I was a good US citizen and used what little influence I had among my social circle to encourage others to follow the COVID protection measures. And I adore Nate Silver. So, pardon me if I confess that all I read in this article was:
Blah blah blah 'I mostly agree with ... an October 2020 anti-lockdown statement signed by a large number of scientists and medical professionals. “Those who are not vulnerable should immediately be allowed to resume life as normal”' blah blah.
I don't have any regrets about the position I took, since it seemed to be based on all the verified information we had at the time. YET, I hope our society will embrace the fact that we were largely wrong to prolong the lockdown measures. Humility doesn't hurt the Left either.
The measures that seem like they should have worked, but people claim they didn't are:
- masks: clearly they worked for the medical professionals that were treating patients during the first waves, as they were directly exposed and didn't get sick, why didn't they work for the population at large? Did we not wear them correctly, consistently?
- schools: It seems obvious that schools could be a huge vector of transmission, kids largely were asymptomatic and when they got sick, they would still spread it, both inside the school and to their vulnerable relatives. Were the school shutdowns a mistake? Should they have been done differently?
RE: masks, paper masks don't do shit, gators even worse. That's what 90% of the population wore. Had we enough N-95s for everyone, I think the mask effectiveness would've increased dramatically, but I doubt folks would put up with wearing one. For me, I still wear N-95s on planes and in crowded places, I understand their effectiveness and it fits my risk/reward profile.
RE: schools, they have been and continue to be a reservoir for COVID and other nasties. Even this September, like clockwork, COVID is ticking back up in the waste treatment tests. I'm still waiting for society to have a conversation about what role schools should fill and how we ensure schools operate the way that people think they should. Additionally, schools should be able to turn away students who are sick--right now it's all honor based and kids with fevers have to be accommodated.
N-95 masks work to keep you from catching the virus and cloth or paper masks (somewhat) prevented you from spreading the virus. Ideally everyone would have worn N-95 masks but the US had four problems:
1) The US didn’t have enough N-95 masks. In Asia where masks in public were more common people used masks from their home supply. I think some segments of the population were resentful that the US didn’t have access to the best masks and Asia did.
2) We had only a general idea of who was high risk.
3) We had only a general idea of the long term impacts of the virus. There was some initial concern that the virus could be like the Zitka virus where mortality rates dramatically increase with the second exposure. If that were the case the second waves could have killed off half the population with wide transmission.
4) Households aren’t homogeneous and it is near impossible to prevent transmission from a possibly asymptomatic child to a high risk adult when they share the same home.
Unfortunately given the lack of consistent messaging about masks in the US one segment of the populations believed that the masks were to protect themselves and the other segment believed it was to protect others. Those that were low risk and believed it was to protect themselves resented the masks and those that saw the masks as a way to protect others resented those that resented the masks. I think those polarized views still persist today.
5) A not insignificant part of the population heard and understood that masks protect others and said "why should I suffer to protect them?"
I observed this sentiment in particular about return to school, and not just about masks. A sizable portion of the population would seemingly do anything to avoid accidentally helping someone else.
Related: I wasn't in the US at the time, but I think a close 6) would have to be the intense polarization and ongoing "culture war," wherein one side was already being told that something else coming out of their mouth was literally killing people, and doubting the veracity of the statement. Wearing a mask is slightly panic-inducing anyway (ever try to muzzle a dog?), and coupled with the fact that one side of the political isle took up its championing, this allowed some members of one side to wear the mask sanctimoniously and some members of the other to avoid or disbelieve any rhetoric (scientific or otherwise) promoting their use. As long as the more general lack of cooperation carries on, the US is at risk of not being able to unify over important things like public health.
Yeah 5) was a real eye opener for me. A lot of conservative thought revolves around the idea that government shouldn't provide services that family, faith, and friends can provide, but when it came right down to it voluntary mask wearing was out because of exactly what you said.
> For me, I still wear N-95s on planes and in crowded places, I understand their effectiveness and it fits my risk/reward profile.
Likewise, however I should also add that in my case there's no risk component — not only because I get free FFP2 masks at my workplace, but also because it appears that one of the many ways that I'm unusual is that masks (and I mean this literally) cause me less issues than does my underwear.
Even if I wear a mask for a 31 km walk, it's the socks and underpants that pinch or restrict first, not the mask.
Paper masks (and, by some measure, even gaiters) are for source control, and they work just fine for that purpose if the literature is anything to go by. Every software project needs it, and our squishy bodies are decidedly not an exception.
I am a little frustrated over an apparent lack of curiosity around mask effectiveness.
* If you think they're an effective measure for the public in general (which is probably closest to my position), then the variation in studies seems like it should still give you pause because it seems like the way mandates and messaging are implemented could undermine the usefulness.
* If you think they're effective in individual cases when people do it diligently, it still seems like you should be worried about the possibility that a lot of people who think they're diligently and correctly masking aren't, including some medical professionals who are regularly exposed to the disease.
* Honestly, even if you don't think they work at all, it still seems like learning why masks don't work would expand our knowledge of the disease.
Of course, we do know about plenty of factors that undermine mask effectiveness: people avoiding them altogether, people wearing ones that don't fit, people not covering their nose, etc. And of course researchers can skew the results with their methodological choices. But there seems to be enough variability in these studies that unknown or underappreciated factors could be significant.
what variability? AFAIK in controlled studies masks work (as in when you actually test things in a lab rather than looking at population statistics), are more effective when both people in the room are wearing them, we know the size of particle they filter and we know the viruses are bigger than that. there's 0 doubt at this point they do what they are supposed to do.
I'm talking about variability in the studies on population-wide masking. The consistency in lab studies is a major part of why I belive masking is an effective public health measure but would like more study on what's causing the variation in ecological studies.
Do viruses float freely in the air, or are they mostly in aerosolized bodily fluids when from an infected persons coughs and sneezes? Cloth masks are great at trapping those and greatly reducing the "muzzle velocity" of droplets that do escape.
Yes, this is the key insight. The mere fact that the virons are smaller than holes in the mask means nothing. The virons aren't expelled from our mouths or noses on their own, but are attached to moisture droplets which _are_ effectively trapped by surgical (and better) masks.
I personally don't know how best to interpret lots of research from the medical community. However, I do believe that the meta-analysis based Cochrane reviews[1] are the most reliable reviews of medical intervention for non-experts (and I consider even the vast majority of doctors as non-experts outside of their particular specialization). The Cochrane Collaboration isn't all knowing, but I don't know of a better alternative source of such information.
In a large meta-analysis[2] the Cochrane Collaboration did not find convincing evidence that masks work. Here is a single sentence taken from the author's conclusions:
"The pooled results of RCTs [Randomly Controlled Trials] did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks."
This gives me pause; I was one of the dedicated mask wearers during the pandemic, but now I realize that we don't know that they did any good. Please note that I am saying we don't know if the masks worked; I'm not saying that the masks didn't work, just that we don't know that they did.
I've included above just a single sentence from the the Cochrane review titled Do physical measures such as hand-washing or wearing masks stop or slow down the spread of respiratory viruses?, the review is available online and is easy to read. I encourage those that think they know that masks either work or don't work to read the entire review for themselves.
My attitude pretty much the whole pandemic was 80/20 rule. Everybody seemed to be fighting for the extremes which gave us less optimal results. I didn't see anybody suggesting masking kids indoors especially during deep winter, but then giving them extra time for outdoor play with no restrictions (distancing etc). The transmission outdoors might not be zero but it would be much less, so it would be a much reduced vector. That seems like a good tradeoff for their mental health. Or if not this exactly, something like this. Or what about class outdoors, or open windows and fans instead of masks. I don't recall there even being a discussion like this; granted I'm not a parent.
(caveat: This all assumes masks work and that kids are actually a big vector. I've heard contrary views on both.)
Almost everyone was pretty wrong about COVID, at least at some points in time.
But it's very rare for anyone to admit it.
I'll admit I was wrong, between sanitizing my hands when it was really in the air, to assuming the vaccines would end it.
Lots of mistakes on my end!
This "everybody was wrong" and "whoopsie!" self-absolution is some of the ugliest and most hypocritical parts of the entire Covid phenomenon. No -- plenty of people were ardently against lockdowns, vaccine mandates, and school shutdowns, but all kinds of pundits and self-selected rule enforcers loudly lambasted and insulted them endlessly.
