Vaccines & the Totalitarian Principle
2021-04-04 · Guest: Dr. Jeffrey Singer (Cato Institute senior fellow and surgeon) · 52:11
Medical and political response to the COVID-19 pandemic
Bob Zadek and Dr. Jeffrey Singer discuss the medical and political response to the COVID-19 pandemic. They critique the shift from medical guidance to government mandates, the “unseen” costs of lockdowns, and the scientific data regarding school reopenings and vaccine efficacy.
Topics: COVID-19, Public Health, Lockdowns, Vaccines, Vaccine Passports, Education, Frédéric Bastiat, CDC
Speakers: Bob Zadek, Dr. Jeffrey Singer
Intro & The Shift from Doctors to Bureaucrats [00:22]
Bob Zadek: Hello everyone, welcome to the Bob Zadek Show, the longest-running live libertarian talk radio show in all of radio. Thank you so much for listening this Easter Sunday morning.
It seems like for the last year, we have all fired our healthcare professionals and replaced the information we were customarily getting from them—now we get it from elected officials or unelected bureaucrats. At least it sure seems that way. We have been getting the most important, or not the most important, but very important medical information, which sounded to us like it was life and death information, from politicians, many of whom were very far away, never met us, didn’t examine us, and had in many instances other agendas besides our health.
Of course, I am talking about COVID, the pandemic, and how we have gotten information which seemed to be necessary for us to stay alive for the last year. And we kind of allowed that to happen. And we took our behavioral advice, our medical advice, from these elected officials. And this morning, I’d like to examine how good was the advice we got. And I kind of wonder whether if we had gotten the same advice from our physician, whether we didn’t have the world’s most winnable medical malpractice case.
Introducing Dr. Jeffrey Singer [02:30]
Bob Zadek: How’s that for a way to start the show? I’m smiling and I’m asking my guest this morning, a dear friend, perhaps the most knowledgeable physician in America on COVID, Dr. Jeffrey Singer. Jeff is a practicing surgeon, general surgeon in the Phoenix, Arizona area, and most importantly is—at least to me this morning—is a Cato scholar and has written and spoken extensively, underlined, bold, extensively, on the subject of COVID and related topics around the country on media of every type and nature in every locale. And Jeff has been gracious enough to share with us this morning what he has learned, what he has observed in his years of following the pandemic. So Jeff, with the warmest possible welcome, welcome to the show this morning.
Dr. Jeffrey Singer: Well, thank you very much for that very kind introduction. I wouldn’t say that I know more about COVID than any other physician. I think that’s inflating my value, but I certainly have spent a great deal of time studying the matter, as both as a practicing physician and how this relates to me and my patients, and also as a senior fellow at the Cato Institute where I deal with health policy studies.
Bob Zadek: Now Jeff, I opened the show with this shot across the medical bow, declaring war, and I mentioned the words you and I in our respective professions perk up when we hear it, which is malpractice. We are professionals and we do our very, very best to give the best advice possible. But for the past year, we have been getting medical advice about the pandemic almost exclusively from politicians and not from our physician. I don’t recall in the past year ever discussing what was best for me from a medical standpoint with my practicing family care doctor or any other physician who I regularly check with. So over the past year, how would you rate the quality of the medical advice, the big picture—we’ll drill down—but since we have been getting medical advice from non-practicing physicians? And I have learned just from being around that in general, putting aside telemedicine—we’ll discuss telemedicine perhaps during this hour—but in general, the standards of healthcare usually require people giving medical advice to at least have some familiarity with the patient. But of course, there is public health, which is a consideration. So tell us, if you will, the big picture. Look back over the past year. What about the quality of the medical advice, the medical advice we have been given? Because that has been the primary source of advice we have gotten to affect our behavior.
Science as a Process vs. Dogma [00:05:45]
Dr. Jeffrey Singer: Well, that’s kind of a complicated question because first of all, I think there’s a tendency, not just on behalf of the press, but on behalf of all of us—we want solid answers that are, you know, rock solid, not subject to change right now. And when we’re dealing with a pandemic, a public health emergency like this, it’s important for everyone to realize that it’s a work in progress. What we know is a work in progress.
