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Comment by kqr | Hacker News Reader

One thing is missing from this discussion that needs to be understood: the Swedish government and related agencies generally do not do things based on common sense.

This may sound ridiculous, but in most cases, it's not. Common sense is wrong so often. The view of the Swedish government is that they are not more intelligent than the citizens. Unless things can be scientifically proved, the individual rights of citizens should not be restricted.

This permeates a lot of public policy in Sweden; I recently had reason to investigate to what extent maternal/neonatal care followed the best of our scientific knowledge and it was extremely close. If you think that's a given, think again. Many countries base their maternal/neonatal care on common sense and old wives' tales instead.

Both approaches are valid, but they are different. With policy based on common sense, you accept that you occasionally (often?) force something wrong on the public, potentially against their better knowledge. With policy based on strong evidence, you are more rarely wrong, but you also get way fewer opportunities to force things on the public, simply because there are so few things we truly know to be true. Doubly so during a novel pandemic.

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That's an attractive thought, but I'm less than convinced it's true. For example, I doubt there's much scientific evidence behind Sweden's zero-tolerance drug policy that literally equates heroin with cannabis [1], or their policy of criminalizing all sex work [2], with the admittedly unusual twist of making buying, not selling, illegal.

[1] https://en.wikipedia.org/wiki/Drug_policy_of_Sweden

[2] https://en.wikipedia.org/wiki/Prostitution_in_Sweden#Current...

> with the admittedly unusual twist of making buying, not selling, illegal.

The twist is probably based on the supposition that for selling to be illegal would mean endangering the the lives of sex workers, who (I assume, as the reasoning goes) are likely to be financially vulnerable. When selling is illegal, there is more risk for the person rendering the services.

When buying is illegal, it still imposes risks on sex workers. First, it hurts their income, meaning fewer sex workers are available, meaning it’s more likely victims will be coerced. Those who participate willingly can be put at risk from their customers when those customers are prosecuted.

A concern for the lives or welfare of sex workers may be among the points used to sell the Nordic model but based on the Norwegian experience they don’t actually care about them.

https://www.amnesty.org/en/latest/news/2016/05/amnesty-inter...

> “If a customer is bad you need to manage it yourself to the end. You only call the police if you think you are going to die. If you call the police, you lose everything.”

> --Sex worker in Norway

> Amnesty International heard how some sex workers who have reported violence to the police in Norway have been evicted from their homes or deported as a result of engaging with the police.

> Under Norway’s laws, sex workers are at risk of forced evictions as their landlords can be prosecuted for renting property to them if they sell sex there.

> A representative of a Norwegian sex workers’ rights organization explained: “If landlords don’t evict, the police will launch a criminal case against them...The police are encouraging landlords to take the law into their own hands and enforce it themselves.”

> People who do sex work are also unable to work together for safety, or hire third party support like security, as this would likely qualify as ‘promotion of prostitution’ under the law.

Just because a legal system places two different things in the same category doesn't mean they're saying they are equal.

For instance, in many states, it is both a felony to steal something worth $300 and commit murder. No one on the planet would say they are equal. In the same way, I doubt there are any legislators in Sweden who say that cannibis and heroin are scientifically equal. They're just classified the same for legal purposes.

But unless I'm reading this wrong, the penalties are equal for dealing either drug.

That doesn't match your analogy, where the two crimes - while both classified as felonies - have radically sentencing guidelines.

You're not reading it wrong, however what they're saying is incorrect.

>For instance, in many states, it is both a felony to steal something worth $300 and commit murder. No one on the planet would say they are equal.

Nobody is. It's like saying stealing and murder shouldn't both be considered crimes because they're so different. Felonies are just crimes that are considered more serious than lower crimes (misdemeanors)--there are loads of grade and classifications within that spectrum. Felonies tied to monetary values are generally written when $X monetary value is a large amount. $300 could've easily been a full month's rent a few decades back, so it was written as a serious offense.

The problem is the law is incredibly slow to update with the times.

As far as scheduling goes that basically mirrors the US and UN. Those categories aren't "levels of danger", but whether something has accepted medical use.

That will always vary country to country - in the UK diacetylmorphine is medicine, despite being highest schedule. And poppy straw is class A just as fentanyl. Does that make it correct to say they are "literally equated"? That's absurd.

(Not saying there aren't very dumb things about the national anti-harm reduction approach, but the scheduling isn't exactly unique internationally, nor really an aspect of what makes the system a massive mess).

Sex work is not criminalized, as you yourself point out.

There are exceptions to that general approach, of course. Even Swedish politicians need to be elected by popular vote, and this requires some amount of people-pleasing, along with the terrible consequences of that.

