I guess the same as people who had the flu in the past, and didn't fully self-quarantined. Not even vaguely guilty. I agree with them, because guilt over this kind of indirect effect can not be general if you hope to live a normal life. So what should and what should not make you feel guilty, of what is acceptable in term of indirect-risky behavior, is mostly cultural/political/religious/choose your naming, the indirect risk is mostly an a posteriori justification for trying to change mass behavior, by the party that want to change it. It's not something based on a objective attempt at ranking behaviors per indirect bad effects, at least when those indirect bad effects are small...Yes, I am not really convinced by utilitarianism, mostly because of that.
I'm not a fan of it either, but how are other systems of ethics different? In the end, they too want "the greatest good for the greatest number", except try to achieve it with various rules of thumb and shortcuts, which of course are mostly cultural/political/religious/choose your naming.
I'm not sure it's true, even theoretically. Most systems have "the greater good for the greater number" as a goal, but certainly not as the only goal (or even the most important one). For example, Justice is often also a goal (often more important than the greater good) (I define the justice as each societal actor get a proportion of the total pie (variously defined) depending on his worthiness (variously defined). This is not a primary goal for utilitarianism, it's at best secondary (in the form of incentive so that net producer of global good are encouraged to produce as much as they can).
But that's not the main point of your comment: I believe there is an advantage of the usual (but suboptimal) rules of thumb utilitarinaism vs classic utilitarianism: The former is not a totalitarism, the second is. Totalitarism is not a problem in general (for physics for example, it is a driving force that I admire), but for government it is, especially when you have a central arbiter much more powerful than any individual or allowed grouping of individuals. It's the recipe for hard dictatorship, regardless of how worthy or altruistic the initial goal seems. The arbiter define the goal, measure it and the total aspect let very little place for unorganised discussion or disagreement. Rules of thumps are maybe less efficient, but they are not total so let unruled liberty spaces from which the system can be reformed....Well, I think I use overly complicated explanantion for something that is quite simple: I do not trust a human (or group of human) that say let us rule, we have the greater good of the greater number as objective. A group of actors, mainly selfish but with some altruistic component, that self-organise in multiple intersecting groups each implementing some reward-punishment system is suboptimal maybe, but do not need any crazy trust in the ruler.
Utilitarianism as a political system is, fo me, synonymous with a benevolent strong (well above human-level cognition) IA.
Utilitarianism as a personal philosophy is not the same. I have admiration for it, coupled with some distrust like for all altruists (are they really sincere?)...I also do not think it make the practitioner especially happy, so as a selfish bastard, I continue to care about myself first, my close ones next, and humanity as a very distant third. At the individual level, this system is maybe less admirable, but it is more actionable and, as you are more able to directly observe happiness of close ones (and, by definition, the most able to observe your own happiness), it's also far less hackable than utilitarianism :-)
Well, the point about altruism always confused me, long before I knew any relevant definitions. So, probably at about 10 years old, I decided that, since I care about myself the most, and about people close to me much more than everyone else, I must be evil. And further, revelaed preferences showed that pretty much everybody else was the same in practice, regardless of whatever high-minded ideals they might've gone about professing and not acting on. A few decades later, and having learned those definitions, my opinions haven't changed much.
The most important thing that I've understood about why people resist to openly accept and universalize this natural attitude, is that its ultimate logical conclusion is fascism. Which doesn't exactly boast a track record of successful implementations.
Of course, the obvious alternative of trying to universalize some ostensibly egalitarian set of ideals also leads to a totalitarianism of slightly different kind, like you mention, which also earned its share of PR problems, even though it isn't quite excluded from polite society unlike the former.
Is there a principled third way? It doesn't seem that there's even a broad undestanding of these issues, much less a significant informed effort to resolve them.
No. There were some people who joked about it and some of those jokes memed and people turned into reality, but I don't believe any of the currently under investigation drugs are ivermectin alternatives.
Quite different. Ivermectin is theorized to bind to viral proteins at locations which make them non-functional.
Molnupiravir acts as a pseudo-nucleotide, it gets incorporated into viral RNA in place of either citidine or uridine which causes the resulting codons to code for the incorrect amino acid leading to mutated and non-functional proteins.
"To mandate vaccines is to state that humans are all born defective, and only become non-defective after jumping through state-approved hoops. It is philosophically corrosive to everything I believe in."
This feels like an isolated demand for rigor. I am constantly choosing to better my existence in many ways because of my 'defects':
* I take ibuprofen (which is government-approved) because my defective body creates headaches
* I upgrade my phone (which is government-approved in various ways) because I need a better camera because my defective eyes don't permanently store images of what they see
* I take the Moderna vaccine because my defective body is incapable of manufacturing the antibodies against a recently-common virulent disease that risks my wellbeing and that of those around me.
All human life is defined by improving our condition, sometimes under the supervision of a government. Regardless of whether those measures are mandated, it is strange to think of some of those actions as perfectly ordinary and some of them as accepting that you're defective.
There's a pretty big difference between "government-approved" and "government-mandated". My body was defective, and produced more teeth than I needed. I am happy that I had the option of getting my wisdom teeth extracted to fix that defect. I would not be happy if I was legally required, or even strongly pressured, to get my wisdom teeth extracted -- despite the fact that it was a real defect in my body.
The difference with vaccine mandates is the argument that, by getting a vaccine, you substantially reduce the burden of the disease on other people, and that reduced burden is worth the cost of imposing the state-mandated hoops. But you have to actually make the case that the cost is worthwhile (well, you don't have to but people are going to be a lot less convinced if you don't).
I say this as someone who got vaccinated at the first available opportunity. "Allowed" and "mandatory" should not be conflated.
I don't disagree. My point is that if you choose to label all of these things as evidence that you are defective, you shouldn't care if the government also labels you defective. The emotional impact of being "defective" loses its meaning when it is applied to every aspect of our daily lives.
That's disregarding the very important point of individual agency. If I decide I need more exercise and choose to do pushups, that's one thing. If the government sends a drill sergeant to yell at me to do pushups, that's a very different thing.
If you have TB and you don't comply with treatment someone from the government will come to your house everyday and watch you take your pills. Do you think that's wrong? Should people be free to walk around with active TB?
BronxZooCobra did not mention congenital TB, I think he was referring to community acquired TB. After two to five days of treatment you are not contagious anymore.
However, it is important that TB patients take their medication full course (6 months). It is the non-compliance that caused the MDRTB (multi drug resistant) and the EXDRTB (extremely drug resistant) strains. And although most are reminded in a friendly way by community health care workers, I have no objection if -when needed, in case of refusal- it is done at 'gun point' or locking them up.
It's worth bearing in mind that individual agency is not a fact of natural law. It is, more or less, a privilege a governing majority grants to the polity over which it exerts sovereignty. Like any privilege, if abused it gets revoked. One of the reasons we enjoy as much individual agency in the US as we do is that people by and large don't take it to extremes -- they rein it in a bit voluntarily when it starts to become clear that it pisses off too many people. If that stops happening, there isn't a God Emperor that will stop the majority from circumscribing the amount of individual agency it tolerates.
That may not be pleasant news, and it may not even be the way the world *ought* to operate, if ethics were as as ineluctable as the Second Law of Thermodynamics. But it's the way the world actually does work, and wise men don't argue with forces of nature.
You have it exactly backwards. Individual agency is the fact of natural law. We trade some of that agency for government to take some of the rough edges off of living around other people. Governments can go farther and use force to make people do things, just like any group of the strong can do to the weak, but the default is individual agency. The fact that it is usual in history for the strong/large group to violate the rights of the weak/small group does not make agency a "privilege."
Natural law in the sense of what ought to be, sure. In the sense of what actually happens, no. The ugly truth is that groups of humans outside of tiny and fortunate and often transitory alliances, will *always* end up with the group imposing limits on individual agency, because it can. I don't take individual agency by my kids as a bedrock principle of my family, and no responsible parent would. My firm doesn't take individual agency by employees as a bedrock principle, and no successful firm would. If I sufficiently piss off the majority in the State of California, it can and will hound me, lock me up, even kill me, notwithstanding any written law or ethical principle, simply because it can.
The fact that I have a substantial degree of agency in my community, on my street, in my town and state, is a lucky thing, something not unnatural (and indeed which generations of our forefathers have sacrificed and struggled to achieve). It's not the natural state of humans. The natural state is that if I had a loud party, or failed to maintain my home nice 'n' neat, or just didn't say hello respectively enough to the local honcho, my neighbors would beat the shit out of me and enforce compliance with the local tribal values. That is indeed the record of most of human existence, from 40,000 BC to ~1600 or so.
The fact that this *doesn't* happen in modern American society -- that I can thumb my nose at my local community and they're reduced to merely verbal protest, or writing angry letters, is a fact of extraordinarily good luck (and some hard work by our predecessors). It's not a state of nature. It's perfectly possible for it to be undermined, and ultimately destroyed, by insufficient attention and effort to maintaining it, both on the part of the majority *and* on the part of any minority.
Game theory shows that altruism is selected against because altruism advantages parasitism.
The only ESS is RECIPROCAL Altruism - where people are required to behave in an altruistic manner, on pain of getting the altruism granted by others revoked (historically, this would result in you being killed or cast out of the tribe or whatever).
We require people to pay taxes and to vaccinate themselves for the good of the group so that we can all enjoy the benefits of living in an altruistic society. But this is only enforceable if failure to meet our minimum standards of altruism actually results in real consequences.
It is, in fact, "natural law" that groups showing reciprocal altruism will require that it be reciprocated, as it is how "altruism" is selected for to begin with.
The thing is: wisdom teeth don't affect anyone but yourself. Not being vaccinated hurts society big time. I'm against vaccine mandates as well, in principle. But since we apparently need 90+% of people to decide to get the vaccine, this principle probably can't be upheld everywhere.
The part where I can't wrap my head around is that the very people who like to talk about "serving your country", "patriotism", etc. etc. refuse to act when for the first time their country actually needs them to do something for society. And this something is as insignificant as a small injection thrice with almost no side effects with a medication so well studied, it trumps all other medication we have ever head in terms of statistics we gathered.
For me, everyone who refuses the vaccine lost their right to talk positively about patriotism, duty or the legitimacy of things like the draft. Because that one time they could have proven they actually meant what they were saying, they refused ...
I think this is an overly binary way of looking at things. There are plenty of people who are willing to do certain things for their country but not other things, and "literally allow people to modify your body" is, I think, high on many people's lists of Thing That Should Be My Decision And My Decision Only.
*Regardless of how insignificant we believe it is*, the idea of a legally mandated injection just grates at my soul. It's one of those things that I think is probably a net benefit in the short term and leads us down a really uncomfortable path in the long term; uncomfortable enough that I don't think we should have it at all.
I'm not the only one who's made the awkward-but-not-entirely-invalid connection between pro-choice bodily autonomy and anti-vaccine-mandate bodily autonomy, y'know?
How is: "If you are not willing to do this minuscule sacrifice, you have no right to vote on me sacrificing the life of my son!" a binary way of looking at things? I think its a very nuanced position, where you have to do the small things you can do yourself first, before earning the right to be asking someone else to sacrifice big time.
I don't see any potential sane way of reasoning where "putting a safe and well tested vaccine into your body" is a bigger burden to ask for than "take that gun and shoot at those people who I tell you are baddies and potentially get yourself killed in the process" ...
Because they disagree on whether bodily modification is a miniscule sacrifice; a lot of people are on the Body Is Sacrosanct train, and you're not going to convince them otherwise by saying that you disagree. I think many people would say that a military draft is actually more acceptable than forcing people to undertake medical procedures, regardless of how harmless we currently think those medical procedures are.
And we're largely not OK with a military draft either, US wars have been fought with volunteers for quite a long time.
I'd consider this a ridiculous position though. Military draft takes away your autonomy and freedoms for the length of the draft and potentially kills you.
Also: I'm not talking about forcing anyone here. I'm of course expecting them to volunteer for their country, if they consider themselves patriots (which they are very obviously not).
Well, that's only because we haven't had a serious war in quite a long time. If there *were* an extended war at an existential level, e.g. a war with China or something that doesn't get resolved with nukes immediately, the draft remains on the books and would come back into force tout suite.
But up until two years ago, this viewpoint was a tiny fringe! It's true that a lot of people tried to slow-walk the recommended vaccine schedule for children, but it was only a few percent who ever tried to avoid getting the mandatory childhood vaccinations that have been required for school in every US state.
The notion that any individual not taking a vaccine harms society is utter and complete conjecture. If not, what study are you citing? How was it conducted? Who took part? What analysis was used?
Nobody needs a study to see that being vaccinated reduces the risk to take up valuable space in the ICU by roughly 90% (numbers vary by age group, but essentially this applies to everyone old enough to vote).
Even with the current Covid prevalence Germany could easily sustain the load on the hospitals if vaccination rates where in the high 90% range ... (but the prevalence wouldn't be the same either)
Your English is far better than my German. Are we talking a comparison between Germany and some similarly situated country with a vaccination rate in the high 90's?
No, we are comparing hospitalization of vaccinated and unvaccinated in Germany here. The data in the report is drawn from hospitals all over Germany.
Vaccination status and Covid infection status is noted in all hospitals in Germany, regardless what you are admissioned for. We also know which patients in the ICU are there for Covid related symptoms.
Since we know the vaccination rates in the population by state, a lot of statistics can be calculated from there ...
There are also comparisions with various other Europeen countries being made, but not in the Report I linked above, except for the last page, where they put the data into international context.
Let me translate some of the interesting data for you:
Vaccination rates:
Total: 65.8%, 12-17 38.6%, 18-59 71.8%, 60+ 84.8%
All following numbers are in the format per 100k "unvaccinated/vaccinated/reduction of risk through vaccination"
Mind you, that's the data for 18th of October through 14th of November. We experienced a huge influx of patients during that period and since. Those numbers are gonna change pretty soon, since in 2-3 weeks all reserves of hospitals might be depleted and the standard of care will probably drop considerably.
There is a huge difference in the two reason to try to convince unvaccinated to take the shot, in fact two big differences:
Get vaccinated because it will eradicate covid : once we reach 70% of adults - correction, 70% of popularion, 80%...no it's 90% now, R will be below 1 and covid will go the way of the dodo... I am very reluctant to mandatory health measures justified by population benefits, but it's me and I get plenty of people would agree on this... But it's not true and I think no epidemiologist will day anything about group immunity and covid eradication anymore. Vaccine efficiency for transmission is not enough for it since delta, and there are likely animal reservoirs anyway... So this reason may be acceptable for some diseases, not for covid.
the other reason is that unvaccinated are more at risk of ending in ICU, thus in case of saturation, taking a place needed by a more civic or careful vaccinated that just had the bad luck of accident, other disease or covid despite vaccine.... This is true, but also very similar to smokers and over eater taking valuable medical resources that could benefit more prudent /civic people. I do not want to go this way, not at all and will resist any small step this way (not necessarily because i am impacted by all, i don't smoke for example and this is clearly the immediate next step in this direction, one that is already partially implemented as higher insurance fee for smokers) but because i see it growing and growing constantly and the end state is both clear and awful. I don't want covid to be a new step in this awful ladder...
BTW 90% vaccination for at risk groups is achieved in quite a few European countries... That still impose various restrictions and blame the unvaccinated for this...this looks more like scapegoating that objective analysis
Smokers and over eaters aren't contagious. They don't all show up in the ICU at once. That's a fine but important difference. If this pandemic had an R of exactly 1, I couldn't care less if people get vaccinated. It's their life and I totally support them being able to chose whether they want to reduce their risk or take their chances.
Hell, I'd even let everyone decide for themselves, if all of them would sign voluntarily a paper claiming to refuse any ICU care, if this implied other people not getting cared for at the best available standards or if it implied that staff has to make overtime.
But this isn't those normal times where we just let everyone live their own lives and nobody gets overly affected by this. This is a moment in time where individual choices with very little effect accumulate in a way that it affects society pretty heavily.
In a way this is like the climate issue. Me driving my car isn't a big deal. A billion people driving their cars is ...
> Nobody needs a study to see that being vaccinated reduces the risk to take up valuable space in the ICU by roughly 90% (numbers vary by age group, but essentially this applies to everyone old enough to vote).
So, by this token violations of bodily autonomy are justified if they reduce the amount of medical care you personally consume? Because saying that "unvaccinated people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable also implies "obese people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable.
If the argument is specifically that the difference is that COVID is contagious and obesity isn't, you would have to make the argument that a marginal person getting vaccinated reduces the total number of people infected with COVID by significantly more than one, which I don't think is supported by the evidence at this point.
> Because saying that "unvaccinated people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable also implies "obese people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable.
It does, at least to the modern left; see NYC sugar-taxes!
Your logic about the marginal patient is interesting. It's a lot like the marginal voter.
Unfortunately, public health has to deal with biology and human behavior. It IS actually true vaccination reduces both case counts as well as case severity. But you're right, one person getting or not getting the vaccine will not tip the scale. Even so, it really does matter that we get a large percentage of the public vaccinated.
In general I support libertarianism, but some things really do have negative externalities. The argument you present here makes me sigh.
Last year I heard the libertarian candidate for president in an interview say that the thinks different communities should be able to have different requirements for vaccination, and people could move if they don't like it. This kind of thinking is impractical, and terrible from a public health perspective. That one statement cost her my marginal (worthless) vote.
I should have been more specific. Borrowing from another context:
The only people who regularly get flu shots are people who regularly get the flu. People who never get the flu usually don't get flu shots. The claim that people who never get the flu not getting flu shots is the reason why people who got flu shots are getting the flu is a perfectly reasonable thing to ask for evidence for.
I admit I may be misunderstanding the general claim.
I’m in an admittedly liberal area in the USA in a liberal bubble, but all of my friends and family get the flu shot each year. They rarely get the flu. Lots of people I know have never had the flu but still get the shot each year. My town and the local university both run flu drives where they encourage everyone of every age to get a flu shot. They all do this because it decreases the spread of influenza, especially protecting people who are immunocompromised.
Certainly there are people who both don’t get a flu shot and don’t get it so they then don’t spread it, but there are also many people who would otherwise have gotten the flu but don’t because they had a flu shot. And those people would certainly have spread it to the people around them (both breakthrough cases and to unvaccinated people). That second group is who need to get the flu shot. Unfortunately, it’s impossible to know who will be in which group beforehand. We can make reasonable guesses (perhaps doctors and nurses are most likely, then teachers and students, then retail workers), but anyone is still a possibility unless they’re in a self-imposed lockdown.
This has been widely established at least since the days of Pasteur, if not Jenner. There's a reason that every developed society has had some form of vaccine mandates for most of the past century and a half (even though many of these "mandates" are actually just conditional mandates if you choose to enroll in school or the military or something else not technically required).
What do you expect 90% vaccinated will achieve that the current 70-80% won't? The reduction in virus transmission of the current vaccines is not great, maybe 1/4 at best but probably more like 1/2...so the reduction of trasmission would be 1/4*%vaccinated + %unvaccinated. We would go from 0.8/4+0.2 = 0.4 to 0.9/4+0.1=0.325...will this magically make R go below 1? More vaccinated people is a good thing... At least among the people more at risk of covid than vaccine (not clear if its all, or people above a certain age)... But hoping that at a certain threshold, vaccination will eradicate covid is untenable, since we had R well above one in countries with 70% vaccinated, in fact since the 80%+ vaccine efficiency against trasmission was reported false. At this point, group immunity by vaccination serve only one clear purpose: stigmatising unvaccinated as the group responsible for the covid problems. I guess for other groups that may have to assume this responsability (like gouvernements), it's very useful
> But hoping that at a certain threshold, vaccination will eradicate covid is untenable, since we had R well above one in countries with 70% vaccinated
So, concretely: do you expect that the number of COVID cases will approach zero, and there will be no further outbreaks, in populations that hit 90% vaccine uptake?
While the vaccines is very effective in reducing severity. it is not effective enough in reducing transmission. So I think Greg's thinking is correct. The Herd Immunity article you link says that enough people have to become "immune to infection" -- that's not what we're presently getting with the vaccine.
I am well aware of the group immunity equation... It's non linear but it's trivial... Using wikipedia notation, if R0 of covid (delta variant} is 5, you need p>0.8. If do you get more than 80% of people immune (Wikipedia speak, in full it means non transmitting, that's what count, not symptom severity) when between half and a quarter of people vaccinated still can transmit. You can't, getting 100% vaccination will not get you here immunity, it will at most reduce the charge of the hospitals... One clear outcome of the covid is that simple épidemiological models are mostly useless (something i didn't expect, they are simple and their hypothesis seems reasonable), but epidemiologist speak about herd immunity anymore... In fact, scientific theories mostly seems cherry picked to justify measures... The prédictions were wrong, countries have varying issues and problems but it's not the good students in term of vaccinating that necessarily are in better shape. Sweden is not a graveyard, India who got hit by the delta is not in the news anymore... So it's very difficult to dee what is happening and even harder to predict what will happen, but one thing is sure : lent supposed democratic gouvernement turned out to be lying not so democratic entities hostile to individuel freedom and responsibility... Given that, i consider their lack of efficiency a blessing...
How much does not being vaccinated hurt society, exactly? Vaccination does not stop the virus from being hosted or spread by humans. COVID also has reservoirs in animal populations, so there is no way to eradicate it from the Earth even if the vaccines were sterilizing.
So what is the marginal benefits to society from everyone being vaccinated above and beyond everyone being vaccinated or having natural immunity?
That depends on how many people chose to not be vaccinated. Germany currently has one of the biggest amounts of ICU beds per capita in the world. Yet ICUs still get inundate with unvaccinated people to a point where it starts to affect the medical care available to other people. That's where it starts to hurt society. I've linked and translated the relevant statistics for Germany elsewhere in this comment thread for the poster Ryan.
If the unvaccinated wouldn't show up in the ICUs, I couldn't care less about them choosing what-ever they feel right for them. It would still hurt society to some degree, as society would have to pick up the slack for the unfortunate, who have a bad outcome of the infection, but I'd consider this within the acceptable limits. We don't condone people smoking, drinking, binge-eating or performing high risk sports after all. And I totally support the "my body my choice"-motto.
Unfortunately that's not what's happening right now. Right now, in Germany, we are very close to a melt-down of the medical system, and numbers show, that, even with the same number of infections, there would be no such issue, if we were above 95% vaccination rate ...
you can not be at 95% vaccination rate in time. Depending if 95% is the total population or the at risk population, I think you can not reach 95% vaccination regardless of time and incentive. 95% is just a huge percentage. This 95% is coming out of thin air, now that ICU saturation may be a problem. When it was not considered a likely issue, western europe countries were mostly self-congratulating about vaccination percentage, playing a pissing contest to see who got a few % more than it's neighbor, and speculate about how herd immunity will be reached real soon at 60, no 70 of adults, no 70 total, correction it's 85% now....well forget about herd immunity, it was never a possibility. This 95% of vaccination is neither realisticaly achievable nor, given the track record of covid prediction, a garantee of anything. You can predict the sign of the effect: more vaccination means less ICU beds busy, all other things being equal. Not a very accurate nor usefull prediction.
So I see one practical effect of this 95% number: Designate the unvaccinated as the sole responsible for the covid troubles. And the economic crisis. And the inflation. Add climate change and loss of hairs too, why not :-)
You are arguing in bad faith here. The 70% figure was given before even the beta variant was discovered. And it was never said as a "truth", but always communicated as the bare minimum required, given the data we had. New variants with higher R values of course change that equation.
And yes: I agree that 95% of the eligible population is very hard to do unless mandated. But the virus doesn't care if we like it. We either do what we must, or we don't. Either way we have to deal with the consequences that come with it.
And yes: the unvaccinated are largely responsible for the current mess in the ICUs. It's them arriving there in large numbers. The vaccinated still only make up 10% of that, if adjusted for the amount of people vaccinated.
It was also largely them opposing what could fix this mess very easily. If everyone acts like an adult for a mere four weeks, this hole thing is over for months. We could stop this pandemic to New Zealand levels whenever we wanted to and then work a rigorous track&trace program with harsh lockdowns of small areas where ever the virus pops up. But again: coordination problems. Some part of the population never cared, some no longer care (me included), some can't be bothered ...
Now we will have to deal with the unrest leading to us losing all those lives we had saved compared to Sweden. I can already see how those who always wanted to go the Swedish route will claim how they always said it would be pointless to do anything, considering that ultimately we will probably match the Swedish death-toll per capita ...
But honestly: if they can't be bothered to get the vaccine, I can't be bothered to care about the spread of the virus after 1,5 exhausting years either. We apparently now need a few 100k deaths to learn a lesson. I can already see those who objected and obstructed all measures blaming the government for not bolstering up the health care system. They won't understand, nor want to hear, that even if we would have been able to double the numbers of employees in the ICU, which is in itself a ridiculous proposition already, this would have only bought us two to three weeks.
This didn't age well at all. The vaccines don't stop transmission and *never did*. And they're more dangerous than all other vaccines combined. So f*** you and your arrogant authoritarian bullshit.
Well, if you make up your own facts I guess in your fantasy world your comment makes sense. I won't even try to look up what you are actually referring to in my comment, considering your manners ...
Your body is defective. It caries numerous communicable diseases. You and everyone else on the planet is mandated not to defecate outside of the designated locations. Do you have a problem with that mandate?
I find the phrase "To mandate vaccines is to state that humans are all born defective," hilarious because it implies the slightest possibility that we're not all born defective in a multitude of ways.
They're saying it's an insult to claim that the microscopic defensive swarm that protects their bodies from constantly evolving enemies isn't also psychic. That we dare say we need to at least warn our immune system what it's up against and give it the chance to develop a variety of specialized weapons otherwise on its own. Meanwhile, we all have blind spots because our retinas are wired backwards, we have a nerve to our throats that loops under our aortas for no reason, and women have to squeeze their babies through their hips.
We require people to do all sorts of things in order to prevent risks to others. It's why you can be pulled over for having a taillight out - it's dangerous to other people on the road. There's nothing stopping you from driving around with no taillights, but it's dangerous for everyone else.
My point as well. But let's stop discussions with people who don't want to follow the general accepted rules - and as result make lives of billions misserable and risking millions of further deaths. In many countries one gets imprisoned on a lot less important things...
"This feels like an isolated demand for rigor." It also feels like they are ignoring the whole "contagious disease" aspect of COVID. Your headache doesn't affect me (unless you're my husband.) Your ability to infect me with COVID does.
I originally wrote "vaccines turned out not to be great on this contagion aspect", but realized I don't actually know. There are studies on viral load in breakthrough cases, but is there any data on how contagious these people really are?
Once a break through happens, they apparently are as contagious as non-vaccinated. However, being vaccinated apparently shortens the length of time they are contagious. The infection rate of a vaccinated index patient apparently is roughly 50% of that of an unvaccinated index patient.
Add to this, that vaccinated people only have 30-50% probability to get infected in the same scenario in which an unvaccinated person gets infected, and you have a pretty good reduction in contagion.
Now add to this that being vaccinated reduces the risk for patients to require ICU care by approximately 80% and you can see why hospitals can operate normally with vastly larger incidence values in the population if everyone is vaccinated, as opposed to a population with large clusters of unvaccinated people.
I find that very unlikely. I've always thought that rare breakthrough cases of measles, mumps, polio, etc. could infect other people - let alone the much more common breakthrough cases of flu. What's changed now is that breakthrough cases of COVID are more common than breakthrough cases of anything else (except maybe flu), because there's a huge pandemic going on.
"s that breakthrough cases of COVID are more common than breakthrough cases of anything else"
How do we know that for polio? IIRC only a very small percentage of even unvaccinated people will develop symptoms like paralysis. The vast majority of people will experience fever, fatigue, vomiting, stiff neck, headache, etc. If you'd been vaccinated as a kid and then felt shitty for 2 days you're not going to go tested for anything let alone polio.
I think they were saying that the absolute number of breakthrough COVID cases is high compared to breakthrough polio cases, which is trivially true since there are no polio cases (in the USA) and many COVID cases.
"The Salk vaccine had been 60–70% effective against PV1 (poliovirus type 1), over 90% effective against PV2 and PV3, and 94% effective against the development of bulbar polio."
If it's 60-70% effective than 30-40% of vaccinated people got polio. Keeping in mind that much like COVID polio was mild for most people. It wasn't like anyone who got polio ended up in an iron lung, I think it was well into the low single digits.
That also stood out to me. We're a bunch of hairless apes creating by the alien process of evolution. We're barely able to hold together a civilization and stave off everything this uncaring universe throws at us to kill us. It is very inspiring to me that we made it so far, and I deeply hope we will make it even farther.
But to think that you have some kind of God-given right to survive a virus is very bizarre to me. There is absolutely no reason why humanity will only ever face threats that it can overcome. If we want to survive we really need to pull all the tricks. And the mRNA vaccines are just marvels of human ingenuity, that will allow us to hold on for a bit longer.
I think a good analogy would be clothing. Mandating people not walk around nude seems like it is a "state-approved hoop" imposed because your naturally unclothed state is "defective".
It's absolutely an assault on bodily autonomy--the right to use my body in the way I choose! I am now no longer wearing shirts outdoors since it is one of my only methods of protesting the government's mandates on my bodily autonomy. Nevermind that it's -20F outside.
This is slightly uncharitable but is basically how I view people who refuse to get vaccinated as a form of protest against even a valid example of government overreach. You're hurting yourself and making this whole damn thing last longer too.
Yes, as nudist I would prefer allowing everybody to be nude but required to poop in a toilet, instead of everybody be clothed and poop anywhere the mood strikes.
"Author briefly looks at 30 of the 66 studies, which we note is much better than most commenters, but still ignores the majority of studies, including the prophylaxis studies."
My reaction to that one is "Oh, person, try me!"
I trawled my way through that Cochrane meta-study of the various studies. A heap of them were "throw everything at the wall and see what sticks" where they dosed people up on ivermectin and whatever they had lying around in the dispensary cupboard; some of them were "you're not testing what you say you're testing when I read your paper" and at least one was "we done screwed up".
One of the positive ones recommended you take your ivermectin with a meal and alcohol, because that made it work better. So at least you get to have a nice steak dinner with a glass of wine, which should make the experience pleasant.
The positive results ranged from "mild" to "really great but it's in Florida". There's no way to say "All the studies or most of them anyway say this works fantastically".
The longer Americans don't get their damn shots already, the stronger the argument against donating the leftover doses becomes: "we can't donate that vaccine, Dr. Scott in the Bay Area hasn't taken his yet! Would you vaccinate some random Nigerian before Dr. Scott?!"
And that's even assuming those shots *could* be donated. Poorer countries have been discarding doses left and right for months.
This finally clarified to me why I've been getting so god damn HEATED about COVID-19 and global warming denialists in general, compared to other things.
It falls under the list of vague "social contract" things I expect everyone to do because I have to do them too.
Eg, I like being loud in public. I like fighting. I like driving fast on mountain roads. I like shooting guns in my back yard.
But, I don't do any of these things, in exchange for everyone else not doing these things; so when I see a defector (someone not getting a vaccine; someone driving perfectly buffed out brodozer with the fake lift and no liner) it pisses me off because: I wanna do stupid shit!
If I can't fight people in line at the grocery store and shoot squirrels at the park with a 762 and drink in public, YOU have to wear a mask and get your fucking shot.
We live in a civil god damn society where 90% of our individual liberty is sacrificed to protect our ability to live groups; and that's good because if we didn't idiots like me would try to box you for wearing a loud shirt or some equally dumb shit.
The social contract breaks down, we return to state of nature, and I box you in the grocery store line before stealing all the bourbon and burning it down on the way out.
Or, alternately, everyone publicly shames you for being a selfish piece of shit, you loose your job, your wife leaves you, and we all stand in a big circle and laugh at how dumb you are.
Or, in reality, Nothing really happens because you are utterly unimportant and literally nobody but your mom cares what happens to you or what you do.
That's a pretty extreme case of putting words in my mouth, and if that's how you interpret my comment, I think that warrants skepticism of your ability to interpret the positions of other people who disagree with you as well.
The point Nah is making is not that masks in themselves are the lynchpin of civilization, but that the social contract which our civilization *does* rely on involved people mutually accepting obligations they don't like in exchange for other people respecting obligations towards them. From that standpoint, you don't mutually and respectfully agree to disregard parts of the social contract you don't like at your discretion, the social contract is what keeps you living in basically peaceful cooperation in the first place.
The problem is not everyone agrees on what shouldn't be allowed. You don't shoot squirrels at the park even though you want to, but why? What if everyone did want to do that and would have no problem with everyone else also doing it?
That's the problem we have now, except 50% of the people have a problem with you shooting squirrels and 50% don't and would also like to do it. And the government isn't even trying to put a number of this, it's just picking one based on ???
This would be defensible if there was an actual vote and the majority actually said "we want this, and we live in a democracy, so suck it up". But afaik even that hasn't happened.
for 1, can you link some polls? I'm not familiar with the area myself so i wouldn't know what are good one.
For 2, come on. We both know polls are pretty much worthless for anything. See the Yes Prime Minister skit for that. It's trivial to change consensus based on a single word choice, plus polls are unlikely to capture the same demographics as those that vote.
For 3, even if true polls are not a substitute for the formal democratic process. We don't choose the president based on polls.
Polls aren't worthless for anything, but yes, they are not a substitute for the formal democratic process. However, if we want to know "does the majority want this," which was the question you were posing earlier, than yes, polls can broadly tell us if Americans do want this. And when answering this question we do not have to think about some of the factors that make presidential polls have a higher relative MOE.
Well, the problem is, like i mentioned in #2 i simply don't trust polls. :V
Going through and reading the actual data on the survey, it's actually not bad, so it updates my priors on the belief a bit. But it still has some problems
1. It was online only, which vastly limits who exactly sees it.
2. The response of the public is contradictory. 65% are in favor of a vaccine for everyone, but only 63% are in favor for giving it to children (who are presumably included in the everyone category).
3. I simply cannot believe that 45% of republicans are in favor of a vaccine mandate. Like seriously, 45%? Or Republicans? That's antithetical to their entire ideology!
Either i'm living in a bubble (very possible), or polls are completely worthless (much higher possibility. How were the polls on Brexit and the 2016 presidential elections?). But fair, i will retract my complaint that governments are not trying to put a number on this. I was incorrect there.
Sure, it was online only, but polls usually correct for non-response. Also, a vaccine mandate "for everyone" presumably means adults, and even if you disagree that that's your interpretation, you have to admit that at least a good amount of respondents would interpret it that way.
And imo your priors are all out of wack. There were errors by individual pollsters, sure, but the poll models were pretty accurate. 538 gave Trump around a 1/4 chance of winning, and just because he won does not mean those polls were worthless-- he had a 25% chance to win. If pollsters gave Clinton only a 51% chance to win, and Trump won, you wouldn't say that the polls are bad-- just because Clinton had the bigger chance to win doesn't mean that because Trump won, polls are worthless. The whole "2016 election means polls are worthless" is just a really, really tired critique.
There's definitely a bigger chance you're in a bubble. We're all pretty much in bubbles. Scott talks about this all the time.
Most Republicans had no issue with vaccine mandates a few years ago. The fact that *about* half do now is testament to how quickly a newly generated political controversy can morph into ostensibly philosophical principle.
This strikes me as odd, because OWID reports only 59% of Americans are fully vaccinated (~70% at least one dose), lower than most other developed countries... surely very few unvaccinated support a mandate, while many of the vaccinated won't support a mandate.
Devil's Advocate counter-argument: we only metaphorically signed the social contract because it had big exceptions in red to which liberties are fair game for regulation. Freedom to move around within one's home town to meet one's loved ones is one of them: locking people up is something we only do to our worst defectors (serious criminals) and preventing them from seeing loved ones is something we pretty much never do (see: the outrage about separating migrant children from their parents).
If I sign a contract allowing you to seize any of my inanimate possessions if necessary, but the contract specifically mentions that *obviously* my infant daughter is not included; and then you stroll in to seize my child; and you say, "oh come on you big crybaby, you didn't complain when I took your bedside table and your frying pan, and anyway it's for her own good, clearly you'd a bad influence on her given how much you're complaining right now"; then I have a pretty clear right to be upset and feel like you're breaking the rules of the arrangement.
In fact, if I may go a bit meta and speculative…
In general, I think the social contract is perceived as trumping a very loosely-defined "natural law"; controversial areas about the state's rights tend to come back to a nebulous category "things which nobody should be allowed to do to another monkey under any circumstances" (e.g. "tell you to get stabbed with a needle against your will", "forbid you from visiting your parents/siblings/significant other" – but also "kill you with premeditation" or "force you to go through with a risky pregnancy"!), as defined against the things which everyone would be allowed to do in a "moral, but anarchic human grouping", but which in an organised society we make special privileges of government enforcers (e.g. "kill enemies if they're currently threatening us and can't be peacefully subdued", "take a percentage of this year's earnings").
In the United States, even at the peak of "lockdown" around March 24, people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise". Never once at any place in any of the United States was any of this ever banned.
And of course, 95% of the time since March 24 has been at far lower restrictions than we had on March 24.
And never once was this wink-and-nudge "it's totally ok to practice your liberties as long as you lie about it" unequally enforced? No one was picked on for doing the thing everyone else did even though it was technically illegal? No one in government abused this power and no one who played along got punished anyway?
In a way, this half measure is even worse than a full measure. Because when people who did get away with it got caught, they just used their power to claim "nah it's ok it's in the spirit of the law" (citation: the dozens of times this happened with politicians), and when the people who didn't get away with it got caught, people said "well they were going against the law, so it's fine they get punished (citation: the times people picnicing alone or playing with their kids in the playground alone were arrested). You've just make the powerful even more above the law then they were already.
