welcome back to the channel did border closure School closure lockdowns shelter in place actually slow the spread of Corona virus well we've got the definitive answer now just out in science advances is a new article that's going to give us what I think is the definitive by that I mean it's the best we're ever going to get the best we're ever going to get answer about whether or not the restrictions placed globally in 2020 and Beyond actually change the Dynamics of the coronavirus infection the title of the paper is is epidemic outcomes following government responses to covid-19 insights from nearly 100,000 models it's by Ron V David and trog Patel it's a brilliant paper it's a really brilliant paper and I'm going to walk you through the paper and what it means and why I think it's going to be the best answer we're ever going to get but first you may you might remember you may remember back in March of 2020 in a two-e period of frenzy all of the governments around the world panicked around the Corona virus and took Extreme Measures in response we had had horrific scenes coming out of a northern Italian city called Bergamo of where there was really healthc care collapse from the Corona virus now people forget that Bergamo has a median age I think in the 80s and it was a very elderly City but that was a very catastrophic scene that was planted in people's memory a few weeks later we'd have New York City again the nursing homes which would have some degree of Health Care collapse because so many people got Corona virus particularly older people all at once we also had a report out from Imperial College London which postulated a million deaths if the US were to take no action in the first wave of the pandemic something that never came to fruition and then the final thing was that policy makers in the Western World looked over in China where the epidemic began and they took lessons from a totalitarian authoritarian government in terms of what you were capable to do to the population so in response to that we did things that we have never done in human history which is have Global Travel bans and suppressed people from congregating in outdoor spaces and we filled skat parks with sand etc etc and we took all these precautions and since then there's been a great deal of interest in knowing whether or not they worked there is one way you would have known for sure whether or not they worked and this is the technique that policy makers should employ when they're debuting things they're uncertain about and that is you have to introduce some random variation in the system you have to either have staggered implementation meaning some municipalities and some schools and some hospitals do something ahead of other municipalities other schools other hospitals you either have to have that or random implementation some hospitals do it some hospitals don't do it but when you just do things willy-nilly when you just do things in sort of a chaotic and uncontrolled way you're end up with data that might not be very useful and that's what these authors are tackling we never did any of those other studies we didn't do staggered implementation we didn't do randomization we didn't do it for any question for lockdowns for Border closure for school reopening those are the big question questions but not even for the smaller ones for 3T vers 6 feet for cohorting for different test strategies for mask and cloth vers surgical the United States ran zero randomized studies on these non-pharmacologic questions enter the recent paper so Ben David and trog Patel look at the literature and they note that there's some papers that conclude that lockdowns work they slow the spread of covid-19 they save lives there's some papers that conclude lockdowns don't work they actually have no effect at all or some might even say that they accelerate the spread of Corona virus and there's some papers that say they had no effect in the middle they say the problem with these papers is everybody is taking a data set of different countries or locations the measures that they implemented and when and how much coron viruses cases hospitalizations and deaths they got on the back end and they're adjusting for other factors like population density and size and things of these nature adjusting for other variables that might have something to do with coronavirus spread that are separate from the policy and that's how everyone does it these large observational sort of studies and what they're saying is instead of doing one study and Publishing it in the landet or one study that shows that it really save lives and Publishing that in the British medical journal because they're the ones who want to hear that what if we were to run 100,000 studies on the topic what if we were to run all of the possible you know really sort of sensible studies you could run on the topic a 100,000 different models asking if these pandemic restrictions helped hurt or had no effect and that's what they do they they get this big data set and they basically run 100,000 models and basically the reason I call their paper the best we're ever going to get and definitive is they're really asking what happens if 10,000 different research teams Run 10 different models over the next year and we pull all those papers together will we get consensus or will we have disagreement one more interesting thing to validate that this method actually gets it the truth they wanted to take something that we have a strong belief actually worked and ask if this method would show that it actually worked and this is called