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Comment by cm2187 | Hacker News Reader

I find it extraordinary that the goalpost has completely moved without even a debate about it.

We were told to enter this lockdown to flatten the curve to under the capacity of the healthcare system so it is not overwhelmed.

Now we are being told we can’t leave the lockdown as someone more could die, ie the objective is not to remain under the capacity of the healthcare system but to go to zero deaths at all costs.

If the healthcare system has spare capacity, which seems to be the case pretty much everywhere, this lockdown is no longer justified.

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I also find it extraordinary that unelected health officials have been allowed to dictate the freedoms of millions of people. These bureaucrats are experts in health and not economics, politics, and law and we're all beholden to them. They're qualified in a specific and narrow field but their decisions are impacting so much more. There's more to our lives and well being than an r0 number.

What we are experiencing right now is a considerable loss of freedom, this is what government intervention looks like, but into the most cherished aspects of our personal lives. How much of this control are governments going to try and hang on to after this is all over?

As far as I know, they are not allowed to dictate the freedoms of millions. They simply report and provide guidance from their angle of expertise, and it is up to elected officials to aggregate the advice of all their consulted experts and their own judgement and hopefully with a bit of listening to their populace as well, to make the decisions.

You are correct. However, some elected officials have (for incompetence, or just wanting to deflect responsibility) completely abdicated from their functions, and they act (or say they act) like whatever the experts tell them.

"We'll reopen when the scientists say so" was a common mantra the past two months in my country. That's an admission of giving up responsibility, IMO.

On top of that, experts not always agree, which makes things even more confusing. Some say (again, my country) that masks and social distancing are "worthless" (in favor of indefinitely long lockdowns), others say that they might work, others say that they definitely work.

What would be a better course of action to take in this crisis? Would you have preferred for your elected leaders to not have taken the consensus expert view?

Or do you think the consensus view of experts is not agreed upon currently?

The latter. I believe there's no real consensus at this point, save for a few points, of which the minutiae require more investigation. A lot on this virus is being learned "on the go" as the situation develops.

Also, some choices made at the time were made in haste, now, like the Science blog warned about "pandemic research exceptionalism", we need to make sure that public policy is subject to the same rigorous line of thinking (an extreme example of not doing so is the bleaching of a beach in Spain), IOW no decisions simply "because it's a crisis".

Public policy and elected officials need to be aware of these unknowns when taking decisions, especially since many of these, in one way or the other, carry negative externalities.

Interesting.

My take has been that they have taken a conservative action with regards to the virus, I've seen locking down as a way for the government to slow down time to try and work out what is going on before then taking a more considered point of view.

There was so much confusion in mid March about what would happen and lockdowns seem to have slowed things down a bit to get a clear head about what the path through is going to be like and I hope they don't rush their next decisions as there are so many things that are still not known.

In the future these current decisions could be wrong and will be wrong, I'm hoping that they aren't badly wrong but who knows... It seems to be considered on what mainstream scientific consensus but that's been wrong before but I feel it's the best we have given the situation.

The primary statement aside, I find it laughable when people parrot the talking points about "unelected" officials being an issue.

As if they were duly elected and making the same decision, the commenter would suddenly be appeased. Or when a judge makes a legal decision that's disagreed with, it's an "unelected official", but when it's to their liking, that concern disappears. Have some intellectual backbone, man.

By the way, if elected officials did their jobs properly and we were all free of the ridiculous political/social climate we find ourselves in, maybe unelected officials wouldn't have to step in to fill the void.

All the three parts of a functioning government (executive, legislative, judicial) have their own duties and responsibilities towards each other and the citizens.

The so-called "unelected officials" (bad term, I'd say, because it's too broad) do not have such responsibilities. They can be either used as scapegoats, as a way to remove responsibility from those who carry it, or use their current influence to push policy in one direction or the other.

All of this might happen, or might not happen at all. "if xxx did their jobs properly" is not an excuse not to remain vigilant.

Health officers are officers of the executive branch in nearly every typical jurisdiction I can think of. They are an extension of the governor/mayor/county executive, who can usually overrule/fire/replace/choose different decisions. And the elected officials are perfectly free to be accountable for the decisions of the executive.

I think the deeper issue here is the much-commented popular distrust or 2nd guessing of "experts". I guess a disease that has a long incubation time and highly variable susceptibility just brings out the worst in people's judgement capabilities.

> I think the deeper issue here is the much-commented popular distrust or 2nd guessing of "experts"

Experts are human, and so they make mistakes like everyone else. See the German study on the autopsies and thrombosis, for example. A similar finding was reported in my country and immediately slammed by some high profile experts (same with convalescent plasma therapy). Some experts are saying that social distancing is useless against this disease. Others let out contradictory statements to the general public.

For those who aren't equipped to understand that at least part of it (some of it is narcissism, but that's another story) is part of the general scientific discourse, it is absolutely understandable to not trust them fully. And even more when the same experts (speaking of my country) said in February that it wasn't a big deal (but few if any admitted they made a mistake).

