The book’s subtitle is overly long, and so is the book. We learn over and over her view, which she seemed to have expressed almost daily at White House meetings, that the key to reining in the pandemic was social distancing, testing, masking, limiting the size of indoor gatherings, and—occasionally—lockdowns.
Unfortunately, given the book’s length, she doesn’t give strong evidence for her views. And at times she reveals herself to have a strange view of “proof.” Also, the evidence against the efficacy of masks—evidence that surfaced well before she finished her book—would cause one to hope that she would address this matter. (See “How Effective Are Cloth Face Masks?” Winter 2021–2022.) But she does not; her support for masking is as strong as it was in 2020.
There are other examples of sloppy thinking. Although Birx claims that she carefully looked at the COVID numbers virtually daily, she fails at times to make important distinctions such as the difference between the infection fatality rate and the case fatality rate. She doesn’t address the famous Great Barrington Declaration (GBD), which advocated focusing government attention on high‐risk populations while leaving much of the rest of society to function unrestrained, though at one point in the book she seems to endorse that idea.
This is from David R. Henderson, “Book Review: Silent Invasion,” Regulation, Spring 2023. It’s my review of Deborah Birx’s long book.
I do give her credit on a few things:
After reading the book, I give Birx credit on three policy issues: First, she is fairly critical of how the Centers for Disease Control substantially slowed the development of COVID tests and gives the private sector kudos for how quickly it reacted. Second, she shows a real understanding of how the absence of property rights for tribal nations badly hurts the people who live there. Third, although she—like me—favors people receiving the COVID vaccines, she wisely points out that they are not a silver bullet for ending the pandemic.
And a very disturbing admission:
Early in her time at the White House, Birx became one of main champions of lockdowns. We were told in March 2020 that we should lock down for 15 days to “flatten the curve.” This meant slowing the rate of spread so that hospitals would not be overwhelmed. Some observers at the time thought that this 15‐day lockdown was just an opening bid and that the government had a longer lockdown in mind. I, naively, didn’t think that. Birx reveals that I should have. In a chapter titled “Turning Fifteen into Thirty,” she writes, “No sooner had we convinced the Trump administration to implement our version of a two‐week shutdown than I was trying to figure out how to extend it. Fifteen Days to Slow the Spread was a start, but I knew it would be just that. I didn’t have the numbers in front of me yet to make the case for extending it longer, but I had two weeks to get them.” That’s revealing in two ways. First, she planned for a much longer lockdown. Second, she knew what she wanted to find and she looked for data to make her case.
Read the whole thing.
READER COMMENTS
Roger McKinney
Apr 4 2023 at 9:36am
Thanks for the insights! Early in the pandemic I listened to a doctor with decades of experience with pandemics who said there is nothing we can do to slow the spread. I never saw him again.
Monte
Apr 4 2023 at 12:29pm
As will the minions who faithfully adhered to every directive that came down from the government or the CDC. Even more repugnant was the self-righteous indignation aimed at those who questioned or resisted those directives.
“I knew these vaccines were not going to protect against infection and I think we overplayed the vaccines, Birx told Fox News Channel’s Neil Cavuto.” She also admits in her book that she “manipulated data and quietly altered CDC guidance without authorization.”
That there were few (if any) consequences for this deception on her part is downright criminal. When managing any black swan event, telling the truth to the public should be paramount. Birx and the Biden administration failed miserably in this regard.
Jon Murphy
Apr 4 2023 at 2:39pm
I think this quote is also indicative of another problem that plagued (pardom the pun) the COVID response, at least here in the US and UK: low quality information. Both Fauci and Brix are now on the record stating that they knew the advice they were giving was low quality. In Fauci’s case, he stated that masks were not necessary even when he knew they were and he repeatedly kept changing the number needed to reach heard immunity. Now, Brix is on record advocating for something she knew was a poor idea.
When Americans turned to public health leaders for advice, we got low quality information (which the experts were overconfident in). Is it any surprise that the public lost confidence in them quickly?
steve
Apr 4 2023 at 9:12pm
How soon should we be able to determine what number you need to reach herd immunity? Would that change if new mutations had different values of R?
I am not sure why she would necessarily mention the GBD. People in the trade knew that we did not know how to achieve focused protection. Even well over a year into the pandemic before vaccines were widely available, we still had lots of nursing home deaths, even in places that claimed to be sympathetic to the ideas of GBD.
I do agree that Fauci should not have lied about masks. It was well intended but wrong. Also agree that the idea of the 2 weeks to flatten the curve was ever mentioned. The concept should have been mentioned without a time frame. Fortunately we learned within a few months how to better treat people and reduce mortality rates by 30%-50% so anyone who got covid after those first few months had a much better chance of survival.
Steve
Jon Murphy
Apr 5 2023 at 6:46am
Given the GBD was written by people “in the trade” and included examples of how to achieve focused protection, I’m not sure what your criticism is supposed to mean here.
steve
Apr 6 2023 at 12:37pm
You must watch too much TV. Not all doctors are experts in everything. They cited examples that were not based upon how nursing homes actually run and they cited no evidence for their ideas. In economist terms, they assumed a can opener.
Steve
Jon Murphy
Apr 6 2023 at 1:18pm
Very little. But I do know the authors of the GBD. I was there when it was written. I have intimate knowledge of the GBD, the discussions surrounding it, and the institutions discussed. I have several papers on the matter (one in Cosmos + Taxis, one in the Journal of Institutional Economics, and one under review at the Southern Economic Journal). Indeed, the public health response to COVID was the subject of my PhD dissertation.
It is true that not all doctors are experts in everything. But if we’re going to play the expert card, I am an expert, they are experts (epidimiologists), Birx and Fauci are not (immuniologists).
Precisely correct. Precisely my point. Precisely the point of the GBD.
Jon Murphy
Apr 5 2023 at 8:39am
These questions are a major reason for my point above that we got lots of low quality advice during the pandemic. Public health officials were making statements with fair higher levels of confidence then they deserved (and, as we see with Brix and Fauci, they made statements confidently they knew were false).
Uncertainty is a key aspect in life. When expects over represent the confidence and precision in their advice, they cause the people who are acting on that advice to act poorly and without a proper level of caution.
For example, we rely on weathermen to help us plan our daily activities. Where I live, it’s going to be cloudy but hot today. In planning my day, I want to know of clouds mean rain. If the weatherman states absolutely no rain today, then I’ll do my walk in the afternoon when it’ll be warmer. If he says there’s a chance of rain in the afternoon, then I’ll do my walk in the morning. If he states with confidence no rain and there is actually a 10% chance, then I’m getting low quality advice.
steve
Apr 6 2023 at 12:42pm
Were you actually reading the predictions or just reading the headlines? I read the entire papers. It was anew virus so it was hard to predict but you do need to plan. Take the Kings college paper so infamous in conservative/libertarian circles. The one where they claimed 2 million people would die. If you actually red it you would know they offered a very wide range of predicted deaths depending upon R values and what actions were taken to mitigate. So their actual real predictions would vary from about 100,000-2 million. (It was mostly about UK numbers so you have to extrapolate a bit.)
Steve
Jon Murphy
Apr 6 2023 at 1:21pm
I kinda doubt that. You don;t seem to know much more than headlines.
Precisely correct! That is precisely my point. That sort of imprecision was lost in the grand pronouncements of the public health officials. That range is precisely why the advice that was given was so low quality. The public was simply told the upper bound. The advice and lockdowns were based on the upper bounds.
In short: the public health officials made overly precise, and thus low quality, claims.
Comments are closed.