Kudos to Prof Tufekci for opening up the newsletter to debate, and to Prof Smith for offering his take. My main problem with his argument is that it seems to hinge on purportedly “high trust” that professoriate enjoys (he speaks of “respected professors”, “trusted community members”).
I don’t know if Prof Smith counts himself in their ranks, but in any case—this ship has sailed already. Prof Smith speaks of them as if they had the credibility capital of 1970s’ Walter Cronkite. I’m sorry, but to me and much of the world they’re like McNamara and LBJ. In other words, you can’t squander what you don’t have.
Michael Mina and Zeynep Tufekci have been exceptions to that precisely because they have been consistently doing what you advocate them not to do: spoke their minds openly, did not shy away from disagreement, and candidly spoke of what they believe they don’t know. I’m sorry to say, but if Prof Tufekci were to start equivocating and indulging in noble lies, that wouldn’t boost the credibility of the “public health community” as such. Quite the opposite—many people would abandon following them and possibly turn to cranks.
Finally—please don’t take it personally, Dr Smith—I’m afraid that your hard delimitation between “expert/scientific debate” and public activism has got a whiff of arrogance to it. People can read. We’ve got sci-hub, NEJM/Lancet un-paywalled their coverage of Covid. My boyfriend’s family (working class/refugee/POC and a few other terms you seem to name-check) had no problems following the gist of the scientific debate back in Feb/March, which might’ve very possibly saved their lives. So I think you really overstate the difference between Prof Tufekci penning a letter to the editor in The Lancet and writing a Substack in terms of what transpires to the public. The biggest argument in favour of going the public route to me is that it’s just faster, and we don’t have much time to spare.
This is a textbook example of "proving too much". The argument is essentially that since publishing an opinion can have ripple effects that might defeat the argument -- or otherwise cause harm --, the argument should not be published. It can be applied equally to many other contentious issues. For example, publicizing police violence can cause the police to "retreat to the donut shop", thus increasing the crime rate, which in turn causes a tough-on-crime shift in public opinion and ultimately more police violence. Yet no one would seriously take be deterred by this from discussing police violence or suggesting countermeasures, and for good reasons: With a bit of work, you can find possible downsides to anything. But it isn't much harder to find upsides to match them. At the end of the day, you can argue your way to any conclusion you want simply by taking the right combination of these downsides and upsides. It's not much different from what is called p-hacking (or the Garden of Forking Paths, if you don't want to blame the author) in experimental science.
Here are Smith's main objections:
S1. Pro-one-dose arguments may cause people who would otherwise go through the full course to skip the second dose.
S2. Any publicly visible disagreement between scientists risks getting weaponized as a proof of science being untrustworthy by dark forces.
S3. Pro-one-dose arguments may give authorities a convenient pretext to skimp on completely vaccinating the marginalized and non-influential.
Here is how to adapt the exact same arguments to argue the opposite points:
S1'. Pro-one-dose arguments may make people otherwise wary of vaccinating themselves decide to give the vaccine a try. (As someone who has BII phobia -- https://en.wikipedia.org/wiki/Blood-injection-injury_type_phobia -- myself, I can confirm that this is a real thing.)
S2'. Silence and monophony can be far more concerning than disagreement. I follow various right-wing publicists -- some I agree with, some I am curious about, and some out of the same interest that makes train wrecks interesting to watch -- and I have rarely seen anti-vac sentiments being justified with the existing disagreements between scientists. The ones I do remember seeing concern the AstroZeneca vaccine (due to the egregious blunders in its study) and the Sinevac one; even there, the worst I have heard is "let's wait for more evidence", which is indistinguishable from left-wing opinion. As the mainstream press is competing at whose 10-word headline can induce the most panic (Reuters just reported on someone getting COVID one week after vaccination, as if this was something unexpected), Steve Sailer of all people gave a reasoned plea for not taking the side-effect panic to heart and just taking the damn vaccines ( https://www.takimag.com/article/lets-be-over-and-done-in-21/ ).
S3'. Anti-one-dose arguments may give authorities a convenient pretext to delay vaccinating the marginalized and non-influential.
