Dr. Satoshi Akima, who does internal medicine in Australia, has some ideas about the economic reasons for ignoring the pandemic.
First, a bit of context to consider from Dr. Lisa Iannattone,
"Disability rates haven't stabilized since the great mass infection event of early 2022 [masks dropped in March 2022]. They're still rising. These are the rates for the US and the UK. How many times do public health leaders plan to have everyone play the chronic disease/disability lottery? What's the plan?"
According to Akima, the two sides around pandemic actions have to do with the competing economic philosophies of Keynes and Hayek. In a very brief nutshell, Keynes influenced the New Deal type of governmental "interference" to prevent abject poverty following the premise that governments must spend to create jobs even if it means going into debt briefly (and government debt isn't like personal debt). Free markets create unemployment because profits depend on lowering wages and cutting costs by outsourcing in a downward spiral that governments should actively prevent through legislation. By contrast, Hayek influenced Milton Friedman and the Chicago School of Economics and Mont Pelerin Society with the underlying premise that limiting corporate freedom is limiting freedom of the people, so government shouldn't interfere in markets, which self-regulate. Hayek said they should almost never interfere, but Friedman took this further to suggest they should never interfere and ran a little experiment to see how well it works (spoiler: not very well). Instead of controlling wealth inequities, the role of government was to use austerity measures and to privatize all services and clear the path for corporate deregulation. And then people died so profits could be free. Here's what Akima says in full, followed by a rebuttal at the end, followed by my concerns with the rebuttal.
"The central error of the pandemic is that of running pandemic management by laissez-faire socioeconomic principles. If you grasp this, all the other errors fall into place as the inevitable consequence of following that line of thought.
Economics is the final bastion of Social Darwinism. Its laissez-faire principles dictate that all Keynesian central government-instituted intervention, even in a crisis, only makes things worse. A crisis should be allowed to run its natural course. A crisis is a welcome process of cleansing out of the unfit, resulting in economic renewal through creative destruction. It is often likened to a forest fire. The charred remains of the fire fertilizes renewal. When the weak, economically unviable units are cleansed out while the strong survive, it is deemed progress. It is an unnatural perversion to intervene in the order of Nature, as it perpetuates the sustenance of unfit and unhealthy “zombie” units. If the vulnerable die from wilfully spreading SARS-CoV-2, that is just an unavoidable historical necessity, the price one pays for progress. The end justifies the means—for the alternatives could only be worse.
The demagogues of laissez-faire had meanwhile devised their own plan: the herd immunity strategy. This involved using SARS-CoV-2 as nature’s gift of a vaccine against itself (there is historical precedent with smallpox variolation). Once enough of the population had been mass infected, the pandemic would end from herd immunity. The sooner everyone was mass infected, the sooner the pandemic would end. Central government intervention to slow the spread would be harmful because it would merely “kick the can down the road” and prolong the pandemic. It was thus necessary to promote rapid SARS-CoV-2 mass “variolation” as a safe and “natural” form of vaccination with “mild” side effects. Thus, СОVID minimisation was born.
All harm arising from SARS-CoV-2 is next blamed on the mRNA vaccine because it is a centrally funded government intervention, which can, therefore, only be harmful because it violates the economic principles of naturalistic laissez-faire. The “anti-vaxx” movement is just a consequence of this. But there is no keener pro-vaxxer than an anti-vaxxer wanting to “naturally” mass vaccinate everyone. During the SARS1 epidemic, we received instructions to wear N95 respirators during PPE training. The 2013 Fauci edited Harrison’s Principles of Internal Medicine stated both influenza and SARS were airborne diseases. Come 2019, there was precedent for deploying PPE as an NPI [non-pharmaceutical interventions] against SARS, just as we had successfully deployed condoms against HIV. The problem is that it pointed towards a path of central government Keynesian intervention using public health measures to quell the looming threat. The very existence of a pathway that would radically slow or stop the spread of disease was an offence to the demagogues of laissez-faire. NPIs, like PPE, were thus an unnatural perversion that would cause more harm than good.