I’ve heard other people say several times we should stop saying “I follow the science.” They should take the word “the” off of it because that almost makes it like a dogma. They should say “I follow science” because science is a method, it’s a process. So it’s a constant process of learning. When you think you’ve gotten the answer, you actually want your fellow scientists to try to replicate what you did and see if they can come up with the same answer because what you really want is to know what the right answer is. And as more information comes in, it’s constantly changing.
So first of all, in the early days of the pandemic, most of the public health experts, to be fair, knew very little. And so what they originally thought or feared needed to adapt over time to new information. And there’s a tendency for the press to hang on their every word. So when in the early days, for example, Dr. Fauci said, “This is going to be nothing more than a flu, everybody ought to just calm down,” then when a few weeks later it became obvious it was going to be something different than that, people said, “Wait a minute, you’re giving me mixed messages.” And so it’s important for everybody to understand, and maybe for these experts to emphasize every time, that what I’m telling you is what I know based upon this moment in time. This is subject to change.
Now, when it comes to us practicing physicians, we come at it from a totally different perspective. Now, what happens is every hospital has such what they call a Chief Medical Officer, which is a physician who’s sort of the liaison between the hospital administration and the medical staff. And they get basically daily memos from the CDC, from the national public health officials. And so these CDC people tell the Chief Medical Officers, “This is what we recommend.” Those Chief Medical Officers pass that downstream to all of us practicing clinicians. But the recommendations coming from public health officials don’t take into consideration tradeoffs because, you know, they’re in their narrow silo. Their mission is to give advice on how to control and/or eradicate this particular public health threat. That’s all they are focused on. And to be fair to them, that’s their job. Okay.
But we clinicians, every day as a matter of what we do, we’re dealing with patients and helping them make decisions because each patient has their own unique situation. And every decision they make involves them making tradeoffs and they have to weigh the risks to them and the benefits to them of any of these decisions. So our mindset is different than the mindset of these public health officials. Our mindset is much more tuned to “What’s the tradeoff involved with doing this?” whereas the mindset of a public health official is not concerned with that.
And so we have this problem that most of us practicing doctors are basically getting passed on down to us the edicts of the public health officials. And there’s this kind of disconnect. There’s a different culture. So many of us are skeptical or saying, “Gee, I think their recommendations are not workable or too broad a brush,” but it’s almost like we can’t say that because we’ve already been told this is what is the official recommendation. And then you get to malpractice and things like that. We get worried that even though my personal thoughts may be skeptical of some of these recommendations, when it’s been publicly announced that this is the recommendation of the official medical experts of the United States government, there’s a pressure on you not to openly deviate from that because then it puts you at risk. So that’s kind of the dynamic at play right now.
From Guidance to Mandates [10:24]
Bob Zadek: Now, what you say, you described the information that CDC passed down as being information. But when it comes from the government, and then when you couple that with the emergency powers assumed by the overwhelming majority—perhaps everyone, but I’ll just say majority because I don’t know better—the overwhelming majority of governors, mayors, county executives and the like, the recommendation gets converted to a mandate.
So along the way in the information stream you have described, a recommendation—when I sit with my physician, the physician as you have said aptly says, “Here’s what I recommend, here’s what you lose if you don’t follow,” and now the physician says, “The decision is yours.” The physician, a sensitive physician, and indeed I suspect it is ethically required, says “Here’s my recommendation, here’s the information you need to make a decision, but the decision is yours.”
That last element, “the decision is yours,” is missing from the dynamic you have said. And it started with a guidance and became a mandate when it got adopted by the officials. So during the whole process, the personalization, the “what’s best for me”—everybody’s circumstances are different—got lost in the mix.
Now, looking back, is my statement naive and idealistic? If the government would have adopted the role of saying, “Here’s what we know, and of course it’s going to be constantly changing, here is the best information we have, deal with it, and you make a decision about going out or going to work, eating at a restaurant, wearing a mask, being on a plane, going on vacation,” would that have produced a profoundly worse overall result, maybe the same, maybe a better overall result?
Now, I snuck in a word, Jeff, which was “overall result.” And you pointed out that the CDC, living in their mandated silo, they are not designed, they are not supposed to make economic decisions. They’re making healthcare decisions, epidemiological decisions. So the question is overall, how would the result have been different if more decision-making were given at the individual, at the physician level, rather than at the mandated government level?
