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Covid-19: the harms of exaggerated information and non‐evidence‐based measures

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Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#81

Post by sdenton4 »

jhanschoo wrote: post #73
jtsnow wrote: post #22

Ioannidis continues to push this evidence-based approach, but I have not yet seen an adequate response to critics such as Nassim Taleb or Yaneer Bar-Yam. They argue that one doesn't need raw evidence to act if the statistical evidence shows that the risks are catastrophic. They published a paper on January 26th which lays out arguments for why conventional risk management approaches are inadequate in these situations…

Taleb's note was probably more relevant back when it was published. It's clear that current measures are measures devised against epidemics, and not "conventional risk-management approaches" for everyday business, which he seems to be criticizing. There's a lot to criticize about the note [1] but its conclusion was appropriate in that a response tailored to the particular epidemic based on conventional risk-assessmen…

/You also have a misreading of what Ioannidis is trying to push for. He isn't advocating against taking action before good evidence comes out. Rather, he is highlighting that our current lack of good evidence about the epidemic is necessitating a greater reaction than may actually be necessary if we had better evidence./

This is kinda the core problem, though: We don't have access to the full evidence (yet) and things already look somewhere between very very bad and mildly catastrophic. (I'll reserve full catastrophe for Giant Asteroid.) If you don't plan for the 'catastrophic' case and it's on the table, you look pretty bad if the error tends in that direction. By the time you KNOW you're in the catastrophic case, it's too late to deal with it.

I've seen the Ioniaddis pieces showing up in a couple places, and he really comes off as a bit of a crank, more concerned about his Stanford-supported stock portfolio than considering the Actually Available evidence. I don't give a fsck about the initial wrong reports in China... Italy's got overflowing hospitals and a very exponential-looking death curve right now. Not enough testing means we're getting better numbers, leading to a sharp spike... but the numbers are still reflecting mostly the worst cases, coz that's who tests are available to. And the numbers of deaths and very bad cases are climbing very, very fast.

Here's a model you can tweak, with plots of available data and estimates of available hospital beds, etc... Just looking at the death curves (can't hide a body, amirite) the 'Fast/North' scenario looks like it fits well for the US. Moderate-to-no mitigation is then modeled at O(3MM) deaths, and strong mitigation drops to O(1MM). So, the error bars that we're playing with are measured in millions of lives.

https://neherlab.org/covid19/

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#82

Post by amiga_500 »

rootusrootus wrote: post #71
ellyagg wrote: post #50

Earlier quoted context omitted.

It's weird because I'm just as afraid of a black swan of unforeseen, runaway financial collapse due to pandemic countermeasures. People seem awfully glib about how many will die from the pursuant depression.

I'm becoming considerably more afraid of the social and economic consequences from the pandemic countermeasures than of the virus itself.

My main fears:

1. They find it does effect kids, it just takes longer

2. They find reinfection is common

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#83

Post by ajnin »

What Ioannidis is advocating is to do nothing until we have scientific certainty of what the correct decision should be, and only then act. What he's not taking into account is that the situation is unfolding right now, and if "do nothing" turns out not to have been the correct decision then you can't go back and change that. If we overreact and cause 20% unemployment for the next year, then a harm has been caused, but if we underreact and 20 million people die, then another harm would have been caused. In the face of this alternative, with not enough data to know the probability of outcome #2, but with enough to know that it can happen, then I think it is rational to choose the route that most surely avoids it.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#84

Post by robocat »

Firstly, there is 10 weeks of evidence on what other countries have done to avoid transmission. Taiwan, Vietnam, South Korea, China, and Japan all show a variety of strategies and have some successes under their belts. Sure, it’s messy social data, and they have systematic differences from other countries, but it’s real data about what is working.

Ioannidis says: “If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.”

The Diamond Princess data shows deaths with a functioning health system. From WaPo: “a doctor at Papa Giovanni XXIII Hospital in Bergamo, where he said there are 500 patients in need of intensive care and just 100 ICU beds”. The deaths in Italy are often due to an overloaded health system, which can easily double the number of deaths. Why ignore that? Italy has 6000 deaths already with 1/5th the population of the US: you need some powerful evidence to assume the US should expect to have a different path to end up with a total of 10k (by say the end of the year).

I think John has good reason to desire evidence based decisions, but sometimes you have to make decisions without enough data and change your game as it develops e.g. look at what effective entrepreneurs do in uncertain times?