A bureaucrat is specifically someone who is an elected official dealing with governance and policy. A bureaucrat who is an expert in health is exactly who you would want advising on an issue that is primarily driven by the management of a pandemic.

But the reality of it is none of these people are making the decisions, they're advising, your governors are making the final calls. So your governors should have information from economists, health officials and other areas and should be making decisions based on their best judgement of all that information.

I have a question in order to compare the USA situation to our own: what kind of statements do the expert panels make, when interviewed by the media or in official communication?

I don't follow US media all that closely, so I don't know enough to comment sorry. I think maybe you are leading to the thought that they still influence public actions through the media, and I'm sure that's true.

I say this because in my country the communication is very un-empathic and some prominent experts truly lack the skill, causing either denial or terror depending on who gets their message.

I'm being told that other countries carry their communication in a much more rational way, but I haven't been able to confirm this (hence the question).

I can only really speak for Australia, where communication has been fairly consistent and level-headed across the official channels at both a federal and state level of government. Most communication stresses caution, but maintains hope and lays out logical, fact based plans for restrictions that people can understand.

At least in April, almost twice as many people had trust in our expert (71%) than our President (45%) or Legislators (41/40%).

https://morningconsult.com/2020/04/08/dr-fauci-is-voters-pre...

Where I live politicians do make the decisions. They are only given advice from the health area. Epidemologists are usually way more educated than your average politician. I would even go as far as saying, that those highly educated people might have a better grasp of philosophical issues than politicians, who are mostly all talk. If I look at politicians at high level here in general, I have to doubt their ethics in general. At least epidemologists did not yet prove to be a lobby tool.

Strawman argument.

Who is saying the goal is “zero deaths at all costs”? I see governors seriously weighing the costs and risks, and talking about the response when (not if) reopening leads to new flare-ups.

Whitmer: “As we start to very shrewdly reopen (edited: autocorrect) sectors, we’ve got to measure every step of the way. If we start to see a spike, we have to be nimble enough to pull back...”

Newsom: “As we move into the next stage of reopening, we will do so with updated guidance to help qualifying businesses make modifications needed to lower the risk of COVID-19 exposure to customers and workers. Californians should prepare now for that second stage of reopening...”

Cuomo: “This is not a sustainable situation.” However, “You see that you reopen too soon or you reopen unintelligently and you can then have an immediate backlash.”

And so on. I concede there may be someone out there arguing for “zero” but I don’t see the goal of even the more aggressively locked down US states being “zero”.

The first 2 sentences are a reasonable point. But even if there is spare capacity, people who go into ICU are dying, so it's not like it's a clean cut judgement call that if there's spare capacity, people will be fine and it was just recovery from an illness. Spare capacity still = a death rate.

I think most all the policymakers are aware that there is going to be a judgement call about lives at risk versus economic cost of the lockdown. I don't think anyone is saying that 0 deaths must be achieved. We don't try to achieve that for anything.

The grownups in the room are weighing when to open and restart the economy against the data-backed risk of disease flaring up and causing a worse shutdown to be required. The kids are asking to go out and play without knowledge of anything.

Also people seem to forget that deaths are not the only problem. Getting out of the icu and surviving is not like a walk in the park where you get a little oxygen and continue with your life. Some % of people will never fully recover and live with health issues for the rest of their life.

> The grownups in the room are weighing when to open and restart the economy against the data-backed risk of disease flaring up and causing a worse shutdown to be required. The kids are asking to go out and play without knowledge of anything.

Are you suggesting anyone who disagrees with this policy is clueless?

I'm saying that I observe that people who are most vehemently advocating for lifting the lockdown seem to be people who are not, shall we say, the most knowledgeable or informed about the severity and risk of the disease.

> Spare capacity still = a death rate.

I'm not trying to be snarky, but you do realize that the people who do not die from Covid-19 will still die eventually, right? We're not making a choice between death or no death, we're mostly making a choice between death now or death in a few years.

> I don't think anyone is saying that 0 deaths must be achieved.

You just used "Spare capacity still = a death rate" as an argument, that's a different version of "0 deaths must be achieved".

This "lock down" thing was completely improvised. I've checked various medical dictionaries, in French and English, and the term is not even there (you will obviously find terms like "quarantine" or "quarantaine", which is a different concept).

It's something invented by politicians. Which is why they also use terms like "shelter in place", which is a concept that was used until now for earthquakes, bomb threats, etc.

And because they improvised this concept, they have no idea how to get out of those "lock downs".

> If the healthcare system has spare capacity, which seems to be the case pretty much everywhere,

This has been achieved by:

1) Reducing quality of care. For one example, ICUs have a one to one nurse to patient ratio, but during covid-19 some ICUs dropped that to one nurse per six patients

2) Building field hospitals

3) Putting a lot of people onto palliative pathways, and not taking them into hospitals

4) Imposing lockdown

Healthcare professionals would argue this isn't spare capacity, it's rationing.

Now we have to look at ways to balance the harms caused by lockdown against the real risk of a second wave of covid-19 infection, and that's not easy to do.

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