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>and thinks they know better than individuals about risk tolerance and decisions Do you think the average American knows more about these issues than the CDC?

>and thinks they know better than individuals about risk tolerance and decisions Do you think the average American knows more about these issues than the CDC? If so, how did they go about getting their knowledge?

tdfx 4y ago
You are absolutely correct from a theoretical standpoint. Completely neutral, independent medical experts should, on average, make better health decisions than an uninformed populace. The problem is when we transfer those assumptions to the real world, all of the most important adjectives in that prior sentence start to fall apart. The managers in the CDC are not neutral or independent. They are by and large bureaucrats who have professional reputations, career trajectory, office politics, and other competing incentives that compete and often conflict with their stated goal of making the "best health decisions" for everyone. This has resulted in the absurd patchwork of logically inconsistent mask and vaccine rules that we've all be subjected to for the past 2 years. For me, this has firmly demonstrated that the structure of these institutions and their methods of public communication have lost the public trust and we cannot give them broad, sweeping powers.
- germinalphrase 4y ago
  Or, perhaps, the CDC should be more independent of political leadership?
  - tdfx 4y ago
    I don't think the most perverse behavior we've seen in the CDC has a been a result of political pressure from the executive branch. They seemed to be fairly effective at maneuvering around the Trump administration's attempts to influence their policy. Like most people, at the beginning of the pandemic, I was on the "better safe than sorry" side of things and was generally supportive of their recommendations. Some of the rules have never made much sense, particularly in regards to masking in restaurants and who was going to have to enforce those rules, but also the insistence on vaccine mandates that filtered down in very logically inconsistent ways to the local level. In an effort to prevent anti-vax conspiracy theorists from having a thread to pull on, they maintained public messaging that was borderline deceitful about the efficacy of the vaccine in preventing reinfection and encouraged ridiculous local regulations like showing vaccine cards to enter establishments. This mirrored the deceitful nature of the "only medical staff need masks" messaging at the beginning of the pandemic to prevent a mask supply shortage. The turning point for me was Omnicron, as it was very quickly apparent this was a distinct, new disease that had a different risk profile than previous variants. But for what appears to be face-saving measures, no guidance was updated and it took months for them to concede that there were other metrics more important than case counts. The insistence of continually extending the federal travel mask mandate is a case in point: I don't know of anyone who believes that the loose paper and cloth masks worn by most of the general public (sometimes covering nose and mouth, more often not) are actually producing a substantial effect in reducing transmission in indoor spaces, and AFAIK it's well understood that anyone at high risk of serious infection is well protected with a properly fitted N95 mask, especially in a well ventilated space like an airplane. At no point has there been a focus on educating people on the efficacy of different types of masks, just a continual hammering of the "mask up" narrative, treating people as too stupid to understand the difference. For what appears to be ass-covering behavior on their part, they have focused on maintaining a consistency of messaging that ignores new data and and discredits any opposing points of view, even from other qualified members of the medical community. They are more focused on projecting authority and consistency than honestly handling nuance and it's become pretty obvious that is not the key to building trusted institutions. I'm not saying disband the CDC, tear down the building, and exile Fauci. I'm simply saying that we need to recognize that the approach that was taken here did not work correctly and has resulted in less institutional trust than we started with and that we need to learn from our mistakes.
    - germinalphrase 4y ago
      I don’t disagree with much here. I’ll just offer that Michael Lewis’ recent reporting does seem to implicate a culture of political awareness that negatively impacts the organization’s ability to engage in effective leadership.
- Retric 4y ago
  If your concern is a patchwork of local rules, that isn’t on the CDC they set consistent national rules. If your concern is changing rules over time that seems more optimal than maintaining the most draconian rules both from a freedom standpoint and a public health one. Essentially you want enough exposure to push herd immunity or lockdown never ends, but not excessive exposure or the health system collapses. If you track the number of people in hospitals over time especially in terms of local hotspots it explains the CDC’s behavior quite well. https://coronavirus.jhu.edu/data/hospitalization-7-day-trend https://coronavirus.jhu.edu/data/hospitalization-7-day-trend
- wrycoder 4y ago
  You forgot major ties with big Pharma. Beyond the point of corruption.
IG_Semmelweiss 4y ago
Trial and error. The velocity of information exchange that happens on the ground from trial and error - compounded by network effects - is far higher than the exchange that is happening in substantially smaller (CDC) groups at the top with slower speed. They don't iterate as fast and have a bias to move slow. More importantly. Average knowledge is not important. What matters is that exchange happens so that the optimal decision is arrived at and communicated much faster by a large group , even if each individual knows very little information themselves. This is the same principle that rules over new tech adoption. You don't need to know how to replicate the new tech, or even how to operate it. You just need to know it works . That's what real (applied?) knowledge is about, at least in the context above.