You need more than scientific knowledge in order to make policy, you also need a quality metric against which to measure the desirability of outcomes. Science can tell you what is likely to happen if you pursue a certain policy, but it cannot tell you if that outcome is good or bad, or more to the point, whether the tradeoffs inherent in any complex policy decisions are worthwhile.

There is a dark side to this. Scientific consensus follows certain rituals and heuristics. Even if you can assume that the scientific consensus is the closest to truth you can get (this is debatable), the approach will fail in some situations.

In particular, in war-like situations where there is little published science, data is scarce, data changes fast and there are policy considerations to be made across a multitude of disparate fields - fields that can not all be quickly evaluated with the scientific method.

IMHO, as I've been saying throughout this crisis, many institutions that do well in peace-time are in a terribly dangerous situation when they follow their normal heuristics and routines today. Strong top leadership (political or otherwise) can mitigate this danger.

Yet most strong top leaders I can name have (a) gained power during some sort of crisis, and (b) turned out to be on the wrong side of history.

Given that Scientific consensus has limitations, what do you propose is better in situations where data is scarce?

How does a strong leader mitigate this danger? Is the leader making choices by following their intuition? Does the leader make choices based on public sentiment?

One possible mechanism by which strong leadership could be more effective is that inaction and uncoordinated action can be less effective than any coordinated decision, regardless of whether that decision happened to be optimal.

I don't know how often this happens in a pandemic or in a political setting, but as an example from software engineering bikeshedding seems somewhat common -- it probably doesn't matter whether curly braces get a new line, but there's probably a benefit to only doing it one way in a codebase. Not that strong leadership is the only path to resolution either, even accepting that some cohesive decision needs to be made, but it does solve that class of problems.

Strong leadership and science are orthogonal dimensions. You can have strong leadership that makes decisions based on evidence and scientific arguments, or not. I would argue the first is always better than the second.

Again in the current crisis the decisions based on scientific evidence (pandemic models developed previously) was to act early and quickly with lots of testing. Most countries did not follow this, but I would say this had nothing to do with what the "scientific approach" was.

Somehow people here conflate scientific with need to wait/establish all information.

However in the end science is a method to establish truth/knowledge about the world around us. It can guide our decisions, but it's not a decision making method.

Let me clarify. You can follow a scientific approach, and you can follow Science the ritual. When uncertainty goes up and time is of the essence, the latter is to a large degree subjected to the limitations and blind spots I highlighted. The former might not, if you adapt it to the current limitations.

I am a scientist, by the way.

What I mean by strong leadership is an intelligent leader that can quickly review evidence from multiple disparate fields and experts (scientists among them) and choose a good approach that takes all available constraints and uncertainties into account. The way a skilled military commander would do.

In particular, such a leader does not focus exclusively on a single metric or concern, unless this is warranted by the situation. But that would be an exceptional circumstance in an exceptional situation.

You may think that the focus on reducing death rates is focusing on a single metric to the exclusion of everything else, but this is not the case. There are plenty of exceptions to this rule being made in every country with a lockdown. Critical infrastructure, economics, mental health, healthcare that's unrelated to Covid19 and so on.

> the approach will fail in some situations.

Well... yes. Everything does. Treating this as a non-starter could be used in literally anything.

> In particular, in war-like situations where there is little published science, data is scarce,

This is actually probably one of the most well researched fields in existence. I'm a little confused about this statement. What do you think they do at places like Annapolis?

I presume marvin is talking about a particular war when in progress, not the phenomenon of war in general.

One interpretation of that as a strategy is "in a crisis with imperfect information we should centralise all power to popular people".

If someone working to evidence (ie, science) can't make good decisions how on earth will strong leadership help? We've seen crisises that led to actual war time situations (pretty much all the wars in the Middle East, particularly when recently the 'strong leadership' in the US when they speculated wrongly that Saddam Hussein had WMDs) where with benefit of hindsight the entire planet would probably have been better off with weaker leaders, more evidence and people just sticking to their normal routines.

Centralising power without a proven strategy is going to lead to more misses than hits. Even now, we don't know what the endgame here is. The lockdowns could still conceivably be failures if they turn out to have delayed all the deaths by 12 months instead of preventing them. We don't know. It is too early to say what did or didn't work.

>evidence (ie, science)

An abrupt leap.

I would move away from a passing vehicle without peer-reviewing its existence. If international and inter-city travel had been shut down in early February some nations would have remained fully functional today. Not to say I agree with current quarantines, but you have to admit there are thresholds for action.

I'd like to know your stance on climate change, btw.