Many, many lives were permanently affected in multiple, very negative ways, with no chance of returning to pre-covid "normal." The resentment and frustration from individual lives being crushed while the entire ordeal seemingly aligned and advanced corporate interests, is only triggered further by the ¯\_(ツ)_/¯ attitude.
I support vaccination and recommend that people follow medical guidelines. But imposing medical procedures on anyone without their informed consent is absolutely immoral. Especially since the COVID-19 vaccines do little or nothing to prevent transmission.
It wasn’t just about preventing transmission - the vaccines dramatically reduced the rate of hospital admissions, which in theory should have allowed the health systems of the world to keep up with fewer infection control restrictions (like lockdowns, masking and social distancing).
I agree that forcing vaccines on people was, at the very least, ethically questionable. OTOH, there was a tremendous amount of misinformation and fear-mongering that would have had an outsized negative effect on the public health response, were vaccines not mandated.
Most "misinformation" was pro-vaccine -- that vaccinated people either could not get sick or could not transmit covid or that natural immunity was inferior to vaccines or altogether irrelevant.
"A vaccinated person gets exposed to the virus, the virus does not infect them, the virus cannot then use that person to go anywhere else, it cannot use a vaccinated person as a host to go get more people." -- Rachel Maddow
"When you get vaccinated, you not only protect your own health and that of the family but also you contribute to the community health ... in other words, you become a dead end to the virus." -- Fauci
"If you have had COVID-19 before, please still get vaccinated" -- Rochelle Walensky
Simultaneously I wish some of the people on your side (or the side you're advocating for here, anyway) didn't spend so much energy insulting those of us who wanted to put in a good faith effort not to exacerbate a community-level problem, and actively tried to provoke our anxiety and anger. Granted, that's probably difficult when you feel you're on the defensive. But I think that defensiveness goes both ways, which may partially explain how your side was mistreated. In principle I wanted your arguments to get a fair hearing, particularly on considering the costs of the measures. What made me most defensive is when there was a valid counterpoint to my own ideas, coming from some of the most vile, sadistic people.
Isn't this more of the same? Now, after the fact, claiming you wish all voices had gotten equal attention? It seems quite apparent that the government + media + corporations collaborated for 2+ years to push one singular narrative and to do as much as possible to reduce or silence anyone who questioned it or attempted to demonstrate that it wasn't entirely true.
To be clear I agree with your previous comment that anybody who now proclaims that they were wrong should either have been opposed to marginalizing your view in the moment, or they owe you a mea culpa. They should recognize that somebody's been out there who had the same conclusion this whole time. Depending on the specific point, I might stop short of saying they were "correct" this whole time because you can get to the same conclusion with different reasoning, and some of the reasoning I heard from your side still seems quite off to me.
As for myself though, you can see from an April 2020 comment that I'm a bit of an anomaly. Even though I felt more aligned with "the other side" I was maybe closer to the middle:
I'm pretty sure I've always, for instance, opposed tech censorship on the subject. Especially during the mid-year riots the way they demonized the anti-lockdown protests by comparison was insane and I recognized it as such then. I could pull up some old tweets if you want.
It’s possible to believe Covid really did kill a lot of people and simultaneously believe that the lockdowns did not prevent enough deaths to be worth their negative effects.
There's some people who are still manage to be newly wrong even today.
For example, asserting that the government was enforcing strict lockdown measures in October 2020, if ever. This is despite obvious evidence that people preferred staying home, such as the still historically low rate of people working from offices.
I wasn't wrong once, from the first videos from China in January 2020. it's been amusing to watch people overthink and moralize and become very rabid over side alley of side alleys of 3 simple facts a high schooler knows: "very contagious respiratory disease bad, vaxx's don't prevent infection or transmission, people like working from home"
It was a hard thing to broach at the time without people frothing at the mouth about how I must be anti vaccine or something:
Has there been any attempt to calculate the cost-benefit of all the various measures and how extreme we should go with them?
I’m guessing it’s hard to quantify and compare. A lot of things like general depression, isolation, kids missing half a year of school, etc. can’t really be evaluated against people dying. And on its surface it seems obvious: uh, people dying is much worse than any of those things.
But if I said that everything we did was to save one life, people probably would generally agree it wasn’t worth it (obviously so: people don’t seem too interested in preventing all kinds of deaths at all costs). What about ten lives? One thousand? Ten thousand? There’s some subjective level where it starts to feel obvious to more and more of us, until a majority of us agree.
But do we have any general sense what that number is? How do we decide how much to care? It might seem ghoulish to decide how many dollars is worth a life, but we do it every day.
With the data we have now, I imagine we can somewhat quantify this given enough sample jurisdictions with different rules? “Masking saves x lives per 1000.” “Closing schools saves y lives per 1000” etc. And perhaps then we’re able to decide “is x lives worth the qualitative harm done?” Probably. “What about y?” Maybe not.
The cost-benefit calculations in terms of excess deaths are irrelevant. It was clear even during the initial outbreak that policymakers primary constraints were the due to uncertainty about the virus and limits on availability of protective gear and ICU beds. Without protective gear there was no way to reduce transmission without isolation and once ICU beds are at capacity mortality rates double and people are dying in the streets and the medical system collapses.
There is no scenarios where the collapse of the medical system is a viable outcome for policymakers that is also compatible with a functioning economy. A collapse of the medical system means non-covid fatalities also increase. Heart attacks, car accidents and childbirth all become mortality contributors. The most likely outcome of a medical system collapse would be martial law, mass graves, economic collapse and potential collapse of essential systems like food distribution.
The idea that policymakers were primarily constrained by the thought of grandpa dying a few years early and weighing it against the grandkids social isolation needs to die.
Initial constraints like ICU bed shortages and gear scarcity definitely had a basis. But those measure lasted long after the bottlenecks got resolved and the risk assessment became clearer. For example, public schools stayed remote while virtually every private school switched to in-person (even California's governor opted for private in-person schooling for their kids).
The public's frustration is that these prolonged, seemingly arbitrary measures outlasted their initial justification.
ICU capacity was a bottleneck that never got resolved. In the US there was never a nationwide effort to mobilize ICU resources to target hot spots other than an initial aborted attempt to gather respirators for the surge in NYC and send a military floating hospital.
Regional programs were put into place to shift patients during a local surge and to mobilize hallways and other non-traditional capacity. In California once capacity dropped below 10% health orders went into effect.
At the beginning of 2023 and well after widespread vaccination the California statewide capacity was at 24% availability with 7% of beds being taken by Covid patients.
The hospital ship was never intended to take covid patients. The idea was the ship would take non-covid cases leaving ICU capacity in hospitals. It turns out that military hospital ships aren’t great for the general population given bulkheads and the general layout of ships.
In Chicago we also spent millions of dollars building extra temporary capacity. It only got something like 38 patients and was quietly dismantled after one month.
Deaths peaked in 2021 but hospitalizations peaked in 2022. Hospitals were at higher capacity in 2022 but treatment protocols had improved reducing mortality rates. Deaths caught the headlines so people missed the surge.
I wonder if suddenly going from masks and sanitizing constantly to immediately stopping (at least in my country) may have contributed to the sudden jump. Also we were encouraged not to visit the hospital unless it was necessary so many opted not to for almost 3 years.
It's not irrelevant, especially considering there were restrictions lasting far longer than "initial uncertainty." It's not like your only choice is to allow for a "collapse" -- as an extreme example, you could decide you're not going to treat covid at hospitals at all (by the way, we make such determinations for other conditions or diseases all the time).
ICU capacity consists of the room, the equipment and the staffing. Once oxygen saturation starts to drop the treatment options are oxygen and eventually intubation and a medically induced coma. There is no realistic scenario where untrained or semi-trained individuals are going to be able to provide that support and even if the staffing shortages could be worked around there wasn’t adequate equipment.
The at home treatment option was to watch the patient drown in their own fluids. There are few people in that scenario that would have the emotional capacity to calmly give support to a close family member or friend when there was no ICU capacity. Their more realistic scenario would be people loading the patient into the car and driving to the nearest hospital. Some percentage of that population will likely turn violent.