What wink-and-nudge are you talking about? I assumed the person meant that they wanted to see their friends and family, and you were always encouraged to go out for a walk with your friends and family. Were they asking about doing something that was actually technically illegal? Because it didn't sound like they were.
(I'm also a bit curious about the politician cases - I thought the most prominent politician case was Gavin Newsom having an indoor unmasked dinner at a restaurant on a date when that was still legal, but he had just ordered a mask mandate to go into effect a week later.)
When you said "people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise"." i assumed the implication was that you just had to justify your reason to visit with an excuse. You couldn't simply visit family because you wanted to, you had to provide an excuse to do the same thing, correct? That's the wink-and-nudge. Because it is technically illegal to see your family or partners without any given reason (Scott mentioned that in his lockdowns post, about how people had gone months without seeing their family/friends because they interpreted the law literally and didn't see the wink-and-nudge).
Oh, I was thinking it wouldn't be an *excuse* - you just had to actually be outside walking.
And in any case, I don't believe any part of the United States had an actual ban on visiting inside the home of a friend or family member for more than about 6-8 weeks in early 2020. It wasn't like the UK, or parts of continental Europe, where you actually weren't even allowed to meet up with friends or family outdoors for several months.
The Tophattington comment was based in the UK. The lockdowns that occurred in other countries, such as Canada and Australia, were much more significant and draconian.
Yes. The set of policies has been extremely difficult in every place, and I think no one should ever use the word "lockdown" because it serves to obscure rather than highlight these differences.
I'm not fine with using a single word to describe everything from a suggestion that people sometimes wear masks at school to welding people into their apartments. And that's what any debate that uses the word "lockdown" (or "flurb", I guess) very quickly becomes.
Describe the actual policy you want to support or criticize. Don't just say "lockdown good" or "lockdown bad" or "lockdown make me crazy".
"people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise""
That's...completely untrue? From November 2020:
"In New York, Gov. Andrew Cuomo last week banned indoor and outdoor gatherings at private residences from having more than 10 people."
Even outdoor gatherings of more than 10 people were banned!
And even if they did allow family gatherings outdoors (which they didn't!), it is still an overreach of state power (and a violation of the Bill of Rights) for the state to limit freedom of assembly indoors, especially in the cold winter months.
It sounds like they *always* allowed gatherings of less than 10 people!
I do think those rules banning outdoor gatherings of more than 10 people were silly, and it probably was overreach to *ban* indoor gatherings of over 10 people (though it was perfectly reasonable to extremely strongly recommend against them).
"In the United States, even at the peak of "lockdown" around March 24, people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise". Never once at any place in any of the United States was any of this ever banned."
Even that much was banned for several months in California, unless you were "meeting" people from at least six feet away. For people who lived alone and didn't have e.g. health emergencies requiring medical treatment, any physical contact with another human being was technically illegal. Enforcement was rather lax, so if you could find a willing co-conspirator you could get away with it, but that's hardly a justification.
I think everyone has amnesia. It truly boggles my mind how some people can act like the lockdowns are just a thing that happened. Do you remember what I remember?
In 2018 I met a girl who grew up in former-Yugoslavia during a civil war. In person schooling was cancelled, she watched math lessons on a TV while staying low to the ground to avoid stray bullets. She went on to get a PhD in math, which is very impressive. I'm so so glad I haven't ever, and probably won't ever, live through that kind of adversity.
In February of 2020 I spoke to a friend living in Beijing. She described a police state, a complete shutdown of society, and she said it had been going on for a month. I was horrified, and I felt so glad that I live in America, instead of China, where I had never suffered, and probably would never suffer, that kind of adversity.
In March 2020 lockdowns were in the air. More and more of society was being interrupted, and it was hard to believe it was real. All of us, very reasonably, didn't want to live like caged animals. But we talked about curve flattening, and overwhelming hospitals, and asked what we absolutely had to do to preserve our way of life. We were just barely convinced that a few weeks of lockdown might be necessary, despite the obvious and incomprehensible adversity it would inflict.
Then a few months later, it feels like some of us just decided that lockdowns aren't bad. I'm not saying they may have been worth it. I'm saying some people were happy to extend them even if it wasn't vitally necessary for the preservation of our civilization. Not as a last resort, acknowledged to be horrible but deemed unfortunately to be necessary, but just cause it might help and why end them. This reversal seems like the kind of gap which cannot be bridged. Anyone who feels this way is Varelse, so alien to me I can't begin to reason with them.
Comparing the lockdowns to not playing loud music after midnight feels very much like comparing genocide so slapping someone in the face. No governmental body has the authority to do this, and when it is necessary it still must necessarily scar our society to the core.
I'm vaccinated for the record, because I think it will end the lockdowns sooner. I will never recover from 2020, and I will never forgive anyone who lost sight of the collateral damage done by the lockdowns.
I would like you to cite the unforgivable collateral damage you are accusing the lockdowns of. As of right now your post is pretty much entirely based on heightened emotional reactions and insinuations that lockdowns in America are analogous to the extremely harsh, if-you-try-to-leave-this-infected-block-we-will-shoot-you-stone-dead Chinese lockdowns and living in a country in the middle of an active civil war.
The difference between excess deaths and covid deaths has been used by many people to argue opposite claims - some claim that these are undercounted covid deaths, some claim that these are deaths due to the covid-mitigation measures, some claim that these are deaths due to the pandemic situation that are independent of mitigation measures and infection itself. I think it's very hard to disentangle these things, but one would expect that if effective mitigation is possible, then there *should* be more deaths due to the mitigation measures than due to covid, because the large number of covid deaths would have been *prevented*.
I agree it's very difficult to disentangle everything. It just strikes me that in terms of mortality whatever is killing so many mid-aged people (the 25-44 range) is to that demographic a much larger public health concern than covid, and it's not really subject to any investigation.
My point is that you have to actually *do* that disentangling to figure out whether the way to prevent those deaths is to do more or less mitigation measures. You can't just assume that the deaths are due to mitigation measures, since it's quite plausible that the deaths are actually being caused indirectly by the widespread presence of a novel disease.
> I think it's very hard to disentangle these things
It's pretty easy actually. If lockdowns kill at detectable levels, you should be able to find places where (1) lockdowns happened, (2) during which infection prevalence was insignificant, (3) during which, or shortly after, there were observable excess deaths. So for instance you can compare American states' performances for the first 6 months of the pandemic, when there was a large variance of infection prevalence. If you do this sanity check, the picture is so blatantly obvious that you don't even have to do regressions to see that [lockdowns + no viral spread = no excess deaths]. This holds both temporally (in a fixed place), and spatially (during a fixed period).
Furthermore, if you plot excess deaths time series, superimposed on a plot of deaths officially attributed to covid, superimposed on a plot of officially detected covid cases, anywhere you look, you'll see that these graphs always trace each other. Cases go up -> official covid deaths go up -> excess deaths go up. Excess deaths go down -> cases have been going down -> official covid deaths go down. Cases approach zero -> excess deaths approach zero.
You can do a regression of excess deaths vs cases/deaths spatially (counties), or temporally, if you want to make real sure, and some people have done this, and the result is—as everyone with a measure of good judgment have pointed out from the very beginning—excess deaths are overwhelmingly dominated by covid related deaths.
So for instance, in Peru, there was a wide discrepancy between excess deaths and official deaths. These were, however, obviously temporally correlated. So officials checked potentially missed deaths (like respiratory failures, pneumonia) that were not officially attributed to covid, and they deduced that, yes, almost all excess are covid deaths, and officially switched to attributing all excess deaths to covid.
I think the only country where the official numbers of Covid deaths was not lower than the excess death rate was Belgium, they classified all unexpected deaths associated with respiratory infections as Covid deaths, even without testing. They got a lot of flak for that, but they defended themselves as being 'transparent'.
I read the first half of your comment and nodded along. But then the second half said exactly the opposite of what I expected. I expected you were going to say that we had maybe four weeks of significant restrictions, and then since then we've been basically unrestricted in the United States, apart from masks and a few kinds of indoor public activity. And people are acting like we lived through the Balkan Wars!
> I expected you were going to say that we had maybe four weeks of significant restrictions, and then since then we've been basically unrestricted in the United States
... One of us has amnesia for sure. That is not how I remember this going down. I had to work from home, away from my team, with increasingly declining mental health for 6+ *months*. And I'm in Michigan; hardly the tightest of regimes on WFH.
The lockdown/WFH experience certainly varied depending on where you lived and what company you worked for.
Not that it makes your experience any less painful, but I had basically the opposite experience. Significantly improved mental (and physical) health doing WFH for about 8 months, and pretty much immediately reverted once I returned to the office.
How many states actually had rules mandating that offices stay closed after about June or July of 2020? My understanding is that none did, but offices stayed closed anyway.
I think I've lost where exactly we are in the dialectic, whether we are debating what the government rules should have been (should the states have mandated office closures for longer or not?), or what companies should have done (should companies have brought people back into their offices earlier?), or something else (should states have mandated the end of work-from-home?). (The use of the word "lockdown" does nothing to help with this, but only serves to run together some extremely different experiences, like the one you and I had, vs the ones that people in Wuhan had in February 2020.)
I'm agnostic between whether the government or individuals are to blame. I just know this was the worst year of my life by far and I want it to be acknowledged that a bad thing happened.
I also was not comparing the lockdowns to the Balkan wars, though I see how that's confusing. I'm trying to point out that these things used to feel alien and we should go back to viewing these circumstances as extreme instead of just "this is how life be sometimes and a better world just isn't in the cards." I never thought the lockdowns were as bad as the war, but I thought they were as remote.
Lastly, the monumental suffering is a billion papercuts. It's illegible and difficult to quantify. If this only happened to a million people it would be just a rough time, but it happened globally for a year and it just sucked a lot of the joy from life for an unfathomable number of people. If the introverts who liked it outnumber the people like me who suffered in hard-to-quantify but very real ways, that would go a ways towards changing my mind. The lack of urgency with which people are discussing polling data around that speaks to a callousness and lack of desire to grapple with the last year. We concentrate on the deaths because they're easy to count.
As an introvert for whom it wasn't that big a disruption to my normal life, it was a) still very negative and b) I recognize that other people like to leave the house even if I don't. If this results in working from home being an option for those who want it even absent pandemic measures, great, but I can still recognise that it sucked for a lot of people.
(N.b. I live in Melbourne, Australia, which had the strictest lockdowns and the longest lockdowns of any developed nation. The American limits look laughable by comparison - no big parties is very different from "no seeing anyone at all")
Do you believe the suffering caused was so immense it outweighs the suffering caused by a death toll 3-10 times above where it currently is? Would you be able to deal with the guilt if it was found out through contact tracing that you were the person who caused another to die from an infectious disease?
Perhaps you'll call me callous for this, but from my own personal experience of living in extreme social isolation for several years due to mental health issues: you can recover from social isolation and the attendant psychic injury. You can't recover from death. I am not trivializing the effects of social isolation, I am saying that if your calculus comes out to "I would rather take on a very high risk of myself/people I know and love dying from a novel pandemic disease than endure four weeks of lockdown", I don't believe you have a good ability to assess threats. You act as if a large portion of the population have had their souls sucked out of them and will never be happy again.
I didn't mind 2020. Apart from losing my job, it was okay. I'm a homebody. I played video games and wrote some free software. Now I'm working from home and delighted that so many other people are interested in "hybrid work", as I'd rather not commute every day.
I wonder how many people are more like you and how many are more like me.
Same. I'll also note, and I shared the same opinion at the time, that at least where I live, actual observation of lockdown requirements was so limited that I argued that the lock down should be lifted even if no lock down and an unchecked pandemic was the second worst realistic outcome, because the worst would be a half heartedly implemented drawn-out lockdown which hurts people's livelihoods while failing to meaningfully limit the disease. Watching how little people actually observed the requirements , I could only think there was no way this would help.
You had me in the first half, until you got to part 2/2 where you describe an imaginary America that doesn't exist.
I live in a state with just about the strictest lockdown measures; and the only things I couldn't do during peak covid was dine/drink inside, shop without a mask, or attend large public gatherings.
I could meet people outside, I could meet people inside, I could get food at restaurants and eat outside, I could shop, I could do whatever the fuck I wanted except for those two things.
Emotional histrionics about living in totalitarian Massachusetts aren't going to change my view here.
It's clearly true that people had different experiences. Obviously some people actually weren't too put out by the arrangement, which is likely why they forgot how barbaric it is. Also, I'm not only referring to the governmental impositions. My employer caused most of my personal suffering by closing the office. I also suffered a fair amount because the local SSC meetup went virtual. We did this as a society, it's not just about the government.
I missed three funerals for close family members due to the lockdowns. I'm not an introvert, I get my most satisfying social interactions at loud, crowded parties and bars. I live in a small studio apartment, so with the office closed and cafes closed and the weather not amenable to staying outside, I spent most of my days in one chair in one room. I hate online shopping, I find great fulfilment from browsing around inside local shops. Going to see movies in theaters is one of my greatest joys. I still can't get proper medical treatment, the psychiatrists in my area won't meet in person nor will they prescribe the medication I need to new patients they haven't met in person (I imagine there's a way to short-circuit this obvious catch-22 but I haven't found it yet), and I can't get my annual STD screen because all the clinics are currently closed unless you're symptomatic.
I know not everyone was as put out as I was. I know not everywhere had the same lockdowns. There's a reason all the things we couldn't do are coming back once we can though. It's because people prefer it that way. People on net prefer having the option to meet other humans in public spaces and interact with a crowd, they like having an excuse to leave their home and explore the space around them. The suffering caused here is monumental, and deserving of fucking acknowledgement. I'm not claiming that the lockdowns were unjustified, just that they were a big fucking deal and deserve the same strict scrutiny today that they deserved and got in March 2020 before some people got acclimated.
There's a metaphor I like that I'll share now, though it's only tangentially relevant. Imagine Quetzalcoatl came down from the sky and credibly proclaimed that he would destroy all the crops on earth, starving billions to death, unless we sacrificed 100 healthy children in his name. In this situation, it would be perfectly rational to round up 100 healthy children and murder them in cold blood. Anyone who argued against it would be wrong, and they would rightfully be accused of essentially wanting to kill billions of people. But if we killed 101 kids, because once you're killing 100 why not kill 101, then that would be awful, the people responsible would be monsters. Lots of the last year I've felt like the guy questioning whether the count was accurate and are we sure we didn't kill 110 kids on accident, and I'm seen as the guy who wants Quetzalcoatl to cause a global famine. How would you feel about the lockdowns if they didn't save lives? Would you be so quick to defend them if they hadn't been absolutely necessary? If not, then the possibility that they may have been stricter than necessary should concern you deeply.
I normally favor erring on the side of personal agency and responsibility. When it comes to a global public health threat that is very, VERY credible, I'll fully admit that draws out a higher-order prior and I'm perfectly fine with erring on the side of harshness if it leads to better results.
I am sorry that this has been very hard for you and lots of people. I feel zero obligation to endorse what to me is tantamount to demanding my community (which consists of a large number of people who are at-risk for COVID and have a history of suffering mass deaths from contagious disease) all fall on our swords so you can continue to party.
The fact that a common punchline about it is that we're the primary victims of the opiod epidemic, along with centuries of history, has made that very clear. I by default assume people outside of my community are at best callously indifferent to our suffering and at worst actively hostile and planning to cause material harm, because historical evidence bears this out. The fact you are saying, in essence, "You should all FOAD because I refuse to even do so little as wear a bit of cloth across my face in public" further cements this as accurate.
>Not going to win you friends
As illustrated above, my community doesn't have friends outside of itself. I have made my peace with that.
I'm making no such demands and it would be unreasonable for you to accept them. Fully agreed.
Just keep in mind that not everyone who's pissed about the lockdown is making that demand. There were two flavors of tragedy last year, both are clearing up now but slower than we'd like, and it's best not to argue about whose tragedy was greater. I mean sometimes we have to, for making policy decisions, but lets not feel like we're winning when someone else has to sacrifice for us.
I am not demanding anyone else make a sacrifice I am not also making myself. Your phrasing makes it seem like like the vast majority of pro-lockdown people are swanning about to parties and are trying to use lockdowns to persecute people.
I wonder if the difference in perspective is partly due to differences in introverts and extroverts. Maybe to some of us, having to commute in traffic 2 hours a day and work in a noisy office is 'barbaric' and working from the comfort of our home is a welcome change. I acknowledge this has been hard on you and many, many others and I don't want that for anyone. You could acknowledge that for some, it was the old way that was hard.
That's actually a hard one. I see a clear parallel: there are two ways of working, some people prefer different ones, ideally we'd have our choice but in practice we don't always, and so switching from one equilibrium to another is morally neutral.
On the other hand, the phrase "in practice we don't have a choice" feels like it's hiding an asymmetry. That is, it feels like being forced out of your comfort zone by lockdowns is different from being forced out by societal equilibria. I acknowledge that that's probably unprincipled, but it's emotionally appealing enough that I'll need to think it through more.
From my perspective, I spent a decade learning to trick my brain into being productive. I had a system. Then suddenly that system became essentially illegal, and I was left with no coping strategies. I assume (unfairly?) that people who like working from home had the same opportunity to learn to cope with the difficulty of working in an office, and so the difficulty they face would be longer term but still smaller in magnitude than the difficulty faced by anyone for whom the situation wasn't an improvement.
Like my competence at my job took such a hit last year it's frankly unreasonable that I wasn't fired. I'm sure if I got to do college over I'd have figured out how to work from home, just as you had your whole life to figure out how to work in an office. But I had no such opportunity, and the discontinuity feels like it must be worse than a life-long issue you can learn to deal with and plan for.
I realize the logic there isn't quite right, and I'm typing this publicly because airing my ignorance like this often leads to opportunities to learn how silly I look to others and build empathy.
I think people vary pretty significantly in their ability to adjust to personally suboptimal environments. Inspect a couple years working in substantially extrovert-favoring environments, and l found it possible to be productive at work, but it came at the cost of most of my overall happiness. The kind of "living nightmare" experiences people describe from the worst levels of lockdown are relatable to me based on that experience, with finally quitting being one of my most profound experiences of relief, while the pandemic for me was nowhere near as difficult emotionally.
"YOU have to wear a mask and get your fucking shot"
1. Who decides that wearing a mask is still part of the social contract in the post-vaccine world? There's no such social contract.
2. Vaccine mandates have a much longer history but the way they're enforced (via restaurants/bars) is novel and not a part of social contract. Enforcing it via the state's own resources (i.e. denying Social Security to the unvaxxed) might make sense, but not the "Papers Please" regime we have now.
"But, I don't do any of these things, in exchange for everyone else not doing these things; so when I see a defector (someone not getting a vaccine; someone driving perfectly buffed out brodozer with the fake lift and no liner) it pisses me off because: I wanna do stupid shit!"
Related: The Dano-Norwegian author Axel Sandemose (a dry-humoured heavy drinker who wrote great novels & essays, including his famous Law of Jante) once wrote about his meeting with a proto-libertarian rich shipower complaining about the lemming-like behaviour of his countrymen, dreamily sighing: "Imagine if everybody in our society at least once did what they most desire to do, if only for five minutes, and preferably all at once."
Axel Sandemoses reaction: "I paled at the mere thought".
I can totally buy "the social contract says you have to do this," but the social contract is typically worked out over decades or centuries.
Some people are worried at "if we couldn't get our shit together and just all vaccinate for something as mild as coronavirus, what would we do for something worse?" And I think that's a good and honesty worry!
Meanwhile, some other people are worried at "if the government can clamp down on us for this virus, what other excuses are they going to find to clamp down on us again?" And I think that's a good and honest worry!
We had similar debates about the war-on-terror versus freedom. And history shows it's important for society to have these debates instead of either side getting to short circuit it, so we can, over time, arrive at our "social contract."
I agree that there's value in having a public debate about what policies we should and shouldn't implement, but then, I think that there's kind of a schelling point around actually following the policies that are implemented until they can be changed according to official channels.
If someone were opposed to the whole host of new TSA safety procedures implemented after 9/11 as security theater, well, I'd have a lot of sympathy for their position. But if they refused to actually follow them when called upon to do so, they'd be refused airline passage at best, imprisoned at worst.
"Most thoughtful" might be damning with faint praise, given that all the other proponents have been pushing fraudulent studies, bogus observational correlations, and unsubstantiated personal anecdotes ("I'm a doctor who has treated 3,000 patients with ivermectin and they all did great!"). Not hard to come across as a giant when everyone else pushing ivermectin is 2-feet tall.
"Most . . . dedicated" isn't even faint praise, as it points to the tendency to belabor certain points ad nauseam, to write long tweet threads dismissing critics while not being fair to their arguments, etc.
A reasonable critique of Fluvoxamine is that the primary outcome of the trial is a bit weird. The primary outcome was hospitalization/emergency room observation lasting more than 6 hours, and the difference detected was in the observation time, which is a bit subjective and not necessarily relevant to the patient
Adding up statistically insignificant results to get a statistically significant one is not a horrible idea.
But. Negative results should be weighted higher than positive. We'll need an elaborate weighting system to compare different studies. An Egyptian study done by some no name (as judged by his citation index for example) should have very little weight compared to a study done by known scientists in a first world country. RCTs should be weighted my higher compared to other studies. Etc. And we would never agree on the exact weights of every parameter. So it is unusable in practice.
However, one exception to the rule could be a situation where we have 20 studies on X and all of them are showing positive results and to get statistically significant results on X we would need a trial with like 1 million people.
Yep, publication and selection biases are such obvious threats, that ignoring them you can literally get a positive result for anything. Which Scott in his extremely polite way notes to people who I'm almost sure are acting in bad faith.
"I also think people are overestimating conservative elites’ role here by deliberately conflating opposition to vaccine *mandates* with opposition to *vaccines*. A lot more elites have come out in favor of the first than the second."
Definitely agreed that this distinction is vital and keeps getting lost in the discourse. I am arguably one of the conservative semi-elite (went to an Ivy law school, clerked for a GOP-nominated federal judge, now working for the state government in a red state). I strongly oppose vaccine *mandates* on both legal/constitutional grounds and on the grounds that the scientific calculus of cost versus benefit doesn't point in the same direction for everyone... But I am vaccinated, my wife is vaccinated, and I generally encourage my adult friends to get vaccinated unless there's a clear contraindication. I feel like I am far from alone on this position, but it rarely gets much traction in the broader discourse.
Thing is, the mandate wasn't announced until September. Trump's getting booed happened about two weeks before, in August. This was also the time period when four conservative radio hosts died from covid after loudly arguing against vaccines and *for* ivermectin and other treatments. They were not arguing against mandates.
I have a Republican friend and business partner who was staunchly anti-vaccine. He thought it was the left trying to control the population. I wonder where he got that idea?
Then a doctor friend of his, also a Republican, got COVID and very nearly died. He spent a month in the hospital and lost something like 60 pounds. His doctor friend told him to get the vaccine.
My friend got the vaccine, but also had the broader realization that political communicators use fear to drive partisanship. He's still a Republican but less prone to believing people like Jack Posobiec. I hope that lasts.
Fair points. I am not sure if conservative radio hosts and podcast hosts count as "elite," but they definitely play a role in driving opinion, and I agree they have generally been more anti-vaccine (as opposed to just anti-mandate) than most elected officials or, say, the National Review or Heritage Foundation staff.
I think many conservatives saw the threat of mandates looming ominously well before they were handed down (given the recent developments, it's hard to say that their fears were wrong) and this unfortunately polluted a lot of the discussion about the effectiveness about vaccines themselves.
I'd believe you, if Republicans EVER made that distinction to the base.
The modal twitter republican thinks the Vaccine was developed by George Soros in collaboration with Lucifer the First of the Fallen to contaminate their precious bodily fluids so Bill Gates and the NWO can.... Do something vaguely sinister?
I know twitter isn't real life, but on the other hand I also know a guy who is refusing to get the shot even though he runs an equipment repair business where every single one of his clients REQUIRE proof of vaccination to work in their shops.
Of the conservatives I know well (about 25), all of them are upper middle class professionals or business owners with a couple million, and 2 of them (who are 75+) have the shot.
Two! Two out of Twenty five! These are not good numbers.
If the republican elite actually believe what you say they do, they certainly aren't coming out and saying it.
“I'd believe you, if Republicans EVER made that distinction to the base.“
Isn’t that pretty much the standard position of every Republican governor right now? Vaccines good, mandates bad? Hell, our state AG is participating in a lawsuit against the federal contractor mandate, while there are literally glowing signs owned by the state telling everyone on the highway to (voluntarily) get vaccinated.
Should the Democrats be judged solely on he wackiest Twitter voices?
Edit: I should have read to the end, you did note “Twitter is not real life”. I would maintain though that the ant-vax messaging is largely not coming from GOP politicians, but other right wing sources. Why it’s caught on so much honestly baffles me, it makes no sense except pure tribal signaling, but even then it’s weird since a lot of the tribe leaders are on board with vaccines.
They got a lot of votes and wield actual power, so that’s not nothing.
I mostly object to the idea that there are no Republicans who are promoting a pro-vax but anti-mandate position, when that is in fact the modal position of GOP elected officials.
Their “base” might be ignoring or actively disagreeing with them, but not because they aren’t trying.
In May Tucker Carlson did a segment where conflated VAERS reported deaths after receiving the vaccine with deaths caused by the vaccine. After telling his viewers that 'everyone in authority wants you to get the vaccine' he said 3000 people died after receiving the vaccine. Tucker or 'The Five' is usually the most watched show on Fox. The segment isn't openly anti-vaccine, but the narrative is 'everyone in authority is pushing you to take this drug, they won't tell you the downsides, here's my estimate of the risk it will kill you which conflates death after receiving the vaccine with death because of the vaccine'.
Trump was also vaccinated in January, and unlike every other president wasn't vaccinated live on air. He was was asked to participate in public service announcements promoting it and declined.
Some conservative politicians have come out in support of it for sure, but a lot of top people simply declined to say very much about it, and indicated a tolerance of vaccine skepticism if not approval for it. Given the lives at stake and the non ideological nature of voluntary self vaccination, the fact that conservative media and political elites are not willing to pay even the most trivial cost with their base in order to save lives and benefit society is a massive indictment of their moral courage.
>I also think people are overestimating conservative elites’ role here by deliberately conflating opposition to vaccine mandates with opposition to vaccines. A lot more elites have come out in favor of the first than the second.
I think you mean "against," not "in favor of," unless I'm misunderstanding?
The problem with taking "vaccine skeptics" seriously is that they have repeatedly proven themselves willing to promote any lie that serves their agenda. (This was true before COVID, and is true of COVID vaccines as well.) That doesn't mean they can't be right, it just means that you can't *assume* they are right.
Most of the current vaccine skeptics are a vastly different sort of person than the pre-COVID vaccine skeptics, so I wouldn't extrapolate from the one to the other.
Are they? Certainly the "anti-mandate" crowd is very different, but the "vaccines don't actually work" / "vaccines have microchips" / "even if the vaccines work I don't want them" crowds seem basically the same to me.
How many people do you know personally from this group before vs after? If you are doing off the cuff sentiment analysis of Twitter or Facebook, then you certainly aren't meeting the vast majority of people in those camps.
I personally know some vaccine skeptics both before and after 2021 and none of them align with what you see on Twitter or Facebook (well, except maybe one).
Yes, we are. My kids got all their routine vaccinations and I had plenty of vaccinations for all sorts of stuff in the Army. I worked as a radar engineer for a while so I'm sure the transmitters won't work...
But seriously, my skepticism is based on a prior that includes straight up disasters like thalidomide, diethylstilbestrol, vioxx, and dengvaxia; ambiguous interventions like statins and psa screening; and overall sketchy behavior by pharma companies. Given that prior, I find it extremely hard to believe that you can rush out a vaccine that is appropriate for LITERALLY EVERYONE after, what, 6 months of safety and efficacy trials? I believe that the vaccine is probably effective at reducing the severity of COVID and it makes sense to administer it on an EUA basis to the demographics that are highly threatened. But to people for whom the COVID risk is <1% or, in the case of kids, <0.01%, does it make sense to accept totally unknown risks from a rushed vaccine?
It would be one thing if the vaccine actually prevented transmission, but the intial trials did not have that as one of the endpoints. As a result, all the double vaxxed are still wearing their masks because even the CDC admits it doesn't stop spread, and all these highly vaxxed European countries are locking down again....
Yes. I have taken the full panel of childhood vaccines. I support most people taking a covid vax based on their age and health status, but I am not getting it myself.
Having served in the German army, I am reasonably certain that I have more vaccinations in total then most people do.
I am heavily sceptical of the mRNA based Covid Vaccines, in particular because the most common sense solution, Sinovac (which is just a flu shot for covid), is essentially verboten in the west. Sinovac protects less but also has less sideffects, this is a tradeoff you commonly make with using live vs dead and attenuated vaccines. It also puts less pressure on the spike protein to mutate, which in my view is good.
I do not see why I should take the unknown long term risks of Moderna/Pfizer, whose agreements with the EU also exclude them from taking responsibility for any damages they may cause, when a flu shot equivalent for covid is available that has already been used 3 billion times.
Should vaccines be mandated, one thing changes, if the vaccine damages me, I can sue the government which mandated these vaccines. Agreements between the EU and Pfizer et al. would prevent me from sueing Pfizer, if I were to take the Vaccine "voluntarily", and then get damaged.
Realistically speaking, going for vaccination with mRNA vaccines as the main approach will require a permanent regimen of boosters every 4 months, or more pratcially boosters before each winter, in perpetuity, on pain of not being able to participate in social life. This is materially very different from every other vaccination campaign.
My favored strategy vs Covid would have been to quickly roll out a European Sinovac analogon (this is just effort, does not require any scientific breakthroughs, and is basically an engeneering problem), vaccinate people below 60 with this, and use mRNA/vector vaccines to protect vulnerable populations. While also looking at new curative therapies.
mRNA vaccines have advantadges, the technology is promising, but using them billions of times before they are fully understood, and at the exclusion of fairly proven tools is just really debatable.
'Ware painting the whole outgroup based on your brush with the most signal-boosted of them.
That said, when I started looking into a group that used numbers and stated what they found, I was far from impressed. I feel ok saying there's fewer reasonable people in this outgroup than my usual outgroups.
"but it’ll just provide pro-lockdown people with an easy opportunity to tar all their opponents as science deniers." They'd do it anyway. They do it non-stop. Anyone with a disfavored opinion is "anti-science". Sanitizing your actions and thoughts to avoid being smeared as stupid is just another kind of surrender.
Yes, but it matters how correct the smear is. If someone calls you a science denier and I look into it and you are anti-vaccines, I’m going to have a lower opinion of you than if the smear is baseless.
Your opponents will smear you no matter what, but how effective the smears are is within your control.
the question was not about picking a position but about protesting by not getting the vaccine. i.e. you'd be perfectly fine thinking whatever you want while also not acting in a potentially ineffectual and/or counterproductive way. if not getting the vaccine is in fact counterproductive, getting it is a more effective way of achieving your aims.
Most of these people aren't nobly dying on their swords. They are demonstrating their party affiliation (street cred) by risking dying-on-their-swords.
I'm more talking about how Adam talks about how they refuse to pick positions based on how effectively they allow him to advance his political goals. Once you say "I don't actually want to achieve my goals", you waive your ability to complain that you aren't achieving your goals.
I think a big part of resistance to vaccines is that they are very visibly not working against the metrics that governments use to decide on restrictions. Hence why European police are currently shooting protestors after deciding to place entire populations under house arrest - the vaccination programme is a failure and their case numbers reflect that.
There are several sub-aspects to this that are really important.
1. The vaccination programme has failed, because its goal was to reduce infections. Germany now has HIGHER numbers than at any previous time, and in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated. Nobody can explain this.
2. By extension this means trial failure. The trials didn't have hospitalizations or deaths as a primary endpoint, they were approved due solely to their effect on case counts. Yet this has turned out to be woefully misleading.
3. Trial failure on something as critical and dangerous as demanding entire populations take an experimental substance is a big deal. Yet, governments and the fanatically pro-vaxx part of society (journalists, public health etc) aren't acting like it's a big deal. They're ignoring it.
4. This requires us to wonder what else the trials were misleading about. If they were so badly wrong on efficacy, were they also badly wrong on safety?
WRT the last point, there is increasing evidence the answer is yes. The FDA has started slowly releasing documents related to the vaccine approval process. The first batch revealed that Pfizer was taken by surprise by the flood of AE reports and had to hire extra staff to process them. Why were they surprised by this, having just done a trial meant to precisely characterize this exact value?
So let me summarize. Increasingly fanatical governments are now creating as much hate as possible towards a segment of the population whose only "crime" is to observe that huge numbers of scientific studies suck, that pharma/public health is riven with conflicts of interest, that experts have been consistently wrong, that the vaccines are experimental, that they have failed to do what they claimed they would do and that this might explain why people seem to have bad reactions quite frequently (depending on brand/region/etc? some people don't seem to encounter any bad reactions and others do).
This is very bad news regardless of who you are or your stance on vaccines.
Spoiler alert: his claim is bullshit. Vaccines actually work even a bit better than we originally hoped ... the problem in Europe is the sheer number of people who, given the choice, decided not to take it, resulting in recent increases in hospitalization to an unsustainable degree in many European countries ...
Which "heavily vaccinated country" currently is mandating a lockdown? I'd consider 90+% vaccination rate "heavily vaccinated", in case this question comes up.
Masks on the other hand are such a mild inconvenience, I look at people opposing them the same I look at people who refuse to wash their hands before leaving the toilet. That's just basic hygiene during an airborne pandemic.
I don't like that mask thing either. And I'm certainly willing to discuss where those masks actually make sense, and where they don't. But people who refuse to get vaxxed "because masks", aren't even on my radar as logical thinking human beings. For this bunch I certainly support government enforced decision making. They already demonstrated that they aren't capable of rational decisions on their own.
I doubt that there are many people who actually think like that though. There aren't many people THAT stupid. Certainly none of the people I know who oppose vaccines jumped to that conclusion with that kind of logic ...
As for masks: grow up. I've been with the volunteer firefighters for more than a decade. Compared to the filters and masks we have to use there when putting out fires you don't even notice the FFP2 variants or those below. If they fog your glasses, put them on correctly. If they pinch your ears and face: get some of your size. It's not that hard and after 1,5 years one could have learned how to use them ...
I think it is no big deal. Yes, somewhat inconvenient, but no big deal.
When outside and not very close to others, you can pull them down, especially if there is a wind of more than about 3 knots (that is a soft breeze). I remember when our engineers designed air flows in the TB hospitals, airflow was considered (evidence based) much more important than masks.
When at home you can take them off, unless one of your close relatives has Covid symptoms. Same when driving your car.
One should wear masks with an understanding of what they are doing: they reduce the size of the aerosol and droplet clouds when you talk (or cough or sneeze).
So you basically only use them in indoor places were there are others, such as shops, and outdoor places where others are close.
On a side note, these fleece neck goiters and bandanas appear not to work (experimentally, that is). Personally I use N95 masks, not only seriously protecting those around me, but also giving some personal protection.
In fact, I only need to wear them a few hours a day.
"Vaccines work better than hoped" -> highest case rate ever with ~70% fully vaccinated. That isn't the outcome anyone expected, no. I'm old enough to remember when health officials were saying 70% would be herd immunity and vaccines were the "way out" of the pandemic.
COVID hasn't suddenly become orders of magnitude more infectious since the start of the vaccinations. Look at Gibraltar. It has a near 100% vaccination rate, yet, cases jumped up at the same time as Germany's anyway. Think about it: that should not be possible, yet, it is happening.
What's actually going on is visible in the UK data because unlike other health agencies (like the German one you just linked), the HSA provides raw data. It shows negative efficacy - the vaccination are much more likely to get infected than the unvaccinated. This then gets adjusted out via some dubious statistical techniques, inverting what the raw data says and leaving an efficacy rate similar to what Germany reports.
I really don't think Germany or other countries would be experiencing anything different, even if the vaccination rate was much higher. Think about it: if 70% vaccination buys you nothing, then how effective is this really? This is not "working better than expected".
In Germany we are talking about a 89% reduction of ICU hospitalization rate for the 60+ age group, 87% reduction in probability of death. Lower age groups fare even better. When the vaccine was still in research, we were told we could consider ourselves lucky, if that number would reach 70%.
You mentioning UK actually shows that you are arguing in bad faith. This data has been very well explained. You are comparing apples to oranges there. Just compare the average age of the vaccinated with the average age of the unvaccinated in that data set. It's a typical case of the Simpsons paradox. Everyone actually interested in knowing what's happening there can find this in no time.
This is just plain wrong. If I compare 100k 60 year olds to 100k 20 year olds, I expect a different outcome.
This is precisely what happens in the UK data, due to the different vaccination rates in different age groups and the large age group compared (18-59). If you break down UK data into age groups of max. 10 years spreads, your entire result disappears and even reverses for ALL age groups!
Maybe the correct way to analyze this would be to have a professional polling firm run a survey to directly estimate the proportion of unvaccinated people (which incidentally would allow us to make a third estimate of UK population). Anybody got a big pile of cash to burn on this?
A good way around all those issues is testing on hospital admission. That way you can get rid of a lot of those sources of error. That's what we do in Germany and the numbers are pretty telling. I've been posting them a few times on this thread, so I'm not gonna post them again, or people will think I'm a spammer ;-)
And the omicron variant appears to be even more infective. First reports are though, that it is much less virulent. Something many virologists, epidemiologists and evolutionary biologists considered a definite possibility ('predicted' would be too strong a term). And the vaccines appear still to be working against the omicron variant.