Science generalizes into engineering etc, so not everything needs to be peer reviewed.

Without the germ model of disease aka science, we would be thinking about Coronavirus very differently. Thousands of years of human history and massive epidemics show how bad following common wisdom based on incorrect models can be.

>>evidence (ie, science)

>An abrupt leap.

Not at all, it seems more that you have a wrong conception what science means. Science is all about evidence, the scientific method is to make observations, then inductive hypotheses that are then tested. All this relies on using evidence. Peer review is one process how evidence can be evaluated, but definitely not the only one. Science is much older than peer review.

We agree on what science means, and my point stands. Swift decisions needed to be made in February.

cycomanic says it better than I; science is not much more than the systematic creation and review of evidence. It isn't easy but it isn't usually very exciting. There would be a scientific consensus that you should get out of the way of a passing vehicle without any need for peer review.

> I'd like to know your stance on climate change, btw.

* Never seen an explanation that convinced me I, my descendants or anyone I know could be at risk from climate change. Particularly after calibrating expectations on the huge amount of background risk over 100 years. Climate change is less threatening than other alternatives over the century (eg, WWIII US/China for economic reasons, peak oil/returning to a pre-fossil-fuel standard of living, maybe it turns out some sort of 1:100 year solar storm takes out the communications grid, plain overpopulation).

* Society could have gone nuclear at any point from around 1970 and solved the coal part of the fossil fuel problem. I've never seen a push for that in a climate demonstration. I don't think the activists are serious about solving problems; they are more interested in making people respect their opinions. It doesn't look to me like they really perceive a threat - they havn't seen anything that scares them enough to try working with their opponents to find compromise solutions. Fukushima vs. the more far out predictions on the climate front are not even remotely comparable levels of risk.

* We're much more likely to be able to solve problems if we embrace cheap energy than trying to preemptively guess at and mitigate uncertain threats.

I just mentioned peer-review as an absurd example. I never equated it to science in general, and it amazes me that it comes across that way. I still stand by my saying that equating evidence to science is an abrupt leap.

Strong leadership "can" mitigate this danger. An interesting question is how likely it is that it'll mitigate it rather than exacerbate the problems. I suspect the type of strong leaders humans usually elect are not the ones that will maximize the chances of mitigating.

I'm unsure what you mean about strong leadership and also why you believe scientific approach means to strife for scientific consensus.

However regarding strong leadership I think the current crisis shows that the autocratic states are typically do worse, look at Russia for example, or even China if they would have reacted better early on we would not have this crisis.

However, dealing with the novel corona virus isn't necessarily a scientific problem, but more of an engineering problem (as opposed to a problem to be solved with common sense).

Science tries to remove inprecise assumptions. Engineering accepts inprecise assumptions and works around them, e.g. building in a safety factor; using masks when there is some evidence they lower R0.

> If you think that's a given, think again. Many countries base their maternal/neonatal care on common sense and old wives' tales instead.

Not a general attack on what you write, just a warning against taking this too far.

As both a father of small children, and as someone born in the early eighties I recently found reason to take a closer look at SIDS which peaked around here around the time when I was born:

Turns out it was explained by doctors and nurses telling people to let their infants sleep upside down instead of on their backs which is what has always been done. And they had good reasons for what they did as well, at least thats what they said:

- sleeping upside down was supposed to strengthen the kids neck and improve early development

- another argument was that it would protect them from being choked if they vomited

Once people went back to allowing their kids to sleep on their backs, SIDS almost vanished over night.

Turns out Chestertons fence is there for a reason.

Same goes for a number of other BS ideas that doctors has pushed even around here like the idea that mothers should use wipe their breasts with antibac before allowing infants to drink milk.

I wonder what the long-term effects of the "put them to sleep on their back" advice will be, though.

Our son hated (and continues to hate) sleeping on his back. We put him down that way because that's what medical advice recommends today, and if he died of SIDS because we didn't we'd feel terrible. But as soon as he learned to roll over, the first thing he did was start sleeping with his butt up in the air. I'm told this is very common, and most infants don't like to sleep on their back, and will avoid it if possible.

Are we going to find out in 20 years that we've raised a generation of kids with lower cognitive abilities and poorer emotional control because they didn't sleep well when they were newborns? That they have asthma and sinus problems from mucus dripping down their throat while asleep? That there's some other unknown risk factor we're not accounting for? That's certainly the case with a lot of common parenting wisdom from the 80s.

Oftentimes both sides of Chesterton's fence suck, but they suck for different reasons. And humans have a bias toward fixing problems they see, not being grateful for problems that were silently averted. That's why we perpetually tear down fences and generate new stocks of problems.