The Seen and the Unseen Costs of Lockdowns [14:15]
Dr. Jeffrey Singer: Again, it’s complicated because I think even as libertarians we can agree that when you have a true public health emergency, then we have to be concerned about externalities. And your behavior, while it should be your choice, if it’s going to threaten the lives of your neighbors, then in principle we could certainly agree that you should be restricted until the emergency passes because everyone is threatening everyone else’s life.
So here’s my take on it. When this originally started hitting the fan, so to speak, it looked very bad and we didn’t know enough. So I think it was reasonable back a year ago to recommend basically everybody hunker down because this looks bad. But as we learned more over the next several months, we needed to make adjustments in our policy.
For example, we now know a year later that 80% of all deaths occur in people over the age of 65. 40% are in nursing homes. We were actually sending people back to nursing homes who presented to the emergency department and were diagnosed with COVID, where they could then share it with their fellow residents. We also know that over 95% of people who die from COVID have pre-existing comorbidities that make them—one of the most prominent ones being obesity. So we know a whole lot more.
We also know that if you’re a young person, like under 20, COVID is actually less dangerous than influenza. And if you’re somewhere between 20 and 45, it’s about the same as influenza. So we should have adjusted our recommendations as the information came in.
But here’s the problem. When you have—and this is just the nature of the beast—when you have a governor put in place a mandate, now that sets a whole different set of incentives in place. It’s what Frédéric Bastiat talked about in the 1800s as “that which is seen and that which is not seen.” So for example, if the governor decides, “Okay, let’s let up on some of our restrictions,” and then case numbers—not necessarily hospitalization numbers or death numbers, but case numbers—start to go up, of course it’s natural for the press to focus on case numbers. So case numbers go up. This looks very bad for the politician politically. The politician can come under criticism for “What are you doing? You see you lifted some of these restrictions and now cases are going up.”
Meanwhile, what is not seen is that the longer everybody is hunkered down, there are first of all economic costs. There are personal lives and futures that are literally destroyed by the economic hit some of them have taken. There are young people whose basically future plans—they’re already starting college—they’re being derailed and maybe permanently. There are even younger people who are not getting in-person education and schooling, particularly inner-city kids who don’t have access to high-speed internet, who are actually regressing educationally, and this is going to horribly affect their future and widen the wealth disparity and all the other disparities.
And then there’s—I’m seeing this as a physician—there are delayed diagnoses of cancer. There are people not getting their routine preventive screening tests done because doctors’ offices have been closed or people are afraid to come to the doctor. Elective procedures, which doesn’t mean unnecessary procedures, just means it’s not an emergency so you can schedule it, they’re being delayed. People who have substance use disorder are being cut off from their rehabilitation programs. People in chronic pain can’t get into their doctors because those offices are closed. All of these things are happening, but their ramifications are much more diffuse and delayed in their presentation. So that’s what Bastiat would call the “unseen.”
So what is seen is the case numbers go up. What is unseen is all the damage from the restrictions if they remain in place. So the natural incentive is going to be for whoever is in charge of placing these restrictions to err on the side of over-caution because of what is seen and what is not seen.
Comparing California and Arizona [18:58]
Dr. Jeffrey Singer: And so that’s where we are today. We have a sort of a patchwork. Some states have been restrictive right up—some states are still restrictive and haven’t lifted their restrictions. Other states have been less restrictive or minimally restrictive. And a year later, it looks like for the most part it doesn’t really matter. The states that were less restrictive and the states that are more restrictive have all gotten to the same place when it comes to case numbers and hospitalization numbers and mortality numbers. But some have done so with much more damage to their population in other areas than other states have. But in terms of just focusing on that one virus, it doesn’t seem to be a lot of difference between states like—you’re talking to me from California, which is just now lifting restrictions. I’m in Arizona, which completely lifted all restrictions two weeks ago. But even before then, since the summer, we’ve been having in-person dining and there’s never been a statewide mask mandate. And I don’t think we’re any worse off than California, at least in terms of COVID. I think we’re better off than California in terms of everything else.
Bob Zadek: Should I have all my listeners put on their mask while they’re listening to you since you’re in a state that has lifted all restrictions? Are you now like Typhoid Mary with a white beard and you’re going to infect all my listeners and watchers of the show? So you don’t have to answer that.
