American Thought Leaders - Will the World Lock Down Again in the Next Pandemic? Dr. Kevin Bardosh

Episode Date: November 1, 2024

“The COVID response caused much more harm than good. That’s my position on that, and I came to it by analyzing and reviewing huge amounts of academic research on all sorts of issues: excess mortality, effects on medical services, mental health, effects on the economy, poverty, food insecurity, education.”In this episode, I sit down with Dr. Kevin Bardosh. He is a medical anthropologist and the director of Collateral Global, a London-based think tank focused on improving pandemic response around the world.“Public health has always had this tension between the authoritarian position, and then the more classical liberal, civil society philosophy,” he says.Four years on, what have we learned about our collective response to the COVID crisis? If another pandemic happened tomorrow, how would our societies react?“There still is this very strong industry—a pandemic industry—that thinks that they did a great job, and that people that are criticizing them are spreading misinformation,” Bardosh says. “And I think that that really needs to change.”We discuss the global fallout from the COVID lockdowns, from rising obesity to rising poverty.“All educational gains since 2000 around the world were wiped out with the school closures,” Bardosh says.Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

The COVID response caused much more harm than good. Excess mortality, effects on medical services, mental health, effects on the economy, poverty, food insecurity, education. In this episode, I sit down with Dr. Kevin Bardosh. He's a medical anthropologist and the director of Collateral Global, a London-based think tank focused on improving pandemic response around the world. Public health has always had this tension between authoritarian positions and the more classical liberal civil society philosophy. Four years on, what have we learned about our collective response to the COVID crisis? If another pandemic happened tomorrow,

how would our societies react? There still is this very strong pandemic industry that thinks that they did a great job and that people that are criticizing them are sort of spreading misinformation. And I think that that really needs to change. This is American Thought Leaders, and I'm Jan Jekielek. Kevin Bardosch, such a pleasure to have you on American Thought Leaders. Pleasure to be here. So you were recently on a panel at the Stanford Health Policy Conference. The panel was Pandemic Policy from a Global Perspective. And it's incredibly fitting that you would be on a panel with such a

name because of your work. So what have we learned about pandemic policy from a global perspective? I think we've learned a lot of different things, but one of them is the policy domino effect. And so what we saw with covid which was really an unprecedented event in so many different ways it was a crisis that we all experienced intimately in our lives interestingly the first really truly digital global crisis you kind of had the spread of a virus but you also had spread of information through our modern technological systems and that created all sorts of cascade effects in terms of fear, but also this sort of meta-narrative, a unifying story on how we had to contain COVID. And so you had lockdowns in over 150 countries around the world, which had never been tried

before. It was a policy experiment. These policies that we implemented were not advised previous to COVID. And we can get into that. But I think what we saw is China, Italy, the UK, and the US locking down and being guided by specific scientific assumptions and elites, and then poor countries following that advice, and I think what we now know beyond doubt really, is that those countries suffered disproportionately from the economic and social impacts of lockdowns and other policies. And they didn't really gain very much in terms of reduced mortality and health benefits. This is interesting. Hindsight is 20-20. How do you even measure these sorts of things, I guess, is the first question that someone might ask. Actually, before COVID, we had a sense of how we should respond to a pandemic influenza, right? Quite equivalent to

COVID in many regards. And if you go and look at the WHO's 2019 pandemic influenza plan, it lists all of the NPIs, non-pharmaceutical interventions that we used around the world. And they basically say the evidence is weak, don't use them. School closures, lockdowns, test and trace, border closures, the whole gamut of things that we sort of threw the kitchen sink at this virus, thinking that it would have an impact, it would change the trajectory of things. And I just, we should have pursued that classic wisdom that was constructed in a moment of calmness. And what was behind that was a particular ideology, we could say, that during a public health crisis, the propensity to overreact

is built into the fight and flight response of human society. We have all these military metaphors that we use for outbreaks. There's this sort of group and herd mentality that takes place. There's a very clear, like, the invader is coming. We need to get into the trenches, right? We need to sacrifice things as well because it's a battle. Previous to COVID, there was this really deep fear and knowledge that the overreaction would be very severe.