"Turns out Chestertons fence is there for a reason."

The bummer is when there's no followup research to validate the new policies.

For example, Atul Gawanda attributes some of the reasonability for the opioid epidemic to updated standards of care for managing pain but then those advocates failing to do any followup studies to assess the outcomes.

[Am Swedish and not a fan of the current policy]

This evidence-driven decision making process (which is indeed the default here) works remarkably well when things are moving slowly. It kills bullshit beautifully. This is normally something I'm quite proud about.

However, it breaks down so badly when you're suddenly facing a one in a hundred years pandemic and you can't act decisively 3-4 months into the pandemic because there's no evidence yet.

Sweden is "peace-damaged". We haven't really had to deal with any national-level crises the since the spanish flu about 100 years ago. The last war was in 1814. 500 soldiers died.

Note that the above mostly applies to national governance - this is the stuff that really gets set into code and culture over time.

At a local e.g. hospital/research unit/private company level, there's fantastic innovation happening on a daily basis, just as in the rest of the world.

This whole thing is kind of like driving a car, except that when you turn the steering wheel, nothing happens, and then two weeks later the wheels start to turn.

They admit thus in the article, when they say there’s no point closing the schools. The time when doing that would have made a difference was a month ago and they didn’t do it, so the damage was done.

> it breaks down when you're suddenly facing a one in a hundred years pandemic

What if you're not actually facing such a thing and you only think you are because the initial non-scientific estimates from government "scientists" are 2 orders of magnitude off the mark, just like the last few times? https://mobile.twitter.com/amasad/status/1252824592453742598...

Most countries are seeing excess mortality compared to previous years, much larger than could be explained by a bad flu year, which means that covid-19 is absolutely a real threat, we haven't seen anything like this in a hundred years, and countries should absolutely take measures to protect the population.

The peak mortality in the UK from this might still beat the 1989 flu epidemic, and it'd probably have done so already if it wasn't for all the lockdowns, but it hasn't officially achieved even that much yet. And our lockdown was relatively late and lax compared to a lot of other countries, so much so that it's probably still a little early to see much effect on the total mortality figures.

(If you're wondering "what 1989 flu epidemic", it probably wasn't well known outside or even inside the UK except amongst people who lived through it.)

I agree.

The 1957 Asian Flu pandemic is widely considered to be the worst pandemic since the 1918 Spanish Flu pandemic. Most figures I see for UK deaths from the Asian Flu in 1957 range from 3500 (for just England and Wales) to 30,000 (which looks at just excess death in the entire UK).

Most estimates I see for 1989 flu epidemic in the UK are around 30,000.

COVID-19 death toll in the UK will almost certainly exceed the both of those death tolls. You're at 18,000 already, and you're likely not even at the peak of the curve yet. And almost certainly, we'll see a second wave come late fall and winter (sadly).

> Most countries are seeing excess mortality compared to previous years

Incorrect.

Some countries are, or more accurately, a few countries.

Sorry, yes you are technically correct. What I meant is that most countries seeing significant numbers of people infected with coronavirus are also seeing excess mortality.

Can you point to some sources?

https://www.nytimes.com/interactive/2020/04/21/world/coronav...

https://euromomo.eu/

New York’s hospitals being overwhelmed, and a massive spike in excess mortality in the city isn’t an estimate. Those are real people sick and dying right now. The same with Spain and northern Italy.

Those regions got hit hard too soon for lockdowns to prevent disaster. Fortunately those disasters gave us a wake up call to lock down early enough elsewhere. If we hadn’t it’s pretty clear every city or region would eventually look like them.

Have you read the Ferguson paper? From the re-tweet you posted, I doubt it. The 1.2 million figure was the absolute highest estimate in the whole paper, and was mentioned off-hand as a worst case scenario if no preventive measures were taken.

In fact, if you read his paper and look at his estimated deaths under various different interventions and time period, and the current death toll, he actually may have underestimated the death toll.

Here, read the paper: https://www.imperial.ac.uk/media/imperial-college/medicine/s...

> Sweden is "peace-damaged". The last sort of national crisis we had besides the spanish flu was the Swedish–Norwegian War of 1814.

The second World War was definitely a national crisis. Huge military mobilisation, disruption to the iron and shipping industries including thousands of sailors dead, rationing, accidental bombings...even though Sweden was neutral that was a far bigger deal for her than the coronavirus has been.

Besides the deaths of those sailors it was a big meh.

[Am living in Sweden but not Swedish] I disagree with you that this is about a "slow evidence based decision process" (paraphrasing). That is actually the most infuriating about the policy. I have encountered this quite often here, it's a "we know better than everyone else" attitude.

