So, the US suicide rate is about 0,014% per year. That is about an order of magnitude to small to account for excess deaths - and that is the total rate, the change in suicide has to be a much smaller number.
I think you will find that an analysis of increases in drug and alcohol related deaths, and reduced medical service will similarly amount to numbers that are much to small to account for the excess deaths.
The baseline excess deaths is 0 - excess deaths is how many more people died than in an average year. More people died in 2020 and 2021, and when they died it was marked as due to covid. What could possible be a non-Covid mechanism for this?
Most of the more popular theories are difficult to reconcile with this graph. I've been challenging people to come up with an explanation for over 3 years, and I haven't seen any rationalizations that I found persuasive.
It seems to me that few people give a shit about the numbers. Most are angrily, personally invested in their familiar set of beliefs about covid and about the stupidity and character flaws of people who disagree.
You seem to be reading a lot into this post that isn't there.
The point of this post is that there is strong evidence that ~1 million people died in the US of Covid. It is useful to answer questions like this independent of surrounding context.
I think there is a subsection of the COVID truthers who say "it was just the flu" but really mean "there are trade offs between life and what makes life worth living, and we fell on the wrong side of the trade off" but I can't really respect the dishonesty. They are knowingly stringing along a lot of people who definitely don't feel the same way.
I don't think I defended the "general pro lockdown pov". I wrote:
> "Usually I’m the one arguing that we have to do cost-benefit analysis, that it’s impractical and incoherent to value every life at infinity billion dollars. And indeed, most lockdown-type measures look marginal on a purely economic analysis, and utterly fail one that includes hedonic costs. Rejecting some safety measures even though they saved lives was probably the right call. Still, I didn’t want to win this hard. People are saying things like “COVID taught us that scientists will always exaggerate how bad things will be.” I think if we’d known at the beginning of COVID that it would kill 1.2 million Americans, people would have thought that whatever warnings they were getting, or panicky responses were being proposed, were - if anything - understated."
I don't know how better to get across that the kind of lockdowns we did were probably an overreaction, but also it's insane to dismiss something that killed a million people as an overreaction that failed to pan out.
> Who cares if “1 mil is a big number” when divorced from population size?
I think it's useful to put it in the context of other problems. For example, are mass shootings a big problem? They kill about 100 people per year. So COVID killed 10,000x that. Is immigrant crime a big problem? A quick Fermi estimate suggests immigrants commit about 100,000 violent crimes per year. So COVID killed 10x more people than are affected by immigrant violent crime. Is cancer a big problem? About 600,000 people die of cancer per year, so COVID killed as many people as cancer during the two years it was most active.
Divorced from everything else in the comment thread here, I just wanted to say thanks for walking back on something in a public comment. It takes strength and I appreciate that you took the time to do that.
I generally wish we could praise and normalise this kind of thing more ('this kind of thing' being things like changing one's mind, admitting missing something, etc), so, in the interest of being the change I want to see in the world, I wrote this comment. :)
1.2 million deaths is about 0.36% of the US population of 330 million in 2020.
So, my new approach is to figure out how many years of lifespan covid cost Americans. Assume the average American is 38.7 years old and would live another 40 years and that there were 330 million people in the US in 2020. So that would imply the population at the beginning of the covid epidemic had 13,200,000,000 more years to live.
The highest estimate I’ve seen for how many Quality-Adjusted Life Years (QALYs discount years spent in comas, dementia, or horrifying pain, although not by all that much) the average covid fatality cost is 12.4 years. For 1.2 million fatalities, that would be 14.9 million years of life lost.
So, that would be 0.12% percent of U.S. lifespans lost due to covid.
Of course, the next question is: What would the toll have been if we didn't do X, Y, or Z?
But does "not doing X," such as not going to crowded apres-ski discos (big super-spreader sites in the late winter of 2020), means governmental decisions to shut apres-ski discos? Or does it mean people privately deciding to not go to discos?
And how big of a real-life difference is there between crowded discos shutting down by government order and discos shutting down because so few people are showing up its not worth paying the staff?
What it appears is that many people's preferred counterfactual is: What if nobody had noticed and/or nobody had cared about covid and thus kept behaving exactly as they had in 2019?
My guess is the death toll in 2020 would have been considerably higher.
But it's hard to realistically imagine a world where nobody notices or cares about a global pandemic.
Your guess that the death toll would have been higher is not based on reality, you are just echoing people who think they are smarter than everyone else. There was no chance that nobody would notice and no chance people would act in 2020 as they did in 2019. To be intellectually honest, you have to focus on things like this ---- People did notice that Cuomo's policies - brutal, penal isolation of old people as if they were criminals assigned to life imprisonment in solitary confinement, but close - within the same structure - to people who were dying from an infectious disease - killed many people who would have lived to see another day under a more compassionate government (and remember that Cuomo's government used threats of violence to impose its will). People also noticed that other people were being arrested for being alone with their family on a beach. This was an unimaginable disgrace to the people who ordered such arrests. I know you are a smart guy, Steve, but sometimes you look at the big picture too much, because that is what your pals look at (see, e.g., poor Murray and his attempts to count artistic value by the number of times names show up in mediocre art history textbooks). Yes there are stupid people who say there were no excess deaths and you can laugh at them all day but you are no better than them if you just focus on false and falsifying Leninist rhetoric about 'in the long run we were probably right'. It might be intellectually fun for you and others like you to brag about how much you understand numbers, and the big picture, but this was not a numbers game, and not a big picture game, from the point of view of the people who made absurdly bad decisions ---- and, because every problem in history is a problem that is based on particular details, and because we will never know how the counterfactuals would have turned out in detail, it is important to treat with respect those who disagree with you about the bad decisions made by people who were in the government and who backed up their bad decision with threats of violence, such as arrests, prison sentences, and unprecedentedly in the United States, threats of denial of basic decent medical support to those who dared to disagree with clowns like Cuomo and others like him.
I remember during the worst of it in late 2020/early 2021, the hospitals here in Utah were getting a bunch of Covid patients from Idaho and such because their hospitals had been completely swamped. Now I imagine what that would have been like if it had happened nation-wide over a week or two once the Delta strain got going (no more super-spreader events required).
I bet you'd have at least double the 1.2 million in excess deaths. Many of them wouldn't be dead from Covid itself (although there would be more of them with no free ICUs anywhere nor staff to surge locally from elsewhere in the US), but still dead.
Fwiw, I don't think the first article of the series was pro lockdown either. The point of *that* article seemed to be that 1.2 million American deaths is a lot of deaths and that it is an important and under-discussed fact. Sure, I suppose one could say that emphasizing the number of deaths is an argument a pro-lockdown person could use to support their case, but that isn't what Scott is doing.
In fact, he said "And indeed, most lockdown-type measures look marginal on a purely economic analysis, and utterly fail one that includes hedonic costs. Rejecting some safety measures even though they saved lives was probably the right call."
If you want to read something focused entirely on the lab leak hypothesis, I would recommend Scott's excellent review of the Rootclaim lab leak debate.
I'm making the much weaker and less-trouble-finding-statistics claim that about the same number of people died of COVID in 2020 as in 2021, so if all the deaths were from vaccines, the 2020 deaths would be unexplained. I agree that you would need more sophisticated statistics to detect a 10% or something effect on death rates.
> Further, both make an implicit assumption that the vaccinated and unvaccinated groups are otherwise demographically equivalent.
No, Silver makes the point that there weren't big differences in mortality between states based on partisanship until the vaccines became available. If pre-existing differences between states were driving the difference in deaths, it should have shown up earlier.
It still relies on the assumption that vaccine decisions cut cleanly across state/party lines rather than some other confounder-- which they clearly don't; even the least vaccine-friendly states still got up to like 60% uptake as I recall.
I think this is a bad way to do this, and the fact people think it didn't happen is support for that argument - people don't believe this because the experts and public health officials who support it are liars who lie all the time. They don't...uh, lie in the way people think they lie, but they definitely massage the facts to fit their narrative.
And the result has been a loss of credibility and usefulness.
Giving false reasons to do good things turns out not to be reliable. It gives you goals other than getting good things done, and like a zany sitcom plot, those goals will eventually take up your whole attention, and your original goal will be tragically or comically abandoned.
(Also helpful to your goal, which I support, would be not speaking like a comic book supervillain. Lives matter. Of course they do. You can acknowledge that society can't be infinitely safe without denying that.)
I appreciate Scott doing this follow-up because I will be more skeptical of his commenters in the future. It's been sometimes challenging to assess the credibility of comments on topics that are novel to me (unlike this one), and this post gives me insight into how many complete morons are among his followers.
I am pulled in two directions: it is extremely frustrating sharing a comments section with a large number of people who have no interest in truthseeking whatsoever, yet who aggressively act like they are the smartest people in the world. On the other hand, it's a huge public service for Scott to be so patient and thorough at exposing so many people with, uh, rationalist skills still at an early stage of development, to what actual reasoning looks like.
It’s unfortunate that the response has been to destroy all of the institutions that are engaged in progress, because you’re mad that they made less progress in 2020 than you wanted! It’s time to move on and stop blocking vaccines, scientific research, new social technologies, etc!
While I am no covid denier, I think you should really take into account all the people who died of other causes (heart attacks, cancer), because they could not or were afraid to access life saving care, including routine screening.
This. I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases.
Well, there was a strain on healthcare providers more generally. And that strain was caused by COVID. How many of the deaths caused by that were COVID deaths we don't know for sure but it was probably a lot and could well have been a million in the US.
If it's not knowable, even to a degree of uncertainty of approximation, then a meaningful cost/benefit analysis can't be made and the attempt to do so is misguided.
But it is knowable. Not only is it knowable, but the knowledge is easily available to just about anyone who's motivated to get at it. Here is a nifty chart I created tracking the top 8 major causes of death from Jan 2020 through May 2023 (first link below). (I've had problems with Google docs before, let me know if you have trouble accessing it.) If you need a basic tutorial on how death certificates work in the US, I've put together a very high-level description below the links.
If you open my chart, you'll definitely see that deaths due to diseases of the heart, malignant neoplasms (cancers), and cerebrovascular disease (strokes and such) would rise during peak COVID. IIRCC, COVID could only be listed as a contributing factor if the patient had been *diagnosed* with it within the 30 days leading up to death. Either these were due to COVID as a contributing factor outside the 30-day window, asymptomatic or perisymptomatic COVID as a contributing factor, or they were deaths because people couldn't get treatment.
HHS tracks ICU usage, and there were definitely people with non-COVID life-threatening illnesses who couldn't access an ICU during peak COVID waves. The CDC estimated that about 100K people died during the first 2 years of the pandemic because of insufficient ICU beds. We can sort of see this in their excess data. Second link...
And here's how death certificates work in the USA...
1. Drs and coroners are required to issue death certificates. There's a standardized way of filling out a death certificates. On the certificate they list the immediate reason of death and the contributing reason of death. If someone dies of pneumonia while in the hospital being treated for COVID, pneumonia will be the immediate cause of death and COVID will be the contributing cause of death. While some jurisdictions allow a "cause of death unknown" option, that's rarely used.
2. There are 3,244 counties in the US. Each county has a health department. Hospitals, MDs, and coroners, are required to file their death certificates with their county health departments. County health departments are required to upload the data from the death certificates to the CDC. So, probably 99.99% of the deaths in the US have a death certificate with an immediate and contributing causes on it.
3. The CDC tracks this data. The CDC puts all this data online via their Wonder app, which anyone can access to download the data and/or create nifty charts from the data.
It's... hopeless, isn't it? No matter how clear, no matter how easy-to-access, no matter how often trotted out - the data are just ignored. After all, why know, when one can pontificate endlessly, make up clever hypotheses, and "just ask questions".
>So, probably 99.99% of the deaths in the US have a death certificate with an immediate and contributing causes on it.
That sounds high. E.g. about 1% of the population goes missing at some point in their lives and are never found. Some may have left on their own steam, but I suspect that a large fraction are killed and not found (since that would be the same order of magnitude as homicides) - and these don't get death certificates.
We have a population of about 340 million people. You're saying 3.4 million will go missing and never be located during the course of their lives? Well, provisionally, if we accept that, and we take the average lifespan of a US person to be 77 years, that gives us about 44,000 people who will go missing every year — given the current US population. That's still a lot of people! That would be about 3,700/month, so I guess I could accept as a reasonable number. But...
It appears that the 1% number originates from the DOJ's NAMUS database, but it's currently offline. So I can't really evaluate its validity.
I see numerous media quotes surrounding that factoid, though. This one was interesting...
> An NPR interview with Todd Matthews, director of communications for the National Missing and Unidentified Persons System in 2013 delved into the nature of missing persons reports and found the same thing.
> “You know, the missing touches everybody, I think. In 2012, we had 661,000 cases of missing persons; and that’s just from that one year. Very quickly, 659,000 of those were canceled. So that means those persons either come back; in some cases, located as deceased persons, maybe never an unidentified person; or just a total misunderstanding. So at the end of 2012, of those 661,000 minus the canceled, we had 2,079 cases that remained at the end of the year as unresolved.”
> As of December 31, 2021, the National Crime Information Center’s (NCIC) database contained 93,718 active missing person records.
> Children under the age of 18 account for 30,400 (32 percent) of the national recorded 93,718 and 39,114 (42 percent) recorded were children under 21 years of age.
According to the DoJ website these missing person records are never purged. They are retained indefinitely until the individual is located or the record is canceled by the agency that entered it. Some of those number date back to when the database was created. And if Todd Matthews is right, then we're only losing between two and three thousand people each year who never turn up. That's a lot less than 44,000/year.
Approx 2.85 million US citizens died last year. And say we had 3,000 unresolved missing peeps last year. That gives 0.1%. OK, so 99.9% instead of 99.99% of people end up with a death certificate at some point. ;-)
Thanks for keeping me honest! But color me doubtful about that 1% figure.
The comment to which I was replying was, "I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases."
The comment to which I was replying was, "I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases."
For example, this hypothesis suggests that the excess deaths should track COVID hysteria (and lockdowns etc). And it's unlikely that COVID hysteria exactly tracked COVID cases.
But the graph of excess deaths seem to track the graph of COVID cases fairly well. That's some evidence against the hypothesis. (Even if it's not enough to completely rule it out.)
The comment to which I was replying was, "I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases."
My sister died of leukemia last month. It becomes very apparent to those of us who have walked the cancer journey of the extremely long supply chains that are required to support cancer care. Example: In the fall of 2024, one of her chemo cycles was pushed a week, because the hospital had clamped down on “non-essential” fluid usage because of an extreme shortage due to a hurricane in Florida (we are located in Denver) destroying the primary distribution center for IV fluids, and fluids are required to flush the chemo to prevent organ damage (the irony here is apparent to me). Many such examples for just the supply chain, let alone the supplies and available hospital staff being diverted because of hospital strain.
I would rephrase that, since as stated, one who wants a high number for death toll could argue that those SHOULD be counted as "covid deaths." I'd instead attribute those deaths to "pandemic" measures, coördinated by global "health agencies."
Absent the NPIs, the number of such deaths (and associated morbidity) could have been worse. You can't meaningfully assess the casualty absent a fuller context. If someone strangles from a seatbelt in a car accident, how do you attribute the death?
For a more apt metaphor, if people were getting strangled while driving normally due to some new kind of seatbelt mandated due to OTHER people getting into car accidents, I would say attributing those deaths to car accidents is bullshit.
I don't see how thar would be an apt metaphor. Absent NPIs, there's a non-zero possibility that hospitals would have been overwhelmed and people would have been afraid to make visits to the doctor. Think of Bergamo, Italy, early in in the pandemic. The pandemic wasn't a function of "other people."
Let’s take out the “should” and just try to count these things in the specific groups, and worry about the “shoulds” later, when we produce several different interpretations of the same data. Do one where you attribute every single excess cardiac fatality to Covid, and one where you attribute every single excess cardiac fatality to NPIs.
We live in these complex interlocking systems and we're actually not bad at dealing with this complexity... when we're not insisting on reality being black and white for our own psychological comfort.
In fact, to get better at modeling complex systems (like a pandemic rolling through healthcare systems and societies across geographies and time), we need to accept uncertainty and some amount of approximation without freaking out and saying it's hopeless to understand anything.
Science has ever proceeded in this way. Imperfectly and unevenly. But that has never been justification to ditch science and the collection and analysis of data and just start speculating.
Who's the "we" you're talking about? "We" as in the denizens of ACX seem to have problems with complexity and "we" keep coming back to simplistic answers that satisfy our prejudices. "We" as in the scientific community (which does not include me), were actually quite good at modeling complex systems — especially when it came to healthcare outcomes of various NPI regimes and various different healthcare systems. Sure there's a lot of arguments about how to interpret the data, but the data is there.
And amen to this...
> Science has ever proceeded in this way. Imperfectly and unevenly. But that has never been justification to ditch science and the collection and analysis of data and just start speculating.
I know one person who died from covid, but he was in a nursing home. A lack of visitors in the nursing home is, in my experience, very bad for health and mortality. Not only does one miss the benefits of social contact, but the nursing home personnel get the idea that no one cares about you, then you die. This was true for all nursing home patients during covid.
I also know one person, my neighbor, who died of cancer during covid. She was taking chemotherapy at home under the care of her elderly and overburdened husband, and almost certainly died sooner than she would have with proper hospital care.
"The total 'excess' deaths roughly matches the reported Covid deaths. California reported around 50,000 Covid deaths in 2021 and saw a bit under total 55,000 deaths above those expected by the model. "
I think the entire argument is because of overly simplistic models. There's rarely one cause of death. It's usually a this + that + the other thing kind of happening, and if any one of them were missing, death wouldn't have happened (at that particular time).
So. COVID put a lot of stress on the system. Thus people died who wouldn't otherwise have died (at that time). I believe that it was extremely rare that it was the STRONGLY predominant cause of death (say over 70% of the reason). But I suspect that it was frequently the reason that (say) 40% of those who died, died at the particular time that they did. (The particular figures are just numbers pulled out of the air. Don't pay much attention to them. They are just there to paint the shape of this argument.)
Note that being shot in the heart is not sufficient to be the single cause of death. Andrew Jackson was shot in the heart in a duel before being elected president. (Well, it *was* with a black powder dueling pistol...small bullet, low power. But he lived through it.) Causation is almost alway complex. Sharpening things down to a single cause almost always cuts away crucial factors. (That's why designing good experiments is so hard.)
> I think the entire argument is because of overly simplistic models. There's rarely one cause of death. It's usually a this + that + the other thing kind of happening, and if any one of them were missing, death wouldn't have happened (at that particular time).
See my very high-level overview of death certificates in the US of A (above). Also, the models are *not* overly simplistic. While I have issues with standard SIR models, the signals in the data that were gathered as the pandemic progressed was pretty clear. And better yet, we can compare to the outcomes of different countries with different NPI regimes, because many other countries put their data online, too.
You (well, I) *CAN'T* pull them from the published data, because they only list a single cause of death. The documents always want to list a single cause, and that's explicitly the thing that I'm denying. (Admittedly, there's often a major contributor, but I'm asserting that a single cause is the exception rather than the most common event, or even *a* common event.)
Sorry for the delayed response. I poked around CDC Wonder last night, for the year 2020, I found that 378,048 deaths had an ICD code of U07.1 (which is code for COVID). Of these, about 94.5% included at least one additional ICD-10 code indicating other conditions, while another 5.5% listed only U07.1 without any other contributing conditions.
I'll admit it took me well over an hour to dig that data out of wonder. Their user interface is a little clunky. Does that answer your concerns? Because I admit I'm all Wondered out.
So, yes, just about no one *died* of COVID without some other ICD code on their death certificate. And, yes, that's to be expected. Especially since the frequency of comorbidities rise with age in the population. Yes, a perfectly healthy person is less likely to die from a pathogen than a person with comorbidities. But perfectly healthy people are less common than one would expect. According to a 2010 study a hair less than fifty percent of the US population has *no* comorbidities. And one quarter of the US population has multiple comorbidity conditions (MCC).
> In 2010, 49.1% of civilian, noninstitutionalized US adults had no chronic conditions, and 24.8% had only 1 chronic condition. One-quarter of US adults had MCC (Table 2); 21.1% had 2 to 3 MCC and 4.9% had 4 or more MCC. For both sexes, older adults had a higher prevalence of MCC than younger adults. Among adults aged 18 to 44 years, men were less likely to have 2 to 3 MCC compared with women (P = .003). For adults aged 18 to 44 years and 45 to 64 years, men were less likely than women to have 4 or more MCC. In contrast, among adults 65 years or older, men were more likely than women to have 4 or more MCC.
Thank you. That's about what I expected, but I also expect that the original data (that the CDC data was compiled from) oversimplified the circumstances of death. If for no other reason, then it would take a HUGE amount of effort to dig those things out. (How do you detect arterial blockage in a corpse? I don't really think that's possible. Blood tends to coagulate after death. [I'm no expert, so I could be wrong here, but that's what I think.])
I also think that "no chronic condition" is a VAST overestimate. Try "no recorded chronic condition". Most of my life I've noticed chronic conditions that weren't serious enough to ask a doctor about. The same seems to have been true (my evaluation, I didn't ask) of everyone I've known well enough to have an opinion about on the subject. (So perhaps 8 to 10 people, but a 100% positive. [OTOH, it's easier to notice something like that if someone complains about it, so it's a highly biased sample.])
That's the most plausible counterargument I've seen, but it's worth noting that even shaving off 10 percent of 1.2 million leaves us with over a million.
Mortality due to drug overdoses is also tracked by the CDC. Deaths due to drug overdoses during the pandemic (including Fentanyl) happened at the rate of between 6000 and 6500 per month. Drug overdose deaths climbed until 2022, and started dropping off a bit beginning 2023. Last time I checked they were still falling.
Undocumented immigrants, tourists, etc., all get death certificates. So their deaths were also tracked by the CDC. But they're lumped in with everyone else. Additionally, death certificates do not include a field indicating whether the deceased was a U.S. citizen or of another nationality. Only "place of birth."
But there are studies that showed the undocumented immigrants died at twice the rate of people legally here. Given that roughly 0.35 percent of the US population died during the pandemic, and given that there were likely 10.5-11.5 million undocumented immigrants in the US during the COVID years, that suggests that approximately 77,000 of those 1.2 million deaths were undocumented immigrants. Roughly 6%.
Not likely. Most undocumented immigrants could be younger, healthier, working population and less of them would be old people in care homes. Even if they were dying double rate compared to people legally in the US, that would not be a big number.
Don't forget about exponential risk increase by age.
<Post exchange analysis of this thread. Substack sends comments to my email, so I have his pre-edited response. NoPie originally wrote: "I cannot believe that you still forget about exponential risk increase by age." NoPie was aggressively rude, I responded with his "I cannot believe with my own "I cannot believe.">
I cannot believe you didn't check your beliefs against the data before expressing your opinion.
I assumed the studies I checked would be normalizing their data, because all good demographers should age-adjust their datasets. The Minnesota study (third link below), shows that your expectations would be true for all ICD categories *except infectious diseases.* I found that to be interesting.
> Theoretically, there may be expectation of lower COVID-19 mortality among immigrants than US-born residents. Literature documents a healthy immigrant effect—where immigrants tend to be healthier than US-born residents (Kennedy et al., 2015).... In addition, in pre-pandemic times, better health outcomes among immigrants were consistent across all ICD-10 disease categories except infectious diseases and external causes (Aldridge et al., 2018).
Here are links to the studies. If you've got anything other than your supposition to counter with, I'd be interested in the some links to support your claim.
This is the study that I based my claim that undocumented immigrants died at 2x the rate of native-born US residents...
Murder quite famously went up, but probably not enough to change excess death statistics.
Traffic deaths, on the other hand, probably did change enough. They dropped during the initial lockdown period then spiked, and haven't come back down all that much (while murder did drop back down, I think by late 2022).
From 2016 to present, every year has had between 36,355 and 43,230 traffic fatalities in the United States. The lowest year is 2019 and the highest year is 2021. 7,000 deaths is not enough to make a noticeable difference in the total excess mortality number.
Overdoses had been soaring, especially since fentanyl arrived c. 2015. Overdose deaths during the covid years were very high, although it's not clear what they would have reached without covid.
Murders and traffic fatalities shot up after May 25, 2020, especially among African Americans, but that was probably mostly due to the temporary triumph of BLM over law enforcement.
Note that these three causes of death hit younger people on average than covid, so they take away much larger expected lifespans per death. On the other hand, their total numbers are quite a lot smaller than covid deaths.
OD deaths were at approx 6K/month at the beginning of the pandemic (first months of 2020, and they rose to 6.5K/month by the end of 2022. They began to fall off in 2023.
The murder rate spiked in 2020 at 6.42 per 100,000 people, up from 4.99 in 2019. Approx 21,500 people. Meanwhile in the same year <checks the NIH website real quick> COVID-19 accounted 697,000 deaths.
Since most murders occur between people who know each other, we can assume lockdowns had a significant role in the rise in the murder rate. I haven't gone over to the FBI website to check that assumption, though.
So roughly 4800 extra murders happened in 2020.
And a quick Google shows that traffic fatalities went up from ~36,000 in 2019 to ~38,800 in 2020. About 2,800 more traffic fatalities during lockdowns.
These numbers are chump change compared to 697,000 deaths from COVID.
CORRECTION! There were ~375,000 COVID deaths in 2020. The NIH website gave me the numbers for a 20-month period from March 2020 through October 2021. It seemed too high. I should have read the report more carefully. But ODs, homicides, and traffic fatalities are still chump change, against total COVID deaths in 2020, but twice as valuable chump change.
Domestic violence murders weren't up much during covid, surprisingly enough. Instead, there was a huge surge in mass shootings at black social events after George Floyd's death unleashed the racial reckoning. Cops retreated to the donut shop, and so people felt more confident carrying their illegal handguns to parties.
I don't see that in the DoJ data. But I didn't dig very deeply. If you've got some DoJ data or data from other sources, I'd be interested in seeing it. There are hella lot of reports on domestic violence up on the DoJ website, though.
ChatGPT sez:
2019 Data:
Total female victims: 1,948
Killed by someone they knew: 1,773 (91%)
Killed by male strangers: 175 (9%)
2020 Data:
Total female victims: 2,059
Killed by someone they knew: 1,604 (89%)
Killed by male strangers: 197 (9.6%)
I didn't check into male-on-male murders, and what percentage where the victim knew the perp. But yes, you're right, it looks like 4K extra murders in 2020 were not due to domestic violence. But still, we're talking drop in the bucket to total COVID deaths.
Also, you forgot to mention suicides. At one point, suicides from the lockdowns were being blamed as a significant contributor to excess deaths in 2020. But that idea didn't pan out. The suicide rate actually dropped in 2020 from 14.5/100,000 in 2019 down to 13.5/100,000 in 2020.
Sure, but comorbidity was an issue. Americans have never been this unhealthy. And 0.3% hardly matches the nightmare scenario we were lead to believe. Moreover, it's probably why you use the word millions instead of 0.3%.
To be fair, 0.3% was exactly in line with many early estimates I saw. Most of the panic was because the broad CI included >1% estimates. It was always odd to me that people continued to implicitly rely on the broad early CI estimates long after better information came along.
Overall, I agree that not only are there a lot of risk factors in line ahead of COVID, but that improvements in those other health factors are probably a better focus for preventing deaths in the next pandemic.
I used million because that's the title of Scott's post. And more nightmarish scenarios were avoided in part because of the protective measures out in place. I agree some of those measures were overprotective in hindsight - but that was hard to know at first, and the main point is that this pandemic was very real and deadly and worth taking some precautions to minimize.
Yes, if you portray COVID deaths as 0.3% of the population, it all looks rather innocuous compared to <gasp> 1.2 million deaths. But if we frame it another way, during the peak of the worst wave, we were losing the equivalent of eleven 747s full of passengers each day. We shut down US air traffic, brought the country to highest alert, and invoked our NATO treaty to get fighters from European members to help patrol our skies, all because four jets were downed and 3,000 people died. If you look at COVID deaths in units of jumbo jets, the pandemic was pretty frigging significant. But most people just shrugged their collective shoulders and complained about their freedumbs being curtailed.
As for comorbidities, it's important not to look at the US as a singular island of health patterns.
For instance, France, because of its higher rates of smoking (roughly 2.5x US), has a higher average rate of COPD, asthma, and lung cancer, related diseases than the US. Asthma, at least, was one of those comorbidities that increased the risk of developing pneumonia from COVID.
And in Germany, two-thirds of men (67%) and half of women (53%) are overweight. Hard to get an apples-to-apples comparison of obesity, though, because the EU defines it slightly differently from the US. But roughly 25% of their population is seriously overweight. Not US rates, but very high.
The most interesting comparison I took from the pandemic is that Finland has a very high overall comorbidity rate, but during the pandemic, it did better than Denmark, which has a population with lower comorbidities. Obviously, comorbidities are an important factor, but they were far from the only factor determining which populations were able to pull through the pandemic with fewer deaths.
Why not consider that pandemic restrictions may have reduced mortality from other causes. This also seems plausible. Less miles driven. Less trips taken. Less exposure to other illnesses. It’s not just a one way street.
You could have figured this out with the article's central argument: excess deaths over normal, non-pandemic conditions. If you had enough lives saved by the lack of activity that it counter-acted a substantive proportion of COVID deaths, the excess deaths count would be materially different from the COVID deaths count.
Not quite. Since the article is using the excess death count to establish the veracity of the Covid death count, this would still need to be explored. But yes, assuming we know those two variables, no need to.
Among old people in retirement homes, access to family and social networks is, in effect, life saving care, and access to family and social networks was brutally denied to millions of such people for a very long time (in terms of their expected future lifespan, two years could have easily been more than half their expected future lifespan). This effect could easily explain hundreds of thousands of the excess deaths.
Frankly, because no one fights for your life as much as your family. The other people are just paid to be there. If you take the most charitable view, they’ll do their best but they have a million other concerns. If your elderly family are in a period of prolonged medical vulnerability, you absolutely need to have a member of your family be their advocate in conversation with the system, because otherwise the system is often laggardly and obtuse.
I've heard that for end-of-life care distant relatives who didn't visit often and feel guilty are the most insistent on prolonging past the point doctors think is wise. But since these people are actually near the end of their lives (not like most people who died of COVID prior to being infected), there isn't actually that much time that the medical system can give the patient.
Not only that, but contact with family is literally what has many old folks going. Cut that off, and they have nothing to look forward to any longer and shuffle off the moral coil. Anecdotal observation but I have seen it enough to trust there is some validity to the claim.
But even more immediately, yes, lack of care. At the start of the pandemic in Canada some nursing home patients were literally abandoned by staff that fled. Found several days later covered in their own feces etc. Given their pre-existing conditions, such abandonment would cause a sharp decline in their overall health leading to much higher death rates.
Not all nursing homes experienced such drama but I'm sure care was compromised in a very high percentage, resulting in many additional deaths.
I'm sure a lot of this kind of second order effects happened, but again it's kind of ridiculous to suggest that it explains more of the surge in mortality than the respiratory virus that looks like the kind of respiratory virus that kills a lot of people. To me it mostly seems like people are unable to conceive a middle ground between the sniffles and the Black Death; since it wasn't the former, it must be the latter.
A close relative of mine died in a nursing home because there was not enough staff to ensure he was getting his meds (his condition was making it really hard for him to swallow). Previously, this was taken care of by his wife, but, when COVID started, she was denied entrance.
Sorry, that was a joke. When I posted that, I thought it would so patently stupid that no one would actually say things like that unironically, but then I read other comments here, and no longer believe that.
It's amazing how much the "will to live" impacts whether you can recover from illnesses later in life. I wouldn't have believed it until I witnessed this phenomenon first hand.
My grandmother struggled with the sudden isolation during the pandemic. Her husband had recently died and she couldn't take care of herself on her own. The isolation in care facilities caused clear health deterioration for her. We made the decision that the increased COVID risk of taking her into our home to care for her was better than her dying alone. Within days of coming to live with us she became physically better. Her ability to walk and her general gait improved dramatically, her incontinence disappeared, she was happier, she reported less weakness and a greater ability to perform basic daily tasks. Her memory improved.
Measurable, tangible health improvements.
When circumstances prevented us from keeping her at home, she went back to a care facility. Her health rapidly deteriorated, she was quickly moved to a wheelchair, and she died soon after. She told me, "I don't want to live anymore," both when she was in the facility before coming to our home and afterward.
A friend of mine is a mortician. In December a few years back she mentioned she was going into their post-holiday 'busy season'. This was before my experience with my grandmother, so I was shocked that people didn't die at regular intervals.
She said, "No, a lot of people hang on until after the holidays, and then they just lose the will to live." Remember that when you're old you tend to have a lot of old friends, too. If all your friends die, but you don't see other old friends at the funeral because they discontinued funerals, that's a highly significant social factor that's being withdrawn.
I think Scott implied in this post that the 1.2M number must either be fully explained by indirect non-infectious factors, or we must accept the 1.2M number as a result of infectious spread. I doubt he would maintain that stance if pressed, but the defense he gives above strongly implies it. I think it's possible that a non-trivial number of deaths were the result of COVID policies that weren't necessary, and not the result of the virus itself. Those deaths may track with reporting because when we saw deaths go up we pushed harder on the harmful social policies. If the policy-related death number is, say, 200k that's a pretty big number that deserves its own reckoning.
This is exactly right. It seems to me that Scott knows that the data on cause of death has been fudged so heavily (or at least altered in a direction that leaves it untrustworthy or unpersuasive to skeptics) that he can't rely on it. So he goes to excess deaths (which have their own issues with assumptions and statistical massage). But this is not very helpful! Massive societal interventions occurred almost exactly in parallel with infections. Accepting the excess at face value, he's left basically saying ipse dixit "and nothing else could plausibly affect this." I think there are lots of small factors that all could pull in the same direction, and I think that little to no good quality science was done to even attempt to quantify.
As an aside, condolences on your mother's situation. We were in a similar place where my father had died one year before covid and my mother was still depressed and learning to cope. She watched too much TV news, got scared, shut herself up for several months, and nearly went nuts. She got through it fortunately, but she now regrets the lost time and is thankful she didn't hide for longer. I did encourage her later on to get the vaccine when available since she was in the risk demographic.
Allow me to push back on points I largely agree with: there's a rush of proving too much in this analysis. Some places were more interventionist than others during COVID. If most of the deaths were indirect, we'd expect these locations to have much lower excess deaths than lockdown jurisdictions. Last I checked, the result was closer to "no effect".
There's some contamination here, of people self-isolating out of fear. But then if we're talking about government policy, it's a fair comparison.
There are two possible interpretations:
1. COVID deaths that increase from lockdowns are offset by a reduction in deaths of despair.
2. Deaths of despair aren't a significant proportion of the excess deaths statistic, but also lockdowns didn't affect them either.
I'd like if there was an easy story to tell here. It seems clear there was a lot of excess suffering during the pandemic, in addition to the extra deaths. It's not clear to me whether many of the trade-offs were worth it. This is why a simple number, like 1.2 million, feels like the wrong 'reckoning'. Like, if we hadn't done anything would we have still settled at 1.2 M? More? Fewer?
The real reckoning is that, once again, despite a crisis and a massive government response, we don't really know which of our efforts were worth the costs and which were worthless but still cost us. That's the big failure. Institutions focused on getting everyone to distance 2 meters, fine, but never did the cluster randomized trials to test whether that's effective, if so how effective, or if 2 meters is the right distance. So what do we do next time? Argue about the same unknowns and never get any less wrong.
Is that really the most important? I guess other things pointed to as big causes of mortality (smoking, diabetes, hypertension, obesity) are likely to have started before you're elderly and there's less to be done about it now (although I suppose nowadays semaglutides actually can treat the chronically obese).
My understanding is that men's lives shorten when their wives die, but for widows it's the other way around (sometimes phrased as men sucking the life out of women).
Yes! Social life and meaning. We'll all (hopefully) be there someday, but it's hard to understand untill you're post-retirement. My dad used to visit with his mother once a week. She complained that he was "never around", much to his consternation. It was a personal sacrifice to him to make time to see her, given everything else he had going on.
But a two hour visit seems like a long time when you've got a full weekend already. When you've got all day, and afterward the whole week ahead of you, time crawls slowly. A week to a 40yo can feel like a month to an 80yo. This is the toll retirement takes on your mental health. When there's nobody relying on you day to day, you lose your edge. It's not an extended vacation. It feels like solitary confinement.
When you say, "hundreds of thousands", are you talking 200k or 800k? The former might be in the noise, but in the latter, you wouldn't see the clear correlative pattern in the data the Scott cites.
If your causal model is "intervention -> lack of access to families -> old folks die 'cause sad a la Padme", then you still need a model for the cause of the interventions. This was pretty clearly COVID cases and deaths, especially in the early years. But now COVID deaths are causing such a ruckus that people do a lot of NPIs, which brings us back around to "COVID is actually doing most of the people killing".
This would predict more deaths in retirement homes, while plain old viral disease would predict fewer deaths in retirement homes, so this hypothesis is testable
Yes, this is one of several testable hypotheses. For the record, 1.2 million deaths (and hundreds of millions of survivors) is a lot, but a good researcher can review the details of about 100,000 deaths - after spending a few days determining how to randomize the events leading to the deaths in question - in about a month of research. 'Covid deaths in the western world' is not an impossibly obscure historical event, and I trust that eventually medical researchers will understand what went wrong.
The way test the size of the two effects is by looking at when the deaths in old age homes happened: did they short follow the five main waves of covid or did they happen randomly throughout periods when they were denied visitation.
I can see either argument, so somebody who feels strongly in favor of one side or the other should test.
That is not a good test, because of course those who lost the will to fight Covid were not going to die from that lack of will when the waves of Covid were at minima, rather than maxima.
Steve, because, as you know (I know you know who Bruce Charlton is, and you probably have read his discussion of how flu was considered, fifty years ago, to be the 'friend' of the elderly), loneliness on its own did not kill, but loneliness combined with an attitude of "I don't care anymore" is what killed when old people whose endorphins were near zero got flu symptoms that they did not anymore have a great desire to struggle against (this is simple understanding of how humans work and I am surprised you said "right" to an obviously falsely posed question --- why did loneliness kill in rhythm with reported covid deaths).
I mean , you are too smart to need me to spell this out, but just in case you need it to be spelled out ---- of course the lonely people died more when the waves of covid were at their worst. Nobody said they predominantly died of loneliness, they died of not wanting to live when they were faced with a wave of covid.
Very plausible, but this might merely decrease the "Covid mortality" as a number. It does not decrease the overall "seriousness" of the pandemic, or reduce the reasons for e.g. requiring people to wear masks.
Scott's argument in the first place was, like, "remember the 1.2 million people who died because of Covid?" - and you can't deny that also those 10% of deaths were directly caused by Covid, can't you?
If you argue ".. but they didn't die of Covid, they died because our health system was unable to cope with the sudden outbreak of Covid" - yes, sure, but maybe quite a large part of those other 1 million US deaths (people who died FROM Covid) were due to the fact that the health system was not ready for the pandemic.
There are those who would quibble that it’s unfair to characterize the health system as “unready for the pandemic” as opposed to “unready for the panic stirred up for various non-medical reasons in the face of a mostly unremarkable disease”.
I don’t *think* I am one of those, but I’m apparently sympathetic enough to that quibble to point it out.
Do you remember when we were hearing about hospital beds filled and not enough ventilators? People were there because they were sick and having trouble breathing.
There was plenty of panic, too, but someone would have noticed if all the hospital patients had just been having panic attacks.
I don’t think anybody of note ever *denied* that there was a disease.
And I was talking about a societal panic, not claiming that anyone claiming to have Covid was actually having a literal panic attack instead.
As an example of the societal panic, I gather that in retrospect the consensus is that we used respirators rather too often.
But I’m not arguing with Scott’s overall point myself — I think it’s quite likely that American did have in the order of a million deaths that can plausibly be blamed on Covid itself. Whether the exact number is 750K or 1.3M is out of my wheelhouse.
A lot of areas kept beds open and reduced availability numbers *in case of* needing them, but ultimately never filled up. Source: family that works in hospitals.
The sheer volume of nurses recording Tiktoks while at work was taken as anecdotal evidence they really weren't that busy either, but it's not a great metric.
Several field hospitals set up in my vicinity, one of them a tent city in large parking lot. No patients ever arrived. On the other hand, hospitals were in financial distress and laid off employees because they didn't have enough patients.
There was a huge covid death toll in New York City in March-April 2020, with 15,000 deaths in April alone.
But the "lockdown" started in mid-March started to work about one week into April. I recall a late-April 2020 New York Times op-ed by a NYC ER doctor. He remarked that background noise all through March and the first week of April was the sirens of ambulances arriving with covid patients. Then, IIRC, about 1pm on April 7, 2020, the sirens mostly stopped.
The health system spent a ton of pointless effort saving, say, patients from the local hospice instead of instituting an age/condition-based triage instead. Example: survival rate of 70+ year olds in ICU in 2020 was <50% but there were still cases where 35 year olds from (say) a car accident had to wait for an ICU spot.
We have a hard time rationing kidneys and livers; denying an old person an ICU bed because they have a baseline survival rate less than. 50% is a pretty tall order.
I was in my residency training during the early pandemic, I would encourage you to really think about how you would go about getting someone, say 72 years old, out of the icu or hospital to open up space for someone else. You get patient transport to bring them to a van and them drop them at home… and then what? They come to the Ed and you tell them you will stabilize according to EMTALA and then… send them home to do it again the next day? Essentially telling patients they should die every day at work would be a psychologically devastating experience for providers. It sounds nice on paper but makes no practical sense.
Also small quibble but I do not think you understand what hospice is
I think there is a mistaken image here of people being “turned away”- the car accident victim is also taken care of here. The issue is that if the icu is full (say of older Covid patients), they would be stuck physically in the ED where care is not going to be as tightly managed. Obviously also a bad situation, and perhaps outcomes are worse, but very different from telling people you won’t try to provide standard of care
How about moving the old Covid patient back to the ED and moving the accident victim to the ICU then? I've no idea if that would have made sense; I don't really mean to make any assertion about what happened or what should've happened as I don't know much about it, I was just going off myst_05's and your comment.
I didn’t say it would’ve looked pretty. But step 1 would be to suspend EMTALA and all other such laws until the emergency is over.
I do know what it is and I also remember crystal clear that there’s been numerous reported instances of people on their deathbed being taken to the hospital after contracting the virus during the initial March-May chaos.
I suppose I still don’t have a sense of how you see this playing out on a patient by patient level. If an older patient refused to leave the hospital because they were still critically ill, does security pick them up and carry them outside? And if this were logically solved, wouldn’t removing EMTALA encourage hospitals to kick out people with no insurance or Medicaid/medicare rather than the elderly?
If someone’s in a critical state how are they “protesting” anything? You move them out of ICU into the regular hospital or if that’s full, into a field hospital (kind of like the ones setup in stadiums and whatnot in 2020). If they’re violently trying to stop the doctors… there’s a whole array of medications at the hospitals disposal to make a person calm down, no need to make a scene. But the vast majority of those who’d be removed would be frail 80 year olds who’d otherwise have another 3-4 years to live, slowly withering away in a retirement home.
> wouldn’t removing EMTALA encourage hospitals to kick out people with no insurance or Medicaid/medicare
Some unfairness would be present temporarily yes. Thats what happens in a crisis.
That was the huge fear justifying lockdowns: that hospitals would be so overwhelmed by covid patients that other patients would deny for lack of care.
A couple of things happened, though: to my surprise, hospital administrators turned out to be surprisingly good at deal with major surges in case loads. And public and private responses to lower risks of infection proved successful and blunting the worst saves of infection.
My great aunt died from cancer in 2021 and it was specifically blamed on her chemotherapy being delayed by two months during the start of Covid - but this was in Russia with a much more cavalier attitude towards healthcare, so I don’t know how prevalent this was in the U.S.
It is certainly possible that people died because of Covid even without actually contracting the disease, but Scott's analysis compares Covid deaths to the increased mortality, and the numbers line up. Unless the numbers are being faked, it is hard to see how deaths from Covid aren't really about 1.2 million.
But there are also various pandemic related behaviour changes things that would make excess death go down. Such as fewer road deaths. Heck even suicides went down during lockdowns.
My memory is that traffic related deaths did not decline which was a huge surprise given decline in ave miles driven? Meme key ain’t what it used to be though…
My memory is that traffic related deaths did not decline which was a huge surprise given decline in ave miles driven? Meme key ain’t what it used to be though…
Routine screening rarely prevents deaths on the timeline you're suggesting. Emergent care for heart attacks, strokes, gunshots... maybe. But not routine screening.
When trying to estimate the effects of NPIs on health outcomes during the COVID years, folks often fail to examine the counterfactual of "How do people react in a COVID world where there's no government effort to encourage or enforce NPIs?"
As a result, it's rarely clear whether folks who claim NPIs are responsible for excess deaths (rather than COVID directly) are saying, "The Government erred in enforcing NPIs", or "The Government erred in encouraging private organizations and individuals to use NPIs" or "People on an individual level reacted irrationally to COVID" or something else. It's not exactly a motte an bailey; it's more just a lack of a precisely stated hypothesis.
I don't think there's any government (or "elite") response that wouldn't have resulted in massive disruption to all kinds of services, including nursing homes, which will serve for a useful example. If half your staff is out sick because they have COVID, and someone dies because they're receiving a lower standard of care, is that death "caused by COVID"? What if people called out sick but wouldn't have absent strict Government guidelines that were in place because of the pandemic? What if the guidelines were put in place by the nursing home w/o government intervention because they were leery of litigation caused by staffing with sick nurses during a pandemic? What about if the nurses were just very worried about this new disease and weren't willing to risk giving it to their patients?
My point is that there's a lot of causal models you can consider for how people could die during a pandemic due to indirect effects from it. Some of those pathways became more or less likely due to the specific set of NPIs, elite message, and cultural circumstances we found ourselves in from 2021 - 2024. But those specific outcomes can't be investigated in a vacuum without considering the counterfactual of what pathways become more or less likely with some different posited set of NPIs, elite messaging, and cultural circumstances.
So even if 120,000 people died from 2021 - 2024 because they were waiting for care, that doesn't answer the question of whether those deaths should "count" as COVID deaths or not.
If we hadn't paid attention to covid at all, not much would have changed in our lives.
Some old and otherwise very sick people would have died more than usual but for a general person it is on the level that we barely happen to know such cases personally. Now we would be discussing and talking – there was a covid spreading around 5 years ago. Does anybody know who has died from it? Maybe an average person knew 1 or 2 old people from his family.
People working in healthcare would have noticed more people dying suddenly from a new type of respiratory virus. Some hospitals would have experienced overload, even more than they happen during nasty flu seasons. The number of deaths from covid as reported by Scott is real because people died indeed.
Provided that the government had allocated resources to deal with overload of hospitals and quick development of vaccine but without creating any panic, the timeline would be exactly the same except that we wouldn't have had any lockdowns, school closures or travel restrictions. We wouldn't have caused crisis in economy and the society would be more cohesive and less split about unnecessary restrictions.
Obviously, it mattered to people who died. Now I will saying something that will make blood boil to many people. Sweden's example showed that the number of those deaths would not be much greater in either case. In fact excess deaths would be lower all things considered.