tdfx 4y ago

You are absolutely correct from a theoretical standpoint. Completely neutral, independent medical experts should, on average, make better health decisions than an uninformed populace. The problem is when we transfer those assumptions to the real world, all of the most important adjectives in that prior sentence start to fall apart. The managers in the CDC are not neutral or independent. They are by and large bureaucrats who have professional reputations, career trajectory, office politics, and other competing incentives that compete and often conflict with their stated goal of making the "best health decisions" for everyone. This has resulted in the absurd patchwork of logically inconsistent mask and vaccine rules that we've all be subjected to for the past 2 years. For me, this has firmly demonstrated that the structure of these institutions and their methods of public communication have lost the public trust and we cannot give them broad, sweeping powers.

germinalphrase 4y ago
Or, perhaps, the CDC should be more independent of political leadership?
- tdfx 4y ago
  I don't think the most perverse behavior we've seen in the CDC has a been a result of political pressure from the executive branch. They seemed to be fairly effective at maneuvering around the Trump administration's attempts to influence their policy. Like most people, at the beginning of the pandemic, I was on the "better safe than sorry" side of things and was generally supportive of their recommendations. Some of the rules have never made much sense, particularly in regards to masking in restaurants and who was going to have to enforce those rules, but also the insistence on vaccine mandates that filtered down in very logically inconsistent ways to the local level. In an effort to prevent anti-vax conspiracy theorists from having a thread to pull on, they maintained public messaging that was borderline deceitful about the efficacy of the vaccine in preventing reinfection and encouraged ridiculous local regulations like showing vaccine cards to enter establishments. This mirrored the deceitful nature of the "only medical staff need masks" messaging at the beginning of the pandemic to prevent a mask supply shortage. The turning point for me was Omnicron, as it was very quickly apparent this was a distinct, new disease that had a different risk profile than previous variants. But for what appears to be face-saving measures, no guidance was updated and it took months for them to concede that there were other metrics more important than case counts. The insistence of continually extending the federal travel mask mandate is a case in point: I don't know of anyone who believes that the loose paper and cloth masks worn by most of the general public (sometimes covering nose and mouth, more often not) are actually producing a substantial effect in reducing transmission in indoor spaces, and AFAIK it's well understood that anyone at high risk of serious infection is well protected with a properly fitted N95 mask, especially in a well ventilated space like an airplane. At no point has there been a focus on educating people on the efficacy of different types of masks, just a continual hammering of the "mask up" narrative, treating people as too stupid to understand the difference. For what appears to be ass-covering behavior on their part, they have focused on maintaining a consistency of messaging that ignores new data and and discredits any opposing points of view, even from other qualified members of the medical community. They are more focused on projecting authority and consistency than honestly handling nuance and it's become pretty obvious that is not the key to building trusted institutions. I'm not saying disband the CDC, tear down the building, and exile Fauci. I'm simply saying that we need to recognize that the approach that was taken here did not work correctly and has resulted in less institutional trust than we started with and that we need to learn from our mistakes.
  - germinalphrase 4y ago
    I don’t disagree with much here. I’ll just offer that Michael Lewis’ recent reporting does seem to implicate a culture of political awareness that negatively impacts the organization’s ability to engage in effective leadership.
Retric 4y ago
If your concern is a patchwork of local rules, that isn’t on the CDC they set consistent national rules. If your concern is changing rules over time that seems more optimal than maintaining the most draconian rules both from a freedom standpoint and a public health one. Essentially you want enough exposure to push herd immunity or lockdown never ends, but not excessive exposure or the health system collapses. If you track the number of people in hospitals over time especially in terms of local hotspots it explains the CDC’s behavior quite well. https://coronavirus.jhu.edu/data/hospitalization-7-day-trend https://coronavirus.jhu.edu/data/hospitalization-7-day-trend
wrycoder 4y ago
You forgot major ties with big Pharma. Beyond the point of corruption.

IG_Semmelweiss 4y ago

Trial and error. The velocity of information exchange that happens on the ground from trial and error - compounded by network effects - is far higher than the exchange that is happening in substantially smaller (CDC) groups at the top with slower speed. They don't iterate as fast and have a bias to move slow. More importantly. Average knowledge is not important. What matters is that exchange happens so that the optimal decision is arrived at and communicated much faster by a large group , even if each individual knows very little information themselves. This is the same principle that rules over new tech adoption. You don't need to know how to replicate the new tech, or even how to operate it. You just need to know it works . That's what real (applied?) knowledge is about, at least in the context above.