For clarity, start with this charming interpretive one-act on public health policy in 2020. You might find it a little sardonic, but that’s the point. It was one of the more entertaining tweets of the day, from @boriquagato.
A growing body of research shows that stringent non-pharmaceutical interventions (NPIs) — “lockdowns” is an often-used shorthand — are not effective in stemming the transmission and spread of COVID-19. A compendium of articles and preprints on the topic was just published by the American Institute for Economic Research (AEIR): “Lockdowns Do Not Control the Coronavirus: The Evidence”. The list was compiled originally by Ivor Cummins, and he has added a few more articles and other relevant materials to the list. The links span research on lockdowns across the globe. It covers transmission, mortality, and other health outcomes, as well as the economic effects of lockdowns. AIER states the following:
“Perhaps this is a shocking revelation, given that universal social and economic controls are becoming the new orthodoxy. In a saner world, the burden of proof really should belong to the lockdowners, since it is they who overthrew 100 years of public-health wisdom and replaced it with an untested, top-down imposition on freedom and human rights. They never accepted that burden. They took it as axiomatic that a virus could be intimidated and frightened by credentials, edicts, speeches, and masked gendarmes.
The pro-lockdown evidence is shockingly thin, and based largely on comparing real-world outcomes against dire computer-generated forecasts derived from empirically untested models, and then merely positing that stringencies and “nonpharmaceutical interventions” account for the difference between the fictionalized vs. the real outcome. The anti-lockdown studies, on the other hand, are evidence-based, robust, and thorough, grappling with the data we have (with all its flaws) and looking at the results in light of controls on the population.”
We are constantly told that public intervention constitutes “leadership”, as if our well being depends upon behavioral control by the state. Unfortunately, it’s all too typical of research on phenomena deemed ripe for intervention that computer models are employed to “prove” the case. A common practice is to calibrate such models so that the outputs mimic certain historical outcomes. Unfortunately, a wide range of model specifications can be compatible with an historical record. This practice is also a far cry from empirically testing well-defined hypotheses against alternatives. And it is a practice that usually does poorly when the model is tested outside the period to which it is calibrated. Yet that is the kind of evidence that proponents of intervention are fond of using to support their policy prescriptions.
Acceptance of risk is a necessary part of a good life, and extreme efforts to avoid it are your own business. Government has no power to guarantee absolute safety, nor should we presume to have such a right. Ongoing COVID lockdowns are an implicit assertion of exactly that kind of government power, despite the impotence of those efforts, and they constitute a rejection of more fundamental rights.
Lockdowns have had destructive effects on health and economic well being while conferring little if any benefit in mitigating harm from the virus. The lockdowns were originally sold as a way to “flatten the curve”, that is, to avoid a spike in cases and an overburdened health care system. However, this arguably well-qualified rationale later expanded in scope to encompass the mitigation of smaller and much less deadly outbreaks among younger cohorts, and then to the very idea of extinguishing the virus altogether. It’s become painfully obvious that such measures are not capable of achieving those goals.
In the U.S., the ongoing lockdowns have been a cause célèbre largely on the interventionist Left, and they have been prolonged mainly by Democrats at various levels of government. In a way, this is not unlike many other policies championed by the Left, often ostensibly designed to help members of the underclasses: instead, those policies often destroy or wrongly obviate incentives and promote dependency on the state. In this case, the plunge into dependency is a reality the Left would very much like to ignore, or to blame on someone else. You know who.
The lockdowns have been largely unsuccessful in mitigating the spread of the virus. At the same time, they have been used as a pretext to deny constitutional rights such as the free practice of religion, assembly, and a broad range of unenumerated rights under the “penumbra” of the Bill of Rights and the Ninth Amendment. What’s more, the severity of the economic blow caused by lockdowns has been borne disproportionately by the working poor and the small businesses who employ so many of them.
Lockdowns are deadly. It’s not clear that they’ve saved any lives, but they have massively disrupted the operation of the health care system with major consequences for those with chronic and undiagnosed conditions. The lockdowns have also led to spikes in mental health issues, alcoholism, drug abuse, and deaths of despair. A recent study found that over 26% of the excess deaths during the pandemic were non-COVID deaths. Those deaths were avoidable or accelerated, whereas the lockdowns have failed to meaningfully curtail COVID deaths. Don’t tell me about reduced traffic fatalities: that reduction is relatively small relative to the increase in non-COVID excess deaths (see below).
The Ethical Skeptic (TES) on Twitter has been tracking a measure of lockdown deaths for some time now. The following graphic provides a breakdown of excess non-COVID deaths since the start of the pandemic. The total “pie” shows almost 320,000 excess deaths through September 26th (avoiding less complete counts in recent weeks), as reported by the CDC. COVID accounted for 202,000 of those deaths, based on state-level reporting. Of the remaining 117,000 excess deaths, TES uses CDC data to allocate roughly 85,000 to various causes, the largest (more than half) being “Suicide, Addiction, Abandonment, and Abuse”. Other large categories include Cardio/Diabetes, Stroke, premature Alzheimers/Dementia death, and Cancer Access. Nearly 32,000 excess deaths remain as a “backlog”, not yet reported with a cause by states.
Also of interest in the graphic are estimates of life-years lost. The vast bulk of COVID victims are elderly, of course, which means that any estimate of lost years per victim must be relatively low. On the other hand, most non-COVID, lockdown-related deaths are among younger victims, with correspondingly greater life-years lost. TES’s aggregate estimate is that lockdown-related excess deaths involve double the life-years lost of COVID deaths. Of course, that is an estimate, but even granting some latitude for error, the reality is horrifying!
John Tierney in City Journal cites several recent studies concluding that lockdowns have been largely ineffective in Europe and in the U.S. While Tierney doesn’t rule out the possibility that lockdowns have produced some benefits, they have carried excessive costs and risks to public health going forward, such as lingering issues for those having deferred important health care decisions as well as disruption in future economic prospects. Ultimately, lockdowns don’t accomplish anything:
“While the economic and social costs have been enormous, it’s not clear that the lockdowns have brought significant health benefits beyond what was achieved by people’s voluntary social distancing and other actions.”
Tierney also discusses the costs and benefits of lockdowns in terms of life years: quality-adjusted life-years (QALY), which is a widely-used measure for evaluating of the use of health care resources:
“By the QALY measure, the lockdowns must be the most costly—and cost-ineffective—medical intervention in history because most of the beneficiaries are so near the end of life. Covid-19 disproportionately affects people over 65, who have accounted for nearly 80 percent of the deaths in the United States. The vast majority suffered from other ailments, and more than 40 percent of the victims were living in nursing homes, where the median life expectancy after admission is just five months. In Britain, a study led by the Imperial College economist David Miles concluded that even if you gave the lockdown full credit for averting the most unrealistic worst-case scenario (the projection of 500,000 British deaths, more than ten times the current toll), it would still flunk even the most lenient QALY cost-benefit test.”
We can now count the World Health Organizationamong the detractors of lockdowns. According to WHO’s Dr. David Nabarro:
“Lockdowns just have one consequence that you must never ever belittle, and that is making poor people an awful lot poorer…. Look what’s happened to smallholder farmers all over the world. … Look what’s happening to poverty levels. It seems that we may well have a doubling of world poverty by next year. We may well have at least a doubling of child malnutrition.”
In another condemnation of the public health consequences of lockdowns, number of distinguished epidemiologists have signed off on a statement known as The Great Barrington Declaration. The declaration advocates a focused approach of protecting the most vulnerable from the virus, while allowing those at low risk to proceed with their lives in whatever way they deem acceptable. Those at low risk of severe disease can acquire immunity, which ultimately inures to the benefit of the most vulnerable. With few, brief, and local exceptions, this is how we have always dealt with pandemics in the past. That’s real life!
President Trump was in a festive mood last Friday, pleased with the May employment report, as he should be. But in his Rose Garden word jam, he made some questionable and unnecessary claims about coronavirus policies in the U.S. and the Swedish experience. I credit Trump for pushing to end the lockdowns as it became clear that they were both unhealthy and unsustainable. However, he’s now way too eager to cover his earlier tracks. That is, he is now defensive about the precautions he advocated on the advice of his medical experts in March and early April.
In the Rose Garden, Trump said that lockdowns were necessary to stop the spread of the virus. But to assert that lockdowns “stopped” or even slowed the spread of the virus is speculation at best, and they had deadly effects of their own. Most of the social distancing was achieved through voluntary action, as I have argued previously. Lockdown advocacy lacked any semblance of geographic nuance, as if uniform application makes sense regardless of population density.
Trump went on to say that Sweden was in “bad shape” because it did not impose a lockdown during the pandemic. This is not a new position for the president, but the facts are anything but clear-cut. Again, there is mixed evidence on whether mandatory lockdowns have a real impact on the spread or mortality of the coronavirus (also see here). That’s not to say that social distancing doesn’t work, but much of the benefit comes from private decisions to mitigate risk via distancing. Of course, that also depends on whether people have good information to act on. And to be fair, Sweden did take certain measures such as banning gatherings of more than 50 people, closing schools, and limiting incoming travel.
