It's also worth noting that the 3 day development of the COVID19 virus is only technically true. We had started development of the mRNA vaccine 10 years earlier for SARS or MERS, which share about 98% of their DNA with COVID19. And just coincidentally was completed right before COVID19 came out. What took 3 days was taking the existing vaccine and adapting it. Which means that for a H1N1 strain the lead up time might be longer than it seems. Ofc all this becomes moot if we can't get testing done before people just develop natural immunity.
Matt what are your thoughts on challenge trials for vaccines? In my mind this was one of the greatest failures of COVID era policy, and republicans seem better positioned from a free market and non nanny state vibes position to support this
If you ever want to cite evidence for the fact that people voluntarily change their behavior in response to a pandemic, whether or not governments set and try to enforce stricter rules / NPIs, which is indeed an absolutely true statement as you claimed, feel free to use my paper! https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.13688
Bonus fact to cite from the same paper: closing schools, and telling people they had to stay at home, were not particularly effective in reducing mortality (and of course had lots of bad auxiliary consequences).
It's odd that the headline is suggesting how Trump can lead, but at the end you discuss the appointment of RFK Jr. which is exactly the worst thing that anybody could do to hurt vaccine development. If he wants to lead he needs to dump RFK or to save face at least get some sane Rs in the Senate to do that.
"Beyond that, the genetic difference between a chicken and a pig is much smaller than the difference between a pig and a human. Multiple crossovers into mammals is bad news."
Isn't this wrong? The genetic difference between a pig and a chicken is *larger* than the difference between pigs and humans.
My greatest fear about the incoming Trump administration, surpassing by far all other possible fears, is that it won't adequately prepare the nation for a possible future pandemic.
. . . . . .
Man, if this is the kind of post Matt is going to have to write about Trump 2.0, it's going to be a grim next four years for Slow Boring. I mean: "But conservatives should take seriously the idea that, especially if you hate NPIs and “lockdowns,” you need to make the sort of big, proactive investments in science and technology that render them unnecessary."
The word "should" in that sentence is carrying a weight far beyond what is humanly possible. Need we tell Matt, if somehow he doesn't already know and that's completely impossible so I'm really confused here, but nahgonnahappen.
Matt Y's insistence on treating Agent Orange like he's a regular politician is adorable in its way, but depending on how the next four years unfold, posts like this may end up aging extremely badly.
A fair criticism of our public health policy is that it can be pretty arbitrary. Per the CDC, 480,000 people a year die from smoking in the US. 41,000 of that is attributed to second-hand smoke. That sounds insanely high, but it's what their studies show. If you divide the number of Americans that died by COVID by the number of the years that the pandemic lasted (again per the CDC), the annual death rate from smoking is higher than the annual death rate from COVID during the pandemic. So smoking is an ongoing health crisis deadlier than COVID and no one gives a shit.
"no one gives a shit" - I don't think that's fair, there's a ton of rules about where you can smoke, the whole university campus where I work is a smoke-free zone, for example. Cigarettes are taxed highly and there are these Surgeon General warning labels on them. Yes, people still smoke and still die of smoking-related causes, but overall it's much reduced from the heyday of smoking back in the 50s.
Get the government to push much harder against smoking, and you'll activate the "muh freedom" crowd and it will become counterproductive (e.g., maybe smoking will become a badge of pride among the MAGAs, a way to own the libs).
I suppose what I meant by that is that we don’t talk about it - no politician is running on it. We put limits on it, but we don’t ban it. We accept that a certain number of people will do it anyway and move on with our day.
And good point about pushing harder and people will push back - that was kind of what I meant too. Recognize the push-back point.
But you can’t reasonably claim that the health establishment has been ignoring smoking for the last few years, the way they have been ignoring pandemic preparedness. They are still changing policies on smoking.
Oh of course not, I meant it as a comparison to COVID policies in terms of recognizing limits of what you can do to stop people from making decisions that will kill them.
The thing about NPIs with Covid is that they were not a lot of bang for your buck because Covid is incredibly contagious. (Though the short term NPIs did lessen the curve during those two really bad winters!)