This all said, even if these all weren't issues, what exactly is being suggested? Not to discuss anything at all in public if the discussion could be abused or misinterpreted? That is, not to discuss anything of any remote importance? Many issues already are suffering from a "fools rush in where angels fear to tread" dynamics. Smith's appeal will not dissuade any fools; it will only make angels more fearful. For better or for worse, going public is a widespread and often functional way of getting concerns heard. As we have seen in the case of CDC guidance, it often works for the greater good. What is gained by ceding this ground to those with less scruples?
Dr. Smith falls into the same trap that Fauci, Osterholm others et. al fell into in the spring of 2020 with respect to good N95 masks, who gets them and why...They knew that masks, good ones not just any, were essential to stopping the spread. Osterholm in particular wrote extensively about how SARS Covid2 had 10,000 times the viral load at day 0 compared to SARS Covid1. There was massive evidence early on that the virus was airborne (Princess Diamond etc.)
The concern by experts that all N95 masks (or close equivalents) be 100% devoted to health professionals led them to tell a noble lie. The trouble with their reasoning is that many health professionals were used to disposing of these n95 masks 10 or more times a day. The demand within health care for these masks was, for all intents and purposes, infinite. All the masks were devoted to health care, good substitutes from China were also in short supply due to trade embargos and xenophobic reactions on both sides, shipments to MN were seized by the Chinese Army for political reasons at the port.
We are still in this world, inferior cloth masks (30% effective) or very poor fitting, and low quality surgical (50%) are what we see when we see people wearing masks.
The lie was told knowingly and with good intentions, a noble lie if there ever was one, but I would argue failing to level with Americans did more to erode public trust early on than anything else that happened....
Respectfully, I think this is absolutely insane. Smith's argument is that people might misuse Zeynep's speech, so we should censor it (or pressure her to self-censor). Let's be clear what is happening here: Smith is not arguing over whether one dose or two is better; he is arguing over whether or not people are even _allowed_ to voice a public opinion on that debate because evil conservatives might "weaponize" that language to further their nefarious, racist policies.
If we follow this logic, then any speech about any issue that is a) important, and b) politicized should not play out in the public sphere. Should we ban discussions of the welfare cliff because conservatives might weaponize it to deprive people of needed transfer payments? Can we discuss gun safety, since conservatives might weaponize it? What about environmental policy? Agricultural policy? Can you imagine Smith's reaction to discussing something like the recent UK court opinion on youth gender transitions? Is there any realm of speech that is important, urgent, and political that we _could_ discuss openly under Smith's view?
This entire article is a call for censorship dressed up in the language of social justice. Take this astounding passage: "It is more difficult to weaponize technical language used in academic journals and grant applications than it is to weaponize exasperated charges of epistemic irresponsibility made in places like Twitter. For this reason alone, we should restrict calls for single-dose trials to venues where experts engage other experts." This a call for outright censorship. Besides, how does Mr. Smith advocate doing this? What methodology does he suggest for restricting discussions of single-dose vaccines on Twitter or anywhere else? Furthermore, I can promise Mr. Smith that the discussions on Twitter are going to be far less civil and more emotional than intelligent opeds in the NYT by the likes of Zeynep Tufekci.
He argues that "that many on the Right weaponize both the narrow constitutional right to free speech and the broader Millian, liberal defense of freedom of speech." What, precisely, is this "narrow" right? The right to speech is broad; the exceptions are narrow. It's a bad-faith linguistic maneuver to undermine the concept of free speech while nodding towards its existence, hoping the reader will just accept the outrageous and patently false assertion that the First Amendment is somehow "narrow." It is not.
Furthermore, Mill's defense of free speech explicitly entertains misuse of speech; practically half of the treatise is about it! Smith writes as if he is pointing out a novel flaw in this centuries-old argument: as if he is the first philosopher to raise the "bad speech" objection to free speech.
After a pointing out that free speech prohibits speech codes and provides for political speech and spending by rich people, he points out that conservatives have said negative things about public health. And that's it; that's the entire treatment of free speech in an article that argues for censoring good-faith public debate about matters of urgent policy in a country of three hundred million people. It's also notable that NYT very much does not permit hate speech, bad faith speech, or wanton attacks on public health officials in its pages. So even if you adopt his superficial anti-free-speech framework, it doesn't apply to an NYT op-ed.
