Let's Go Back to Ignoring CDC and Federal Health Guidance Like We Always Have

About a couple of weeks ago, the Centers for Disease Control and Prevention (CDC) made an abrupt change in its recommendations for individuals fully vaccinated against COVID-19. Instead of recommending face mask usage in various public settings, the CDC decided to recommend that vaccinated individuals are safe in almost every indoor and outdoor scenario: "You can resume activities without wearing a mask or staying 6 feet apart." Dr. Anthony Fauci, who is the Director of National Institute of Allergies and Infectious Diseases [NIAID], also said that day that vaccinated people do not need masks while outdoors. While this might come off as a step in the right direction or a warranted sigh or relief, it made me ask a vital question: why are we listening to the CDC or Fauci in the first place? 

You might think that listening to the government experts is the way to go in the middle of a pandemic. After all, those who work at such organizations as the CDC, FDA, and NIH have a good amount of topical expertise. Normally, I would be for heeding good advice from experts. However, I hesitate to take my COVID-related advice from the government, especially given how the U.S. federal government has operated on this front. For one, the CDC has historically and institutionally been an exceptionally cautious agency in terms of its advice. If you look at some of the advice that government agencies in the past have given, it is amazing how many Americans ignore it:

• The U.S. Department of Agriculture (USDA) recommends eating two cups of fruit and 2.5 cups of vegetables a day. According to the CDC, only 1 in 10 eat the recommended amount.
• The CDC defines "moderate drinking" as one alcoholic drink for women and two alcoholic drinks for men. The CDC also says that 2 out of 3 Americans drink above moderate levels at least once a month. 
• The CDC also recommends that pregnant women avoid drinking all together, even though 1 out of 9 pregnant women drinks anyways. 
• The CDC doesn't want you smoking, yet 14 percent of Americans smoke regularly.
• The CDC would like for people to exercise at least twice a week. How many people are successful? According to a 2018 CDC report, just 23 percent get enough exercise.
• The CDC recommends at least seven hours of sleep, but 1 out of 3 Americans do not get enough sleep.

I'm not here to say that all the aforementioned recommendations are bad or inaccurate. However, when it comes to the main indicators of good diet, exercise, and adequate sleep, Americans generally disregard what the government recommends them. But it's not just that. The government dropped the ball with its initial response to the pandemic. In April 2020, I detailed 15 ways in which pre-existing government policies got in the way of an adequate response. Both the CDC and FDA botched mass testing. FDA regulations delayed rollout of face masks, ventilators, and hand sanitizers. This is to say nothing of state and local regulations, but I'm going to keep my focus on the federal government today. Let's see a few examples of how the federal government handled their response to the pandemic and how they went about recommendations:

