On Politics, Policy, and Public Health

Macedo and Lee are right about the failure of the political system, but as I show in a research paper posted on SSRN, their review of the science is seriously flawed.

The authors use a simple statistical analysis to argue that “lockdowns” did not work. The global literature, however, shows that control policies were effective in reducing transmission. In the U.S., 300,000 deaths could have been averted before vaccines became widely available. This suggests that choices by policymakers and the public — generally short of lockdowns — did save lives.

Macedo and Lee’s concern about viewpoint diversity relates to the Great Barrington Declaration, which emphasized the harms of lockdowns and called for protecting the most vulnerable but offered no concrete plans for implementing these ideas. The response from public health scientists, however, explicitly recognized the social and economic costs and critiqued the declaration on scientific and practical grounds.

They have a more compelling case regarding schools, which were slower to reopen in some cities. They attribute this to liberal Democrats, but the scientific and general literature published in the summer of 2020 is remarkably well balanced, with the likely harms and limited public health benefits both clearly identified. Policymakers were balancing benefits and harms, as they understood them.

Macedo and Lee are right to call for a policy process that respects evidence, recognizes uncertainty, and acknowledges legitimate differences in values and preferences. There will always be uncertainty about the epidemiological facts, but public health agencies should be more proactive in generating the information needed to inform policy choices.