In Covid’s Wake

The COVID-19 pandemic affected all our lives. People sickened, and many died. Businesses closed, and people lost their livelihoods and jobs. Schools closed, and parents, especially essential workers, struggled to balance their work with unavailable childcare. Appropriately, In Covid’s Wake takes a step toward processing what went wrong and what we can learn from the way information flowed, political decisions were made, and research was and wasn’t used and communicated throughout the pandemic.

The book raises concerns reminiscent of those in Emily Oster’s Expecting Better (Penguin, 2014) and Crib Sheet (Penguin, 2019)—namely, that the medical and public health fields are unwilling to present nuanced medical advice to the masses. Instead, in the case of pregnancy and infant care, experts provide strict guidance around issues such as breastfeeding, sleep training, and alcohol consumption during pregnancy.

During the pandemic, this same approach of dismissing the masses’ ability to make decisions drove public health guidance. Oddly, this continued even while pandemic research demonstrated that most people were already social distancing and taking precautions ahead of policy (Austan Goolsbee and Chad Syverson, 2021, “Fear, Lockdown, and Diversion: Comparing Drivers of Pandemic Economic Decline 2020,” Journal of Public Economics 193:104311). It turns out that most people behave quite reasonably in the face of the threat of a potentially fatal infection by an unknown pathogen.

Schoolchildren learn the scientific method almost every year of elementary and middle school science. Reporting the results of scientific exploration is an important, if final, step in the scientific method. It is, frankly, my own least favorite part of conducting research. I’ve satisfied my own curiosity long before I finish communicating the results. In Covid’s Wake argues clearly that scientists, and the journalists who cover them, are failing in this step of communicating scientific results. Science communication and its effectiveness seem like a rich area for research to inform scientists of more effective ways to communicate their results. And there exists an experimental literature on science communication. König et al. (L. M. König, M. S. Altenmüller, J. Fick, J. Crusius, O. Genschow, and M. Sauerland, 2025, “How to Communicate Science to the Public? Recommendations for Effective Written Communication Derived from a Systematic Review,” Zeitschrift für Psychologie 233 [1]: 40–51) present a meta-analysis of science communication experiments with guidelines for how to effectively communicate. Additional research on questions such as when patients are more likely to follow medical advice or public health guidelines might serve us all well.

Some of the lack of communication during the pandemic, however, was a choice by public health authorities to further their policy goals.

Much of In Covid’s Wake provides a case study of public choice concerns likely well known to readers of The Independent Review. Roger Koppl writes prolifically, in Expert Failure (Cambridge University Press, 2018), about how the singlemindedness of an expert can lead to failure and how expert competition might moderate this concern. Jon Murphy (2023, “Cascading Expert Failure,” Journal of Institutional Economics 19 [1]: 52–69) recognized how expert failure in one sector can cascade through to other sectors: “Institutions that encourage uniform expert advice, as opposed to a diversity of opinion, can contribute to cascading expert failure.” Koppl et al. (Roger Koppl, Kira Pronin, Nick Cowen, et al., 2025, “Bespoke Science: The Use of Ad Hoc Scientific Advisory Committees in the Covid-19 Pandemic,” Public Choice) analyze how the choice to form an ad hoc committee for COVID policy advice provided policymakers with more control over the narrative and preferred outcomes from that committee than did relying on standing emergency management infrastructure.

Macedo and Lee extensively document expert failures during the COVID-19 pandemic. Public health experts’ focus solely on how policy choices might influence COVID infection rates ignored other large costs to those policies. Both Murphy and In Covid’s Wake describe examples of how a lack of diverse opinions led to significant failures in public policy regarding COVID, which particularly harmed workers without the luxury of being able to work on their laptops at home. Macedo and Lee’s pitch—to those on the left, but one with which classical liberals also might agree—is to respect “the equal dignity of citizens with whom we disagree” (p. 286).

This literature on experts and on bureaucracy, as well as Macedo and Lee’s book, recommends more competition to improve future decision-making. But bureaucratic competition works only if users learn from their mistakes and penalize those making them. In Covid’s Wake describes how, in fact, states did not learn. The authors describe how states pursuing wildly different policies experienced similar infection and death rates, and officials associated with more costly policies were just as likely to be reelected as those associated with less costly policies. In the moment, we failed to learn from the evidence provided by federalism as states adopted varying strategies with staggered timing. Without any penalty for poor decision-making, there’s little incentive to improve.

More public choice studies of decision-making in public health and other medical f ields are greatly needed, much as Koppl et al. (2025) recommend. As much as economists are accused of invading others’ intellectual domains, the pandemic underscored the need for more knowledge and use of the economic way of thinking in public health and greater consideration of how to best set up institutions so that that knowledge is well used and communicated during a crisis.

Many criticize economists’ desire to put a dollar value on everything, including life, art, and social connection. The pandemic, however, highlighted the importance of weighing both first-order and second-order effects of policy. Public health experts desired to reduce deaths due to COVID, over and above any other possible costs or benefits to policy choices. Macedo and Lee compellingly argue that public health experts were not just narrow-thinking but wrong. The authors lay out a case for more effective checks and balances on expert power and for finding ways for the priorities of folks out of power to be considered. For example, the authors commend the role of those serving in the House of Representatives to represent their varied constituents and their range of living and working circumstances.

One strength of the book is that it puts so many pieces in one place: the cover-up about the potential origins of the virus, the use of grant-making to bring dissenters in line, and the chilling discourse to shut down any contrary discussion to the authorities’ preferred position. Too many decision-makers ignored, misrepresented, or scapegoated valuable detractors such as the writers and signers of the Great Barrington Declaration.

Macedo and Lee document how the Great Barrington Declaration aligned quite well with preexisting plans and public health research on the effectiveness of nonpharmaceutical interventions, herd immunity arising from both vaccinations and disease recovery, and the costs of shutdowns and isolation. Yet the Great Barrington Declaration was lied about by prominent public health experts (e.g., Thomas Frieden, former director of the Centers for Disease Control and Prevention; p. 108). Social media was strong-armed into deplatforming views contrary to preferred policy views or seen to promote vaccine hesitance. Stanford University faculty censored Dr. Scott Atlas for being critical of school and restaurant closures in Michigan. Crushing dissent doesn’t promote scientific discovery, as In Covid’s Wake makes clear.

Something is rotten in the state of public health. Macedo and Lee shine light on the rot. As a researcher, my bias is toward advocating more research. In Covid’s Wake provides caution in this optimism: Governments had extensive, researchbacked plans for a pandemic prior to COVID-19—plans that were universally scrapped in favor of being seen to be “doing something.”

As in every other war on an inanimate object—poverty, drugs, or, in this case, COVID—the government was ultimately unsuccessful and likely harmed many in pursuit of that war. Young people were shut out from schools, the dying from their families, the working class from their jobs, and so on—with effects that we continue to measure and learn about as they ripple through people’s lives and the economy.