David Zweig on Schools, Science, and the Media's COVID Failure

Episode Summary

Investigative journalist David Zweig joins Anish Koka and Anthony DiGiorgio to discuss his book An Abundance of Caution: American Schools, The Virus, and a Story of Bad Decisions — a heavily cited account of how public health authorities, the media, and a politically homogenous expert class got COVID policy badly wrong, especially for children. The conversation covers why U.S. media coverage was uniquely alarmist compared to the rest of the world, how Americans overestimated child COVID mortality by as much as 40 times, the role of "technological solutionism" in making school closures possible when they never would have been before, and what it would actually take to rebuild public trust in institutions that squandered it. The episode opens with a discussion of MidJourney's foray into medical imaging and what it reveals about AI hype cycles in medicine.

Resource:
David's Book: https://www.amazon.com/Abundance-Caution-American-Schools-Decisions/dp/0262053993

Chapter Markers

00:00 Welcome and intro: David Zweig

01:14 MidJourney enters medical imaging — hype or breakthrough?

05:35 Incidentalomas, cash-pay scanning, and who bears the cost

08:55 Ultrasound physics and why AI won't replace radiologists yet

14:00 Transition to the book: An Abundance of Caution

17:00 The Twitter Files and Zweig's COVID journalism

23:00 Political monoculture in public health and legacy media

41:43 Sweden, BLM protests, and the shifting COVID rules

43:06 The empirics on children: what the data actually showed

50:29 American media's uniquely alarmist pandemic coverage

56:31 Living in a deep blue area: why data couldn't penetrate the narrative

58:18 Anthony's ICU story and the Gellman Amnesia moment

59:50 How do we rebuild trust in public health?

1:08:28 Technological solutionism: why school closures were impossible before Zoom

1:10:07 1950s flu epidemics — schools stayed open with 50% of kids out sick

1:25:20 Newsroom monoculture, book publishing, and the conservative imprint problem

1:28:08 Reforming institutions vs. questioning their foundations

1:36:39 Wrap-up: the pandemic as a case study in how society functions

Co-Host Handles

@anish_koka and @drdigiorgio

Show Handle

@drsloungepod

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Transcript

SPEAKER_00 0:00

If you like your healthcare plan, you keep your healthcare plan. Nobody knew that healthcare could be so complicated. It finally beat Medicare. This is the Doctor's Lounge.

SPEAKER_02 0:16

So we're live on the Doctor's Lounge with a tremendous journalist, my one of my probably my favorite journalists at this point, David Zwai. David, who is David? David is a New York Times, sorry, New York-based investigative journalist. He's been in the New York Times. And he has written for all sorts of places. He's written for The Atlantic, The New York Magazine, The Free Press. I'll already mention the New York Times, Wired, and he's also featured prominently in the Twitter files. He's also in a band. He's a rock star. He's literally a rock star, right? I mean you should say that.

SPEAKER_00 0:46

Those kids are behind me. But yes.

SPEAKER_02 0:48

That profile pick. I couldn't show that profile. You know that, you know, he had that one profile pick where you look like super sexy, you look like whatever. I was like, I can't show my wife this picture.

unknown 0:57

Like, what the heck?

SPEAKER_00 0:58

Nice. This is a good introduction. I like this.

SPEAKER_02 1:01

So anyway, so um, so I was like, no, no, no. In real life, he's really not that good looking. I'm kidding.

SPEAKER_00 1:07

Thanks, Anishna.

SPEAKER_02 1:09

It's all AI, it's all a filter. No. Anyway, uh, keep your wives away, all right? His so his background. So he released two music albums in the early 2000s. He's a writer. Part of the we're gonna spend hopefully the uh a large chunk of time talking about his fantastic book on uh COVID and everything that went wrong with COVID and why he was one of the few people that kind of could see through it. Uh the book is called An Abundance of Caution. So, David, welcome to the show.

SPEAKER_00 1:35

Thanks for having me. I'm a big fan, as you know. I listen to many of your podcast episodes, read your substacks.

SPEAKER_02 1:42

Uh, thanks, David. That's super. I appreciate it. Thank you. Yeah, I'm always I'm always excited to hear David. Whenever, yeah, I'm always excited to hear David's thoughts on the show.

SPEAKER_00 1:49

Niche gets some sort of like probing text from me after them. You know, what about this point?

SPEAKER_02 1:55

No, I love it. It's fantastic. David always reminds me when we talk. I'm like, right, I am not actually a journalist. I'm just pretending to be one. So we're gonna a little different. We're gonna we're gonna start with some news that's been current events before we get into the book, right? And uh what really kind of lit the world on fire per what is it early this week, last week, was Midjourney. Midjourney is a AI company. It's a straight up AI company that is leaders in image generation, right? You will put in a prompt. The thing that's eating all the compute in the world is like people putting computes about like make a squirrel fly and put it in Italy on a boat. And there's suddenly a squirrel in Italy on a boat. That's that's companies like Midjourney that do that, and Midjourney is one of the best that does it. And suddenly Mid Journey entered the medical arena. And that resulted in quite a tiff between the tech bros, as they hate to be called, and the doctors. But it's fascinating. When I first saw it, I mean it's a very neat, slick video of Midjourney entering the medical imaging space, where they essentially are partnered with a company called Butterfly. Butterfly is well known to most, at least cardiologists, because they have this cool little handheld ultrasound probe that hooks up to your iPhone or your iPad. That's it. You generate, you can generate pretty darn good images, ultrasound images of the body with just that. So gone is like when we trained this massive behemoth machine with a probe and, you know, whatever, cooling systems and whatnot. Right now it's just like you with an ultrasound probe that Butterfly makes and hook it up to an iPhone, you can generate some pretty nice images, save it on the cloud, send it to people and stuff. So pretty so anyway. So uh Mid Journey has uh kind of teamed up with Butterfly, put a bunch of these ultrasounds on a chip, put it in essentially a vertical tube, you step and put that entire system into a medical spa. So, you know, this cool med spa where as you walk in, you're getting like shotgunned with peptides and the next station, the next station after you get your 12 peptides that you get sprayed with is uh basically a tube. I'm kidding, that that is not what happens in the video. You don't get any peptides, but anyway, you you stand in this tube and then water fills up the tube, right? And then suddenly some scanning process happens, and then you generate this beautiful tomographic looking ultrasound-based uh images. And of course, I mean it's such a slick video and it's such a cool concept. The moment that happened, literally the tech world like exploded and was like, oh my god, this is amazing. You know, Tyler Cohen, who I mean wasn't fantastic with COVID, but anyway, Tyler Cohen, smart guy, economist, even he got into it and retweeted some post that said, do everything you can to live 20 years longer, because once you get to that point, I'm paraphrasing, everyone's gonna live to 100 or 120 based on this thing. And of course, that resulted in quite the uh pushback from a bunch of like cart doctors that do ultrasound. We're like, wait a sec, this is we're maybe a little over our skis here. Well, so Anthony, Anthony got Anthony and I for some reason have very similar takes on this. We didn't discuss this actually. But Anthony, what was your take on it?

SPEAKER_01 4:52

I shockingly agree. I know. Yeah, if people want to get a whole body scan, let them go to whole body scan. If you're if you're gonna pay cash out of it. But I think if if you're gonna pay cash, you shouldn't, and you find some incidental thing, you shouldn't expect your insurance to just go ahead and pay for it. And this is again why I'm not totally against utilization management insurance, because if you're gonna get a whole body scan and pay cash, but then expect this to socialize the cost of every follow-up. I don't think that's fair to the people who pay premiums or the taxpayers who are gonna be paying for every workup of every incidental loan. You should expect to pay cash for that as well if you're gonna start the whole thing with paying cash. But I'm all in favor of people exercising the freedom to do that. I don't really care one way or another. Again, the thing I always come back to is the healing crystal industry in the United States is two billion dollars a year. People are gonna waste their money on stuff that doesn't necessarily work, but if they want to, that's their God-given right.

SPEAKER_02 5:40

David, what what were your thoughts as a somewhat of a layperson in terms of I'm sure you saw some of this brouhaha and back back and forth. What was your initial impression of the mid-journey scanner when you heard about it?

SPEAKER_00 5:50

Uh to me, this seems like it's probably one of those things when you think about AI overall, not just this like particular use case. And it's sort of an echo, I think, of what happened when the internet kind of first came out and became more prominent, which is that things are there's probably a baseline truth that will ultimately come to fruition, but it is overhyped the speed at which the technology is actually useful and successful in that way. So, like maybe in a year or five years or 10 years, there will be some AI-enabled mid-journey type of product that really can live up to some of these sort of diagnostic promises. But it seems like that's certainly not the case now. And I'm sure you guys know, remember this sort of, I think it's somewhat infamous now, sort of prediction that all the radiologists would be on the breadline. You know, one, this is the very first thing that like AI is gonna take over. It's so easy. This is perfect use case that could just read radiographs, boom, awesome. Well, lo and behold, of course, there are now more radiologists in demand. And without, I'm not saying that's a perfect analog to the mid-journey case, but just that, like, you know, we've got to take a lot of these predictions with a grain of salt.

