Call Me Back - with Dan Senor - Will We Do Better Next Time?

Episode Date: February 19, 2021

Jim is the former editor of Popular Mechanics, where he helped reposition that century-old brand to become a major voice on contemporary tech issues. He currently co-hosts the How Do We Fix It? podcast and is working on a book about man-made disasters. Previously, Jim was executive editor at National Geographic Adventure.  He’s the monthly tech columnist for Commentary Magazine and is with the Manhattan Institute, the most important urban policy think tank in the U.S. 

We're going to be in a much, much better position for vaccines post-corona. This will be a really positive story that comes out of this episode. The whole revolution in mRNA vaccines is really, really huge. And I think we're also going to move to a situation where we start developing vaccines for diseases that haven't hit us yet. Welcome to Post-Corona, where we try to understand COVID-19's lasting impact on the economy, culture, and geopolitics. I'm Dan Senor. Is there any good news? Are there any lessons from this crisis that should give us some optimism about how we contend with future pandemics? That's what we try to untangle today with

science journalist Jim Meggs. Jim helps us think about the promise of the kind of public-private partnerships that gave birth to Operation Warp Speed, as well as the new critical infrastructure we are building for vaccine manufacturing and hopefully distribution, and how we discern the public health news we get from political leaders, public health authorities, and the media to inform our decisions during a crisis. We also discuss what we've learned about cultures at large institutions, from government agencies to big companies, and how they can make better decisions in a future crisis like this one. Jim's the former editor of Popular Mechanics,

where he helped reposition that century-old brand to become a major voice on contemporary tech issues. He currently co-hosts the How Do We Fix It podcast and is working on a book about man-made disasters. Previously, Jim was executive editor at National Geographic Adventure. He's the monthly columnist for Commentary Magazine and is with the Manhattan Institute. You've heard from other Manhattan Institute guests on this podcast before. I think it's the most important urban policy think tank in the United States. How much better will we be prepared for the next pandemic? This is Post-Corona.

And I'm pleased to welcome science journalist Jim Meggs to our podcast. Welcome to Post-Corona, Jim. Great to be here. I mean, we're not actually in Post-Corona yet, but we are on the Post-Corona podcast. God willing, we will be at Post-corona at some point in the not-too-distant future. Let's hope. I have been criticized by some of our listeners for dedicating too many episodes to doom and gloom, and many of our listeners want some more happy talk. Now, I'm actually not as gloomy as some episodes have suggested. I mean, we've done some episodes, for instance, on the future of New York City, which at least in the near term I'm very concerned about, short to medium term.

But in other areas, I'm actually quite optimistic. And one of those areas is where I wanted to start with you today. And that, you know, when I asked the question sort of what has worked during this pandemic, and it strikes me that one of the things that has worked is Operation Warp Speed. It may not be perfect. I get that it has a lot of problems. But what it has accomplished so far is pretty extraordinary. And I want to just explain the high level. So Operation Warp Speed is a public-private vaccine development initiative. It was launched by the president via presidential

order in May of last year. And it was comparable to kind of industrial level mobilization comparable to World War II, you know, World War II's arsenal of democracy, where they were taking over, the government was taking over auto plants to build arms and equipment for the war. And so from the beginning of Operation Warp Speed, the mission was development, manufacturing, and then obviously vaccine distribution. And so far through Operation Warp Speed, there have been something like 50 million vaccines, more actually, produced and delivered with 50 million doses, with hundreds of millions, obviously, on the way to close to 100,000 certified distributing facilities, recipients that will distribute the vaccine doses across

the United States. And Operation Warp Speed's initial goal was 20 million doses by December 20th, and we're obviously way past that. Although they certainly didn't hit that, they got a lot of blowback for over-promising in those early weeks. And I think part of our perception for their problems, that there have been huge problems

in Operation Warp Speed, comes from as much from the poor messaging initially as from the legitimate glitches during those early weeks. So it was almost like they over-promised and under-delivered rather than what seems to be the current administration's approach, which is the opposite. Exactly. And it's sort of classic Trump. They claimed they were going to perform miracles, and then they only performed some really impressive achievements, but they fell far short of the promises.

Yeah. So when I compare it to World War II and the arsenal of democracy, one could argue that was even more complicated, at least from a distribution standpoint, because there, once the equipment was manufactured, they had to get it to the Department of Army and Navy, not to, you know, 97,000 distribution recipients across the country using, you know, FedEx and UPS. So this is, one could argue, elements of this were more complicated than what we, within the World War II industrial mobilization. But I want to start with what you, because you've written a lot about Operation Warp Speed. what has got you most impressed and optimistic about the way it's worked?

Well, there are two main things that I think we really have to be pleased about. And one is that the vaccines exist at all. I mean, we knew it was possible, but even the leading experts thought it would take a couple of years to get the first vaccines through the various trials they need to get through, and that we'd be pretty happy with vaccines that had an efficacy of 50 or 60 percent. That was what would be considered a tolerably good efficacy of a new vaccine. And instead, in less than a year, we got vaccines with efficacy of 95%. So in about half the time that was predicted. So that's a real home run.

