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CDC Policies Have Been Based on Myopic Analysis

Dear CDC: You can't claim to be making analytically-sound policy recommendations if your scientific inquiry is dedicated to a fraction of the issue at hand. This BBC interview with Dr. Fauci confirms everything I feared about its decision-making process.

Around the 5 minute mark Dr. Fauci concedes that we'll never know if the CDC's recommended restrictions struck the "right balance" between fighting COVID and the "unintended consequences" of these policies' impact on education, mental health, and economic hardship.

Unintended? yes. Unpredictable? No. A drunk driver doesn't intend to cause harm, but we all know their probability of doing so is significantly reduced by getting a ride home.

The CDC's pledge to the American people doesn't bind it to reduce near-term deaths from disease. Its pledge is to maximize benefits to society using the highest quality scientific data.

You can't do that if you're judging the impact of your actions over a few months' time horizon, while ignoring the near- and longer-term collateral damage. Yet, that's what we got.

And here we are, having spent more money fighting COVID than it would have taken to keep Medicare A in the black for the remainder of this century. Just one of the more disturbing transfers of well-being from younger and lower-income people to older, wealthier people over the past two years.

And after all that? To admit we'll never know if we did the right thing? If you think estimating the full impact of policy decisions isn't possible, then I suggest you read this report from June of 2020, available at the website of the National Institutes of Health.

"We estimate that shelter in place restrictions need to prevent at least 154,586 COVID-19 deaths for each month they are in effect to demonstrate cost effectiveness relative to limited reopening, a threshold which is unlikely to be met. While readers may experience this calculus favoring a limited reopening over a return to shelter in place as unduly grisly, we would suggest that the healthcare community, focused on patient care, may (understandably) skew toward a perspective that emphasizes the costs of lives lost to disease over the costs of unemployment rivaling the Great Depression and dislocated family and educational lives. However, the disparities in how the socio-economic burden is imposed upon the most disadvantaged relative to the well-off may be even more inequitable than the disparities in health outcomes with which the healthcare community is so familiar"

This report isn't definitive. It just demonstrates that the calculations I suggest above were not only possible. They were being performed--and disregarded.

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