The thing is the story they give is "we are evidence based, rational...,have the best methods", but completely ignore scientific evidence from outside Sweden. Example 1.: asymptomatic spread, despite several countries having evidence to the contrary the story here is, it's not important (in fact they slightly changed the tune is used to be negligible or nonexistent) Example 2: the chief epidemiologist has repeatedly said he "believes" the spread will go done in summer, without significant evidence. Example 3: sometimes the statements even contradict themselves. Example masks, the story (and there is actually a lot of propaganda around this) is still they don't help, because non95 masks are not completely closed. On the other hand the recommendation from the public health agency, (same who gives advice about the masks) for health workers treating covid19 patients is either goggles +mask (often there are no Googles) or visor without mask. How can a surgical mask which is not 100% tight not help, but at the same time a visor which is open to the sides is sufficient.

It's not really true vs false, it's a matter of deciding what level of evidence is convincing. One point is that we already know the approximate effectiveness of social distancing from many 1918 data points and its epidemic with similar contagiousness. Some places in 1918 did it and some did not, like San Francisco vs Philadelphia where the difference was stark.

Maybe the effect will be less this time for some inexplicable reason but I would not want to run the experiment in my country.

So no requirement for parachutes in planes, then? They’ve never been proven in a double blind study.

They don't block 100% of the air, so they can't possibly be effective.

Proven in a double blind study is not the only method of proof. You can also use model organisms. So you throw goats out of airplanes with and without automatically opening parachute ave see what happens. Or you can have an extremely good grasp on the mechanism of action of what you’re doing. Somewhere on Earth today a complicated piece of machinery is being fabricated and assembled that has never existed before and is going to be 90% as good as the final production version.

Multiple methods of proof of varying reliabilities exist.

Epidemics are something for which the mechanism of action is fairly well understood. The exact response of R to various measures is not known beforehand, but we can make decent guesses about what will reduce transmission.

The details of the epidemic matter, though. For example, closing schools is a fairly obvious intervention in flu epidemics - kids are really likely to get it and bring it home to their families, especially since they don't have the immunity that some adults might. It may actually be completely useless in this epidemic. Whilst kids can be infected, they generally seem to have very mild cases and there's some evidence they're no good at passing the infection on to others.

> there's some evidence they're no good at passing the infection on to others

May I ask: What evidence of this did you find convincing?

From my own digging it seemed like this was a claim from China, which merely indicated that it was rare that, in a family, the child got it first and gave it others.

However, when the epidemic really started taking off, it was the middle of CNY and kids weren't in school, which could completely account for why they didn't observe child->adult transmission.

I'd love to be wrong about this, though.

The China evidence was fairly compelling (they did contact tracing and were unable to find a single case where the child was the transmitter).

Schools didn't close in Australia (although many parents kept their children at home). There have been zero cases traced to child transmission, even in a few cases where a teacher or worker at a school got it from another place and brought it to school and those individual schools had to be closed.

There was a single cluster based around a school in Sydney but it was found to be parent-to-parent transmission.

Singapore didn't close schools during their early phase (until 2 weeks ago) and contact traced every single case. Zero were attributable to child-to-child contact.

It's possible this is all luck though.

Schools in Australia are closed now, not reopening since Easter break.

Kinders (preschool child daycare centers) remain open, and are now free - 100% paid for by the government.

It's the school holidays in many states (I'm Australian).

All schools will open for term 2, with Victoria and the ACT saying parents should prefer to keep children at home when possible while the other states are advising there will be more face-to-face[1].

[1] https://www.theguardian.com/australia-news/2020/apr/13/are-s...

In Vic children are held home, except for those of essential workers and if vulnerable; school started last week. Source: I'm managing son in grade 4. They just started using Cisco WebEx to connect with AV.

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4...

Here's an article from a microbiologist here in NZ who's been one of the public faces of decoding the current scientific understanding of COVID for the general population: https://thespinoff.co.nz/society/23-04-2020/siouxsie-wiles-w...

I keep coming back to since we don't know the details very well right now and risk of catastrophe is high then executing the laundry list of interventions is the most prudent option until we have better data.

Maybe we figure out that children and teenagers basically don't get it or spread it. Then we can guardedly reopen schools. But not before we aren't certain it isn't going to blow up in our faces.

Unemployment directly leads to suicide over the long run, and that’s not even mentioning the extra suicide and overdose-related deaths from the unique conditions of isolation and constant fear mongering we are all collectively being exposed to.

It’s not clear that our interventions are going to help, given that the economic damage is going to introduce mortality (dud to the aforementioned suicide/overdose) in individuals who never would have been harmed by covid.