> The most likely outcome of a medical system collapse would be martial law, mass graves, economic collapse and potential collapse of essential systems like food distribution.
No it’s not. You are dramatically overestimating how many people need life-saving medical services. If we had no emergency healthcare system at all and everyone who needed to go to the hospital just died instead, yes it would suck and yes we would have lower life expectancy but civilization would largely continue.
Yes, civilization would have largely survived a partial and temporary collapse of the US healthcare system that was a potential outcome from covid.
There were multiple countries where the medical system came close to collapse. India in 2021 is a case study of a medical system pushed beyond its limits (https://www.nytimes.com/2021/06/28/world/asia/india-coronavi...) and civilization largely continued.
But there is a lot of latitude between normal and survived.
Let’s assume that US policymakers considered taking no-action and let the ICUs collapse. Could policymakers in that scenario reasonably expect that teachers would continue to teach? Would the school system function if 20% of school teachers decided to not risk death and opted out?
That answer was easy to get and the answer was that schools would be shutting down.
How many essential workers would opt-out? How many need to drop-out to care for children? How many because they are sick? For how long? How does that impact fuel and food distribution?
Can we expect crowds would gather at hospitals? How many in that case become violent? How do we control crowds? Do we call in the national guard?
I’m not sure I can see any scenario that a policymaker could consider where reducing spread wasn’t the only viable option.
It’s still not as clear cut as patient in and gets bed. There was some tweaking that had to be done to triage patients better then determine who most likely needed a bed. At UF Hospitals, they used discrete event simulation to figure out how to streamline this process. Not sure how many others went through the same thing. Point is, hospitals share some of the blame too
Discrete event simulations is used to get better utilization of a constrained resource. The fact that hospitals were using it just reinforces that ICU capacity was considered a serious constraint by policymakers. Discrete event simulation will give policy makers more confidence in capacity models but doesn’t improve patient outcomes or reduce treatment time.
Hospital protocols also improved over time to reduce the need for respirators and the disease moderated but there was no magic protocol that really reduced disease progression or duration. Out of my social circle there were anti-vaxers that contracted covid late in the pandemic and spent weeks in the hospital (four total, two deaths) even with late stage protocols.
It is not for constrained resources. You might be thinking of linear programming. It deals in constraints to achieve an objective. Discrete event simulation deals in queues.
In this case the queue was wait time for an ICU bed and the simulation allowed them to better model how events (infection, admission, resolution) would impact ICU wait times. This allowed policymakers to better understand the tipping point where ICU wait times went non-linear.
CONCLUSIONS
Treatment with ivermectin did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19. (Funded by FastGrants and the Rainwater Charitable Foundation; TOGETHER ClinicalTrials.gov number, NCT04727424. opens in new tab.)
Your argument is incoherent. You’re saying deaths is an irrelevant metric because actually the risk is the medical system collapses and you get … more deaths.
No, they're saying that excess deaths is a rearward looking metric that nobody had the luxury of actually having at the present time when decisions were being made.
It's very easy to make decisions in retrospect when you have all the information that could be useful. It's very hard to make decisions in the present when that information doesn't exist yet.
>>> What about ten lives? One thousand? Ten thousand?
Are 200,000 lives meaningful enough?
Silver's regression model shows that for each 1% increase in the vote share for the blue candidate, the covid death rate in that state (statistically) would fall by 15.5 per million population.
In areas where the blue candidate received 20% of the vote, and the red candidate received 80%, the model predicts 1,793 deaths per million.
And in areas where blue got 80% and red got 20%, the model predicts 864 deaths per million.
A 300% greater death rate [1] is a startlingly high penalty to pay for an ideology. This is at least 200,000 deaths [2] attributed to political ideology. Not to mention the tremendous excess suffering that did not result in death.
And, no, it's not because red areas are older than blue areas. It's because red ideologues got the vaccine in far lower numbers.
[1] Coefficients show that blue at 0% would have a death rate of 2,103 per million, and blue at 100% would have a death rate of 554 per million.
[2] 2,103 - 554 = 1,549 excess deaths per million for red, multiplied by 45% of the US population is roughly 230,000.
It's because red ideologues got the vaccine in far lower numbers.
Vaccine refusal played a part, certainly, in connection with the fact that conservatives are older. In many instances, a lot older. In other instances, not really that much older. The trend is unidirectional but the degree varies by state, as you'll find when you start comparing West Virginia and Florida to Maine and Vermont.
But the truth is inescapable: the older someone was, the more they needed to get vaccinated and boosted... and the less likely they did.
*The differences in state death rates are very likely because of differences in vaccine uptake*
Just to be clear, I don’t mean to imply that COVID is intrinsically more likely to target Republicans or anything like that. Rather, my claim is that COVID is considerably more deadly in people who haven’t been vaccinated, and since Republicans are less likely to be vaccinated than Democrats, state partisanship serves as a proxy for this.
Indeed, we can look at vaccination directly.
... age and vaccination rates alone explain more than half of the variation in COVID death rates between states since Feb. 2021.
However Silver didn't mention age being strongly correlated (either way) with being vaccinated, which is interesting, given the rest of the article it'd be expected to be stated if it was.
He actually spent a lot of time working around the obvious: that COVID absolutely is intrinsically more likely to target Republicans. Not because of any merits or demerits associated with being a Republican, but because "Republican" is strongly correlated with "old as hell" in many if not most US states, as well as "more likely to reject vaccines."
Right-wing media figures consistently fed their audience a diet of vaccine skepticism, conspiracy theories, and promotion of useless alternative treatments; e.g., https://www.nytimes.com/2021/07/17/us/politics/coronavirus-v... . Because their audience skews older, this messaging had unusually-deadly consequences.
Why there's anything controversial about any of this, I have no clue. How does it make sense for him to write "I don't mean to say that COVID targets Republicans," followed by a paragraph that states exactly why it does?
The whole point of the article is to address that criticism. Thats why he controlled for age. Also, red and blue states had similar death rates before vaccines, despite the virus still being more deadly to older people then.
The point of that statement is, the virus doesn't target someone because they're a Republican, but Republicans have been more likely to die from it because they're more likely to be unvaccinated.
Obviously rearward looking metrics were irrelevant and no one, including me, is suggesting otherwise. You can make policies with the goal of reducing deaths in advance of measurement, and policymakers did.
The argument I am criticizing never mentions rearward metrics as a problem.
My impression was that a segment of the population felt that the lockdowns and other constraints imposed by policymaker were primarily fear based. This may have been due a perceived difference between religious versus secular acceptance of death (a continuation versus end). My point isn’t that policymakers can’t make nuanced decisions about the value of a human life (since it is done on a regular basis) but instead that from a policymakers perspective it was irrelevant. The bigger concern was the collapse of the health care system which is a non-negotiable.
The assumption that friends and family will calmly watch a family member’s untended death from covid when ICUs are over capacity and that essential workers will continue to show up for work knowing there is no hope for care if they fall ill is unrealistic in my opinion.
"Using an event study approach and data from 43 countries and all U.S. states, we measure changes in excess deaths following the implementation of COVID-19 shelter-in-place (SIP) policies. We do not find that countries or U.S. states that implemented SIP policies earlier had lower excess deaths. We do not observe differences in excess deaths before and after the implementation of SIP policies, even when accounting for pre-SIP COVID-19 death rates."
FWiW, because it's a very unique situation globally, W.Australia a state 3x the size of Texas with a population a bit over 2 million people effectively "sheltered in place" by airlocking its borders - international and inter state flights had to quarentine, road transport on the one major transport road to the eastern state was pick up | drop off with out of state drivers quarentined, shipping through the port was non contact with crews quarentined.
W.Australia's COVID-19 vaccine roll-out began 22 February 2021.
The state remained isolated from 24th March 2020 until 3rd March 2022, by which time essentially every person in the state had been double vaccinated.
For the most part people continued life as before, now and again the capital city would have portions "locked down" when there was an active case in order to contain spread and test potential carriers.
The first active case was the 21st February 2020, contained. The first COVID death was 1st Mar 2020.
Active case numbers stayed low until There was no real increase in active cases until February 2022. There was no significant increase in deaths due to COVID until March 2022.