It was thus not acceptable that Covid is airborne. Everything had to be done to oppose any evidence that might hinder the mass variolation of the population with SARS-CoV-2 to bring the pandemic to a radical conclusion. To argue for the herd immunity strategy, they effectively claimed that as there were no RCTs (“gold standard”) to show the moon was made of mineral, it must be made of cheese; i.e. there were no RCTs showing that NPIs worked, therefore, SARS2 mass infection is safe and effective.
The scientific errors committed during the SARS-CoV-2 pandemic can readily be understood as having occurred on the basis of socioeconomic and political interference in the scientific process. Similar forces in the nineteenth century colluded to interfere with the acceptance of cholera as a waterborne contagious infectious disease with the opposition from laissez-faire groups to germ theory. Germ theory favoured the contagionist position that central government interference was necessary to stop disease spread between subjects. But the nineteenth century was the age of empire and industrial revolution, which encouraged strong government initiative with a more optimistic view of the ability of science to transform society for the better. That is why the 19th century did better in conquering cholera than we have done in conquering SARS-CoV-2."
Then he links to an older post from March to further explain his position:
"Death in Hamburg by Richard Evans is a book written in 1987 for our Covid age. The title, a reference to Thomas Mann's Death in Venice. This is one of the best books I've ever read. From legendary Cambridge historian, Sir Richard J Evans comes a historical epic that unfolds in a grand Dickensian narrative, set in a Victorian-era bleak house of indescribable inequities on the backdrop of the satanic mills of a post-industrial revolution German landscape. It reads like it was written for the Covid age, but was surprisingly first published in 1987, at the height of the HIV pandemic.
The book is equally a commentary on the rise of neoliberal Thatcherism in Britain and its adoption of decentralised laissez-faire economics. It was the same laissez-faire ideology that, to disastrous effect, had dominated the decision-making of the ruling Hamburg merchant clique at the time of the 1892 Hamburg cholera epidemic. It contrasted to centralised public health policy in Berlin, where no outbreak occurred. The 1892 cholera outbreak should never have happened—they already “had all the tools” to prevent it with public health interventions. Only political forces moved to undermine scientific consensus. History has simply forgotten the lessons from this failure.
Since 1987, libertarians have become more extreme in their anarcho-capitalist radicalism than Thatcher or Hayek could ever have imagined, thus making this book even more relevant today than ever before. Hayek accepted central planning for infectious diseases. His heirs do not.
Hayek's "Freedom and the Economic System" in Socialism and War The narrative is fleshed out with infectious disease epidemiology on mortality and morbidity in a way that only graphically illustrates the impacts of Dickensian levels of grinding poverty and hardship. The statistical narrative in numbers cannot but shock modern readers. Then there are the medical characters locked in a battle for dominance. Jane Austen complained that Dickensian neo-Gothic characters were too grotesque to be credible. Were the figures in medical science history not real characters, one might level a similar complaint. If today we see the droplet vs aerosol camps do battle, back then, the debate was between the contagionists and the miasmatists. On the right, the heroic figure of the Prussian Robert Koch led the charge towards decisive interventionism based on contagionist germ theory. On the left, we find the Social Democrat Rudolf Virchow, who mostly rejected contagionism (except in cholera and then only reluctantly.
The capitals of empire were not going to tolerate the great unwashed of the working classes staying a Petri dish of pestilence, crime, and revolution. The flea and scabies-infested masses swimming in faeces needed to be cleaned up in an age where cleanliness was Godliness. As Koch’s contagionism coupled with central intervention to prevent disease triumphed, Pettenkofer saw his life’s work being buried by history. Determined to strike back, he ordered a culture of Vibrio cholerae from Koch’s lab in Berlin and proceeded to drink it before witnesses. Pettenkofer only got mild diarrhoea, his stool remaining culture positive until day 6, leading him to declare Koch’s contagionist view of cholera to have been falsified! It was the period equivalent of scoring a favourable “Gold Standard” Cochrane review.
