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Posts Tagged ‘Centers for Disease Control’

I’ve written many times about the value of cost-benefit analysis for government policy.

My go-to example is that a nationwide 5-mph speed limit would reduce traffic fatalities, but the resulting economic damage would be so pervasive that there would a net reduction in life expectancy.

In other words, the indirect effects would outweigh the direct effects.

But that’s just a theoretical example.

We now have a real-world case study thanks to a remarkably short-sighted decision about the Johnson & Johnson vaccine by bureaucrats at the Food and Drug Administration (FDA).

Ronald Bailey of Reason is very blunt about the deadly consequences.

The U.S. Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) issued a statement today “recommending a pause in the use” of Johnson & Johnson’s COVID-19 vaccine…based on six cases of a rare blood clot disorder in people who had been inoculated with the one-dose vaccine. There have been six cases out of 6.8 million people who have already been inoculated with the vaccine. The blood clot incidents all occurred in women between the ages of 18 and 48. Those odds amount to one in 1.13 million, which is comparable to your annual chances of being struck by lightning (1 in 1.22 million). For comparison, a November 2020 meta-analysis in The Lancet found that more than one in five very ill hospitalized and post-mortem* COVID-19 patients experienced venous thromboembolism—that is, blood clots in their veins. A 2010 study in the Journal of American Preventive Medicine reported that the annual incidence of thromboembolism between the ages of 15 and 44 was about 1.5 cases per 1,000 people. In addition, the risk of blood clots from taking oral contraceptives is about 1 in 1,000 annually. …By focusing on the not-yet-proven, very low risk of blood clots versus the known risks of the increased misery, hospitalizations, and deaths that the Johnson & Johnson vaccine would have prevented, our overly cautious public health bureaucrats will likely cause more sickness and deaths among Americans than would otherwise have occurred.

Just in case you’re tempted to dismiss the above article because of Reason‘s libertarian perspective, Philip Bump’s article in the Washington Post makes the same point about tradeoffs.

It’s easy to imagine the internal debate at the Centers for Disease Control and Prevention upon learning that six cases of a rare, dangerous blood clot have been found in women who received the Johnson & Johnson vaccine. Allowing the vaccine to be distributed while experts reviewed the cases risks exposing more people to the possible problem. Pausing distribution, though, runs a different risk… Given that about 6.8 million doses of the Johnson & Johnson vaccine have been administered and that there have been only six such incidents, the rate at which those red dots occur is about 1 in 1.1 million vaccinations. …By way of comparison, every year about 12 in 100,000 Americans die in a car crash. …more than 561,000 people in the United States have died of covid-19, the disease caused by the virus. That’s about 1.8 percent of the 31.2 million people who have contracted it. Given the effectiveness of the Johnson & Johnson vaccine in preventing serious illness and death, vaccinating 6.8 million people could have…protected millions of people probably prevented thousands of deaths — with six problematic incidents.

Mr. Bump makes the broader point that each of us make cost-benefit decisions every day.

Nearly everything we do is a balance between risk and reward. Driving down the street, as mentioned above. Walking outside, where a meteorite could suddenly slam into your skull. Sitting on your couch, where your floor could give way or an electrical fire could break out or a bear could crash through your window. None of these things is likely, so we don’t worry about them, but they could. We draw a balance.

The people on Twitter who can do math (regardless of ideology) were united in their disdain for what the bureaucrats did.

Such as:

And:

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And that’s just a very small sampling.

For my modest contribution to this discussion, I want people to have liberty to take the J&J vaccine, regardless of the shameful actions of the bureaucrats in Washington (or their counterparts at the state level).

Indeed, I also want them to have the freedom to take the AZ vaccine.

Let adults make their own choices about costs and benefits, about risks and rewards.

That means they can choose vaccines (or not), as well as whether to vape, to own a gun, to donate/sell organs, or to try experimental treatments.

Liberty is not only a good principle, it also generates the best health outcomes.

P.S. To learn more about the harmful policies of the FDA, click here and here.