SPEAKER_02 7:08

Look, I thought it was, I thought it was super cool. And I was like, and I totally could get why they put it in a med spa. It wasn't like they were like, oh, let's do a med spa and put this in. It was literally like, hmm, the problem from a physics standpoint is that ultrasound does not go through air. So somehow, what are we gonna do? Put people in a vat of gel? Like when you do, when I do an ultrasound, right? I literally put gel on my little probe and I stick it on your chest so that the beam can actually go through the gel, go through your body. You need like this continuous interface, right? So the problem for Midjourney was like, hmm, how do we, what are we gonna do? Put like vats of water in doctor's offices or in a doctor office type thing? Or are we gonna put it in like have like the pods all through San Francisco because San Francisco is where there's gonna be massive demand for this natural right next to the homeless guy who's taking a dump is gonna be mentioned he's awesome.

SPEAKER_01 7:56

But then they're gonna demand that Medicaid pay for it as well for everybody.

SPEAKER_02 8:00

Of course. Yes.

SPEAKER_00 8:02

But can you speak to but can you guys speak to the, you know, for like a lay person? Yeah. There's obviously different diagnostic tools have different pluses and minuses. You get a CAT scan for one thing, an MRI for something else, and an ultrasound for yet again something else, that they each look at different types of tissue and mass. So the idea, and I don't know if this was the claim, but I thought the idea that an ultrasound is going to be this like incredible diagnostic tool struck me as a little bit surprising, just given the fact that there are a lot of limitations. Ultrasound's amazing, but there's also limitations where in other instances you need a CT or you need an MRI because the ultrasound doesn't I'll let you guys talk to that. There's a reason Dr.

SPEAKER_01 8:48

DeGiorgio cannot read ultrasounds because exactly. I live in the central nervous system, and everything I look at is encased in bone, and ultrasound does not penetrate bone. I did ultrasound a spine today in surgery, but that was after a laminectomy where I removed the bone so we could use ultrasound to make sure that we had a wide enough decompression. So just for CNS, you know, visualizing the brain and spine, and ultrasound's worthless on somebody who's not had a surgery where some of the bone surrounding the brain or spine has been removed. So the mid-journey thing is not going to affect the MRI industry that predominantly lives on intracranial and interspinal processes.

SPEAKER_02 9:23

Yeah, and then and again, it's just the if you were to solve, I mean, you need to be close. I mean, ultrasound is like a very like it's very dynamic. Now I can and it's it's just the physics of like how close can your beam get to the thing. So I don't know, maybe there's some technology I don't understand. Maybe you solve the physics of that and are able to get close enough to do it. But even then, there's issues with ultrasound in terms of what everyone wants is like, I want to find that tumor, right? I'm sure it'll find something like large, no question. So it's not that the mis, it's not like it's completely useless. I'm sure at some level it'll catch things. But to the level that you're thinking about in terms of discriminating, like literally ultrasound is just bouncing off tissue and coming back, and then you're generating an image based on that, right? And so it relies on, it will rely if you want to find like small cancers, that signal that the cancer cells or clump of cancer cells has has to have a different ultrasound signal than the surrounding normal tissue. Ultrasound is not very good at that. That's that's something called, you know, contrast. Uh, you know, could I I made I gave the example of a prostate, right? In order to do a good prostate ultrasound, you would have to insert a probe rectally to get close enough to the ultrasound to do it. Now I'm sure there's Silicon Valley folks. I'm at Shamat Patelopea will like gladly sign up to get one every six months or something based on what he talks about imaging. But even if you did that, it's still not as good as MRI, right? And then in terms of differentiating like normal tissue from abnormal tissue, because the ultrasound properties aren't that different between cancer cells and non-cancerous cells, right? So, but but even if you got to MRI capabilities, say ultrasound became so good and you could somehow AI machine learning gets you to be as good as MRI, all right, in terms of that contrast, which MRI is the best probably when you're looking at the prostate. The problem comes that MRI, right now, when you people MRI the prostate all the time, right? There's something called a pyrads score, and that's that's an objective grading system. Pyrads four is considered, is the actual definition is like something to the effect of likely cancer. Almost every Pyrads 4 lesion that's found in the prostate ends up getting a biopsy because you don't you don't want to miss that. What is the positive predictive value of a pyrads for lesion? Positive predictive value, meaning given that you see something that's there, what is the possibility that the predictability that is a malignancy? It's 40 to 50 percent. And that's for a pyrads 4 lesion. So, I mean, the fact even if ultrasound got good enough, you're still as MRI, you're still stuck with, you know, if you catch all these prostate lesions that are Pyrads 4, half you're doing all these biopsies where half of them will be negative. So there's a lot of different things that I think folks aren't aren't really quite, I think, thinking And that's at the highest level you're saying.

SPEAKER_00 12:07

If there's like a really subtle, very, very early stage thing, then the predictive value presumably would be much lower.

SPEAKER_02 12:15

Right. Exactly right, exactly right. And then that's what I'm saying. And ultrasound is like nowhere close to MRI. So you're talking about anyway. So I thought it was interesting. But uh that being said, I thought I thought that I I have a tough time, I had a tough time, really, tough time really getting too worked up about it because it's like, okay, well, as Anthony's saying, people want to spend their money on on woo-woo type stuff, they're welcome to spend their money on on woo. It's just you have to kind of track, you know, the downstream effect of that, because the downstream effect of that is socialized to all of us in terms of our premiums going up, Medicare dollars and all that stuff. But I how do you get away from it? It seems like when that whole discussion was taking forward, it just I always come back to the original problem is third-party payment for elective stuff, right? If you took away third party payment for elective stuff, then you know you could go to town. I I don't see how you get away get away from that. But as Anthony said very, very well during one of those exchanges, is like, well, insurance companies aren't dumb. And they'll basically be like, well, if the reason for doing this is because you got some incidental scan in San Francisco, then sorry, you have to pay for this. So right.

SPEAKER_00 13:13

Well, I think that's an interesting point because I think most people perhaps might think, look, if someone's paying for this out of pocket, you know, go to it. But the interesting point is, right, if it then there's some incidental finding, then what happens? If insurance covers that, then we're all paying for it anyway. So it's not we shouldn't think about it as simply the cost of the procedure itself, but rather all of the downstream procedures that will then take place from all these kind of potentially or likely false, false positives that it's picking up. If you want to look for something, you're gonna find something. I mean, a human body, right? So uh yeah, that to me is the interesting part. So then, but you suspect that insurance companies would balk at that anyway.

SPEAKER_02 13:56

I think so. I think they could be smart enough to do that.

SPEAKER_00 13:58

Until there's an outcry and you'll get some idiot politician and be, you know, you must cover it.

SPEAKER_01 14:03

Exactly.

SPEAKER_00 14:03

Exactly. For sure.

SPEAKER_01 14:05

Or it'll go, you know, to something that doesn't have utilization review, like standard Medicare, standard Medicaid, uh, where everything you know essentially gets approved unless it meets some narrow criteria. But then the government gets to pick and choose winners and losers, which is you know we're all fans of centralized control here, right?

SPEAKER_02 14:21

Yes. So that brings us to our next point. We're gonna spend two minutes on it because it segues into in into David's book. Anthony, Anthony is a pugilist, all right? He I mean he's a neurosurgeon, so of course he's gonna be a pugilist, right? He's not he's not backing on. So Anthony is frequently, I see getting into these kerfuffles on online. And one of the people who got into kerfuffles was a Canadian physician. Like, I believe his specialty is suicidology. I don't know what that means.

SPEAKER_01 14:44

Which I think is is the the biggest growing specialty in Canada these days.

SPEAKER_02 14:48

Hey, Canada innovates, man. They're you know, made the euthanizing people is something they're innovating in. But can you give me a little blurb on what was the source of the disagreement you were having with the great Tyler Black?

SPEAKER_01 14:59

Well, it's just whether or not it is on these these downstream consequences. Are we going to expect for a centralized system to just go ahead and pay for this, or are markets gonna work? And we have a blatant disagreement about the role of markets in healthcare. And the reason I like markets is I like decentralized control and decentralized decision making. If you put everyone under, like if we had a Medicare for All system, if Obama had passed Medicare for All instead of Obamacare, then that means 100% of healthcare spending would fall under the Secretary of Health and Human Services. That means that that person would be able to control all healthcare spending and they could decide whether or not to pay for mid-journey and all the downstream consequences. So when you have a single payer system, it centralizes control and that the central authority, whether you love them or whether you hate them, will be able to make these decisions broad on the entirety of healthcare. $5 trillion will be in that person's purview. So I don't like it because I don't like centralization of control. People like Tyler do like when control is centralized. And I think we see what the downstream consequences are when things go wrong with centralized control, like we saw in COVID, he says, leading into the next topic.

