Renewed questions about the virus, and hard-to-face answers
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My child’s school district went remote when I and thousands of other parents told teachers and administrators at individual schools that we were pulling our kids out regardless of their policies.
Same with work: I told my manager in the 3rd week of March I was working remotely starting the following week. So many others did the same thing that my employer closed the office and went remote. My wife’s company also voluntarily went remote the same week.
This was all before state mandated closures and lockdowns, etc. People, in huge numbers, started trying to protect themselves and their families. We had NO IDEA how this virus was going to progress, and what we would learn the hard way.
In retrospect, it’s beneficial to a certain point of view to reframe what happened as some sort of top-down authoritarian dystopia. But the reality at the time was bottom-up and we should not forget that.
https://www.vumc.org/health-policy/covid19-model-vanderbilt-...
The rapid decline in travel precedes the statewide order.
Let's not pretend that the TSA makes travelers "safer"...admittedly, if you've seen the crap people try to take onboard you might disagree. Regardless, the "public demand for safety" is not that. There is a demand for disclosed risk. The world is not safe, but if A happens when B happens % of the time, people are able to feel like they are making informed choices (even if the choices are misinformed). When this cannot be established or remains largely in dispute, society in the USA starts to crumble. So what the US gets is lots of theater with less and less disclosure of actual numbers until it becomes a stream of random noise.
This pandemic has highlighted the well-known quality about the US public. The US public demands a specific kind of answers, but the media and government continue to play sensationalism and politics, while everyone else scrambled. That's what I won't forget.
Its a good point, but that ignores that co-opting "useful tragedies" are how authoritarian fanatics grasp power.
There is no reason why it can't be both: A bottom-up response that has morphed into a dystopian power grab.
I got a mask early and asked to stop travel as well, but that was from listening to media. Which would invert the pyramid back to top-down.
So yeah, in some circles it was bottom-up, but there were also people harmed by "authoritarian" top-down measures. It's important to remember that not everyone's experiences and circumstances are the same as our own.
A lot of at-risk students live in multi-generational homes and it was obvious even early on that older people were at higher risk from COVID. Families did not want to risk their kids bringing home a case and killing grandma.
Our district did a good job of prioritizing assistance for families who needed it, including meal pickup and delivery options, as well as remote schooling rooms before they began general reopening. But at least in my neighborhood, the loudest voices for re-opening schools were among the professional class who were struggling with managing remote schooling while working full-time at home. A lot of lower income families were working less than professionals because we have a big service sector around here which was largely idled. Financial support like UI and eviction moratoriums were bigger issues to them than remote schooling.
At no time was I ever forced to stay home. It's just that everything was closed-- and a lot of things weren't closed but I wouldn't set foot in there (like the gym).
Ironically, we already had had covid and didn't know it.
According to [0], 70.2% of US adults are overweight or obese. The base rate seems like an important fact when making this point.
[0]: https://www.niddk.nih.gov/health-information/health-statisti...
This is really a lot. The last time I was in USA, it did not look like so.
This article is a complete mess in this section. Yes, emails from February 2020 revealed the scientific community still had a lack of understanding of the virus’ ability to spread from a pre-symptomatic host (often confused or merged with “asymptomatic” hosts who seem to typically not transmit due to lower viral load).
That isn’t exactly a scandal, it’s exactly what was being said publicly at the time too. There wasn’t anything surprising in the emails to anyone who followed the news and discussion in March-May 2020. We all saw, for instance, Fauci in the White House insisting 6 feet was enough to protect people because droplets from a cough don’t travel farther (wrong: overseas research and contact tracing showed the virus can be airborne and travel more than 6 feet inside a room), right alongside the early insistence that masks weren’t needed to reduce disease spread. Exactly what was being said in the emails was said publicly on TV.
Meanwhile, the emails seemed to show a lack of understanding of just how dangerous Covid-19 would be. We hit 600,000 deaths while the worst case models being discussed in Spring 2020 (on TV and privately) were just between 60k and 200k deaths. The virus did far more damage than people feared at first when lockdowns went into place.
Not only in this section, but overall.