If people were afraid of getting medical treatment and died of other things because of that, then wouldn't we see the excess deaths be less-closely related to reported covid deaths? Either it'd be correlated with lockdown measures (if people are afraid of being isolated in a hospital) or with news stories about how bad covid is (if people are afraid of catching covid).
I know someone who died of a heart attack during the pandemic, because he didn't seek medical attention due to fears of dying alone in a hospital due to isolation measures (so instead he made his wife wake up to him dead in bed beside her - not cool to do to a partner). So I'm not saying this didn't happen, but I doubt it was a significant fraction of excess deaths.
I have heard from more than one person who had to fight to keep COVID off a death certificate. "Oh, it was because of delayed treatment caused by COVID!"
Also, of course, there's nothing to prevent an original outbreak from being followed by a wave of deaths from the lockdown and other reactions to COVID.
My boss died from this. He had a heart condition that he had a surgery for that generally calls for three days of observation afterwards because of a known complication that sometimes occurs afterwards. Instead, he was sent home immediately after the surgery and died that night from the known complication. I guess maybe he would have died from it anyway, but presumably it's something that can be dealt with in the hospital or they would not normally keep them for monitoring.
As for iatrogenic deaths, I would expect more medical errors from overworked and overstressed docs, not fewer. Same with telemedicine, some things that have diagnostic value don't transfer across the screen (e.g. ease or difficulty of movement, various smells).
Spot on. While I understand there's some debate about the precise numbers of deaths (especially in countries with poorer record-keeping), it's frustrating to see people pretend that COVID wasn't a big deal.
I think that's a result of the overreaction and counterproductive measures (and sometimes just spiteful measures) put in place in response to the pandemic. The reality is that the pandemic was a really bad global tragedy that may have been completely avoidable depending on the source of the virus, and the response to the pandemic was a more or less global tragedy, maybe not as bad as COVID but maybe worse depending on how you count the economic impacts, that was completely avoidable.
We more or less aren't capable of having even slightly nuanced public debates, so I think to a lot of people conceding that COVID actually was really bad feels like conceding the argument before it begins.
I certainly wouldn't be surprised to learn, at some remote future time, that all the chaos that arose from Covid, in multiple fields, actually killed way more people than the condition itself.
Yeah we now all have Covid Rage Virus. It kills dialogue, fair-mindedness, goodwill towards others, common sense, friendliness, and some relationships. May be worse than covid itself
What's even more frustrating to me that even the contingent on board with it having been a big deal is lukewarm at best about ending gain-of-function. Sure, maybe this pandemic wasn't caused by a lab leak, but the next one very well might be, but nobody gives a damn.
People are allergic to nuance, is a lot of it. It’s not enough to criticize the response to covid, they have to take it to the extreme of pretending it was all fake news.
There's certainly room for debate about "with" versus "of."
There's the old meme, of course, of a guy halfway through his car's windshield, bleeding out, and someone with a microphone asking him "so when did you come down with COVID?"
But it's the same on the other side -- a lot of people on the "with" side seem to be doing the equivalent of "sure, an eight-ton rock fell on him ... but he had diabetes!"
My mother was in her late 80s in mid-2020. She had numerous health problems.
Then she got COVID and was dead within ten days.
Did those other health problems contribute to her dying instead of recovering? Absolutely ... and the death certificate says so, listing heart problems and high blood pressure as secondary causes of death. If I get crushed by a Mack truck while crossing the street, that was my main cause of death even if I was a walking heart attack / stroke risk.
I don't think such memes are actually worth bringing up. I haven't seen any actual evidence that traffic deaths were being miscategorized as caused by COVID, but people keep handwaving to that effect.
I, for one, find it frustrating to see the denial arguments equivocate between “covid statistics include deaths happening for unrelated reasons” and “clearly nobody is claiming this unrelated cause of death was being counted as covid, that would be silly and irrelevant”. I do realise it is different people saying the different things, but the overall combination is very draining.
And people also handwave that if there were any comorbidities, then it wasn't COVID that did the killing.
Those are the extremes. I agree that there's reasonable skepticism as to whether any particular death was "mostly" due to COVID or "mostly" due to something else. Some people disagree, on either end, and some of those disagreements aren't really very reasonable.
In my mother's case, there were comorbidities, but there hadn't been any recent emergencies with those comorbidities, so it's reasonable to think of COVID as the "tipping point" cause of death.
How many others got misidentified and not removed because they didn't receive mass media attention, who knows. But I would be highly skeptical that the "COVID traffic deaths" would be more than a couple thousand at absolute most, and even that's on the very high uncharitable end of estimates.
My understanding is that deaths attributed to traffic accidents (rather than COVID) also rose, and the common explanation was that with less traffic cars were driving faster, while Sailer argued that after George Floyd there was a decline in policing (Scott also argued that, he might have just focused on homicide). I was going to suggest look at the total number of traffic accidents and see if the fatality rate per crash changed, but if crashes were up because vehicles were driving faster, then you'd expect that to cause an increase in the fatality rate by itself and it could be hard to detect a fraction being misclassified as COVID deaths amidst that increase. I don't think it's impossible though. COVID deaths vary a lot by age, in a different patterns to traffic & homicide deaths. Sailer has also written about different patterns by race following Floyd, and while there was a time when COVID deaths varied by that as well, I don't think that persisted.
I don't really understand what you're saying here. Let me pick a concrete example to discuss: someone is 82, and has COPD (a complication of smoking that leads to chronically poor lungs). They come down with COVID and die 8 days later, because of respiratory failure (suppose they weren't an ECMO candidate). Suppose that, if they hadn't had COPD, then they wouldn't have died. Are you saying that they should be counted as a COPD death, rather than a COVID death, because they wouldn't have died if not for the COPD? That doesn't make sense, because they also wouldn't have died if not for the COVID infection. So you could say that they died because of COPD, and they died because of COVID, but you can't say that they didn't die of COVID without also saying they didn't die of COPD. If you say they died of neither COVID nor COPD, then I'm not sure how useful your notion of causation is.
They should be counted as so-and-so percent of a COPD death and statistically, X number of people dying this way should be counted as a certain number of Covid deaths and a certain number of COPD deaths, where each one is less than X.
We're trying to figure out how many people would have been saved if we were able to prevent COVID cases. So what we care about is the number of deaths that happened, but would not have happened if the person involved didn't have COVID - our hypothetical person is an example of this. It's also correct to say that our hypothetical person should be counted among the people who would have been saved if we were able to prevent COPD, but I don't think anyone here is talking about the costs of COPD. The discussion here is about the costs of COVID.
(To use the car crash analogy, someone walking across the street absentmindedly and being hit by a distracted driver could be said to have died from crossing the street absentmindedly and the driver being distracted. In a discussion of the societal cost of distracted driving, this death should be considered as 100% part of the social cost of distracted driving. A policy that prevents distracted driving would have prevented this death, for example, even though a policy to prevent absentminded street-crossing would also have prevented it.)
I think I need a little more than "someone somewhere profited from this pandemic" in order to entertain a theory where significant portions of the pandemic were faked. An obvious question is, for example, whether those selling the shots also faked the pandemic in Africa, which also saw significant excess deaths?
"...in order to entertain a theory where significant portions of the pandemic were faked."
And note that the faking and or conspiracy needs to be world-wide. Europe, China, Australia and New Zealand had to be in on it, too. As well as a lot of other countries. Maybe not Sudan.
Yeah. Did the weird lobbying corruption between pharmaceutical companies and politicians contribute to the rabid support in favor of vaccines and against literally any other possible cure? Almost certainly. Did it lead them to fake Covid or its primary attributes? Almost certainly not.
If I was a politician and had to choose between supporting either the methos of avoiding a disease or methods of curing the disease, I would, of course, prefer avoidance. Although I'd rather also support the cure, just somewhat less. Avoidance is better than cure because a disease, before it's cured, is likely to cause tissue damage in your body, much more than e.g. vaccines that also cause a little tissue damage.
this is really, really silly: vaccination is far and away the best approach humans have developed to addressing viral illness if you look at the track record of the past century. Anything other than prioritizing vaccines would be a very strange policy.
Anxiously awaiting sci fi where we live in a post scarcity utopia, but for a hundred powerful cartels that are constantly injecting planned obsolescence into everything to justify their trades. But the one man not in any secret society discovered their secret and the whole house of cards is about to come tumbling down!
"Excess deaths" is not a measured quantity, to compute it requires a fairly sophisticated model of expected deaths. This, perhaps, explains why a number of countries, including Sweden, reported negative excess deaths during the covid pandemic.
If a novel disease arises there will be a large incentive to treat it. Whoever develops that treatment will profit. This is not a problem. It's the way the system is designed.
Should people not be paid for developing life-saving medical treatments? I have my criticisms of pharma patent trolling, but developing a treatment that craters mortality from a widespread disease which kills 1-2% of those infected seems worthy of compensation.
Criticizing the pharmaceutical companies for producing life-saving medical treatments is a really bad idea. IMO, the vaccine makers should have gotten a lot *more* money, maybe a percentage of the GDP loss avoided.
Obviously we need to take care not to incentivize them to produce ineffective or harmful treatments, but that part of the system seems to have worked quite well -- though I do wonder if perhaps in a situation where hundreds of thousands are dying every month we should find a way to reduce the required testing time a little more. The COVID vaccines were created in January of 2020 but not deployed until December of 2020, mostly because it took ~8 months to test them. With the benefit of perfect hindsight we can wish that we'd put them into production immediately and started vaccinating medical personnel in maybe March or April, and mass vaccinations in June or July. Of course, that would be foolish because they might have been ineffective or dangerous; testing is important. But we can and should ask how much risk would have increased with shorter testing periods and whether we should have traded that risk against the ongoing deaths.
In the future, as we gain experience with mRNA vaccines, I'm hopeful that we can establish baseline safety standards for the mRNA carrier component so all we have to do is differential testing of the effectiveness of the encoded antigens. That probably wouldn't reduce the time it takes to test for effectiveness, but it might significantly reduce the time it takes to test for safety (which has to be done before effectiveness testing can really be done). Also, using a standardizable strategy like mRNA might enable standardization of production facilities, enabling production lines to be converted in days, maybe hours. Similarly, it should enable standardization of shipping and storage. Taken all together, it seems possible that mRNA could make it possible to begin delivering vaccines for a new virus in as little as two months after the virus is identified and isolated.
And we really want to make that sort of rapid development and delivery highly profitable for pharma, because it would be extremely beneficial for humanity. Imagine if every doctor's office and pharmacy in America had ample stocks of the vaccine in March 2020. We'd have had no lockdowns, no masking, no kids struggling to learn at home, no supply shock... most everyone would have just gotten a shot and gone on with their normal lives, avoiding a million deaths, and trillions in economic losses and federal deficit spending. Pipe dream? Maybe not.
I also believe that we could have started vaccinate people against covid in July or August, 2020.
It could be with less known safety, more experimental while other studies are being done but for the most vulnerable it could still be a big gain. The benefit/risk ratio would have been quite high.
It wasn't done mostly because covid wasn't such a big deal. It was causing more panic than it deserved.
The UK removed covid from High consequence infectious diseases list.
It is just formal decision but in practice experts in the field didn't think of covid as something that requires disregarding usual safety rules for vaccine trials etc. This highlights the disconnect of what the society including most politicians and rationalists thought about covid and what the highest experts in the field thought about covid.
Obviously, most people on this site disagrees with experts. But that's exactly the point, disagreement with experts due to emotions and not expert knowledge or thinking.
Very few people are antivax. Maybe 5% of parents don't vaccinate their children. We don't have antivax laws, yet. Who knows what will happen with Trump.
Whereas lockdowns were wrong and yet forced to all as the policy. Evidence deniers had won temporarily.
Instead of sounding like a literal strawman saying "DO YOUR OWN RESEARCH SHEEPLE", do you want to steelman yourself and provide some information about the royalties and how it goes beyond "pharma company makes new vaccine, gets paid"
'Go research this phrase' generally means that the point isn't for you to learn a true fact, the point is for you to encounter the same propaganda and go down the same rabbit holes and fall into the same community that the speaker did in order to get them where they are now.
(But seriously, when I read this comment I was confused because it took me a few moments to parse this as about a vaccine rather than a photograph. Neither set of royalties causes deaths though.)
Good analysis, and far more than I would have bothered to do, which is “excess death rate, QED.” I think when numbers get large it is very hard for people to have an intuitive sense of what they mean, so they latch onto poor heuristics like “do I know anyone who died of Covid?” Relevant: the average American only knows 600 people (according to the NYT).
The average American may know only 600 people, but each of those people has ~2 parents, ~1 sibling, ~4 cousins, ~1 spouse. What's driving my skepticism on these numbers is that nobody I know in my office reported that their mom died of COVID, or that they needed a day off for their aunt's funeral. I didn't observe an uptick in "R.I.P. Uncle Joe" posts from my 300 Facebook friends. I'm not going to argue that my experiences are better than hard data, but still, nothing in my experience is consistent with the data.
This is Forbes data from Jan. ~1% of used car sales in 2023 were for the Chevrolet Malibu. More than 90% of American households have a car, and nearly a quarter (~22%) have three.
It stands to reason that a buttload of those households have Chevy Malibus, and I know I don't have the math skills to just figure out how that shakes out but I do know I see plenty of Malibus on American roads with me.
Shifting gears, I can say from experience in my work that, where we look for (among many other things) size differences between the pupils of the eyes. It's anecdata, but around 25% of Americans have a substantial enough difference in pupillary size that we have to investigate it. It nearly always ends up being nothing, a subclinical data point that enters the chart and sleeps there.
The point I want to make is that people's lives are full of facts and statistics, much of which is publicly available. We nevertheless miss that data or discard them because it's not relevant, apparently useful, or doesn't serve some immediate purpose. But, those rare things happens *all the time*, because there are so vastly many of us.
Did you know that migratory birds have been observed having an average of 3 snails on them? Over the long epoch of several million years, snails accidentally hitching rides on (or inside of) birds could explain much of the diversity of snails on Hawaii, a set of islands far removed from, well, anything. How in the hell would you know something like that unless you were A) a malacologist or B) very bored this morning while waiting for patients to filter in?
We only know this stuff because we take the time to look. It doesn't rise to conscious awareness because there's no obvious need for it, unless you're motivated to look or so bored that you'll read about snails.
Okay, but whether my secretary needed to take a few days off to attend her sister's funeral is something that I actually do have reason to pay attention to, unlike her pupil diameter or the number of snails on her boobie.
Some years I go to four funerals and others I don't go to any. The claimed increase in the death rate is 20%, or maybe a little less. I'm not convinced that this would be noticeable at a personal level, at least not over a short period of time. And then, as I get older I expect I'll probably go to more funerals anyway... Population statistics are very different from personal experience.
I don't know what the mean, median, mode, and standard deviation of funeral attendance in your life is, but I bet you'd be skeptical of the 1.2 million excess death total in a year that you went to zero.
If you average 2 funerals a year, then the chance of a year with none is 13%. If an extra 500k people died in the USA in 2020 then that means the chance of no funeral is 9%. A difference that is far too small to draw any conclusions from, on a sample size of one.
In my own personal network. My kids' pediatrician died of covid. My husband's friend lost his father (not sure how old but I think under retirement age). Our family friends in Queens NY lost their grandfather to covid. I followed composer Sarah Duke on Instagram, her husband was young and healthy and was brutally hit by covid and she shared the whole journey until his death.
I remember vividly seeing pictures in March or April 2020 of a funeral home in Brooklyn with covered stacks of bodies because they couldn't keep up with the funerals fast enough. My social media feed was full of quiet small funerals outdoors from friends of friends who lost relatives. That was only the first few months of the pandemic really but it makes me baffled why people don't remember those days. It was publicly shared information.
I expect people know most of the 600 very tangentially, so that they are unlikely to hear about their family members dying. And of the people they know more closely, the 600 often already includes their family members.
The excess deaths were some 20% of the normal amount of deaths, so the uptick shouldn't have been obviously noticeable.
How many Facebook friends post about a death in any given year? It might be interesting to actually gather statistics on your feed, rather than going off a gut feeling about how many you think you see in a normal year, and how many you think you saw in 2020 and 2021.
There were entire subreddits devoted to posting the dying Facebook posts of “uncle Joe”. In a lot of cases the family would be completely unwilling to admit that their loved one died of Covid because they had for months been loudly proclaiming to their echo chamber how it was a hoax to begin with. No one wants egg on their face while grieving.
The fact is you probably do know folks tangentially related to you who had a loved one die of Covid, but the same social milieu that makes you likely to question the official figures would stigmatize advertising your loved ones death from the virus.
My observation was not that there were few people stating that Uncle Joe died of COVID. It's that I saw few reports of Uncle Joes dying. And given that my social milieu - Facebook in particular - comprises mostly educational (very liberal college) and professional (left leaning field) associates, it skews liberal beyond second-degree consanguinity. I feel like I was paying pretty close attention to whether anyone I knew had relatives dying because I was very concerned about my elderly parents and in-laws and my infant contacting COVID.
I'm not using my experience to dispute the data, but at the same time I'm not going to accept someone telling me that experience didn't happen the way I remember because of some aggregate data.
I’m not sure what your point is. If you don’t dispute that the deaths happened, then you need to accept that your experience is an artifact of reporting bias or exists as a statistical outlier.
Also, your Facebook newsfeed is not a random sample. Even if we grant that you were putting an insane amount of your attention into keeping track of the health status of your vague acquaintances, that information very well may not percolate its way to your newsfeed in the first place.
“I like these less because they’re class- and location- stratified, so your chance of knowing them goes up or down a lot depending on your own characteristics.”
But COVID deaths *were*, in fact, class- and location-stratified, certainly more than MS - further explaining how some people (think they) know nobody who died of COVID.
Example: my aunt worked at a nursing home in NY which had something like 16% mortality in the March - May 2020 wave. She knew like 30 people who died of COVID.
Most of the conspiracy theories at this point are elaborate and require a great deal of complexity. I am not sure there is much value in arguing against them.
One of the worst parts of this community is how people will, without providing any context or explain how it is relevant, lazily link to an old post from Scott. Both lazy and condescending.
The post in question is Scott arguing that conspiracy theories are worth arguing against rather than ignoring, even if they seem very wrong. The current post is an example of Scott doing exactly that, and the commenter above is (much more concisely) saying roughly what Chris Kavanaugh was before.
I think that conspiracy theories are worth arguing against, but only by people who are already experts on something related. If the topic is new for you, it is probably not worth your time researching everything from scratch. You would basically have to out-learn the conspiracy theorists, while the expert is already ahead of them.
So I am happy with Scott posting against conspiracy theories, but there is no way I would try researching the same thing to make my own informed opinion on the topic -- it would take literally years to get to a useful level of medical knowledge, and I don't have that much free time.
Just because "many of [you] in the audience" approve of lazily posting a link and giving no context or synopsis whatsoever, doesn't mean it's good practice to lazily post a link and giving no context or synopsis whatsoever. This place is supposed to have etiquette above that of your typical subreddit; and "Scott said this, QED" is below the level of thought this place is supposed to exhibit as well.
A related argument (to the died of covid / with covid controversy) is that the death of an 86 yr old is not the same as the death of a 34 yr old: in the first case covid merely hastened what was inevitable, depriving the old person of at most a few low quality-of-life years. In a sense an old person is always dying _with_ whatever condition is the proximate cause of their death. It would be interesting to see how many quality of life adjusted years we collectively lost due to covid and compare that to car accidents or smoking.
You seem to assume there is a social benefit from years of college, but Bryan Caplan's "The Case Against Education" argues otherwise. Our own host has discussed how wasteful education for doctors like himself is quite popular even though the example of Ireland shows undergrad isn't necessary for them https://slatestarcodex.com/2015/06/06/against-tulip-subsidies/
My one link was to Scott Alexander's post about whether doctors need to go to undergrad first. I merely referenced Bryan Caplan, who was making an argument against his own interest as a college professor. If you want actual studies on the social vs private benefit of education, here you go https://www.econlib.org/archives/2013/10/international_e.html
The fact that you enjoyed college is not evidence against that. You might enjoy it if the government provided you with hookers & blow, but that would just be a pecuniary transfer for your consumption. College is heavily subsidized on the assumption that there are spillovers to the public good.
TR wasn't even talking about "social benefit." He was talking about quality of life. You're the one who brought up social benefit and it was a complete non sequitur.
"You seem to assume there is a social benefit from years of college..."
The two things being (implicitly) compared here are not two years of college vs. two years doing something else such as working or being in the military. It is two years of college while either (a) being on campus and interacting with the people there (profs, fellow students, police ...) or (b) doing this all via Zoom from the student's childhood bedroom.
(a) is a much better way to spend two years of one's life than (b). Especially if the student has carefully chosen the college to be near, say, a beach (e.g. Santa Barbara Community College, UCSB).
College, and young adulthood more generally, is when people are (hopefully) building the foundations for the rest of their lives: getting qualifications, gaining experience of independent living, perhaps even meeting their future spouses. Even if you think we send too many people to college -- and personally I'm inclined to agree on that point -- majorly disrupting someone's life at this stage is going to potentially have far bigger ramifications than letting his grandmother die at the age of 82 instead of 86, callous as it sounds.
And of course, it's not just college students who are affected. Anecdotally, lots of teachers in both the UK and the US report a big uptick in mental health problems amongst their students, and whilst maybe this would have happened anyway (anxiety and depression were on the rise even before COVID), it's at least plausible that spending several of their most impressionable years being kept away from their peers and told that they might end up accidentally killing granny if they went outside could have exacerbated the problem. For older people, lockdowns might mean a two- or three-year delay in getting married, which in turn might mean they're now too old to have children, or too old to have as many children as they otherwise would. And so on. Life isn't like a computer; you can't just switch it off and switch it on again and expect it to keep working like before.
Not only that but grandma's QOL during the additional 4 years takes a bit as well: she can't see family, she is essentially a prisoner in an institution, and instead of seeing her grandkids enjoying college and building a foundation for their adult lives, she seems them holed up at home listening to Zoom lectures.
This is correct and massively under-discussed. Extended solitary confinement is a terrible punishment imposed on the worst prisoners. Yet not only is it dismissed from the calculation of NPI costs, people actually pretend that the elderly should be grateful for it. Someone who's 85 has probably 5-7 more years left. Locking them down for a year or two to supposedly avoid Covid not only plausibly hastens their demise but also turns a significant fraction of their time into a life hardly worth living.
I view the idea that letting someone older die 4 years sooner than they otherwise would have (an underestimate to be sure, but we can run with it) is not worth the in-person schooling experience of a 19 year old as monstrously callous. It's strange to me that you take it as self-evident.
If you were told that you had a choice between a 19 year old having to do freshman year remotely at a college or putting a bullet in a 80 year old's brain, you'd think the choice is obviously do the latter because the value of an old person's continued life is minimal?
That's not what I meant. I mean in practice in the real world, who would get to decide that without creating incredibly terrible decisions. Even if everyone could agree on a definition that covered all use cases (which is impossible) there would surely be abuses of that system.
I agree. And there's a lot of fulfillment in living in your 80's and continuing to be present for your loved ones compared to some restrictions on the range of experiences in college one might experience. Saying "quality" doesn't mean your views on the value of a life are correct.
You have it inverted. I was saying in addition of the value of life to the the older person who is alive and still able to have fulfilling experiences, their continued existence is also fulfilling to people who care about them. It's part of the overall benefit of their not dying that you are weighing against the value of a more vibrant college scene.
Grandma not dying is of significant interest to grandma, but it's also of interest to people who happen to care about grandma. That's part of the overall utility calculation you are trying to invite. Why, I'd be willing to bet that odd as you might find it, there are lots of people who would be willing to trade off attending college remotely rather than in person for a few years in order for their grandma to live 4 more. This might be a foreign idea to you - "insane" in your own words - but that's an ordinary way to order one's desires.
Agreed! Thank you for saying this! I have no problem with someone making the argument by posing the question of whether age should be taken into account when healthcare has to be rationed and under what conditions. but to claim that for anyone to say that "old people's lives matter" is insane and madness?
Plenty of old people live meaningful and fulfilling lives (my grandfather traveled the world throughout his 80s and was healthy enough to play baseball with my kids in the park at age 89, just saying).
But even if they didn't! At what age do human lives stop mattering? Why is a 79 year old more valuable than an 81 year old? A 75 year old? A 69 year old?
Should a 19 year old give up college to care for an elderly parent? People do that all the time. What if there's no one else able to care for them? Are they wrong? This just makes no sense.
This philosophy logically extended turns into a horrible dystopia very quickly.
I'm familiar with it thanks. You didn't address any of my points. I wonder if you're serious or trolling. Not because of your views but because you don't admit that it's your position which is outside the mainstream and requires a defense not the other way around.
Do you really believe that all 80 year olds automatically have bad quality of life?
Can you say something about how the repugnant conclusion relates to the debate of whether it is worth sacrificing in-person classes to delay the deaths of senior citizens?
* You compare "a 19 year old" to "an 80 year old," but in fact the 19 year olds in college way outnumber the octogenarians who died
* You assume that closing college is a 0%-100% choice in whether an 80 year old dies of Covid, when we don't even have any good evidence that it made any measurable difference at all
I'm following the comparison of the person who I replied to. I was not the one who introduced the direct comparison. I agree that it doesn't properly model the actual tradeoffs, but it's not my comparison to start with. The underlying issue is someone who decided that 80 year old lives aren't worth much and it is "insane" to think they are. They invite you to judge years of an elderly life against in-person attendance at a college and see that the latter is self-evidently of higher value.
We are not making a choice here between whether a 19 year old or an 80 year old gets to live. In reality, we were making a choice between a set of experiences young adults olds might have vs. some increased risk across the general public that they'll experience death or a significant reduction of quality in life that happens to increase significantly with age. There is lots of evidence that mitigative behavior collectively reduced said risk.
You should also reverse the scenario. If you were 80 years old, and you were going to die soon but you had a 1/6 chance (my upper-bound estimate of the ratio of college students to elderly people who counterfactually would have gotten and died from covid without lockdowns) of extending your life by a few years by making your grandchild do their freshman year of college remotely, would you do it? I would imagine probably not.
Of course, the college student who plays russian roulette with her grandfather's life so she can go party on campus for a year also comes out of this looking pretty bad.
I think this is just "selfishly imposing costs on others for your own benefit is bad".
The scenario already allowed for the reverse, since it was presented simply as a choice for a 3rd party. The participants are not the ones imposing the consequences. Kill the 80 year old who would live another 4 quality years is the meaning of "soon" and the choice was doing that or not compared to the offered tradeoff. This is not realistic, but it is the contrast that was set up by the person I initially responded to who was trying to communicate just how worthless years lived beyond a certain age are.
If we change the scenario entirely in the way you offer, someone extending their life four years by transforming a young person's in-person schooling to remote is defensible and is ultimately a vastly oversimplified version of what public health in the face of pandemic has long done with various forms of quarantine.
At 1/6 (my absolute upper bound on the estimate of the number of life years saved by lockdowns per year of remote schooling for university students) it is defensible, and approaching an absolute slam-dunk win from a public health perspective. At 1/1000 (my lower bound) it is not defensible.
I personally think the public health people made the wrong call with lockdowns but I don't think their call was *drastically* wrong (though separately I *do* think they made terrible calls with what particular things were allowed and forbidden).
Part of the problem that occurs in these discussions is people have ambiguous use of the term "lockdown." America never really had "lockdowns" in the formal sense at all, but the term was picked up early in the pandemic as it was describing the policy of significantly more restrictive nations. The closest the US came to lockdown-like behavior lasted for a brief period in the spring of 2020.
That said, we did have a series of both formal restrictions and informal recommended behavioral changes that were mitigative, but inconsistent with each other and suboptimal. This is what people usually somewhat unartfully call "lockdown." Slapped together, these collectively were effective enough to keep the seroprevalence down until vaccination rates climbed in a way that saved a very large number of lives and long-term health problems. At the same time, they were drastically inferior to what a nation like New Zealand was doing and the gaps likely cost a large number of lives and caused a lot of heartache among the still living. The US response sat in the zone of "could be a lot better" but also "could be a lot worse." It's sad when you think about the conventional wisdom prior to this was the US and its once vaunted CDC were among the best situated to weather a pandemic.
If you were to knock out any one pillar in the US strategy in suppressing community spread, in isolation it wouldn't necessarily have moved the needle a large amount. Even if all the legal restrictions were removed, the specter of death would've still had many people behaving with more caution. The problem with trying to isolate any one thing and estimate its contribution, however, is that mitigative recommendations were interlocking. They contributed to each others' effectiveness and communicated a sense of urgency and danger that unto itself also likely influenced propensity to safe behavior. An answer to any one particular "was this necessary?" is generally, "sort of, yes" with an added, "and you can only pull so many blocks out of the jenga tower."
Your imagination apparently works differently than mine! I usually try not to speed in residential neighborhoods, even if the people are old, and I assume even old residents would like me to do that.
... I also don't speed in residential neighborhoods. I don't think I am understanding how your analogy works - are you saying it's sufficiently selfish for old people to be against speeding that it should outweigh their own concern for their safety?
Or do you object to the more general idea that we tend to take a dim view of people choosing the side of the tradeoff that benefits themself, even if the benefit they get is larger than the costs to others (less so if the cost is trivial and the benefit is large, as in your speeding example but not as in the original example)?
Imagine telling an 18-year-old: “If you do your first two years of college remotely, you’ll live four years longer.” They say, “Yeah, that sounds like a fair trade.”
What mental illness are they suffering from, exactly?
"It would be interesting to see how many quality of life adjusted years we collectively lost due to covid and compare that to car accidents or smoking."
I did a back-of-the-envelope calculation for this a few years back with the intent of comparing Covid to other types of deaths that people are familiar with. I did this using the California excess deaths per age group and then combined it with life expectancy for that age group.
Going from memory, Covid (at the time, but we were fairly far into it) cost the average American about 5 weeks of life expectancy (more death amongst the elderly, but the 'cost' in years was lower ... interestingly the lost years were pretty flat between most age demographics [maybe within 2x]; fewer 25-34 year olds died, but they lost more years of expected life when they did; I didn't try to adjust for health ...]
I was unable to find a reasonable comparable, though. This also works out to something like a "double your miles driven per year for 10 - 20 years" risk, which I find to be unhelpful.
Smoking for a lifetime probably, on average, costs you more years of life than Covid. Driving fatalities per year are much less. I don't know of anything 'common' in the middle.
Ooo, I wonder about the lock downs vs quality of life years.
E.g China had strong lockdowns and only 5,272 listed deaths.
India has a similar population and 533,570 deaths.
So we could say that China saved about 500k lives.
I asked Perplexity to work out the lockdown duration in person years. E.g the population affected by the lockdowns with the duration applied, e.g 10 weeks in Wuhan.
It gave 14,431,091 + 573k (it didn't think it had strong data for).
So just over 15 million human years.
So to compensate the people who died would have had to have lived 30 years in average to have made it one to one.
However life under lock down isn't the same as years not lived.
Personally I'd just had a new child and work from home. So we weren't going to be going out anyway. My memory is that we had maybe a 5% quality of life reduction due to the intense lockdowns in the Philippines. It was worse for 2x two week lockdowns where I had to line up to get food from the supermarket and apart from that couldn't go outside.. I couldn't go for a run outside and had to do beep test style running back and forwards inside. But when partly opened up there was almost no car traffic and running on the streets was way nicer than now. Less traffic and pollution.
Wearing a face mask is something we were already doing outside. Wearing a face shield for a while was a little annoying.
However my wifey's Mum had a stroke and then caught COVID in the hospital and died 2 weeks later whilst still being ravaged by COVID (delta at the time, it hit us HARD).
Thankfully Perplexity is better at researching than me and suggests the China style lockdowns were worth a 30% Quality of Life reduction. Although the global average was 12-18%
So 30% of 15 million is 4.5 million years.
Now the 500k people should have lived at least 9 years or more before it turns out to be a net positive.
Perplexity suggests that the Quality is life years lost in India was 8 million.
Or to put that another way, the lockdowns in China were 56% (basically half) the list quality of life years as compared to that of the deaths in India.
But it's different compared to USA stats.
> The U.S. COVID-19 death toll of 1.2 million resulted in 9.7–13.2 million years of life lost, depending on adjustment criteria.
The USA lockdowns affected 27.9 million person-years.
The USA quality of life adjustments of the lockdowns are listed as 15%
So 27.9 x 0.15 = 4.185 million years of life adjustments.
So the death toll was over double that of the lockdown toll in terms of quality of life.
They could have certainly pushed lockdowns harder and faster (as part of the Hammer and Dance) to reduce the death toll related Quality of Life years.
It feels like to me that normalising to Quality of Life years for the lockdown vs death toll is a good way of post-hoc analysing the results and comparing.
There's of course going to be those people badly affected by COVID lockdowns (e.g Travel agencies or resorts) who probably didn't know anyone or almost no one who died.
The lockdowns also disproportionately affected lower income people and those in less developed nations, like Bangladesh. Whilst the virus more targeted the elderly.
However countries applying counter measures for this, like providing stimulus checks seems to have somewhat offset the cost imbalance. Or those like in Sweden were the least affected because of the good social support.
China and India have similar populations but very different demographics. ChatGPT thinks there are 280M vs 159M people over 60, and ~55% vs ~35% of 40+-year-olds. So I think the expected number of covid deaths in China with Indian levels of lockdowns should be at least 1.5-2 times higher than in India.
I remember a back of the envelope calculation that suggested it was pretty comparable in QALY impacts to the opioid/fentanyl epidemic (fewer deaths [though still 100's of thousands], but more QALY's lost per death) over a similar time frame. Not sure what to think of that in terms of our response to either of the problems.
"Bottom line: Using CDC opioid-involved overdose‐death counts for 2020-2024 and the most recent peer-reviewed estimate that each fatal opioid overdose removes ~38 healthy life-years on average, I estimate the U.S. lost ≈12.7 million quality-adjusted life years (QALYs) to the opioid epidemic in the five years 2020-2024. Even under conservative assumptions this burden remains above 11 million QALYs, underscoring that opioid toxicity has erased more healthy life in this short span than many leading chronic diseases."
That basically matches the estimated 12 million QALYs lost to COVID.
Interestingly that almost exactly matches the O3 estimate of QALYs lost to the opioid epidemic over the 2020-2024 period. Roughly 1/4 the deaths, but about 4x the QALYs lost per death.
"Bottom line: Using CDC opioid-involved overdose‐death counts for 2020-2024 and the most recent peer-reviewed estimate that each fatal opioid overdose removes ~38 healthy life-years on average, I estimate the U.S. lost ≈12.7 million quality-adjusted life years (QALYs) to the opioid epidemic in the five years 2020-2024. Even under conservative assumptions this burden remains above 11 million QALYs, underscoring that opioid toxicity has erased more healthy life in this short span than many leading chronic diseases.""
I rather doubt this number. Average age of US covid deaths was a little over 77. The average life expectancy of any 77 year old is around 10-12 years (depending on male or female). But covid deaths also disproportionately hit the sickest with many co-morbidities. I find it hard to believe that the average 77 year old who died of covid had an equal life expectancy to the average 77 year old in the general population.
It's probably within an order of magnitude (10x), but I'm not convinced it's particularly close like within a factor of 2. Just as an example, around 200,000 of covid deaths were nursing home residents. The average life expectancy for any nursing home resident is 1-2 years (all, not the sickest and weakest which you'd expect from the covid cohort). Over half don't make it 6 months. That's a lot to counterbalance with the remaining deaths.
That's why the average amount of life lost per COVID death has been estimated at around a decade. Certainly not as bad as Spanish Flu, which killed the young more than the old. Won't we be screwed if something like that happens again and people continue to be so stupid in their response.
It’s so weird to me that people see this as a case of leadership being stupid - it’s rather a case of transparency causing all the problems. Leadership did as well as in any crisis in all of human history, but because we see there were costs as well as benefits, people have decided that we don’t want leadership any more.
There is a basic immaturity to me in the view that doesn't accept:
1. the profound imperfection of human institutions across all history and places;
2. that uncertainty is a basic feature of existence that all the lovely leadership in the world cannot manage it away.
There is so much room for criticism, but the value of the criticism is so that we respond better then next time calamity hits.
Raging because the data is imperfect and complex or because the guidance in an emergency was contradictory or that some measures were counterproductive is to rage at reality as it is.
So many people worked so hard to take care of so many other people during this mess. It was traumatic and people are still recovering. From trauma, we can grow or we can freeze. We really do have some choice about that.
I get that this pandemic and the handling of it -- like 9/11 did for some other people or Watergate and Vietnam before them, and so on -- led a lot of people to lose faith in all kinds of things. And that losing faith (along with the willingness to hang in there with nuance) is a normal kind of grieving process.
But persistence in the belief that the world *should* have done more for me than it has is ultimately a childish view that needs to be outgrown in order to live the life we do have.
I think this is also the case (at least as Americans) where we really suffered from having 50 states as laboratories of democracy because people can point to ineffectual leadership on both sides to find reasons for their side rather than looking at the cases where the leadership pursued level head decisioning and made reasonable tradeoffs.
Interesting. I wonder how many life year-equivalents were lost due to lockdowns? 300+ million people locking down for a few weeks would surpass 13.5 pretty easily, but we would likely need to do some kind of adjustment for actual death verses the significant loss of [enjoyment, freedom, career advancement, etc.].
This is so strange. At literally NO point during Covid was I 'locked down,' and I lived in a liberal college town. The way people talk as though everyone was under house arrest is literally not true. It's so weird to me.
So in my state, entire industries were literally told they could not operate. Restaurants were either take out or closed. Other states forced the closure or churches and other public accommodations. Lots of people lost jobs over this, including a close family member of mine. People got arrested for going to the beach.
There were no people local to me that were getting arrested for going outside, but it was possible. My boss wrote me a letter that I kept in my vehicle saying I was an essential employee in case I did get pulled over. If the police were more supportive of the lockdowns they could (and often should) have been arresting people for violating the orders.
Maybe your location didn't involve such orders, or maybe the people around you just ignored them all.
I don’t see any example of lockdown in what you say - just paranoia that someone might be treated as though they were locked down. Is a snow day lockdown? What if you get to play outside in warm sunny weather during your snow day?
Okay, so China literally locked people in their homes, and the West didn't do that. I still don't have a problem with the term "lockdown" (mainly because it's what the leaders who implemented these programs and the journalists who wrote about them called them) to describe the significant restrictions on movement, business, recreation, and normal life that were mandated on ordinary people in a totalitarian fashion.
"I was still allowed outside of my home" is not a reasonable response to what anyone complaining about the lockdowns (outside of China) is worried about.
This is the sort of thing that GPT-o3 with search is usually great at. It gives an estimate of about 9 million QALY lost over 2020 to 2023. Note that QALY lost due to long Covid are explicitly omitted, since the evidence on that isn't great and the numbers are pretty up in the air. The sources seem reasonable, although I haven't checked them individually.
I think the argument can be stated as '1.2M Covid deaths did not lose nearly as much QUALYs as 1.2M totally random deaths would have, which is why it doesn't feel as bad as other events with similar body counts.'
I think that's true, but also it wasn't *all* old and sick people, lots of QUALYs were still lost here and there - even if we only lost the QUALYs we'd expect for 600,000 'random' deaths, that's still a lot, more than how we talk about it.
Also, of course, lots of QUALYs were lost to non-death... after a bout of Covid, I lost my ability to taste sweet, and it's never come back. Others have much more debilitating long-term effects.
My grandmother died a little over a year ago at the age of 99. The last few years of her life were certainly of low quality on several different dimensions, for a host of reasons I won't go into here.
She didn't die from or with COVID. But if she had died from or with COVID during the first year of the pandemic, she, I, and the rest of our family would have been deprived of the the opportunity for her to meet my son. And I know, for a fact, from conversations with her, that moments like that with her great grandchildren made her few remaining "low qualify of life years" worth it to her and her family.
This is what makes quality adjusted life years so fraught. I understand the need to make trade-offs within any system, and in healthcare that sometimes means prioritizing one life over another. But I also think it's pretty gross when people seem to write off elderly people's last few years of life as being "low quality". That's a value judgement that 1) you can't make in the aggregate and 2) you can't determine just by considering medical conditions.
The "quality adjusted" part is less important than the "life years" part, IMO. (And it's unfortunate that the whole conceptual space is now taken up by "QALYs", which imposes this inherently-subjective and extremely difficult-to-reckon concept of "quality adjustment" on what is otherwise a simple matter of arithmetic on actuarial tables.)
It's very reasonable not to discount the final years of an octogenarian's life on quality grounds, but the fact remains that if someone in their 80s dies of COVID, it's a loss of 5-10 expected years, depending. This is clearly less significant than the death of a young person who could live another 50, even without any dubious quality adjustment at all.
What accounts for the global discrepancy between officially 7 million (US makes up one sixth) to unofficially 20-30 million (US makes up something closer to its age-adjusted share of the global population). Is the gap mostly China or a lot of countries? Do death rates seem close in countries perceived to have reliable data? Should we expect undershoot of expected mortality going forward?
That's a good chart there. Russia was such a strange case, they were able to develop a perfectly good vaccine but almost nobody agreed to take it, so combined with an elderly population they had the worst excess mortality in the planet. I wonder if they've had any kind of post-COVID reckoning.
It truly is insane. Russian government managed to make one good thing in years, and yet that was the thing which provoked widespread "resistance" among all social groups. Russians would happily accept war, poverty, corruption, they would ask no questions about police violence or shutdown of free speech. But vaccines? That's where they draw the line.
I don't think 70% approval rating is a meaningful figure. It can unpack to something like "Do you prefer Putin to the criminal 90s or some other form of political instability?" or "Do you prefer Putin to the clowns he didn't remove from public politics in one way or the other?"
OTOH, Russia has a long history of "The tsar is good, it's the boyars who screw us up". And it wasn't Putin who personally developed the vaccines.
So I don't know why Russia had high levels of covid/vaccine skepticism but this is not a contradiction.
It literally _must _ be yes, mathematically. Everyone is eventually going to die. So if some people die early, that is fewer people available to die later. No matter what the cause for an increase in deaths, there must be a corresponding decrease in deaths at some point in the future to balance it out.
India (3x the population of the US) had less than 1/2 the total reported Covid deaths of the US (~550,000 vs 1.2 million), so maybe 1/10th the per-capita death rate.
India is poorer, but has fewer overweight and obese people.
Reporting is probably poorer.
I don't think anyone knows if the number is correct, or off by 10x.
This is *deaths* attributed to Covid. I'm confident about the death part :-)
But he US might well assign more deaths to Covid because testing was much more extensive and India might just see a lot more deaths but not score them as Covid.
One would need to look at overall Indian (and Latvian and Greek and ...) deaths over time. I'm sure the data is available. I don't know where to get it.
My guess is that it exists but too small a signal to measure vs noise. If 1.2 million undershoot is spread out over the next 20 years, it could be just a 2% decrease, and it bounces around about that much and will certainly be affected by other health trends and medical progress.
Given that everyone alive during Covid will die eventually, then yeah, any given person who died during Covid means some year is eventually going to have one less death than it would have otherwise.
"My guess is that it exists but too small a signal to measure vs noise. If 1.2 million undershoot is spread out over the next 20 years, it could be just a 2% decrease"
With the bulk of the deaths clustered in the 65+ age demographic (and that clustered in the older of *that* demographic) it should not spread out over 20 years. Lots of people who would have died within, say, 5 years of 2020-21 should have died in those two years. I'd expect that to show up soon-ish rather than spread out over 20 years.
Maybe an undershoot would be more visible if looked at in age-bins (so no obvious undershoot for the 25 year olds, but an obvious undershoot for the 85+ crowd)?
I think you are underestimating their life expectancy.
The life expectancy for a 65 year old male is 17 more years. The life expectancy for a 65 female is 20 additional years. Those are averages, so 50% will live longer.
Even the average 80 year old has 10 more years.
Counterintuitively for some, the longer you stay alive, the higher your predicted lifespan will be.
The average female newborn will live to 79. The average female 79 year old will live to 89.
I remember COVID skeptics being asked to bet if mortality would subsequently undershoot due to getting rid of the "dry tinder", but I don't recall anyone taking the bet.
The issue is the terms of the bet. Let's say 1.2 million dry tinder might have otherwise had a mean life expectancy of five more years in the no-pandemic counterfactual, so, to simplify the math, assume 120k undershoot of an average 3 million deaths, which is -4%. The difference between 2019 (before covid) and the average of 23 and estimate for 24 (which are pretty close and so plausibly "post-covid") according to CDC is around 230k or +8%. Are expectations of future mortality numbers good enough to know precisely whether that gap otherwise should have been 50% larger? I doubt it. And if the excess death undershoot is spread out even more and unevenly while other things are changing too, it just doesn't seem the kind of dispute easy to resolve with bets with terms that are both well-defined and epistemically reasonable.
All that being said, I think something to look for in the future may be claims of progress in mortality, longevity, etc. - where small percent changes are the norm - that could be largely mere artifacts of long slow "mortality dividends" of dry-tinder undershoot.
There are a lot of countries that just don't have the infrastructure to begin to put together a count because of unavailability of tests, or just simple nonexistence of a public health system to collect data. e.g. when a man dies of covid a village in South Africa he doesn't go to the hospital and there is no coroner to record the death.
Also there is the issue of age. Over 65 makes up 90% of covid deaths. The US has about twice the percentage of people over 65 as the world population, so our death rate is just going to be higher no matter what.
Then there is China who had such a draconian lockdown that they were able to actually halt the spread of the virus until after the vaccine and the much weaker but faster spreading omicron strain came out. So, even if they reported true statistics, which I doubt, their death rate would have been massively lower than the US. And China is 1/6 of the world population, so that's going to skew the numbers a lot.
It’s probably mostly low to middle income countries that don’t have great statistics. China likely had very little undercount until late 2023 when they ended their zero covid policy - though they probably have an undercount in the month or two after that.
Total death numbers are likely fairly accurate in most countries, though there are some (like Somalia and Venezuela) where I expect we have few if any meaningful demographic statistics.
It’s probably mostly low to middle income countries that don’t have great statistics. China likely had very little undercount until late 2023 when they ended their zero covid policy - though they probably have an undercount in the month or two after that.
Total death numbers are likely fairly accurate in most countries, though there are some (like Somalia and Venezuela) where I expect we have few if any meaningful demographic statistics.
It amazes me how the rightward shift of the tech community has motivated so many previously intelligent people to accept conspiratorial ideas (like Covid denialism and antivax) they previously would have dismissed as being for low-IQ nutters. Nothing has actually changed about how plausible these ideas are, only how normalized they’ve become on the online right.
It's crazy how anti-vax jumped from the left to the right so rapidly. Before COVID it was Marin county that had third world measles vaccine rates and West Virginia with the highest in the country. But I guess that's just the tips of the horseshoe.
The antivax community has always been an exercise in horseshoe theory. It's always been granola essential oil hippies and religious homeschoolers sharing health tips.
It feels to me like the New Age movement has finally found its natural home on the right. The antivax movement’s roots in crunchy hippy counterculture once kept it mostly restricted to the cultural left. But as the hippies have grown old and cranky and normie conservatives have grown increasingly conspiratorial and less respectful of traditional authority, the distance between these two groups has grown narrower and narrower. Covid was just the catalyst that finally fused them together.
Maybe just because I'm in another country, but I don't remember dishonesty.