> It has a near 100% vaccination rate, yet, cases jumped up at the same time as Germany's anyway. Think about it: that should not be possible, yet, it is happening.
There was a big debate about "sterilizing immunity" at the start of the vaccine deployment. The public really wanted to hear that they *were* sterilizing, the scientists kept on saying "we don't know." And, then, it feels like each side walked away hearing what they wanted to hear.
This is another case where there's a difference between what the scientists say, and what the media reports the scientists have said.
In broad strokes, it looks like the vaccine provides pretty good resistance to hospitalization/death over the long term (such as we have it), but the resistance to *infection* wanes after maybe 6 months.
So if Gibraltar did a big vaccine push of their population over a few weeks, that would keep their cases low in the short-term, but they would start rising because Gibraltar hasn't sealed its borders.
Gibraltar doesn't even know their own vaccination rate. They have a lot of border traffic and they have been vaccinating a lot of people who aren't actually living in Gibraltar (because they do work there). Spaniards and people from Gibraltar cross borders a lot.
People pointing out Gibraltar should explain first, how Gibraltar can have a vaccination rate above 100% and why it's so different in vaccination rate than GB. My guess is: it isn't all that different from GB, which is why we see the infection rate going up there as well ...
One should take into account that the humoral immunity (antibodies) wears off after a few months, while the cell-mediated immunity (mainly T-cells) appears to persist much longer. The reason why infections may increase (IgA antibodies in the mucosa are the relevant ones here), but severe disease and death remain rare in the vaccinated (and the 'naturally' infected).
His claim (1) cherry picks a baffling but real UK government report (https://twitter.com/DPiepgrass/status/1457615206251520002), and I'm still looking for an explanation for it, but any reasonable explanation must explain why the data looks very different everywhere else.
I always recommend OWID's data explorer for checking basic facts like the Germany thing (https://ourworldindata.org/explorers/coronavirus-data-explorer). Germany and UK are outliers in their high case loads (given they both have decent vaccination rates) and dismissives love speaking about outliers as if they are representative. To me, the UK is the more interesting outlier of the two because it has reached an unusually high number of cumulative cases: 151,000 per million. In contrast, only Germany has only 73,000 cumulative cases per million since the beginning of the pandemic, so most unvaccinated Germans may still be susceptible to Covid.
The last I heard was that the UK fully reopened. One explanation, therefore, might be that UK is unusually good at detecting Covid cases and the true number of cases isn't that far above 15% of the population. The percent fully vaccinated in UK is about 68%, and if (for the sake of argument) immunity has waned (or was never acquired) in 25% of the vaccinated, then we'd have only 51% immune, leaving (after subtracting a small % of prior infections) almost 49% of the population potentially susceptible (and remember, the AstraZeneca was popular in the UK and only 74% effective in the first place).
Claim (2) implies vaccines are less effective against death/hospital than against infection, which goes against everything I've seen, [citation needed]. It also implies regulators around the world ignored hospitalization/death in trials, [citation needed].
I spoke too soon: UK antibody levels have been over 90% for 4-5 months! That's weird. Why do so many people keep getting infected if they already have antibodies? Also not sure why they use the word "modeled" on those charts...
Maybe the answer is: children! The >90% number is for ADULTS, and the same page says that that a there are low rates of "antibodies from prior infection" (<15%) among primary and secondary students. Meanwhile, BBC reports November 18 that "Covid cases highest in younger children in England": https://www.bbc.com/news/health-59336666
"723 cases recorded per 100,000 among children aged five to nine. That's up week-on-week from 484.5 per 100,000. The rate for 10 to 19-year-olds is 694.2, up from 571.7."
Indeed, that's higher than all adult cases combined.
And of course, the rate of Covid deaths in the UK is quite low now, as I would expect. Wish for an "edit" button so I don't have to keep replying to myself!
Vaccines which haven't been given can't be working, duh. Those protests are in countries with barely 70% vaccination rates. We have very good data in Europe showing that vaccines do in fact work better then we hoped for originally.
In Germany for example the health care providers are on the verge to collapse within the next 3-5 weeks. Yet official data of the patients admitted, and their vaccination status, clearly shows, that even if the infection rate was the same, with everybody vaccinated, we wouldn't even notice anything special in the hospitals. In Germany we could easily support rates of 3,000/100,000 infections, if everyone was vaccinated. If you look at current prevalence data, there is a clear correlation between vaccination rates, infection rates and hospitalizations ...
So, those people have no moral right to protest against those lockdowns they themselves are actually causing ...
Where do you get this idea that they "work better than hoped for originally"? Trial data said 95% efficacy and health officials claimed herd immunity at 70% or lower. Germany's own figures that you linked to above show now 75% efficacy at best, and Germany is that at supposed herd immunity threshold now, yet you claim the situation is now worse than before.
Think about how much drastically more infectious COVID would have had to become since the start of August for your claim to be true. Where is this astonishingly more effective mutation and why isn't it affecting places like Sweden, which has an identical vaccination rate?
Health agencies use a technique called TNCC adjustment on their "vaccinated vs unvaccinated infections" data. It's not raw rates as you would expect, at least, not if Germany's agencies are doing the same thing as the UK and elsewhere. In the UK you can see the raw data pre-adjustment and it actually says the opposite of what they report. They struggle to explain why their adjustment technique changes the raw data so heavily - they assert that unvaccinated and vaccinated people behave very differently, but have no proof of this and it seems very wrong (unvaccinated people are not hiding at home terrified of corona).
Prof. Drosden, the guy who created the first PCR test for Covid, was talking on his podcast about the vaccines in June 2020 and said that we'd be lucky if we got something which prevented 70% of all deaths. We actually got something, which, in the German health care system, so far manages to reduce those numbers by 87% for 60+ year olds, and even way more for younger age groups. In my book 87% > 70%.
As for efficacy: you obviously have no idea what the term in that context meant. It never meant what you are claiming it did. Also: you are confounding vaccination rates and vaccination efficacy in your very own sentence here, as if those two were the same thing. That's just bs.
Also: Covid DID become way more infectious since August 2020. The delta variant is so infectious that we need way beyond 90% vaccination rate to reach the same target we hoped to reach with 70% vaccination rate and the alpha variant. Especially since the immunity granted by vaccinations isn't sterile (at least not for long).
As for the data in the UK: you have been educated multiple times about it now by various people in this thread. You just keep ignoring that a vaccinated 49 year old and an unvaccinated 22 year old don't have the same innate risks. Then you explain this difference away with "They struggle to explain why their adjustment technique changes the raw data so heavily - they assert that unvaccinated and vaccinated people behave very differently," which is so ridiculous, I'm gonna stop responding to this thread now ...
> hey struggle to explain why their adjustment technique changes the raw data so heavily - they assert that unvaccinated and vaccinated people behave very differently
Are you unaware about differences between 20 years old and 50 years old?
Are you surprised that 50 years old die more often than 20 years olds?
Why adjusting for age would not affect expected death rate?
Table 6 Footnote 1, Page 24: "Comparing case rates among vaccinated and unvaccinated populations should not be used to estimate vaccine effectiveness against COVID-19 infection. Vaccine effectiveness has been formally estimated from a number of different sources and is summarised on pages 5 to 8 in this report. The case rates in the vaccinated and unvaccinated populations are unadjusted crude rates that do not take into account underlying statistical biases in the data and there are likely to be systematic differences between these 2 population groups." It goes on to provide a few examples.
Pages 8 and 9 describe effectiveness against all infection and effectiveness against transmission respectively.
Maybe I had attack of blindness or something, but it indicates that vaccines work. We care about serious illness and deaths, if COVID is as serious as cold then it is nothing to really worry about (I still would not prefer to get cold).
Deaths and serious cases are clearly reduced, even without controlling for anything except age.
Cases are massively affected by various problems, for example that only part will be ever detected and who is being tested is likely strongly correlated with who is infected.
Also, Michael was lying about
> in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated. Nobody can explain this.
Directly under table that recommends reading footnotes there are footnotes:
The case rates in the vaccinated and unvaccinated populations are unadjusted crude rates that do not take into account underlying statistical biases in the data and there are likely to be systematic differences between these 2 population groups. For example:
•people who are fully vaccinated may be more health conscious and therefore more likely to get tested for COVID-19 and so more likely to be identified as a case (based on the data provided by the NHS Test and Trace)
•many of those who were at the head of the queue for vaccination are those at higher risk from COVID-19 due to their age, their occupation, their family circumstances or because of underlying health issues
•people who are fully vaccinated and people who are unvaccinated may behave differently, particularly with regard to social interactions and therefore may have differing levels of exposure to COVID-19
•people who have never been vaccinated are more likely to have caught COVID-19 in the weeks or months before the period of the cases covered in the report. This gives them some natural immunity to the virus for a few months which may have contributed to a lower case rate in the past few weeks
Maybe "lying" is a too strong word but reading table with data listing about 70% reduction in death rate and serious infection rate, ignoring explanation and then claiming "Nobody can explain this."?
Maybe if it would formed as "what is going on" rather than
> I think a big part of resistance to vaccines is that they are very visibly not working against the metrics that governments use to decide on restrictions.
then I would be more charitable. And I lost again about hour on investigating claims that I should assume to be misinformation.
About 70% reduction in death rate described as "visibly not working".
Read the other 6 columns, the ones which matter. The first two ones is very distorted data, because it doesn't come from a source where everything but the vaccination status was equal. You can twist this data into any direction by changing the amount of tests in either group. Unless you adjust for test-positivity rate this data is useless.
In Germany you see the same distortion in reverse, because only the unvaccinated have to test themselves all the time to get anywhere. And thus nobody really cares for those numbers. ICU admissions and death are the numbers which count.
And there the table shows a massive advantage in all age groups of being vaccinated, despite GB having used the double dose vaccine with the least efficiency (they didn't and couldn't know back then), despite GB having been the first country to get to a substantial amount of vaccinations and despite GB having been slacking on boosters.
Matter for which purposes? For individuals making their own health choices, I agree that hospitalization and deaths are more important. For public health policy making (i.e., mandates), I disagree that cases are unimportant.
(Standard disclaimer: If you're going to claim that the mandates are to "protect the health system," then you need to also mandate 5 servings of veggies/day and outlaw coke and booze.)
If you want to use the kind of data found in the first two columns, at least restrict it to test results taken at hospitals upon admission. We have that data in Germany, and it shows the same pattern as the ICU and death data, just with much much higher numbers.
If we put this data side-by-side with the test results from all over Germany, you don't find a match between those two samples. The source of the data matters when trying to interpret it.
I've heard that 20 year olds have higher STD rates than 55 year olds too, even when they use condoms on a higher percentage of their sexual encounters.
If I told you that people who take daily aspirin were more likely to die of a heart attack across the whole population, even after stratification by age, which if the following is more likely as an explanation?
1) the properly double-blinded large sample RCTs showing huge effectiveness of aspirin at reducing heart attacks are wrong, or
2) there's some factor(s) other than age that predicts whether people take daily aspirin, and *maybe* it/they correlate strongly with heart attack risk?
It's almost impossible to stratify heavily enough in an observational study to avoid some risk of Simpson's paradox.
I think this comment makes a strong case that the rush to vaccinate everyone is the result of overconfidence in a trite slogan like "TrUsT tHe ScIeNcE!" where "the science" is a clinical trial run by a multinational, decabillion-dollar company that is in the business of getting drugs approved.
Which vaccination programme? Is the goal to reduce infections, reduce, cases, reduce hospitalization, or reduce deaths? The situation on the UK is that most are vaccinated infections are widespread, but are only leading to hospitalisation and death among the unvaccinated. If you define " success" as "nobody dies", that's failure..if you define "success" as "vaccines prevent serious consequences for the vaccinated, the unvaccinated take their own chances", its success.
Tophattington's perspective must seem very noble and principled from inside their own head, but my GOD is it noxious to have to read. Not a single ounce of consideration is given to the externalities of individual decision-making, nor one moment spent to contemplate the fragility of the structure that provides them the comfort and safety to opine flatulently about the INJUSTICES their government DARED subject them to.
Only a decadent, privileged, and morally depraved society would allow its members to become so detached from reality that they could feel ENTITLED to forget how desperately nature is trying to kill them, and how tenuous our grasp on civilization is.
" they could feel ENTITLED to forget how desperately nature is trying to kill them,"
It reminds me of the dipshits saying childbirth is totally natural and therefor doesn't require medicalization.
"Out of all primates, humans experience some of the most dangerous births. Without access to modern medical care, 0.5 - 3% of births result in the death of the mother, and up to 15% of births result in the death of the infant. Chimpanzee birth appears to be much less risky, especially for the mother, though precise mortality data is not available. One explanation for this difference is that the chimpanzee neonate’s head is much smaller than the mother’s pelvis, allowing it to pass through the birth canal with little chance of becoming stuck. Meanwhile the human neonate's head is approximately as large as the mother’s pelvis, which makes for a tight fit during birth. The risk doesn’t end there. After a successful birth, even healthy human newborns are fragile and have only a fraction of the motor function that newborns of our closest primate relatives possess. Historically, around 27% of human infants die during their first year of life."
Cannot agree more with this. I had to pay to fly to the US so that I was assured to have a vaccine these idiots just throw into the trash because FREEDOM! I'm exhausted.
I mean, it's basically in response to a prompt to explain his perspective, not his arguments. A passionate emotive diatribe like that probably gives you a much better picture of how he looks at the world than any reasonable amount of sober argumentation.
Better on what metrics? This is an honest question, btw because I sincerely don't see how such calculations can work out.
Suppose, we try to maximize the freedom of people. Death seem to be an ultimate decrease in freedom and preventing it is extremely important. Even if freedom was the only thing we cared about, restricting freedom of those who use it to dramatically increase the chances of death of others seem to be the right decision, giving us more total freedom.
Re: the hacker news section, I feel like you are not giving journalists a hard enough time for this. You yourself saw that a lot of stories initially about Ivermectin were genuinely terrible, you even wrote a post about it: https://astralcodexten.substack.com/p/too-good-to-check-a-play-in-three
These stories weren't terrible just because the editor wanted to have something short, rather they were saying things that were directly misleading, or conspicuously lacking context. If the general case was that most people had done the research but they just couldn't write as much about it, the above post would never have happened.
I think the point becomes that the incentives are strongly against doing the research, rather than that the journalists are unable to do it - the people calling the shots believe that good journalism is uneconomical
Perhaps authors are paid (at least approximately) by the word, and thus extra words that no-one reads are a real cost to the publisher? I genuinely don't know how the modern market for 'journalism' works
Scott, did you know you were mentioned on yesterday's episode of the Joe Rogan Experience? It was in reference to your essay last week about ivermectin. Tim Pool was the guest, and he brought your findings up as a retort to Rogan's positive claims about ivermectin. I recommend listening to the interview, starting at the 17:00 mark, and waiting for this key part of the conversation:
Tim Pool: "Now there's an interesting point that just came up today. I can't remember the guy's name, it might be Scott Alexander, I'm not sure, and they found a correlation between worms and parasites and curing COVID. So one of the hypotheses for Uttar Pradesh--people there have a high propensity for parasite infestation, and so if you've got worms and your immune system's being bogged down or strained, you get sick, you're more likely to die, and have a serious reaction. You take ivermectin, you cure those worms, your immune system is more robust. I'm not saying it discredits everything--"
Joe Rogan: "No, no, no, it stops viral replication. It's not as simple as, like, you don't have worms anymore so your immune system is stronger. Because there's plenty of people that don't have worms, that have an immune system that gets wrecked by COVID. What they're showing is, that there's a direct correlation between taking ivermectin and having positive results. The problem is..."
...and I'm sick of transcribing it. Just listen to it yourself, and please share your thoughts on Rogan's interpretation of medical science regarding ivermectin.
You should also weigh in on Joe Rogan's Cure for COVID, which he goes on to mention in the episode (and has in several past episodes). It includes ivermectin, monoclonal antibodies, and some other stuff (probably vitamin megadoses).
I would never understand why would someone take medical advice from Joe Rogan. Or listen to what he has to say about medical research. To be frank, he is just not smart or educated enough for his opinion to have any weight. And i do enjoy some of his interview podcasts and have nothing against him personally.
Yeah. I can understand being suspicious of elite experts. I don’t get being entirely credulous of non-elite “experts” (outside of literal holy men maybe).
This. This is the most obvious problem with all dismissives.
Sure, you've got all kinds of good reasons to not to trust "the establishment". That's very understandable. Yet somehow a random blogger cherry-picking some official and unofficial data and turning that into an outrageous conclusion ... is trustworthy?!
> To be frank, he is just not smart or educated enough for his opinion to have any weight.
Sure, and that's what he openly says to his audience, ie. that he's a moron and you shouldn't listen to him for medical advice. But he's just repeating what actual doctors that he personally knows have been telling him, so to most people, when someone who has world class doctors and physicists on his podcast says something, it does carry weight (an arguably should carry *some* weight).
> But Scott has the intelligence and expertise to analyze the available information. Rogan does not.
Rogan isn't analyzing this information, he's repeating what he's been told by people who do have that expertise, like I said. Maybe the experts he knows are wrong in this case, but you seem to be implying that this epistemic procedure is fundamentally flawed, and it's just not. He's doing exactly what people have been saying for years now, "trust the experts", so don't turn it around now saying, "oh wait, no, not those experts".
I don't watch Rogan so I have to ask: does he also bring mainstream scientists/doctors on his show and treat them respectfully, or does he generally bring on people who agree with him?
I think "seems honest" >>>>>> "seems smart" for a lot of people. I'm not even sure I disagree with them on this, just have different expectations of who is smart and honest.
Rogan says he's not a medical expert, but it really feels like the conservative version of "clown nose on, clown nose off" commentary that Jon Stewart and John Oliver do.
I find the “top down / bottom up” commentary most interesting here.
It looks like a feedback loop in play as well: the more “out there” the bottom up network gets, the more the top down network increases its prior that the bottom up network is mostly cranks and quacks. This makes the top down network more willing to dismiss out-of-consensus opinions. As a result, people with more trust in the bottom up networks increase their priors that the top-down network is overly censorious. So they are more likely to take “out there” ideas seriously, and the cycle repeats.
At least, that’s how I see this. Am I right that there’s a feedback loop in play here? What could be done to stop it?
The issue is that good stats is expensive. I think the only feasible route is a bunch of billionaire philanthropists start funding medical studies, such that they're big enough to not be noise, prestigious enough to be listened to, but not owned by the pharmaceutical companies.
Education, so that not only a small circle of experts can understand the ways in which the bottom is "out there". As it is, scientific establishment is in practice the modern priesthood, where its pronouncement are supposed to be taken on faith, and heresies are rated only by how charismatic their purveyors are.
Of course, nobody has any idea as to how to go about endowing large parts of the population with education adequate to this task, and many aren't even sure that this is desirable. After all, the priesthood model boasts milleniums of pedigree...
" There are dozens of positive double-blind RCTs of homeopathy."
Arguably, this is because endocrine disruptors can have a non-monotonic dose-response curve at very low doses. Google "bisphenol A, non-monotonic dose response curve" to get some sense of what I'm talking about. And 'homeopathy' has a tendency to use a single set of glassware in its dilutions, meaning that most homeopathic dilutions that claim to have zero active substance actually have microgram quantities of substance or less. And we know that microgram quantities of substance can exert biological effects that are qualitatively different than larger doses.
Our sense of smell is the quickest way to demonstrate this. Indole, for example, smells floral at low doses and fecal at high doses, for example. "fecal" is different than "really, really floral." And with scents we're already talking about qualitative differences at sub-microgram levels of exposure.
Homeopathy studies sometimes show real effects because they're banging into a real effect whose mechanism is poorly understood, especially by the homeopaths.
A lot of "homeopathic" medications also use low enough dilutions that they're just boringly ordinary herbal medicine in practice - I'm taking some at the moment where most of the ingredients are present at a few parts in 1000, plenty high enough that nonsense about water memory need not be invoked. (Of course, I wish that the people coming up with this stuff would realise the insanity of the theory, but in the meantime they're often the easiest way to buy some herbal remedies.)
Also, little known fact about p-values: if you draw 200 random samples from one and the same population and test them against each other for a significant difference of a random variable, lets say with a t-test, from that 100 tests on average 5 will suggest a significant difference between the groups. I am sure that by now there are several hundred studies on homeopathy, even excluding the ones that were never published. Some of them showing significant results would therefore to be expected.
I'll reiterate that much of formal homeopathic 'theory' is garbage and I'm not defending it. But my point is that there are people who dismiss results related to homeopathy out of hand due to a lack of plausible mechanism. And there is a plausible mechanism or mechanisms, though admittedly the observed results rely, in part, on poor homeopathic dilution technique. The evidence might be a set of flukes. But that's not the only plausible reading. In short: There's reason to dismiss less and engage more.
As for the "physician that has reported zero deaths and 5 hospitalizations with 2,400 COVID-19 patients", I'm just going to leave the public statement by the Brazilian Research Ethics Board:
Basically, his research had ethical approval for a single hospital in Brasilia, for patients with mild COVID. Somehow, the published data is from many hospitals in Amazonas, with a 50% mortality in the placebo group, with a high proportion of liver and kidney failure in the placebo group. However, since the study was blinded, there was no way to know those deaths were in the placebo group, and the study should have been halted for investigation and possibly unblinding. When requested, the author did not provide information about the chain of distribution of the placebo pill, and it can't be discarded that the control patients were actually receiving a harmful medication instead. The "independent data monitoring committee" was composed led by the study's sponsor. The consent forms presented were different from the ones approved, with suppression of clauses that guaranteed compensation and assistance in case of harms or contraception (androgen blockers have high teratogenic potential)
The Tophattingdon comment is quite sad to read. I can’t recall if it was Scott but the idea that self sacrifice is a finite resource seems very applicable here.
In any case, the UK did get ahead initially on vaccine procurement and really has been free of restrictions (to the point of even getting rid of very low cost measures like masks in shops) for a few months now. When the initial lockdown measures were brought in back in March 2020, snap opinion polls put them at 98% support! The government were behind the public, many of whom had effectively locked down already.
If you opposed lockdown, fine, these things are difficult to quantify. But it was (particularly initially) a very popular policy that is only not being enacted now because of the amount of vaccines that have been administered reducing the death rate to a level deemed acceptable. Hopefully Paxlovid reduces this further.
But not being vaccinated when you know it’s sensible is just strange. It hasn’t been mandated! You’re free to have a good thing or not have it if you don’t want. If you end up getting badly ill with Covid or pass it to someone you love, what will this bizarre protest have been for?
I think we'd see the amount and intensity of lockdowns backing off at a similar rate even if a vaccine or treatment was never developed. I don't think it's true that vaccines are why lockdowns are easing, and I'm confident you can't prove that hypothesis.
Proving that hypothesis would indeed be difficult, however I do believe it’s true (at least in a UK context). Cases in the UK have been hovering around 40k a day for a while whereas deaths are about 150 a day. That’s not great, but it’s not shut everything down territory either (or even shut anything down).
I guess the issue is quite nuanced in that if there was no chance of a vaccine/cure then you can’t just lockdown forever, however given that vaccines are here and cures coming, the need for a lockdown is eased.
I suppose a better way of thinking about it is the number of daily deaths (or another similar measure) you’re willing to accept before imposing restrictions. For most people it’s a curve - the more deaths there are the more likely you are to support restrictions (granted lockdown opposers may just oppose restrictions entirely). If you accept that vaccines reduce daily deaths and that the uk govt bases policy at least somewhat on public opinion then the connection is obvious. Vaccines aren’t the only factor, but all of their associated benefits sure make it easier to pursue a looser policy.
So you think that in two otherwise-identical situations, where one has many COVID deaths and one has few COVID deaths, more people will support restrictions in the situation with few COVID deaths? That seems obviously wrong and also contradicted by the facts (countries have lifted restrictions when there are few deaths, such as earlier this summer, and raised restrictions when there are many deaths, such as right now).
It’s a bit of a simplification but it seems fairly obviously true to me. If there’s an infectious disease that will kill a maximum of 5 people a day in the UK, I oppose all restrictions. If it was going to kill/was killing 50,000 people a day and restricting contacts would help prevent this, then yeah, I would support quite a lot of restrictions. This may not be true for you specifically, but I think it holds true for most people.
people were talking mandates for months prior to that. Some individual employers were already mandating it. Mandates were on everybody's mind the minutes the vaccine was released. The NYT and WaPo were writing big thinkpieces about how mandates are good and "here's a legal theory for how biden could implement a mandate".
Right, but what was the predicate for that discussion? It was vaccine resistance. If people had flocked to get it like with polio there would be no need for the articles in the first place. Instead the articles would've been about rationing due to supply shortages.
We have school vaccine mandates in all 50 states for measles and chickenpox -- a disease that, like COVID, is much more fatal in adults than children -- and almost no one bats an eye. These diseases have never killed more than 6 or 700 people in any given year in the US.
Yet here we are, 750,000 dead, and there's an entire cohort of people who practically *all* have those vaccines but draw the line at the one thing that would put all this behind us. It's madness.
I'm debating the terminology here, though; "refusal" and "resistance" all imply refusal of something, resistance against something. If taking a vaccine is a person's choice, then not taking it isn't a refusal, it's also a choice.
Because it's strongly recommend. By doctors, health professionals of all kinds, politicians, etc. The resistance is to "doing what Blue America recommends". The refusal is give even an announce of credence to the other side of the culture war.
It is perfectly legal to go around and say rude things to everyone around you, but probably a bad idea. If a large group of people did this because they think politeness is bad, “politeness resistant” would be a decent name to refer to them even though there was absolutely no mandate that they had to be polite.
This analogy is interesting, but it's not exact; politeness is a value, as well as a set of actions; vaccines are not a value, and they're not a set of actions in the same sense as politeness.
There certainly seem to be people who have being anti-vaccine as a terminal value in the same way that people have politeness as a terminal value. I’m pretty sure this was the case long before mandates too.
My expectation is that the people who coined the term "vaccine resistant" care about vaccination on (among other things) a basis of "wanting to not contribute to killing somebody else's grandparents", in which case 'being vaccinated' and 'being polite' seem reasonably seen as being value-based in the 'valuing prosociality' sense.
Also, many or most of the people who have MMR etc vaccines in the US received those when they were not adults and unable to make decisions for themselves. If they refused the MMR vaccine, it's likely someone would have grabbed them and forcibly medicated them.
to be fair, they did it under huge economic pressure; your options are: 1) vaccinate your kid and send them to government-paid-for school, 2) don't vaccinate them, and invest huge amounts of time and effort into educating them yourself, or 3) don't vaccinate them, don't educate them, and people with guns come and take your children away for neglect.
On the subject of "Trump gets booed", I spent some time digging but eventually found a video that actually had the clip in question, starts at around 1:20 https://www.youtube.com/watch?v=EK0kcZjIDi4
Personally I don't hear any actual boos; I'm prepared to believe that some people in the crowd did boo the line based on the reaction afterwards, but it doesn't seem to have been the widespread reaction.
While I do think Scott's own chosen numbers and studies don't say what he wants them to, they aren't what I consider to be the most important data on the matter.
Rather than randomized controlled trials, what I'm seeing is an environment where some countries allow and encourage a wide range of treatments, and have near zero case fatality and were almost unaffected by covid, while others have much higher case rates and much higher case fatality rates. Many of these countries seem competent, and I can't really explain them without assuming that they're using some sort of treatment that works.
In addition, whenever a country switches from not treating covid to treating covid, it works.
Not all of the competent countries that have low case fatality and treatments that are not allowed or encouraged in America use ivermectin. Most use a complicated mix of drugs, supplements and catalysts, each with their own special purpose and timing. I want more attention on trying to replicate exactly what they're doing.
Could you be more specific about what countries you’re talking about? Brazil is one of the countries that had ivermectin studies but it’s not exactly done a great job in the pandemic. They’ve recently been better but I’d bet that they’ll have another spike soon given that the USA looked similarly good three months ago.
If you google (covid death rate) the first result should be John Hopkins mortality analyses, that's my main source for death rate/etc. Near zero does not equal zero, we can quibble over definitions, but when I look at the list I see lots of near zeros.
It does take more work to check what each country specifically is doing, but when last I checked trustworthy countries that actually treated covid and didn't ignore it and got results much better than the competition included Iceland, Singapore, Denmark, South Korea and Japan. Lots of less trustworthy countries also did stuff that they say worked.
If you want to bash countries that used ivermectin, Peru is the problem country that stands out. It and other similar situations do make me think betting everything on ivermectin would be stupid. But data from India and elsewhere makes me think it's worth checking. Furthermore, the principle, that we should check drugs that might work, seems like it would absolutely succeed, because someone seems to have found a working cure.
I haven't looked into this too much, but last time I checked briefly I thought the most likely explanation was a combination of age and underreporting.
COVID mostly only kills old people, but different countries have extremely different numbers of old people. Japan is 28% over-65s compared to Pakistan being 4%. If COVID only kills old people (oversimplification but not totally wrong) we should expect Japan to have 7x the mortality rate of Pakistan by this factor alone.
Excess mortality could be comparable,but even that can get iffy.
I have tried to compare Russian anti Covid performance with western anti Covid performance (compared to China, I at least speak the language and have been there for more then just holiday) and well...
Even things I would normally assess as quite reliable in Russia probably arent all that reliable concerning Covid. I eventually gave up.
The TLDR that I am assessing as mostly true: Russia did well initially, because the first Cases where in its not very densely populated far eastern regions. Incidently, these are also regions where stuff like Yersinia Pestis is endemic among rodents, and the local authorities in terms of health are pretty level headed, common sense and quite dedicated to their communities (those who arent dedicated to their communities migrate to Moscow or St. Petes). This first wave, the kept under control, Vietnam or initial cases in Japan like, by full contact tracing.
There was much claiming of credit, mostly be people in Moscow having fuck all to do with it, and a resulting massive overestimation of Rusian health care and anti pandemic capabilities by the authorities.
Yeah, then the Virus, coming from Italy, hit highly arrogant "rules dont apply to me" Moscow, needless to say, things went massively downhill.
Russia for the most part counts "died mostly of Covid" rather then "died with Covid", which explains their relatively low case fatality rate for Covid.
What I get from doctors in Russia is that they would have a slightly higher to roughly equal CFR then the west does, if they would count like the west (note that the west does not count uniformly either). A really harsh thing is that the 90s in Russia killed so many males aged 50-70 that their population of males aged 80+ is really low compared to peer countries, which lessens proportions of the realy vulnerable to Covid demographic in Russia.
Essentially, country by country comparisons could perhaps be done by comparing excess mortality. Even if they dont under or overreport, definitions are not uniform.
If you think of finding effective treatments like solving a murder mystery, the last thing you worry about is every bit of information you receive being perfectly credible. You certainly don't won't to disparage or destroy the careers of anyone who ends up giving you bad info. It's 100% expected that you will pursue many dead threads. It should be possible to complete large trials on all these drugs and many more in a couple weeks and let the webcam video trial data be available for everyone to analyse.
The overwhelming point here is that even today is that a very large percentage of people who test positive are recommended to do nothing other than drink fluids.
> I kind of sympathize with this (and am considering refusing the booster to protest them not sending spare doses to the Third World), but refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases), but it’ll just provide pro-lockdown people with an easy opportunity to tar all their opponents as science deniers.
"Maybe you think the Nazis are evil, but fighting a war against them seems like the most counterproductive way to protest them. Not only will this ensure that your people get more oppressed (due to the ravages of war), but it'll just provide pro-nazi people with an easy opportunity to tar all their opponents as warmongers"
The difference is that fighting the Nazis will stop the Nazis sooner (and perhaps is the only way to stop the Nazis). Fighting the vaccine doesn’t stop the lockdowns sooner.
I think this aversion to ultra long form is what turns me off from most articles in the media.
For me, most of the value in a piece is being able to reconstruct the argument/summary from the presented evidence/story, and having enough material to be reasonably confident that my understanding is correct. (The evidence/story also lets me come to my own conclusions that diverge from the author's.) Articles that just say "the data says X" or "he did X because Y" with very little/no follow up infuriate me.
I'm sure journalists try to give good backgrounds, but I think they underestimate how much background is actually preferable. (Or maybe people like me are a different target audience.)
I personally would gladly read one 30 page article about a single subject than 30 one pagers summarizing the daily news.
On a side note, this difference between just having the summary vs having the summary along with a massive amount of data reminds me of one of the last paragraphs of "Varieties of Argumentative Experience":
The high-level generators of disagreement can sound a lot like really bad and stupid arguments from previous levels. “We just have fundamentally different values” can sound a lot like “You’re just an evil person”. “I’ve got a heuristic here based on a lot of other cases I’ve seen” can sound a lot like “I prefer anecdotal evidence to facts”. And “I don’t think we can trust explicit reasoning in an area as fraught as this” can sound a lot like “I hate logic and am going to do whatever my biases say”. If there’s a difference, I think it comes from having gone through all the previous steps – having confirmed that the other person knows as much as you might be intellectual equals who are both equally concerned about doing the moral thing – and realizing that both of you alike are controlled by high-level generators.
Amen. There ought to at least be articles where there is a "main" article of the usual length with a "details" article explaining all the evidence that went into the "main" one. Then they can still cater to the mainstreamies who like short.
Yes, give journalists a break. (And you should take some of your own medicine and give the FDA a break, too.) One of the reasons they (or their editors) are as cautious as you observe with (naive I would say) surprise is because they *know* if there's anything to nitpick about what they've said a pack of rabid Internet Experts will instantly savage them. In that world, the only safe option is to print stuff that fits the shibboleths of your major protective tribe, because they you know you *won't* get savaged by your in-group, no matter how many silly mistakes you made, and the critique by your out-group can be dismissed as the usual poo-flinging (even if it isn't) and you'll have your own poo-flingers to back you up.
Furthermore, thoughtful and centrist authors (and editors) get shoved out, because they are unhappy with always just writing partisan sloganeering pap, and unhappy with the viciousness with which they are treated if they try to tackle hard subjects in reasonable ways. So they exit the job and we are increasingly left with shills and hacks who don't shilling and hacking.
It's a God-damned mess, and a reversion to where we were about 40,000 years ago, and I blame the Internet. It's turned us all into instant soi-disant experts, 'cause we read a few Wikipedia articles and googled some stuff ("look! I have a link to a paper where the words I want appear in the abstract! That makes my half-assed screed as credible as a paper in PNAS, pretty much...")
There is absolutely a place for robust criticism, by anybody credentialed or not, of expert judgment, and this is absolutely healthy for expertise -- e.g. science prospers this way. But there's a genuine line between being a useful gadfly and critic and being a pack of fucking chimps hooting and flingiing poo and ruining any possibility of reasoned discussion.
I don't know how we put the genie back in the bottle, or if it's even possible -- this behavior seems wired in to human beings at some unfortunate level, I guess because Nature hasn't had enough time to evolve us to be more adaptive in groups larger than the Dunbar Number. But it's pretty discouraging to watch. Continues to erode my faith in any kind of democratic institution. (And probably not just mine, I think: the amount of contemporary sympathy for a Strong Man that can just shut the gabbling interest groups up and Restore The Republic(TM) is concerning. This is after all the ultimate fate of democracies that gave the Founders pause...too much fratricidal chaos in the Senate and the people turn to an Augustus in disgust.)
Try it yourself and get back to me. That is, try being public about *your* area of expertise and inviting the whole wide world to critique you and see what happens.
I feel like you're illustrating part of the problem, unintentionally. You're saying "Gee, it doesn't seem like a problem to me to be in that other fellow's shoes." The willingness of people to say this is part of the problem, I think. We are insufficiently respecting the fact that it is very, very hard to know what it's like to be in someone else's shoes, and therefore pre-requisites for good discussion and fruitful debate are a certain amount of giving others the benefit of the doubt: "I don't know what it's like to be in your shoes, so when you do something that seems *to me* to make no sense, or be stupid, I'll start off by assuming I'm missing something about your experience."
Doesn't mean at all that you can't make the criticism, or challenge, but it's done with a safety margin of awareness you may well be missing something.
Hm. It kind of depends on level of potential opposition. I am quite active in some places (mailing list with relatively high rate of "you are terribly wrong for following reasons" responses), the entire point code review in programming is to criticize what someone produced - and I do it for relatively active open source software.
But I never published on national newspapers or appeared in TV.
I watched a set of videos a little while ago about people whose image became a giant Internet meme, like the "overly involved girlfriend." They're very interesting, and kind of disheartening. People's lives really were changed, and not in a good way, just by being *recognized* everywhere. We already know people have been hounded into suicide, and one would like to say oh they must have had a predisposing weakness but....I'm not so sure. Thing is, you could quit that mailing list. You could leave your company, or even your profession, and escape the attention and the critique. What happens when you can't? I am not sure anyone who hasn't experienced it can grasp how trapped you are.
But any major publisher of news/analysis will have detractors all the time, usually yelling loudly with little fairness or rigor, no matter if the article is accurate or inaccurate. Not sure why a long-form article would be any worse than usual.
In my article, for instance, yes it was very long, but none of the complainants found any mistakes/errors. They didn't show up to read it, they showed up to heckle.
It's hard to read this as anything other than a plea to trust the experts (the FDA) and their designated spokespeople (the press). Since we know neither are trustworthy, this seems misguided. Yes, they're going to get savaged (by which I mean people are going to say bad things about them) by packs of rabid Internet experts. But if they were any good, the rabid Internet experts would almost never have a point, and that's not the case.
Well, first of all I make a rebuttable presumption that your leading hypothesis is wrong. I find it very unlikely that either the FDA or the press, taken as a whole, are unusually high in the levels of incompetent or corrupt people in them. In my life experience it's generally very unlikely that idiots or wicked people strongly concentrate in any given job description, except possibly criminal or trial lawyer[1].