And so we just sort of threw that out as the pandemic took hold for lots of different complicated reasons. Basically, we wouldn't have had lockdown if it was 20 years before because we wouldn't have had the digital infrastructure to work from home. The best data that we have on this is from the International Labor Organization, a UN body, and they estimated that 17% of the world actually could stay home at the height of global lockdown in April 2020. So we think, okay, yeah, lockdown was this sort of successful thing,

but actually only about, it's about 500 million people around the world could actually stay home. So we pursued this unprecedented infection control policy that was unrealistic given the nature of society. Recognizing the impact of that is, I mean, it's the work that I do. The lockdown in Wuhan, in China, they viewed the lockdown as a success because they replicated it later in other places. How is it that people decided that that's an advisable approach? It's a great question. I mean, we have this very, very clear pivot early on during the pandemic. You can read The Guardian. They're criticizing the Chinese lockdown. This is a human rights disaster. And then a week later, they're saying, we need to lock down the UK.

And in fact, there was an interview by Freddie Sayers at Unheard with Neil Ferguson, and it's this great quote where he said, you know, we didn't think we would ever be able to do this in a democracy. And then China did it, and we all thought, oh, let's do it. And in fact, there's an interesting story around or different ideas around why Italy locked down, that it had to do with the political parties and the tensions between the North and the South. And so there's

different sort of ideas there. But one thing that's important to realize, so there's the digital part, right, in terms of how lockdown came to be the genesis. There's also the reaction in China to bird flu in the 1990s and then SARS in the early 2000s. A containment strategy, right? With poultry, I mean, with bird flu, they culled millions and millions of birds. Very draconian, militaristic response. And that was at a time when the Chinese CDC was coming of age. And so the bird flu response in the 1990s really influenced the culture of the Chinese public health establishment. And then in the US, after 9-11, you have this biosecurity model that comes out of the Bush administration, including mass surveillance

and sort of the centralization of power in the NIH under Anthony Fauci, right? And a very particular vision of how you're going to deal with these biological threats that are seen as existential threats to the nation. And so those are very centralistic tendencies. And public health has always had this tension between the center, authoritarian centrist positions, and then the more liberal, classical liberal, civil society philosophy. So lockdown obviously is one side of that tradition or history.

The problem is that public health has taken on, and this comes from tradition in medicine, a very paternalistic stance in terms of its relationship to society, right? It thinks it knows best. And that's the nature of mandates, right? We don't trust the population to be able to understand risk. And so we're going to tell them what they have to do, basically acting like a police force. And the problem with that is that public health, like it's an asymmetry of information. They don't understand your life or my life. And one of the most absurd or telling arguments against this is how many public health officials broke their own rules, right? So in the UK, where I'm based, Boris Johnson was forced out of government because of party gate. And I mean, it goes on and on, including Neil Ferguson, the mathematical

modeler who's sort of visiting his mistress. So, you know, if you're making these rules, and there were so many different rules, they're constantly changing and absurd rules, right? I think that's quite a telling aspect of this whole thing. So something that's been a key feature of your work at Collateral Global has been looking at basically the cost-benefit of these interventions. Because that's really how I've learned we have to look at any intervention, frankly. Because you obviously want the benefit. There's always a cost. Some scale could be tiny, but the benefit has to be greater. So explain to me how you see that today with the data available. Yeah, I think that the COVID response caused much more harm than good.

That's my position on that. And I came through it by analyzing and reviewing huge amounts of academic research on all sorts of issues. So excess mortality, effects on medical services, mental health, effects on the economy, poverty, food insecurity, education. I mean, so just to pick a couple of stats, and these are mostly like UN data, right? So from the World Bank's report in 2022, 400 million people around the world fell into poverty. When you compare 2019 to 2022, 350 million fell into food insecurity. In terms of educational impacts, all educational gains since 2000 around the world were wiped out with the school closures. Just explain that to me. How does that work exactly?

So there's different ways of measuring school educational losses. And all of these issues, all of these stats have a history. There's methodological issues, there's a huge debate in each field, arguing back and forth. But these are from their UNICEF data, where they have a certain benchmark on how they measure what they call learning poverty. And so the UNICEF report that came out, I think about two years ago now, estimated that the school closures contributed to a 14% reduction in learning outcomes.

