A few months back, Alex Tabarrok criticized the delay in approving the new vaccines:
I am getting very angry at people like Anthony Fauci who say that FDA delay is necessary or useful to alleviate vaccine hesitancy.
Fauci told Fox News that the FDA “really scrutinises the data very carefully to guarantee to the American public that this is a safe and efficacious vaccine. I think if we did any less, we would add to the already existing hesitancy on the part of many people because … they’re concerned that we went too quickly.”
The WSJ says much the same thing just with a slightly different flavor:
…this regulatory rigmarole is essentially a placebo to reassure the public it will be safe to get inoculated.
The ‘we must delay to allay’ argument is deadly and wrong.
Now Fauci is at it again, this time with first-dose-first:
“We’re telling people [two shots] is what you should do … and then we say, ‘Oops, we changed our mind’?” Fauci said. “I think that would be a messaging challenge, to say the least.”
Fauci said he spoke on Monday with health officials in the United Kingdom, who have opted to delay second doses to maximize giving more people shots more quickly. He said that although he understands the strategy, it wouldn’t make sense in America. “We both agreed that both of our approaches were quite reasonable,” Fauci said.
So the “experts” have decided that the risk of the public eventually figuring out that they were lied to, and that thousands died needlessly, is smaller than the risk that the public will lose faith in the experts if they change their minds? Yes, I guess that’s possible. But what sort of training in social psychology does Fauci have that would allow him to make that sort of life and death decision?
And if first-dose-first is not reasonable for the US, then why is it reasonable for the UK?
Fauci said the science doesn’t support delaying a second dose for those vaccines, citing research that a two-shot regimen creates enough protection to help fend off variants of the coronavirus that are more transmissible, whereas a single shot could leave Americans at risk from variants such as the one first detected in South Africa.
Then why does Fauci approve of the J&J vaccine, which is one dose? You might argue that J&J was tested as one dose, but that doesn’t answer the question. AFAIK, the test of J&J vaccine did not show any more efficacy against the South African strain than did one dose of Pfizer or Moderna.
Fauci acknowledged that the United States repeatedly has shifted strategy during the pandemic — including his own reversal on whether Americans should wear face coverings — but said that the stakes are higher when it comes to communicating about vaccines.
“People are very skeptical on vaccines, particularly when the government is involved,” he said.
But if the stakes are higher, isn’t that even more reason to get it right?
Personally, I believe that the public would have more respect for experts if they didn’t repeatedly lie to us for our own good, if they honestly told us exactly what they believed.
I was just a boy when I first heard the term ‘confidence man’. The phrase sounded sort of good—a person who inspires confidence. Later I learned that it was equivalent to con man. Thus confidence is a two-edged sword, something that can help you or hurt you.
Don’t try to make me confident; act in such a way that I will respect you. That will give me confidence.
Right now, I don’t have much confidence.
READER COMMENTS
Garrett
Mar 2 2021 at 3:39pm
Not to mention Fauci says things like this:
Ok, so why should anybody get the vaccine? This is terrible messaging.
Jon Murphy
Mar 2 2021 at 4:03pm
I think you’re dead-on right here. Adam Smith writes in The Theory of Moral Sentiments (pg 337 of the Liberty Fund Edition):
When Fauci lies, all he is doing is undermining the credibility of experts. It ought to be no wonder that anti-vaxx conspiracies have jumped so much lately. Fauci is playing right into their hands.
Airman Spry Shark
Mar 2 2021 at 4:14pm
This is an odd phrasing; they’re not merely equivalent, they’re synonymous. ‘Con’ in this context is simply short for ‘confidence’.
Scott Sumner
Mar 2 2021 at 11:34pm
Yeah, I should have said “meant con man”
Alan Goldhammer
Mar 2 2021 at 5:26pm
Economists should stick to economics and let experts in vaccine development do the work they need to do. You risk looking like Peter Navarro who claimed to know everything about drug development, witness his statement about the utility of hydroxychlorquine. Fauci is not at the FDA, nor has he seen the full BLAs for any of the vaccines. The vaccines were studied at two dose regimens and even J&J is now looking at a two dose regimen for their vaccine and very well may amend their license application pending that data.
You need to recognize that the vaccines were studied in limited patient populations and when large patient populations end up being studied maybe the current 95% efficacy drops down. If you are so confident in the numbers, just refuse to get your second vaccination and track your health as part of a larger experiment. Write to Alex and ask him to set up a database to track the results.
Calling someone a liar will have repurcussions somewhere down the line (best example here is a certain person with an itch Twitter finger). You better have concrete evidence if you call somebody out.
Jon Murphy
Mar 3 2021 at 8:57am
Of course, the point of the post is that Fauci is not “sticking” to his area of expertise. Throughout the pandemic, he and other public health experts have veered far outside their silos into areas of social psychology, sociology, economics, law, business, logistics, politics, manufacturing, etc. When experts start pronouncing on matters outside their field, things can get messy. Further, when one tries to confine a problem to just a certain field and ignores the contexts in which it arises, there can be cascading problems (see my latest working paper here).
