Tribalism comes for pandemic science | Hacker News Reader

Tribalism comes for pandemic science

thenewatlantis.com

120 pointsseinundzeit206 comments

There are times I'm glad I left health science/biology/medicine as a field and it's interesting to watch people slowly realize just how badly structured the entire human health field is organized (from academic research to research hospitals to profit hospitals to world health organizations) and how all the incentives are messed up.

The closer you get in biology to human health, the more ego, tribalism, and assholery you have to deal with. Something about "saving lives" really brings out the intelligent jerks and the sharks.

As a contrast, I enjoy working in computing so much more. The experiments people run are replicable, the code compiles, and people (in general) are far less egotistical and arrogant (still plenty of sharks, though).

I've watched enough major paradigm shifts in my own fields to know that embracing humility, admitting your own ignorance, and being open to new ideas is key to the furtherment of science.

Dumb question, but what's a "shark" in this context?

Sharks are opportunists- for example people who wait for somebody else to do all the hard work, then come in, take over and get all the credit. It's not a really strong analogy but I've heard many people in biotech referring to sharks in that context.

I will second this as I am currently working in the biotech field. The amount of short sighted thinking and opportunism from small start ups to the most massive CMO's in the world is staggering.

My take is that the whole field is extremely underfunded and that breeds levels of competition and short term profit seeking, but that's probably a biased opinion.

I'm sure if the field had the level of VC support that traditional software/computing gets we would be making huge strides with our humanity.

I don't know if the field is underfunded. What I'd say is that the area is very risky (few ideas really pan out), there are lots of powerful incumbents who want to retain the many-billion-$ revenue streams, and it's very costly to test. But I also see people wasting huge amount of money chasing ideas that really would be better handled with shotgunning (the tech VCs I used work with said "why would I want to invest $20M in a biotech that fails after 20 years, when i can invest $1M in 20 tech startups and one of them will make $1B in 2-3 years?").

It's not clear to me that investing more money helps, either. For example, the NIH doubled its budget during the Clinton era, leading to far higher numbers of grad students being trained than there were positions (prof, etc) in their fields. So there was a glut, super-high competition for a limited number of spaces, and many people dropped out of the race to be a prof and instead went to be ML/data science people at ads firms.

that's tragic. it seems the funnels of money that exist can't get anywhere meaningful without aggressive fundraising and being first to some buzzword

Not to sound alarmist, but recent events have felt like the early warning of a pending collapse of our country. When I saw healthcare workers and officials abandon logic, reason, and evidence to put their weight behind justifying recent mass protests, I really lost a lot of faith. These protests obviously will result in thousands more deaths (much larger in number than unjust police-involved deaths). This is no longer about losing faith in institutions alone, but really about losing faith in fellow citizens who are willfully burying their heads in the sand and willfully acting in bad faith nearly all the time. Of course, there is plenty of blame to hand out for all sides, going back well before recent events and well before COVID-19 itself.

My question for HN: what has happened to past societies when they reach this point, where emotions and tribalism cause all sides to hate each other, to talk past each other, to hold each other to unequal standards, to use every last loophole/technicality to win through bad faith means, etc.? Have any such societies de-escalated from there to a point of stability again?

I agree the times are worrying. What's keeping me reassured is that the radical protest elements are very small with regard to our countries population's. There are far more people not expressing their opinion and it gives me hope that cool heads are silently prevailing.

Edit: typo

I think that you are making the same mistake that you are accusing healthcare workers and officials of making. You are assuming that these protests will "obviously" result in thousands more deaths because it feels that way to you. I believe that that's pretty unlikely, though, since there are probably fewer than a million protestors across the country. Many of the protestors are wearing masks and the protests being outside reduces the risk of spreading the disease. There will certainly be some spread due to the protests, but probably not nearly as much as at grocery stores or churches. You are also assuming that this is just about unjust police-involved deaths; it is not. It is about the many millions of negative interactions with the police and justice system that perpetuate poverty (police lying under oath, egregious sentences for non-violent crimes, etc.) I don't think it's a bad faith argument to say that correcting these injustices is more important than maintaining a totally strict quarantine.

The reason both sides talk past each other is because they have different values and different assumptions. Based on your post your first priority is preventing deaths and your assumption is that these protests will cause more deaths than they prevent. My first priority is living in a fair world, with preventing deaths being a close second. My assumption is that the protests will not cause a large number of excess deaths, but that they do have a high chance of moving our justice system closer towards real justice. I also am making the assumption that living in a fair and just society will increase overall health outcomes over the long term.

I believe that most (but definitely not all) people don't argue in bad faith, they just have different values and make different assumptions. There's not much that can be done about having different values, but better data can help every side have more similar assumptions, which should help opinions to converge somewhat.

I don't think number of deaths (from whatever cause) was the primary point of the post you're replying to. The concern is pretty clearly the destruction of trust, the widespread lack of logical consistency amongst people we're supposed to defer to due to their expertise, etc.

> You are assuming that these protests will "obviously" result in thousands more deaths because it feels that way to you. I believe that that's pretty unlikely, though, since there are probably fewer than a million protestors across the country. Many of the protestors are wearing masks and the protests being outside reduces the risk of spreading the disease.

I am not the one saying this. Trevor Bedford (Associate Professor in the Department of Epidemiology at the University of Washington) noted that the protests will add 200-1100 deaths per day of protests: https://twitter.com/trvrb/status/1269533303536664576. This is based on his mathematical modeling of the protests.

> I don't think it's a bad faith argument to say that correcting these injustices is more important than maintaining a totally strict quarantine.

My point is that if one [demographic or political] subset of people gets to evaluate the tradeoffs and decide for themselves that yes, protesting is worth it even with the risks of the coronavirus, then everyone should get to exercise that choice. You and I should get to exercise that choice when we visit a business or take on some outdoor activity or whatever. It seems to me that personal discretion is allowed only for favored groups and causes, and that seems in itself, unjust.

> The reason both sides talk past each other is because they have different values and different assumptions.

I think this is probably correct. So to rephrase my question, can a society with two big groups holding such divergent values survive? Or is it inevitable that is splits apart?

can a society with two big groups holding such divergent values survive? Or is it inevitable that is splits apart?

There are historical examples in both directions, so arguably we don't know.

A society that didn't survive: Russia during the Bolsheviks. One group was so aggressive it took over completely.

A society that did come back from the brink: perhaps Britain during the 1970s?

https://en.wikipedia.org/wiki/Winter_of_Discontent

Left / right conflict resulted in widespread strikes, three day weeks, an IMF bailout, power cuts, garbage piling up in streets, bodies going unburied, hyperinflation and so on. It was resolved after voters replaced the left wing government with a right wing one that radically reformed trade union laws and refocused policy on inflation control, but at the cost of a huge recession. The UK pivoted from quite far leftism to (for Britain) nearly libertarian government within the span of one or two elections; eventually Thatcher's libertarian policies led to riots and she was kicked out by her own party. After that both parties moved more towards each other, paving the way for many years of Blairite centrism.

Most of the mathematical models for viral transmission so far have not aligned with observed reality. Is there any particular for relying on Prof. Bedford's model as opposed to others?

Whenever science and politics intersect, science loses. If science is studying something apolitical like the metabolism of water bear or a quasar burst from a distant galaxy it’s fine. Throw politics in the mix and the waters become muddied very quickly when funding and reputational concerns motivate and corrupt a delicate process.

Politics is like Lennie who wants to pet the rabbits. Science is like the rabbits.

I am honestly and hearteningly surprised to even hear these sentiments from someone else here, which I have now observed for years. It's one reason why I love HN.

I'm not in the science field, but I absolutely am a student of human nature (and mindfulness). It's unbelievable how much the mechanism of science is dirtied, distorted, and abused by our emotional pride, greed, tribalism, fear, and all other aspects of human nature, which show that - for all our intelligence - we humans are wired for survival, and only wired for truth if and when it helps that survival. If truth comes at odds with it, we will lie - even if to ourselves, and at very deep subconscious levels - as much as we need to.

Rationalisation: https://en.wikipedia.org/wiki/Rationalization_(psychology)

How this biological reality plays out is complex. It's not just in our lizard brain, but the entire realm of our secondary limbic brain, with its 'tribal' swirl of social emotions and resulting behaviours. 'Survival' means a great of things, not just literal survival right in front of you right now. It's a powerful and primary goal coursing through our blood and all behaviour at the deepest and most subtle levels. We would do well to educate about this fact, and practice mindfulness to be able to see it in ourselves.

That is pretty unfair to Lennie; at least his intentions were good.

The people who said that lockdown needed to be limited in length because people couldn't take it for long were right.

Unfortunately, due to not understanding exponentials, many advocated for starting the lockdown later: hence the UK's delayed lockdown and therefore highest death toll in Europe.

The people advocating for "herd immunity" never addressed the death rate; a death rate of even 0.5% in the UK would be three hundred thousand people, plus more with lingering side effects. As it is, we've confirmed 287k infected for 40k deaths, or 0.5% of the country infected. A very, very long way from immunity.

What does that 287k include? Presumably just positive test cases? Probably there are far more undiagnosed infections that didn't require hospitalization. If the IFR was really 14% like your numbers suggest, we would see politicians putting themselves in submarines, lol. That's almost halfway to black plague IFR. The CDC's recent data suggests an actual IFR of well below 1%.

> Unfortunately, due to not understanding exponentials, many advocated for starting the lockdown later.

I think you misunderstand the reasoning. If you want to wipe a disease out you lockdown as soon as you can. If you want to flatten the curve, you lockdown just before the peak, so as to prevent it. Or if you are ok with flattening the curve for a longer time, you lock down just before you reach capacity.

I'm sorry, I've been reading and re-reading this. Were you being snarky? With perfect forethought, why would anyone ever choose against wiping out the disease early?

Because you think the virus is too contagious and the attempt will fail. Or alternatively, because you don't realize in the beginning that the disease is deadly enough to be worth a lock down.

Because that would require global synchronised and incredibly intensive lockdown of the type that has never happened ever before in history. You'd need to eradicate it globally and simultaneously including in war zones, third world countries etc. That's implausible, which is why the only thing that can work is to just let it spread and deal with the fallout. Sometimes called "herd immunity".

> Unfortunately, due to not understanding exponentials, many advocated for starting the lockdown later: hence the UK's delayed lockdown and therefore highest death toll in Europe.

UK's strategy was as advised by various epidemiology teams across the country, predominantly Imperial and Oxford. They understand exponentials. That's epidemiology 101.

> The people advocating for "herd immunity" never addressed the death rate; a death rate of even 0.5% in the UK would be three hundred thousand people, plus more with lingering side effects.

That was acknowledged. They were concerned that suppression was infeasible, and would cause more deaths e.g. if there is a second wave during UK winter, or if lockdown has knock on health impacts.

> As it is, we've confirmed 287k infected for 40k deaths, or 0.5% of the country infected. A very, very long way from immunity.

The number of confirmed cases is smaller than the number of actual cases, since many cases are asymptomatic and hence typically not tested.

Epidemiology and public health is a complex field, beyond armchair analysis.

I read everything downthread of this and am flummoxed at how much people are talking past each other. If the UK has 40k deaths, the only way the UK is close to herd immunity is if the IFR 0.05%. People can quibble about how many actual cases there are, but no matter how you slice it, reinforcing the parent poster, we are a long way from herd immunity.

Also, remember that if you want to argue the IFR down, that means you're arguing the R0 up, which makes herd immunity more difficult.

actually I think there's been a tremendous amount of discussion wrt the true fatality rate, and since the lockdown started, estimates across the board have been tumbling.

People deciding that a certain arbitrary fatality rate would be unacceptable, and lockdown adversely affecting basically everyone was preferable, usually do so without any kind of reasoning but hide behind the notion that life has near infinite value.

If you trust the death rate, and the number of deaths reported are both accurate, the UK is at 40k/300k = 13%. A very long way from immunity, but not 0.5%.