• Face Masks at Onset of Pandemic: At the beginning of the pandemic, there was mixed messaging about wearing masks. The federal government went from recommending that we do not wear masks and subsequently recommending that we do masks, with mask shortages being cited as the reason for the initial guidance. In short, it was acceptable to mislead the public on masks because we did not have enough masks at the beginning. Can you see how people can be confused when someone like Fauci said at the beginning of the pandemic that we do not need masks to Fauci wearing two masks at the beginning of 2021?  
• School Closures: Last summer, Senator Rand Paul (R-KY) and Dr. Anthony Fauci were arguing in a Senate Committee hearing about whether schools should be open. Back in the summer, Fauci thought that children were a high enough risk. Fauci got around to admitting in November that children were unlikely vectors of COVID. The data did not change in the interim to justify a change. As I pointed out in July, there was plenty of evidence to show that schools could be open. Fauci chose to ignore the evidence because it was politically expedient to do so.
• Herd Immunity: At the beginning of the pandemic, Fauci thought that herd immunity would be around 60 percent. Later in the year, he increased it to 70 percent and eventually upped it to 85 percent. According to an interview Fauci had with the New York Times, he did not base his estimation on science. He looked at polling data. When he saw that at least 60 percent were willing to get the vaccine, he increased his estimate to encourage people to get vaccinated. Granted, herd immunity can be an elusive concept since still do not know how long immunity, either that from the vaccines or natural immunity lasts. But it's harder to take an estimate seriously when it is based on a gut reaction. 
• Outdoor Transmission Risk: Earlier this year, CDC Director Rochelle Walensky said that the risk of outdoor COVID transmission was about 10 percent. That figure was based on a study released in February (Bulfone et al., 2021). It turns out that one of the co-authors of that study said that Walensky misrepresented the study and over-exaggerated the risk of outdoor transmission. It looks like outdoor transmission risk is lower than 0.1 percent. That really only happened either in large crowds or if you were in someone's face. Plus, that was before vaccines. Given that vaccines are shown to be effective at minimizing COVID spread, the odds are even lower....so low that the CDC finally got around to recommending that fully vaccinated people can be outdoors (and most indoor venues) without a mask. Walensky exaggerated by the order of two magnitudes to try to be needlessly stringent. Let that sink in for a moment. 
• Fully Vaccinated People (CDC): Back in March, the CDC was much more strict and arbitrary with its recommendations for fully vaccinated people, e.g., fully vaccinated people should only hang out with other vaccinated people. As I argued last month, vaccines are safe and effective. Since vaccines were meant to be the end-game to get us back to a "pre-pandemic normal," it would follow that fully vaccinated people are safe to more or less resume living as they had prior to the beginning of the pandemic. However, that is not what happened. I would surmise that the CDC remained strict up until its May 13 interim recommendation to try to get more people vaccinated. But if little to nothing changes, why bother getting vaccinated? While I am glad that the CDC changed their tune, I would also contend that the initial recommendation based on stringency actually impeded the vaccination campaign.
• Face Masks for Fully Vaccinated (Fauci): On May 18, Fauci wanted to explain the confusion over the CDC's new mask recommendations for the fully vaccinated. While interviewing with Good Morning America, he said that he did not want to give mixed messaging before the CDC recommendations, and then proceeded to say that the chance of getting infected while indoors was low. Contrast to when Fauci was testifying before the Senate a couple of months earlier when he was wearing two masks while vaccinated. He got into a heated argument with Senator Paul (again!) about why fully vaccinated people should wear masks. Paul accused Fauci of practicing "theater," and Fauci vehemently disagreed. It looks like Paul was right after all: wearing masks for the fully vaccinated is political theater. 

If the government were to potentially have any legitimate role in pandemic response, at least from a libertarian standpoint, it would be to give solid, evidence-based recommendations for the public to follow. As I have already shown, that has been far from the case during this pandemic. Messaging on the most important aspects of flattening the curve and non-pharmaceutical interventions have been mismanaged. It has further eroded the American people's trust in experts, which further contributes to the post-truth world in which we live. All that has been accomplished with such arbitrary and inconsistent messaging is rendering the CDC more irrelevant. 

I think this leads to another point: we gave too much credence to the likes of the CDC. As their history has shown, they are going to be stricter than most Americans can handle. Plus, given the mismanagement, we should not be leaving it up to the CDC or Fauci to tell us how to live our lives. As Robby Soave at Reason Magazine points out, "Normal does not mean the CDC grants permission to enjoy life again; normal means ignoring the CDC and enjoying life anyway." As much as fear has driven so many personal decisions and as much as risk assessment has been eroded as a concept, I hope that we can get back to living our lives without unreasonable fear and without needing approval from the federal government to do so. 