What seems far more likely to me is that both those professions are filled with human beings, who have a certain regrettable but inevitable level of incompetence, narcissism, tribalism, and ethical compromise. We are none of us angels. That definitely calls on the one hand for a vigorous level of critique and challenge from the general public, no question about it. I have already said as much in what I wrote.
But -- and this is my point -- there is a style of critique and challenge which moves from helpful to mutually suicidal. If you end up helping destroy social trust *entirely* -- if you reach a point where you really are persuading people that, in your example, the FDA and the American press are *utterly* untrustworthy, just a pack of orcs from Mordor, then you are no longer helping to uphold standards, you are instead undermining the foundations of civil society. Id est, there is a qualitative and important difference betweek encouraging skepticism and encouraging contempt.
Unless your ultimate goal is violent revolution and a brand-new form of civil society (and history should be a stern warning about how likely *that* is to work out well), then you need to rein it in, take half a loaf instead of none, be satisfied with *progress* in the goal of more truth while at the same time doing your part to maintain social cohesion so that the republic can continue to function.
I'll bite that bullet. The FDA might not be noticeably worse than most gatherings of so-called experts, in that they're usually right but wrong often enough that you shouldn't trust them with anything really important - if it matters, check it yourself, and your health absolutely matters.
Similarly, if you see a doctor about a serious condition, go get a second opinion and also look up the condition online. If you have an important contract, don't just blindly trust your lawyer, read it yourself as well. Experts will know more than you but they won't care as much about you as you do, and adding your own efforts is at worst a waste of time and energy.
I agree with everything you said. If I gave a different impression above, it was a mistake and I'm happy to correct that if you have any pointers to where it might be.
>In my life experience it's generally very unlikely that idiots or wicked people strongly concentrate in any given job description, except possibly criminal or trial lawyer.
CEOs apparently have a higher rate of psychopathy than lawyers (although lawyers are up there).
Wouldn't surprise me. I bet surgeons do, too. There are places where you kind of have to be a cold bastard with a charming exterior to survive in the job.
“One of the reasons they (or their editors) are as cautious as you observe with (naive I would say) surprise is because they *know* if there's anything to nitpick about what they've said a pack of rabid Internet Experts will instantly savage them”
But they aren’t cautious! “We don’t have the resources or page space to be thorough, so we will be cautious” is disappointing but justifiable. But instead, they just say lots of bold things that are wrong (or at least uninformed).
I don't think so. I think what they are doing is retreating into tribalism. They're saying things that match up with the shibboleths of their major protecting tribe, because that keeps them shielded. It's like in the 18th century days when pamphlets were written by people with powerful patrons, and they said whatever was OK with the patron, and nothing that wasn't.
I think it's important to understand that the very existence of people, and groups, without powerful patrons -- who are not beholden to *any* powerful interest group -- is actually a fragile and historically unusual thing, something that relies on there being enough public space to get stuff wrong (which fallible human beings do all the time) *without* being destroyed.
When you ramp up the pressure on independent people and agencies to get stuff right past a certain productive level, you don't get superhuman performance, you get ordinary humans to abandon the field, and it gets occupied by bullshitters, con men, and the advance guard of your enemies.
I think this is more or less true, but to me the implied takeaway is that while e.g. journalists might be largely competent and capable of doing good work, their environment prevents them from doing so, so we should exercise strong skepticism of their outputs. I'm not sure if this is the takeaway you're suggesting though.
I'd go a step further and suggest that fields like journalism tend to filter for people who're not inclined to do thorough and objective investigation, because if you were such a person, would you want to work in an environment which discouraged you from doing it?
Yes, absolutely, I agree 100% in exercising very strong skepticism of the work of most journalists. If nothing else, they're on a deadline, they almost never have relevant field expertise in whatever they're reporting on, *and* they're major motivation is getting eyeballs and page clicks, which means they are going to aim at sensationalism. Who wants to read "well, the conventional wisdom turned out to be wise, except for a few caveats which we will now enumerate in a convenient bullet list sorted by priority..." Booooring.
I'm really talking about the style and manner of skepticism, that's all. When I read some flaming piece in the media, I'm deeply skeptical, but I *don't* assume it's because the writer is human trash, I just say he's a normal person with normal human weaknesses subject to certain forces. I may seriously doubt the truth of what he's saying, but I don't jump from there to questioning his worth as a human being, assuming he enjoys lying for living, if that makes sense. I think it's possible to be very skeptical without being (or encouraging) deep contempt.
> refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases)
More lockdowns will also increase lockdown resistance due to lockdown fatigue. People just want to move on now with whatever is the new normal. If his ultimate goal is to force governments to give up on lockdowns as a public health measure, then I imagine a little pain right now to avoid all future lockdowns is worth it.
Is there any data on the combined prevalence of ivermectin-suceptible parasites so that somebody can redo the analysis without focusing on one species?
"I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns."
I don't understand how anyone thinks this will lead to fewer lockdowns at the moment. Cases were plenty low in the northern cities to justify removal of mask mandates and time/crowd size restrictions. They were mostly not. Cases were much higher in Florida, and they did not have mask mandates.
"I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns. I think it’s easy to get discouraged about this given the many “okay, in just a few weeks this will all be over and we can reopen for real” bait-and-switches, but in the long run I do think we’ve gotten less locked down as case numbers have declined. I don’t know how much of that has been epidemiologists agreeing the crisis is less severe vs. anti-lockdown activists forcing governments’ hands."
Speaking for myself and the community I live in (northeastern US, fairly liberal), lockdown type measures have decreased significantly. I think there are 2 factors:
1. People who are vaccinated feel much safer than they did a year ago (which they are!).
2. Between delta and what seems to be the continued refusal of huge numbers of the population to get vaccinated, it's not clear ambient covid risk is going to change any time soon. So at this point it feels like saying "I'm still not comfortable going to a restaurant" means, I "I won't go to a restaurant for the next several years." I think the calculus there was different when folks though the pandemic would be largely over in a few months to a year.
Scott seems a little too kind to IVMmeta, which seems to be part of a weird large-scale effort to paint all sorts of random stuff as miracle cures for Covid, and whose wordiness is matched only by the one-sidedness of the analysis.
Scott has a superhuman power to treat people with respect even as they are shitting on him. He had the same experience with Nathan Robinson before all of Nate's workers quit.
Tangentially, regarding mandated lockdowns vs mandated vaccines, I'd love to see a book review here of "The Premonition: A Pandemic Story" (by Michael Lewis, who also wrote Moneyball and The Big Short) (apparently previously mentioned on ACX [in this comment](https://astralcodexten.substack.com/p/open-thread-171/comment/1933890)), which includes a third option of something like "mandated data reporting". It tells the tale of the people in the US who were trying to make an effective COVID response happen back in January and February of 2020, and the things that got in their way. One notable suggestion was that rather than mandatory lockdowns, the government should have made a temporary exception to medical privacy laws and set up (mandated?) reporting of COVID test results on a localized-to-the-neighborhood basis, and made this data highly-visible so that neighborhoods and states could restrict travel and do voluntary lockdowns. (I may be misremembering the suggestion a bit.) And also that closing schools is way more important than restricting movements of adults.
> First, the claim that I "[appear] to be against all treatments, labeling them all "unorthodox" and "controversial", even those approved by western health authorities, including casirivimab/imdevimab, bamlanivimab, sotrovimab, and paxlovid." They suggest I am turning my readers away from other treatments including ones that are already standard of care in western health systems.
> This is false and I don't know where they're getting it from.
I assume it comes from that you wrote
> This is from ivmmeta.com, part of a sprawling empire of big professional-looking sites promoting unorthodox coronavirus treatments.
and those treatments are among the ones their empire happens to have pages on. (Go to the very top of the page for the list.)
I wonder if blood pressure medicine would cure covid. It's an odd disease for which comorbidities seem to matter a lot more than usual. Mild worm cases might be one of them. As I recall, high blood pressure is one of them, with unknown mechanism. Lots of people have high blood pressure and don't know it. If we gave a random sample of people with early covid high blood pressure medication, maybe we'd find they'd do better, on average, than a control group because we'd accidentally be catching some of them with untreated high blood pressure.
This paper is actually cited in my Strongyloides hypothesis paper. This paper dealt with a lot of different parasites, but did not seem to report Strongyloides. This is important, because it's the only one including all the different parasites that paper mentioned that undergoes hyperinfection and dissemination. Relevant because COVID-19 is associated with eosinopenia even without steroids, which may effect Strongyloides more so than other parasites given its ability for dissemination.
The general idea here is that Th2 loaded patients have decreased risk of decompensation because they have less risk of a cytokine storm associated with Th1 immune responses. So they do better clinically, but clear the virus slower. So patients with parasites generally do clinically better with COVID, but would be expected to clear the virus at a slower rate. But of course, with strongyloides ... if a patient develops eosinopenia in response to COVID (or steroids) all bets may be off...
To understand those positions, imagine more concretely. Imagine hostile aliens who say we expect your father to die and have no further treatment options beyond watchful waiting. Also, we urge you to stop waiting. No, we won't permit his doctor prescribe or administer a cheap, known-safe drug that you think might help, and we feel so strongly about this we will fight it in court for as long as it takes for us to win or him to die, whichever comes first.
Anecdote is not data. This proves very little about the efficacy of ivermectin as a treatment. It does demonstrate a lot about how to erode public trust, and why many people might look at the public health care decisions on Covid-19 and see Moloch, mouth open... and assume malice instead. Much easier to understand malice.
"Probably 'Trust Science' is not the right way to reach proponents of pseudoscientific medicine" - or indeed anyone who remembers what science was when it was still science. Nullius in verba. The entire point of science is that trust is unnecessary when you have replication - and we have a replication crisis, generally.
> I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns.
For any prediction market of the form "Will lockdowns end/vaccine mandates be repealed/mask mandates be repealed/free travel be restored when metric X is reached?" where X is something like case count, death count, vaccination rate, etc. and not something political like polls, elections, protests, civil war, etc. I would bet that the outcome will *not* occur when metric X is reached.
The reason for this is exactly as you said, over the last two years politicians around the world have made all sorts of promises about how these restrictions are just temporary and every single time not-temporary has turned into permanent or recurring.
I'm curious, Scott, what metric you would pick and would you bet on it?
For someone who looks at the very recent history of politicians making promises and then failing to keep them (see: two weeks to flatten the curve), this idea that "if we just do what they say they'll finally let us be free again" is hollow. It is just someone making another promise in a long serious of promises where they ask us to give up personal freedom today (right to personal medical choice) in exchange for future freedom (freedom of association, freedom of travel), but if history is any predictor of the future those future freedoms will never come.
Looking at a bit longer of a history, one can remember 9/11 where a whole load of rights were trampled on in the name of stopping terrorism, and many of those were intended to be temporary measures to deal with an immediate/imminent threat. Now, 20+ years later, those temporary measures are a permanent fixture in our lives (see: airport/airplane regulations like I can't bring a bottle of water into the airport).
I would like to be convinced that there is a path forward that actually restores our freedoms once they are removed, but at the moment I see no such path and the best strategy seems to be to avoid giving up the freedom in the first place (such as freedom of personal medical choice). Even if you are a strong believer and advocate for vaccines in general, there is value in the social signal that you are unwilling to give up yet another freedom. Often times one must take calculated risks to achieve some larger goal (like slowing the rate of erosion of personal freedoms in this case), and if you are at low-risk of death/disability from COVID-19 then this may be a stand worth making. You can even use it as a bargaining chip: "As soon as my freedoms are restored, I will get vaccinated." in a larger political battle.
excellent post. Refusal to get vaccinated seems self defeating (at least for those at risk, 40+ or with some other issues. For the 30- in good health, it's not clear if the very small risk of bad covid is higher than the very small risk of bad vaccine reaction. I think it is, but information is not coherent nor easy to find), but so does hunger strikes and similar types of protests. In some context, the self defeating aspect is good signal of how far you are ready to take the protest, which in game theory is a way for the weaker party to win against a stronger one, if the stronger party is not ready to loose as much...
It may be sad to come to those extremities, but as you said, history of western governments behavior show a very clear trend since at least 9/11, and for people opposing this trend, vaccine refusal is maybe much more rational than what would seems. That's not surprising, if you really know all factors at stake and game-theory model of the different actors strategy, irrational behavior is very rare, so much that when it looks irrational, it's wise to try to complete the picture with neglected factors. And irrational behavior is certainly much less common than the strategy of calling your opponent irrational ;=)
> if at least N people are playing a game, at least one of them is playing a different game.
I think your comparison to a hunger strike is very apt, as well as your assessment that signalling how far you are willing to go and how much you are willing to risk is a powerful means of avoiding conflict by allowing pre-calculation of the winner prior to any actual physical confrontation.
Interestingly, the optimal figurehead for this position is someone who believes that COVID-19 is extremely deadly, thinks vaccines are 100% effective, and still refuses to get vaccinated as long as the freedom reduction exists. This person would strongly signal, "I am willing to risk my life to oppose these policies, so if you want to continue escalating this to some kind of armed conflict be prepared to fight to the death".
If the Democrats ever want to win the culture war permanently, all they need to do is pass a law that mandates breathing, and watch as half the other side holds their breath permanently in protest.
The comment about the LHC makes me think of a question that comes often to my mind: how did the physics academia end up being so good at pooling resources together? It's not just the LHC - the tradition comes from before and outside: Fermilab, Kamiokande, and a lot of other high-energy physics experiments.
In principle the same bad incentives that make medicine/biology/social science professors focus on making their own career about their "own" project and potential discoveries should apply to physics. These incentives (mostly fighting for grants) are what causes this "smallholding" of research.
But for some reason it doesn't apply to physics. I've been (shortly) in that world and there's a general attitude of "yeah, we need to say blah blah for the grants, but what really matters your internal contribution to big project". I'm not sure where that comes from, and whether it could be transplanted to other sciences. This would be much better than putting whatever can be salvaged from 30 random pieces of biased research into one metastudy...
Once upon a time, a bunch of clever physicists said "finance our many-gigabuck project and we will give you the mightiest weapon ever with which to smite your greatest enemies ever. And maybe cheap, clean abundant power as well". And they pulled it off. There was also something with radar and computers going on about that time.
Ever since, politicians have been suckers for that argument. Give physicists (and maybe some other sorts of scientists, but particularly physicists) huge gobs of money in big concentrated chunks, and maybe we'll get technological miracles in return. Physics academia isn't pooling its own resources together, it's pooling everybody else's. Because they can.
Uh, yeah sure, but no, not really. I'm used to all modern physics developments being pop-historied into "and so because project manhattan"... but it's just not true.
The first problem is that your reasoning works for within-borders collaborations. The jingoistic logic of military research for sure opens up the money pipe (but not just for physics https://en.wikipedia.org/wiki/United_States_Army_Medical_Research_Institute_of_Infectious_Diseases). Yet CERN routinely has researchers coming over from Europe, the USA, Japan, India, Pakistan, Russia, Israel, Turkey, and a bunch of other equally not-very-allied countries. They come to work hands-on the projects, and then return to their respective universities with that knowledge. A pretty bad strategy from the "smite your enemies" point of view. And you could argue CERN still develops cutting-edge tech that could be used elsewhere. (Magnets? I don't know, some of the latest useful applications have actually been in medicine, proton therapy and the like.) But what about the Kamiokande detector, the IceCube project, the Pierre Auger project, etc etc? The best (non-fundamental physics result) that you could get out of Pierre Auger is "how do we transport large buckets of water around very long roads", that I'm pretty sure has already been solved.
A bit of history about kingoism and CERN itself: it was created precisely to put together European nuclear physicists in the same place, so that they'd all be one merry family and not develop nuclear weapons to blow up each other. It was kind of unremarkable until the US government decided to stop funding Fermilab, at which point CERN saw an opportunity to take the lead, did a couple of mid-budget experiments, found the W/Z bosons, and _after_ that success the European countries thought "uh this may be a nice way to own the US, let's throw money at it".
The second answer to your point is that expenditure in physics is not particularly high with respect to other fields. Take the Swiss National Science Foundation, which I know first hand and I can witness is not shy with money for physics https://data.snf.ch/key-figures/disciplines (you have to check the CSV, the plot is not enough).
Over the 2016-2020 five-year period, social sciences gets 1.3 billion CHF, Maths/Physics/Engineering together get 1.6B, and Biology/Medicine 1.8B, which sounds about as expected to me. (A bit annoyed by the expenditure on social sciences, since I don't see much expenditure in experimental materials, but that's a different story.) Specifically for Physics only is 0.4B (adding Astronomy into the mix, which I guess is fair, but probably not what the kind of field you were thinking about with politicians being suckers for promises of a new radar-style breakthrough). For comparison aggregated Biology is 0.8B and Medicine the other 1.0B.
For the European Research Council (again you can get a CSV with data here https://erc.europa.eu/projects-figures/project-database), I find that for the same 5 years, 2.0B went into Social/Humanities (SH in the data), 2.5B into Medicine/Biology (LS in the data) and 3.8B into Physics/Engineering (PE in the data). Again comparable amounts. Remarkable, a lot of the PE money went to "Earth System Science", "Products & processes engineering", and "Synthetic chemistry & materials". Big-project fundamental physics, such as we're discussing, falls under "Fundamental constituents of matter", which got 0.39B.
I tried finding good data for the US, but I'm not so familiar with how public research operates there and didn't find anything useful. If you have a link to an official page with a similar breakdown I'd actually appreciate it a lot.
Anyway - this is admittedly still a lot of money for physics. The point is that (big-project fundamental particle) physics doesn't get an oversized piece of the public research cake. Medicine gets more (which I think it's reasonable, being more pressing). They both have the same bad incentives when it comes to obtaining grants. My question stands: why has this very specific area of research been able to focus all its money into a few large-scale experiments, while others get equally large amounts of money that ends up inefficiently distributed amongst hundreds and hundreds of small departments that do lots of inconclusive N=10 experiments?
PS: "Physics academia isn't pooling its own resources together, it's pooling everybody else's. Because they can." This is true of all publicly funded research, and besides the point. I guess it's just a "don't tread on me" jab at public research per se, so I'm ignoring it for the discussion.
Physics is still a pretty outsize chunk (3.5 G$) but not nearly as dominant as it used to be. Bio/medical funding has exploded, and this does not even cover the NIH which has an even larger budget and just does bio with some chem, no physics. I think most people agree the US has scaled back its investment in high-energy physics considerably since the heyday of the 60s.
That is quite a bit for a single year, yeah. But even CS gets 2.8 billion. I'm quite amazed by the 18 going to biology, I didn't picture it as such big of a field (maybe because of it being in the shadow of medicine). Most of psychology being "Other" is also kinda funny.
If it were *just* weapons, that would be a reasonable argument. But physicists pivoted pretty quickly to cheap clean abundant energy, and mumble something other miracles nobody can predict but will probably be useful for more than just blowing people up. Same with most of the other fields of "Big Science".
Remember, the "atomic age" of the 1950s and early 1960s was generally perceived as a *good* thing. The nuclear weapons had proved that "atomic scientists" could do mighty things, and almost everyone trusted that they would quickly be doing mighty good peaceful things.
I can assure you that nearly all of big-project high-energy physics research has no application whatsoever to cheap clean abundant energy / similar miracles, and the grant proposals do not even touch the subject. For the record, high-energy does not mean "how do we generate large amounts of energy", but "how do we make this one little small particle go really fast".
Work on actual energy sources has mostly switched to engineers, including projects like ITER (which with its promises of "it'll be done in 10 years" over the last several decades doesn't really attract many physicists looking for the next big discovery).
> Remember, the "atomic age" of the 1950s and early 1960s was generally perceived as a *good* thing.
And this, I promise, is no longer the case, at least in contemporary western Europe. It seems to me that contemporary USA doesn't regard it anymore as a perfect jolly good time either, but I may be biased because of reading what people like Scott write. Kind of anecdotal, but illustrative, is that particle physicists try to distance themselves from the "nuclear" adjective lest the public starts complaining about Hiroshima and three-eyes fishes.
Either way, I don't see how that helps understand the initial question. Your argument was that physics has more money than other sciences, which I think it's by now clear not to be the case. If you want to say "ah it's all the same" and wrap it under some evil "Big Science", the question that still interests me (and I'd say anyone who cares about improving medical research) is why some of that "Big Science" is able to coordinate at such a large scale, and why some other stays attached to its feudal practices.
I can assure you that no congressman voting to authorize gigabucks for these projects, or for the organizations that would predictably fund these projects, ever read the grant proposals.
I'm fully vaccinated, my wife and children are vaccinated. My wife and I got our first shots in March. I am strongly against forced lockdowns and mandated vaccination. I've added my name to a list at my employer that refuses to show proof of vaccinations, because I find demanding it immoral, particularly since the vast majority of the company works from home, and will continue to do so in perpetuity.
I'm also against the rhetoric that the radical left uses on those who are vaccine hesitant. It will get absolutely zero of them to get vaccinated. It makes them dig their heels in more.
Do you want Republicans to win a supermajority in the next set of elections? Then keep this crap up!
(This last comment wasn't directed at Scott; he's been quite reasonable and hasn't branded his ideological opponents in a mean-spirited way. I'm just frustrated with the current political climate.)
What do I want to see instead? Encouragement and incentives. Towards the beginning of general availability of vaccines, I saw plenty of local stores with "for hire" signs offering a $500 signing bonus if you show proof of vaccination. That's fantastic! Restaurants offering indoor seating to the vaccinated, but not turning away any business would also be great.
Using force will turn people against you. If the Biden administration was simply saying stuff like "to the majority of Americans getting vaccinated, we thank you!" Without denigrating those who are hesitant as science deniers or stupid or even terrorists. Assholes on Twitter cheering on as people get fired due to vaccination status will not produce good results.
Lockdowns and similar measures while the population doesn't have access to vaccines seem warranted to me, but they just don't seem justified once those that want to be have been vaccinated. The disease just seems to be not deadly enough to justify it, no worse than a bad flu year (for the vaccinated). And trying so hard to save those that don't want to be vaccinated seems unproductive, maybe even counterproductive since it concentrates various denier groups.
Here in The Netherlands we have a pretty good vaccination rate (83% of >=12 yo) but our health care system is days away from collapsing. We got a light lockdown two weeks ago that isn't working and will probably get a stronger lockdown tomorrow. It is a tough place to be in. Urgent medical has been scaled down and soon we'll need triage for emergency care, but many people are just fed up with lockdowns.
Belgium seems a few weeks behind, but on a similar trajectory. And i guess it's the same for you : the 65+ and other more vulnerable people have a much higher rate of vaccination. I do not see how trying to reach the very small percentage of non vaccinated vulnerable people will change anything. At this point they are probably unreachable by normal means, not even sure forced vaccination would work if it is on the table, but it will be too late even if it does. Strong lockdowns will not be accepted especially around Christmas, even in the most compliant countries (like Belgium). But i am still somehow optimistic, in believing health system collapse or even non anecdotic icu triage is unlikely. A combination of self-isolation through fear, school holidays, a lot of still unused work days off, wrong reporting of ic capacity, may limit the problems. Also, given the general non reliability of mathematical modeling of covid epidemiology, i dare to use the previous waves as examples: we got close but did not exceed max capacity in quite a lot of the currently problematic countries... It could be a "lucky" coincidence... Or it could be there are various self-adjusting feedbacks at play...
I hope you are right and I agree that self-adjusting feedbacks are a very plausible mechanism. It has been clear for a while that official lockdown policy differences only have a limited effect on outcome differences.
Rather than enforcing vaccination and movement restrictions I would lower the standard of care for the unvaccinated. This would take the form of tent hospitals equipped with oxygen and medicines but no intensive care beds. The nursing and doctor to patient ratio would be much lower but could be augmented with military medics.
I believe this would have a much greater chance of actually being effective while getting to the root of the problem: hospital staff burnout. If some anti-vaxxers die because of this, well, that's a sacrifice I, as a vaccinated person, am willing to make (and I honestly think anti-vaxxers too would be happier with this than the lockdowns or forced vaccination plans).
By the way my perspective is as a New Zealander where my region hasn't had a single case in well over a year, internal borders will be coming down in two weeks though so we will be getting it then.
I appreciate being highlighted and I think Scott is broadly correct that conservative elites are responding to the incentives created by the base. That said I think it's really important to observe that even when the policy is ideologically neutral, will directly save the lives of their base, and the conservative elites believe it is correct (they got vaccinated), they are not willing to pay any cost in terms of popularity with the base in order to support that policy. Tucker Carlson even went on air to scaremonger about VAERS.
If your answer to the ongoing legitimacy crisis of public health officials, is to increase their epistemic virtue, it's important to note that red tribe perception of epistemic virtue flows through Fox News and Talk Radio. That media has just shown itself totally unwilling to resist pandering to their audiences suspicions even when lives are on the line and they think the policy at issue is correct.
Epistemic virtue is it's own reward and I think it's worth (especially on a blog like this) pushing mainstream institutions to be more inclusive of conservatives and their ideas. What is missed when you ignore conservative elites is that their actions drive down the marginal returns on investment in epistemic virtue in terms of authority generated for institutions and therefore have helped to create the incentive structure where elite institutions maximally pander to educated blue tribers.
Governments didn't randomly decide to do lockdowns for no reason. They did it because they everything was on fire (metaphorically speaking) and they needed to stop the disease from killing millions of people.
The idea that this is some sort of bizarre power grab is completely nonsensical. Lockdowns are unpopular and make people angry; why would politicians randomly decide to lock people down for no reason? It's bad for their tax base (which means less money and power) and it is bad for their own future electability (doing important things, even if they are unpopular, is a good way to not get re-elected).
People are born defective in tons of ways. It's just a fact. You have mutations in you that make you defective, in big ways and small. Heck, the fact that you created a moral system based around this stuff is itself defective, because it isn't congruent or consistent with reality.
We vaccinate people because it stops people from getting sick and dying at nearly the same rate. We do various restrictions because it lowers transmission rates.
"Governments didn't randomly decide to do lockdowns for no reason. They did it because they everything was on fire (metaphorically speaking) and they needed to stop the disease from killing millions of people."
But they *didn't* stop the disease from killing millions of people.
And they didn't need to. What they needed to do, was to conspicuously look like they were Doing Something. Which, mission accomplished. If there had been some quiet invisible intervention that cut the death toll by half, and if it were absolutely known to them that lockdowns would have done no good, the quiet invisible intervention would have been optional but the lockdowns would still have been politically mandatory.
>I actually think this might be more of a crux between us than anything about ivermectin itself. The same people behind ivmmeta have put up websites claiming that 19 different substances, including HCQ, testosterone-blockers, the spice curcumin, vitamins A, C, and D, etc, all cure coronavirus with pretty large effect sizes.
Did you just do a meta-analysis on a bunch of meta-analyses? How much more meta can we go?
"The same people behind ivmmeta have put up websites claiming that 19 different substances, including HCQ, testosterone-blockers, the spice curcumin, vitamins A, C, and D, etc, all cure coronavirus with pretty large effect sizes. I think this is because they are using a nonconventional form of statistics which is always going to find positive effects. [...] I think ivmmeta is trying to pioneer a new way of thinking about science and statistics without p-values, but I think its new way is actually bad and will get positive results almost all the time."
Why do you think it's a new, nonconventional form of statistics? To me it sounds like the same old p-hacking, garden of forking paths, file drawer problem...
Now that case rates are higher in vaccinated people, this argument had a short shelf-life, didn't it? "refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases)".
ivmmeta.com says "We also note that the author has never contacted us" at the end of the "AT response" section. The feedback forms at ivmmeta.com don't request the identify of the person filling out the form, so they can't know with confidence that AT didn't contact them.
ivmmeta.com isn't "trying to pioneer a new way of thinking about science and statistics without p-values". Their Figure 1 has a graph along the bottom with their "probability results from ineffective treatment" as a function of time, 1 in 100 on January 9 (of an unspecified year!) to 1 in 10 billion on January 6 (of a different unspecified year, but probably 2022). The probability that a result would be observed with ineffective treatment is a p value. If you don't like reading a graph, look at the first table at: https://ivmmeta.com/#results The column title "Probability of an equal or greater percentage of positive results from an ineffective treatment" matches the definition of a p-value.
They might be wrong, but they aren't boldly doing science without p-values.
I wish they were -- frequentist statistics is wrong, and Bayesian statistics is correct. Bayesian statistics doesn't have p-values. I haven't seen medical papers that made a substantial attempt to use them on real problems, but I would like to. But that's not what ivmmeta.com is doing; they are consistently frequentist throughout.
It’s a useful protest for people like me who have almost zero risk from covid.
How would you feel if you caught it and passed it on to a relative whose risk is not almost-zero?
To be fair, Fitzgerald could have near-zero risk of catching COVID in the first place, via isolation from society.
I guess the same as people who had the flu in the past, and didn't fully self-quarantined. Not even vaguely guilty. I agree with them, because guilt over this kind of indirect effect can not be general if you hope to live a normal life. So what should and what should not make you feel guilty, of what is acceptable in term of indirect-risky behavior, is mostly cultural/political/religious/choose your naming, the indirect risk is mostly an a posteriori justification for trying to change mass behavior, by the party that want to change it. It's not something based on a objective attempt at ranking behaviors per indirect bad effects, at least when those indirect bad effects are small...Yes, I am not really convinced by utilitarianism, mostly because of that.
I'm not a fan of it either, but how are other systems of ethics different? In the end, they too want "the greatest good for the greatest number", except try to achieve it with various rules of thumb and shortcuts, which of course are mostly cultural/political/religious/choose your naming.
I'm not sure it's true, even theoretically. Most systems have "the greater good for the greater number" as a goal, but certainly not as the only goal (or even the most important one). For example, Justice is often also a goal (often more important than the greater good) (I define the justice as each societal actor get a proportion of the total pie (variously defined) depending on his worthiness (variously defined). This is not a primary goal for utilitarianism, it's at best secondary (in the form of incentive so that net producer of global good are encouraged to produce as much as they can).
But that's not the main point of your comment: I believe there is an advantage of the usual (but suboptimal) rules of thumb utilitarinaism vs classic utilitarianism: The former is not a totalitarism, the second is. Totalitarism is not a problem in general (for physics for example, it is a driving force that I admire), but for government it is, especially when you have a central arbiter much more powerful than any individual or allowed grouping of individuals. It's the recipe for hard dictatorship, regardless of how worthy or altruistic the initial goal seems. The arbiter define the goal, measure it and the total aspect let very little place for unorganised discussion or disagreement. Rules of thumps are maybe less efficient, but they are not total so let unruled liberty spaces from which the system can be reformed....Well, I think I use overly complicated explanantion for something that is quite simple: I do not trust a human (or group of human) that say let us rule, we have the greater good of the greater number as objective. A group of actors, mainly selfish but with some altruistic component, that self-organise in multiple intersecting groups each implementing some reward-punishment system is suboptimal maybe, but do not need any crazy trust in the ruler.
Utilitarianism as a political system is, fo me, synonymous with a benevolent strong (well above human-level cognition) IA.
Utilitarianism as a personal philosophy is not the same. I have admiration for it, coupled with some distrust like for all altruists (are they really sincere?)...I also do not think it make the practitioner especially happy, so as a selfish bastard, I continue to care about myself first, my close ones next, and humanity as a very distant third. At the individual level, this system is maybe less admirable, but it is more actionable and, as you are more able to directly observe happiness of close ones (and, by definition, the most able to observe your own happiness), it's also far less hackable than utilitarianism :-)
Well, the point about altruism always confused me, long before I knew any relevant definitions. So, probably at about 10 years old, I decided that, since I care about myself the most, and about people close to me much more than everyone else, I must be evil. And further, revelaed preferences showed that pretty much everybody else was the same in practice, regardless of whatever high-minded ideals they might've gone about professing and not acting on. A few decades later, and having learned those definitions, my opinions haven't changed much.
The most important thing that I've understood about why people resist to openly accept and universalize this natural attitude, is that its ultimate logical conclusion is fascism. Which doesn't exactly boast a track record of successful implementations.
Of course, the obvious alternative of trying to universalize some ostensibly egalitarian set of ideals also leads to a totalitarianism of slightly different kind, like you mention, which also earned its share of PR problems, even though it isn't quite excluded from polite society unlike the former.
Is there a principled third way? It doesn't seem that there's even a broad undestanding of these issues, much less a significant informed effort to resolve them.
No. There were some people who joked about it and some of those jokes memed and people turned into reality, but I don't believe any of the currently under investigation drugs are ivermectin alternatives.
Thank you. I think Pierre Kory mentioned this on some podcast but unless I can hunt that down my assumption is that this is untrue.
In case your interested:
Theoretical antiviral mechanisms of ivermectin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203399/
Theoretical antiviral mechanism of molnupiravir: https://www.nature.com/articles/s41594-021-00651-0
Yes, molnupiravir, this was it, thank you. I guess the conclusion is that the mechanisms are different?
Quite different. Ivermectin is theorized to bind to viral proteins at locations which make them non-functional.
Molnupiravir acts as a pseudo-nucleotide, it gets incorporated into viral RNA in place of either citidine or uridine which causes the resulting codons to code for the incorrect amino acid leading to mutated and non-functional proteins.
It's actually super awesome.
I was reading about this yesterday and it sounds pretty cool, but the thing I don't understand is: how does this not also screw up my own DNA?
I feel like the rate of posts on ACX has dramatically increased these last 10 minutes.
But not from ivmmeta. They criticize Scott but never link to his criticism so their reader can decide for themselves.
Which is because the site is built to be cut-and-pasted responses to Internet arguments.
"To mandate vaccines is to state that humans are all born defective, and only become non-defective after jumping through state-approved hoops. It is philosophically corrosive to everything I believe in."
This feels like an isolated demand for rigor. I am constantly choosing to better my existence in many ways because of my 'defects':
* I take ibuprofen (which is government-approved) because my defective body creates headaches
* I upgrade my phone (which is government-approved in various ways) because I need a better camera because my defective eyes don't permanently store images of what they see
* I take the Moderna vaccine because my defective body is incapable of manufacturing the antibodies against a recently-common virulent disease that risks my wellbeing and that of those around me.
All human life is defined by improving our condition, sometimes under the supervision of a government. Regardless of whether those measures are mandated, it is strange to think of some of those actions as perfectly ordinary and some of them as accepting that you're defective.
There's a pretty big difference between "government-approved" and "government-mandated". My body was defective, and produced more teeth than I needed. I am happy that I had the option of getting my wisdom teeth extracted to fix that defect. I would not be happy if I was legally required, or even strongly pressured, to get my wisdom teeth extracted -- despite the fact that it was a real defect in my body.
The difference with vaccine mandates is the argument that, by getting a vaccine, you substantially reduce the burden of the disease on other people, and that reduced burden is worth the cost of imposing the state-mandated hoops. But you have to actually make the case that the cost is worthwhile (well, you don't have to but people are going to be a lot less convinced if you don't).
I say this as someone who got vaccinated at the first available opportunity. "Allowed" and "mandatory" should not be conflated.
I don't disagree. My point is that if you choose to label all of these things as evidence that you are defective, you shouldn't care if the government also labels you defective. The emotional impact of being "defective" loses its meaning when it is applied to every aspect of our daily lives.
That's disregarding the very important point of individual agency. If I decide I need more exercise and choose to do pushups, that's one thing. If the government sends a drill sergeant to yell at me to do pushups, that's a very different thing.
If you have TB and you don't comply with treatment someone from the government will come to your house everyday and watch you take your pills. Do you think that's wrong? Should people be free to walk around with active TB?
I wasn't born with active TB. Nor were most other people.
Huh? You’ve lost me.
BronxZooCobra did not mention congenital TB, I think he was referring to community acquired TB. After two to five days of treatment you are not contagious anymore.
However, it is important that TB patients take their medication full course (6 months). It is the non-compliance that caused the MDRTB (multi drug resistant) and the EXDRTB (extremely drug resistant) strains. And although most are reminded in a friendly way by community health care workers, I have no objection if -when needed, in case of refusal- it is done at 'gun point' or locking them up.
It's worth bearing in mind that individual agency is not a fact of natural law. It is, more or less, a privilege a governing majority grants to the polity over which it exerts sovereignty. Like any privilege, if abused it gets revoked. One of the reasons we enjoy as much individual agency in the US as we do is that people by and large don't take it to extremes -- they rein it in a bit voluntarily when it starts to become clear that it pisses off too many people. If that stops happening, there isn't a God Emperor that will stop the majority from circumscribing the amount of individual agency it tolerates.
That may not be pleasant news, and it may not even be the way the world *ought* to operate, if ethics were as as ineluctable as the Second Law of Thermodynamics. But it's the way the world actually does work, and wise men don't argue with forces of nature.
You have it exactly backwards. Individual agency is the fact of natural law. We trade some of that agency for government to take some of the rough edges off of living around other people. Governments can go farther and use force to make people do things, just like any group of the strong can do to the weak, but the default is individual agency. The fact that it is usual in history for the strong/large group to violate the rights of the weak/small group does not make agency a "privilege."
Natural law in the sense of what ought to be, sure. In the sense of what actually happens, no. The ugly truth is that groups of humans outside of tiny and fortunate and often transitory alliances, will *always* end up with the group imposing limits on individual agency, because it can. I don't take individual agency by my kids as a bedrock principle of my family, and no responsible parent would. My firm doesn't take individual agency by employees as a bedrock principle, and no successful firm would. If I sufficiently piss off the majority in the State of California, it can and will hound me, lock me up, even kill me, notwithstanding any written law or ethical principle, simply because it can.