300k confirmed cases / 59M population = .5% of the country having had the virus.

Of course, this is inaccurate, since many more have had it and not gotten confirmed positive tests.

> 0.5% of the country infected

Your own numbers show this is totally incorrect: death rate 0.5% times 40k deaths, means infected is 8 million (or more precisely the count was that number some weeks ago as deaths take time to happen).

this has been an obvious calculation from the start and I am not the only person trying to correct the misuse of the confirmed infected count (287k) for your conclusion.

Honest question: why do you not know this?

> why do you not know this?

Leading with an insult?

I agree that the numbers don't match up and the country is almost certainly more infected than we think, but we cannot know how widely infected we are until we've done the testing! Even the death rate has a factor of two variance between "definitely COVID" and "excess deaths".

The failure to ramp up testing is yet another thing to blame the poor government response for.

I apologise: my question was rude.

However, your comments feel to me like an engineers rationalisation - technically correct but misdirected. The feeling is vague, and my words are not describing it correctly. I suspect that I would need a high bandwidth medium to discuss this.

It's a misstatement that's not needed to make the point - if we assume 8 million infected, that's far too few to talk about herd immunity; and achieving herd immunity would involve many times more deaths than the current (already very sad) number.

> It's a misstatement

How do you know that?

My point is that the misstatement is so commonly made, and I am trying to understand why it is so very common, from someone who has made the statement in such a way that it is harder for them to generate an excuse for the mistake (edit: and high karma, so presumably educated, informed, and maybe has nous to self-reflect).

An order of magnitude difference does matter to me, and I think if the infected population is over 10%, then that is significant.

I apologise for being rude though.

Just a quiet reminder that accounting for other peoples' actions with "partisanship" and "tribalism" is just a very easy way to stop thinking about their reasoning or motivation. If someone explained your behavior away as unthinking loyalty or allegiance you would be offended-- and rightfully so.

P.S. This article is not an apolitical analysis of politics, this journal is not an apolitical scientific journal.

Evaluating whether an opinion is partisan is not ignoring their reasoning or motivation. Quite the opposite, it is evaluating their reasoning and motivation and determining the extent to which that reasoning and motivating is influence and determined by partisanship or group affiliation.

Expert opinion is supposed to be formed by empirical evidence and science. Not political affiliation or personal opinion. For instance, an expert opinion would be, "protests of X size stand to increase rates of infection by Y%" Whether or not a certain protest justified in accepting that increase of infection is a question of personal values not medical science.

Is protesting against police brutality worth the increased rate of infection? Is protesting against the lockdowns and subsequent mass unemployment worth the increased rates of infection? It's fine to form your own answers to these questions. But these are questions determined by values, not science. Expert opinions have no business trying to answer these. But medical experts are making the latter statement, and are doing so in a way that comes off as extremely partisan:

> We can show that support by facilitating safest protesting practices without detracting from demonstrators’ ability to gather and demand change. This should not be confused with a permissive stance on all gatherings, particularly protests against stay-home orders. Those actions not only oppose public health interventions, but are also rooted in white nationalism and run contrary to respect for Black lives.

How on Earth are we supposed to trust these experts' advice on when to lift lockdowns when they openly state that resistance to lockdowns is rooted in white nationalism? Let alone the double standard in supporting some protests while opposing others. As much as I am inclined to defer to experts, messages like these makes it extremely hard for me to do so here. When medical experts are making statements like these, it is highly indicative of reasoning informed by partisanship rather than science.

Here's some possibilities:

There's a lot of experts out there, and depending on how the people who fill your feed pick and choose them, they can make them say anything they want. Some experts might change their minds when confronted with a new extraordinary situation. Others are, well, not experts, they just have the credentials of experts.

"Experts" have been decried as hypocrites and frauds since the time of Lao Zi, for what its worth. All your interactions with expertise are mediated and indirect, except the expertise you yourself have.

"don't wrestle with a pig. You'll both get dirty but the pig will love it"

Somehow the lowest kind of politics, on all sides, manage to drag us all down to their level. A culture war is just like any other war in the sense that on the battlefields nobody wins, and both sides lose.

As a child growing up late last century, I always wondered how prosperous progressing culture's could have collectively devolved into the dark ages. I saw the seeds of the unraveling start in the 80's, but like any exponential process, it took some time to become a clear vector.

I am not sure this is a preventable or correctable evolution at this point, as the devolution forces are enshrined within the system itself, leaving only room for a collapse at the meta level.

I may be wrong. I truly hope I am.

"You’re probably doing it right now — skimming quickly to the end of this piece to see if I’m criticizing you or only those other people who behave so irresponsibly."

An article decrying prejudice gives us its own demonstration of it. Does that somehow make the case better?

An article decrying prejudice lets the reader give their own demonstration of it.

Question:

Has anyone here changed their mind about COVID19 in a major way as the data has become more complete?

Just wondering. I have sensed in myself tribalistic tendencies of not changing my mind when the data changes. I'm trying hard to look at myself and recognize it and experiment with different thoughts.

I find myself bouncing between thinking we have overreacted to then thinking that my perception of an overreaction is paradoxical because we did lock down and have contained the virus' damage to some extent. I'm trying hard to be super open-minded about the data, and recognizing that I'm just a simple primate whose brain doesn't want to expend energy and resorts to bias to conserve it.

I was very worried about Covid-19 when the initial data and charts were coming out of China and Italy. It seemed like it was going to quickly overwhelm all the hospitals in America. Since then, I've become much less scared about the impact on me personally, and more skeptical about the need for most (not all) lockdown measures. This was based on my reading of antibody prevalence data, and data on death rates separated out by age and risk factors.

At this point, I think Sweden strategy makes the most sense. It is sustainable for many months, unlike more extreme lockdowns. Additionally, I think more strict lockdowns on older population makes sense. For 90%+ of the population, I think we can lift most/all lockdown measures today.

My opinion of its severity has dropped and continues to drop quite significantly. I bought a lot of supplies in late January because I saw videos coming out of China of people dropping in the streets and them welding entire buildings shut with people in them, stuff I'd never seen before.

I still don't fully know how to reconcile that with what happened. That is, more than just saying "oh, those videos were fake"... well, why? Who made them? Why were they made? I dunno. Even ignoring those it still looks an awful lot like China covered an awful lot of stuff up.

Regardless, whatever made it overseas didn't seem to do that. Evidence at this point seems to suggest a lot more people got it than we realized, without them even realizing it [1]. Any number of possible reasons. Unfortunately, between the tribalism, the outright coverups by the Chinese, and the "errors" if you are generous and "lies" if you are not in our own media, I don't expect to ever have a good grasp of what actually happened.

(Even so, purchasing supplies was the right move. Our local stores never really quite "ran out" of stuff for extended periods of time, but I was reasonably well prepared for what was certainly some supply chain disruption, and had a good practice run for some other real disaster in the future. Got a better idea of how to stock the food up in more effective ratios now.)

[1]: Possibly concerning, and I hope some follow-up study is done on this. Estimates of modern spread rates of disease based on COVID-19 could end up being really wrong if we underestimate how far it spread.

I was skeptical of covid-19 from the start (check my comment history) even though the data appeared to be against me initially. My "gut" told me we were overreacting though, and a lot of things didn't make sense (like the aircraft carrier full of asymptomatic sailors). I was browbeaten and I conformed, assuming the data would eventually prove me wrong. I dutifully wore a mask and social distanced and didn't let my kids go to the park to be a "team player" but now I'm kind of angry that I'm slowly being vindicated. Not because I was "correct" in my predictions, but because of how sure the zealots were of their position while browbeating me into conformance.

I'll never get an apology, of course. It'll just be the same old "not my fault, I formed my view based on the expert guidance of the time, what else could I have done?" Strong opinions, loosely held, indeed.

I was pro lockdown at the beginning. Now, I’m convinced that we could have gotten most of the benefits with a substantially less invasive approach, especially outside the mega cities.

Or a shorter harder lockdown earlier on, combined with rigorous test and trace programme.

I think it's pretty clear the best use of a lock down is to allow time to develop and improve the infrastructure and protocols to do this properly.

But if you lack the competence or political/social will to do this properly, all you really have in the face of rising (or rising again) case numbers rolling lock downs and wait in hope of a vaccine. Or failing to manage it spectacularly, that also seems to be an option.

Testing/tracing is very, very hard in the United States. In my own community, we have immigrants who are afraid to talk to the government at any level due to fears of deportation. You have the libertarians who refuse all but the most basic interactions with anything government. You have some other specific immigrant communities who are here legally, but have a deep, deep distrust of government due to abuses back in their original countries. Add in a language divide and a population strewn across many different jurisdictions (several major cities cross state/county lines) and it is just a mess.

At the start (by which I mean late Feb/early March as I wasn't paying attention before then), I believed it all. I was worried about the ventilator crisis and wanted to find ways to help manufacture or mass create them.

Towards the end of March I started to realise that I kept reading about the supposed impending ventilator shortage, but it should have happened already and yet we didn't seem to be ever quite running out. Then a newspaper published some article about the history of Professor Ferguson and his failed foot-and-mouth disease models. I went and read some papers about the failings of epidemiology and was really shocked at how divergent the views were on the utility of these models.

Then in the comments on that story, I found someone linking to https://swprs.org/a-swiss-doctor-on-covid-19/ which just had so much data, so many links to raw sources and interviews with skeptical doctors. At that point I started to realise that many of the comments I was reading here on HN appeared to be mixing up predictions with reality; I kept reading people here talk about how Italy was experiencing mass deaths and hospital overflow yet on the SWPRS site there were links to actual articles in Italian where hospital officials said they hadn't yet run out of capacity, they weren't yet turning people away, they were just worried it might start soon. And this kept happening. Moreover my attempts to point this out kept getting voted down, so that's when I realised it was going ideological. A lot of people were desperate to correct "misinformation" and were just getting angry at anything that contradicted the official narrative. There was no rational reason to vote down posts saying "actually the situation is better than you think" yet it was happening.

So I guess that's the point I became a serious lockdown skeptic. The disparity between what people consuming regular media believed vs what the raw (often non English) data was saying just became too wide. And after that I believe everyone has been catching up, especially now with this "protests against health policies are dangerous but protests against racism aren't" nonsense.

Yes, but early. I changed my mind from thinking it was "just the flu - I'm going to get it, but probably won't be able to tell it apart from a cold" to "this is probably a big deal that I really don't want to get" in late February. Haven't found any information to make me change my mind since, even as public opinion has yo-yo'd.

The critical information for me was data on hospitalization rates, along with some math on hospital capacity and exponential infection rates. Before, I'd looked at the death rate for 20-40 year olds of ~0.1% and figured it wasn't a big problem for me. Then I realized that the 20% "severe" cases out of Wuhan was actually the percentage that required hospitalization, not just the percentage that develop pneumonia (which is ~60% of symptomatic cases, ~30% of infections). And it doesn't vary by age range nearly as much as the death rate does: while only about 0.1% of 20-40 year olds die from COVID-19, 3-5% end up in the hospital, only about 4x lower than the ~20% of 65+ seniors that do. (These numbers already account for asymptomatic infections, which are about 50% of cases. The Wuhan numbers didn't, so halve them.) And the average hospital stay lasts for 3-5 weeks. With the doubling time of unchecked COVID-19, we could potentially end up with 150M infections during the time period of one hospitalization. 10% hospitalization rate over the whole population, and that's 15M hospitalizations, well over the number of hospital beds in the U.S.

If you gather data from a wide variety of sources instead of grabbing the latest headline, most of the relevant data hasn't actually changed all that much since February. Back then we were saying a roughly 2% CFR; now best estimates are a 1-1.25% IFR, which is completely consistent with that when you add the new information that 50% of infections are asymptomatic, which was discovered in late February. IFRs in situations where the whole population was tested (eg. South Korea, the Diamond Princess) were about 0.7-1.5%, depending on the age of the population. The age curve data from Wuhan has held up remarkably well across Europe and NYC. R0 and doubling time was pretty consistent across most temperate northern climates before the lockdowns (1.5-2.5 days in most of Europe and the U.S.). The progression of the virus when unchecked was also quite consistent between Wuhan, Italy, and NYC, as was the effect of the lockdown.