But a new vaccine going through the necessary testing phases typically takes, doesn't it take something like five years? Traditionally, we've said five years is kind of the benchmark. There are ways to speed that up. But even with all of that, Fauci and others thought it would take a couple of years initially, or at least that we needed to be prepared for them taking that long. So it's a stunning accomplishment. That's one thing we shouldn't forget. We shouldn't just take it for granted that anybody can come up with a vaccine and not only get it through the trials, but have tens, hundreds of millions of doses ready to roll so quickly.

The other thing is- What was the key innovation there in terms of the clinical trials, in terms of how they ran the clinical trials? They benefited in part from the prevalence of the disease because COVID was so prevalent. You knew that a large proportion of people in the trials were going to be exposed to it. So that helped them get really good results quickly, but they also were able to run the trials somewhat simultaneously and overlap the trials more aggressively than they typically would. And so that was a big help. But especially, the other big takeaway from this for me is the effectiveness of the public-private partnership. The government didn't take over Moderna or Pfizer and try to run them.

It wasn't quite like taking over a Ford plant to make B-17s. What they did was, in the Moderna case, they gave them money for the development. And in both cases of Pfizer and Moderna, they signed a contract that we will buy your doses. The thing that makes vaccine development so expensive and slow, partly, is you've got to go through all these tests with the public, then there's a very good chance the vaccine won't work. So you don't really want to start investing a lot of money in the technology and the factories to make the vaccine until you're sure it's going to work. So you get it through the trials and then it's like, okay, now let's invest in producing the vaccine. Here, they already had a signed contract.

They had a signed contract with the federal government. With the federal government to buy millions. I believe, I think the first one was for 50 million doses. And so that took all that risk out of it. They could now afford to start manufacturing the vaccine before they knew it was going to work. And that's a real game changer. So the minute you get the authorization that you've cleared the trials, you've got doses ready to ship. And the government's view on this was the worst that happens is we spend money to manufacture all these doses, and then we learn that the vaccine doesn't work. That's the downside risk. The upside risk is we've manufactured all these doses, and then we learn that the vaccine doesn't work, that's the downside risk. The upside risk is we've manufactured all these doses, and if we learn it does work,

we're ready to go. Right. So the government took on the risk. They let the private sector do what the private sector does well, but they relieve them of a lot of the risk. And this is something, sometimes we see bad cases where the government relieves, say, banks of risk that creates a bad incentive for the banks to take bad risks. But here, it was an emergency. We needed these vaccines. I think it was a good policy. And I think we should be looking at these kinds of public-private partnerships carefully, but look for this model. There are certain things that the private sector just does much better than the federal government. And if you look around the world at how other countries are trying to handle the vaccine rollout, the U.S. is looking very, very good. And I think ultimately...

Give me a contrast. Well, first of all, there's this whole perception that Operation Warp Speed hasn't gone very well. And there were legitimate glitches initially. I still would say the vaccination distribution rollout is not going seamlessly. We should be doing more doses. But we're doing better than almost every other country in the world. Only Israel has done a phenomenal job. I know you did a podcast on that. They've done an extraordinary job of getting

the vaccine to their population. So we are kind of at the top of the list in terms of getting our population vaccinated. About 12% of Americans have received at least one dose of the vaccine. About close to 5% have the two doses. And now we're just learning that with the Pfizer vaccine, the second dose isn't even really necessary. We suspected all along that one dose would provide a lot of protection from COVID. But now, new paper that just came out a couple of days ago, Pfizer has announced that they are seeing efficacy of more than 90% for the first dose. And they're advising, we've just put off the second dose. Use those. What would have doses that would have been used for people's second dose ought to go to a bigger group of people for their first dose. That's a real game changer. So we shouldn't

look at the problems as being something that the U.S. is doing uniquely badly and rather as we're doing something pretty impressive in a way that has been not quite perfect. I mean, there are definitely things that we could have done better, but we have these vaccines on hand. A lot of other countries, the vaccines they've developed aren't working very well. China's having problems with their vaccines, or they're just not getting them distributed, or they didn't order enough doses of the vaccines when they had the chance. It seems like the other downside risk for pharma companies is if they race to a particular vaccine and a competitor beats them to it, then they could become obsolete before they even finish

their process. And Operation Warp Speed also protected against that. And this happens a lot. This has happened in a number of other cases. I think there was a company developing a Zika vaccine, for example, that wound up being not necessary. And there's cases where companies have developed vaccines for diseases that disappeared on their own. The vaccine had no market. Or other cases where companies develop vaccines and somebody else beats them to the market. It's a high risk operation. And vaccines aren't huge money makers for big pharma because it's not a medicine that you take every day like something for a heart

condition or something like that. It's something that people take maybe a handful of times in their lifetime. So it's not necessarily a huge moneymaker compared to some other kinds of pharmaceuticals. So you basically argue that faced in a once-in-a-century public health crisis, most of our institutions, not all, but most of them basically worked. They worked better than most of us think. Think about all the things that didn't go wrong. There's this whole science of disasters and there's this idea of what's called a hyper disaster where you have a huge failure in one part of your infrastructure. let's say the internet went out, not just for hours, but say for weeks, if that happened, we could have other crucial systems failing, including

the power grid and the water systems and the food delivery. Certainly, if the power grid went down for an extended period of time over a lot of the U.S., the grocery store's shelves would be bare within days. The gas stations wouldn't have any fuel. Your electricity, you know, people would be freezing in their houses. So you might have this cascading set of disasters. A pandemic is one of the things that researchers who study this say could set off that kind of hyper disaster. But it didn't happen.

