Patterico's Pontifications

12/24/2020

Why Yascha Mounk Is Losing Trust in the Institutions

Filed under: General — JVW @ 11:10 am



[guest post by JVW]

Yascha Mounk, the editor of the new online journal of opinion (he modestly refers to it as “a newsletter,” but I’m going to upgrade it) Persuasion, has a compelling piece in yesterday’s edition titled “Why I Am Losing Trust in the Institutions.” He covers the recent controversy regarding the CDC’s temporary determination to prioritize COVID-19 vaccinations based upon occupational and racial considerations rather than age considerations, even though they acknowledged that this would likely cause thousands of senior citizens to die who otherwise might be spared. He does an excellent job in explaining how this decision was reached:

On November 23rd, Kathleen Dooling, a public health official at the CDC, gave a presentation to the Advisory Committee on Immunization Practices (ACIP), which is tasked with developing the recommendation on who should first get access to the vaccine against Covid. In a stark departure from the course of action adopted in virtually every other developed democracy, Dooling recommended that 87 million essential workers—a very broad category including bankers and movie crews as well as teachers or supermarket cashiers—should get the vaccine before older Americans, even though the elderly are much more likely to die from the disease. The committee unanimously accepted the recommendations.

Dooling’s presentation laid out three different metrics for evaluating whether 87 million “essential workers” or Americans over the age of 65 should be next in line: feasibility, science, and ethics. According to the CDC’s own evaluation, considerations of feasibility give us reasons to prioritize older Americans. This makes sense. It is both difficult to determine who should count as an essential worker and to communicate to people who do fall into that category that they are eligible. A straightforward age cut-off makes it easier to decide who’s in and reach the target population. As a result, prioritizing the older than 65s leads by this metric.

Considerations of “science” also seemed to point in the same direction. As the presentation acknowledged, the likelihood of dying from Covid strongly depends on age. According to the CDC’s model, prioritizing essential workers over the elderly would therefore increase the overall number of deaths by between 0.5% and 6.5%. In other words, it would likely result in the preventable deaths of thousands of Americans.

And yet, the presentation concluded that science does not provide a reason to prioritize the elderly. For, as Kathleen Dooling wrote in one of the most jaw-dropping sentences I have ever seen in a document written by a public official, differences in expected consequences that could amount to thousands of additional deaths are “minimal.”

This allowed Dooling to focus on “ethical” principles in selecting the best course of action. Highlighting the most important consideration in red, Dooling emphasized that “racial and ethnic minority groups are underrepresented among adults > 65.” In other words, America’s elderly are too white to be considered a top priority for the distribution of the vaccine against Covid. It is on this basis that ACIP awarded three times as many points to prioritizing the more racially diverse group of essential workers, making the crucial difference in the overall determination. Astonishingly, the higher overall death toll that would have resulted from this course of action does not feature as an ethical reason to prioritize older Americans.

I have quoted quite liberally from Mr. Mounk’s piece, and rather than explicate the rest of his thoughts in this post, I simply urge everyone to click over to his piece and read it in full. But I will let slip that he affirms Andrew Sullivan’s observation of two years ago that “we all live on campus now,” and as the title of his piece indicates, Mr. Mounk declares that this social justice silliness is corroding his — and, I venture it is safe to say, so many others’ — trust in societal institutions that ought to be above this sort of fatuous grandstanding.

Meanwhile, the boss had a Twitter back-and-forth on this very same subject with lefty writer Kevin Drum of Mother Jones, who unsurprisingly is far more sanguine about prioritizing younger essential workers over elderly retirees for vaccination, partly of course because younger “essential” workers are indeed a more racially diverse cohort. Patterico made the same argument on Twitter that Yashca Mounk would later make in his piece: What about elderly minorities, especially the black community, who without the vaccine will presumably (at least according to what we have seen thus far) die at a higher rate than elderly whites? Set aside for a moment the obnoxious argument that social justice dictates that younger and more diverse age-groups have priority over older and whiter age-groups: How is social justice served by using the vaccine to theoretically save X young black lives as opposed to Y older black lives, especially if it turns out (as it very well might) that Y is greater than X? Obviously the right solution in the eyes of the rabid social justice mob would be to have all black and brown people move to the front of the line, but even the CDC realizes that is fraught with peril, both from a moral and a practical standpoint. Patterico’s entire Twitter exchange with Kevin Drum can be found here, but this is the major part when Drum addresses our host’s question:

It probably won’t shock any readers of this blog if I declare my belief that Patterico and Yascha Mounk have the better of the argument. As Mr. Mounk points out, if our institutions mindlessly adopt the fashionable intellectual pablum marketed under the banner of social justice then they shouldn’t expect the rest of us to hold them in any particular esteem.