Even more importantly, non-experts have incredible value to add! Oftentimes, generalists outperform narrow experts in novel situations (see David Epstein's book _Range_, or his Atlantic article). People like Zeynep were out _way_ in front of experts on many aspects of this pandemic and to some extent still are. As far as I know, WHO is _still_ prevaricating on whether to admit that COVID spreads via aerosols, and CDC has been a complete disaster, even going so far as to recommend _against_ tests in August. The "experts" very often get it wrong and are deeply susceptible to groupthink and preserving their reputation within a very small group of like-minded people.
Generalists like Matt Yglesias, Yascha Mounk, and Nate Silver were arguably instrumental in calling attention to the insane CDC vaccination recommendation. Largely because of their bringing attention to a catastrophic abdication of science in favor of gauzy social justice ideology that would have killed more minorities for the "benefit" of more white deaths, CDC reversed the heinous recommendations they were considering.
The article is rife with alarmism and catastrophism. Consider the assertion that "the rhetoric around a single-dose trial could be twisted by people as a pretext for denying second doses the marginalized." Sure, it could be, but literally _any_ discussion of the vaccine rollout could be used maliciously.
Furthermore, once you begin discussing equity and fairness, you've left the science world and entered the political. Unless you can imprison or execute your political enemies, you need to deal with them, so Smith's points around the equity implications of this discussion actually argue for _more_ public debate.
Then there are the really wild logical misses. "An easy strategic choice in response to vaccine distribution woes will be to deny poor communities and communities of color both doses of the vaccine until all those "battling" the virus receive two doses. All they need is quasi-scientific cover for unequal spatial distribution of a two-dose vaccine distribution." We have already decided to deny rich people, poor people, young people, old people, people of color, and white people the vaccine until doctors and nurses have been vaccinated. What on earth is he talking about here? The---very popular---position to vaccinate healthcare workers before anyone else is already playing out irrespective of debates about the one- vs. two-shot plan.
Finally, the structure of this argument is emblematic of a lot of low-quality discourse that tends to emerge from the weirder corners of academia these days: ancient, boring arguments dressed up in the neoteric language of social justice and rife with irrelevant paeans to the political ideology of their readers. Smith's argument is actually straightforward: "we should limit speech that could be used to advance policies I don't agree with." That's an old argument, one long debated and dismissed in free societies. Smith buries that fundamental claim amidst a long scream of fury at the Right and discursions into social justice, housing, transportation, urban planning, and racist pharmacists---all of which may appeal to very far-left ideologues but has little to do with his core argument. It serves instead of whip up anger and righteous indignation to distract from the illiberal, totalitarian, profoundly elitist, but ultimately simplistic argument he is making.
Dr. Smith makes some very good points. However I would disagree with "One tactic is to avoid turning a scientific disagreement into acrimonious public disagreement. It is more difficult to weaponize technical language used in academic journals and grant applications than it is to weaponize exasperated charges of epistemic irresponsibility made in places like Twitter." When you look at other highly-politicized scientific issues like climate change and GMOs, they didn't start because public intellectuals challenged aspects of the science. Rather, they started because groups with different values found ways to make different types of science fit their agenda. It's also worth acknowledging that while there are several scientific questions over the vaccination regime, it's also a values question which deserves to be discussed in the open, not just academic journals.
I find myself jumping to a Worst Case Scenario. It stems from a thought process that's recently emerged in my solitary locked-down, internet-intensive life.
My Worst Case Scenario here is that public thought becomes so burdened by the fear of dangerous consequences that all the interesting stuff just goes away.
The questions about single-dosing Covid-19 vaccines are vitally consequential. I'm looking forward to following this issue, not only for the impact it could have but also for the process by which it is explored.
This Fear of Thinking Things Through is one of the roots of cancel culture: if someone's complex ideas are perceived as tainted, their entire thought process must be quashed. But cancel culture is just one aspect of this fear. With regard to Covid-19 I've encountered some frustrating personal concerns that just don't get answered. For example, I want to know whether it's possible for an adult to actually need medical care after a Covid-19 immunization (because one trial volunteer apparently did seek care for a high fever.) Does anyone know, and will they tell us? I'm still improvising masks that can best keep ME uninfected in the aftermath of the "noble lie" that scottU mentions here. And (this is really dangerous, watch out: has anyone ever really contracted Covid-19 outdoors?)
