Dangerous groupthink at the CDC on vaccine priorities
mittee reached its decision. tion program.” generally worse health outcomes
As James Surowiecki, au“Strongly agree . . . for equity - and fixing that disparity should thor of “The Wisdom of Crowds,” reasons . . .” be a priority. But it’s not puzIf you watch the YouTube pointed out, when a large group “I think equity is a priority.” zling how the committee decided video of the now-infamous Noacts as though a complicated “I want to applaud the entire this was the most equitable plan, vember meeting of the CDC’s problem is a no-brainer, that conversation today around the given that deprioritizing seniors Advisory Committee on Immudoesn’t mean the solution is obemphasis on equity and identiwould also deprioritize older minization Practices, you’ll hear vious; it means something has fying that the racial, ethnic and norities, the highest-risk group, Chairman José Romero thank evgone badly wrong. low-income disparities in the imand quite probably result in eryone for a “robust discussion.” Either way, despite Romepact of (COVID-19) warrants primore deaths among those peoShortly thereafter, the commit-ple.ro’saccolade,thediscussionoforitizationofessentialworkers.” tee unanimously agreed that eswhether to prioritize essential It’s striking how many people The committee had just seen sential workers should get vacworkers was anything but rocommented on this question, and data indicating that most people cinated ahead of the elderly, bust. The committee left only 10 with such otherwise-content-free thought seniors were the secondeven though they’d been told minutes for it, during which not affirmations. It’s also striking highest priority group, right afthis would mean up to 6% more one of those 14 intelligent and that the same group reversed itter health-care workers, and yet deaths. This decision was supdedicated health professionals self 13 to 1 only a month later, afno one suggested the easy, popuported in part by noting that suggested adopting the plan that ter it turned out there were also lar route that also saved the most America’s essential workers are kills the fewest people. A conreputational consequences for lives. more racially diverse than its sedensed but highly representative endorsing this particular quest Unfortunately, the vaccine nior citizens. sample: for equity. committee’s turnaround is just
On Dec. 20, after the public be“This is where we can really elEquity is clearly a pressing one of a string of related erlatedly noticed this attempted evate the issue of health equity.” public health problem. COVID-19 rors. Looking back over the past geronticide, the advisory panel “If we’re serious about valuing has disproportionately affected nine months, it’s as if the public walked it back. Let’s dwell on the equity . . . we need to have that Black and other minority comhealth community deliberately flawed process by which the com- baked in early on in the vaccina- munities - who already suffered decided to alienate large groups of Americans, usually in the name of saving someone else.
The World Health Organization told us travel bans don’t work, apparently because they harm tourist economies; then we were told masks don’t work, apparently because experts worried that hoarding them would leave health-care workers without personal protective equipment; the public health community fell suddenly silent about the dangers of large gatherings during the George Floyd protests; Anthony Fauci admitted he’d been lowballing his estimates of the point at which we’ll reach herd immunity.
Collectively, they suggest a community of experts with a lot of public health models but no good mental model of the public. They may be talking at us, but they’re really talking only to each other.