It's incredible to me that you can look at the Covid response and see anything but an astonishing series of failures by public health authorities (vaccine development was a rare bright spot). Anyone with basic scientific literacy and critical thinking ability has consistently been _months_ ahead of public health recommendations. Early prep for the pandemic, the FDA's breathtaking negligence in historical ongoing limitation of tests[4], mask recommendations, indoor vs outdoor spread risk, fomite vs air spread risk, the priority and manner of the vaccine rollout, outdoor-protest risk, relative herd immunity in hard-hit places like NY.... it's very difficult to think of a shift in the science that the medical policy and communications establishment wasn't stubbornly holding on to weeks and months later than everyone scientifically-literate was fairly confident.

This isn't an argument for rushing consensus before the evidence is strong enough, but the reasoning behind the initial mistakes was consistently laughably stupid, relying on vague platitudes instead of intellectual rigor[1]. Medical culture is plagued with innumeracy, illusory hard binaries, poor critical thinking, and knee-jerk hyper-conservatism. While the first three are an unforgivable gap that the medical establishment needs to engage in some hard self-examination over, the latter is possibly a reasonable baseline culture for normal circumstances[2]. However, it's horribly maladaptive in a situation like a pandemic, where time is a critical factor and the baseline cost of inaction is thousands of lives a day, trillions of dollars, as well as the PV of the future cost of exponential spread.

As always, I'll clarify that this is not a criticism of _doctors_ as individuals. All of the doctors I know are at least moderately intelligent and well-intentioned, but professional culture is a powerful force and medical school is a heavy-duty indoctrination device that I've seen make too many people _worse_ at thinking. I'm fairly close socially to a lot of doctors of various ages, and I've only seen the most intelligent[3] ones I know manage to shake off this brainwashing enough to recover their critical thinking abilities.

Throw in the challenges of political engagement with expert fields....suffice it to say that Alex Tabarrok's fucking Twitter account was a better source of public health understanding than the WHO/CDC/FDA/policymakers combined.(I started that sentence as a joke, but I'm actually pretty sure that those ignoring the latter in favor of the former would have had a healthier, happier, safer pandemic experience).

[1] For example, Bob Wachter, the chairman of the Dept of Medicine at UCSF, came around to the idea of loosening the second-dose-reserved-at-all-costs orthodoxy after a little while, citing the basic math that the numerate among us had been screaming about since the beginning of the vaccine drive. His reason for his initial disagreement? "An unnecessary curveball". Doctors' misuse of and amateurish engagement with science would be amusing if it wasn't killing so many people.

[2] though the lever is probably jammed too hard in one direction due to liability concerns and inaction bias

[3] To the extent that pedigrees are useful for calibrating where this bar is: my double-Ivy-League-educated physician sister is miles below this intelligence bar

[4] As far as I'm concerned, the FDA has more blood on their hands than anyone at this point. Anybody who paid any attention to them before March 2020 should be completely unsurprised