You know, we had some shortages. Remember when you couldn't get yeast because everybody was home baking bread and then they discovered they can make sourdough bread. There were shortages of certain things. The supply lines were definitely strained at times, but the markets adapted. They figured out how to get things done, and nobody went hungry because of lack in the supply chains. The damage to the economy was enormous, but the lights stayed on, the water kept flowing, there was food on the store shelves. And I think one thing that we should really be appreciative of is the internet kept functioning.

Imagine more than 40% of people went from working in offices to working at home virtually overnight. The loads on the data networks were redistributed dramatically. Zoom went from a few million users a day to hundreds of millions around the world. I have the data here. In late 2019, well before the pandemic, Zoom was hosting something like 10 million meeting participants per day. And by the first or second month of the pandemic really hitting the U.S., so call it kind of early, late winter, early spring 2020, that number was 300 million a day. So from like 10 million participants a day to 300 million. So it went from being this interesting tool that some people use, but the truth is most colleagues I have at companies and firms across the country, really globally, all believed when Zoom would come up, it was always viewed as this tool that was

probably difficult to use, probably not terribly safe, and just wasn't worth the hassle. And we went from that being the attitude of most major companies to flip a switch, and every company totally depended on it, and it basically working. It worked, and the internet itself was working. The ISPs kept people connected. The FCC asked them to make some changes to make sure that relieve data caps for people in low-income areas and make sure people weren't cut off at a time when access was so important. And they, by and large, complied to those voluntary requests. So I think in some ways, the free market and private companies, they responded to some things that the government asked them to do, but they also responded to their

customers and kept things operating. So at a time when we are legitimately concerned about some serious failures on the part of our government and serious failures worldwide, we should also maybe count our blessings a little bit that we didn't enter the kind of much worse situation that we could have. And think about, as we recover from all this, think about what are the lessons both from what went wrong but also from what went right. What enabled us to weather this crisis, this ongoing crisis, without greater problems? There's lessons there, too. Let's spend a minute talking about the pros and cons of different approaches, because depending on your, it seems like your ideological, your political ideological outlook, you want to approach the pandemic with a certain set

of prescriptions. And the breakdown usually is you're expecting a very centralized approach from Washington, which in some senses, in some ways makes sense, given, for instance, Operation Warped Speed, where you really need a centralized approach. On the other hand, it may be entirely realistic in a country that has 50 plus governors, thousands of counties and county commissioners and county health commissioners and all these different jurisdictions and different decision-making processes and different criteria for how decisions are made in each of these local areas, there's a limit to how much can be done with a centralized approach. And so you therefore have many critics saying, aha, so much of the breakdown in the U.S. was

a function of this highly federalist system we have, which is not set up for serious national crisis management. What is your reaction? When there's a crisis, we often assume that there is some super competent federal agency that's going to swoop in and take charge of every detail. Remember after Hurricane Katrina, there was a lot of blame given at the White House and FEMA for their failures, and there was a lot they didn't do very well. But the notion that when there is a terrible weather event

in a part of the country, that all responsibility for responding to it is on the part of the White House is just not the way the system works. You know, Louisiana had its own National Guard. The city had its own disaster plan. And in fact, there was a very broad response that didn't get a lot of coverage at the time. It was just a little more decentralized than people think.

You know, a FEMA helicopter is not going to land in your yard 12 hours after a hurricane with a cup of hot chocolate. That's not the way things work. But we kind of want them to work that way. So in this crisis, there's this assumption that, say, for vaccine distribution, there should have been one huge, hyper-competent federal vaccine distribution, and everyone would sign up through one portal to get their appointment, and the government would keep track of everyone. Well, in a country like Israel that has a national health system, they have everyone's data, and it's all connected. That is how they did it. It worked really well. So I'm not saying this

can't ever work, but it's not really the way things generally work in the U.S. You could argue that that should have been one channel, that the federal government should have done a better job of setting up its own distribution path, but also enabling the states to do their own more decentralized approaches. So some doses are going through hospitals, some are going through drugstores, some are going through public health clinics. And a range of approaches is probably the way to enable the most flexibility and resiliency. If you have a single portal, you've got the chance that it's going to be like the launch of Obamacare, where they set up one system, they had months to work on it, and it was, of course, we all remember, a terrible disaster. The CDC set up a portal for making appointments that the federal government made available

to the states. Most of them wisely turned it down because that too has turned into a big disaster. So who was responsible for that? Was that a Deloitte project? Not to beat up on Deloitte, but I'm just curious, it seems more of a problem with the federal government running one of these projects than a particular company's, particular vendor's role. So what didn't work about the National Registry?