I remember some mistakes that were corrected - and, in one case, the public corrections never got through (that the whole "wash your hands/clean surfaces" thing where the later correction that it was airborne never got through to the public). And it was certainly the case that if you were following experts online then they were ahead of the official communications. But that's true of just about anything; official advice always takes time to catch up with scientific knowledge, if for no other reason than that it requires consensus.
But we got things like "vaccines prevent spread", quickly followed by "no they don't; they reduce it" and then "but not by that much" as each variant made the vaccine less effective than the previous one. Sure, they were still saying "vaccines prevent spread" for three or four weeks after it had become obvious that they didn't, but that's not dishonesty, that's the process where scientific research becomes official communications being very slow.
The main example I recall of calculated dishonesty is an ironic one for people who're generally COVID denialist. The public messaging at the beginning was that masks were not effective, because they were worried about an undersupply for medical workers and didn't want regular people buying them up. They reversed course once the supply was secure. There were some cases of pragmatic (if poorly considered) dishonesty like this, but it's all consistent with public officials trying to cope with a serious pandemic where the public often responds in perverse and unhelpful ways.
If they were so good at thinking ahead and dealing with the unhelpful masses, they should have predicted that lying to them in such an obvious way would cause then to trust then even less, making their good-intentioned interventions less effective in the future.
This is the entire point of having simple heuristics like “just tell the truth” instead of galaxy-braining every specific situation: because you’re probably not smart enough to do it properly anyway.
I never said they were good at it, and I do think this cost them valuable trust, but given ordinary human behavior, I think a substantial contingent of people were going to distrust them anyway.
Was this actually a thing somewhere, or is it just something people say?
If it was actually a thing, how much of a thing? Official country-wide government policy, a local low-ranking official making an unofficial tweet, or somewhere in-between?
My bet is some random media worker mis-spoke, or something like that.
I'll have to wait until I have more time to delve into this more, but as I recall the messaging on this point at the time was concerted and coordinated, but t not very long-lasting.
Okay, so the linked article seems to suggest the tweet occurred at a point where the US system thought covid wasn't properly airborne ("The WHO and the CDC were saying the same thing that I was saying, so the science supported me.") Or perhaps attempting to make a more nuanced argument about how the public masking wouldn't change much at that point. (e.g. if the incidence in the public at large is very low, then each individual mask won't stop many instances of covid - because the user probably wouldn't have been exposed /anyway/).
So it looks to me like this doesn't support the interpretation that this was officially sanctioned, calculated dishonesty.
"Was this actually a thing somewhere, or is it just something people say?"
The US Surgeon General posted on Twitter in late March 2020:
"... my office have consistently recommended against the general public wearing masks as there is scant or conflicting evidence they benefit individual wearers in a meaningful way..."
I'm not an expert at the twitter interface. Your link goes to tweet one of three. Am I right in thinking the other two parts are the images below?
If not, you ought to cite them too, for completeness.
If the images are parts 2 & 3 - then the wider picture seems to be that they were asking people not to wear masks if they were in a low risk situation while supply was also limited. It's not really a nefarious pivot or underhand to change advice when the situation also changes.
I agree the text in isolation was misleading, but that's a problem with the format, and the problem looks to me like a failure to realise how it would be interpreted rather than some sort of lie.
This is anecdotal, of course, but I don't remember any official messaging at all about masks not working. But I distinctly remember messaging that we should hold off buying them to ensure medical professionals had access to supplies early on, which of course implies that they do work.
It was specifically that masks didn't work for limiting transmission when worn by normal untrained people in casual settings, so the general populace shouldn't buy them because 1) medical staff needs them more 2) it won't do anything for you anyways.
This was, indeed, a pretty odd combination of ideas to hold in one's head. Since when do you need special training to cover your face? But that's what was said for about a month before it was recommended for everyone. I do think it damaged trust somewhat and I wish the government had just instituted formal rationing on masks early on to reserve supply for hospitals.
EDIT: To clarify, public health officials were not deliberately lying to mislead the public and secure their own mask supplies. There was a pre-existing belief in medical science that masking did not slow the spread of pandemic respiratory illness, influenced by an over-reliance on RCTs for evidence and a backlash away from 1800s miasma theory: https://pmc.ncbi.nlm.nih.gov/articles/PMC8504883/
Of course, at the very beginning of the pandemic when nobody had COVID except in NY and a few other places, it was basically true that wearing masks provided no benefit in (most) "casual settings." There was nothing to protect against for the majority of people. I don't know, but can imagine, it being said off the cuff as something valid today without any thought about the guidance being very contextual.
I stand corrected, though I think you're overstating his initial claims. He didn't say drug store masks don't work, he said they "[don't] really do much to protect you", which implies they do do something to protect you. And you removed the two qualifiers in your quotation, where he said "Now, in the United States, there is absolutely no reason whatsoever to wear a mask." This implies that there might be a reason to wear a mask if circumstances change or in another location.
I completely agree with your final sentence though. With rare exception public officials should always tell the truth, even if they think doing so will result in some negative consequences. The long term erosion of trust has severe consequences, some of which we're now seeing.
I can confirm that this initial messaging on masks not being helpful for the public absolutely did occur. I think the concept they were trying to communicate was more subtle: “Masks are unlikely to help the public because their exposure is less concentrated than what healthcare workers are exposed to.” But it came off as more black and white. And in retrospect was just wrong (“aerosol generating procedures” being much more infective than coughing fits remains a nonsensical idea that healthcare is somehow still holding on to) on a number of levels and was absolutely an unforced error created by panic. They were terrified we would run out of PPE.
There was a lot of dishonesty. I'm not talking about things that could be charitably interpreted as mistakes or bad calls, like when the NYC health commissioner said early on that there was nothing to worry about and people should continue to take the subway and congregate for the holidays, I'm talking about flat-out lies. I'm talking about things like the head of the CDC going before a Senate committee and claiming that if you get vaccinated you can't spread COVID.
When was that said? The vaccines weren’t expected to be neutralizing, but the Pfizer and Moderna vaccines were so effective against the original wild-strain SARS-CoV-2 that they were neutralizing. The other vaccines (e.g. AstraZeneca, Janssen) were not neutralizing, but they weren’t initially available in the US (and only Janssen was ever approved). I think that “if you get vaccinated, you can’t spread COVID” was therefore true until the Beta variant.
The non-neutralizing nature of the mRNA vaccines with the Beta variant wasn’t confirmed until 10 April 2021 when data from Israel first showed that people with a Pfizer vaccination were able to spread Beta asymptomatically. And Beta struggled to spread widely outside of South Africa and Israel; Alpha mostly outcompeted it, so it was reasonable to refer to “you” (ie the typical American) as not being able to spread COVID if vaccinated until the Delta wave in late June/early July.
It wasn't true. It was never true. She made the claim that "vaccinated people do not carry the virus, don't get sick, and that is not just in the clinical trials but it's also in real world data," in March 2021 based on a CDC study that showed nothing of the sort. What it did show was that vaccinated people had a 90% lower risk of infection two weeks after their second dose, which is distinctly different from a 100% lower risk of infection, and distinctly different from sterilizing immunity.
She made her claim, the one I quoted above, to the Senate committee in May of 2021. There was no evidence for sterilizing immunity. To make a claim honestly, you need evidence for the claim, not just a lack of evidence that the claim is false.
There was so much blatant dishonesty, that it astounds me when people act like there wasn’t, or “can’t recall” any. Why did they NOT lie about.
- origin
- masks
- mortality
- transmission effectiveness
- vaccine safety
- prevention of all kinds
- herd immunity
- slow the spread
- lockdowns
- protesting government response is “white supremacy”
- contradictory response to protests based on what the protest was about (transmission is not a problem if you’re at a George Floyd protest, but you’re a “white suprematist super spreader” if you’re protesting government tyranny).
- children must get vaccinated with a novel mRNA transaction therapy or they’ll DIE. In reality, children were not at risk.
Who is your “they” here? Because I didn’t see the scientists lying, I saw the politicians lying about what the scientists said (mostly, because the politicians were too fucking stupid to understand what the scientists said and were trying to “simplify” for non-scientists and ended up taking away so many qualifications that they weren’t telling the truth).
Origin is still the same answer as ever “natural causes more likely, can’t completely rule out lab leak, can completely rule out intentional spread”
Masks: cloth masks went from “no evidence they work” (which was true; no-one had ever studied it) to “better than nothing” (also true) to “still not very good and we’ve actually got some supplies of N95s now, so why not use them instead” (also true).
Mortality: went from “appears to be really high, but we’re only seeing the worst cases” to “1% or so” - and it appears to be a population-wide 0.3%, and there are a lot of people who either never got COVID or only got it after vaccination which definitely reduced the risk of death.
Transmission: well, yeah, the vaccine effectiveness was way higher on wild-type in the original trials in July 2020 than on Delta in July 2021. So of course the story changed. That’s not a lie, that’s the facts changing.
vaccine safety: how has the story changed? There are some risks that are either rare or minor, the same as just about every other vaccine.
Prevention: now, there is a real scandal here, which is the refusal of the scientific establishment to accept that COVID is an airborne disease and the total determination to stick to the idea that it only spread in droplets. That was a scientific fuck-up. But it wasn’t a lie; it wasn’t dishonest. They were just wrong and stubborn and wouldn’t listen to the people who had the evidence.
Herd immunity: is real, but requires you to get the reproducibility number under 1; vaccines alone weren't enough after Delta. Delta changed a lot of things and was worse than expected; so any statement made before July 2021 wasn’t a lie, just wrong.
Slow the spread: Yeah, this was a stupid idea - you need to keep the R number under 1 until you reach eradication. Riding the wave up and down was correctly assessed as a risk by an Imperial College scientific report early on and yet just about every country did it. So can we blame the politicians and not the scientists, please?
Lockdowns: These worked when implemented properly. Sadly, the countries that did lock down properly generally got didn’t push vaccination aggressively enough. So Australia, Japan, Thailand, etc all had a massive wave in 2022 (or China in 2023). The only country that did get everyone vaccinated before unlocking was New Zealand, which had one of the lowest deathrates anywhere (the lowest of those with trustworthy statistics).
Floyd protests: yes this was bloody silly, though the version I recall was that the Floyd protesters were OK because they wearing masks and the anti-NPI protestors weren’t OK because they weren’t - but I admit I’m in a different country and that just never seemed like an especially big deal.
“They,” just to start off, would be Dr. Fauci (NIAID), Dr. Robert Redfield (CDC), Dr. Tedros Adhanom Ghebreyesus (WHO), Dr. Deborah Birx (White House Coronavirus Response Coordinator in 2020), Dr. Rochelle Walensky, (appointed CDC Director on January 20, 2021).
Just to name a few (the heads of major scientific institutions and groups managing public health).
All lied. All deliberately mislead. All were repeatedly, demonstrably wrong.
Those are the political leaders of scientists, they were not actively working scientists. Not one of them published a single peer-reviewed paper on COVID.
Then you weren't watching. The scientsts you refer to were telling each other things in their own personal emails which they were directly denying in public.
The people who don't remember it are absolutely sold on the idea of not believing it, and have (subconsciously) taken every effort to forget anything that isn't The Narrative. The rationalizing will abound as it does with our dear host.
As a foreigner you probably didn't see it. I kept a list.
• Covid will not be a deadly pandemic
• Closing the borders is racist
• Masks don’t work
• Lockdown two weeks to flatten the curve
• Trump didn’t close the borders fast enough
• Lockdown three months to flatten the curve
• Masks work
• Lockdown until Covid is gone
• Covid CANNOT be solved at the state level
• It was never about Herd Immunity
• Saying the virus came from a lab is racist
• One mask doesn’t work but two masks definitely work
• Lockdown because symptomatic spread will kill old people
• Asymptomatic cases can still have long term damage, ground glass lesions, and such
• Lockdown until a cure
• Every hospitalization with Covid must count as a Covid hospitalization regardless of the reason for admission.
• Don’t trust any vaccine announced under the Trump administration
• The vaccine announced the day after votes were counted is safe and effective
• Vaccinated people cannot transmit Covid-19
• We must mask children because science says so.
• The vaccine has no side effects
• We will not mandate the vaccine
• We must vaccinate as many people as possible to get Herd Immunity
• You can return to your life after getting the vaccine
• The virus probably came from a lab
• Only N95 masks work
• The NIH doesn’t fund Gain of Function research
• The vaccine was never about stopping transmission
• Vaccine side effects mean it’s working
• The vaccine has no effect on women’s menstrual cycles so stop being hysterical
• The Wuhan NIH research doesn’t count as Gain of Function research because some gain of function researchers decided those gains of function didn’t meet the legal definition
• Asymptomatic transmission among vaccinated people is fine, will not kill old people, and don’t worry about long term damage, ground glass lesions, and such
• You can return to your life after getting booster shots every six months for the rest of your life
• We will take your life from you if you don’t get the vaccine
• We will use the FBI to investigate parents who complain about school vaccine mandates
• The vaccine turns symptomatic illness asymptomatic, but don’t worry about the increase in asymptomatic spread
• Go ahead and get infected with the virus after your vaccine to improve your immunity.
• Peter Daszak, the guy who organized the “lab leak is a conspiracy theory” letter in the Lancet, proposed to build Covid-19 for DARPA in 2018.
• Vaccinated people can spread Covid-19 just as easily as non-vaccinated people can.
• The spike in heart attacks and vascular conditions isn’t from the vaccine, it’s from the lockdowns.
• Unvaccinated children will be removed from school.
• Covid MUST be solved at the state level.
• The vaccine actually does affect menstrual cycles but you should get it anyway.
• Hospitalizations with Covid don’t count as Covid hospitalizations if Covid wasn’t the reason for admission.
• The case for masking children has collapsed
• Leading scientists knew it came from a lab but hid their opinions to promote “international harmony.”
• Even though the case for masking children has collapsed we’re going to do it anyway.
• Even though mask mandates are illogical, all that matters is that they align with the “community’s goals.”
• Mask mandates didn’t make much of a difference anyway.
• Fauci: “Vaccines don’t protect overly well” from Covid infection.
• The vaccine was bad because it was Trump’s fault.
• A vital part of hurricane preparedness is to get vaccinated.
• When the FDA told people not to take ivermectin that was totally just an informal recommendation.
• Department of Energy: “The virus came from the lab.”
Some of the things in your list are bullshit, some of the things in your list are wild exaggerations, some of the things in your list are “some low-level state official may have said something like this.” Every single thing in your list needs a citation.
The main thing that I would describe as dishonesty was the very early anti masking instructions. The reasons for this one are obvious although from my point of view it would have been better to just tell the truth and seize the supplies.
In the US there was a massive campaign of censorship where the government put pressure on social media companies to censor anyone who went against the official narrative. They even threatened scientists careers to force them to sign on to a public declaration that contradicted what they actually believed https://en.wikipedia.org/wiki/Lancet_letter_(COVID-19)
On top of that the public health bureaucracies issued decrees that were clearly motivated by politics and not public health e.g. at a time when they had banned all large outdoor gatherings and closed public parks and beaches, they issued a declaration that BLM protests were not a risk to spread covid, and were in fact good for public health.
Official communication about COVID was often dishonest, but the current administration's official commissions are deeply and transparently dishonest, and it doesn't motivate people on the right to conclude "we should disregard or reverse everything the administration says." This clearly isn't a behavior people apply consistently across the board.
Right. If the politicians du jour is grossly dishonest, half the population will have absolutely no trust in their leadership, while the other half will be solidly on team "well, they're *our* lying liars and it's not really lying if it's what they have to do to beat *your* lying liars". This is catastrophically bad for society, no matter which half is in which position.
Maybe try electing politicians who aren't grossly dishonest lying liars at all?
I think this is the crux of it. If the science had been squeaky clean from Day 1, we wouldn't in the place we now are. Once the fundamental trust in professional objectivity is lost, a doorway to lunacy opens up that will not be easy to close again.
It exposed how fragile the knowledge base for epidemiology actually is, that is for sure. But you can’t just not make decisions in an environment where you have all the facts. I think it could certainly be executed better in the future but in practice it is very hard to both convey nuance and uncertainty to the public while also trying to push the policy you think needs to happen in the moment. How would you do it?
I agree this is a genuinely hard problem. I would even argue it is impossible to have a useful conversation online, because it requires so much good faith on the part of the interlocutors.
I think sometimes about all the “lies” that FDR told in the run up to WW2. Do we wish he didn’t do that?
I think there needs to be more appreciation of just how great an achievement objective science was. It took us maybe a million years to get there. You throw that out the window because of a media driven panic? That's not good. People in power need to recognise the importance of the average citizen fundamentally trusting science and act accordingly. But, post the arrival of social media, many areas of gov became convinced that narrative control was all that mattered. That is fundamentally untrue.
"it is very hard to both convey nuance and uncertainty to the public while also trying to push the policy you think needs to happen in the moment. How would you do it?"
Short answer: with humility and honesty.
Longer answer: I think you start off with a bad assumption, namely that one needs to push a policy. How would I do it?
Provide the best available information while being honest about your confidence in said information.
When your opinion changes, explain why.
Only advocate for or institute policies backed by force of law if you have a very high degree of confidence, otherwise focus on providing information and advice.
Trust people.
Grant them autonomy.
Own your mistakes.
If you egregiously mess up, or consistently demonstrate poor judgement, resign from your position of authority.
If you're worried that things will fall apart without you, recognize that you're not a very good leader, because good leaders build robust systems that can operate without any one specific person. Start making corrections now.
Don't try to expand your sphere of authority anytime you see someone doing something objectionable.
The thing is, in a crisis, where there is high threat and high uncertainty, when people are overwhelmed and exhausted, we humans are going to do all these things badly.
Which is why we need our systems not to depend so much on the individual character of leaders.
In the 1980s, I taught at UCBerkeley about the lack of pandemic preparedness despite the high likelihood, near certainty, that there would be one in the coming decades. There were books and articles and loads of research done on this back then. The work ahead was to improve infrastructure for preparedness, not to rely on the good character of individuals. A lot of that work never happened and so when this pandemic came were were not nearly as prepared as we could have been.
One of the reasons for that is that as a society and as a human race, we are not yet that good at long-term planning, or at making short-term sacrifices in service of long-term well-being. This human frailty exists at the individual level all the way up to big organizations.
I disagree. Populism and general anti-science and anti-elitist thinking spread via social media had been undermining trust in experts long before Covid. People were actively looking for any excuse to disbelieve the authorities from the very beginning, especially given the obvious political and social ramifications of something as disruptive as a pandemic. There was nothing new or unusual about how experts handled an event like this other than that it happened during the age of social media.
Well, I think we're fundamentally agreeing. The advent of social media and the unprecedented level of connectivity that it afforded, created an environment where previously repressed and marginalised conspiracy material could now achieve take off. Yet, the Big Gov response of attempted narrative control simply did not work.
It worked throughout most of the 20th century, but in the 21st century we raised our standards and got more honesty, and as a result the attempted narrative control no longer worked. We got more accurate and reliable messaging, and as a result people started to understand that it was not perfectly accurate and perfectly reliable (even though it was better than all the things they trusted without complaint in the past).
There was nothing new or unusual about the CDC and FDA shutting down the University of Washington study that discovered Covid because they supposedly violated HIIPA? Or the FDA refusing to grant permits to testing companies because they didn't file their applications on mailed CD-ROMs? Or the CDC developing a test that was a month late and didn't work because it was literally contaminated with Covid?
In retrospect, yes, I agree, you're right. These sorts of systemic failures of a shit system aren't anything new, they're par for the course forever, and also why nobody trusts these jackwads nor should they.
What you are asking for is the opposite of “squeaky clean”. What we got during Covid was much cleaner scientific information than at any other point in history, because scientists were talking directly to the public. But it turns out that seeing scientists speak made people realize that scientists aren’t an alien race of godlike intelligences who are perfect on everything, and they decided that if they’re not like this, then we might as well not listen to them at all.
We lost the fundamental trust in professional objectivity because we allowed transparency and honesty.
But they weren’t all being transparent and honest. Too few were honest about the level of genuine uncertainty, and too many were quick to declare the current best guess as “expert consensus” and label anyone who questioned it a science denier.
And then they started using their newly elevated platforms to push obvious politics rather than just communicating scientific fact.
It probably would be better if public pronouncements were even more honest about uncertainty. There are a lot of such ways I have endorsed. But I think it’s also true that experts during the COVID pandemic did at least as good by this measure as experts at nearly any time in history before then.
My contention is that it is precisely the visibility of uncertainty and disagreement that was a large factor in the loss of trust.
Can you think of a time when there was better honesty?
No, nobody was under the illusion that scientists were intelligent at an alien level. We knew they were fallible. What we expected is that they would present us information, put some guidelines into place, and then let us keep our rights. Instead they became medical tyrants, forcing medical interventions that violate bodily autonomy through mandates. They also failed to acknowledge that there are other kinds of health, such as social health, mental health, academic progress, social trust.
It is not that scientists are flawed, which we know, it is that they tried to assume the role of dictators even though they were wrong about so much, especially the risk to children.
You must be talking about some different event. Scientists didn't do any of the things you mention, except for talking about social health, mental health, academic progress, and social trust - which were mainly discussed by scientists. The only thing I vaguely recognize in what you say is the fact that politicians in some jurisdictions required masks or proof of vaccination for participation in some public spaces - but scientists did not usurp any power, this was governments acting within their established authority, sometimes with reference to scientists.
Everyone who could read a study knew that Covid was an airborne blood disease transmitted by stale air, and that cloth masks did nothing, and that the 6 ft separation rule concocted by the CDC which was used to close half the school systems in the country did nothing, by MAY OF 2020. May.
May.
And the CDC was saying to bleach your door knobs a year later. I know people at the CDC who were responsible for issuing policy guidance, and they were ignoring the science and posting things from the Occupy Democrats Facebook page. It was a giant fucking joke, and the USA would have been better off without the CDC involved at all.
When the CDC and FDA first became aware of Covid on-soil from the U Washington assay, the Washington scientists were in a panic that we had a pandemic on our hands and the CDC and FDA both instructed UW to STAND DOWN because they didn't have the appropriate permits to test for diseases because they only had a research permit, and then told them they violated HIIPA and hung up the phone.
Later, the CDC said we will have "one and only one" test for Covid that the CDC would develop, they didn't give any permits for private tests, and the test they developed shipped three weeks late and DIDN'T WORK BECAUSE IT WAS CONTAMINATED WITH COVID.
The only reason anyone ever got tests in 2020 was because of Mike Pence.
These are real things that actually happened, and nobody got fired.
It’s funny how people on the right who complain about being lied to by the mainstream media/establishment, they never bring up the countless lies and misinformation coming from Trump in 2020.
Speaking as a right wing guy who complains about being lied to by the healthcare establishment during covid...
What do you want me to say about Trump lying? He does it all the time, he's very dishonest, and thats bad. People don't typically cite him as a reliable source so it doesn't come up much, but it is bad
I think that the objection is less specific. I suspect that the RW-ers I know, would say the same. They don't trust what DJT says. However, they parrot the general talking points of the administration (e.g. Tariffs are both paid by foreign countries while simultaneously boosting domestic production, DOGE is eliminating loads of corruption and saving $100s of Billions). At least to me, this seems to better articulate the [edit: +apparent] hypocrisy being alluded to.
The double standards are insane. The president, who people should be looking towards in times of national crisis, lies through his teeth about how big of a problem Covid is and peddles snake oil treatments. And all you have to say is, idk it’s bad.
But, the medical establishment that has been 99% correct on everything deserves all the vitriol because there was conflicting information about mask usages in the early parts of Covid and maybe Covid made out of a bio lab (which still isn’t 100% confirmed).
My understanding is that during the early days of Covid, the health department (under Trump btw) discouraged masks because there was a shortage of masks and they wanted to save them for medical workers/high risk people. Eventually, it was corrected. Deliberate or not, lies made with good intentions happen everywhere. If other parts of academia were as politicized as epidemiology had became, you would literally trust no one.
Is there a time in the past where you think the healthcare was more honest than it was in 2020 or 2021?
My claim is that they were at least as honest during the pandemic as they have ever been, and it is partially because of the honesty of admitting mistakes that people now think they should never be trusted.
But why believe people who were even more dishonest? During the Delta wave three antivax conservative radio hosts died of COVID in a single month. These people made a very lucrative income from partisanship.
It is surprising to me that so many of them are so stupid. I also was distrustful of various official communications, but by the power of reasoning was able to come to reasonable conclusions such as "taking the vaccine is good", "covid is not that dangerous to me personally, but low-cost measures that inhibit transmission are not a major imposition", and "mask recommendations are not part of a new world order scheme to extract your adrenochrome". It didn't take me that much mental effort to navigate between the conspiracy theories and rigid adherence to the CDC gospel.
This is such an ironclad argument. That's why the frequent dishonesty deployed by internet atheists gave me a prior that young earth creationism is probably correct
I remember many examples of dishonesty. The efficacy of masks (or not), risks to children, the need for the most draconian lockdown measures (e.g. closing outdoor spaces), double standards for which activities were allowable and which weren't (e.g. social justice protests)... I was cognizant of the dishonesty in real-time and it still makes me angry.
But I still don't traffic in conspiracy theories. I believe myself to be a savvy enough consumer of a variety of sources of information that I can differentiate between what's likely to be true and what's likely to be false. Of course I have my biases and blind spots, but I think, or at least hope, that they aren't too egregious, and that I'm self-aware enough to assign confidence levels and come up with a realistic world-view accordingly.
I understand why people have come to distrust elite individuals and institutions. I understand why certain conspiracy theories have emotional appeal. But I expect reasonably intelligent people to stay true to a core set of principles, navigate their distrust and their emotions, and not be pulled in by dishonest, biased anti-elites, simply because they stand in opposition to the dishonest, biased elites.
The problem is that the level of dishonesty and failure that you are observing here is likely comparable or lower to the levels of dishonesty and failure that have existed among medical authorities at any other time in history - you shouldn’t stop trusting someone just because they became more honest about the fact that they are only 80-90% reliable.
Interesting, I haven't particularly noticed that. Can you point to some examples of rationalist groups being crazily conspiracy-theory-ish? Of course, the rationalist community has always supported all kinds of wild thought experiments much weirder than these, I'm wondering about cases that are more than that.
I think part of the issue is that Scott's blog exists at the intersection of a few different communities: the rationalist community, the centrist classical liberal community, the anti-woke community... So I think a lot of the commenters here with the worst epistemic hygiene may not really be "rationalists", or at least, might be more centrally from some other community.
Not to say that there's no crossover with "core rationalism", and I don't want to do a no-true-rationalist thing here, but I think you see more of this stuff in Scott's comments than on LW, for example.
This was both six years ago, and before the "mainstreaming" via both the NYT article and move to substack. So most likely the rationalist ratio is likely far, far lower than 13% now. This at least matches my anecdotal experience, where people who I typically see making dumb mistakes that would be caught by skimming the sequences never end up identifying as rationalist. Same with using this as identifying known rationalists (from their shared handle on LW)
Yeah this has always been a property of Scott's blog, though maybe more pronounced in recent years?
I've definitely encountered more IRL people who know of ASX then I ever did (a grand total of 0, I'm pretty sure) in the SSC days, which suggests a broadening of audience.
Ah, yeah, I certainly don't think of Scott's commentariat as being very representative of rationalist discourse or the rationalist community these days. I assumed Swallow meant something different, but maybe not.
I think part of the issue is that Scott's blog exists at the intersection of a few different communities: the rationalist community, the centrist classical liberal community, the anti-woke community... So I think a lot of the commenters here with the worst epistemic hygiene may not really be "rationalists", or at least, might be more centrally from some other community.
Not to say that there's no crossover with "core rationalism", and I don't want to do a no-true-rationalist thing here, but I think you see more of this stuff in Scott's comments than on LW, for example.
'Here are largely-undisputed all-cause mortality statistics from CDC and census.gov' is a level of crazy conspiracy-theory-ness I'm pretty comfortable with :)
Oh c'mon, we all lived through a hodge podge of policies and random claims from scientists and officials. It may have not made us all conspiracy theorists, but if were paying any attention it sure changed how you perceived "experts."
It really shouldn’t have! This is how experts function, and function well! People have unreasonable expectations, which past expert communities lived up to by hiding their failures.
If you do trivia competitions, you’ll understand that informed guesses that are nowhere near perfect can still be the best option, and lead to you reliably winning over the competition.
Informed guesses are often necessary. Falsely claiming your informed guesses are actually indisputable scientific fact never is.
Flat out *making shit up* because the facts you know make your desire to virtue signal about a murdered fentanyl addict inconvenient is a whole other level of credibility-nuking.
I think it's valuable to separate scientists from spokespeople from politicians from policy wonks from corporate interests in thinking about this.
Science is, as it has ever been, messy and imperfect. And yet an incredible human endeavor and still improving decade over decade.
Politicians (and their spokespeople) and corporate interests have never been very truthful because the incentives don't run that way.
If you lived through Watergate, Vietnam, the two gulf wars (with for sure WMDs!), a couple of finance-sector-engineered economic crises, the lies of tobacco and pesticide companies, the extent of child abuse and coverup in the Catholic church (and elsewhere), and all the stuff in-between, or some fraction of those, the hodgepodge is not remotely surprising.
I think the pandemic hit a bunch of people with more limited life experience and many of those people are now understandably gobsmacked that the world doesn't work better than they thought it did.
You should consider, here, whether the previous dismissal of these ideas as "for low-IQ nutters" wasn't also influenced by political considerations. It's not a given that this was a shift that made people net less rational.
The growing institution of Alternative media has herded the cattle with Candace Owens snd Catturdism, and therefore it’s politically advantageous to pander to the cattle if you’re a tech bro trying to change the world or get rich.
I wonder if people coming from countries with a hyper-inflationary past have easier time dealing with big numbers like this. I bet to somebody from Turkey or Argentina 1.2 million deaths are more believable (in fact maybe too normal as in desensitized?) than somebody from say Brunei or Switzerland.
Contrast "I only actually know one person who died of Covid" with the breathless "expert" and media hyping at the time that we should expect to see hordes of dying people staggering the streets because emergency rooms and entire hospitals would be flooded, then the hordes' corpses to be stacked like cord wood awaiting a mass bulldozer burial. Then, poof, after the beaches and playgrounds were reopened, it seemed to have been more like a bad flu season (not to mention actual flu disappearing for some mysterious reason). The cognitive dissonance is massive.
For real. This discussion is honestly just darkly humorous as someone who worked the Covid floors from March 2020 through July 2021. Those of us who were there remember.
Anyone in healthcare would be agape at this stuff. You know, the people who were actually taking care of all the Covid patients. Who also got sick, who also died, burned out, left the field despite years of training and debt for that training. Because it was such a horror. And now to see people dismiss all of that because they didn't personally stand in the hospitals and see it with their own eyes. Like Paris doesn't exist if you haven't been there yourself.
I was a healthcare provider during Covid and it changed me and my career permanently. Me along with many many others I know directly.
Hospitals aren't equipped to deal with a large public spike above baseline use of medical services. Recall how in the beginning of the pandemic, supplies like toilet paper, and rubbing alcohol became nigh inaccessible. The supply chain wasn't equipped to quickly respond to a significant change in demand, even though these are cheap and abundant goods.
If an industry takes 20% of our GDP I would expect edge cases to be worked out and available. Handling unforeseen spikes is something expected of the tech industry, but somehow medical system needs all our money and can't be bothered to think on their feet and handle a slightly above normal spike.
It takes a lot more time and resources to scale up the operations of a hospital dealing with highly infectious patients than it does to scale up the production of toilet paper.
If you are trying to build a hospital with exactly the same equipment in the same configuration sure. In an emergency I'd expect other solutions (deputizing the public like EMTs and those with some medical training) and nurses to expand the number of workers and making beds out of things not hospital beds. Especially if it's taking 20% of our GDP.
20% of our GDP is what we're spending under business-as-usual scenarios.
If you don't have proper facilities and appropriately observed safety protocols, sticking a bunch of sick people together to care for them makes outcomes worse rather than better (because they're infecting other patients and workers.) Even under ordinary circumstances, hospital-induced comorbidities are a significant risk. There simply aren't enough regular people with adequate training to safely run hospital-like facilities who can be deputized in order to dramatically increase our capacity to provide medical care under pandemic conditions.
> deputizing the public like EMTs and those with some medical training
Why would you think that would work? Is EMT training just all for show and any Joe blow off the street can do it at the drop of the hat?
The reason medicine and tech don’t behave in the same way is that the human capital of medicine has a way longer lead time and the regulatory framework is far stricter. EMTs, nurses, phlebotomists, RTs, PTs, OTs, SLPs, NPs, PAs, MD/DOs can’t just be conjured out of the ether. You either need to dramatically over expand your resource pool for edge cases, or accept that trade offs will need to be accepted when the system shock occurs.
This is why you need a federal government in a capitalistic system. Capitalism ensures that if 1 medical provider voluntarily kept excess production available, then he would be put out of business by his competitors. This massively parallel computing machine of industrial competition is what is so brilliant about capitalism but it does mean that you need intelligent governance to deal with the shortcomings.
Having 20% excess capacity sitting around means building a lot of extra hospital wings to sit around empty and hiring a lot of extra doctors and nurses to do nothing. Nobody is willing to pay for that during business as normal, so we have what we have.
I mean, we did see a million deaths. I don't know if this qualifies as a "horde" of corpses, but you could build a pretty sweet skull pyramid out of it.
This was my whole point in the last post - people act as if this was "hyped" or "overestimated", whereas in fact it was the largest mass casualty event in American history and if anyone had given the true number at the beginning of the pandemic, people would have been even more scared than they were. It's just that people are able to ignore a million deaths because that's 1/300th of the population and dead people don't write thinkpieces about how angry they are to have died.
A lot of hospitals did get overwhelmed. You didn't hear about it because you weren't in those hospitals and, I predict, don't know any of the doctors or nurses who were on the front line.
I once worked in an actually flooded-by-hordes emergency room - not during COVID, but during a blizzard in Ireland that the locals were completely unprepared for (they almost never get snow). Every bed occupied, gurneys lining the hallways, some patients on the floor, long line of people waiting to get it, stretching out the door. What percent of people in Ireland do you think were in that emergency room, or know someone who was? Would the average person on the street have thought "Yeah, I am personally connected to the overcrowdedness of this emergency room?" How exactly do you see this working?
You say this, but 1-4% mortality for the entire population was floated early on. Everyone I know expected way higher than a million death and for it to be spread across demographics equally. I remember thinking 3 to 12 million would be a reasonable estimate when they were still using NY and Italy as the estimation.
And? Some people happen to be over 65, and still value their lives greatly. Even more people have relatives above the age of 65, and would greatly prefer if they didn't die a painful death years ahead of their time.
"Effective vaccine" that was not a vaccine. Did not stop people from getting Covid. Did not stop people from transmitting the virus. Did not build up any immunity keeping "vaccinated " people from testing positive for Covid over and over. The only thing left in defense of the "vaccine" was the weak, "Well, you would have been sicker without the vaccine" . . . and I would like to know how that would be proved.
You are aware that people who've had the MMR vaccine can still get Measles, right? And people with the flu vaccine can still get the flu? There is a range of efficacy in vaccines, like with all other things.
The vaccines, generally speaking, reduced the risk of dying of Covid by factor of ten or so, which is far better than nothing. For the early variants, they probably would have prevented the spread well enough to eradicate the disease if everyone had become vaccinated, but the virus evolved too fast, became to virulent and too good at evading the immunity conferred by the vaccination to achieve that. As far as I recall, that was a bit of a surprise even for the experts. Still, without the vaccines, things would probably have turned out way worse in terms of casualties.
Not trying to be political (really!), but the predictions (like you mention) and the actual results reminded me a lot of the AIDS epidemic in the early 1980s.
The AIDS deaths started rising sharply, folks started projecting the curve and warning that everyone was at risk, things DID get worse, but ... there was also clustering and lots (maybe most?) people didn't personally know anyone who got AIDS or maybe knew only one person.
Other areas (e.g. San Francisco) had lots of people who knew 10s or 100s of people who died of AIDS.
But the exponential stopped exponenting as AIDS burned through the super at-risk population. And the general public might be forgiven for wondering why if things were so bad they weren't noticing anything particularly unusual. And wondering why they were supposed to panic?
Not quite the same here, but the parallels are similar enough I think. Folks in the medical community really noticed this in their own lives. Folks who worked a lot with the elderly probably noticed this in their own lives. For a lot of the rest of us we needed the news to remind us how bad things were because we weren't seeing it.
AIDS has R0 less than 1 via heterosexual intercourse in places outside Africa. So it wasn't going to break out of some relatively small subpopulations. COVID was not like that, it was a respiratory virus that hit everyone who breathes.
Right. AIDS wasn't going to break out of some relatively small subpopulations.
But in 1985 we were getting articles saying things such as this:
"By early this year, most Americans had become aware of AIDS, conscious of a trickle of news about a disease that was threatening homosexuals and drug addicts. AIDS, the experts said, was spreading rapidly. The number of cases was increasing geometrically, doubling every ten months, and the threat to heterosexuals appeared to be growing."
The doubling didn't go on forever and the heterosexual population wasn't totally unaffected (e.g. Arthur Ashe, Isaac Asimov) but that wasn't the message ordinary Americans were getting in 1985. Without news coverage, most Americans in 1985 wouldn't have known about AIDS. And would not have though to be worried about it. Folks in SF didn't need the news.
I forget if Covid eventually surpassed HIV in deaths. But it seems to me that there is remarkable similarity in the entire process, but compressed into 2 years instead of 40. (Government denial, then government acceptance, then Anthony Fauci changing policy to allow better responses when demanded by patient advocates, then better treatments, and eventually a preventative that means we don’t have to worry too much.)
I agree large numbers were floated. Small numbers were also floated. I think if God came down and said "the true number will be 1.2 million, even with pretty extreme countermeasures like locking down the whole country for months", most people would have interpreted that as "the large number people were right", albeit not the absolute largest.
I never saw anyone say 4%. I hang out in groups who’ve been thinking about this for a long time, who range from totally mainstream to batshit crazy and their consensus at the start was 1%, moved lower very fast, as low at 0.1%, then rebounded to roughly whar actually happened. I would say we knew the likely scale by May or June 2020
Fairly early predictions of deaths sans countermeasures turned out to be accurate. You can project the mortality among those who *did* become infected and compare that against who didn't in 2020. It's harder to estimate what the loss of a functioning health care system would've done to mortality, but even that's something you can ballpark. The projected scenarios that seemed gloomy were on the money as far as that goes.
There were countermeasures - people aren't just going to behave normally as corpses pile up - but it's just innately hard to to predict what political will is going to look like, particularly so in the United States. Losing over a million people is staggering, and a significantly worse overall outcome than some global peers such as Japan.
I think a lot of this is missing concentration. New York City did, in fact, have piles of corpses in the street. Everyone I know from New York City knows lots of folks who died of Covid.
I know a few.
My family members who live in rural North Carolina know zero.
> My family members who live in rural North Carolina know zero.
It’s probably also an issue of New Yorkers being much more willing to say that someone they know died of Covid, whereas the rural south which got absolutely ravaged by the delta wave had folks who would have a bunch of egg on their face if they admitted that pawpaw died of that virus that up until yesterday they had been loudly proclaiming to be a hoax.
Actually living in the south and knowing a lot of Covid deniers... there's *some* of this, but not as much as you'd think. Most folks who have someone close to them die of Covid change their tunes pretty quickly. Often they're vocal advocates for the protections they argued against.
Generally people are people, not caricatures. You can show them all the facts and figures you want and they won't budge an inch, but when they have real life experiences with the things they adapt.
I lived and worked in healthcare in the rural south through Covid. At least in east TN there were plenty of people dying from small places in the mountains where their absence would be noted given how small the community was. Some church outbreaks had multiple congregants die from a pretty small population. It was surreal driving home from the hospital past the freaking freezer truck full of bodies and seeing TGI Fridays packed to the gills with old gomers just half a mile down the street.
People are people, and people the world around are extremely invested in saving face.
I got curious about the skull pyramid thing - assuming each skull is around 17.5cm wide and lies on its side, and that they pack 1, 4, 9, 16, 25 etc, you would get a pyramid roughly 25-30m tall, and probably quite a bit wider (because skulls are sort of irregularly shaped). Which is impressive but not, like, skyscraper-sized.
But the pyramid of Giza is something like 150m high and 200m wide.
For visual impact, I think you could instead just clad a giant pyramid in skulls, or make a bunch of smaller pyramids and put them all together in a large flat plain.
For your skull-clad pyramid, you put the skulls upright next to each other. We again use the 17.5cm width, but now each step is 25cm high. The number of skulls per layer goes 1, 4, 8, 12, 16, 20 etc. This one is a monster: 194m tall and 135m wide. I'd suggest making it look more like a Mayan pyramid, so that you can add a bit of width and make it a nice round 200x200x200m. Estimating cost is a challenge, ad building costs are so variable and depend on so many factors (land cost, labour costs, transportation costs, material costs etc). If built analogously to a skyscraper, then the cost per might be anything from $450 million to $1.8 billion (assuming a floor height of 4m and cost-per-floor at Dubai vs New York prices). Just as a sanity check, the bulk cost of the concrete alone should be something like $160 million (at around $134 per m3 and assuming you fill the whole pyramid up with it), so I suspect the higher price is more accurate. If you don't want to use real skulls, then I found ceramic skulls on sale for around $8. Assuming a bulk discount ($4 per skull), this makes them by far the cheapest part of the whole exercise ($4.8 million). The folk from construction physics can probably math this out a lot better than I can.
My final suggestion, since we've made a flat-topped pyramid, is to have a chamber of important covid-related figures' skulls in the heart of the pyramid, and put the inevitable gift shop and restaurant on the roof.
In re: the discussion above about the true rationalist commenters vs the riff raff at this-a-here blog, this comment is first ballot Hall of Fame True Rationalist material.
This comment alone makes me glad for this whole mess of a comments section.
Would like to express my agreement with this sentiment. Cry6Aa's comment was a delight to find (and will be getting relentlessly linked to my circle of friends).
I know this is not the view you're arguing for, but this we/them frame in the face of a huge shared calamity speaks to the real dissolution of a functioning society to me.
Besides the young people resenting the old people, there are millions of people with chronic illness in any given year, millions undergoing cancer treatment with wrecked immune systems, bunches of newborn vulnerable babies, bunches of pregnant women who are also medically vulnerable. Bunches of people without great access to healthcare or who can't economically afford to miss work. *And then there are all the people who love them.*
And it makes me worry that these guys who are so resentful of the price they paid during a national calamity don't have anyone to love. Because if you love someones in your life, chances are one or more of those someones are vulnerable in some kind of way, and you would feel eager in the face of such a threat to have things to do that would make the ones you love be just a little less likely to get really sick or die.
The tradeoffs in some situations were absolutely terrible, no doubt. But all of life requires tradeoffs. And exceptional times require some really big ones. None of us is promised smooth sailing for any amount of time, ever.
That's a really profound kind of experience to have people you know commit suicide and it's really awful that that was part of your Covid time experience, that direct trauma of losing people that way during a time that was already horrible.
I'm sure you're right that at least part of the reason for the suicides we saw increasing during that time were due to social isolation. For the healthcare workers who committed suicide, it seems like those were maybe fueled by the moral injury and overwhelm of being a healthcare worker at that time.
I'm a psychologist who works with individuals and families and so I had a front seat view to the small, medium, and enormous mental health impacts of peak Covid time. In addition to the people who suffered from terrible isolation (young and old), I think the tradeoffs were also especially horrible for children and for parents of children.
I also had a prolonged non-Covid physical health threat that emerged for me during Covid (cancer) and so I had a front row seat to the impacts on hospital-based workers beyond those I know from my private practice. And I saw how various doctors and nurses and other staff carried the weight of tradeoffs, everyone carrying a slightly different mix of burdens and trauma. I also worked with quite a few patients who had severe social anxiety who experienced a couple of years of real relief from it for the first time in their lives as a result of the permission to stay home and the opening of working from home. So while Covid and all that came with it was a horror for mental health broadly speaking, there are also other stories in there as well.
I think the only difference between you and me on this topic maybe is that I took from my experience of that time the sense that most everyone is doing the best they can all the time. That humans and human systems have forever been very flawed. That there's a real limit on our capacity to make good decisions in an environment of high risk and high uncertainty and where the conditions are rapidly changing. I see those limits and tradeoffs as built into the human condition and into the reality of the world we live in.
And then I witnessed up close so so many people daily doing acts of generous and heroic kindness -- including to me personally hundreds of times -- that despite the losses I experienced and witnessed, I also feel a profound gratitude to be here, to be alive in this world, as messed up as it is. I feel a lot of grace is due to all the people who worked really hard to take care of others in a situation none of us has ever been in and for which there was no adequate road map (including because we failed to do the planning for this that had been mapped out decades ago). Long-term planning being another weakness of humans.
I also think criticism is important and it's key that we all in various ways reckon with the losses, the tradeoffs, and the costs of the different choices made in different times and places through the pandemic. I see the value of this not in assigning blame but in preparing us to do it better next time. To me that means wrestling with the nuance and complexity rather than drawing quick judgments and conclusions. Bringing curiosity, in other words.
There's a view I think that everyone who was in any way on the front lines of responding to the pandemic *should have known better* about a whole range of things, *should have communicated better* and should have overall *been better people*. And of course there were in there here and there some truly venal and opportunistic people as well as the usual mix of people of mediocre competency. To me, this is where humanity is as a whole at this moment. We would like everyone to be better and having those wishes for humanity is good. But we live in this world where people are how they are -- an incredible mixed bag. Glory and horror all wrapped up together. I have no confidence that if you'd dropped me into any other frontline role than the one I had that I would have done better than those people in those positions. I had my hands absolutely full with the position I had and was bending under the weight of it every day until it kinda broke me.
I guess I want to say there is relief in accepting this. It doesn't mean don't ever be angry or give up and don't do anything to make things better. But accepting all this as where we are as humans means that one's actions can move better from a place of calm and compassion and the choices we make from that place tend to be better ones than the choices made from rage. And also it feels a whole lot better.
I think (I don't know if I'm right) that a lot of the political discord we've seen since Covid (though it obviously was well along already) was fueled by the lack of official acknowledgement of the need for grieving, reckoning, criticism, and taking responsibility. I could write a huge proposal sitting right here with ways I think institutions and governments needed and still need to create official space for people to grieve and recover as well as to reckon and criticize.
Grief unprocessed can lead to both rage and depression (as well as a whole host of other health problems) and my country at least (US) has done a very poor job of making space for grief. Not because people suck so much as that historically as a culture and an economy, we have not prioritized emotional health and connection. Instead we have prioritized economic productivity, accumulation, and status. While at the same time, we didn't do the work over the past decades to set up our institutions to respond well to this specific kind of calamity, which then exposed a lot of people to the particular foibles and weaknesses of individual humans even more than would ordinarily happen in a crisis.
I think you are entitled to whatever feelings you have about what went on during Covid, how all of it impacted you and the people you cared about. If it leads you mainly to anger and blame, I guess I want to say have hope, there is a place on the other side of that that feels better. And it runs through you validating everything you feel and felt about the pandemic and not from minimizing it (which I don't hear you doing).