SPEAKER_00 16:06

But wait, I just have a question. So I assume the counterargument to you would be well, are you advocating then for private carrier?

SPEAKER_02 16:15

That's the correct system, and that or is that not I'm just trying to think through what it what is the So the source of the disagreement, the source of the disagreement was, to be clear, was Anthony wrote this piece saying, look, I could care less about the Majorney Scanner, let people pay their own money, and uh let the markets deal with this, uh, in the sense of downstream costs, insurance companies could deny, etc. I mean, that that's what Anthony was basically saying. Tyler, of course, feels Dr. Black feels that no, no, no, this is ridiculous. You big-brained, you know, he automatically like puts down any anyone that says anything about market and healthcare because he thinks that's that's stupid, that's a stupid argument, and is saying we must control what healthcare the consumer can access because we know best. That's what Tyler's Tyler is saying. And Tyler, the s the science, the capitalist. Yeah, right. So which which gets us to and and and and I think I I do think that is the crux of so much that gets us wrong, right? Uh David uh uh David wrote this great book called An Abundance of Caution that he worked really hard on, very well researched on what happened with COVID. And so much of it is tied up in this exact thing that there's this group of people that know and understand the science, and we must tell you when school is going to be open, when you should wear masks, what color masks you should wear, probably, if you can go to church.

SPEAKER_00 17:38

If by the way, wasn't that the uh Bangladesh, where they had the different color masks? And they had different, correct me if I'm wrong, they had different results depending on the color of the mask. So to me, that would automatically just make the whole study suspect. But anyway, I digress. Right.

SPEAKER_02 17:54

So David, so anyway, so that so the book is the An Abundance of Caution, it's it's great. We'll have a link to it uh in the show notes. What was the thing, David, that got you questioning the science? Because the science, you know, early, early on was we must flatten the curve, lock down for two weeks. So at what point were you as a, and again, you're a guy who lives in New York, you're not like some guy that's living sitting on a porch in I don't want to, I don't want to get anyone in trouble, but I mean you're not living, you're not staying in some rural area. You're like a New York Times Atlantic, you're a science guy. And when did things start to go off the rails for you?

SPEAKER_00 18:26

Well, it's interesting because when we talk about quote, the science, to my mind, very early on, I was trying to follow the science, but not the science with the little trademark symbol, but rather the evidence. So for me, uh, you know, and early on, I had no instinct initially to disbelieve what we were being told. I kind of went along with everything. But very shortly thereafter, just because this is just how my mind works, I'm the type of person I'm just always looking to find out information on my own. It's not just for medical or healthcare stuff, but like any random thing. If there's some claim about a car or like a new phone or gadget, I'm like, wait a minute, is that true? And I'm like digging around and looking up just to find out the actual sort of underlying data behind something. So pretty early, I just thought there was a complete absence of real information being given in the media. Much of my book is about the failure of the media. It's sort of like the twin, the twin failures are the public health establishment and the media. And the two of them together created ultimately the big failure. And so found there was a complete absence of real information in the American media, by and large. Instead, and this is something I extensively document, and this wasn't only in the beginning of the pandemic, but continued for years, which was the New York Times and all these other prestigious news outlets were regularly quoting so-called experts, Fauci or whomever else, or oftentimes unnamed experts. They would just say, experts say, you know, and that so an unnamed thing, but yet there wasn't any information, there wasn't any evidence behind it. It was just here, experts say that you should be doing such and such, or Anthony Fauci says schools should be closed until such and such. But there was never any investigative work behind those claims, or very rarely was there. So for me, I was just like, wait a minute, where did he get that from? Is that true? So I started digging around in probably in April of 2020, just trying to find actual data. And it wasn't that hard to find. You just had to make a little bit of an effort, and that kind of set me on the path. And I think I'm largely referred to as the person I wrote the first major piece in America that came out strongly for reopening the schools at the very beginning of May of 2020, because I had looked at all the data I had I had spoken with or communicated with a bunch of people in Europe, because no one in America was going to do this. So various physicians and epidemiologists and others, like making sure I was understanding all of the data and the evidence. And I just put together this compendium of like, here is all the stuff, here's stuff from the World Health, here's what we found out from China, here's some study in Iceland, and blah, blah, blah, all this stuff. The evidence was there very, very that in a lot of respects what we were doing didn't make sense. And we could get into more detail, but at its core, what I didn't realize this necessarily, I certainly didn't realize this going into it on like a like a conscious level, but I realized I care very much about sort of empiricism, or maybe even kind of a step back like EBM, or I guess public health evidence-based public health. And and I argue that there is a real just kind of escape from an evidence based process in America. So and that that's it's kind of a book length argument about th this sort of unmooring, this untethering from an evidence based um process.

SPEAKER_02 21:55

But David, do you think that a lot of your search for empiricism? in this particular case was driven by a sense of injustice. Well was it emotional, I should say, right? I mean, look, there's many things in life that we don't run around like, where's the evidence for that, right? Because most of us, like I know, where's the evidence? I'm not searching constantly to figure out whether the earth is flat or not. I just take it on somebody's thing and that the earth is not flat and was there a moon landing or not? Do we go in a rock? I mean, my point is there's a lot of things that we don't go down rabbit holes to figure out where is the empiricism for this or not. Your search for empiricism in this case was driven by the fact that you have two young children. You have a very nice forward, by the way, that really beautifully goes through how it is you started on this path. And but it comes through that it's extremely emotional as a parent, right, who loves their children, who knows and understands how important social connections are, right? And can you imagine like taking a young boy who's five or six who's or who's used to rough housing and playing with other kids and being like, nope, you can't do that. And there's that visceral sense of injustice that some people have like you being like, is this is this real? Like why is that? And that's what prompts you on that search, right? Uh is that the right basis to go hunting for empiricism?

SPEAKER_00 23:12

Well, sure. It's hard to think of a better reason to do anything. I mean I rarely write about anything that I have no that I feel like there's no stakes there. I don't I'm not interested in being dispassionate in my pursuit of trying to find something out. I do try to interpret and take information dispassionately, but the impetus for researching, I mean it's like, why do we research anything? You know, hopefully it's something that that's important. And needless to say, I mean the the school closures and then kind of more broadly the overall pandemic response, I mean, I still strongly feel that like this has not been adequately absorbed or reckoned with. And when I say reckoned with I don't necessarily mean people being punished or something like that. I mean that the sort of example I always give is like if the this sort of modern university in America is thousands of faculty members studying the most arcane, ultra like narrow niche stuff. You have someone I always think of like there's some professor somewhere studying the sartorial habits of like 15th century peasants in England or something. It's like highly, highly niche stuff. Yet why there should be hundreds and hundreds of scholars at the university level studying the pandemic. And yet there aren't to my aware you know there are people dabbling. But like this was the most radical experiment conducted on the entire population as as far as like a kind of like public health intervention is concerned that any of us had ever lived through or anyone for the last hundred years. This was an extraordinary moment and to me I know most people are bored and sick of the pandemic I am talking about it to some extent but on the other hand I have two feelings on the on one level I it's like I'm sick of it. I've moved on I don't think about it every day. But on the other hand, there's something endlessly fascinating about it to me because it was something so wild, so radical that happened and it's like to a large extent been memory hold. So I don't know if I went off you know grid from what the the prompt you had for me. But all this is to say this was an incredibly important thing that was happening in our society. You don't need to be some like hardcore libertarian to acknowledge that like these were tremendous and extremely atypical infringements on our liberties. And like boy that warrants like a real, real close analysis in real time, which I was trying to do and now post hoc right.

SPEAKER_02 25:56

And that burden of proof you're saying you know if you're going to essentially saying that look if you're going to tell me that my child cannot interact with another child for X number of months and he's only going to be five once or six months and this is an important time. Remote learning my God right I mean that that whole thing if you're going to make me do these drastic things you're saying the burden of proof has to be on them to show you that this is what one should do. So David in trying to steel man again their point you know steel man try to create some points. At some point there's a level of uncertainty that makes extraordinary interventions okay. For instance at the time to remind everyone Italy was I think March was when Italy was we'd already seen the pictures from Wuhan right Wuhan was like a stream of just disaster you know that famous picture that poor ophthalmologist young healthy dead right and and there was all the stuff from Bergamo. So there's a sense that we did not know and there's all this disparate stuff. The nursing home data was this the cruise ship data was this yes Ionidis was saying IFR, the fatality rate is this, but there's genuine uncertainty is my point about what exactly the fatality rate is. What exactly is the fatality rate for kids? You know so we have no idea for some time about what this was so was it not a reasonable thing to do until we figured out what was going down to lockdown for some to some level.