Why We Shouldn't Heed Israel-Palestine Conflict Analysis From Such Comedians As Trevor Noah or John Oliver

La plus ça change, la plus c'est la même chose. The more things change, the more they stay the same. That is certainly how I feel about the Israel-Palestine conflict. There were a few recent events that led to the altercation between Israel and Gaza. One is the Sheikh Jarrah incident in East Jerusalem, a legal dispute over property rights and paying rent. Protests began over an eviction of six Palestinians in the Sheikh Jarrah neighborhood. The Israeli Supreme Court ruled in favor of the Jewish landlords, a property which has been owned by the Jewish community since 1876. Without getting into "whose fault it is," there was also a clash between Israeli police and Muslim worshipers at the Al-Aqsa mosque at the end of the Islamic month of Ramadan. Hamas issued Israel an ultimatum to cease its police and military enforcement of Israeli law. Israel ignored it by reinforcing its borders with Gaza. Hamas fired rockets into Israel targeting civilians. Israel returned fire by targeting military outposts and now there is outrage on both sides. 

All of this escalated conflict led to celebrities throwing in their two cents. The Daily Show host Trevor Noah was one of the earlier "commentators," framing the conflict in terms of power balance. Comedian John Oliver proceeded to outdo Trevor Noah by accusing Israel of "war crimes" and "apartheid." Needless to say, neither one of these comedians are a fan of Israel based on their monologues. Today, my goal is to take on their pseudo-intellectual comments and show where they both went wrong. 

The nature of Hamas. Before getting into any of what Noah or Oliver had to say about what is going on in the Middle East, I think it is best to ask ourselves who Hamas is. Hamas is a terrorist organization that is governing the Gaza Strip. Calling Hamas a terrorist organization is not my opinion or an attempt to call names. Hamas is officially designated as a terrorist organization by such entities as the United States, Australia, and the European Union. Hamas is oppressing its own citizens, according to the NGO Freedom House. Life under Hamas is so authoritarian that I feel sorry for the Gazan civilians that are used as pawns in Hamas' ploy. Hamas' original charter called for the annihilation of Israel. Even its 2017 revision of its charter does not recognize Israel and views Israel strictly in adversarial terms. How do you broker peace with an enemy who would solely be satisfied if you no longer existed? 

Body Count Argument. One of the main arguments used by these comedians is that a higher body count means that one side is right. Rather than look at motive, intent, or morality, Noah tells us that we should "ask who is dead and who is alive." Oliver similarly argues that because there are ten times as many casualties on the Palestinian side as their are on the Israeli side, the higher body count makes the Palestinian side right. 

For one, the appropriateness or moral justification is not based solely on how many civilians die. But let's ask ourselves why the disparity exists in the first place. Hamas uses its citizens as human shields by planting its military complexes amongst residential areas. Its goal is to maximize casualties so that the international community, including Noah and Oliver, can feel a sense of outrage and support a terrorist organization. Conversely, Israel uses the Iron Dome to protect its citizens, something that Oliver takes issue with. Israel's goal is to minimize civilian casualties. Why should Israel doing a better job at protecting its citizens render Israel the bad guy? If it were not for Iron Dome, there would be considerably more dead Israelis. If the goal is equality, how many Jews need to die to make Noah or Oliver happy? 

Power Balance and Military Might. One of the main arguments that Noah particularly uses is that because Israel is more powerful, it has more responsibility. He analogizes the situation to a teenager fighting his younger, four-year-old brother. Let's forget that most sibling rivalries do not entail one sibling trying to kill the other, as we see with Hamas trying to exterminate Israel. Essentially, the argument that both Noah and Oliver make are that "if you are weaker, you are in the right." By that "logic," that would mean the Taliban was right, as were the white nationalist protesters at Charlottesville in 2017. Military might does not have bearing on whether one side is right or not. If anything, both sides have a moral obligation to behave properly in a time of war, something which Hamas does not care about at all. All Noah and Oliver do in framing the problem in such a way is to absolve Hamas from any responsibility. 