"Shelter in state until vaccinations rolled out" for a state that was already largely independant and isolated worked just fine - the deaths started once the borders opened, but at rates greatly below those seen elsewhere in the world thanks to a vaccination buffering.
As someone that lives in Perth, our experience as a while through COVID was actually a net positive. Not to take away from anyone who lost loved ones, but Perth basically gained the benefits of COVID (WFH shift, better health funding, better remote technologies) and very few of the negatives.
It is an extremely rare situation though, and would not have been possible if it were not the most isolated capital city in the world.
Almost nowhere on earth did "stay at home" actually happen. We all had these so-called mandates, but people (especially in more rural areas) pretty much did whatever the hell they wanted with no repercussions since there was almost zero enforcement. They were out and about, shopping for their khakis at "essential" businesses, eating at the restaurants who refused to closed (also with no consequence) and basically ignoring the mandates. We don't have a valid experiment group because everywhere was the control group.
I presume you are right for where you are, but I don't think your experience was universal. I live in a rural part of Vermont. My impression is that the mandates here were generally well obeyed. No restaurants were open. Grocery shopping was very limited. Public social gatherings did not happen. Whether coincidence or not, we seem to also be one of the areas with relatively low Covid deaths.
Nowhere on earth is a big statement. If you at least qualified it as "country-side" that would have been a bit more understandable (very low density making it pretty much impossible to control), but as others said, no, there are place where "stay at home" actually happen.
I live in Paris, and at the height of "stay at home" mandates, it was a ghost town. I had an actual reason to get out a few times, and let me tell you there were less people outside in broad daylight than there currently is in the middle of the night, which was really eerie.
There was enforcement too, since the police had pretty much nothing else to do there during the full mandates (not the latter weaker ones).
In Canada (and likely elsewhere), there were a number of restrictions which were tied to hospital capacity. As the number of available ICU beds dropped: more restrictions were put in place, and vice versa.
A lot of emphasis was placed on preventable deaths. That is; situations where we’re turning away a patient that we could’ve saved, because we don’t have a bed available for them.
I thought this was a solid, intuitive approach. Preventable deaths are really, really unfortunate.
Yeah that approach really resonated with me as well. A very straightforward concept: how much capacity do we have for higher risk behaviour? And in this case the cut-off for higher risk may be “yeah we’re not going to hockey games for a while.”
For individuals, it may not have been. Thousands of people going along to each game all with relatively low individual risk of contracting COVID.
But if after every hockey game 20 hospital beds get used up, that's as risky for the health system as allowing a restaurant to serve uncooked chicken for an evening.
The confounder for this is that there was a 2 week lag between the hockey game and cases showing up in the emergency room and we basically (outside of China) gave up on doing contact tracing, so nobody knows how people were specifically infected.
I’m making up an example. But the gist is that we have an ordered list of things that apply stress to the healthcare system and we basically move the cut-off up or down that list depending on how our healthcare resourcing is working out.
Do we need to call in military hospital ships? Maybe we do stuff that reduces communication of disease, reduces driving to reduce road accidents, etc.
Where I live it was communicated more than once, “avoid doing riskier things this holiday season because the emergency services you expect to be available may not be.”
Fellow Canadian here - I think the suggestion that restrictions were tied to hospital capacity is a bit off. Restrictions were largely political - driven extensively by polling - and changed frequently with minimal or nonexistent reasoning.
Here in Ontario, the McKinsey-driven "Science Table" frequently referenced hospital capacity in their reports, but their modelling often ended up being off by orders of magnitude.
While I concur that preventable deaths are unfortunate, I don't think there's evidence to suggest that most - all? - of the restrictions put in place had any noticeable impact on preventable deaths from Covid.
If anything, those restrictions very much enabled other deaths - from mental health challenges, isolation, depression, substance abuse, delayed medical screening - that very much were preventable.
While we don't have a full picture yet, it's telling that excess mortality remains heavily elevated even though most of the population has had Covid and been vaccinated.
Most people don't even know how to mentally frame the problem. It's the number of life years lost that matters, not the number of lives, e.g. the death of a child with their whole life before them is worse than the death of an elderly person who's already on deaths door. Current statitics focus solely on number of deaths rather than expected years of life lost so we can't even make a fair assessment of the trade-offs involved in different policies.
> There’s some subjective level where it starts to feel obvious to more and more of us, until a majority of us agree.
I had this same thought during COVID, but like you said, it's not something others want to talk about. COVID was serious, but the American reaction to it was so strange. The whole approach to masking at restaurants has to be one of the most bizzare moments of American history.
It doesn't matter. You can't have these conversations without being censored anymore.
My works HR department got sick of having people use "logic" and "evidence" to argue against their policies. After kicking a few people out the door and generally saying you can't talk about this at work anymore, nobody talks about it.
>use "logic" and "evidence" to argue against their policies.
Many times when folks who tell me they're presenting "logic" and "evidence" in a debate they're personally invested in there's grave flaws in both their logic and evidence presented. The freedom to intellectually debate HR's policies in a company is rightly limited, you can call it "censorship" but endless uninvited earnest debate about policies isn't really wanted or needed in the workplace.
And this is where the resentment came from as well. It was always well understood that HR is not exactly there to help you, but I know I personally snapped at one drone ( and eventually quit ) over those inflexible policies dictated from clouds above.
At the end of the day, you can
always choose not to play.
edit: I dont want to name the policy as it may identify the company. It was a particularly idiotic one though.
People who use “logic” and “evidence” usually tend to do so in a manner so out of context and so obstinately, it tends to negative the validity of their points, at least that is my experience.
I think that's kind of with the benefit of hindsight though. In 2020 we really didn't know if this stuff would kill everyone or just be a nuisance/deadly if you're vulnerable.
We did know by April at least (IIRC basically right after that cruise ship docked). Wikipedia for example [0] had CFR stats broken down by age group showing it was basically a nuisance to people under 50 and only breaking 1% mortality for people over 60 (i.e. it didn't affect children or the working population, so closing schools was known at the time to be a stupid idea. IIRC Fox News were pointing this out at the time), and IIRC at the time the CDC was estimating ~30% asymptomatic cases, so an even lower IFR.
Some governments became drunk with power and ended up implementing authoritarian measures which were pretty obviously useless at actually stopping the virus. Stopping people from wandering the beach alone or sharing a car with their partner, for example.
I am familiar with the case of Spain, but I’m sure in other countries the situation was similar.
This utilitarian reduce-to-numbers approach misses the important matter of the inevitability of death.
In the grand scheme of things, all those who died purely from COVID were going to die anyway.
A more important question is what has happened as a result of societies responses to this pandemic, especially in light of how marginal this virus' lethality was (this was no plague).
It has set precedent that in the case of relatively minor social distress, the government can take unlimited power, and the populace will just knod their heads.
It has also set precedent that the old can parasitize the young even further. Saving a few boomers a few years is worth masking up young school kids, affecting their communicative and social development.
The only silver lining to this has been the resulting explosion of remote work, which of course the boomers are now trying to undo. Fortunately, that's a cat-out-of-the-bag.
It's unfortunate that the boomers didn't learn an important lesson from their parents, who fought WW2 - sometimes dying is the right and proud thing to do.
> Has there been any attempt to calculate the cost-benefit of all the various measures and how extreme we should go with them?
In Australia there is huge pushback politically about holding an inquiry to determine what could be done better, a lot of politicians hid behind faceless "health advice" for their actions that wouldn't last a minute when the public servants involved face an inquiry.
Current estimates of the jobkeeper program put it at $110,000 per job saved, in comparison to the median wage of $52,338. Basically all of it went into the pockets of big companies rather than paid directly to people. That was just one of many programs at the time, debt blew out by hundreds of billions which the populace on both sides strangely cheered on.
You’d have a better argument if you cited the age population bomb where retired seniors are starting outnumber working adults.
Today, most countries are not going to do lockdowns for Covid due to the data. That was temporary for a highly infectious airborne virus that we didn’t know much about at the time, which was overwhelming our hospitals.
Today, no one is closing anything since we know much more about the virus, and it’s becoming less lethal. All people are asking today is for everyone to either regularly vaccinate, wear good masks indoors (no need for this outdoors), or both. That isn’t going to result in either isolation or depression.