SPEAKER_00 27:17

So I'm very very interested in this exact thing that you're asking like I find it endlessly fascinating the idea and I spend a lot of time in the book talking about the precautionary principle. And I I interviewed this really great philosopher Eric Winsburg who who thought deeply about the precautionary principle and he he focuses on on the sort of ethics of models which is like to my mind doesn't get nearly enough attention on on how much of an impact models have on society. And they certainly did in the pandemic and they certainly do with climate change. But anyway, without digressing into the models but the point is that of course when you are presented with an unknown threat but something that appears to be potentially catastrophic, that precautionary principle would dictate that you're going to act accordingly to the quote better safe than sorry. A lot of philosophers don't even believe that the precautionary principle exists as a thing that any time you make a choice, you are creating to some extent a kind of pro-con sort of risk reward type of balance sheet in your head precautionary principle you're taking a guess at what at the risk and the reward will be, but you're still creating this kind of balance and when there is an unknown on one side it makes sense. What my argument is that the initial school closures and broader lockdowns that happened outside of perhaps a very very small number of places that they were both reasonable but wrong. So I get it I understand not crazy try something initially but they were wrong. They weren't beneficial I mean I think you know there's a ton of evidence that this did not do anything. Maybe it helped in a few small places but for a lot of reasons that I get into in the book and that we could get into for why they weren't actually effective. But that shifts though of course once we start gaining more information and there's there are these pandemic but but early on when we you're speaking in hindsight in terms of we knew that are you saying that we should have known in real time that it was wrong? I I think that would be challenging. I think it's possible but it is challenging when there is something scary happening and this sort of complexity of the world. So I think it was reasonable even though in retrospect not effective or appropriate to do and I think reasonable people could disagree with me. I'm trying to be intellectually honest with myself because when I look at it now I'm like that was so stupid. But at the time there it was not wildly unreasonable to do some of these measures even if they were ineffective. I think they became unreasonable very quickly though. And that's where I kind of hit the gas in my book with my argument is not this kind of like March 15th business, but rather the once the 15 days to slow the spread expired, that for me is when everything changes.

SPEAKER_01 30:18

After the 15 days yeah summer 2020 we things were calming back down again. The official stance of the American Academy of pediatrics was that in-person learning was paramount and important. Donald Trump comes out and says we should get kids back to school and they instantly changed their recommendation on their official webpage. And you see this shift we saw it again later as the vaccine was approaching release and there was actually a group that published a letter delaying the vaccine until after the election so Donald Trump would not get credit for it. So how much of this went from pure science to pure politics it seems like so much of this was driven by hate to use the term but Trump derangement syndrome just the fact that they wanted Donald Trump to be wrong in every instance and there was this like coordinated push where science really got thrown out the window for politics. Is that what happened?

SPEAKER_00 31:06

Yes and but I think it's more like everything it's more complex than just that or at least it's complex to sort of take it apart and understand why and how that played out as it did. So you're correct. Right. As soon as once Trump tweeted in all caps we must open the schools in the fall with like 15 exclamation points ironically of course that ensured that the schools wouldn't open because the left sort of establishment so to speak were entirely reactive against Trump. It's like if you guys have a have a dog as a pet, like part of training a dog, you understand that when you pull on the leash, the dog has a reactive mechanism inside that they like instinctively pull back against it. You're not supposed to just tug your dog on the leash and humans also tend to have that reactive tendency um and that certainly was the case with Trump. And so I spend a lot of time in the book talking about and taking apart this tribal partisan response. And yes, we saw it with the AAP I mean it was just nakedly naked embarrassingly unforgivably partisan what they did immediately following Trump's uh tweet. And then more broadly the AAP's conduct overall was just abominable. I mean I have this my book is larded with endnotes and to her credit my editor at MIT Press actually made me cut like I have hundreds and hundreds of citations but she made me cut even more of them and I had these like lengthy multi-page like explanations just for individual endnotes. I'm a bit of a like maximalist with this minutiae but I mean I have this end note where I talk about the AAP was involved in a I think they filed an amicus brief on this lawsuit in Texas, I think it was um regarding mask mandates and their argument was that the Texas government I don't know if it was the governor himself or whatever, but that they did not want to allow mask mandates and the AAP came against them and they said and part of their reasoning was that wearing a mask is no different for a child to be around adults and it's no different than being around adults wearing sunglasses. And so that in this this ridiculous study that they point out and I go through anyway sorry going a little far afield here but all this is to say it was so like nakedly partisan. And one of the things that's interesting and I think why you guys if I can take a guess at your uh political leanings is that by and large and there's statistics on this to back it up it's not just like conjecture by and large people who work in public health lean left strongly left and that's particular in epidemiology but it's also within in medicine at large it does depend on the specialty if you're in an ortho or something it's last year but uh and probably neuro as well but by and large these are fields that lean very far left the vast majority of people if you're going to become an epidemiologist you're probably a left leaning Democrat. Well you you couple that with a sort of legacy prestige media that also lean very far left and there is this you end up with this very uniform monoculture as far as the ideology and that created a very very dangerous situation where you had everyone reactive against Trump and having this kind of very deep motivated reasoning to believe certain things to be true, to dismiss evidence that didn't fit within this particular framework. So one of the dynamics in America that was so interesting that I think in some regards set the United States quite different from a lot of its peers is the particular political dynamic in our country. And you know what people forget or may not realize is that there's nothing inherently like quote progressive about wanting everything locked down or like wanting schools to remain closed. That was framed as like this is the caring thing to do. We need to care about the kids blah blah we got to keep everyone everything locked down. There were plenty of countries that have the opposite political structure where there right where there was very progressive people in power who wanted everything open and then there's the reverse where you had more conservative governments in charge and they wanted things open or closed. There was no the point is there is no there's nothing intrinsic about being a quote progressive and being in favor of lockdowns. It just played out that way in America had you know a Hillary Clinton or someone been in like it could have played out the opposite for all we know. Although one could argue with the the uh influence of the teachers unions maybe not but nevertheless there's nothing but it was so embedded in our society the idea of like I'm a good liberal I'm gonna wear a mask and I'm gonna stay home and I'm gonna let like my neighbor's mom and pop business go bankrupt because I'm a good person. Like it was so deeply like felt but there was nothing actually intrinsically like progressive or liberal about that at all.

SPEAKER_01 36:12

Well you saw it when their perceived cause became the cause celeb for the Black Lives Matter riots, right? Because now all of a sudden you can't lock down you have to allow protests in the name of public health. Right? So you saw it shifting with the wind just you know commerce is bad rioting and protesting is good just depends on what's the perceived goodness of that cause.

SPEAKER_02 36:31

One of the things I really liked about your book was that you go into great detail about why the empirics were wrong. You know so we spent a lot of time so far in the last five, 10 minutes talking about the political, the tribal inusivists the blinders that people had on but it's interesting because well there there's two lines of attack here, right? One line of attack here is that the empiricism of this, especially when it came to and again your book is focused on schools and children, right? So the empiricism when it came to that, you're you provide really detailed analysis and and like you said, you were one of the first who wrote one of the very long essays questioning the empiricism itself because you weren't willing to just argue from an ideological frame. You very much wanted to say hey guys there's lots and lots and lots of data that suggests that this is not happening. And and you lay it out very nicely one in terms of comparing it to other places but also other societies but also looking at this whole concept of healthy children versus sick children, right, David? So okay there are deaths that have happened in children you acknowledge you show that but it's relevant to understand who those children were and what their comorbid conditions were correct?

SPEAKER_00 37:39

Well of course and one of the things that I try to kind of contextualize is we all including kids face any number of uh threats every day. That's part of being a person and you can mitigate those threats if you want to avoid getting in a car accident you could never get in a car that's true but then you also wouldn't be able to visit your parents or go to the store or do any number of things we conduct our lives and it's very tragic, but a certain number of kids die every year probably traveling to or from school for one reason or another. We have more than 50 million children in America roughly K to 12 some portion but of course parents still send their kids to school knowing there's some risk and and short of death there's all sorts of other risks they might they'll pick up a virus maybe they'll get beat up by a bully maybe someone like any number of things can happen but we go about life because living a flourishing life means not the constant attempt to mitigate a risk. That's not a flourishing life. And the data are pretty clear on this that in the first couple years of the pandemic, the number of kids and this is from and again I'm I have citations for everything. So one of the things that's incredibly important to me in my book and I in my writing at large is that I always try to have backup for any claim that I make because one of the things that pisses me off so much and that I critique a lot in the book was that as I touched on this earlier in our conversation, you have places like the New York Times and elsewhere where they were just constantly saying shit without any evidence behind it. Like you need a citation you need give me something and they wouldn't do that. And that's one of my criticisms of the media and also by the way health professionals often just say shit without having some well what's the actual evidence behind this? So I thought it behooved me if my book is critiquing all these people that I better have evidence for every claim that I make and I believe I do. It's just hundreds and hundreds of uh let's go through some stuff because I thought it was excellent.