And that was equivalent to one in eight students in low- and middle-income countries falling below that benchmark. And schools were closed for very long periods of time in certain countries, up to 200 days. And it didn't quite make sense. So, for example, I've worked in Uganda for about two years of my life, a long time ago.

They closed schools for two years. They had immunization requirements in, you know, very poor arid regions in the north of the country. And then you compare it to Tanzania next door, where they didn't have those requirements. And the outcomes, I mean, are better in Tanzania because you didn't have those collateral harms. So we have these outliers. There's Sweden, there's Nicaragua, there's Tanzania because you didn't have those collateral harms. So we have these outliers. There's Sweden, there's Nicaragua, there's Tanzania. There's these different countries that didn't pursue the Maximist policies. And overall, their outcomes are better

because they didn't have these collateral effects on their populations. I remember in the data set that Dr. Enides showed in terms of excess mortality, one thing I noticed that New Zealand, which had really draconian, if I recall, NPIs or lockdown policies, fared as one of the best, in fact. That's interesting, given what you just said. Yes. New Zealand is a very wealthy country. It's an island. It's isolated, right? And it has the infrastructure maybe to pursue a more, I mean, it pursued zero COVID essentially, which was like theoretically a fantasy. But anyhow, they pursued that for a period of time. I think there were a lot of harms in New Zealand. And also the world is not New Zealand. Theoretically, lockdowns can work. Like

if we all just stay home, a respiratory virus isn't going to spread around. The question more is, can human beings, can 8 billion people in over nearly 200 countries actually do that? The answer is no. Well, because, you know, the argument was something like this, right? Or at least in my mind, right? The argument would be something like this. The initial variants of the virus are quite lethal. And over time, they get less lethal, but maybe even perhaps more infectious.

But perhaps more infectious. And so if you can kind of ride out those lethal strains at the beginning, and eventually maybe you get hit, which is indeed I think what happened in New Zealand. You get hit by a strain that isn't so bad, right? And then the problems aren't as big. But the other thing is, something you mentioned earlier, is that 17% of people were assessed as being able to shelter in place at all, right, in terms of their life. But I suspect that those are very disproportionately in countries like New Zealand, highly developed countries.

Yeah. I mean, I'll throw out another interesting factoid on COVID. So this is the International Monetary Fund. So up until, you know, from the beginning until September 2021, governments around the world spent $17 trillion to respond to COVID, right? But only 8% of that went to the health sector. So you have a health crisis, right? A pandemic of a century. And only 8% of your funding is actually going to the area of government that's dealing with health. This gets back to the response itself, right? What were governments doing?

They were trying to deal with the economic fallout of their policies. And I think there really needs to be a lot of work thinking about how the healthcare system can respond better to these inevitable surges in respiratory viruses, but also other diseases that are spreading. I mean, just to pick, right now we have Marburg outbreak in Germany. We have bird flu issues in the US. We have a monkeypox sort of situation in Africa that the WHO declared was an emergency, which I don't agree with that, this sort of sledgehammer of using emergency declarations. But anyhow, so I think there needs to be some really creative thinking about surge

capacity that accepts that these things are here to stay and develops alternative strategies, including focus protection, which was one of the great Barrington declarations. Well, and your point also on the learning outcomes, like the learning outcomes will be seen over, the cost will be seen over time. So, you know, this stat that I just mentioned, not to pick on New Zealand, but the stat that we just discussed in New Zealand is the immediate, I think it was immediate all-cause mortality, I think that was the statistic. So basically, it's like the immediate costs

they were able to do very well, but there might be longer term costs that aren't seen yet because of these dramatic economic interventions, right? Yeah, so I mentioned the UNICEF report on education. They estimate that those long term effects could go upwards of $21 trillion for the current generation of students. Okay, fine. So New Zealand can lock down and maybe have some nominal better outcomes. But the global north locking down holds some responsibility for other countries like Uganda or India

or Peru pursuing those policies because they thought, oh well, the north is doing it, the global north, we're going to pursue the same types of infection control policies. And this gets to the heart of global health governance and really the abysmal failure of the WHO and other actors in this space that I've worked with and alongside for 15 years. So I was involved in the Ebola outbreak response in West Africa. I was involved in the Zika pandemic.

