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Comment by DiogenesKynikos | Hacker News Reader

It's worth noting that Bhattacharya was one of the originators of the "Great Barrington Declaration," which advocated dropping almost all measures to limit the spread of SARS-CoV-2, with the aim of quickly achieving herd immunity through widespread infection. This was in mid-2020, before any vaccine was available. This strategy would likely have doubled the death rate in the United States, had it been implemented. That is to say, this study goes strongly against Bhattacharya's oft-expressed views on how the pandemic should have been handled, and one should approach Bhattacharya's criticisms with a good dose of skepticism.

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This is a misrepresentation of ‘focused protection’ and Bhattacharya supported - and still supports - a vaccine strategy, which you insinuate he did not.

The comment you're replying to clearly specified this was a strategy that was advocated before vaccines were available. If you believe, as the signatories of the declaration did, that natural immunity to the virus is possible, then it's not a vaccine focused strategy, it's a strategy that's independent to any vaccine. It's not as if anyone thought that such a strategy wouldn't lead to the infection of essentially all of humanity, and it doesn't say anywhere in it that they expect there not to be durable natural immunity (in which case the policy is self-defeating and absurd), so while it's not an antivax proposal, it's clearly not vaccine focused.

It's plainly true that "focused protection" is a euphemism for letting the virus tear through the vast, the vast majority of the population.

> the vast, the vast majority of the population

The plan specifically is to (somehow) isolate vulnerable people and only "let er rip" for the rest of us. I'm skeptical on how this could have actually worked (or how well it actually did work in Florida), but that's the actual proposal.

There's the GBD proposal, and then there's the actual media tours by the GBD proponents, particularly on Fox, where COVID-19 was downplayed. Some of them famously wrote columns how there'd be maybe 10,000 fatalities and it was like the flu. Is it surprising that downplaying the virus also worked against spending huge amounts of money to protect the elderly? Like govt renting hotels to isolate elderly living with families? Or providing deliveries so they could stay at home?

I think Dr. Jay B seemed reasonable and honest enough. For instance you can find him saying that he's not comfortable comparing it to the flu, since he suspects flu deaths may be greatly overcounted. He talks now (not sure about before) about deliveries and hotels as you say. Etc.

But yes, the loudest dissenters seemed to be contrarians, rather than people with a specific plan. They take a big mash of GBD, "lol it's not that bad, not everybody's going to get it", "lol everybody's going to get it so there's nothing we can do anyway", "we're not obligated to look out for other people anyway", etc etc with all the inherent contradictions. Any signal that went against "THE COVID NARRATIVE" they signal boosted.

Something like insecurity must have been driving this stuff. I think some of the counter-maintstream points were right, particularly about being sober about tradeoffs, but overall it was a total embarrassment. Granted the other side wasn't much better.

I think Jay B was better than most of the GBD supporters because he seemed to focus more on the targeted prevention. The problem was he didn't counter the downplaying of SARS-CoV-2 by people using his own seroprevalence paper (which had problems), or at least I never saw him push back on Atlas and others. So his criticism about public health issues is completely devoid of his own part in the story. They went heavy with part 1 (COVID isn't that bad for non-elderly) and were surprised that downplaying the impact didn't shift resources to the elderly. If people using his data were saying the overall IFR was like the flu, why should the govt go way into debt protecting the elderly?

> I'm skeptical on how this could have actually worked (or how well it actually did work in Florida), but that's the actual proposal.

I don't see piles of dead people in florida, do you? Guess what went down in florida worked just as well as the most hardcore lockdown regions around. Almost like masks and lockdowns didn't do a damn thing at all. Who would have guessed?

Dr Jay B made it sound like it was supposed to work better than lockdowns at protecting the elderly. At best it seems about the same.

I mean by your logic, focused protection didn't do a damn thing either.

Turns out you can’t control or contain a highly contagious respiratory virus. To think we could was peak human arrogance.

Several countries were highly effective at controlling it, and had far lower death tolls as a consequence.

These countries are very diverse in many respects, so one can't claim that they only succeeded due to some particular quirk they share in common: China, New Zealand, Australia, Vietnam, Taiwan, Singapore, and others.

FWIW I'll jump on the other side and note that most of these are island nations which makes it a lot easier.

China is not an island nation.

Very few places in the world actually tried “focused protection” or seriously tried anything at all, so we probably won’t know until the next pandemic hits and we hopefully try something then.

The only thing we really learned, at least in the USA, is what happens when you basically do nothing society-wide in the face of a pandemic. Outside of a few major metro areas, the country was just like Florida. Business closures on paper but not enforced, weak stay-at-home suggestions that were largely ignored, voluntary travel restrictions that were similarly ignored and unenforced.

The school closures were the one major exception, where at least briefly, actual collective, coordinated action happened.

Isolation of vulnerable people is problematic because ~5% of the population was highly vulnerable, and actually isolating them would require extreme resources that we simply don't have. Rather, what was meant from the statements of signatories and drafters, was to let it rip for 99.5% of the population and offer less actual protection to the rest than we gave to the least protected in our scenario.

Great to be sceptical about it, because that’s how we end up with robust plans that stand a chance of actually working.

But, for all the protesting about how GBD would have failed the old and vulnerable, it missed the point that we actually already did fail the old and vulnerable.

It’s argued as if we succeeded.

But for all our efforts, we failed those that really did need protection. They were stuck. (And some still are.) Community transmission rates were really high. And that matters when you’re in a vulnerable group, because anything >0 is basically “high”.

All our efforts were general protection, which helped groups that didn’t really need help, but didn’t help the groups that really needed it.

Indeed, the idea that "focused protection" could keep the elderly (and all the other at-risk people, who are nearly half of the US population) safe while the virus ripped through the rest of the population was absurd. Of course, we now know that herd immunity would never have been achieved, so the entire premise of the "focused protection" strategy was incorrect.

Allowing virtually the entire population to become infected before the advent of vaccines would have been devastating. Things were bad enough as it was, with 1 million deaths in the US alone. At least most people in the US were vaccinated before their first infection - things would have been that much worse if the US had fully followed Bhattacharya's advice and actively sought herd immunity in mid-2020.

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