Tribalism comes for pandemic science • Hacker News Board

Re: Tribalism comes for pandemic science

#81

Post by yokaze » Mon, Jun 08, 2020, 9:14 PM UTC

Snoozle wrote: post #62

eirini1 wrote: post #55

Earlier quoted context omitted.

obviously you listen to the epidemiologist, not the economist. The economist is an expert on the economy and not on pandemics, and therefore will always give advice that is aimed at keeping up the economy and not saving people and preventing the spread of the virus. Its baffling to me that you think an economist has any kind of valid input on this matter. At best an economist could advise you on how to keep the econo…

Economic problems come with a cost on human life. There are numerous studies and paper that show how bad being poor and unhappy are for a person's health. Why WOULDN'T we consider the economic ramifications?

Maybe we would, but it isn't like there is consensus on economist side. And it isn't like not having a lockdown is good for the economy , because that has clear economical consequences too:

https://www.nytimes.com/2020/04/14/opinion/coronavirus-reope...

Re: Tribalism comes for pandemic science

#82

Post by salmon30salmon » Mon, Jun 08, 2020, 9:16 PM UTC

matthewdgreen wrote: post #45

salmon30salmon wrote: post #2

This is so very disheartening. I will speak only for the United States, as I am not familiar enough with other countries to comment. Not only is this impacting nearly every single person in the country, it is ruining the financial situation of over 40m people, primarily concentrated within the most financially vulnerable. This is because leaders on the left and right have refused to respond to new data, and are worki…

I guess I am on the “left”, and my view throughout this thing has been “do what the experts say we should, while maintaining a diversity of expert views.” This is also the vibe I get from most of my “left” friends. Moreover, Europe has largely followed its experts’ advice —- and with a few exceptions they’ve largely brought cases under control, so it’s not like the advice was bad. This “pox on both houses” post, in w…

This has largely _not_ been a Federal response, this has largely been in the hands of the States, at least in regards to setting the policies. State epidemiologists are currently more "powerful" than the CDC in most states, so blaming the response on who is in majority control of the Federal government is short-sighted.

Yes, the (lack of) organized Federal response influenced the severity of the issue in the early days, but we can't lay blame at that level for what has taken place in each state since that time.

The issue isn't whether lockdowns work. Of course they do. People spread disease to one another, limit the number of people that contact each other and the disease will abate. That isn't what is worthy of debate. Rather, we should be debating if lockdowns are worth the cost, and what other methods could we use to mitigate the disease while still maintaining some amount of normalcy.

If we have that debate, it needs to be super local. Density is the driver of any pandemic with human to human transmission. NYC is the most dense city in the United States, and has a huge reliance on densely packed public transit. Dallas is incredibly sprawled and has very little transit use. They need fundamentally different responses.

It is this lack of nuance that is troubling.

Re: Tribalism comes for pandemic science

#83

Post by salmon30salmon » Mon, Jun 08, 2020, 9:19 PM UTC

ardy42 wrote: post #72

Snoozle wrote: post #62

Earlier quoted context omitted.

Economic problems come with a cost on human life. There are numerous studies and paper that show how bad being poor and unhappy are for a person's health. Why WOULDN'T we consider the economic ramifications?

>> At best an economist could advise you on how to keep the economy afloat under the restrictions the epidemiologists has advised. > Why WOULDN'T we consider the economic ramifications? He's not saying that. He's talking about who should be giving the marching orders. Let me put it another way: in a war, the generals decide what equipment the military needs and the economists figure out how to produce it. You don't h…

But before you go to war, the leaders listen to a diversity of opinions. Could diplomacy work? Could sanctions? What about an alliance prior to war? Could we use covert methods? The problem here is that we waged war without having that discussion. We went straight to the Generals (in our case, epidemiologists) without getting the opinion of the diplomats, allies, covert ops (economists, labor groups, civil rights groups) etc.

Re: Tribalism comes for pandemic science

#84

Post by im3w1l » Mon, Jun 08, 2020, 9:21 PM UTC

pjc50 wrote: post #17

The people who said that lockdown needed to be limited in length because people couldn't take it for long were right. Unfortunately, due to not understanding exponentials, many advocated for starting the lockdown later : hence the UK's delayed lockdown and therefore highest death toll in Europe. The people advocating for "herd immunity" never addressed the death rate; a death rate of even 0.5% in the UK would be thre…

> Unfortunately, due to not understanding exponentials, many advocated for starting the lockdown later.

I think you misunderstand the reasoning. If you want to wipe a disease out you lockdown as soon as you can. If you want to flatten the curve, you lockdown just before the peak, so as to prevent it. Or if you are ok with flattening the curve for a longer time, you lock down just before you reach capacity.