> now best estimates are a 1-1.25% IFR

Just FYI, the CDC gives their best estimate at 0.26% IFR. (source: https://reason.com/2020/05/24/the-cdcs-new-best-estimate-imp... , note that 0.26% adds in the estimated 35% asymptomatic population)

I'm surprised at how little effect even a strict lockdown (western style - Wuhan style was much more effective) had compared with the Swedish approach. I did not expect cases to rise so slowly and even plateau with the policy that Sweden chose, and I did not expect cases and deaths to decrease so slowly with the policies that Spain, France, Belgium and Italy chose.

I now suspect that ending lockdowns, temporarily banning just a couple of high risk activities such as conferences and clubbing, universal mask wearing, and extra protection in hospitals and long term care homes might be enough, at least until October (in the Northern hemisphere).

I'm in the same boat as you. It's exhausting to try to avoid these tendencies. How comfy it must be to give in and accept them with no further thought.

The most frustrating times are those moments when I fear I'll never root out all of my biases or tribalistic tendencies and become an enlightened human. But onward and upward, eh?

I don’t know what you mean by “change your mind”. I’ve come to understand that it is much less infectious outdoors, that it is more responsive to moderate social distancing than we though initially (possibly due to super spreading?) and that masks appear to work well. This has made me more relaxed about many activities.

I continue to believe that it’s an extremely infectious RNA virus that will spread exponentially in situations where people are in close proximity or indoors without social distancing and masks. I think New Orleans, NYC, Lombardy, Wuhan, and the ongoing situation in Brazil are more than enough evidence for that. I also think the success of Europe and China in using social distancing plus test/trace/isolate to tamp down their epidemics is pretty solid evidence that this was the right strategy, and I’m incredibly disappointed that America was incapable of executing on it.

The question I think you’re asking is: given that we failed to take the right advice, have I given up on trying to make us take it? And the answer is: basically yes. I think we’ll have to let nature take its course and protect ourselves now.

Specifically, I was asking if you had informed opinions on the virus that are now significantly different than the informed opinions you hold now?

Echoing GP - the additional data on how contagious it appears it isn't in circumstances of brief, well-ventilated contact, helps me feel safer outdoors. Over the last two weeks, we've had or visited two different outdoor get-togethers with friends, sitting and chatting in the lawn 6-10 years apart, and feeling like it was no big deal to step forward briefly to (for instance) hold out a dish of cupcakes for your friend to grab one.

I definitely wouldn't have felt comfortable with that a month ago.

And I still don't want to do that more than once a week or so.

I at first thought exponential was an overhyping - and that it would self limit far more. It quickly became clear that the long incubation period and infectivity made it very not self limiting, especially with the absolute hash made of the response as ass-covering was preferred over getting real data. Now we are largely in an awkward halting problem situation of not knowing if it will trigger a second wave and if the second wave will level off, form an endemic stable background rate, or explode again.

Say we believe that the number of people that will be killed be coronavirus is 10^x where x is a gaussian random variable with mean 5 and standard deviation 1. What is the expected number of people killed? In the case we believe to be most common, the expected number of people to be killed is 100,000. However, the the mean value of this distribution is 1.4 million, https://www.wolframalpha.com/input/?i=X%7EGaussian%285%2C1%2...

This is a the very strongest mathematical case for pessimism that I can give. Any argument that "we should have been less cautious" is automatically bullshit.

I was less worried about it at the beginning - I think I had a decent understanding of how fatal it was, but underestimated how contagious it was.

I think I came around to a mental model of how to react fairly early on, though. The basic model was stay at home until either a vaccine arrives or until we have anti-viral treatments that reduce severity and improve outcomes. Neither has happened, so I'm in the same boat.

It's great - great - that the lockdown has reduced occurrences of it so much. And I recognize the argument that if we've tamped down on it enough, that it's safer to go out there. But... an x% less likelihood of catching it doesn't mean it will be x% less severe when you do catch it. I think that a lot of non-technical people are confused on that point.

And finally, even if we did have really good contact-tracing... that doesn't help you, it only helps your friends. There are still those two days when people are contagious without being symptomatic. That's just still reality, I don't see a way around that. A healthy people can die from interacting with a seemingly healthy person.

Besides, what happened to contact tracing anyway? I thought we were going to have this snazzy contact-tracing tech on our phones and watches by now, courtesy of Apple and Google. I'm sure our contact-tracing is still lousy overall. It's great we have more tests, but we're not at the point where we would have been able to stop February in its tracks.

So overall... yeah, I've changed my minds in ways, like recognizing that the probabilities are more on my side than they used to be, so I feel a little safer if I have to go to the doctor/dentist for non-COVID reasons. But other than that, it's still a super-contagious virus that has a decent chance of really screwing up your life even if you aren't 80+, so... I'm still in the "stay at home until treatment/virus improves" camp.

"The basic model was stay at home until either a vaccine arrives or until we have anti-viral treatments that reduce severity and improve outcomes."

Something key about this statement: This was not what the public was initially told. We were told that the lockdown was to flatten the curve while testing was ramped up and to ensure that the rate of infection was slowed to prevent a spike from causing avoidable deaths due to an overwhelmed health care system. It wasn't sold as reduction of the area under the curve.

The narrative of staying locked down until a vaccine was developed didn't happen until after the lockdown became a political football. That was a ridiculous notion, based on the typical time to develop vaccines, especially since a coronavirus vaccine has never been developed before for SARs or any others.

It's not like there was one unified message about this, ever. Yes, it was commonly understood that preventing "avoidable" deaths from stressed hospitals was a sufficient reason to lock down, but that doesn't mean that it was unanimous that it was the only reason. From the beginning, if you ask ten people what "people are saying", you'll get ten different answers. My own impression of what the public was initially told does not match up to yours.

We flattened the curve for a little while. It's about to get unflattened.

This is so very disheartening. I will speak only for the United States, as I am not familiar enough with other countries to comment. Not only is this impacting nearly every single person in the country, it is ruining the financial situation of over 40m people, primarily concentrated within the most financially vulnerable. This is because leaders on the left and right have refused to respond to new data, and are working with the same plans set in March. We _now_ know that children are at a very low risk, people under 40 are very low risk. Most risk is within shared living situations (migrant workers, retirement homes, prisons). We can respond to the _real_ risks and use a nuanced approach that actually saves lives. But instead, the left says "lockdown lockdown lockdown" and the right says "open 100%"... Both are full of shit to the point of it being disgusting.

This isn't a game. This has life and death consequences so far beyond COVID-19, and the lack of foresight that the partisans are demonstrating will have reverberations for generations. We are playing the life of real people, we are risking the financial security of real people, who have families and debts and dreams.

Finally, the fact that the public health sector has devolved into partisanship really has me worried for when we _actually_ have a repeat of Spanish Flu, or a more virulent Ebola etc. Then we are screwed.

Edit: fixed a typo

In fairness, the right has been pretty consistent about tailoring the response according to risk—i.e., those who are at risk should isolate and everyone else should resume work. They happened to be right in this regard. The left has also made exceptions in their “lockdown everything” policy, specifically with regard to their own protests (and the response of pandemic experts is a particularly interesting case study of the polarization of science production as opposed to the polarization of science consumption).

I didn't want to get into a game of who has been most wrong, because that will automatically trigger people to go back to their camps and hunker down. I agree that the "isolate the vulnerable, continue with life otherwise" is most likely the best outcome. The fact that this idea is attributed to the right is going to mean it is DOA, for the most part.

The main problem youi'll have with that is that many people assume that the value of a human life is infinite and we must expend all resources possible to save individuals. Neither of those makes for good economics, so folks who include economics and balanced risk into their equations often conflict with folks who want to take the "safest possible action with respect to human life".

The safest possible solution would be for the super wealthy pay to keep the population fed and housed while we wait for a vaccine or improved treatments. Otherwise, the virus will continue to propagate, the poor will have to risk their lives and the virus will inevitably reach the rich and their families in a later wave anyway as was the case with the 1918 flu.

Addendum: I posted this fully understanding how unpopular it would be with this crowd. If we ever get hit with a a more fatal and contagious virus this may be our only way of preserving life. And as things stand with our industrial meat processes I suspect we will have more viruses to contend with.

I can't tell if this is sarcastic or not, but I will assume it is not.

It is not this simple. You can't, in our current system, shift wealth that readily and quickly. Even if you could, how would you approach possibly selling this in a democracy? And assuming it was feasible, and we could get popular support for it, how would it be implemented? Rationing cards? Government ran food stores?

This is NOT the Spanish Flu. It is very different in its behavior. There is currently no evidence to expect a more deadly, virulent second wave. Please remember that the Spanish Flu was anomalous because it had a more deadly second wave. Almost all viruses, as a function of evolution, become less deadly over time.

And this ignores all of the vast improvements in our understanding of sickness and hygiene, our availability of clean, sanitary conditions etc. Hell, even the change in density between 1918 and 2021 is massively changed.

> You can't, in our current system, shift wealth that readily and quickly.

The Fed seems to be doing just that

One way would be to have a monthly payment similar to Trump's $1200 [stimulus check] every month. The government can later recoup that through more equitable tax policies on the ultra wealthy and massive corporations.

This has been proposed by legitimate legislators. https://twitter.com/SenSanders/status/1270000771132731397

As for your claim to a lack of a second wave, I'll have to defer to the experts on that. I'm looking at a historical case for a worse case scenario which I think is prudent to consider.

I don't know what Trump's $1200 monthly payment refers to, the welfare payments came from the us federal govt and state govts. A better reference is Andrew Yang's proposed $1000/month payment.

Understandable. Partisanship is the scourge of our generation.

i would like to know how to "isolate the vulnerable"...?! We send to an island? we weld inside home? We should talk only if we have a realizable plan and not a "dream/idealistinc" plan.

Well we were able to somewhat effectively isolate the entire country, so I would say have modified stay-home orders that target those who are most vulnerable. That, in addition to common sense acts like hand washing, isolating the sick etc. would go a long way to flatten the curve enough to not overwhelm the hospitals, which after-all was the original goal.

The problem is that you can't isolate the most vulnerable fully. The current lockdown works because it reduces the spread through the wider society, including all the people who are in contact with the most vulnerable. If you don't do that, then we have the Sweden scenario where inevitably there's someone young and fit and infected who brings the disease into the institutions that should be protected, because these young and fit and infected people work there or go there to deliver things.

Alternatively, you need a total quarantine isolation - e.g. anyone working in a care home should live there and can't touch their kids if they go to a school where will be spread because everyone else's parents are not on lockdown. Or the most vulnerable will die.

And has been widely discussed, Sweden has had a lot of excess deaths. Look at death rates compared to Finland, Norway, Denmark.

An interesting game theoretical interplay has been an almost irresistible force that draw almost all democracies towards the same behavior: if it was possible for 100% of confidence to separate the group of people at risk from the people whose risk factor is small (e.g. pick some threshold like smaller than the risk dying of any other cause), then sure, it would have worked.

But the moment a number of apparently healthy and young people start dying from it, people start thinking thateither a) it's hard to know in advance whether you're at risk (e.g. unknown pre-existing conditions) or b) the disease is stronger than previously thought.

And that's even if the actual cause has nothing to do with (a) or (b), i.e. if the data was just a statistical fluke or misattributed deaths (e.g. people dying from X who also had sars-cov-2 in their system). It doesn't matter; there is no time to get to the bottom of things. The authorities have to play it safe, least they will be proven to have acted recklessly. And even if they try to be "brave" and plow ahead, the public opinion will quickly sway towards playing ir safe.