Well here's the thing. If there were a new shocking ear worm parasite that was 100% fatal but only infected people the day before they were going to die of something else, that ear worm parasite could kill millions of people in a year and cause the largest fatality event in US history, and it still wouldn't really matter because those people were going to die anyway.
Excess deaths that year would be close to 8,000 because that is the number of deaths in one day. If the parasite moved all deaths forward by two days then excess deaths would be close to 16,000. In order to get excess deaths up to 1 million you have to move deaths forward about 100 days.
I think by that time, you’re talking real sacrifice - people lose several months of time with literally everyone they love.
It’s not as bad as a war that kills tens of millions of people decades early and thus leads the average person to lose several years of life, but I think we get a sense of the magnitude.
I think it's reasonable to assume that a very large number of people who died from Covid had their deaths moved up one to two years, and a few moved up around five.
Emergency rooms and hospitals were flooded. I know a PA who pivoted to work directly with COVID patients pretty much from the start and it was an absolute nightmare for them.
It's not cognitive dissonance, it's survivorship bias. It was "only" 1.2 million deaths because various measures were taken. It's like saying the Y2K bug was overblown because nothing really happened come Jan 1st, 2000 - but that was because legions of programmers had been employed to actually fix the bug in affected systems. That is always the curse of "preventing bad things from happening" as opposed to "making good things happen" - if you prevent something bad from happening, it can look like you've done nothing at all.
Some one up above, about the harm of government-issued NPIs, pointed out that there would still be a lot of ad hoc NPIs done in the baseline.
That applies in the other direction, too. Even for a disease that genuinely kills 1% of a population acting like normal, people will react and restrict contact in a way that reduces the impact, even with no government-led interventions or vaccines.
Right. If no official measures had been in place, it probably would have been 1.5 million deaths. No official measures except vaccine development, 1.25 million deaths.
The observed death rate isn't that far off what you'd get if you postulate the disease running unchecked until the population reached herd immunity, and even in the absence of official countermeasures you'd have lots of people taking private ones. That 1.2 million people died *anyway*, means there isn't really much room for the official measures to have done much good.
And then there's the world where we imagine no official measures but also no official impediment to vaccine deployment and distribution, and I'm pretty sure the death toll is well under a million in that one.
I'm not sure how you are deriving these numbers (personal intuition?), but this isn't what you see in epidemiological publications at all.
Also, herd immunity wasn't ever achieved. We don't have herd immunity right now. Things are much better than they were from 2020-2022, but COVID is still circulating, acting like quite bad influenza waves crashing against us. The disease burden is substantial. Turns out our immune system's limitations + viral evolution is able to frustrate herd immunity for this disease. That hope was decisively dashed in late 2021 when it became clear that developing an immune response through vaccination / exposure was insufficient to produce lasting immunity in the general population.
Even assuming these numbers are true, without getting into details like your confidence in them and whether they would have been available at the time when they would have mattered: Would you have decided "Eh, only 300k additional deaths, that's not worth a lockdown"? Especially if it was a matter of public record and you had to expect someone eventually writing nasty headlines about your decision?
I'm fairly confident in those estimates, for reasons that I've discussed here too many times to want to repeat. But as to your question, oh hell yes. First off, if you read my statement carefully, that's 250,000 lives saved (US only) by vaccines, and 50,000 by mandatory lockdowns, masking, social distancing and all the rest. If anyone here is assuming that because I opposed lockdowns I'm also an antivaxxer, then please just shut up and go away.
And second, even setting aside concerns about pesky little things like civil liberties, and the economic cost of the lockdowns, and the effects on the mental and social health of American adults, if you ask me to trade fifty *million* children going through a year and a half of half-baked zoomschooling, against fifty thousand mostly septuagenarians dying five years earlier than they otherwise would have, then there's no contest.
Even if we assume 99% of the kids came through just fine, and the 1% that don't suffer only a 1% reduction in QALYs per year from the educational shortfall, the lockdowns fail the consequentialist math. And I'm not a consequentialist.
You haven't answered my question whether any of these numbers (1.2M, 1.25M, 1.5M) would have been available in early 2020 at the same confidence. Hindsight is always easy.
Oh, sorry, yes I missed that. These numbers would definitely have been available at the time, if someone had wanted them. I mostly took these numbers from my own analysis in 2020. and that of people like Zvi Mowshowitz, and the subsequent observation that the actual infection and death tolls were tracking pretty closely with the "we fuck it all up and our interventions are useless" predicts right up until the vaccine rollout. At which point there was a substantial drop in mortality, though less so with infections.
The thing that should *not* have been available with confidence in early 2020, was the belief that lockdowns, mask mandates, and "social distancing" were going to dramatically reduce the death toll. Those were unprecedented interventions, with no proper scientific studies to back them up and based on multiple dubious assumptions.
As best-guess "maybe this will work; let's put it out there as a recommendation" measures, sure, worth a try for all we knew in 2020. But an intervention that is intrusive, mandatory, and controversial, is one that really needs to be backed up by the sort of science we can be confident in.
The distortion of reality where people pretend that hospitals weren’t flooded is ridiculous. They were. It was insane. I’ve never seen anything like it before or since.
Also It’s pretty clear why the actual flu disappeared — enough people were wearing masks that it couldn’t spread. Note that flu is spread via droplet transmissions so simple masks are highly effective against it
I think a lot of the comments section is missing the concentration thing. New York City had mass graves. A random town in Iowa may have seen zero cases.
I don't know if it's clear any respiratory disease spreads via droplets rather than aerosols now. COVID is just more transmissible than the flu (measles being super-transmissible is why we're starting to see outbreaks now that vaccination has dropped a little).
Hospitals were either flooded or empty depending on where you were.
NY hospitals got demolished because Wuhan is where all the garments are made, and the places that got bombed are tied in with the fashion industry. Wuhan, Milan, London, NY. It spread after Fashion Week. One or several Chinese fashion industry execs were Patient Zero.
Statistically, nationwide, hospitals were not overwhelmed. In fact most were under-occupied because they were saving beds, or at least that was the argument they made when they claimed taxpayer bailouts. There were local anecdotes in certain places, New York most prominently. But even there, they brought in the hospital ships and built out extra capacity and nobody used it.
Meanwhile, against the anecdotes of people claiming hospital flooding, there were the three hospital visits I made during the Covid period, twice with my mother, once with a child. The places were ghost towns. I've never seen the ER so quiet and with so few patients. Like three people in a space that normally seated 200.
I'm not claiming those observations necessarily generalize. But neither do the anecdotes of flooding.
Hospital overload is like traffic congestion. 90% of the day, highways are empty. But at the time that everyone wants to drive, they get crowded. Hospitals were under capacity for most of the pandemic because there were plans to try to save capacity - but when a big wave hit anywhere, they got flooded. (See New York in March 2020, Houston in June 2020, etc)
COVID turned out to be significantly more contagious than influenza. The globes' attempts to mitigate COVID spread actually appears to have wiped out one of the major circulating influenza lineages, which has simplified the vaccination formulation going forward.
The excess deaths chart above does NOT look like "a bad flu season", unless you mean something like Spanish Flu. Actual flu disappeared because measures that failed to stop COVID reduced R0 enough for them, enough to kill off some old flu strains https://www.livescience.com/flu-virus-types-extinct-covid-19.html
During the Delta wave hospitals in my area -- an area with low vaccine uptake -- got slammed and had to bring in hundreds of medical personnel from out of state.
During this same period my local state representative was posting antivax crap on Facebook.
Why do you demand perfection from experts but ignore the political partisans who got people killed?
Delta hit red areas hard because the red areas dodged the earlier waves and had lower herd immunity than the northeast did. NYC fared very well during Delta because they all had immunity from earlier infections.
This needs to be analyzed regionally and without political bias.
I higher vaccination rate among people under age 35 would not have made a difference. A higher vaccination rate of people over age 65 would probably have made a tremendous difference. And neither rate matters much now that the vaccine is less than 40% effective at stopping spread anyway.
(After that made news I called him an complained because multiple tenants from my property in Branson were in the hospital with COVID. One of them was under 40 and overweight but not morbidly obese. Fortunately they all survived.)
Or maybe they were listening to these people right as the Delta wave was surging. This is literally at my local hospital.
I can retype "a higher vaccination rate of people over age 65 would probably have made a tremendous difference" if you like. Otherwise I'm not sure what your point is.
Remember that the “immunity” New York had during delta wasn’t just from higher vaccine uptake and earlier immune system encounters with the virus - it was also from behavioral changes triggered by living in a place that was hard hit. The brain is the biggest organ in the immune system, just like it’s the most sensitive erogenous zone.
Unless NYC shut the subway down during Delta then NYC has infinite vector potential no matter what other "behavioral changes" they tried to implement. No amount of separation is going to tamp down being stuck in an enclosed poorly ventilated space, given what we know about how the virus is transmitted by stale air.
You don’t have to shut down the subway to reduce spread in the subway - as long as fewer people are using the subway it will contribute less spread. (Presumably quadratically, because spread is proportional both to the number of infected people present and the number of uninfected people present).
I suppose a reduction in subway ridership may have had some impact, but the fact that basically the entire city all got Covid at the same time six months earlier probably had a dramatically larger effect. And that effect wasn't present in the red areas that had their first wave during Delta. These are areas, keep in mind, without anything remotely approximating a subway.
My point is that if we're talking about people's perceptions, the news stories that would tend to show that conditions were really bad were often balanced by news stories that showex that they were not nearly as bad as anticipated.
> we should expect to see hordes of dying people staggering the streets because emergency rooms and entire hospitals would be flooded, then the hordes' corpses to be stacked like cord wood awaiting a mass bulldozer burial
This more or less DID happen in New York City, so I don't think it was unreasonable for people at the time with imperfect information to think it may happen in other places. I was turned away from the emergency room and told not to come back unless I thought I was going to die.
> actual flu disappearing for some mysterious reason
This is such a perfect encapsulation of covid denier idiocy. "It's a mystery that with everyone staying home and wearing masks and trying to prevent the transmission of a disease that is more virulent than the flu, there were fewer flu infections this year! The NWO doesn't want you to think about this!" I don't know, there's one explanation that jumps out as pretty plausible to me!
In my city, the hospital where my stepmom works had a network of tents set up outside the building to handle the overcrowding, and the (Republican) governor sent us several freezer vans to hold corpses until they could be properly autopsied because the morgue couldn't hold them all (and because the medical examiner was actually not just declaring every death a covid death if there was a positive covid test, but was ensuring every corpse had a proper investigation into cause of death).
It makes sense that COVID killed a million or so in the US. That's a 0.3% mortality rate, or 3x the flu. It also made plenty of sense to have a strict lockdown as an initial response to the virus. The question is why did we keep it shut down after we figured out that it was going to be an endemic virus and all of those people would die of it eventually anyway. And most damningly, why did we keep it shut down for another year after the vaccine came out? All the conspiracy talk is just a distraction from discussing the very real authoritarian nightmare that was inflicted on us by the administrative state. If you had asked people in 2019 if we should shut down the economy for two years and print trillions of dollars causing massive inflation in response to a virus only 3x worse than the flu, they would have thought you were insane.
It was more than 3x as deadly. About 500,000 died in the US that first year. The worst flu season of the 21st century only had 80,000 deaths in the US and many had more like 20-30,000. So we're talking 6x-15x depending on the flu season. And that's with all the measures we took to prevent transmission.
The "3x the flu" number is an average ranging from the beginning of the pandemic (more lethal virus, no vaccines) to the end (much less lethal virus, lots of vaccinated people).
Comparing it to actual flu waves, you also have to take into account that Covid was, and became even more so, much more infectious than the flu, such that sooner or later everyone got it, whereas each flu wave only hits a few % of the population.
But, yes, initally it was much more deadly than the flu (10x as lethal as the nastiest flu strains IIRC).
If you average it over a long enough time, you can just say that it had exactly the same mortality as flu (it converges to 1x as t=>oo). This reduces my sympathy in justifying the 3x number, significantly.
You're using a very weird definition of mortality. My point is not that more people die the longer you wait. It's that the probability of dying of the disease decreased with time (because the virus mutated into strains with lower mortality, and vaccines were rolled out), but for the initial measures, it's justified to base them on the mortality for the variants that circulated then in the absence of vaccines, and at that time "10× more lethal and twice as infectious as a the nastiest strains of flu since the Spanish Flu" was a reasonable estimate.
My comment was not intended as a rebuke. You said "The "3x the flu" number is an average ranging from the beginning of the pandemic...to the end...." and "[but initially] 10x more lethal." My point was just that averaging over a period of time (3x from beginning to end) eventually converges to 1x since you are averaging a finite peak with an exponential decay back to baseline. In other words, you could pick any multiplier between 10x and 1x and there exists a time period for which this is the correct average. The ability to chose any number raises the question of why one might pick "3x." Again, my comment was at least half tongue in cheek.
That's part of it, but not nearly all. The Omikron variants had a significantly lower fatality rate, even among unvaccinated people, and by that time most people had not had the infection yet.
The difference was Covid-19 was NOVEL, not that it was that much more deadly. The difference was that unlike the flu, basically everyone caught it, all in the same year.
Flu x 3 is not a great way to look at it. If you were over 65, it was 7*[Flu], and if you were under 35 it was 0.5*[Flu] or lower.
Note that just saying "it turned out fine so the precautions were unnecessary" is not valid reasoning. What you *can* argue is something like that countries that didn't do a lockdown had similar death rates, which might or might not be true. But my point is that the argument needs to be a little more complex than what you said.
Note that I mentioned in my comment that it was reasonable as an initial reaction. Erring on the side of caution is a reasonable approach to an unknown disease. But by June 2020, those initial unknowns were pretty much all known. Also, it didn't "turn out fine." It was essentially the worst outcome possible. Containment was a complete failure and 100% of the population got the disease.
"What you *can* argue is something like that countries that didn't do a lockdown had similar death rates, which might or might not be true."
A reasonable pair for comparison (and *I* remember saying this in 2020/21 so this isn't hindsight bias, though I didn't write anything and you don't have to believe me ...) is Sweden and Denmark. Similar populations (though not identical) and Denmark locked down much harder than Sweden.
I have seen analysis that claim that Sweden did *better* than Denmark, but that analysis requires sophisticated math and I am skeptical.
Disappointing, because philosophically I much preferred the Swedish approach of providing guidance to the population and expecting them to behave reasonably. It would be nice if that ALSO resulted in fewer deaths. But I don't think that it did.
The UK is a popular country to compare against Sweden by those who opposed the lockdowns and the UK experienced 3,389 reported covid deaths per million, but that comp tended to arise afterwards and I think Denmark is better.
if you look at excess deaths as opposed to reported deaths I believe Sweden comes out pretty dang similar to other Nordics other the whole pandemic period.
I feel like you are cherry picking here. Sweden is right at the median for death rate of countries in Europe in your source. And Denmark is near the bottom. Unless you have some actual hard criteria here, like age structure of population, for using Denmark in particular I would say it's not really valid.
Buuut, you didn't keep it shut down. At what point did you have to stop getting permission from the local police to leave your house? That's when lockdown ended.
Needing permission from the police to leave your house is a lockdown. If you can just leave your house whenever you like, then you’re not locked down, so there’s no lock down.
We (England) had a lockdown from 26 March 2020 to 28 May 2020 and then again from 5 November 2020 to 8 March 2021.
Yeah, I don't understand where this meme comes from. We had school closures, restrictions on indoor commerce (usually fine w/ a mask), and were encouraged to get vaccines. I know other parts of the world had stricter interventions and a bunch of lefties were enormous hypocrites about SJ protests, but even in NYC at the height of it, I don't think people were locked in their houses.
You will justifiably find this highly annoying, but in the US, people often use "lockdowns" to refer to all the NPIs deployed here, collectively. This is true even though only a few of them could (arguably) qualify, like school closures.
I was in Italy at the time, and we were only permitted to leave our apartment to go to the grocery store for several months, and had to carry around papers certifying that we were going somewhere that was necessary for several more months after that. There wasn’t anywhere in the US that had this style of restriction, and it became common to use “lockdown” to mean “needing to wear a mask at the grocery store” in the US.
Tens of thousands of people lost their businesses. Tens of thousands lost their careers. Hundreds of thousands had to relocate their families.
What the hell are you talking about?
Is it a “request” to shut down your business while strip clubs and Costco remain open?
Is it a “request” to be targeted by police if you want to walk around without a mask?
Is it a “request” to be blocked from accessing facilities if you don’t comply with nonsensical policy they just invited 3 seconds prior?
Is it a “request” to have to quit your job (as opposed to being fired for not getting an experimental mRNA transfection therapy) to watch your kids during school hours since the school won’t open for them, but your still get the joyous opportunity to pay for the closed schools as though they’re open?
In California, it was illegal for anyone to leave their home for "nonessential" reasons from roughly March 2020 through September 2020. And if you did have an "essential" reason to leave, there was a very limited set of places to go.
No, they didn't literally have a policeman standing outside everyone's door to check. If you were willing to lie about what was "essential", you would almost certainly get away with it. I'd still consider that a lockdown.
0.3% is also consistent with the Diamond Princess, as close to a laboratory environment as possible, where the mortality rate was around 0.38% (~14 deaths, ~3700 people on board).
> "All the conspiracy talk is just a distraction from discussing the very real authoritarian nightmare that was inflicted on us by the administrative state."
I don't think it's a distraction. I think that given that ~1/5th of the ACX comment section seems to believe this false thing, it is a separate but also-serious problem, and it's worth talking about it. We can't have a sensible discussion about how bad the real facts are until we agree on them!
> The question is why did we keep it shut down after we figured out that it was going to be an endemic virus and all of those people would die of it eventually anyway.
> If you had asked people in 2019 if we should shut down the economy for two years
We didn't do that! Restaurants reopened before the end of 2020, despite it being obviously impossible to eat in a restaurant without spreading a respiratory disease. Real "shut down everything in-person" restrictions only lasted six weeks before economic reality and cabin fever forced people to reopen while pretending that viral particles couldn't move more than 6 feet indoors.
Scott should implement a rule: when discussing COVID lockdown everyone should have to preface each comment with the jurisdiction in which they lived so we can see what actual measures they lived under.
I will start this grand tradition and admit that I lived in Florida and mostly self-isolated the first three months. I remember how ghostly downtown was when it really hit people that this was happening. I also remember most people shrugging and moving on with their lives within around four months with maybe half masking consistently. Given Florida's place in history as the flagship of low-restriction state governance, my experience may not resemble that of blue staters.
We never once shut down the economy. As far as I can tell, we shut down 5% of the economy (GDP decreased by 2.2%, while in other recent years it had been growing by about 2.4% per year, so at most 5% of the economy was shut down.)
If you want to correct someone’s exaggeration, try not to exaggerate in the opposite direction.
It was a lot more than 5%. They just made up for it by printing trillions of dollars and handing it out. This, of course, caused the inflation mess. If Biden hadn't been such an idiot and lifted all the economy at the beginning of 2021 we probably would have had a much better recovery and less inflation. We probably wouldn't be dealing with Trump today.
What have excess deaths looked like in the years since Covid, 2023 and 2024?
If I weren’t so lazy, I would look this up. I can imagine a scenario in which this number is low or negative, with fewer deaths in these years than expected. And if that were the case, I would think of Covid as having accelerated the deaths of the difference. The people meant to die in 2023 and 2024 died in 2020 or 2021 instead.
And that might explain why it just doesn’t feel like a 1.2 million deaths tragedy.
This is the worst graph you could use to prove your point because it compares different cohorts of different sizes.
Death is strongly correlated with age (duh). If everyone dies at age 75 then you would expect a difference proportional to the difference in birth rate between 1940–1944 and 1945–1950, and those are really different periods because of World War 2 and the following baby boom. In reality it's more smoothed out of course but this still seems too big of a factor to ignore.
So from the graph alone I really cannot tell if the ~10% increase we are seeing in 2024 compared to 2019 is above or below expectation based on changes in demographics between those years.
And at least eyeballing it, the data from early 2025 seems higher compared with 2023 and 2024 which at least suggests a dip in those years.
If you look at the comment I’m responding to, this graph exactly addresses the question there. You can create scenarios to explain what the graph shows, but the comment asked if excess were down after Covid and the answer is clearly no.
The question was whether there were fewer deaths in 2023 and 2024 “than expected” (which would indicate a pull-forward effect of mostly older patients dying).
”Than expected” doesn't mean “than 5 years ago” if there are reasons to expect the death rate to be higher than 5 years ago regardless of COVID (i.e., the baby boom).
So no, it doesn't answer the question, at least not convincingly.
And you do need strong evidence if you want to deny there is a pull-forward effect, since we know that COVID deaths disproportionally affected the elderly (and secondarily the obese, who generally have lower life expectancy as well), which nobody denies, so purely statistically you would expect the death rate post-COVID to be lower “than expected”, everything else being equal.
It seems to me the "pull-forward" theory proponents should actually present some actual evidence their theory is accurate other that just saying it makes sense so it must be true. If you have a better graph I would love to look at it. Given the oldest boomers are around 80 years old, and their life expectancy is also around 80 (although really more given the life expectancy for anyone at age 75 is around 12 years), a 10% increase in deaths seems highly, highly unlikely without some other cause.
I've given you a perfectly reasonable explanation why the pull-forward theory is likely, you just chose to ignore it. It relies only on facts that I assume you already accept to be true: that COVID disproportionally killed people with shorter life expectancies, namely: the elderly, the obese, the infirm.
Then it logically follows that the survivors have higher than average life expectancy, resulting in a reduced death rate in the following years, if everything went back to normal.
Of course there is an “if” there. You could argue that the introduction of COVID has permanently increased the human death rate which offsets the expected short-term decline (which would mean life expectancy at birth is lower post-COVID). This is plausibly true at least to *some* extent, but if you want to make a specific claim about how strong that effect is the ball is back in your court. Also this is not actually an argument against the pull-forward effect per se; it's just an explanation why the death rate doesn't go below average levels *despite* the pull-forward effect.
Note that the effect on the death rate of the pull-forward effect is likely to be small because deaths don't very neatly occur at the end of life expectancy.
What, exactly, are you arguing against? The pull-forward theory is that people who died of covid would otherwise have died later, AKA, they would not have been immortal. Really the only alternative to this is immortality.
And why are people so excited about the pull-forward theory, anyway? There seems to be an implication that it makes things ok again, and yet, dying sooner is worse than dying later (assuming quality of life above 0). All sorts of humanity's most celebrated achievements - agricultural revolution, eradication of smallpox, antibiotics - only delayed death, rather than preventing it entirely.
I started writing this comment to Calvin, but then threw it out when I realized it didn't contradict him, but I guess I'll resurrect it now.
==
Let's say we have 10M elderly and we expect 5% to die each year, so 500K deaths. Also 500K people age into elderly, nice and even.
Then a virus comes along and kills an extra 10% in year N, so we're down to 9M next year. However, out of these 1M deaths, it was strongly correlated to the worst health, so 250K of them were going to die in year N+1 and 250K would die in year N+2 and 250K would die in the year N+3. The remaining 250K were from the otherwise healthy elderly.
Now, in year N+1, we would normally expect there to be a population of 10M and 500K deaths, but 250K of those deaths happened in year N. So we have a population of 9M and 250K deaths.
I'm a bit confused if you are agreeing or disagreeing with me.
What you describe is essentially what I'm arguing: that since COVID killed people with relatively low life expectancy, we should logically see a reduction in death rate post-COVID, barring other effects.
It sounds like you're arguing that if the pull-forward effect is significant, then we should see a stronger dip than we've seen, and that argues against a pull-forward effect. But I'm not sure we have accurate enough data to tell whether there is a dip, as I've explained above.
Note that you used exaggerated numbers to get the desired effect: a 200% increase in deaths during COVID while more realistic estimates are 20-25% (though over roughly a 2-year period). Additionally, you assume ¾ of victims would have a life expectancy of only 2 years; I think it's plausible the average was higher but still far below average overall (say, 5 or 10 years) which would make the dip shallower and wider.
I understand you were using the example to explain the principle, and didn't claim your numbers were accurate, but we do need to use accurate numbers to estimate the size of the dip.
Even with your numbers, the dip is significantly smaller than a peak: a 200% increase followed by 44% decrease over the next three years. If it turns out that e.g. a 25% peak results only in a 5% dip in the following years, that wouldn't necessarily be visible in a low-resolution graph that includes lots of other phenomena too.
By the way you have to account for the fact that the US has an uneven population pyramid, with many Baby Boomers who are going to die in the coming decades, which is why I suspect the numbers are trending up in the first place.
I'll grant you that there is no obvious decline to compensate for the COVID peak, but the graph is also conveniently missing the data from 2024, which is really important: does 2024 continue the sharp decline from 2021–2023 or continue the upward trend from 2010? That seems a really important question we cannot answer with this data.
And as I said, there is significant demographic change as well, so ideally I'd like to see this data controlled by age.
The idea you're referring to is often called the "pull-forward effect" or "mortality displacement," where a spike in deaths during an event like a pandemic reduces subsequent mortality because many of those who died were already near the end of their life expectancy. Let’s examine the available evidence to see if there’s support for this theory regarding COVID-19 deaths after 2021, using data and trends from reliable sources.
### Background from the Provided Link
The Census Bureau article you referenced confirms a significant spike in U.S. deaths during 2020 and 2021 due to COVID-19. It notes a 19% increase in deaths from 2019 to 2020 (from 2,854,838 to 3,390,029), the largest in 100 years, with deaths remaining elevated in 2021 (19.7% higher than 2019). The data highlights that older adults, particularly those aged 85 and older, accounted for a disproportionate share of deaths, suggesting that many fatalities were among those with pre-existing health vulnerabilities. However, the article’s data stops at 2021, so we need to look at more recent sources to assess post-2021 trends and the pull-forward effect.[](https://www.census.gov/library/stories/2022/03/united-states-deaths-spiked-as-covid-19-continued.html)
### Evidence on Post-2021 Mortality Trends
1. **Decline in Overall and COVID-19 Deaths Post-2021**:
- **2022 Data**: According to the CDC’s provisional mortality data, the total number of U.S. deaths in 2022 was approximately 3,273,705, with an age-adjusted death rate of 832.8 per 100,000, a 5.3% decrease from 879.7 in 2021. COVID-19-associated deaths dropped significantly to 244,986 (7.5% of total deaths) in 2022 from 462,193 in 2021, a 47% reduction. This indicates a notable decline in both overall and COVID-19-related mortality after the pandemic’s peak.[](https://www.cdc.gov/mmwr/volumes/72/wr/mm7218a3.htm)
- **2023 Data**: The decline continued into 2023, with provisional data reporting 3,090,582 total deaths and an age-adjusted death rate of 750.4 per 100,000, a 6.1% drop from 2022. COVID-19 deaths fell to 49,928 (1.6% of total deaths), a 68.9% decrease from 2022. This suggests a sustained reduction in mortality as the pandemic’s direct impact waned.[](https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a1.htm)
2. **Natural Increase Rebounding**:
- A Census Bureau report indicates that natural increase (births minus deaths) began recovering post-2021. In 2021, natural increase was only 144,013 due to high mortality and a 3.5% drop in births. By 2022, it rose to 236,155, and by 2023, it reached 531,432, driven by fewer deaths and increased births. The number of states with more deaths than births (natural decrease) also dropped from 25 in 2022 to 19 in 2023, suggesting a return toward pre-pandemic mortality patterns. This rebound could be consistent with the pull-forward effect, as fewer deaths in later years might reflect the prior loss of vulnerable populations.[](https://www.census.gov/library/stories/2023/12/state-population-estimates.html)
3. **Excess Mortality Trends**:
- Excess mortality, defined as deaths above expected levels based on pre-pandemic trends, provides insight into whether deaths dropped below normal after the pandemic. A study published in 2024 found that excess deaths declined from 655,735 in the first pandemic year (March 2020–February 2021) to 586,505 in the second (March 2021–February 2022). However, for younger individuals (under 65), excess deaths increased in the second year, particularly for non-COVID causes like alcohol, drugs, and homicides, suggesting that the pull-forward effect may be more pronounced among older populations.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC10988222/)
- Another analysis noted that excess mortality was highly concentrated among older age groups in 2020, with those aged 85 and older accounting for 34% of excess deaths despite being only 3% of the population aged 25 and older. This supports the idea that COVID-19 disproportionately affected those closer to natural life expectancy, potentially reducing subsequent mortality.[](https://www.census.gov/library/stories/2021/02/indirect-impact-of-covid-19-results-in-higher-pandemic-death-toll.html)
4. **Pull-Forward Effect Discussion**:
- A post on X by @Voltaire765 references the pull-forward effect, citing Alex Berenson’s Substack, which argues that after the initial COVID-19 death spikes, mortality should drop below normal as those who died early (primarily elderly and sick) were no longer at risk. The post suggests that five years post-COVID, mortality data in the U.S. and Britain might reflect this. While this aligns with the theory, X posts are not conclusive evidence, and Berenson’s claims require scrutiny against primary data.
- The significant drop in COVID-19 deaths from 2021 to 2023, alongside a decrease in overall death rates, aligns with the idea that the pandemic accelerated mortality among vulnerable groups, particularly the elderly. The high proportion of deaths among those aged 85+ (e.g., 307,169 COVID-19 deaths from January 2020 to June 2023) supports the notion that many who died were already at higher risk due to age or comorbidities.[](https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/)
- **Non-COVID Excess Deaths**: While COVID-19 deaths plummeted, excess deaths from other causes (e.g., drug overdoses, homicides) increased, particularly among younger populations, which offsets the expected drop in overall mortality. This suggests that the pull-forward effect may not fully explain post-2021 trends, as societal disruptions from the pandemic contributed to other mortality risks.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC10988222/)
- **Vaccination and Immunity**: The sharp decline in COVID-19 deaths after 2021 is also attributed to widespread vaccination and prior infections, which reduced mortality risk. This confounds the pull-forward effect, as lower deaths may reflect improved immunity rather than solely the loss of vulnerable individuals.
### Conclusion
There is evidence supporting the pull-forward effect post-2021, particularly among older populations. The significant decline in overall and COVID-19 death rates from 2021 to 2023, combined with a rebound in natural increase, suggests that the high mortality during 2020–2021 may have reduced the number of vulnerable individuals, leading to fewer deaths in subsequent years. However, this effect is not universal across all groups, as younger populations saw increased non-COVID mortality, and factors like vaccination, undercounting, and data lags complicate the analysis. While the theory holds some weight, especially for the elderly, it’s not the sole driver of post-pandemic mortality trends.
For further details, you can explore the CDC’s National Vital Statistics System (https://www.cdc.gov/nchs/nvss/index.htm) for updated mortality data or the Census Bureau’s population estimates (https://www.census.gov) for natural change trends. If you’d like me to generate a chart comparing death rates or excess mortality across years, let me know!
I really don’t think that it matters what evidence you present about this, because Covid skeptics have a remarkable ability to ignore any facts that contradict their beliefs. Anyone getting their beliefs from people like RFK and Alex Berenson, who are really shameless in the way they twist facts, are not people who can be persuaded. In general, conservatives have decided reality is whatever they want it to be to a remarkable degree
I think this is true of some people but not others. All of these people were convinced because someone argued them into their position, and if people are constantly arguing for these ideas but refuse to argue against them because "nobody can be convinced", they win by default.
More realistically, I don't think I will change the mind of any hardcore conspiracy theorist. But I think some conspiracy theorists will refine their conspiracy theories to be more plausible (while learning some useful things about good thinking skills), and people who are not yet either explicitly conspiracy theorists nor anti-conspiracy-theorists will hone their thinking skills and be less likely to believe conspiracy theories in the future.
But it was avoidable. International travel could have been suspended to prevent the virus from entering, then with a lower baseline and non-endemic virus in other countries we could more easily isolate & contact-trace the few who brought it in.
Many pandemic preparedness plans have been written. If you truly care about preventing tragedies, you may wish to read one of them and perhaps convince people to implement it.
Maybe this is true of the people you know, but the conservatives I know (which are many; I was raised very conservative) have very insane views on Covid, most of which are not remotely based on fact and many of which are mutually exclusive (ie Covid can’t be both a leaked Chinese bioweapon AND designed as a plot to enrich Anthony Fauci).
If it changes the mind of conversatives he knows, but not the minds of conservatives you know, that's a victory. Because a world where some people change their minds and some don't is of course better than a world where nobody did.
I see somebody has never been to the Historic Downtown Anthony Fauci Bio-Thunderdome, which doubles as his mountaintop fortress. Shaped like a skull, naturally.
Mostly because that's what elites they look up to believe (or pretend to). So it's those elites that largely need to be convinced, or utterly discredited and overthrown. Both approaches prove to be pretty difficult in practice...
I think most True Believers were "convinced" of whatever conspiracy theory because
1. It flatters their egos to think that only THEY can see the truth, and that everyone else is just a sheep
2. It validates their rage at having to do something they consider inconvenient or scary. If it's a conspiracy from the NWO, the mask or vaccine requirement is not just an annoyance meant to save lives (which would not be socially acceptable to complain about), but a form of tyrannical oppression that MUST be resisted
3. It is a tool they can use to partisan ends. First Dems did this (Kamala's insistence during the primary that she wouldn't take a vaccine rushed out by Trump), then the valence flipped (afaict because the actual acting president changed, even though the vaccine really was made as quickly as possible under Trump's aegis)
I don't think these people were convinced rationally, they just accepted something they already wanted to believe. I still think it is good to make sure that true arguments for correct conclusions are ubiquitous, because otherwise low-information people end up believing conspiracy bullshit by default.
Fireflies flash in specific ways to find mates, birds pick their own song out of a squawking forest.
Somewhere out there there's a budding rationalist who just hasn't deeply weighed out the alternative views on <your topic here>. If you speak thoughtfully, it can cut through the noise and resonate where it matters, even if that's like 1% of people.
I believe this because I've often had 'conversion' experiences after reading arguments similar to this one. Though more often each argument moves me just a few degrees.
This one didn't radically flip my view, but reinforced it slightly, and better prepped me to help acquaintances and in-laws weigh key evidence in a calm and respectful way.
My most unsubstantiated conviction is that the talkorigins archive wasn't a failure at all and we should have doubled down on it and done extensive argument mapping for all controversial topics.
(Maybe AI has already quietly solved for this, "@grok is this true? @grok what are the flaws with this argument?")
I was raised christian conservative, then went to university as a left-leaning atheist, and am now a researcher (and still atheist). Unfortunately, I would say your last sentence applies cleanly across the entire political spectrum. Science is rife with it.
The problem is and was very simple; Covid was a time with very little confidence, yet the scientific establishment pretended high certainty about a long list of things that later turned out to be provably false (masks don't work, then suddenly they are obligatory; Trump is pushing the vaccine development dangerously fast and one month after Biden's election it's suddenly 100% safe; vaccines fully stop the spread so we can open up again oops actually they only protect the person taking it; Lockdowns are sad but necessary actually countries without lockdowns did just as fine; Lab leak is conspiracy theory well actually most intelligence agencies consider it the most likely reason, etc.). And social science already had been doing the same for social justice, so it was straightforward to extend that mistrust just one category further.
When people lose trust in the institutions, they start looking elsewhere. These other places however have little to no quality control, so it's easy for grifters to get a foothold. It's stupid, it's completely avoidable, but that's what happens if you burn your long-term credibility in the name of the short-term greater good(which actually turns out to be wrong later anyway).
I agree somewhat but also disagree. I agree a lot of our institutions and "establishments" failed very badly during covid (and continue to fail in many other areas), however, the widespread embrace of conspiracies and obvious misinformation started way before any of the events you mentioned. For example, I remember many conservatives I knew promoting the "Plandemic" movie almost as soon as the lockdowns started. I also remember at least one acquaintance trying to argue with me that the covid vaccines were dangerous before they were even invented.
Also, I remember some of those events differently than you do. I know some Democrats said Trump was rushing the vaccine approvals, but that wasn't the general consensus on the left. Similarly, after the vaccines rolled out I saw a number of articles warning that if covid mutated the vaccines would be much less effective, which is what happened.
Agreed: it's a big problem that authorities believe they can't admit uncertainty, frequently playing armchair psychologist when that isn't actually their area of expertise.
So, the US suicide rate is about 0,014% per year. That is about an order of magnitude to small to account for excess deaths - and that is the total rate, the change in suicide has to be a much smaller number.
I think you will find that an analysis of increases in drug and alcohol related deaths, and reduced medical service will similarly amount to numbers that are much to small to account for the excess deaths.
The baseline excess deaths is 0 - excess deaths is how many more people died than in an average year. More people died in 2020 and 2021, and when they died it was marked as due to covid. What could possible be a non-Covid mechanism for this?
I'd strongly advise people to look at the CDC's graph of excess deaths per week due to all causes from 2018 thru 2023:
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Most of the more popular theories are difficult to reconcile with this graph. I've been challenging people to come up with an explanation for over 3 years, and I haven't seen any rationalizations that I found persuasive.
Eyeballing it somewhere around late 70s for the US https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/
Well over 80 in Australia https://www.statista.com/statistics/1245896/australia-number-of-coronavirus-deaths-by-age-group-and-gender/
Worldwide no idea
It seems to me that few people give a shit about the numbers. Most are angrily, personally invested in their familiar set of beliefs about covid and about the stupidity and character flaws of people who disagree.
You seem to be reading a lot into this post that isn't there.
The point of this post is that there is strong evidence that ~1 million people died in the US of Covid. It is useful to answer questions like this independent of surrounding context.
I think there is a subsection of the COVID truthers who say "it was just the flu" but really mean "there are trade offs between life and what makes life worth living, and we fell on the wrong side of the trade off" but I can't really respect the dishonesty. They are knowingly stringing along a lot of people who definitely don't feel the same way.
I don't think I defended the "general pro lockdown pov". I wrote:
> "Usually I’m the one arguing that we have to do cost-benefit analysis, that it’s impractical and incoherent to value every life at infinity billion dollars. And indeed, most lockdown-type measures look marginal on a purely economic analysis, and utterly fail one that includes hedonic costs. Rejecting some safety measures even though they saved lives was probably the right call. Still, I didn’t want to win this hard. People are saying things like “COVID taught us that scientists will always exaggerate how bad things will be.” I think if we’d known at the beginning of COVID that it would kill 1.2 million Americans, people would have thought that whatever warnings they were getting, or panicky responses were being proposed, were - if anything - understated."
I don't know how better to get across that the kind of lockdowns we did were probably an overreaction, but also it's insane to dismiss something that killed a million people as an overreaction that failed to pan out.
> Who cares if “1 mil is a big number” when divorced from population size?
I think it's useful to put it in the context of other problems. For example, are mass shootings a big problem? They kill about 100 people per year. So COVID killed 10,000x that. Is immigrant crime a big problem? A quick Fermi estimate suggests immigrants commit about 100,000 violent crimes per year. So COVID killed 10x more people than are affected by immigrant violent crime. Is cancer a big problem? About 600,000 people die of cancer per year, so COVID killed as many people as cancer during the two years it was most active.
Divorced from everything else in the comment thread here, I just wanted to say thanks for walking back on something in a public comment. It takes strength and I appreciate that you took the time to do that.
I generally wish we could praise and normalise this kind of thing more ('this kind of thing' being things like changing one's mind, admitting missing something, etc), so, in the interest of being the change I want to see in the world, I wrote this comment. :)
Man, now I'm kind of sad that whoever that commenter was, they wiped out the record of whatever they said and changed their mind about.
1.2 million deaths is about 0.36% of the US population of 330 million in 2020.
So, my new approach is to figure out how many years of lifespan covid cost Americans. Assume the average American is 38.7 years old and would live another 40 years and that there were 330 million people in the US in 2020. So that would imply the population at the beginning of the covid epidemic had 13,200,000,000 more years to live.
The highest estimate I’ve seen for how many Quality-Adjusted Life Years (QALYs discount years spent in comas, dementia, or horrifying pain, although not by all that much) the average covid fatality cost is 12.4 years. For 1.2 million fatalities, that would be 14.9 million years of life lost.
So, that would be 0.12% percent of U.S. lifespans lost due to covid.
Of course, the next question is: What would the toll have been if we didn't do X, Y, or Z?
But does "not doing X," such as not going to crowded apres-ski discos (big super-spreader sites in the late winter of 2020), means governmental decisions to shut apres-ski discos? Or does it mean people privately deciding to not go to discos?
And how big of a real-life difference is there between crowded discos shutting down by government order and discos shutting down because so few people are showing up its not worth paying the staff?
What it appears is that many people's preferred counterfactual is: What if nobody had noticed and/or nobody had cared about covid and thus kept behaving exactly as they had in 2019?
My guess is the death toll in 2020 would have been considerably higher.
But it's hard to realistically imagine a world where nobody notices or cares about a global pandemic.
Your guess that the death toll would have been higher is not based on reality, you are just echoing people who think they are smarter than everyone else. There was no chance that nobody would notice and no chance people would act in 2020 as they did in 2019. To be intellectually honest, you have to focus on things like this ---- People did notice that Cuomo's policies - brutal, penal isolation of old people as if they were criminals assigned to life imprisonment in solitary confinement, but close - within the same structure - to people who were dying from an infectious disease - killed many people who would have lived to see another day under a more compassionate government (and remember that Cuomo's government used threats of violence to impose its will). People also noticed that other people were being arrested for being alone with their family on a beach. This was an unimaginable disgrace to the people who ordered such arrests. I know you are a smart guy, Steve, but sometimes you look at the big picture too much, because that is what your pals look at (see, e.g., poor Murray and his attempts to count artistic value by the number of times names show up in mediocre art history textbooks). Yes there are stupid people who say there were no excess deaths and you can laugh at them all day but you are no better than them if you just focus on false and falsifying Leninist rhetoric about 'in the long run we were probably right'. It might be intellectually fun for you and others like you to brag about how much you understand numbers, and the big picture, but this was not a numbers game, and not a big picture game, from the point of view of the people who made absurdly bad decisions ---- and, because every problem in history is a problem that is based on particular details, and because we will never know how the counterfactuals would have turned out in detail, it is important to treat with respect those who disagree with you about the bad decisions made by people who were in the government and who backed up their bad decision with threats of violence, such as arrests, prison sentences, and unprecedentedly in the United States, threats of denial of basic decent medical support to those who dared to disagree with clowns like Cuomo and others like him.
I remember during the worst of it in late 2020/early 2021, the hospitals here in Utah were getting a bunch of Covid patients from Idaho and such because their hospitals had been completely swamped. Now I imagine what that would have been like if it had happened nation-wide over a week or two once the Delta strain got going (no more super-spreader events required).
I bet you'd have at least double the 1.2 million in excess deaths. Many of them wouldn't be dead from Covid itself (although there would be more of them with no free ICUs anywhere nor staff to surge locally from elsewhere in the US), but still dead.
Fwiw, I don't think the first article of the series was pro lockdown either. The point of *that* article seemed to be that 1.2 million American deaths is a lot of deaths and that it is an important and under-discussed fact. Sure, I suppose one could say that emphasizing the number of deaths is an argument a pro-lockdown person could use to support their case, but that isn't what Scott is doing.
In fact, he said "And indeed, most lockdown-type measures look marginal on a purely economic analysis, and utterly fail one that includes hedonic costs. Rejecting some safety measures even though they saved lives was probably the right call."
If you want to read something focused entirely on the lab leak hypothesis, I would recommend Scott's excellent review of the Rootclaim lab leak debate.
https://www.astralcodexten.com/p/practically-a-book-review-rootclaim
I'm making the much weaker and less-trouble-finding-statistics claim that about the same number of people died of COVID in 2020 as in 2021, so if all the deaths were from vaccines, the 2020 deaths would be unexplained. I agree that you would need more sophisticated statistics to detect a 10% or something effect on death rates.
We don't just know that vaccines didn't cause extra deaths, we can see that they lowered them. https://www.natesilver.net/p/fine-ill-run-a-regression-analysis https://ourworldindata.org/grapher/united-states-rates-of-covid-19-deaths-by-vaccination-status
> Further, both make an implicit assumption that the vaccinated and unvaccinated groups are otherwise demographically equivalent.
No, Silver makes the point that there weren't big differences in mortality between states based on partisanship until the vaccines became available. If pre-existing differences between states were driving the difference in deaths, it should have shown up earlier.
It still relies on the assumption that vaccine decisions cut cleanly across state/party lines rather than some other confounder-- which they clearly don't; even the least vaccine-friendly states still got up to like 60% uptake as I recall.
I think this is a bad way to do this, and the fact people think it didn't happen is support for that argument - people don't believe this because the experts and public health officials who support it are liars who lie all the time. They don't...uh, lie in the way people think they lie, but they definitely massage the facts to fit their narrative.
And the result has been a loss of credibility and usefulness.
Giving false reasons to do good things turns out not to be reliable. It gives you goals other than getting good things done, and like a zany sitcom plot, those goals will eventually take up your whole attention, and your original goal will be tragically or comically abandoned.
(Also helpful to your goal, which I support, would be not speaking like a comic book supervillain. Lives matter. Of course they do. You can acknowledge that society can't be infinitely safe without denying that.)
Counterpoint: Truth matters.
Very true. And surprised Scott Alexander would throw this up considering the arguments on whoever's side hasn't and will unlikely ever change.
I appreciate Scott doing this follow-up because I will be more skeptical of his commenters in the future. It's been sometimes challenging to assess the credibility of comments on topics that are novel to me (unlike this one), and this post gives me insight into how many complete morons are among his followers.
I am pulled in two directions: it is extremely frustrating sharing a comments section with a large number of people who have no interest in truthseeking whatsoever, yet who aggressively act like they are the smartest people in the world. On the other hand, it's a huge public service for Scott to be so patient and thorough at exposing so many people with, uh, rationalist skills still at an early stage of development, to what actual reasoning looks like.
I am very much with you in this.
It’s unfortunate that the response has been to destroy all of the institutions that are engaged in progress, because you’re mad that they made less progress in 2020 than you wanted! It’s time to move on and stop blocking vaccines, scientific research, new social technologies, etc!
While I am no covid denier, I think you should really take into account all the people who died of other causes (heart attacks, cancer), because they could not or were afraid to access life saving care, including routine screening.
See also this, albeit anecdotal, comment: https://www.astralcodexten.com/p/the-other-covid-reckoning/comment/119032511
I can easily see, say, 10 per cent of the total excess deaths being caused by this, especially by the end of the period.
This. I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases.
I know a guy who died from a vaccine after white genocide.
That was me!!! I died from a vaccine shortly after they genocided me.
I’m the vaccine, all of the above is lies and russian propaganda!
Not sure this is knowable
Well, there was a strain on healthcare providers more generally. And that strain was caused by COVID. How many of the deaths caused by that were COVID deaths we don't know for sure but it was probably a lot and could well have been a million in the US.
If it's not knowable, even to a degree of uncertainty of approximation, then a meaningful cost/benefit analysis can't be made and the attempt to do so is misguided.
But it is knowable. Not only is it knowable, but the knowledge is easily available to just about anyone who's motivated to get at it. Here is a nifty chart I created tracking the top 8 major causes of death from Jan 2020 through May 2023 (first link below). (I've had problems with Google docs before, let me know if you have trouble accessing it.) If you need a basic tutorial on how death certificates work in the US, I've put together a very high-level description below the links.