On a more meta level, it’s not even clear what “stick to X” really means outside the unrealistically demarcated world of academia. That a pandemic is a public health problem is an entirely arbitrary distinction. I could just as easily say it’s an economics problem since everything is about allocating scarce resources (PPE, vaccines, hospital beds, etc); everything else is just secondary. Or, one could claim its a biological problem since it’s all about the biology of how the virus works; everything else is just secondary. Or, one could claim its really a chemical problem, since it’s really all about just producing medicines; everything else is just secondary. Etc.
The reality is that creating clear demarcations between fields in a real world problem posits precise and accurate lines where there are none. Science and life do not happen in a vacuum. To treat real-world problems as though they do is the pretense of knowledge.
Jon Murphy
Mar 3 2021 at 8:59am
Does Fauci proudly boasting that he did lie about the current pandemic, the AIDS pandemic, the Zika threat to the US, and the Ebola threat to the US count? Phil Magness has done yeoman’s work collecting Fauci’s various statements.
Ethan
Mar 3 2021 at 9:33am
Medical Professionals should stick to making safe and effective treatments for illness. Economists should stick to weighing tradeoffs.
You miss the broader point. A first dose first regime will lead to less deaths. The fact that the studies were 95% effective with two doses is irrelevant to the broader question of how do we distribute a limited resource.
There is ample evidence that a single dose is effective at reducing the symptoms of the virus. If we can get more immunity by having everyone be at 80% reduction in symptoms then we are in a way better spot then if we have half, or a quarter of the people at 95%. The most important factor that you are missing is the arbitrary nature of the FDA guidelines on how a drug gets approved. The drug companies are trying to prove out a certain efficacy and meet the timeline requirements of the FDA. This has nothing to do with real world application as you mention. What we should be looking at is the relevant trade-offs of different types of distribution based on known efficacy rates. Trade-Offs sound like economists.
To your last point, Fauci has admitted he lied. He “lied to ration masks.” Ask any economist about rationing, and I don’t think many would say lie to people. Ask a doctor and he might. Doctors have a lane as well, and they should stick to it.
Susan Mayfield
Mar 5 2021 at 2:08pm
Hi Alan, Can we talk economics without all of the partisanship??
Mark Brophy
Mar 8 2021 at 7:05pm
No, economics is partisan and will always generate strife.
David Henderson
Mar 2 2021 at 6:44pm
Excellent post, Scott. I posted in on Facebook.
Daniel Hill
Mar 2 2021 at 7:03pm
What better way to build confidence in a vaccine than to let millions of people receive it and not get sick? If that doesn’t convince the vaccine skeptics, nothing will anyway.
Mark Brophy
Mar 8 2021 at 7:07pm
So far, 600 people in the United States have died from taking Covid vaccines. How many is too many? I suspect everyone has a different answer.
Mark Z
Mar 2 2021 at 7:50pm
Until empirical evidence shows that Fauci’s strategy works as he speculates, it seems like it could just as easily be the opposite: treating something (like vaccines) as though they might be extremely dangerous and requires extraordinary caution may make people more wary of it rather than less. If I regularly see a bunch of police cars speeding toward some neighborhood, sirens blaring, I don’t think to myself, “that must be a nice, safe neighborhood, I’ll take my nighttime walks there from now on.”
Scott Sumner
Mar 2 2021 at 11:35pm
Everyone, Lots of good comments.
BC
Mar 3 2021 at 2:05am
Here is a David Friedman blog post about Fauci changing his estimate of herd immunity threshold based on (the scientifically irrelevant factor) of Americans’ willingness to vaccinate:
http://daviddfriedman.blogspot.com/2021/01/fauci-lying-greyhound-racing-and-trump.html
Despite this and Scott’s examples, I still view Fauci as being more credible than most other public health officials that I have heard speak to the general public. That’s a statement about those other public health officials rather than Fauci. At least, Fauci often admits that he’s lying.
C. L. Hunt
Mar 3 2021 at 9:16am
I see your point, but you’re kind of suggesting that a confidence man would have felt better to you… Basically, you would feel better to follow someone who acted completely confident, even if they didn’t know what they were talking about. Isn’t it good that experts walk back what they’ve said when they’ve made a mistake?
It does save lives to assure the general public the vaccine is safe. It does make sense to have different vaccination strategies in different cultures. “Science doesn’t support…” doesn’t mean a culture doesn’t. There are tradeoffs that are being made for the GENERAL public… Fauci is not, in fact, kowtowing to the white American science man, because, contrary to popular belief amongst them, they are not the only ones who live here.
Scott Sumner
Mar 3 2021 at 3:09pm
Alan, You said:
“and even J&J is now looking at a two dose regimen for their vaccine and very well may amend their license application pending that data.”
You don’t seem to understand my point. I favor the two dose regimen. I am advocating first dose first, which is exactly what we are doing with J&J. Are you saying the FDA decision allowing J&J is wrong? If not, what is your point? Are you simply saying “trust the experts”? Especially when the experts justify their views by saying they don’t want the public to lose confidence? Would you rather the experts say they favor a policy because it will save lives?
Yes, I’m not expert. For instance, on March 1, 2020 I did a post questioning the expert consensus that masks were a bad idea. So I plead guilty to speaking on topics outside of my area.
Comments are closed.