This seems to be an especially strong force since people today have an unprecedented capability of communicating and broadcasting "gossip". Even China's strictly controlled public communications wasn't able to censor spontaneous outrage from the citizens. And the fact that China reacted they way they did, set a high bar; any country that wanted to act differently had to be play it pretty convincingly to their populace (e.g. "we can do it, because we're different, we are so disciplined we can pull it off")

For example, consider Sweden's approach. I have no idea whether their strategy is right or wrong, how should I know? experts disagree.

But it surely takes a lot of confidence to pull that off, knowing that opposition parties will feast on any opportunity to publicly decry your recklessness.

Covid-19 is real and it kills people, it's effects can be and will be measured.

We do make tradeoffs between economy and safety all the times, but we do that for things we're used to (traffic, pollution, diseases prevention, ...), so some people expect we can do the same kinds of tradeoffs with covid-19.

Again, I'm not an expert and have no idea on how to compute such a tradeoff.

But my point is that there is a inanimate force that is just pulling that card off the table.

It doesn't help that in some countries it also became such a heavily partisan topic.

I'm not from the US. I live in a country whose government has been very proactive and the population is generally supportive of the (re cently lifted) lockdown. And that's a country where rarely the populace has anything good to say about the government (a popular saying "it's raining, damned government!")

Playing it safe seems much more effective politically, that unless you want to play some "strong man" narrative like some governments did, there doesn't seem to be any advantage in taking excessive risks.

That raises the question of how to identify the sick. SARS-CoV-2 infections can be transmissible before the infected shows any symptoms, if they present at all.

Personally, I don't feel that there are many population centers in the US that are prepared to do the kind of testing that seems like would be needed to properly identify the sick.

Apparently this is not really the case any longer: https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-pat...

> i would like to know how to "isolate the vulnerable"...?!

We could start by NOT sending people with confirmed COVID-19 infections to live with them.

There are a lot of empty hotel and dorm rooms right now so that would be a good start. A lot of those who have died so far were infected in family homes with many people living in close quarters. We should focus our limited resources on providing safe living spaces where those at highest risk can isolate themselves if they voluntarily choose to do so.

No country has successfully done isolation of vulnerable, while there are many countries that have successfully eradicated or at least brought it to extremely low levels.

With cheaper testing, pooled testing protocols, etc. we could potentially test every household in the US every couple of weeks for less than we spend on auto insurance.

You can do both. Iceland isolated their older population quite well.

Sure, but if you do both, isolating the elderly becomes easier because there is less prevelance and slip-ups are less likely to cause issues. It is a totally different strategy than what he was saying. The US stopped nursing home visits as partial form of isolation.

To fully isolate you would need workers to go through quarantine periods before entering on shifts. Many vulnerable live at home so you'd have to provide support to isolate their cohabitants as well or something else. Physician specialists that serve vulnerable and non-vulnerable populations without enough overlap to split duties with similar doctors between both populations would need to operate inside a bubble boy setup or something.

The vulnerable also include people with pre-diabetes, heart conditions, etc. that may not be diagnosed, though maybe you just treat them as those not to be isolated.

This requires a citation. It's intuitively far easier to quarantine 1% of the population than 90+%.

To protect 1%, you need to isolate them absolutely from everyone else who will be infected.

To protect 90%, it's sufficient if you reduce the rate of spread below 1, which means that it's sufficient to have a (realistically achievable) "quarantine" that reduces the number of contacts 3-4 times. It's possible to have much less contact with people, it's very limiting to have no contact at all.

There's a huge world of difference between the contact limitations required for a true quarantine (essentially, zero contact) and what "lockdown" has meant in most places, with most people continuing to work with other people just with much less contact.

It's not at all clear to me how much more limiting the isolation required for the 1% is than the current quarantine measures. I certainly doubt that it means "no contact at all". It's also not clear to me that a very strict isolation for the 1% is overall better than a moderately strict "quarantine" for the remainder (trolley problem). It's also not sustainable to maintain quarantine indefinitely, and the economic ramifications alone will compound (exponential--not linear--decay). At some point, "quarantine" becomes a net negative for the vulnerable 1%, never mind the remainder. Further, as so many things do, these economic impacts are and will continue to be the most severe among the most economically vulnerable. It's certainly sustainable for 1% of people to isolate indefinitely; it's not sustainable at all for the rest of society to quarantine indefinitely and that sustainability falls off earlier for the most marginalized communities than it does for the rest of us.

I mean isolation of vulnerable while letting infections elsewhere raise to saturation. No (non-micro state) country has gotten close to saturation/herd immunity yet.

I'm not sure if you're trying to refute my post or support it, but your comment certainly supports my point. No country has gotten close to saturation/herd immunity yet, and it would be economically ruinous (and not uniformly so) to maintain current quarantine measures until we get there.

I’m saying there is no one to learn from, no one did that strategy yet. The UK almost did.

> the right has been pretty consistent about tailoring the response according to risk

Have we forgotten that "this is all a liberal hoax"? Remember HCQ is a cure-all? That's not being consistent--that's completely ignoring science.

The right in the US has been consistent about tailoring its message to AI driven talking points that drive social media engagement. Nothing more.

How about a "free market" solution? Give everybody who earns under $40K a year $2,000 per month unconditionally for the next 6 months. And let businesses reopen. Now, people who want to can go back to work and have a $2K bonus per month on top. Or they can forgo that and sit at home.

Let's see how people actually vote with their feet and wallets.

This, and so much more of this.

I was very careful to mention that the right was correct about this one point. I was hoping to dissuade this kind of overtly partisan reflex post. Clearly I failed.

A stopped clock is correct twice a day--we don't suddenly consider its accuracy improved.

Trying to thread needles like this is disingenuous, at best, and makes you look like an apologist, at worst.

You have a set of political leaders actively hunting for a hook that is sufficiently platable and plausible that they can get people to swallow in order to be exploited for their own power gain. Giving cover to that deserves neither praise nor quarter.

There are plausible solutions that have scientific backing. There are also plausible economic solutions. There are also degrees to those solutions--Switzerland shows this even though it is now matching the US in per capita Covid cases.

NONE of those solutions that would benefit the people have been proposed at the federal level here in the US.

Show me where I argued that their “accuracy improved”. Like I said in the previous post, I’m only noting that they were correct in this instance. I’m certainly not making arguments that Trump’s administration is doing a good job.

> In fairness, the right has been pretty consistent about tailoring the response according to risk—i.e., those who are at risk should isolate and everyone else should resume work.

I don't think that was being consistent about "tailoring the response according to risk [from the virus]," but rather being consistent about tailoring the response to pre-existing policy preferences. An ideal lock-down requires significant temporary bottom-up government economic intervention, which the right opposes on principle. The policy of "those...at risk should isolate and everyone else should resume work" fits nicely with existing right wing ideas: keep government intervention to a minimum by maximally individualizing health burdens. The difficulty is that might not actually attack the problem very well.

> tailoring the response to pre-existing policy preferences

Well, that's true of the left as well. A "bottom-up government economic intervention" fits nicely with existing left wing ideas.

> Well, that's true of the left as well. A "bottom-up government economic intervention" fits nicely with existing left wing ideas.

That's true, but the different political ideologies are better at handling different kinds of problems. Public health emergencies like this one are the kind of thing that benefits from a properly-resourced, centrally coordinated response; a solution that happens to lean left.

Each side would of course argue that its own methods for handling each kind of problem is superior.

The US never went into an actual lockdown in most places.

"Lockdown" is New York where R0 is 0.75. "Lockdown" is not California or Texas where R0 basically sits at 1.0.

R0 of 0.75 after the last 3 months would basically mean Covid cases in the single digits basically everywhere in the US. But, no, we can't actually get people's attention before we start piling body bags in the streets.

The people in the US who are "Open all the things!" are also the "I'll be damned if I'm wearing a mask." Ummm.

You can argue about the finer points all you want, but when you can't get people to do the basics, you're sunk.

Do you have a source for your R0 values? As far as I know there have been no per-state R0s released, though current estimates put ~20% at antibody positive [^1] in New York meanwhile Texas has a very low infection rate in comparison.

This likely has much more to do with relative densities than lockdown strategy. Texas is low density, and it was necessary to have looser restrictions in many areas due to distance to essentials like groceries. And indeed for Texas this seems to have been a fine call.

And Texas still has a declining rate of new cases despite continuing to reopen, and we have been in a decline for over 30 days despite bars and restaurants being open.

The complaints against mask wearing have primarily been against legal mandates. I wear a mask but I don't support fining or jailing Americans if they choose not to, especially since they are likely to be old, poor or a minority.

I don't believe anyone has been piling bodybags in the streets, though it's an excellent scaremongering claim. Remember lockdown was planned for a few weeks to flatten hospitalization rate - which it did.

[^1]:https://www.wsj.com/articles/the-numerical-language-of-covid...

You can get per state R0 values. rt.live is a website (that is not part of russia today), the RT url comes from "R0". It's from the people that sold instagram to facebook.

They do have per state R values. This does show that NY is at about 0.8. Texas is 1.02 currently. The one negative with their calcs is their R values seem too sensitive to daily conditions. It's a great visualization of infection rates too, please look at that.

To look at the daily infection numbers, find Texas, click on the "show new cases" tab. Texas has about 1500 new cases per day now. They've had a steady increase in new cases per day since mid April, when they were about 750 new pos cases/day. They are really growing. I'm not sure where your stats about Texas doing well are. It looks to me like the positive cases are unfortunately increasing there steadily, and it's a precursor to increasing hospitilization. I have family there, I'm increasingly concerned.

They get their data feed from https://covidtracking.com/api/v1/states/daily.csv which is downloadable. Look at TX (some days have multiple updates, you have to calculate the delta yourself). US date style, positives: 6/7 74978, 6/6 73553, 6/5 71613, the increases are very clear in daily positive cases; those counts are total pos counts to that date of course.

Another place to see per state (such as Texas) is https://www.worldometers.info/coronavirus/usa/texas/. Go down to 'daily new cases in texas' click on 7 day moving average. They've really been growing per day in new positive cases. One note, different websites show the current day's data differently (some show values that up dated in the middle of the day, others show one day late, so looking at the very latest rhs data point is sometimes confusing).

Texas absolutely shows the potential of opening up increasing infection rates. Alabama is another state that is hurting but reached a top, see Arkansas too. Florida was down but is now showing highest per day infection rates historically (7 day average, looks like new records beating 2 months ago). Some states are better, plenty are getting worse.

The number of diagnosed cases or positive test results is only loosely correlated with the number of actual infections. Thus any calculation of R values based on cases isn't mathematically valid.

> The number of diagnosed cases or positive test results is only loosely correlated with the number of actual infections.

Then that just means that we are likely underestimating R0--possibly by a huge amount. Okay, I agree with you.

Infections aren't LESS than the diagnosed cases and positive test results. So, all the calculations from data about the estimates of R0 are all a lower bound, not an upper one.

As such, our estimates of R0 are likely painting a much rosier picture than reality. Probably not the point you were trying to make.

You missed the point. There are a lot of cases which are never formally counted as "cases" because people recover without ever being diagnosed. We don't know whether that fraction of unreported cases has increased or decreased over time. Outside of a few limited areas there hasn't been enough random population sampling to draw any reliable conclusions one way or the other.

You have just said that we probably have quite a few cases of Covid which are not counted and are not part of the model because they were undiagnosed. I agree.

If we somehow magically started accounting for those cases the R0 would immediately go up (more cases per unit time means increased R0) unless the number of those cases is zero.

Thus, the R0 estimates we have are currently all underestimates. Covid is likely more contagious than we are calculating, not less.

Now, this doesn't matter to the people who recover, of course. And it effectively is correct in that people who simply recover aren't a big problem and so the R0 is roughly "correct" in the aggregate.

However, that incorrect R0 DOES matter when you start talking about vulnerable populations and how far you need to go to protect them.

