Anthony LaMesa: The interview

The best thing you should read this week

Anthony LaMesa is one of the sharpest COVID19 policy analysts on twitter. You can follow him @ajlamesa. He evaded my attempts to interview him on my Podcast Plenary Session, but agreed to this interview. Enjoy, it is terrific. I think I agree with every single word.

-Vinay

Tell us about yourself?  

I grew up in a working-class family in the eastern part of Connecticut and have attended public schools my entire life — from kindergarten through higher education. I’ve taught at an Arizona public school and at NGOs in Guatemala City and Oaxaca. More recently, I’ve consulted for a World Bank education fund and for a Unicef organization. I also do freelance research work. I have a master’s degree in social policy and development and believe it’s extremely important to understand schools as one essential component of a broader social contract and welfare system. 

I consider you to be the among the last true progressives left on COVID19 issues.  You actually champion progressive ideology in all your recommendations.  Do you think this characterization is apt?  

That’s very kind of you to say, although I think there are many people who share my worldview, yourself included. I think people like myself wish our Covid-19 response had prioritized a holistic understanding of public health and social well-being instead of a narrow focus on reducing “cases” as much as possible. I wish we had defended essential public goods — like public schools and libraries — during the pandemic instead of abandoning them and their users. 

Very early on, you were open to the idea that Sweden made the right choices.  Is that accurate, and how do you feel about Sweden now?

Sweden’s pandemic response was imperfect, but it’s insane to label the country a “pariah state.” I admired Sweden for respecting its constitution — while other countries pushed the boundaries of what was constitutional — and the basic civil, social, and economic rights of its citizens during a once-in-a-generation global crisis. I think Sweden was correct to keep primary and lower secondary schools open. This was good for children, important for keeping basic services functional, and consistent with the Swedish government’s goal of mainstreaming feminism throughout its policymaking. Today, Sweden continues to impose some sensible limits on hospitality establishments and large gatherings, but has avoided the coercive mandates of other European countries while still achieving a vaccination rate above the EU average. 

It’s tragic that Sweden lost more residents to Covid-19 than its neighbors, but it’s unclear if locking down or closing schools would have led to fewer deaths. In the 1990s, Sweden devolved long-term care responsibilities to municipalities and invited for-profit operators to manage care homes. Neighboring countries entered the pandemic with superior long-term care policies. Moreover, it’s worth noting that Sweden’s per capita death toll is quite a bit lower than countries like Belgium, France, Italy, Portugal, Spain, and the United Kingdom — all of which imposed mask mandates, curfews, and strict lockdowns.

Closing schools: a bad decision or a catastrophic one?  Why?

In retrospect, I don’t think it was a good idea to close primary and lower secondary schools in March 2020, but I can understand why the uncertainty of the moment led to that outcome. I think it was a bad decision to keep schools closed beyond April when we had pretty reliable data from China and Europe that children were at low risk of severe disease or death from Covid-19. It was a catastrophic decision for many U.S. districts to not even attempt to open schools in fall 2020. And then, even after Biden was sworn into office, the administration only set a goal of reopening K-8 schools, which condemned U.S. high school students to some of the rich world’s longest school closures. Many high school students left education to find work and will never graduate; others did’t have the support they needed to apply to college. 

Denying children public education for over a year has shaken the faith many parents have in government. Our pandemic school policy was a colossal policy failure on the scale of the Iraq War. We must make sure this never happens again and that probably means reflecting on our governance and institutional arrangements for public education. Hyperlocal control of public schools was a barrier to reopening them, because there was a leadership vacuum. 

Why do you think so many of our fellow progressives were on the wrong side of the school issue?

Well, first, I think we should be careful about assuming many progressives were on the wrong side. A lot of progressives were very upset about the school closures, but didn’t feel safe speaking out in pubic or on social media, especially in spring and summer 2020. Nevertheless, there were some very vocal progressive voices — especially in elite progressive media — who were passionately against reopening schools until cases were close to zero or unrealistic investments were made in facilities. Trump’s vocal support for reopening schools in summer 2020 probably made opposing school reopening a logical position for prominent progressive journalists and activists, especially given it was a presidential election year. 

Masking kids—let’s start with school age kids. Do you think it is a good idea?  If so, what ages?