While the full tale has not been told, and Sweden’s death rate is high on a per capita basis, several other Western European countries that imposed lockdowns have had even higher death rates. The following chart is from the Institute for Health Metrics and Evaluation (IMHE). It is expressed in terms of coronavirus deaths per 100,000 of population. The orange line is Sweden, the purple line is Belgium, and the light blue line is the UK. Actuals are reported through June 4th. While Sweden’s death toll has a somewhat steeper gradient, the level remains well below both Belgium and the UK. It is also lower than the death rates for Italy and Spain, and it is about the same as France’s death rate. Yes, a number of other countries have lower death rates, including the U.S., but the evidence is hardly consistent with Trump’s characterization.
Sweden’s big mistake was not it’s decision to rely on voluntary social distancing, but in failing to adequately protect highly vulnerable populations. The country’s elderly skew older than most countries by several years. Residents of nursing homes have accounted for about half of Sweden’s coronavirus deaths, an international outlier. Inadequate preparedness in elder care has been a particular problem, including a lack of personal protective equipment for workers. There was also a poorly implemented volunteer program, intended to fill-out staffing needs, that appears to have aggravated transmission of the virus.
Sweden has also experienced a concentration of cases and deaths among its large immigrant population. It has the largest immigrant population among the Nordic countries, with large numbers of low income migrants from Syria, Iraq, Iran, Somalia and parts of Eastern Europe. Earlier in the pandemic, according to one estimate, 40% of coronavirus fatalities in Stockholm were in the Somali population. These immigrants tend to live in dense conditions, often in multigenerational households. Many residents with health problems tend to go untreated. Conditions like Vitamin D deficiency and high cholesterol, apparent risk factors for coronavirus severity, likely go untreated in these communities. In addition, language barriers and traditional trust relationships may diminish the effectiveness of communications from public health authorities. In fact, some say the style of Swedish public health messaging was too culturally idiosyncratic to be of much use to immigrants. And one more thing: immigrants are a disproportionately high 28% of nursing home staff in Sweden, implying an intimacy between two vulnerable populations that almost surely acts as a risk multiplier in both.
It might be too harsh to suggest that that Sweden could have prevented the outsized impact of the virus on immigrants. However, Sweden’s coronavirus testing has not been as intensive as other Nordic countries. More testing might have helped alleviate the spread of the virus in nursing homes and in immigrant communities. But the vulnerabilities of the immigrant population might be more a matter of inadequate health care than anything else, both on the demand and supply sides.
Contrary to Trump’s characterization, Sweden’s herd immunity strategy is not the reason for it’s relatively high death rate from the virus. Several countries that imposed lockdowns have had higher death rates. And Sweden’s death rate has been heavily concentrated among the aged in nursing homes and its large immigrant population. It’s possible that Sweden’s approach led to a cavalier attitude with respect identifying vulnerable groups and taking measures that could have protected them, including more intensive testing. Nevertheless, it’s inaccurate and unfair to scapegoat Sweden for not imposing a mandatory lockdown. The choice is not merely whether to impose lockdowns, but how to protect vulnerable populations at least cost. In that sense, general lockdowns are a poor choice.
The coronavirus pandemic differs in a few important ways from the much deadlier Spanish flu pandemic of 1918-19. Estimates are that as much as 1/3rd of the world’s population was infected during that contagion, and the case fatality rate is estimated to have been 10-20%. The current pandemic, while very serious, will not approach that level of lethality.
Another important difference: the Spanish Flu was very deadly among young adults, whereas the Coronavirus is taking its greatest toll on the elderly and those with significant co-morbidities. Of course, the Spanish Flu infected a large number of soldiers and sailors, many returning from World War I in confined conditions aboard transport vessels. A major reason for its deadliness among young adults, however, is thought to be the “cytokine storm“, or severe inflammatory response, it induced in those with strong immune systems.
It’s difficult to make a perfect comparison between the pandemics, but the charts below roughly illustrate the contrast between the age distribution of case mortality for the Spanish Flu in 1918, shown in the first chart, and Covid-19 in the second. The first shows a measure of “excess mortality” for each age cohort as the vertical gap between the solid line (Spanish flu) and the dashed line (the average of the seven previous seasons for respiratory diseases). Excess mortality was especially high among those between the ages of 15 and 44.
The second chart is for South Korea, where the Covid-19 pandemic has “matured” and was reasonably well controlled. We don’t yet have a good measure of excess case mortality for Covid-19, but it’s clear that it is most deadly among the elderly population. Not to say that infected individuals in younger cohorts never suffer: they are a higher proportion of diagnosed cases, severe cases are of extended duration, and some of the infected might have to deal with lasting consequences.
One implication of these contrasting age distributions is that Covid-19 will inflict a loss of fewer “life years” per fatality. If the Spanish flu’s median victim was 25 years old, then perhaps about 49 life years were lost per fatality, based on life expectancies at that time. At today’s life expectancies, it might be more like 54 years. if Covid-19’s median victim is 70 years old, then perhaps 15 life-years are lost per fatality, or about 73% less. And that assumes the the median Covid victim is of average health, so the loss of life years is probably less. But what a grisly comparison! Any loss is tragic, but it is worth noting that the current pandemic will be far less severe in terms of fatalities, excess mortality (because the elderly always die at much higher rates), and in life-years lost.
Is that relevant to the policy discussion? It doesn’t mean we should throw all caution to the wind. Ideally, policy would save lives and conserve life-years. We’d always put children on the lifeboats first, after all! But in this case, younger cohorts are the least vulnerable.
The flu pandemic of 1918-19 is often held to support the logic of non-prescription public health measures such as school closures, bans on public gatherings, and quarantines. Does the difference in vulnerabilities noted above have any bearing on the “optimal” level of those measures in the present crisis? Some argue that while a so-called lockdown confers health benefits for a Spanish flu-type pandemic in which younger cohorts are highly vulnerable, that is not true of the coronavirus. The young are already on lifeboats having few leaks, as it were.
My view is that society should expend resources on protecting the most vulnerable, in this case the aged and those with significant co-morbidities. Health care workers and “first responders” should be on the list as well. If well-targeted and executed, a Covid-19 lockdown targeted at those groups can save lives, but it means supporting the aged and afflicted in a state of relative isolation, at least until effective treatments or a vaccine prove out. A lockdown might not change living conditions greatly for those confined to skilled care facilities, but much can be done to reduce exposure among those individuals, including a prohibition on staff working at multiple facilities.
Conversely, the benefits of a lockdown for younger cohorts at low risk of death are much less compelling for Covid-19 than might be suggested by the Spanish flu experience. In fact, it can be argued that a complete lockdown denies society of the lowest-hanging fruit of earlier herd immunity to Covid-19. Younger individuals who have more social and economic contacts can be exposed with relative safety, and thus self-immunized, as their true mortality rate (including undiagnosed cases in the denominator) is almost zero to begin with.
Then we have the economic costs of a lockdown. Idle producers are inherently costly due to lost output, but idle non-producers don’t impose that cost. For Covid-19, prohibiting the labor of healthy, working age adults has scant health benefits, and it carries the high economic costs of lost output. That cost is magnified by the mounting difficulty of bringing moribund activities back to life, many of which will be unsalvageable due to insolvency.
The lockdown question is not binary. There are ways to maintain at least modest levels of production in many industries while observing guidelines on safety and social distancing. In fact, producers are finding inventive ways of maximizing both production and safety. They should be relied upon to create these solutions. The excess mortality rates associated with this pandemic will continue to come into focus at lower levels with more widespread serological testing. That will reinforce the need for individual autonomy in weighing risks and benefits. Hazards are always out there: reckless or drunk drivers, innumerable occupational hazards, and the flu and other communicable diseases. Protect yourself in any way you see fit, but if you are healthy, please do so without agitating for public support from the rest of us, and without imposing arbitrary judgments on which activities carry acceptable risk for others.
If there’s one simple lesson in economics that’s hard to get across it’s the destructive nature of protectionism. The economics aren’t hard to explain, but for many, the lessons of protectionist failure just don’t want to sink in. Putting aside matters of national security, the harms of protectionism to the domestic economy are greater than any gains that might inure to protected firms and workers. Shielding home industries and workers from foreign competition is generally not smart nor an act of patriotism, but that sentiment seems fairly common nonetheless.
The Pathology of Protectionism
Jingoistic slogans like “Buy American” are a pitch for voluntary loyalty to American brands. I’m all for voluntary action. Still, that propaganda relies on shaming those who find certain foreign products to have superior attributes or to be more economical. This feeds a psychology of economic insularity and encourages those who favors trade barriers, which is one of the earliest species of failed central planning.