Let's bring up another point about military might. While Noah acknowledges that "Israel could crush Gaza 'like that,'" what he glosses over is that Israel has not done so. Those who criticize Israel love to lob the argument of "Israel is being disproportionate." If Israel were to be proportionate, it would use all of its military might to indiscriminately target civilians, which is exactly what Hamas has done for years. But Israel does not do that. It does its best to target military outposts only, which is all the more challenging when Hamas intentionally hides among civilians. Using civilians as human shields is a tactic that even the United Nations has criticized on more than one occasion. Israel even gives a one-to-two-hour warning to Gazan citizens, a painstaking courtesy that no other army has extended in such a situation. Military experts actually have lauded Israel for doing such a good job at minimizing Palestinian civilian casualties (Merriam and Schmitt, 2015).

What Would You Do? It's a fair question to ask, but it was one that neither Noah nor Oliver bothered to ask. How would the United States react if it were attacked? We have an idea: it's called Pearl Harbor. Could any country say that they would not defend their borders if their civilians were indiscriminately barraged with rocket-fire from a belligerent entity? Hamas has set its genocidal intent on Israel before, and has done so unambiguously. Noah and Oliver imply that Israel should just "sit back and see what happens" because they allege Israel is the oppressor. There have been multiple times in history where Jews were expected to "sit back and take it," and I can tell you it did not turn out well. If someone says they want to wipe you out of existence, that is the sort of threat you take seriously. 

Oliver criticizes Israel for attacking civilian areas, but conveniently forgets is that this conflict is a war. As we already brought up, Hamas hides amongst its citizens and uses them as human shields. As previously mentioned, Israel does its best to minimize civilian casualties. At the same time, civilian casualties during wartime are as lamentable as they are inevitable, an inevitability that is acknowledged by the Rome Statute [Article 8(2)b(4)]. 

Conclusion. If nothing else, this has reminded me why I don't take my opinions on foreign policy from celebrities. They presented themselves as objective, unbiased observers of the conflict when they were far from it. Although Noah and Oliver have First Amendment rights to say what they want, there is still a moral obligation to not propagate one-sided lies, especially given the media influence they have. 

I did not cover the West Bank today mainly because the current military conflict is with the Gaza Strip. Even so, Oliver's accusation of there being apartheid of Palestinians (particularly in the West Bank since Israel withdrew from the Gaza Strip back in 2005) is a baseless one (see my previous coverage of the allegations of Israel being an apartheid state here and here). My analysis today also does not cover treatment of Israeli Arabs within Israel's borders, something both Noah and Oliver briefly touch upon. Am I here to say that Israel is perfect? As I have said before and will say again, no nation-state is perfect. There are a lot of complexities within that part of the world, but other developed countries also have their issues with how they treat minorities. It does not render the United States, France, or Denmark apartheid states. I'm not here to say that Israel does not have serious internal issues (because it does, like any country), but it is disingenuous to disproportionately criticize and demonize Israel while ignoring or minimizing much more egregious human rights violations (e.g., the civil war in Syria or literal concentration camps in China). 

The situation either inside Israel's borders or in the West Bank has more historical, legal, and moral nuance than the situation with Hamas, which may not be saying much given who Hamas is. With Gaza, it is clear-cut. Hamas is a known terrorist organization knowingly and belligerently targeting Israeli civilians. It has no qualms with oppressing its own citizens, disregarding norms about warfare, or using violence towards its desire to see a world without Israel. Israel unquestionably has the moral high ground when it comes to the conflict with Hamas. The fact that Oliver or Noah cannot see the qualitative difference between Israel and a terrorist organization such as Hamas makes me wonder why anyone listens to them in the first place. 

Biden's COVID Vaccine Patent Waiver Won't Help and Will Probably Do Harm

In this pandemic, it is a race between getting people vaccinated and the growth of the COVID variants. If we can get enough people vaccinated quickly enough, it would mean reaching herd immunity, or at least close enough to herd immunity where we can minimize the spread of variants. Last week, President Biden's administration advocated for an idea to accelerate vaccine production: waiving intellectual property (IP) protections for the COVID vaccines. U.S. Trade Representative Katherine Tai announced that the U.S. would support the World Trade Organization (WTO) petition of India and South Africa to suspend IP protections so that generic manufacturers can manufacture their own versions of COVID vaccines. Tai's argument is that "desperate times call for desperate measures." To help fulfill the demand for the vaccines, Tai assumes that removing the IP protections will translate in a ramped-up manufacturing and production of vaccines. There are a few issues with the assumption of the Biden administration. 