At this point, with vaccines available to all children five and older and significant natural immunity in the population, I think masks should be optional at all levels for both children and teachers. For those who want to wear them, schools could provide free surgical masks (students and teachers) and medical respirator masks (older students and teachers) through the end of the academic year. Prior to widespread vaccine availability, I think the WHO, UNICEF, and ECDC guidance made sense: no masks for children under five, limited masking for children under 12, and masking like adults for children 12 and older. 

Masking is problematic for literacy instruction and socializing, so I think it was never appropriate to mandate student masks in pre-K or primary school classrooms.

Now let’s talk about masking 2-4 year olds. Only the USA, under the guidance of the American Academy of Pediatrics and CDC does this. Is it sensible?

I think it’s absurd to require children under five to mask. The French explicitly prohibit student masks in their nursery schools. It’s probably even unwise for staff and teachers caring for and educating children this young to mask. One French study shared by the European Commission found that young children in child care and pre-K settings often responded negatively to masked teachers. Of course, I think teachers should always have the choice to mask, but let’s not pretend that there were never harms associated with masked teachers and caregivers interacting with young children. 

It’s also worth noting that masked educators are particularly problematic for children with special needs. A child with an IEP for a language delay will be served by a mask speech therapist in New York — is it a good idea for a child already suffering from a language delay to receive interventions from a masked therapist whose speech will be muffled? Norwegian guidance explicitly advises speech therapists and special educators — professionals meeting one-on-one with students — against masking.

How should vaccines have been distributed in Jan 2021?

We should have prioritized the elderly and medically vulnerable. Connecticut and Florida both adopted this approach. Such an approach would not only have provided the earliest protection to those most at risk, but would also have sent a message to the elderly that it was particularly important for them to get vaccinated. Targeting the medically vulnerable for early vaccination in the U.S. was tricky, because we don’t have a true health care system and nearly 100 million uninsured and underinsured residents are effectively excluded from the “system” we do have. How could the government invite these excluded people with co-morbidities to seek early vaccination if there were no medical records to use for outreach? Instead, states just put out long lists of medical conditions and some people without documented co-morbidities lied to get early access to vaccines while others — the poor and vulnerable with multiple co-morbidities — had no idea they qualified for early vaccination.

Many U.S. states also prioritized a massive number of essential workers, but the lists probably should have been narrower and targeted those serving vulnerable populations in congregate settings: hospitals, long-term care, prisons, and homeless shelters. In the U.S., I would have also prioritized teachers and school staff — many states did this — despite schools being relatively low-risk environments. School reopening politics were particularly complicated here and prioritizing teachers was sensible to reassure both teachers and parents about the safety of schools.

What were the greatest pandemic errors made by the political right?

In December 2020, the Trump administration did not act aggressively enough to demand transparency from China about the situation in Wuhan. I suspect a President Hillary Clinton may have been more aggressive with the Chinese about demanding that U.S. scientists and health experts get access to Wuhan. Once community transmission was present in the U.S., many on the political right — especially individuals aligned with Trump — downplayed the seriousness of the disease with incredibly unhelpful rhetoric. Moreover, some Republican governors failed to expand Medicaid and paid sick leave during the pandemic — cruel and counterproductive to the stated goal of keeping economies open and vibrant. If you kept everything open and didn’t also provide citizens with robust social supports, you weren’t following the Nordic pandemic playbook. 

The political left?

Some on the political left ignored the collateral damage of Covid-19 restrictions, especially school closures, mental health damage, and domestic violence. I also think some on the political left fetishized the responses of countries like China and New Zealand without deeply thinking about the context for those responses — China’s authoritarianism and New Zealand’s geographic isolation. I’ve always said that you fight the pandemic with the country you have, not the country you wish you had. It’s absurd to think the U.S. could have set up New Zealand’s hotel quarantine system — we would have had to totally shut the southern border, which would have had terrible consequences for Mexico and asylum-seekers. 

Is Omicron bad news? Or will it hasten the pandemic’s end?

The European Medicines Agency believes that Omicron will move us “towards a scenario that will be closer to endemicity.” It does seem like Omicron will produce a massive amount of natural immunity and hybrid immunity. And, psychologically, Omicron has forced a lot of anxious people to “meet the virus” for the first time. I hope that this spring will be the most normal season — whatever normal means now — since winter 2020. 

