Medical Examiner

The Plight of the Pandemic Advice-Giver

Individuals cannot stand in for a federal agency

a hand with masks
Photo by Vera Davidova on Unsplash

“Emily Oster is my C.D.C.,” reads a tweet last month from NPR White House correspondent and parent Scott Detrow. It’s a joke, but it’s also not, as a recent New York Times profile of Oster observes, citing the tweet and describing her as “a lodestar for a certain set of parents.”

Oster, an economist at Brown University, is not a medical professional. But she has spent the pandemic doling out advice on her Substack, Parent Data (some issues of which have been reprinted on Slate) as well as writing occasionally for the Atlantic. As the author of books on pregnancy and raising kids, with a robust following on Instagram (at least for an academic), she was well-positioned to be a trusted source for parents in the pandemic. Her advice is data-based and nuanced, often acknowledging that choices come down to personal risk tolerance. Her analysis has been particularly useful in cases where the CDC offered up less-than-helpful black-and-white edicts. For example, in the run-up to Thanksgiving, Oster offered a thoughtful framework for thinking through the risks, suggesting readers look at their own local case counts and plan to quarantine before and after seeing people outside their home. Meanwhile, the CDC (just a week before the holiday!) advised no travel whatsoever (it didn’t work). And she was an early proponent of reopening schools, which, though not a universally shared opinion, provided succor to parents driven to extremes by remote learning. But as the Times piece points out at length, Oster gave this advice without an epidemiological background or special insight into realities of public health infrastructure or the concerns of budget-strapped schoolteachers.

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Pointing out the limits of Oster’s expertise is worthwhile, especially since her advice is widely shared and on occasion clashes with that of perhaps more qualified professionals. The Thanksgiving advice echoed how public health professionals were thinking through risks for themselves. But there was considerable backlash to an Atlantic headline, and to a similar headline on a Slate interview with Oster, urging parents to treat their unvaccinated kids like vaccinated grandparents. Indeed, as I have edited pieces about COVID and risk and kids, I have encountered advice that goes against hers. But reading the Times profile left me with another, larger feeling: It’s such a perfect encapsulation of the past year that we are even having to joke that a single (very smart) economist is serving as our Centers for Disease Control and Prevention in the first place.

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Oster is not the only one in this position, and is more qualified than many. As Tim Reuqarth has observed in Slate, there has been an “epidemic of armchair epidemiology,” with everyone from data scientists to Silicon Valley folks offering their analysis. We’ve spent the pandemic relying on people of varying levels of expertise—charismatic people with large followings and a willingness to dispense easy-ish, actionable advice—for help. Part of this is because that is how we always operate: America loves a TV doctor, or really, a TV-anyone who is ready to tell them what to eat and how to live and where to direct steam. Our tendency to follow celebrities (or microcelebrities, or newly minted microlebrities) for health advice would naturally grow all the stronger during a time when we are in desperate need of it, as a novel virus spread across the globe and suddenly basic hygiene felt like a matter of life and death.

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It was under these conditions that the official scientific agency established to, among other things, distribute vetted fact sheets during a health emergency appeared to be a little out to lunch. It failed to detect the virus in a timely manner in February, was late to the punch on masks that spring, and took until May 2021 to full-throatedly warn that the virus spreads through the air. “From the pandemic’s earliest days, the agency had been subject to extreme politicization and troubled by what looked, at least from the outside, like pathological clumsiness,” wrote Jeneen Interlandi in a sweeping New York Times Magazine article last week on said clumsiness. Interlandi describes an organization of more than 11,000 people that is “sprawling in its reach and extremely constrained in what it can do,” tasked with issuing guidance on both ongoing and novel circumstances but with a budget that does not accommodate the unexpected. In short, as you have probably observed, it is not very nimble.

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Oster is nimble. Her specialty is gazing into the data or lack thereof and explaining what it says. To be clear, she is qualified to do this: Her Harvard economics dissertation focused on an effect of hepatitis B on China’s population; public health is a central focus of her peer-reviewed publications. She is an experienced researcher with something valuable to contribute who has, in the pandemic, been elevated to a position of some public prominence, along with many other individual academics and doctors (see most notably: Anthony Fauci). But what helps when there are novel circumstances and high stakes is collaboration—collaboration between people with experience dealing with similar-if-very-different problems, like past diseases. What helps is maybe a diverse group of these kinds of people, with the tools to gather more information quickly, housed under the same umbrella organization. What helps to have during the pandemic is … well, something like a well-organized, funded, and agile CDC.

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Of course, Oster knows this—wants this, too. “I figure there is an off chance that someone at the CDC reads this,” she began a May 20 edition of her newsletter, just after the organization announced that vaccinated adults no longer have to mask up. She proceeded to launch into a series of questions about how this affected kids, and what the risk is to, say, a 1-year-old who cannot mask. She noted that she had data-based opinions on these questions, as do others. But she seemed to acknowledge that these were, well, just one woman’s informed opinions. “The fact is that the CDC should have the ability to collate these opinions together,” Oster wrote. “So please please can we get something here?”

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