I think key investors and patent holders in mRNA technology, which had been until recently waz a significant sunk cost, had made some manner of cost-benefit analysis and were satisfied with the results.
I think it’s a fairly simple equation for most people. “Am I going to be (negatively) affected by this?” And this was obviously true for COVID even from the start.
The controversy occurred when people found out that they were definitely negatively affected by all the lockdown policies when they still hadn’t had COVID.
In the post truth era, the only rights answer is the one that serves one’s geopolitical goals. Don’t like China, look at what zéro Covid did to their economy. Don’t like America, look at all the people who died. Is it even possible to find an acceptable subjective answer when things are polarized?
Stata is fairly ubiquitous in statistical circles, especially those working in econometrics. While I preferred using Stata in academia, it is expensive and R is similar, just not as easy to use.
Agreed. Stata makes common statistical operations easy, and the higher-level licenses are extremely powerful. But I prefer R because it's so much more flexible when trying to perform more complex data manipulations. Plus lots of statistical papers with new techniques include R code.
As noted in other replies, this isn’t the Stata homepage, but rather an academic page about the use of the program. Apologies for the confusion, I chose it because it has images that neatly match what Silver shows.
Although the body of this article is about Covid policies and vaccine usage, which seems to have set off a whole round of discussion here on that topic, my sense was that the point of this article was more general:
> So my aim is generally to focus on stylized facts that are true and robust. And to keep repeating them. I like simple (or simple-seeming) claims that — and I can’t emphasize this last part enough — I expect will hold up to scrutiny.
As somebody who presents results of analyses and models for a living, I couldn’t agree more. Present the simplest possible finding that gets the point across and move on. Maybe mention “and this holds up when accounting for x, y, z”, or just keep those analyses in the backup slides in case you have a feisty audience member. Nobody cares how complex your model is, just that it works.
To be fair, COVID's death rate has such a strong association with (very) old age, that not accounting for it is quite questionable. In the article, Nate mentioned himself that Mormon population is 100x higher in Utah and that's a significant effect. The COVID death rate of over 85 years old is more than 100x higher than the very young.
I'm not questioning the results, just that accounting for age when analyzing COVID is definitely a reasonable question to ask for any conclusion.
This is all fine, but the focus on deaths is sort of missing the larger societal problem. The COVID devastation is also about long COVID, and even people who had COVID but either recovered “fully” or never displayed symptoms. None of this is over, and we are so, so fucked.
edit: Which is to say: The Great Barrington Declaration was wrong directionally as well. We really needed to optimize to eliminate COVID as much as possible to have a hope of a return to normality. Death is not the only issue with COVID. Too fucking late now, but anyone who supported that is a quack and should have been stripped of their license.
> The COVID devastation is also about long COVID, and even people who had COVID but either recovered “fully” or never displayed symptoms. None of this is over, and we are so, so fucked.
SARS-CoV-2 is certainly with us to stay, so in that sense it's not over. But beyond that, I don't see how "we are so, so fucked" as you say. Covid is no doubt taking a small nibble out of life expectency, and yes there is some long Covid still taking its own nibble out of productivity and life satisfaction ... but it's not that big a part of the big picture. Covid is killing less than half as many people in the US at this point as lung cancer, and those deaths are overwhelmingly amongst the elderly. I don't want to be overtly callous, but knocking a few years of life off people well into retirement is hardly going to bring the country to its knees. There are essentially no Covid deaths among people under age 18, and among the working age population, cases requiring hospitalization or leading to long term debilitization are rare.
Those who suffer, of course, suffer. We shouldn't be unsupportive of them in their trials. But Covid as a public health crisis is largely over.
The reason why life expectancy is going down is because middle age people are dying. People dying in their 80s has almost no impact on life expectancy calculations
Isn’t life expectancy an average? If so, then reducing any input values (people dying earlier than they otherwise would) would reduce the average. Doesn’t matter in which n-tile the reductions occur.
Wouldn't a person dying 40 years early have a tenfold impact on the average compared to someone dying 4 years early. Early being compared to the expectancy calculated without them.
Each time you catch COVID, you risk the chance of getting long COVID.
You pretend that it's not a big deal, but those numbers are going to pile up into a giant ball of health issues for a lot of people as the years progress. And for many of them, those issues are happening far outside "old age." Go get something that fucks you up for life in your 30s and then get back to us about how it's no big deal.
I love doom more than the average person, by what I would say is a quite significant margin... but I don't see this at all.
I've had covid at least twice, including some awful symptoms a month after recovery that had me convinced I had long covid as well... a few months later (now years) not so much.
While I do know many people of who have lost loved ones from Covid, I don't know anyone, or know anyone who knows anyone who has any serious "long-covid" symptoms.
To be clear, I'm not doubting that long-covid exists. But I'm very skeptical, based on my own observations, that "we are so, so fucked" and covid of all things is the source of that "fucking". Personally I think a lot of the post-covid strangeness is because, for a variety of other reasons (not the least of which is rapidly progressing climate change), people are under tremendous stress and at the same time can't quite articulate what that stress is, nor find relief from it.
A lot of people (not me) did believe there was going to be a return to normal post-covid, and the increasingly obvious impossibility of this is causing people to have tremendous mental health problems. But long-covid itself being the source is something that I just don't see anywhere.
And, as I said, I'm not afraid of being labeled a "doomer", so if you have some good sources to read up on, I'm all ears (er, eyes).
> I don't know anyone, or know anyone who knows anyone who has any serious "long-covid" symptoms.
You are fortunate. I know several who have those symptoms (ranging in age from my own - mid-30's - to my parents' - early 60's), and have had several friends relate their own observations of loved-ones. If Long Covid isn't real, there's an astonishingly-coincidental prevalence of fatigue and impaired cognition from some other source, which is correlated with those who (from my own observations) took less precautions regarding Covid and/or who caught it more often.
I recognize the irony of responding to your anecdata with my own. No, I don't have any hard data to provide - though given the partisanship observed in the reporting of COVID _itself_, I have somewhat lost faith in the availability of trustworthy data about public health.
I'm not arguing that long covid isn't real (in fact I explicitly state "To be clear, I'm not doubting that long-covid exists"), just that I'm not convinced that we are "we are so, so fucked" (to quote parent).
Your anecdata is appreciated since I share your lost faith in data about public health.
> prevalence of fatigue and impaired cognition from some other source
I personally think anxiety and unspoken stress regarding climate collapse and other forms of society degradation we're experiencing and seeing accelerate are responsible for a good deal of this. Everyone I know certainly seems more tired, more stressed out, and with fuzzier thinking, but I don't think that is a byproduct of long covid. People can't even openly talk about this seriously, even though nearly everyone is clearly feeling it. There are also plenty of people in aggressive denial about this which makes it even harder to discuss.
> I personally think anxiety and unspoken stress regarding climate collapse and other forms of society degradation we're experiencing and seeing accelerate are responsible for a good deal of this.
I don't doubt the symptoms, but I think there's always been a percentage of the population that suffers from these types of symptoms. They get rediagnosed as the latest thing every so often, and the latest one is Long COVID. Even if COVID is a trigger (and really any illness could be), there's probably something else underlying all of these.
> A lot of people (not me) did believe there was going to be a return to normal post-covid, and the increasingly obvious impossibility of this is causing people to have tremendous mental health problems
What is not normal in your opinion at this point? Covid still exists as another illness that goes around, but from my point of view everything else has been back to normal for quite a while.
I think the post you responded to is referring to non-covid stuff, like the economy still seems pretty weird, there are teacher and daycare worker shortages, and just service worker shortages in general, and there seems to be other weird stuff coming out of the era like a ton of shoplifting and a seeming pull-back by police forces.
It's unclear (to me) how real or unusual any of these things are, or whether they were caused by the pandemic or were already baked in somehow, but from an intuitive point of view, I do find myself frequently thinking "why isn't stuff working right?" more often than I think I was four years ago.
I don't know enough to comment on long Covid, but I think an element of it is that for a long time we've denied that sometimes illnesses require substantial recovery time.
I remember reading a lot of old stories as a kid where someone would get the flu or a generic fever and take multiple months to recover. Industrial society made that economically infeasible but our biology didn't change.
I don't think it should be surprising to anyone that having a massive population of a virus in your lungs and elsewhere has long term effects.