The flu is much much much less contagious and considerably more seasonal with sharper peaks. NPIs WOULD make a huge difference with bird flu.
The thing about the flu is its not novel like Covid and we routinely produce vaccines for it. So I really don't understand the concern around this. Throw an H5N1 variant in the next round of shots and be done with it. Does anyone remember the 2009 H1N1 pandemic? I sure don't, and my wife was pregnant at the time. But then again, we get flu shots every year, so we check that box and don't worry about it.
There is no way any kind of "lockdown" or NPI mandates are going to be accepted outside of some ultra blue enclaves. If people don't want to get vaccinated, that's their problem.
I'm assuming that this passage should read: "Beyond that, the genetic difference between a chicken and a pig is much LARGER than the difference between a pig and a human. Multiple crossovers into mammals is bad news."
I hate it when Matt runs Covid articles. None of us could've done any better! None of us have perfect foresight, secret knowledge or divine judgment, and neither did the public health workers! We did the best we could; there isn't a "perfect response" timeline, because every decision came with trade-offs and consequences we can't see, even with 20/20 hindsight. It was a natural disaster, stop taking it so personally.
If we replayed the COVID scenario again knowing what we know now, and given the institutional changes we have made, would we get the significantly better outcome that one might hope for on take 2?
I think MY's view is "no because we never took the time to stop and evaluate the results of the things we tried in an institutional-knowledge kind of way."
I'd like a moratorium on COVID retrospectives. Matt brings it up today in the context of bird flu. And indeed that may turn out to be another once in a century pandemic. But we're always getting scares and nothing has been like COVID since the Spanish (sic) flu.
Basically, we learned nothing from COVID and that's probably OK because the things we're arguing about (like NPIs and vaccine mandates) are irrelevant because the odds are we aren't going to have another COVID-like pandemic for years and years.
And yet we argue about all the actions we took or didn't take regarding COVID over and over and over. Enough. Give it a good long rest.
He makes a strong point that things that used to be once in a century no longer are, with growing population, growing meat consumption, and growing air travel.
And between HIV, swine flu, Ebola, Zika, Covid, and bird flu, we’ve had enough close scare in the past few decades to be clear these things aren’t as rare as we like.
On the one hand, you have a richer breeding ground for contagious diseases for the reasons you lay out: people are mobile, population is bigger (for now), there's more interaction between people and animals.
On the other side, you have systems in place that are much better at tracking and responding to potentially emergent diseases (for now: thanks, RFK Jr!).
It's not totally clear which side will tend to win that race, but on the whole I'd put my money on the latter. I mean, density was low, people didn't eat much meat, and transportation was highly limited in the early 14th century. The bubonic plague appeared to overcome those handicaps mostly because no one had a clue about how to fight it.
So, yeah, we'll probably have more *threats* over the years, but most of those will turn out to be wet firecrackers, at least compared to 1919 and COVID.
Is your argument here something like: "real large-scale pandemics happen on a time scale far enough apart that trying to learn from one won't make a difference by the time the next one hits"?
Whatever preparations we make now will basically all be forgotten by the time another pandemic hits. I believe it was around 2012 or so that the Obama administration cut the hell out of funds for PPE stockpiles, given higher priorities and the need to "tighten our belts." That's because no one took the possibility of a COVID-like pandemic seriously enough to protect funds for it.
Doing vaccine research is great. Doing the R&D necessary to know how to quickly develop vaccines in extremis is all to the good, but isn't that really just science and what we should be doing in any case? But stockpiling supplies, building production capacity, preparing for smarter NPIs? All sound good but trust me they'll be dismantled and forgotten by the time we face another COVID situation, unless we turn out to be extremely unlucky with another COVID type disease hitting.
The NPIs that we won’t forget about are the ones that get put into building codes. (NPIs in the form of improved sanitation did away with cholera so effectively it’s hard to even think of that as an example.) There should be a big push to retrofit existing buildings and require of new buildings that they filter air well. HEPA/MERV filters and far-UVC sterilization especially. The best virus is a virus that doesn’t make it to your lungs.