R0 does not exist outside of context either. We like to think to R0 has being whole numbers. R2, R4 etc. Or small decimals.. R1.5.. But really, _everyone single person that gets infected_ actually lowers R0 a tiny bit, as they are now recovered. Combine this with the late breaking evidence that there is some cross reactive immunity in T cells with other coronaviruses, and we see that R0 is completely meaningless without more data. If R0 is a lot higher, lets say 7.5 or some absurd amount, and we do have such a cross-reactive immunity, herd immunity may come at 40%. See, it needs context.

Ok, so I spent some time digging into their source code. This is a model, and like many models it's output is fully dependent on the input. In this case we're dealing with significant inputs and assumptions tied to factors such as onset, delay, testing correctness and a lot of things we just don't have data for.

I'm going to share some quotes from the code.

> Our goal is to translate positive test counts to the dates where they likely occured. Since we have the distribution, we can distribute case counts back in time according to that distribution. To accomplish this, we reverse the case time series, and convolve it using the distribution of delay from onset to confirmation. Then we reverse the series again to obtain the onset curve.

> We assume a poisson likelihood function and feed it what we believe is the onset curve based on reported data. We model this onset curve based on the same math in the previous notebook

> We calculate this by figuring out how many cases we'd expect there to be yesterday total when adjusted for bias and plugging it into the first equation above. We then have to re-bias this number back down to get the expected amount of onset cases observed that day.

I don't want to invalidate efforts to build models because models are important, but it's also important to frame models as being statistical models and in this attempting to resolve R0 values from self-reported data, across districts with dramatically altered reporting methodology is extraordinarily fraught with peril. Even the model authors indicate this and have made several improvements, and models will naturally evolve over time.

Then let's touch on some of the stats we're looking at. Remember we are dealing with a sampled phenomenon - as our sampling rate changes (the amount of testing we're doing), our case rate will naturally rise. We want more testing because it helps us determine more accurate numbers, but it also means we need to understand we may see spikes in our daily reported cases. We therefore want to be careful with using small samples (3 or 4 days).

You'll also notice we have natural declines that align with the weekends - it's not because the disease takes the weekends off. One of the dangers of reading the worldometers graphs is that they're inclusive of all the data, including data from March/April which is probably underestimate.

Texas started lessening quarantine restrictions on May 16th, and indeed until about the 29th we see a pretty consistent decline (well past any incubation time). From the 30th to today's data (and always take the current day with a grain of salt because reporting isn't always instant) we do see a growth, primarily due to several abnormal spikes in the last week. When we compare that against deaths we don't see those same spikes represented - and in the last two days of the series (excluding today) we see a declining pattern again (but two days a pattern does not make).

So it's wrong to say "Texas has about 1500 new cases per day now. They've had a steady increase in new cases per day since mid April, when they were about 750 new pos cases/day. They are really growing.". The 7 day average keeps us at 1200 or less, with the exception of the last few days.

I pulled the hospitalization data from [^2] (xlsx format unfortunately) and while hospitalizations are technically increasing as a whole, that is almost entirely in the TSA of Houston (though Dallas/Ft Worth and Longview/Tyler show some increase as well) with 19 other TSAs declining or remaining steady. So, I wouldn't be overly concerned for your family, the data indicates things are generally going quite well.

I would be careful in how we read data.

[^2]: https://dshs.texas.gov/coronavirus/additionaldata/

> I don't believe anyone has been piling bodybags in the streets, though it's an excellent scaremongering claim.

New York was. Although the point wasn't intended to be about scaremongering, it was more about how people don't seem to have the ability to pay attention unless life kicks them personally in the balls.

Most people in the Northeast knew someone personally who died of Covid--when someone's Grandma you know dies of Covid, you'll put your mask on and stay locked down so yours doesn't, and you'll get mad about the people who won't.

That's why I chose California, which nominally has a lockdown, to contrast against Texas, which nominally doesn't, to contrast against New York, which really locked down, to show that the US really didn't lockdown very well.

I was in California after the orders--"Hey, we can't hang out inside the coffee shop. I got it! Let's hang out on the sidewalk outside!" <facepalm> Or, "Hey let's have a Mother's Day party"--two of which now account for more than 50% of the Covid cases in Santa Cruz county.

And all this is because we didn't have a unified response in the US to make people pay fucking attention.

And, even in "Open all the things!" Texas, it's not helping much. Most businesses run until they get a Covid case in the employees and then shut down for several weeks--lather, rinse, repeat. So, instead of everybody shutting down simultaneously and cutting down the number of cases, we have individual businesses shutting down hodgepodge which still hammers people's jobs and as a bonus doesn't help bring the Covid numbers down.

Yes, I'm glad we shut down to prevent overrunning the medical system. However, that was just "Step 1".

"Step 2" was not supposed to be "Do nothing else and then throw up your hands in 90 days."

The idea of isolation was most prominently attempted by Sweden, the UK, and the Netherlands.

To call it "right in this regard" is, in this regard, wrong. These countries are leading the per-capita corpse count. In the case of Sweden, deaths are about ten-fold that of neighbouring and rather similar Norway. And people are still dying at peak levels in Sweden, while Norway now goes a week without deaths.

Of course it's "right" to "keep vulnerable people away from danger". It just doesn't work. Elderly people in care homes need, well, care. Also food, and medical attention, and housecleaning, and maybe even social contact. All of those needs are provided by young people. How is this separation supposed to work?

In the Netherlands, I don't think this was even attempted, apart from forbidding visitors.

The US will not resume its position as a functioning democracy until both sides reconcile their differences. But when those differences are on the opposite sides of the political spectrum, perhaps we should be considering other options.

At this point, with COVID and the riots, its a matter of life and death.

> perhaps we should be considering other options.

You mean splitting into 2 countries (blue USA and red USA)? Then whichever country fares worse economically will find a way to blame the more prosperous one, and it could mean war.

> the left says "lockdown lockdown lockdown"

of course that hasn’t really been the case over the last week or so.

This is about what we value most. People on the right then to value individualism, self-sufficiency, and self-determination more. While people on the left value equity, and community more. You can see these values reflected in what each side is willing to take risks for.

> We _now_ know that children are at a very low risk, people under 40 are very low risk.

… at very low risk of death, but there seems to be increasing evidence that some COVID-19 survivors, including children, suffer serious, and possibly permanent health effects.

If we could just convince the hoaxers that wearing masks in public is not emasculating, and convince the doomers that we need to flatten the curve rather than attempt to completely contain the virus, we could go back to something bordering on normal life pretty quickly while we waited for vaccines to come along and kill off the virus altogether. And then we would be prepared to react to the next pandemic, too.

Exactly. We need some humility in people. It is okay to admit that this is (thankfully!) not as bad as we thought, but it is still bad. It will still kill a lot of people. We need to take it seriously, but not as seriously as we feared. The doomers need to have the humility to admit that, and the hoaxers need to have the humility to admit that it is worse than the seasonal flu.

Again, I fear people don't realize that this isn't a game. This is disastrously bad and getting worse every. single. day.

> the hoaxers need to have the humility to admit that it is worse than the seasonal flu.

I don't believe any significant number actually thinks that, it's their counter to "everybody will die, the science is settled". They will aim for something on the opposite extreme, that is a pretty common reaction.

Imho: if you don't try to convince them that an asteroid is about to crash into earth, but instead tell them that lots of people are scared to death of an asteroid crashing into earth, they'll have a much easier time saying "okay, sure, I don't want them to be scared, I can wear a mask when I go shopping, I guess".

> Again, I fear people don't realize that this isn't a game. This is disastrously bad and getting worse every. single. day.

Where you live, maybe. Where I live, we haven't had a case in 10 days in the county of 330k people, we've had laughably low deaths to begin with, the curve was pretty much flattened the moment we went into constraints ... and we still have mandatory masks with no end in sight, and our local government still does not go back to normal mode, the trash is still getting picked up on irregular schedules etc.

It's neither disastrous here, and it's not getting worse. But a lot of people are still scared out of their mind. And we need to help them to breathe and calm down, and tell them that it was scary, but that it's okay to go back outside. And at some point we'll have to tell them that they need to go back outside because we can't keep society running around them without them.

I mean the response is a disaster, not the epidemic itself. The fact that 40m are unemployed, that income tax receipts have nosedived, that business are shuttering leading to blight etc. Those are the long term disasters in the making.

Oh, my mistake, I misunderstood. Thanks for clearing that up!

> and the hoaxers need to have the humility to admit that it is worse than the seasonal flu.

Seasonal flu happens every year. Novel virus pandemics happen once per century. Seasonal flu is much more deadly, just spread out over longer timeline. And estimated covid mortality rate for my age group falls every week. I'm still not convinced it's measurably worse than the flu (for my age group).

In my state the virus has killed less than 2,000 people with a population of 27 million and hospitalization rates continue to plummet in spite of lifted restrictions weeks ago. The problem I have with all arbitrary Covid rules is that they're not based on any objective criteria. For example, if we were rational, we would base policy entirely on local hospital capacity and hospitalization count (the original impetus for draconian shut downs was the belief that hospitals would get overrun, which never happened in 99% of the country). We cannot live in bubbles forever, and the disease may well persist forever with no vaccine. There's no threshold being set for arbitrary rules (i.e. if Covid hospitalizations less than X, restrictions lifted). So we just get this random enforcement of arbitrary policies, where you have leaders in CA fining people for being on the beach, in the sun, in open air, where there's extremely small chance of transmission. For my own part, I choose my own risks, and if you want to a wear a mask, go for it. But the curve was flattened even in places that never had restrictions. So we know by now this isn't the plague. We gotta move on. We only get so many trips around the sun. Can't live it in fear.

That's exactly the strategy that Washington state is following. We even have a dashboard where can see the indicators, and they are things like infection rates per day per capita over 7 days, hospitilization rates.

I think that the root problem that needs to be addressed is that to a lot of people, scientists and the media appear to put politics before truth.

The recent hydroxychloroquine is an obvious example [1]; The Lancet should never have published something with data so obviously questionable, and the media should not have picked it up so immediately as political ammunition. But the result is that the media appears to be "once again" lying to the public.

[1] https://news.ycombinator.com/item?id=23421797

This happened again today, with Washington Post publishing an article based on a study that was submitted to Nature on March 22, 2020. They used this old data (2 months ago is old in this case) to claim that the lockdown saved millions upon millions of lives. To be that disingenuous can't be accidental, I am afraid. And I am normally a fan of WaPo

The data is indeed old but China began its lockdown on January 24th and South Korea a month later. Those countries seem to be the central focus of the study with regards to evaluating the effectiveness of the shutdown(s).

I'm only a layperson but it doesn't seem too far-fetched that they could extrapolate from how those countries "flattened the curve" to come up with a ballpark estimate of global fatalities averted. After all, other countries mostly followed a similar "curve flattening" pattern (as far as I'm aware).

At the very least, I don't see anything inherently disingenuous.

Side note: FWIW, the study itself says the authors last "updated" it on May 13th (not the data itself though it appears).

IMO, it is pretty easy to see why an extrapolation is faulty. Let us look at two different reasons:

1. Density. China and South Korea are far more dense than most of the western world. Seoul has a density of 42,000 per square mile. New York City, the densest city in the US, has a density of 23,000 per square mile. The next top 10 most populous cities in the USA have an average density of 5,000 per square mile. Over half of South Koreans live in an urban environment, while less than 25% of Americans do. Density, and the number of interactions someone has in a day, is a major determining factor in the spread of any airborne virus.

Density also has implications for transit use, which in NYC was shown to be a large source of transmission.

2. Demographics. Italy, the United States and Sweden all have very different demographics and cultures. In Italy, many people live in multi-generational housing, and nursing home usage is far lower than the United States. The average age of Italy is also higher. Sweden is more like the US in terms of nursing homes, but still lower. As the older folks are far more likely to die from this, or even have detectable infections, the way each country manages their aging population will have a huge impact on mortality.