Can you die with COVID19 rather than from COVID19?  Why was this controversial to say?

There seems to be an emerging consensus that some people have been hospitalized and died “with” Covid-19 instead of “from” Covid-19. From the U.S. to Finland to Italy, you now hear scientists and governments talking about the distinction and trying to unpack data. Of course, a lot of people — the majority? — are still dying “from” Covid-19 and this is somewhat of a grey area. I think it was controversial to discuss the “with” and “from” distinction, because the discourse around Covid-19 has been so toxic and many felt that exploring this issue amounted to “Covid denial.” 

Should college kids be mandated to be double vaxxed?  Triple vaxxed?  Stay in their rooms?

Undergraduate students are typically 18 to 22 years old and therefore face very little risk of severe disease or death from Covid-19. I prefer engagement and empowerment over mandates, but dormitories, dining halls, and other university facilities are crowded congregate settings, so I understand why some schools have decided to mandate vaccination even if I don’t necessarily think the mandates accomplished much. If colleges and universities are going to impose mandates, I think that prior infection should count as a dose for the primary series or the booster. 

I do think it’s unacceptable how some colleges and universities — Connecticut College and Yale come to mind — have imposed extremely onerous restrictions on their students, all of which have already submitted to vaccine mandates. It’s absurd to force undergraduates to “lock down” in their rooms for weeks after arrival. Or to ban them from visiting local restaurants and shops, like Yale has done. Administrators are not preparing students to be independent and responsible adults with these paternalistic policies. 

The development offices at certain colleges and universities must be anxious. Students who endured a couple years of virtual instruction and Wuhan-style treatment in dorms probably won’t be donating a cent to their alma matters after they graduate. 

Honestly, as a general rule, I think we should be worrying a lot more about unvaccinated and unboosted elderly and medically vulnerable people and a little less about unvaccinated college students. The U.S. has done a poor job boosting the elderly compared to Western European countries, including in nursing homes where large pharmaceutical corporations failed to quickly deploy boosters to residents. 

Should democrats pay the price for school closures? Are they responsible?

That’s tough to say. Republicans and Donald Trump didn’t help with erratic demands to reopen schools delivered in all-caps on Twitter. Some national Democrats — for example, Neera Tanden and others connected to the Biden campaign  — really politicized the reopening of schools in summer 2020 at the same time as nearly all the European governments had already begun preparing to reopen their schools. The dominant discourse was that, because Trump didn’t fight the virus as well as European countries reopening their schools, we couldn’t safely do so. This rhetoric ignored that, when countries like France and Spain reopened all of their schools in fall 2020, their epidemiological conditions were worse than our own. A mid-September Biden campaign advertisement even flashed an image of an empty classroom with the words “our kids not safe in school.” It was wrong to weaponize the education of our children so intensely during the presidential campaign. 

At the same time, some Democrats showed great leadership on reopening schools. Connecticut’s Ned Lamont and Rhode Island’s Gina Raimondo both did very good jobs reopening the schools in their states — as did many Democratic mayors and elected school board members. Ultimately, our hyperlocal school governance arrangements mean that national politicians have very little influence over local school decisions, but I do think that some national Democrats — Biden, Tanden, Pelosi, etc. — could have spoken more responsibly about school safety in order to give local officials “space” for making the tough decision to reopen. 

Did twitter help public health or hinder it?

Academics will have to assess how Twitter’s Covid content policies impacted the public health response. Some individuals had tweets censored for expressing unorthodox Covid-19 opinions, but then “Covid alarmists” faced no censorship for spreading truly insane lies that undoubtedly scared the crap out of millions of people and almost certainly led some parents to pull their children out of school.

Sometimes I feel like the past two years have turned me into a bit of a Luddite — without high-speed internet, I think our pandemic response would have been more traditional and lockdowns clearly would have been impossible. And, without social media platforms like Twitter, some of the most prominent lockdown advocates and fear-mongers wouldn’t have had a platform to reach the general public. At the same time, I’ve learned a lot on Twitter from more responsible voices — and the platform has enabled these individuals to push back against problematic reporting in mainstream media, such as the New York Times’ coverage of children, schools, and Covid. 