The fact that I have a substantial degree of agency in my community, on my street, in my town and state, is a lucky thing, something not unnatural (and indeed which generations of our forefathers have sacrificed and struggled to achieve). It's not the natural state of humans. The natural state is that if I had a loud party, or failed to maintain my home nice 'n' neat, or just didn't say hello respectively enough to the local honcho, my neighbors would beat the shit out of me and enforce compliance with the local tribal values. That is indeed the record of most of human existence, from 40,000 BC to ~1600 or so.
The fact that this *doesn't* happen in modern American society -- that I can thumb my nose at my local community and they're reduced to merely verbal protest, or writing angry letters, is a fact of extraordinarily good luck (and some hard work by our predecessors). It's not a state of nature. It's perfectly possible for it to be undermined, and ultimately destroyed, by insufficient attention and effort to maintaining it, both on the part of the majority *and* on the part of any minority.
Game theory shows that altruism is selected against because altruism advantages parasitism.
The only ESS is RECIPROCAL Altruism - where people are required to behave in an altruistic manner, on pain of getting the altruism granted by others revoked (historically, this would result in you being killed or cast out of the tribe or whatever).
We require people to pay taxes and to vaccinate themselves for the good of the group so that we can all enjoy the benefits of living in an altruistic society. But this is only enforceable if failure to meet our minimum standards of altruism actually results in real consequences.
It is, in fact, "natural law" that groups showing reciprocal altruism will require that it be reciprocated, as it is how "altruism" is selected for to begin with.
A tough truth nicely said.
You mean PE?
The thing is: wisdom teeth don't affect anyone but yourself. Not being vaccinated hurts society big time. I'm against vaccine mandates as well, in principle. But since we apparently need 90+% of people to decide to get the vaccine, this principle probably can't be upheld everywhere.
The part where I can't wrap my head around is that the very people who like to talk about "serving your country", "patriotism", etc. etc. refuse to act when for the first time their country actually needs them to do something for society. And this something is as insignificant as a small injection thrice with almost no side effects with a medication so well studied, it trumps all other medication we have ever head in terms of statistics we gathered.
For me, everyone who refuses the vaccine lost their right to talk positively about patriotism, duty or the legitimacy of things like the draft. Because that one time they could have proven they actually meant what they were saying, they refused ...
I think this is an overly binary way of looking at things. There are plenty of people who are willing to do certain things for their country but not other things, and "literally allow people to modify your body" is, I think, high on many people's lists of Thing That Should Be My Decision And My Decision Only.
*Regardless of how insignificant we believe it is*, the idea of a legally mandated injection just grates at my soul. It's one of those things that I think is probably a net benefit in the short term and leads us down a really uncomfortable path in the long term; uncomfortable enough that I don't think we should have it at all.
I'm not the only one who's made the awkward-but-not-entirely-invalid connection between pro-choice bodily autonomy and anti-vaccine-mandate bodily autonomy, y'know?
How is: "If you are not willing to do this minuscule sacrifice, you have no right to vote on me sacrificing the life of my son!" a binary way of looking at things? I think its a very nuanced position, where you have to do the small things you can do yourself first, before earning the right to be asking someone else to sacrifice big time.
I don't see any potential sane way of reasoning where "putting a safe and well tested vaccine into your body" is a bigger burden to ask for than "take that gun and shoot at those people who I tell you are baddies and potentially get yourself killed in the process" ...
Because they disagree on whether bodily modification is a miniscule sacrifice; a lot of people are on the Body Is Sacrosanct train, and you're not going to convince them otherwise by saying that you disagree. I think many people would say that a military draft is actually more acceptable than forcing people to undertake medical procedures, regardless of how harmless we currently think those medical procedures are.
And we're largely not OK with a military draft either, US wars have been fought with volunteers for quite a long time.
I'd consider this a ridiculous position though. Military draft takes away your autonomy and freedoms for the length of the draft and potentially kills you.
Also: I'm not talking about forcing anyone here. I'm of course expecting them to volunteer for their country, if they consider themselves patriots (which they are very obviously not).
Well, that's only because we haven't had a serious war in quite a long time. If there *were* an extended war at an existential level, e.g. a war with China or something that doesn't get resolved with nukes immediately, the draft remains on the books and would come back into force tout suite.
But up until two years ago, this viewpoint was a tiny fringe! It's true that a lot of people tried to slow-walk the recommended vaccine schedule for children, but it was only a few percent who ever tried to avoid getting the mandatory childhood vaccinations that have been required for school in every US state.
"I am.not able to take part in this war , because my doctor has advised me at not ones to allow a bullet to enter my body". -- Woody Allen.
The central example of service to ones country is military service, and that can involve some pretty serious body.modofication. also jabs.
The notion that any individual not taking a vaccine harms society is utter and complete conjecture. If not, what study are you citing? How was it conducted? Who took part? What analysis was used?
> If not, what study are you citing?
Studies that report lowered severity and interactivity of vaccinated people.
The "common sense" study, where right now in my country hospitals have to close entire sections to redirect forces to care for the unvaccinated.
You want numbers? https://www.kbv.de/media/sp/2021-11-19_Corona_Report.pdf
That's actual "boots on the ground" data ...
Nobody needs a study to see that being vaccinated reduces the risk to take up valuable space in the ICU by roughly 90% (numbers vary by age group, but essentially this applies to everyone old enough to vote).
Even with the current Covid prevalence Germany could easily sustain the load on the hospitals if vaccination rates where in the high 90% range ... (but the prevalence wouldn't be the same either)
Your English is far better than my German. Are we talking a comparison between Germany and some similarly situated country with a vaccination rate in the high 90's?
No, we are comparing hospitalization of vaccinated and unvaccinated in Germany here. The data in the report is drawn from hospitals all over Germany.
Vaccination status and Covid infection status is noted in all hospitals in Germany, regardless what you are admissioned for. We also know which patients in the ICU are there for Covid related symptoms.
Since we know the vaccination rates in the population by state, a lot of statistics can be calculated from there ...
There are also comparisions with various other Europeen countries being made, but not in the Report I linked above, except for the last page, where they put the data into international context.
Let me translate some of the interesting data for you:
Vaccination rates:
Total: 65.8%, 12-17 38.6%, 18-59 71.8%, 60+ 84.8%
All following numbers are in the format per 100k "unvaccinated/vaccinated/reduction of risk through vaccination"
Symptomatic: total: 817.6 | 212.8 | 74 % , 12-17 968.1/90.8/91%, 18-59 867.3/257.3/70% , 60+ 524.7/150.8/71%
Hospitalized: total: 37.1/7.6/80% , 12-17 4.6/0.3/92% , 18-59 24.5/3.0/88% , 60+ 107.4/15.7/85%
ICU: total 5.8/0.9/85% , 12-17 0/0/- , 18-59 3.5/0.2/94% , 60+ 18.5/2.0/89%
Death: total 3.9/1.0/75% , 12-17 0/0/- , 18-59 0.4/<0.1/88% , 60+ 19.6/2.6/87%
Mind you, that's the data for 18th of October through 14th of November. We experienced a huge influx of patients during that period and since. Those numbers are gonna change pretty soon, since in 2-3 weeks all reserves of hospitals might be depleted and the standard of care will probably drop considerably.
There is a huge difference in the two reason to try to convince unvaccinated to take the shot, in fact two big differences:
Get vaccinated because it will eradicate covid : once we reach 70% of adults - correction, 70% of popularion, 80%...no it's 90% now, R will be below 1 and covid will go the way of the dodo... I am very reluctant to mandatory health measures justified by population benefits, but it's me and I get plenty of people would agree on this... But it's not true and I think no epidemiologist will day anything about group immunity and covid eradication anymore. Vaccine efficiency for transmission is not enough for it since delta, and there are likely animal reservoirs anyway... So this reason may be acceptable for some diseases, not for covid.
the other reason is that unvaccinated are more at risk of ending in ICU, thus in case of saturation, taking a place needed by a more civic or careful vaccinated that just had the bad luck of accident, other disease or covid despite vaccine.... This is true, but also very similar to smokers and over eater taking valuable medical resources that could benefit more prudent /civic people. I do not want to go this way, not at all and will resist any small step this way (not necessarily because i am impacted by all, i don't smoke for example and this is clearly the immediate next step in this direction, one that is already partially implemented as higher insurance fee for smokers) but because i see it growing and growing constantly and the end state is both clear and awful. I don't want covid to be a new step in this awful ladder...
BTW 90% vaccination for at risk groups is achieved in quite a few European countries... That still impose various restrictions and blame the unvaccinated for this...this looks more like scapegoating that objective analysis
Smokers and over eaters aren't contagious. They don't all show up in the ICU at once. That's a fine but important difference. If this pandemic had an R of exactly 1, I couldn't care less if people get vaccinated. It's their life and I totally support them being able to chose whether they want to reduce their risk or take their chances.
Hell, I'd even let everyone decide for themselves, if all of them would sign voluntarily a paper claiming to refuse any ICU care, if this implied other people not getting cared for at the best available standards or if it implied that staff has to make overtime.
But this isn't those normal times where we just let everyone live their own lives and nobody gets overly affected by this. This is a moment in time where individual choices with very little effect accumulate in a way that it affects society pretty heavily.
In a way this is like the climate issue. Me driving my car isn't a big deal. A billion people driving their cars is ...
> Nobody needs a study to see that being vaccinated reduces the risk to take up valuable space in the ICU by roughly 90% (numbers vary by age group, but essentially this applies to everyone old enough to vote).
So, by this token violations of bodily autonomy are justified if they reduce the amount of medical care you personally consume? Because saying that "unvaccinated people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable also implies "obese people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable.
If the argument is specifically that the difference is that COVID is contagious and obesity isn't, you would have to make the argument that a marginal person getting vaccinated reduces the total number of people infected with COVID by significantly more than one, which I don't think is supported by the evidence at this point.
> Because saying that "unvaccinated people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable also implies "obese people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable.
It does, at least to the modern left; see NYC sugar-taxes!
Your logic about the marginal patient is interesting. It's a lot like the marginal voter.
Unfortunately, public health has to deal with biology and human behavior. It IS actually true vaccination reduces both case counts as well as case severity. But you're right, one person getting or not getting the vaccine will not tip the scale. Even so, it really does matter that we get a large percentage of the public vaccinated.
In general I support libertarianism, but some things really do have negative externalities. The argument you present here makes me sigh.
Last year I heard the libertarian candidate for president in an interview say that the thinks different communities should be able to have different requirements for vaccination, and people could move if they don't like it. This kind of thinking is impractical, and terrible from a public health perspective. That one statement cost her my marginal (worthless) vote.
> by significantly more than one
why?
If people who could vaccinate and refused would be refused hospital care in case of ICU shortage then I would be fully accepting that.
But the problem is that in some places at least people die because people who refuse to vaccinate overloaded hospitals.
Or because to avoid overloading hospitals operations and treatment was cancelled.
The fact you demand someone links you a study that vaccination reduces contagion makes me inclined to believe you are being facetious at best.
I should have been more specific. Borrowing from another context:
The only people who regularly get flu shots are people who regularly get the flu. People who never get the flu usually don't get flu shots. The claim that people who never get the flu not getting flu shots is the reason why people who got flu shots are getting the flu is a perfectly reasonable thing to ask for evidence for.
I admit I may be misunderstanding the general claim.
I’m in an admittedly liberal area in the USA in a liberal bubble, but all of my friends and family get the flu shot each year. They rarely get the flu. Lots of people I know have never had the flu but still get the shot each year. My town and the local university both run flu drives where they encourage everyone of every age to get a flu shot. They all do this because it decreases the spread of influenza, especially protecting people who are immunocompromised.
Certainly there are people who both don’t get a flu shot and don’t get it so they then don’t spread it, but there are also many people who would otherwise have gotten the flu but don’t because they had a flu shot. And those people would certainly have spread it to the people around them (both breakthrough cases and to unvaccinated people). That second group is who need to get the flu shot. Unfortunately, it’s impossible to know who will be in which group beforehand. We can make reasonable guesses (perhaps doctors and nurses are most likely, then teachers and students, then retail workers), but anyone is still a possibility unless they’re in a self-imposed lockdown.
This has been widely established at least since the days of Pasteur, if not Jenner. There's a reason that every developed society has had some form of vaccine mandates for most of the past century and a half (even though many of these "mandates" are actually just conditional mandates if you choose to enroll in school or the military or something else not technically required).
Many of them make homeschooling either illegal or highly inconvenient, therefore making mandates essntially unconditional.
What do you expect 90% vaccinated will achieve that the current 70-80% won't? The reduction in virus transmission of the current vaccines is not great, maybe 1/4 at best but probably more like 1/2...so the reduction of trasmission would be 1/4*%vaccinated + %unvaccinated. We would go from 0.8/4+0.2 = 0.4 to 0.9/4+0.1=0.325...will this magically make R go below 1? More vaccinated people is a good thing... At least among the people more at risk of covid than vaccine (not clear if its all, or people above a certain age)... But hoping that at a certain threshold, vaccination will eradicate covid is untenable, since we had R well above one in countries with 70% vaccinated, in fact since the 80%+ vaccine efficiency against trasmission was reported false. At this point, group immunity by vaccination serve only one clear purpose: stigmatising unvaccinated as the group responsible for the covid problems. I guess for other groups that may have to assume this responsability (like gouvernements), it's very useful
> But hoping that at a certain threshold, vaccination will eradicate covid is untenable, since we had R well above one in countries with 70% vaccinated
This effect is not necessarily linear. https://en.wikipedia.org/wiki/Herd_immunity
So, concretely: do you expect that the number of COVID cases will approach zero, and there will be no further outbreaks, in populations that hit 90% vaccine uptake?
No idea, I would need to research specific numbers.
Even if such data is available it would likely take week or two of work to get model that likely is so simplified that it would be worthless.
While the vaccines is very effective in reducing severity. it is not effective enough in reducing transmission. So I think Greg's thinking is correct. The Herd Immunity article you link says that enough people have to become "immune to infection" -- that's not what we're presently getting with the vaccine.
I am well aware of the group immunity equation... It's non linear but it's trivial... Using wikipedia notation, if R0 of covid (delta variant} is 5, you need p>0.8. If do you get more than 80% of people immune (Wikipedia speak, in full it means non transmitting, that's what count, not symptom severity) when between half and a quarter of people vaccinated still can transmit. You can't, getting 100% vaccination will not get you here immunity, it will at most reduce the charge of the hospitals... One clear outcome of the covid is that simple épidemiological models are mostly useless (something i didn't expect, they are simple and their hypothesis seems reasonable), but epidemiologist speak about herd immunity anymore... In fact, scientific theories mostly seems cherry picked to justify measures... The prédictions were wrong, countries have varying issues and problems but it's not the good students in term of vaccinating that necessarily are in better shape. Sweden is not a graveyard, India who got hit by the delta is not in the news anymore... So it's very difficult to dee what is happening and even harder to predict what will happen, but one thing is sure : lent supposed democratic gouvernement turned out to be lying not so democratic entities hostile to individuel freedom and responsibility... Given that, i consider their lack of efficiency a blessing...
How much does not being vaccinated hurt society, exactly? Vaccination does not stop the virus from being hosted or spread by humans. COVID also has reservoirs in animal populations, so there is no way to eradicate it from the Earth even if the vaccines were sterilizing.
So what is the marginal benefits to society from everyone being vaccinated above and beyond everyone being vaccinated or having natural immunity?
That depends on how many people chose to not be vaccinated. Germany currently has one of the biggest amounts of ICU beds per capita in the world. Yet ICUs still get inundate with unvaccinated people to a point where it starts to affect the medical care available to other people. That's where it starts to hurt society. I've linked and translated the relevant statistics for Germany elsewhere in this comment thread for the poster Ryan.
If the unvaccinated wouldn't show up in the ICUs, I couldn't care less about them choosing what-ever they feel right for them. It would still hurt society to some degree, as society would have to pick up the slack for the unfortunate, who have a bad outcome of the infection, but I'd consider this within the acceptable limits. We don't condone people smoking, drinking, binge-eating or performing high risk sports after all. And I totally support the "my body my choice"-motto.
Unfortunately that's not what's happening right now. Right now, in Germany, we are very close to a melt-down of the medical system, and numbers show, that, even with the same number of infections, there would be no such issue, if we were above 95% vaccination rate ...
you can not be at 95% vaccination rate in time. Depending if 95% is the total population or the at risk population, I think you can not reach 95% vaccination regardless of time and incentive. 95% is just a huge percentage. This 95% is coming out of thin air, now that ICU saturation may be a problem. When it was not considered a likely issue, western europe countries were mostly self-congratulating about vaccination percentage, playing a pissing contest to see who got a few % more than it's neighbor, and speculate about how herd immunity will be reached real soon at 60, no 70 of adults, no 70 total, correction it's 85% now....well forget about herd immunity, it was never a possibility. This 95% of vaccination is neither realisticaly achievable nor, given the track record of covid prediction, a garantee of anything. You can predict the sign of the effect: more vaccination means less ICU beds busy, all other things being equal. Not a very accurate nor usefull prediction.
So I see one practical effect of this 95% number: Designate the unvaccinated as the sole responsible for the covid troubles. And the economic crisis. And the inflation. Add climate change and loss of hairs too, why not :-)
You are arguing in bad faith here. The 70% figure was given before even the beta variant was discovered. And it was never said as a "truth", but always communicated as the bare minimum required, given the data we had. New variants with higher R values of course change that equation.
And yes: I agree that 95% of the eligible population is very hard to do unless mandated. But the virus doesn't care if we like it. We either do what we must, or we don't. Either way we have to deal with the consequences that come with it.
And yes: the unvaccinated are largely responsible for the current mess in the ICUs. It's them arriving there in large numbers. The vaccinated still only make up 10% of that, if adjusted for the amount of people vaccinated.
It was also largely them opposing what could fix this mess very easily. If everyone acts like an adult for a mere four weeks, this hole thing is over for months. We could stop this pandemic to New Zealand levels whenever we wanted to and then work a rigorous track&trace program with harsh lockdowns of small areas where ever the virus pops up. But again: coordination problems. Some part of the population never cared, some no longer care (me included), some can't be bothered ...
Now we will have to deal with the unrest leading to us losing all those lives we had saved compared to Sweden. I can already see how those who always wanted to go the Swedish route will claim how they always said it would be pointless to do anything, considering that ultimately we will probably match the Swedish death-toll per capita ...
But honestly: if they can't be bothered to get the vaccine, I can't be bothered to care about the spread of the virus after 1,5 exhausting years either. We apparently now need a few 100k deaths to learn a lesson. I can already see those who objected and obstructed all measures blaming the government for not bolstering up the health care system. They won't understand, nor want to hear, that even if we would have been able to double the numbers of employees in the ICU, which is in itself a ridiculous proposition already, this would have only bought us two to three weeks.
This didn't age well at all. The vaccines don't stop transmission and *never did*. And they're more dangerous than all other vaccines combined. So f*** you and your arrogant authoritarian bullshit.
Well, if you make up your own facts I guess in your fantasy world your comment makes sense. I won't even try to look up what you are actually referring to in my comment, considering your manners ...
Your body is defective. It caries numerous communicable diseases. You and everyone else on the planet is mandated not to defecate outside of the designated locations. Do you have a problem with that mandate?
I am defective because I can’t see well, and the government mandates I wear glasses when I drive. Why is this ok?
I find the phrase "To mandate vaccines is to state that humans are all born defective," hilarious because it implies the slightest possibility that we're not all born defective in a multitude of ways.
They're saying it's an insult to claim that the microscopic defensive swarm that protects their bodies from constantly evolving enemies isn't also psychic. That we dare say we need to at least warn our immune system what it's up against and give it the chance to develop a variety of specialized weapons otherwise on its own. Meanwhile, we all have blind spots because our retinas are wired backwards, we have a nerve to our throats that loops under our aortas for no reason, and women have to squeeze their babies through their hips.
We require people to do all sorts of things in order to prevent risks to others. It's why you can be pulled over for having a taillight out - it's dangerous to other people on the road. There's nothing stopping you from driving around with no taillights, but it's dangerous for everyone else.
My point as well. But let's stop discussions with people who don't want to follow the general accepted rules - and as result make lives of billions misserable and risking millions of further deaths. In many countries one gets imprisoned on a lot less important things...
"This feels like an isolated demand for rigor." It also feels like they are ignoring the whole "contagious disease" aspect of COVID. Your headache doesn't affect me (unless you're my husband.) Your ability to infect me with COVID does.
I originally wrote "vaccines turned out not to be great on this contagion aspect", but realized I don't actually know. There are studies on viral load in breakthrough cases, but is there any data on how contagious these people really are?
Once a break through happens, they apparently are as contagious as non-vaccinated. However, being vaccinated apparently shortens the length of time they are contagious. The infection rate of a vaccinated index patient apparently is roughly 50% of that of an unvaccinated index patient.
Add to this, that vaccinated people only have 30-50% probability to get infected in the same scenario in which an unvaccinated person gets infected, and you have a pretty good reduction in contagion.
Now add to this that being vaccinated reduces the risk for patients to require ICU care by approximately 80% and you can see why hospitals can operate normally with vastly larger incidence values in the population if everyone is vaccinated, as opposed to a population with large clusters of unvaccinated people.
From 1796 to 2019 vaccines prevented vaccinated people from infecting unvaccinated people. Last couple years sure turned that on its head.
I find that very unlikely. I've always thought that rare breakthrough cases of measles, mumps, polio, etc. could infect other people - let alone the much more common breakthrough cases of flu. What's changed now is that breakthrough cases of COVID are more common than breakthrough cases of anything else (except maybe flu), because there's a huge pandemic going on.
"s that breakthrough cases of COVID are more common than breakthrough cases of anything else"
How do we know that for polio? IIRC only a very small percentage of even unvaccinated people will develop symptoms like paralysis. The vast majority of people will experience fever, fatigue, vomiting, stiff neck, headache, etc. If you'd been vaccinated as a kid and then felt shitty for 2 days you're not going to go tested for anything let alone polio.
I think they were saying that the absolute number of breakthrough COVID cases is high compared to breakthrough polio cases, which is trivially true since there are no polio cases (in the USA) and many COVID cases.
"The Salk vaccine had been 60–70% effective against PV1 (poliovirus type 1), over 90% effective against PV2 and PV3, and 94% effective against the development of bulbar polio."
If it's 60-70% effective than 30-40% of vaccinated people got polio. Keeping in mind that much like COVID polio was mild for most people. It wasn't like anyone who got polio ended up in an iron lung, I think it was well into the low single digits.
That also stood out to me. We're a bunch of hairless apes creating by the alien process of evolution. We're barely able to hold together a civilization and stave off everything this uncaring universe throws at us to kill us. It is very inspiring to me that we made it so far, and I deeply hope we will make it even farther.
But to think that you have some kind of God-given right to survive a virus is very bizarre to me. There is absolutely no reason why humanity will only ever face threats that it can overcome. If we want to survive we really need to pull all the tricks. And the mRNA vaccines are just marvels of human ingenuity, that will allow us to hold on for a bit longer.
I pray that we never face an *actual* threat.
> your body develops six kidneys but only keeps two
very quick googling failed to find this one. Do you have a link explaining this one?
Wow, this made my day!
I think a good analogy would be clothing. Mandating people not walk around nude seems like it is a "state-approved hoop" imposed because your naturally unclothed state is "defective".
It's absolutely an assault on bodily autonomy--the right to use my body in the way I choose! I am now no longer wearing shirts outdoors since it is one of my only methods of protesting the government's mandates on my bodily autonomy. Nevermind that it's -20F outside.
This is slightly uncharitable but is basically how I view people who refuse to get vaccinated as a form of protest against even a valid example of government overreach. You're hurting yourself and making this whole damn thing last longer too.
This actually made me laugh out loud for real.
In all seriousness, I find that state sanctioned mandate to wear clothes in public makes much less sense than vaccine mandate.
It seems to me that a most basic rule of thumb is to restrict actions with moderate-high value of harm to others compared to harm to oneself.
This value is much less for not wearing clothers when it is cold than for not being vaccinated during a pandemic.
Requiring people not to shit on the floor seems like a better analogy.
Yes, as nudist I would prefer allowing everybody to be nude but required to poop in a toilet, instead of everybody be clothed and poop anywhere the mood strikes.
"Author briefly looks at 30 of the 66 studies, which we note is much better than most commenters, but still ignores the majority of studies, including the prophylaxis studies."
My reaction to that one is "Oh, person, try me!"
I trawled my way through that Cochrane meta-study of the various studies. A heap of them were "throw everything at the wall and see what sticks" where they dosed people up on ivermectin and whatever they had lying around in the dispensary cupboard; some of them were "you're not testing what you say you're testing when I read your paper" and at least one was "we done screwed up".
One of the positive ones recommended you take your ivermectin with a meal and alcohol, because that made it work better. So at least you get to have a nice steak dinner with a glass of wine, which should make the experience pleasant.
The positive results ranged from "mild" to "really great but it's in Florida". There's no way to say "All the studies or most of them anyway say this works fantastically".
The longer Americans don't get their damn shots already, the stronger the argument against donating the leftover doses becomes: "we can't donate that vaccine, Dr. Scott in the Bay Area hasn't taken his yet! Would you vaccinate some random Nigerian before Dr. Scott?!"
And that's even assuming those shots *could* be donated. Poorer countries have been discarding doses left and right for months.
Well, this explains why you were asking "who needs editors?" in the open thread.
re. "To mandate vaccines is to state...."
This finally clarified to me why I've been getting so god damn HEATED about COVID-19 and global warming denialists in general, compared to other things.
It falls under the list of vague "social contract" things I expect everyone to do because I have to do them too.
Eg, I like being loud in public. I like fighting. I like driving fast on mountain roads. I like shooting guns in my back yard.
But, I don't do any of these things, in exchange for everyone else not doing these things; so when I see a defector (someone not getting a vaccine; someone driving perfectly buffed out brodozer with the fake lift and no liner) it pisses me off because: I wanna do stupid shit!
If I can't fight people in line at the grocery store and shoot squirrels at the park with a 762 and drink in public, YOU have to wear a mask and get your fucking shot.
We live in a civil god damn society where 90% of our individual liberty is sacrificed to protect our ability to live groups; and that's good because if we didn't idiots like me would try to box you for wearing a loud shirt or some equally dumb shit.
The social contract breaks down, we return to state of nature, and I box you in the grocery store line before stealing all the bourbon and burning it down on the way out.
Or, alternately, everyone publicly shames you for being a selfish piece of shit, you loose your job, your wife leaves you, and we all stand in a big circle and laugh at how dumb you are.
Or, in reality, Nothing really happens because you are utterly unimportant and literally nobody but your mom cares what happens to you or what you do.
That sounds like it leads to the "I fight you for groceries" outcome, not a "shake hands" outcome.
There are things between "indefinite worldwide mask mandate" and "no masks forever". You're engaging in very blatant splitting here.
That's a pretty extreme case of putting words in my mouth, and if that's how you interpret my comment, I think that warrants skepticism of your ability to interpret the positions of other people who disagree with you as well.
The point Nah is making is not that masks in themselves are the lynchpin of civilization, but that the social contract which our civilization *does* rely on involved people mutually accepting obligations they don't like in exchange for other people respecting obligations towards them. From that standpoint, you don't mutually and respectfully agree to disregard parts of the social contract you don't like at your discretion, the social contract is what keeps you living in basically peaceful cooperation in the first place.
I dunno, whatever the relevant penalties are in your jurisdiction, I guess.
The problem is not everyone agrees on what shouldn't be allowed. You don't shoot squirrels at the park even though you want to, but why? What if everyone did want to do that and would have no problem with everyone else also doing it?
That's the problem we have now, except 50% of the people have a problem with you shooting squirrels and 50% don't and would also like to do it. And the government isn't even trying to put a number of this, it's just picking one based on ???
This would be defensible if there was an actual vote and the majority actually said "we want this, and we live in a democracy, so suck it up". But afaik even that hasn't happened.
Go look at polls-- most Americans support the vaccine mandates. It's not everyone, sure, but it's definitely a majority.
for 1, can you link some polls? I'm not familiar with the area myself so i wouldn't know what are good one.
For 2, come on. We both know polls are pretty much worthless for anything. See the Yes Prime Minister skit for that. It's trivial to change consensus based on a single word choice, plus polls are unlikely to capture the same demographics as those that vote.
For 3, even if true polls are not a substitute for the formal democratic process. We don't choose the president based on polls.
https://news.northwestern.edu/stories/2021/10/survey-shows-most-americans-continue-to-support-vaccine-mandatesand-want-more/ was the first link on google when I looked up "how many people support a vaccine mandate" and you can search that yourself to see other websites-- I'm just mentioning my search to let you know I wasn't trying to cherry pick data.
Polls aren't worthless for anything, but yes, they are not a substitute for the formal democratic process. However, if we want to know "does the majority want this," which was the question you were posing earlier, than yes, polls can broadly tell us if Americans do want this. And when answering this question we do not have to think about some of the factors that make presidential polls have a higher relative MOE.
Well, the problem is, like i mentioned in #2 i simply don't trust polls. :V
Going through and reading the actual data on the survey, it's actually not bad, so it updates my priors on the belief a bit. But it still has some problems
1. It was online only, which vastly limits who exactly sees it.
2. The response of the public is contradictory. 65% are in favor of a vaccine for everyone, but only 63% are in favor for giving it to children (who are presumably included in the everyone category).
3. I simply cannot believe that 45% of republicans are in favor of a vaccine mandate. Like seriously, 45%? Or Republicans? That's antithetical to their entire ideology!
Either i'm living in a bubble (very possible), or polls are completely worthless (much higher possibility. How were the polls on Brexit and the 2016 presidential elections?). But fair, i will retract my complaint that governments are not trying to put a number on this. I was incorrect there.
Sure, it was online only, but polls usually correct for non-response. Also, a vaccine mandate "for everyone" presumably means adults, and even if you disagree that that's your interpretation, you have to admit that at least a good amount of respondents would interpret it that way.
And imo your priors are all out of wack. There were errors by individual pollsters, sure, but the poll models were pretty accurate. 538 gave Trump around a 1/4 chance of winning, and just because he won does not mean those polls were worthless-- he had a 25% chance to win. If pollsters gave Clinton only a 51% chance to win, and Trump won, you wouldn't say that the polls are bad-- just because Clinton had the bigger chance to win doesn't mean that because Trump won, polls are worthless. The whole "2016 election means polls are worthless" is just a really, really tired critique.
There's definitely a bigger chance you're in a bubble. We're all pretty much in bubbles. Scott talks about this all the time.
Most Republicans had no issue with vaccine mandates a few years ago. The fact that *about* half do now is testament to how quickly a newly generated political controversy can morph into ostensibly philosophical principle.
This strikes me as odd, because OWID reports only 59% of Americans are fully vaccinated (~70% at least one dose), lower than most other developed countries... surely very few unvaccinated support a mandate, while many of the vaccinated won't support a mandate.
Devil's Advocate counter-argument: we only metaphorically signed the social contract because it had big exceptions in red to which liberties are fair game for regulation. Freedom to move around within one's home town to meet one's loved ones is one of them: locking people up is something we only do to our worst defectors (serious criminals) and preventing them from seeing loved ones is something we pretty much never do (see: the outrage about separating migrant children from their parents).
If I sign a contract allowing you to seize any of my inanimate possessions if necessary, but the contract specifically mentions that *obviously* my infant daughter is not included; and then you stroll in to seize my child; and you say, "oh come on you big crybaby, you didn't complain when I took your bedside table and your frying pan, and anyway it's for her own good, clearly you'd a bad influence on her given how much you're complaining right now"; then I have a pretty clear right to be upset and feel like you're breaking the rules of the arrangement.
In fact, if I may go a bit meta and speculative…
In general, I think the social contract is perceived as trumping a very loosely-defined "natural law"; controversial areas about the state's rights tend to come back to a nebulous category "things which nobody should be allowed to do to another monkey under any circumstances" (e.g. "tell you to get stabbed with a needle against your will", "forbid you from visiting your parents/siblings/significant other" – but also "kill you with premeditation" or "force you to go through with a risky pregnancy"!), as defined against the things which everyone would be allowed to do in a "moral, but anarchic human grouping", but which in an organised society we make special privileges of government enforcers (e.g. "kill enemies if they're currently threatening us and can't be peacefully subdued", "take a percentage of this year's earnings").
In the United States, even at the peak of "lockdown" around March 24, people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise". Never once at any place in any of the United States was any of this ever banned.
And of course, 95% of the time since March 24 has been at far lower restrictions than we had on March 24.
And never once was this wink-and-nudge "it's totally ok to practice your liberties as long as you lie about it" unequally enforced? No one was picked on for doing the thing everyone else did even though it was technically illegal? No one in government abused this power and no one who played along got punished anyway?
In a way, this half measure is even worse than a full measure. Because when people who did get away with it got caught, they just used their power to claim "nah it's ok it's in the spirit of the law" (citation: the dozens of times this happened with politicians), and when the people who didn't get away with it got caught, people said "well they were going against the law, so it's fine they get punished (citation: the times people picnicing alone or playing with their kids in the playground alone were arrested). You've just make the powerful even more above the law then they were already.
What wink-and-nudge are you talking about? I assumed the person meant that they wanted to see their friends and family, and you were always encouraged to go out for a walk with your friends and family. Were they asking about doing something that was actually technically illegal? Because it didn't sound like they were.
(I'm also a bit curious about the politician cases - I thought the most prominent politician case was Gavin Newsom having an indoor unmasked dinner at a restaurant on a date when that was still legal, but he had just ordered a mask mandate to go into effect a week later.)
When you said "people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise"." i assumed the implication was that you just had to justify your reason to visit with an excuse. You couldn't simply visit family because you wanted to, you had to provide an excuse to do the same thing, correct? That's the wink-and-nudge. Because it is technically illegal to see your family or partners without any given reason (Scott mentioned that in his lockdowns post, about how people had gone months without seeing their family/friends because they interpreted the law literally and didn't see the wink-and-nudge).
The politician example, there's a ton of them. A quick search turns up https://fee.org/articles/these-12-high-profile-politicians-got-caught-violating-their-own-covid-rules/ and https://www.foxnews.com/politics/mcauliffe-maskless-on-amtrak-skirting-federal-mask-mandates
Oh, I was thinking it wouldn't be an *excuse* - you just had to actually be outside walking.
And in any case, I don't believe any part of the United States had an actual ban on visiting inside the home of a friend or family member for more than about 6-8 weeks in early 2020. It wasn't like the UK, or parts of continental Europe, where you actually weren't even allowed to meet up with friends or family outdoors for several months.
The Tophattington comment was based in the UK. The lockdowns that occurred in other countries, such as Canada and Australia, were much more significant and draconian.
Yes. The set of policies has been extremely difficult in every place, and I think no one should ever use the word "lockdown" because it serves to obscure rather than highlight these differences.
I'm not fine with using a single word to describe everything from a suggestion that people sometimes wear masks at school to welding people into their apartments. And that's what any debate that uses the word "lockdown" (or "flurb", I guess) very quickly becomes.
Describe the actual policy you want to support or criticize. Don't just say "lockdown good" or "lockdown bad" or "lockdown make me crazy".
You mean "has been extremely *different* in every place", right?
Yes, weird typo I had.
"people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise""
That's...completely untrue? From November 2020:
"In New York, Gov. Andrew Cuomo last week banned indoor and outdoor gatherings at private residences from having more than 10 people."
source: https://www.usatoday.com/story/news/nation/2020/11/17/how-new-york-enforce-ban-private-gatherings-10-people/6324499002/
Even outdoor gatherings of more than 10 people were banned!
And even if they did allow family gatherings outdoors (which they didn't!), it is still an overreach of state power (and a violation of the Bill of Rights) for the state to limit freedom of assembly indoors, especially in the cold winter months.
It sounds like they *always* allowed gatherings of less than 10 people!
I do think those rules banning outdoor gatherings of more than 10 people were silly, and it probably was overreach to *ban* indoor gatherings of over 10 people (though it was perfectly reasonable to extremely strongly recommend against them).
"In the United States, even at the peak of "lockdown" around March 24, people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise". Never once at any place in any of the United States was any of this ever banned."
Even that much was banned for several months in California, unless you were "meeting" people from at least six feet away. For people who lived alone and didn't have e.g. health emergencies requiring medical treatment, any physical contact with another human being was technically illegal. Enforcement was rather lax, so if you could find a willing co-conspirator you could get away with it, but that's hardly a justification.
I think everyone has amnesia. It truly boggles my mind how some people can act like the lockdowns are just a thing that happened. Do you remember what I remember?
In 2018 I met a girl who grew up in former-Yugoslavia during a civil war. In person schooling was cancelled, she watched math lessons on a TV while staying low to the ground to avoid stray bullets. She went on to get a PhD in math, which is very impressive. I'm so so glad I haven't ever, and probably won't ever, live through that kind of adversity.
In February of 2020 I spoke to a friend living in Beijing. She described a police state, a complete shutdown of society, and she said it had been going on for a month. I was horrified, and I felt so glad that I live in America, instead of China, where I had never suffered, and probably would never suffer, that kind of adversity.
In March 2020 lockdowns were in the air. More and more of society was being interrupted, and it was hard to believe it was real. All of us, very reasonably, didn't want to live like caged animals. But we talked about curve flattening, and overwhelming hospitals, and asked what we absolutely had to do to preserve our way of life. We were just barely convinced that a few weeks of lockdown might be necessary, despite the obvious and incomprehensible adversity it would inflict.