It's hard to stand up a large website to serve diverse community overnight. It's not the easiest thing. So it's quite possible another vendor would have done a better job. But one of the things you look for in preventing disasters is you watch out for the single point of failure. You know, if you rely on one particular piece of technology and then that thing breaks, that's a real problem. If you have a more distributed approach, then one part can break, but other parts continue to function. Markets work like that.

So I think when we look at the government response here, we could have used a good national portal for appointments. We could have used a good national portal for appointments. We could have used some federal help in the states, but we also needed the states to do their own distribution. Some did better than others. And it's interesting, the ones that have done well, you know, they aren't always the most affluent or the technical powerhouses. Alaska and West Virginia are two of the best states. So in terms of vaccine distribution, so far the ones doing best are Alaska, North Dakota, and West Virginia. That's correct.

Why? What are they doing well? One thing that's interesting in Alaska is they are allowing the people who are closest to the population to make a lot of the decisions. So for example, the native tribes in Alaska, instead of being part of a centrally run program, the government just basically gave them the doses to distribute to their populations because they know where their people are.

They know what the needs are. And in some cases, they literally were distributing some doses by dog sled. They did a really good job of getting the doses out there. Sometimes you're better off instead of expecting, say, in the Katrina example, that FEMA should come in in an emergency and know everything about your community and fix everything overnight. Maybe your local National Guard that knows the roads and knows the communities is going to be a better frontline disaster response team than the federal government can be. And I think we're seeing that with the vaccinations. As we get to the point where

the supply starts catching up with demand, and that's going to happen soon, then the fact that you could get your vaccine from your doctor or from your local pharmacy or at a public health clinic or at a mass vaccination center like at the Javits Center in New York or something, those will all be options. They'll work differently for different people. And if one has troubles, the other ones can pick up the slack. This is why I'm skeptical that big centralized programs are always the best way. There's certain things they're needed for, but we should be wary of assuming that a big centralized top-down system is going to understand the needs of the local communities or even necessarily be the most efficient way

of handling a challenge like vaccine distribution? So we had, as you mentioned, we had Scott Gottlieb on a few weeks ago, and he made the prediction on vaccine distribution that we were going to have a demand problem pretty quickly, that the demand problem was going to overtake the supply problem. The fact is, we're manufacturing and distributing plenty of doses. What he was concerned about is a lot of people were not convinced they needed to get the vaccine, and the difficulty to get a vaccine, for some of the reasons you're speaking to, just making the appointment and the whole hassle of taking half a day to go deal with it was going to be a

big obstacle. He was more worried about demand. And I want to, there's a recent poll that came out that was sponsored by the commission by the Kaiser Family Foundation. It's just released within the last couple of weeks. They had a nationally representative sample of over 1,000 adults. And strikingly, over a third of respondents said they did not intend to get the vaccine. That's a problem. And that may be one, you know, that is partly at least what Scott is worried about. How did we wind up here? All we've been talking about for the last 10 months publicly. Every public debate has been about the pandemic. It's permeated every minute of news coverage. It dominated the presidential election. Our lives have all been turned upside down by it. And here we are now,

where over a third of the public says thanks, but no thanks to the vaccine. It's really worrisome, but it's a problem with really deep roots. The public's trust in institutions and experts has been declining for years. And sometimes for good reason, when we see things like contradictory statements out of the CDC, a lot of people still remember, oh, you shouldn't wear a mask, oh, you should wear masks. People who are disinclined to trust the government to begin with seize on that kind of stuff and say, well, why should we trust you about anything? And then there's politicians who – Well, can we just stay on that for a minute? Yeah. Can you speak to the CDC and the World Health Organization's early statements and guidance on how to deal with the pandemic and why they contributed to the confusion?

Yes. So there is some distrust of organizations that's not well-founded. Sadly, too often there is good reason to be distrustful of statements. The World Health Organization early on in the pandemic was virtually running cover for China, first insisting that there was no community transmission, no person-to-person transmission of the virus. As late as about January 15th, they were still saying that. Meanwhile, Taiwan had already shut down. They didn't believe a word coming out of China. They assumed that China was lying about the virus. And it's no coincidence that they lead the world in terms of keeping this virus

under control within their borders. So in the US, the CDC was also, they did some things well, but they tended to downplay the risk. A big question early on was, how is it spread? How similar is it to other respiratory viruses? There was a huge bias in the public health community in favor of assuming that it was similar to influenza, something that spreads mostly from sneezes, coughs, runny noses, touching things, or what they call the respiratory droplets that you emit when you talk. But they made this optimistic assumption that that was it. And no one wanted to deal with the risk that those droplets might be able to stay suspended in air much longer,

that the disease might be airborne for much longer periods. I remember here in New York City, where you and I are, Mayor de Blasio in March was at a press conference with his health commissioner, and I have the quote here, coronavirus is not something that hangs in the air he said it requires literally literally underlined the transmission of fluids it has to get right on you yeah it has to get right on you and that was and he and the governor were encouraging us to go about our business go to crowded restaurants they were you know de blasio was recommending that people go to live theater because it has to get right on you. You don't have anything to worry about. Right.