Meanwhile, it’s still a reality that majority of the globe will be exposed to this, so the lockdown is not avoiding death but instead just _postponing_ it. We need to hunker down insofar as we are close to exceeding medical capacity, but when we are not on the brink of medical collapse we need to be opening up.

Unfortunately the public policy has been built around irrational fear rather than “straight talk”. Thus why people are scared shitless that their teenage children, or elementary school children, will did if they return to school (rather than merely being a vector to infect their parents).

I’m on mobile but I have citations for the link between unemployment vs suicide that I’ll try to edit and stick in here in an hour or so. Last thing is that people should understand that the serological data, while not entirely reliable, is indicating from multiple sources that true IFR is .2-.8%, and furthermore that relative risk varies massively as a function of age/obesity/etc. So this seems to be one of the worst diseases to be practicing national lockdown for. (Avoiding hospital overrun was a great goal but the goalposts have now moved over time).

Also the IMHE model is so laughably bad that I actually am shocked that the authors are considered “experts”. It predicts 0 deaths after some point in June (I forget the day, I think june 6) because it naively assumed a .3 R_0 based off of the wuhan data, which they apparently assumed would hold for the US. In other words my understanding is the model is pretending that we’re going to contain covid. And they actually were crazy enough to lower the estimated deaths to 60,000 which we can already see is ridiculous.

I really wish I was in Sweden right now...

I forgot you can't edit comments on HN later.

Here's a study linking unemployment and suicide: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1732539/pdf/v05...

Note that they call it "causal" but it's still using statistical magic, but I think the idea that unemployment leads to suicide is one of those that seems like a sane default assumption, so as much as I distrust these kinds of analyses in general, I think it's relevant here.

I have question. If you don't care about one out of 20 of your friends, family and neighbors drying, people you know. Why do you pretend to care about some out of work schmuck you don't know offing himself?

Seems like your argument is trying to abuse the fact that I care.

Where are you getting that 5% mortality rate? That is an order of magnitude higher than what the data currently indicates, and is exactly what I meant about widespread fear mongering.

BTW the rhetorical technique you are using seems to basically be concern trolling. It’s the debate equivalent of a thought terminating cliche. It will never lead to a useful discussion.

Because 5% morality is what you get when the healthcare system breaks down. Which would be a direct result of letting the pandemic rip.

It's easy, take the 0.7-1% measured fatality rate. Double that to account for under counting. Then triple it to account for complete breakdown of the healthcare system

There 5%.

Advice: None of this is hard to sort out and you are flailing at it.

Your 0.7-1% fatality rate is not in line with current figures, which peg it closer to 0.35%. I've been rounding up to 0.5% for the US to account for the poor state of health here.

The rest of your napkin math is completely absurd and is just you progressively multiplying an arbitrary number until you magically hit that 5% number that you started out with. Funny how that works.

You should understand that even the 5% mortality when hospitals are overran is likely to be a huge overestimate for the same reason that we have been overestimated CFR all along. The vast majority of cases are not a big deal and don't need medical care whatsoever. But particularly for those over 70, you get covid and you have like a 1/8 chance of dying. It's that population that does get crushed when hospitals are overwhelmed, but when you run the hospitalization numbers, it's not clear that we would overrun the hospitals.

Which is a moot point btw since my actual position is end the lockdown but reinstate policies briefly if we are at the edge of the precipice.

Looking at https://old.reddit.com/r/COVID19/comments/g4tqvk/dutch_antib... you can see that for every 500 20-29 year olds who get infected, we have one hospitalization. Even 60 year olds only have a 3.4% hospitalization rate, which while high does not support your assertion without a much, much more rigorous analysis.

Thanks for the discussion. I'll keep following along.

>Your 0.7-1% fatality rate is not in line with current figures, which peg it closer to 0.35%. I've been rounding up to 0.5% for the US to account for the poor state of health here.

My 0.7-1% fatality rate? What you talking about my? I'm not pulling that out of my keister.

From here.

https://twitter.com/Bob_Wachter/status/1253538428114870277

>11/ Why? 142K confirmed NYC cases, so 21% of city (8.4M) -> 1.76M, or 12.5x confirmed case count, more in sync with other studies. If right, then true mortality rate (~15K deaths in NYC) about 0.8%, which also seems credible. There’ll be lots more of these serology studies soon.

Since you don't know who Robert Watcher is

https://profiles.ucsf.edu/robert.wachter

So your argument is that suicide rates might be higher in the future because of unemployment and that those deaths might outweigh the deaths from COVID19. Now this might be true, however the reduction in traffic deaths will outweigh them both. Just to show that number of deaths by itself is a poor measure.