If you open my chart, you'll definitely see that deaths due to diseases of the heart, malignant neoplasms (cancers), and cerebrovascular disease (strokes and such) would rise during peak COVID. IIRCC, COVID could only be listed as a contributing factor if the patient had been *diagnosed* with it within the 30 days leading up to death. Either these were due to COVID as a contributing factor outside the 30-day window, asymptomatic or perisymptomatic COVID as a contributing factor, or they were deaths because people couldn't get treatment.
HHS tracks ICU usage, and there were definitely people with non-COVID life-threatening illnesses who couldn't access an ICU during peak COVID waves. The CDC estimated that about 100K people died during the first 2 years of the pandemic because of insufficient ICU beds. We can sort of see this in their excess data. Second link...
Major causes of death 2020-2023
https://drive.google.com/file/d/1cFMYy2-_UYZz_2fWvxDynVfIAp52-WFX/view?usp=sharing
Excess Deaths 2018 to beginning of 2023...
https://drive.google.com/file/d/153SObMIzH4WBI-0cY0eA6Ars5B6pjL4e/view?usp=sharing
And here's how death certificates work in the USA...
1. Drs and coroners are required to issue death certificates. There's a standardized way of filling out a death certificates. On the certificate they list the immediate reason of death and the contributing reason of death. If someone dies of pneumonia while in the hospital being treated for COVID, pneumonia will be the immediate cause of death and COVID will be the contributing cause of death. While some jurisdictions allow a "cause of death unknown" option, that's rarely used.
2. There are 3,244 counties in the US. Each county has a health department. Hospitals, MDs, and coroners, are required to file their death certificates with their county health departments. County health departments are required to upload the data from the death certificates to the CDC. So, probably 99.99% of the deaths in the US have a death certificate with an immediate and contributing causes on it.
3. The CDC tracks this data. The CDC puts all this data online via their Wonder app, which anyone can access to download the data and/or create nifty charts from the data.
It's... hopeless, isn't it? No matter how clear, no matter how easy-to-access, no matter how often trotted out - the data are just ignored. After all, why know, when one can pontificate endlessly, make up clever hypotheses, and "just ask questions".
I CAN'T FUCKING STAND IT!
Thank you for your service!
Great comment!
nit:
>So, probably 99.99% of the deaths in the US have a death certificate with an immediate and contributing causes on it.
That sounds high. E.g. about 1% of the population goes missing at some point in their lives and are never found. Some may have left on their own steam, but I suspect that a large fraction are killed and not found (since that would be the same order of magnitude as homicides) - and these don't get death certificates.
We have a population of about 340 million people. You're saying 3.4 million will go missing and never be located during the course of their lives? Well, provisionally, if we accept that, and we take the average lifespan of a US person to be 77 years, that gives us about 44,000 people who will go missing every year — given the current US population. That's still a lot of people! That would be about 3,700/month, so I guess I could accept as a reasonable number. But...
It appears that the 1% number originates from the DOJ's NAMUS database, but it's currently offline. So I can't really evaluate its validity.
I see numerous media quotes surrounding that factoid, though. This one was interesting...
https://www.wvnstv.com/digital-desk/how-many-missing-persons-are-found-in-the-u-s-yearly/
> An NPR interview with Todd Matthews, director of communications for the National Missing and Unidentified Persons System in 2013 delved into the nature of missing persons reports and found the same thing.
> “You know, the missing touches everybody, I think. In 2012, we had 661,000 cases of missing persons; and that’s just from that one year. Very quickly, 659,000 of those were canceled. So that means those persons either come back; in some cases, located as deceased persons, maybe never an unidentified person; or just a total misunderstanding. So at the end of 2012, of those 661,000 minus the canceled, we had 2,079 cases that remained at the end of the year as unresolved.”
> As of December 31, 2021, the National Crime Information Center’s (NCIC) database contained 93,718 active missing person records.
> Children under the age of 18 account for 30,400 (32 percent) of the national recorded 93,718 and 39,114 (42 percent) recorded were children under 21 years of age.
According to the DoJ website these missing person records are never purged. They are retained indefinitely until the individual is located or the record is canceled by the agency that entered it. Some of those number date back to when the database was created. And if Todd Matthews is right, then we're only losing between two and three thousand people each year who never turn up. That's a lot less than 44,000/year.
Approx 2.85 million US citizens died last year. And say we had 3,000 unresolved missing peeps last year. That gives 0.1%. OK, so 99.9% instead of 99.99% of people end up with a death certificate at some point. ;-)
Thanks for keeping me honest! But color me doubtful about that 1% figure.
The comment to which I was replying was, "I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases."
The comment to which I was replying was, "I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases."
We can know a few things.
For example, this hypothesis suggests that the excess deaths should track COVID hysteria (and lockdowns etc). And it's unlikely that COVID hysteria exactly tracked COVID cases.
But the graph of excess deaths seem to track the graph of COVID cases fairly well. That's some evidence against the hypothesis. (Even if it's not enough to completely rule it out.)
The comment to which I was replying was, "I know a guy who died of cancer significantly earlier because he couldn't access the treatments he needed because of COVID. There are probably many such cases."
My sister died of leukemia last month. It becomes very apparent to those of us who have walked the cancer journey of the extremely long supply chains that are required to support cancer care. Example: In the fall of 2024, one of her chemo cycles was pushed a week, because the hospital had clamped down on “non-essential” fluid usage because of an extreme shortage due to a hurricane in Florida (we are located in Denver) destroying the primary distribution center for IV fluids, and fluids are required to flush the chemo to prevent organ damage (the irony here is apparent to me). Many such examples for just the supply chain, let alone the supplies and available hospital staff being diverted because of hospital strain.
I would rephrase that, since as stated, one who wants a high number for death toll could argue that those SHOULD be counted as "covid deaths." I'd instead attribute those deaths to "pandemic" measures, coördinated by global "health agencies."
Absent the NPIs, the number of such deaths (and associated morbidity) could have been worse. You can't meaningfully assess the casualty absent a fuller context. If someone strangles from a seatbelt in a car accident, how do you attribute the death?
For a more apt metaphor, if people were getting strangled while driving normally due to some new kind of seatbelt mandated due to OTHER people getting into car accidents, I would say attributing those deaths to car accidents is bullshit.
I don't see how thar would be an apt metaphor. Absent NPIs, there's a non-zero possibility that hospitals would have been overwhelmed and people would have been afraid to make visits to the doctor. Think of Bergamo, Italy, early in in the pandemic. The pandemic wasn't a function of "other people."
Nonsense. The data does *not* support your assertions. Read my response to Phanatic above.
Or people could just be dead honest and attribute every single goddam death,past present and future to "fools who don't share my opinions."
Let’s take out the “should” and just try to count these things in the specific groups, and worry about the “shoulds” later, when we produce several different interpretations of the same data. Do one where you attribute every single excess cardiac fatality to Covid, and one where you attribute every single excess cardiac fatality to NPIs.
I so agree.
We live in these complex interlocking systems and we're actually not bad at dealing with this complexity... when we're not insisting on reality being black and white for our own psychological comfort.
In fact, to get better at modeling complex systems (like a pandemic rolling through healthcare systems and societies across geographies and time), we need to accept uncertainty and some amount of approximation without freaking out and saying it's hopeless to understand anything.
Science has ever proceeded in this way. Imperfectly and unevenly. But that has never been justification to ditch science and the collection and analysis of data and just start speculating.
Who's the "we" you're talking about? "We" as in the denizens of ACX seem to have problems with complexity and "we" keep coming back to simplistic answers that satisfy our prejudices. "We" as in the scientific community (which does not include me), were actually quite good at modeling complex systems — especially when it came to healthcare outcomes of various NPI regimes and various different healthcare systems. Sure there's a lot of arguments about how to interpret the data, but the data is there.
And amen to this...
> Science has ever proceeded in this way. Imperfectly and unevenly. But that has never been justification to ditch science and the collection and analysis of data and just start speculating.
We as in humans as a whole.
I know one person who died from covid, but he was in a nursing home. A lack of visitors in the nursing home is, in my experience, very bad for health and mortality. Not only does one miss the benefits of social contact, but the nursing home personnel get the idea that no one cares about you, then you die. This was true for all nursing home patients during covid.
I also know one person, my neighbor, who died of cancer during covid. She was taking chemotherapy at home under the care of her elderly and overburdened husband, and almost certainly died sooner than she would have with proper hospital care.
For what it is worth, this is pretty much the conclusion that the article at one of Scott's links (https://mistybeach.com/mark/Covid.html) drew:
"The total 'excess' deaths roughly matches the reported Covid deaths. California reported around 50,000 Covid deaths in 2021 and saw a bit under total 55,000 deaths above those expected by the model. "
Note: I am the author of the document.
I think the entire argument is because of overly simplistic models. There's rarely one cause of death. It's usually a this + that + the other thing kind of happening, and if any one of them were missing, death wouldn't have happened (at that particular time).
So. COVID put a lot of stress on the system. Thus people died who wouldn't otherwise have died (at that time). I believe that it was extremely rare that it was the STRONGLY predominant cause of death (say over 70% of the reason). But I suspect that it was frequently the reason that (say) 40% of those who died, died at the particular time that they did. (The particular figures are just numbers pulled out of the air. Don't pay much attention to them. They are just there to paint the shape of this argument.)
Note that being shot in the heart is not sufficient to be the single cause of death. Andrew Jackson was shot in the heart in a duel before being elected president. (Well, it *was* with a black powder dueling pistol...small bullet, low power. But he lived through it.) Causation is almost alway complex. Sharpening things down to a single cause almost always cuts away crucial factors. (That's why designing good experiments is so hard.)
But why are you pulling numbers out of the air, when you can dig them up yourself? I refer you to <"Ta Da!">, CDC Wonder.
https://wonder.cdc.gov/
> I think the entire argument is because of overly simplistic models. There's rarely one cause of death. It's usually a this + that + the other thing kind of happening, and if any one of them were missing, death wouldn't have happened (at that particular time).
See my very high-level overview of death certificates in the US of A (above). Also, the models are *not* overly simplistic. While I have issues with standard SIR models, the signals in the data that were gathered as the pandemic progressed was pretty clear. And better yet, we can compare to the outcomes of different countries with different NPI regimes, because many other countries put their data online, too.
You (well, I) *CAN'T* pull them from the published data, because they only list a single cause of death. The documents always want to list a single cause, and that's explicitly the thing that I'm denying. (Admittedly, there's often a major contributor, but I'm asserting that a single cause is the exception rather than the most common event, or even *a* common event.)
Sorry for the delayed response. I poked around CDC Wonder last night, for the year 2020, I found that 378,048 deaths had an ICD code of U07.1 (which is code for COVID). Of these, about 94.5% included at least one additional ICD-10 code indicating other conditions, while another 5.5% listed only U07.1 without any other contributing conditions.
I'll admit it took me well over an hour to dig that data out of wonder. Their user interface is a little clunky. Does that answer your concerns? Because I admit I'm all Wondered out.
So, yes, just about no one *died* of COVID without some other ICD code on their death certificate. And, yes, that's to be expected. Especially since the frequency of comorbidities rise with age in the population. Yes, a perfectly healthy person is less likely to die from a pathogen than a person with comorbidities. But perfectly healthy people are less common than one would expect. According to a 2010 study a hair less than fifty percent of the US population has *no* comorbidities. And one quarter of the US population has multiple comorbidity conditions (MCC).
> In 2010, 49.1% of civilian, noninstitutionalized US adults had no chronic conditions, and 24.8% had only 1 chronic condition. One-quarter of US adults had MCC (Table 2); 21.1% had 2 to 3 MCC and 4.9% had 4 or more MCC. For both sexes, older adults had a higher prevalence of MCC than younger adults. Among adults aged 18 to 44 years, men were less likely to have 2 to 3 MCC compared with women (P = .003). For adults aged 18 to 44 years and 45 to 64 years, men were less likely than women to have 4 or more MCC. In contrast, among adults 65 years or older, men were more likely than women to have 4 or more MCC.
https://www.cdc.gov/pcd/issues/2013/12_0203.htm
Thank you. That's about what I expected, but I also expect that the original data (that the CDC data was compiled from) oversimplified the circumstances of death. If for no other reason, then it would take a HUGE amount of effort to dig those things out. (How do you detect arterial blockage in a corpse? I don't really think that's possible. Blood tends to coagulate after death. [I'm no expert, so I could be wrong here, but that's what I think.])
I also think that "no chronic condition" is a VAST overestimate. Try "no recorded chronic condition". Most of my life I've noticed chronic conditions that weren't serious enough to ask a doctor about. The same seems to have been true (my evaluation, I didn't ask) of everyone I've known well enough to have an opinion about on the subject. (So perhaps 8 to 10 people, but a 100% positive. [OTOH, it's easier to notice something like that if someone complains about it, so it's a highly biased sample.])
That's the most plausible counterargument I've seen, but it's worth noting that even shaving off 10 percent of 1.2 million leaves us with over a million.
Immigration didn't surge in 2020.
But why would we care about those when we could rely on your vague hunches?
Why know if you can hypothesize and leave clever one-liners? /s
The curves are similar for other countries, too.
Mortality due to drug overdoses is also tracked by the CDC. Deaths due to drug overdoses during the pandemic (including Fentanyl) happened at the rate of between 6000 and 6500 per month. Drug overdose deaths climbed until 2022, and started dropping off a bit beginning 2023. Last time I checked they were still falling.
Undocumented immigrants, tourists, etc., all get death certificates. So their deaths were also tracked by the CDC. But they're lumped in with everyone else. Additionally, death certificates do not include a field indicating whether the deceased was a U.S. citizen or of another nationality. Only "place of birth."
But there are studies that showed the undocumented immigrants died at twice the rate of people legally here. Given that roughly 0.35 percent of the US population died during the pandemic, and given that there were likely 10.5-11.5 million undocumented immigrants in the US during the COVID years, that suggests that approximately 77,000 of those 1.2 million deaths were undocumented immigrants. Roughly 6%.
Not likely. Most undocumented immigrants could be younger, healthier, working population and less of them would be old people in care homes. Even if they were dying double rate compared to people legally in the US, that would not be a big number.
Don't forget about exponential risk increase by age.
<Post exchange analysis of this thread. Substack sends comments to my email, so I have his pre-edited response. NoPie originally wrote: "I cannot believe that you still forget about exponential risk increase by age." NoPie was aggressively rude, I responded with his "I cannot believe with my own "I cannot believe.">
I cannot believe you didn't check your beliefs against the data before expressing your opinion.
I assumed the studies I checked would be normalizing their data, because all good demographers should age-adjust their datasets. The Minnesota study (third link below), shows that your expectations would be true for all ICD categories *except infectious diseases.* I found that to be interesting.
> Theoretically, there may be expectation of lower COVID-19 mortality among immigrants than US-born residents. Literature documents a healthy immigrant effect—where immigrants tend to be healthier than US-born residents (Kennedy et al., 2015).... In addition, in pre-pandemic times, better health outcomes among immigrants were consistent across all ICD-10 disease categories except infectious diseases and external causes (Aldridge et al., 2018).
Here are links to the studies. If you've got anything other than your supposition to counter with, I'd be interested in the some links to support your claim.
This is the study that I based my claim that undocumented immigrants died at 2x the rate of native-born US residents...
https://pubmed.ncbi.nlm.nih.gov/38703491/
This gives some different numbers but agrees that immigrants died at significantly higher rates...
https://pubmed.ncbi.nlm.nih.gov/38018488/
Here's the Minnesota study I quoted from...
https://link.springer.com/article/10.1007/s11113-021-09668-1
I don't argue against that undocumented immigrants (UI) might have higher rates of dying from covid (compared to legal residents in their age group).
But you didn't address the issue about UI age groups at all.
You simply did 2 × percentage of UI × 1.2 million.
Murder quite famously went up, but probably not enough to change excess death statistics.
Traffic deaths, on the other hand, probably did change enough. They dropped during the initial lockdown period then spiked, and haven't come back down all that much (while murder did drop back down, I think by late 2022).
From 2016 to present, every year has had between 36,355 and 43,230 traffic fatalities in the United States. The lowest year is 2019 and the highest year is 2021. 7,000 deaths is not enough to make a noticeable difference in the total excess mortality number.
Overdoses had been soaring, especially since fentanyl arrived c. 2015. Overdose deaths during the covid years were very high, although it's not clear what they would have reached without covid.
Murders and traffic fatalities shot up after May 25, 2020, especially among African Americans, but that was probably mostly due to the temporary triumph of BLM over law enforcement.
Note that these three causes of death hit younger people on average than covid, so they take away much larger expected lifespans per death. On the other hand, their total numbers are quite a lot smaller than covid deaths.
OD deaths were at approx 6K/month at the beginning of the pandemic (first months of 2020, and they rose to 6.5K/month by the end of 2022. They began to fall off in 2023.
The murder rate spiked in 2020 at 6.42 per 100,000 people, up from 4.99 in 2019. Approx 21,500 people. Meanwhile in the same year <checks the NIH website real quick> COVID-19 accounted 697,000 deaths.
Since most murders occur between people who know each other, we can assume lockdowns had a significant role in the rise in the murder rate. I haven't gone over to the FBI website to check that assumption, though.
So roughly 4800 extra murders happened in 2020.
And a quick Google shows that traffic fatalities went up from ~36,000 in 2019 to ~38,800 in 2020. About 2,800 more traffic fatalities during lockdowns.
These numbers are chump change compared to 697,000 deaths from COVID.
CORRECTION! There were ~375,000 COVID deaths in 2020. The NIH website gave me the numbers for a 20-month period from March 2020 through October 2021. It seemed too high. I should have read the report more carefully. But ODs, homicides, and traffic fatalities are still chump change, against total COVID deaths in 2020, but twice as valuable chump change.
Domestic violence murders weren't up much during covid, surprisingly enough. Instead, there was a huge surge in mass shootings at black social events after George Floyd's death unleashed the racial reckoning. Cops retreated to the donut shop, and so people felt more confident carrying their illegal handguns to parties.
I don't see that in the DoJ data. But I didn't dig very deeply. If you've got some DoJ data or data from other sources, I'd be interested in seeing it. There are hella lot of reports on domestic violence up on the DoJ website, though.
ChatGPT sez:
2019 Data:
Total female victims: 1,948
Killed by someone they knew: 1,773 (91%)
Killed by male strangers: 175 (9%)
2020 Data:
Total female victims: 2,059
Killed by someone they knew: 1,604 (89%)
Killed by male strangers: 197 (9.6%)
I didn't check into male-on-male murders, and what percentage where the victim knew the perp. But yes, you're right, it looks like 4K extra murders in 2020 were not due to domestic violence. But still, we're talking drop in the bucket to total COVID deaths.
Also, you forgot to mention suicides. At one point, suicides from the lockdowns were being blamed as a significant contributor to excess deaths in 2020. But that idea didn't pan out. The suicide rate actually dropped in 2020 from 14.5/100,000 in 2019 down to 13.5/100,000 in 2020.
The answer is no, there were no other significant drivers of death during the peak pandemic.
Sure, but comorbidity was an issue. Americans have never been this unhealthy. And 0.3% hardly matches the nightmare scenario we were lead to believe. Moreover, it's probably why you use the word millions instead of 0.3%.
To be fair, 0.3% was exactly in line with many early estimates I saw. Most of the panic was because the broad CI included >1% estimates. It was always odd to me that people continued to implicitly rely on the broad early CI estimates long after better information came along.
Overall, I agree that not only are there a lot of risk factors in line ahead of COVID, but that improvements in those other health factors are probably a better focus for preventing deaths in the next pandemic.
I used million because that's the title of Scott's post. And more nightmarish scenarios were avoided in part because of the protective measures out in place. I agree some of those measures were overprotective in hindsight - but that was hard to know at first, and the main point is that this pandemic was very real and deadly and worth taking some precautions to minimize.
I was surprised to learn that "comorbidity" doesn't mean "another cause of death," it means "another medical issue," including high blood pressure.
Yes, if you portray COVID deaths as 0.3% of the population, it all looks rather innocuous compared to <gasp> 1.2 million deaths. But if we frame it another way, during the peak of the worst wave, we were losing the equivalent of eleven 747s full of passengers each day. We shut down US air traffic, brought the country to highest alert, and invoked our NATO treaty to get fighters from European members to help patrol our skies, all because four jets were downed and 3,000 people died. If you look at COVID deaths in units of jumbo jets, the pandemic was pretty frigging significant. But most people just shrugged their collective shoulders and complained about their freedumbs being curtailed.
As for comorbidities, it's important not to look at the US as a singular island of health patterns.
For instance, France, because of its higher rates of smoking (roughly 2.5x US), has a higher average rate of COPD, asthma, and lung cancer, related diseases than the US. Asthma, at least, was one of those comorbidities that increased the risk of developing pneumonia from COVID.
And in Germany, two-thirds of men (67%) and half of women (53%) are overweight. Hard to get an apples-to-apples comparison of obesity, though, because the EU defines it slightly differently from the US. But roughly 25% of their population is seriously overweight. Not US rates, but very high.
The most interesting comparison I took from the pandemic is that Finland has a very high overall comorbidity rate, but during the pandemic, it did better than Denmark, which has a population with lower comorbidities. Obviously, comorbidities are an important factor, but they were far from the only factor determining which populations were able to pull through the pandemic with fewer deaths.
Why not consider that pandemic restrictions may have reduced mortality from other causes. This also seems plausible. Less miles driven. Less trips taken. Less exposure to other illnesses. It’s not just a one way street.
Looked into this and it was a mixed bag unlikely to affect numbers much either way.
You could have figured this out with the article's central argument: excess deaths over normal, non-pandemic conditions. If you had enough lives saved by the lack of activity that it counter-acted a substantive proportion of COVID deaths, the excess deaths count would be materially different from the COVID deaths count.
Not quite. Since the article is using the excess death count to establish the veracity of the Covid death count, this would still need to be explored. But yes, assuming we know those two variables, no need to.
Among old people in retirement homes, access to family and social networks is, in effect, life saving care, and access to family and social networks was brutally denied to millions of such people for a very long time (in terms of their expected future lifespan, two years could have easily been more than half their expected future lifespan). This effect could easily explain hundreds of thousands of the excess deaths.
How is it life saving care?
Frankly, because no one fights for your life as much as your family. The other people are just paid to be there. If you take the most charitable view, they’ll do their best but they have a million other concerns. If your elderly family are in a period of prolonged medical vulnerability, you absolutely need to have a member of your family be their advocate in conversation with the system, because otherwise the system is often laggardly and obtuse.
I've heard that for end-of-life care distant relatives who didn't visit often and feel guilty are the most insistent on prolonging past the point doctors think is wise. But since these people are actually near the end of their lives (not like most people who died of COVID prior to being infected), there isn't actually that much time that the medical system can give the patient.
Not only that, but contact with family is literally what has many old folks going. Cut that off, and they have nothing to look forward to any longer and shuffle off the moral coil. Anecdotal observation but I have seen it enough to trust there is some validity to the claim.
But even more immediately, yes, lack of care. At the start of the pandemic in Canada some nursing home patients were literally abandoned by staff that fled. Found several days later covered in their own feces etc. Given their pre-existing conditions, such abandonment would cause a sharp decline in their overall health leading to much higher death rates.
Not all nursing homes experienced such drama but I'm sure care was compromised in a very high percentage, resulting in many additional deaths.
I'm sure a lot of this kind of second order effects happened, but again it's kind of ridiculous to suggest that it explains more of the surge in mortality than the respiratory virus that looks like the kind of respiratory virus that kills a lot of people. To me it mostly seems like people are unable to conceive a middle ground between the sniffles and the Black Death; since it wasn't the former, it must be the latter.
A close relative of mine died in a nursing home because there was not enough staff to ensure he was getting his meds (his condition was making it really hard for him to swallow). Previously, this was taken care of by his wife, but, when COVID started, she was denied entrance.
> when COVID started, she was denied entrance.
See, COVID was responsible for his death. Add that to the tally.
Yes in one sense, but we are trying to separately allocate deaths caused by our response to COVID.
Sorry, that was a joke. When I posted that, I thought it would so patently stupid that no one would actually say things like that unironically, but then I read other comments here, and no longer believe that.
It's amazing how much the "will to live" impacts whether you can recover from illnesses later in life. I wouldn't have believed it until I witnessed this phenomenon first hand.
My grandmother struggled with the sudden isolation during the pandemic. Her husband had recently died and she couldn't take care of herself on her own. The isolation in care facilities caused clear health deterioration for her. We made the decision that the increased COVID risk of taking her into our home to care for her was better than her dying alone. Within days of coming to live with us she became physically better. Her ability to walk and her general gait improved dramatically, her incontinence disappeared, she was happier, she reported less weakness and a greater ability to perform basic daily tasks. Her memory improved.
Measurable, tangible health improvements.
When circumstances prevented us from keeping her at home, she went back to a care facility. Her health rapidly deteriorated, she was quickly moved to a wheelchair, and she died soon after. She told me, "I don't want to live anymore," both when she was in the facility before coming to our home and afterward.
A friend of mine is a mortician. In December a few years back she mentioned she was going into their post-holiday 'busy season'. This was before my experience with my grandmother, so I was shocked that people didn't die at regular intervals.
She said, "No, a lot of people hang on until after the holidays, and then they just lose the will to live." Remember that when you're old you tend to have a lot of old friends, too. If all your friends die, but you don't see other old friends at the funeral because they discontinued funerals, that's a highly significant social factor that's being withdrawn.
I think Scott implied in this post that the 1.2M number must either be fully explained by indirect non-infectious factors, or we must accept the 1.2M number as a result of infectious spread. I doubt he would maintain that stance if pressed, but the defense he gives above strongly implies it. I think it's possible that a non-trivial number of deaths were the result of COVID policies that weren't necessary, and not the result of the virus itself. Those deaths may track with reporting because when we saw deaths go up we pushed harder on the harmful social policies. If the policy-related death number is, say, 200k that's a pretty big number that deserves its own reckoning.
This is exactly right. It seems to me that Scott knows that the data on cause of death has been fudged so heavily (or at least altered in a direction that leaves it untrustworthy or unpersuasive to skeptics) that he can't rely on it. So he goes to excess deaths (which have their own issues with assumptions and statistical massage). But this is not very helpful! Massive societal interventions occurred almost exactly in parallel with infections. Accepting the excess at face value, he's left basically saying ipse dixit "and nothing else could plausibly affect this." I think there are lots of small factors that all could pull in the same direction, and I think that little to no good quality science was done to even attempt to quantify.
As an aside, condolences on your mother's situation. We were in a similar place where my father had died one year before covid and my mother was still depressed and learning to cope. She watched too much TV news, got scared, shut herself up for several months, and nearly went nuts. She got through it fortunately, but she now regrets the lost time and is thankful she didn't hide for longer. I did encourage her later on to get the vaccine when available since she was in the risk demographic.
Allow me to push back on points I largely agree with: there's a rush of proving too much in this analysis. Some places were more interventionist than others during COVID. If most of the deaths were indirect, we'd expect these locations to have much lower excess deaths than lockdown jurisdictions. Last I checked, the result was closer to "no effect".
There's some contamination here, of people self-isolating out of fear. But then if we're talking about government policy, it's a fair comparison.
There are two possible interpretations:
1. COVID deaths that increase from lockdowns are offset by a reduction in deaths of despair.
2. Deaths of despair aren't a significant proportion of the excess deaths statistic, but also lockdowns didn't affect them either.
I'd like if there was an easy story to tell here. It seems clear there was a lot of excess suffering during the pandemic, in addition to the extra deaths. It's not clear to me whether many of the trade-offs were worth it. This is why a simple number, like 1.2 million, feels like the wrong 'reckoning'. Like, if we hadn't done anything would we have still settled at 1.2 M? More? Fewer?
The real reckoning is that, once again, despite a crisis and a massive government response, we don't really know which of our efforts were worth the costs and which were worthless but still cost us. That's the big failure. Institutions focused on getting everyone to distance 2 meters, fine, but never did the cluster randomized trials to test whether that's effective, if so how effective, or if 2 meters is the right distance. So what do we do next time? Argue about the same unknowns and never get any less wrong.
Virtually all of the medical literature indicates having a social life and avoiding loneliness is the most important *health* factor for oldsters.
Is that really the most important? I guess other things pointed to as big causes of mortality (smoking, diabetes, hypertension, obesity) are likely to have started before you're elderly and there's less to be done about it now (although I suppose nowadays semaglutides actually can treat the chronically obese).
Once you're in your eighties, it really is isolation.
It's never the cause of death on the paperwork, of course. But isolate oldsters, and lots of them will die shortly thereafter.
Just think about the cliché of a person dying shortly after s/he loses a spouse.
My understanding is that men's lives shorten when their wives die, but for widows it's the other way around (sometimes phrased as men sucking the life out of women).
Yes! Social life and meaning. We'll all (hopefully) be there someday, but it's hard to understand untill you're post-retirement. My dad used to visit with his mother once a week. She complained that he was "never around", much to his consternation. It was a personal sacrifice to him to make time to see her, given everything else he had going on.
But a two hour visit seems like a long time when you've got a full weekend already. When you've got all day, and afterward the whole week ahead of you, time crawls slowly. A week to a 40yo can feel like a month to an 80yo. This is the toll retirement takes on your mental health. When there's nobody relying on you day to day, you lose your edge. It's not an extended vacation. It feels like solitary confinement.
When you say, "hundreds of thousands", are you talking 200k or 800k? The former might be in the noise, but in the latter, you wouldn't see the clear correlative pattern in the data the Scott cites.
If your causal model is "intervention -> lack of access to families -> old folks die 'cause sad a la Padme", then you still need a model for the cause of the interventions. This was pretty clearly COVID cases and deaths, especially in the early years. But now COVID deaths are causing such a ruckus that people do a lot of NPIs, which brings us back around to "COVID is actually doing most of the people killing".
This would predict more deaths in retirement homes, while plain old viral disease would predict fewer deaths in retirement homes, so this hypothesis is testable
Yes, this is one of several testable hypotheses. For the record, 1.2 million deaths (and hundreds of millions of survivors) is a lot, but a good researcher can review the details of about 100,000 deaths - after spending a few days determining how to randomize the events leading to the deaths in question - in about a month of research. 'Covid deaths in the western world' is not an impossibly obscure historical event, and I trust that eventually medical researchers will understand what went wrong.
The way test the size of the two effects is by looking at when the deaths in old age homes happened: did they short follow the five main waves of covid or did they happen randomly throughout periods when they were denied visitation.
I can see either argument, so somebody who feels strongly in favor of one side or the other should test.
That is not a good test, because of course those who lost the will to fight Covid were not going to die from that lack of will when the waves of Covid were at minima, rather than maxima.
Why did loneliness kill in rhythm with reported covid deaths?
Right.
Steve, because, as you know (I know you know who Bruce Charlton is, and you probably have read his discussion of how flu was considered, fifty years ago, to be the 'friend' of the elderly), loneliness on its own did not kill, but loneliness combined with an attitude of "I don't care anymore" is what killed when old people whose endorphins were near zero got flu symptoms that they did not anymore have a great desire to struggle against (this is simple understanding of how humans work and I am surprised you said "right" to an obviously falsely posed question --- why did loneliness kill in rhythm with reported covid deaths).
I mean , you are too smart to need me to spell this out, but just in case you need it to be spelled out ---- of course the lonely people died more when the waves of covid were at their worst. Nobody said they predominantly died of loneliness, they died of not wanting to live when they were faced with a wave of covid.
Very plausible, but this might merely decrease the "Covid mortality" as a number. It does not decrease the overall "seriousness" of the pandemic, or reduce the reasons for e.g. requiring people to wear masks.
Scott's argument in the first place was, like, "remember the 1.2 million people who died because of Covid?" - and you can't deny that also those 10% of deaths were directly caused by Covid, can't you?
If you argue ".. but they didn't die of Covid, they died because our health system was unable to cope with the sudden outbreak of Covid" - yes, sure, but maybe quite a large part of those other 1 million US deaths (people who died FROM Covid) were due to the fact that the health system was not ready for the pandemic.
There are those who would quibble that it’s unfair to characterize the health system as “unready for the pandemic” as opposed to “unready for the panic stirred up for various non-medical reasons in the face of a mostly unremarkable disease”.
I don’t *think* I am one of those, but I’m apparently sympathetic enough to that quibble to point it out.
Do you remember when we were hearing about hospital beds filled and not enough ventilators? People were there because they were sick and having trouble breathing.
There was plenty of panic, too, but someone would have noticed if all the hospital patients had just been having panic attacks.
I don’t think anybody of note ever *denied* that there was a disease.
And I was talking about a societal panic, not claiming that anyone claiming to have Covid was actually having a literal panic attack instead.
As an example of the societal panic, I gather that in retrospect the consensus is that we used respirators rather too often.
But I’m not arguing with Scott’s overall point myself — I think it’s quite likely that American did have in the order of a million deaths that can plausibly be blamed on Covid itself. Whether the exact number is 750K or 1.3M is out of my wheelhouse.
I remember people being concerned about that. I also remember it not being an issue in a lot of areas (outside of NYC's initial outbreak), and that ultimately ventilators didn't matter in most cases. Most field hospitals that got stood up didn't treat a single patient: https://www.npr.org/2020/05/07/851712311/u-s-field-hospitals-stand-down-most-without-treating-any-covid-19-patients
A lot of areas kept beds open and reduced availability numbers *in case of* needing them, but ultimately never filled up. Source: family that works in hospitals.
The sheer volume of nurses recording Tiktoks while at work was taken as anecdotal evidence they really weren't that busy either, but it's not a great metric.
Several field hospitals set up in my vicinity, one of them a tent city in large parking lot. No patients ever arrived. On the other hand, hospitals were in financial distress and laid off employees because they didn't have enough patients.
I was surprised, but hospital administrators turned out to be surprisingly good at expanding capacity and dealing with the challenges of covid.
There was a huge covid death toll in New York City in March-April 2020, with 15,000 deaths in April alone.
But the "lockdown" started in mid-March started to work about one week into April. I recall a late-April 2020 New York Times op-ed by a NYC ER doctor. He remarked that background noise all through March and the first week of April was the sirens of ambulances arriving with covid patients. Then, IIRC, about 1pm on April 7, 2020, the sirens mostly stopped.
The health system spent a ton of pointless effort saving, say, patients from the local hospice instead of instituting an age/condition-based triage instead. Example: survival rate of 70+ year olds in ICU in 2020 was <50% but there were still cases where 35 year olds from (say) a car accident had to wait for an ICU spot.
We have a hard time rationing kidneys and livers; denying an old person an ICU bed because they have a baseline survival rate less than. 50% is a pretty tall order.
I was in my residency training during the early pandemic, I would encourage you to really think about how you would go about getting someone, say 72 years old, out of the icu or hospital to open up space for someone else. You get patient transport to bring them to a van and them drop them at home… and then what? They come to the Ed and you tell them you will stabilize according to EMTALA and then… send them home to do it again the next day? Essentially telling patients they should die every day at work would be a psychologically devastating experience for providers. It sounds nice on paper but makes no practical sense.
Also small quibble but I do not think you understand what hospice is
Is it less devastating to turn away the car accident victim in the example?
I think there is a mistaken image here of people being “turned away”- the car accident victim is also taken care of here. The issue is that if the icu is full (say of older Covid patients), they would be stuck physically in the ED where care is not going to be as tightly managed. Obviously also a bad situation, and perhaps outcomes are worse, but very different from telling people you won’t try to provide standard of care
How about moving the old Covid patient back to the ED and moving the accident victim to the ICU then? I've no idea if that would have made sense; I don't really mean to make any assertion about what happened or what should've happened as I don't know much about it, I was just going off myst_05's and your comment.
I didn’t say it would’ve looked pretty. But step 1 would be to suspend EMTALA and all other such laws until the emergency is over.
I do know what it is and I also remember crystal clear that there’s been numerous reported instances of people on their deathbed being taken to the hospital after contracting the virus during the initial March-May chaos.
I suppose I still don’t have a sense of how you see this playing out on a patient by patient level. If an older patient refused to leave the hospital because they were still critically ill, does security pick them up and carry them outside? And if this were logically solved, wouldn’t removing EMTALA encourage hospitals to kick out people with no insurance or Medicaid/medicare rather than the elderly?
If someone’s in a critical state how are they “protesting” anything? You move them out of ICU into the regular hospital or if that’s full, into a field hospital (kind of like the ones setup in stadiums and whatnot in 2020). If they’re violently trying to stop the doctors… there’s a whole array of medications at the hospitals disposal to make a person calm down, no need to make a scene. But the vast majority of those who’d be removed would be frail 80 year olds who’d otherwise have another 3-4 years to live, slowly withering away in a retirement home.
> wouldn’t removing EMTALA encourage hospitals to kick out people with no insurance or Medicaid/medicare
Some unfairness would be present temporarily yes. Thats what happens in a crisis.
That was the huge fear justifying lockdowns: that hospitals would be so overwhelmed by covid patients that other patients would deny for lack of care.
A couple of things happened, though: to my surprise, hospital administrators turned out to be surprisingly good at deal with major surges in case loads. And public and private responses to lower risks of infection proved successful and blunting the worst saves of infection.
My great aunt died from cancer in 2021 and it was specifically blamed on her chemotherapy being delayed by two months during the start of Covid - but this was in Russia with a much more cavalier attitude towards healthcare, so I don’t know how prevalent this was in the U.S.
It is certainly possible that people died because of Covid even without actually contracting the disease, but Scott's analysis compares Covid deaths to the increased mortality, and the numbers line up. Unless the numbers are being faked, it is hard to see how deaths from Covid aren't really about 1.2 million.
That's assuming normal medicine does save that many lives, which Scott has debated Robin Hanson about https://www.overcomingbias.com/p/response-to-scott-alexander-on-medical and on the specific subject of screening see https://www.overcomingbias.com/p/beware-cancer-screenshtml If hospitals are engaging in triage by cutting back on the least essential care, that could have minimal effect given how inessential so much medical care is in the US.
But there are also various pandemic related behaviour changes things that would make excess death go down. Such as fewer road deaths. Heck even suicides went down during lockdowns.
My memory is that traffic related deaths did not decline which was a huge surprise given decline in ave miles driven? Meme key ain’t what it used to be though…
Yes, the fewer people on the road were driving like maniacs.
Or they simply weren't stuck in traffic. Tough to have a fatal accident at 15 mph.
I just mentioned that potential cause in another comment and now I see you beat me to it.
Being the only car on 30 miles of four-lane is a really tempting experience.
My memory is that traffic related deaths did not decline which was a huge surprise given decline in ave miles driven? Meme key ain’t what it used to be though…
Routine screening rarely prevents deaths on the timeline you're suggesting. Emergent care for heart attacks, strokes, gunshots... maybe. But not routine screening.
When trying to estimate the effects of NPIs on health outcomes during the COVID years, folks often fail to examine the counterfactual of "How do people react in a COVID world where there's no government effort to encourage or enforce NPIs?"
As a result, it's rarely clear whether folks who claim NPIs are responsible for excess deaths (rather than COVID directly) are saying, "The Government erred in enforcing NPIs", or "The Government erred in encouraging private organizations and individuals to use NPIs" or "People on an individual level reacted irrationally to COVID" or something else. It's not exactly a motte an bailey; it's more just a lack of a precisely stated hypothesis.
I don't think there's any government (or "elite") response that wouldn't have resulted in massive disruption to all kinds of services, including nursing homes, which will serve for a useful example. If half your staff is out sick because they have COVID, and someone dies because they're receiving a lower standard of care, is that death "caused by COVID"? What if people called out sick but wouldn't have absent strict Government guidelines that were in place because of the pandemic? What if the guidelines were put in place by the nursing home w/o government intervention because they were leery of litigation caused by staffing with sick nurses during a pandemic? What about if the nurses were just very worried about this new disease and weren't willing to risk giving it to their patients?
My point is that there's a lot of causal models you can consider for how people could die during a pandemic due to indirect effects from it. Some of those pathways became more or less likely due to the specific set of NPIs, elite message, and cultural circumstances we found ourselves in from 2021 - 2024. But those specific outcomes can't be investigated in a vacuum without considering the counterfactual of what pathways become more or less likely with some different posited set of NPIs, elite messaging, and cultural circumstances.
So even if 120,000 people died from 2021 - 2024 because they were waiting for care, that doesn't answer the question of whether those deaths should "count" as COVID deaths or not.
Thank you. The lack of consideration for this counterfactual scenario blows my mind.
If we hadn't paid attention to covid at all, not much would have changed in our lives.
Some old and otherwise very sick people would have died more than usual but for a general person it is on the level that we barely happen to know such cases personally. Now we would be discussing and talking – there was a covid spreading around 5 years ago. Does anybody know who has died from it? Maybe an average person knew 1 or 2 old people from his family.
People working in healthcare would have noticed more people dying suddenly from a new type of respiratory virus. Some hospitals would have experienced overload, even more than they happen during nasty flu seasons. The number of deaths from covid as reported by Scott is real because people died indeed.
Provided that the government had allocated resources to deal with overload of hospitals and quick development of vaccine but without creating any panic, the timeline would be exactly the same except that we wouldn't have had any lockdowns, school closures or travel restrictions. We wouldn't have caused crisis in economy and the society would be more cohesive and less split about unnecessary restrictions.
Obviously, it mattered to people who died. Now I will saying something that will make blood boil to many people. Sweden's example showed that the number of those deaths would not be much greater in either case. In fact excess deaths would be lower all things considered.
If people were afraid of getting medical treatment and died of other things because of that, then wouldn't we see the excess deaths be less-closely related to reported covid deaths? Either it'd be correlated with lockdown measures (if people are afraid of being isolated in a hospital) or with news stories about how bad covid is (if people are afraid of catching covid).
I know someone who died of a heart attack during the pandemic, because he didn't seek medical attention due to fears of dying alone in a hospital due to isolation measures (so instead he made his wife wake up to him dead in bed beside her - not cool to do to a partner). So I'm not saying this didn't happen, but I doubt it was a significant fraction of excess deaths.
I have heard from more than one person who had to fight to keep COVID off a death certificate. "Oh, it was because of delayed treatment caused by COVID!"
Also, of course, there's nothing to prevent an original outbreak from being followed by a wave of deaths from the lockdown and other reactions to COVID.
Just like you "know" that a motorcycle death was attributed to COVID. But you don't know that lockdowns themselves caused any deaths at all.
Right here in this very thread we have counter-examples to your claim. So I don't see at all what you intend in posting such a falsehood.
But then lockdowns might have saved lives as well. We can't just go on a few anecdotes.
The claim was that it had not killed. It killed.
What counter-examples?
It would certainly be cool to see someone figure out:
* how many people died as a result of actually having Covid
* how many people died as a result of all the chaos that Covid created in multiple fields
Personally, I'd guess the second figure would be higher than the first.
My boss died from this. He had a heart condition that he had a surgery for that generally calls for three days of observation afterwards because of a known complication that sometimes occurs afterwards. Instead, he was sent home immediately after the surgery and died that night from the known complication. I guess maybe he would have died from it anyway, but presumably it's something that can be dealt with in the hospital or they would not normally keep them for monitoring.
It also presumably prevented some iatrogenic deaths, too. I have no idea how you decided on your 10%, so let's call it even?
"I can see" !== "I decided". A ballpark estimate.
As for iatrogenic deaths, I would expect more medical errors from overworked and overstressed docs, not fewer. Same with telemedicine, some things that have diagnostic value don't transfer across the screen (e.g. ease or difficulty of movement, various smells).
Keep in mind, absent NPIs those numbers could have been significantly higher. The point being they're still pandemic-caused deaths.
Spot on. While I understand there's some debate about the precise numbers of deaths (especially in countries with poorer record-keeping), it's frustrating to see people pretend that COVID wasn't a big deal.
I think that's a result of the overreaction and counterproductive measures (and sometimes just spiteful measures) put in place in response to the pandemic. The reality is that the pandemic was a really bad global tragedy that may have been completely avoidable depending on the source of the virus, and the response to the pandemic was a more or less global tragedy, maybe not as bad as COVID but maybe worse depending on how you count the economic impacts, that was completely avoidable.
We more or less aren't capable of having even slightly nuanced public debates, so I think to a lot of people conceding that COVID actually was really bad feels like conceding the argument before it begins.
I certainly wouldn't be surprised to learn, at some remote future time, that all the chaos that arose from Covid, in multiple fields, actually killed way more people than the condition itself.
Yeah we now all have Covid Rage Virus. It kills dialogue, fair-mindedness, goodwill towards others, common sense, friendliness, and some relationships. May be worse than covid itself
What's even more frustrating to me that even the contingent on board with it having been a big deal is lukewarm at best about ending gain-of-function. Sure, maybe this pandemic wasn't caused by a lab leak, but the next one very well might be, but nobody gives a damn.
People are allergic to nuance, is a lot of it. It’s not enough to criticize the response to covid, they have to take it to the extreme of pretending it was all fake news.
There's certainly room for debate about "with" versus "of."
There's the old meme, of course, of a guy halfway through his car's windshield, bleeding out, and someone with a microphone asking him "so when did you come down with COVID?"
But it's the same on the other side -- a lot of people on the "with" side seem to be doing the equivalent of "sure, an eight-ton rock fell on him ... but he had diabetes!"
My mother was in her late 80s in mid-2020. She had numerous health problems.
Then she got COVID and was dead within ten days.
Did those other health problems contribute to her dying instead of recovering? Absolutely ... and the death certificate says so, listing heart problems and high blood pressure as secondary causes of death. If I get crushed by a Mack truck while crossing the street, that was my main cause of death even if I was a walking heart attack / stroke risk.
Car accidents examples just aren't helpful here. It isn't relevant to the point people are arguing.
I was pointing to the silly extremes some people stake out on both sides of the debate.
If you don't find something relevant, feel free to ignore it.
I don't think such memes are actually worth bringing up. I haven't seen any actual evidence that traffic deaths were being miscategorized as caused by COVID, but people keep handwaving to that effect.
I, for one, find it frustrating to see the denial arguments equivocate between “covid statistics include deaths happening for unrelated reasons” and “clearly nobody is claiming this unrelated cause of death was being counted as covid, that would be silly and irrelevant”. I do realise it is different people saying the different things, but the overall combination is very draining.
And people also handwave that if there were any comorbidities, then it wasn't COVID that did the killing.
Those are the extremes. I agree that there's reasonable skepticism as to whether any particular death was "mostly" due to COVID or "mostly" due to something else. Some people disagree, on either end, and some of those disagreements aren't really very reasonable.
In my mother's case, there were comorbidities, but there hadn't been any recent emergencies with those comorbidities, so it's reasonable to think of COVID as the "tipping point" cause of death.
Excess deaths serve as a check on misattribution.
Yes, they do.
But, as with many issues, some people base their conclusions on rumor or assumption rather than on evidence.
https://www.fox35orlando.com/news/fox-35-investigates-questions-raised-after-fatal-motorcycle-crash-listed-as-covid-19-death
Thanks for the link, this was indeed documented.
You're welcome. Glad I could help.
There was at least one, and probably the most famous, but it was later removed: https://www.fox35orlando.com/news/fox-35-investigates-questions-raised-after-fatal-motorcycle-crash-listed-as-covid-19-death
How many others got misidentified and not removed because they didn't receive mass media attention, who knows. But I would be highly skeptical that the "COVID traffic deaths" would be more than a couple thousand at absolute most, and even that's on the very high uncharitable end of estimates.