So now, but that’s very important what you have said, is that from a health standpoint, it doesn’t matter between states—Florida, Arizona, and many, many others that were infinitely less restrictive, and New York, California, Illinois, states that are far more restrictive. From a health standpoint, it’s a wash. From all other standpoints, the restrictive states have profoundly overall harmed their citizens. So in fact, one can say if we do the scorecard now, the less restrictive was clearly, from an overall “what’s best for the citizens and the voters,” from an overall standpoint, is it profoundly clear beyond discussion that overall less restrictive policy has, with hindsight, shown to be the better approach?
Dr. Jeffrey Singer: I think so. But again, that’s taking into consideration the tradeoffs. If you’re just focused on numbers of cases or hospitalization numbers, then you may come up with a different answer. But if you’re looking at this holistically, like what are you giving up in return for this, I think that it would have been much better to—like I say, in the beginning it’s very reasonable to do what we did because we didn’t know and we needed to think and be prepared for the worst. But as we learned more, we should have modified our approach and focused more on minimizing the risk to those most vulnerable and minimizing the chances of spread while allowing as many people who were less vulnerable, for whom this virus is just like a common flu virus or a bad cold going around—and like I say, for a lot of the younger population that’s all it is. I mean, you’re always going to have an exception, you’re always going to report on a case of somebody who didn’t do well, but as a general rule, if you’re under the age of 30 or something like that, this is a terrible virus or cold that’s going around that we’ve dealt with since we could remember, and we never panicked over it.
So if we were able to design our recommendations and policies in a way that allowed as many people who were less vulnerable to get back to what they needed to do and instead focused our protection on the most vulnerable, I think we certainly would be in the same place we’re in now at the worst, but we would have done less damage in other areas. And so that’s basically my position. I think the evidence is bearing it out. We could see because we have 50 different experiments that took place here in the United States. I don’t think there’s such a variation among the different states as to what their restrictions were. And I don’t think you could argue that those states that were the most restrictive have had the better outcomes. Look what’s going on right now in Michigan. Michigan stands out in the United States as a state in which not only are case numbers going up, but so are hospitalization numbers going up. In other states like Florida, which just had a big spring break thing, case numbers are going up, but hospitalization numbers and mortality numbers continue to come down. So that suggests to me that a lot of those case numbers are going up on young healthy people who were partying over spring break. But here’s an example: Michigan, we’re seeing cases go up in about five other states in the Northeast, all of which were very restrictive. And then you have other states like mine in Arizona—we I think we rank 50th in the country now in case numbers—and a lot of other states that were less restrictive where we’re not seeing cases go up. So you certainly can’t make the argument that restriction has been the best way to go. Let’s say that at the very minimum, I’ll stick my neck out and say super restrictive policies lasting for close to a year don’t seem to be terribly effective.
Government Interference in the Doctor-Patient Relationship [24:25]
Bob Zadek: Now, one last question, then I want to go to vaccines where there’s so much misinformation. But as the last question on this line of discussion, when you give your patients rely upon you, you are the source of the information about their health in your area of specialization. To what extent is the advice you give to your patients based upon information you have gotten from government as opposed to from medical literature, training, seminars and the like? And the reason I’m asking is physicians have, in your opinion, just—we’re not going to drill down—but could physicians have done a better job, have, for example, sharper elbows and protested more that government and especially governors were interfering with the relationship between physician and patient, just the way government does and you have written about it eloquently and persuasively, just the way government does in prescription drugs, a topic for another show of course? But is this another example of either physicians allowing or governments imposing their medical advice between physician and patient? Does your profession—could they have done anything differently? Could they have been more proactive? Because after all, they’re the direct contact with the patients.
Dr. Jeffrey Singer: Well, you know, there’s the same kind of pressures in the medical profession that are right now affecting people throughout life. You know, there’s an official way to think, and if you don’t think according to the conventional wisdom, to the narrative, then you’re immediately derided as “anti-science” and you’re dismissed. You might be blocked on social media now by the social media sites. So I think that’s a part of it.
For example, when I’m talking to my patients, I tell them, “This is what the CDC recommends.” And then I’ll say, “If you want my personal opinion, this is my personal opinion. But I have to tell you that this is what the CDC recommends. Now you make your choice.”