And because nobody has to really *do* anything personally on a daily basis, it (hopefully) won’t turn into an awful, exhausting morality play the way everything else does.
Everyone gets a pass on the first few months, but by about mid-summer 2020, there was enough information out there that many people in this comment section probably could have done a better job setting policy than the people who were in charge.
I mean, many of the talking points were being made in 2020 and 2021. We were right then, and just because the rest of the world is slowly coming around to realize it does not mean that it could not have done so faster. The response could absolutely have been better.
"Trump isn’t going to be shutting down nuclear power plants."
You're probably correct, but I'm pretty sure the only reason Trump hasn't pledged to shut down nuclear power plants is because it "owns the libs" to keep operating them. I mean, Trump has previously pledged to subsidize coal mining . . . .
I have serious worry that shutting down nuclear plants could morph into the "own the libs" play, as *real* conservatives just burn fossil fuels with no worry.
“ Trump, at the time he was in office, advocated for those — he funded vaccine development, he worked with industry, his team worked with credentialed scientists, and they did a pretty good job of it.” And the left called it “Horse Medicine”.
Allow me to vent...as a the child of a public school teacher (and union rep!) I will never forgive the Seattle Education Association (teacher's union) for keeping my first-grader at home until April 2021, and then going back half-time. And requiring masks for kids in fall 2021, despite everyone having been vaccinated. And then going on strike to delay the start of school for a week in 2022.
They lost all credibility and SPS attendance has dropped to the point that school closures are necessary.
That was very bad, and I'm genuinely sorry to hear that.
I teach in higher ed in the UK, where (like in most of Europe) school closures were much shorter than in lots of US urban districts, and the effect of even relatively short closures on students were devastating - even for affluent students. We're still seeing students who are functionally illiterate and innumerate (and we're pressured to allow them to get undergraduate degrees, which is a whole other thing I could rant at length about) as a result of those closures. Remote schooling doesn't work for any but the most high-performing students (who'd probably thrive academically pretty much no matter what).
I'm pretty worried about a public school death spiral out here - seems like a lot of chatter I'm hearing is from folks who want their kids in public school in theory, but don't want to be "holding the bag" by being the last ones to pull out. Really bad situation, especially with a simultaneous budget crunch. It feels like some prominent elected official (mayor? governor?) will need to come out and say "we're done with social engineering attempts, the only metric we care about is academic performance" to reverse the trend.
Same here in IL. Except our stupid and selfish Chicago Teacher's Union went even further and walked out in January of 2022. These actions created a huge outflow from the city back to the suburbs. I don't see this reversing for an entire generation until we have another city collapse like in the late 90s.
This makes me feel especially grateful we were in Rhode Island - a blue state - but our governor (who is now Secretary of Commerce) was paying attention to the data and really pushed hard for schools to reopen quickly. She got a ton of parent pushback. But she was on TV every week early in the pandemic trying to persuade people to send their kids back. My son started in-person preK in June 2020 and my daughter in-person 2nd grade in fall 2020. I was so nervous about it then, but so grateful for it now.
Fall 2020-winter 2021 I might have had a little grace, especially if too many people were getting sick to even be able to run a school, and also with knowledge of vaccines around the corner. But post-vaccine, yes, let 'er rip, proceed normally, and get to work.
There is a question about what “proceed normally” means. What are the conditions under which a school should mandate that a sick student stays home? The 2021 version where any symptom means staying home is too strict, but the Florida version of “come in even if you have measles” is surely not right either, and I don’t think it’s clear we had the best balance in 2019.
It's also worth noting that the 3 day development of the COVID19 virus is only technically true. We had started development of the mRNA vaccine 10 years earlier for SARS or MERS, which share about 98% of their DNA with COVID19. And just coincidentally was completed right before COVID19 came out. What took 3 days was taking the existing vaccine and adapting it. Which means that for a H1N1 strain the lead up time might be longer than it seems. Ofc all this becomes moot if we can't get testing done before people just develop natural immunity.