My understanding is that deaths attributed to traffic accidents (rather than COVID) also rose, and the common explanation was that with less traffic cars were driving faster, while Sailer argued that after George Floyd there was a decline in policing (Scott also argued that, he might have just focused on homicide). I was going to suggest look at the total number of traffic accidents and see if the fatality rate per crash changed, but if crashes were up because vehicles were driving faster, then you'd expect that to cause an increase in the fatality rate by itself and it could be hard to detect a fraction being misclassified as COVID deaths amidst that increase. I don't think it's impossible though. COVID deaths vary a lot by age, in a different patterns to traffic & homicide deaths. Sailer has also written about different patterns by race following Floyd, and while there was a time when COVID deaths varied by that as well, I don't think that persisted.
I don't really understand what you're saying here. Let me pick a concrete example to discuss: someone is 82, and has COPD (a complication of smoking that leads to chronically poor lungs). They come down with COVID and die 8 days later, because of respiratory failure (suppose they weren't an ECMO candidate). Suppose that, if they hadn't had COPD, then they wouldn't have died. Are you saying that they should be counted as a COPD death, rather than a COVID death, because they wouldn't have died if not for the COPD? That doesn't make sense, because they also wouldn't have died if not for the COVID infection. So you could say that they died because of COPD, and they died because of COVID, but you can't say that they didn't die of COVID without also saying they didn't die of COPD. If you say they died of neither COVID nor COPD, then I'm not sure how useful your notion of causation is.
They should be counted as so-and-so percent of a COPD death and statistically, X number of people dying this way should be counted as a certain number of Covid deaths and a certain number of COPD deaths, where each one is less than X.
We're trying to figure out how many people would have been saved if we were able to prevent COVID cases. So what we care about is the number of deaths that happened, but would not have happened if the person involved didn't have COVID - our hypothetical person is an example of this. It's also correct to say that our hypothetical person should be counted among the people who would have been saved if we were able to prevent COPD, but I don't think anyone here is talking about the costs of COPD. The discussion here is about the costs of COVID.
(To use the car crash analogy, someone walking across the street absentmindedly and being hit by a distracted driver could be said to have died from crossing the street absentmindedly and the driver being distracted. In a discussion of the societal cost of distracted driving, this death should be considered as 100% part of the social cost of distracted driving. A policy that prevents distracted driving would have prevented this death, for example, even though a policy to prevent absentminded street-crossing would also have prevented it.)
A ridiculous comparison.
I think I need a little more than "someone somewhere profited from this pandemic" in order to entertain a theory where significant portions of the pandemic were faked. An obvious question is, for example, whether those selling the shots also faked the pandemic in Africa, which also saw significant excess deaths?
"...in order to entertain a theory where significant portions of the pandemic were faked."
And note that the faking and or conspiracy needs to be world-wide. Europe, China, Australia and New Zealand had to be in on it, too. As well as a lot of other countries. Maybe not Sudan.
Right? This argument not only proves too much: Is cancer a psyop by insurance companies?
Also disproves capitalism. The invisible hand of the market doesn't exist, it's shadow cabals all the way down.
Yeah. Did the weird lobbying corruption between pharmaceutical companies and politicians contribute to the rabid support in favor of vaccines and against literally any other possible cure? Almost certainly. Did it lead them to fake Covid or its primary attributes? Almost certainly not.
If I was a politician and had to choose between supporting either the methos of avoiding a disease or methods of curing the disease, I would, of course, prefer avoidance. Although I'd rather also support the cure, just somewhat less. Avoidance is better than cure because a disease, before it's cured, is likely to cause tissue damage in your body, much more than e.g. vaccines that also cause a little tissue damage.
An ounce of prevention etc etc...
this is really, really silly: vaccination is far and away the best approach humans have developed to addressing viral illness if you look at the track record of the past century. Anything other than prioritizing vaccines would be a very strange policy.
What other possible cures? Paxlovid?
“Against literally any other cure”. Like Paxlovid, developed by the same company that made one of the most popular vaccines?
Reminds me of The Man in the White Suit.
https://en.wikipedia.org/wiki/The_Man_in_the_White_Suit
But expanded to every market all at once.
Anxiously awaiting sci fi where we live in a post scarcity utopia, but for a hundred powerful cartels that are constantly injecting planned obsolescence into everything to justify their trades. But the one man not in any secret society discovered their secret and the whole house of cards is about to come tumbling down!
"Excess deaths" is not a measured quantity, to compute it requires a fairly sophisticated model of expected deaths. This, perhaps, explains why a number of countries, including Sweden, reported negative excess deaths during the covid pandemic.
If a novel disease arises there will be a large incentive to treat it. Whoever develops that treatment will profit. This is not a problem. It's the way the system is designed.
Should people not be paid for developing life-saving medical treatments? I have my criticisms of pharma patent trolling, but developing a treatment that craters mortality from a widespread disease which kills 1-2% of those infected seems worthy of compensation.
Criticizing the pharmaceutical companies for producing life-saving medical treatments is a really bad idea. IMO, the vaccine makers should have gotten a lot *more* money, maybe a percentage of the GDP loss avoided.
Obviously we need to take care not to incentivize them to produce ineffective or harmful treatments, but that part of the system seems to have worked quite well -- though I do wonder if perhaps in a situation where hundreds of thousands are dying every month we should find a way to reduce the required testing time a little more. The COVID vaccines were created in January of 2020 but not deployed until December of 2020, mostly because it took ~8 months to test them. With the benefit of perfect hindsight we can wish that we'd put them into production immediately and started vaccinating medical personnel in maybe March or April, and mass vaccinations in June or July. Of course, that would be foolish because they might have been ineffective or dangerous; testing is important. But we can and should ask how much risk would have increased with shorter testing periods and whether we should have traded that risk against the ongoing deaths.
In the future, as we gain experience with mRNA vaccines, I'm hopeful that we can establish baseline safety standards for the mRNA carrier component so all we have to do is differential testing of the effectiveness of the encoded antigens. That probably wouldn't reduce the time it takes to test for effectiveness, but it might significantly reduce the time it takes to test for safety (which has to be done before effectiveness testing can really be done). Also, using a standardizable strategy like mRNA might enable standardization of production facilities, enabling production lines to be converted in days, maybe hours. Similarly, it should enable standardization of shipping and storage. Taken all together, it seems possible that mRNA could make it possible to begin delivering vaccines for a new virus in as little as two months after the virus is identified and isolated.
And we really want to make that sort of rapid development and delivery highly profitable for pharma, because it would be extremely beneficial for humanity. Imagine if every doctor's office and pharmacy in America had ample stocks of the vaccine in March 2020. We'd have had no lockdowns, no masking, no kids struggling to learn at home, no supply shock... most everyone would have just gotten a shot and gone on with their normal lives, avoiding a million deaths, and trillions in economic losses and federal deficit spending. Pipe dream? Maybe not.
I also believe that we could have started vaccinate people against covid in July or August, 2020.
It could be with less known safety, more experimental while other studies are being done but for the most vulnerable it could still be a big gain. The benefit/risk ratio would have been quite high.
It wasn't done mostly because covid wasn't such a big deal. It was causing more panic than it deserved.
The UK removed covid from High consequence infectious diseases list.
https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid#status-of-covid-19
It is just formal decision but in practice experts in the field didn't think of covid as something that requires disregarding usual safety rules for vaccine trials etc. This highlights the disconnect of what the society including most politicians and rationalists thought about covid and what the highest experts in the field thought about covid.
Obviously, most people on this site disagrees with experts. But that's exactly the point, disagreement with experts due to emotions and not expert knowledge or thinking.
While you're at it, track revenues for vaccine deniers like Bret Weinstein and Russell Brand.
People can be stupid without being paid to be so. Comments sections & twitter are full of them.
Yes, these people are often known as fans. They are the ones paying Weinstein and Brand.
Very few people are antivax. Maybe 5% of parents don't vaccinate their children. We don't have antivax laws, yet. Who knows what will happen with Trump.
Whereas lockdowns were wrong and yet forced to all as the policy. Evidence deniers had won temporarily.
Instead of sounding like a literal strawman saying "DO YOUR OWN RESEARCH SHEEPLE", do you want to steelman yourself and provide some information about the royalties and how it goes beyond "pharma company makes new vaccine, gets paid"
Also, wouldn't the "covid is not real" argument apply to all other diseases equally? I mean, pharma companies get paid for those, too.
When people know a useful fact, they say it.
'Go research this phrase' generally means that the point isn't for you to learn a true fact, the point is for you to encounter the same propaganda and go down the same rabbit holes and fall into the same community that the speaker did in order to get them where they are now.
It's not a truth claim. It's a recruitment pitch.
Do you mean the Zapruder film, or the bullet itself that killed Kennedy? One of those must be the shot you are concerned with, right?
(But seriously, when I read this comment I was confused because it took me a few moments to parse this as about a vaccine rather than a photograph. Neither set of royalties causes deaths though.)
Good analysis, and far more than I would have bothered to do, which is “excess death rate, QED.” I think when numbers get large it is very hard for people to have an intuitive sense of what they mean, so they latch onto poor heuristics like “do I know anyone who died of Covid?” Relevant: the average American only knows 600 people (according to the NYT).
The average American may know only 600 people, but each of those people has ~2 parents, ~1 sibling, ~4 cousins, ~1 spouse. What's driving my skepticism on these numbers is that nobody I know in my office reported that their mom died of COVID, or that they needed a day off for their aunt's funeral. I didn't observe an uptick in "R.I.P. Uncle Joe" posts from my 300 Facebook friends. I'm not going to argue that my experiences are better than hard data, but still, nothing in my experience is consistent with the data.
How many people do you know that own a modern Chevy Malibu (ca. 2020+)?
I have no idea because I have almost no reason to know what my acquaintances drive.
This is Forbes data from Jan. ~1% of used car sales in 2023 were for the Chevrolet Malibu. More than 90% of American households have a car, and nearly a quarter (~22%) have three.
It stands to reason that a buttload of those households have Chevy Malibus, and I know I don't have the math skills to just figure out how that shakes out but I do know I see plenty of Malibus on American roads with me.
Shifting gears, I can say from experience in my work that, where we look for (among many other things) size differences between the pupils of the eyes. It's anecdata, but around 25% of Americans have a substantial enough difference in pupillary size that we have to investigate it. It nearly always ends up being nothing, a subclinical data point that enters the chart and sleeps there.
The point I want to make is that people's lives are full of facts and statistics, much of which is publicly available. We nevertheless miss that data or discard them because it's not relevant, apparently useful, or doesn't serve some immediate purpose. But, those rare things happens *all the time*, because there are so vastly many of us.
Did you know that migratory birds have been observed having an average of 3 snails on them? Over the long epoch of several million years, snails accidentally hitching rides on (or inside of) birds could explain much of the diversity of snails on Hawaii, a set of islands far removed from, well, anything. How in the hell would you know something like that unless you were A) a malacologist or B) very bored this morning while waiting for patients to filter in?
We only know this stuff because we take the time to look. It doesn't rise to conscious awareness because there's no obvious need for it, unless you're motivated to look or so bored that you'll read about snails.
Okay, but whether my secretary needed to take a few days off to attend her sister's funeral is something that I actually do have reason to pay attention to, unlike her pupil diameter or the number of snails on her boobie.
Some years I go to four funerals and others I don't go to any. The claimed increase in the death rate is 20%, or maybe a little less. I'm not convinced that this would be noticeable at a personal level, at least not over a short period of time. And then, as I get older I expect I'll probably go to more funerals anyway... Population statistics are very different from personal experience.
I don't know what the mean, median, mode, and standard deviation of funeral attendance in your life is, but I bet you'd be skeptical of the 1.2 million excess death total in a year that you went to zero.
If you average 2 funerals a year, then the chance of a year with none is 13%. If an extra 500k people died in the USA in 2020 then that means the chance of no funeral is 9%. A difference that is far too small to draw any conclusions from, on a sample size of one.
I agree with this entirely. Statistics that sound scary often don't translate well into real life.
In my own personal network. My kids' pediatrician died of covid. My husband's friend lost his father (not sure how old but I think under retirement age). Our family friends in Queens NY lost their grandfather to covid. I followed composer Sarah Duke on Instagram, her husband was young and healthy and was brutally hit by covid and she shared the whole journey until his death.
I remember vividly seeing pictures in March or April 2020 of a funeral home in Brooklyn with covered stacks of bodies because they couldn't keep up with the funerals fast enough. My social media feed was full of quiet small funerals outdoors from friends of friends who lost relatives. That was only the first few months of the pandemic really but it makes me baffled why people don't remember those days. It was publicly shared information.
I expect people know most of the 600 very tangentially, so that they are unlikely to hear about their family members dying. And of the people they know more closely, the 600 often already includes their family members.
The excess deaths were some 20% of the normal amount of deaths, so the uptick shouldn't have been obviously noticeable.
How many Facebook friends post about a death in any given year? It might be interesting to actually gather statistics on your feed, rather than going off a gut feeling about how many you think you see in a normal year, and how many you think you saw in 2020 and 2021.
There were entire subreddits devoted to posting the dying Facebook posts of “uncle Joe”. In a lot of cases the family would be completely unwilling to admit that their loved one died of Covid because they had for months been loudly proclaiming to their echo chamber how it was a hoax to begin with. No one wants egg on their face while grieving.
The fact is you probably do know folks tangentially related to you who had a loved one die of Covid, but the same social milieu that makes you likely to question the official figures would stigmatize advertising your loved ones death from the virus.
My observation was not that there were few people stating that Uncle Joe died of COVID. It's that I saw few reports of Uncle Joes dying. And given that my social milieu - Facebook in particular - comprises mostly educational (very liberal college) and professional (left leaning field) associates, it skews liberal beyond second-degree consanguinity. I feel like I was paying pretty close attention to whether anyone I knew had relatives dying because I was very concerned about my elderly parents and in-laws and my infant contacting COVID.
I'm not using my experience to dispute the data, but at the same time I'm not going to accept someone telling me that experience didn't happen the way I remember because of some aggregate data.
I’m not sure what your point is. If you don’t dispute that the deaths happened, then you need to accept that your experience is an artifact of reporting bias or exists as a statistical outlier.
Also, your Facebook newsfeed is not a random sample. Even if we grant that you were putting an insane amount of your attention into keeping track of the health status of your vague acquaintances, that information very well may not percolate its way to your newsfeed in the first place.
“I like these less because they’re class- and location- stratified, so your chance of knowing them goes up or down a lot depending on your own characteristics.”
But COVID deaths *were*, in fact, class- and location-stratified, certainly more than MS - further explaining how some people (think they) know nobody who died of COVID.
Example: my aunt worked at a nursing home in NY which had something like 16% mortality in the March - May 2020 wave. She knew like 30 people who died of COVID.
Most of the conspiracy theories at this point are elaborate and require a great deal of complexity. I am not sure there is much value in arguing against them.
https://www.astralcodexten.com/p/contra-kavanaugh-on-fideism
One of the worst parts of this community is how people will, without providing any context or explain how it is relevant, lazily link to an old post from Scott. Both lazy and condescending.
The post in question is Scott arguing that conspiracy theories are worth arguing against rather than ignoring, even if they seem very wrong. The current post is an example of Scott doing exactly that, and the commenter above is (much more concisely) saying roughly what Chris Kavanaugh was before.
I think that conspiracy theories are worth arguing against, but only by people who are already experts on something related. If the topic is new for you, it is probably not worth your time researching everything from scratch. You would basically have to out-learn the conspiracy theorists, while the expert is already ahead of them.
So I am happy with Scott posting against conspiracy theories, but there is no way I would try researching the same thing to make my own informed opinion on the topic -- it would take literally years to get to a useful level of medical knowledge, and I don't have that much free time.
Many of us in the audience both charitably grant the likelihood of relevance *and* don't find reading an old Scott post to be that much of a hardship.
Just because "many of [you] in the audience" approve of lazily posting a link and giving no context or synopsis whatsoever, doesn't mean it's good practice to lazily post a link and giving no context or synopsis whatsoever. This place is supposed to have etiquette above that of your typical subreddit; and "Scott said this, QED" is below the level of thought this place is supposed to exhibit as well.
uugr explained why it was on-point. I didn't say "QED", just as I don't say that for most of my comments.
A related argument (to the died of covid / with covid controversy) is that the death of an 86 yr old is not the same as the death of a 34 yr old: in the first case covid merely hastened what was inevitable, depriving the old person of at most a few low quality-of-life years. In a sense an old person is always dying _with_ whatever condition is the proximate cause of their death. It would be interesting to see how many quality of life adjusted years we collectively lost due to covid and compare that to car accidents or smoking.
You seem to assume there is a social benefit from years of college, but Bryan Caplan's "The Case Against Education" argues otherwise. Our own host has discussed how wasteful education for doctors like himself is quite popular even though the example of Ireland shows undergrad isn't necessary for them https://slatestarcodex.com/2015/06/06/against-tulip-subsidies/
My one link was to Scott Alexander's post about whether doctors need to go to undergrad first. I merely referenced Bryan Caplan, who was making an argument against his own interest as a college professor. If you want actual studies on the social vs private benefit of education, here you go https://www.econlib.org/archives/2013/10/international_e.html
The fact that you enjoyed college is not evidence against that. You might enjoy it if the government provided you with hookers & blow, but that would just be a pecuniary transfer for your consumption. College is heavily subsidized on the assumption that there are spillovers to the public good.
TR wasn't even talking about "social benefit." He was talking about quality of life. You're the one who brought up social benefit and it was a complete non sequitur.
Of course the social benefit is relevant to public policy.
"You seem to assume there is a social benefit from years of college..."
The two things being (implicitly) compared here are not two years of college vs. two years doing something else such as working or being in the military. It is two years of college while either (a) being on campus and interacting with the people there (profs, fellow students, police ...) or (b) doing this all via Zoom from the student's childhood bedroom.
(a) is a much better way to spend two years of one's life than (b). Especially if the student has carefully chosen the college to be near, say, a beach (e.g. Santa Barbara Community College, UCSB).
Fair enough, holding college constant but using Zoom could be similarly wasteful.
College, and young adulthood more generally, is when people are (hopefully) building the foundations for the rest of their lives: getting qualifications, gaining experience of independent living, perhaps even meeting their future spouses. Even if you think we send too many people to college -- and personally I'm inclined to agree on that point -- majorly disrupting someone's life at this stage is going to potentially have far bigger ramifications than letting his grandmother die at the age of 82 instead of 86, callous as it sounds.
And of course, it's not just college students who are affected. Anecdotally, lots of teachers in both the UK and the US report a big uptick in mental health problems amongst their students, and whilst maybe this would have happened anyway (anxiety and depression were on the rise even before COVID), it's at least plausible that spending several of their most impressionable years being kept away from their peers and told that they might end up accidentally killing granny if they went outside could have exacerbated the problem. For older people, lockdowns might mean a two- or three-year delay in getting married, which in turn might mean they're now too old to have children, or too old to have as many children as they otherwise would. And so on. Life isn't like a computer; you can't just switch it off and switch it on again and expect it to keep working like before.
Not only that but grandma's QOL during the additional 4 years takes a bit as well: she can't see family, she is essentially a prisoner in an institution, and instead of seeing her grandkids enjoying college and building a foundation for their adult lives, she seems them holed up at home listening to Zoom lectures.
This is correct and massively under-discussed. Extended solitary confinement is a terrible punishment imposed on the worst prisoners. Yet not only is it dismissed from the calculation of NPI costs, people actually pretend that the elderly should be grateful for it. Someone who's 85 has probably 5-7 more years left. Locking them down for a year or two to supposedly avoid Covid not only plausibly hastens their demise but also turns a significant fraction of their time into a life hardly worth living.
I view the idea that letting someone older die 4 years sooner than they otherwise would have (an underestimate to be sure, but we can run with it) is not worth the in-person schooling experience of a 19 year old as monstrously callous. It's strange to me that you take it as self-evident.
If you were told that you had a choice between a 19 year old having to do freshman year remotely at a college or putting a bullet in a 80 year old's brain, you'd think the choice is obviously do the latter because the value of an old person's continued life is minimal?
And who gets to define quality?
That's not what I meant. I mean in practice in the real world, who would get to decide that without creating incredibly terrible decisions. Even if everyone could agree on a definition that covered all use cases (which is impossible) there would surely be abuses of that system.
I agree. And there's a lot of fulfillment in living in your 80's and continuing to be present for your loved ones compared to some restrictions on the range of experiences in college one might experience. Saying "quality" doesn't mean your views on the value of a life are correct.
You have it inverted. I was saying in addition of the value of life to the the older person who is alive and still able to have fulfilling experiences, their continued existence is also fulfilling to people who care about them. It's part of the overall benefit of their not dying that you are weighing against the value of a more vibrant college scene.
Grandma not dying is of significant interest to grandma, but it's also of interest to people who happen to care about grandma. That's part of the overall utility calculation you are trying to invite. Why, I'd be willing to bet that odd as you might find it, there are lots of people who would be willing to trade off attending college remotely rather than in person for a few years in order for their grandma to live 4 more. This might be a foreign idea to you - "insane" in your own words - but that's an ordinary way to order one's desires.
I agree. It’s ridiculous that you think one year in college has more quality than four years in one’s 80s.
Agreed! Thank you for saying this! I have no problem with someone making the argument by posing the question of whether age should be taken into account when healthcare has to be rationed and under what conditions. but to claim that for anyone to say that "old people's lives matter" is insane and madness?
Plenty of old people live meaningful and fulfilling lives (my grandfather traveled the world throughout his 80s and was healthy enough to play baseball with my kids in the park at age 89, just saying).
But even if they didn't! At what age do human lives stop mattering? Why is a 79 year old more valuable than an 81 year old? A 75 year old? A 69 year old?
Should a 19 year old give up college to care for an elderly parent? People do that all the time. What if there's no one else able to care for them? Are they wrong? This just makes no sense.
This philosophy logically extended turns into a horrible dystopia very quickly.
I'm familiar with it thanks. You didn't address any of my points. I wonder if you're serious or trolling. Not because of your views but because you don't admit that it's your position which is outside the mainstream and requires a defense not the other way around.
Do you really believe that all 80 year olds automatically have bad quality of life?
Can you say something about how the repugnant conclusion relates to the debate of whether it is worth sacrificing in-person classes to delay the deaths of senior citizens?
Problems here:
* You compare "a 19 year old" to "an 80 year old," but in fact the 19 year olds in college way outnumber the octogenarians who died
* You assume that closing college is a 0%-100% choice in whether an 80 year old dies of Covid, when we don't even have any good evidence that it made any measurable difference at all
I'm following the comparison of the person who I replied to. I was not the one who introduced the direct comparison. I agree that it doesn't properly model the actual tradeoffs, but it's not my comparison to start with. The underlying issue is someone who decided that 80 year old lives aren't worth much and it is "insane" to think they are. They invite you to judge years of an elderly life against in-person attendance at a college and see that the latter is self-evidently of higher value.
We are not making a choice here between whether a 19 year old or an 80 year old gets to live. In reality, we were making a choice between a set of experiences young adults olds might have vs. some increased risk across the general public that they'll experience death or a significant reduction of quality in life that happens to increase significantly with age. There is lots of evidence that mitigative behavior collectively reduced said risk.
You should also reverse the scenario. If you were 80 years old, and you were going to die soon but you had a 1/6 chance (my upper-bound estimate of the ratio of college students to elderly people who counterfactually would have gotten and died from covid without lockdowns) of extending your life by a few years by making your grandchild do their freshman year of college remotely, would you do it? I would imagine probably not.
Of course, the college student who plays russian roulette with her grandfather's life so she can go party on campus for a year also comes out of this looking pretty bad.
I think this is just "selfishly imposing costs on others for your own benefit is bad".
The scenario already allowed for the reverse, since it was presented simply as a choice for a 3rd party. The participants are not the ones imposing the consequences. Kill the 80 year old who would live another 4 quality years is the meaning of "soon" and the choice was doing that or not compared to the offered tradeoff. This is not realistic, but it is the contrast that was set up by the person I initially responded to who was trying to communicate just how worthless years lived beyond a certain age are.
If we change the scenario entirely in the way you offer, someone extending their life four years by transforming a young person's in-person schooling to remote is defensible and is ultimately a vastly oversimplified version of what public health in the face of pandemic has long done with various forms of quarantine.
At 1/6 (my absolute upper bound on the estimate of the number of life years saved by lockdowns per year of remote schooling for university students) it is defensible, and approaching an absolute slam-dunk win from a public health perspective. At 1/1000 (my lower bound) it is not defensible.
I personally think the public health people made the wrong call with lockdowns but I don't think their call was *drastically* wrong (though separately I *do* think they made terrible calls with what particular things were allowed and forbidden).
Part of the problem that occurs in these discussions is people have ambiguous use of the term "lockdown." America never really had "lockdowns" in the formal sense at all, but the term was picked up early in the pandemic as it was describing the policy of significantly more restrictive nations. The closest the US came to lockdown-like behavior lasted for a brief period in the spring of 2020.
That said, we did have a series of both formal restrictions and informal recommended behavioral changes that were mitigative, but inconsistent with each other and suboptimal. This is what people usually somewhat unartfully call "lockdown." Slapped together, these collectively were effective enough to keep the seroprevalence down until vaccination rates climbed in a way that saved a very large number of lives and long-term health problems. At the same time, they were drastically inferior to what a nation like New Zealand was doing and the gaps likely cost a large number of lives and caused a lot of heartache among the still living. The US response sat in the zone of "could be a lot better" but also "could be a lot worse." It's sad when you think about the conventional wisdom prior to this was the US and its once vaunted CDC were among the best situated to weather a pandemic.
If you were to knock out any one pillar in the US strategy in suppressing community spread, in isolation it wouldn't necessarily have moved the needle a large amount. Even if all the legal restrictions were removed, the specter of death would've still had many people behaving with more caution. The problem with trying to isolate any one thing and estimate its contribution, however, is that mitigative recommendations were interlocking. They contributed to each others' effectiveness and communicated a sense of urgency and danger that unto itself also likely influenced propensity to safe behavior. An answer to any one particular "was this necessary?" is generally, "sort of, yes" with an added, "and you can only pull so many blocks out of the jenga tower."
> I would imagine probably not.
Your imagination apparently works differently than mine! I usually try not to speed in residential neighborhoods, even if the people are old, and I assume even old residents would like me to do that.
... I also don't speed in residential neighborhoods. I don't think I am understanding how your analogy works - are you saying it's sufficiently selfish for old people to be against speeding that it should outweigh their own concern for their safety?
Or do you object to the more general idea that we tend to take a dim view of people choosing the side of the tradeoff that benefits themself, even if the benefit they get is larger than the costs to others (less so if the cost is trivial and the benefit is large, as in your speeding example but not as in the original example)?
Imagine telling an 18-year-old: “If you do your first two years of college remotely, you’ll live four years longer.” They say, “Yeah, that sounds like a fair trade.”
What mental illness are they suffering from, exactly?
"It would be interesting to see how many quality of life adjusted years we collectively lost due to covid and compare that to car accidents or smoking."
I did a back-of-the-envelope calculation for this a few years back with the intent of comparing Covid to other types of deaths that people are familiar with. I did this using the California excess deaths per age group and then combined it with life expectancy for that age group.
Going from memory, Covid (at the time, but we were fairly far into it) cost the average American about 5 weeks of life expectancy (more death amongst the elderly, but the 'cost' in years was lower ... interestingly the lost years were pretty flat between most age demographics [maybe within 2x]; fewer 25-34 year olds died, but they lost more years of expected life when they did; I didn't try to adjust for health ...]
I was unable to find a reasonable comparable, though. This also works out to something like a "double your miles driven per year for 10 - 20 years" risk, which I find to be unhelpful.
Smoking for a lifetime probably, on average, costs you more years of life than Covid. Driving fatalities per year are much less. I don't know of anything 'common' in the middle.
Ooo, I wonder about the lock downs vs quality of life years.
E.g China had strong lockdowns and only 5,272 listed deaths.
India has a similar population and 533,570 deaths.
So we could say that China saved about 500k lives.
I asked Perplexity to work out the lockdown duration in person years. E.g the population affected by the lockdowns with the duration applied, e.g 10 weeks in Wuhan.
It gave 14,431,091 + 573k (it didn't think it had strong data for).
So just over 15 million human years.
So to compensate the people who died would have had to have lived 30 years in average to have made it one to one.
However life under lock down isn't the same as years not lived.
Personally I'd just had a new child and work from home. So we weren't going to be going out anyway. My memory is that we had maybe a 5% quality of life reduction due to the intense lockdowns in the Philippines. It was worse for 2x two week lockdowns where I had to line up to get food from the supermarket and apart from that couldn't go outside.. I couldn't go for a run outside and had to do beep test style running back and forwards inside. But when partly opened up there was almost no car traffic and running on the streets was way nicer than now. Less traffic and pollution.
Wearing a face mask is something we were already doing outside. Wearing a face shield for a while was a little annoying.
However my wifey's Mum had a stroke and then caught COVID in the hospital and died 2 weeks later whilst still being ravaged by COVID (delta at the time, it hit us HARD).
Thankfully Perplexity is better at researching than me and suggests the China style lockdowns were worth a 30% Quality of Life reduction. Although the global average was 12-18%
So 30% of 15 million is 4.5 million years.
Now the 500k people should have lived at least 9 years or more before it turns out to be a net positive.
Perplexity suggests that the Quality is life years lost in India was 8 million.
Or to put that another way, the lockdowns in China were 56% (basically half) the list quality of life years as compared to that of the deaths in India.
But it's different compared to USA stats.
> The U.S. COVID-19 death toll of 1.2 million resulted in 9.7–13.2 million years of life lost, depending on adjustment criteria.
The USA lockdowns affected 27.9 million person-years.
The USA quality of life adjustments of the lockdowns are listed as 15%
So 27.9 x 0.15 = 4.185 million years of life adjustments.
So the death toll was over double that of the lockdown toll in terms of quality of life.
They could have certainly pushed lockdowns harder and faster (as part of the Hammer and Dance) to reduce the death toll related Quality of Life years.
It feels like to me that normalising to Quality of Life years for the lockdown vs death toll is a good way of post-hoc analysing the results and comparing.
There's of course going to be those people badly affected by COVID lockdowns (e.g Travel agencies or resorts) who probably didn't know anyone or almost no one who died.
The lockdowns also disproportionately affected lower income people and those in less developed nations, like Bangladesh. Whilst the virus more targeted the elderly.
However countries applying counter measures for this, like providing stimulus checks seems to have somewhat offset the cost imbalance. Or those like in Sweden were the least affected because of the good social support.
My Perplexity thread of research:
https://www.perplexity.ai/search/how-much-time-in-weeks-was-chi-rAMs0_uQQnyLuza10MuJXQ
China and India have similar populations but very different demographics. ChatGPT thinks there are 280M vs 159M people over 60, and ~55% vs ~35% of 40+-year-olds. So I think the expected number of covid deaths in China with Indian levels of lockdowns should be at least 1.5-2 times higher than in India.
I remember a back of the envelope calculation that suggested it was pretty comparable in QALY impacts to the opioid/fentanyl epidemic (fewer deaths [though still 100's of thousands], but more QALY's lost per death) over a similar time frame. Not sure what to think of that in terms of our response to either of the problems.
I asked 03 and it said:
"Bottom line: Using CDC opioid-involved overdose‐death counts for 2020-2024 and the most recent peer-reviewed estimate that each fatal opioid overdose removes ~38 healthy life-years on average, I estimate the U.S. lost ≈12.7 million quality-adjusted life years (QALYs) to the opioid epidemic in the five years 2020-2024. Even under conservative assumptions this burden remains above 11 million QALYs, underscoring that opioid toxicity has erased more healthy life in this short span than many leading chronic diseases."
That basically matches the estimated 12 million QALYs lost to COVID.
O3 estimates 12 +- 1 million QALYs lost to Covid. That’s 10 QALY per death, which seems reasonable if it was mostly old people dying.
Interestingly that almost exactly matches the O3 estimate of QALYs lost to the opioid epidemic over the 2020-2024 period. Roughly 1/4 the deaths, but about 4x the QALYs lost per death.
"Bottom line: Using CDC opioid-involved overdose‐death counts for 2020-2024 and the most recent peer-reviewed estimate that each fatal opioid overdose removes ~38 healthy life-years on average, I estimate the U.S. lost ≈12.7 million quality-adjusted life years (QALYs) to the opioid epidemic in the five years 2020-2024. Even under conservative assumptions this burden remains above 11 million QALYs, underscoring that opioid toxicity has erased more healthy life in this short span than many leading chronic diseases.""
And the opioid epidemic was/is a very big deal! I wrote about it challenging my libertarian-leaning perspective https://entitledtoanopinion.wordpress.com/2020/08/11/a-contrary-perspective-on-the-opioid-epidemic/
I rather doubt this number. Average age of US covid deaths was a little over 77. The average life expectancy of any 77 year old is around 10-12 years (depending on male or female). But covid deaths also disproportionately hit the sickest with many co-morbidities. I find it hard to believe that the average 77 year old who died of covid had an equal life expectancy to the average 77 year old in the general population.
Perhaps the QALYs lost by people who did not die make up for the difference? At any rate the order of magnitude seems correct.
It's probably within an order of magnitude (10x), but I'm not convinced it's particularly close like within a factor of 2. Just as an example, around 200,000 of covid deaths were nursing home residents. The average life expectancy for any nursing home resident is 1-2 years (all, not the sickest and weakest which you'd expect from the covid cohort). Over half don't make it 6 months. That's a lot to counterbalance with the remaining deaths.
That's why the average amount of life lost per COVID death has been estimated at around a decade. Certainly not as bad as Spanish Flu, which killed the young more than the old. Won't we be screwed if something like that happens again and people continue to be so stupid in their response.
It’s so weird to me that people see this as a case of leadership being stupid - it’s rather a case of transparency causing all the problems. Leadership did as well as in any crisis in all of human history, but because we see there were costs as well as benefits, people have decided that we don’t want leadership any more.
Thank you, these are the words I wanted.
There is a basic immaturity to me in the view that doesn't accept:
1. the profound imperfection of human institutions across all history and places;
2. that uncertainty is a basic feature of existence that all the lovely leadership in the world cannot manage it away.
There is so much room for criticism, but the value of the criticism is so that we respond better then next time calamity hits.
Raging because the data is imperfect and complex or because the guidance in an emergency was contradictory or that some measures were counterproductive is to rage at reality as it is.
So many people worked so hard to take care of so many other people during this mess. It was traumatic and people are still recovering. From trauma, we can grow or we can freeze. We really do have some choice about that.
I get that this pandemic and the handling of it -- like 9/11 did for some other people or Watergate and Vietnam before them, and so on -- led a lot of people to lose faith in all kinds of things. And that losing faith (along with the willingness to hang in there with nuance) is a normal kind of grieving process.
But persistence in the belief that the world *should* have done more for me than it has is ultimately a childish view that needs to be outgrown in order to live the life we do have.
I think this is also the case (at least as Americans) where we really suffered from having 50 states as laboratories of democracy because people can point to ineffectual leadership on both sides to find reasons for their side rather than looking at the cases where the leadership pursued level head decisioning and made reasonable tradeoffs.
13.5 million life years, as I posted yesterday.
Interesting. I wonder how many life year-equivalents were lost due to lockdowns? 300+ million people locking down for a few weeks would surpass 13.5 pretty easily, but we would likely need to do some kind of adjustment for actual death verses the significant loss of [enjoyment, freedom, career advancement, etc.].
This is so strange. At literally NO point during Covid was I 'locked down,' and I lived in a liberal college town. The way people talk as though everyone was under house arrest is literally not true. It's so weird to me.
So in my state, entire industries were literally told they could not operate. Restaurants were either take out or closed. Other states forced the closure or churches and other public accommodations. Lots of people lost jobs over this, including a close family member of mine. People got arrested for going to the beach.
There were no people local to me that were getting arrested for going outside, but it was possible. My boss wrote me a letter that I kept in my vehicle saying I was an essential employee in case I did get pulled over. If the police were more supportive of the lockdowns they could (and often should) have been arresting people for violating the orders.
Maybe your location didn't involve such orders, or maybe the people around you just ignored them all.
I don’t see any example of lockdown in what you say - just paranoia that someone might be treated as though they were locked down. Is a snow day lockdown? What if you get to play outside in warm sunny weather during your snow day?
if the government issues an insane, massively tyrannical order, but then enforces it only 1% of the time, that's still extremely bad
not as bad as if they enforced it 100%, but extremely bad
Okay, so China literally locked people in their homes, and the West didn't do that. I still don't have a problem with the term "lockdown" (mainly because it's what the leaders who implemented these programs and the journalists who wrote about them called them) to describe the significant restrictions on movement, business, recreation, and normal life that were mandated on ordinary people in a totalitarian fashion.
"I was still allowed outside of my home" is not a reasonable response to what anyone complaining about the lockdowns (outside of China) is worried about.
This is the sort of thing that GPT-o3 with search is usually great at. It gives an estimate of about 9 million QALY lost over 2020 to 2023. Note that QALY lost due to long Covid are explicitly omitted, since the evidence on that isn't great and the numbers are pretty up in the air. The sources seem reasonable, although I haven't checked them individually.
https://chatgpt.com/share/682f26a7-47c8-8010-9b3e-b4864e9cfb17
If the deaths were just pulled forward in time a few years, we would see *less* excess deaths in the years that follow.
I think the argument can be stated as '1.2M Covid deaths did not lose nearly as much QUALYs as 1.2M totally random deaths would have, which is why it doesn't feel as bad as other events with similar body counts.'
I think that's true, but also it wasn't *all* old and sick people, lots of QUALYs were still lost here and there - even if we only lost the QUALYs we'd expect for 600,000 'random' deaths, that's still a lot, more than how we talk about it.
Also, of course, lots of QUALYs were lost to non-death... after a bout of Covid, I lost my ability to taste sweet, and it's never come back. Others have much more debilitating long-term effects.
My grandmother died a little over a year ago at the age of 99. The last few years of her life were certainly of low quality on several different dimensions, for a host of reasons I won't go into here.
She didn't die from or with COVID. But if she had died from or with COVID during the first year of the pandemic, she, I, and the rest of our family would have been deprived of the the opportunity for her to meet my son. And I know, for a fact, from conversations with her, that moments like that with her great grandchildren made her few remaining "low qualify of life years" worth it to her and her family.
This is what makes quality adjusted life years so fraught. I understand the need to make trade-offs within any system, and in healthcare that sometimes means prioritizing one life over another. But I also think it's pretty gross when people seem to write off elderly people's last few years of life as being "low quality". That's a value judgement that 1) you can't make in the aggregate and 2) you can't determine just by considering medical conditions.
The "quality adjusted" part is less important than the "life years" part, IMO. (And it's unfortunate that the whole conceptual space is now taken up by "QALYs", which imposes this inherently-subjective and extremely difficult-to-reckon concept of "quality adjustment" on what is otherwise a simple matter of arithmetic on actuarial tables.)
It's very reasonable not to discount the final years of an octogenarian's life on quality grounds, but the fact remains that if someone in their 80s dies of COVID, it's a loss of 5-10 expected years, depending. This is clearly less significant than the death of a young person who could live another 50, even without any dubious quality adjustment at all.
What accounts for the global discrepancy between officially 7 million (US makes up one sixth) to unofficially 20-30 million (US makes up something closer to its age-adjusted share of the global population). Is the gap mostly China or a lot of countries? Do death rates seem close in countries perceived to have reliable data? Should we expect undershoot of expected mortality going forward?
You could look at the excess death rates here: https://ourworldindata.org/grapher/excess-deaths-cumulative-per-100k-economist and compare them to the official statistics. I'd imagine India makes a big part of the gap. Russia too, maybe.
> Should we expect undershoot of expected mortality going forward?
I was also wondering this. I think the answer should be "yes", right?
That's a good chart there. Russia was such a strange case, they were able to develop a perfectly good vaccine but almost nobody agreed to take it, so combined with an elderly population they had the worst excess mortality in the planet. I wonder if they've had any kind of post-COVID reckoning.
It truly is insane. Russian government managed to make one good thing in years, and yet that was the thing which provoked widespread "resistance" among all social groups. Russians would happily accept war, poverty, corruption, they would ask no questions about police violence or shutdown of free speech. But vaccines? That's where they draw the line.
I know right? Like 70% approve of Putin but 10% trusted him enough to take his vaccine. It never made sense to me.
I don't think 70% approval rating is a meaningful figure. It can unpack to something like "Do you prefer Putin to the criminal 90s or some other form of political instability?" or "Do you prefer Putin to the clowns he didn't remove from public politics in one way or the other?"
OTOH, Russia has a long history of "The tsar is good, it's the boyars who screw us up". And it wasn't Putin who personally developed the vaccines.
So I don't know why Russia had high levels of covid/vaccine skepticism but this is not a contradiction.
China is another telling example. They were able to weld shut doors to lock everyone down, but weren't willing to force old people to get vaccinated.
It literally _must _ be yes, mathematically. Everyone is eventually going to die. So if some people die early, that is fewer people available to die later. No matter what the cause for an increase in deaths, there must be a corresponding decrease in deaths at some point in the future to balance it out.
India (3x the population of the US) had less than 1/2 the total reported Covid deaths of the US (~550,000 vs 1.2 million), so maybe 1/10th the per-capita death rate.
India is poorer, but has fewer overweight and obese people.
Reporting is probably poorer.
I don't think anyone knows if the number is correct, or off by 10x.
You can look at per-country data here:
https://www.worldometers.info/coronavirus/#countries
The USA is between Latvia and Greece for covid death *rate*.
Canada and Denmark have less than 1/2 the US rate.
This is just confirmed cases, right? I think the US did a lot more testing than other countries, especially compared to India.
This is *deaths* attributed to Covid. I'm confident about the death part :-)
But he US might well assign more deaths to Covid because testing was much more extensive and India might just see a lot more deaths but not score them as Covid.
One would need to look at overall Indian (and Latvian and Greek and ...) deaths over time. I'm sure the data is available. I don't know where to get it.
No undershoot of expected mortality since Covid.
https://ourworldindata.org/grapher/excess-mortality-p-scores-average-baseline?country=~USA
My guess is that it exists but too small a signal to measure vs noise. If 1.2 million undershoot is spread out over the next 20 years, it could be just a 2% decrease, and it bounces around about that much and will certainly be affected by other health trends and medical progress.
Given that everyone alive during Covid will die eventually, then yeah, any given person who died during Covid means some year is eventually going to have one less death than it would have otherwise.
"My guess is that it exists but too small a signal to measure vs noise. If 1.2 million undershoot is spread out over the next 20 years, it could be just a 2% decrease"
With the bulk of the deaths clustered in the 65+ age demographic (and that clustered in the older of *that* demographic) it should not spread out over 20 years. Lots of people who would have died within, say, 5 years of 2020-21 should have died in those two years. I'd expect that to show up soon-ish rather than spread out over 20 years.
Maybe an undershoot would be more visible if looked at in age-bins (so no obvious undershoot for the 25 year olds, but an obvious undershoot for the 85+ crowd)?
I think you are underestimating their life expectancy.
The life expectancy for a 65 year old male is 17 more years. The life expectancy for a 65 female is 20 additional years. Those are averages, so 50% will live longer.
Even the average 80 year old has 10 more years.
Counterintuitively for some, the longer you stay alive, the higher your predicted lifespan will be.
The average female newborn will live to 79. The average female 79 year old will live to 89.
https://www.ssa.gov/oact/STATS/table4c6.html
I remember COVID skeptics being asked to bet if mortality would subsequently undershoot due to getting rid of the "dry tinder", but I don't recall anyone taking the bet.
The issue is the terms of the bet. Let's say 1.2 million dry tinder might have otherwise had a mean life expectancy of five more years in the no-pandemic counterfactual, so, to simplify the math, assume 120k undershoot of an average 3 million deaths, which is -4%. The difference between 2019 (before covid) and the average of 23 and estimate for 24 (which are pretty close and so plausibly "post-covid") according to CDC is around 230k or +8%. Are expectations of future mortality numbers good enough to know precisely whether that gap otherwise should have been 50% larger? I doubt it. And if the excess death undershoot is spread out even more and unevenly while other things are changing too, it just doesn't seem the kind of dispute easy to resolve with bets with terms that are both well-defined and epistemically reasonable.
All that being said, I think something to look for in the future may be claims of progress in mortality, longevity, etc. - where small percent changes are the norm - that could be largely mere artifacts of long slow "mortality dividends" of dry-tinder undershoot.
There are a lot of countries that just don't have the infrastructure to begin to put together a count because of unavailability of tests, or just simple nonexistence of a public health system to collect data. e.g. when a man dies of covid a village in South Africa he doesn't go to the hospital and there is no coroner to record the death.
Also there is the issue of age. Over 65 makes up 90% of covid deaths. The US has about twice the percentage of people over 65 as the world population, so our death rate is just going to be higher no matter what.
Then there is China who had such a draconian lockdown that they were able to actually halt the spread of the virus until after the vaccine and the much weaker but faster spreading omicron strain came out. So, even if they reported true statistics, which I doubt, their death rate would have been massively lower than the US. And China is 1/6 of the world population, so that's going to skew the numbers a lot.
It’s probably mostly low to middle income countries that don’t have great statistics. China likely had very little undercount until late 2023 when they ended their zero covid policy - though they probably have an undercount in the month or two after that.
Total death numbers are likely fairly accurate in most countries, though there are some (like Somalia and Venezuela) where I expect we have few if any meaningful demographic statistics.
It’s probably mostly low to middle income countries that don’t have great statistics. China likely had very little undercount until late 2023 when they ended their zero covid policy - though they probably have an undercount in the month or two after that.
Total death numbers are likely fairly accurate in most countries, though there are some (like Somalia and Venezuela) where I expect we have few if any meaningful demographic statistics.
It amazes me how the rightward shift of the tech community has motivated so many previously intelligent people to accept conspiratorial ideas (like Covid denialism and antivax) they previously would have dismissed as being for low-IQ nutters. Nothing has actually changed about how plausible these ideas are, only how normalized they’ve become on the online right.
It's crazy how anti-vax jumped from the left to the right so rapidly. Before COVID it was Marin county that had third world measles vaccine rates and West Virginia with the highest in the country. But I guess that's just the tips of the horseshoe.
The antivax community has always been an exercise in horseshoe theory. It's always been granola essential oil hippies and religious homeschoolers sharing health tips.
It feels to me like the New Age movement has finally found its natural home on the right. The antivax movement’s roots in crunchy hippy counterculture once kept it mostly restricted to the cultural left. But as the hippies have grown old and cranky and normie conservatives have grown increasingly conspiratorial and less respectful of traditional authority, the distance between these two groups has grown narrower and narrower. Covid was just the catalyst that finally fused them together.
It’s like sport teams with a player moving from one team to another. The loyalty is to the team - not to the player.
It’s really not surprising at all when you remember how incredibly dishonest the official communication about COVID was.
Maybe just because I'm in another country, but I don't remember dishonesty.
I remember some mistakes that were corrected - and, in one case, the public corrections never got through (that the whole "wash your hands/clean surfaces" thing where the later correction that it was airborne never got through to the public). And it was certainly the case that if you were following experts online then they were ahead of the official communications. But that's true of just about anything; official advice always takes time to catch up with scientific knowledge, if for no other reason than that it requires consensus.