SPEAKER_02 39:43

So when this happened in around March, right? I've mentioned it many times on the show I'll say it again I have a my eldest daughter had a liver transplant she's had immunosuppressants. So literally she is one of those children that is like super high risk right early on and I had no idea and all I saw were these scary scary pictures. So I was terrified. So I didn't care if the school was going to be open or not like in March she was not going to school. So she came to she's went to a room and again I was working through the pandemic so I was going to the hospital every single day and I did not want to be the one who was going to get her sick and be responsible for that. So she was quarantined in a room it's a nice room we live in a nice suburb and stuff but still she was quarantined in a room leave food outside she would take it she had access to electronics and stuff but it's pretty pretty freaking terrible and we I did that for 14 days in March, right? And what finally one like at that point I was getting no word about the fact that there were transplant kids that were like all dying in the hospital. Because if that had happened if the transplant community kind of that had activated in that yeah she would she probably would still be there or she she would have gone on much longer right in it should be like Rapunzel. But but when I didn't hear that, I mean it's so severe to do that to a child right yeah I immediately was like all right I think we're good because this seems very very low risk to children. And that intuition from being connected to the transplant community and being a physician and stuff you know the frustrating thing is there was data that was being put out that said exactly that that you detail in your book, right? You detail this fact that there's a paper published in uh MM the Morbidity and mortality weekly report in this the CDC's House journal that looked at 1482 Americans hospitalized with with COVID from March 1st to March 28 in 14 states, including California and the early horrendous hotspot of New York that turned out to be extremely unique, right? That was the part of the problem with the COVID whole thing was that New York was a bloody disaster and that was the first terrible thing in the U.S. And literally everyone thought that New York was going to play out at every major city in the United States. That didn't turn out to be the case. But anyway but this study was done in New York and it found that zero to four, this is all from your book, zero to four year olds and five to 17 year olds each accounted for 0.4% of the total hospitalizations, which was similar to the data that was seen in China. And that should have been reassuring. And yet and this is all done and then remember this all happened while schools were still open right so while schools were open there was very strong data that was echoed around the world to suggest that children were at extremely low risk of something bad happening. So American public health authorities should have known that school aged kids and adolescents accounted for 0.4% of COVID hospitalizations while schools were open. That's just hospitalizations. And yet the news media did not run with that as the story. The news media instead ran ran the framing as COVID was disreproaching high risk to men, black people, people with obesity underlying conditions. Not one of the news items mentioned the dramatic reassuring statistics regarding kids and adolescents. Why David? Why did that not happen? What was going on?

SPEAKER_00 42:46

You probably are familiar with the expression if it bleeds it leads and what's interesting is and some researchers out of Dartmouth did an interesting analysis which I quote in the book where they actually you know the methodology I don't know precisely how they do it but they didn't announce like a there are these ways of doing kind of sentiment analysis of text. And they found that the American media was way out of step with the media outside the United States regarding its coverage of the pandemic overall and specifically its coverage of children that the United States was uniquely alarmist in the way that the media covered the data the evidence or lack of evidence regarding a lot of this stuff. So the public was deeply deeply misinformed about what was happening and and there was an there are a number of polls on this one of them and I'll get this precise numbers wrong but people were asked to estimate the proportion of at different age brackets, you know, children and then maybe you know adolescents then maybe 20 to age 40, whatever, to estimate the different age brackets for what portion of the overall deaths they accounted for. And they estimated kids They overestimated that their portion of deaths by something like 40 times. So it's hard to even grapple with that number. It's not like, oh, they overestimated it by 40%. That would be a lot, 40% or even 100%. This is 40x. Like it's so, like the numerically, it's so dramatically off, it's very hard to even conceptualize how wrong the average citizen was about perceiving risks to various people. And incidentally, I mean, young adults too, and people in their 20s and 30s, the estimates were way, way off as well. But to kids was even more escape velocity. And just touching on something in niche that's interesting, that you said, I was contacted by a lot of parents during the pandemic who had children who were either ostensibly or genuinely at greater risk, parents in some sort of immunocompromised state in their children. And these are parents who were contacting me saying, I want the damn school open. My kid, this is not good for them. I've looked at the evidence, I've read, I've seen this, and like, I don't think they're at any greater risk than they are in a normal flu season. And I send them to school then. You only get one like you only get one time to be in third grade. That's it. There's only one year of third grade, right? There's only one senior prom. There's only one time you get to play on the football team as a freshman, whatever it is. These things don't happen twice. And parents, a lot of them at least, recognize that, including parents of children who were at greater risk. And one of the things that annoyed me so much is that is when people place themselves as the sort of like champion and the sort of protector of certain groups. And you had, I think this guy, Ed Young, I think that was his name, Ed Young at the Atlantic. He was the most prominent of many people who was like, I am virtuous and I am gonna stick up for all the immunocompromised people. And here's what we need to do. Well, it's like, whoa, buddy, tap the brakes. Not everybody who is at ostensibly greater risk wants you to speak for them. So, but this is how a lot of the narratives were cast, right? This framing of like, how of like you are a piece of if you wanted schools open or if you were running a small business and you needed your business to open so you didn't go into debt, which by the way, those things have health effects and health consequences too. So it bothered me greatly as people who are in similar situations to you, Anish, with children were saying, like, I don't want this guy speaking for me. Like, this isn't how I feel. Like, I want the kids, my kids to experience a normal life. I don't think they're at greater risk. And indeed, they weren't at greater risk when you look at the data from the CDC. And I quoted in the book and I give links if someone wants to look it up. The CDC um mortality estimates for influenza in several seasons in the decade prior to the pandemic, not one, but several, multiple, whatever, uh, were higher than the mortality rates for COVID in any individual season. So it's really important for people to recognize that the broader narrative, this is those Republican who say this is just the flu. Well, for children, it was like, and again, the CDC's own mortality estimates show that. So it's very, very challenging to kind of bring information to people that goes against this sort of like story that they've been told, and then that gets compounded if they have a kind of like partisan or ideological belief system that wants something to be true, and then it gets compounded a third time. I live in a very deep, deep blue area. It's so blue, it's like you know, the bottom of the ocean, this dot where I am.

SPEAKER_02 47:55

And it's like it's so blue, it's the reflecting pool blue, David. You gotta update it.

SPEAKER_00 47:59

It's just yes, without algae. Yes. And it's like so culturally, just it like it became incredibly difficult to have conversations with people when something went against all of these kind of incentives for them to feel otherwise. And it didn't matter what information they I could show them though, even now looking back, I could show them those statistics from the CDC regarding flu mortality in multiple seasons and how it exceeded the COVID mortality. It won't matter. It won't penetrate when people are incentivized to think and feel in a different way. And that's a very, very challenging kind of information environment to be able to operate in and be effective. And that was what I tasked myself with was um I tended to be pretty unusual in that I wrote a lot of pieces that were quote unquote contrarian and challenged the sort of accepted position. But I wrote them in publications that generally were part of that legacy media establishment. So it was a pretty rare lane because my mission was, and it still is now as a writer, it feels good to say things for people who you know are going to support you, the proverbial preaching to the choir, but I'm motivated by trying to persuade. I always try to persuade people if I can. So, but that was a very difficult task.

SPEAKER_01 49:27

Thank you for taking that stance. And that resonate another point you mentioned is these things only happen one time for kids going to prom and all that. And maybe if you're governor of a major state, you only get the chance to go to French laundry once while you're a governor of that state for your birthday. So we maybe we should get be a little more forgiving. The California Medical Association just published a piece uh a few weeks ago talking about this breakdown in trust to public health. And they, of course, largely blamed Elon Musk and the Republicans and Casey Means and Trump. And my counter to that was all these other things. And uh, I'm sure as a journalist you're familiar with Gellman Amnesia, right? Where you read something in a in a news magazine that you're intimately familiar with, you spot all the errors, and then you turn to the next story and you just trust it at face value. But for me, that happened when there was a story in the local media about how my hospital where I was working at was overflowing. The ICU was overflowing. And I'm walking around the ICU and it's empty bed, empty bed, empty bed. Right. And so at that moment, I think the veil was lifted. And I realized like most of the media is, as you put it, kind of full of shit. And so I appreciate people like you that gave this other point. But to this idea, the CMA article and this idea that now most of us don't trust media and don't trust public health, how do we regain that? Is it just, do we just need to be have more honest journalists like you, more people evaluating the evidence in a scientific manner? Like, what's the route to regain trust in public health, trust in vaccines, and get back to where we were pre-COVID? Or has that ship sailed?