Continued to read through the article and just be aware that a lot of the statistics the author cites are questionable. For instance, the 88% number here leads to an article from April 2020. Even without looking it up, I remember articles from may 2020 debunking this number. A simple Google reveals the real number is probably around 50% and that 88% is an outlier. https://pubmed.ncbi.nlm.nih.gov/33119402/
Polifact has an article on the 88% number https://www.politifact.com/article/2020/apr/28/are-88-covid-... “ The 88% death rate was among patients who either died or recovered. It did not account for the roughly three-quarters of patients involved in the study who were still on a ventilator at the end of the study, leaving in doubt what the eventual mortality rate will be.”
Using that number a year later is extremely irresponsible and it’s obvious to me the author is cherry-picking numbers to support their preconceived position.
[1] Please use the original title, unless it is misleading or linkbait - https://news.ycombinator.com/newsguidelines.html).
[2] When changing a title, it's best to use representative language from the article itself https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
Wuhan lab leak? Probably. Long Covid debunked? Not even. Social distancing cost lives because we didn’t achieve herd immunity? Really? Really?
Correct me if I'm missing something, but this comment is completely wrong.
The cited paper compares 2017 excess deaths in the US vs. similar aged populations in Europe. The "excess death rates" for 2020, as cited in the linked paper, is estimated COVID-19 death counts for the US (which isn't even what "excess deaths" is).
The cited paper makes an apples-to-oranges comparison. The 2017 figure (~400k) is an estimate of excess deaths in the US compared to age-specific death rates of an average of five European countries. The 2020 number is the CDC estimate of coronavirus deaths (~375k). In any case, this is considerably smaller than the overall excess mortality (from the US baseline, not a comparison to Europe), which is estimated at 522k (and doesn't count the first two months of the year)[1].
In this comment, I only point out verifiable facts. People can come to their own conclusion about the extent to which the original article makes good faith or bad faith arguments based on citations to the literature.
[1]: https://jamanetwork.com/journals/jama/fullarticle/2778361
I bring it up because, yea execution was not perfect. I expected this in the beginning. But so many people act like the response should have been perfect. Critique what was wrong with it and learn. However, assuming everyone who made a decision we didn't like as evil isn't going to help us at all. At some point in the future, there will be another world wide pandemic. It could be tomorrow, it could be 20 years from now, it could be 100 years from now. Unless everyone stays within 10 miles within home, it will happen again. And it may be be worst, like Ebola with flu-like transmission, or it may be not as bad. Whatever the case, lessons learned now will influence decisions later.
No, no one is demanding "perfect" here, just a media and governmental infrastructure that responds to changing data to accurately inform the public and enact policies which properly balance the risks of the virus with the potential harms of the intervention. Instead what we're getting is constant overhyping of the threat (e.g. emphasizing that the % of children being hospitalized by the Delta variant is higher as a way of downplaying the reduced hospitalizations in the older, vaccinated population) to support various power grabs like restricting freedom of movement and assembly, mandating pharmaceutical interventions, and consolidating the economy into the hands of large, entrenched corporations.
The fact that this pandemic is nowhere near the level of 1918's and yet we are blithely accepting the proposition "we can never go back to normal" should be giving everyone serious pause right now.
Speaking about the war on reality (original title):
This article claims an infection fatality rate of 0.15%.
Currently we list 604 thousand Americans dead from COVID, that’s 0.18% of the entire population - not the infected population. Brazil is at 0.23%, and rising fast. Worldwide it’s almost 4 million out of 181M reported cases. That’s over 2% IFR.
If one were to assume that everyone in these countries was infected and we are just really awful at reporting, that number is still wrong. But the US is currently reporting a hair over 1:10 people as having been infected, and Brazil has not crossed that threshold yet, so 0.15% is already empirically - to use the technical term - horse shit [1].
Since the quarantine was about firewalling especially vulnerable populations, I won’t hazard a guess as to how this would have scaled, but we do know that if it had scaled, a great many people would have not had or lost access to medical equipment and labor that was in extremely short supply. The argument about how we didn’t actually run out of beds or labor may or may not be true for the rate of exposure we actually experienced but claiming that would not have been affected by a do-nothing policy is arguing both sides.
[1] This article should make you cussing-angry, because this sort of retroactive second-guessing is going to get a lot of people killed the next time around. Most especially old people.
Using this argument, we can justify anything that was done in the past on the basis of "well, we're here to argue it over now, so it must have been the right thing".
> Currently we list 604 thousand Americans dead from COVID, that’s 0.18% of the entire population - not the infected population. Brazil is at 0.23%, and rising fast. Worldwide it’s almost 4 million out of 181M reported cases. That’s over 2% IFR.