In what sense? I'm in a deep red state, and I haven't noticed much "devastation" in my community due to COVID. Seems like you can work yourself up about anything. Doomscroll enough Type 2 diabetes articles and you'll convince yourself that COVID is the absolute least of USA's public health problems compared to the complications resulting from that.
I haven't read the specifics of the GBD, but isn't some of the "it was clearly quackery" confounded by:
1. In 2020 especially, and even now, the specifics of long covid and other side effects, as compared to other downsides of lockdowns on mental health/delayed treatments are hard to predict? We don't have the counterfactual of what would have been the 3-5-10 year implications of a multi-year lockdown.
2. Does the general directionality of that change in a world where it's obvious that global lockdown/elimination of covid wasn't feasible because there isn't some global government to impose it? As long as a large enough population wasn't going along with the elimination strategy, it makes it less viable and more costly for everyone else. If the "2 week lockdown and it all goes away" had happened, then absolutely that would have been right. If all of, say, Europe doesn't lock down and everywhere else does, then how long of a lockdown do you need in order to have it do anything, and at that length, what other major problems emerge?
At least personally, the point I somewhat gave up on elimination was when the first variants started emerging from South Africa and Europe. It seems like that's generally borne out too - I'd be curious what the infection/long covid rates in the more successfully locked down countries like New Zealand or Japan are at this point.
The west did not go for a strategy of elimination through lockdown. Rather, the strategy was to delay the spread, initially only so that the health care system could keep up, and later in the hope that vaccines would arrive in time to curb the brunt of it - as they did.
The GBD is easy to find and a short read (https://gbdeclaration.org/), it does not refer to any elimination strategy - instead it discusses the costs of "Keeping these measures in place until a vaccine is available".
I don't see any quackery in the GBD. (Which is not to say that they were right.)
Yea, for sure. Mostly responding to the OP more than stating what happened. I think we generally agree - for better or worse, most of the world decided on some limited strategy, which made the prospect of doing any sort of elimination essentially impossible. In that light, balancing whatever success at delaying infections vs. the downsides of being even partially locked down is a non-quack question in my mind.
I recall clearly, at the time, the first two weeks of lockdown. No one, anywhere, had a clue wtf was going on, except that some new virus was spreading like wildfire, that it spread before symptoms appeared, and it seemed like Italy had a crazy high death rate.
Blaming people with the knowledge of hindsight is just plain wrong.
Later lockdowns? Now that's a different conversation.
Quebecs lockdowns continued for 2 years and were far more draconian than the rest of North America.
As far as I understand this was mostly a factor of our public hospital systems being absolutely over capacity and the government doing whatever it could to keep up.
Needless to say I’ve since moved away to a region with a more functional health care system and that allows families to gather together as desired.
Yea, by october when the "maybe we shouldn't do a lockdown any more" talk was 6+ months in, it feels like it's clearly in the "there's a case to be made" zone.
I'm not too worried about a random sick deer in the middle of some forest infecting a whole bunch of humans. The worry with animals is that they could mutate the virus into something much more nasty. Especially in factory farm settings where animals aren't properly cared for and are packed in like sardines while covered in shit and open sores, and where workers who are also treated terribly could end up getting exposed.
Lockdowns could do a lot to reduce spread and protect people from infection in large population centers, but certain areas are basically breeding grounds for disease and even before covid they were a risk for things like antibiotic resistant bacteria. Ignoring them was always going to be a problem.
I brought up covid in animals because the original poster mentioned the elimination of covid in the context of lockdowns.
The fact that covid can move between animal and human populations would seem to mean that lockdowns for the purpose of elimination will not work. Eventually humans would be reinfected from animals - mice, rats, pets, etc.
This has perhaps already happened. There is dna evidence that omicron evolved in mice and then jumped back into humans [0].
On the idea of lockdowns to eliminate the virus:
> The coronavirus’ ability to infect so many different animals, and to spread within some of those populations, is worrying news: It means there’s virtually no chance the world will ever be rid of this particularly destructive coronavirus, scientists said [1].
It would be a bummer to be locked down for months or years in an effort to eliminate the virus, and have to deal with the negative repercussions of lockdowns during and afterwards, only for everyone to become reinfected again from animals, and the whole thing start up again.
My apologies if I misunderstood your reply. You did seem to have a different angle than the original post. I just don't get it when people mention lockdowns to eliminate covid, when such a thing isn't possible.
I'm not sure what to say about your concern that animals can evolve a more dangerous virus. That seems like it can go either way. Animal evolved variants can also be less dangerous, like omicron, which is a good thing. Also locked down humans could be more vulnerable to more dangerous variants, their immune systems not having any prior exposure. How can anyone be so sure lockdowns always help?
Eliminating Covid stopped being an option roughly around January 2020. The partial elimination you seem to be implying with "as much as possible" was never an option. It was always all or nothing.
Even NZ gave up on our island defence once Omicron got in. We'd managed to stave off widespread Delta, but Omicron was far more transmissible, but also, far less lethal, and its arrival and spread came just after we started vaccinating.
So by then the cost/benefit analysis made it clear that reopening, while bringing more sickness, would ultimately cost less than not.
The isolation caused some havoc in our economy that we're still recovering from, but large amounts of excess deaths brings its own economic impacts that would likely have been far worse.
Right, and they had the "advantages" of having no limitations on government power, and assigning no value to individual freedom. If they couldn't do it, it's lunacy to believe that anyone else could.
I think the severity of long Covid might be more debilitating as it is my understanding that the long-term consequences of pneumonia is not as long lasting. I've not known of people that have had to change their whole way of life, and possibly their career, because of pneumonia or flu but have met a few that have had to do so as a consequence of long Covid.
My brother has it. Persistently elevated heart rate and breathing issues, to the point that walking up a flight of stairs would leave him winded when he was suffering the worst. I believe he's gotten a bit better since, but not fully recovered.
His resting heart rate is up 20bpm, and it can take 10-15 minutes after exerting himself for it to return to that new normal. He's almost certainly at risk for a stroke due to whatever caused the change, and it left him more susceptible to being sick- he's gotten COVID 3 times despite the vaccines, while the rest of his family has only had it once or twice, on top of the usual flu and colds going around that his kids bring home from school.
Edit: noting the sibling comment, he also had no confounding factors, aside from being slightly overweight. Even our elderly parents have gotten COVID with no lingering symptoms.
It's not the scientific method but if something is very common, and I have several hundred friends, relatives and work colleagues of various backgrounds and states of health then I should have heard of someone experiencing it, no?
I've seen no evidence on this thread that proves it's super-common so apart from funding my own research project, what do you suggest?
Yes. That's how anecdata works. If enough people observe they don't know anyone either with or post long covid, it starts to move significance. I've known two people with ME over 50 years and it doesn't alter my sense of their personal anguish or its economic and wider health consequences.
I have no doubt long covid exists and will need significant funding in research and targeted health care. It won't need as much as, or return as much as the spend on paediatrics or obstetrics, per capita.
I know a few people who are impacted by it. But they all, if I recall correctly, have confounding factors. For example, I know two people with MS where Covid has completely wrecked havoc -- and a year or so later are still largely devastated.
There's also the fact that for a lot of people, COVID isolation meant a precipitous decline in physical and social activity that lasted for years.
We know this stuff can fuck you up pretty bad both mentally and physically. Depressive symptoms and a steep decline in physical fitness is very much the expected outcome from that.
I think it's very possible there ARE occasional life-long consequences of the flu and other such infections that are so normalized we don't even notice.
"Results: Patients with post-COVID syndrome scored lower for emotional stability, equanimity, positive mood, and self-control. Extraversion, emotional stability, and openness correlated negatively with anxiety and depression levels. Conscientiousness correlated negatively with anxiety."
people have been desperate to paint Covid as no worse than the flu from the beginning of the pandemic, and it seems like no amount of time or facts will stop them.
> Covid is now here to stay, ranking somewhere in severity between the common cold, flu or pneumonia.
I know it’s ideologically motivated, but it’s surprising people just bold-faced lie about the impact of COVID, when the stats are there for everyone to see. In the US, COVID is on track to kill ~200K people this year:
The cold and flu will not kill anywhere near this number, pneumonia is a consequence of respiratory illness, not a disease in itself, and before COVID, this would be considered an absolutely insane amount of deaths.