SPEAKER_00 50:50

Yeah, I mean, the ship has definitely sailed to an extent. Whether we can get the ship to turn around, to push the metaphor, you know, that remains to be seen. Um, funny you bring this up because I actually was working on a piece about this actually, and I won't go into detail now, but the story is more complex than a lot of us realize. There's some interesting uh polling data about like the which groups have have lost trust in public health and when. But just kind of more broadly, to me that the solution, and it's not an easy one, is you have to, and this gets back to the beginning of our conversation about the mid-journey thing. You have to not overhype shit. You have to not oversell and overstate your confidence when or when it's not there or shouldn't be there. And unfortunately, a lot of people in public health seem to have a very kind of like patriarchal view of their role about, and there is this expression called the noble lie, where a lot of them knew what they were saying wasn't quite true, but it felt true, or it was directionally true. So therefore I'm gonna say it anyway. Anthony Fauci infamously in one interview had said, if it's something to the effect of, if it seems like you're overreacting, then you're doing the right thing. Well, it's like, what? You know, like that there was such a there was some interesting, I found these interesting documents from the UK in their health establishment where they were kind of had this whole advocacy advocacy plan on how to manipulate the public to behave. So what's become kind of like fascinating to me is the kind of social control and political components that took place during the pandemic, and it should be of interest to anyone, regardless of their politics, about how government officials and others use information in a manner to manipulate the public to get them to behave in certain ways. And when you talk about, and like as dumb as much of the public is, the public aren't that stupid. And people can sniff out when they're being And one of the things that I think ultimately really harmed public health was when people, and there were many things that did, of course, but one of them was, and of course, you know, the the kind of hypocrisy with the BLM George Floyd where it's what one day they're saying, if anyone who protests, you're a horrible person, but then literally the next day it's like, everyone go out by the thousands in the streets, it's fine. So that was one thing. But I to me, I think the larger piece that harmed the relationship between the public and health officials was that people, and you know, Anish, you talked about, look, if I saw transplant kids in the community who were winding up in the hospital in large numbers and getting becoming very ill, you were gonna lock your daughter in her room for a long time until you figured out what to do. And your point is very well taken because one of the things I talk about in the book is imagine there's a tornado in Mississippi. And after the tornado, there is just this trail of destruction. And you live in this small town and you walk out your door and you can see the trail of destruction. You don't need to be told by the media or by an official that this was dangerous. They may say, when the radar is showing another tornado is coming, you're going to run back into your house and get into the basement or wherever the safe place is. You don't need to be told about that. And what's different is after a while, people looked around and they looked outside their door and there wasn't a trail of destruction. This isn't to say that many, many people did not become very ill, and many of them even died because of COVID. This isn't saying that that didn't happen, but we have a country of 340 million people, and almost all of them, not all, sadly, but almost all of them, were not at great risk and did not die or even become seriously ill. And so it was the equivalent of stepping out your door and being told there is a hurricane going on, and you step out your door and it's like kind of a pleasant sunny day. And what's interesting is the guy who is the head of CNN for a brief while, I quote him in the book because when he eventually, it's very fascinating how candid he was in an interview, and he said that CNN he felt like had kind of jumped the shark after a while. And for this exact point, he said people eventually got tired of having screaming siren on the screen and the headlines and and you know the death count and like all these emergency signals going on all the time. And they're like, everyone I know seems to be okay. My neighbor got sick, but she said it was like a cold. I was pretty knocked out for a few days, really bad fever, but I'm okay. And maybe they know a relative or a friend or someone who did pass away and it's horrible. But just statistically, statistically, whatever the numbers are, I'm gonna misquote them now, and it depends at what point in the pandemic, but it's one out of 300 people or whatever it may have been were sadly going to succumb to this. That means most people did not even know someone directly who died. Again, these are still horrific numbers, and we don't want this to happen. I'm not minimizing what the danger and the harm from COVID to many people, but rather trying to make people understand that you have to position, you know, relative to everything else that happens in society. And Anish, you'll appreciate this. I think in the book, one of the examples I give is every day on TV, there was like this in CNN and all the channels, there's like this running counters, these various dashboards of like the amount of cases there are in any particular city or the amount of deaths or blah, blah, blah, or hospitalizations. They had all these like things. And on the front page of the New York Times or homepage online, they had these all these dashboards. So of course, this becomes it was almost gamified. It became like entertainment in a way, morbid entertainment, but entertainment nonetheless, like when you walk into a Vegas casino with 30 different screens showing sporting events. This was the equivalent of that with all these statistics. Now, imagine if every day on the front page of the New York Times or the homepage of their website, there is a running counter of everyone who dies of cardiovascular disease. Every day that's just the counter, it's going up and you're seeing this. How do you think that would impact the public discussion, the public perception and conversation around cardiovascular disease? Do you think it would increase the discussion around it and how we might want to treat it or behave differently? Of course it would, because that becomes the topic everyone's thinking about. So the fact that they made this something, this sort of like this almost like casino-like game of looking at statistics on dashboards, they forced a kind of narrative intrusion into people's minds that ultimately people observed a disconnect from their reality. So this was a very long-winded way of me saying that the way to gain trust is to have the things you say match reality.

SPEAKER_02 58:08

Yeah, that's well very well said. Two things. One, you one of the things that you introduced that is, I thought, very interesting in terms of why things happened the way it did in terms of the lockdowns was that it could happen. In prior eras with epidemics that swept across, where tons of children were sick, like half the kids were like out of school, but school was still open, it just it just couldn't happen because it just wouldn't happen because it couldn't happen. So you describe the term technological solutionism. Um, that the ability, I mean the internet, laptops, uh, zoom, cameras, I mean, we were at a place technologically where you could actually technically feasibly have a virtual class. Now, it's not going to be nearly as good. It's, of course, there's that missing social collection and stuff. So talk to me a little bit about that.

SPEAKER_00 58:56

Yeah. I mean, in the middle of the last century, I forget it was in the you guys might remember late 50s or in the 60s, there was an influenza epidemic. And I have these, I found these wonderful old articles in the New York Times. Um, you know, it's so fun, like going back and looking through the archives, and you can see, and they give all these statistics about schools in the New York area. And it was like some of these schools, like 50% of the kids were out sick in a given day. And there were like tons of kids were really sick, which never happened during the pandemic, where you had that many kids like wildly ill. And you know what happened? The schools didn't close. Like the school, they it like now, and indeed, the only time that they canceled a football game they were talking about, it was some football, maybe some team in New Jersey or something, was because there just weren't enough kids to field the team. Now, what's fundamentally different about what happened during the COVID pandemic was like a reverse, where it was everything was ostensibly prophylactic, where you had healthy children who were all sequestered at home, which was the opposite. So they back then the schools remained open when there were tons of sick kids. This time there were not a lot of sick kids, but the schools remained closed. And I view it as two things. One as part of this technological kind of solutionism where we actually had the ability to work from home. And when I say we, I mean the laptop class, the wealthier, more kind of white-collar workers. Of course, the more blue-collar people who kept society running, they had to go to work. So they kept the lights on. They were guys working on the, you know, the gas lines and the slaughterhouses and the cashiers. I think that includes people delivering your food and everything else. But the people who it is worth noting, because just talking about models again, that the people who created the models, and these models were the foundation of the sort of like intellectual foundation of our response. It is worth noting that the people who create the models are the same people who are able to comfortably stay home. And this was one of the most classest, or possibly the most classest public policy or not interventions that I can think of in history in our country, where the poor and working class were expected to keep society running, the infrastructure of it, and deliver and imagine, I mean, it's hard to think of a more kind of like exaggerated storyline than the poor people delivering food to the wealthy people who stayed home in their luxurious houses watching television, their kids in the air-conditioned bedroom, and the adult, you know, corporate attorney on their, you know, laptop.

SPEAKER_02 1:01:41

So didn't you see the Hollywood, all the Hollywood stars, Gal Gadot? They sang a song for us, David. I mean, they were truly virtuous, they were closeted in there and they were singing to us to make us feel better as Anthony and me were walking the hospitals. It was very I felt so hardened by that.

SPEAKER_00 1:01:59

Right. So it's kind of fascinating. Actually, physicians were, I would argue, one of the very few sort of white-collar, highly paid professions who actually still went to work. And what's interesting is, and we can draw a contrast, there was another guy, I think out of Georgetown, who I interviewed for the book, really smart, interesting guy who talked about, um, he's a philosopher and talking about the ethics of professionals. And when we think about a society, what do we owe each other? And when you think about physicians, you know, went to work and healthcare workers, you know, had to go to the hospital, and cashiers went to a grocery store, slaughterhouse people went to the slaughterhouse, and so on. There was one profession who were deemed essential workers, quote unquote, or deemed themselves essential, but who didn't go to work. And that's teachers. They did, I'm not saying they didn't work hard doing remote learning. Many of them did. Many of them really were behaved and performed valiantly and respectably, but the teachers' unions really enabled teachers to be unique and that they were positioned as an essential part of our society, a critical piece of our national sort of intellectual infrastructure. Yet they did not have to go into work in the way that all these other people who were also essential workers did have to go into work. And what this philosopher guy, uh, I think it's Solmacy was his last name, I think. And what he argued, and there's there's this kind of really interesting tradition going back to like the Middle Ages when you talk about the professional class and whether they're teachers or I don't know if it's like a blacksmith or something back in the day, what have you, but where that there was a sense of responsibility and a sense of a sort of there's this ethical piece of being part of a village, part of a community. And what's interesting to me is that many of the things that the ideological left position themselves as caring about the most, kind of caring about the poor, caring about a more the left tends to be associated, of course, more with a kind of collectivist mentality. It's quite ironic that the party of collectivism enabled and enacted and advocated for policies that were extremely classist and individualist and that had no collectivism at all. You were, it was, of course, positioned as help everybody and you're part of the collective by staying home, but that but that was never real. You know, a very significant portion of the population never stayed home. They couldn't, they had to go to work. So um, it kind of flipped things on its head in that way, and the in the same way that in in medicine, as you both know, you don't do an intervention, whether that's like a procedure, a surgery, or a therapeutic medication. You don't do something without first having evidence that to believe that this is going to be successful, the old FDA policy that you have to show something is safe and effective before it gets approved. At least theoretically, that's what they that's what they aim for, right? But we did the opposite. In this instance, schools being open, that is the norm. And the not norm, the intervention is closing the schools. But they did not show that this was safe or effective to close schools. So all these things were were flipped. They were inverted. This sort of like policy of, you know, do no harm first was inverted. And the policies of the left for collective responsibility and collective kind of just just a communal sort of like adherence to what do you owe your society was flipped from what the left traditionally um views itself as being a proponent of. And and I even had, sorry, one more, I even had uh this really wonderful feminist uh scholar who I interviewed in the book, and she went into it too. And the reason I mention this is only because I tried to approach this apolitically. Politically. This is not me saying, like, I'm some like hardcore right wing guy and those damn lefties. There were very, very kind of ideologically leftist scholars and experts who I interviewed in my book who very clearly made the case about how a lot of these policies were actually the opposite in many regards of what the left ostensibly uh believes.