Regardless of the exact number, isn't it a bit disturbing to you that, per the article, "Americans also estimated that the share of COVID-19 deaths for people between 18 and 24 was 8%"? The fact that we're so misinformed can't be a good thing, can it?
For my money, it's plausible that we massively overreacted (or misreacted) to covid. The opposite is also plausible though. It's a good thing that we're having this conversation and it's mildy creepy that we haven't been able to have it until now.
Finally, there's a question that always comes up with this topic: is it permissible for public employees to lie to the public in order to get them to do the right thing (or whatever they think the right thing is)? A lot of the anger over the government's handling of covid has to do with that. It isn't unreasonable to believe (as I do) that, consequences be damned, the government is obligated to tell the truth and should not lie to get people to act a certain way.
I can only say what is needed : a medicine is number one. Making society resilient against airborne viruses and we need absolute data on what tools we have to stop a virus in a room with people.
But last but not least it’s also a behavioral problem (which you allude to from a different angle) where people are making decisions that allow the virus to spread. I talked to a red cross doctor and he said that distancing and masks in a hospital setting is pretty much enough to kill transmission. It was his opinion that truly honoring the guidelines would have stopped it.
The correct numbers have been available on the CDC website the entire time, unfortunately a lot of people either don’t care or don’t find it useful to memorize those statistics. Not great to see but I think it track’s with the public usually mangling other statistical numbers as well when surveyed.
> A lot of the anger over the government's handling of covid has to do with that. It isn't unreasonable to believe (as I do) that, consequences be damned, the government is obligated to tell the truth and should not lie to get people to act a certain way.
Agree, the fact that so many government leaders spent a year downplaying the danger of the virus and lying to their followers to try to win an election or for other political reasons should make people angry and upset. It’s always sad seeing the stories of someone who was led astray by those leaders and subsequently even refused the vaccine and died of Covid-19 because they had been convinced it was just a common cold that only killed nursing home patients.
If one were to assume that everyone in these countries was infected and we are just really awful at reporting, that number is still wrong. But the US is currently reporting a hair over 1:10 people as having been infected, and Brazil has not crossed that threshold yet, so 0.15% is already empirically - to use the technical term - horse shit [1].
Your analysis is severely flawed from the fact that you are equating the number of "confirmed cases" with "number of infections," but many infections are never confirmed with a test (and indeed never even become symptomatic).
The article links to a source to support its 0.15% number, but some others are below:
Nature, estimates about 0.5% for USA: https://www.nature.com/articles/s41586-020-2918-0
World Health Organization, median IFR of 0.27% (0.05% for those under 70): https://www.who.int/bulletin/online_first/BLT.20.265892.pdf
0.5 and 0.27 are both larger #s than 0.15, so that supports the GP's point.
The articles's tone is distinct and specific, and going to rub some people the wrong way, but tone shouldn't be confused with the correctness or incorrectness of an argument.
I'd say unfortunately, because tone is far too prevalent in online media, but the horse seems to have bolted on keeping the tone neutral, and I'd wager a strong tone likely leads to higher "engagement", so people have collectively decided with their actions how they feel about tone.
1)I'm no mathematician or statistician, but as I understand it the IFR also counts an estimate of those presumed to have had an asymptomatic case. A published study earlier this month estimates that the reported number of non-hospitalized cases between February and September of 2020 accounts for 1 out of every 7 cases of reported infection because of reasons like the symptoms weren't typical or didn't appear at all, amongst others. I don't know if that puts the IFR as low as they are saying, but it's still pretty low.
https://academic.oup.com/cid/article/72/12/e1010/6000389
2) The lockdowns have not shown any statistical data to the effect of controlling the transmission of the disease. As an aside, they actually have some support that they may have created a negative impact overall as people were forced to reside with family members who contracted and passed on the disease. There are plenty of anecdotal pieces of evidence on both sides of the argument on the subject of lockdowns. That in and of itself should be an indicator for caution and moderation when calling for unilateral action.
3) Even if one subscribes to the idea that the lockdowns did have a positive effect in controlling the rate of infection, the lockdowns were never billed as protecting the vulnerable. That was masking. The lockdowns were billed as an effort to stop hospitals from being overwhelmed. Sure, while there were hotspots and times of higher activity, I have not personally come across data that shows that these hospitals were ever in danger of being over-whelmed. However, I have personally seen examples of people who have lost their jobs in the medical industry because the shift to a laser focus on COVID-19 caused someone to lose their job due to lack of the necessary funding.