For example, people going about their day like normal, and then returning to their shared home with their Grandma would put Grandma at a much higher risk of infection. That is the Italy scenario. In the United States, where the old either live independently or in a group home, their vectors are much more limited. Test and trace everyone going to and working at a nursing home. It should also be noted that the areas if NYC most heavily hit are also more multi-generational than the rest of the city and country.

So see, you can't take one nation and extrapolate it out to the world. That is a faulty model and those who championed it should know better.

What you're saying makes sense, thank you.

I'm wondering though, are you saying it because the study did indeed fail to account for all those factors or are you basing it my (probably poor) interpretation/description of it? :-) If you're going off my comments, I may have done a disservice as my laypersons understanding of the topic is pretty rudimentary.

FWIW, the study does indeed model other countries like the US and Italy so I'd be surprised if much of what you speak of was not taken into account.

I certainly don't think they modeled one nation and simply extrapolated that out into the world without other considerations. I apologise if my words gave that impression... Even I can see how stupid that would be.

Here's the link if anyone is interested https://www.nature.com/articles/s41586-020-2404-8_reference....

Hey,

Not sure if you are comfortable with R or Python, but you can look at the code here: https://codeocean.com/capsule/1887579/tree/v1

They do not seem to be taking cultural or demographic information into account. A lot of the data is sourced from the Johns Hopkins data set and fed into an SRI type model, with some data about when and how strict lockdowns where.

It is actually pretty sloppy to be given so much weight.

Cheers, I will indeed take a look. Thanks.

> I think that the root problem that needs to be addressed is that to a lot of people, scientists and the media appear to put politics before truth.

Fully agree here. I'm aware of Heterodox Academy trying to tackle this problem in the academic world--is there an analog solving for media bias?

At this point, the only thing I'm hoping for is basically total media collapse.

It's actually proceeding apace. By its very nature, being slick TV shows and edited textual content, it'll superficially look like everything's fine until the very end, but the layoffs continue to roll through, marginal outlets are closing, the viewership drops, the respect keeps finding new lows... it's still looking good and may even come sooner than you think.

This does not, on its own, solve the problem, but it makes the problem possible to solve.

Yes for TV news. Not for every kind of news. Some outlets are having a good crisis.

In the UK the Daily Telegraph is giving back the government furlough/support money as it doesn't need it. So is The Spectator. Interestingly these are the right wing newspapers. Why give up free money? Because the government really needs it but the newspapers don't, given that they are profitable and subscriptions have been rising, not falling.

https://www.spectator.co.uk/article/a-statement-from-the-cha...

The Daily Telegraph has doubled subscriptions in March alone.

By your words, let's allow vastly heightened danger to those over 40.

How about, we have national regulations for safe interactions, rules requiring ppe when appropriate, and available ppe. Your company has to provide it if you work together. It turns out its very very hard to provide ppe that protects people when they work closely together (see the meat packing plants, see hospitals). My families economic safety is also impacted if I'm dead or in the hospital with covid, even if they are all in your 'safe' category. Only a few 100 kids will die unnecessarily so we can open the economy?

How many kids die of the flu each and every year? How many kids die of malaria? Of tuberculoses? Where were you during the last strong flu season? Get off your high horse and actually contribute ideas instead of fear.

In [1] it says in the last 10 years the # of deaths from the flu was 10 to 60k, avg about 30k for all americans. I'm not contributing fear. I'm talking about the facts of the situation and the fact is its a serious issue. I'm frustrated that so many people act like it won't hurt them so they dont care somehow. We have to make serious choices between variations of opening up and helping the economy vs saving people. We need to do this in an informed way and not what can ideologically help or hurt various politicians.

[2] is a great article about how different cities in 1918 made various choices about socially isolating and the impact of that.

1. https://www.cdc.gov/flu/about/burden/index.html

2. https://www.smithsonianmag.com/history/journal-plague-year-1...

You are creating a Sophie's Choice in your dichotomy of "opening and helping the economy vs. saving people". It isn't that black and white and I would hope you understand that. It is "saving people vs. saving people". That is the stark choice we have to make. It isn't "getting a haircut vs. killing children" or even "helping small business vs. giving old people another year or two". It is literally lives vs lives. If you are so disconnected from the reality of a majority of the country to not understand that three months without work is a life risking disaster, then you won't see the damage created by our continued draconian response to a virus which is much different than originally assumed.

My point is, if you stratify death rates by age[1] you see that children are at a very, very low risk from COVID-19. This is the nuanced approach that universal lockdowns trample over.

You literally employed the "think of the children" fallacy[2] (technically appeal to emotion) when you know well that children are at a low risk.

I mentioned flu, TB, and malaria because they kill legions of children every year. TB killed 200,000 children in 2018[3]. Malaria kills .5 million children a year worldwide[4]. So don't tell me you care about the children. Unless of course you mean American or European children, in which case make your case but admit to yourself that you are viewing the world through a lens of personal risk, not actual risk.

Either you want to save the children, in which case we need to dedicate 20% of our GDP to combating TB, malaria and flu worldwide, or you only care about local children, in which case you are okay with burning through 20% of our GDP to prevent kids from getting a disease which isn't dangerous to them.

[1] https://twitter.com/daniellevitt22/status/126945491074919628...

[2] https://en.wikipedia.org/wiki/Think_of_the_children

[3] https://www.who.int/news-room/fact-sheets/detail/tuberculosi...

[4] https://ourworldindata.org/malaria#all-charts-preview

Putting it as saving people vs saving people is a better way to put it than I did. I agree that it's not a straightforward issue.

In Sweden it's the opposite: the right wants lockdown and the left opposes it.

Just goes to show you how insidious partisanship is. It's clearly not about liberty or policy principals, but rather whatever solution one party puts forward, the other has no choice but to oppose it.

One of my favorite pet daydreams is trying to figure out a way of abolishing political parties altogether...

It's a nice dream, but I would settle for having more than 2 political parties. Then at least we could break out of the "are you with Us or are you with Them" dichotomy.

> Just goes to show insidious partisanship is

I think this is the wrong take away. The corona debate in Sweden is pretty healthy. Not very partisan and neither side has dug their heels in.

It's interesting why this isn't the case in the US, too. Conservatives in the US are much older, and the people in the at-risk age groups are disproportionately Republican. Yet they oppose the lockdown. Liberals, who are the ones being laid off and bearing the economic brunt of the lockdown while being at much lower risk to their own health support it.

Evolutionary you can see a case for having society members of both keeping culture and changing culture at the same time.

Roughly Conservatives don't like change (lockdown) Liberals like change (lockdown)

I don't think so. Everyone is in agreement over broad strokes of no-lockdown. Different parties just disagree on the details of how to execute that strategy. Some leftwing party: "Why did we have so many precariously employed temp-workers in retirement homes? Of course they will spread the disease the disease, and they don't care complain about health code violations". Some rightwing party: "Why was there insufficient national coordination? Of course districts can't do this on their own" Some other rightwing party "Person X handled this incompetently and should be fired".

I guess I am on the “left”, and my view throughout this thing has been “do what the experts say we should, while maintaining a diversity of expert views.” This is also the vibe I get from most of my “left” friends. Moreover, Europe has largely followed its experts’ advice —- and with a few exceptions they’ve largely brought cases under control, so it’s not like the advice was bad.

This “pox on both houses” post, in which you try to blame both sides equally (while also ignoring the fact that only one controls the executive branch of the Federal government), does not comport with my lived reality.

This has largely _not_ been a Federal response, this has largely been in the hands of the States, at least in regards to setting the policies. State epidemiologists are currently more "powerful" than the CDC in most states, so blaming the response on who is in majority control of the Federal government is short-sighted.

Yes, the (lack of) organized Federal response influenced the severity of the issue in the early days, but we can't lay blame at that level for what has taken place in each state since that time.

The issue isn't whether lockdowns work. Of course they do. People spread disease to one another, limit the number of people that contact each other and the disease will abate. That isn't what is worthy of debate. Rather, we should be debating if lockdowns are worth the cost, and what other methods could we use to mitigate the disease while still maintaining some amount of normalcy.

If we have that debate, it needs to be super local. Density is the driver of any pandemic with human to human transmission. NYC is the most dense city in the United States, and has a huge reliance on densely packed public transit. Dallas is incredibly sprawled and has very little transit use. They need fundamentally different responses.

It is this lack of nuance that is troubling.

This is nuts. Large portions of the response were absolutely in the hands of the Federal government, which failed catastrophically. These range from the elimination of our pandemic response team [0] to the early testing debacle, which resulted from bad tests distributed by CDC (and early failures to scale up private testing using Federal powers and expedited FDA approval) [1], to the lack of coordination between states —- typically an essential function of the Federal government —- to reticent distribution of stimulus funds that were needed to bolster an effective lockdown and support state budgets [2]. Let’s not even start with the weird Federal PPE hijackings that nobody has ever properly gotten to the bottom of. My own state governor (a Republican) had to send state police to protect imports of testing kits, so they wouldn’t be stolen by the Federal government [3].

This isn’t even close to complete, and it’s just the official response. I won’t even get into the totally catastrophic and shifting moral leadership we received from the White House, the weird stuff about opening for Easter. And ugh, the fact that close allies of WH cabinet members were deliberately funding astroturf “anti-lockdown” movements that argued for opening up even against the administration’s own recommendations [4].

Honestly, from your response I can only assume that you haven’t been reading the news since January.

[0] https://www.snopes.com/fact-check/trump-fire-pandemic-team/ [1] https://www.google.com/amp/s/www.nytimes.com/2020/03/28/us/t... [2] https://www.google.com/amp/s/www.vox.com/platform/amp/2020/4... [3] https://www.google.com/amp/s/amp.cnn.com/cnn/2020/04/30/poli... [4] https://www.google.com/amp/s/www.nytimes.com/2020/04/22/opin...

I totally agree with you, that the Federal response was pretty terrible. And I understand and am aware of the topics you provided.

However, that does not change where we are today. It would have probably helped us get to "today" a lot earlier, and it would have probably saved many, many lives which were unfortunately lost. But my argument is how we respond _today_ to new information, and how the partisanship endemic in our culture today does not allow for us to pivot in a meaningful way. If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did. But unfortunately, despite now being armed with that knowledge, we are not pivoting on the plan we made back in March.

Even our knowledge of treating it has improved. The CFR is down across the board. We now know oxygen replacement therapy is better than invasive ventilators. We know that a majority of the spread is in nosocomial or in nursing homes. We know that remdisivir shows promise. We know that treating with anti-inflammatory drugs is helpful. We know better ways to prevent cytokin storms. We know better how to respond to clotting. Focusing just on the ventilator learnings, we can treat people with oxygen replacement therapy without them being in the ICU, while invasive ventilator treatment requires an ICU. This lowers the number of ICU beds needed, and thus should shift the hospital capacity discussion.

But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science"

I will ignore the personal attack, beyond saying that questioning someones understanding of a topic at such a basic level has no place in proper debate.

> If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did.

I don't know how to respond to that - I technically agree with you, the loudest least educated voices probably wouldn't have wanted to lock down. The lack of info and the panic level probably positively contributed to saving more lives. I'm totally okay with that. I believe that knowing then what we know now, we absolutely should have done what we did, and then some. We didn't have enough testing capacity. We know that if we had locked down even earlier, we would have saved a significant number of additional lives.

It's true that part of the argument was based on hospital capacity. But the models today are still consistent with the view that the capacity in many areas would have been overwhelmed in many places had we done nothing. I think the key there is that civilians were going to "do something" and stay at home even if the government didn't tell them to, no matter what.

> But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science"

It's best to step away from that kind of absolutist language (none, all) - it just tends to bait people.

I think that you’re very wrong that the lack of a coordinated response by the Federal government was only an issue “in the early days”. I think the ongoing lack of Federal action (and particular economic support) has more or less trapped us into a long-term poor and fragmented state-by-state “whack-a-mole” strategy. The fact that CFR has dropped a bit does not mean there won’t be major second waves that flow back and forth between the states: we may already be seeing those in some southern and western states. It’s not too late to fix this, but we won’t.