And it's one thing for a health agency like the CDC to say, we don't know what the risk is. But it wasn't just de Blasio. Even the CDC itself, they didn't just say, we don't have the data to know whether it's airborne or not. And if it is airborne, that's worrisome. Masks and other precautions could certainly help in that regard. But they didn't say that. They said, we don't have any data that's airborne, so therefore don't worry about it being airborne in effect. And the World Health Organization did

the same thing. There were many scientists around the world who are experts in this kind of airborne transmission of disease. They finally got to the point where they were literally lobbying the CDC to acknowledge this risk and to acknowledge that we really don't know even how those respiratory droplets behave. You think they're all settling to the ground within six feet, but not if there's a strong ventilation current carrying them around an indoor setting. And once they dry out and they are much lighter, but they still have the viral load, they can stay suspended now, we know, for potentially hours, or they can be resuspended. They settle to a desk, but then you drop a newspaper on it and a big cloud of them filters

back up in the air again. So this was a risk that a lot of scientists were aware of. They were talking about it. They were warning about it. And oddly, the major public health organizations were conservative about raising the alarm. I call this the precautionary paradox. Sometimes an organization is so determined to follow its own safety rules that it actually makes decisions that are less safe because it doesn't want to say anything until it has a real powerful set of data to support it. But in this case, all they had to say was, yeah, it might be airborne and that would be bad, so let's take precautions just in case, and they almost said the opposite. So in one of your pieces, you cite the Challenger,

the NASA Challenger launch decision as an example of this phenomenon, to describe this problem that you argue is pervasive in organizations that have been operating for a long time in one way. In fact, you wrote, an institution that does everything by the book will eventually, and I quote here, have trouble seeing problems that aren't in the book. Yeah. The NASA thing is fascinating. We all remember, for those of us who are old enough, remember the Challenger disaster. And we all remember the conclusion that everybody quickly reached, which was that NASA had recklessly kind of rolled the dice. It was a very cold morning. They knew that might exacerbate- 1986, right?

Yeah, it was January. They knew that the cold weather might exacerbate the leakage of little jets of flame out of the solid fuel boosters. If you picture the space shuttle, it had those two solid fuel boosters on each side of the huge fuel tank. They knew that problem might be worse, or they suspect it might be worse in cold weather, and they launched anyway. So everybody assumes that the NASA leaders were just being reckless because they wanted to stick to a schedule or they wanted to impress the White House. They wanted to protect their budget. And they were what one researcher called amoral calculators. But this brilliant sociologist named Diane Vaughn studied this case for years.

She interviewed everybody involved. And she realized in the end, actually, the people who made that decision were following the NASA rules. And the NASA rule was, you make no major change in the launch plan unless you have very strong data in support of the change. If you say, we're going to launch, you need to have solid data that all your systems are safe and good to go. If you say, no, we're going to scrub a launch need to have solid data that all your systems are safe and good to go. If you say, no, we're going to scrub a launch, you also need to have all this data. So the engineers who were worried about the launch, who tried to get them to scrub it at

the last minute, they didn't really have much data. So NASA said, well, show us your data. Let's have a meeting. They had the meeting, but there wasn't enough data. They said, well, show us your data. Let's have a meeting. They had the meeting, but there wasn't enough data. They said, well, we can't make huge changes without data. We have to go ahead and launch. That's what our safety protocols say. So in a weird way, by following their own protocols, they made this terrible, much riskier decision. When you see the CDC not telling people that there are hints, there are worrisome hints that COVID might be airborne. Instead saying, well, we don't have enough research, we don't have enough data, so we can't recommend a change in public health procedures without the data. When in fact, not launching the space shuttle or warning people about airborne COVID would have had very little cost in the sense of risk. They were decisions that in retrospect would be so easy to make.

And yet these institutions, they're not staffed by dumb people or immoral people, but they're staffed by people who are really, really inclined to carefully follow rules. Normally that's a good thing, but sometimes in a crisis, you need more flexibility. When President Biden recently introduced his scientific advisory team, he said, and I quote here, everything we do will be grounded in science, facts, and the truth. Science, facts, and the truth. So it's consistent with this whole trust the science slogan that we hear and see all the time. What is your reaction to that frame for how we should think about every issue? Is it that simple?

Well, it's never that simple. The people who always say trust the science, they're not usually scientists for one thing. And it is a good policy on the whole to want to make sure that any policy choices we make are backed up by science. But often, the real crucial decision in the end is not just science, it's also a matter of our values, it's a matter of the weight we want to put on different goals. So for example, science... Yeah, societal interests, political, political decision-making.