The cognitive resistance to a liberal trade regime might have to do with the concentrated benefits of protectionist measures relative to the more diffuse (but high) costs it imposes on society. Some of the costs of protectionism manifest only with time, which makes the connection to policy less obvious to observers. Or again, obstructing trade and taxing “others” in the hope of helping ourselves may simply inflame nationalist passions.
Both Democrats and Republicans rally around policy measures that tilt the playing field in favor of domestic producers, often severely. And again, this near unanimity exists despite innumerable bouts with the laws of economics. I mean, how many times do you have to be beaten over the head to realize that this is a mistake? Unfortunately, politicians just don’t live in the long-term, they leap to defend powerful interests, and they seldom pay the long-term consequences of their mistakes.
Joe Biden’s “Buy American”
The Biden Administration has pushed a “Made In America” agenda since the President took office, It’s partly a sop to unions for their election support. Much of it had to do with tightening waivers granted under made-in-America laws (dating back to 1933) governing foreign content in goods procured by the federal government. The most recent change by Biden is an increase in the requirement for domestic content to 60% immediately and gradually to 75% from there. Also, “price preferences” will be granted to domestic producers of goods to strengthen supply chains identified as “critical”, including active pharmaceutical ingredients, certain minerals including rare earths and carbon fibers, semiconductors and their advanced packaging, and large capacity batteries such as those used in EVs.
There’s a strong case to be made for developing domestic supplies of certain goods based on national security considerations. That can play a legitimate role where defense goods or even some kinds of civilian infrastructure are involved, but Biden’s order applies much more broadly, including protections for industries that are already heavily subsidized by taxpayers. For example, the CHIPS Act of 2022 included $76 billion of subsidies and tax credits to the semiconductor industry.
“‘Buy American,’ like protectionism generally, can protect some blue-collar jobs — but at a steep price: A Peterson Institute for International Economics study concludes that it costs taxpayers $250,000 annually for each job saved in a protected industry. And lots of white-collar jobs are created for lawyers seeking waivers from the rules. And for accountants tabulating U.S. content in this and that, when, say, an auto component might cross international borders (U.S., Canadian, Mexican) five times before it is ready for installation in a vehicle.”
Biden’s new rules will increase the cost of federal procurement. They will squeeze out contracts with foreign suppliers whose wares are sometimes the most price-competitive or best-suited to a project. This is not a prescription for spending restraint, and it comes at a time when the federal budget is under severe strain. Here’s George Will again:
“This will mean more borrowing, not fewer projects. Federal spending is not constrained by a mere shortage of revenue. So, Biden was promising to increase the deficit. And this policy, which elicited red-and-blue bonhomie in the State of the Union audience, also will give other nations an excuse to retaliate (often doing what they want to do anyway) by penalizing U.S. exporters of manufactured goods. ….. Washington lobbyists for both will prosper.”
Domestic manufacturers who find their contracting status “protected” from foreign competition will face less incentive to perform efficiently. They can relax, rather than improve or even maintain productivity levels, and they’ll feel less pressure to price competitively. Those domestic firms providing goods designated by the government as “critical” will be advantaged by the “price preferences” granted in the rules, leading to a less competitive landscape and higher prices. Thus, Biden’s “Buy American” order is likely to mean higher prices and more federal spending. This is destructive and counter to our national interests.
Donald Trump’s Tariffs
In a recent set of proposals trialed for his presidential election campaign, Donald Trump called for “Universal Baseline Tariffs” on imported goods. In a testament to how far Trump has stumbled down the path of economic ignorance, his campaign mentions “patriotic protectionism” and “mercantilism for the 21st century”. Good God! Trump might be worse than Biden!
This isn’t just about China, though there are some specific sanctions against China in the proposal. After all, these new tariffs would be “universal”. Nevertheless, the Trump campaign took great pains to cloak the tariffs in anti-China rhetoric. Now, I’m very unfavorably disposed to the CCP and to businesses who serve or rely on China and (by implication) the CCP. Certainly, in the case of China, national security may dictate the imposition of certain forms of protectionism, slippery slope though it might be. Nevertheless, that is not what universal tariffs are about.
One destructive consequence of imposing tariffs or import quotas is that foreign governments are usually quick to retaliate with tariffs and quotas of their own. Thus, export markets are shut off to American producers in an escalating trade conflict. That creates serious recession risks or might reinforce other recessionary forces. Lost production for foreign markets and job losses in the affected export industries are the most obvious examples of protectionist harm.
Then consider what happens in protected industries in the U.S. and the negative repercussions in other sectors. The prices charged for protected goods by domestic producers rise for two reasons: more output is demanded of them, and protected firms have less incentive to restrain pricing. Just what the protectionists wanted! In turn, with their new-found, government-granted market power, protected firms will compete more aggressively for workers and other inputs. That puts non-protected firms in a bind, as they’ll be forced to pay higher wages to compete with protected firms for labor. Other inputs may be more costly as well, particularly if they are imported. These distortions lead to reduced output and jobs in non-protected industries. It also means American consumers pay higher prices for both protected and unprotected goods.
Consumers not only lose on price. They also suffer a loss of consumer sovereignty to a government wishing to manipulate their choices. When choices are curtailed, consumers typically lose on other product attributes they value. It also curtails capital inflows to the U.S. from abroad, which can have further negative repercussions for U.S. productivity growth.
When imports constitute a large share of a particular market, it implies that foreign nations have a comparative advantage in producing the good in question. In other words, they sacrifice less to produce the good than we would sacrifice to produce it in the U.S. But if country X has a comparative advantage in producing good X, it means it must have a comparative disadvantage in producing certain other goods, let’s say good Y. (That is, positive tradeoffs in one direction necessarily imply negative tradeoffs in the other.) It makes more economic sense for other countries (country Y, or perhaps the U.S.) to produce good Y, rather than country X, since country Y sacrifices less to do so. And that is why countries engage in trade with each other, or allow their free citizens to do so. It is mutually beneficial. It makes economic sense!
To outlaw or penalize opportunities for mutually beneficial trade will only bring harm to both erstwhile trading partners, though it might well benefit specific interests, including some third parties. Those third parties include opportunistic politicians wishing to leverage nationalist sentiments, their cronies in protected industries, and the bureaucrats, attorneys, and bean counters who manage compliance.
When Is Trade Problematic?
Protectionists often accuse other nations of subsidizing their export industries, giving them unfair advantages or dumping their exports below cost on the U.S. market. There are cases in which this happens, but all such self-interested claims should be approached with a degree of skepticism. There are established channels for filing complaints (and see here) with government agencies and trade organizations, and specific instances often prompt penalties or formal retaliatory actions.
There are frequently claims that foreign producers and even prominent American businesses are beneficiaries of foreign slave labor. A prominent example is the enslavement of Uyghur Muslims in China, who reportedly have been used in the manufacture of goods sold by a number of big-name American companies. This should not be tolerated by these American firms, their customers, or by the U.S. government. Unfortunately, there is a notable lack of responsiveness among many of these parties.
Much less compelling are assertions of slave labor based on low foreign wage rates without actual evidence of compulsion. This is a case of severely misplaced righteousness. Foreign wage rates may be very low by American standards, but they typically provide for a standard of living in the workers’ home country that is better than average. There is no sin in providing jobs to foreign workers at a local wage premium or even a discount, depending on the job. In fact, a foreign wage that is low relative to American wages is often the basis for their comparative advantage in producing certain goods. Under these innocent circumstances, there is no rational argument for producing those goods at much higher cost in the U.S.
Very troublesome are the national security risks that are sometimes attendant to foreign trade. When dealing with a clear adversary nation, there is no easy “free trade” answer. It is not always clear or agreed, however, when international relations have become truly adversarial, and whether trade can be usefully leveraged in diplomacy.
As I noted earlier, protectionism has appeal from a nationalist perspective, but it is seldom a legitimate form of patriotism. It’s not patriotic to limit the choices and sovereignty of the individual, nor to favor certain firms or workers by shielding them from competition while penalizing firms requiring inputs from abroad. We want our domestic industries to be healthy and competitive. Shielding them from competition is the wrong approach.
So much of the “problem” we have with trade is the infatuation with goals tied to jobs and production. Those things are good, but protectionists focus primarily on first-order effects without considering the damaging second-order consequences. And of course, jobs and production are not the ultimate goals of economic activity. In the end, we engage in economic activity in order to consume. We are a rich nation, and we can afford to consume what we like from abroad. It satisfies wants, it brings market discipline, and it leads to foreign investment in the American economy.
Biden and Trump share the misplaced objectives of mercantilism. They are both salesmen in the end, though with strikingly different personas. Salesmen want to sell, and I’m almost tempted to say that their compulsion causes them see trade as a one-way street. Biden is selling his newest “Buy American” rules not only as patriotic, but as a national security imperative. The former is false and the latter is largely false. In fact, obstructions to trade make us weaker. They will also contribute to our fiscal imbalances, and that contributes to monetary and price instability.
