Whatever Happened to ‘Follow the Science’?

F rom the start of the pandemic, writers at National Review and elsewhere have argued that governors and presidents cannot set policy just by “following the science.” Science has no legitimate way of assessing the public’s tolerance for certain measures and intrusions. Nor does it have the ability to weigh competing and contrary claims of political and economic liberty against public-health priorities.

It’s a problem we’ve seen over and over again. Governor Gavin Newsom will try to ward off criticism as illegitimate or troglodyte in nature, because he is “following the science.” Or some governments will see fit to foreswear responsibility for their own political decisions by inappropriately delegating governance to the public-health bodies that should merely inform them. Even Dr. Anthony Fauci has conflated policy with the findings of science, saying that criticism of him and his contradictory statements is really just criticism of science itself.

But what I wrote 18 (!) months ago remains true: While governments “ought to be informed by science in making their decisions,” it is ultimately the case that “the findings and speculations of epidemiologists (and economists) cannot substitute for political judgment.”

I made the argument that there were competing values besides stopping infection — things we ought not to do, even if the medical and scientific authorities, primarily concerned with stopping infection, would have us do them. But many others argued that, in an emergency, as much deference as possible should be given to qualified experts and institutions that are meant to address public-health problems.

Now the argument is being turned around. You can see it when the U.K.’s vaccine-advisory board recommended against giving vaccines to healthy 12-to-15-year-olds. The board thought that the risk of COVID to this age group was so small that the benefits of the vaccine were too marginal, in light of known rare risks of the vaccine in young people, such as myocarditis — an enlargement of the heart that usually does desist over time. The vaccine board did this despite political pressure to the contrary. “Ministers have let it be known they are very keen on getting this age group vaccinated — both through their public pronouncements and privately behind the scenes,” the BBC reported. The U.K. government seems likely to reject the advice and make these vaccines available, as other countries have done.

The U.S. is seeing a similar controversy play out over booster shots.  Last week, Marion Gruber, director of the FDA’s Office of Vaccines Research and Review (OVRR), and OVRR deputy director Phil Krause resigned in protest of the Biden administration’s pressure to roll out a booster-shot program for those whose existing vaccines may be waning in effect. Reporting on this reflected a larger “potential mutiny,” because the collection of medical experts and regulators view the administration’s booster push as “premature, unnecessary, and out of step with regulators’ opinions.”

This raises really interesting questions about whether governments should contravene medical experts on questions that are almost exclusively medical in nature, for political reasons.  Cards on the table, my instinct is more on the side of regulators in these instances, and against pushy governments. But the question has to be asked and answered fairly.

Throughout the pandemic, we have been faced with claims that the FDA tends to move too slowly, or too quickly.

“Public health is too slow” tends to be an argument made by techno-optimists and libertarians who see the public-health agencies as unhealthily obsessed with their own credibility, and genuinely too risk-averse to do the right thing even when it’s staring them in the face. The libertarian thinker Alex Tarrabok has been arguing from the beginning for a much more aggressive posture from these agencies. Other thinkers have suggested that the only way for these agencies to have credibility is to move quickly once they have good enough evidence. And it’s not unreasonable: The CDC has been particularly slow to update guidelines with new evidence in this pandemic, and its recommendations on food preparation would ruin most of the steak and turkey dinners in this country. For what gain?

But probably more common among the public, and peculiarly present among vaccine skeptics, is the view that the FDA and other public-health agencies are moving too quickly, are too easily bought out, or are just plain biased by their relationships to big pharmaceutical companies. This view isn’t entirely without reason. An FDA regulator who approved the drug OxyContin, by Purdue Pharmaceutical — the drug that kicked off the opioid crisis — got a very cushy gig from the company itself.

If you think medical regulators tend not to be cautious enough, the resignations of two senior officials over vaccines at the FDA because of political pressure is going to set off a ton of alarm bells.

But it brings up another interesting question. Let’s say that the scientific and medical authorities trying to pump the brakes on the U.K. and U.S. governments’ pharmaceutical interventions are basically right that, in a pure risk-and-reward sense, we don’t have the evidence to recommend juvenile vaccines for COVID, or boosters for the already-vaccinated. Or let’s assume that their determination is at least justifiable.

Even so, do politicians have a right to assess the potential downsides as being too minuscule to hold up? Do they have a right to let the political sentiments of the people, even people who are unnecessarily afraid, weigh on their judgment of what should be, basically, a medical question?

After all, long before the data even came in on testing, a substantial portion of the U.K. public came to believe that juvenile vaccines are necessary. Data from Israel and elsewhere are convincing many Americans that boosters are necessary. Many are committed to the view that the pandemic cannot end for their household until even its infant members receive the shot. Psychologically, many citizens would be left unsatisfied if the end to this crisis were merely a judgment about population risks, rather than an action they can participate in themselves.

Or do politicians have a duty to courageously stand up to public opinion when it runs against the advice of our regulators? For months, people have been arguing that the data our agencies and other medical experts have collected on COVID-19 vaccines are so good, and so overwhelming, that politicians do, in fact, have a duty to tell the truth, to advertise their safety and effectiveness.  Well, now the shoe is on the other foot. Do politicians have a duty to stand up for the truth that regulators and “the science” aren’t so clear, to admit that there are limits to our knowledge, and to assert that where the risk of inaction is perfectly tolerable, we can tolerate doing nothing?

Clearly we are not dealing with an excess of courage among politicians. We know this because they are not confronting the public with anything yet. Instead, they are still cajoling their agencies to get on board with a program that was determined by something other than the experts.