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#85

Post by wwweston »

rootusrootus wrote: post #71
ellyagg wrote: post #50

Earlier quoted context omitted.

It's weird because I'm just as afraid of a black swan of unforeseen, runaway financial collapse due to pandemic countermeasures. People seem awfully glib about how many will die from the pursuant depression.

I'm becoming considerably more afraid of the social and economic consequences from the pandemic countermeasures than of the virus itself.

We had our chance to get this together years beforehand. We even had a chance to have lower impact interventions be effective 2-3 months ago.

There are no chances for light economic impacts now. Use lighter mitigation methods and productivity and demand will get hit by the illness and death itself, both the first order effects that hit those infected (which would be wider), and the second order effects as people improvise their own rightly fearful responses. The main difference you can count on is that the timing would move closer to the peak. AFAICT nobody has a clear model of whether it would be better or worse.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#87

Post by RobertRoberts »

rglullis wrote: post #31
RobertRoberts wrote: post #2

Common sense needs to prevail over mania, numbers over hyperbole and science over conjecture. But even then, this is hard if our data is collected poorly and then poorly disseminated. So what is the answer then? Maybe a strengthening of resolve against all forms of panic? Is there a single event in history has been solved by panic?

This line of thinking is backwards. Usually the problems that we don't solve are the ones where we should have taken stronger measures (i.e, "panicked") earlier instead of waiting for evidence of a threat. We did listen to the ones crying (i.e, "panicking") over Y2K bug and a lot of money was spent on it before January 1st, 2000, so that got solved swiftly. On the other hand: - Had we listened to the ones crying (i.e…

Every circumstance you mentioned was not "solved" with panic, but was solved with thoughtful and persitant action.

If you are proposing the only way to "thoughtful and persistent action" is by being induced by panic. Then I would appreciate your evidence of this.

For example the 2038 problem is more serious that Y2k. My actions today (as soon as I found out about it) was to alter all current and future systems and plan to alter all current systems in place in the near future.

No panic needed to take this action.

Do you believe the only way to motivate people is to panic them? Do you not see a long term down side to this approach?

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#88

Post by wwweston »

ajnin wrote: post #83

What Ioannidis is advocating is to do nothing until we have scientific certainty of what the correct decision should be, and only then act. What he's not taking into account is that the situation is unfolding right now, and if "do nothing" turns out not to have been the correct decision then you can't go back and change that. If we overreact and cause 20% unemployment for the next year, then a harm has been caused, b…

> if we under-react and 20 million people die, then another harm would have been caused

And it's worth noting if anything on the order of millions of people die, then there going to be economic impacts -- that's a hell of a demand crater and productivity shock.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#89

Post by RobertRoberts »

jbay808 wrote: post #24
RobertRoberts wrote: post #2

Common sense needs to prevail over mania, numbers over hyperbole and science over conjecture. But even then, this is hard if our data is collected poorly and then poorly disseminated. So what is the answer then? Maybe a strengthening of resolve against all forms of panic? Is there a single event in history has been solved by panic?

Does 'panic' mean 'reacting to a problem with a severity of response that is proportionate to how big of a problem it will be in the future, rather than how big of a problem it is now'? Probably many problems have been solved by this.

The definition of panic is: "A sudden, overpowering feeling of fear, often affecting many people at once. synonym: fear."

The reason we don't panic about the number 1 killer of Americans is because we are rational about it. We've researched and considered the cause and results carefully.

The solution to something that causes fear is not more fear is it?

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#90

Post by Barrin92 »

jsnell wrote: post #60
CriticalCathed wrote: post #43

Earlier quoted context omitted.

Um. He doesn't advocate do nothing. He specifically says the opposite. Read the paper. WTF?

Sure he recommends researching vaccines faster, giving people flu vaccines since the flu is more serious than Covid, admitting fewer Covid patients into hospital care, and doing more research so that we're better prepared next time when something actually serious happens. Or if this is serious, doing more research so that the data is the most accurate possible. I think calling that doing nothing is pretty generous. S…

he seems to advocate individual hygiene and avoiding the public when sick, which also btw seems to be the response that countries like Japan, Taiwan and Singapore have taken, where complete lockdowns or closures have largely been avoided. Together with tracing they seem to have handled the situation just fine.
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