Like “Buy American”, Trump’s tariffs are misguided. Apparently, Trump and other protectionists wish to tax the purchases of foreign goods by American consumers and businesses. In fact, they fail to recognize tariffs as the taxes on Americans that they are! And tariffs represent a pointed invitation to foreign trading partners to impose tariffs of their own on American goods. You really can’t maximize anything by foreclosing opportunities for gain, but that’s what protectionism does. It’s astonishing that such a distorted perspective sells so well.
I’m not terribly surprised to learn that scientific advancement has slowed over my lifetime. A recent study published in the journal Nature documented a secular decline in the frequency of “disruptive” or “breakthrough” scientific research across a range of fields. Research has become increasingly dominated by “incremental” findings, according to the authors. The graphic below tells a pretty dramatic story:
The index values used in the chart range “from 1 for the most disruptive to -1 for the least disruptive.” The methodology used to assign these values, which summarize academic papers as well as patents, produces a few oddities. Why, for example, does the tech revolution of the last 40 years create barely a blip in the technology index in the chart above? And why have tech research and social science research always been more “disruptive” than other fields of study?
Putting those questions aside, the Nature paper finds trends that are basically consistent across all fields. Apparently, systematic forces have led to declines in these measures of breakthrough scientific findings. The authors try to provide a few explanations as to the forces at play: fewer researchers, incrementalism, and a growing role of large-team research that induces conformity. But if research has become more incremental, that’s more accurately described as a manifestation of the disease, rather than a cause.
Steven F. Hayward skewers the authors a little, and perhaps unfairly, stating a concern held by many skeptics of current scientific practices. Hayward says the paper:
“… avoids the most significant and obvious explanation with the myopia of Inspector Clouseau, which is the deadly confluence of ideology and the increasingly narrow conformism of academic specialties.”
Conformism in science is nothing new, and it has often interfered with the advancement of knowledge. The earliest cases of suppression of controversial science were motivated by religious doctrine, but challenges to almost any scientific “consensus” seem to be looked upon as heresy. Several early cases of suppression are discussed here. Matt Ridley has described the case of Mary Worley Montagu, who visited Ottoman Turkey in the early 1700s and witnessed the application of puss from smallpox blisters to small scratches on the skin of healthy subjects. The mild illness this induced led to immunity, but the British medical establishment ridiculed her. A similar fate was suffered by a Boston physician in 1721. Ridley says:
“Conformity is the enemy of scientific progress, which depends on disagreement and challenge. Science is the belief in the ignorance of experts, as [the physicist Richard] Feynman put it.”
When was the Scientific Boom?
I couldn’t agree more with Hayward and Ridley on the damaging effects of conformity. But what gave rise to our recent slide into scientific conformity, and when did it begin? The Nature study on disruptive science used data on papers and patents starting in 1945. The peak year for disruptive science within the data set was … 1945, but the index values were relatively high over the first two decades of the data set. Maybe those decades were very special for science, with a variety of applications and high-profile accomplishments that have gone unmatched since. As Scott Sumner says in an otherwise unrelated post, in many ways we’ve failed to live up to our own expectations:
“In retrospect, the 1950s seem like a pivotal decade. The Boeing 707, nuclear power plants, satellites orbiting Earth, glass walled skyscrapers, etc., all seemed radically different from the world of the 1890s. In contrast, airliners of the 2020s look roughly like the 707, we seem even less able to build nuclear power plants than in the 1960s, we seem to have a harder time getting back to the moon than going the first time, and we still build boring glass walled skyscrapers.”
It’s difficult to put the initial levels of the “disruptiveness” indices into historical context. We don’t know whether science was even more disruptive prior to 1945, or how the indices used by the authors of the Nature article would have captured it. And it’s impossible to say whether there is some “normal” level of disruptive research. Is a “normal” index value equal to zero, which we now approach as an asymptote?
Some incredible scientific breakthroughs occurred decades before 1945, to take Einstein’s theory of relativity as an obvious example. Perhaps the index value for physical sciences would have been much higher at that time, were it measured. Whether the immediate post-World War II era represented an all-time high in scientific disruption is anyone’s guess. Presumably, the world is always coming from a more primitive base of knowledge. Discoveries, however, usually lead to new and deeper questions. The authors of the Nature article acknowledge and attempt to test for the “burden” of a growing knowledge base on the productivity of subsequent research and find no effect. Nevertheless, it’s possible that the declining pattern after 1945 represents a natural decay following major “paradigm shifts” in the early twentieth century.
The Psychosis Now Known As “Wokeness”
The Nature study used papers and patents only through 2010. Therefore, the decline in disruptive science predates the revolution in “wokeness” we’ve seen over the past decade. But “wokeness” amounts to a radicalization of various doctrines that have been knocking around for years. The rise of social justice activism, critical theory, and anthropomorphic global warming theology all began long before the turn of the century and had far reaching effects that extended to the sciences. The recency of “wokeness” certainly doesn’t invalidate Hayward and Ridley when they note that ideology has a negative impact on research productivity. It’s likely, however, that some fields of study are relatively immune to the effects of politicization, such as the physical sciences. Surely other fields are more vulnerable, like the social sciences.
Citations: Not What They Used To Be?
There are other possible causes of the decline in disruptive science as measured by the Nature study, though the authors believe they’ve tested and found these explanations lacking. It’s possible that an increase in collaborative work led to a change in citation practices. For example, this study found that while self-citation has remained stable, citation of those within an author’s “collaboration network” has declined over time. Another paper identified a trend toward citing review articles in Ecology Journals rather than the research upon which those reviews were based, resulting in incorrect attribution of ideas and findings. That would directly reduce the measured “disruptiveness” of a given paper, but it’s not clear whether that trend extends to other fields.
Believe it or not, “citation politics” is a thing! It reflects the extent to which a researcher should suck-up to prominent authors in a field of study, or to anyone else who might be deemed potentially helpful or harmful. In a development that speaks volumes about trends in research productivity, authors are now urged to append a “Citation Diversity Statement” to their papers. Here’s an academic piece addressing the subject of “gendered citation practices” in contemporary physics. The 11 authors of this paper would do well to spend more time thinking about problems in physics than in obsessing about whether their world is “unfair”.
Science and the State
None of those other explanations are to disavow my strong feeling that science has been politicized and that it is harming our progress toward a better world. In fact, it usually leads us astray. Perhaps the most egregious example of politicized conformism today is climate science, though the health sciences went headlong toward a distinctly unhealthy conformism during the pandemic (and see this for a dark laugh).
Politicized science leads to both conformism and suppression. Here are several channels through which politicization might create these perverse tendencies and reduce research productivity or disruptiveness:
Political or agenda-driven research is driven by subjective criteria, rather than objective inquiry and even-handed empiricism
Research funding via private or public grants is often contingent upon whether the research can be expected to support the objectives of the funding NGOs, agencies, or regulators. The gravy train is reserved for those who support the “correct” scientific narrative
Promotion or tenure decisions may be sensitive to the political implications of research
Government agencies have been known to block access to databases funded by taxpayers when a scientist wishes to investigate the “wrong questions”
Journals and referees have political biases that may influence the acceptance of research submissions, which in turn influences the research itself
The favorability of coverage by a politicized media influences researchers, who are sensitive to the damage the media can do to one’s reputation
The chance that one’s research might have a public policy impact is heavily influenced by politics
The talent sought and/or attracted to various fields may be diminished by the primacy of political considerations. Indoctrinated young activists generally aren’t the material from which objective scientists are made
In fairness, there is a great deal of wonderful science being conducted these days, despite the claims appearing in the Nature piece and the politicized corruption undermining good science in certain fields. Tremendous breakthroughs are taking place in areas of medical research such as cancer immunotherapy and diabetes treatment. Fusion energy is inching closer to a reality. Space research is moving forward at a tremendous pace in both the public and private spheres, despite NASA’s clumsiness.
I’m sure there are several causes for the 70-year decline in scientific “disruptiveness” measured in the article in Nature. Part of that decline might have been a natural consequence of coming off an early twentieth-century burst of scientific breakthroughs. There might be other clues related to changes in citation practices. However, politicization has become a huge burden on scientific progress over the past decade. The most awful consequences of this trend include a huge misallocation of resources from industrial planning predicated on politicized science, and a meaningful loss of lives owing to the blind acceptance of draconian health policies during the Covid pandemic. When guided by the state or politics, what passes for science is often no better than scientism. There are, however, even in climate science and public health disciplines, many great scientists who continue to test and challenge the orthodoxy. We need more of them!
I leave you with a few words from President Dwight Eisenhower’s Farewell Address in 1961, in which he foresaw issues related to the federal funding of scientific research:
“Akin to, and largely responsible for the sweeping changes in our industrial-military posture, has been the technological revolution during recent decades.