Matt what are your thoughts on challenge trials for vaccines? In my mind this was one of the greatest failures of COVID era policy, and republicans seem better positioned from a free market and non nanny state vibes position to support this
If you ever want to cite evidence for the fact that people voluntarily change their behavior in response to a pandemic, whether or not governments set and try to enforce stricter rules / NPIs, which is indeed an absolutely true statement as you claimed, feel free to use my paper! https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.13688
Bonus fact to cite from the same paper: closing schools, and telling people they had to stay at home, were not particularly effective in reducing mortality (and of course had lots of bad auxiliary consequences).
I didn't get it until August 2024!
“the genetic difference between a chicken and a pig is much smaller than the difference between a pig and a human.”
Isn’t it the other way around? Pigs and humans are both mammals.
It's odd that the headline is suggesting how Trump can lead, but at the end you discuss the appointment of RFK Jr. which is exactly the worst thing that anybody could do to hurt vaccine development. If he wants to lead he needs to dump RFK or to save face at least get some sane Rs in the Senate to do that.
"Beyond that, the genetic difference between a chicken and a pig is much smaller than the difference between a pig and a human. Multiple crossovers into mammals is bad news."
Isn't this wrong? The genetic difference between a pig and a chicken is *larger* than the difference between pigs and humans.
My greatest fear about the incoming Trump administration, surpassing by far all other possible fears, is that it won't adequately prepare the nation for a possible future pandemic.
. . . . . .
Man, if this is the kind of post Matt is going to have to write about Trump 2.0, it's going to be a grim next four years for Slow Boring. I mean: "But conservatives should take seriously the idea that, especially if you hate NPIs and “lockdowns,” you need to make the sort of big, proactive investments in science and technology that render them unnecessary."
The word "should" in that sentence is carrying a weight far beyond what is humanly possible. Need we tell Matt, if somehow he doesn't already know and that's completely impossible so I'm really confused here, but nahgonnahappen.
+eleventy gigazillion
Matt Y's insistence on treating Agent Orange like he's a regular politician is adorable in its way, but depending on how the next four years unfold, posts like this may end up aging extremely badly.
Recommended reading: https://davidpepper.substack.com/p/10-lessons-from-a-dark-past
A fair criticism of our public health policy is that it can be pretty arbitrary. Per the CDC, 480,000 people a year die from smoking in the US. 41,000 of that is attributed to second-hand smoke. That sounds insanely high, but it's what their studies show. If you divide the number of Americans that died by COVID by the number of the years that the pandemic lasted (again per the CDC), the annual death rate from smoking is higher than the annual death rate from COVID during the pandemic. So smoking is an ongoing health crisis deadlier than COVID and no one gives a shit.
"no one gives a shit" - I don't think that's fair, there's a ton of rules about where you can smoke, the whole university campus where I work is a smoke-free zone, for example. Cigarettes are taxed highly and there are these Surgeon General warning labels on them. Yes, people still smoke and still die of smoking-related causes, but overall it's much reduced from the heyday of smoking back in the 50s.
Get the government to push much harder against smoking, and you'll activate the "muh freedom" crowd and it will become counterproductive (e.g., maybe smoking will become a badge of pride among the MAGAs, a way to own the libs).
I suppose what I meant by that is that we don’t talk about it - no politician is running on it. We put limits on it, but we don’t ban it. We accept that a certain number of people will do it anyway and move on with our day.
And good point about pushing harder and people will push back - that was kind of what I meant too. Recognize the push-back point.
But you can’t reasonably claim that the health establishment has been ignoring smoking for the last few years, the way they have been ignoring pandemic preparedness. They are still changing policies on smoking.
Oh of course not, I meant it as a comparison to COVID policies in terms of recognizing limits of what you can do to stop people from making decisions that will kill them.
The thing about NPIs with Covid is that they were not a lot of bang for your buck because Covid is incredibly contagious. (Though the short term NPIs did lessen the curve during those two really bad winters!)