Today’s horror is that the reverse of what happened in the Hamburg of 1892 is underway, when centralised action was forced to be taken based on the triumph of a scientific consensus favouring Koch's contagionist model. Instead, we see the victory of Hamburg-styled laissez-faire overcoming a growing scientific consensus around the principle that Covid is airborne, demanding another Koch-styled state-lead engineering intervention to clean the air like the 19th century cleaned our drinking water. Once more, laissez-faire rebels against centralised intervention by public health in favour of an approach favouring “individual responsibility” amid a fatalist dogmatism arguing all state intervention is futile.
Postscript. The background setting opening chapter is slow-paced. Don’t let this put you off. If you find it dry, skim-read or skip to the second chapter, which plunges you headlong into a world of woe that is anything but dry. But do return to reread the opening chapter later on if you like the book. Once the dramatic momentum reaches its climax, you find a litany of period quotes that look like they were penned as satire by the Neoliberal John Snow, only to realise they are direct historical quotations. . . . I was just thinking: how ironic that a minimiser like Christian Drosten should be associated with the institute carrying Robert Koch's name—one associated with definitive state-led preventative public health action that rejected laissez-faire because it detracted from focusing on poverty as the real root cause of disease. Virchow also rejected Semmelweis because the focus on handwashing placed the onus of reform too much onto individual responsibility and away from the fight against poverty. The Balloux-like foolish centrist is the centre-leftist Pettenkofer in a halfway house between contagionism and miasmatism. Evans describes Pettenkofer’s theories as “contingent contagionist”. Only in deep groundwater was cholera (the X factor) transformed by a mysterious “Y factor” to spread as a contagion. Only once in deep groundwater, under the influence of a “Z factor”, could the disease induce pathology as a miasma. Never could cholera induce pathology as a waterborne contagion ingested through drinking water. Thus, Pettenkofer held boiling or filtering drinking water to be useless.
He clung to a fatalistic dogma that once an epidemic had erupted, it was futile to take any action. This fatalism found favour with the laissez-faire Hamburg merchant class, who feared the economic impacts of lockdowns—the “panic” they induced was “worse than the disease”. Engineering solutions were dismissed using Pettenkofer as justification for being too expensive and futile.
By contrast, Koch’s contagionist views favoured a centralised interventionist approach to public health, with sweeping lockdowns enforced by cordons sanitaires. Being a libertarian opposed to authoritarian state intervention, Virchow tended to side with Pettenkofer. The Hamburg laissez-faire style of rule biased them towards Pettenkofer’s theory that cholera acted as a contagion only in deep-seated groundwater, necessitating no radical engineering overhaul of sewerage systems, as well as rejection of lockdown and quarantine. Koch’s centralised public health matched the approach adopted by Westminster in eliminating cholera from London with its engineering marvel of modern sewerage systems. This was adopted by other cities like Berlin, where Koch established Vibrio cholerae as the cause of cholera. The progress of bacteriology and engineering galvanised great capitals of empire to order decisive public health interventions that would prevent the spread of contagions brought back to Europe from far-distant colonies. Cholera was usually referred to back then as “Asiatic cholera” brought back from the South Asian subcontinent colonies. The way this echoes Trump’s term “the China virus” for SARS-CoV-2 is striking. The conquest of cholera in the age of John Snow and Robert Koch represented a triumph of scientific reason, but there were additional social factors facilitating that."
"It's simpler than this: Political fortunes are tied to public will. The public doesn't value impingements on recreational liberty. It's not rebellion against a neo-Keynesian framework. It's human stupidity and indolence coming to political fruition. For the near total inability of humans to weigh inter temporal benefits and costs efficiently and effectively, see prospect theory. Government reflect the lowest common denominator in society. What we see is what we are, collectively. There is no secret conspiracy or systemic Schumpeterian meat grinder waiting with open arms. The average person is catastrophically ignorant, selfish, and myopic. They won't demand quality unless they're told what 'quality' is. Not a pleasant message, but that's reality. . . .There's enormous tension between short term and longterm thinking, and the incentives are stacked against longterm - biologically, socially, and politically. We CAN be more and do better. It starts with the individual. Human potential is staggering. We can become so much more than we are. And moving toward that ideal of rationality, being informed, making measured decisions, fostering stability, and growing collective benefit is intoxicating!!!"
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