But we got things like "vaccines prevent spread", quickly followed by "no they don't; they reduce it" and then "but not by that much" as each variant made the vaccine less effective than the previous one. Sure, they were still saying "vaccines prevent spread" for three or four weeks after it had become obvious that they didn't, but that's not dishonesty, that's the process where scientific research becomes official communications being very slow.
The main example I recall of calculated dishonesty is an ironic one for people who're generally COVID denialist. The public messaging at the beginning was that masks were not effective, because they were worried about an undersupply for medical workers and didn't want regular people buying them up. They reversed course once the supply was secure. There were some cases of pragmatic (if poorly considered) dishonesty like this, but it's all consistent with public officials trying to cope with a serious pandemic where the public often responds in perverse and unhelpful ways.
If they were so good at thinking ahead and dealing with the unhelpful masses, they should have predicted that lying to them in such an obvious way would cause then to trust then even less, making their good-intentioned interventions less effective in the future.
This is the entire point of having simple heuristics like “just tell the truth” instead of galaxy-braining every specific situation: because you’re probably not smart enough to do it properly anyway.
I never said they were good at it, and I do think this cost them valuable trust, but given ordinary human behavior, I think a substantial contingent of people were going to distrust them anyway.
Was this actually a thing somewhere, or is it just something people say?
If it was actually a thing, how much of a thing? Official country-wide government policy, a local low-ranking official making an unofficial tweet, or somewhere in-between?
My bet is some random media worker mis-spoke, or something like that.
I'll have to wait until I have more time to delve into this more, but as I recall the messaging on this point at the time was concerted and coordinated, but t not very long-lasting.
It was a tweet from the US Surgeon General at the time (Jerome Adams): https://www.npr.org/sections/health-shots/2022/04/28/1095295980/jerome-adams-masking
It's particularly ironic as Twitter started removing antimask tweets later in the pandemic.
Okay, so the linked article seems to suggest the tweet occurred at a point where the US system thought covid wasn't properly airborne ("The WHO and the CDC were saying the same thing that I was saying, so the science supported me.") Or perhaps attempting to make a more nuanced argument about how the public masking wouldn't change much at that point. (e.g. if the incidence in the public at large is very low, then each individual mask won't stop many instances of covid - because the user probably wouldn't have been exposed /anyway/).
So it looks to me like this doesn't support the interpretation that this was officially sanctioned, calculated dishonesty.
"Was this actually a thing somewhere, or is it just something people say?"
The US Surgeon General posted on Twitter in late March 2020:
"... my office have consistently recommended against the general public wearing masks as there is scant or conflicting evidence they benefit individual wearers in a meaningful way..."
https://x.com/surgeon_general/status/1244020292365815809
Six weeks later you were a bad person if you didn't wear a mask. Even if the mask was cloth or knitted.
In 2016 (so before Covid ...) the medical establishment was writing articles such as "The surgical mask is a bad fit for risk reduction":
https://pmc.ncbi.nlm.nih.gov/articles/PMC4868614/
Things pivoted HARD in a very short period of time.
I'm not an expert at the twitter interface. Your link goes to tweet one of three. Am I right in thinking the other two parts are the images below?
If not, you ought to cite them too, for completeness.
If the images are parts 2 & 3 - then the wider picture seems to be that they were asking people not to wear masks if they were in a low risk situation while supply was also limited. It's not really a nefarious pivot or underhand to change advice when the situation also changes.
I agree the text in isolation was misleading, but that's a problem with the format, and the problem looks to me like a failure to realise how it would be interpreted rather than some sort of lie.
This is anecdotal, of course, but I don't remember any official messaging at all about masks not working. But I distinctly remember messaging that we should hold off buying them to ensure medical professionals had access to supplies early on, which of course implies that they do work.
It was specifically that masks didn't work for limiting transmission when worn by normal untrained people in casual settings, so the general populace shouldn't buy them because 1) medical staff needs them more 2) it won't do anything for you anyways.
This was, indeed, a pretty odd combination of ideas to hold in one's head. Since when do you need special training to cover your face? But that's what was said for about a month before it was recommended for everyone. I do think it damaged trust somewhat and I wish the government had just instituted formal rationing on masks early on to reserve supply for hospitals.
EDIT: To clarify, public health officials were not deliberately lying to mislead the public and secure their own mask supplies. There was a pre-existing belief in medical science that masking did not slow the spread of pandemic respiratory illness, influenced by an over-reliance on RCTs for evidence and a backlash away from 1800s miasma theory: https://pmc.ncbi.nlm.nih.gov/articles/PMC8504883/
Of course, at the very beginning of the pandemic when nobody had COVID except in NY and a few other places, it was basically true that wearing masks provided no benefit in (most) "casual settings." There was nothing to protect against for the majority of people. I don't know, but can imagine, it being said off the cuff as something valid today without any thought about the guidance being very contextual.
//Since when do you need special training to cover your face?//
The answer to this doesn't seem to be what you think.
At least, not for everyone.
Have you not seen people covering their mouth and not their nose?
Even after being told what to do incessantly?
Fauci specifically said that the masks you can buy at the drug store don't work and that there's "absolutely no reason whatsoever to wear a mask."
https://www.usatoday.com/story/news/health/2020/02/17/nih-disease-official-anthony-fauci-risk-of-coronavirus-in-u-s-is-minuscule-skip-mask-and-wash-hands/4787209002/
Fauci himself later claimed that the *motivation* for telling that lie was to prevent a run on masks that were needed by healthcare workers.
https://slate.com/technology/2021/07/noble-lies-covid-fauci-cdc-masks.html
It never seemed to occur to Fauci that when people find out that you have been lying to them then they stop believing what you tell them.
Fauci is wrong more often than many people like to believe. He was also wrong about how transmissible AIDS was.
I stand corrected, though I think you're overstating his initial claims. He didn't say drug store masks don't work, he said they "[don't] really do much to protect you", which implies they do do something to protect you. And you removed the two qualifiers in your quotation, where he said "Now, in the United States, there is absolutely no reason whatsoever to wear a mask." This implies that there might be a reason to wear a mask if circumstances change or in another location.
I completely agree with your final sentence though. With rare exception public officials should always tell the truth, even if they think doing so will result in some negative consequences. The long term erosion of trust has severe consequences, some of which we're now seeing.
I can confirm that this initial messaging on masks not being helpful for the public absolutely did occur. I think the concept they were trying to communicate was more subtle: “Masks are unlikely to help the public because their exposure is less concentrated than what healthcare workers are exposed to.” But it came off as more black and white. And in retrospect was just wrong (“aerosol generating procedures” being much more infective than coughing fits remains a nonsensical idea that healthcare is somehow still holding on to) on a number of levels and was absolutely an unforced error created by panic. They were terrified we would run out of PPE.
There was a lot of dishonesty. I'm not talking about things that could be charitably interpreted as mistakes or bad calls, like when the NYC health commissioner said early on that there was nothing to worry about and people should continue to take the subway and congregate for the holidays, I'm talking about flat-out lies. I'm talking about things like the head of the CDC going before a Senate committee and claiming that if you get vaccinated you can't spread COVID.
When was that said? The vaccines weren’t expected to be neutralizing, but the Pfizer and Moderna vaccines were so effective against the original wild-strain SARS-CoV-2 that they were neutralizing. The other vaccines (e.g. AstraZeneca, Janssen) were not neutralizing, but they weren’t initially available in the US (and only Janssen was ever approved). I think that “if you get vaccinated, you can’t spread COVID” was therefore true until the Beta variant.
The non-neutralizing nature of the mRNA vaccines with the Beta variant wasn’t confirmed until 10 April 2021 when data from Israel first showed that people with a Pfizer vaccination were able to spread Beta asymptomatically. And Beta struggled to spread widely outside of South Africa and Israel; Alpha mostly outcompeted it, so it was reasonable to refer to “you” (ie the typical American) as not being able to spread COVID if vaccinated until the Delta wave in late June/early July.
It wasn't true. It was never true. She made the claim that "vaccinated people do not carry the virus, don't get sick, and that is not just in the clinical trials but it's also in real world data," in March 2021 based on a CDC study that showed nothing of the sort. What it did show was that vaccinated people had a 90% lower risk of infection two weeks after their second dose, which is distinctly different from a 100% lower risk of infection, and distinctly different from sterilizing immunity.
https://people.com/health/vaccinated-people-do-not-appear-carry-spread-covid-19/
She made her claim, the one I quoted above, to the Senate committee in May of 2021. There was no evidence for sterilizing immunity. To make a claim honestly, you need evidence for the claim, not just a lack of evidence that the claim is false.
https://www.cnn.com/2021/05/21/politics/walensky-comments-cdc-guidance-fact-check
There was so much blatant dishonesty, that it astounds me when people act like there wasn’t, or “can’t recall” any. Why did they NOT lie about.
- origin
- masks
- mortality
- transmission effectiveness
- vaccine safety
- prevention of all kinds
- herd immunity
- slow the spread
- lockdowns
- protesting government response is “white supremacy”
- contradictory response to protests based on what the protest was about (transmission is not a problem if you’re at a George Floyd protest, but you’re a “white suprematist super spreader” if you’re protesting government tyranny).
- children must get vaccinated with a novel mRNA transaction therapy or they’ll DIE. In reality, children were not at risk.
The list goes on and on.
Who is your “they” here? Because I didn’t see the scientists lying, I saw the politicians lying about what the scientists said (mostly, because the politicians were too fucking stupid to understand what the scientists said and were trying to “simplify” for non-scientists and ended up taking away so many qualifications that they weren’t telling the truth).
Origin is still the same answer as ever “natural causes more likely, can’t completely rule out lab leak, can completely rule out intentional spread”
Masks: cloth masks went from “no evidence they work” (which was true; no-one had ever studied it) to “better than nothing” (also true) to “still not very good and we’ve actually got some supplies of N95s now, so why not use them instead” (also true).
Mortality: went from “appears to be really high, but we’re only seeing the worst cases” to “1% or so” - and it appears to be a population-wide 0.3%, and there are a lot of people who either never got COVID or only got it after vaccination which definitely reduced the risk of death.
Transmission: well, yeah, the vaccine effectiveness was way higher on wild-type in the original trials in July 2020 than on Delta in July 2021. So of course the story changed. That’s not a lie, that’s the facts changing.
vaccine safety: how has the story changed? There are some risks that are either rare or minor, the same as just about every other vaccine.
Prevention: now, there is a real scandal here, which is the refusal of the scientific establishment to accept that COVID is an airborne disease and the total determination to stick to the idea that it only spread in droplets. That was a scientific fuck-up. But it wasn’t a lie; it wasn’t dishonest. They were just wrong and stubborn and wouldn’t listen to the people who had the evidence.
Herd immunity: is real, but requires you to get the reproducibility number under 1; vaccines alone weren't enough after Delta. Delta changed a lot of things and was worse than expected; so any statement made before July 2021 wasn’t a lie, just wrong.
Slow the spread: Yeah, this was a stupid idea - you need to keep the R number under 1 until you reach eradication. Riding the wave up and down was correctly assessed as a risk by an Imperial College scientific report early on and yet just about every country did it. So can we blame the politicians and not the scientists, please?
Lockdowns: These worked when implemented properly. Sadly, the countries that did lock down properly generally got didn’t push vaccination aggressively enough. So Australia, Japan, Thailand, etc all had a massive wave in 2022 (or China in 2023). The only country that did get everyone vaccinated before unlocking was New Zealand, which had one of the lowest deathrates anywhere (the lowest of those with trustworthy statistics).
Floyd protests: yes this was bloody silly, though the version I recall was that the Floyd protesters were OK because they wearing masks and the anti-NPI protestors weren’t OK because they weren’t - but I admit I’m in a different country and that just never seemed like an especially big deal.
“They,” just to start off, would be Dr. Fauci (NIAID), Dr. Robert Redfield (CDC), Dr. Tedros Adhanom Ghebreyesus (WHO), Dr. Deborah Birx (White House Coronavirus Response Coordinator in 2020), Dr. Rochelle Walensky, (appointed CDC Director on January 20, 2021).
Just to name a few (the heads of major scientific institutions and groups managing public health).
All lied. All deliberately mislead. All were repeatedly, demonstrably wrong.
Those are the political leaders of scientists, they were not actively working scientists. Not one of them published a single peer-reviewed paper on COVID.
"I didn’t see the scientists lying"
Then you weren't watching. The scientsts you refer to were telling each other things in their own personal emails which they were directly denying in public.
The people who don't remember it are absolutely sold on the idea of not believing it, and have (subconsciously) taken every effort to forget anything that isn't The Narrative. The rationalizing will abound as it does with our dear host.
As a foreigner you probably didn't see it. I kept a list.
• Covid will not be a deadly pandemic
• Closing the borders is racist
• Masks don’t work
• Lockdown two weeks to flatten the curve
• Trump didn’t close the borders fast enough
• Lockdown three months to flatten the curve
• Masks work
• Lockdown until Covid is gone
• Covid CANNOT be solved at the state level
• It was never about Herd Immunity
• Saying the virus came from a lab is racist
• One mask doesn’t work but two masks definitely work
• Lockdown because symptomatic spread will kill old people
• Asymptomatic cases can still have long term damage, ground glass lesions, and such
• Lockdown until a cure
• Every hospitalization with Covid must count as a Covid hospitalization regardless of the reason for admission.
• Don’t trust any vaccine announced under the Trump administration
• The vaccine announced the day after votes were counted is safe and effective
• Vaccinated people cannot transmit Covid-19
• We must mask children because science says so.
• The vaccine has no side effects
• We will not mandate the vaccine
• We must vaccinate as many people as possible to get Herd Immunity
• You can return to your life after getting the vaccine
• The virus probably came from a lab
• Only N95 masks work
• The NIH doesn’t fund Gain of Function research
• The vaccine was never about stopping transmission
• Vaccine side effects mean it’s working
• The vaccine has no effect on women’s menstrual cycles so stop being hysterical
• The Wuhan NIH research doesn’t count as Gain of Function research because some gain of function researchers decided those gains of function didn’t meet the legal definition
• Asymptomatic transmission among vaccinated people is fine, will not kill old people, and don’t worry about long term damage, ground glass lesions, and such
• You can return to your life after getting booster shots every six months for the rest of your life
• We will take your life from you if you don’t get the vaccine
• We will use the FBI to investigate parents who complain about school vaccine mandates
• The vaccine turns symptomatic illness asymptomatic, but don’t worry about the increase in asymptomatic spread
• Go ahead and get infected with the virus after your vaccine to improve your immunity.
• Peter Daszak, the guy who organized the “lab leak is a conspiracy theory” letter in the Lancet, proposed to build Covid-19 for DARPA in 2018.
• Vaccinated people can spread Covid-19 just as easily as non-vaccinated people can.
• The spike in heart attacks and vascular conditions isn’t from the vaccine, it’s from the lockdowns.
• Unvaccinated children will be removed from school.
• Covid MUST be solved at the state level.
• The vaccine actually does affect menstrual cycles but you should get it anyway.
• Hospitalizations with Covid don’t count as Covid hospitalizations if Covid wasn’t the reason for admission.
• The case for masking children has collapsed
• Leading scientists knew it came from a lab but hid their opinions to promote “international harmony.”
• Even though the case for masking children has collapsed we’re going to do it anyway.
• Even though mask mandates are illogical, all that matters is that they align with the “community’s goals.”
• Mask mandates didn’t make much of a difference anyway.
• Fauci: “Vaccines don’t protect overly well” from Covid infection.
• The vaccine was bad because it was Trump’s fault.
• A vital part of hurricane preparedness is to get vaccinated.
• When the FDA told people not to take ivermectin that was totally just an informal recommendation.
• Department of Energy: “The virus came from the lab.”
• CIA: “The virus came from the lab.”
Shame you didn’t keep the list of where you saw those so you know who to stop trusting.
Oh I know. :)
Some of the things in your list are bullshit, some of the things in your list are wild exaggerations, some of the things in your list are “some low-level state official may have said something like this.” Every single thing in your list needs a citation.
This is a good thread. Don’t try to junk it.
"They never said this" is a pretty amazing example of how egregores rewrite people's memories. I literally have quotes from Joe Biden in there.
Everyone who uses the term egregore as if it meant something should have the nearest egregore shoved up their ass.
You’re mischaracterizing what I said. That’s your thing.
The main thing that I would describe as dishonesty was the very early anti masking instructions. The reasons for this one are obvious although from my point of view it would have been better to just tell the truth and seize the supplies.
In the US there was a massive campaign of censorship where the government put pressure on social media companies to censor anyone who went against the official narrative. They even threatened scientists careers to force them to sign on to a public declaration that contradicted what they actually believed https://en.wikipedia.org/wiki/Lancet_letter_(COVID-19)
On top of that the public health bureaucracies issued decrees that were clearly motivated by politics and not public health e.g. at a time when they had banned all large outdoor gatherings and closed public parks and beaches, they issued a declaration that BLM protests were not a risk to spread covid, and were in fact good for public health.
Outright lies were relatively rare. Undue certainty, arguments from authority, and demonization of even reasonable skepticism was extremely common.
Official communication about COVID was often dishonest, but the current administration's official commissions are deeply and transparently dishonest, and it doesn't motivate people on the right to conclude "we should disregard or reverse everything the administration says." This clearly isn't a behavior people apply consistently across the board.
Right. If the politicians du jour is grossly dishonest, half the population will have absolutely no trust in their leadership, while the other half will be solidly on team "well, they're *our* lying liars and it's not really lying if it's what they have to do to beat *your* lying liars". This is catastrophically bad for society, no matter which half is in which position.
Maybe try electing politicians who aren't grossly dishonest lying liars at all?
I think this is the crux of it. If the science had been squeaky clean from Day 1, we wouldn't in the place we now are. Once the fundamental trust in professional objectivity is lost, a doorway to lunacy opens up that will not be easy to close again.
Of course, cutting edge science is never squeaky-clean. But many statements contradicted established science for public policy purposes.
It exposed how fragile the knowledge base for epidemiology actually is, that is for sure. But you can’t just not make decisions in an environment where you have all the facts. I think it could certainly be executed better in the future but in practice it is very hard to both convey nuance and uncertainty to the public while also trying to push the policy you think needs to happen in the moment. How would you do it?
I agree this is a genuinely hard problem. I would even argue it is impossible to have a useful conversation online, because it requires so much good faith on the part of the interlocutors.
I think sometimes about all the “lies” that FDR told in the run up to WW2. Do we wish he didn’t do that?
I think you're on to something here. :)
I think there needs to be more appreciation of just how great an achievement objective science was. It took us maybe a million years to get there. You throw that out the window because of a media driven panic? That's not good. People in power need to recognise the importance of the average citizen fundamentally trusting science and act accordingly. But, post the arrival of social media, many areas of gov became convinced that narrative control was all that mattered. That is fundamentally untrue.
"it is very hard to both convey nuance and uncertainty to the public while also trying to push the policy you think needs to happen in the moment. How would you do it?"
Short answer: with humility and honesty.
Longer answer: I think you start off with a bad assumption, namely that one needs to push a policy. How would I do it?
Provide the best available information while being honest about your confidence in said information.
When your opinion changes, explain why.
Only advocate for or institute policies backed by force of law if you have a very high degree of confidence, otherwise focus on providing information and advice.
Trust people.
Grant them autonomy.
Own your mistakes.
If you egregiously mess up, or consistently demonstrate poor judgement, resign from your position of authority.
If you're worried that things will fall apart without you, recognize that you're not a very good leader, because good leaders build robust systems that can operate without any one specific person. Start making corrections now.
Don't try to expand your sphere of authority anytime you see someone doing something objectionable.
Follow your own rules and guidelines.
Be selfless.
This all seems like a good aspirational list.
The thing is, in a crisis, where there is high threat and high uncertainty, when people are overwhelmed and exhausted, we humans are going to do all these things badly.
Which is why we need our systems not to depend so much on the individual character of leaders.
In the 1980s, I taught at UCBerkeley about the lack of pandemic preparedness despite the high likelihood, near certainty, that there would be one in the coming decades. There were books and articles and loads of research done on this back then. The work ahead was to improve infrastructure for preparedness, not to rely on the good character of individuals. A lot of that work never happened and so when this pandemic came were were not nearly as prepared as we could have been.
One of the reasons for that is that as a society and as a human race, we are not yet that good at long-term planning, or at making short-term sacrifices in service of long-term well-being. This human frailty exists at the individual level all the way up to big organizations.
I disagree. Populism and general anti-science and anti-elitist thinking spread via social media had been undermining trust in experts long before Covid. People were actively looking for any excuse to disbelieve the authorities from the very beginning, especially given the obvious political and social ramifications of something as disruptive as a pandemic. There was nothing new or unusual about how experts handled an event like this other than that it happened during the age of social media.
Well, I think we're fundamentally agreeing. The advent of social media and the unprecedented level of connectivity that it afforded, created an environment where previously repressed and marginalised conspiracy material could now achieve take off. Yet, the Big Gov response of attempted narrative control simply did not work.
It worked throughout most of the 20th century, but in the 21st century we raised our standards and got more honesty, and as a result the attempted narrative control no longer worked. We got more accurate and reliable messaging, and as a result people started to understand that it was not perfectly accurate and perfectly reliable (even though it was better than all the things they trusted without complaint in the past).
There was nothing new or unusual about the CDC and FDA shutting down the University of Washington study that discovered Covid because they supposedly violated HIIPA? Or the FDA refusing to grant permits to testing companies because they didn't file their applications on mailed CD-ROMs? Or the CDC developing a test that was a month late and didn't work because it was literally contaminated with Covid?
In retrospect, yes, I agree, you're right. These sorts of systemic failures of a shit system aren't anything new, they're par for the course forever, and also why nobody trusts these jackwads nor should they.
What you are asking for is the opposite of “squeaky clean”. What we got during Covid was much cleaner scientific information than at any other point in history, because scientists were talking directly to the public. But it turns out that seeing scientists speak made people realize that scientists aren’t an alien race of godlike intelligences who are perfect on everything, and they decided that if they’re not like this, then we might as well not listen to them at all.
We lost the fundamental trust in professional objectivity because we allowed transparency and honesty.
And in a snit, we took our footballs home, where we now sit on the internet and rage. It's rather dispiriting.
Yes, it's true that the previous centuries had imbued scientists with godlike authority. And then Covid pulled the curtain back.
But they weren’t all being transparent and honest. Too few were honest about the level of genuine uncertainty, and too many were quick to declare the current best guess as “expert consensus” and label anyone who questioned it a science denier.
And then they started using their newly elevated platforms to push obvious politics rather than just communicating scientific fact.
It probably would be better if public pronouncements were even more honest about uncertainty. There are a lot of such ways I have endorsed. But I think it’s also true that experts during the COVID pandemic did at least as good by this measure as experts at nearly any time in history before then.
My contention is that it is precisely the visibility of uncertainty and disagreement that was a large factor in the loss of trust.
Can you think of a time when there was better honesty?
No, nobody was under the illusion that scientists were intelligent at an alien level. We knew they were fallible. What we expected is that they would present us information, put some guidelines into place, and then let us keep our rights. Instead they became medical tyrants, forcing medical interventions that violate bodily autonomy through mandates. They also failed to acknowledge that there are other kinds of health, such as social health, mental health, academic progress, social trust.
It is not that scientists are flawed, which we know, it is that they tried to assume the role of dictators even though they were wrong about so much, especially the risk to children.
You must be talking about some different event. Scientists didn't do any of the things you mention, except for talking about social health, mental health, academic progress, and social trust - which were mainly discussed by scientists. The only thing I vaguely recognize in what you say is the fact that politicians in some jurisdictions required masks or proof of vaccination for participation in some public spaces - but scientists did not usurp any power, this was governments acting within their established authority, sometimes with reference to scientists.
Everyone who could read a study knew that Covid was an airborne blood disease transmitted by stale air, and that cloth masks did nothing, and that the 6 ft separation rule concocted by the CDC which was used to close half the school systems in the country did nothing, by MAY OF 2020. May.
May.
And the CDC was saying to bleach your door knobs a year later. I know people at the CDC who were responsible for issuing policy guidance, and they were ignoring the science and posting things from the Occupy Democrats Facebook page. It was a giant fucking joke, and the USA would have been better off without the CDC involved at all.
When the CDC and FDA first became aware of Covid on-soil from the U Washington assay, the Washington scientists were in a panic that we had a pandemic on our hands and the CDC and FDA both instructed UW to STAND DOWN because they didn't have the appropriate permits to test for diseases because they only had a research permit, and then told them they violated HIIPA and hung up the phone.
Later, the CDC said we will have "one and only one" test for Covid that the CDC would develop, they didn't give any permits for private tests, and the test they developed shipped three weeks late and DIDN'T WORK BECAUSE IT WAS CONTAMINATED WITH COVID.
The only reason anyone ever got tests in 2020 was because of Mike Pence.
These are real things that actually happened, and nobody got fired.
Well written
It’s funny how people on the right who complain about being lied to by the mainstream media/establishment, they never bring up the countless lies and misinformation coming from Trump in 2020.
Speaking as a right wing guy who complains about being lied to by the healthcare establishment during covid...
What do you want me to say about Trump lying? He does it all the time, he's very dishonest, and thats bad. People don't typically cite him as a reliable source so it doesn't come up much, but it is bad
I think that the objection is less specific. I suspect that the RW-ers I know, would say the same. They don't trust what DJT says. However, they parrot the general talking points of the administration (e.g. Tariffs are both paid by foreign countries while simultaneously boosting domestic production, DOGE is eliminating loads of corruption and saving $100s of Billions). At least to me, this seems to better articulate the [edit: +apparent] hypocrisy being alluded to.
The double standards are insane. The president, who people should be looking towards in times of national crisis, lies through his teeth about how big of a problem Covid is and peddles snake oil treatments. And all you have to say is, idk it’s bad.
But, the medical establishment that has been 99% correct on everything deserves all the vitriol because there was conflicting information about mask usages in the early parts of Covid and maybe Covid made out of a bio lab (which still isn’t 100% confirmed).
> who people should be looking towards in times of national crisis
Why do you think this? No, they shouldn't. Didn't people learn this after George "Weapons of Mass Destruction" Bush's invasion of Iraq?
> conflicting information
You're making it sound like an honest mistake instead of a deliberate lie intended to manipulate the public.
My understanding is that during the early days of Covid, the health department (under Trump btw) discouraged masks because there was a shortage of masks and they wanted to save them for medical workers/high risk people. Eventually, it was corrected. Deliberate or not, lies made with good intentions happen everywhere. If other parts of academia were as politicized as epidemiology had became, you would literally trust no one.
>People don't typically cite him as a reliable source so it doesn't come up much
This statement seems to come out of a reality where the 2020 "Trump actually won the vote" conspiracy narrative didn't happen.
Is there a time in the past where you think the healthcare was more honest than it was in 2020 or 2021?
My claim is that they were at least as honest during the pandemic as they have ever been, and it is partially because of the honesty of admitting mistakes that people now think they should never be trusted.
What about.
But why believe people who were even more dishonest? During the Delta wave three antivax conservative radio hosts died of COVID in a single month. These people made a very lucrative income from partisanship.
https://www.nbcnews.com/politics/politics-news/trio-conservative-radio-hosts-died-covid-will-their-deaths-change-n1278258
It is surprising to me that so many of them are so stupid. I also was distrustful of various official communications, but by the power of reasoning was able to come to reasonable conclusions such as "taking the vaccine is good", "covid is not that dangerous to me personally, but low-cost measures that inhibit transmission are not a major imposition", and "mask recommendations are not part of a new world order scheme to extract your adrenochrome". It didn't take me that much mental effort to navigate between the conspiracy theories and rigid adherence to the CDC gospel.
Who was in charge of the executive when that dishonest communication was happening?
This is such an ironclad argument. That's why the frequent dishonesty deployed by internet atheists gave me a prior that young earth creationism is probably correct
I remember many examples of dishonesty. The efficacy of masks (or not), risks to children, the need for the most draconian lockdown measures (e.g. closing outdoor spaces), double standards for which activities were allowable and which weren't (e.g. social justice protests)... I was cognizant of the dishonesty in real-time and it still makes me angry.
But I still don't traffic in conspiracy theories. I believe myself to be a savvy enough consumer of a variety of sources of information that I can differentiate between what's likely to be true and what's likely to be false. Of course I have my biases and blind spots, but I think, or at least hope, that they aren't too egregious, and that I'm self-aware enough to assign confidence levels and come up with a realistic world-view accordingly.
I understand why people have come to distrust elite individuals and institutions. I understand why certain conspiracy theories have emotional appeal. But I expect reasonably intelligent people to stay true to a core set of principles, navigate their distrust and their emotions, and not be pulled in by dishonest, biased anti-elites, simply because they stand in opposition to the dishonest, biased elites.
The problem is that the level of dishonesty and failure that you are observing here is likely comparable or lower to the levels of dishonesty and failure that have existed among medical authorities at any other time in history - you shouldn’t stop trusting someone just because they became more honest about the fact that they are only 80-90% reliable.
YES. first thing I thought when I saw the title. rationalist groups especially
have become self-parody
Interesting, I haven't particularly noticed that. Can you point to some examples of rationalist groups being crazily conspiracy-theory-ish? Of course, the rationalist community has always supported all kinds of wild thought experiments much weirder than these, I'm wondering about cases that are more than that.
I think part of the issue is that Scott's blog exists at the intersection of a few different communities: the rationalist community, the centrist classical liberal community, the anti-woke community... So I think a lot of the commenters here with the worst epistemic hygiene may not really be "rationalists", or at least, might be more centrally from some other community.
Not to say that there's no crossover with "core rationalism", and I don't want to do a no-true-rationalist thing here, but I think you see more of this stuff in Scott's comments than on LW, for example.
https://slatestarcodex.com/2019/07/04/some-clarifications-on-rationalist-blogging/
This was both six years ago, and before the "mainstreaming" via both the NYT article and move to substack. So most likely the rationalist ratio is likely far, far lower than 13% now. This at least matches my anecdotal experience, where people who I typically see making dumb mistakes that would be caught by skimming the sequences never end up identifying as rationalist. Same with using this as identifying known rationalists (from their shared handle on LW)
Yeah this has always been a property of Scott's blog, though maybe more pronounced in recent years?
I've definitely encountered more IRL people who know of ASX then I ever did (a grand total of 0, I'm pretty sure) in the SSC days, which suggests a broadening of audience.
Ah, yeah, I certainly don't think of Scott's commentariat as being very representative of rationalist discourse or the rationalist community these days. I assumed Swallow meant something different, but maybe not.
I think part of the issue is that Scott's blog exists at the intersection of a few different communities: the rationalist community, the centrist classical liberal community, the anti-woke community... So I think a lot of the commenters here with the worst epistemic hygiene may not really be "rationalists", or at least, might be more centrally from some other community.
Not to say that there's no crossover with "core rationalism", and I don't want to do a no-true-rationalist thing here, but I think you see more of this stuff in Scott's comments than on LW, for example.
One of these days I'll come out as a part-time obscurantist...
This post.
'Here are largely-undisputed all-cause mortality statistics from CDC and census.gov' is a level of crazy conspiracy-theory-ness I'm pretty comfortable with :)
The comment thread that made Scott feel like it was necessary to explain why he believes there were a milllion Covid deaths in the Us.
Oh c'mon, we all lived through a hodge podge of policies and random claims from scientists and officials. It may have not made us all conspiracy theorists, but if were paying any attention it sure changed how you perceived "experts."
And this made you reflexively believe people who lie incessantly about everything, instead of the people who occasionally lie?
It seems much more likely it's about tribal and emotional affinity and hatred of scientists for being part of blue tribe.
It really shouldn’t have! This is how experts function, and function well! People have unreasonable expectations, which past expert communities lived up to by hiding their failures.
If you do trivia competitions, you’ll understand that informed guesses that are nowhere near perfect can still be the best option, and lead to you reliably winning over the competition.
Informed guesses are often necessary. Falsely claiming your informed guesses are actually indisputable scientific fact never is.
Flat out *making shit up* because the facts you know make your desire to virtue signal about a murdered fentanyl addict inconvenient is a whole other level of credibility-nuking.
I think it's valuable to separate scientists from spokespeople from politicians from policy wonks from corporate interests in thinking about this.
Science is, as it has ever been, messy and imperfect. And yet an incredible human endeavor and still improving decade over decade.
Politicians (and their spokespeople) and corporate interests have never been very truthful because the incentives don't run that way.
If you lived through Watergate, Vietnam, the two gulf wars (with for sure WMDs!), a couple of finance-sector-engineered economic crises, the lies of tobacco and pesticide companies, the extent of child abuse and coverup in the Catholic church (and elsewhere), and all the stuff in-between, or some fraction of those, the hodgepodge is not remotely surprising.
I think the pandemic hit a bunch of people with more limited life experience and many of those people are now understandably gobsmacked that the world doesn't work better than they thought it did.
You should consider, here, whether the previous dismissal of these ideas as "for low-IQ nutters" wasn't also influenced by political considerations. It's not a given that this was a shift that made people net less rational.
The growing institution of Alternative media has herded the cattle with Candace Owens snd Catturdism, and therefore it’s politically advantageous to pander to the cattle if you’re a tech bro trying to change the world or get rich.
I wonder if people coming from countries with a hyper-inflationary past have easier time dealing with big numbers like this. I bet to somebody from Turkey or Argentina 1.2 million deaths are more believable (in fact maybe too normal as in desensitized?) than somebody from say Brunei or Switzerland.
Contrast "I only actually know one person who died of Covid" with the breathless "expert" and media hyping at the time that we should expect to see hordes of dying people staggering the streets because emergency rooms and entire hospitals would be flooded, then the hordes' corpses to be stacked like cord wood awaiting a mass bulldozer burial. Then, poof, after the beaches and playgrounds were reopened, it seemed to have been more like a bad flu season (not to mention actual flu disappearing for some mysterious reason). The cognitive dissonance is massive.
If you worked in a hospital that first winter of 2020-2021 it was certainly not a "bad flu season". It was a nightmare.
For real. This discussion is honestly just darkly humorous as someone who worked the Covid floors from March 2020 through July 2021. Those of us who were there remember.
Anyone in healthcare would be agape at this stuff. You know, the people who were actually taking care of all the Covid patients. Who also got sick, who also died, burned out, left the field despite years of training and debt for that training. Because it was such a horror. And now to see people dismiss all of that because they didn't personally stand in the hospitals and see it with their own eyes. Like Paris doesn't exist if you haven't been there yourself.
I was a healthcare provider during Covid and it changed me and my career permanently. Me along with many many others I know directly.
Hospitals aren't equipped to deal with a large public spike above baseline use of medical services. Recall how in the beginning of the pandemic, supplies like toilet paper, and rubbing alcohol became nigh inaccessible. The supply chain wasn't equipped to quickly respond to a significant change in demand, even though these are cheap and abundant goods.
Not to mention the supply chain in general being wrecked by lockdowns.
If an industry takes 20% of our GDP I would expect edge cases to be worked out and available. Handling unforeseen spikes is something expected of the tech industry, but somehow medical system needs all our money and can't be bothered to think on their feet and handle a slightly above normal spike.
Just-in-time logistics has become normal.
It takes a lot more time and resources to scale up the operations of a hospital dealing with highly infectious patients than it does to scale up the production of toilet paper.
If you are trying to build a hospital with exactly the same equipment in the same configuration sure. In an emergency I'd expect other solutions (deputizing the public like EMTs and those with some medical training) and nurses to expand the number of workers and making beds out of things not hospital beds. Especially if it's taking 20% of our GDP.
20% of our GDP is what we're spending under business-as-usual scenarios.
If you don't have proper facilities and appropriately observed safety protocols, sticking a bunch of sick people together to care for them makes outcomes worse rather than better (because they're infecting other patients and workers.) Even under ordinary circumstances, hospital-induced comorbidities are a significant risk. There simply aren't enough regular people with adequate training to safely run hospital-like facilities who can be deputized in order to dramatically increase our capacity to provide medical care under pandemic conditions.
> deputizing the public like EMTs and those with some medical training
Why would you think that would work? Is EMT training just all for show and any Joe blow off the street can do it at the drop of the hat?
The reason medicine and tech don’t behave in the same way is that the human capital of medicine has a way longer lead time and the regulatory framework is far stricter. EMTs, nurses, phlebotomists, RTs, PTs, OTs, SLPs, NPs, PAs, MD/DOs can’t just be conjured out of the ether. You either need to dramatically over expand your resource pool for edge cases, or accept that trade offs will need to be accepted when the system shock occurs.
This is why you need a federal government in a capitalistic system. Capitalism ensures that if 1 medical provider voluntarily kept excess production available, then he would be put out of business by his competitors. This massively parallel computing machine of industrial competition is what is so brilliant about capitalism but it does mean that you need intelligent governance to deal with the shortcomings.
Having 20% excess capacity sitting around means building a lot of extra hospital wings to sit around empty and hiring a lot of extra doctors and nurses to do nothing. Nobody is willing to pay for that during business as normal, so we have what we have.
I mean, we did see a million deaths. I don't know if this qualifies as a "horde" of corpses, but you could build a pretty sweet skull pyramid out of it.
This was my whole point in the last post - people act as if this was "hyped" or "overestimated", whereas in fact it was the largest mass casualty event in American history and if anyone had given the true number at the beginning of the pandemic, people would have been even more scared than they were. It's just that people are able to ignore a million deaths because that's 1/300th of the population and dead people don't write thinkpieces about how angry they are to have died.
A lot of hospitals did get overwhelmed. You didn't hear about it because you weren't in those hospitals and, I predict, don't know any of the doctors or nurses who were on the front line.
I once worked in an actually flooded-by-hordes emergency room - not during COVID, but during a blizzard in Ireland that the locals were completely unprepared for (they almost never get snow). Every bed occupied, gurneys lining the hallways, some patients on the floor, long line of people waiting to get it, stretching out the door. What percent of people in Ireland do you think were in that emergency room, or know someone who was? Would the average person on the street have thought "Yeah, I am personally connected to the overcrowdedness of this emergency room?" How exactly do you see this working?
You say this, but 1-4% mortality for the entire population was floated early on. Everyone I know expected way higher than a million death and for it to be spread across demographics equally. I remember thinking 3 to 12 million would be a reasonable estimate when they were still using NY and Italy as the estimation.
1% is an entirely reasonable estimate if the pandemic had ripped through the population without any countermeasures early on.
Not for people under 65 (and even less so the younger you go). Which started to become apparent when this got published: https://www.nytimes.com/interactive/2020/obituaries/people-died-coronavirus-obituaries.html
Are people over 65 somehow not a part of the population then?
And? Some people happen to be over 65, and still value their lives greatly. Even more people have relatives above the age of 65, and would greatly prefer if they didn't die a painful death years ahead of their time.
Yes, 1% was about right if you caught the original virus early on
Yeah, and then we shut down substantial parts of the economy for a year, folks wore masks, and we developed a effective vaccine at record speed.
It's not even clear what case you're trying to make here.
Scott said:
> and if anyone had given the true number at the beginning of the pandemic, people would have been even more scared than they were.
People were making estimates wildly worse than 1.2 million at the beginning of the pandemic.
They were also making estimates wildly better than 1.2 million at the beginning of the pandemic.
It's almost like the fact of uncertainty itself is hard to grasp as a feature of the world.
"Effective vaccine" that was not a vaccine. Did not stop people from getting Covid. Did not stop people from transmitting the virus. Did not build up any immunity keeping "vaccinated " people from testing positive for Covid over and over. The only thing left in defense of the "vaccine" was the weak, "Well, you would have been sicker without the vaccine" . . . and I would like to know how that would be proved.
You are aware that people who've had the MMR vaccine can still get Measles, right? And people with the flu vaccine can still get the flu? There is a range of efficacy in vaccines, like with all other things.
It’s only a vaccine if it is made from live vaccinia virus to stop smallpox. Otherwise it’s just “sparkling immune system training”.
The vaccines, generally speaking, reduced the risk of dying of Covid by factor of ten or so, which is far better than nothing. For the early variants, they probably would have prevented the spread well enough to eradicate the disease if everyone had become vaccinated, but the virus evolved too fast, became to virulent and too good at evading the immunity conferred by the vaccination to achieve that. As far as I recall, that was a bit of a surprise even for the experts. Still, without the vaccines, things would probably have turned out way worse in terms of casualties.
Not trying to be political (really!), but the predictions (like you mention) and the actual results reminded me a lot of the AIDS epidemic in the early 1980s.
The AIDS deaths started rising sharply, folks started projecting the curve and warning that everyone was at risk, things DID get worse, but ... there was also clustering and lots (maybe most?) people didn't personally know anyone who got AIDS or maybe knew only one person.
Other areas (e.g. San Francisco) had lots of people who knew 10s or 100s of people who died of AIDS.
But the exponential stopped exponenting as AIDS burned through the super at-risk population. And the general public might be forgiven for wondering why if things were so bad they weren't noticing anything particularly unusual. And wondering why they were supposed to panic?
Not quite the same here, but the parallels are similar enough I think. Folks in the medical community really noticed this in their own lives. Folks who worked a lot with the elderly probably noticed this in their own lives. For a lot of the rest of us we needed the news to remind us how bad things were because we weren't seeing it.
AIDS has R0 less than 1 via heterosexual intercourse in places outside Africa. So it wasn't going to break out of some relatively small subpopulations. COVID was not like that, it was a respiratory virus that hit everyone who breathes.
Right. AIDS wasn't going to break out of some relatively small subpopulations.
But in 1985 we were getting articles saying things such as this:
"By early this year, most Americans had become aware of AIDS, conscious of a trickle of news about a disease that was threatening homosexuals and drug addicts. AIDS, the experts said, was spreading rapidly. The number of cases was increasing geometrically, doubling every ten months, and the threat to heterosexuals appeared to be growing."
The doubling didn't go on forever and the heterosexual population wasn't totally unaffected (e.g. Arthur Ashe, Isaac Asimov) but that wasn't the message ordinary Americans were getting in 1985. Without news coverage, most Americans in 1985 wouldn't have known about AIDS. And would not have though to be worried about it. Folks in SF didn't need the news.
Surely one has to control a bit for the effects of people changing their behavior in response to those warnings. https://vimeo.com/43187299
I forget if Covid eventually surpassed HIV in deaths. But it seems to me that there is remarkable similarity in the entire process, but compressed into 2 years instead of 40. (Government denial, then government acceptance, then Anthony Fauci changing policy to allow better responses when demanded by patient advocates, then better treatments, and eventually a preventative that means we don’t have to worry too much.)
I agree large numbers were floated. Small numbers were also floated. I think if God came down and said "the true number will be 1.2 million, even with pretty extreme countermeasures like locking down the whole country for months", most people would have interpreted that as "the large number people were right", albeit not the absolute largest.
I never saw anyone say 4%. I hang out in groups who’ve been thinking about this for a long time, who range from totally mainstream to batshit crazy and their consensus at the start was 1%, moved lower very fast, as low at 0.1%, then rebounded to roughly whar actually happened. I would say we knew the likely scale by May or June 2020
Fairly early predictions of deaths sans countermeasures turned out to be accurate. You can project the mortality among those who *did* become infected and compare that against who didn't in 2020. It's harder to estimate what the loss of a functioning health care system would've done to mortality, but even that's something you can ballpark. The projected scenarios that seemed gloomy were on the money as far as that goes.
There were countermeasures - people aren't just going to behave normally as corpses pile up - but it's just innately hard to to predict what political will is going to look like, particularly so in the United States. Losing over a million people is staggering, and a significantly worse overall outcome than some global peers such as Japan.
I think a lot of this is missing concentration. New York City did, in fact, have piles of corpses in the street. Everyone I know from New York City knows lots of folks who died of Covid.
I know a few.
My family members who live in rural North Carolina know zero.
> My family members who live in rural North Carolina know zero.
It’s probably also an issue of New Yorkers being much more willing to say that someone they know died of Covid, whereas the rural south which got absolutely ravaged by the delta wave had folks who would have a bunch of egg on their face if they admitted that pawpaw died of that virus that up until yesterday they had been loudly proclaiming to be a hoax.
Actually living in the south and knowing a lot of Covid deniers... there's *some* of this, but not as much as you'd think. Most folks who have someone close to them die of Covid change their tunes pretty quickly. Often they're vocal advocates for the protections they argued against.
Generally people are people, not caricatures. You can show them all the facts and figures you want and they won't budge an inch, but when they have real life experiences with the things they adapt.
I lived and worked in healthcare in the rural south through Covid. At least in east TN there were plenty of people dying from small places in the mountains where their absence would be noted given how small the community was. Some church outbreaks had multiple congregants die from a pretty small population. It was surreal driving home from the hospital past the freaking freezer truck full of bodies and seeing TGI Fridays packed to the gills with old gomers just half a mile down the street.
People are people, and people the world around are extremely invested in saving face.
I got curious about the skull pyramid thing - assuming each skull is around 17.5cm wide and lies on its side, and that they pack 1, 4, 9, 16, 25 etc, you would get a pyramid roughly 25-30m tall, and probably quite a bit wider (because skulls are sort of irregularly shaped). Which is impressive but not, like, skyscraper-sized.
For comparison, the famous Christ the Redeemer statue that looms over Rio de Janeiro is 30 meters tall.
But the pyramid of Giza is something like 150m high and 200m wide.
For visual impact, I think you could instead just clad a giant pyramid in skulls, or make a bunch of smaller pyramids and put them all together in a large flat plain.
I did the numbers.
For your skull-clad pyramid, you put the skulls upright next to each other. We again use the 17.5cm width, but now each step is 25cm high. The number of skulls per layer goes 1, 4, 8, 12, 16, 20 etc. This one is a monster: 194m tall and 135m wide. I'd suggest making it look more like a Mayan pyramid, so that you can add a bit of width and make it a nice round 200x200x200m. Estimating cost is a challenge, ad building costs are so variable and depend on so many factors (land cost, labour costs, transportation costs, material costs etc). If built analogously to a skyscraper, then the cost per might be anything from $450 million to $1.8 billion (assuming a floor height of 4m and cost-per-floor at Dubai vs New York prices). Just as a sanity check, the bulk cost of the concrete alone should be something like $160 million (at around $134 per m3 and assuming you fill the whole pyramid up with it), so I suspect the higher price is more accurate. If you don't want to use real skulls, then I found ceramic skulls on sale for around $8. Assuming a bulk discount ($4 per skull), this makes them by far the cheapest part of the whole exercise ($4.8 million). The folk from construction physics can probably math this out a lot better than I can.
My final suggestion, since we've made a flat-topped pyramid, is to have a chamber of important covid-related figures' skulls in the heart of the pyramid, and put the inevitable gift shop and restaurant on the roof.
In re: the discussion above about the true rationalist commenters vs the riff raff at this-a-here blog, this comment is first ballot Hall of Fame True Rationalist material.
This comment alone makes me glad for this whole mess of a comments section.
Would like to express my agreement with this sentiment. Cry6Aa's comment was a delight to find (and will be getting relentlessly linked to my circle of friends).
To your point: the doctors and nurses I know were despondent and exhausted during this time.
Their hospitals were over capacity, they were working constant overtime and people were dying left and right.
The feeling among their crowd were they were making this enormous sacrifice every day and nobody seemed to care.