I led a mosquito control program in Haiti Zika pandemic. I led a mosquito control program in Haiti for USAID. I'm a medical anthropologist. There was this idea that medical anthropology and social science needs to challenge the biomedical gaze, right? So the reductionism of medicine when we're responding to these diseases, the militaristic tendency, the command and control tendency. And there was some of that in West Africa that was quite pivotal in terms of improving communication between communities in terms of burials, finding different ways to do contact tracing, or even localized quarantines that were in line with traditional healers and looking at the social structure of society. But then when COVID

happened, those same anthropologists, suddenly they were embroiled in their own political tribalism in the West, right? So the pandemic was politicized. If you were against lockdowns or mandatory policies, you were right-wing, right? I mean, I don't see it this way. This is an issue about facts and truth. Does it work or does it not? This is not a political issue, or it shouldn't be. Basically, what you're talking about here is these types of policies, it's almost like they forget about how humans need to interact with each other. And in some ways, you know, you could even argue atomize people, right? Break up social structure. Yes. And I think there's a ton of evidence, probably, maybe you can actually speak to that, you know, what evidence is there that that's what happened? I mean, we had an incredible amount of groupthink

in our scientific class about what to do. We had an abdication from the politicians of the classic role of the politician, which is trade-offs, follow the science, these sort of mantras that took on almost like quasi-religious overtones during the pandemic. And I think as a society, we are becoming more reductionistic in our ideas, and we're losing a sense of what it means to be human in its sort of full sort of variation. And, I mean, this has a long tradition in academia.

I mean, I often thought about BF Skinner's work on behavioralism during COVID, right? Our governments had nudge committees and we were engaged in propaganda and thinking about crafting public opinion and society in a certain direction. And so now when public health talks about the crisis of trust, I think people see through that. Certainly in North America, the immunization requirements, and we had different phases. And when I was experiencing this, I kept on thinking,

okay, now is going to be a time where we get out of this command and control infrastructure and we say, actually, people can behave responsibly. It's not public health's role to be a policeman. But we kept on going in that direction. So people will say, oh, well, maybe we can have a lockdown for a certain period of time and then we can lift it and then we can impose this and lift it. But they're playing like this anchor game, right? They're trying to be this command and control, almost like a behavioralistic philosophy. I think that what we saw was when you throw a sledgehammer at a disease, that level of fear is going to continue for quite a long time.

By sledgehammer, you mean the messaging that this is something to be greatly afraid of again and again. We exaggerated the risk. A lot of the things that slowly society is coming to understand about COVID in terms of the risk was known quite early on, actually. And so personally, myself, I was very concerned about COVID in January and February of 2020. And then as March was rolling around, I looked at the data from China and elsewhere, and I thought for myself and my family, it's not really that big of a concern. Are there any studies that show, that talk about this question of how, you know, society has been altered through this process? Yeah, there is certainly a lot of studies on that issue. I mean,

it's a complicated one. There's certainly a lot more on mental health, which we're seeing in terms of young people. And there's a lot of other issues, right? It's not like COVID was the only thing that's affected young people. There's all sorts of other changes, including social media right now, that have never been done before in the history of humans, having these smartphones for teenagers, right, that's shaping social relationships in all sorts of ways. Or the reduction of children running around in groups in their neighborhoods, right, outdoors. They're all sort of atomized behind a screen. And certainly, I mean, one of the major things was this increase in unhealthy lifestyle behaviors,

including screen use. So screen use went up very dramatically among especially young people. Increases in sedentary behavior, obesity, a big thing, right, in terms of long-term health impacts. I remember this study, I think it was the American Psychological Association. Almost half of people expressed that they had a weight gain in their survey and then that the mean of that was something to the tune of 30 pounds wow right like just kind of like astonishing numbers right this and this was in early 2021 um and almost like almost unbelievable right and this is you know kind of a mainstream stat that was provided i think what we see is people were affected very differently,

right? So some people, they really gained a lot of weight and suffered a lot. And then other ones, if you had a garden, you were outside gardening and taking time off, right? And this is Jay Bhattacharya's term, the laptop class. And I think that that really is a useful heuristic to understand what took place. Explain to me why. Because of the digital revolution, some people could work from home and stay home, right? And they saw this as sort of a holiday, a time to spend with their kids, right? Very busy families, people are very busy, they got time to stay home.