First, IP protections are a moot point since Moderna already has foregone its patent protections for its vaccines. Plus, three COVID vaccine manufacturers licensed their technologies to Indian manufacturers. The fact that none of the other vaccine manufacturing companies have seized the opportunity to create their own version of the vaccine suggests that IP protections are not the issue. 

Second is that there is a misdiagnosis of the problem by the Biden administration. The assumption is that the bottleneck is being caused by the IP protections. Per the previous point, that is unlikely to be the case. As financial services company Morningstar mentions in its market assessment, removing IP protections will not affect the market. Adar Poonawalla, who is the CEO of the world's largest vaccine manufacturer, made the same argument. The main issue is manufacturing capacity, specifically with building safe and efficient mRNA manufacturing that is at scale. This is all the more true considering that vaccine technology is so complicated that it cannot be reverse-engineered the same way that other pharmaceuticals can be. 

Third, we might not have a supply shortage for much longer. If we assume that current vaccine manufacturers are accurate with their projections, we should have enough doses for 7 billion doses by the end of the year.

Fourth, the waiver will not help countries in need receive the vaccines in time. As the Biotechnology Industry Association points out, "Handing needy countries a recipe book without the ingredients, safeguards, and sizable workforce needed will not help people waiting for the vaccine. Handing them the blueprint to construct a kitchen that -- in optimal conditions -- can take a year to build will not help us stop the emergence of dangerous new COVID variants." 

Finally, it might go beyond simply not doing any good. It could end up doing harm, as the American Intellectual Property Law Association illustrates. The purpose of IP protections is to incentivize innovation and collaboration. It takes millions of dollars to fund such research and development efforts, not to mention other risks undertaken. If the IP protections are waived in this pandemic, it would establish a precedent to undermine incentives to create treatments and vaccines in future pandemics. 

How do we deal with the issue of the current supply shortage? One solution is to continue to build upon current global vaccine partnerships (e.g., COVAX). Another is to replace the patent system with a prize system, which would keep the incentives for inventors in place while making sure monopolistic or oligopolistic power takes place. In any case, all Biden's move would do is to give false hope and could very well undermine IP protections for the foreseeable future.

The Latest Child Tax Credit Modifications Will Cost More Than a Pretty Penny: Let's Not Make Them Permanent

Former Chicago Mayor Rahm Emanuel once say that you never let a crisis go to waste. The government certainly does that in respects to expanding power and clout in an emergency. We saw that when the U.S. government spent $1.9 trillion on a supposed relief bill that had little to do with pandemic relief. One of the features of that bill, the American Rescue Plan Act of 2021 [ARP], was the expansion of the child tax credit [CTC]. Per the IRS, the goal of the expansion is to reduce child poverty. The ARP's CTC expansion has three main components. The first is that the maximum credit increases from $2,000 per child to $3,000 per child ($3,600 if the child is under 6 years old). Second, the CTC now includes 17-year olds. Third is that the CTC is now fully refundable. The last part is important because as the Tax Policy Center (TPC) points out, it makes the tax credit more accessible to households in the lowest quintile. 

Last week, Biden proposed the American Families Plan [AFP], a major spending bill focused on families and children. The Ivy League Wharton School of Business found in its analysis of the Plan that it would cost $2.5 trillion, which is $700 billion more than the White House estimate of $1.8 trillion. Included in the Plan are two modifications of the CTC. One is that the expansion in the ARP would be extended to 2025. The second is that the CTC would remain permanently refundable. Let's forget for a moment that the AFP as a whole is estimated to reduce the GDP by 0.33 percent by 2031 and increase the government debt by 6.2 percent by 2031 (Wharton). I previously covered the CTC in 2015 and 2016, but I really want to get into the issues with the recent expansion from the ARP and the proposal of the AFP.