The emerging dumbing-down of public discourse is only the next step of a more systemic trivialization of the online world that derives from the need for clicks. Recently I was curious about possible physiological reasons for why winter was making me so hungry. But I had to scroll through pages of results with words like "Control,""Temptation,""Overdoing,""Craving" that are aimed at the message: "Oh No! Don't eat more in winter, You Might get Fat!"
Between well-meaning public advocacy and trivial click-bait journalism, I fear we're heading towards even more profound public ignorance.
Good "counter article" by Dr Smith — and good counter-comments to it thus far. At first I thought Dr Smith's arguments made a lot of sense, but the commenters are changing my mind. I look forward to the debate as it unfolds.
No, a governor cannot just decide to deny a second dose to some people. Under an Emergency Use Authorization - the present approval for both Pfizer and Moderna - no one can legally vary from the prescribed two dose regimen.
And Smith goes way overboard in his speculation in most of his other arguments.
Stretch out the possible options for vaccine delivery.
1. Suppose there is an effective vaccine made of a modified coronavirus that can be delivered by a once-dose aerosol so that roomsful of people can be "done" together without any need to keep records.
2. Another vaccine requires three injected doses to achieve maximum efficacy. Records of who & when would have to be kept.
Also need to consider possibility of using jet injectors for oral/nasal spray & intramuscular routes.
The critical factor to consider is the time taken to process each person, seconds or minutes, and the need to repeat by recall.
I initially didn't think that there was a good counter argument to be made, but after reading Smith's piece and even after reading the comments on it, it seems to me that "people skipping the second shot before there's good evidence for it" is a solid concern. Patients are always finding reasons/excuses to skip their meds, cut their dosages etc., and not just for cost reasons. Following a multi dose regimen is simply more work.
This makes it likely that high profile advocacy for a single dose trial will cause some people to skip getting a second dose, since most people will have to go to a special location at a certain time (or wait in line) to get it -- all too easy to rationalize if the time is inconvenient, the lines are long, etc..
I wouldn't venture a guess as to how important this is (need data), but I think it's a legitimate concern
Kudos to Prof Tufekci for opening up the newsletter to debate, and to Prof Smith for offering his take. My main problem with his argument is that it seems to hinge on purportedly “high trust” that professoriate enjoys (he speaks of “respected professors”, “trusted community members”).
I don’t know if Prof Smith counts himself in their ranks, but in any case—this ship has sailed already. Prof Smith speaks of them as if they had the credibility capital of 1970s’ Walter Cronkite. I’m sorry, but to me and much of the world they’re like McNamara and LBJ. In other words, you can’t squander what you don’t have.
Michael Mina and Zeynep Tufekci have been exceptions to that precisely because they have been consistently doing what you advocate them not to do: spoke their minds openly, did not shy away from disagreement, and candidly spoke of what they believe they don’t know. I’m sorry to say, but if Prof Tufekci were to start equivocating and indulging in noble lies, that wouldn’t boost the credibility of the “public health community” as such. Quite the opposite—many people would abandon following them and possibly turn to cranks.
Finally—please don’t take it personally, Dr Smith—I’m afraid that your hard delimitation between “expert/scientific debate” and public activism has got a whiff of arrogance to it. People can read. We’ve got sci-hub, NEJM/Lancet un-paywalled their coverage of Covid. My boyfriend’s family (working class/refugee/POC and a few other terms you seem to name-check) had no problems following the gist of the scientific debate back in Feb/March, which might’ve very possibly saved their lives. So I think you really overstate the difference between Prof Tufekci penning a letter to the editor in The Lancet and writing a Substack in terms of what transpires to the public. The biggest argument in favour of going the public route to me is that it’s just faster, and we don’t have much time to spare.
This is a textbook example of "proving too much". The argument is essentially that since publishing an opinion can have ripple effects that might defeat the argument -- or otherwise cause harm --, the argument should not be published. It can be applied equally to many other contentious issues. For example, publicizing police violence can cause the police to "retreat to the donut shop", thus increasing the crime rate, which in turn causes a tough-on-crime shift in public opinion and ultimately more police violence. Yet no one would seriously take be deterred by this from discussing police violence or suggesting countermeasures, and for good reasons: With a bit of work, you can find possible downsides to anything. But it isn't much harder to find upsides to match them. At the end of the day, you can argue your way to any conclusion you want simply by taking the right combination of these downsides and upsides. It's not much different from what is called p-hacking (or the Garden of Forking Paths, if you don't want to blame the author) in experimental science.