Then a few months later, it feels like some of us just decided that lockdowns aren't bad. I'm not saying they may have been worth it. I'm saying some people were happy to extend them even if it wasn't vitally necessary for the preservation of our civilization. Not as a last resort, acknowledged to be horrible but deemed unfortunately to be necessary, but just cause it might help and why end them. This reversal seems like the kind of gap which cannot be bridged. Anyone who feels this way is Varelse, so alien to me I can't begin to reason with them.
Comparing the lockdowns to not playing loud music after midnight feels very much like comparing genocide so slapping someone in the face. No governmental body has the authority to do this, and when it is necessary it still must necessarily scar our society to the core.
I'm vaccinated for the record, because I think it will end the lockdowns sooner. I will never recover from 2020, and I will never forgive anyone who lost sight of the collateral damage done by the lockdowns.
I would like you to cite the unforgivable collateral damage you are accusing the lockdowns of. As of right now your post is pretty much entirely based on heightened emotional reactions and insinuations that lockdowns in America are analogous to the extremely harsh, if-you-try-to-leave-this-infected-block-we-will-shoot-you-stone-dead Chinese lockdowns and living in a country in the middle of an active civil war.
Compare total excess deaths to covid deaths (especially 25-44):
https://www.usmortality.com/excess
https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/
"Expected deaths" there means average the last 5 years and adjust for population growth.
The difference between excess deaths and covid deaths has been used by many people to argue opposite claims - some claim that these are undercounted covid deaths, some claim that these are deaths due to the covid-mitigation measures, some claim that these are deaths due to the pandemic situation that are independent of mitigation measures and infection itself. I think it's very hard to disentangle these things, but one would expect that if effective mitigation is possible, then there *should* be more deaths due to the mitigation measures than due to covid, because the large number of covid deaths would have been *prevented*.
I agree it's very difficult to disentangle everything. It just strikes me that in terms of mortality whatever is killing so many mid-aged people (the 25-44 range) is to that demographic a much larger public health concern than covid, and it's not really subject to any investigation.
My point is that you have to actually *do* that disentangling to figure out whether the way to prevent those deaths is to do more or less mitigation measures. You can't just assume that the deaths are due to mitigation measures, since it's quite plausible that the deaths are actually being caused indirectly by the widespread presence of a novel disease.
> I think it's very hard to disentangle these things
It's pretty easy actually. If lockdowns kill at detectable levels, you should be able to find places where (1) lockdowns happened, (2) during which infection prevalence was insignificant, (3) during which, or shortly after, there were observable excess deaths. So for instance you can compare American states' performances for the first 6 months of the pandemic, when there was a large variance of infection prevalence. If you do this sanity check, the picture is so blatantly obvious that you don't even have to do regressions to see that [lockdowns + no viral spread = no excess deaths]. This holds both temporally (in a fixed place), and spatially (during a fixed period).
Furthermore, if you plot excess deaths time series, superimposed on a plot of deaths officially attributed to covid, superimposed on a plot of officially detected covid cases, anywhere you look, you'll see that these graphs always trace each other. Cases go up -> official covid deaths go up -> excess deaths go up. Excess deaths go down -> cases have been going down -> official covid deaths go down. Cases approach zero -> excess deaths approach zero.
You can do a regression of excess deaths vs cases/deaths spatially (counties), or temporally, if you want to make real sure, and some people have done this, and the result is—as everyone with a measure of good judgment have pointed out from the very beginning—excess deaths are overwhelmingly dominated by covid related deaths.
So for instance, in Peru, there was a wide discrepancy between excess deaths and official deaths. These were, however, obviously temporally correlated. So officials checked potentially missed deaths (like respiratory failures, pneumonia) that were not officially attributed to covid, and they deduced that, yes, almost all excess are covid deaths, and officially switched to attributing all excess deaths to covid.
I'm amazed you have access to such quality data. Is that publicly available?
Yes, Karl, spot on.
I think the only country where the official numbers of Covid deaths was not lower than the excess death rate was Belgium, they classified all unexpected deaths associated with respiratory infections as Covid deaths, even without testing. They got a lot of flak for that, but they defended themselves as being 'transparent'.
It appears they were right.
I read the first half of your comment and nodded along. But then the second half said exactly the opposite of what I expected. I expected you were going to say that we had maybe four weeks of significant restrictions, and then since then we've been basically unrestricted in the United States, apart from masks and a few kinds of indoor public activity. And people are acting like we lived through the Balkan Wars!
Not Logan, but...
> I expected you were going to say that we had maybe four weeks of significant restrictions, and then since then we've been basically unrestricted in the United States
... One of us has amnesia for sure. That is not how I remember this going down. I had to work from home, away from my team, with increasingly declining mental health for 6+ *months*. And I'm in Michigan; hardly the tightest of regimes on WFH.
The lockdown/WFH experience certainly varied depending on where you lived and what company you worked for.
Not that it makes your experience any less painful, but I had basically the opposite experience. Significantly improved mental (and physical) health doing WFH for about 8 months, and pretty much immediately reverted once I returned to the office.
How many states actually had rules mandating that offices stay closed after about June or July of 2020? My understanding is that none did, but offices stayed closed anyway.
I think I've lost where exactly we are in the dialectic, whether we are debating what the government rules should have been (should the states have mandated office closures for longer or not?), or what companies should have done (should companies have brought people back into their offices earlier?), or something else (should states have mandated the end of work-from-home?). (The use of the word "lockdown" does nothing to help with this, but only serves to run together some extremely different experiences, like the one you and I had, vs the ones that people in Wuhan had in February 2020.)
I'm agnostic between whether the government or individuals are to blame. I just know this was the worst year of my life by far and I want it to be acknowledged that a bad thing happened.
I also was not comparing the lockdowns to the Balkan wars, though I see how that's confusing. I'm trying to point out that these things used to feel alien and we should go back to viewing these circumstances as extreme instead of just "this is how life be sometimes and a better world just isn't in the cards." I never thought the lockdowns were as bad as the war, but I thought they were as remote.
Lastly, the monumental suffering is a billion papercuts. It's illegible and difficult to quantify. If this only happened to a million people it would be just a rough time, but it happened globally for a year and it just sucked a lot of the joy from life for an unfathomable number of people. If the introverts who liked it outnumber the people like me who suffered in hard-to-quantify but very real ways, that would go a ways towards changing my mind. The lack of urgency with which people are discussing polling data around that speaks to a callousness and lack of desire to grapple with the last year. We concentrate on the deaths because they're easy to count.
As an introvert for whom it wasn't that big a disruption to my normal life, it was a) still very negative and b) I recognize that other people like to leave the house even if I don't. If this results in working from home being an option for those who want it even absent pandemic measures, great, but I can still recognise that it sucked for a lot of people.
(N.b. I live in Melbourne, Australia, which had the strictest lockdowns and the longest lockdowns of any developed nation. The American limits look laughable by comparison - no big parties is very different from "no seeing anyone at all")
Do you believe the suffering caused was so immense it outweighs the suffering caused by a death toll 3-10 times above where it currently is? Would you be able to deal with the guilt if it was found out through contact tracing that you were the person who caused another to die from an infectious disease?
Perhaps you'll call me callous for this, but from my own personal experience of living in extreme social isolation for several years due to mental health issues: you can recover from social isolation and the attendant psychic injury. You can't recover from death. I am not trivializing the effects of social isolation, I am saying that if your calculus comes out to "I would rather take on a very high risk of myself/people I know and love dying from a novel pandemic disease than endure four weeks of lockdown", I don't believe you have a good ability to assess threats. You act as if a large portion of the population have had their souls sucked out of them and will never be happy again.
I didn't mind 2020. Apart from losing my job, it was okay. I'm a homebody. I played video games and wrote some free software. Now I'm working from home and delighted that so many other people are interested in "hybrid work", as I'd rather not commute every day.
I wonder how many people are more like you and how many are more like me.
Same. I'll also note, and I shared the same opinion at the time, that at least where I live, actual observation of lockdown requirements was so limited that I argued that the lock down should be lifted even if no lock down and an unchecked pandemic was the second worst realistic outcome, because the worst would be a half heartedly implemented drawn-out lockdown which hurts people's livelihoods while failing to meaningfully limit the disease. Watching how little people actually observed the requirements , I could only think there was no way this would help.
You had me in the first half, until you got to part 2/2 where you describe an imaginary America that doesn't exist.
I live in a state with just about the strictest lockdown measures; and the only things I couldn't do during peak covid was dine/drink inside, shop without a mask, or attend large public gatherings.
I could meet people outside, I could meet people inside, I could get food at restaurants and eat outside, I could shop, I could do whatever the fuck I wanted except for those two things.
Emotional histrionics about living in totalitarian Massachusetts aren't going to change my view here.
It's clearly true that people had different experiences. Obviously some people actually weren't too put out by the arrangement, which is likely why they forgot how barbaric it is. Also, I'm not only referring to the governmental impositions. My employer caused most of my personal suffering by closing the office. I also suffered a fair amount because the local SSC meetup went virtual. We did this as a society, it's not just about the government.
I missed three funerals for close family members due to the lockdowns. I'm not an introvert, I get my most satisfying social interactions at loud, crowded parties and bars. I live in a small studio apartment, so with the office closed and cafes closed and the weather not amenable to staying outside, I spent most of my days in one chair in one room. I hate online shopping, I find great fulfilment from browsing around inside local shops. Going to see movies in theaters is one of my greatest joys. I still can't get proper medical treatment, the psychiatrists in my area won't meet in person nor will they prescribe the medication I need to new patients they haven't met in person (I imagine there's a way to short-circuit this obvious catch-22 but I haven't found it yet), and I can't get my annual STD screen because all the clinics are currently closed unless you're symptomatic.
I know not everyone was as put out as I was. I know not everywhere had the same lockdowns. There's a reason all the things we couldn't do are coming back once we can though. It's because people prefer it that way. People on net prefer having the option to meet other humans in public spaces and interact with a crowd, they like having an excuse to leave their home and explore the space around them. The suffering caused here is monumental, and deserving of fucking acknowledgement. I'm not claiming that the lockdowns were unjustified, just that they were a big fucking deal and deserve the same strict scrutiny today that they deserved and got in March 2020 before some people got acclimated.
There's a metaphor I like that I'll share now, though it's only tangentially relevant. Imagine Quetzalcoatl came down from the sky and credibly proclaimed that he would destroy all the crops on earth, starving billions to death, unless we sacrificed 100 healthy children in his name. In this situation, it would be perfectly rational to round up 100 healthy children and murder them in cold blood. Anyone who argued against it would be wrong, and they would rightfully be accused of essentially wanting to kill billions of people. But if we killed 101 kids, because once you're killing 100 why not kill 101, then that would be awful, the people responsible would be monsters. Lots of the last year I've felt like the guy questioning whether the count was accurate and are we sure we didn't kill 110 kids on accident, and I'm seen as the guy who wants Quetzalcoatl to cause a global famine. How would you feel about the lockdowns if they didn't save lives? Would you be so quick to defend them if they hadn't been absolutely necessary? If not, then the possibility that they may have been stricter than necessary should concern you deeply.
I normally favor erring on the side of personal agency and responsibility. When it comes to a global public health threat that is very, VERY credible, I'll fully admit that draws out a higher-order prior and I'm perfectly fine with erring on the side of harshness if it leads to better results.
I am sorry that this has been very hard for you and lots of people. I feel zero obligation to endorse what to me is tantamount to demanding my community (which consists of a large number of people who are at-risk for COVID and have a history of suffering mass deaths from contagious disease) all fall on our swords so you can continue to party.
>Solitary confinement
If you live alone, that's on you.
>Not interested in my community's health
The fact that a common punchline about it is that we're the primary victims of the opiod epidemic, along with centuries of history, has made that very clear. I by default assume people outside of my community are at best callously indifferent to our suffering and at worst actively hostile and planning to cause material harm, because historical evidence bears this out. The fact you are saying, in essence, "You should all FOAD because I refuse to even do so little as wear a bit of cloth across my face in public" further cements this as accurate.
>Not going to win you friends
As illustrated above, my community doesn't have friends outside of itself. I have made my peace with that.
I'm making no such demands and it would be unreasonable for you to accept them. Fully agreed.
Just keep in mind that not everyone who's pissed about the lockdown is making that demand. There were two flavors of tragedy last year, both are clearing up now but slower than we'd like, and it's best not to argue about whose tragedy was greater. I mean sometimes we have to, for making policy decisions, but lets not feel like we're winning when someone else has to sacrifice for us.
I am not demanding anyone else make a sacrifice I am not also making myself. Your phrasing makes it seem like like the vast majority of pro-lockdown people are swanning about to parties and are trying to use lockdowns to persecute people.
I wonder if the difference in perspective is partly due to differences in introverts and extroverts. Maybe to some of us, having to commute in traffic 2 hours a day and work in a noisy office is 'barbaric' and working from the comfort of our home is a welcome change. I acknowledge this has been hard on you and many, many others and I don't want that for anyone. You could acknowledge that for some, it was the old way that was hard.
That's actually a hard one. I see a clear parallel: there are two ways of working, some people prefer different ones, ideally we'd have our choice but in practice we don't always, and so switching from one equilibrium to another is morally neutral.
On the other hand, the phrase "in practice we don't have a choice" feels like it's hiding an asymmetry. That is, it feels like being forced out of your comfort zone by lockdowns is different from being forced out by societal equilibria. I acknowledge that that's probably unprincipled, but it's emotionally appealing enough that I'll need to think it through more.
From my perspective, I spent a decade learning to trick my brain into being productive. I had a system. Then suddenly that system became essentially illegal, and I was left with no coping strategies. I assume (unfairly?) that people who like working from home had the same opportunity to learn to cope with the difficulty of working in an office, and so the difficulty they face would be longer term but still smaller in magnitude than the difficulty faced by anyone for whom the situation wasn't an improvement.
Like my competence at my job took such a hit last year it's frankly unreasonable that I wasn't fired. I'm sure if I got to do college over I'd have figured out how to work from home, just as you had your whole life to figure out how to work in an office. But I had no such opportunity, and the discontinuity feels like it must be worse than a life-long issue you can learn to deal with and plan for.
I realize the logic there isn't quite right, and I'm typing this publicly because airing my ignorance like this often leads to opportunities to learn how silly I look to others and build empathy.
I think people vary pretty significantly in their ability to adjust to personally suboptimal environments. Inspect a couple years working in substantially extrovert-favoring environments, and l found it possible to be productive at work, but it came at the cost of most of my overall happiness. The kind of "living nightmare" experiences people describe from the worst levels of lockdown are relatable to me based on that experience, with finally quitting being one of my most profound experiences of relief, while the pandemic for me was nowhere near as difficult emotionally.
So I'm curious, do you have an idea for how social distancing could have been done effectively, that would not have disrupted your live so badly?
"YOU have to wear a mask and get your fucking shot"
1. Who decides that wearing a mask is still part of the social contract in the post-vaccine world? There's no such social contract.
2. Vaccine mandates have a much longer history but the way they're enforced (via restaurants/bars) is novel and not a part of social contract. Enforcing it via the state's own resources (i.e. denying Social Security to the unvaxxed) might make sense, but not the "Papers Please" regime we have now.
I can relate to this:
"But, I don't do any of these things, in exchange for everyone else not doing these things; so when I see a defector (someone not getting a vaccine; someone driving perfectly buffed out brodozer with the fake lift and no liner) it pisses me off because: I wanna do stupid shit!"
Related: The Dano-Norwegian author Axel Sandemose (a dry-humoured heavy drinker who wrote great novels & essays, including his famous Law of Jante) once wrote about his meeting with a proto-libertarian rich shipower complaining about the lemming-like behaviour of his countrymen, dreamily sighing: "Imagine if everybody in our society at least once did what they most desire to do, if only for five minutes, and preferably all at once."
Axel Sandemoses reaction: "I paled at the mere thought".
I can totally buy "the social contract says you have to do this," but the social contract is typically worked out over decades or centuries.
Some people are worried at "if we couldn't get our shit together and just all vaccinate for something as mild as coronavirus, what would we do for something worse?" And I think that's a good and honesty worry!
Meanwhile, some other people are worried at "if the government can clamp down on us for this virus, what other excuses are they going to find to clamp down on us again?" And I think that's a good and honest worry!
We had similar debates about the war-on-terror versus freedom. And history shows it's important for society to have these debates instead of either side getting to short circuit it, so we can, over time, arrive at our "social contract."
I agree that there's value in having a public debate about what policies we should and shouldn't implement, but then, I think that there's kind of a schelling point around actually following the policies that are implemented until they can be changed according to official channels.
If someone were opposed to the whole host of new TSA safety procedures implemented after 9/11 as security theater, well, I'd have a lot of sympathy for their position. But if they refused to actually follow them when called upon to do so, they'd be refused airline passage at best, imprisoned at worst.
I think registering for the draft is part of our social contract, but if someone refused to do that, they should not be cast out of society.
We have to have rules, even rules I don't like, but we also need to leave room for people to rebel against them to find out if they are wrong.
Thank you for the kind mention, I'm happy you read the thread. The analysis has been completed as of this morning, about to start writing up.
I'm in the bay area next week and would love to meet (again) and talk through all this if you're up for it.
(a DM on Twitter is probably the best way to get in touch)
"Most thoughtful" might be damning with faint praise, given that all the other proponents have been pushing fraudulent studies, bogus observational correlations, and unsubstantiated personal anecdotes ("I'm a doctor who has treated 3,000 patients with ivermectin and they all did great!"). Not hard to come across as a giant when everyone else pushing ivermectin is 2-feet tall.
"Most . . . dedicated" isn't even faint praise, as it points to the tendency to belabor certain points ad nauseam, to write long tweet threads dismissing critics while not being fair to their arguments, etc.
A reasonable critique of Fluvoxamine is that the primary outcome of the trial is a bit weird. The primary outcome was hospitalization/emergency room observation lasting more than 6 hours, and the difference detected was in the observation time, which is a bit subjective and not necessarily relevant to the patient
Adding up statistically insignificant results to get a statistically significant one is not a horrible idea.
But. Negative results should be weighted higher than positive. We'll need an elaborate weighting system to compare different studies. An Egyptian study done by some no name (as judged by his citation index for example) should have very little weight compared to a study done by known scientists in a first world country. RCTs should be weighted my higher compared to other studies. Etc. And we would never agree on the exact weights of every parameter. So it is unusable in practice.
However, one exception to the rule could be a situation where we have 20 studies on X and all of them are showing positive results and to get statistically significant results on X we would need a trial with like 1 million people.
Yep, publication and selection biases are such obvious threats, that ignoring them you can literally get a positive result for anything. Which Scott in his extremely polite way notes to people who I'm almost sure are acting in bad faith.
"I also think people are overestimating conservative elites’ role here by deliberately conflating opposition to vaccine *mandates* with opposition to *vaccines*. A lot more elites have come out in favor of the first than the second."
Definitely agreed that this distinction is vital and keeps getting lost in the discourse. I am arguably one of the conservative semi-elite (went to an Ivy law school, clerked for a GOP-nominated federal judge, now working for the state government in a red state). I strongly oppose vaccine *mandates* on both legal/constitutional grounds and on the grounds that the scientific calculus of cost versus benefit doesn't point in the same direction for everyone... But I am vaccinated, my wife is vaccinated, and I generally encourage my adult friends to get vaccinated unless there's a clear contraindication. I feel like I am far from alone on this position, but it rarely gets much traction in the broader discourse.
Thing is, the mandate wasn't announced until September. Trump's getting booed happened about two weeks before, in August. This was also the time period when four conservative radio hosts died from covid after loudly arguing against vaccines and *for* ivermectin and other treatments. They were not arguing against mandates.
I have a Republican friend and business partner who was staunchly anti-vaccine. He thought it was the left trying to control the population. I wonder where he got that idea?
Then a doctor friend of his, also a Republican, got COVID and very nearly died. He spent a month in the hospital and lost something like 60 pounds. His doctor friend told him to get the vaccine.
My friend got the vaccine, but also had the broader realization that political communicators use fear to drive partisanship. He's still a Republican but less prone to believing people like Jack Posobiec. I hope that lasts.
Fair points. I am not sure if conservative radio hosts and podcast hosts count as "elite," but they definitely play a role in driving opinion, and I agree they have generally been more anti-vaccine (as opposed to just anti-mandate) than most elected officials or, say, the National Review or Heritage Foundation staff.
I think many conservatives saw the threat of mandates looming ominously well before they were handed down (given the recent developments, it's hard to say that their fears were wrong) and this unfortunately polluted a lot of the discussion about the effectiveness about vaccines themselves.
I'd believe you, if Republicans EVER made that distinction to the base.
The modal twitter republican thinks the Vaccine was developed by George Soros in collaboration with Lucifer the First of the Fallen to contaminate their precious bodily fluids so Bill Gates and the NWO can.... Do something vaguely sinister?
I know twitter isn't real life, but on the other hand I also know a guy who is refusing to get the shot even though he runs an equipment repair business where every single one of his clients REQUIRE proof of vaccination to work in their shops.
Of the conservatives I know well (about 25), all of them are upper middle class professionals or business owners with a couple million, and 2 of them (who are 75+) have the shot.
Two! Two out of Twenty five! These are not good numbers.
If the republican elite actually believe what you say they do, they certainly aren't coming out and saying it.
“I'd believe you, if Republicans EVER made that distinction to the base.“
Isn’t that pretty much the standard position of every Republican governor right now? Vaccines good, mandates bad? Hell, our state AG is participating in a lawsuit against the federal contractor mandate, while there are literally glowing signs owned by the state telling everyone on the highway to (voluntarily) get vaccinated.
Should the Democrats be judged solely on he wackiest Twitter voices?
Edit: I should have read to the end, you did note “Twitter is not real life”. I would maintain though that the ant-vax messaging is largely not coming from GOP politicians, but other right wing sources. Why it’s caught on so much honestly baffles me, it makes no sense except pure tribal signaling, but even then it’s weird since a lot of the tribe leaders are on board with vaccines.
This seems to imply either that they aren't the real leaders, or that the influence they wield is greatly overestimated.
They got a lot of votes and wield actual power, so that’s not nothing.
I mostly object to the idea that there are no Republicans who are promoting a pro-vax but anti-mandate position, when that is in fact the modal position of GOP elected officials.
Their “base” might be ignoring or actively disagreeing with them, but not because they aren’t trying.
Here is a compilation of pro-vaccine (not pro-mandate) pieces that National Review has put out: https://www.nationalreview.com/corner/national-review-says-the-vaccines-are-good-a-collection/
And here is a statement from Marco Rubio: https://www.cbsnews.com/news/marco-rubio-everyone-covid-vaccine/
Republicans do (sometimes) make the distinction to the base.
In May Tucker Carlson did a segment where conflated VAERS reported deaths after receiving the vaccine with deaths caused by the vaccine. After telling his viewers that 'everyone in authority wants you to get the vaccine' he said 3000 people died after receiving the vaccine. Tucker or 'The Five' is usually the most watched show on Fox. The segment isn't openly anti-vaccine, but the narrative is 'everyone in authority is pushing you to take this drug, they won't tell you the downsides, here's my estimate of the risk it will kill you which conflates death after receiving the vaccine with death because of the vaccine'.
Trump was also vaccinated in January, and unlike every other president wasn't vaccinated live on air. He was was asked to participate in public service announcements promoting it and declined.
Some conservative politicians have come out in support of it for sure, but a lot of top people simply declined to say very much about it, and indicated a tolerance of vaccine skepticism if not approval for it. Given the lives at stake and the non ideological nature of voluntary self vaccination, the fact that conservative media and political elites are not willing to pay even the most trivial cost with their base in order to save lives and benefit society is a massive indictment of their moral courage.
>I also think people are overestimating conservative elites’ role here by deliberately conflating opposition to vaccine mandates with opposition to vaccines. A lot more elites have come out in favor of the first than the second.
I think you mean "against," not "in favor of," unless I'm misunderstanding?
Or maybe it's "in favor of the opposition" in which case I'd argue the wording is slightly ambiguous.
The problem with taking "vaccine skeptics" seriously is that they have repeatedly proven themselves willing to promote any lie that serves their agenda. (This was true before COVID, and is true of COVID vaccines as well.) That doesn't mean they can't be right, it just means that you can't *assume* they are right.
Most of the current vaccine skeptics are a vastly different sort of person than the pre-COVID vaccine skeptics, so I wouldn't extrapolate from the one to the other.
Are they? Certainly the "anti-mandate" crowd is very different, but the "vaccines don't actually work" / "vaccines have microchips" / "even if the vaccines work I don't want them" crowds seem basically the same to me.
How many people do you know personally from this group before vs after? If you are doing off the cuff sentiment analysis of Twitter or Facebook, then you certainly aren't meeting the vast majority of people in those camps.
I personally know some vaccine skeptics both before and after 2021 and none of them align with what you see on Twitter or Facebook (well, except maybe one).
Yes, we are. My kids got all their routine vaccinations and I had plenty of vaccinations for all sorts of stuff in the Army. I worked as a radar engineer for a while so I'm sure the transmitters won't work...
But seriously, my skepticism is based on a prior that includes straight up disasters like thalidomide, diethylstilbestrol, vioxx, and dengvaxia; ambiguous interventions like statins and psa screening; and overall sketchy behavior by pharma companies. Given that prior, I find it extremely hard to believe that you can rush out a vaccine that is appropriate for LITERALLY EVERYONE after, what, 6 months of safety and efficacy trials? I believe that the vaccine is probably effective at reducing the severity of COVID and it makes sense to administer it on an EUA basis to the demographics that are highly threatened. But to people for whom the COVID risk is <1% or, in the case of kids, <0.01%, does it make sense to accept totally unknown risks from a rushed vaccine?
It would be one thing if the vaccine actually prevented transmission, but the intial trials did not have that as one of the endpoints. As a result, all the double vaxxed are still wearing their masks because even the CDC admits it doesn't stop spread, and all these highly vaxxed European countries are locking down again....
Yes. I have taken the full panel of childhood vaccines. I support most people taking a covid vax based on their age and health status, but I am not getting it myself.
Having served in the German army, I am reasonably certain that I have more vaccinations in total then most people do.
I am heavily sceptical of the mRNA based Covid Vaccines, in particular because the most common sense solution, Sinovac (which is just a flu shot for covid), is essentially verboten in the west. Sinovac protects less but also has less sideffects, this is a tradeoff you commonly make with using live vs dead and attenuated vaccines. It also puts less pressure on the spike protein to mutate, which in my view is good.
I do not see why I should take the unknown long term risks of Moderna/Pfizer, whose agreements with the EU also exclude them from taking responsibility for any damages they may cause, when a flu shot equivalent for covid is available that has already been used 3 billion times.
Should vaccines be mandated, one thing changes, if the vaccine damages me, I can sue the government which mandated these vaccines. Agreements between the EU and Pfizer et al. would prevent me from sueing Pfizer, if I were to take the Vaccine "voluntarily", and then get damaged.
Realistically speaking, going for vaccination with mRNA vaccines as the main approach will require a permanent regimen of boosters every 4 months, or more pratcially boosters before each winter, in perpetuity, on pain of not being able to participate in social life. This is materially very different from every other vaccination campaign.
My favored strategy vs Covid would have been to quickly roll out a European Sinovac analogon (this is just effort, does not require any scientific breakthroughs, and is basically an engeneering problem), vaccinate people below 60 with this, and use mRNA/vector vaccines to protect vulnerable populations. While also looking at new curative therapies.
mRNA vaccines have advantadges, the technology is promising, but using them billions of times before they are fully understood, and at the exclusion of fairly proven tools is just really debatable.
'Ware painting the whole outgroup based on your brush with the most signal-boosted of them.
That said, when I started looking into a group that used numbers and stated what they found, I was far from impressed. I feel ok saying there's fewer reasonable people in this outgroup than my usual outgroups.
"but it’ll just provide pro-lockdown people with an easy opportunity to tar all their opponents as science deniers." They'd do it anyway. They do it non-stop. Anyone with a disfavored opinion is "anti-science". Sanitizing your actions and thoughts to avoid being smeared as stupid is just another kind of surrender.
Yes, but it matters how correct the smear is. If someone calls you a science denier and I look into it and you are anti-vaccines, I’m going to have a lower opinion of you than if the smear is baseless.
Your opponents will smear you no matter what, but how effective the smears are is within your control.
I guess my point is I don't pick positions based on effectiveness of achieving my aims; that feels like working backwards from a conclusion, to me.
the question was not about picking a position but about protesting by not getting the vaccine. i.e. you'd be perfectly fine thinking whatever you want while also not acting in a potentially ineffectual and/or counterproductive way. if not getting the vaccine is in fact counterproductive, getting it is a more effective way of achieving your aims.
Something not being true isn't a sufficient condition for people not to tar you with it, but it is a necessary one.
Deliberately shutting yourself out of the public discourse and nobly dying on your sword is also a form of surrender.
Most of these people aren't nobly dying on their swords. They are demonstrating their party affiliation (street cred) by risking dying-on-their-swords.
I'm more talking about how Adam talks about how they refuse to pick positions based on how effectively they allow him to advance his political goals. Once you say "I don't actually want to achieve my goals", you waive your ability to complain that you aren't achieving your goals.
I think a big part of resistance to vaccines is that they are very visibly not working against the metrics that governments use to decide on restrictions. Hence why European police are currently shooting protestors after deciding to place entire populations under house arrest - the vaccination programme is a failure and their case numbers reflect that.
There are several sub-aspects to this that are really important.
1. The vaccination programme has failed, because its goal was to reduce infections. Germany now has HIGHER numbers than at any previous time, and in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated. Nobody can explain this.
2. By extension this means trial failure. The trials didn't have hospitalizations or deaths as a primary endpoint, they were approved due solely to their effect on case counts. Yet this has turned out to be woefully misleading.
3. Trial failure on something as critical and dangerous as demanding entire populations take an experimental substance is a big deal. Yet, governments and the fanatically pro-vaxx part of society (journalists, public health etc) aren't acting like it's a big deal. They're ignoring it.
4. This requires us to wonder what else the trials were misleading about. If they were so badly wrong on efficacy, were they also badly wrong on safety?
WRT the last point, there is increasing evidence the answer is yes. The FDA has started slowly releasing documents related to the vaccine approval process. The first batch revealed that Pfizer was taken by surprise by the flood of AE reports and had to hire extra staff to process them. Why were they surprised by this, having just done a trial meant to precisely characterize this exact value?
So let me summarize. Increasingly fanatical governments are now creating as much hate as possible towards a segment of the population whose only "crime" is to observe that huge numbers of scientific studies suck, that pharma/public health is riven with conflicts of interest, that experts have been consistently wrong, that the vaccines are experimental, that they have failed to do what they claimed they would do and that this might explain why people seem to have bad reactions quite frequently (depending on brand/region/etc? some people don't seem to encounter any bad reactions and others do).
This is very bad news regardless of who you are or your stance on vaccines.
You're going to need to include some links to your rather outrageous claims.
Official data for Germany can be found here: https://www.kbv.de/html/corona-report.php
Spoiler alert: his claim is bullshit. Vaccines actually work even a bit better than we originally hoped ... the problem in Europe is the sheer number of people who, given the choice, decided not to take it, resulting in recent increases in hospitalization to an unsustainable degree in many European countries ...
Which "heavily vaccinated country" currently is mandating a lockdown? I'd consider 90+% vaccination rate "heavily vaccinated", in case this question comes up.
Masks on the other hand are such a mild inconvenience, I look at people opposing them the same I look at people who refuse to wash their hands before leaving the toilet. That's just basic hygiene during an airborne pandemic.
I don't like that mask thing either. And I'm certainly willing to discuss where those masks actually make sense, and where they don't. But people who refuse to get vaxxed "because masks", aren't even on my radar as logical thinking human beings. For this bunch I certainly support government enforced decision making. They already demonstrated that they aren't capable of rational decisions on their own.
I doubt that there are many people who actually think like that though. There aren't many people THAT stupid. Certainly none of the people I know who oppose vaccines jumped to that conclusion with that kind of logic ...
The actual vaccination data is here: https://coronadashboard.government.nl/landelijk/vaccinaties
As for masks: grow up. I've been with the volunteer firefighters for more than a decade. Compared to the filters and masks we have to use there when putting out fires you don't even notice the FFP2 variants or those below. If they fog your glasses, put them on correctly. If they pinch your ears and face: get some of your size. It's not that hard and after 1,5 years one could have learned how to use them ...
I think it is no big deal. Yes, somewhat inconvenient, but no big deal.
When outside and not very close to others, you can pull them down, especially if there is a wind of more than about 3 knots (that is a soft breeze). I remember when our engineers designed air flows in the TB hospitals, airflow was considered (evidence based) much more important than masks.
When at home you can take them off, unless one of your close relatives has Covid symptoms. Same when driving your car.
One should wear masks with an understanding of what they are doing: they reduce the size of the aerosol and droplet clouds when you talk (or cough or sneeze).
So you basically only use them in indoor places were there are others, such as shops, and outdoor places where others are close.
On a side note, these fleece neck goiters and bandanas appear not to work (experimentally, that is). Personally I use N95 masks, not only seriously protecting those around me, but also giving some personal protection.
In fact, I only need to wear them a few hours a day.
The question is why does he insist on believing such obvious bullshit?
Because otherwise he'd have to ponder why he chose to believe such obvious bullshit for the last months ;-)
People are way to invested in their theories to back down.
Because confirmation bias is the most insidious and deadly thing on the face of the Earth.
"Vaccines work better than hoped" -> highest case rate ever with ~70% fully vaccinated. That isn't the outcome anyone expected, no. I'm old enough to remember when health officials were saying 70% would be herd immunity and vaccines were the "way out" of the pandemic.
COVID hasn't suddenly become orders of magnitude more infectious since the start of the vaccinations. Look at Gibraltar. It has a near 100% vaccination rate, yet, cases jumped up at the same time as Germany's anyway. Think about it: that should not be possible, yet, it is happening.
What's actually going on is visible in the UK data because unlike other health agencies (like the German one you just linked), the HSA provides raw data. It shows negative efficacy - the vaccination are much more likely to get infected than the unvaccinated. This then gets adjusted out via some dubious statistical techniques, inverting what the raw data says and leaving an efficacy rate similar to what Germany reports.
I really don't think Germany or other countries would be experiencing anything different, even if the vaccination rate was much higher. Think about it: if 70% vaccination buys you nothing, then how effective is this really? This is not "working better than expected".
In Germany we are talking about a 89% reduction of ICU hospitalization rate for the 60+ age group, 87% reduction in probability of death. Lower age groups fare even better. When the vaccine was still in research, we were told we could consider ourselves lucky, if that number would reach 70%.
You mentioning UK actually shows that you are arguing in bad faith. This data has been very well explained. You are comparing apples to oranges there. Just compare the average age of the vaccinated with the average age of the unvaccinated in that data set. It's a typical case of the Simpsons paradox. Everyone actually interested in knowing what's happening there can find this in no time.
The data I'm talking about is case rates per 100k so age has nothing to do with it.
This is just plain wrong. If I compare 100k 60 year olds to 100k 20 year olds, I expect a different outcome.
This is precisely what happens in the UK data, due to the different vaccination rates in different age groups and the large age group compared (18-59). If you break down UK data into age groups of max. 10 years spreads, your entire result disappears and even reverses for ALL age groups!
What you are doing here is "lying with numbers". See also: https://twitter.com/BadCOVID19Takes/status/1462096642669117450
> The data I'm talking about is case rates per 100k so age has nothing to do with it.
This does not follow.
50 year old people are also more likely to be infected in general than 20 year old, also when you count it in cases per 100k.
Here more limitations apply, some illnesses may be more prevalent among young.
In the same way as 50 year old people are more likely to die than 20 year old, also when you count it in cases per 100k.
> It's a typical case of the Simpsons paradox.
No, the UK data is not a typical case, because the data is already binned into smallish age groups (https://twitter.com/DPiepgrass/status/1457615206251520002)
I just found a reasonable-sounding answer: that there are no accurate estimates of the total number of people in the UK, and since vaccination rates are high, modest errors in population estimates make a big difference to estimated case counts among the unvaccinated: https://theconversation.com/covid-19-why-infection-rates-among-double-vaccinated-older-adults-look-worse-than-they-are-167836
Maybe the correct way to analyze this would be to have a professional polling firm run a survey to directly estimate the proportion of unvaccinated people (which incidentally would allow us to make a third estimate of UK population). Anybody got a big pile of cash to burn on this?
The NIMS population estimates appear to be accurate enough. The numbers obtained this way have been replicated via independent methodologies:
https://www.hartgroup.org/what-is-real-world-vaccine-effectiveness/
A good way around all those issues is testing on hospital admission. That way you can get rid of a lot of those sources of error. That's what we do in Germany and the numbers are pretty telling. I've been posting them a few times on this thread, so I'm not gonna post them again, or people will think I'm a spammer ;-)
You are using "infected" as a single.bucket ,when you really need to distinguish h between infections, cases, hospitalisation s and deaths.
Yes, COVID has become ~7 times more infectious since the start of vaccinations, thanks to the Delta variant.
And the omicron variant appears to be even more infective. First reports are though, that it is much less virulent. Something many virologists, epidemiologists and evolutionary biologists considered a definite possibility ('predicted' would be too strong a term). And the vaccines appear still to be working against the omicron variant.
> It has a near 100% vaccination rate, yet, cases jumped up at the same time as Germany's anyway. Think about it: that should not be possible, yet, it is happening.
There was a big debate about "sterilizing immunity" at the start of the vaccine deployment. The public really wanted to hear that they *were* sterilizing, the scientists kept on saying "we don't know." And, then, it feels like each side walked away hearing what they wanted to hear.