– JVW

35 Responses to “Why Yascha Mounk Is Losing Trust in the Institutions”

  1. I’m content with being an extremely low priority for the vaccine: I’m not elderly but also not a schoolkid who wants to go back to campus, and I work from home in a job that wouldn’t be considered “essential.” I’ll be happy to wait my turn in line.

    JVW (30a532)

  2. Excellent post, JVW. Thank you.

    felipe (630e0b)

  3. I think this is another case of confirmation bias and taking somebody else’s word uncritically.

    The “1a” group (sensibly) was health-care professionals.

    The “1b” group, which is 15% of the population, includes frontline essential workers (“educational staff, including daycare workers, food and agricultural workers, manufacturing workers, U.S. postal service employees, public transit workers and grocery store workers”) AND people aged 75 and over. The latter are 8% of the population.

    1b does not include movie crews or other media personnel, as the quoted article falsely claims.

    CDC panel says frontline essential workers, people 75 years and older should get Covid vaccine next

    The plan was approved by a 13-1 vote obey CDC’s panel.

    Dave (1bb933)

  4. As long as Kevin Drum puts his money where his mouth is, I’m fine with his argument. That means he refuses to take the vaccine, as well as his wife and his elderly mother, until all minorities in the health care industry get it.

    If he doesn’t, he’s a hypocrite.

    Hoi Polloi (139bf6)

  5. Query — what if the reason propounded was that we need to restart the economy and vaccinating the essential workers was more important than reducing the number of deaths? How would people react?

    Second Query — We know the CDC was put under enormous pressure over the past year. What if the CDC decided to do Trump’s bidding, but cloaked it in the language of the insufferably woke?

    I understand the loss in faith in institutions. But the need to be woke isn’t the only thing causing it.

    Appalled (1a17de)

  6. @3: I think this is another case of confirmation bias and taking somebody else’s word uncritically.

    Don’t think so. From the CNBC article you linked:

    “Dr. Henry Bernstein of Northwell Cohen Children’s Medical Center, who voted against Sunday’s recommendation, explained that he was in favor of including those 65 years of age and older.

    Dr. Peter Szilagyi of the University of California, Los Angeles said one reason to prioritize essential workers is that minority communities are disproportionately represented among essential workers.“

    beer ‘n pretzels (042d67)

  7. I don’t think these recommendations are binding on the states.

    Yes there is another reason for giving it to “essential workers” because this can be done at a place of employment, but how do you collect people aged 65+ and the vaccine has to be kept at least refrigerated, lest it degrade? (The Astra Zeneca vaccine won’t have that problem)

    https://www.fiercepharma.com/manufacturing/astrazeneca-hopes-warmer-storage-needs-for-covid-19-vaccine-will-be-advantage-against

    But it could be another two to three months off, assuming no new pstacles apear like the virus disappearing and then you can’t prove the vaccine works.

    You could place it a medical clinic and invite people to make appointments, too.

    One thing that is being done, is if at the end of a day there’s vaccine left over, they give it to anybody present.

    Sammy Finkelman (081278)

  8. The lone ranger and tonto are surrounded by commanches. The lone ranger tells tonto looks like we are in trouble now. Tonto says “What you mean we white man!” As the song says “those who are now first will later (NOW) be last! for the times they are a changing!”

    asset (0ed384)

  9. Good post, JVW. “Fatuous grandstanding” seems to be baked into the social justice viewpoint – no matter the issue at hand.

    In contrast, this from Marci’s link:

    “The focus on people who are age 65 and older or who have comorbidities will protect the most vulnerable populations,” Chair of Texas’ Vaccine Advisory Panel Imelda Garcia said in a statement. “This approach ensures that Texans at the most severe risk from COVID-19 can be protected across races and ethnicities and regardless of where they work.”

    Dana (cc9481)

  10. Dave:

    Your comment reminded me that I failed to include a link to the presentation that Ms. Dooling gave on November 23. The link was included in Yascha Mounk’s original piece. I have gone back and added it above.

    Here’s the thing, though: You’re trying to refute the inferences made by Ms. Dooling’s presentation of 11/23 by citing a regulation adopted on December 20, even though Patterico and Kevin Drum were debating this issue on December 18. That’s not too helpful if you are asserting that Yascha Mounk and/or Patterico have overreacted. Nowhere in Ms. Dooling’s 11/23 presentation did the word “frontline” appear, and certainly not between “essential” and “worker.” Nor did she make any attempt to define who would be an essential worker. It’s really not hard to imagine that essential workers would come to mean whomever the CDC wants it to mean, and that’s a sort of arbitrary power that unelected government bureaucrats ought not to wield.

    Here’s what you told us:

    The “1b” group, which is 15% of the population, includes frontline essential workers (“educational staff, including daycare workers, food and agricultural workers, manufacturing workers, U.S. postal service employees, public transit workers and grocery store workers”) AND people aged 75 and over. The latter are 8% of the population.