These interventions aren't harm-free, though, even putting aside the obvious effect on children's education. Nurses, doctors and other key workers have children and shutting down all the schools is going to be very disruptive to them. A surprising number of countries rely on schools to make sure some children are actually fed. There's also the problem of policing what those children do when they're out of school. And on a darker note, schools are a very important early warning system for domestic violence and abuse against kids, and there are some frankly very worrying claims that murders of kids have spiked dramatically in at least some parts of the US. It's likely that there are children who are dead now that wouldn't be if countries hadn't taken the "prudent option" of imposing a probably-ineffective intervention, quite possibly a substantial number.

It's important to try to better understand the effect of various measures on R. In the present situation in the US and Europe, though, what matters most is quickly reducing R. There will be time for more experimentation with different measures (e.g., different regions trying slightly different interventions) later, but right now, plausibility is the best guide.

Well, yes. But there's not enough time right now to do that goat study, and that's what we're advocating if we want to follow science to the exclusion of common sense.

There’s both inductive and deductive reasoning. A fact can be proven be mere logical reasoning.

I don’t need a double blind study in that case because gravity has been proven before and there’s no reason to assume it doesn’t apply to everybody (or rather every body) alike.

There has been a randomized controlled trial to test if parachutes reduce injuries when jumping out of planes.

However, it found that parachutes do not reduce injuries: https://www.bmj.com/content/363/bmj.k5094

I think the term you're looking for is conventional wisdom vs common sense.

Agreed that conventional wisdom is often wrong.

I can imagine a wild in which the US pursues science based policy, but it swiftly results in the corruption of science to provide evidence that fits certain conclusions. I think this already happens to a degree in certain fields, and especially among think tanks.

This isn’t a reason to avoid science based policies, but just a potential snare along the way.

> Unless things can be scientifically proved, the individual rights of citizens should not be restricted.

Sorry, but this doesn't make, err, common sense. If you have a huge fire, would you put off evacuation order until it is scientifically proven that an area will burn down? By the time you are sure, it's usually too late.

It is not logical either - numerous exceptions can be found, including in this pandemic.

We already have a lot of scientific knowledge about how fires burn that we can apply to firefighting, so this is a non problem.

But it’s exactly the kind of country I want to live in. It’s my life, my right to do what I want within reason. Within reason should err on freedom.

That's one way of looking at it. But the one that decides seems quite sure of the opposite of what is considered common sense.

https://tegnellcitat.se/

He's not a humble man.

Except that the article gives evidence to the contrary.

There is nothing very 'scientifically more accurate' about Sweden's approach to COVID.

This is the 'Swedish Model' narrative which borders on propaganda, promulgating an exceptional view of the Swedish government.

More often than not, bureaucrats take decisions they think are right, but which can just as easily be base on the arrogance or myopic view of the local institution.

Every response in this COVID article illustrates that:

- 'Closing borders' has been imminently successful in slowing the spread of Covid in almost every case - either giving more time for officials to prepare, aggressively suppressing it (Korea), or - locking out the disease almost completely (Taiwan).

- The 'trust-based' Swedish approach is irrational - because the issue is not 'trust'. The issue is literally physical distance. If Swedes are 'going to restaurants and school' and 'restaurants are a serious vector' - then COVID will spread, it's that simple.

- "What evidence was this approach based on? It is difficult to talk about the scientific basis of a strategy with these types of disease, because we do not know much about it and we are learning as we are doing, day by day. Closedown, lockdown, closing borders — nothing has a historical scientific basis, in my view. "

This is not true! We have historical data from pandemics, particularly from America which demonstrate cities that went on lockdown were able to recover more quickly from the Spanish flue. Moreover - the issue is risk. The more 'unknowns' there are, the more likely we err on the side of caution, not risk.

- "We do not need to close down everything completely because it would be counterproductive" we're 100% certain that lock-downs prevent spread - the issue then becomes one of value vs. cost, but it's not fair to them to indicate it's 'counter-productive'.

Even his testimony about 'asymptomatic spread' is strongly challenged by some evidence. Yes, we don't know for sure, but to assume the negative, given the consequences, does not fit this 'we use science not common sense' pragmatism. It's just plain risky.

"I recently had reason to investigate to what extent maternal/neonatal care followed the best of our scientific knowledge and it was extremely close. If you think that's a given, think again. Many countries base their maternal/neonatal care on common sense and old wives' tales instead."

This is only anecdotal and it's not substantiated.

...