Here are Smith's main objections:
S1. Pro-one-dose arguments may cause people who would otherwise go through the full course to skip the second dose.
S2. Any publicly visible disagreement between scientists risks getting weaponized as a proof of science being untrustworthy by dark forces.
S3. Pro-one-dose arguments may give authorities a convenient pretext to skimp on completely vaccinating the marginalized and non-influential.
Here is how to adapt the exact same arguments to argue the opposite points:
S1'. Pro-one-dose arguments may make people otherwise wary of vaccinating themselves decide to give the vaccine a try. (As someone who has BII phobia -- https://en.wikipedia.org/wiki/Blood-injection-injury_type_phobia -- myself, I can confirm that this is a real thing.)
S2'. Silence and monophony can be far more concerning than disagreement. I follow various right-wing publicists -- some I agree with, some I am curious about, and some out of the same interest that makes train wrecks interesting to watch -- and I have rarely seen anti-vac sentiments being justified with the existing disagreements between scientists. The ones I do remember seeing concern the AstroZeneca vaccine (due to the egregious blunders in its study) and the Sinevac one; even there, the worst I have heard is "let's wait for more evidence", which is indistinguishable from left-wing opinion. As the mainstream press is competing at whose 10-word headline can induce the most panic (Reuters just reported on someone getting COVID one week after vaccination, as if this was something unexpected), Steve Sailer of all people gave a reasoned plea for not taking the side-effect panic to heart and just taking the damn vaccines ( https://www.takimag.com/article/lets-be-over-and-done-in-21/ ).
S3'. Anti-one-dose arguments may give authorities a convenient pretext to delay vaccinating the marginalized and non-influential.
This all said, even if these all weren't issues, what exactly is being suggested? Not to discuss anything at all in public if the discussion could be abused or misinterpreted? That is, not to discuss anything of any remote importance? Many issues already are suffering from a "fools rush in where angels fear to tread" dynamics. Smith's appeal will not dissuade any fools; it will only make angels more fearful. For better or for worse, going public is a widespread and often functional way of getting concerns heard. As we have seen in the case of CDC guidance, it often works for the greater good. What is gained by ceding this ground to those with less scruples?
Dr. Smith falls into the same trap that Fauci, Osterholm others et. al fell into in the spring of 2020 with respect to good N95 masks, who gets them and why...They knew that masks, good ones not just any, were essential to stopping the spread. Osterholm in particular wrote extensively about how SARS Covid2 had 10,000 times the viral load at day 0 compared to SARS Covid1. There was massive evidence early on that the virus was airborne (Princess Diamond etc.)
The concern by experts that all N95 masks (or close equivalents) be 100% devoted to health professionals led them to tell a noble lie. The trouble with their reasoning is that many health professionals were used to disposing of these n95 masks 10 or more times a day. The demand within health care for these masks was, for all intents and purposes, infinite. All the masks were devoted to health care, good substitutes from China were also in short supply due to trade embargos and xenophobic reactions on both sides, shipments to MN were seized by the Chinese Army for political reasons at the port.
We are still in this world, inferior cloth masks (30% effective) or very poor fitting, and low quality surgical (50%) are what we see when we see people wearing masks.
The lie was told knowingly and with good intentions, a noble lie if there ever was one, but I would argue failing to level with Americans did more to erode public trust early on than anything else that happened....
Respectfully, I think this is absolutely insane. Smith's argument is that people might misuse Zeynep's speech, so we should censor it (or pressure her to self-censor). Let's be clear what is happening here: Smith is not arguing over whether one dose or two is better; he is arguing over whether or not people are even _allowed_ to voice a public opinion on that debate because evil conservatives might "weaponize" that language to further their nefarious, racist policies.