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Every so often, I highlight tweets that deserve attention because they say something important, usually in a clever and succinct fashion.

Today, I’m highlighting what I consider to be the year’s best tweet.

The tweet is from Matthew Lesh of the Adam Smith Institute in London and it shows the big difference between private sector results and government incompetence.

Some readers may wonder if he is being unfair? Is the tweet merely libertarian-style grousing?

Well, consider this recent story from the Washington Post, which details how government incompetence at the Centers for Disease Control (CDC) greatly delayed testing capacity.

On Jan. 13, the World Health Organization had made public a recipe for how to configure such a test, and several countries wasted no time getting started: Within hours, scientists in Thailand used the instructions to deploy a new test. The CDC would not roll out one that worked for 46 more days. …The agency squandered weeks as it pursued a test design far more complicated than the WHO version and as its scientists wrestled with failures… The CDC’s response to what became the nation’s deadliest pandemic in a century marked a low point in its 74-year history. …Without tests to identify the early cases, health authorities nationwide were unable to isolate the infected and trace the rapid spread among their close contacts. …120 public health labs were without a government-approved test of their own and, with few exceptions, depended wholly on getting the CDC’s kits. …companies had no incentive to navigate regulatory hurdles and mass-produce kits.

The above story describes how the CDC screwed up at the start of the pandemic.

In her December 27 column for the Washington Post, Megan McArdle highlights a new example of CDC incompetence.

…the now-infamous November meeting of the CDC’s Advisory Committee on Immunization Practices…unanimously agreed that essential workers should get vaccinated ahead of the elderly, even though they’d been told this would mean up to 6 percent more deaths. This decision was supported in part by noting that America’s essential workers are more racially diverse than its senior citizens. …the discussion of whether to prioritize essential workers was anything but robust. …not one of those 14 intelligent and dedicated health professionals suggested adopting the plan that kills the fewest people. …for the past nine months, public health experts have insisted that minimizing deaths should override other concerns, even quite important ones. So how, in this case, did equity conquer death?

Let’s close with some excerpts from Aaron Sibarium’s article on the same issue for the Washington Free Beacon.

The committee openly acknowledged that its initial plan would result in more deaths than “vaccinating older adults first.” But, the panel said, the plan would reduce racial disparities—something they deemed more important than saving lives… The result was an explicitly race-conscious plan that would have prioritized shrinking the case gap between races over saving the most lives. …All of this—the exclusions, the contradictions, the moral redundancies—helped disguise the agenda that it justified, giving unscientific value judgments an air of scientific assuredness.

The really amazing aspect of this story is that there almost surely would be more minority deaths if this this approach was implemented.

But the “woke” bureaucrats though that would have been okay since there would have been an even-greater increase in white deaths.

This is healthcare version of their warped view that it’s okay to support policies that reduce income for poor people so long as the rich incur even greater losses.

Anyhow, I guess we should “congratulate” the CDC for showing it can compete with the WHO in the contest to see which bureaucracy had the worst response to the coronavirus (we already had plenty of evidence that the FDA is incompetent).

We can add this column to my series (here, here, here, and here) on how government blundering magnified the coronavirus pandemic.

P.S. If I had the flair for self-promotion that you often find in D.C., I would have been tempted to claim that my tweet from earlier today deserves some sort of recognition.

But I don’t need attention and affirmation. I simply want people to understand that it’s reprehensible that we have cossetted international bureaucrats (who get lavish, tax-free salaries!) pushing sloppy and ideological nonsense that will make the world less prosperous.

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I’ve written four columns (here, here, here, and here) on the general failure of government health bureaucracies to effectively respond to the coronavirus.

The pattern was so pronounced that it even led me to unveil a Seventh Theorem of Government.

I’m not surprised at this outcome, of course, given the poor overall track record of the public sector.

But I was negatively surprised to learn how red tape from these bureaucracies prevented the private sector from quickly reacting to the crisis.