The media perspective is mind-blowing: everyone seems to give 'Noble Sweden' the benefit of the doubt with respect to their measures, talking about the supposed effectiveness of it ... but if a Republican Governor were to suggest literally the same measures, they'd be mocked mercilessly on CNN.

This is happening literally, today on CNN: governors/mayors wishing to make limited openings of their states, remaining still more closed than Sweden, and wherein they have fewer cases than Sweden, are getting the harsh treatment.

I do think they all need to get hard questions from the press, but let's not pretend there's anything more magical going on here with respect to the policy or behaviuor, and treat these groups more 'in kind'.

This has little to do with common sense vs Science. You can easily make the scientific case towards controlling the borders and isolating, it simply hasn't been done in Sweden's case. Handwaving away the necessity for scientifically vetting the idea of closing the borders, behind the idea that every country in Europe is already infected isn't good enough to claim a meritious victory for science over common sense.

The four debates Jordan Peterson did with Sam Harris about the reduction of information down to science and the necessity for building value structures and behavioural interpretations of facts proves to me that Science can't tell you how to behave. It can show you what facts will prevent death and what won't, but we never have enough resources to sciencetifically test every single decision tree outcome, there are an infinite number of objective facts. We make best guesses about which idea to follow based on value structure and gathered information we build over time.

Sweden's version of common sense is to follow what the scientific signallers are telling them, their reaction to the virus is an expression of culture and law that has little to do with the facts. They can't lockdown even if it was better.

Australia locked down and followed the norms for great success with double the population to Sweden, despite having similar issues with aged care facilities. Finland is performing well.

I don't see the evidence to support the Swedish solution, nor it as virtous example of science over common sense.

>I don't see the evidence to support the Swedish solution, nor it as virtous example of science over common sense.

The strong point of Sweden's response is that the Swedish economy is going to suffer much less. Other countries will have to piece their economies together after their lockdowns end. Furthermore, Sweden can keep things going as they are for a long time. How long do you think Australia could keep its lockdown going?

If there's going to be evidence to show that Sweden was right then it'll likely take a few years before we can measure the economic impact and all that brings with it. I'm not saying they are right, I'm just saying it's too early to tell that they're wrong.

I'm all good with Sweden doing what it wants, it's nice to see a country stand up for it's own values and culture and laws in the face of a deadly virus and find an outcome that works.

Pushing a weak argument about the virtues of science as a reasoning for doing so seems a bit much.

Australia will go as long as necessary, it is taking this opportunity to do the largest economic reform in 30 years. Australia relies on reform to stop itself from becoming the 'poor white trash in asia' (Lee Kuan Yew). Reductions in corporation tax, strengthening of unions and many more changes. Retail had been slowing down pre-covid and the mining is out of it's boom cycle. There has been rumblings for change coming for a while and all this lockdown is a great way to rejig the setup. We are setting up our agriculture to boom in the 30s so in the long term we should be okay.

The IMF predicts that Sweden's GDP is going to shrink 6.8% this year. Denmark, Norway and Finland are predicted to shrink only 6.5%, 6.3% and 6.0% respectively, despite locking down more aggressively than Sweden.

https://www.imf.org/en/Countries/SWE

https://www.imf.org/en/Countries/DNK

https://www.imf.org/en/Countries/NOR

https://www.imf.org/en/Countries/FIN

Australia is talking about being to reduce the lockdown in 4 weeks.

The Australian lockdown isn't complete - shops are still open, can go to offices if required, schools will open next term except in one state (it's holidays at the moment).

The economic cost is high, but unclear how much more than Sweden. Unemployment in Sweden hit 8% in the most recent quarter[1], while Australia's is forecast to reach 10%.

The IMF is forecasting -6.8% growth in Sweden[3], vs -6.7 in Australia[4]

[1] https://www.nytimes.com/reuters/2020/04/20/world/europe/20re...

[2] https://www.abc.net.au/news/2020-04-13/coronavirus-unemploym...

[3] https://www.imf.org/en/Countries/SWE

[4] https://www.imf.org/en/Countries/AUS

I dont understand the point you are making. Australia’s lockdown has been progressing and alleviating at the same rate as the rest of the world. Most countries are having a reprieve. Japan is going into lockdown lite and Australia’s economy was slowing pre covid anyway.

That was in response to "Furthermore, Sweden can keep things going as they are for a long time. How long do you think Australia could keep its lockdown going?"

I was giving evidence to show the impact on the Australian economy isn't obviously higher than the impact on Sweden, but with 1/10th of the number of deaths.

Deferring decision making from experts to the common people is exactly what "common sense" is.

And it's a pretty bad idea to use common sense to solve a problem that zero people alive today have ever encountered. None of have endured an unvaccinatable pandemic.

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