SPEAKER_02 1:06:23

David, do you think that uh the media had a large role to play in what happened? Why is it that you have an ecosystem where you clearly have political tribalism in the sense of public health leaders and the AAP that flip-flopped as soon as Trump said open the schools? But why is it that the vast majority of the media was at that time, and still to this day, are simply stenographers for hyperpartisan public health type people who basically are transmitting this constant propaganda, if you will.

SPEAKER_01 1:06:54

Like not just the media, Anish. Academia, right?

SPEAKER_00 1:06:58

Yeah, academia as well. Well, and I'm glad you mentioned that, Anthony, because well, what I've noticed about the media, to my surprise, is there are, of course, plenty of excellent investigative journalists and others. But it seems as though, and the evidence points this shows this, most journalists seem to be pretty lazy and disinterested in really investigating things, or at least they're disinterested in investigating things that may make their side look bad. I don't think so. And here's why, and this ties into the broader thing about talking where Anthony mentioned with medicine as well and with public health. And again, I'm going back to my earlier point. These institutions tend to be very uniform ideologically, that, and particularly medicine, when you think about it, you know, self-selects for a certain type of person. Not all physicians, not you guys, but not all, but by and large, and many of these traits are really important and really good things. I have a lot of medical people in my family. So it's like I have great respect and regard for people who go into medicine, but it does it selects for people who are oftentimes very bright, who work incredibly hard, and who are very motivated and dedicated to do good work and help people. Those are incredibly important traits and totally appropriate. But it also selects for people who are very good rule followers. And listening to hierarchy, you guys can tell me when you're a resident, you probably are not going to challenge your attending very often. Maybe you'll have a gentle pushback on something if you're uncertain. But wouldn't be alive if I did. Right. So the structure, it it selects for a certain type of person, not a hundred percent of them, but by and large, and many of the traits it selects for are selects for are really important. But some of but one of the downsides is that people who go into this tend to not be iconoclass. They tend not to be kind of independent, free critical thinkers. They're really good at thinking and working really hard within a particular structure and system. And so you have those people within medicine who are kind of like listening to, oh, well, Fauci says this. You know, I mean, the average physician, that that was the funny part is you have someone anytime I would get into kind of a debate with someone on Facebook or whatever else, that sort of like mic drop for them was always, yeah, well, I'm gonna listen to my pediatrician, not you. So I'm like, do you think your pediatrician has read even one study on any of this stuff? Do you think maybe they looked at the abstract? Maybe. Um, do you think they read the all the randomized control trials on masking before the pandemic? Are you high? Of course they didn't. So the idea that sort of regular physicians had the kind of impetus and critical thinking skills to actually look at the evidence, look at the data rather than just take the word for it from the sort of authorities that didn't happen. And then on the flip side with the media, how do you get to the New York Times and be a staff writer there? By and large, you get there by getting, you know, straight A's or close to it in high school, then you go to Brown or Yale, and then maybe you go to Columbia journalism school. There is a pipeline. Well, how do you do all these things? You do them not by being some kind of outrageous, interesting, creative thinker, but by knowing how to play the game, how to be an insider. Some of these people are very bright. It doesn't mean they're not smart, but they're bright in a certain way, oftentimes, within a certain frame. They are not good. The reason they became successful is because they know how to operate within the system as it is. That's how you get into Brown. That's how you get into Columbia, that's how you get into the New York Times, is that you check the boxes for the things that show competency. And again, I don't, there are plenty of people who are very bright and who do excellent work, but I'm talking about the broader system in place. So you have these twin institutions of medicine and public health on one side and the media on the other, and they all are selecting for certain personality types, and by and large, are all uniform ideologically. So years ago, media wasn't always this way. You had people, uh, you had kind of like journalists back in the day. There was a much more of kind of like a blue-collar kind of strain within newsrooms. You think back to like the 1960s and 70s with a lot of these reporters, Norman Mailer, people like that, these kind of tough guys, you know, and just the sort of like curmudgeonal journalists like pounding the pavement. That kind of guy is really an anomaly these days in a modern sort of prestige newsroom. So I think the ideological kind of uniformity is really one of the most damaging components of this within public health and within the media. And one of the solutions, and of course, I'm not in charge of newsrooms, so I can't implement this, but we would have a very, very different information environment if there was a real concerted effort when we talk about DEI, not for diversity of skin color, but rather diversity of intellectual and political viewpoints. And even someone who's gone to community college in West Virginia, but is really bright. Imagine them writing pieces for the front page from the New York Times regularly and having a quarter of the staff, people of that background or similar, we would have a very, very different news environment than when almost everyone there is from a similar kind of academic background.

SPEAKER_02 1:12:38

David Barbie Weiss could not survive at the New York Times.

SPEAKER_00 1:12:41

Right, exactly. So the idea that like she's the most, you know, elite credential. I did she go, I think she went to Columbia. Right. And she's all the elite credentials, exactly.

SPEAKER_02 1:12:50

And she is, you know And she was out of step with one very important thing. And and you know, that that whole that whole thing is.

SPEAKER_00 1:12:56

There is an extreme kind of like mean girls environment at a lot of these places, the kind of just you know, petty kind of exclusionary social construct in a lot of these environments. So my solution to this, which again, I have no power to implement, would be for newsrooms to diversify politically, sociopolitically. Here's a funny thing. If you go on to, and this I wrote about this with Wikipedia, when they write the different Wikipedia entries on a number of the New York Times opinion page columnist, Michelle Goldberg and whoever else these other people, it just says, like, Michelle Goldberg, columnist at the New York Times, blah, blah, blah. Then you get to Brett Stevens and it says, conservative columnist at New York Times. So if you have to add this qualifier, if someone's not like a liberal, then there's no qualifier. You don't need to explain who they are, then they're just a columnist. But if you're not that, then it's conservative columnists. Like that should tell you everything. The fact that you need to add this like special category. By the way, same thing with book publishing. There are these like three or four very large publishing companies, Penguin Random House and a few others. And then within each of these large publishing companies, they have a zillion different imprints. It's like a little mini label, mini publishing house within the large publishing house. There are like two or three or four conservative imprints that can publish your book. So if you write a book that somehow challenges kind of like accepted dogma, you almost always have to go to one of the quote conservative imprints or just an independent conservative publisher. Unless you're super famous, if you're someone with a huge following, then sure, they'll take you on at like random house proper at the flagship. But otherwise, you have to go to the special imprint. I mean, like none of this is good for our society. None of this is good for the intellectual environment. So that's the area where I think great, great benefits could come. If someone had the courage or the desire to kind of start to change.

SPEAKER_02 1:15:00

I think you and Anthony have this almost wistful idea. You maintain this idea, both of you, that the institutions have power, have some and they can do great things. And so you both, I think, have this insistence that, hey, we must try to reform captured institutions so we can make them do good. In some sense, I'm talking, you know, Anthony, you know, talks about the AMA in this way. And I don't know, for me, I see this whole thing play out. And just like you talked about how technology technological solutionism kind of allows this to happen, it's like so obvious that like now that our entire society was like organized in a way that allowed these bad things to happen. And so then the question is, well, how why is that? So for instance, take the nursing homes, right? There's no argument that the nursing homes had massive bad morbidity mortality, right? But that all exists because we've created a society where we take our old people and we put them in a bunch of dorms right next to each other where like we have a weird, screwed up way of taking care of our elderly now, right? And it's Medicaid funded, so it's off of our plate. So the state does it. And okay, the state does that, it's not gonna do it very well. It's gonna set up this whole dorm-like nursing home concept, which then takes out 20% of them when you have some uh some pandemic come in, right? Our public schools, right? We have this large amount of money via property taxes, federal funds that are going to these public schools. And now suddenly the control of our children's education and how they get educated, right? Whether it be with the latest great technology or whether it be with whatever visitor is coming in that is some political thing, right? It's like it's we have gone, we have strayed so far from where we started. We and we take a lot of these things to be granted. Like I think we have to start examining the fundamental underpinnings of many of these things. For instance, should we have this vast expansive public school system that essentially is a de facto default that you can't really escape from unless you send your kid to like a $4,000 year private school, right? Like, you know, $4,000 or whatever. Yeah, that was a good one.