I don't know that any numbers are really going to add up for quite some time. I do think that the imposition of unilateral action like lockdowns was a terrible idea and the cost of doing so will continue to show itself over the next several years. Data will continue to change and be updated just like it is for all major medical events. It appears to me that perhaps the best course of action is making recommendations to people and letting them chose their own path. The history of this country and trying to impose something by force is not exactly stellar.
In some ways this is similar to the response to the issues around Y2K. Did we need to spend as much as we did on that? We don’t have an alternate universe to compare with.
The figure I most often cite is 0.68% from the study by Gideon Meyerowitz-Katz and Lea Merone[1]. That paper is skeptical of serosurveys that show high incidence (see the discussion of reference 61, which is by Ioannidis).
Ioannidis responded with the paper you cited, the preprint of which contained a personal and unprofessional attack against Meyerowitz-Katz, removed from the published version, though a scientific critique remains. Meyerowitz-Katz responded on Twitter[2], mostly to the substantive critiques. There's more drama around this, with a number of prominent virologists taking M-K's side (see the Twitter threads).
Also see the PubPeer reviews for this paper[3], which contain more serious criticism of Ioannidis.
I go into detail here to make a few points. The main one is that, especially when there's legitimate scientific controversy, citing a single paper can really fail to give the whole picture. Another is that "the science" isn't one simple monolithic set of beliefs, even on such a seemingly basic statistical question, but is actually more of a conversation.
[1]: https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v...
[2]: https://twitter.com/GidMK/status/1376304539897237508
[3]: https://pubpeer.com/publications/9FE142DA15F748FA283605C7201...
If you are calculating the bounds on a ratio, then you use the smallest denominator you have to establish the upper bound, and the largest denominator to set the lower bound. That’s reported cases and the total population respectively.
The article claims that 0.15% have died. Basic math on the published statistics say at least 0.18% have died in the US, and 0.23% in Brazild, which last I heard is still in the grip of it. Sometimes you should put down your citations and look out the window.
The argument of the article is that people fucked up and we should get to the bottom of it. That The IFR of 0.9% was too high, it’s really 1/6th of that, which sounds pretty damning. It is not an accident when you bring up that actuals are multiples of predicted. The discrepancy is your hook, and a small error does not demand action (ie, let it go).
Hooks that lie are called manipulative.
The author is claiming a factor of 6 overestimation, and by the most cynical reading of the death statistics it cannot possibly be greater than 4, and in all likelihood is more like 2. Ie, let it go, and stop attacking disaster science.
[1]: https://pubmed.ncbi.nlm.nih.gov/33289900/
[2]: https://www.medrxiv.org/content/10.1101/2021.05.12.21256975v...
2. 0.15% is not "the current best estimate", but an estimate by John P. A. Ioannidis who has published some remarkable sophistry at the beginning of the pandemic, which was (while not technically wrong) absurdly misleading IMHO.
I'd say best estimates for the IFR now a) acknowledge that it depends enormously on age (looks like a pretty exponential relationship), thus on the age structure of a country/state, and b) put it, for the US, say, between 0.2% and >1%.
This is sure to be one of many articles that use the benefit of hindsight to paint policymakers and scientists who were being cautious, deferring to the scientific consensus as it was best understood at the time, and operating with very little very messy real life data as deceivers because they didn't magically know everything from the beginning.
Misc comments:
It's not okay to just say that only the old, fat, and vulnerable are at risk of dying so why should everyone else have to take all these precautions? The lack of empathy is staggering.
"Stay at home orders" didn't literally mean stay confined to your house at least around here. You could go outside at literally any time during the past year regardless of orders.
Moving the goalposts and "covering up their failures" has another less-pejorative name "updating your recommendations based on research and data." If you're upset that scientists didn't tell the public "here's our recommendation based on the data we have -- it's probably not perfect so you should just not listen to us and go with your gut" I don't know what to tell you. Everyone was sanitizing everything at the beginning of the pandemic until it came out that transmission was basically entirely airborn then everyone stopped. Those flip-floppers working for Big Purell.
If you talk about Europe and parts of Asia, I can tell you from experience that, no, you couldn't go out of the house for long periods of time in certain hourly intervals during the past year.