I mean, these all factor in. You're right. So science might be able to tell you that, yes, if we continue adding CO2 to the atmosphere at the rate we are, we are going to see higher temperatures and other problems. But it can't say,

so therefore we need to institute global socialism. But there are definitely people out there saying like, trust the science, we have to dismantle capitalism. Science doesn't tell you anything about the solution. It only tells you about the problem or how the world works. When you start looking at solutions, then you need to also apply other metrics. And I think we see that a lot in this COVID situation, for example, with reopening schools. We're seeing teachers unions say, well, we can't do anything until we have the right scientific proof that it's safe. Science is indicating that sending kids back to schools is surprisingly safe.

But the real question in the end is also one of values. What level of risk is it fair to ask teachers to take? What level of damage to our children from being socially and educationally deprived? What level is okay? How do we balance those two concerns? The worries of teachers, which I don't discount. I don't blame them for being worried. And the needs of our children. These are delicate, difficult problems that science can inform our thinking on them, but

science can't answer it. It can't be the final answer. We need leaders. We need policymakers to make some tough calls. Right. I mean, what trust the science often devolves into is being asked to, when trusting the science, you're really being asked to accept one's preferred policy agenda and their set of prescriptions for how to address a particular issue, not the science beneath, not the debate, the scientific debate. And it's often a debate between science, between different schools of thought and science. It's not a clear consensus

that informs the policy prescription. It's often not. I mean, science is not a vote of experts. And the process of science is really set up to challenge the authority of experts. It's anybody can come and challenge and establish theory. And if they are able to put together the experiments and the evidence to make their point, they can change the scientific consensus. That said, the major areas where science is in consensus, say, for example, that vaccines work and they're safe. That is an overwhelmingly powerful scientific consensus. We shouldn't encourage the public to say, well, you never know. Experts have been wrong before because it's an important issue in public health for people to be vaccinated.

The distrust of scientific institutions is a real problem. Unfortunately, it's partly promoted by the kind of people who keep saying, trust the science. And then in the very next breath, they're saying, and now accept my controversial policy proposal because I say it's based on science. The people who don't like the policy often wind up also doubting the science. I think that's part of the resistance to climate science. People know that some on the left see it as an endorsement of a traditional kind of left-wing centralized policies. So therefore, they assume that the science itself is wrong, which it isn't. And it's the policies that might be misguided,

but the science is pretty solid. And I think this gradual erosion and trust in scientific expertise and other kinds of expertise is a real problem. And at a time when we really need people to be vaccinated to save their lives, the fact that so many are resisting it is kind of heartbreaking. So it can, I mean, science can tell us which, for instance, which demographic groups, which age groups, which groups with certain health histories are at greatest risk of dying from COVID and therefore should probably be vaccinated first. But science can't tell us who sort of deserves to be based on societal interests. That's for political and governmental leaders to determine. Yeah, there was a lot of confusion early on. The CDC assembled a panel to assess who should get the vaccines, and they implied this

very complex kind of social justice algebra to the problem. And now, the underlying urge there is a good one. You want to make sure that we get the vaccine to these marginalized communities. Minorities are at much greater risk of getting COVID, of dying from COVID. And a lot of people in minority communities aren't very well connected to the health care system. They don't necessarily have a regular doctor or insurance. So extra effort to make sure they get vaccinated is really important. But the recommendations out of this committee were so complicated and they seemed to be suggesting that young people in certain minorities should get the

vaccine before some old people because the older population tends to be somewhat whiter than the younger population. So it was almost like they were saying, let's make sure we sacrifice some old white people just in order to redress past instances of inequality in healthcare system, as opposed to saying, let's make sure that the most vulnerable people in minority communities, they don't get overlooked again. Those are two different things. It was very confused. The CDC then had to kind of roll back their recommendations. A lot of states were juggling this idea of who should get vaccinated first for well into the

period when they had their vaccines, but then everyone was confused about who was on the 1A list and the 1B list, and it kept changing. It was unfortunate when the most important issue was getting as many people vaccinated as quickly as possible, and it got a little bit derailed by these other goals. So on that vein, in the early months of the pandemic, if you look at the public opinion research, polls showed overwhelming support for masks, for social distancing, for quarantining, and people thought they were, quote, following the science when they did, followed all those, took all those measures. And then, and there was, in the media, you know, a lot of finger wagging at those isolated areas that didn't follow those measures, people who attended Trump rallies, people who in certain parts of the country insisted on going to the gym or going to a tattoo parlor.

And there was a little bit of kind of cultural elite hectoring at certain demographics. And then the summer came and we had the Black Lives Matter protests. And suddenly many in the media and a lot of public health experts started sounding, you know, a lot more relaxed about the risks of thousands, tens of thousands of people who don't know each other clustering together, marching the streets, shouting together for hours at a time, many of them not wearing masks, certainly not social distancing. And all of a sudden, a group of something like 1,200 health experts signed an open letter encouraging the protests, not just blessing them, encouraging them. So describe what was going on there and why this adds to the confusion of trust the science.