But I think most of the research there shows that there was a sort of honeymoon phase and then things started to deteriorate. So we're often making generalizations about society, but we're dealing with a lot of variation, right? Absolutely. And this is, you know, you have such an incredible task in front of you at Collateral Global. I mean, really what you're trying to do is understand the entirety of the collateral damages of this unbelievable intervention that we couldn't even imagine four and a half years ago, I guess, right? Yeah, absolutely.

And so we're doing that. We have different country working groups. So, I mean, you have to assess this at a country level. One of our major goals are to do cost-benefit analyses of the policies retrospectively, right, in Canada, the U.S., the U.K., India, African countries, elsewhere. And what we see is in the mainstream public health establishment, WHO, and also the academic institutes, there isn't quite an interest in this approach that we're taking, but we actually feel like it's the most significant lesson from COVID. So our organization is quite critical. How do you get the information that you're using, the data that you're using to do this in all these places? The kind of odd thing is there's a lot of published research

on this, right? There's a lot of gaps too. And there's methodological problems. I mean, you get into the weeds, it's complicated. I remember in Canada, this was maybe in late 2021, I did a review for an organization, and I was quite overwhelmed. There were about maybe 100 or 200 studies in Canada on harms from all the different social science disciplines. And yet, if you looked at the Canadian media, they seldomly reported on this, on this academic research. So there's certainly a gap in the research that's been done and then

the public awareness of it. And I think that's changing over time. But, you know, during 2020, 2021, 2022, it was difficult to get this position into the mainstream news. It reminds me a bit of what Harvard professor Peter Blair said in the panels the other day, that this really key element is to be able to communicate the information effectively. And this has been, this has just been such a huge challenge. You said you're a medical anthropologist. Tell me a little bit about how you got into this all. I studied the history and philosophy of science.

I was an undergrad at UBC. Became very interested in the history of medicine and actually spent some time in India during my undergraduate degree. And there I sort of looked at the healthcare system in India, sort of health problems that were facing people and thought, well, might as well do something useful like become a doctor, which didn't quite work out. And I became very interested in the way that society interacts with medicine, right, as a, in terms of delivery of services, but then also the prevention of disease. And then I ended up also becoming very fascinated by foreign aid programs on tropical diseases, so neglected tropical diseases. So hookworm, sleeping sickness, onchocerciasis, rabies, this kind of stuff.

And I ended up doing a PhD in Edinburgh between the social and political science department and the medical school and spent a lot of time in East Africa designing and evaluating programs for, they're called NTDs, neglected tropical diseases. So often in very poor rural areas, dealing with like sissy flies, they spread sleeping sickness,

and different vector control programs, or rabies vaccination, sanitation for hookworm, and these kind of programs. So that's embroiled in the politics of international aid, right? Local politics as well. Out of that, I became obsessed with this notion of effectiveness, right? How do you ensure that your program is effective? You have these plans, let's say, from the boardroom in Geneva,

like we're going to eliminate NTDs, neglected tropical diseases, right? We have these benchmarks. We want to reduce sleeping sickness in West Africa or Central Africa by 50% by such and such year. And then you have all of these different tactics that you're using. But, you know, you're dealing with humans and power and interests and the complexity of corruption. Exactly. It's a big issue, right? Motivation, right?

And so it's not always clear how this works. So I was interested in the translation of these global plans down through the social network, down into the village. And so my work always looked at that, but then also wanted to be useful to the program manager. So it's an information issue. Like the people at the top might not realize, like, well, actually you have this

global plan, but this is the local reality. And also the variation in the reality. It's very interesting because something that has been sort of obsessing me lately is this sort of growing disconnect, it would seem, between decision makers and the accountability for the actions, especially the second order effects that might not be obvious of certain decisions and policies and so forth. I imagine it's something you've looked at a lot. Yes, absolutely. We're interested in using the COVID years and the lessons to reform the way that public health thinks about itself and the way that it acts in the world.