a falsification test about 12 years ago in jamama anupam Jenna from Harvard and myself we wrote an article about falsification tests we said we ought to do more of this in observational research and these authors have done it they followed our our guidance and I'm glad they did here's what they did they took something that we think really did work which was measles vaccination policies a few decades ago there was a certain rate of measles we implemented all these policies to slow the spread of measles back then we had vaccines that I don't know prevented you from getting the virus once you got the vaccine that was that was an old time that was the old the good old days and well of course the Corona virus is the type of virus that it would be unlikely that a vaccine would halt transmission anyway that's another story I've talked about that on the channel before they picked measles vaccination policies and then they asked did different places that implemented these policies at different times have a reduction in measles commensurate with proof that the policy actually worked and in fact they found in every analytic plan statistically significant that the policies actually slow the spread of measles so that proves this method if you take something that you really have confidence actually works can show that it actually works like it is capable of validating something let's turn to co9 so we know this method of trying all these sorts of plausible analytic plans it sort of simulates the research community and if something really works perhaps even all or the majority of the analytic plans will show that it works what happens when you put it on the covid-19 questions and the answer is extremely sobering they found a small handful this is 100,000 different models 100,000 different ways to to query if the Restriction actually slowed the spread of covid-19 a tiny handful showed that it did slow the spread of covid-19 a tiny handful showed that it accelerated the spread of covid-19 and the vast majority of analytic plans the vast vast majority of analytic plans showed that it had no sign ific effect on covid-19 spread absolutely null and they did this many different ways they did this for policies recommended in 2020 versus those recommended Beyond and every way you looked at the data you find the same picture under a few set of Select assumptions you can show that it quote unquote works and you can publish your bmj paper for instance if you cherry-pick your co-variants and under a few set of assumptions you can show for sure it didn't work or spread the virus but most of the time you find null effects that it just didn't do much the effect sizes are trivial it probably probably didn't do much and that's what they find and this tells us so many things one it tells us that if you're keeping up with the literature and you're waiting for that Economist from Harvard to prove if the policies helped or hurt you're going to be waiting a long time because they're going to prove it helps and next week they're going to prove it hurts they're going to show this great Multiverse of variability that's one thing we're never going to get a definitive study this is the definitive study because these authors are simulating what's going to happen in the next 15 and 20 and years when they keep running studies some will say it work some will say it spread and most will say it didn't do anything the next point it didn't do anything is probably the right answer it's probably the right answer because these totalitarian regimens change things on the margin the vast majority of human behavior was voluntary human behavior these restrictions came at great social cost and created a strong public backlash they had no credible evidence when they launched them they launched them in a way that was incapable of generating credible evidence that's what this paper show I'll talk more about that and they mostly show it didn't work and the thing is when you study medicine in public health a long time you find that in the grand scheme in the grand Human Experience most of the things we do that we think help and most of the things we do that we think hurt mostly just do don't do anything most of the things we do don't do anything a few things really do work few things don't the next Point some of these policies are a complete Fiasco let's say School closure School closure has a massive learning loss to these kids keeping it close for 18 months like these derange cities like Los Angeles and San Francisco that is an extremely harmful intervention to Children their educational levels have plummeted they've lost grade levels we know that educational attainment predicts longevity predicts uh you know if you're going to be a teen parent if you're going to die by gun violence if you're going to live a long and prosperous life education is the pathway to riches and Longevity and that was taken away from these kids and it had minimal to no impact on coronav virus spread and this paper also validates that idea so we harmed kids as we did over and over in the pandemic with no credible evidence and we didn't gain much from it moreover the policy makers you know this is the thing that wasn't covered enough is that what did fouchy get wrong I had a video about that recently but the thing fouchy and Tedros and all these pontificating Public Health blo Hearts got wrong was they implemented huge sweeping policies that have never been implemented even I was okay with that but they did it in a way that they would never be able to know if they made the right choice or the