I think what happened there was that the public health experts who were supporting the protest, again, they meant well. The inequities in healthcare are a real problem, but what they did was they demolished the trust in their own expertise because what they showed was we're people who put the science first except when the political winds change and then we'll say something completely different. But we still need you to trust us no matter what, because it's science. The idea that we need to address racism in this country is an important issue, but it's not science.

It's something else. And I think this is something that people, they see it, and then they assume that everything the experts tell them is not right. A lot of the support for masks and stuff, this is part of when that all became politicized. There was a lot of politicizing of COVID on both sides. The Trump White House was really unfortunate in a lot of their statements of COVID on both sides. The Trump White House was really unfortunate in a lot of their statements, and I think were very counterproductive. But there was also on the left, a real tendency to want to grab on to COVID as an issue that could promote some of their priorities. And everybody's claiming that they're supported by science, but the public saw it as

people are essentially taking the positions they take for political reasons and trust really went out the window. You saw this terrible thing where in some parts of the country, not wearing a mask became some kind of a bold political statement. I mean, it's just really depressing to see people overreacting in that way. And people also are very alert to hypocrisy. So when they would see people say that, you know, you can't go out, you can't do this, you can't do that, and then someone would be caught, you know, the government of California caught having dinner at, you know, the French Laundry, one of the most expensive restaurants in the country with a bunch of lobbyists. Well, the public notices that and they resent it and they start believing that the policies they're being told to follow aren't really based on science and

they don't believe anything the experts say. As we think forward post-corona, in terms of what will be born out of this pandemic that could serve us well in anticipation of future health crises, talk about the infrastructure for vaccine development and manufacturing in the United States, where it was pre-corona and where it will be post-corona? We're going to be in a much, much better position for vaccines post-corona. This will be a really positive story that comes out of this episode. The whole revolution in mRNA vaccines is really, really huge. And I think we're also going to move to a situation where we start developing vaccines for diseases that haven't hit us yet. A lot of people have been proposing this

for a while. When we're developing the technology to do this, to essentially develop vaccines for the leading coronaviruses that are likely to infect us, kind of in general, get them tested, get them through the trials, and then when a variant of one of these coronaviruses comes, you can tweak the vaccine and put it into production without having to go through all the trials again. If you think about the way they do the flu vaccine

every year, the flu virus changes a lot from year to year, faster than coronavirus has changed. The flu vaccine then is tweaked every year. They don't have to go through all these clinical trials to the same degree. So we can get an updated fresh flu vaccine every year that is hopefully better matched to this year's version of the flu. If we could do this on a broad basis against these potential respiratory viruses, against a broad spectrum of them, that would be really a great thing. And that's another area where it's going to require some kind of public-private partnership. You can't expect the companies to take on all this risk of developing these on their own, but it wouldn't necessarily be that much money. It might be a few billion we could

get ourselves protected in advance. And the next time a potential pandemic rears its head, we could have vaccines out there in a matter of weeks or months instead of a year. And what about our distribution capabilities? I mean, as I said, in warp speed, we're distributing to 100,000, 97,000 recipient centers, which has been messy. Yeah, yeah. And could that be permanently changed? I think we'll learn a lot from looking at what worked and what didn't.

But I think the real challenge we're going to see, it's not the distribution per se. It's knowing who the patients are. We don't have any kind of national health database that is really coherent. It's part of our decentralized way of doing things in the United States. Under Obamacare, there was supposed to be a big revolution in medical data collection. There was to some extent, but partly because of our privacy laws, which I think are important in healthcare, you can't just say, here's my database of every person in the US and start signing them up for the vaccines in some particular

order and then be able to call each one within a week. We're just not set up for that. And maybe we need something more like that. I'm somewhat reluctant to see the federal government in charge of... I was a skeptic about Obamacare, and I think in a lot of areas, the decentralized approach is better. But here's an area where certainly we could use better information. So I think in the future, that's the real challenge, is knowing who needs to get the vaccine and getting to them and communicating with them in a simple way. Once you have that, you could set up every drugstore, Walmart, and then supplement that with county health departments and other things, kind of what we're doing now,

but making sure that the right people are getting to the center at the right time. It's not so much a matter of where do the trucks go, it's where do the patients go. This is a big success of the Israeli system, but they're called Kupat Cholim, which translates to health funds, the equivalent of their sort of the closest approximate as to like an HMO. There are basically four of these large HMO-like organizations and their ability to communicate with all their members. So not only help people sign up, but once they sign up,

make sure they're in touch with them through an app, on their phone, on their smartphone for their second dose. And just the communication lines are extraordinary. I mean, the only other country that has something comparable to that is Estonia, which is a much smaller population. So the Israel model in this respect is especially interesting. Yeah, yeah. So I don't have any easy solution to this, but I think that it'll be important to learn the lessons of this one. And in fact, as you said, we're going to have a lot of work getting those vaccine-hesitant people, getting to them and not

strong-arming them, because that backfires, but at least urging them, getting into the communities, using community leaders, religious leaders to help spread the message, to get those hesitant people in to get their shots. Is there going to be a transition away from conventional vaccine development and manufacturing to MRNA, which is radically different from conventional vaccines? Yeah, I think we'll have both. And I think that if one thing that the pandemic shows us is that there are certain types of diseases that if you don't have a vaccine,