Today, let’s take a closer look at one of those bureaucracies, the Atlanta-based Centers for Disease Control (CDC).

Eric Boehm, writing for Reason, has a nice summary of the CDC’s failures.

Over the past three decades, the Centers for Disease Control (CDC) has seen its taxpayer-funded budget doubled. Then doubled again. Then doubled again. And then nearly doubled once more. But spending nearly 14 times as much as we did in 1987 on the agency whose mission statement says it “saves lives and protects people from health threats” did not, apparently, help the CDC combat the emergence of the biggest disease threat America has faced in a century. In fact, …inflating the CDC’s budget may have weakened the agency’s ability to handle its core responsibility by giving rise to mission creep and bureaucratic malaise. …the CDC’s budget has ballooned from $590 million in 1987 to more than $8 billion last year. If the agency had grown with inflation since 1987, it would have a budget of about $1.3 billion today. …Has all that extra funding made America safer? …hindsight now suggests that the CDC should have spent more time and money researching emergent influenza-like infectious diseases, a project that received just $185 million in funding… Instead, the CDC was doing things like spending $1.75 million on the creation of a “Hollywood liaison”.

A big problem with bureaucracies is that they engage in mission creep. They concoct new roles and responsibilities in hopes of justifying bigger budgets and more staff.

The CDC certainly is no exception. In its early years, the bureaucracy had a targeted mission, focusing on diseases posing a major threat to public health, such as malaria, plague, and tuberculosis.

Over the years, though, it has lost focus and become involved with social issues.

Daniel Greenfield opines on the CDC’s foolish diversions on issues such as obesity.

The Centers for Disease Control has…one job which it messes up every time. The last time the CDC had a serious workout was six years ago during the Ebola crisis. Back then CDC guidelines allowed medical personnel infected with Ebola to avoid a quarantine and interact with Americans… There were no protocols in place for treating the potentially infected resulting in the further spread of the disease inside the United States. …Meanwhile, CDC personnel had managed to mishandle Ebola virus samples, accidentally sending samples of the live virus to CDC labs. …During the Ebola crisis, the CDC had been spending…$2.6 million on gun violence studies. But the CDC has a history of wasting money on everything from a $106 million visitor’s center with Japanese gardens, a $200K gym, a transgender beauty pageant, not to mention promoting bike paths. …the CDC’s general incompetence…, like that of other government agencies, just ticks along wasting money. In 1999, the CDC announced a plan to end syphilis in 5 years…an unserious social welfare proposal that wanted to battle racism and was such a success that by 2018, syphilis rates had hit a new record high. … The CDC’s fight against the “obesity epidemic” is even sillier. That includes…giving LSU over a million bucks to work with farmers’ markets. Obesity obviously can kill people, but it’s not something that the CDC can or should be trying to fix. …Unfortunately, the CDC, like every federal agency, has drifted from its core mission into social welfare. …No one thinks about the CDC until we need it and discover it doesn’t work. And then the same story repeats itself a few years later while the CDC goes back to battling obesity and racism. …We don’t need a CDC that changes people’s minds about eating chocolate or engaging in unprotected sex. There are already multiple redundant parts of the government that are trying and failing there.

In a column for Forbes, Larry Bell reviewed the history of the CDC’s politicized campaigning against gun ownership.

In 1996, the Congress axed $2.6 million allocated for gun research from the CDC out of its $2.2 billion budget, charging that its studies were being driven by anti-gun prejudice. …There was a very good reason for the gun violence research funding ban. Virtually all of the scores of CDC-funded firearms studies conducted since 1985 had reached conclusions favoring stricter gun control.  This should have come as no surprise, given that ever since 1979, the official goal of the CDC’s parent agency, the U.S. Public Health Service, had been “…to reduce the number of handguns in private ownership”… Sociologist David Bordura and epidemiologist David Cowan characterized the public health literature on guns at that time as “advocacy based upon political beliefs rather than scientific fact”. …Dr. Katherine Christoffel, head of the “Handgun Epidemic Lowering Plan”, a CDC-funded organization…said: “guns are a virus that must be eradicated…”

Michelle Minton of the Competitive Enterprise Institute wrote for Inside Sources about the CDC’s senseless efforts to restrict vaping.