The flu is much much much less contagious and considerably more seasonal with sharper peaks. NPIs WOULD make a huge difference with bird flu.
The thing about the flu is its not novel like Covid and we routinely produce vaccines for it. So I really don't understand the concern around this. Throw an H5N1 variant in the next round of shots and be done with it. Does anyone remember the 2009 H1N1 pandemic? I sure don't, and my wife was pregnant at the time. But then again, we get flu shots every year, so we check that box and don't worry about it.
There is no way any kind of "lockdown" or NPI mandates are going to be accepted outside of some ultra blue enclaves. If people don't want to get vaccinated, that's their problem.
I'm assuming that this passage should read: "Beyond that, the genetic difference between a chicken and a pig is much LARGER than the difference between a pig and a human. Multiple crossovers into mammals is bad news."
I hate it when Matt runs Covid articles. None of us could've done any better! None of us have perfect foresight, secret knowledge or divine judgment, and neither did the public health workers! We did the best we could; there isn't a "perfect response" timeline, because every decision came with trade-offs and consequences we can't see, even with 20/20 hindsight. It was a natural disaster, stop taking it so personally.
To try to steel-man MY's view here:
If we replayed the COVID scenario again knowing what we know now, and given the institutional changes we have made, would we get the significantly better outcome that one might hope for on take 2?
I think MY's view is "no because we never took the time to stop and evaluate the results of the things we tried in an institutional-knowledge kind of way."
I'd like a moratorium on COVID retrospectives. Matt brings it up today in the context of bird flu. And indeed that may turn out to be another once in a century pandemic. But we're always getting scares and nothing has been like COVID since the Spanish (sic) flu.
Basically, we learned nothing from COVID and that's probably OK because the things we're arguing about (like NPIs and vaccine mandates) are irrelevant because the odds are we aren't going to have another COVID-like pandemic for years and years.
And yet we argue about all the actions we took or didn't take regarding COVID over and over and over. Enough. Give it a good long rest.
He makes a strong point that things that used to be once in a century no longer are, with growing population, growing meat consumption, and growing air travel.
And between HIV, swine flu, Ebola, Zika, Covid, and bird flu, we’ve had enough close scare in the past few decades to be clear these things aren’t as rare as we like.
On the one hand, you have a richer breeding ground for contagious diseases for the reasons you lay out: people are mobile, population is bigger (for now), there's more interaction between people and animals.
On the other side, you have systems in place that are much better at tracking and responding to potentially emergent diseases (for now: thanks, RFK Jr!).
It's not totally clear which side will tend to win that race, but on the whole I'd put my money on the latter. I mean, density was low, people didn't eat much meat, and transportation was highly limited in the early 14th century. The bubonic plague appeared to overcome those handicaps mostly because no one had a clue about how to fight it.
So, yeah, we'll probably have more *threats* over the years, but most of those will turn out to be wet firecrackers, at least compared to 1919 and COVID.
Is your argument here something like: "real large-scale pandemics happen on a time scale far enough apart that trying to learn from one won't make a difference by the time the next one hits"?
Pretty much.
Whatever preparations we make now will basically all be forgotten by the time another pandemic hits. I believe it was around 2012 or so that the Obama administration cut the hell out of funds for PPE stockpiles, given higher priorities and the need to "tighten our belts." That's because no one took the possibility of a COVID-like pandemic seriously enough to protect funds for it.
Doing vaccine research is great. Doing the R&D necessary to know how to quickly develop vaccines in extremis is all to the good, but isn't that really just science and what we should be doing in any case? But stockpiling supplies, building production capacity, preparing for smarter NPIs? All sound good but trust me they'll be dismantled and forgotten by the time we face another COVID situation, unless we turn out to be extremely unlucky with another COVID type disease hitting.
The NPIs that we won’t forget about are the ones that get put into building codes. (NPIs in the form of improved sanitation did away with cholera so effectively it’s hard to even think of that as an example.) There should be a big push to retrofit existing buildings and require of new buildings that they filter air well. HEPA/MERV filters and far-UVC sterilization especially. The best virus is a virus that doesn’t make it to your lungs.
