I happened to attend an excellent webinar the other day organized by The New York Academy of Sciences, “COVID-19: The Road Ahead,” featuring presentations by Peter Daszak (EcoHealth Alliance), Michael Osterholm (CIDRAP, University of Minesota), and Nahid Badelia (Boston University Medical School). The preceding boldface link takes you to a summary of the webinar, and to a link of a video of the webinar itself (near the bottom of the page). The three presentations are together about an hour long, with 15 minutes or so given to Q&A.
Daszak, a zoologist, discusses the zoonotic origins of COVID-19. Osterholm, an epidemiologist, discusses public health measures going forward. And Badelia, a frontline clinician, discusses clinical issues going forward. All excellent and informative presentations, but Osterholm’s was exceptional, both for its informativeness and its realism.
Osterholm’s comments on testing, whether PCR or serologic, ought to become a more prominent part of public discussion of these issues (not that he entirely lacks prominence). There are far too many commentators out there striking convenient poses on the imperative to “test, test, test” (or worse still, “Where are those tests, dammit? I wished them into existence a long time ago!”), but as Osterholm puts it (in a slightly different but related context), such wishes are “on a collision course with destiny.” You don’t need to hear me explain this; just listen to him. (I have yet to read Osterholm’s book or academic work, but this Op-Ed in The New York Times is excellent.)
One useful lesson here is that people should stop making free-floating demands to be effected by other people dealing with COVID-19 until and unless (at a minimum) they evince some real-world understanding of the logistics of the demands they’re making. They should, even more so, stop engaging in retrospective quarterbacking by demanding the impossible ex post facto, then grandstanding about their capacity to do so as though they had offered the advice ex ante.
It’s one thing to pretend to omniscience and omnipotence after the fact, and another thing to have either thing when it actually matters to some expected outcome in the future. A commentator who waits a month, then from the safety of retrospection, tells his readers that “we” should have done widespread serological testing a long time ago, goddammit–without explaining why that would have been the optimal use of scarce resources, without acknowledging the gaps in our knowledge of immunity or infection rates now, without explaining where this testing capacity would come from, without even acknowledging the basic fact that the disease materialized a few months ago–has no idea what he’s talking about, and should bluntly be described that way. He’s issuing rhetorically convenient demands to reality that reality has no interest in accommodating.*
I don’t mean to slight the other two presentations. Daszak’s presentation, the more purely scientific of the three, raises some important questions about potential conflicts between development economics and public health. And Badelia’s presentation usefully underscores the importance of sheer spatio-temporal detail in clinical matters. Clinical success depends on intelligent decision-making focused on otherwise tedious minutiae: exactly where things are located in space and time, along with exactly how and when you act in relation to them. (I’m reminded here of the ancient Greek conception ho kairos in this connection, a concept with fertile, and I suspect unexplored, implications for applied ethics. I haven’t read any of Badelia’s academic work, but I have an ILL out on this paper.)
By coincidence, the day after the NYAS webinar, I ran a modest webinar of my own, featuring my brother Suleman Khawaja, discussing COVID-19 with my critical thinking class at Felician (Phil 100), along with a few invited guests (George Abaunza, Alison Bowles, Shikha Dalmia, Ray Raad, and Michael Young). I stupidly forgot to record the webinar, so unfortunately, I don’t have video of it (and am not sure I could have shown it anyway, given FERPA privacy regulations, along with the requirements of two-party consent states where my students might be residing). That said, we had an excellent discussion both in the webinar and afterwards. I’m hoping to summarize some of it and continue the conversation here.
*Consider the conveniently hand-waving quality of this “methodological” advice:
Only now are we starting to see serological testing, and, as expected, early results show that the disease is far less dangerous than originally reported. We don’t yet know how much less dangerous, though, because early serological tests are mostly in isolated, non-representative towns. Why didn’t we do this sooner? Why did we cause so much pain and suffering? Why did we choose to stumble in the dark when we had access to candles and torches?
So why didn’t Jason Brennan suggest that we do serological testing of the entire population earlier? What serological tests would he have run, exactly? What are the performance characteristics of the tests he has in mind? What would these tests have told us, anyway–“as expected”? His claim that “only now are we starting to see serological testing” suggests that we should have started it earlier. Great. When? How? With what expected outcome?
“Early results show that the disease is far less dangerous than originally reported.” How can early results be taken as conclusive? I thought Brennan’s point was that we should wait for all of the relevant data to come in before rendering judgment. “Far less dangerous than originally reported” by whom? What metric of “danger” does Brennan have in mind? Without answers to these obvious questions, he might as well be saying nothing.
A methodological suggestion: a person who postures as an expert on methodology so acidly critical of the methodological practices of others should produce methodological commentary that answers more questions than it provokes. Rhetorical questions are not, in and of themselves, a truth-tracking methodology, in epidemiology or anywhere else.
“Why didn’t we do this sooner?” Why didn’t who do what sooner? If Brennan actually had an answer to that question–to both the who and the what–he’d be a much richer man than he currently brags about being. Think of the money to be made, Brennan: if you’d thought of universal serological testing just a few months ago, you’d have made millions or even billions on it, given the demand for it (whether warranted or not) right now.
But we needn’t insist that Brennan himself enact his own retrospective advice. It’s not like I’d trust a lab test designed by Jason Brennan. So where were all of those Kirznerian entrepreneurs who saw an opening here, and rushed to fill the expected gaps in supply and demand? They didn’t need to force anyone to take serological tests. They could have invited test subjects to consent to be tested, then agreed to pay them for their participation. If libertarian economists like Jeffrey Tucker and Peter Earle are to be believed, people can widely be trusted to make all the right decisions for themselves without government intervention of any kind. So we can predict that people would have jumped at the opportunity, way back in the fall of 2019 or even before that, to get serological testing for antibodies for COVID-19. Why didn’t they?