In this revolution, research has become central; it also becomes more formalized, complex, and costly. A steadily increasing share is conducted for, by, or at the direction of, the Federal government.
Today, the solitary inventor, tinkering in his shop, has been over shadowed by task forces of scientists in laboratories and testing fields. In the same fashion, the free university, historically the fountainhead of free ideas and scientific discovery, has experienced a revolution in the conduct of research. Partly because of the huge costs involved, a government contract becomes virtually a substitute for intellectual curiosity. For every old blackboard there are now hundreds of new electronic computers.
The prospect of domination of the nation’s scholars by Federal employment, project allocations, and the power of money is ever present and is gravely to be regarded.
Yet, in holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy could itself become the captive of a scientific-technological elite.”
When Covid-19 began its awful worldwide spread in early 2020, the Swedes made an early decision that ultimately proved to be as protective of human life as anything chosen from the policy menu elsewhere. Sweden decided to focus on approaches for which there was evidence of efficacy in containing respiratory pandemics, not mere assertions by public health authorities (or anyone else) that stringent non-pharmaceutical interventions (NPIs) were necessary or superior.
“Professor Johan Giesecke, who first recruited [Sweden’s State epidemiologist Anders] Tegnell during his own time as state epidemiologist, used a rare interview last week to argue that the Swedish people would respond better to more sensible measures. He blasted the sort of lockdowns imposed in Britain and Australia and warned a second wave would be inevitable once the measures are eased. ‘… when you start looking around at the measures being taken by different countries, you find very few of them have a shred of evidence-base,’ he said.
Giesecke, who has served as the first Chief Scientist of the European Centre for Disease Control and has been advising the Swedish Government during the pandemic, told the UnHerd website there was “almost no science” behind border closures and school closures and social distancing and said he looked forward to reviewing the course of the disease in a year’s time.”
Giesecke was of the opinion that there would ultimately be little difference in Covid mortality across countries with different pandemic policies. Therefore, the least disruptive approach was to be preferred. That meant allowing people to go about their business, disseminating information to the public regarding symptoms and hygiene, and attempting to protect the most vulnerable segments of the population. Giesecke said:
“I don’t think you can stop it. It’s spreading. It will roll over Europe no matter what you do.”
He was right. Sweden had a large number of early Covid deaths primarily due to its large elderly population as well as its difficulty in crafting effective health messages for foreign-speaking immigrants residing in crowded enclaves. Nevertheless, two years later, Sweden has posted extremely good results in terms of excess deaths during the pandemic.
Excess deaths, or deaths relative to projections based on historical averages, are a better metric than Covid deaths (per million) for cross-country or jurisdictional comparisons. Among other reasons, the latter are subject to significant variations in methods of determining cause of death. Moreover, there was a huge disparity between excess deaths and Covid deaths during the pandemic, and the gap is still growing:
Excess deaths varied widely across countries, as illustrated by the left-hand side of the following chart:
Interestingly, most of the lowest excess death percentages were in Nordic countries, but especially Sweden and Norway. That might be surprising in terms of high Nordic latitudes, which may have created something of a disadvantage in terms of sun exposure and potentially low vitamin D levels. Norway enacted more stringent public policies during the pandemic than Sweden. Globally, however, lockdown measures showed no systematic advantage in terms of excess deaths. Notably, the U.S. did quite poorly in terms of excess deaths at 8X the Swedish rate,
The right-hand side of the chart above shows that Sweden experienced a significant number of Covid deaths per million residents. The figure still compares reasonably well internationally, despite the country’s fairly advanced age demographics. Most Covid deaths occurred in the elderly and especially in care settings. Like other places, that is where the bulk of Sweden’s Covid deaths occurred. Note that U.S. Covid deaths per million were more than 50% higher than in Sweden.
NPIs Are Often Deadly
Perhaps a more important reason to emphasize excess deaths over Covid deaths is that public policy itself had disastrous consequences in many countries. In particular, strict NPIs like lockdowns, including school and business closures, can undermine public health in significant ways. That includes the inevitably poor consequences of deferred health care, the more rapid spread of Covid within home environments, the physical and psychological stress from loss of livelihood, and the toll of isolation, including increased use of alcohol and drugs, less exercise, and binge eating. Isolation is particularly hard on the elderly and led to an increase in “deaths of despair” during the pandemic. These were the kinds of maladjustments caused by lockdowns that led to greater excess deaths. Sweden avoided much of that by eschewing stringent NPIs, and Iceland is sometimes cited as a similar case.
Oxford Stringency Index
I should note here, and this is a digression, that the most commonly used summary measure of policy “stringency” is not especially trustworthy. That measure is an index produced by Oxford University that is available on the Our World In Data web site. Joakim Book documented troubling issues with this index in late 2020, after changes in the index’s weightings dramatically altered its levels for Nordic countries. As Book said at that time:
“Until sometime recently, Sweden, which most media coverage couldn’t get enough of reporting, was the least stringent of all the Nordics. Life was freer, pandemic restrictions were less invasive, and policy responses less strong; this aligned with Nordic people’s experience on the ground.”
Again, Sweden relied on voluntary action to limit the spread of the virus, including encouragement of hygiene, social distancing, and avoiding public transportation when possible. Book was careful to note that “Sweden did not ‘do nothing’”, but it’s policies were less stringent than its Nordic neighbors in several ways. While Sweden had the same restrictions on arrivals from outside the European Economic Area as the rest of the EU, it did not impose quarantines, testing requirements, or other restrictions on travelers or on internal movements. Sweden’s school closures were short-lived, and its masking policies were liberal. The late-2020 changes in the Oxford Stringency Index, Book said, simply did not “pass the most rudimentary sniff test”.
Sweden’s economy performed relatively well during the pandemic. The growth path of real GDP was smoother than most countries that succumbed to the excessive precautions of lockdowns. However, Norway’s economy appears to have been the most stable of those shown on the chart, at least in terms of real output, though it did suffer a spike in unemployment.
The Bottom Line
The big lesson is that Sweden’s “light touch” during the pandemic proved to be at least as effective, if not more so, than comparatively stringent policies imposed elsewhere. Covid deaths were sure to occur, but widespread non-Covid excess deaths were unanticipated by many countries practicing stringent intervention. That lack of foresight is best understood as a consequence of blind panic among public health “experts” and other policymakers, who too often are rewarded for misguided demonstrations that they have “done something”. Those actions failed to stop the spread in any systematic sense, but they managed to do great damage to other aspects of public health. Furthermore, they undermined economic well being and the cause of freedom. Johan Giesecke was right to be skeptical of those claiming they could contain the virus through NPIs, though he never anticipated the full extent to which aggressive interventions would prove deadly.
Statistics and measurement might not be critical to the exercise of the authoritarian impulse, but they have served to enable the technocratic tyranny idealized by contemporary statists. Certain influential thinkers have claimed our ability to compile statistics helps give rise to the bureaucratized state. I ran across a great post that led with that topic: “The Brutalization of Compassion” by David McGrogan. The mere ability to compile relevant statistics on a population and its well being (income, jobs, wages, inequality, mortality, suicide, etc… ) can motivate action by authorities to “improve” matters. The purpose might be to get ahead of rival states, or the action might be rationalized as compassion. But watch out! McGrogan quotes a bit of cautionary wisdom from Lionel Trilling:
“‘When once we have made our fellow men the objects of our enlightened interest,’ he put it, something within us causes us to then ‘go on and make them the objects of our pity, then of our wisdom, ultimately of our coercion.’”
Ultimately, to pursue their vision, interventionists must impose controls on behaviors. In practice, that means any variance or attempted variance must be penalized. Here’s McGrogan’s description of the steps in this process:
“The conceptualisation of the population as a field of action, and the measurement of statistical phenomenon within it – the taking of an ‘enlightened interest’ in it – gives rise to both ‘pity,’ or compassion, and the application of ‘wisdom’ to resolve its problems. What is left, of course, is coercion, and we do not need to look far to identify it in the many means by which the modern state subjects the population to a kind of Tocquevillian ‘soft despotism,’ constantly manipulating, cajoling and maneuvering it this way and that for its own good, whether through compulsory state education or ‘sin taxes’ or anything in between.”
Follow the Scientism
I can’t neglect to mention another important condition: the hubris among apparatchiks who imagine the state can improve upon private institutions to achieve social betterment. They will always fail in attempts to replace the action of the private markets and the price mechanism to process information relating to scarcities and preferences. Absent that facility, human planners cannot guide flows of resources to their most valued uses. In fact, they nearly always botch it!
