A, a week ago NZ got the first Delta, today we have 107, stats people think cases are peaking. We have a hard, near total lockdown as no one want this loose, it would kill 10000 plus.
Does this mean there is a balance in favor of not imposing lockdowns; who knows? No one knows if a CB analysis is absent. The latter should include effect of vaccination and the ameliorative effects of an ever-widening range of medicines which have been shown in many peer-reviewed clinical studies to save lives and reduce the severity of the disease. But governments set their face against this. One wonders why.
Finally it should be noted that Covid-19 is not smallpox (lethality about 30%). Huge numbers of people who have competent immune function remain either asymptomatic or totally immune to the virus (lethality 0.007% - 5.4% or more depending on age and co-morbidity).
Quoting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110323/ :
> In the first few months of the viral pandemic, there were scattered media reports of individual instances of suicide ostensibly related to the effect of COVID-19 and several articles published in scientific journals that principally relied on such media reports ...
> Analyses of actual suicide rates during the COVIDE-19 pandemic based on national and regional/local health statistics from across the world, however, provide a different picture. A majority of such comprehensive data-based studies report a modest reduction in total suicide rates whereas the remainder report no significant net increase in suicide rates during the first year of the COVID-19 pandemic
Quoting https://www.bbc.com/news/55949640 : "The only reliable recent data available on suicides in England - from the University of Manchester - has found that rates have not risen during lockdown."
Quoting https://blogs.bmj.com/bmj/2021/03/10/louis-appleby-what-has-... : "Now we have reports from several countries, based on national or state-level suicide data. They come from Australia, New Zealand, the USA, Canada, Peru, Norway and Sweden—high income countries in most cases—and they carry a consistent message. Suicide rates have not risen."
Suicide is relative very rare. Even antidepresant drug trials find it very difficult to establish if they increase suicidality because of rarity. There are some antidepresants that are thought to increase suicides in children and still can be prescribed because of some improvement in the quality of life.
Lockdowns however where mostly bad except in some cases. I think that some young people who spend a lot of time playing games were happy. Incidentally they are also the ones who are most active online.
But even if it has no effect, the harm of lockdowns can be in other ways. The drug overdose deaths and increased alcoholism for example seems to be true. Any suicides can still follow after several years.
There is no evidence that there are consequent suicides. Nor that they are ignored.
You write "not yet" .... a hand-wavy statement which instantly adds FUD any topic.
It could be that lockdowns cause people to suddenly die 3 years years later. I could make up lots of "it could be" scenarios. Unsupported claims, with evidence contrary to the claim, should not be used to make policy decisions.
And this is a hypothetical about making a policy decision.
Yes, let's also reduce premature deaths due to obesity, smoking and alcohol use. You write that like you think it's farcical, but many people advocate for exactly that.
One problem is that many companies make lot of companies make a lot of money pushing sugary foods, tobacco, and alcohol.
That money affords political power preventing stricter laws.
John Oliver, for example, did a segment on Last Week Tonight about how tobacco companies prevent change, in https://en.wikipedia.org/wiki/Tobacco_(Last_Week_Tonight) , with examples of how, for example, PMI sued Uruguay at the WTO to prevent including obligatory health warnings on tobacco boxes.
There was no Big Iron Lung opposing the polio vaccine.
People smoke, drink alcohol and eat junk food would never accept the level of restrictions we had with lockdowns. One thing is to put a warning on a box, a different things is to actually prohibit buying that box and smoking with a high penalty.
And vaccines are much more effective and considerably less intrusive than any NPIs. The problem is that people so much overemphasised their effect and actively resisted vaccine challenge studies (with volunteers deliberately wanting to get infected) to speed up vaccine trials. The whole world could have been vaccinated by now and delta variant booster be ready by now.
Quoting https://en.wikipedia.org/wiki/COVID-19_lockdowns :
> Research and case studies have shown that lockdowns are effective at reducing the spread of COVID-19, therefore flattening the curve.[4] The World Health Organization's recommendation on curfews and lockdowns is that they should be short-term measures to reorganize, regroup, rebalance resources, and protect health workers who are exhausted. To achieve a balance between restrictions and normal life, the WHO recommends a response to the pandemic that consists of strict personal hygiene, effective contact tracing, and isolating when ill.