Re: Tribalism comes for pandemic science

#85

Post by manfredo » Mon, Jun 08, 2020, 9:22 PM UTC

eirini1 wrote: post #55

guygurari wrote: post #50

Earlier quoted context omitted.

> “do what the experts say we should, while maintaining a diversity of expert views.” I don’t think this is an actual strategy. If there is a diversity of views, which experts do you listen to? Also, experts in which field? Epidemiologists have generally recommended very strict shutdowns, but they are not economists and are not experts on the economic ramifications. Some economists agree with strict lockdowns, others…

obviously you listen to the epidemiologist, not the economist. The economist is an expert on the economy and not on pandemics, and therefore will always give advice that is aimed at keeping up the economy and not saving people and preventing the spread of the virus. Its baffling to me that you think an economist has any kind of valid input on this matter. At best an economist could advise you on how to keep the econo…

We could easily eliminate a greater share of premature deaths if the government sent soldiers to force Americans to exercise at the point of a bayonet. Probably more than will die in this pandemic (~650,000 deaths due to heart disease each year). Does that mean this is a wise course of action? Of course not. The negative consequences in terms of reduction of civil liberties vastly outweighs the medical benefit. The same logic needs to be applied here.

The epidemiologist isn't trained in thinking about the persisting scar on opportunity left by lockdowns. A response to a pandemic that solely cares about limiting lives lost due to the virus stands to inflict massive harm as people lose their jobs and social unrest triggered by the suspension of civil liberties.

Medical professionals are experts in medicine. Not in making holistic decisions about the course of society. They absolutely should have a prominent spot in sharing information with the leaders of society, but their advice needs to be weighed against the costs of carrying out that advice.

Re: Tribalism comes for pandemic science

#86

Post by mdemare » Mon, Jun 08, 2020, 9:22 PM UTC

JPKab wrote: post #24

Question: Has anyone here changed their mind about COVID19 in a major way as the data has become more complete? Just wondering. I have sensed in myself tribalistic tendencies of not changing my mind when the data changes. I'm trying hard to look at myself and recognize it and experiment with different thoughts. I find myself bouncing between thinking we have overreacted to then thinking that my perception of an overr…

I'm surprised at how little effect even a strict lockdown (western style - Wuhan style was much more effective) had compared with the Swedish approach. I did not expect cases to rise so slowly and even plateau with the policy that Sweden chose, and I did not expect cases and deaths to decrease so slowly with the policies that Spain, France, Belgium and Italy chose.

I now suspect that ending lockdowns, temporarily banning just a couple of high risk activities such as conferences and clubbing, universal mask wearing, and extra protection in hospitals and long term care homes might be enough, at least until October (in the Northern hemisphere).

Re: Tribalism comes for pandemic science

#87

Post by mdemare » Mon, Jun 08, 2020, 9:25 PM UTC

KarlKemp wrote: post #49

throwaway894345 wrote: post #7

Earlier quoted context omitted.

In fairness, the right has been pretty consistent about tailoring the response according to risk—i.e., those who are at risk should isolate and everyone else should resume work. They happened to be right in this regard. The left has also made exceptions in their “lockdown everything” policy, specifically with regard to their own protests (and the response of pandemic experts is a particularly interesting case study o…

The idea of isolation was most prominently attempted by Sweden, the UK, and the Netherlands. To call it "right in this regard" is, in this regard, wrong. These countries are leading the per-capita corpse count. In the case of Sweden, deaths are about ten-fold that of neighbouring and rather similar Norway. And people are still dying at peak levels in Sweden, while Norway now goes a week without deaths. Of course it's…

In the Netherlands, I don't think this was even attempted, apart from forbidding visitors.

Re: Tribalism comes for pandemic science

#88

Post by nostrademons » Mon, Jun 08, 2020, 9:29 PM UTC

JPKab wrote: post #24

Question: Has anyone here changed their mind about COVID19 in a major way as the data has become more complete? Just wondering. I have sensed in myself tribalistic tendencies of not changing my mind when the data changes. I'm trying hard to look at myself and recognize it and experiment with different thoughts. I find myself bouncing between thinking we have overreacted to then thinking that my perception of an overr…

Yes, but early. I changed my mind from thinking it was "just the flu - I'm going to get it, but probably won't be able to tell it apart from a cold" to "this is probably a big deal that I really don't want to get" in late February. Haven't found any information to make me change my mind since, even as public opinion has yo-yo'd.