you really can't stop it. We have very few tools to stop it. Hopefully it'll change the investment picture some so that there's more long-term investment in vaccine development. And I do think that we, I'm typically a fan of keeping markets as free as possible, but I think this is an area where some government investment in vaccine development and research is appropriate, especially as part of a plan to study the potential pathogens around the world and begin to do the groundwork so we're ready to develop vaccines against them more quickly. You have been very critical of the world of science journalism, your peers, your colleagues in the journalism business that cover science. And so I guess my first question is why? Why have you been

so critical of not all, but most science journalism? And then secondly, what would you prescribe going forward post-corona for how we think about how we get information about science? How could regular consumers, regular citizens get their information about science, particularly in anticipation of what will inevitably be another public health crisis? So how should we think about how we get our information? Yeah. Well, let's first, since we don't want to bring everybody down, I would say that most of the information we got early on on the pandemic from the media was actually pretty good. In fact, the media was often ahead of the public health

authorities. Most people learned about the risks of airborne COVID, for example, not from the government, but from news sources. And I think if you look at people deciding to stop going to restaurants and deciding to socially distance, that came before the lockdown orders in many states. People were reading the information and they were making their own sensible decisions to try to stay safer. So there was some good stuff, but the media as a whole is bad at science. The reporters who are dedicated to the science beat do great. The New York Times, the Atlantic Monthly, quite a few others have really done excellent work in this field. But if you had a science story to a reporter who's not typically covering science, he or she will often do a really bad job because journalists tend not to understand how science works.

They don't know how to put a story into context. And we all have a weakness for dramatic, scary anecdotes. So just the other day, there was a report that I think in the state of Oregon or Washington, a few people who had gotten the vaccine were diagnosed with COVID. And that was a national headline, like, oh my God, some people who were vaccinated got COVID. Well, if you say the vaccine has an efficacy of 95%, yeah, 5% of the people might get a case. It's almost sure to be a very, very mild case. So

they still benefited from the vaccine, but some people are still going to get it. That is not news. That is background noise. The press, a good reporter would say, well, this really, this doesn't matter. and it's not really responsible to put a big headline on this as if this shows a problem with the vaccine. It means the vaccine is working just as we predicted it would. That is way too common. Taking a few stories out of context, blowing them out of proportion, and not giving the readers the tools to understand the way that, say, a vaccine, the way a vaccine works is not only is it bad journalism, but it leads the public to misunderstandings that can really be dangerous.

Where would you see the best science journalism as this situation, as this pandemic escalated? What were your sources? Yeah. So there are a number. There are people who are working in established publications. Wired has been very good on this. The Atlantic has generally been good. The New York Times has been good when it's their science team doing the reporting, when it's their political team or other people getting into scientific facts in the context of other types of stories, they can be pretty bad, allowing the political narrative that they're conveying to kind of make them use certain pieces of scientific information incorrectly. I also am a big fan of Zeynep Tufekci, who's just a really interesting thinker, sociologist,

data scientist, who's done really fantastic work on COVID. Like a lot of the interesting journalists today, she does a lot of work independently. She's got a newsletter, a sub stack, and she's a good one to follow. Not an epidemiologist, but someone who is watching the work in this field very carefully. So I would say that journalists at their best have been excellent in this pandemic, but journalism as a whole is not particularly good at science stories. Well, our friends at the Commentary Magazine podcast provide almost a daily dosage of crushingly morose commentary, to use their phrase. And I'm pleased that you have given us a balance take, some stuff to be worried about, but there's a lot of optimism. It sounds like you come out of all this somewhat upbeat. A mix. There's so much we should have done better from the get-go.

If you read Lawrence Wright's great piece in The New Yorker that came out in the early January, if there's any piece about COVID that should go into a time capsule, if 20 years from now somebody wants to know what happened, that piece is really quite an eye-opener, both successes and enormous missteps in the early days. And so we could have done a lot better, but we did better than we might have. And I think what we learned from this will make really significant differences going forward. I do think we'll be better prepared. If you look at the countries around the world that did best against COVID, they were the ones that experienced SARS in particular and MRSA. They were the countries that had some experience with previous pandemics, and they were on

alert for this kind of problem in take on how we navigate through this pandemic and what things may look like when we come out of it. Happy to be here. Hopefully, next one will be short and quickly resolved with all the great vaccines we have ready to pull off the shelf. From your lips to God's ears. Thanks. That's our show for today. If you want to follow Jim Meggs on Twitter, he's at James Meggs, M-E-I-G-S. You can also find his work at commentarymagazine.com and at the Manhattan Institute, manhattan-institute.org. Be sure to subscribe to Jim's podcast, How Do We Fix It?, which you can find wherever you get your podcasts. If you have questions or ideas for future episodes of Post Corona, tweet at me, at Dan Senor. Post Corona is produced and edited by Ilan Benatar.

Until next time, I'm your host, Dan Senor.