We are arguing over two different things. I am arguing the direct response to the virus. How the lockdowns were implemented, where and for who. I agree that the federal response was bad all over, and now it is most obvious in the lack of financial assistance to both individuals and states.

Please keep in mind also, that for states that are not in (NY, NJ, CA, MI, LA) there hasn't been a _first wave_. We need to keep that in mind before we point to states like FL and GA as having a 2nd wave. Their waves were largely curtailed by the stay-home orders in place. We need to either admit we want these orders to last until there is a vaccine, or increase our threshold for acceptable case levels.

I don’t actually think we disagree that much. The problem is that we were supposed to use our early lockdowns in the “high cases” states (NY/NJ/CA) to control the epidemic and bring it down to manageable levels. At least in NY/NJ this seems to have worked. We were supposed to use our lockdowns in the “low cases” states to bring the caseload down near zero. This has not really worked that well, largely because the lockdowns were poorly implemented, and because states ended them before they had really crushed community spread to a level where testing and tracing could work.

Now there’s superficial (early) evidence that many of the low-cases states are entering a second stage of exponential growth. There may not be much room for us to simply manage the caseload at some “acceptable level” if those states really catch fire. The problem is that the only tool we have to manage this — if indeed it bears out and hospitals become overwhelmed - is another lockdown. But the lockdowns have become a political hot potato, and at least one side is dead-set against them. It seems unlikely that we’ll be able to use this tool again until things get Very Bad.

Compare this to most of continental Europe, where both high-case and low-case nations have succeeded with lockdowns, and governments are moving into a phase where careful management is likely to control the epidemic entirely going forward.

In my state we have leaders looking at data on county and zip code levels, and assigning "stages" to counties that affect how open the businesses can be, based off of how stable their numbers are looking. What's it like in yours?

That sounds like what we are doing in Wa state. It's too early to know how it will pan out.

> “do what the experts say we should, while maintaining a diversity of expert views.”

I don’t think this is an actual strategy. If there is a diversity of views, which experts do you listen to? Also, experts in which field? Epidemiologists have generally recommended very strict shutdowns, but they are not economists and are not experts on the economic ramifications. Some economists agree with strict lockdowns, others do not. So it’s not at all clear what “listen to the experts” means in this case.

We listened to the ones who were already employed to be in charge of this kind of thing, and we haven't had a case in 2 weeks, lockdown is over.

The only answer I can come up with for this is a larger team of specialists in the relevant areas combined with a small number of generalists to coordinate between the experts and synthesize the findings.

obviously you listen to the epidemiologist, not the economist. The economist is an expert on the economy and not on pandemics, and therefore will always give advice that is aimed at keeping up the economy and not saving people and preventing the spread of the virus. Its baffling to me that you think an economist has any kind of valid input on this matter. At best an economist could advise you on how to keep the economy afloat under the restrictions the epidemiologists has advised.

We could easily eliminate a greater share of premature deaths if the government sent soldiers to force Americans to exercise at the point of a bayonet. Probably more than will die in this pandemic (~650,000 deaths due to heart disease each year). Does that mean this is a wise course of action? Of course not. The negative consequences in terms of reduction of civil liberties vastly outweighs the medical benefit. The same logic needs to be applied here.

The epidemiologist isn't trained in thinking about the persisting scar on opportunity left by lockdowns. A response to a pandemic that solely cares about limiting lives lost due to the virus stands to inflict massive harm as people lose their jobs and social unrest triggered by the suspension of civil liberties.

Medical professionals are experts in medicine. Not in making holistic decisions about the course of society. They absolutely should have a prominent spot in sharing information with the leaders of society, but their advice needs to be weighed against the costs of carrying out that advice.

Economic problems come with a cost on human life. There are numerous studies and paper that show how bad being poor and unhappy are for a person's health. Why WOULDN'T we consider the economic ramifications?

Maybe we would, but it isn't like there is consensus on economist side. And it isn't like not having a lockdown is good for the economy , because that has clear economical consequences too:

https://www.nytimes.com/2020/04/14/opinion/coronavirus-reope...

>> At best an economist could advise you on how to keep the economy afloat under the restrictions the epidemiologists has advised.

> Why WOULDN'T we consider the economic ramifications?

He's not saying that. He's talking about who should be giving the marching orders. Let me put it another way: in a war, the generals decide what equipment the military needs and the economists figure out how to produce it. You don't have the economists saying: the economy is good at making buses, it makes sense to us to weld extra armor to them rather than to design a tank from scratch, so go fight the war in armored buses.

But before you go to war, the leaders listen to a diversity of opinions. Could diplomacy work? Could sanctions? What about an alliance prior to war? Could we use covert methods? The problem here is that we waged war without having that discussion. We went straight to the Generals (in our case, epidemiologists) without getting the opinion of the diplomats, allies, covert ops (economists, labor groups, civil rights groups) etc.

> But before you go to war, the leaders listen to a diversity of opinions. Could diplomacy work? Could sanctions? What about an alliance prior to war? Could we use covert methods? The problem here is that we waged war without having that discussion. We went straight to the Generals (in our case, epidemiologists) without getting the opinion of the diplomats, allies, covert ops (economists, labor groups, civil rights groups) etc.

You're leaning a bit too hard on the analogy: you can't negotiate with a virus. The pandemic is more akin to an attack by an irrationally implacable enemy with a couple months advance warning of the threat at the border. In the analogy, the policy options are: resist, Y/N? If Y, then how effectively?

When a country is attacked, does its leadership typically first consult with its economists to determine if resistance is cost effective vs. just letting the enemy take territory or kill citizens with little opposition? Usually the generals evaluate what they can achieve, and if success unachievable, then alternatives are considered. Surrender is always an option, but it's usually towards the bottom of the list.

> When a country is attacked, does its leadership typically first consult with its economists to determine if resistance is cost effective vs. just letting the enemy take territory or kill citizens with little opposition?

Yes, countries very often let the enemy take territory or kill citizens because resistance wouldn't be cost effective. All countries of course try to project the image that they wouldn't, that their territory and the lives of their citizens are priceless. But border skirmishes happen all the time and the vast majority of them don't lead to war.

People's lives and livelihoods are strongly coupled to the economy though. Heavy economic damages result in skyrocketing suicides and homelessness. It's not like shutting down the economy only hurts "gluttonous corporations" and "greedy capitalists"

in a world where losing a job can be just as disastrous to one's health as disease, you really don't think their opinions are valid whatsoever? not everyone has large savings or the ability to work from home.

Political realism is about optics. If the Democrats back down on their egregious lockdowns they'll look even more disorganized than they did in the primaries so it's not worth the risk when the progressive arm of the party is still throwing a tantrum and Biden is struggling to unify the party. On the other side, many Republican states have constituencies that see COVID as a matter of personal responsibility and which feel that nearly any restriction is overreach by the government. So neither group has an incentive to back pedal even if both would probably benefit from pivoting. Couple this with the reality that the scientific communities seem to have embraced making normative statements outside the direct scope of their fields (sometimes even acting against or excluding peers with political differences) and you have little reason for people to act on good advice anyway.

The democrats are not in control of the country, they are in control of a few states but there's a lot of different ideas gonig around. No one would say NY would be better off if they hadn't cut it down a lot and shut down. Washington state is another place that looked like it was going to get out of control but the shutdown moved us from worst in the us to a much smaller impact than originally feared.

Now look at Texas where their daily positive covid 19 detection has double in the past weeks from about 750 a day to 1500 a day. They are going to have a lot more people getting really sick, because that just following from daily exposure. See https://www.worldometers.info/coronavirus/usa/texas/ (go to daily new cases in texas, click on 7 day average). You can se e the same data at rt.live (find Teaxs, click on per day).

The testing rate has also increased. Raw number of positive tests is a shit metric used to spread FUD and taken out of context

What you say is not true - it could be true potentially but the data shows that's not the case. Tests counts relatively stable recently but pos counts went up and percent of tests that were positive also increased.

See https://www.covidexitstrategy.org/. As you see on this page, many states are increasing absolute number of tests - Texas is actually steady for a week at around 18k tests per day. But the % of people testing positive is increasing (see that same website).

On that page scroll to 'how is my state doing on testing' and look at Texas, it's interesting to compare states. Notice last week number of daily tests was around 18k/day. Test positivity went from 5.5% to 7.7%.

This isn't a political issue, it's just the actual numbers. Compare to say Wyoming (increased tests unlike Texas from 472 to 690 per day, test positivity went down there). Oregon is getting worse (2.4k tests/day, in the last week 1.5% to 3.4% of tests are pos).

Texas is having increasing covid-19 positive tests, it's not from increasing the number of tests and icu bed space is going down. This website gives the data source so you can look at it yourself.

You are missing the nuance once again. I am glad you mentioned Oregon, because I am in Oregon and have been following my states response pretty closely, for obvious reasons.

Oregon recently had an outbreak at a seafood plant, and retirement center. The seafood outbreak infected around 125 people, the retirement center around 35. There is also a smaller outbreak at a food processing plant in Washington County, with I believe 5-10 infections.

Here is the secret, Oregon is _now_ doing contact tracing. So _everyone_ at Pacific Seafood was tested, despite a vast majority showing no symptoms. These people would _not_ have been tested two weeks ago. Two weeks ago, testing was generally voluntary and people would request tests if they felt they needed one. Now, people who have confirmed interaction with infected individuals are being tested by state mandate. So of course, now Oregon will have more cases discovered and more positive tests.

You see how your "actual numbers" still don't tell the whole story? There is context in every single state, city, county that you miss just looking at raw numbers. Without that context you make generalizations about what the data is telling you. Stop that.

Yes, Texas should be watched, but the health authority in Texas does not seem to be worried. My own governor, Kate Brown, who has taken this (imo) too seriously, has stated publicly that she _fully expects_ an increase in cases over the coming weeks as we reopen. But now, we have the hospital and treatment capacity to handle it.

And about the Texas example, where ICU beds are decreasing. The site you linked does not seem to really mention what those ICU patients are in for. When states reopen, so do car wrecks, workplace injuries, major surgeries etc. A bypass surgery will require a few days in an ICU, so now that major surgeries are happening again, of course ICU capacity would be taxed. Again, as I've been saying, you lack context. This time last year, what was the ICU bed utilization in Texas? Now that we see that intubation and invasive ventilators actually worsens outcomes, how many COVID patients can be treated _outside_ of an ICU?

As I said in my original post, we are not updating our metrics to meet new understandings. ICU beds are a silly metric now, but they sure are scary!

> The democrats are not in control of the country, they are in control of a few states...<

Yes but (assuming I understand your point correctly) the U.S. federal government isn't in control of the country either in this context. They certainly could have been more cooperative with states in terms of distributing supplies and communicating new developments as they came in but, short of bringing in troops and asserting themselves by force, they lack the authority to implement a hard nation wide lockdown. Given the early panic over the virus it's hard to imagine a federal level quarantine not resulting in violence.

>No one would say NY would be better off if they hadn't cut it down a lot and shut down.<

I'm not sure if I phrased my first post badly or if we agree here. When I said the lockdowns were egregious compared to Rep. states I was speaking relative to the present. I agree things would have been much worse if early and cautious action hadn't been taken.

>Now look at Texas where their daily positive covid 19 detection has double in the past weeks from about 750 a day to 1500 a day. They are going to have a lot more people getting really sick, because that just following from daily exposure.<

This is basically the entire national debate. We've seen increasingly that just getting the corona virus isn't a death sentence for most people. Texas' infections have been rising, which will by extension lead to some amount of additional deaths, but Texas also has an extremely low death toll compared to other states in terms of deaths per million people (going by Worldometer). The significance of this is that most infected arent going to die and dying after infection, for the most part, isn't a random lottery and so whether it's wise or not to continue to force people to remain in lock-down is a value/political judgement rather than a distinctly scientific one. This holds especially true when people in need are refraining from visiting hospitals for fear of getting the virus and instances of depression and suicide have risen dramatically as a consequence of lock-down policies. You can argue fewer people might still die with heavy lock-down measures in the present but those deaths arent the same people and so what's ultimately being dicussed is whether or not it's fair to drive certain individuals to death or unnecessary physical suffering in order to save people they largrly have no relation with. And that's before discussing the small business owners who have lost their life's work due to government mandates (consumers didn't stop going out by choice after all).