I happen to think it’s unfortunate because there’s this groupthink, and this affects every field, not just medicine. Of course, this is not unique. I remember reading in the history books about how Ignaz Semmelweis, who believed that you should wash your hands between patients and you may stop infections, he was derided as some sort of cook. And of course now we find it hard to believe that he was derided. So you have a lot of that going on in the medical field as well. And to be honest, some of these doctors are cooks. Some of them come up with ideas that are not really well thought out, they’re not evidence-based, some of them are being pseudo-scientific. So you know, I don’t want to say that it’s—like in most things, it’s complicated. But as a general rule, there is a tendency to pressure us clinicians to basically just toe the official party line. Otherwise, we fear that we’re going to be professionally ostracized as well as publicly ostracized. So like in everything else, we tend to comply and conform.
Vaccine Efficacy and Mixed Messaging [28:13]
Bob Zadek: Now, the vaccine. Now a lot of what’s being discussed in the media is the vaccine. Delivery, who gets it in what order—that’s almost purely a political decision, not a clinical decision. It’s kind of offensive to me, but we’re not going to discuss that. But on the vaccine, today on April 4th, once Americans get vaccinated, there’s even today such mixed messaging from CDC about how we should behave. We have Rochelle Walensky, who says in the same sentence, “Once you’re vaccinated, not much to worry about, you can’t get infected, if you do get infected it’s going to be very mild, you can’t infect others, and highly unlikely, almost impossible you’re going to end up hospitalized if you do get infected.” And then she says, “We’re doomed.”
So speak—kind of I’m going to be a little intrusive, but not a lot—you’ve been vaccinated. You’re a grandfather, you have kids, you have family, you have friends, you have Bob. So how do you behave now that you are vaccinated? Are you cautious? The CDC would have us—Fauci would say wear at least 15, maybe 20 masks at the same time just to be on the safe side. So what is the advice you give to the people you care most about? And you, Jeff, since you’re such an empathic guy, people you care most about is a very large list, I am sure. So what is your off-the-cuff, non-medical, how do you, Jeff the guy, how do you advise people who are asking your advice about once you’re vaccinated, how to order your life?
Dr. Jeffrey Singer: Okay, well first of all, the mixed messaging I think is really harmful because our ticket out of this mess is to get reach something close to herd immunity. And of course to reach herd immunity it doesn’t require everyone to get vaccinated. Another way to get immune is to get the infection and have natural immunity. I don’t recommend that approach. I’d much rather have vaccination than get sick and risk death. So, and I don’t want to feel the sickness. So obviously vaccination is the preferred way to go.
We’re incredibly fortunate that these vaccines, particularly the mRNA vaccines, which are a brand new technology that doesn’t even involve using a live or dead or modified virus, it just uses messenger RNA, it’s incredibly effective. So while there’s always exceptions, and people need to understand that science—that things in medical science are never 100%, but generally speaking, if you get vaccinated with any of the three available vaccines right now, you’re pretty much 100% guaranteed that you will not get severely ill enough to be in the hospital and you will not die. So there’s almost 100% guarantee against severe infection leading to hospitalization or death. And there’s, depending on the vaccine, there could be upwards of 95% or more protection against even getting the virus.
There is a very tiny percentage of people who may get infected from the virus and be one of those asymptomatic cases. So they’re unknowingly carrying the virus with them, like before this existed, of course, before we had a vaccine, and they could be spreading it to others. However, now there’s a lot of data coming in—originally it came in from Israel, but it’s coming in now from the CDC just reported on this last week—even among those who become asymptomatically infected, their viral titers, viral load seem to be greatly reduced by the fact that they were vaccinated. Asymptomatic people tend to have lower viral loads and are less likely to spread than symptomatic people anyway. But asymptomatic vaccinated people who become asymptomatically infected have it even lower.
So while it’s possible that you could be immune and feel great and unknowingly spreading a virus to other people, that’s extremely unlikely. Let’s just say that. It’s extremely unlikely. So armed with the information that you are, number one, almost guaranteed that you won’t get sick enough to go to the hospital and you won’t die, and if you get a case it’ll be a mild case, and you’re highly unlikely to be spreading the virus to others, well that tells me a couple of things.
Number one, I can hang out with other immunized people without concern. I can take my mask off, I can hug, I can kiss, I can shake hands and do all the things that human beings need to do because I’m highly unlikely to be able to spread my virus to that person who is highly unlikely to contract it in the first place because they’re immunized as well. So that’s step number one.