Does wealth inequality and stagnating wages breed vaccine hesitancy (as vaccines are one of the last ways you can exert control over your life in a world increasingly out of your control)? 

Insofar as wealth inequality and stagnating wages contribute to exclusion from a profit-driven U.S. health care “system,” I think one could certainly make the case that both have contributed to exceptionally high levels of vaccine hesitancy in our country. Some Americans didn’t trust that the vaccines were actually free or feared medical bills from side effects. So, rejecting vaccination may have felt like a way to maintain control over fragile livelihoods. 

Should vaccines be mandated? If so, what ages?

Like I said about college students, I’m generally uncomfortable with mandates and would prefer engagement and empowerment over coercion. For example, Latin American countries have long used conditional cash transfer (CCT) programs — Brazil’s Bolsa Família is the most famous — to encourage parents to vaccinate their children and enroll them in school. I think the Biden administration might have been more successful focusing on community organizing and cash payments during fall 2021 instead of announcing a politically toxic OSHA mandate, which has now been overturned by the Supreme Court. That said, given Covid-19 age stratification data, some mandates are probably more reasonable than others. For example, Greece, Czechia, and Italy mandating vaccination of the elderly probably makes more sense than the U.S. mandating vaccination of school children and college students. Depending on the disease, sometimes it’s very important to vaccinate elderly people and sometimes it’s very important to vaccinate children.

There used to be the slogan Love conquers hate—do you think fear conquers love:  with respect to COVID19 response?

It has sometimes felt like certain Twitter pundits and cable news doctors believe that fear-mongering is a way to demonstrate compassion or love. I think that’s what we generally call abuse, yes? In December 2020, the New York Times published an op-ed entitled “It’s Time to Scare People About Covid” — I was horrified. I’ve also really hated the messaging around masks that “wearing a mask is less painful than going on a ventilator” — I mean, really? In Mexican airports, they constantly play an announcement that “taking care of yourself is taking care of each other.” This is empowering messaging that I can get behind — love and protect yourself to love and protect others.

Progressivism is a philosophical view.  What does it mean to you, and what were ways in which people who identify as progressives actually promoted regressive pandemic policies?

I strongly support teachers’ unions and traditional public schools, but I think progressivism must be about more than just supporting unions and “progressive institutions.” I believe progressivism should be about optimizing freedom, well-being, and self-actualization for as many people as possible — and, yes, children are people. Amartya Sen’s “Development as Freedom” influenced how I think about progressivism and policymaking. In an alternative universe, Sen’s theory of “linked freedoms” — health care, education, political dissent, economic markets, and equality — could have inspired a progressive pandemic response grounded in freedom and privileging resources over restrictions. To an extent this is what the Scandinavians did and, as a result, they avoided much of the social trauma experienced in countries — and U.S. states — that imposed draconian lockdowns and lengthy school closures. 

In the U.S., regressive pandemic policies from so-called “progressives” took a variety of forms. The San Francisco Board of Education tolerated some of the longest public school closures in the rich world — despite private schools being open— as they debated renaming their shuttered buildings. Many “progressive” cities forced “non-essential” small businesses with a few customers a day to close (e.g. rug shops, dress boutiques, etc.) even as they imposed zero restrictions on Kroger, Target, and Walmart. Park and playground closures in “progressive” cities denied poor children access to jungle gyms and swimming pools while middle-class and rich parents could entertain their children with these amenities in spacious back yards. Some “progressive” business owners forced their employees to mask all day long in hot kitchens while not providing paid sick leave.

Were the GBD authors treated fairly/ unfairly?

I think much of the Great Barrington Declaration criticism was in bad faith. They proposed a conceptual framework — focused protection — for responding to the pandemic without draconian lockdowns and school closures. Of course, they couldn’t provide specific policy interventions for every country on the planet with unique social conditions and institutions, so some people used the absence of those specifics to suggest their framework was unrealistic. And, as the authors point out, they did include a lengthy FAQ with general ideas applicable to most countries, such as providing hotel rooms to elderly people living in multi-generational households. In our current post-vaccine phase of the pandemic, the logic of focused protection is more compelling than ever and one could certainly argue that the John Snow Memorandum has aged worse than the GBD.