As I pointed out elsewhere here, "lockdown" is a broad term.
Do not change the goalposts. You wondered why we don't implement method to reduce deaths due to obesity, alcohol use, and tobacco.
I gave you one a very clear reason.
I most assuredly did not say that prohibiting the sales of tobacco, with a high penalty, was the only way to reduce those deaths.
And I pointed to tobacco companies specifically fighting putting warnings on a box.
But lockdowns in this strict sense was the most stupid idea ever. Outdoor events had very little effect on covid spread anyway.
If covid was a short term problem, it would make some sense. But it wasn't. The research is inconclusive at best. The studies are not on the level of pharmaceutical interventions. Remember how long it took to prove that ivermectin is not effective? Nothing with the same level of rigor has been done with lockdowns.
I stand by my assertion that we don't implement prohibitions at the same level with smoking, drug use and junk food as we did with lockdowns. The reason for leaving home is to meet other people or visit places. If you close an indoor pub or a restaurant that's a measure but not really a lockdown as people could still order food or wine and eat and drink outside. So, in this sense lockdowns are equal to blanket alcohol prohibition. Even if it worked to some extent in 1920s in the US, people voted to stop it. It wasn't a recommendation to stay at home like a warning on tobacco box, it was an order with high penalties. And I think in Australia it is still like that. They have added exercise for valid reason. But what if I don't want to exercise but only walk around and enjoy nature or a beach?
Why do you say the research is inconclusive?
The Wikipedia link showing support for lockdowns as you describe is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881715/ . Some quotes:
> Lockdowns are found to be the most significant NPIs in terms of variations to the Rt
> The results, which where published in July, paint quite a grim picture which unfortunately has been later confirmed: measures in place after the strict lockdown is lifted are not enough to avoid the overwhelming of the healthcare system.
> Early implementation of lockdowns has been found associated with large reduction of incidence.
> The results confirm the effectiveness of lockdowns and travel bans.
> Furthermore they suggest that partial lockdowns might be as effective as full lockdowns if implemented earlier.
Or, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325386/ where Itay's red zone is closest to a full lockdown:
> the red zone policy was by far the most successful in reducing the rate of growth of new cases, hospitalizations in regular wards and ICUs.
> the red zone is an instrument that makes it possible to rapidly bring down cases and the speed of transmission of the virus and consequently both hospitalizations and deaths (being very correlated). However, it implies severe social and economic consequences due to forced economic activity suspensions and restrictions on the freedom of movement. Therefore, this choice can be considered as a tool of last resort in cases of dramatic spread of the epidemic or when the local health system is close to the collapse.
> There is a vast literature on the effects of nonpharmaceutical interventions (NPIs) of various measures on the speed of spread of COVID-19 ... Many studies have proven the effectiveness of these measures in reducing the spread of severe acute forms of COVID-19
You write "we don't implement prohibitions at the same level with smoking, drug use and junk food".
I'll again point out the guideline that lockdowns are meant as "short-term measures to reorganize, regroup, rebalance resources, and protect health workers who are exhausted."
With evidence that it works - experience in enacting a cordon sanitaire for smallpox, Ebola, and SARS outbreaks: https://en.wikipedia.org/wiki/Cordon_sanitaire_(medicine)
What sort of evidence is there that a short term intervention will help reduce deaths due to smoking, drug use and junk food?
Do you know what is a metastudy? And that the biggest metastudy about ivermectin actually tended to support that it is slightly effective? So, how do we know that ivermectin is actually non-effective? Because those positive studies have big limitations that make the results very suspect.
It takes a lot of time to read through every study, its methodology, limitations etc. I have had not time for that but others have done and those reviews have very big error bars about their effectiveness and overall evidence is not very convincing.
Medicine is a field which is very complicated and as in stock market, past experience with similar things do not guarantee future results with different diseases. Researchers needed more than 50 years to realize that stomach ulcer is caused by bacteria. Before that they believed that no bacteria could live in such acidic environment. So, don't bring an examples about different diseases. It does work like that in medicine.
But now everybody on the internet is an expert and reads one study, selectively quotes something without even understanding full implications and thinks that they have proven everything. No, that's not a game I am playing here.