You're not representing the article fairly. For example, here is the passage where the author mentions obesity:
Vitamin D and exercise have both been linked to better outcomes for COVID-19 patients. In the U.S. 78% of people hospitalized for COVID-19 were overweight or obese. Lockdowns caused Americans to gain an average of two pounds per month and reduce their daily steps by 27%, thereby increasing the likelihood of adverse COVID-19 outcomes.
If you disagree, fine, but at least disagree with what she's actually saying.
> thereby increasing the likelihood of adverse COVID-19 outcomes.
Assuming they get the virus! Which the lockdowns were supposed to prevent! If you do the math and the benefit of the lockdowns were small, and the risk from gaining weight was large, then fine, but the pathologic case of this logic looks like: "The government wouldn't let me drive to the store today because of the tornadoes. They say I should go tomorrow, at which point I'll be older, and therefore statistically a worse driver, putting me at an increased risk."
I'm VERY open to critiquing the lockdowns on these kinds of grounds, I'm just getting sick of folks with an agenda bringing a condescending tone and the false appearance of logic to a complex discussion.
The key words being "supposed to". COVID killed as many people as it did despite lockdowns that destroyed the economy and ruined everyone's lives for the past 15 months.
Cuba is in the Caribbean...
Nobody was saying not to protect those people or lacking empathy for them. In fact, the opposite is true. We were saying that we should have focused our measures on protecting just them, rather than treating everyone as equally vulnerable.
https://www.milwaukeeindependent.com/articles/governor-tony-...
And here's the actual order https://evers.wi.gov/Documents/COVID19/EO094-COVIDRecommenda...
It actually calls out staying as close to home as possible and not even travelling to a second home if someone owned it.
I think every state had its own variation but ultimately after around April 2020 everyone has been free to get in a car and drive anywhere or get on a plane and fly anywhere within the USA. Some states had compliance regimes where you were supposed to quarantine or be tested after arriving, or be fined, but many did not. I traveled to one state with such an order twice and each time it was essentially voluntary - there was a theoretical fine if I didn’t follow the rules, but no one ever checked up on me to make sure I had a negative test. Unlike overseas governments (Singapore, Australia, China, vietnam, etc) our restrictions were basically on the honor system everywhere.
I believe one major exception is Hawaii where they actually did enforce quarantines somewhat and jailed or expelled tourists, and also had the lowest cumulative per-capita covid death tolls.
When high IFR:s are presented to the public, most people (both old and young) believe it applies to them, it is misguided in both directions.
I have no patience for works like this, written by people for whom any modification to their existence, even the most minor and most voluntary, is one change too many (and a sign of malign conspiracy to destroy them). Masks? Nah, who knows whether they're effective. Distance? No, it's not a big deal if I just don't. Vaccine to avoid the above? No, it's "too experimental" and I "just don't trust it" no matter whether it's based on decade-old or century-old technology.
The author makes no concrete suggestions about what we should do differently, and I think it's because for them, any change to their behavior whatsoever is one change too many. It's all well and good to try to help people as long as it doesn't require any personal effort or sacrifice after all, and as long as absolutely no mistakes are made and no missteps ever occur. In the mind of the author, anybody who would dare ask them to do anything at all to help their fellow human is a ghoul who must have an ulterior motive. This says much more about the author than it does the people asking.
It's tempting to ask sanctimonious questions, like, how many people would have had to die before this person considered that that loss of life might justify temporarily changing their behavior, or (the horror) listening to the government or working with their fellow man just a little? How bad would something have to be before they'd agree to try, just try, to do something that might help?
What a shame that there are so many selfish and conspiratorial people in American society.
[1] https://mobile.twitter.com/galexybrane?ref_src=twsrc%5Egoogl...
What if a disease that is maybe 4x or 5x a bad flu really wasn't worth upending all of civil society (particularly for its youngest) to combat? Wow, it's almost like the Hippocratic Oath says "first, do no harm" for a reason!
* US total COVID-19 deaths: 600.000
* US total population: 328.200.000
= 0.18% COVID-19 deaths of total population. The IFR must be even higher.
An endless rehash of shoulda, woulda, coulda seems unproductive.
With the vaccinations being rolled out, I see no reason to stay in eternal quarantine.
Unless some new vaccine evading hyperdangerous mutant strain emerges, then yes, we have a lasting problem, but I don't see solid data, that this is happening.
Edit: In either case, it is good, that vaccination research and production got a huge boost. But I really want to get rid of the mask as soon as possible.
Great opportunity for one to start a new HN