Our health agencies had the information and the resources, so they should have been planning for this, but they weren’t. The problem isn’t because they’re underfunded, it’s that they are bloated and mismanaged. …a close look at how CDC spends its budget reveals it has strayed from this mission of protecting Americans from communicable diseases, turning more toward influencing people’s lifestyle choices. …Indeed, prior to the COVID-19 pandemic, CDC and other agencies were busy sounding the alarm about the nonexistent “epidemic” of youth vaping. Collectively, they spent billions on anti-vaping advertisements, biased research and lobbying, wasted countless hours of congressional hearing time, and squandering public trust. Had they remained focused on infectious disease, might have been prepared to fight real epidemics, like the COVID-19. …there’s nothing new about exploiting a crisis to expand budgets and score political points. Similar claims of inadequate funding were made during the 2014 outbreak of Ebola, for which various health agencies got an additional $5.4 billion. And what do we have to show for it now?

Let’s wrap up by noting that squandering money should be viewed as the CDC’s indirect failure.

The direct failure was how the bureaucracy bungled its one legitimate function of fighting infectious disease.

Jacob Sullum, writing for the New York Post, explains what happened.

The grand failure of federal health bureaucrats foreclosed the possibility of a more proactive and targeted approach… At first, the Centers for Disease Control and Prevention ­monopolized COVID-19 tests. When the CDC began shipping test kits to state laboratories in early February, they turned out to be defective. The CDC and the Food and Drug Administration initially blocked efforts by universities and businesses to develop and conduct tests… The CDC still insists that “not everyone needs to be tested for COVID-19.” But without testing everyone — or at least representative samples — for both the virus itself and the antibodies to it, we can do little better than guess its prevalence, its lethality and the extent of immunity among the general public. …Our ignorance about COVID-19 will have profound consequences, potentially leading to an overreaction that wrecks the economy while saving relatively few lives… You can thank the same agencies on which we are relying to guide us through this crisis.

Veronique de Rugy of the Mercatus Center summarizes the issue, noting that the CDC is a monumental failure.

The lack of preparedness at every level of government (federal, state, and local) has nothing to do with a lack of funding or inadequate staffing. Instead, it has everything to do with governments’ bloat, mismanagement, cronyism, and poor focus. That’s particularly true of the Centers for Disease Control (CDC). …it is no secret how much the CDC is to blame for the country’s lack of preparedness to take on the coronavirus (followed very closely in ineptitude by the Food and Drug Administration). …By now, every major newspaper has reported on the incredible failure of the CDC during this crisis. …Messing up is not a new thing for the CDC. However, unlike what its employees and political allies like to claim, the agency’s poor record and its lack of preparedness has nothing to do with a lack of funding. …For instance, funding for its National Center for Emerging and Zoonotic Infectious Diseases—which aims to prevent diseases like Ebola—received only $514 million in 2018, a tiny sliver (less than 5%) of total CDC funding. And less than half of that $514 million went to emerging diseases like COVID-19. The rest of that budget is spent on stuff like chronic fatigue. Meanwhile, funding…to prevent smoking, alcohol consumption, and poor diets…received nearly $1 billion over that same time, almost double the funding for infectious-disease prevention.

Here’s a look (courtesy of Chris Edwards) at what’s happened to the CDC budget over time.

As you can see, the bureaucrats got more and more funding. Yet when America needed competence, they didn’t deliver.

P.S. The bureaucrats are not the only ones to blame. A big reason for the CDC’s lack of focus is that headline-seeking and vote-buying politicians created new roles and responsibilities. The CDC was happy to get more power, staff, and money, of course (just as it will be happy to get more power, staff, and money as a reward for its failure to deal with the coronavirus).

P.P.S. It’s almost as if there’s a lesson to be learned.

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