Step number two, if I’m among other people who have not been vaccinated, I don’t have to worry about them giving me the virus for what I’ve already said. And the chances of me spreading a virus to them, again, is extremely unlikely. Now, it still would make sense to be careful with people who are extremely vulnerable because you care about them and you don’t want to be that extremely unlikely person who spread a virus to this extremely vulnerable person who could then die. So I would still recommend being cautious among vulnerable people who are not immunized. Like, you know, if you want to visit a relative who is immunocompromised or is in the nursing home and hasn’t—most of the nursing home patients have been vaccinated now, so that doesn’t—that’s maybe a moot point. But if you want to visit some very chronically ill, frail relative, you might still want to wear a mask around them, but visit them. You might want to do that because you’d feel awful if you were that really, really rare case that spread the virus to them and they died.
But otherwise, when it comes to interacting with other people, immunized people don’t really have to worry. Now, when you’re outside, even before we had the vaccine, it made no sense to wear a mask outside. What we know is that this spreads usually by aerosol at relatively close contact. The CDC has been telling us for a year you have to be six feet away, but now they’re modifying it. And many other countries—the World Health Organization was always saying about a meter away, and countries in Europe have varied from three feet to five feet to two feet. Nobody really knows for sure. Six feet is safe. 100 feet’s even safer. But between three to six feet distance, and usually for a length of enough time for that aerosol to kind of land on the person.
So for example, if I’m walking down the street on a beautiful day and breathing in the fresh smell of orange blossoms here in Phoenix, and another person passes me on the sidewalk for one second, we cross each other’s paths, unless I hold that guy still and breathe closely into his face several times, I’m not going to give him the virus and he’s not going to give me the virus. So we don’t need to be—and I see people actually don a mask as they approach me for fear that they’re going to catch something as we pass by for that one second. If you’re riding a bicycle out in the open air, who are you going to catch the virus from? Not only that, but the mask tends to protect others from you, and also if that other person’s wearing a mask it protects you from them because it mainly reduces your spray. So if you’re riding a bicycle out in the open, I don’t know why you’re wearing a mask. Or if you’re in your car by yourself, why are you wearing a mask? Who are you going to give it to? I think a lot of people think that this is a virus that’s flying around like mosquitoes or something and could land on you. It’s not like that.
So when you’re out in public places where there’s wide space, you don’t need to wear a mask. When you’re in an enclosed space where there’s not good ventilation, unless you know who you’re with, it’s probably still advisable until we get more immunity in society to wear a mask. Now, of course, as a libertarian, I respect property rights. So when I’m coming into a store, if it says “masks required,” I obey that because that’s their right to say that. Not only that, but from a practical standpoint, if I’m going into a supermarket, I don’t want to frighten the other people in the supermarket. So since there’s no way of knowing among all these dozens of strangers in a supermarket who’s been vaccinated and therefore is no threat to others and who hasn’t been vaccinated, it’s just easier for everybody to wear a mask in there so nobody gets anyone frightened. At least if you’re considerate to your fellow neighbors. So I guess that’s it in a nutshell.
The Liberty Implications of Vaccine Passports [37:33]
Bob Zadek: Now, there’s been a lot of discussion about relatively recently about something called vaccine passports. And as a libertarian, Jeff, to me, where do I jump? I jump to ID card, show me your papers. Right away, I jump to the darkest parts of Western cultural and military history. And I have this cringe, cringe-like reaction. What is—and it’s very new, so the phrase pops up a lot, but there’s not a lot of detail. What’s going—what is this issue about vaccine passports? What are they? What is the public health use of vaccine passports? And should we be expecting, because that seems to be the tendency of our government, such like no-fly lists and things of that nature, to identify people in society who are more risky than others? So give us—tell us the state of the play with vaccine passports. Useful? Are they imminent? What’s going on?