SPEAKER_01 1:17:03

We're not in the New York area. Boy. Or San Francisco, man. $4,000 a week.

SPEAKER_02 1:17:07

Yeah, and then and then it it takes you to like, you know, the it goes back all the way, you know, where we're gonna and we're gonna wrap up here. And in talk in terms of talking where this all started, in terms of Tyler Black and this, you know, oh, this big-brained libertarian, you know, making fun of uh the these these principles of decentralizing and and and and returning power to local communities and individuals. Oh, and by the way, perhaps we shouldn't be so much we shouldn't scoff at folks that are not utilitarians, right? Everything we're talking about so far has been this idea that, like, okay, look, pandemic was bad enough and it makes sense to lock everyone down and do these things, right? It's like, okay, then what is the point of like having individual rights to like do you have the right to breathe anymore? I mean, if public health can shut you down at any time, then so meaning it the point is, and again, we've come a long way from this from Supreme Court decisions on smallpox and the the idea that you can compel vaccination because if it's in the society's best interest, right? I really think we this this whole this whole the pandemic and everything you talk about in your book should really make people think about how it is we've come to where we are and whether or not we need to move back to that individual rights type society, which which says, no, I'm sorry. I don't care that you're the state. You do not have the ability to prevent me from congregating with my friends and sorry, or congregating in prayer with my religious community. No, you do not have the right to prevent me and a group of 20 adults from setting up a school and and doing to whether there's a pandemic, whether it's smallpox, whether the IFR is 4% or 6% or 8%, I don't care. It's my local decision to pick, right? And and I'll make it. So I I wonder maybe that'll be the subject of another another hour or something of things.

SPEAKER_01 1:18:45

So David and I are the idealists for wanting to reform individual institutions, but you're not the idealist for wanting to reform the entire United States. I just want to start from start, I want to get back to basics. Yeah.

SPEAKER_00 1:18:56

Well, you make a good point about, you know, uh and it it it is a good point. I sort of spend a lot of time talking about how to reform these institutions, but here we are on, you know, Substack and Riverside Podcast platform that technology also is enabling to some extent a decentralized ability that there are someone like Matt Taibi or whomever, like who can just do his own thing and is not beholden to a particular publisher to them. There's so the challenge is when you have such a kind of like fragmented environment, it is hard for people to figure out who do I trust, where do I get my information? So I it doesn't mean that they shouldn't get it from these diverse sources, but it it create, you know, inevitably people have jobs, they have they're busy with, you know, doing what they're doing. They they want kind of like one place they can go to where it's like, yeah, I basically trust everything in there. But unfortunately, you can't. And it kind of this gets into deep philosophical questions about like, what does it mean to be a good citizen?

SPEAKER_03 1:19:57

Yeah.

SPEAKER_00 1:19:58

What does it mean to be informed? And look, as busy lives as most people have, people also choose to spend a hell of a lot of time watching sports and doing all sorts of stupid shit that like maybe they should spend a little bit of time trying to become a little bit more informed about certain issues. Again, just to be a good citizen. And the reason they don't get informed, I think, by and large, is to some extent a marker of a successful society that like you can be materially. I think about this and talk about this to people all the time because it's fascinating to me. I know plenty of people who are very well off materially. They've become successful in any number of fields, they lead very comfortable lives, and they are like totally ignorant about like most things going on in society. And I think someone could argue, well, that's a sign of a very successful society that like you don't have to be engaged. You can like just do your thing and become successful and you don't have to care. Right. But the flip side of that is you wind up with something like the pandemic, where it really harms a lot of people. And if you are one of those people who's kind of like default liberal who's reasonably well off, or even better than reasonably well off, and you're kind of not super knowledgeable or engaged politically, but you just have the default kind of like, yeah, I'm gonna vote for mom Donnie or whatever, because he's like a good guy. Yeah, there's and I'm friends with people who think this way in New York City, I mean, even though you're laughing, there are plenty of people who are like, What? What's wrong with that? Because they're just, they're not on X. They don't give a shit. They're like working at their job, they're making money, hanging out with their kids. They just don't care. And they're kind of like, they just hear stuff in the ether. And ultimately, but the danger of that, of course, is that then you wind up with real harm happening, and you wind up with some lunatic tyrant, you know, like the the health commissioner out in, you know, Santa Clara County, California, where I wrote this big article on on how she uh on how they prevented, you know, people from congregating at church. I mean, then they ultimately had uh people spying on the church with binoculars behind like a chain-link fence, and then they set up electronic monitoring of cell phone uh metadata and like monitoring where people were moving, like crazy, crazy stuff. Well, how does that happen? It happens when you have materially comfortable people or bread and circus, maybe people who aren't even that materially comfortable, who are just totally disengaged politically and instead are watching Love Island or sports or whatever else in their spare time, and and then you wind up with with tyrants.

SPEAKER_02 1:22:32

No, uh I think it's a it's an excellent again, you like bring up excellent points, and again, we have to have it back because we're we're running late.

SPEAKER_00 1:22:39

But you know, you know the I'm just gonna become a third member of the doctor's doctor's lounge and the janitor who stopped by to chat.

SPEAKER_02 1:22:46

Right, because you know, I look at uh Anthony Anthony's pushback is completely right. This I like what what are we gonna do? This is it's all idealism in one form uh or the other, of course, but but it's so hard. You want, of course, some type of institutions that you trust that can give you that can give stuff because you can only take John Locke's go search, go hunt for the evidence yourself. It's like, okay, I can hunt for the evidence myself, and I think the earth is flat now. Like, what it's like, wait, like anyway, so it's tough. But really, I find your book details so well how it is everything went so wrong, and all of it was in the name of science and virtue. And I I I really hope it's read by the right people who have some some level of introspection.

SPEAKER_00 1:23:25

I'll tell you, I know at least a few people who I was quite surprised. Um, there was a person on NPR who interviewed me, and I thought it might be a slightly adversarial interview. And instead, she was incredibly supportive and deferential and off the air, talked with me about how much she enjoyed the book and and the sort of internal pushback she received at NPR. She wanted to run a piece, I think it was on the Great Barrington Declaration, not a pro, you know, Great Barrington, but just like a piece at all, discussing it, like, whoa, this interesting thing happened. And the higher ups were like, no, we're not doing that. No. And she's like, well, wait a minute. I'm not advocating for it. I just think this is newsworthy. They're like, yeah, we're not doing that.

SPEAKER_02 1:24:07

Yeah. I think you have, I think the way you presented it in the book was was excellent in the sense that you didn't come at it as a partisan. I don't know. Like I said, highly referenced, highly cited. You clearly have a view, you clearly have a place you're coming from and you're looking for answers, so you can make but all that and Anthony, I find, does this, does a great job of doing this as well in terms of giving reasoned explanations, other than just rather than just being like, well, everyone that doesn't think my B is an idiot. So fantastic book. Well, thank you.

SPEAKER_00 1:24:33

David, thank you for I would say to anyone listening who hasn't read the book or who's hasn't already turned off the podcast, is that ultimately, I and and you could tell me if you disagree, but any good book, I think, is about more than the book, than the topic. And to me, the book, the pandemic is really just the backdrop for for it's a case study for something larger. And the questions are, how does our society operate? And that's really what the book is about. The pandemic is simply the kind of scaffolding for exploring deeper questions about how do the gears of a society turn? And how do the gears within our own minds turn, this in internal psychology of individual citizens turn in relation to the media, in relation to trusted experts. So that to me is what I hope people will get out of the book, and what I hope will continue with the book to come in the future is that people will use it not just as an important document of what happened, not a just a historical analysis, but you can very easily look at that analysis and then project it onto any multitude of present circumstances to try to get like a viewpoint into how society functions and how we as individuals function.

SPEAKER_02 1:25:54

Sir that's a great point. Very well said. We will end on that note. Thank you so much uh for coming on again. And we are 100% have to have you back on a on the book.

SPEAKER_01 1:26:01

We would love to. Love to the book. The name of the book, An Abundance of Caution American Schools, the virus, and the story of bad decisions. Gotta make sure and plug the title, right? Yes.

SPEAKER_00 1:26:11

Yeah, I'm very bad at doing that, so I'm glad you did.

SPEAKER_01 1:26:13

All right. Excellent.

SPEAKER_02 1:26:14

All right, thanks.