Especially your last question. My statement was that we don't forcefully take away cigarettes from smokers. I don't know if that would be effective or not but that was never for consideration. We don't do first of all because we value people's freedom to choose and we don't think that it is ever appropriate to force people like that.
Where are these studies? I linked to multiple papers, themselves containing links to other papers, all stating that lockdowns are effective.
Put up or shut up.
Otherwise you're one of the people you're complaining about.
I personally read https://astralcodexten.substack.com/p/lockdown-effectiveness...
You wrote: "everybody on the internet is an expert and reads one study, selectively quotes something without even understanding full implications and thinks that they have proven everything"
You didn't even point to a study.
Were the red zones in Italy effective? That's the closest Italy had to the specific type of lockdown you mention. And I pointed to a study which argued that it was indeed effective.
I asked you a question do you know what a metastudy is? You didn't answer, so I suppose the answer is no. You are not qualified to even read the studies and understand what they really say.
As far as I read from the study you quoted, there was no clear data that showed that the red zones in Italy were effective. Italy had one of the worst results overall. Arguing that lockdowns there were effective is like a mockery of science.
Quoting from it:
> In doing so, I analyze 348 articles written by more than 2518 authors in the first 12 months of the emergency.
If you honestly believe "higher" is a meaningful point, then "peer-reviewed review in the scientific literature" is "higher" than someone's review in a personal newsletter.
You cannot possibly believe that newsletter summary you pointed to contains "practically all meaningful available evidence". Quoting the same review paper I linked to:
> searchers in PudMed for restrictions AND COVID, lockdown AND COVID, (control measures) AND COVID and (social distancing) AND COVID return more than 2000, 2900, 3000 and 8000 results respectively. Furthermore, any systematic review should play with synonymous and similar words. This monumental work, which would end up with well more than fifteen thousand papers is left for the future and it would benefit from a large collaboration.
If your statement is true then either Astral Codex Ten managed to read and review 10K+ papers on the topic, or you somehow know that most of those papers are not meaningful.
As for "no clear data" about Italy's red zones, what is unclear about these quotes from that Italy paper?:
> the red zone policy was by far the most successful in reducing the rate of growth of new cases, hospitalizations in regular wards and ICUs.
> the red zone is an instrument that makes it possible to rapidly bring down cases and the speed of transmission of the virus and consequently both hospitalizations and deaths (being very correlated). However, it implies severe social and economic consequences due to forced economic activity suspensions and restrictions on the freedom of movement. Therefore, this choice can be considered as a tool of last resort in cases of dramatic spread of the epidemic or when the local health system is close to the collapse.
> The package of measures contained in the red policy well responds to the need of quickly reducing the speed of transmission of COVID-19 and consequent hospitalizations.
That sounds pretty clear to me, and you haven't highlighted the faults, nor identified where I've mis-understood things, beyond making seemingly unsupported statements of fact.
I'll be clear as well. Stay-at-home orders for, say, New York might have been useless while the red zone orders for Italy were useful.
But your argument appears to be that no lockdowns for COVID were useful, while I can point to at least one case where it was successful.
Regarding "metastudy", the term "meta-analysis" is far more frequently used. A quick HN search shows I'm aware of that concept, yes. https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...
I ignored that question as it appeared a meaningless ad hominem, especially as you weren't actually pointing to any meta-analysis to back your claims, nor demonstrating that you are qualified to read the primary literature and able to understand what they really say.
Literature review is not higher that meta-analysis. It quotes one study but how reliable it is?
What about ivermectin? A lot of studies find it effective. That's not the final conclusion however.
If you want to play the FUD game, I'll again remind you that the sole citation you've provided is to a non-peer reviewed review in a personal newsletter.
You still haven't explained how you can interpret a paper with statement like:
> The package of measures contained in the red policy well responds to the need of quickly reducing the speed of transmission of COVID-19 and consequent hospitalizations"
as having "no clear data that showed that the red zones in Italy were effective".
Based on this exchange so far, I have precisely zero faith that you can wade through the misinformation on ivermectin - https://en.wikipedia.org/wiki/COVID-19_misinformation#Iverme... - or understand the relevant research literature - https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_rese... .
To quote you - "everybody on the internet is an expert and reads one study, selectively quotes something without even understanding full implications and thinks that they have proven everything. No, that's not a game I am playing here."