Great Antidote: Jay Bhattacharya on the US Response to COVID-19 - Deep Dive

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Jay Bhattacharya with Juliette Sellgren
Great Antidote host Juliette Sellgren and guest Jay Bhattacharya discuss the origins of the Great Barrington Declaration, the mistakes and challenges made throughout the pandemic, and reflect on what lessons we can learn from the past few years. 
From early 2020 until now, the lives of individuals all around the world have been impacted by the spread of covid-19 and related variants. In addition to the consequences of the virus, there are serious questions about the responses to the spread of the virus by elected & public health officials, scientists, and institutional leaders at every level. Great Antidote host Juliette Sellgren and guest Jay Bhattacharya discuss some of the mistakes and challenges throughout the pandemic and reflect on what lessons we can learn from the past few years. Jay Bhattacharya is a professor of medicine at Stanford University, a research associate at the National Bureau of Economic Research, and co-author of the Great Barrington Declaration with Martin Kulldorff and Sunetra Gupta. The Great Barrington Declaration has more than 929,000 signatories, according to their website.

Jay Bhattacharya begins by answering Juliette Sellgren’s questions about what young people should know with the advice to be curious and open to other ideas because of the quality of the ideas - not necessarily the person espousing them. At the end, he gives an example of something he was wrong about: he was surprised by the speed of the creation of a vaccine and how that changed some of his thinking about lockdowns and related responses. 

When Bhattacharya lists the 3 major failures of public health officials he points to 
  1. Pride and hubris of those who pushed draconian measures like lockdowns and didn’t consider any of the harms they were imposing; He says, “we have no technology that can stop the spread of this disease.” 
  2. Ignoring the almost 1,000x difference between the young (under 30) and old and not choosing the easy strategy of protecting older, vulnerable people while not disrupting the lives of younger people so much. Relying on disease suppression instead of focusing creatively on protecting the vulnerable was a big mistake. 
  3. Attempts by the public health establishment, big tech, and the political establishment to limit what could be included in the public debate in the hopes of increasing compliance. A full debate in the public sphere would have led to fewer deaths and fewer harms. 

Bhattacharya was an early skeptic about the mortality rates estimates based on his knowledge of respiratory viruses and previous pandemics like H1N1 in 2009. A study he co-authored looking for antibodies in larger, non-hospital samples suggested that the average death rate in the general community was much smaller than others believed. He points out this is not generalizable to vulnerable communities like the elderly and people living in nursing homes. He blames the focus on the worst outcomes like in China and Italy as opposed to typical outcomes for causing the fear and panic that lead to quick and bad decision making. 

Sellgren and Bhattacharya also discussed the exceptions and “theatrical” aspects of many restrictions (wearing masks only while walking to a table in a restaurant, plexiglass screens) which were not only ineffective but also caused doubt about the seriousness of measures that are imposed. This also undermines the public's trust in the public health community. Bhattacharya compares the scientific community and public health officials to a young doctor who desires to be seen to be “doing something” even if that something isn’t supported by actual evidence.

Bhattacharya also talks about how the Great Barrington Declaration came about in October of 2020 because all the authors had concerns about the lockdown strategies being pursued. He expressed serious concerns about school closures and our inability to predict and to mitigate the harms that were caused by lockdowns, especially poor children. He also expressed concerns about other health problems caused by lockdowns like delayed or foregone cancer screening and people thrown into poverty as a consequence of lockdowns. Sellgren shares two stories from family friends. One from a physician’s assistant who is seeing a 50% decrease in cancer diagnosis because of people not getting screened.  The second story was of a Kindergarten teacher struggling with kids who have spent a large portion of their early lives with more limited social interaction.  

When Sellgren ask Bhattacharya to speculate about some of the differences between this and previous pandemics, he points to the ruling “Laptop class” with jobs that could be done at home who made a virtue of work from home then blamed those who wouldn’t or couldn’t go along. He suggests that it’s the technology we have, like Zoom, that allowed lockdowns to be implemented and sustained. He suggests that if these technologies didn’t exist we wouldn’t have had the lock downs and we would have thought more creatively. 

All this led to a lack of acknowledgement of the harms of lockdowns, especially the harms to children, young people, working class people, the poor, and the elderly. Bhattacharya speaks about the increase in suicidal contemplation among young adults. Bhattacharya identifies closing schools as the worst measure and insists that covid was never as much of a threat as stated.  Bhattacharya talks about how  doctors were scared and perceptions of doctors were set by public health. Public health made a virtue of panic. They were scared for themselves, too risk-averse, tyrannical, and ill informed. 

Bhattacharya credits his training in economics to help him think about collateral harms and costs differently from others. He says this training helped prime him to think about side effects as well as direct effects; unintended effects as well as intended effects, then to compare them. He says lockdowns were viewed as costless but are, in fact, the single most costly, harmful measure we've implemented in modern times. 

One of the most disturbing parts of the interview is the concerns Bhattacharya raises about powerful people in the government like Anthony Fauci and Francis Collins attempting to silence dissenting views. Because of the financial and reputational power that comes with their positions, their participation in the public debates risks silencing experts with relevant expertise who might be concerned about the impact disagreement would have on their careers.  Another Great Antidote podcast recently looked at this type of danger regarding US International Relations with Chris Coyne and others on free speech and related topics are listed below.  This part starts around 27:14. 

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People, places, and things mentioned in this episode 

This is a contentious topic and our understanding of events leading up to and during the pandemic is still evolving. Many intelligent and informed people disagree about the evidence and how to interpret it. There are major disagreements about the benefits and costs of 
-wearing masks and mask efficiency
-vaccination of healthy people
-the use of lockdowns (compounded by various definitions of what qualifies as a “lockdown”) and especially with regard to their effectiveness at helping temporarily reduce pressure on hospitals and health services workers. 
-interrupted or irregular school experiences
-restrictions on travel 
-federal, state, and local government responses
-prioritizing public health over other also important government responsibilities  
-how much of individuals’ responses were due to private choice vs government coercion 

To help put some of this in the larger context here is some additional Information and data sources relevant to these topics:
Resources compiled by Christy Lynn