wrong choice all you had to do with staggered implementation all you had to do was listen to lafr time about his school reopening proposal and how to do that in the context of a cluster randomized trial all you had to do was have your policy but collect data along the way and refine your polic policy as things went on very likely masking kids under five does nothing cloth masking didn't do anything they never tested these policies rigorously and they never change course and that is not what a scientist does that's why they're not scientists in my opinion they're not true scientists they're people who studied science who enjoy seeing themselves on TV they enjoy making proclamations but a real scientist runs experiments in real time to course correct to know if they got it right or wrong in my mind fouchi has the least excuse because he is the head of A5 billion research fund used to fund infectious disease science he could have snapped his fingers and gotten a randomized control trial of 3 feet versus 6 feet he's testifying in front of the house says I don't have anything to do with 6 feet he could have let's study 6 feet versus 3 feet run it in a month in a bunch of schools and show that 3 feet is non inferior there's no increased there's no uh uh unnecessary increased harmful increased risk of trans transission move to 3T then do 3 verse one then do you know nothing verse three then do different cohorting you could run these studies in real time he had the budget he has the power he's got the connections he never did any of that he just went on TV and said to do something while not studying it he he was on TV so much he didn't have time to actually think about research proposals he was on TV 20 times a day so that to me is the failure that's what's unjustified back to this paper this is going to be the definitive paper on lockdowns there's never going to be a paper better than this paper I doubt that there could be because they're really running 10,000 not 10,000 100,000 different papers and totality of the evidence shows it didn't do anything some says it's beneficial and some says it's harmful harmful let's not forget it's harm it's not even just saying no benefit it's just saying it's spread the coron virus we're not going to get the perfect answer here but it is almost overwhelmingly the case that it didn't work that well when you talk about the US entering into a pact with global Nations to uh March lock step into future pandemics based on their policy I think that's a bad idea I think the real failure of the pandemic was an Evidence generation failure that people wanted to take firm stances and say we knew things that we had absolutely no idea of we don't know School closure help people almost certainly harm them a great deal vaccine mandates almost certainly harm people a great deal no evidence that they helped border closure total Fiasco every variant spread anyway this paper is not validating what we did we spent collectively 20 trillion dollars on pandemic we had millions of people die and to leave the pandemic with no knowledge about what actually works what does in underw circumstances is abject failure the coronavirus pandemic did not happen during the Middle Ages but we're no better than the people who survive the Black Death they learn nothing we learn nothing that to me is really unacceptable I really wonder how people you know I see so many people defending fouchy and other policy makers saying that they did the best with what they had at the time no they didn't actually they could have run studies I don't understand how do you defend zero studies and that's the other thing some people say well you can't do a study of masking no masking I was like I appreciate that you're wrong about it I appreciate you're wrong but let's say you're wrong let's just indulge you and being wrong you don't think you could have done a study of n95 ver surgical oh well I guess you could have done that oh so there is a study that every single person thinks could have been done or let's say oh surgical we know that doesn't work okay then n95 verse n94 that thing with the loop ears you don't think you can do that study oh everybody has a study that they think is possible they're just different points on the equipo spectrum they ran zero studies I don't know how anyone can justify zero studies this paper is a very clever paper science advances this is a paper that shows that the analytic flexibility in the existing data set is so much that you will never get a conclusive answer on any policy with 20 trillion dollar and 7 million dead people you have no idea if you helped or hurt and that is the greatest and most stinging indictment on global policy makers ever and we can talk a lot about people who said whatever on Twitter and who got things right or who got things wrong the failure are the people who had the ear of politicians who actually set pandemic policy number one is fouchy number two is Ted Ros number three I mean these are the global scientists that people turned to in this crisis they were on TV all the time maybe number three is aish jaw you know they're on TV all the time and they never used that influence or power to run even one credible study on this topic how is that justified I think that's what I find so shocking so I have a peace out insensible medicine it's called Anthony fouchy failed during the coronavirus response a new paper in science advances led by Ben David and Patel shows how and why and I want one more comment at the end that name Ben David sounds familiar to me why is that sound