Government provision of public goods is one concession worth making, but the state capacity needed to fulfill this legitimate function is subject to severe mission creep: we frequently see efforts to characterize goods and service as “public” despite benefits that are almost wholly private (e.g. education). Likewise, we often hear exaggerated claims of “harms” requiring state intervention (e.g. carbon emissions). These situations often hinge purely on politics. Even when legitimate external benefits or costs can be identified, there is a pretension that they can be accurately measured and corrected via subsidies or taxes. This is far-fetched. At best, it’s possible to vouch for the directional appropriateness of some interventions, but the magnitude of corrective measures is variable and essentially unknowable. Too often we see government failure via over-subsidization of politically favored activities and over-penalization of politically disfavored activities.
One of the most egregious errors of intervention is the over-application of the precautionary principle: if risks are associated with an activity, then it must be curtailed. This often relies on measurements of highly uncertain causes and effects, and it involves aggregation subject to its own biases.
Just as questionable is the ability of “experts” to model natural or behavioral processes such that outcomes can be “predicted” over horizons extending many decades forward. That interventionists tend to ignore the uncertainties of these predictions is the most blatant and damaging conceit of all, not least because the public and the media usually have limited knowledge with which to assess the phenomenon in question.
Public Health Tyranny
The Covid pandemic presented a compelling excuse for precautionists in government and even private institutions to impose radical controls under a set of claims they called “the science”. These claims were often false and really antithetical to the principles of scientific inquiry, which calls for continually questioning hypotheses, even when they represent “consensus”. Yet a series of questionable scientific claims were used to justify abridgment of basic freedoms for the general population, most of whom faced little risk from the virus. This included lockdowns of schools and churches, business closures, cancellation of public events (except of course for protests and riots by Leftists), deferred medical care, vaccine mandates, and mask mandates. The damage these measures inflicted was fierce, and in the end we know that it was almost entirely unnecessary. Still, the public health establishment seems all too willing to ignore the facts in its readiness to repeat the whole range of mistakes at the slightest uptick in what’s now an endemic infection.
Standard Issue Cronyism
In the wake of the pandemic, we’ve witnessed a surge in calls for government to enhance the security of our nation’s supply chains. Too large a share of the critical goods required by domestic industries are produced overseas, which has made supply disruptions, and the threat of future disruptions, especially acute. Right on cue, advocates of industrial policy and planning have arranged for the federal government to provide $85 billion to domestic producers of semiconductors under the so-called CHIPS Act. But semiconductor producers are in no need of government incentives to “re-shore” production:
“… there has been even more chipmaking investment dedicated to the U.S. market, even as federal subsidies have languished. Construction is now underway at four major U.S. facilities and will continue with or without subsidies—something even Intel reluctantly acknowledged when it delayed the groundbreaking ceremony on its much‐ballyhooed Ohio facility to protest congressional inaction. This is because, as numerous experts have explained over the last year, there are real economic and geopolitical reasons to invest in additional U.S. semiconductor production—no federal subsidies needed.”
Moreover, the global shortage of computer chips appears to be ending. The subsidies will unnecessarily enrich industrialists and their shareholders, provide a source of graft to bureaucrats and various middle men, and likely over-allocate resources to domestic production of chips. Industrial planning of this kind has a long history of failure, and this time won’t be different.
We also see repeated over-application of the precautionary principle and rising dominance of industrial policy in climate and energy policy. Enormous sacrifices are imposed on consumers for the sake of minuscule changes in global carbon emissions and the “expected” long-term path of future “global” temperatures. The interventions taken in pursuit of these objectives are draconian, limiting choices and raising the cost of virtually everything produced and consumed. They distort the direction of physical investment, disfavoring reliable sources of base load capacity needed for growth, and also disfavoring the safest and most reliable zero-carbon alternative: nuclear power. The renewable energy sources foolishly pushed by the state and the ESG establishment are environmentally costly in their own right, and they don’t work when natural conditions are unfavorable. As one wag says about the climate provisions of the ironically named Inflation Reduction Act, “Gonna be a lot more Solyndras coming”.
And talk about sloppy! Our “trusted representatives” in Congress could hardly be bothered to pretend they’d done their homework. They neglected to provide any quantitative carbon and temperature impacts of the legislation. This must be a case of true honesty, because they really have no idea!
Delusions of Central Planning
One great weakness (among many) of arguments for state industrial planning is the assumption that government agents are somehow more competent, efficient, and “pure of heart” than agents in the private sector. Nothing could be more laughable. On this point, some of the most incisive commentary I’ve seen is provided by the masterful Don Boudreaux, first quoting Georgetown philosopher Jason Brennan before adding his own entertaining thoughts:
The typical way the left argues for the state is to describe what economists in the 1850s thought markets would be like under monopoly or monopsony, and then compare that to a state run by angels. Both halves of the argument are bad, and yet philosophy treats this as if it were rigorous and sophisticated.
“Far too many policy proposals are nothing more than prayers to the state-god. ‘We entreat you, Oh Powerful and Sacred One, to relieve our people of this or that misery, blemish, and market imperfection! We beseech you to bestow upon us – your faithful servants – cosmic justice, safety from new pathogens, unkind thoughts, and microaggressions, and protection from each and every burden of reality that we can imagine being cured by an omniscient, benevolent, and omnipotent deity! If we obey – and sacrifice to you without complaint our treasure and our freedoms – you will provide!’
I do not exaggerate. Pick at random any proposed government intervention offered by the likes of Progressives or national conservatives, and you’ll discover that the workability of this proposed intervention, when evaluated honestly, rests on nothing more solid than the above absurd faith that the state is – or, when in the right hands, will be – a secular god.”
On the idealization of government’s ability to “plan the economy” rationally, here is more from Boudreaux, first quoting the great Deirdre McCloskey:
Deep in left-wing thought about the economy, and in a good deal of right-wing thought, too, is the premise, as Isaiah Berlin once put it with a sneer, that government can accomplish whatever it rationally proposes to do. As has been often observed about leftists even as sweet as John Rawls, the left has no theory of the behavior of the government. It assumes that the government is a perfect expression of the will of The People.
“And nothing is more unscientific – indeed, more mystical – than is this still-commonplace practice of most Progressives, and also of very many conservatives, to analyze the economy and society, and to offer policy recommendations, using such a juvenile ‘understanding’ of the state. Yet such an ‘understanding’ of the state permeates the work even of some Nobel laureates in economics – laureates such as Paul Krugman and Joseph Stiglitz. This ‘understanding’ of the state is inseparable also from the work of pundits too many to count…
That these professors and pundits think of themselves as scientific – and are widely regarded as being especially intelligent, thoughtful, and scientific – testifies to the strength of the cult of democratically rubber-stamped coercion.”
Humans have proven to be incredible documentarians. The advent of measurement techniques and increasingly sophisticated methods of accounting for various phenomena has enabled better ways of understanding our world and our well being. Unfortunately, a by-product was the birth of scientism, the belief that men in authority are capable not only of measuring, but of fine-tuning, the present and future details of society and social interaction. Those pretensions are terribly mistaken. However, the actions of Congress and the Biden Administration prove that it’s adherents will never be persuaded, despite repeated demonstrations of the futility of central planning. Their words of compassion are no comfort — they must coerce the ones they “love”.
Understanding the severity of the coronavirus pandemic is more straightforward when measured in terms of excess deaths, rather than total Covid deaths. We’ve had a large number of excess deaths in the U.S., but not all of them can be attributed to Covid. It’s also worth asking whether some of the deaths were avoidable, because that reflects even more profoundly on the success or failure of public policy and the health care system in dealing with the challenge. Unfortunately, while the precise number of avoidable deaths the nation has suffered is speculative, it is nevertheless significant.
A huge problem with using total Covid deaths as a measure of pandemic severity is that no one is confident in the accuracy of official statistics. There are reasons to suspect over-counting in the U.S. due to financial incentives created for hospital systems by the CARES Act. These were exacerbated by the CDC’s absurd 2020 recommendations for the completion of death certificates. Essentially, any non-primary Covid entry on a death certificate was sufficient to count the death as from Covid. No other disease is or has ever been tallied like that.
There is an important distinction between deaths “with Covid” and deaths “from Covid” that has been acknowledged only recently by health authorities. A death “with Covid” can occur when a patient tests positive for Covid after being admitted to a hospital for another primary ailment. Thus, deaths from other causes like heart failure have been improperly coded as Covid deaths under the CDC’s guidelines. Even tragedies like auto fatalities have been coded as Covid deaths.
At the same time, some public health “elites” insist that many Covid deaths in the community have gone unreported. That might have been true in the early weeks of the pandemic. However, post-mortem testing by medical examiners began to spread by April 2020, though there was a shortage of tests, and the CDC issued guidelines to encourage it late in the year.
Counting excess deaths from all causes avoids these controversies, including differences across countries in the way they record Covid deaths. It’s also possible to break down excess death into broad categories of causes, though the task is complex.