Dr. Jeffrey Singer: First of all, I’m hoping that as we reach herd immunity in the next several months, hopefully, that becomes like a moot point. Now, of course, keep in mind there’s only one virus that’s ever been eradicated in human history, that’s the smallpox virus. That last case was in 1977 and that took 200 years to eradicate. So we’re not going to eradicate COVID, but if we reach something approximating herd immunity, then we generally relegate COVID to just another one of those respiratory viral infections that comes and goes like the flu or like some cold. And in fact, the tendency for viruses is to evolve to forms that are less deadly because those that don’t kill their host tend to survive and replicate. So that’s—so this whole—I’m hoping that this whole discussion about vaccine passports kind of fades away as it becomes less worth considering.
Now, again as a libertarian, I believe that if a property owner has a sign on their store saying “no shirt, no shoes, no vax, no service,” that’s their right and I have to respect that. But if you’re going to—and it’s reasonable for countries to want to make sure that you’re not carrying an infectious disease into their country when you’re landing, you know, at their point of entry, that could hurt their citizens. Many of us who travel are familiar with these yellow vaccination certificate cards. They’ve been around for decades. I have one. For example, when I’ve traveled to parts of the world where yellow fever is endemic, I had to prove that I had vaccination against yellow fever. So I had with me a card. It’s approved by the World Health Organization and the Department of Health and Human Services, and it has on there I was vaccinated on this and this date with this and this vaccine, lot number, and there’s a little stamp by my doctor showing it was—and that’s acceptable.
Now, if you have something like that, you know, I don’t see that as necessarily, you know, invasive of my property. I own the information and it stays with me. If you have, on the other hand, what we’ve heard discussed is sort of a centralized government database that controls your vaccination information and then you download onto your smartphone an app where you could have a QR code that you show people. A lot of problems with that. Number one, in order to have that in a centralized government database, there’s going to have to be some other vital information about you to find you in that database, and that’s subject to hacking. So there are privacy concerns. Every place that you use that, there’s going to be another opportunity for that information to be stolen. There’s an equity problem because not everybody has a smartphone. And of course, experience has told us these things could evolve into ways to track people throughout the country. Every place you go, every place you use it, there’s now a digital trail that you’ve left behind. And even though we would—it would be implemented without this intention, any healthy, skeptically healthy—well, you know what I mean, a skeptically healthy libertarian would say, “Yeah, I hear that you have no intention, but I also know these things have a way of evolving into that.” So that should be very frightening.
If you could come up with something like that card I’ve been talking about that is more difficult to forge—because one, we all are getting a card when we get vaccinated now that says what we’ve got and what date. Problem is that those things are being sold now in the black market, they could be easily forged. So if you could devise something akin to when you print your boarding pass to get on a plane as opposed to using the QR code in your phone. When you have a printed boarding pass, there are basically just a couple of identifiers in the barcode just basically confirming you are who you say you are and you paid for the ticket. And so if you could have something that is on a card that you keep with you and own and control the information, and all it has on there is something that verifies, “Yes, this person who vaccinated Jeffrey Singer on March whatever, this person does exist, he did do that vaccination, and this is Jeffrey Singer,” and if that’s all that’s on the card, I have no problem in principle with something like that and I could see it could be useful. But I’m hoping—number one, can that be developed? I read recently that Israel came up with something like that, they call it a green certificate. It wouldn’t even be a passport, it would be a certificate basically. And there was a report in the New York Times earlier in March about that, but I’m told by a couple of Israeli libertarian friends I have that that’s sort of—people have stopped using it, they just started ignoring it. So for a few weeks it was very helpful, but now it’s not being—apparently it’s falling out of favor there in Israel. But if you could come up with something like that, I don’t have an issue with that because then you don’t have to worry about privacy, about tracking, you just basically have a certificate that is less difficult to forge that’s on your person that if a person wants to be convinced that you are immune and not a threat, you could show it to them.
The Science of School Reopenings [44:32]
Bob Zadek: The last COVID-related topic that I think we’ll have time for, but it’s important to many of our listeners, is what has been happening in the K through 12 educational system with respect to COVID. From all that you have said and all that you have written, and many or most of your colleagues have written, the worst is kind of behind us. We’re on the mend. You’ve told us about the vaccine. You’ve told us that younger Americans, young kids, K through 12, the K through 12 group of Americans are highly unlikely to contract the virus. If they do, they’ll be asymptomatic, no problem. In your opinion, is there any reason, putting aside all the politics, is there any reason from your specialized vantage point that all schools should not be open, business as usual? And if you have hesitation, what is the risk of doing so today?