If we follow this logic, then any speech about any issue that is a) important, and b) politicized should not play out in the public sphere. Should we ban discussions of the welfare cliff because conservatives might weaponize it to deprive people of needed transfer payments? Can we discuss gun safety, since conservatives might weaponize it? What about environmental policy? Agricultural policy? Can you imagine Smith's reaction to discussing something like the recent UK court opinion on youth gender transitions? Is there any realm of speech that is important, urgent, and political that we _could_ discuss openly under Smith's view?
This entire article is a call for censorship dressed up in the language of social justice. Take this astounding passage: "It is more difficult to weaponize technical language used in academic journals and grant applications than it is to weaponize exasperated charges of epistemic irresponsibility made in places like Twitter. For this reason alone, we should restrict calls for single-dose trials to venues where experts engage other experts." This a call for outright censorship. Besides, how does Mr. Smith advocate doing this? What methodology does he suggest for restricting discussions of single-dose vaccines on Twitter or anywhere else? Furthermore, I can promise Mr. Smith that the discussions on Twitter are going to be far less civil and more emotional than intelligent opeds in the NYT by the likes of Zeynep Tufekci.
He argues that "that many on the Right weaponize both the narrow constitutional right to free speech and the broader Millian, liberal defense of freedom of speech." What, precisely, is this "narrow" right? The right to speech is broad; the exceptions are narrow. It's a bad-faith linguistic maneuver to undermine the concept of free speech while nodding towards its existence, hoping the reader will just accept the outrageous and patently false assertion that the First Amendment is somehow "narrow." It is not.
Furthermore, Mill's defense of free speech explicitly entertains misuse of speech; practically half of the treatise is about it! Smith writes as if he is pointing out a novel flaw in this centuries-old argument: as if he is the first philosopher to raise the "bad speech" objection to free speech.
After a pointing out that free speech prohibits speech codes and provides for political speech and spending by rich people, he points out that conservatives have said negative things about public health. And that's it; that's the entire treatment of free speech in an article that argues for censoring good-faith public debate about matters of urgent policy in a country of three hundred million people. It's also notable that NYT very much does not permit hate speech, bad faith speech, or wanton attacks on public health officials in its pages. So even if you adopt his superficial anti-free-speech framework, it doesn't apply to an NYT op-ed.
Even more importantly, non-experts have incredible value to add! Oftentimes, generalists outperform narrow experts in novel situations (see David Epstein's book _Range_, or his Atlantic article). People like Zeynep were out _way_ in front of experts on many aspects of this pandemic and to some extent still are. As far as I know, WHO is _still_ prevaricating on whether to admit that COVID spreads via aerosols, and CDC has been a complete disaster, even going so far as to recommend _against_ tests in August. The "experts" very often get it wrong and are deeply susceptible to groupthink and preserving their reputation within a very small group of like-minded people.
Generalists like Matt Yglesias, Yascha Mounk, and Nate Silver were arguably instrumental in calling attention to the insane CDC vaccination recommendation. Largely because of their bringing attention to a catastrophic abdication of science in favor of gauzy social justice ideology that would have killed more minorities for the "benefit" of more white deaths, CDC reversed the heinous recommendations they were considering.
The article is rife with alarmism and catastrophism. Consider the assertion that "the rhetoric around a single-dose trial could be twisted by people as a pretext for denying second doses the marginalized." Sure, it could be, but literally _any_ discussion of the vaccine rollout could be used maliciously.
Furthermore, once you begin discussing equity and fairness, you've left the science world and entered the political. Unless you can imprison or execute your political enemies, you need to deal with them, so Smith's points around the equity implications of this discussion actually argue for _more_ public debate.
Then there are the really wild logical misses. "An easy strategic choice in response to vaccine distribution woes will be to deny poor communities and communities of color both doses of the vaccine until all those "battling" the virus receive two doses. All they need is quasi-scientific cover for unequal spatial distribution of a two-dose vaccine distribution." We have already decided to deny rich people, poor people, young people, old people, people of color, and white people the vaccine until doctors and nurses have been vaccinated. What on earth is he talking about here? The---very popular---position to vaccinate healthcare workers before anyone else is already playing out irrespective of debates about the one- vs. two-shot plan.