First some simple accounting. Let’s define all-cause mortality during a period (Mort) as Covid deaths (C) plus plus all other mortality (M), or Mort = C + M. Expected mortality in the absence of a pandemic would be Exp(Mort) = Exp(M). Usually this expected value is taken as an average of deaths over several previous years. Therefore, excess mortality during the pandemic is:
EM = C + M – Exp(M)
How many excess deaths have we actually seen during the pandemic? According to Our World In Data, the figure was 950,000 as of Jan 9th. USMortality.com puts the excess at about 965,000 through the end of 2021. So these two sources are in close agreement, which says a lot given the usual difficulty of getting pandemic numbers to tie-out across sources
Through 2021, cumulative Covid deaths (by date of death) were almost 850,000. That’s less than excess deaths, so it’s obvious that other factors have contributed to the excess. Interestingly, 2021 was worse for excess deaths than 2020 for all age groups except 85+. Some have suggested the most vulnerable in this highly vulnerable age group had already succumbed to Covid in 2020, but there may have been other reasons for the difference.
As noted above, some of the Covid deaths were misattributions. If we understand C to include only deaths “from Covid”, then we must acknowledge that M includesdeaths from other causes but “with Covid”, as well as all deaths without Covid diagnoses. For example, because of the confounded way in which Covid deaths have been counted, a death from heart disease could end up in the official count of C, but it should be included in M instead.
The figures above imply 100,000+ excess deaths during the pandemic not associated with Covid diagnoses. If we add to those the “with Covid”, incidental total, then perhaps 300,000 – 400,000 excess deaths during the pandemic were from non-Covid primary causes!
Lockdown effects are a prime suspect in these non-Covid deaths. For example, if health care was deferred because hospitals cancelled or delayed elective procedures, or because patients feared the hospital environment, that would certainly manifest in premature deaths. Deaths of despair or neglect were also in excess, as one should expect when populations are subjected to prolonged periods of isolation.
These kinds of deaths are so-called “lockdown” deaths because they could have been avoided without such stringent policy measures and the propagation of fear by public health authorities. Those who might protest this nomenclature should note that lockdowns have been unsuccessful in mitigating the pandemic (and see here). After all, in terms of excess deaths, the Swiss approach was quite successful!
Many of the excess pandemic deaths were avoidable. Prolonged lockdown policies were driven by politics rather than sound public health reasoning. However, within the Covid death totals there is another category of avoidable deaths, and it is every bit as controversial. This post from The Ethical Skeptic (TES) goes into great detail on the matter. He takes a strong position, and some of his assertions and his accounting are subject to challenge. I sometimes find that TES’s posts contain ambiguities, and the graphical evidence he presents is often poorly labeled. Still, he has proven correct on other controversial issues, such as the ancestry and surprisingly early “vintage” of the Omicron variant.
Most of the “avoidable” Covid deaths (again, as distinct from the non-Covid lockdown deaths) occurred well after the primary symptoms of the infection (fever, cough, and cytokine storm) had passed. In the end, the real killers were follow-on problems induced by Covid, primarily related to blood clotting and compromised vascular integrity from endothelial dysfunction. These deadly complications were known very early in the pandemic. The following schematic from TES shows a Covid “death timeline”. The figures listed under the schematic show the large share of clotting and vascular problems involved in these deaths.
Over the past two years, not all of these patients were placed on anticoagulants or blood thinners early in the course of their infections. Indeed, many of them were told to “go home and sleep it off”. This is what happened to TES as well as a number of commenters on his Twitter account. I know several individuals who received the same advice from medical professionals. Even among the hospitalized, many were not placed on these drugs in a timely fashion, or until it was too late. TES adds the wrinkle that his physician indicated he should have been vaccinated! Short of that, tough luck, said the healer.
TES blames this medical “malfeasance” on the CDC’s Emergency Use Authorizations (EUA) for the Covid vaccines. In fact, he calls these deaths “EUA Shadow Deaths”, citing legal requirements associated with EUAs that would appear to prohibit alternatives such as therapies and even tests or studies of alternatives. That contention seems questionable given the CDC’s issuance of other EUAs for certain treatments, and there was no shortage of published experiments conducted during 2020-21.
The vaccine EUAs were not issued until late 2020, but TES claims that forces leading up to those EUAs were responsible for the failure to put patients on anticoagulants/blood thinners even earlier in 2020. The schematic says more than half of Covid deaths through the end of 2021 involved blood coagulation issues, and I have no reason to doubt those figures, which TES sources from the CDC. But He uses a value of 50% of Covid deaths to estimate that 421,000 Covid deaths were avoidable.
I’m not sure about that total, or rather, the use of the term “avoidable” in all those cases. I am sure, however, that we’ve seen a remarkable under-emphasis on therapeutics (and see here and here) relative to the emphasis on vaccines. The news media contributed to the dysfunction by condemning certain promising therapies for political reasons.
I’m also sure that there have been a meaningful number of patients who should have received anticoagulants/thinning agents but did not. Why did they not? Plausibly, the restrictions imposed by the vaccine EUAs made a difference, but clearly the medical community was not tuned into what should have been an obvious treatment regimen.
How many Covid deaths were truly avoidable? TES’s estimate of 421,000 seems too high if only because we can’t expect the dissemination of information through the medical community to be perfect. Moreover, some of these patients were undoubtedly on blood thinners already, or there might have been contraindications preventing the use of anticoagulants/thinners.
Nevertheless, a substantial number of deaths could have been avoided by more timely use of therapeutics and less stringent lockdown measures. Here is a chart from a tweet by TES showing another accounting for excess deaths:
Here, TES uses a slightly longer time frame, through about February 5, 2022, so the “EUA Shadow Death” total is somewhat larger, about 437,000, than shown in the earlier schematic. He attributes about 800,000 excess deaths, or 77%, to Covid, most of which he believes were avoidable deaths.
Lockdown deaths account for some of the additional 236,000 excess deaths reported in the chart, and probably a large share of the roughly 90,000 non-natural deaths labeled #3 (SAAAAD = “Suicide Addiction Abandonment Abuse Accident & Despair”; the two other categories in #3 relate to non-Covid illnesses acquired in-hospital or adverse reactions to medications). The Unknown/Abnormal category may include some lockdown deaths, but more on that category below.
If TES is correct about shadow deaths, the “avoidable” pandemic death total might account for well over half of all excess deaths. I suspect it might account for half, but even if less, it’s clear that avoidable deaths have been a huge part of the pandemic’s toll.
Vaccine Adverse Events
There’s been much speculation about the large number of Unknown/Abnormal deaths that have been coded during the pandemic: more than 65,000 in the chart above. One caveat is that an “unknown” cause of death usually means the cause is ambiguous: there might have been several factors contributing to the death such that the medical examiner was unable to assign a definitive cause. That status can be temporary as well. Still, the surge is noteworthy.
Unfortunately, there were an unusual number of excess deaths in younger age brackets in 2021, especially in the second half of the year after vaccinations had reached a fairly large share of the population. The pace of those deaths hasn’t yet abated in 2022. The next chart, from USMortality.com, showsexcess mortality in the 25 – 44 age bracket in 2020 – early 2022.
Many of these prime age deaths could be a continuing hangover from deferred medical care and depression. There are claims, however, that the vaccines themselves killed a significant number of individuals. The upsurge in excess deaths suggests to some that the vaccines have had a much greater number of “adverse events” than we’ve seen reported by the CDC and the news media.
Here is how TES presents the data on excess deaths and vaccinations. The chart title is his somewhat confusing attempt to summarize the meaning of the lines plotted. The left axis measures the pace of vaccinations by week and the right access measures weekly excess non-Covid natural-cause deaths.
I have no doubt as to the efficacy of the vaccines against serious Covid outcomes in high-risk groups, though vaccine efficacy has been drastically overstated by the Biden Administration. The balance of risks for older individuals is clearly in favor of vaccination. Still, I’ve long felt that vaccination is less compelling for people in younger age brackets, and it’s possibly a bad idea. That’s both because Covid is a much smaller risk to them and because of possible vaccine risks, such as myocarditis.
To the extent that natural-cause, non-Covid excess deaths among younger age cohorts have been driven by unnecessary vaccinations, those deaths were avoidable. I’m not convinced of the significance, and it’s clear that among hospitalized Covid patients, outcomes have been better among the vaccinated. The following chart is from the link in the previous paragraph:
That sort of pattern might mean more deaths among the unvaccinated could have been avoided, on balance, had they opted for the jab. In almost all things, however, I believe we should eschew blanket mandates and instead offer protection to those seeking it in the high-risk population.
As many as 30% of Covid deaths to date are likely misattributions in which Covid was not really the primary cause of death. Nevertheless, excess Covid deaths “from Covid” as the primary cause are probably approaching 700,000 today.
