

It isn't just public health institutions, it's much bigger than that. Americans (and Europeans, Australians and others I would guess) are losing faith and confidence in all of their one-time opinion leaders and intellectual authorities. It's been happening to clergymen for years, now it's happening to university professors and to "public intellectuals" of all sorts. When the topic turns to journalism and journalists, the drop-off in trust is even worse. I don't think that anyone really trusts journalists any longer, like we all did back in the day.

The push originally came from the left with all of its quasi-Marxist theories of ideology, and continued in post-modernist attacks on the very idea of truth. Today the distrust is probably most pronounced on the right.

How did it happen? It’s not simply a matter of being wrong. It’s okay to be wrong

It's not ok to be wrong when the ones who are wrong are demanding that the entire economy be shut down and the entire population be placed under effective house-arrest. The price of being wrong is a function of the price of being wrong.

A loss of credibility, therefore, happens for other reasons. In the case of coronavirus, we believe there are five reasons: Incompetence

The first is kind of inevitable when people are trying to predict the future. Nobody is competent to do that, not even scientists. They can only do it with the aid of models, which oftentimes seem based on guesswork as much as anything else. With coronavirus, the models seemed to assume unchecked exponential increase and hence resulted in doomsday scenarios of millions of dead and overrun hospitals. And that in turn led to horrendously bad policy.

The demographic cohort in which coronavirus deaths are most prevalent is the elderly. Particularly the elderly with other serious health problems, such as COPD or cardio-vascular problems, any one of which could prove fatal. So a great many coronavirus fatalities are actually cases of death by multiple causes. These are people who were hanging on by a thread, and coronavirus pushed them over.

It didn't help that Governors and other officials in a number of America's largest states issued state orders that nursing homes could not reject coronavirus patients, along with orders that acute care hospitals transfer less serious coronavirus patients to nursing homes to clear beds for an anticipated overwhelming surge in cases that never materialized. Nursing homes are precisely where the most fragile elderly are congregated. So an appalling percentage of coronavirus fatalities occurred among nursing home residents. This is something that most of the media doesn't really want to cover and it's a story waiting to be told. (I believe that close to 50% the fatalities in my California county were associated with nursing homes).

The June 27 New York Post wrote:

"In at least 24 states, the majority of deaths were nursing-home-related. New Hampshire recorded the largest percentage of nursing-home COVID-19 deaths, with 80 percent, or 293, of the state's fatalities coming from the facilities. Rhode Island and Minnesota followed, each with 77 percent, according to the database, which includes stats from the facilities, along with local, state and federal governments."

It's probably even worse than that, since reporting rules vary from state to state. Some states (including New York State where the patient-transfer policy originated) don't require nursing homes to directly report coronavirus deaths. (It's probably on the death certificate, but it isn't collated.) And many nursing home residents are moved to regular hospitals before they finally die and probably aren't recorded as nursing home deaths because they didn't actually die in a nursing home.

waffling

During the first few months of this the WHO was still insisting (on the basis of what China was telling them) that there was no evidence of person to person transmission. Today they act like you are a murderer if you set foot outside your house without a mask (unless it's to riot for a cause they approve of).

moving the goalposts

The opinion piece that CC posted points out that the original goal was to "flatten the curve" to prevent hospitals from being overwhelmed. That succeeded. Now the goal seems to have shifted to complete eradication of the disease, which isn't likely to happen any more than we've eliminated the common cold or influenza. I don't have any confidence in herd immunity or a new vaccine either. Neither of these stops influenza which mutates so rapidly that new strains appear yearly. Immunity and vaccines do help keep a lid on it, which is probably all that we can expect.

disregarding unintended consequences

We saw that up above with the nursing homes. Bad policy there is probably responsible for tens of thousands of unnecessary deaths. We may never know the extent of the nursing home debacle unless New York State releases its numbers.

And the fact is often ignored that the United States can't just be shut down forever until the disease disappears entirely, assuming that it ever does. That seems to be the prescription from some of the medical professionals. The economic consequences alone would be too devastating, massive unemployment, general economic collapse leading to widespread hardship and suffering, and potentally to more fatalities than the disease has caused.

Policy makers have to weigh the alternatives -- stopping the disease entirely comes with the cost to the country of what would be necessary to accomplish it. The danger that the disease represents might not justify the cost of fully suppressing it. Sometimes you just have to choose the least-bad course of action.

and being political...

That's almost certainly the single most important reason for the public loss of confidence in the public health profession. It's just too obvious to everyone that positions on what should be scientific matters are being chosen for political reasons, with an eye towards which policies will hopefully hurt which political opponents.

[Syne]

Speaking of waffling, seems it took weeks just for them to decide what to call it, and not offend anyone by alluding to its origin...which also politicized it from the start.