My point about the parties themselves was purely meant to highlight that at this stage both sides could probably be managing their policies better (regardless of value distinctions) but neither wants to make it look like the other team was correct. The irony is that neither side would be taking the same actions since for Dem states like California this would be loosening up a little while for Rep stated it would be tightening up or at least implementing financial support for at-risk individuals and their cohabitants. From here, my broader point was that it's an election year and so, regardless of if any particular state is actually beholden to a particular plan of action, anyone who breaks too far off from the party line (in a manner that risks bad optics) is going to lose clout within their party. I'm not endorsing that as the way things should be but that's the apparent state of things going by the predominantly partisan split in terms of current lock-down action.

>This is because leaders on the left and right have refused to respond to new data, and are working with the same plans set in March.

As the article somewhat loosely implies, the problem is that all new data becomes suspect when all of our institutions are openly politicized.

You think these biases only exist with respect to COVID? The marginalized right (consider the viceral response you're about to have to reading these next sentences) has been saying the same thing about academia for at least a decade. That goes for climate change and much of modern psychological theory. And no, these aren't extreme far right Nazis/incels as people like to stereotype, these are near center moderates, these are (typically in the minority) doctors, scientists, engineers, this is the so called silent majority that is denied a voice on most modern platforms. And part of the reason that our society is gridlocked is that the majority has decided that this minority is not allowed a voice because in a one dimensional two party system one side falls closer to morally repugnant views, so we throw the baby out with the bathwater.

Our institutions are collapsing because actors are no longer operating in good faith. And those in power believe there are morally justified in suppressing opposing views.

Edit: and I'd like to add, another contribution to gridlock is the tendency for black and white thinking that at this point I'm starting to accept is extremely common human nature - there is a world of nuance between criticism and outright denial that is inevitably ignored almost any time someone expresses criticism for, say, climate change resources or the media (explicitly not scientist) derived predictions.

I had no visceral response to what you said :)

I agree, groupthink is a natural artifact of groups. If there are more liberal people in a group, their groupthink will be more liberal. Couple this with confirmation bias and we have a problem. Couple _that_ with the fact that there are actors, both from a profit motive and for other motives, that are attempting to exacerbate and increase that divide, and we have an even larger problem.

There are a lot of moderate liberals who are willing to admit that the political homogeneity of academia is a serious problem as well. Heterdox academy is a bipartisan coalition of academics devoted to addressing this problem.

The right has also raised awareness about this in the media, and I (moderate liberal) couldn't agree more. We can't begin to really solve these problems and get everyone on board so long as we have openly partisan epistemological institutions--bias is the enemy of truth and we're maximizing it when we should be minimizing it. Those on the left will be quick to accuse the right of being anti-science and there's certainly some truth there, but I'm very suspicious of the idea that the falling political diversity is a function of the right selecting out of these fields rather than explicit or implicit discrimination (and at least within certain fields of academia, preliminary studies indicate a majority of faculty are willing to openly admit that they would discriminate against conservative candidates).

EDIT: I’m definitely not being downvoted out of the same kind of partisan tribalism that TFA is calling out. ◔̯◔

"The left" doesn't say "lockdown lockdown lockdown".

As a card-carrying (ANTIFA, laminated) member of the left, I consider countries like Austria, South Korea, or maybe Germany the gold standard: lockdown, yes, but continually adjusted, exchanging the most draconian measures with lesser ones when more knowledge allows more targeting, or when infection numbers sink.

All those countries have now effectively exited lockdowns, at levels of single-digit daily deaths. This allows further lockdown-free reduction by amassing resources for contact tracing every single infection.

Meanwhile, the US, UK, Brasil, and other countries are seeing thousands of deaths daily because they stopped maybe two or three weeks too early, and/or did it half-heatedly and/or failed to use that time to stand up alternatives to lockdown.

This has won them absolutely nothing, economically, as far as I can tell: Germany is at +3% unemployment (6.6% total) while the US is on >15%. And except hoping for the weather to make a difference, they will either continue to see people dying and incurring the cost of people self-quarantine. Or they'll change course, do another round of sustained lockdowns after all, and use that time to think of an excuse for wasting three months and 100,000 lives on a thought process that took competently managed countries the better part of the last in-person meeting they had this year.

Everyone has their own theory about why some countries do better than others, but we don’t yet know why: https://www.theguardian.com/world/2020/jun/07/immunological-...

Does it help to jump to conclusions about the cause being lockdown variations, or weather, or sunlight, or political leanings?

Anybody can cherry-pick their example countries to support their argument, but so far I can find counter-examples to their points whenever I look. I do agree lockdowns have their place (e.g. New Zealand has eliminated the disease using a lockdown, and the Asian success stories).

Pollen is apparently another cause of variation: https://www.medrxiv.org/content/10.1101/2020.06.05.20123133v...

Of course, there are multiple causes, and trying to pin variation in infection rates or deaths on a single factor would be silly. Hopefully we find the driving factors... Spring or vitamin D could explain why Italy doctors are opining that the disease is less deadly now than in March.

,,people should not be walking around with masks''

What Fauci was telling to people is not science. I was wearing my N100 masks when I had the chance, because I hadn't seen any evidence of masks making the coronavirus more infectious, but much evidence to the contrary. The whole anti-mask propaganda made it hard to me to trust scientific leaders, and even some papers at this point.

The anti-mask “propaganda” was obviously an only partially successful effort to preserve the supply of masks for first responders. If the CDC/WHO and came out and said everyone wear masks in the beginning of march the supply would have spiked harder and faster than it already did, likely resulting in more health care worker fatalities.

Successful or not they lied to the public openly about the benefits of wearing masks. Not only does this destroy whatever credibility they had with the public, but it also shields government and health officials who failed to stockpile enough masks for inevitable outbreaks and offshored our medical productive capacity to China from accountability (making it more likely we will face the same shortages during the next, inevitable crisis).

There's almost certainly a lot of safe opening up we could do. What would make it dramatically safer would be pro-social behavior from people on the right. The protesters are all wearing masks and doing their best to maintain social distance outside of the actions. They calculate that it is worth the risk. Time will tell, but the calculus isn't merely do the protests increase the spread? but also will they achieve political goals that have a large bearing on public health, specifically the health of people whom the US Coronavirus response is already systematically failing (black people, whose lives matter).

> The protesters are all wearing masks

Really? I keep seeing people saying this. It’s laughably false. Here is the governor of MI at a protest that breaks her own rules about social distancing and protests, directly between two men without masks. (Just one high profile example.)

https://mobile.twitter.com/TPCarney/status/12689028204108431...

Been to a major one, and a very, very high percentage of the people there wore masks, enough that it was consistently odd to see people without them. Also people trying as much as possible to keep a little space between each other. Who wasn't wearing masks, consistently? White male police (the National Guard was all masked). Doubt me if you want. Obviously a rhetorical "all" and very easy to find photographic counterexamples. But certainly most.

Also there were many people distributing masks to the maskless, and people whose sole mission was to pump hand sanitizer onto people's hands. The people in the crowd care about the virus and for the most part when right back to social distancing after leaving the protest.

Great article, especially the bit about the healthcare professionals' statement on BLM protests. However this article (and the public at large) fail to distinguish between what doctors practice, and science. Medical doctors are about as far from scientists as you can get: they're highly trained robots. They don't perform science; at best they write up a case study. Jumping to conclusions from insufficient data is what they consider "expertise".

"Tribalism" didn't come for pandemic science. Tribalists did.

Every individual has the power to behave forthrightly, with epistemic hygiene. You can't shove the responsibility to do that onto a nebulous interstitial emergent effect.

Science as you know it is dead: https://guscost.com/2020/05/12/pandemic-woo/

That was a really poor read. Anxiety from lockdown is going to kill more people than coronavirus?

Like, I'm not exactly an ardent supporter of lockdown but it's clear we've saved many lives by keeping hospitalizations minimal. Even if that estimate is below what initial models suggested, it's inept to suggest it was useless.

Likewise you fail to actually link to any stats to support claims about increased suicide rates or deaths from heart attacks, while linking to a 404 as a source for New York state supposedly hiding pushing covid cases into nursing homes.

Science has issues but this is trending towards baseless tabloid journalism instead of a serious introspection of methodological flaws.

You skipped over a lot, and we will see about the rest. I can’t prove most of it right now, but it is what I think. In fairness it is perhaps way too cynical for your taste, so if you prefer a serious introspection, try this: https://americanaffairsjournal.org/2020/05/science-without-v...

> Likewise you fail to actually link to any stats to support claims about increased suicide rates

Currently there are about 40,000 deaths by suicide in the US each year. We know that deaths by suicide will increase because of economic downturn. We have some understanding of this after 2007 and similar. No-one working in suicide prevention thinks we'll come anywhere near doubling the 40,000 number.

“Yuval Levin is director of social, cultural, and constitutional studies at the American Enterprise Institute, editor of National Affairs, and a senior editor of The New Atlantis.” Useful context before the click.

I try in general to steer clear and not to comment on anything regarding both the pandemic and the protests, but I gotta say that that open letter is the most bizarre take I've read on both issues. Or it at least gives even Trump's most outrageous tweets a run for their money.

"In this century, we have become accustomed to heated political debates that somehow avoid contact with reality."

Which is a big problem. It keeps the US from actually doing anything.

(Then again, that may be a good thing. The current administration does not do much follow-through, so most of the weirder ideas stay rhetoric and don't get implemented. Compare the rise of the Nazi party. Much of the stuff they planned to build in the early years was actually built, from the "People's Radio" to the autobahns. With the organization in place to build, arming up for WWII could be done effectively. If the Nazis were all hype, they would not have been able to do much beyond their borders.)

Fascism is private enterprise under total government control. Of course it'll be very effective at getting things done, both the autobahns and the gas chambers. Communism is pretty effective too. It's government-owned enterprise under total government control. The only thing that really changes is who owns the means of production. And, well, under Communism you're de-facto a slave to the state as well. Not having a job was illegal in e.g. the Soviet Union.

The fact that US political establishment is unable to enact quick change is kind of by design, IMO. While they are at each other's throats, they don't have the time to attack We The People. That, in my book, is a good thing.

Communism is known for economically collapsing on itself, that's not very efficient or productive.

Yes. But it takes decades for it to do so, and in the initial stages it can appear to be quite effective. And as any communist will tell you, "it's not really communism" if it collapses on itself, killing tens of millions of people in the process.

Are you sure they were not simply spending the riches made by the previous regime? I think that's the case of every European communist regime, not sure how it was outside of Europe.

We need a Russian to comment with some examples of the exceedingly black humour that developed under communism.

For whatever reason, this comes to mind -

A judge meets a colleague in the corridor who's chuckling and wiping tears from his eyes, saying "Ah, I just heard the best joke of my life!" - "So tell me?" - "I can't, I just assigned 20 years of hard labor for it.."

But the Soviet economic sytem was one where you could go to a shop and ask "You don't have sausage, I suppose?" and they would answer "No! Here we don't have milk, the shop on the other side of the road doesn't have sausage!"

As a mere suggestion, Vitaly Vitaliev writes beautifully in English.

https://en.wikipedia.org/wiki/Vitali_Vitaliev

I'd recommend "Borders Up," ostensibly about drinking culture around the world. Good fun, but rather more than that somehow.

Soviet-born Russian-American here. How may I be of service? Some of that humor, BTW, could land you in a labor camp if a secret KGB agent (секретный сотрудник) heard it. So it was only shared with very trusted audiences.

Tell me a joke!

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