Comment by nullc | Hacker News Reader

Comment by nullc | Hacker News Reader

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One thing this analysis misses is the crystals.

As in: The CDC is a huge government bureaucracy that employs (and cannot swiftly fire) enormous numbers of people from diverse backgrounds. If RCTs aren't the standard, well then why not also wear crystals to ward off the virus? They're inexpensive, and they couldn't hurt-- you can probably find a poorly controlled study to support it too.

The CDC is not human, it is a meat-and-paper-political-machine. You cannot understand it's actions under the same framework you'd use to judge another person.

The CDC must contain internal defenses against hokum which are much stronger than any person needs to personally have.

So why does the CDC sometimes provide overly conservative advice even when doing so causes death? For the same reason the scorpion stings: it's in its nature.

It's far from clear to me that a CDC which did make a more prudent facemask recommendation would actually be a better organization overall. Sure, it would have gotten this one right, but it would have likely given other bad advice as a result.

>As in: The CDC is a huge government bureaucracy that employs (and cannot swiftly fire) enormous numbers of people from diverse backgrounds. If RCTs aren't the standard, well then why not also wear crystals to ward off the virus? They're inexpensive, and they couldn't hurt-- you can probably find a poorly controlled study to support it too.

Alexander's discussion of parachutes gave some good heuristics for when you should trust common sense vs require an RCT, which explains why his advice doesn't generalize to advocating crystals.

The heuristic was basically that you should trust common sense when

a) there's a solid scientific model of the key dynamics,

b) the purported remedy is cheap, and

c) the costs of not stopping the threat are disproportionately high.

Crystals meet b)[1] and c) but fail a) -- we don't have a validated model of crytal/virus interactions. In contrast, we know that (some) viruses (including this one) spread through unimpeded airflow, and masks impede said airflow. We know that high-speed impacts between your body and the ground are deadly, and parachutes demonstrably slow the falling speed of objects.

Thus, you should go with common sense in the absence of an RCT for parachutes and masks but not crystals.

[1] They might fail b) depending on the particular charlatan!

I strongly suspect that the virus doesn't survive in vitro when exposed to a multitude of crystals! A sodium chloride crystal, for example.

Due to placebo effect you could probably even extract a "reduces symptoms" in a not very good human study too.

:)

I don't disagree that you could setup a criteria which would admit masks and parachutes but deny crystals. But would it also deny all (or even almost all) other manner of 'obvious' snake oil past or future?

The post discusses this at length, maybe you should review those points about how to generalize the advice before commenting on it?

Also, salt healing doesn’t involve salts touch the virus in any way know to break them down.

I didn't know there was such a thing as 'salt healing', specifically but just goes to show that if a thing exists then there is snake oil of it.

Your prior post asserted crystals might pass (b) and (c) but fail (a); my response was simply that I am not entirely convinced that it would unless a was fairly rigorous.

And what the CDC appears to be doing-- requiring a RCT-- can be seen as an extremely rigorous (a).

Sorry about the communications failure-- communication is hard. I appreciated your response, even if I apparently missed the point.

I was using "salt healing" and "crystal healing" interchangeably because you mentioned specifically sodium chloride crystals.

And I don't see a communications failure; you're communicating your idea fine, it's just based on not having read, and misunderstanding, the heuristics the author advocated for "when to require an RCT".

>And what the CDC appears to be doing-- requiring a RCT-- can be seen as an extremely rigorous (a).

And once again, it's a poor handling of evidence, for exactly the same reason it would be to "not advocate parachutes for jumping out of a plane" until the RCTs come in. That can only "be seen as rigorous" if you ignored the very considerations the author mentions.

I'll just excerpt a characteristic portion so you don't have to go to the site:

>>Goofus started with the position that masks, being a new idea, needed incontrovertible proof. When the few studies that appeared weren’t incontrovertible enough, he concluded that people shouldn’t wear masks.

>>Gallant would have recognized the uncertainty – based on the studies we can’t be 100% sure masks definitely work for this particular condition – and done a cost-benefit analysis. Common sensically, it seems like masks probably should work. The existing evidence for masks is highly suggestive, even if it’s not utter proof. Maybe 80% chance they work, something like that? If you can buy an 80% chance of stopping a deadly pandemic for the cost of having to wear some silly cloth over your face, probably that’s a good deal. Even though regular medicine has good reasons for being as conservative as it is, during a crisis you have to be able to think on your feet.

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