I know this is not the view you're arguing for, but this we/them frame in the face of a huge shared calamity speaks to the real dissolution of a functioning society to me.
Besides the young people resenting the old people, there are millions of people with chronic illness in any given year, millions undergoing cancer treatment with wrecked immune systems, bunches of newborn vulnerable babies, bunches of pregnant women who are also medically vulnerable. Bunches of people without great access to healthcare or who can't economically afford to miss work. *And then there are all the people who love them.*
And it makes me worry that these guys who are so resentful of the price they paid during a national calamity don't have anyone to love. Because if you love someones in your life, chances are one or more of those someones are vulnerable in some kind of way, and you would feel eager in the face of such a threat to have things to do that would make the ones you love be just a little less likely to get really sick or die.
The tradeoffs in some situations were absolutely terrible, no doubt. But all of life requires tradeoffs. And exceptional times require some really big ones. None of us is promised smooth sailing for any amount of time, ever.
That's a really profound kind of experience to have people you know commit suicide and it's really awful that that was part of your Covid time experience, that direct trauma of losing people that way during a time that was already horrible.
I'm sure you're right that at least part of the reason for the suicides we saw increasing during that time were due to social isolation. For the healthcare workers who committed suicide, it seems like those were maybe fueled by the moral injury and overwhelm of being a healthcare worker at that time.
I'm a psychologist who works with individuals and families and so I had a front seat view to the small, medium, and enormous mental health impacts of peak Covid time. In addition to the people who suffered from terrible isolation (young and old), I think the tradeoffs were also especially horrible for children and for parents of children.
I also had a prolonged non-Covid physical health threat that emerged for me during Covid (cancer) and so I had a front row seat to the impacts on hospital-based workers beyond those I know from my private practice. And I saw how various doctors and nurses and other staff carried the weight of tradeoffs, everyone carrying a slightly different mix of burdens and trauma. I also worked with quite a few patients who had severe social anxiety who experienced a couple of years of real relief from it for the first time in their lives as a result of the permission to stay home and the opening of working from home. So while Covid and all that came with it was a horror for mental health broadly speaking, there are also other stories in there as well.
I think the only difference between you and me on this topic maybe is that I took from my experience of that time the sense that most everyone is doing the best they can all the time. That humans and human systems have forever been very flawed. That there's a real limit on our capacity to make good decisions in an environment of high risk and high uncertainty and where the conditions are rapidly changing. I see those limits and tradeoffs as built into the human condition and into the reality of the world we live in.
And then I witnessed up close so so many people daily doing acts of generous and heroic kindness -- including to me personally hundreds of times -- that despite the losses I experienced and witnessed, I also feel a profound gratitude to be here, to be alive in this world, as messed up as it is. I feel a lot of grace is due to all the people who worked really hard to take care of others in a situation none of us has ever been in and for which there was no adequate road map (including because we failed to do the planning for this that had been mapped out decades ago). Long-term planning being another weakness of humans.
I also think criticism is important and it's key that we all in various ways reckon with the losses, the tradeoffs, and the costs of the different choices made in different times and places through the pandemic. I see the value of this not in assigning blame but in preparing us to do it better next time. To me that means wrestling with the nuance and complexity rather than drawing quick judgments and conclusions. Bringing curiosity, in other words.
There's a view I think that everyone who was in any way on the front lines of responding to the pandemic *should have known better* about a whole range of things, *should have communicated better* and should have overall *been better people*. And of course there were in there here and there some truly venal and opportunistic people as well as the usual mix of people of mediocre competency. To me, this is where humanity is as a whole at this moment. We would like everyone to be better and having those wishes for humanity is good. But we live in this world where people are how they are -- an incredible mixed bag. Glory and horror all wrapped up together. I have no confidence that if you'd dropped me into any other frontline role than the one I had that I would have done better than those people in those positions. I had my hands absolutely full with the position I had and was bending under the weight of it every day until it kinda broke me.
I guess I want to say there is relief in accepting this. It doesn't mean don't ever be angry or give up and don't do anything to make things better. But accepting all this as where we are as humans means that one's actions can move better from a place of calm and compassion and the choices we make from that place tend to be better ones than the choices made from rage. And also it feels a whole lot better.
I think (I don't know if I'm right) that a lot of the political discord we've seen since Covid (though it obviously was well along already) was fueled by the lack of official acknowledgement of the need for grieving, reckoning, criticism, and taking responsibility. I could write a huge proposal sitting right here with ways I think institutions and governments needed and still need to create official space for people to grieve and recover as well as to reckon and criticize.
Grief unprocessed can lead to both rage and depression (as well as a whole host of other health problems) and my country at least (US) has done a very poor job of making space for grief. Not because people suck so much as that historically as a culture and an economy, we have not prioritized emotional health and connection. Instead we have prioritized economic productivity, accumulation, and status. While at the same time, we didn't do the work over the past decades to set up our institutions to respond well to this specific kind of calamity, which then exposed a lot of people to the particular foibles and weaknesses of individual humans even more than would ordinarily happen in a crisis.
I think you are entitled to whatever feelings you have about what went on during Covid, how all of it impacted you and the people you cared about. If it leads you mainly to anger and blame, I guess I want to say have hope, there is a place on the other side of that that feels better. And it runs through you validating everything you feel and felt about the pandemic and not from minimizing it (which I don't hear you doing).
Anyway, those are some of my thoughts.
Well here's the thing. If there were a new shocking ear worm parasite that was 100% fatal but only infected people the day before they were going to die of something else, that ear worm parasite could kill millions of people in a year and cause the largest fatality event in US history, and it still wouldn't really matter because those people were going to die anyway.
Now extrapolate.
Excess deaths that year would be close to 8,000 because that is the number of deaths in one day. If the parasite moved all deaths forward by two days then excess deaths would be close to 16,000. In order to get excess deaths up to 1 million you have to move deaths forward about 100 days.
I think by that time, you’re talking real sacrifice - people lose several months of time with literally everyone they love.
It’s not as bad as a war that kills tens of millions of people decades early and thus leads the average person to lose several years of life, but I think we get a sense of the magnitude.
Ooo good point.
I think it's reasonable to assume that a very large number of people who died from Covid had their deaths moved up one to two years, and a few moved up around five.
Emergency rooms and hospitals were flooded. I know a PA who pivoted to work directly with COVID patients pretty much from the start and it was an absolute nightmare for them.
It's not cognitive dissonance, it's survivorship bias. It was "only" 1.2 million deaths because various measures were taken. It's like saying the Y2K bug was overblown because nothing really happened come Jan 1st, 2000 - but that was because legions of programmers had been employed to actually fix the bug in affected systems. That is always the curse of "preventing bad things from happening" as opposed to "making good things happen" - if you prevent something bad from happening, it can look like you've done nothing at all.
Some one up above, about the harm of government-issued NPIs, pointed out that there would still be a lot of ad hoc NPIs done in the baseline.
That applies in the other direction, too. Even for a disease that genuinely kills 1% of a population acting like normal, people will react and restrict contact in a way that reduces the impact, even with no government-led interventions or vaccines.
Right. If no official measures had been in place, it probably would have been 1.5 million deaths. No official measures except vaccine development, 1.25 million deaths.
The observed death rate isn't that far off what you'd get if you postulate the disease running unchecked until the population reached herd immunity, and even in the absence of official countermeasures you'd have lots of people taking private ones. That 1.2 million people died *anyway*, means there isn't really much room for the official measures to have done much good.
And then there's the world where we imagine no official measures but also no official impediment to vaccine deployment and distribution, and I'm pretty sure the death toll is well under a million in that one.
I'm not sure how you are deriving these numbers (personal intuition?), but this isn't what you see in epidemiological publications at all.
Also, herd immunity wasn't ever achieved. We don't have herd immunity right now. Things are much better than they were from 2020-2022, but COVID is still circulating, acting like quite bad influenza waves crashing against us. The disease burden is substantial. Turns out our immune system's limitations + viral evolution is able to frustrate herd immunity for this disease. That hope was decisively dashed in late 2021 when it became clear that developing an immune response through vaccination / exposure was insufficient to produce lasting immunity in the general population.
Even assuming these numbers are true, without getting into details like your confidence in them and whether they would have been available at the time when they would have mattered: Would you have decided "Eh, only 300k additional deaths, that's not worth a lockdown"? Especially if it was a matter of public record and you had to expect someone eventually writing nasty headlines about your decision?
I'm fairly confident in those estimates, for reasons that I've discussed here too many times to want to repeat. But as to your question, oh hell yes. First off, if you read my statement carefully, that's 250,000 lives saved (US only) by vaccines, and 50,000 by mandatory lockdowns, masking, social distancing and all the rest. If anyone here is assuming that because I opposed lockdowns I'm also an antivaxxer, then please just shut up and go away.
And second, even setting aside concerns about pesky little things like civil liberties, and the economic cost of the lockdowns, and the effects on the mental and social health of American adults, if you ask me to trade fifty *million* children going through a year and a half of half-baked zoomschooling, against fifty thousand mostly septuagenarians dying five years earlier than they otherwise would have, then there's no contest.
Even if we assume 99% of the kids came through just fine, and the 1% that don't suffer only a 1% reduction in QALYs per year from the educational shortfall, the lockdowns fail the consequentialist math. And I'm not a consequentialist.
You haven't answered my question whether any of these numbers (1.2M, 1.25M, 1.5M) would have been available in early 2020 at the same confidence. Hindsight is always easy.
Oh, sorry, yes I missed that. These numbers would definitely have been available at the time, if someone had wanted them. I mostly took these numbers from my own analysis in 2020. and that of people like Zvi Mowshowitz, and the subsequent observation that the actual infection and death tolls were tracking pretty closely with the "we fuck it all up and our interventions are useless" predicts right up until the vaccine rollout. At which point there was a substantial drop in mortality, though less so with infections.
The thing that should *not* have been available with confidence in early 2020, was the belief that lockdowns, mask mandates, and "social distancing" were going to dramatically reduce the death toll. Those were unprecedented interventions, with no proper scientific studies to back them up and based on multiple dubious assumptions.
As best-guess "maybe this will work; let's put it out there as a recommendation" measures, sure, worth a try for all we knew in 2020. But an intervention that is intrusive, mandatory, and controversial, is one that really needs to be backed up by the sort of science we can be confident in.
The distortion of reality where people pretend that hospitals weren’t flooded is ridiculous. They were. It was insane. I’ve never seen anything like it before or since.
Also It’s pretty clear why the actual flu disappeared — enough people were wearing masks that it couldn’t spread. Note that flu is spread via droplet transmissions so simple masks are highly effective against it
I think a lot of the comments section is missing the concentration thing. New York City had mass graves. A random town in Iowa may have seen zero cases.
I don't know if it's clear any respiratory disease spreads via droplets rather than aerosols now. COVID is just more transmissible than the flu (measles being super-transmissible is why we're starting to see outbreaks now that vaccination has dropped a little).
Hospitals were either flooded or empty depending on where you were.
NY hospitals got demolished because Wuhan is where all the garments are made, and the places that got bombed are tied in with the fashion industry. Wuhan, Milan, London, NY. It spread after Fashion Week. One or several Chinese fashion industry execs were Patient Zero.
Statistically, nationwide, hospitals were not overwhelmed. In fact most were under-occupied because they were saving beds, or at least that was the argument they made when they claimed taxpayer bailouts. There were local anecdotes in certain places, New York most prominently. But even there, they brought in the hospital ships and built out extra capacity and nobody used it.
Meanwhile, against the anecdotes of people claiming hospital flooding, there were the three hospital visits I made during the Covid period, twice with my mother, once with a child. The places were ghost towns. I've never seen the ER so quiet and with so few patients. Like three people in a space that normally seated 200.
I'm not claiming those observations necessarily generalize. But neither do the anecdotes of flooding.
Hospital overload is like traffic congestion. 90% of the day, highways are empty. But at the time that everyone wants to drive, they get crowded. Hospitals were under capacity for most of the pandemic because there were plans to try to save capacity - but when a big wave hit anywhere, they got flooded. (See New York in March 2020, Houston in June 2020, etc)
Even in New York, they never used really overflow capacity. The Javits Center and hospital ships never saw more than a handful of patients.
COVID turned out to be significantly more contagious than influenza. The globes' attempts to mitigate COVID spread actually appears to have wiped out one of the major circulating influenza lineages, which has simplified the vaccination formulation going forward.
The excess deaths chart above does NOT look like "a bad flu season", unless you mean something like Spanish Flu. Actual flu disappeared because measures that failed to stop COVID reduced R0 enough for them, enough to kill off some old flu strains https://www.livescience.com/flu-virus-types-extinct-covid-19.html
During the Delta wave hospitals in my area -- an area with low vaccine uptake -- got slammed and had to bring in hundreds of medical personnel from out of state.
During this same period my local state representative was posting antivax crap on Facebook.
Why do you demand perfection from experts but ignore the political partisans who got people killed?
Delta hit red areas hard because the red areas dodged the earlier waves and had lower herd immunity than the northeast did. NYC fared very well during Delta because they all had immunity from earlier infections.
This needs to be analyzed regionally and without political bias.
My county had a vaccination rate lower than 30%. Even today it's only 42%. A higher vaccination rate would have made a difference.
I higher vaccination rate among people under age 35 would not have made a difference. A higher vaccination rate of people over age 65 would probably have made a tremendous difference. And neither rate matters much now that the vaccine is less than 40% effective at stopping spread anyway.
Okay man. I just think a lot of old people were listening to people like these guys on the radio.
https://www.nbcnews.com/politics/politics-news/trio-conservative-radio-hosts-died-covid-will-their-deaths-change-n1278258
Or maybe they were listening to Brian Seitz, my local state rep who was anti vax.
https://www.riverfronttimes.com/news/in-missouri-legislature-anti-vax-calls-come-from-inside-the-house-36049972
(After that made news I called him an complained because multiple tenants from my property in Branson were in the hospital with COVID. One of them was under 40 and overweight but not morbidly obese. Fortunately they all survived.)
Or maybe they were listening to these people right as the Delta wave was surging. This is literally at my local hospital.
https://www.news-leader.com/story/news/politics/2021/08/16/anti-vaccine-protest-held-outside-springfield-mercy-hospital-missouri-covid-19-misinformation/8130578002/
Just a few weeks earlier they were turning away patients because they were overwhelmed. Fortunately they brought in out of state personnel by August.
https://apnews.com/article/mo-state-wire-michael-brown-springfield-business-coronavirus-pandemic-fea74a1cc80d3bd632aa29d417f2aa87
I can retype "a higher vaccination rate of people over age 65 would probably have made a tremendous difference" if you like. Otherwise I'm not sure what your point is.
Remember that the “immunity” New York had during delta wasn’t just from higher vaccine uptake and earlier immune system encounters with the virus - it was also from behavioral changes triggered by living in a place that was hard hit. The brain is the biggest organ in the immune system, just like it’s the most sensitive erogenous zone.
Unless NYC shut the subway down during Delta then NYC has infinite vector potential no matter what other "behavioral changes" they tried to implement. No amount of separation is going to tamp down being stuck in an enclosed poorly ventilated space, given what we know about how the virus is transmitted by stale air.
You don’t have to shut down the subway to reduce spread in the subway - as long as fewer people are using the subway it will contribute less spread. (Presumably quadratically, because spread is proportional both to the number of infected people present and the number of uninfected people present).
I suppose a reduction in subway ridership may have had some impact, but the fact that basically the entire city all got Covid at the same time six months earlier probably had a dramatically larger effect. And that effect wasn't present in the red areas that had their first wave during Delta. These are areas, keep in mind, without anything remotely approximating a subway.
Did you pay attention to the refrigerated trucks and patients spilling out of New York City hospitals into tents in parks in winter 2020?
Well, there's also the hospital ship that got sent to New York to handle the expected overflow and then turned out not to be needed.
Possibly because of mitigation steps, the rise and fall of the wave and early, limited acquired immunity by the time the ship showed up.
Maybe 🤷♂️
My point is that if we're talking about people's perceptions, the news stories that would tend to show that conditions were really bad were often balanced by news stories that showex that they were not nearly as bad as anticipated.
Yes, there were errors of oversupply and errors of undersupply. It’s important to count them both, and weight them by how much harm they did.
...those scenarios were what would happen *if we didn't take precautions* to slow the spread.
Then we *did* that, in a massive way, and things turned out better.
This is classic 'Why do I need this umbrella, I'm not even getting wet' thinking.
> we should expect to see hordes of dying people staggering the streets because emergency rooms and entire hospitals would be flooded, then the hordes' corpses to be stacked like cord wood awaiting a mass bulldozer burial
This more or less DID happen in New York City, so I don't think it was unreasonable for people at the time with imperfect information to think it may happen in other places. I was turned away from the emergency room and told not to come back unless I thought I was going to die.
> actual flu disappearing for some mysterious reason
This is such a perfect encapsulation of covid denier idiocy. "It's a mystery that with everyone staying home and wearing masks and trying to prevent the transmission of a disease that is more virulent than the flu, there were fewer flu infections this year! The NWO doesn't want you to think about this!" I don't know, there's one explanation that jumps out as pretty plausible to me!
In my city, the hospital where my stepmom works had a network of tents set up outside the building to handle the overcrowding, and the (Republican) governor sent us several freezer vans to hold corpses until they could be properly autopsied because the morgue couldn't hold them all (and because the medical examiner was actually not just declaring every death a covid death if there was a positive covid test, but was ensuring every corpse had a proper investigation into cause of death).
It makes sense that COVID killed a million or so in the US. That's a 0.3% mortality rate, or 3x the flu. It also made plenty of sense to have a strict lockdown as an initial response to the virus. The question is why did we keep it shut down after we figured out that it was going to be an endemic virus and all of those people would die of it eventually anyway. And most damningly, why did we keep it shut down for another year after the vaccine came out? All the conspiracy talk is just a distraction from discussing the very real authoritarian nightmare that was inflicted on us by the administrative state. If you had asked people in 2019 if we should shut down the economy for two years and print trillions of dollars causing massive inflation in response to a virus only 3x worse than the flu, they would have thought you were insane.
It was more than 3x as deadly. About 500,000 died in the US that first year. The worst flu season of the 21st century only had 80,000 deaths in the US and many had more like 20-30,000. So we're talking 6x-15x depending on the flu season. And that's with all the measures we took to prevent transmission.
The "3x the flu" number is an average ranging from the beginning of the pandemic (more lethal virus, no vaccines) to the end (much less lethal virus, lots of vaccinated people).
Comparing it to actual flu waves, you also have to take into account that Covid was, and became even more so, much more infectious than the flu, such that sooner or later everyone got it, whereas each flu wave only hits a few % of the population.
But, yes, initally it was much more deadly than the flu (10x as lethal as the nastiest flu strains IIRC).
If you average it over a long enough time, you can just say that it had exactly the same mortality as flu (it converges to 1x as t=>oo). This reduces my sympathy in justifying the 3x number, significantly.
You're using a very weird definition of mortality. My point is not that more people die the longer you wait. It's that the probability of dying of the disease decreased with time (because the virus mutated into strains with lower mortality, and vaccines were rolled out), but for the initial measures, it's justified to base them on the mortality for the variants that circulated then in the absence of vaccines, and at that time "10× more lethal and twice as infectious as a the nastiest strains of flu since the Spanish Flu" was a reasonable estimate.
My comment was not intended as a rebuke. You said "The "3x the flu" number is an average ranging from the beginning of the pandemic...to the end...." and "[but initially] 10x more lethal." My point was just that averaging over a period of time (3x from beginning to end) eventually converges to 1x since you are averaging a finite peak with an exponential decay back to baseline. In other words, you could pick any multiplier between 10x and 1x and there exists a time period for which this is the correct average. The ability to chose any number raises the question of why one might pick "3x." Again, my comment was at least half tongue in cheek.
The virus was "less lethal" to people who'd been infected previously, which was an increasing proportion of the population over time.
That's part of it, but not nearly all. The Omikron variants had a significantly lower fatality rate, even among unvaccinated people, and by that time most people had not had the infection yet.
The difference was Covid-19 was NOVEL, not that it was that much more deadly. The difference was that unlike the flu, basically everyone caught it, all in the same year.
Flu x 3 is not a great way to look at it. If you were over 65, it was 7*[Flu], and if you were under 35 it was 0.5*[Flu] or lower.
That's because more people got it. The actual mortality rate of covid is 3-4x of the flu https://www.ahcancal.org/News-and-Communications/Blog/Pages/Flu-or-COVID-19---Which-is-Worse.aspx
Also, I'm pretty sure that the flu mortality statistics are overstated because there are so many cases of the flu that never get reported.
Note that just saying "it turned out fine so the precautions were unnecessary" is not valid reasoning. What you *can* argue is something like that countries that didn't do a lockdown had similar death rates, which might or might not be true. But my point is that the argument needs to be a little more complex than what you said.
Note that I mentioned in my comment that it was reasonable as an initial reaction. Erring on the side of caution is a reasonable approach to an unknown disease. But by June 2020, those initial unknowns were pretty much all known. Also, it didn't "turn out fine." It was essentially the worst outcome possible. Containment was a complete failure and 100% of the population got the disease.
I think some people didn't get it until vaccines were available.
Some of us never tested positive and have no reason other Bayesian priors to believe that we got it :-)
"What you *can* argue is something like that countries that didn't do a lockdown had similar death rates, which might or might not be true."
A reasonable pair for comparison (and *I* remember saying this in 2020/21 so this isn't hindsight bias, though I didn't write anything and you don't have to believe me ...) is Sweden and Denmark. Similar populations (though not identical) and Denmark locked down much harder than Sweden.
Reported Covid deaths per 1M:
Sweden: 2,682
Denmark: 1,511
https://www.worldometers.info/coronavirus/
I have seen analysis that claim that Sweden did *better* than Denmark, but that analysis requires sophisticated math and I am skeptical.
Disappointing, because philosophically I much preferred the Swedish approach of providing guidance to the population and expecting them to behave reasonably. It would be nice if that ALSO resulted in fewer deaths. But I don't think that it did.
The UK is a popular country to compare against Sweden by those who opposed the lockdowns and the UK experienced 3,389 reported covid deaths per million, but that comp tended to arise afterwards and I think Denmark is better.
if you look at excess deaths as opposed to reported deaths I believe Sweden comes out pretty dang similar to other Nordics other the whole pandemic period.
https://academic.oup.com/eurpub/article/34/4/737/7675929
I feel like you are cherry picking here. Sweden is right at the median for death rate of countries in Europe in your source. And Denmark is near the bottom. Unless you have some actual hard criteria here, like age structure of population, for using Denmark in particular I would say it's not really valid.
Buuut, you didn't keep it shut down. At what point did you have to stop getting permission from the local police to leave your house? That's when lockdown ended.
Needing permission from the police to leave your house is a lockdown. If you can just leave your house whenever you like, then you’re not locked down, so there’s no lock down.
We (England) had a lockdown from 26 March 2020 to 28 May 2020 and then again from 5 November 2020 to 8 March 2021.
Absolutely, but if you never had a lockdown, then it's unreasonable to complain about having had a lockdown.
No where in US was ever on mandatory police enforced lock down.
Yeah, I don't understand where this meme comes from. We had school closures, restrictions on indoor commerce (usually fine w/ a mask), and were encouraged to get vaccines. I know other parts of the world had stricter interventions and a bunch of lefties were enormous hypocrites about SJ protests, but even in NYC at the height of it, I don't think people were locked in their houses.
So the US never had a lockdown? So why are all these people complaining about a US lockdown?
You will justifiably find this highly annoying, but in the US, people often use "lockdowns" to refer to all the NPIs deployed here, collectively. This is true even though only a few of them could (arguably) qualify, like school closures.
You forgot the millions who were displaced, and the hydrants of thousands of businesses and jobs deleted due to the non-existent “lockdowns.”
Businesses lost their licenses if they opened.
That’s a lockdown.
I was in Italy at the time, and we were only permitted to leave our apartment to go to the grocery store for several months, and had to carry around papers certifying that we were going somewhere that was necessary for several more months after that. There wasn’t anywhere in the US that had this style of restriction, and it became common to use “lockdown” to mean “needing to wear a mask at the grocery store” in the US.
Because they are weak, soft people, who respond to any request that they act like responsible adults as a grave imposition.
Tens of thousands of people lost their businesses. Tens of thousands lost their careers. Hundreds of thousands had to relocate their families.
What the hell are you talking about?
Is it a “request” to shut down your business while strip clubs and Costco remain open?
Is it a “request” to be targeted by police if you want to walk around without a mask?
Is it a “request” to be blocked from accessing facilities if you don’t comply with nonsensical policy they just invited 3 seconds prior?
Is it a “request” to have to quit your job (as opposed to being fired for not getting an experimental mRNA transfection therapy) to watch your kids during school hours since the school won’t open for them, but your still get the joyous opportunity to pay for the closed schools as though they’re open?
I've been trying to figure out a concise answer to that question for 4 years....
In California, it was illegal for anyone to leave their home for "nonessential" reasons from roughly March 2020 through September 2020. And if you did have an "essential" reason to leave, there was a very limited set of places to go.
No, they didn't literally have a policeman standing outside everyone's door to check. If you were willing to lie about what was "essential", you would almost certainly get away with it. I'd still consider that a lockdown.
0.3% is also consistent with the Diamond Princess, as close to a laboratory environment as possible, where the mortality rate was around 0.38% (~14 deaths, ~3700 people on board).
Yes it is amazing how well that initial death rate estimate has held up!
> "All the conspiracy talk is just a distraction from discussing the very real authoritarian nightmare that was inflicted on us by the administrative state."
I don't think it's a distraction. I think that given that ~1/5th of the ACX comment section seems to believe this false thing, it is a separate but also-serious problem, and it's worth talking about it. We can't have a sensible discussion about how bad the real facts are until we agree on them!
People who disagree are going to be the loudest by far. If it's 1/5th of the comments, it's probably actually 1/25th of the readers.
> The question is why did we keep it shut down after we figured out that it was going to be an endemic virus and all of those people would die of it eventually anyway.
> If you had asked people in 2019 if we should shut down the economy for two years
We didn't do that! Restaurants reopened before the end of 2020, despite it being obviously impossible to eat in a restaurant without spreading a respiratory disease. Real "shut down everything in-person" restrictions only lasted six weeks before economic reality and cabin fever forced people to reopen while pretending that viral particles couldn't move more than 6 feet indoors.
Scott should implement a rule: when discussing COVID lockdown everyone should have to preface each comment with the jurisdiction in which they lived so we can see what actual measures they lived under.
I will start this grand tradition and admit that I lived in Florida and mostly self-isolated the first three months. I remember how ghostly downtown was when it really hit people that this was happening. I also remember most people shrugging and moving on with their lives within around four months with maybe half masking consistently. Given Florida's place in history as the flagship of low-restriction state governance, my experience may not resemble that of blue staters.
We never once shut down the economy. As far as I can tell, we shut down 5% of the economy (GDP decreased by 2.2%, while in other recent years it had been growing by about 2.4% per year, so at most 5% of the economy was shut down.)
If you want to correct someone’s exaggeration, try not to exaggerate in the opposite direction.
It was a lot more than 5%. They just made up for it by printing trillions of dollars and handing it out. This, of course, caused the inflation mess. If Biden hadn't been such an idiot and lifted all the economy at the beginning of 2021 we probably would have had a much better recovery and less inflation. We probably wouldn't be dealing with Trump today.
What have excess deaths looked like in the years since Covid, 2023 and 2024?
If I weren’t so lazy, I would look this up. I can imagine a scenario in which this number is low or negative, with fewer deaths in these years than expected. And if that were the case, I would think of Covid as having accelerated the deaths of the difference. The people meant to die in 2023 and 2024 died in 2020 or 2021 instead.
And that might explain why it just doesn’t feel like a 1.2 million deaths tragedy.
You can indeed look this up. Your hypothetical is incorrect
https://ourworldindata.org/grapher/excess-mortality-p-scores-average-baseline?country=~USA
This is the worst graph you could use to prove your point because it compares different cohorts of different sizes.
Death is strongly correlated with age (duh). If everyone dies at age 75 then you would expect a difference proportional to the difference in birth rate between 1940–1944 and 1945–1950, and those are really different periods because of World War 2 and the following baby boom. In reality it's more smoothed out of course but this still seems too big of a factor to ignore.
So from the graph alone I really cannot tell if the ~10% increase we are seeing in 2024 compared to 2019 is above or below expectation based on changes in demographics between those years.
And at least eyeballing it, the data from early 2025 seems higher compared with 2023 and 2024 which at least suggests a dip in those years.
If you look at the comment I’m responding to, this graph exactly addresses the question there. You can create scenarios to explain what the graph shows, but the comment asked if excess were down after Covid and the answer is clearly no.
The question was whether there were fewer deaths in 2023 and 2024 “than expected” (which would indicate a pull-forward effect of mostly older patients dying).
”Than expected” doesn't mean “than 5 years ago” if there are reasons to expect the death rate to be higher than 5 years ago regardless of COVID (i.e., the baby boom).
So no, it doesn't answer the question, at least not convincingly.
And you do need strong evidence if you want to deny there is a pull-forward effect, since we know that COVID deaths disproportionally affected the elderly (and secondarily the obese, who generally have lower life expectancy as well), which nobody denies, so purely statistically you would expect the death rate post-COVID to be lower “than expected”, everything else being equal.
It seems to me the "pull-forward" theory proponents should actually present some actual evidence their theory is accurate other that just saying it makes sense so it must be true. If you have a better graph I would love to look at it. Given the oldest boomers are around 80 years old, and their life expectancy is also around 80 (although really more given the life expectancy for anyone at age 75 is around 12 years), a 10% increase in deaths seems highly, highly unlikely without some other cause.
I've given you a perfectly reasonable explanation why the pull-forward theory is likely, you just chose to ignore it. It relies only on facts that I assume you already accept to be true: that COVID disproportionally killed people with shorter life expectancies, namely: the elderly, the obese, the infirm.
Then it logically follows that the survivors have higher than average life expectancy, resulting in a reduced death rate in the following years, if everything went back to normal.
Of course there is an “if” there. You could argue that the introduction of COVID has permanently increased the human death rate which offsets the expected short-term decline (which would mean life expectancy at birth is lower post-COVID). This is plausibly true at least to *some* extent, but if you want to make a specific claim about how strong that effect is the ball is back in your court. Also this is not actually an argument against the pull-forward effect per se; it's just an explanation why the death rate doesn't go below average levels *despite* the pull-forward effect.
Note that the effect on the death rate of the pull-forward effect is likely to be small because deaths don't very neatly occur at the end of life expectancy.
What, exactly, are you arguing against? The pull-forward theory is that people who died of covid would otherwise have died later, AKA, they would not have been immortal. Really the only alternative to this is immortality.
And why are people so excited about the pull-forward theory, anyway? There seems to be an implication that it makes things ok again, and yet, dying sooner is worse than dying later (assuming quality of life above 0). All sorts of humanity's most celebrated achievements - agricultural revolution, eradication of smallpox, antibiotics - only delayed death, rather than preventing it entirely.
I started writing this comment to Calvin, but then threw it out when I realized it didn't contradict him, but I guess I'll resurrect it now.
==
Let's say we have 10M elderly and we expect 5% to die each year, so 500K deaths. Also 500K people age into elderly, nice and even.
Then a virus comes along and kills an extra 10% in year N, so we're down to 9M next year. However, out of these 1M deaths, it was strongly correlated to the worst health, so 250K of them were going to die in year N+1 and 250K would die in year N+2 and 250K would die in the year N+3. The remaining 250K were from the otherwise healthy elderly.
Now, in year N+1, we would normally expect there to be a population of 10M and 500K deaths, but 250K of those deaths happened in year N. So we have a population of 9M and 250K deaths.
That's a death rate of 2.78%.
So we would really see a dip.
I'm a bit confused if you are agreeing or disagreeing with me.
What you describe is essentially what I'm arguing: that since COVID killed people with relatively low life expectancy, we should logically see a reduction in death rate post-COVID, barring other effects.
It sounds like you're arguing that if the pull-forward effect is significant, then we should see a stronger dip than we've seen, and that argues against a pull-forward effect. But I'm not sure we have accurate enough data to tell whether there is a dip, as I've explained above.
Note that you used exaggerated numbers to get the desired effect: a 200% increase in deaths during COVID while more realistic estimates are 20-25% (though over roughly a 2-year period). Additionally, you assume ¾ of victims would have a life expectancy of only 2 years; I think it's plausible the average was higher but still far below average overall (say, 5 or 10 years) which would make the dip shallower and wider.
I understand you were using the example to explain the principle, and didn't claim your numbers were accurate, but we do need to use accurate numbers to estimate the size of the dip.
Even with your numbers, the dip is significantly smaller than a peak: a 200% increase followed by 44% decrease over the next three years. If it turns out that e.g. a 25% peak results only in a 5% dip in the following years, that wouldn't necessarily be visible in a low-resolution graph that includes lots of other phenomena too.
If anything, it's up on trend. Total deaths in USA: 2.71 million in 2015, 2.84 in 2019 (+0.13), 2.98 in 2023 (+0.15).
https://ourworldindata.org/grapher/number-of-deaths-per-year?time=earliest..2024&country=~USA
It's actually on or slightly below the trend started from 2010: https://i.imgur.com/0N0TmQR.png
By the way you have to account for the fact that the US has an uneven population pyramid, with many Baby Boomers who are going to die in the coming decades, which is why I suspect the numbers are trending up in the first place.
I'll grant you that there is no obvious decline to compensate for the COVID peak, but the graph is also conveniently missing the data from 2024, which is really important: does 2024 continue the sharp decline from 2021–2023 or continue the upward trend from 2010? That seems a really important question we cannot answer with this data.
And as I said, there is significant demographic change as well, so ideally I'd like to see this data controlled by age.
I was curious about that as well, and so, as a midwit, i did what every midwit should: I asked an AI (Grok):
Here was my question:
this link shows deaths due to covid. https://www.census.gov/library/stories/2022/03/united-states-deaths-spiked-as-covid-19-continued.html however, the data ends at 2021. Im wondering if deaths dropped significantly after the pandemic due to the deaths being concentrated amongs those who would have died soon anyway. Is there any evidence of that theory?
Ill copy its answer in a reply.
The idea you're referring to is often called the "pull-forward effect" or "mortality displacement," where a spike in deaths during an event like a pandemic reduces subsequent mortality because many of those who died were already near the end of their life expectancy. Let’s examine the available evidence to see if there’s support for this theory regarding COVID-19 deaths after 2021, using data and trends from reliable sources.
### Background from the Provided Link
The Census Bureau article you referenced confirms a significant spike in U.S. deaths during 2020 and 2021 due to COVID-19. It notes a 19% increase in deaths from 2019 to 2020 (from 2,854,838 to 3,390,029), the largest in 100 years, with deaths remaining elevated in 2021 (19.7% higher than 2019). The data highlights that older adults, particularly those aged 85 and older, accounted for a disproportionate share of deaths, suggesting that many fatalities were among those with pre-existing health vulnerabilities. However, the article’s data stops at 2021, so we need to look at more recent sources to assess post-2021 trends and the pull-forward effect.[](https://www.census.gov/library/stories/2022/03/united-states-deaths-spiked-as-covid-19-continued.html)
### Evidence on Post-2021 Mortality Trends
1. **Decline in Overall and COVID-19 Deaths Post-2021**:
- **2022 Data**: According to the CDC’s provisional mortality data, the total number of U.S. deaths in 2022 was approximately 3,273,705, with an age-adjusted death rate of 832.8 per 100,000, a 5.3% decrease from 879.7 in 2021. COVID-19-associated deaths dropped significantly to 244,986 (7.5% of total deaths) in 2022 from 462,193 in 2021, a 47% reduction. This indicates a notable decline in both overall and COVID-19-related mortality after the pandemic’s peak.[](https://www.cdc.gov/mmwr/volumes/72/wr/mm7218a3.htm)
- **2023 Data**: The decline continued into 2023, with provisional data reporting 3,090,582 total deaths and an age-adjusted death rate of 750.4 per 100,000, a 6.1% drop from 2022. COVID-19 deaths fell to 49,928 (1.6% of total deaths), a 68.9% decrease from 2022. This suggests a sustained reduction in mortality as the pandemic’s direct impact waned.[](https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a1.htm)
2. **Natural Increase Rebounding**:
- A Census Bureau report indicates that natural increase (births minus deaths) began recovering post-2021. In 2021, natural increase was only 144,013 due to high mortality and a 3.5% drop in births. By 2022, it rose to 236,155, and by 2023, it reached 531,432, driven by fewer deaths and increased births. The number of states with more deaths than births (natural decrease) also dropped from 25 in 2022 to 19 in 2023, suggesting a return toward pre-pandemic mortality patterns. This rebound could be consistent with the pull-forward effect, as fewer deaths in later years might reflect the prior loss of vulnerable populations.[](https://www.census.gov/library/stories/2023/12/state-population-estimates.html)
3. **Excess Mortality Trends**:
- Excess mortality, defined as deaths above expected levels based on pre-pandemic trends, provides insight into whether deaths dropped below normal after the pandemic. A study published in 2024 found that excess deaths declined from 655,735 in the first pandemic year (March 2020–February 2021) to 586,505 in the second (March 2021–February 2022). However, for younger individuals (under 65), excess deaths increased in the second year, particularly for non-COVID causes like alcohol, drugs, and homicides, suggesting that the pull-forward effect may be more pronounced among older populations.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC10988222/)
- Another analysis noted that excess mortality was highly concentrated among older age groups in 2020, with those aged 85 and older accounting for 34% of excess deaths despite being only 3% of the population aged 25 and older. This supports the idea that COVID-19 disproportionately affected those closer to natural life expectancy, potentially reducing subsequent mortality.[](https://www.census.gov/library/stories/2021/02/indirect-impact-of-covid-19-results-in-higher-pandemic-death-toll.html)
4. **Pull-Forward Effect Discussion**:
- A post on X by @Voltaire765 references the pull-forward effect, citing Alex Berenson’s Substack, which argues that after the initial COVID-19 death spikes, mortality should drop below normal as those who died early (primarily elderly and sick) were no longer at risk. The post suggests that five years post-COVID, mortality data in the U.S. and Britain might reflect this. While this aligns with the theory, X posts are not conclusive evidence, and Berenson’s claims require scrutiny against primary data.
- A study from Boston University suggests that in some regions, like New England and mid-Atlantic counties, lower-than-expected deaths in 2020–2021 could be partly due to the pull-forward effect, as vulnerable individuals died earlier from COVID-19, reducing subsequent mortality from other causes. However, this was not universal, and undercounting of COVID-19 deaths in some communities complicates the picture.[](https://www.bu.edu/sph/news/articles/2023/covid-19-deaths-in-the-us-continue-to-be-undercounted-research-shows-despite-claims-of-overcounts/)
### Critical Analysis of the Pull-Forward Effect
- **Support for the Theory**:
- The significant drop in COVID-19 deaths from 2021 to 2023, alongside a decrease in overall death rates, aligns with the idea that the pandemic accelerated mortality among vulnerable groups, particularly the elderly. The high proportion of deaths among those aged 85+ (e.g., 307,169 COVID-19 deaths from January 2020 to June 2023) supports the notion that many who died were already at higher risk due to age or comorbidities.[](https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/)
- The rebound in natural increase and fewer states experiencing natural decrease by 2023 suggest that mortality is stabilizing, potentially because the pool of high-risk individuals was reduced during the pandemic’s peak.[](https://www.census.gov/library/stories/2023/12/state-population-estimates.html)
- **Counterpoints and Limitations**:
- **Non-COVID Excess Deaths**: While COVID-19 deaths plummeted, excess deaths from other causes (e.g., drug overdoses, homicides) increased, particularly among younger populations, which offsets the expected drop in overall mortality. This suggests that the pull-forward effect may not fully explain post-2021 trends, as societal disruptions from the pandemic contributed to other mortality risks.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC10988222/)
- **Data Completeness**: Provisional data for 2022 and 2023 are incomplete due to reporting lags (1–8 weeks), which could affect the accuracy of death counts, especially for recent periods. This makes it challenging to definitively confirm a below-normal mortality drop.[](https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm)[](https://www.cdc.gov/mmwr/volumes/72/wr/mm7218a3.htm)
- **Undercounting**: Research indicates that COVID-19 deaths were undercounted, particularly in minority and low-income communities, which could mask the true extent of mortality displacement. If excess deaths were higher than reported, the subsequent drop might be less pronounced than expected.[](https://www.bu.edu/sph/news/articles/2023/covid-19-deaths-in-the-us-continue-to-be-undercounted-research-shows-despite-claims-of-overcounts/)
- **Vaccination and Immunity**: The sharp decline in COVID-19 deaths after 2021 is also attributed to widespread vaccination and prior infections, which reduced mortality risk. This confounds the pull-forward effect, as lower deaths may reflect improved immunity rather than solely the loss of vulnerable individuals.
### Conclusion
There is evidence supporting the pull-forward effect post-2021, particularly among older populations. The significant decline in overall and COVID-19 death rates from 2021 to 2023, combined with a rebound in natural increase, suggests that the high mortality during 2020–2021 may have reduced the number of vulnerable individuals, leading to fewer deaths in subsequent years. However, this effect is not universal across all groups, as younger populations saw increased non-COVID mortality, and factors like vaccination, undercounting, and data lags complicate the analysis. While the theory holds some weight, especially for the elderly, it’s not the sole driver of post-pandemic mortality trends.
For further details, you can explore the CDC’s National Vital Statistics System (https://www.cdc.gov/nchs/nvss/index.htm) for updated mortality data or the Census Bureau’s population estimates (https://www.census.gov) for natural change trends. If you’d like me to generate a chart comparing death rates or excess mortality across years, let me know!
I really don’t think that it matters what evidence you present about this, because Covid skeptics have a remarkable ability to ignore any facts that contradict their beliefs. Anyone getting their beliefs from people like RFK and Alex Berenson, who are really shameless in the way they twist facts, are not people who can be persuaded. In general, conservatives have decided reality is whatever they want it to be to a remarkable degree
I think this is true of some people but not others. All of these people were convinced because someone argued them into their position, and if people are constantly arguing for these ideas but refuse to argue against them because "nobody can be convinced", they win by default.
More realistically, I don't think I will change the mind of any hardcore conspiracy theorist. But I think some conspiracy theorists will refine their conspiracy theories to be more plausible (while learning some useful things about good thinking skills), and people who are not yet either explicitly conspiracy theorists nor anti-conspiracy-theorists will hone their thinking skills and be less likely to believe conspiracy theories in the future.
But it was avoidable. International travel could have been suspended to prevent the virus from entering, then with a lower baseline and non-endemic virus in other countries we could more easily isolate & contact-trace the few who brought it in.
Australia and New Zealand both accomplished that!
Many pandemic preparedness plans have been written. If you truly care about preventing tragedies, you may wish to read one of them and perhaps convince people to implement it.
Maybe this is true of the people you know, but the conservatives I know (which are many; I was raised very conservative) have very insane views on Covid, most of which are not remotely based on fact and many of which are mutually exclusive (ie Covid can’t be both a leaked Chinese bioweapon AND designed as a plot to enrich Anthony Fauci).
If it changes the mind of conversatives he knows, but not the minds of conservatives you know, that's a victory. Because a world where some people change their minds and some don't is of course better than a world where nobody did.
I see somebody has never been to the Historic Downtown Anthony Fauci Bio-Thunderdome, which doubles as his mountaintop fortress. Shaped like a skull, naturally.
>All of these people were convinced because someone argued them into their position
Most people don't work like that. They simply believe whatever their social circle believes.
True, but that kicks the can down to why their social circle decided to believe it.
Mostly because that's what elites they look up to believe (or pretend to). So it's those elites that largely need to be convinced, or utterly discredited and overthrown. Both approaches prove to be pretty difficult in practice...
I think most True Believers were "convinced" of whatever conspiracy theory because
1. It flatters their egos to think that only THEY can see the truth, and that everyone else is just a sheep
2. It validates their rage at having to do something they consider inconvenient or scary. If it's a conspiracy from the NWO, the mask or vaccine requirement is not just an annoyance meant to save lives (which would not be socially acceptable to complain about), but a form of tyrannical oppression that MUST be resisted
3. It is a tool they can use to partisan ends. First Dems did this (Kamala's insistence during the primary that she wouldn't take a vaccine rushed out by Trump), then the valence flipped (afaict because the actual acting president changed, even though the vaccine really was made as quickly as possible under Trump's aegis)
I don't think these people were convinced rationally, they just accepted something they already wanted to believe. I still think it is good to make sure that true arguments for correct conclusions are ubiquitous, because otherwise low-information people end up believing conspiracy bullshit by default.
Fireflies flash in specific ways to find mates, birds pick their own song out of a squawking forest.
Somewhere out there there's a budding rationalist who just hasn't deeply weighed out the alternative views on <your topic here>. If you speak thoughtfully, it can cut through the noise and resonate where it matters, even if that's like 1% of people.
I believe this because I've often had 'conversion' experiences after reading arguments similar to this one. Though more often each argument moves me just a few degrees.
This one didn't radically flip my view, but reinforced it slightly, and better prepped me to help acquaintances and in-laws weigh key evidence in a calm and respectful way.
My most unsubstantiated conviction is that the talkorigins archive wasn't a failure at all and we should have doubled down on it and done extensive argument mapping for all controversial topics.
(Maybe AI has already quietly solved for this, "@grok is this true? @grok what are the flaws with this argument?")
Credit to just writing this post and it existing as a reference in the future.
I was raised christian conservative, then went to university as a left-leaning atheist, and am now a researcher (and still atheist). Unfortunately, I would say your last sentence applies cleanly across the entire political spectrum. Science is rife with it.
The problem is and was very simple; Covid was a time with very little confidence, yet the scientific establishment pretended high certainty about a long list of things that later turned out to be provably false (masks don't work, then suddenly they are obligatory; Trump is pushing the vaccine development dangerously fast and one month after Biden's election it's suddenly 100% safe; vaccines fully stop the spread so we can open up again oops actually they only protect the person taking it; Lockdowns are sad but necessary actually countries without lockdowns did just as fine; Lab leak is conspiracy theory well actually most intelligence agencies consider it the most likely reason, etc.). And social science already had been doing the same for social justice, so it was straightforward to extend that mistrust just one category further.
When people lose trust in the institutions, they start looking elsewhere. These other places however have little to no quality control, so it's easy for grifters to get a foothold. It's stupid, it's completely avoidable, but that's what happens if you burn your long-term credibility in the name of the short-term greater good(which actually turns out to be wrong later anyway).
I agree somewhat but also disagree. I agree a lot of our institutions and "establishments" failed very badly during covid (and continue to fail in many other areas), however, the widespread embrace of conspiracies and obvious misinformation started way before any of the events you mentioned. For example, I remember many conservatives I knew promoting the "Plandemic" movie almost as soon as the lockdowns started. I also remember at least one acquaintance trying to argue with me that the covid vaccines were dangerous before they were even invented.
Also, I remember some of those events differently than you do. I know some Democrats said Trump was rushing the vaccine approvals, but that wasn't the general consensus on the left. Similarly, after the vaccines rolled out I saw a number of articles warning that if covid mutated the vaccines would be much less effective, which is what happened.
Agreed: it's a big problem that authorities believe they can't admit uncertainty, frequently playing armchair psychologist when that isn't actually their area of expertise.