A few minutes later, he said:

[...] Be alert, wash your hands a lot where you're in areas where there's a lot of common touch surfaces you might be touching, avoid sick people as much as you can, but there's not much else you can do at this point.

He also said wearing masks would be going overboard in response to a question if people should buy masks. He said he travelled internationally "yesterday" (which would have been February 9th if the video was uploaded the day of the lecture) and didn't wear a mask. He said he saw people wearing masks with their noses out or with masks around their neck (implying it wouldn't be effective to tell people to wear masks?) and also that it's uncomfortable to wear an N95 for too long, so he wouldn't recommend the general public to wear a mask unless sick (in which case "maybe" they should wear a surgical mask).

I think his prediction and advice should probably be judged negatively and reflect poorly on him / Center for Health Security, but I'm not sure how harshly he/ CHS should be judged.

Edit: Also, at 42:10 he said "I do think that it's not containable in any country, it just appears to be so now." I think this was also wrong, since clearly some countries have managed to avoid major outbreaks.

It's actually worse than that. As I discovered when researching COVID giving opportunities for the FRAPPE donor group last year, Johns Hopkins experts explicitly recommended against wearing DIY masks in early March (a position reversed by the end of the month) and were not discouraging people from pressing ahead with travel plans as late as March 6. Sanjay had a phone call with them about a year ago in which he confronted them about these reversals, and they offered a sort of half-hearted defense.

I don't have any inside information about why CHS made the choices it did, but my naive view is that I agree with your comment that mistakes like these should reflect poorly on CHS. CHS's core competency may be more in the area of pandemic preparedness than dealing with the pandemic once it's already here, but their experts were quoted in the media a TON last spring and had significant ability (= responsibility) to shape the public conversation about COVID, particularly in the US. And yet lots and lots of people far less credentialed than CHS epidemiologists had correctly figured out by the first week of March that it was smart to wear a mask and to avoid being around others more than... (read more)

Fwiw, my vague memory is that some other people at CHS, including Tom Inglesby (the director) did better than Adalja. I think Inglesby's Twitter was generally pretty sensible though I don't have time to go back and check. I'd guess that, like most experts, he was too pessimistic about travel restrictions, though. Maybe masks, too?

To be fair, the Johns Hopkins Center isn't just Adalja. I'm not aware of the list of things they do, but for instance, they kept an updated database in the early stage of the virus outbreak that was extremely helpful for forecasting!

Adalja also confidently predicted the infection fatality rate for the rest of 2020 to be around 0.6% (on the Sam Harris podcast)  despite thinking the virus can't be contained (if true, this would have led to more ICU beds and oxygen shortages in lots of places). In reality, the IFR was more like 0.9% or higher for countries like the US and UK. Probably it was lower for countries with younger demographics, but I don't even think Adelja was basing his estimates on that. 

(TBC, this isn't as big a mistake compared to other statements or compared to Ioannidis who completely disgraced himself throughout 2020 and ongoing, but I find it worth pointing out because I remember distinctly that, at the time when Adalja said this, there was a lot of fairly strong evidence for higher IFRs, including published estimates. I thought 0.6% seemed [edit]hard to defend, though I don't remember how much he flagged that there's a substantial chance it's significantly higher. Importantly, it would have been higher than it actually turned out to be, if Adalja had been right about "the virus can't be contained.")  

One feature of the things that me and William have picked up on is that early on (say in Feb 2020 or earlier) advice coming from very respectable organisations was relatively poor.

I don’t think this should be seen as evidence that these organisations did badly (maybe a bit that they were over-confident) but that this was a very difficult situation to do things well in.

I discuss the GHS index at greater length in my answer.

they do both seem to disagree with the case for most travel bans, which seems incorrect in hindsight

Can you say more about this, or point me to good resources off the top of your head? I didn't follow the conversation on travel bans, and currently don't have a good sense of what people think about them.

In particular, is the rough basis for "incorrect in hindsight" the impression that travel bans were a potentially essential part of the successful containment strategy of some countries such as New Zealand? Or are there other major considerations as well?

"effective pandemic response is not about preparation"
 

FYI - my impression is that pandemic preparedness is often defined broadly enough to include things like research into defensive technology (e.g. mRNA vaccines). It does seem like those investments were important for the response.

Hello, Thank you for the interesting thoughts. The comments on the GHS index are useful and insightful.

Your analysis of COVID preparation on Twitter is really really interesting. Well done for doing that. I have not yet looked at your analysis spreadsheet but will try to do that soon.

To touch on a point you said about preparation, I think we can take a bit more of a nuanced approach to think about when preparation works rather than just saying "effective pandemic response is not about preparation". Some thoughts from me on this (not just focused on pandemi... (read more)