familiar oh he's an author of the Santa Clara C prevalence study this is a study that tried to estimate how many people had already hadn't recovered from covid-19 in first quarter of 2020 in Santa Clair County just down the road here and he's somebody who used to go on TV early in the pandemic exercising caution saying lockdown might do more harm than good saying we don't really know the infection fatality rate of the virus he ran his own study people criticize the Santa CL County study and I agree with some of the criticism particularly stuff around confidence intervals but here's what they don't say why the hell did we have Stanford professors have to do their own study on seral prevalence why didn't the CDC with their 40,000 employees and their billion doll budget run a Serial seral prevalence study from many sampled hotspots around the country over and over and keep that running statistic on the website why are we relying on these people that's a CDC failure even to rely on Ben David okay next point Ben David famously and there's a column written by J bachari on this topic was asked to keep his mouth shut by Bob Harrington who was then the chair of medicine now the dean of Cornell he was asked not to comment on these policies because they were so controversial we forget but in 2020 you couldn't be an academic and say School closure is a bad idea you might have risked being fired or reprimanded at your University or had your promotion in tenure sabotaged so Ben David sometime in the course of 2020 he was an associate professor back then he went quiet scared into silence in my opinion that is the real most inappropriate part of about the pandemic while they were implementing policy that they're not testing and going on TV and saying you got to do it while all that's going on there's a back campaign to prevent anyone who disagrees from ever voicing that opinion either by pulling them in the office the classic Academic Way by threatening their funding fouches implicitly threatens their funding because if you disagree with the man in charge of the $5 billion portfolio funding you might not get funing in the future the campaign by Collins and fouchy to discredit the great barington declaration authors as Fringe epidemiologist this is all going on in the backdrop so what you have is a total Fiasco a total evidence Fiasco where people making proclamations don't run studies and sabotage any critics who disagree with them what an interesting what an interesting thing terrible really but not many people see it my way I wonder why why they don't see it yet I don't think I think most academics don't see it my way because they didn't actually keep up with all these things very they didn't watch it very closely all right those are my thoughts and that's why I think with time and if they were to actually have more discussions about this topic which they still don't want to do but if they were to they would eventually concede that these points are very damning epidemic outcomes following government response to covid-19 100,000 models their conclusion is we don't know anything they write let me read you the quote the concent of estimates around a Zero Effect weekly suggest the government response did little to nothing to change the burden of covid-19 I think that's a mistake it should say it's suggests not weekly suggest there's no week about it it suggests they did little to nothing some analyses even suggest harm and very few suggest benefit it's about the same harm and benefit that's a damning indictment of what we did CH changing people's lives arresting people who weren't wearing a masks ticketing people for being outdoors all these horrific abuses of the police state in the mistaken name of Public Health pushed by people who weren't studying these issues at all and now we're left with a data set so full of you'll never be able to find the signal again we're not we're not that many generations away from the ignorant people who live through the black death and we're just as ignorant in many ways we're just as ignorant technological progress masks just how stupid the average scientist is and how how little we've come forward and I think that to me is the most sobering sort of sociologic takeaway about about science in in this time all right those are some thoughts it's a great paper it's a really brilliant paper um a lot of credit to Ben David and uh who unfortunately was I think pushed into silence uh and uh jro Patel for this sort of really nice analysis next time somebody says there's a paper that shows lockdown helps sit from the Lancet you can tell them yeah there's 100,000 other anal analytic plans and 96,000 of them show no effect and maybe a few show their effect and a few show harm so you can cherry pick all day but this is going to be the definitive study that shows probably null effects like most things in biom medicine and public health have a null effect most of the things we tried in human history that we thought were promising didn't do that much probably that's the case here but more than that the uncertainty bounds are so great and that is an indictment of the people who set the policy in a way that they would never be able to face any accountability for what they said because no data could ever be provided that what they said was right or wrong and that to me is anti-science the most deepest form of anti-science to keep talking and not studying the things you're saying all right if you like this video you know what to do like subscribe comment leave a message below I'll be back with more until next time