The Pandemic: Science vs Public Policy

Science is a method that helps us understand the facts, but it can't tell us what to do with those. Public policy hopefully bases itself on science, but it does involve deciding on collective goals and attempting to move toward them. Further, there are often multiple goals, many of which are often in tension with each other. So there's always going to be at least some gap -- "follow the science" is a pithy slogan, but reality is more complicated.

I've thought about this gap off and on throughout the pandemic. For instance very early on, when it was unclear exactly how the virus spread, public policy in the US and elsewhere discouraged buying masks for people not working in health care. If we assumed that the virus was primarily spread via surface contact, this made sense -- masks rated less than N95 weren't believed to be all that effective at preventing inhalation of virus particles, and if the spread was primarily via surfaces, working to reserve N95s for medical workers who were in close enough contact with infected individuals to be exposed to both surface and air transmission made was sound. Once we had more data that showed the primary transmission was through the air, and that it was clearer that pre- and asymptomatic individuals were contagious, reducing the airborne spread of the virus from infected individuals became much more important, and switching the guidance on masks made sense.

I didn't feel that was very well communicated, though. From a public health and public policy standpoint, I've felt that there's been a number of times where communication was unclear or incomplete. That's one persistent challenge in public policy, and one I've definitely observed in this situation.

At other times, though, I've felt that public policy has diverged from what you'd expect based only on the science of the virus. For instance, we were getting more and more data about young children being far less vulnerable to getting ill, even as the dangers of crowded enclosed spaces became clearer. Given that, I would have expected that bars be closed and schools open, but we got the opposite. Here I think we see the challenge of multiple goals being in tension, as public officials had to balance not just public health, but economic health too. Closing bars and other businesses would have had a much more direct economic impact than closing schools (though of course closed schools still had a large impact, especially with childcare implications, though that opens up a whole other line of inquiry around gender and economics).

A third challenge I've observed is that even when public policy is closely aligning with what we've learned from science, we don't actually know how to reliably shift public behavior. The faltering vaccination campaigns are the prime example here. You'd think "take this shot and avoid a deadly disease" would be an easy sell, but... well here we are. What's the way forward now? In the U.S., I don't think government mandates would be productive. I do think businesses and institutions mandating vaccines would be, and that's probably how it'll play out. But it'll be uneven, and that unevenness will contribute to the already big divergences we're seeing throughout the country on so many measures.

PVW said:

What's the way forward now?

I don't know. The nation is short on the contemplative humility that comes through these posts of yours. 

Agreed. I have been more disappointed in humanity over the past year than I expected to be. 

The way forward? Maybe we keep working towards solutions and making adjustments that best fit pandemic science, and behavioral science. 

And hope those efforts and solutions increase the odds, so that if it comes down to it, dumb luck can save civilization from collapse. [Not sure that makes sense together]

I think the door-to-door approach may be the only way left. It was a mistake to “make it a program” to be attacked by the media and politicians.  People who are hesitant are only persuaded by those they trust. Trust doesn’t come in commercials/PSAs. Maybe the churches?

jimmurphy said:

I think the door-to-door approach may be the only way left. It was a mistake to “make it a program” to be attacked by the media and politicians.  People who are hesitant are only persuaded by those they trust. Trust doesn’t come in commercials/PSAs. Maybe the churches?

 Two truths:

1. Trump-allied politicians and media will find fault with any pandemic strategy proposed under Biden.

2. Trump-allied politicians and media find that opposition is better for their political success/profits than supporting any pandemic strategy proposed under Biden.

jimmurphy said:

I think the door-to-door approach may be the only way left. It was a mistake to “make it a program” to be attacked by the media and politicians.  People who are hesitant are only persuaded by those they trust. Trust doesn’t come in commercials/PSAs. Maybe the churches?

 That is a good idea -- I imagine some churches are active in getting the word out but I'm sure they can do more. 

I saw a report on News12 NJ last week that said only 43% of East Orange residents are vaccinated. EO isn't exactly Trump country.   

Smedley said:

I saw a report on News12 NJ last week that said only 43% of East Orange residents are vaccinated. EO isn't exactly Trump country.

More context: On the upside, the 43% figure for East Orange comprises all ages; for adults, the rate is a bit higher, at 55%. On the downside, those rates are for one dose of any vaccine; the fully vaccinated total for East Orange adults is 45%.

In another thread, there was some discussion that roughly half of unvaccinated Americans appear (mostly through polling) to be never-vaxxers. Anecdotally, the other half are less partisan about it and hesitant more for historical and informational reasons, where outreach could make a difference. East Orange may be an example of those places.

People with a platform who can reach vaccine-hesitant people should use it.  We might get to herd immunity by reaching them.  The refusers are a different story.  But a lot of people may not know how easy it can be to get vaccinated.

I was pleased to see the newest Met had posted a vaccine PSA on his Twitter feed.

What is most frustrating about those refusing to get a vaccine is that if they do get sick they will once again cause a shortage of hospital beds. Some areas are already experiencing a shortage.

Lessons from Florida Man:

https://www.nytimes.com/2021/08/02/opinion/Covid-Florida-vaccines.html

So let’s talk about what the right means when it talks about “freedom.” Since the pandemic began, many conservatives have insisted that actions to limit the death toll — social distancing, wearing a mask and now getting vaccinated — should be matters of personal choice. Does that position make any sense?

Well, driving drunk is also a personal choice. But almost everyone understands that it’s a personal choice that endangers others; 97 percent of the public considers driving while impaired by alcohol a serious problem. Why don’t we have the same kind of unanimity on refusing to get vaccinated, a choice that helps perpetuate the pandemic and puts others at risk?

True, many people doubt the science; the link between vaccine refusal and Covid deaths is every bit as real as the link between D.U.I. and traffic deaths, but is less obvious to the naked eye. But why are people on the right so receptive to misinformation on this subject, and so angry about efforts to set the record straight?

Remember the arguments about personal freedoms when compulsory seatbelt wearing was introduced? And various speed & passenger limits etc for probationary drivers?
And the loud complaints, some still continuing, about smoking in planes, buses, restaurants and other public spaces?

Just over 100 years ago consumer expectations of buying ‘freshly butchered meat’ were completely different to ours. Their expectations of redress if things went wrong were different, too. 
Public health is a difficult field to manage, and citizens and businesses will often complain as changes are introduced. That doesn’t mean the changes aren’t needed.

Lead story on OAN explains it all - illegal aliens are to blame!