Debating the debate

My take on a piece by Tyler Cowen about the proposed debate between Peter Hotez and RFK Jr

I enjoy reading Tyler Cowen. Thanks to him I have discovered Bryan Caplan's Case Against Education, which has changed my mind on the value of high school and college education.

On Wednesday Tyler published an opinion piece in Bloomberg advising Hotez not to debate RFK Jr. He argues a debate is not the right format to have a scientific discussion; instead, the discussion should happen through peer-reviewed journals.

I want to discuss some underlying assumptions that I perceive in Tyler's piece:

1. A debate is meant to adjudicate the scientific truth

2. Values and preferences shouldn't be discussed in a debate

3. People need to be protected from conspiracy theorists

Let's dive into what Tyler wrote.

Recently, Joe Rogan offered to donate $100,000 to a charity of vaccine scientist Peter Hotez’s choice if he appeared on his podcast to debate presidential candidate and longstanding vaccine skeptic Robert F. Kennedy Jr. Most scientists consider the major questions settled — and not in Kennedy’s favor.

I am not sure whether Tyler is referring to vaccines generally or Covid-19 vaccines specifically. If the latter, I would have appreciated if he had expanded on how he considers the major questions to be “settled.”

My current understanding is that Covid-19 vaccines:

• are effective at preventing transmission and infection for only a very short window after vaccination

• are effective at reducing risks of hospitalization and deaths, especially for vulnerable people

• cause more serious side effects than flu vaccines, especially for young men who receive two Moderna shots in quick succession

I have a low confidence in all three of my statements. The CDC and the FDA are unfortunately pretty silent on the first point.¹ I am someone who could definitely benefit if two well-articulated people were to openly debate all three statements.²

But a public debate is not a sufficiently structured setting for adjudicating right from wrong on these issues.

My impression is that for Tyler the only purpose of the debate is to convince the audience that one’s statements are correct.

I disagree with this view of the scientific process. I think our understanding of most phenomena is limited and incomplete, especially on a question like Covid-19 vaccine effectiveness where we sorely lack good data. For instance, to the best of my knowledge, we don't have randomized case control studies testing the hypothesis that the vaccines reduce the risks of severe illness, hospitalization, and death, and therefore can’t be as confident as we would like in that hypothesis.

Many observational studies show that, among vaccinated people, the risk of being hospitalized for (or with) Covid is lower than among unvaccinated people. But the question is whether there is actual causation or mere correlation. Of course researchers take into account confounding factors in their models to rule out other hypotheses. For instance, we know that wealthier people have better health outcomes, so researchers include wealth proxies such as someone’s ZIP code to make sure the difference in outcomes isn’t only due to wealth and other residual factors.

But we can never fully address all confounding factors.³ For instance, some people are more risk averse than others and will both get vaccinated and avoid crowded areas. If they don't get hospitalized, was it because of the vaccine or their cautious behavior?

Therefore, if someone says they are very confident on some of these questions, I’d want to know where that confidence comes from. In other words, I’d hope Joe Rogan would ask them what is to me the foundational scientific question: “How do you know?”

A lot of macroeconomics is counterintuitive anyway, so mere verbal sallies do not settle whether a particular set of claims is valid.

I don’t think any economic school of thought has a lot of things figured out. To quote Scott Cunningham: “When all is said and done, my hunch is [empirical microeconomics] really [is] a very primitive scientific field. Like maybe 2023 is the equivalent of being a century away from using leeches to heal the body as they did in medicine. I think maybe we’ve just been growing.”

Given this primitive state of knowledge, the goal shouldn't be to “settle” or “adjudicate”, but to understand where there's agreement and disagreement, what's our level of confidence in specific statements, and where we need to dig deeper. We should also be clear about which phenomena can't be explained by current theories.

Tyler comes back to adjudicating right and wrong a few times but a debate is also the perfect place to discuss values. There's a tendency by some to tie science and policy. It’s comical that someone can be labeled a climate denier if they don't agree with a specific climate policy, even though they agree the Earth has been warming and will continue to warm due to human activity.

Science and policy are distinct. Science can inform policy but can’t dictate it. People’s values and personal situation shape their policy preferences.

Part of the the discussion about Covid vaccines relates to values and policy — for instance, should some people have been required to get vaccinated to avoid losing their job or getting expelled from college? In my opinion, a lawyer and a former fighter are as qualified as anyone else to discuss values and policy.

As a general rule, one should not debate publicly with conspiracy theorists.

The obvious question is — who decides who is a conspiracy theorist?

This leads me to believe that Tyler fears that “the public” will be mislead. In other words, I am smart enough to know who’s right but you aren't so I need to protect you from conspiracy theorists.

So when someone demands a public debate on an issue, be suspicious.

Be suspicious of open discussions? If this were a Biden v Trump debate rematch I’d tend to agree — having two people interrupt and insult each other isn’t very conducive to discussing nuanced subjects. But a 2-3 hour discussion moderated by someone who has interviewed two thousands guests and gives them time to explain themselves?

I disagree with Tyler. I think I’d benefit from that debate.

1. The CDC does not seem to make strong claims about transmission or infection. For example, under the FAQ “How long does protection from a COVID-19 vaccine last?”, the CDC writes: “Scientists are monitoring how long COVID-19 vaccine protection lasts. Recent data show that 1 dose of the updated COVID-19 vaccine better protects you against more serious illness, hospitalization, and death. People who have received the updated COVID-19 vaccine in recent months are better protected against severe illness from COVID-19 than those who have not gotten it.”

The FDA also does not mention transmission or infection. On April 18, the FDA modified its Covid-19 vaccines guidelines. To encourage vaccination, the FDA wrote: “COVID-19 continues to be a very real risk for many people, and we encourage individuals to consider staying current with vaccination, including with a bivalent COVID-19 vaccine. The available data continue to demonstrate that vaccines prevent the most serious outcomes of COVID-19, which are severe illness, hospitalization, and death.”

2. To be clear I’m not interested in hearing about Wi-Fi radiation.

3. The authors of this study note the following limitations, which is standard in any observational study: “Data on SARS-CoV-2 exposure risk and mask use were not collected; biases might also arise because of differences in testing behaviors between vaccinated and unvaccinated persons, which might result in residual confounding.”