Dr. Jeffrey Singer: Well, I would modify what you said. I wouldn’t say K through 12. Grade school is highly unlikely to contract or spread the illness. When you get into adolescence and high school age, actually the risk of contracting and spreading the illness approximates that of adults. But under age 20, there’s only been 226 deaths in the United States out of what, 560,000, that are under the age of 20. So if you’re under the age of 20, your chances of getting seriously ill to the point where you have to be in the hospital and die is extremely small.
But in K through 6, let’s say, these young kids, there’s very little risk of spread, and there’s been research on that showing that for well over a year now. Interestingly, Rochelle Walensky, who’s the new CDC director, she herself was an author of a research paper last summer showing that. And in many countries they have not closed the schools, at least K through grade school level. And the younger children who are in the early development years, there are crucial milestones both in their cognitive development and in their socialization development that they’re missing out on right now. And in some cases this could have—we don’t know how long, but this could have long-term consequences. Hopefully not too long, hopefully they can be made up. But we don’t know that for sure.
There have been reports, for example, in students in the Virginia suburbs of DC who’ve actually had regression in their reading skills because they’re missing school. So younger children generally need in-person education. They don’t do as well remotely on the screen. Also, there are a lot of households where, you know, you have a single parent who has to go to work and can’t be there to kind of supervise that their child is doing what’s supposed to be done on the screen.
Now, you could make the argument that when you’re dealing with high school or middle school kids, when there’s a lot of this—when the case load is high in the community and it’s going around, you can make the argument of either hybrid or remote learning for these older kids. Number one, they’re older and they seem to do okay with remote and hybrid learning. But even then—and this is mostly anecdotal—but experience has been that a lot of kids just don’t show up because even though they’re supposed to log on and participate, they’re not doing it. Or they’re not doing it as diligently as they should be. So in general, missing school in person has been really harmful to the younger generation.
Bob Zadek: But can it be—is there any, can any case be made for not at K through 6, would you have picked, let’s maybe eliminating middle school, K through 6, is there any rational scientific justification for anything other than business as usual in those grades today?
Dr. Jeffrey Singer: Well, no. In fact, even the CDC a few weeks ago revised their guidelines for that. And they said that the research shows that three-feet distancing is just as good as six-feet distancing. You don’t need six-feet distancing, which is important because if you require six-feet distancing, now a lot of schools can’t accommodate every student with that kind of distance between desks. So three-feet distancing is sufficient. And that if they’re taking necessary precautions—mask wearing, hand washing, that kind of thing—in fact, it might be the safest place to be.
When there’s even no—it’s been discovered and the CDC has said this, there’s no correlation to the rate of spread within the community because when you’re in the classroom, three feet apart from one another, wearing masks and there’s good ventilation in the school, you’re actually safer there than in the general community where if you’re accompanying your parent, let’s say, to the supermarket, you’re much more likely to pick it up from an adult there. So there is no scientific reason to keep schools closed.
You know, there are some representatives of the teachers’ union basically insisting on zero risk. Now that many states have prioritized vaccination of teachers, now that they’re immune, they’re saying, “Well, that’s not good enough. I need the children to be immune too.” But there’s no such thing in life as zero risk. The teacher driving to the school to teach the children took a risk of getting killed in a car accident driving to the school. And when you yourself are immunized, like we said earlier in this program, and you’re facing a classroom of young children who are highly unlikely to contract or spread the virus and they’re wearing masks and you’re in the front of the classroom, there is no scientific rational basis for insisting that they get vaccinated.
Conclusion [51:00]
Bob Zadek: Jeff, we’re running out of time. Thank you so, so much. I wish the entire country could hear what you have shared with us this hour. Thank you so much, and I refer all of our listeners to your work at cato.org. Cato has some wonderful material on mistakes that are made, lessons for the future, all the good that can come out of this horrible year we have made through if the country is wise enough to learn from the experience. So Jeff, thank you so, so much. Thanks to all my friends at Cato and to all my friends and listeners out there. Enjoy this Easter Sunday and 2021 promises to be—and this is the best one can say—a regular year. So thank you so much, Jeff. Thanks again, always a pleasure to meet you again, albeit digitally. Hope to see you soon in person. Bob Zadek saying thank you so much for listening and thank you to all my friends out there. Have a good Easter Sunday.