This is another case where there's a difference between what the scientists say, and what the media reports the scientists have said.
In broad strokes, it looks like the vaccine provides pretty good resistance to hospitalization/death over the long term (such as we have it), but the resistance to *infection* wanes after maybe 6 months.
So if Gibraltar did a big vaccine push of their population over a few weeks, that would keep their cases low in the short-term, but they would start rising because Gibraltar hasn't sealed its borders.
Gibraltar doesn't even know their own vaccination rate. They have a lot of border traffic and they have been vaccinating a lot of people who aren't actually living in Gibraltar (because they do work there). Spaniards and people from Gibraltar cross borders a lot.
People pointing out Gibraltar should explain first, how Gibraltar can have a vaccination rate above 100% and why it's so different in vaccination rate than GB. My guess is: it isn't all that different from GB, which is why we see the infection rate going up there as well ...
One should take into account that the humoral immunity (antibodies) wears off after a few months, while the cell-mediated immunity (mainly T-cells) appears to persist much longer. The reason why infections may increase (IgA antibodies in the mucosa are the relevant ones here), but severe disease and death remain rare in the vaccinated (and the 'naturally' infected).
The data I linked is updated every Friday. Data is provided by hospitals and all health insurances operating in Germany combined.
His claim (1) cherry picks a baffling but real UK government report (https://twitter.com/DPiepgrass/status/1457615206251520002), and I'm still looking for an explanation for it, but any reasonable explanation must explain why the data looks very different everywhere else.
I always recommend OWID's data explorer for checking basic facts like the Germany thing (https://ourworldindata.org/explorers/coronavirus-data-explorer). Germany and UK are outliers in their high case loads (given they both have decent vaccination rates) and dismissives love speaking about outliers as if they are representative. To me, the UK is the more interesting outlier of the two because it has reached an unusually high number of cumulative cases: 151,000 per million. In contrast, only Germany has only 73,000 cumulative cases per million since the beginning of the pandemic, so most unvaccinated Germans may still be susceptible to Covid.
The last I heard was that the UK fully reopened. One explanation, therefore, might be that UK is unusually good at detecting Covid cases and the true number of cases isn't that far above 15% of the population. The percent fully vaccinated in UK is about 68%, and if (for the sake of argument) immunity has waned (or was never acquired) in 25% of the vaccinated, then we'd have only 51% immune, leaving (after subtracting a small % of prior infections) almost 49% of the population potentially susceptible (and remember, the AstraZeneca was popular in the UK and only 74% effective in the first place).
This story explains pretty well how a large outbreak is still possible, but I wish I had a source of global seroprevalence data... for now, googling for UK data I find that 91-93% of UK people have antibodies either from infection or a vaccine (https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19latestinsights/antibodies) so the UK pandemic should burn out soon, unless maybe there are people with antibody levels too low to quickly stop infection?
Claim (2) implies vaccines are less effective against death/hospital than against infection, which goes against everything I've seen, [citation needed]. It also implies regulators around the world ignored hospitalization/death in trials, [citation needed].
Oh, and I tried googling for seroprevalence/antibody data for Germany but couldn't quickly find a useful measure.
I spoke too soon: UK antibody levels have been over 90% for 4-5 months! That's weird. Why do so many people keep getting infected if they already have antibodies? Also not sure why they use the word "modeled" on those charts...
Maybe the answer is: children! The >90% number is for ADULTS, and the same page says that that a there are low rates of "antibodies from prior infection" (<15%) among primary and secondary students. Meanwhile, BBC reports November 18 that "Covid cases highest in younger children in England": https://www.bbc.com/news/health-59336666
"723 cases recorded per 100,000 among children aged five to nine. That's up week-on-week from 484.5 per 100,000. The rate for 10 to 19-year-olds is 694.2, up from 571.7."
Indeed, that's higher than all adult cases combined.
And of course, the rate of Covid deaths in the UK is quite low now, as I would expect. Wish for an "edit" button so I don't have to keep replying to myself!
+1
Vaccines which haven't been given can't be working, duh. Those protests are in countries with barely 70% vaccination rates. We have very good data in Europe showing that vaccines do in fact work better then we hoped for originally.
In Germany for example the health care providers are on the verge to collapse within the next 3-5 weeks. Yet official data of the patients admitted, and their vaccination status, clearly shows, that even if the infection rate was the same, with everybody vaccinated, we wouldn't even notice anything special in the hospitals. In Germany we could easily support rates of 3,000/100,000 infections, if everyone was vaccinated. If you look at current prevalence data, there is a clear correlation between vaccination rates, infection rates and hospitalizations ...
So, those people have no moral right to protest against those lockdowns they themselves are actually causing ...
Where do you get this idea that they "work better than hoped for originally"? Trial data said 95% efficacy and health officials claimed herd immunity at 70% or lower. Germany's own figures that you linked to above show now 75% efficacy at best, and Germany is that at supposed herd immunity threshold now, yet you claim the situation is now worse than before.
Think about how much drastically more infectious COVID would have had to become since the start of August for your claim to be true. Where is this astonishingly more effective mutation and why isn't it affecting places like Sweden, which has an identical vaccination rate?
Health agencies use a technique called TNCC adjustment on their "vaccinated vs unvaccinated infections" data. It's not raw rates as you would expect, at least, not if Germany's agencies are doing the same thing as the UK and elsewhere. In the UK you can see the raw data pre-adjustment and it actually says the opposite of what they report. They struggle to explain why their adjustment technique changes the raw data so heavily - they assert that unvaccinated and vaccinated people behave very differently, but have no proof of this and it seems very wrong (unvaccinated people are not hiding at home terrified of corona).
Prof. Drosden, the guy who created the first PCR test for Covid, was talking on his podcast about the vaccines in June 2020 and said that we'd be lucky if we got something which prevented 70% of all deaths. We actually got something, which, in the German health care system, so far manages to reduce those numbers by 87% for 60+ year olds, and even way more for younger age groups. In my book 87% > 70%.
As for efficacy: you obviously have no idea what the term in that context meant. It never meant what you are claiming it did. Also: you are confounding vaccination rates and vaccination efficacy in your very own sentence here, as if those two were the same thing. That's just bs.
Also: Covid DID become way more infectious since August 2020. The delta variant is so infectious that we need way beyond 90% vaccination rate to reach the same target we hoped to reach with 70% vaccination rate and the alpha variant. Especially since the immunity granted by vaccinations isn't sterile (at least not for long).
As for the data in the UK: you have been educated multiple times about it now by various people in this thread. You just keep ignoring that a vaccinated 49 year old and an unvaccinated 22 year old don't have the same innate risks. Then you explain this difference away with "They struggle to explain why their adjustment technique changes the raw data so heavily - they assert that unvaccinated and vaccinated people behave very differently," which is so ridiculous, I'm gonna stop responding to this thread now ...
Kudos on having the patience to argue with error in this way. It is exhausting but it does a very valuable service.
> hey struggle to explain why their adjustment technique changes the raw data so heavily - they assert that unvaccinated and vaccinated people behave very differently
Are you unaware about differences between 20 years old and 50 years old?
Are you surprised that 50 years old die more often than 20 years olds?
Why adjusting for age would not affect expected death rate?
The differences are not explainable via age because the relevant data is already age stratified.
Someone above has linked to an example report so you can see it for yourself.
In the age stratified version of the report the opposite of what your graph shows is happening though ...
> in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated. Nobody can explain this.
it is well explained.
Vaccinated population is much older, and they die from cancer, heart disease and other non-COVID related things.
nonvaccinated teenager is far less likely to die than vaccinated 50 year old, because it is vaccine rather than some magical cure-all elixir
This analysis is easy to find, see for example https://www.covid-datascience.com/post/israeli-data-how-can-efficacy-vs-severe-disease-be-strong-when-60-of-hospitalized-are-vaccinated or https://www.washingtonpost.com/outlook/2021/08/31/covid-israel-hospitalization-rates-simpsons-paradox/ (not reviewed but look competent)
It is a typical case of Simpson’s paradox.
I'm not talking about unstratified death data. I'm talking about age-stratified VE in cases themselves.
please, link to the dataset / analysis
> age-stratified
Is it still in some huge chunks like 30 to 50 old in one bin?
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1034383/Vaccine-surveillance-report-week-46.pdf
Table 6, Page 23, first two columns for cases. 10 year age bins.
The vaccinated and unvaccinated populations are not the same size. Page 15 shows percent vaccinated for each age group.
They are normalized to rates (per 100k).
Table 6 Footnote 1, Page 24: "Comparing case rates among vaccinated and unvaccinated populations should not be used to estimate vaccine effectiveness against COVID-19 infection. Vaccine effectiveness has been formally estimated from a number of different sources and is summarised on pages 5 to 8 in this report. The case rates in the vaccinated and unvaccinated populations are unadjusted crude rates that do not take into account underlying statistical biases in the data and there are likely to be systematic differences between these 2 population groups." It goes on to provide a few examples.
Pages 8 and 9 describe effectiveness against all infection and effectiveness against transmission respectively.
Maybe I had attack of blindness or something, but it indicates that vaccines work. We care about serious illness and deaths, if COVID is as serious as cold then it is nothing to really worry about (I still would not prefer to get cold).
Deaths and serious cases are clearly reduced, even without controlling for anything except age.
Cases are massively affected by various problems, for example that only part will be ever detected and who is being tested is likely strongly correlated with who is infected.
Also, Michael was lying about
> in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated. Nobody can explain this.
Directly under table that recommends reading footnotes there are footnotes:
The case rates in the vaccinated and unvaccinated populations are unadjusted crude rates that do not take into account underlying statistical biases in the data and there are likely to be systematic differences between these 2 population groups. For example:
•people who are fully vaccinated may be more health conscious and therefore more likely to get tested for COVID-19 and so more likely to be identified as a case (based on the data provided by the NHS Test and Trace)
•many of those who were at the head of the queue for vaccination are those at higher risk from COVID-19 due to their age, their occupation, their family circumstances or because of underlying health issues
•people who are fully vaccinated and people who are unvaccinated may behave differently, particularly with regard to social interactions and therefore may have differing levels of exposure to COVID-19
•people who have never been vaccinated are more likely to have caught COVID-19 in the weeks or months before the period of the cases covered in the report. This gives them some natural immunity to the virus for a few months which may have contributed to a lower case rate in the past few weeks
Maybe "lying" is a too strong word but reading table with data listing about 70% reduction in death rate and serious infection rate, ignoring explanation and then claiming "Nobody can explain this."?
Maybe if it would formed as "what is going on" rather than
> I think a big part of resistance to vaccines is that they are very visibly not working against the metrics that governments use to decide on restrictions.
then I would be more charitable. And I lost again about hour on investigating claims that I should assume to be misinformation.
About 70% reduction in death rate described as "visibly not working".
Pffft.
Read the other 6 columns, the ones which matter. The first two ones is very distorted data, because it doesn't come from a source where everything but the vaccination status was equal. You can twist this data into any direction by changing the amount of tests in either group. Unless you adjust for test-positivity rate this data is useless.
In Germany you see the same distortion in reverse, because only the unvaccinated have to test themselves all the time to get anywhere. And thus nobody really cares for those numbers. ICU admissions and death are the numbers which count.
And there the table shows a massive advantage in all age groups of being vaccinated, despite GB having used the double dose vaccine with the least efficiency (they didn't and couldn't know back then), despite GB having been the first country to get to a substantial amount of vaccinations and despite GB having been slacking on boosters.
Matter for which purposes? For individuals making their own health choices, I agree that hospitalization and deaths are more important. For public health policy making (i.e., mandates), I disagree that cases are unimportant.
(Standard disclaimer: If you're going to claim that the mandates are to "protect the health system," then you need to also mandate 5 servings of veggies/day and outlaw coke and booze.)
If you want to use the kind of data found in the first two columns, at least restrict it to test results taken at hospitals upon admission. We have that data in Germany, and it shows the same pattern as the ICU and death data, just with much much higher numbers.
If we put this data side-by-side with the test results from all over Germany, you don't find a match between those two samples. The source of the data matters when trying to interpret it.
Are these tests performed on everyone being admitted, irrespective of clinical presentation? Please link to some of these analyses if available.
I've heard that 20 year olds have higher STD rates than 55 year olds too, even when they use condoms on a higher percentage of their sexual encounters.
I now noticed
> in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated
Infection detection is heavily depended on testing, so various distortions are far more likely to appear there than in mortality rate.
Though I am curious what is in actual data.
If I told you that people who take daily aspirin were more likely to die of a heart attack across the whole population, even after stratification by age, which if the following is more likely as an explanation?
1) the properly double-blinded large sample RCTs showing huge effectiveness of aspirin at reducing heart attacks are wrong, or
2) there's some factor(s) other than age that predicts whether people take daily aspirin, and *maybe* it/they correlate strongly with heart attack risk?
It's almost impossible to stratify heavily enough in an observational study to avoid some risk of Simpson's paradox.
Well, I think you've definitely made a strong case that a good part of the resistance to vaccines is the result of overconfidence in one's reasoning.
I think this comment makes a strong case that the rush to vaccinate everyone is the result of overconfidence in a trite slogan like "TrUsT tHe ScIeNcE!" where "the science" is a clinical trial run by a multinational, decabillion-dollar company that is in the business of getting drugs approved.
No, we also think that slogan is dumb.
Which vaccination programme? Is the goal to reduce infections, reduce, cases, reduce hospitalization, or reduce deaths? The situation on the UK is that most are vaccinated infections are widespread, but are only leading to hospitalisation and death among the unvaccinated. If you define " success" as "nobody dies", that's failure..if you define "success" as "vaccines prevent serious consequences for the vaccinated, the unvaccinated take their own chances", its success.
"No anti-vaxxer ever locked me down."
Unless you consider death the ultimate lockdown.
He's still commenting here, so death hasn't locked him down yet.
The matter of treatment delay response was not addressed. Pity.
Tophattington's perspective must seem very noble and principled from inside their own head, but my GOD is it noxious to have to read. Not a single ounce of consideration is given to the externalities of individual decision-making, nor one moment spent to contemplate the fragility of the structure that provides them the comfort and safety to opine flatulently about the INJUSTICES their government DARED subject them to.
Only a decadent, privileged, and morally depraved society would allow its members to become so detached from reality that they could feel ENTITLED to forget how desperately nature is trying to kill them, and how tenuous our grasp on civilization is.
" they could feel ENTITLED to forget how desperately nature is trying to kill them,"
It reminds me of the dipshits saying childbirth is totally natural and therefor doesn't require medicalization.
"Out of all primates, humans experience some of the most dangerous births. Without access to modern medical care, 0.5 - 3% of births result in the death of the mother, and up to 15% of births result in the death of the infant. Chimpanzee birth appears to be much less risky, especially for the mother, though precise mortality data is not available. One explanation for this difference is that the chimpanzee neonate’s head is much smaller than the mother’s pelvis, allowing it to pass through the birth canal with little chance of becoming stuck. Meanwhile the human neonate's head is approximately as large as the mother’s pelvis, which makes for a tight fit during birth. The risk doesn’t end there. After a successful birth, even healthy human newborns are fragile and have only a fraction of the motor function that newborns of our closest primate relatives possess. Historically, around 27% of human infants die during their first year of life."
https://isemph.org/Obstetrical-Dilemma
Cannot agree more with this. I had to pay to fly to the US so that I was assured to have a vaccine these idiots just throw into the trash because FREEDOM! I'm exhausted.
I mean, it's basically in response to a prompt to explain his perspective, not his arguments. A passionate emotive diatribe like that probably gives you a much better picture of how he looks at the world than any reasonable amount of sober argumentation.
He's an idiot. Got it.
I understand that YOU don't care to understand his perspective. Scott was the one who asked, and presumably does.
Yes I do not care for simple idiots who in the name of freedom will cause as much harm to themselves and others. Spiteful, proudly stupid creatures.
Better on what metrics? This is an honest question, btw because I sincerely don't see how such calculations can work out.
Suppose, we try to maximize the freedom of people. Death seem to be an ultimate decrease in freedom and preventing it is extremely important. Even if freedom was the only thing we cared about, restricting freedom of those who use it to dramatically increase the chances of death of others seem to be the right decision, giving us more total freedom.
Less of this please. It's not necessary, kind, or bringing evidence of truth.
Re: the hacker news section, I feel like you are not giving journalists a hard enough time for this. You yourself saw that a lot of stories initially about Ivermectin were genuinely terrible, you even wrote a post about it: https://astralcodexten.substack.com/p/too-good-to-check-a-play-in-three
These stories weren't terrible just because the editor wanted to have something short, rather they were saying things that were directly misleading, or conspicuously lacking context. If the general case was that most people had done the research but they just couldn't write as much about it, the above post would never have happened.
I think the point becomes that the incentives are strongly against doing the research, rather than that the journalists are unable to do it - the people calling the shots believe that good journalism is uneconomical
> reviewing all the studies would have taken too much space
Even in online-only article?
Online, your space constraint is "how long can you make your article before people decide they aren't going to bother reading it?"
There appears to be no attention paid to the possibility that people might not read something that's too short.
I skipped over the section that Scott labeled "you can skip down to XXX if you want."
I don't think Scott's under any requirement to lay out why each quack study is quack, but lack of space isn't an excuse.
Perhaps authors are paid (at least approximately) by the word, and thus extra words that no-one reads are a real cost to the publisher? I genuinely don't know how the modern market for 'journalism' works
Scott, did you know you were mentioned on yesterday's episode of the Joe Rogan Experience? It was in reference to your essay last week about ivermectin. Tim Pool was the guest, and he brought your findings up as a retort to Rogan's positive claims about ivermectin. I recommend listening to the interview, starting at the 17:00 mark, and waiting for this key part of the conversation:
Tim Pool: "Now there's an interesting point that just came up today. I can't remember the guy's name, it might be Scott Alexander, I'm not sure, and they found a correlation between worms and parasites and curing COVID. So one of the hypotheses for Uttar Pradesh--people there have a high propensity for parasite infestation, and so if you've got worms and your immune system's being bogged down or strained, you get sick, you're more likely to die, and have a serious reaction. You take ivermectin, you cure those worms, your immune system is more robust. I'm not saying it discredits everything--"
Joe Rogan: "No, no, no, it stops viral replication. It's not as simple as, like, you don't have worms anymore so your immune system is stronger. Because there's plenty of people that don't have worms, that have an immune system that gets wrecked by COVID. What they're showing is, that there's a direct correlation between taking ivermectin and having positive results. The problem is..."
...and I'm sick of transcribing it. Just listen to it yourself, and please share your thoughts on Rogan's interpretation of medical science regarding ivermectin.
You should also weigh in on Joe Rogan's Cure for COVID, which he goes on to mention in the episode (and has in several past episodes). It includes ivermectin, monoclonal antibodies, and some other stuff (probably vitamin megadoses).
I would never understand why would someone take medical advice from Joe Rogan. Or listen to what he has to say about medical research. To be frank, he is just not smart or educated enough for his opinion to have any weight. And i do enjoy some of his interview podcasts and have nothing against him personally.
Yeah. I can understand being suspicious of elite experts. I don’t get being entirely credulous of non-elite “experts” (outside of literal holy men maybe).
This. This is the most obvious problem with all dismissives.
Sure, you've got all kinds of good reasons to not to trust "the establishment". That's very understandable. Yet somehow a random blogger cherry-picking some official and unofficial data and turning that into an outrageous conclusion ... is trustworthy?!
But then, it's not just ONE random blogger, is it? You're listening to a whole parade of them, a veritable small world fallacy: https://www.lesswrong.com/posts/StxoR4EqAYB3duRjK/trust-and-the-small-world-fallacy
> To be frank, he is just not smart or educated enough for his opinion to have any weight.
Sure, and that's what he openly says to his audience, ie. that he's a moron and you shouldn't listen to him for medical advice. But he's just repeating what actual doctors that he personally knows have been telling him, so to most people, when someone who has world class doctors and physicists on his podcast says something, it does carry weight (an arguably should carry *some* weight).
There are millions of doctors. Some of them say stupid shit. Scott is not running his own trials either. He is using the research done by others.
But Scott has the intelligence and expertise to analyze the available information. Rogan does not.
> But Scott has the intelligence and expertise to analyze the available information. Rogan does not.
Rogan isn't analyzing this information, he's repeating what he's been told by people who do have that expertise, like I said. Maybe the experts he knows are wrong in this case, but you seem to be implying that this epistemic procedure is fundamentally flawed, and it's just not. He's doing exactly what people have been saying for years now, "trust the experts", so don't turn it around now saying, "oh wait, no, not those experts".
Experts are pretty clear on this matter. There are no sizable positive effects. The treatment doesn’t work.
It seems Rogan lacks the skills needed to determine who and why is an expert and who is not. Who should be trusted and who shouldn’t .
Rogan lacks either the will or the ability to differentiate an expert from a con man.
I don't watch Rogan so I have to ask: does he also bring mainstream scientists/doctors on his show and treat them respectfully, or does he generally bring on people who agree with him?
In other words, is he a case of: https://www.lesswrong.com/posts/StxoR4EqAYB3duRjK/trust-and-the-small-world-fallacy
> when someone who has world class doctors and physicists on his podcast says something
I don't watch Joe Rogan, does he have a randomly selected sample of doctors, or does he have weird contrarian doctors?
He only invited weird, contrarian doctors to talk. One of the worst was Kelly Brogan.
I think "seems honest" >>>>>> "seems smart" for a lot of people. I'm not even sure I disagree with them on this, just have different expectations of who is smart and honest.
Rogan says he's not a medical expert, but it really feels like the conservative version of "clown nose on, clown nose off" commentary that Jon Stewart and John Oliver do.
I stopped listening to Rogan and Weinstein a year or two ago and I'm glad I did...
I find the “top down / bottom up” commentary most interesting here.
It looks like a feedback loop in play as well: the more “out there” the bottom up network gets, the more the top down network increases its prior that the bottom up network is mostly cranks and quacks. This makes the top down network more willing to dismiss out-of-consensus opinions. As a result, people with more trust in the bottom up networks increase their priors that the top-down network is overly censorious. So they are more likely to take “out there” ideas seriously, and the cycle repeats.
At least, that’s how I see this. Am I right that there’s a feedback loop in play here? What could be done to stop it?
The issue is that good stats is expensive. I think the only feasible route is a bunch of billionaire philanthropists start funding medical studies, such that they're big enough to not be noise, prestigious enough to be listened to, but not owned by the pharmaceutical companies.
Education, so that not only a small circle of experts can understand the ways in which the bottom is "out there". As it is, scientific establishment is in practice the modern priesthood, where its pronouncement are supposed to be taken on faith, and heresies are rated only by how charismatic their purveyors are.
Of course, nobody has any idea as to how to go about endowing large parts of the population with education adequate to this task, and many aren't even sure that this is desirable. After all, the priesthood model boasts milleniums of pedigree...
" There are dozens of positive double-blind RCTs of homeopathy."
Arguably, this is because endocrine disruptors can have a non-monotonic dose-response curve at very low doses. Google "bisphenol A, non-monotonic dose response curve" to get some sense of what I'm talking about. And 'homeopathy' has a tendency to use a single set of glassware in its dilutions, meaning that most homeopathic dilutions that claim to have zero active substance actually have microgram quantities of substance or less. And we know that microgram quantities of substance can exert biological effects that are qualitatively different than larger doses.
Our sense of smell is the quickest way to demonstrate this. Indole, for example, smells floral at low doses and fecal at high doses, for example. "fecal" is different than "really, really floral." And with scents we're already talking about qualitative differences at sub-microgram levels of exposure.
Homeopathy studies sometimes show real effects because they're banging into a real effect whose mechanism is poorly understood, especially by the homeopaths.
A lot of "homeopathic" medications also use low enough dilutions that they're just boringly ordinary herbal medicine in practice - I'm taking some at the moment where most of the ingredients are present at a few parts in 1000, plenty high enough that nonsense about water memory need not be invoked. (Of course, I wish that the people coming up with this stuff would realise the insanity of the theory, but in the meantime they're often the easiest way to buy some herbal remedies.)
Also, little known fact about p-values: if you draw 200 random samples from one and the same population and test them against each other for a significant difference of a random variable, lets say with a t-test, from that 100 tests on average 5 will suggest a significant difference between the groups. I am sure that by now there are several hundred studies on homeopathy, even excluding the ones that were never published. Some of them showing significant results would therefore to be expected.
Isn't that a very common observation?
Here's a comic on the topic.
https://xkcd.com/882/
I'll reiterate that much of formal homeopathic 'theory' is garbage and I'm not defending it. But my point is that there are people who dismiss results related to homeopathy out of hand due to a lack of plausible mechanism. And there is a plausible mechanism or mechanisms, though admittedly the observed results rely, in part, on poor homeopathic dilution technique. The evidence might be a set of flukes. But that's not the only plausible reading. In short: There's reason to dismiss less and engage more.
As for the "physician that has reported zero deaths and 5 hospitalizations with 2,400 COVID-19 patients", I'm just going to leave the public statement by the Brazilian Research Ethics Board:
https://conselho.saude.gov.br/ultimas-noticias-cns/2095-nota-publica-cns-elucida-a-sociedade-brasileira-fatos-sobre-estudo-irregular-com-proxalutamida
Basically, his research had ethical approval for a single hospital in Brasilia, for patients with mild COVID. Somehow, the published data is from many hospitals in Amazonas, with a 50% mortality in the placebo group, with a high proportion of liver and kidney failure in the placebo group. However, since the study was blinded, there was no way to know those deaths were in the placebo group, and the study should have been halted for investigation and possibly unblinding. When requested, the author did not provide information about the chain of distribution of the placebo pill, and it can't be discarded that the control patients were actually receiving a harmful medication instead. The "independent data monitoring committee" was composed led by the study's sponsor. The consent forms presented were different from the ones approved, with suppression of clauses that guaranteed compensation and assistance in case of harms or contraception (androgen blockers have high teratogenic potential)
The Tophattingdon comment is quite sad to read. I can’t recall if it was Scott but the idea that self sacrifice is a finite resource seems very applicable here.
In any case, the UK did get ahead initially on vaccine procurement and really has been free of restrictions (to the point of even getting rid of very low cost measures like masks in shops) for a few months now. When the initial lockdown measures were brought in back in March 2020, snap opinion polls put them at 98% support! The government were behind the public, many of whom had effectively locked down already.
If you opposed lockdown, fine, these things are difficult to quantify. But it was (particularly initially) a very popular policy that is only not being enacted now because of the amount of vaccines that have been administered reducing the death rate to a level deemed acceptable. Hopefully Paxlovid reduces this further.
But not being vaccinated when you know it’s sensible is just strange. It hasn’t been mandated! You’re free to have a good thing or not have it if you don’t want. If you end up getting badly ill with Covid or pass it to someone you love, what will this bizarre protest have been for?
I think we'd see the amount and intensity of lockdowns backing off at a similar rate even if a vaccine or treatment was never developed. I don't think it's true that vaccines are why lockdowns are easing, and I'm confident you can't prove that hypothesis.
Proving that hypothesis would indeed be difficult, however I do believe it’s true (at least in a UK context). Cases in the UK have been hovering around 40k a day for a while whereas deaths are about 150 a day. That’s not great, but it’s not shut everything down territory either (or even shut anything down).
I guess the issue is quite nuanced in that if there was no chance of a vaccine/cure then you can’t just lockdown forever, however given that vaccines are here and cures coming, the need for a lockdown is eased.
I suppose a better way of thinking about it is the number of daily deaths (or another similar measure) you’re willing to accept before imposing restrictions. For most people it’s a curve - the more deaths there are the more likely you are to support restrictions (granted lockdown opposers may just oppose restrictions entirely). If you accept that vaccines reduce daily deaths and that the uk govt bases policy at least somewhat on public opinion then the connection is obvious. Vaccines aren’t the only factor, but all of their associated benefits sure make it easier to pursue a looser policy.
"For most people it’s a curve - the more deaths there are the more likely you are to support restrictions" I don't think this is true.
So you think that in two otherwise-identical situations, where one has many COVID deaths and one has few COVID deaths, more people will support restrictions in the situation with few COVID deaths? That seems obviously wrong and also contradicted by the facts (countries have lifted restrictions when there are few deaths, such as earlier this summer, and raised restrictions when there are many deaths, such as right now).
It’s a bit of a simplification but it seems fairly obviously true to me. If there’s an infectious disease that will kill a maximum of 5 people a day in the UK, I oppose all restrictions. If it was going to kill/was killing 50,000 people a day and restricting contacts would help prevent this, then yeah, I would support quite a lot of restrictions. This may not be true for you specifically, but I think it holds true for most people.
In Australia you can literally prove that; Lockdowns / restrictions are tied to vaccine rates.
In Melbourne restrictions were lessened at 70%, 80% and 90% of the eligible population vaccinated [1], and we're losing retail masks in about 2 weeks.
[1] https://www.coronavirus.vic.gov.au/victorias-roadmap
Lockdown restriction removal is tied to vaccine rates in a world with vaccines. That says nothing about how things would be in a vaccine free world.
Re: mandates - it's worth noting that Trump's getting booed happened in August. Biden announced the mandate two weeks later.
So people were already saying f-you to the vaccine in general. They weren't booing the OSHA mandate.
people were talking mandates for months prior to that. Some individual employers were already mandating it. Mandates were on everybody's mind the minutes the vaccine was released. The NYT and WaPo were writing big thinkpieces about how mandates are good and "here's a legal theory for how biden could implement a mandate".
Right, but what was the predicate for that discussion? It was vaccine resistance. If people had flocked to get it like with polio there would be no need for the articles in the first place. Instead the articles would've been about rationing due to supply shortages.
We have school vaccine mandates in all 50 states for measles and chickenpox -- a disease that, like COVID, is much more fatal in adults than children -- and almost no one bats an eye. These diseases have never killed more than 6 or 700 people in any given year in the US.
Yet here we are, 750,000 dead, and there's an entire cohort of people who practically *all* have those vaccines but draw the line at the one thing that would put all this behind us. It's madness.
what is "vaccine resistance" without a mandate? that doesn't make any sense.
Refusal to use safe, effective and free vaccine.
Yes, it is not as effective as I would like, yes tax-funded free things are funded from taxes and yes it was not tested for 50 years.
Nevertheless it is clearly a good idea to use it, as far as I see.
I'm debating the terminology here, though; "refusal" and "resistance" all imply refusal of something, resistance against something. If taking a vaccine is a person's choice, then not taking it isn't a refusal, it's also a choice.
Because it's strongly recommend. By doctors, health professionals of all kinds, politicians, etc. The resistance is to "doing what Blue America recommends". The refusal is give even an announce of credence to the other side of the culture war.
It is perfectly legal to go around and say rude things to everyone around you, but probably a bad idea. If a large group of people did this because they think politeness is bad, “politeness resistant” would be a decent name to refer to them even though there was absolutely no mandate that they had to be polite.
This analogy is interesting, but it's not exact; politeness is a value, as well as a set of actions; vaccines are not a value, and they're not a set of actions in the same sense as politeness.
There certainly seem to be people who have being anti-vaccine as a terminal value in the same way that people have politeness as a terminal value. I’m pretty sure this was the case long before mandates too.
My expectation is that the people who coined the term "vaccine resistant" care about vaccination on (among other things) a basis of "wanting to not contribute to killing somebody else's grandparents", in which case 'being vaccinated' and 'being polite' seem reasonably seen as being value-based in the 'valuing prosociality' sense.
Also, many or most of the people who have MMR etc vaccines in the US received those when they were not adults and unable to make decisions for themselves. If they refused the MMR vaccine, it's likely someone would have grabbed them and forcibly medicated them.
Many of the people turning down the COVID vaccine forced their own children to be MMR vaccinated.
to be fair, they did it under huge economic pressure; your options are: 1) vaccinate your kid and send them to government-paid-for school, 2) don't vaccinate them, and invest huge amounts of time and effort into educating them yourself, or 3) don't vaccinate them, don't educate them, and people with guns come and take your children away for neglect.
"If people had flocked to get it like with polio"
People *did* flock to get it. I remember checking a website 10 times a day to see when I could get an appointment. There was a mad crush to get them.
On the subject of "Trump gets booed", I spent some time digging but eventually found a video that actually had the clip in question, starts at around 1:20 https://www.youtube.com/watch?v=EK0kcZjIDi4
Personally I don't hear any actual boos; I'm prepared to believe that some people in the crowd did boo the line based on the reaction afterwards, but it doesn't seem to have been the widespread reaction.
While I do think Scott's own chosen numbers and studies don't say what he wants them to, they aren't what I consider to be the most important data on the matter.
Rather than randomized controlled trials, what I'm seeing is an environment where some countries allow and encourage a wide range of treatments, and have near zero case fatality and were almost unaffected by covid, while others have much higher case rates and much higher case fatality rates. Many of these countries seem competent, and I can't really explain them without assuming that they're using some sort of treatment that works.
In addition, whenever a country switches from not treating covid to treating covid, it works.
Not all of the competent countries that have low case fatality and treatments that are not allowed or encouraged in America use ivermectin. Most use a complicated mix of drugs, supplements and catalysts, each with their own special purpose and timing. I want more attention on trying to replicate exactly what they're doing.
Could you be more specific about what countries you’re talking about? Brazil is one of the countries that had ivermectin studies but it’s not exactly done a great job in the pandemic. They’ve recently been better but I’d bet that they’ll have another spike soon given that the USA looked similarly good three months ago.
> have near zero case fatality
Which countries have actual zero case fatality?
If you google (covid death rate) the first result should be John Hopkins mortality analyses, that's my main source for death rate/etc. Near zero does not equal zero, we can quibble over definitions, but when I look at the list I see lots of near zeros.
It does take more work to check what each country specifically is doing, but when last I checked trustworthy countries that actually treated covid and didn't ignore it and got results much better than the competition included Iceland, Singapore, Denmark, South Korea and Japan. Lots of less trustworthy countries also did stuff that they say worked.
If you want to bash countries that used ivermectin, Peru is the problem country that stands out. It and other similar situations do make me think betting everything on ivermectin would be stupid. But data from India and elsewhere makes me think it's worth checking. Furthermore, the principle, that we should check drugs that might work, seems like it would absolutely succeed, because someone seems to have found a working cure.
I haven't looked into this too much, but last time I checked briefly I thought the most likely explanation was a combination of age and underreporting.
COVID mostly only kills old people, but different countries have extremely different numbers of old people. Japan is 28% over-65s compared to Pakistan being 4%. If COVID only kills old people (oversimplification but not totally wrong) we should expect Japan to have 7x the mortality rate of Pakistan by this factor alone.
As for underreporting, kind of obvious. https://astralcodexten.substack.com/p/mantic-monday-judging-april-covid#comment-1341776 makes a good argument that cases in India are underreported by a factor of about 30x, compared to in First World countries I think it's a factor of 3 or so.
I don't trust any cross-national comparisons that don't adjust for these two factors and I suspect most of them don't.
This is indeed a massive issue.
Excess mortality could be comparable,but even that can get iffy.
I have tried to compare Russian anti Covid performance with western anti Covid performance (compared to China, I at least speak the language and have been there for more then just holiday) and well...
Even things I would normally assess as quite reliable in Russia probably arent all that reliable concerning Covid. I eventually gave up.
The TLDR that I am assessing as mostly true: Russia did well initially, because the first Cases where in its not very densely populated far eastern regions. Incidently, these are also regions where stuff like Yersinia Pestis is endemic among rodents, and the local authorities in terms of health are pretty level headed, common sense and quite dedicated to their communities (those who arent dedicated to their communities migrate to Moscow or St. Petes). This first wave, the kept under control, Vietnam or initial cases in Japan like, by full contact tracing.
There was much claiming of credit, mostly be people in Moscow having fuck all to do with it, and a resulting massive overestimation of Rusian health care and anti pandemic capabilities by the authorities.
Yeah, then the Virus, coming from Italy, hit highly arrogant "rules dont apply to me" Moscow, needless to say, things went massively downhill.
Russia for the most part counts "died mostly of Covid" rather then "died with Covid", which explains their relatively low case fatality rate for Covid.
What I get from doctors in Russia is that they would have a slightly higher to roughly equal CFR then the west does, if they would count like the west (note that the west does not count uniformly either). A really harsh thing is that the 90s in Russia killed so many males aged 50-70 that their population of males aged 80+ is really low compared to peer countries, which lessens proportions of the realy vulnerable to Covid demographic in Russia.
Essentially, country by country comparisons could perhaps be done by comparing excess mortality. Even if they dont under or overreport, definitions are not uniform.
"Unless you are bipolar or in some kind of special bizarre high-risk category"
Do you think fluvoxamine would have a significant interaction with blood thiners for the 10 days that the treatment lasts?
If you think of finding effective treatments like solving a murder mystery, the last thing you worry about is every bit of information you receive being perfectly credible. You certainly don't won't to disparage or destroy the careers of anyone who ends up giving you bad info. It's 100% expected that you will pursue many dead threads. It should be possible to complete large trials on all these drugs and many more in a couple weeks and let the webcam video trial data be available for everyone to analyse.
The overwhelming point here is that even today is that a very large percentage of people who test positive are recommended to do nothing other than drink fluids.
> I kind of sympathize with this (and am considering refusing the booster to protest them not sending spare doses to the Third World), but refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases), but it’ll just provide pro-lockdown people with an easy opportunity to tar all their opponents as science deniers.
"Maybe you think the Nazis are evil, but fighting a war against them seems like the most counterproductive way to protest them. Not only will this ensure that your people get more oppressed (due to the ravages of war), but it'll just provide pro-nazi people with an easy opportunity to tar all their opponents as warmongers"
The difference is that fighting the Nazis will stop the Nazis sooner (and perhaps is the only way to stop the Nazis). Fighting the vaccine doesn’t stop the lockdowns sooner.