The critical information for me was data on hospitalization rates, along with some math on hospital capacity and exponential infection rates. Before, I'd looked at the death rate for 20-40 year olds of ~0.1% and figured it wasn't a big problem for me. Then I realized that the 20% "severe" cases out of Wuhan was actually the percentage that required hospitalization, not just the percentage that develop pneumonia (which is ~60% of symptomatic cases, ~30% of infections). And it doesn't vary by age range nearly as much as the death rate does: while only about 0.1% of 20-40 year olds die from COVID-19, 3-5% end up in the hospital, only about 4x lower than the ~20% of 65+ seniors that do. (These numbers already account for asymptomatic infections, which are about 50% of cases. The Wuhan numbers didn't, so halve them.) And the average hospital stay lasts for 3-5 weeks. With the doubling time of unchecked COVID-19, we could potentially end up with 150M infections during the time period of one hospitalization. 10% hospitalization rate over the whole population, and that's 15M hospitalizations, well over the number of hospital beds in the U.S.

If you gather data from a wide variety of sources instead of grabbing the latest headline, most of the relevant data hasn't actually changed all that much since February. Back then we were saying a roughly 2% CFR; now best estimates are a 1-1.25% IFR, which is completely consistent with that when you add the new information that 50% of infections are asymptomatic, which was discovered in late February. IFRs in situations where the whole population was tested (eg. South Korea, the Diamond Princess) were about 0.7-1.5%, depending on the age of the population. The age curve data from Wuhan has held up remarkably well across Europe and NYC. R0 and doubling time was pretty consistent across most temperate northern climates before the lockdowns (1.5-2.5 days in most of Europe and the U.S.). The progression of the virus when unchecked was also quite consistent between Wuhan, Italy, and NYC, as was the effect of the lockdown.

Re: Tribalism comes for pandemic science

#89

Post by sacred_numbers » Mon, Jun 08, 2020, 9:35 PM UTC

throwawaysea wrote: post #26

Not to sound alarmist, but recent events have felt like the early warning of a pending collapse of our country. When I saw healthcare workers and officials abandon logic, reason, and evidence to put their weight behind justifying recent mass protests, I really lost a lot of faith. These protests obviously will result in thousands more deaths (much larger in number than unjust police-involved deaths). This is no longe…

I think that you are making the same mistake that you are accusing healthcare workers and officials of making. You are assuming that these protests will "obviously" result in thousands more deaths because it feels that way to you. I believe that that's pretty unlikely, though, since there are probably fewer than a million protestors across the country. Many of the protestors are wearing masks and the protests being outside reduces the risk of spreading the disease. There will certainly be some spread due to the protests, but probably not nearly as much as at grocery stores or churches. You are also assuming that this is just about unjust police-involved deaths; it is not. It is about the many millions of negative interactions with the police and justice system that perpetuate poverty (police lying under oath, egregious sentences for non-violent crimes, etc.) I don't think it's a bad faith argument to say that correcting these injustices is more important than maintaining a totally strict quarantine.

The reason both sides talk past each other is because they have different values and different assumptions. Based on your post your first priority is preventing deaths and your assumption is that these protests will cause more deaths than they prevent. My first priority is living in a fair world, with preventing deaths being a close second. My assumption is that the protests will not cause a large number of excess deaths, but that they do have a high chance of moving our justice system closer towards real justice. I also am making the assumption that living in a fair and just society will increase overall health outcomes over the long term.

I believe that most (but definitely not all) people don't argue in bad faith, they just have different values and make different assumptions. There's not much that can be done about having different values, but better data can help every side have more similar assumptions, which should help opinions to converge somewhat.

Re: Tribalism comes for pandemic science

#90

Post by umvi » Mon, Jun 08, 2020, 9:35 PM UTC

eirini1 wrote: post #55

guygurari wrote: post #50

Earlier quoted context omitted.

> “do what the experts say we should, while maintaining a diversity of expert views.” I don’t think this is an actual strategy. If there is a diversity of views, which experts do you listen to? Also, experts in which field? Epidemiologists have generally recommended very strict shutdowns, but they are not economists and are not experts on the economic ramifications. Some economists agree with strict lockdowns, others…

obviously you listen to the epidemiologist, not the economist. The economist is an expert on the economy and not on pandemics, and therefore will always give advice that is aimed at keeping up the economy and not saving people and preventing the spread of the virus. Its baffling to me that you think an economist has any kind of valid input on this matter. At best an economist could advise you on how to keep the econo…

People's lives and livelihoods are strongly coupled to the economy though. Heavy economic damages result in skyrocketing suicides and homelessness. It's not like shutting down the economy only hurts "gluttonous corporations" and "greedy capitalists"