And because nobody has to really *do* anything personally on a daily basis, it (hopefully) won’t turn into an awful, exhausting morality play the way everything else does.
> None of us have perfect foresight, secret knowledge or divine judgment, and neither did the public health workers!
I agree, the public health apparatus should be dismantled.
Everyone gets a pass on the first few months, but by about mid-summer 2020, there was enough information out there that many people in this comment section probably could have done a better job setting policy than the people who were in charge.
I mean, many of the talking points were being made in 2020 and 2021. We were right then, and just because the rest of the world is slowly coming around to realize it does not mean that it could not have done so faster. The response could absolutely have been better.
"Trump isn’t going to be shutting down nuclear power plants."
You're probably correct, but I'm pretty sure the only reason Trump hasn't pledged to shut down nuclear power plants is because it "owns the libs" to keep operating them. I mean, Trump has previously pledged to subsidize coal mining . . . .
I have serious worry that shutting down nuclear plants could morph into the "own the libs" play, as *real* conservatives just burn fossil fuels with no worry.
“ Trump, at the time he was in office, advocated for those — he funded vaccine development, he worked with industry, his team worked with credentialed scientists, and they did a pretty good job of it.” And the left called it “Horse Medicine”.
Allow me to vent...as a the child of a public school teacher (and union rep!) I will never forgive the Seattle Education Association (teacher's union) for keeping my first-grader at home until April 2021, and then going back half-time. And requiring masks for kids in fall 2021, despite everyone having been vaccinated. And then going on strike to delay the start of school for a week in 2022.
They lost all credibility and SPS attendance has dropped to the point that school closures are necessary.
Good job, guys.
That was very bad, and I'm genuinely sorry to hear that.
I teach in higher ed in the UK, where (like in most of Europe) school closures were much shorter than in lots of US urban districts, and the effect of even relatively short closures on students were devastating - even for affluent students. We're still seeing students who are functionally illiterate and innumerate (and we're pressured to allow them to get undergraduate degrees, which is a whole other thing I could rant at length about) as a result of those closures. Remote schooling doesn't work for any but the most high-performing students (who'd probably thrive academically pretty much no matter what).
I'm pretty worried about a public school death spiral out here - seems like a lot of chatter I'm hearing is from folks who want their kids in public school in theory, but don't want to be "holding the bag" by being the last ones to pull out. Really bad situation, especially with a simultaneous budget crunch. It feels like some prominent elected official (mayor? governor?) will need to come out and say "we're done with social engineering attempts, the only metric we care about is academic performance" to reverse the trend.
Same here in IL. Except our stupid and selfish Chicago Teacher's Union went even further and walked out in January of 2022. These actions created a huge outflow from the city back to the suburbs. I don't see this reversing for an entire generation until we have another city collapse like in the late 90s.
https://www.illinoispolicy.org/chicago-teachers-union-uses-covid-19-to-walk-out-on-students-again/
The CTU has a faculty lounge in the 5th circle of hell.
This makes me feel especially grateful we were in Rhode Island - a blue state - but our governor (who is now Secretary of Commerce) was paying attention to the data and really pushed hard for schools to reopen quickly. She got a ton of parent pushback. But she was on TV every week early in the pandemic trying to persuade people to send their kids back. My son started in-person preK in June 2020 and my daughter in-person 2nd grade in fall 2020. I was so nervous about it then, but so grateful for it now.
Fall 2020-winter 2021 I might have had a little grace, especially if too many people were getting sick to even be able to run a school, and also with knowledge of vaccines around the corner. But post-vaccine, yes, let 'er rip, proceed normally, and get to work.
There is a question about what “proceed normally” means. What are the conditions under which a school should mandate that a sick student stays home? The 2021 version where any symptom means staying home is too strict, but the Florida version of “come in even if you have measles” is surely not right either, and I don’t think it’s clear we had the best balance in 2019.