    Even by your own account the 1b people are to include at this time only those aged at least 75, and the whole issue at hand is why younger and otherwise healthy “essential workers” ought to be a higher priority than those aged 65-74, just because it would satisfy some race-based social justice diktat.

    JVW (30a532)

  11. This is, of course, genocidal.

    Kevin M (ab1c11)

  12. I will point out that the only deaths I personally know of were both in their 50’s with co-morbidities and Black, and happened from exposure in mid-March. Neither would be classified as “essential frontline workers” although both did non-profit work among risk-taking populations.

    Not sure what that implies about these rules, since no reasonable rule would have included them first.

    Kevin M (ab1c11)

  13. If the vaccine prevented transmission of the virus from otherwise careless young people to old people, giving grocery and delivery workers the vaccine early might make sense.

    But I suspect that it will make young people who are inclined to consider themselves invulnerable, feel more so, and justify them taking more risks than they are now (which is already the engine of spread). If they remain contagious, it could have the opposite effect — making them more likely to transmit the virus while remaining asymptomatic.

    Kevin M (ab1c11)

  14. Also, how does one claim to be a front-line worker? Does a social worker qualify? How about someone who volunteers at a soup kitchen or an insurance salesman?

    Kevin M (ab1c11)

  15. Deciding who lives and who dies is why governments are instituted among men deriving their just powers from the consent of the governed, comrades. The “ethics” of statism? Yeah, right.

    nk (1d9030)

  16. Deciding who lives and who dies is why governments are instituted among men deriving their just powers from the consent of the governed those left alive.

    Kevin M (ab1c11)

  17. People who are particularly vulnerable, including the elderly, should be taking maximum precautions.

    The people who are processing, delivering, shelving, etc our food and other necessities of life do not have that luxury, and because they come in contact with many more people, they have more opportunities to acquire the virus, and more opportunties to spread it.

    At first glance, the ~15% of the population in “1b” are split roughly evenly between the most elderly and the most active/exposed (due to working), which seems like a reasonable compromise to provide some protection to both groups.

    Dave (1bb933)

  18. What you really should be discussing, comrades, is not what those mooks are saying but whodaf**k are they to be saying it?

    nk (1d9030)

  19. At first glance, the ~15% of the population in “1b” are split roughly evenly between the most elderly and the most active/exposed (due to working), which seems like a reasonable compromise to provide some protection to both groups.

    Is this stuff supposed to be driven by empirical studies of virus transmission and mortality backed up by real data, or is it supposed to be based upon what government bureaucrats think is a “reasonable compromise” or what is demanded by true wokeness? I think this is the heart of the question and what Yascha Mounk and our host are getting at. The whole point of all this kerfuffle is the suggestion that rather than relying purely on hard data, the CDC wanted to take into account the ethical principles so beloved by Ms. Dooling which incorporated alarming racial considerations.

    JVW (30a532)

  20. Is this stuff supposed to be driven by empirical studies of virus transmission and mortality backed up by real data, or is it supposed to be based upon what government bureaucrats think is a “reasonable compromise”

    You sound like you think there’s some inconsistency between the two.

    Decisions based on “empirical studies” often require judgment calls, because the data never provides all the information you’d ideally want.

    If A and B lead to similar expected outcomes, and you’re not sure which is the marginally better choice, it is perfectly reasonable to hedge (if possible) by splitting the difference. That automatically halves your worst-case loss.

    Dave (1bb933)

  21. Thank you, JVW. Our New Reality is grim indeed.

    Simon Jester (13e0ee)

  22. Decisions based on “empirical studies” often require judgment calls, because the data never provides all the information you’d ideally want.

    Or in this case, as both Mr. Mounk and our host suggest, information you would just as soon downplay if not outright ignore because it doesn’t give you proper room to virtue signal.

    JVW (30a532)

  23. 3

    You are quoting the (still bad) revised plan after the first plan got heavily criticized. This is all explained in the link.

    James B. Shearer (163eb8)

  24. You are quoting the (still bad) revised plan after the first plan got heavily criticized.

    I quoted the plan being implemented.

    One reason decisions like this are reviewed by a panel is to solicit feedback from a variety of experts and improve the final product.

    If the revised plan is better than the original, then the system worked.

    Dave (1bb933)

  25. Half or a quarter worked maybe if one principle is still wrong..

    Sammy Finkelman (081278)

  26. More debate: https://www.nytimes.com/2020/12/24/magazine/who-should-get-the-covid-vaccine-next.html

    Some of the people here may decide on when you or I get the vaccine, and not all of them seem to care how many deaths there are, just whose deaths.

    Kevin M (ab1c11)

  27. If the revised plan is better than the original, then the system worked.

    No, it just prevented a terrible plan from going into effect. The resulting plan may still be bad, just not as bad.