Is that tracking deaths from COVID or deaths with COVID? I have doubts that the numbers are not overstated (by how much, I'm not sure).
Looking at CDC data for excess deaths from Jan through July 2023*, excess deaths have averaged around 1.7%. Deaths reported as being due to COVID are running at 2.7%.
Annualizing and turning the data back to excess deaths, that means of the ~200K people that "COVID is on track to kill", only about 53.4K total excess deaths are expected, projecting from Jan-Jul, or projecting mid-Jan-Jul, excess would be only 31.5K.
Perhaps COVID is saving 146K-169K lives and then killing 200K this year?
* This is to avoid the recent data incompleteness. If I include more recent data records, my argument becomes stronger, not weaker. Setting aside the first two weeks in January, the average drops to 1.0% excess deaths overall.
The death from/with covid distinction is only relevant here if there is a systematic difference in over/under reporting of covid deaths between red and blue states. If it's a constant bias regardless of state, it would not change the conclusion of the article. And it could only change the conclusion of the article directionally if covid deaths in red states are significantly overreported compared to blue states.
Some fraction of us are fucked, but surely not “we” as a whole. The vast majority of people I know have had Covid (many multiple times), and the vast majority are now perfectly fine.
> We really needed to optimize to eliminate COVID as much as possible
This was already impossible by Feb. 2020 when it was spreading like wildfire in China, Iran, and Italy.
> to have a hope of a return to normality.
We have already returned to normality, so reality doesn’t back up your assertion.
You have to stack long COVID against the long term mental health and social effects of lockdown, including but not limited to the atrocious loss of learning in school children, domestic abuse situations that spiraled, and an already alarming teen mental health problem that Jonathan Haidt has been documenting for about a decade.
Lockdowns did make sense initially, especially during the dominance of the Wuhan strain. But some countries like Taiwan and SK with experience dealing with respiratory virus pandemics opened up way sooner, smartly, and did not suffer tremendously for it.
> The COVID devastation is also about long COVID, and even people who had COVID but either recovered “fully” or never displayed symptoms. None of this is over, and we are so, so fucked
You're right by way of the literature available to evaluate this claim. (Even jobs numbers are starting to note that some amount of the worker shortage is likely related to long COVID) Most of the "oh i got it [a few times] and i'm fine" posts are ignoring the long tail risks here.
Unfortunately, it will take 5-20 years for many of the worst long tail consequences of mass spread of sars-cov-2 to become imminently clear. (Enjoy access to your medical specialists while you can! There's not enough slack in the system for doubled-or-worse hazard ratios for most serious conditions, lol!) Decision makers broadly prioritized public dining over prudence. For this choice, we get at least an entire generation picking up sars-cov-2, likely yearly, and our reward will be a horrifying number of early deaths and disability.
This tragedy is so senseless and so avoidable. Zero COVID was and still is the rational strategy; "Let-er-rip" (and the GBD by extension) is anything but rational.
Poz rates in NY state have been sitting near 60ish percent, don't forget your well fitted respirator, usps is doing another round of free test distribution (RATs but better than nothing), and good luck out there. solidarity.
> Zero COVID was and still is the rational strategy
How? The vaccines are mediocre at best and are nowhere near good enough to get R < 1 (except maybe in a population where most people already had COVID, and that’s a big maybe). Masks might be effective enough if everyone wears a good one correctly, but good luck — even if you convinced people, people like eating indoors. And seeing each other’s faces, etc. And the antigen tests are not terrible sensitive.
>This tragedy is so senseless and so avoidable. Zero COVID was and still is the rational strategy
That statement is beyond ridiculous. Zero COVID was a pipe dream (as in: flat out impossible to achieve by any realistically implementable policy) by the time Omicron appeared, which really means: by the time it was spreading in Africa and India.
>This is all fine, but the focus on deaths is sort of missing the larger societal problem. The COVID devastation is also about long COVID, and even people who had COVID but either recovered “fully” or never displayed symptoms.
And to your point, it is about everyone else who couldn't get the care they needed because COVID overwhelmed our infrastructure.
These numbers vindicate the GBD - the change here isn't big enough to justify the society-level responses, coercion or mass human rights violations. We're seeing that the vaccine didn't even bring COVID down to sub-exponential growth. If a 3% risk of death in West Virginia justifies parking up society then a 1% risk of death in Vermont would. Neither does.
If the outcome lands on people who choose to take risks, there is no need for the police to step in.
Most any serious viral infection can potentially cause post-viral syndrome, but there is nothing particularly dangerous about SARS-CoV-2. And there is no realistic possibility of eliminating that virus. There is no sterilizing vaccine. It is now endemic worldwide through humans and multiple animal species. It's time to move on.
The notion of punishing people for exercising their freedom of expression is horrifying. That is unacceptable in a modern liberal society.
Interesting read, but as far as I can tell, this has not been peer-reviewed. At a casual glance, it didn't seem to be a survey or a summary of peer-reviewed research, either.
In other words, if I'm right, this is an opinion piece.
I think we’ve returned to a new, more callous form of reality, where mass injury, illness, and death are normalized, and any real concern for public health or intervention, including that which was considered entirely rational before COVID, is now greeted as impossible or insanity.
Yea, this is one of the sad long term consequences I've taken away from COVID: I used to think that when a crisis happened, we would all pull together and rely on each other to do the right thing and collectively act to help.
Now, I know that when the next crisis happens, half of the country is going to whine and complain, deny, protest, defy, and belligerently do everything in their power to deliberately make it worse. I've totally lost faith in humanity.
I think it very much depends on where you live. Rural America returned to normal a long time ago. Many cities, like San Francisco and Atlanta, have not and are still feeling the effects to varying degrees.
Urban American returned to normal a few months later than Rural America, but we're talking like, April 2022. SF is still suffering from some dynamics that started during COVID but it's not like there are still lockdowns or compulsory masking or anything like that.
I lived in Atlanta for most of my life and commuted downtown daily for over a decade. For unrelated reasons, I moved away in July of 2020 during the lockdown.
I returned this past week for work and the city certainly did not seem back to normal. The areas around Broad Street and the intersection of Baker and Peachtree are usually bustling during lunchtime, it was a ghost town.
If your definition of normal is not lockdowns or mask requires then yes we're back to normal, but in large cities it's a new normal and certainly not a pre-pandemic normal.
The person you're replying to didn't suggest voting for Republicans; that's just something you invented because of the uniquely American habit of assuming politics is a zero-sum game with exactly two players.
I hate the state of our political system so much...
The real fuckery is the system-wide insistence that there's only two sides to every debate and that the line between the two parties defines the terms of the debate.
What has the Republican party done exactly to support OSHA protections or worker benefits? Nothing? Oh so perhaps it isn't about the party but about how our politicians are bought and sold by business interests.
Please stop trying to make something partisan that isn't.
- the neighbouring tribe learned to ride horses and started a campaign for domination
- some strange curse fell upon the land killing ⅓ of the population which left the fields unworked and the land barren
We're still the same species with the same instincts for survival, the same alarm mechanisms for detecting impending catastrophic situations and the same urge to act upon impending disasters. Modern society has - especially since the introduction of antibiotics - largely done away with those traditional doom scenarios. We're no longer starving, no longer dying in droves from infectious diseases, no longer totally at the mercy of nature... but our alarm mechanisms are still in place although they are differently tuned in different people. In some people - you seem to be one of those - these mechanisms are so finely tuned that they pick up minute signals which are amplified until they trigger the 'impending catastrophic situation' alarm (we're so, so fucked) where those same signals do not even register for others. The same is true for other triggers like 'climate change', 'migration', 'systemic ...-ism' and others where some people are completely taken over by their alarms going off where others don't even hear a single bell. Many of these triggers - 'systemic ...-ism' and to a lesser extent 'migration' being prime examples - are intentionally amplified because those who do the amplification stand to gain power (and money) by doing so, others - 'climate change' - are being used by third parties for monetary gain ('greenwashing' and the multitude of 'green' scams like 'carbon offsets'/'carbon credits') or political power.