> Not only will this ensure that your people get more oppressed (due to the ravages of war)
are you aware of death camps and similar?
This comparison is absurd, in addition to gbear605 mentioned - as Nazis managed to be more deadly to occupied populations than military activity.
Re the journalistic standard of concision:
I think this aversion to ultra long form is what turns me off from most articles in the media.
For me, most of the value in a piece is being able to reconstruct the argument/summary from the presented evidence/story, and having enough material to be reasonably confident that my understanding is correct. (The evidence/story also lets me come to my own conclusions that diverge from the author's.) Articles that just say "the data says X" or "he did X because Y" with very little/no follow up infuriate me.
I'm sure journalists try to give good backgrounds, but I think they underestimate how much background is actually preferable. (Or maybe people like me are a different target audience.)
I personally would gladly read one 30 page article about a single subject than 30 one pagers summarizing the daily news.
On a side note, this difference between just having the summary vs having the summary along with a massive amount of data reminds me of one of the last paragraphs of "Varieties of Argumentative Experience":
The high-level generators of disagreement can sound a lot like really bad and stupid arguments from previous levels. “We just have fundamentally different values” can sound a lot like “You’re just an evil person”. “I’ve got a heuristic here based on a lot of other cases I’ve seen” can sound a lot like “I prefer anecdotal evidence to facts”. And “I don’t think we can trust explicit reasoning in an area as fraught as this” can sound a lot like “I hate logic and am going to do whatever my biases say”. If there’s a difference, I think it comes from having gone through all the previous steps – having confirmed that the other person knows as much as you might be intellectual equals who are both equally concerned about doing the moral thing – and realizing that both of you alike are controlled by high-level generators.
Amen. There ought to at least be articles where there is a "main" article of the usual length with a "details" article explaining all the evidence that went into the "main" one. Then they can still cater to the mainstreamies who like short.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290143/
Maybe look more broadly at effect on other viruses I read somewhere it was used in Africa on influenza reducing annual mortality from 800 to 20
Yes, give journalists a break. (And you should take some of your own medicine and give the FDA a break, too.) One of the reasons they (or their editors) are as cautious as you observe with (naive I would say) surprise is because they *know* if there's anything to nitpick about what they've said a pack of rabid Internet Experts will instantly savage them. In that world, the only safe option is to print stuff that fits the shibboleths of your major protective tribe, because they you know you *won't* get savaged by your in-group, no matter how many silly mistakes you made, and the critique by your out-group can be dismissed as the usual poo-flinging (even if it isn't) and you'll have your own poo-flingers to back you up.
Furthermore, thoughtful and centrist authors (and editors) get shoved out, because they are unhappy with always just writing partisan sloganeering pap, and unhappy with the viciousness with which they are treated if they try to tackle hard subjects in reasonable ways. So they exit the job and we are increasingly left with shills and hacks who don't shilling and hacking.
It's a God-damned mess, and a reversion to where we were about 40,000 years ago, and I blame the Internet. It's turned us all into instant soi-disant experts, 'cause we read a few Wikipedia articles and googled some stuff ("look! I have a link to a paper where the words I want appear in the abstract! That makes my half-assed screed as credible as a paper in PNAS, pretty much...")
There is absolutely a place for robust criticism, by anybody credentialed or not, of expert judgment, and this is absolutely healthy for expertise -- e.g. science prospers this way. But there's a genuine line between being a useful gadfly and critic and being a pack of fucking chimps hooting and flingiing poo and ruining any possibility of reasoned discussion.
I don't know how we put the genie back in the bottle, or if it's even possible -- this behavior seems wired in to human beings at some unfortunate level, I guess because Nature hasn't had enough time to evolve us to be more adaptive in groups larger than the Dunbar Number. But it's pretty discouraging to watch. Continues to erode my faith in any kind of democratic institution. (And probably not just mine, I think: the amount of contemporary sympathy for a Strong Man that can just shut the gabbling interest groups up and Restore The Republic(TM) is concerning. This is after all the ultimate fate of democracies that gave the Founders pause...too much fratricidal chaos in the Senate and the people turn to an Augustus in disgust.)
> if there's anything to nitpick about what they've said a pack of rabid Internet Experts will instantly savage them
So what? I would be really surprised if that would be main reason for journalism issues.
Try it yourself and get back to me. That is, try being public about *your* area of expertise and inviting the whole wide world to critique you and see what happens.
I feel like you're illustrating part of the problem, unintentionally. You're saying "Gee, it doesn't seem like a problem to me to be in that other fellow's shoes." The willingness of people to say this is part of the problem, I think. We are insufficiently respecting the fact that it is very, very hard to know what it's like to be in someone else's shoes, and therefore pre-requisites for good discussion and fruitful debate are a certain amount of giving others the benefit of the doubt: "I don't know what it's like to be in your shoes, so when you do something that seems *to me* to make no sense, or be stupid, I'll start off by assuming I'm missing something about your experience."
Doesn't mean at all that you can't make the criticism, or challenge, but it's done with a safety margin of awareness you may well be missing something.
> Try it yourself and get back to me.
Hm. It kind of depends on level of potential opposition. I am quite active in some places (mailing list with relatively high rate of "you are terribly wrong for following reasons" responses), the entire point code review in programming is to criticize what someone produced - and I do it for relatively active open source software.
But I never published on national newspapers or appeared in TV.
I watched a set of videos a little while ago about people whose image became a giant Internet meme, like the "overly involved girlfriend." They're very interesting, and kind of disheartening. People's lives really were changed, and not in a good way, just by being *recognized* everywhere. We already know people have been hounded into suicide, and one would like to say oh they must have had a predisposing weakness but....I'm not so sure. Thing is, you could quit that mailing list. You could leave your company, or even your profession, and escape the attention and the critique. What happens when you can't? I am not sure anyone who hasn't experienced it can grasp how trapped you are.
> That is, try being public about *your* area of expertise and inviting the whole wide world to critique you and see what happens.
My experience: people just ignore me. Though when I published about a politicized topic, I got mostly detractors: https://medium.com/big-picture/talking-to-climate-deniers-514177e31888
But any major publisher of news/analysis will have detractors all the time, usually yelling loudly with little fairness or rigor, no matter if the article is accurate or inaccurate. Not sure why a long-form article would be any worse than usual.
In my article, for instance, yes it was very long, but none of the complainants found any mistakes/errors. They didn't show up to read it, they showed up to heckle.
It's hard to read this as anything other than a plea to trust the experts (the FDA) and their designated spokespeople (the press). Since we know neither are trustworthy, this seems misguided. Yes, they're going to get savaged (by which I mean people are going to say bad things about them) by packs of rabid Internet experts. But if they were any good, the rabid Internet experts would almost never have a point, and that's not the case.
Well, first of all I make a rebuttable presumption that your leading hypothesis is wrong. I find it very unlikely that either the FDA or the press, taken as a whole, are unusually high in the levels of incompetent or corrupt people in them. In my life experience it's generally very unlikely that idiots or wicked people strongly concentrate in any given job description, except possibly criminal or trial lawyer[1].
What seems far more likely to me is that both those professions are filled with human beings, who have a certain regrettable but inevitable level of incompetence, narcissism, tribalism, and ethical compromise. We are none of us angels. That definitely calls on the one hand for a vigorous level of critique and challenge from the general public, no question about it. I have already said as much in what I wrote.
But -- and this is my point -- there is a style of critique and challenge which moves from helpful to mutually suicidal. If you end up helping destroy social trust *entirely* -- if you reach a point where you really are persuading people that, in your example, the FDA and the American press are *utterly* untrustworthy, just a pack of orcs from Mordor, then you are no longer helping to uphold standards, you are instead undermining the foundations of civil society. Id est, there is a qualitative and important difference betweek encouraging skepticism and encouraging contempt.
Unless your ultimate goal is violent revolution and a brand-new form of civil society (and history should be a stern warning about how likely *that* is to work out well), then you need to rein it in, take half a loaf instead of none, be satisfied with *progress* in the goal of more truth while at the same time doing your part to maintain social cohesion so that the republic can continue to function.
-----------------
[1] A joke, mostly.
I'll bite that bullet. The FDA might not be noticeably worse than most gatherings of so-called experts, in that they're usually right but wrong often enough that you shouldn't trust them with anything really important - if it matters, check it yourself, and your health absolutely matters.
Similarly, if you see a doctor about a serious condition, go get a second opinion and also look up the condition online. If you have an important contract, don't just blindly trust your lawyer, read it yourself as well. Experts will know more than you but they won't care as much about you as you do, and adding your own efforts is at worst a waste of time and energy.
I agree with everything you said. If I gave a different impression above, it was a mistake and I'm happy to correct that if you have any pointers to where it might be.
>In my life experience it's generally very unlikely that idiots or wicked people strongly concentrate in any given job description, except possibly criminal or trial lawyer.
CEOs apparently have a higher rate of psychopathy than lawyers (although lawyers are up there).
Wouldn't surprise me. I bet surgeons do, too. There are places where you kind of have to be a cold bastard with a charming exterior to survive in the job.
“One of the reasons they (or their editors) are as cautious as you observe with (naive I would say) surprise is because they *know* if there's anything to nitpick about what they've said a pack of rabid Internet Experts will instantly savage them”
But they aren’t cautious! “We don’t have the resources or page space to be thorough, so we will be cautious” is disappointing but justifiable. But instead, they just say lots of bold things that are wrong (or at least uninformed).
I don't think so. I think what they are doing is retreating into tribalism. They're saying things that match up with the shibboleths of their major protecting tribe, because that keeps them shielded. It's like in the 18th century days when pamphlets were written by people with powerful patrons, and they said whatever was OK with the patron, and nothing that wasn't.
I think it's important to understand that the very existence of people, and groups, without powerful patrons -- who are not beholden to *any* powerful interest group -- is actually a fragile and historically unusual thing, something that relies on there being enough public space to get stuff wrong (which fallible human beings do all the time) *without* being destroyed.
When you ramp up the pressure on independent people and agencies to get stuff right past a certain productive level, you don't get superhuman performance, you get ordinary humans to abandon the field, and it gets occupied by bullshitters, con men, and the advance guard of your enemies.
Your comments are usually worth paying attention to, but this (and what you've written elsewhere in this thread) is very insightful. Thank you.
+1
What a nice thing to say. Thanks for taking the time to write it, much appreciated.
I think this is more or less true, but to me the implied takeaway is that while e.g. journalists might be largely competent and capable of doing good work, their environment prevents them from doing so, so we should exercise strong skepticism of their outputs. I'm not sure if this is the takeaway you're suggesting though.
I'd go a step further and suggest that fields like journalism tend to filter for people who're not inclined to do thorough and objective investigation, because if you were such a person, would you want to work in an environment which discouraged you from doing it?
Yes, absolutely, I agree 100% in exercising very strong skepticism of the work of most journalists. If nothing else, they're on a deadline, they almost never have relevant field expertise in whatever they're reporting on, *and* they're major motivation is getting eyeballs and page clicks, which means they are going to aim at sensationalism. Who wants to read "well, the conventional wisdom turned out to be wise, except for a few caveats which we will now enumerate in a convenient bullet list sorted by priority..." Booooring.
I'm really talking about the style and manner of skepticism, that's all. When I read some flaming piece in the media, I'm deeply skeptical, but I *don't* assume it's because the writer is human trash, I just say he's a normal person with normal human weaknesses subject to certain forces. I may seriously doubt the truth of what he's saying, but I don't jump from there to questioning his worth as a human being, assuming he enjoys lying for living, if that makes sense. I think it's possible to be very skeptical without being (or encouraging) deep contempt.
>The entire ivermectin advantage in Ravakirti et al comes from 4/50 people dying in the experimental group compared to 0/50 in the control group.
Typso?
> refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases)
More lockdowns will also increase lockdown resistance due to lockdown fatigue. People just want to move on now with whatever is the new normal. If his ultimate goal is to force governments to give up on lockdowns as a public health measure, then I imagine a little pain right now to avoid all future lockdowns is worth it.
Is there any data on the combined prevalence of ivermectin-suceptible parasites so that somebody can redo the analysis without focusing on one species?
>the spice curcumin
If they're pushing curcumin, they definitely don't know pharmacology. E.g. https://www.science.org/content/blog-post/curcumin-waste-your-time
"I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns."
I don't understand how anyone thinks this will lead to fewer lockdowns at the moment. Cases were plenty low in the northern cities to justify removal of mask mandates and time/crowd size restrictions. They were mostly not. Cases were much higher in Florida, and they did not have mask mandates.
Simpson's paradox.
There is a great website for debating such things seen here: (both sides)
I created this debate scaffold
https://www.kialo.com/is-it-possible-to-decide-on-the-basis-of-recent-research-whether-or-not-to-take-ivermectin-to-treat--ppx-covid-19-55238?path=55238.0~55238.3&active=~55238.3
Lose 1 French typographic point for diluting the spelling of « écrasez l'infâme ». :-)
"I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns. I think it’s easy to get discouraged about this given the many “okay, in just a few weeks this will all be over and we can reopen for real” bait-and-switches, but in the long run I do think we’ve gotten less locked down as case numbers have declined. I don’t know how much of that has been epidemiologists agreeing the crisis is less severe vs. anti-lockdown activists forcing governments’ hands."
Speaking for myself and the community I live in (northeastern US, fairly liberal), lockdown type measures have decreased significantly. I think there are 2 factors:
1. People who are vaccinated feel much safer than they did a year ago (which they are!).
2. Between delta and what seems to be the continued refusal of huge numbers of the population to get vaccinated, it's not clear ambient covid risk is going to change any time soon. So at this point it feels like saying "I'm still not comfortable going to a restaurant" means, I "I won't go to a restaurant for the next several years." I think the calculus there was different when folks though the pandemic would be largely over in a few months to a year.
Scott seems a little too kind to IVMmeta, which seems to be part of a weird large-scale effort to paint all sorts of random stuff as miracle cures for Covid, and whose wordiness is matched only by the one-sidedness of the analysis.
Scott has a superhuman power to treat people with respect even as they are shitting on him. He had the same experience with Nathan Robinson before all of Nate's workers quit.
Good luck renewing your COVID vaccine passport after holding off the booster shot.
Tangentially, regarding mandated lockdowns vs mandated vaccines, I'd love to see a book review here of "The Premonition: A Pandemic Story" (by Michael Lewis, who also wrote Moneyball and The Big Short) (apparently previously mentioned on ACX [in this comment](https://astralcodexten.substack.com/p/open-thread-171/comment/1933890)), which includes a third option of something like "mandated data reporting". It tells the tale of the people in the US who were trying to make an effective COVID response happen back in January and February of 2020, and the things that got in their way. One notable suggestion was that rather than mandatory lockdowns, the government should have made a temporary exception to medical privacy laws and set up (mandated?) reporting of COVID test results on a localized-to-the-neighborhood basis, and made this data highly-visible so that neighborhoods and states could restrict travel and do voluntary lockdowns. (I may be misremembering the suggestion a bit.) And also that closing schools is way more important than restricting movements of adults.
> First, the claim that I "[appear] to be against all treatments, labeling them all "unorthodox" and "controversial", even those approved by western health authorities, including casirivimab/imdevimab, bamlanivimab, sotrovimab, and paxlovid." They suggest I am turning my readers away from other treatments including ones that are already standard of care in western health systems.
> This is false and I don't know where they're getting it from.
I assume it comes from that you wrote
> This is from ivmmeta.com, part of a sprawling empire of big professional-looking sites promoting unorthodox coronavirus treatments.
and those treatments are among the ones their empire happens to have pages on. (Go to the very top of the page for the list.)
I wonder if blood pressure medicine would cure covid. It's an odd disease for which comorbidities seem to matter a lot more than usual. Mild worm cases might be one of them. As I recall, high blood pressure is one of them, with unknown mechanism. Lots of people have high blood pressure and don't know it. If we gave a random sample of people with early covid high blood pressure medication, maybe we'd find they'd do better, on average, than a control group because we'd accidentally be catching some of them with untreated high blood pressure.
https://twitter.com/AviBittMD/status/1463388842090799109
Also: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00334-5/fulltext
This paper is actually cited in my Strongyloides hypothesis paper. This paper dealt with a lot of different parasites, but did not seem to report Strongyloides. This is important, because it's the only one including all the different parasites that paper mentioned that undergoes hyperinfection and dissemination. Relevant because COVID-19 is associated with eosinopenia even without steroids, which may effect Strongyloides more so than other parasites given its ability for dissemination.
The general idea here is that Th2 loaded patients have decreased risk of decompensation because they have less risk of a cytokine storm associated with Th1 immune responses. So they do better clinically, but clear the virus slower. So patients with parasites generally do clinically better with COVID, but would be expected to clear the virus at a slower rate. But of course, with strongyloides ... if a patient develops eosinopenia in response to COVID (or steroids) all bets may be off...
To understand those positions, imagine more concretely. Imagine hostile aliens who say we expect your father to die and have no further treatment options beyond watchful waiting. Also, we urge you to stop waiting. No, we won't permit his doctor prescribe or administer a cheap, known-safe drug that you think might help, and we feel so strongly about this we will fight it in court for as long as it takes for us to win or him to die, whichever comes first.
Or spare the imagination and read this: https://rescue.substack.com/p/a-judge-stands-up-to-a-hospital-step
Anecdote is not data. This proves very little about the efficacy of ivermectin as a treatment. It does demonstrate a lot about how to erode public trust, and why many people might look at the public health care decisions on Covid-19 and see Moloch, mouth open... and assume malice instead. Much easier to understand malice.
"Probably 'Trust Science' is not the right way to reach proponents of pseudoscientific medicine" - or indeed anyone who remembers what science was when it was still science. Nullius in verba. The entire point of science is that trust is unnecessary when you have replication - and we have a replication crisis, generally.
> I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns.
For any prediction market of the form "Will lockdowns end/vaccine mandates be repealed/mask mandates be repealed/free travel be restored when metric X is reached?" where X is something like case count, death count, vaccination rate, etc. and not something political like polls, elections, protests, civil war, etc. I would bet that the outcome will *not* occur when metric X is reached.
The reason for this is exactly as you said, over the last two years politicians around the world have made all sorts of promises about how these restrictions are just temporary and every single time not-temporary has turned into permanent or recurring.
I'm curious, Scott, what metric you would pick and would you bet on it?
For someone who looks at the very recent history of politicians making promises and then failing to keep them (see: two weeks to flatten the curve), this idea that "if we just do what they say they'll finally let us be free again" is hollow. It is just someone making another promise in a long serious of promises where they ask us to give up personal freedom today (right to personal medical choice) in exchange for future freedom (freedom of association, freedom of travel), but if history is any predictor of the future those future freedoms will never come.
Looking at a bit longer of a history, one can remember 9/11 where a whole load of rights were trampled on in the name of stopping terrorism, and many of those were intended to be temporary measures to deal with an immediate/imminent threat. Now, 20+ years later, those temporary measures are a permanent fixture in our lives (see: airport/airplane regulations like I can't bring a bottle of water into the airport).
I would like to be convinced that there is a path forward that actually restores our freedoms once they are removed, but at the moment I see no such path and the best strategy seems to be to avoid giving up the freedom in the first place (such as freedom of personal medical choice). Even if you are a strong believer and advocate for vaccines in general, there is value in the social signal that you are unwilling to give up yet another freedom. Often times one must take calculated risks to achieve some larger goal (like slowing the rate of erosion of personal freedoms in this case), and if you are at low-risk of death/disability from COVID-19 then this may be a stand worth making. You can even use it as a bargaining chip: "As soon as my freedoms are restored, I will get vaccinated." in a larger political battle.
excellent post. Refusal to get vaccinated seems self defeating (at least for those at risk, 40+ or with some other issues. For the 30- in good health, it's not clear if the very small risk of bad covid is higher than the very small risk of bad vaccine reaction. I think it is, but information is not coherent nor easy to find), but so does hunger strikes and similar types of protests. In some context, the self defeating aspect is good signal of how far you are ready to take the protest, which in game theory is a way for the weaker party to win against a stronger one, if the stronger party is not ready to loose as much...
It may be sad to come to those extremities, but as you said, history of western governments behavior show a very clear trend since at least 9/11, and for people opposing this trend, vaccine refusal is maybe much more rational than what would seems. That's not surprising, if you really know all factors at stake and game-theory model of the different actors strategy, irrational behavior is very rare, so much that when it looks irrational, it's wise to try to complete the picture with neglected factors. And irrational behavior is certainly much less common than the strategy of calling your opponent irrational ;=)
This reminds me of the great article https://putanumonit.com/2018/08/22/player-of-games/ and my favorite quote from it:
> if at least N people are playing a game, at least one of them is playing a different game.
I think your comparison to a hunger strike is very apt, as well as your assessment that signalling how far you are willing to go and how much you are willing to risk is a powerful means of avoiding conflict by allowing pre-calculation of the winner prior to any actual physical confrontation.
Interestingly, the optimal figurehead for this position is someone who believes that COVID-19 is extremely deadly, thinks vaccines are 100% effective, and still refuses to get vaccinated as long as the freedom reduction exists. This person would strongly signal, "I am willing to risk my life to oppose these policies, so if you want to continue escalating this to some kind of armed conflict be prepared to fight to the death".
Thanks for this link....gooood stuf :-)
"having all you excellent readers who are masochistic enough to read ten thousand word essays speculating about intestinal parasites."
Our complete and genuine pleasure!
If the Democrats ever want to win the culture war permanently, all they need to do is pass a law that mandates breathing, and watch as half the other side holds their breath permanently in protest.
That wasn't nearly as clever as you thought it was.
The comment about the LHC makes me think of a question that comes often to my mind: how did the physics academia end up being so good at pooling resources together? It's not just the LHC - the tradition comes from before and outside: Fermilab, Kamiokande, and a lot of other high-energy physics experiments.
In principle the same bad incentives that make medicine/biology/social science professors focus on making their own career about their "own" project and potential discoveries should apply to physics. These incentives (mostly fighting for grants) are what causes this "smallholding" of research.
But for some reason it doesn't apply to physics. I've been (shortly) in that world and there's a general attitude of "yeah, we need to say blah blah for the grants, but what really matters your internal contribution to big project". I'm not sure where that comes from, and whether it could be transplanted to other sciences. This would be much better than putting whatever can be salvaged from 30 random pieces of biased research into one metastudy...
Once upon a time, a bunch of clever physicists said "finance our many-gigabuck project and we will give you the mightiest weapon ever with which to smite your greatest enemies ever. And maybe cheap, clean abundant power as well". And they pulled it off. There was also something with radar and computers going on about that time.
Ever since, politicians have been suckers for that argument. Give physicists (and maybe some other sorts of scientists, but particularly physicists) huge gobs of money in big concentrated chunks, and maybe we'll get technological miracles in return. Physics academia isn't pooling its own resources together, it's pooling everybody else's. Because they can.
Uh, yeah sure, but no, not really. I'm used to all modern physics developments being pop-historied into "and so because project manhattan"... but it's just not true.
The first problem is that your reasoning works for within-borders collaborations. The jingoistic logic of military research for sure opens up the money pipe (but not just for physics https://en.wikipedia.org/wiki/United_States_Army_Medical_Research_Institute_of_Infectious_Diseases). Yet CERN routinely has researchers coming over from Europe, the USA, Japan, India, Pakistan, Russia, Israel, Turkey, and a bunch of other equally not-very-allied countries. They come to work hands-on the projects, and then return to their respective universities with that knowledge. A pretty bad strategy from the "smite your enemies" point of view. And you could argue CERN still develops cutting-edge tech that could be used elsewhere. (Magnets? I don't know, some of the latest useful applications have actually been in medicine, proton therapy and the like.) But what about the Kamiokande detector, the IceCube project, the Pierre Auger project, etc etc? The best (non-fundamental physics result) that you could get out of Pierre Auger is "how do we transport large buckets of water around very long roads", that I'm pretty sure has already been solved.
A bit of history about kingoism and CERN itself: it was created precisely to put together European nuclear physicists in the same place, so that they'd all be one merry family and not develop nuclear weapons to blow up each other. It was kind of unremarkable until the US government decided to stop funding Fermilab, at which point CERN saw an opportunity to take the lead, did a couple of mid-budget experiments, found the W/Z bosons, and _after_ that success the European countries thought "uh this may be a nice way to own the US, let's throw money at it".
The second answer to your point is that expenditure in physics is not particularly high with respect to other fields. Take the Swiss National Science Foundation, which I know first hand and I can witness is not shy with money for physics https://data.snf.ch/key-figures/disciplines (you have to check the CSV, the plot is not enough).
Over the 2016-2020 five-year period, social sciences gets 1.3 billion CHF, Maths/Physics/Engineering together get 1.6B, and Biology/Medicine 1.8B, which sounds about as expected to me. (A bit annoyed by the expenditure on social sciences, since I don't see much expenditure in experimental materials, but that's a different story.) Specifically for Physics only is 0.4B (adding Astronomy into the mix, which I guess is fair, but probably not what the kind of field you were thinking about with politicians being suckers for promises of a new radar-style breakthrough). For comparison aggregated Biology is 0.8B and Medicine the other 1.0B.
For the European Research Council (again you can get a CSV with data here https://erc.europa.eu/projects-figures/project-database), I find that for the same 5 years, 2.0B went into Social/Humanities (SH in the data), 2.5B into Medicine/Biology (LS in the data) and 3.8B into Physics/Engineering (PE in the data). Again comparable amounts. Remarkable, a lot of the PE money went to "Earth System Science", "Products & processes engineering", and "Synthetic chemistry & materials". Big-project fundamental physics, such as we're discussing, falls under "Fundamental constituents of matter", which got 0.39B.
I tried finding good data for the US, but I'm not so familiar with how public research operates there and didn't find anything useful. If you have a link to an official page with a similar breakdown I'd actually appreciate it a lot.
Anyway - this is admittedly still a lot of money for physics. The point is that (big-project fundamental particle) physics doesn't get an oversized piece of the public research cake. Medicine gets more (which I think it's reasonable, being more pressing). They both have the same bad incentives when it comes to obtaining grants. My question stands: why has this very specific area of research been able to focus all its money into a few large-scale experiments, while others get equally large amounts of money that ends up inefficiently distributed amongst hundreds and hundreds of small departments that do lots of inconclusive N=10 experiments?
PS: "Physics academia isn't pooling its own resources together, it's pooling everybody else's. Because they can." This is true of all publicly funded research, and besides the point. I guess it's just a "don't tread on me" jab at public research per se, so I'm ignoring it for the discussion.
You can get some data here:
https://ncsesdata.nsf.gov/fedfunds/2018/html/ffs18-dt-tab017.html
Physics is still a pretty outsize chunk (3.5 G$) but not nearly as dominant as it used to be. Bio/medical funding has exploded, and this does not even cover the NIH which has an even larger budget and just does bio with some chem, no physics. I think most people agree the US has scaled back its investment in high-energy physics considerably since the heyday of the 60s.
Thanks, that's perfect!
That is quite a bit for a single year, yeah. But even CS gets 2.8 billion. I'm quite amazed by the 18 going to biology, I didn't picture it as such big of a field (maybe because of it being in the shadow of medicine). Most of psychology being "Other" is also kinda funny.
If it were *just* weapons, that would be a reasonable argument. But physicists pivoted pretty quickly to cheap clean abundant energy, and mumble something other miracles nobody can predict but will probably be useful for more than just blowing people up. Same with most of the other fields of "Big Science".
Remember, the "atomic age" of the 1950s and early 1960s was generally perceived as a *good* thing. The nuclear weapons had proved that "atomic scientists" could do mighty things, and almost everyone trusted that they would quickly be doing mighty good peaceful things.
I can assure you that nearly all of big-project high-energy physics research has no application whatsoever to cheap clean abundant energy / similar miracles, and the grant proposals do not even touch the subject. For the record, high-energy does not mean "how do we generate large amounts of energy", but "how do we make this one little small particle go really fast".
Work on actual energy sources has mostly switched to engineers, including projects like ITER (which with its promises of "it'll be done in 10 years" over the last several decades doesn't really attract many physicists looking for the next big discovery).
> Remember, the "atomic age" of the 1950s and early 1960s was generally perceived as a *good* thing.
And this, I promise, is no longer the case, at least in contemporary western Europe. It seems to me that contemporary USA doesn't regard it anymore as a perfect jolly good time either, but I may be biased because of reading what people like Scott write. Kind of anecdotal, but illustrative, is that particle physicists try to distance themselves from the "nuclear" adjective lest the public starts complaining about Hiroshima and three-eyes fishes.
Either way, I don't see how that helps understand the initial question. Your argument was that physics has more money than other sciences, which I think it's by now clear not to be the case. If you want to say "ah it's all the same" and wrap it under some evil "Big Science", the question that still interests me (and I'd say anyone who cares about improving medical research) is why some of that "Big Science" is able to coordinate at such a large scale, and why some other stays attached to its feudal practices.
I can assure you that no congressman voting to authorize gigabucks for these projects, or for the organizations that would predictably fund these projects, ever read the grant proposals.
I'm fully vaccinated, my wife and children are vaccinated. My wife and I got our first shots in March. I am strongly against forced lockdowns and mandated vaccination. I've added my name to a list at my employer that refuses to show proof of vaccinations, because I find demanding it immoral, particularly since the vast majority of the company works from home, and will continue to do so in perpetuity.
I'm also against the rhetoric that the radical left uses on those who are vaccine hesitant. It will get absolutely zero of them to get vaccinated. It makes them dig their heels in more.
Do you want Republicans to win a supermajority in the next set of elections? Then keep this crap up!
(This last comment wasn't directed at Scott; he's been quite reasonable and hasn't branded his ideological opponents in a mean-spirited way. I'm just frustrated with the current political climate.)
What do I want to see instead? Encouragement and incentives. Towards the beginning of general availability of vaccines, I saw plenty of local stores with "for hire" signs offering a $500 signing bonus if you show proof of vaccination. That's fantastic! Restaurants offering indoor seating to the vaccinated, but not turning away any business would also be great.
Using force will turn people against you. If the Biden administration was simply saying stuff like "to the majority of Americans getting vaccinated, we thank you!" Without denigrating those who are hesitant as science deniers or stupid or even terrorists. Assholes on Twitter cheering on as people get fired due to vaccination status will not produce good results.
Lockdowns and similar measures while the population doesn't have access to vaccines seem warranted to me, but they just don't seem justified once those that want to be have been vaccinated. The disease just seems to be not deadly enough to justify it, no worse than a bad flu year (for the vaccinated). And trying so hard to save those that don't want to be vaccinated seems unproductive, maybe even counterproductive since it concentrates various denier groups.
Here in The Netherlands we have a pretty good vaccination rate (83% of >=12 yo) but our health care system is days away from collapsing. We got a light lockdown two weeks ago that isn't working and will probably get a stronger lockdown tomorrow. It is a tough place to be in. Urgent medical has been scaled down and soon we'll need triage for emergency care, but many people are just fed up with lockdowns.
Belgium seems a few weeks behind, but on a similar trajectory. And i guess it's the same for you : the 65+ and other more vulnerable people have a much higher rate of vaccination. I do not see how trying to reach the very small percentage of non vaccinated vulnerable people will change anything. At this point they are probably unreachable by normal means, not even sure forced vaccination would work if it is on the table, but it will be too late even if it does. Strong lockdowns will not be accepted especially around Christmas, even in the most compliant countries (like Belgium). But i am still somehow optimistic, in believing health system collapse or even non anecdotic icu triage is unlikely. A combination of self-isolation through fear, school holidays, a lot of still unused work days off, wrong reporting of ic capacity, may limit the problems. Also, given the general non reliability of mathematical modeling of covid epidemiology, i dare to use the previous waves as examples: we got close but did not exceed max capacity in quite a lot of the currently problematic countries... It could be a "lucky" coincidence... Or it could be there are various self-adjusting feedbacks at play...
I hope you are right and I agree that self-adjusting feedbacks are a very plausible mechanism. It has been clear for a while that official lockdown policy differences only have a limited effect on outcome differences.
Rather than enforcing vaccination and movement restrictions I would lower the standard of care for the unvaccinated. This would take the form of tent hospitals equipped with oxygen and medicines but no intensive care beds. The nursing and doctor to patient ratio would be much lower but could be augmented with military medics.
I believe this would have a much greater chance of actually being effective while getting to the root of the problem: hospital staff burnout. If some anti-vaxxers die because of this, well, that's a sacrifice I, as a vaccinated person, am willing to make (and I honestly think anti-vaxxers too would be happier with this than the lockdowns or forced vaccination plans).
By the way my perspective is as a New Zealander where my region hasn't had a single case in well over a year, internal borders will be coming down in two weeks though so we will be getting it then.
I appreciate being highlighted and I think Scott is broadly correct that conservative elites are responding to the incentives created by the base. That said I think it's really important to observe that even when the policy is ideologically neutral, will directly save the lives of their base, and the conservative elites believe it is correct (they got vaccinated), they are not willing to pay any cost in terms of popularity with the base in order to support that policy. Tucker Carlson even went on air to scaremonger about VAERS.
If your answer to the ongoing legitimacy crisis of public health officials, is to increase their epistemic virtue, it's important to note that red tribe perception of epistemic virtue flows through Fox News and Talk Radio. That media has just shown itself totally unwilling to resist pandering to their audiences suspicions even when lives are on the line and they think the policy at issue is correct.
Epistemic virtue is it's own reward and I think it's worth (especially on a blog like this) pushing mainstream institutions to be more inclusive of conservatives and their ideas. What is missed when you ignore conservative elites is that their actions drive down the marginal returns on investment in epistemic virtue in terms of authority generated for institutions and therefore have helped to create the incentive structure where elite institutions maximally pander to educated blue tribers.
WRT: Tophattington:
Governments didn't randomly decide to do lockdowns for no reason. They did it because they everything was on fire (metaphorically speaking) and they needed to stop the disease from killing millions of people.
The idea that this is some sort of bizarre power grab is completely nonsensical. Lockdowns are unpopular and make people angry; why would politicians randomly decide to lock people down for no reason? It's bad for their tax base (which means less money and power) and it is bad for their own future electability (doing important things, even if they are unpopular, is a good way to not get re-elected).
People are born defective in tons of ways. It's just a fact. You have mutations in you that make you defective, in big ways and small. Heck, the fact that you created a moral system based around this stuff is itself defective, because it isn't congruent or consistent with reality.
We vaccinate people because it stops people from getting sick and dying at nearly the same rate. We do various restrictions because it lowers transmission rates.
"Governments didn't randomly decide to do lockdowns for no reason. They did it because they everything was on fire (metaphorically speaking) and they needed to stop the disease from killing millions of people."
But they *didn't* stop the disease from killing millions of people.
And they didn't need to. What they needed to do, was to conspicuously look like they were Doing Something. Which, mission accomplished. If there had been some quiet invisible intervention that cut the death toll by half, and if it were absolutely known to them that lockdowns would have done no good, the quiet invisible intervention would have been optional but the lockdowns would still have been politically mandatory.
>I actually think this might be more of a crux between us than anything about ivermectin itself. The same people behind ivmmeta have put up websites claiming that 19 different substances, including HCQ, testosterone-blockers, the spice curcumin, vitamins A, C, and D, etc, all cure coronavirus with pretty large effect sizes.
Did you just do a meta-analysis on a bunch of meta-analyses? How much more meta can we go?
"The same people behind ivmmeta have put up websites claiming that 19 different substances, including HCQ, testosterone-blockers, the spice curcumin, vitamins A, C, and D, etc, all cure coronavirus with pretty large effect sizes. I think this is because they are using a nonconventional form of statistics which is always going to find positive effects. [...] I think ivmmeta is trying to pioneer a new way of thinking about science and statistics without p-values, but I think its new way is actually bad and will get positive results almost all the time."
Why do you think it's a new, nonconventional form of statistics? To me it sounds like the same old p-hacking, garden of forking paths, file drawer problem...
Now that case rates are higher in vaccinated people, this argument had a short shelf-life, didn't it? "refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases)".
The technology blog "AT" is very likely Ars Technica, with this post that repeatedly mentions c19ivermectin.com when they probably meant ivmmeta.com: https://arstechnica.com/science/2021/09/the-anonymous-meta-analysis-thats-convincing-people-to-use-ivermectin/ This AT post is dated 2021-09-21. Perhaps someone with more enthusiasm than me can dig through old versions of ivmmeta.com and discover whether the complaints about AT appeared soon after 2021-09-21.
ivmmeta.com says "We also note that the author has never contacted us" at the end of the "AT response" section. The feedback forms at ivmmeta.com don't request the identify of the person filling out the form, so they can't know with confidence that AT didn't contact them.
ivmmeta.com isn't "trying to pioneer a new way of thinking about science and statistics without p-values". Their Figure 1 has a graph along the bottom with their "probability results from ineffective treatment" as a function of time, 1 in 100 on January 9 (of an unspecified year!) to 1 in 10 billion on January 6 (of a different unspecified year, but probably 2022). The probability that a result would be observed with ineffective treatment is a p value. If you don't like reading a graph, look at the first table at: https://ivmmeta.com/#results The column title "Probability of an equal or greater percentage of positive results from an ineffective treatment" matches the definition of a p-value.
They might be wrong, but they aren't boldly doing science without p-values.
I wish they were -- frequentist statistics is wrong, and Bayesian statistics is correct. Bayesian statistics doesn't have p-values. I haven't seen medical papers that made a substantial attempt to use them on real problems, but I would like to. But that's not what ivmmeta.com is doing; they are consistently frequentist throughout.