So we have a big job ahead of us. What research now do you have in the pipeline? A lot of different studies, actually. We, so, I mean, Collateral Global is growing. We have a global network of researchers, about 50 to 100 people so far. And so we have all different types of studies that are coming out of that. Personally, I have two studies that are going to be coming out in the next couple of weeks, actually, on immunization requirements. So we've talked a lot about lockdowns and what I call

NPIs, non-pharmaceutical interventions. But I've written quite extensively about the immunization requirements across North America, but also the digital certificates in Europe. And so we actually have a study. It's the first one to estimate how many Americans lost their jobs because of these immunization requirements. There's no research showing how many people lost their jobs and the social impact of these policies. It was very difficult for us to get this quite nominal amount of money to do this study. And I think people are going to be quite shocked when the results come out.

It's in the millions of people. And so getting back to the distrust issue, I mean, those individuals are going to have a lifetime of upsetness towards public health because losing your job has all sorts of ramifications. It's sort of an ironic twist of COVID because if you go to any public health department, the social determinants of health are a core part of how you understand health. And yet with COVID, we sort of threw that out the window to some degree. So one is on that. The second paper is actually, it relates to regulatory issues. So we have a crisis of scientific integrity in our regulatory bodies.

And so we reanalyzed the FDA's original risk benefit assessment for Moderna, specifically around young men 18 to 25. And their assumptions in the models are so unrealistic. And so that risk benefit assessment was used to authorize the Moderna vaccine in the U.S. And so we reanalyze it with different parameters, and we actually find that the risk benefit flips. It's a net negative. Using their own data. Yeah, using their own model, but just putting in more realistic assumptions into it. And so there needs to be a lot of reanalysis and reflection in the scientific community. And I think the conference here at Stanford is a step in the right direction. But I've been to quite a number of pandemic conferences

over the last couple months where sort of the viewpoints that I'm expressing here are very marginalized. And so there still is this very strong industry, a pandemic industry, that thinks that they did a great job and that people that are criticizing them are sort of spreading misinformation. And I think that that really needs to change. As we finish up, what do you make of the new Stanford president's comments at the beginning, opening up the conference. Yeah, I think they're great. So that's Professor Levin. I mean, there's nothing revolutionary about this. We're a university, right? We want to welcome diverse viewpoints and have debates about them. I think in the back scene there, it was quite challenging to get some of our colleagues on the other side to come and have that debate. So I think across university campuses in the U.S., there's this sort of larger conversation about academic freedom, freedom of speech, etc.

And I think COVID is part of that conversation. Getting back to this groupthink and the scientific elite, so people will say to me, oh, surely we're not going to lock down again. But there is a new pandemic strategy that's come out of COVID. It's called the 100-Day Mission, and this is signed by the G7, G20,

and it's supported by the scientific community in North America and Europe. And the idea is next time we have a pandemic, we lock down for 100 days and we have a vaccine that's ready for mass immunization at 100 days. That's an incredible period of time to do safety studies. They're going to have to reevaluate the way that RCTs and safety signals are understood to do that. And then something that's not stated explicitly as well, then you're going to, how do you get people to take that? Well, you're going to

probably rely on the digital infrastructure that we saw with digital IDs and certificates. And so I think that we have this, I call it a lockdown doctrine that's been developed out of the pandemic. And it is our default position. And so my work is to challenge my colleagues in the scientific community, but also the policy community to just think like, does that model really fit with what happened during COVID? Does it make sense to redo it? I mean, is that what you're asking? Exactly. Yeah. Right. And well, I look forward to reading a lot more of your work.

Thanks. Well, Kevin Bardosh, it's such a pleasure to have had you on. Thank you. Thank you all for joining Kevin Bardosh and me on this episode of American Thought Leaders. I'm your host, Jan Jekielek.