The main argument for the CTC expansion is that of poverty reduction. The CTC helps to reduce tax liability for parents with dependents. If it reduces poverty, it must be a good deal, right? The Left-leaning Urban Institute estimates that the CTC from the ARP would reduce poverty by one percentage point, to 12.8 percent (Wheaton et al., 2021, p. 4). Similarly, the Left-leaning Center on Budget and Policy Priorities goes as far as estimating that the CTC and EITC in the ARP will collectively reduce child poverty by 40 percent. 

That sounds nice until you get into the issue of making the CTC refundable. On the one hand, it does provide greater access to the CTC for lower-income households. On the other hand, it takes a tax credit and de facto turns it into a direct cash transfer. The Right-leaning American Enterprise Institute puts those estimates from the above Left-leaning think-tanks into question with a report on child allowances (Winship, 2021). In this report, Winship outlines how government cash transfers such as the CTC substitutes work income, thereby undermining efforts to reduce unemployment. This is especially true since this will be the first time in U.S. history that cash benefits will be extended to nonworking parents. As an additional point, AEI scholar Angela Rachidi touches upon the fact that increases under the ARP will barely get many families above the poverty line, thereby doing little to create a long-term path out of poverty. 

We have already seen this phenomenon play out with another direct cash transfer: unemployment benefits. When unemployment benefits reach a certain level, they disincentivize work. As research from the Right-leaning Heritage Foundation illustrates (Rector et al., 2020), the Earned Income Tax Credit [EITC] did not succeed at reducing poverty or increasing employment. 

Seeing what has happened with other direct cash transfers such as unemployment benefits and the EITC, I am concerned that the refundability and the increase of the CTC size will act in contrary to the intent of poverty reduction and improving employment figures. In case diminishing the primary argument is not adequate, let's take a few other factors into consideration.

• Cost of the CTC. The Congressional Budget Office [CBO] estimated that the expansion under the ARP is going to cost us $88.8 billion over the next ten years. If we were to make the CTC permanent, the Right-leaning Tax Foundation found that it would cost $1.6 trillion over ten years.
• Tax Code Neutrality. The CTC is a provision in the tax code that incentivizes child rearing. Why should childless households pay for those who decide to have children? What business does the IRS have in punishing or rewarding people for the size of families they choose to have or whether to have children? 
• Getting At the Root of the Problem. Advocates of the CTC argue that childcare is too expensive. The issue with a CTC, especially one with refundability, is that it is de facto acts as a demand-side subsidy. What happens when you increase demand while supply stays the same? It increases prices, which is a point I have brought up with federal subsidies towards college loans and LIHEAP. So how does the CTC lower childcare prices?  It does nothing to address the rising cost of education, healthcare, or food. It does nothing to contribute towards welfare reform. It is just more money being handed out, which is the premise behind a direct cash transfer. If the cost of childcare is the problem, then we need to find ways to reduce the costs. I can save this topic for another time, but I will leave with one suggestion that was brought up by the libertarian Cato Institute (Bourne, 2018). Regulations on childcare facilities include stringent staff-to-child ratios. If we were to loosen the ratio regulations, it could lower childcare costs from 9 to 20 percent. If we were to put our focus on the drivers of high childcare costs, we could provide a more targeted and less costly solution to affordable childcare. 

October 8, 2021 Addendum: Researchers from the University of Chicago recently released a working paper on the effects of Biden's CTC requirements (Corinth et al., 2021). One result is that 1.5 million workers (or 2.6 percent of working parents) would leave the workforce. The second is that it will do nothing to reduce deep child poverty. Third, with the new data used in this study, it shows that the effects of reducing general child poverty have been overstated in other studies.