Finally, the structure of this argument is emblematic of a lot of low-quality discourse that tends to emerge from the weirder corners of academia these days: ancient, boring arguments dressed up in the neoteric language of social justice and rife with irrelevant paeans to the political ideology of their readers. Smith's argument is actually straightforward: "we should limit speech that could be used to advance policies I don't agree with." That's an old argument, one long debated and dismissed in free societies. Smith buries that fundamental claim amidst a long scream of fury at the Right and discursions into social justice, housing, transportation, urban planning, and racist pharmacists---all of which may appeal to very far-left ideologues but has little to do with his core argument. It serves instead of whip up anger and righteous indignation to distract from the illiberal, totalitarian, profoundly elitist, but ultimately simplistic argument he is making.
Dr. Smith makes some very good points. However I would disagree with "One tactic is to avoid turning a scientific disagreement into acrimonious public disagreement. It is more difficult to weaponize technical language used in academic journals and grant applications than it is to weaponize exasperated charges of epistemic irresponsibility made in places like Twitter." When you look at other highly-politicized scientific issues like climate change and GMOs, they didn't start because public intellectuals challenged aspects of the science. Rather, they started because groups with different values found ways to make different types of science fit their agenda. It's also worth acknowledging that while there are several scientific questions over the vaccination regime, it's also a values question which deserves to be discussed in the open, not just academic journals.
I find myself jumping to a Worst Case Scenario. It stems from a thought process that's recently emerged in my solitary locked-down, internet-intensive life.
My Worst Case Scenario here is that public thought becomes so burdened by the fear of dangerous consequences that all the interesting stuff just goes away.
The questions about single-dosing Covid-19 vaccines are vitally consequential. I'm looking forward to following this issue, not only for the impact it could have but also for the process by which it is explored.
This Fear of Thinking Things Through is one of the roots of cancel culture: if someone's complex ideas are perceived as tainted, their entire thought process must be quashed. But cancel culture is just one aspect of this fear. With regard to Covid-19 I've encountered some frustrating personal concerns that just don't get answered. For example, I want to know whether it's possible for an adult to actually need medical care after a Covid-19 immunization (because one trial volunteer apparently did seek care for a high fever.) Does anyone know, and will they tell us? I'm still improvising masks that can best keep ME uninfected in the aftermath of the "noble lie" that scottU mentions here. And (this is really dangerous, watch out: has anyone ever really contracted Covid-19 outdoors?)
The emerging dumbing-down of public discourse is only the next step of a more systemic trivialization of the online world that derives from the need for clicks. Recently I was curious about possible physiological reasons for why winter was making me so hungry. But I had to scroll through pages of results with words like "Control,""Temptation,""Overdoing,""Craving" that are aimed at the message: "Oh No! Don't eat more in winter, You Might get Fat!"
Between well-meaning public advocacy and trivial click-bait journalism, I fear we're heading towards even more profound public ignorance.
Good "counter article" by Dr Smith — and good counter-comments to it thus far. At first I thought Dr Smith's arguments made a lot of sense, but the commenters are changing my mind. I look forward to the debate as it unfolds.
No, a governor cannot just decide to deny a second dose to some people. Under an Emergency Use Authorization - the present approval for both Pfizer and Moderna - no one can legally vary from the prescribed two dose regimen.
And Smith goes way overboard in his speculation in most of his other arguments.
Stretch out the possible options for vaccine delivery.
1. Suppose there is an effective vaccine made of a modified coronavirus that can be delivered by a once-dose aerosol so that roomsful of people can be "done" together without any need to keep records.
2. Another vaccine requires three injected doses to achieve maximum efficacy. Records of who & when would have to be kept.
Also need to consider possibility of using jet injectors for oral/nasal spray & intramuscular routes.
The critical factor to consider is the time taken to process each person, seconds or minutes, and the need to repeat by recall.
I initially didn't think that there was a good counter argument to be made, but after reading Smith's piece and even after reading the comments on it, it seems to me that "people skipping the second shot before there's good evidence for it" is a solid concern. Patients are always finding reasons/excuses to skip their meds, cut their dosages etc., and not just for cost reasons. Following a multi dose regimen is simply more work.
This makes it likely that high profile advocacy for a single dose trial will cause some people to skip getting a second dose, since most people will have to go to a special location at a certain time (or wait in line) to get it -- all too easy to rationalize if the time is inconvenient, the lines are long, etc..
I wouldn't venture a guess as to how important this is (need data), but I think it's a legitimate concern