The pandemic was certainly bad enough without a slew of bad calls by the public health and medical establishments. Of the 950,000+ excess deaths that occurred through the end of 2021, over 100,000 were not attributed to Covid. If we include deaths mis-attributed to Covid, the non-Covid total is likely in excess of 300,000 and could be as high as 400,000. It’s time to acknowledge that lockdowns and fear-mongering led to a large number of those deaths, and most of those deaths were avoidable. However, while I am skeptical, the number of deadly adverse effects from vaccines in the prime age population is an open question.
Another class of avoidable deaths was a product of the underemphasis on Covid therapies by the medical establishment. There were many cases of promising, repurposed drugs that were shouted down after so-called experts insisted that their use must be withheld until adequate randomized control trials (RCTs) had confirmed their efficacy. Not only did this ignore the long history of clinical evidence as a guide to medical practice. It also ignored the frequent real-world inadequacies that plague RCTs.
At the same time, obvious complications of the vascular system, primarily blood clotting, were not treated in a timely way or as a precautionary treatment’s, at least prior to hospitalization. Adding a conservative allowance for these deaths to the other avoidable deaths probably means that at least half of the excess deaths during the pandemic were avoidable. As of March 2022, that’s over half a million deaths! We can chalk it up to mismanagement and miscommunication by the public health establishment with a dash of ignorance, and perhaps some malfeasance, by health care practitioners. The death of expertise, indeed!
We might be just be done with the coronavirus pandemic. That is, it appears to be transitioning to a more permanent endemic phase. What follows are a few details about the Omicron wave and its current status, an attempt to put the risks of Covid in perspective, and a few public policy lessons that are now gaining broad currency but should have been obvious long ago.
What’s The Status?
The Omicron variant became the dominant U.S. strain of the coronavirus in December. Omicron outcompeted Delta, which was very good news because Omicron is far less severe. The chart below (from the CDC Data Tracker site) shows Omicron’s rapid ascendance and displacement of the Delta variant. The orange bar segments represent the proportion of cases of the Delta strain, while the purple and pink segments are Omicron sub-variants known as BA.1 and BA.2, respectively. BA.2 is even more transmissible than BA.1 and is likely to become dominant over the next month or so. However, the BA.2 sub-variant appears to be far less virulent than Delta, like BA.1.
Despite a record number of infections over a period of a month or so, the Omicron wave is tapering just as rapidly as it ramped up, as the next chart demonstrates. In fact, covidestim.org shows that cases are now receding in all states, DC, and Puerto Rico. Here are new cases per million people from Our World in Data:
Whether BA.2 causes cases to plateau for a while, or even a secondary Omicron “wavelet”, is yet to be seen. That would be consistent with the normal Hope-Simpson seasonal pattern of viral prevalence in the northern hemisphere (hat tip: HOLD2):
Data problems make the Omicron wave difficult to assess, however. We don’t know the share of incidental infections for the U.S. as a whole, but more than half of hospitalized Covid patients in Massachusetts and Rhode Island are classified with incidental infections. The proportion in the UK is estimated to be rising and approaching 30% of total cases, with much higher percentages in many regions of England, as shown below.
As I’ve emphasized in the past, case numbers should not be the primary gauge of the state of the pandemic, especially with a more highly contagious but relatively mild variant like Omicron. Hospitalizations are a better measure, but only if “incidental” infections are removed from the counts. That’s been acknowledged only recently by the public health establishment, and even the Biden Administration is emphasizing it as a matter of sheer political expediency. Another measure that might be more reliable for assessing the pandemic in the community as a whole is the number of emergency room patients presenting Covid-like symptoms. From the CDC Data Tracker:
There is no doubt that incidental infections create complications in caring for patients with other ailments. That has a bearing on the utilization of hospital capacity. Generally, however, strains on hospital capacity during the pandemic have been greatly exaggerated. This is not to diminish the hard work and risks faced by health care workers, and there have been spot shortages of capacity in certain localities. However, in general, staffed beds have been more than adequate to meet needs. This chart, like a few others below, is courtesy of Phil Kerpen:
With the more highly transmissible variants we have now, it’s not at all surprising to see a high proportion of incidental cases among inpatients. Incidental infections are likely to inflate counts of Covid deaths as well, given the exceptional and odd way in which Covid deaths are being recorded. It will be some time until we see full U.S. data on cases and deaths net of incidental infections. Moreover, many of the Covid deaths in December and January were from lingering Delta infections, which might still be a factor in the February counts.
How Are Your Odds?
The mild or asymptomatic nature of most Omicron cases, the large proportion of incidental hospitalizations, and the knowledge that Omicron is not a deep respiratory threat should offer strong reassurance to healthy individuals that the variant does not pose a great risk. According to a recent CDC report, in a sample of almost 700,000 vaccinated individuals aged 65 or less without co-morbidities, there were no Covid fatalities or ICU admissions during the 10 months from December 2020 through October 2021. There was only one fatality in the sample of healthy individuals older than 65. There were just 36 fatalities across the full sample of over 1.2 million vaccinated individuals, so COVID’s fatality risk was only about 0.3%. Of those deaths, 28 were among those with four or more risk factors (including co-morbidities and > 65 years). And this was before the advent of Omicron!
I have a few doubts about the CDC’s sample selection and vagaries around certain definitions used. Nevertheless, the results are striking. However, the study did not address risks to unvaccinated adults. Another more limited CDC study found that vaccinated patients were still less likely than the unvaccinated to require critical care during the Omicron wave.
A separate CDC study found a 91% reduction in the likelihood of death for Omicron relative to Delta. A study from the UK (see summary here) found that Omicron cases were 59% less likely than Delta cases to require hospitalization and 69% less likely to result in death within 28 days of a positive test. Omicron was far less deadly among both the vaccinated and the unvaccinated, and the latter had a larger reduction in the likelihood of death. The study was stratified by age as well, with less severe outcomes for Omicron among older cohorts except in the case of death, for which there was no apparent age gradient.
Another unnecessarily contentious issue has been the risk to children during the pandemic. Based on the data, there should never have been much doubt that these risks are quite low. Apparently, however, it was advantageous for teachers’ unions to insist otherwise. Phil Kerpen soundly debunks that claim with the following chart:
Covid has been less deadly to children from infancy through 17 years than the pre-pandemic flu going back to 2012! Oh yes, but teachers FEAR transmission from the children! That claim is just as silly, since children are known to be inefficient transmitters of the virus (and see here).
Now that Omicron has relegated the Delta variant to the history books, the risks going forward seem much more manageable. Omicron is less severe, especially for the vaccinated. Levels of acquired (natural) immunity from earlier infections are now much higher against older strains, and Omicron infections seem to be protective against Delta.
“Those are roughly the same odds that in the course of a year you will die in a fire, or that you’ll perish by falling down stairs. Going anywhere near automobiles is a bigger risk: you’re three times more likely during a given year to be killed while riding in a car, and also three times more likely to be a pedestrian casualty. The 150,000-to-1 odds of a Covid death are even longer than the odds over your lifetime of dying in an earthquake or being killed by lightning.”
Yet with all this research confirming the low odds of death induced by Omicron, why have we seen recent deaths at levels approaching previous waves? First, many of those deaths are carried over from Delta infections. That means deaths should begin to taper rapidly as February reports roll in. And remember that daily reports do not show deaths by date of death. Deaths usually occur weeks or even months before they are reported. That also means some of the deaths reported might be “harvested” from much earlier fatalities. Second, given the high levels of incidental Omicron infections, some of those deaths are misattributed to Covid, an issue that is not new by any means. Finally, while Omicron is relatively mild for most people, the high rate of transmission means that a high number of especially vulnerable individuals may be infected with severe outcomes. We have seen much more severe consequences for the unvaccinated, of course, and for those with co-morbidities.
Things We Should Have Known
I’ll try to keep this last section brief, but as an introduction I’ll just say that it’s almost as if we’ve been allowing the lunatics to run the asylum. To paraphrase one comment I saw recently, if you wonder why there is so much dissent, you ought to consider the fact the much of what our governments have done (along with many private organizations) was to prohibit things that were demonstrably safe (e.g., going outside, using swing sets, or attending schools) and to encourage things that were demonstrably harmful (e.g., deferring medical care, or masking small children).
The following facts are only now coming into focus among those who’ve been “following the politics” rather than “the science”, despite pretensions to the latter.
If there is one simple message everyone needs to hear, it is to stop allowing the virus bogeyman to rule your life. It will never go away completely, and it is likely to present risks that is are comparable to the flu going forward. In fact, it might well compete with the flu, which means we won’t be dealing with endemic Covid plus historical flu averages, but some smaller union of the two case loads.
So get out, go back to work, or go have some fun! Get back truckin’ on!
In advanced civilizations the period loosely called Alexandrian is usually associated with flexible morals, perfunctory religion, populist standards and cosmopolitan tastes, feminism, exotic cults, and the rapid turnover of high and low fads---in short, a falling away (which is all that decadence means) from the strictness of traditional rules, embodied in character and inforced from within. -- Jacques Barzun