    Kevin M (ab1c11)

  28. The New York Times reports that in New York, some hospital workers are jumping the line for vaccines.

    This is when a hospital gets vaccines, for its employees and tries to administer it in some kind of priority. (and it’s only a matter of a few days. Some of these workers are actin like the supply might be cut off!)

    https://www.nytimes.com/2020/12/24/nyregion/nyc-hospital-workers-covid-19-vaccine.html

    At NewYork-Presbyterian Morgan Stanley Children’s Hospital, one of the most highly regarded hospitals in New York City, a rumor spread last week that the line for the coronavirus vaccine on the ninth floor was unguarded and anyone could stealthily join and receive the shot…

    …Most of the vaccinations in the New York region to date have involved hospitals giving shots to their own employees, a relatively easy process compared with what is to come as part of the largest vaccination initiative in the nation since the 1940s.

    ..At some major hospitals in Manhattan, doctors and nurses have recalled scrolling through social media and pausing to make a snap judgment each time they saw a selfie one of their colleagues had posted of getting vaccinated: Did that person deserve to be vaccinated before they were?

    The anesthesiologists at Mt. Sinai hospital don’t like the fact that they are low on the list (second tier)

    Stories have begun to circulate of a plastic surgeon who managed to get vaccinated early, of doses being thrown out at one Manhattan hospital because of poor planning. On group chats, doctors debate how — and whether — to try to get vaccinated ahead of schedule.

    At Mount Sinai Hospital, some doctors told others that you could talk your way into receiving a vaccine just by getting in line and repeating that you do “Covid-related procedures,” one Mount Sinai doctor, who requested anonymity for fear of retribution, recalled…

    Phase 2, which includes other kinds of “essential workers” won’t begin until late January.

    And then many doctors in small isolated clinics aren’t being supplied with the vaccine. What was above though, involved, people all working at the same hospital.

    https://www.nytimes.com/2020/12/17/us/covid-vaccine-health-workers.html

    Sammy Finkelman (081278)

  29. More from today’s paper:

    Still, The Times interviewed four health care workers at Morgan Stanley Children’s Hospital, all of whom expressed resentment at colleagues and dismay that hospital administrators had allowed the vaccine distribution system to devolve.

    One nurse at Morgan Stanley Children’s Hospital said she had gone as far as to confront a social worker who she believed had jumped the line about why the social worker thought she deserved the vaccine ahead of others.

    “She said, ‘We have to go to E.R. sometime,’ but that’s not true,” the nurse said of the social worker.

    At some places, doctors and nurses who work in dedicated Covid-19 units were not included in the priority group.

    This maybe should have been expected.

    Are they going to set priorities within the same hospital with extreme care, or won’t it in fact be slapdash??

    Are they really going to police it?

    Sammy Finkelman (081278)

  30. There’s another issue: consent forms.

    Some people getting it as a proxy for their (usually) elderly family members complained that you could only say yes, not no. But if it is needed, an unsigned form is equivalent to a no.

    Of course an alternative person could sign it. But that’s always true.

    One question: If the vaccine is truly necessary why is any consent needed? It sounds like it might be a liability release. Of course, it’s way to stop duplicate shots or maybe a shot to be taken by someone who shouldn’t receive it, or they think they shouldn’t receive it.

    Right now they want to give it to people who recovered from Covid, and to pregnant women, but not to those under 16 or is it 18?

    There are some other categories of people who were excluded from the trials, like cancer patients. They could use logic on this.

    Sammy Finkelman (081278)

  31. Terrorist or criminal attack in Nashville, Tennessee early this morning (explosion of RV parked overnight that came with a 15-minute warning) that caused a lot of smoke but limited damage to buildings.

    Warning came from car and said: “Evacuate now. There is a bomb. A bomb is in this vehicle and will explode,”

    No word yet on possible perpetrators or “cause” if any.

    Shots were heard about an hour and a half before the explosion.

    Sammy Finkelman (081278)

  32. Thanks, Sammy for posting on that. Back in the day on this blog, a former prolific poster would call that a “Back at the Ranch” incident.

    urbanleftbehind (a6c8cb)

  33. This is the Biden Admin that Patterico wants. At least he won’t send mean tweets.

    Bill OReilly (72569b)

  34. Shots were heard about an hour and a half before the explosion.

    These shots were on the recording. The police may have arrived closer to the detonation.

    There was a female voice (possibly artificial) on the recording, which started a countdown at 15 minutes.

    Police chief says they made the right decision in starting an evacuation and not waiting to check out if the bomb was real.

    It completely destroyed one building and damaged an AT&T location. Other got damaged. Some possible trace of human remains were found but no victim.

    Sammy Finkelman (081278)


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