Were the ZeroCOVID proponents treated fairly or unfairly?

First, I think it’s important to acknowledge we don’t understand what “Zero Covid” actually means. Does it mean no transmission? Does it mean no severe disease or death? Does it mean very little severe disease and death? Zero Covid proponents have conveniently adjusted the definition to fit whatever country or policy they want to celebrate at the moment. That said, Zero Covid is a dangerous ideology and I think proponents have arguably been treated too generously in the mainstream media. Fortunately, international media now seems to be covering the human rights abuses in Xi’An. Even the Guardian is now publishing op-eds critical of Australia’s abandoned Zero Covid strategy.

Was the news balanced or was it skewed?

In the U.S., one Dartmouth study found that mainstream coverage of the Covid-19 pandemic was overwhelmingly negative. It found that 87 percent of Covid-19 coverage in national U.S. media was negative compared to 51 percent in international media. Think about some of the New York Times coverage — recovered patients having psychotic episodes or losing their teeth. More balanced and responsible coverage would have acknowledged uncertainty about issues like “long Covid” and would have provided appropriate context for data. For example, if a story said 25 children were testing positive in a school district, did the story provide the denominator? If pediatric ICU occupancy increased from 10 to 20 in a hospital, were the numbers emphasized or a scary percentage increase? 

Can we heal post COVID19? What is our political future?

Yes, I think we can. Perhaps as a consequence of the extended isolation resulting from misguided pandemic measures, many Americans have rediscovered the power of community and come to the realization that our pre-pandemic lives were too isolated. I was impressed that many U.S. cities created new pedestrian streets during the pandemic in order to promote more togetherness in safe outdoor spaces. Public spaces where people from different backgrounds come together are so important for maintaining a healthy democracy. A country’s public schools serve a similar function. 

I identify as a social democrat and supported Sanders and Warren during the 2020 Democratic primary. I believe the U.S. needs more, not fewer, public goods. I worry, however, that the extended Covid-19 school closures and lockdowns have turned many Democrats against a bigger role for government. This is tragic, because the U.S. has the worst social indicators in the rich world and we desperately need universal health care, public child care, and mandatory paid sick leave. I would not be surprised if Republicans took back control of Congress in 2022 and a Republican president the White House in 2024. Given my politics, I hope this doesn’t  happen. I think Colorado’s Democratic governor, Jared Polis, could be competitive in 2024. He’s spoken eloquently about the need to get vaccinated and restore as much normalcy as possible, because we have very few years on this planet.

I wrote a controversial piece that pointed out the lack of checks and balances on the ability to declare pandemic states of emergency may provide a path for a future toppling of democracy in the USA—what do you think of my article?

I do recall your piece and think you were treated unfairly. Scholars and citizens in many countries share your worries. POLITICO Europe published a powerful article entitled “Welcome to Draghistan” where it detailed concerns from a vocal group of Italian intellectuals — constitutional law professors and human rights advocates — about the country’s two-year state of emergency during which parliament has basically been rubber-stamping executive decrees. 

Democracies are fragile and a novel respiratory virus circulating is not a good reason to suspend basic rights and constitutional protections for years on end. Sweden and Japan didn’t force businesses to close or impose domestic restrictions on movement, because their constitutions didn’t allow for those measures. Two very different countries and cultures, but both honored their constitutions. 

Anything I missed?

Sweden’s experience during the Spanish Flu pandemic motivated the country to begin building one of the world’s great welfare states. Build Back Better appears to be dead, but I hope we will still see transformative social policy progress at the state level — could California deliver the country’s first universal health care system? The U.S. arguably has the weakest social welfare institutions — and most troubling social indicators — of any rich country. When I think about “living with the virus,” I think about a resilient and healthy society prioritizing social well-being. KN95 vending machines, QR codes forever, and incessant rapid testing all interest me less than universal health care, paid sick leave, and social housing. Finland and Norway have lower per capita death tolls than Thailand and Vietnam and I believe this is primarily because of their strong welfare states and low poverty. A society can’t mask its way out of overcrowded housing and the absence of labor rights. Let’s address poverty, inequality, and social exclusion in order to keep Americans healthy and happy long after the pandemic has been declared over.