Are we 'fucked'? That depends on who you ask. Ask me and I'll say "only if we want to be". Is SARS-2 going to be with us for the foreseeable future? Yes, most likely. Is that a big problem? No, not really since it has rapidly mutated to become 'yet another Corona-related upper airway infection' while our species has developed a form of natural immunity which has taken the edge off the disease. Upper airway diseases are annoying and lead to a loss in productivity, sure, but they tend not to mail or kill. What remains is the long tail of the initial pandemic and even more of the (over)reaction to it, especially in those countries which had strict lockdown regimes. Recovering from the damage caused by those measures will take a lot of time and money and it can only be hoped that a lesson will be learned from this experience.
As to returning to 'normality' I can safely state that we have done so quite a while ago here in Sweden [1].
> The outbreak in northern China started in May 1977
Coincidence? Do they have a climate conducive to these sorts of viruses combined with a large enough population to make it likely they get infected first or is this my selection bias in noticing when it says "started in China" versus any other country?
To me on an individual level, it feels like there isn't much unclear about covid if you know how to filter unlikely conspiracy theories and such. In what way do you see politics colouring the generally established information?
I think the funny thing is that Nate can be a flippant twit on Twitter but has totally fallen for it in critiques of him. Essentially this article is “a bunch of people baselessly speculated about an assertion I made, so I’m going to spend lots of time proving something they don’t care about”
"Bunch of people" doesn't seem like a good characterization considering he's at least partially responding to Martin Kulldorff, a professor of medicine and biostatistician at Harvard and a co-author of the GBD.
A biostatistician who told this professional stats guy to go consult a statistician after taking a guess at a confounding variable. He could have run those numbers himself, but apparently didn't bother, because Silver took him up on it and Kulldorff was completely wrong.
It would be less egregious if it has been a bunch of random people. It was someone who really should have known better. Instead, it provides more evidence that Kulldorff is seeking to confirm an ideological position and tossing his medical and biostatistical accomplishments aside to do it.
> Instead, it provides more evidence that Kulldorff is seeking to confirm an ideological position and tossing his medical and biostatistical accomplishments aside to do it.
Nobody is immune to this. It’s just more frustrating when their ideological position is opposed to yours.
Nobody is immune to this. But he really did fail to do an easy test. Someone with his level of experience should have been able to make a challenge that wasn't trivial to refute, and being insulting in the process.
Especially since he happens to be in the thick of a position that is easily accused of being anti science. One would think that makes it doubly incumbent not to make such trivial errors.
As a bystander this seems accurate, but at the end of the article Nate himself states that he has little hope that it will convince people on Twitter/X. It's more about credibility to his own readership, I suppose.
Getting in an argument (vs disagreement) in real life is worthless. Getting into an argument on the Internet has even less value.
Personally I think this was an easy article for him to write because he already had the data and he wants more subscribers (please take this take as neutral opinion and not a dis to Silver)
Yep, always good to keep in mind that the audience for public discussion is not the small number of people you're discussing with, but the large number of people reading the discussion.
That depends on what the goal is. It's worthless if you're trying to convince the other side. But in many cases, you're actually trying to convince the audience, and certainly for something like a blogpost here, I'd argue that it is not only the case, but successful, since at minimum we know it got posted to hackernews and has traction.
FWIW, I think Twitter is a rabid cesspool that will be a big piece in the downfall of humanity, but I didn't really share your assessment. For whatever reason he decided to write this blog post, I thought it was really interesting, insightful, and I appreciated the detail and clarity of thought that went into it (e.g. the analysis at the bottom of the article that showed vaccination rates were the real factor that resulted in differences in death rates, and that partisanship was really just a proxy for that).
So, Twitter folk may not care about what he showed in this post, but FWIW I certainly appreciated it.
Typical narcissist. I'll always think of Nate Silver as the bedraggled man with a mid-range stare on election night 2016. Silver's utility is limited to knowing what the establishment talking points are.
I don't know about other countries but in Austria nurses were highly incentivized to report deaths immediately following a vaccination or weeks after an infection has passed as a covid death in the sense of national statistics.
I would not be surprised if this "nudging" of on the ground reports over the course of the pandemic has rendered the data around covid deaths unreliable.
The death counts from Canada from that era are very questionable.
As early as June of 2020, the "public health" authority in Canada's most-populous city (4th highest population in North America) revealed that the counting of deaths was being done using a methodology that sounds quite dubious:
"Individuals who have died with COVID-19, but not as a result of COVID-19 are included in the case counts for COVID-19 deaths in Toronto."
Attributing what happened in Ontario to the whole of Canada is something that happens way too often.
As a Western Canadian resident, I don't think it's fair or reasonable to extrapolate about all of Canada from a single tweet from a TO health authority, and an article with a disclaimer about it's own accuracy.
There well may be problems, but please keep in mind that while 50% of Canadians live between Montreal and Toronto, 50% of Canadians don't, and many of us live lifestyles that have absolutely nothing to do with that region and it's governance.
The very questionable counting of deaths seems to have been going on in the other more-populated non-Ontario provinces, too.
Alberta was using a dubious death-counting approach, as described in this April 2021 article:
"According to Dr. Deena Hinshaw, any death that has been flagged where COVID-19 is a possible cause is included in the initial count, even if the official cause of death remains unknown."
Quebec's counting of deaths as of May 2022 (and apparently before that) was also dubious:
"Quebec’s interim public health director, Dr. Luc Boileau, has acknowledged that the province has seen a “huge” number of deaths linked to COVID-19. Quebec’s high death toll, he said last Thursday, is explained by the fact the province counts a COVID-19 death as any death involving someone who has the disease.
He said a government study from January indicated that around 30 per cent of the official COVID-19 deaths in the province’s hospitals involved people who tested positive for COVID-19 but whose principle cause of death was not the disease. He said about 40 per cent to 50 per cent of official COVID-19 deaths in the province involve people who had the disease but who died of other causes."
What is the standard way of “counting deaths” for a disease that can be co-morbid?
Does the method chosen differ from other countries and diseases?
Strictly speaking, no one does of HIV virus, they die of opportunistic infections made possible by AIDS.
For COVID, the disease can kill you, as well as make it easier for other things to kill you. If you die of a heart attack while COVID positive, on a ventilator, with super low blood O2 readings, did you die of a heart attack, or did you die of COVID? Is there any reason why your death must be limited to a single disease for statistical purposes?
You say that counting COVID deaths this way is dubious, but is it out of line with regular epidemiological practice?
I don't have reference from the top of my head, but I seem to remember that the UK also started with the same counting methodology, then fixed it a few months into COVID. If my memory serves, the difference between the curves was pretty negligible.
In the US, deaths within 28 days of a positive covid test were counted as a covid death, unless they were vaccinated, in which case they also had to be sick (IIRC). So our data about how many lives vaccination saved is really corrupt, the unvaccinated count higher than it should be.
On top of that there was also monetary incentive for hospitals to add covid as a cause of death for anyone who died.
I’m not offering a source, but I’ve seen those claims made repeatedly, with no real rebuttal.
At this stage, I’m willing to take the claims at face value.
Even if the letter of the guidance was honest and impartial, I’m absolutely certain second order effects would come to bear.
If I recall right, there was even an attempt to have /all/ deaths during lockdown attributed to COVID on the misguided assumption that the only possible response was tight lockdown, and so any collateral was attributable to the cause of that lockdown, i.e., COVID. (Lots of groupthink there…) So even though we didn’t get that written into the guidance, I’m sure there would have been a strong bias to being very conservative when attributing cause to anything other than COVID.
Point is that I don’t think we even need to go as far as malicious intent to render the figures highly questionable. But then if you want to also layer nefariousness on top, the numbers become almost unbearably meaningless.
So take excess mortality. Surprise, nothing changes. Did you read the article, the part where it mentions all the little things people try and bring up on the path to confirmation bias?
Blah blah blah 'I mostly agree with ... an October 2020 anti-lockdown statement signed by a large number of scientists and medical professionals. “Those who are not vulnerable should immediately be allowed to resume life as normal”' blah blah.
I don't have any regrets about the position I took, since it seemed to be based on all the verified information we had at the time. YET, I hope our society will embrace the fact that we were largely wrong to prolong the lockdown measures. Humility doesn't hurt the Left either.