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Tribalism comes for pandemic science

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Re: Tribalism comes for pandemic science

#111

Earlier quoted context omitted.

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 da…

This is nuts. Large portions of the response were absolutely in the hands of the Federal government, which failed catastrophically. These range from the elimination of our pandemic response team [0] to the early testing debacle, which resulted from bad tests distributed by CDC (and early failures to scale up private testing using Federal powers and expedited FDA approval) [1], to the lack of coordination between stat…

I totally agree with you, that the Federal response was pretty terrible. And I understand and am aware of the topics you provided.

However, that does not change where we are today. It would have probably helped us get to "today" a lot earlier, and it would have probably saved many, many lives which were unfortunately lost. But my argument is how we respond _today_ to new information, and how the partisanship endemic in our culture today does not allow for us to pivot in a meaningful way. If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did. But unfortunately, despite now being armed with that knowledge, we are not pivoting on the plan we made back in March.

Even our knowledge of treating it has improved. The CFR is down across the board. We now know oxygen replacement therapy is better than invasive ventilators. We know that a majority of the spread is in nosocomial or in nursing homes. We know that remdisivir shows promise. We know that treating with anti-inflammatory drugs is helpful. We know better ways to prevent cytokin storms. We know better how to respond to clotting. Focusing just on the ventilator learnings, we can treat people with oxygen replacement therapy without them being in the ICU, while invasive ventilator treatment requires an ICU. This lowers the number of ICU beds needed, and thus should shift the hospital capacity discussion.

But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science"

I will ignore the personal attack, beyond saying that questioning someones understanding of a topic at such a basic level has no place in proper debate.

Re: Tribalism comes for pandemic science

#112
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…

At the start (by which I mean late Feb/early March as I wasn't paying attention before then), I believed it all. I was worried about the ventilator crisis and wanted to find ways to help manufacture or mass create them.

Towards the end of March I started to realise that I kept reading about the supposed impending ventilator shortage, but it should have happened already and yet we didn't seem to be ever quite running out. Then a newspaper published some article about the history of Professor Ferguson and his failed foot-and-mouth disease models. I went and read some papers about the failings of epidemiology and was really shocked at how divergent the views were on the utility of these models.

Then in the comments on that story, I found someone linking to https://swprs.org/a-swiss-doctor-on-covid-19/ which just had so much data, so many links to raw sources and interviews with skeptical doctors. At that point I started to realise that many of the comments I was reading here on HN appeared to be mixing up predictions with reality; I kept reading people here talk about how Italy was experiencing mass deaths and hospital overflow yet on the SWPRS site there were links to actual articles in Italian where hospital officials said they hadn't yet run out of capacity, they weren't yet turning people away, they were just worried it might start soon. And this kept happening. Moreover my attempts to point this out kept getting voted down, so that's when I realised it was going ideological. A lot of people were desperate to correct "misinformation" and were just getting angry at anything that contradicted the official narrative. There was no rational reason to vote down posts saying "actually the situation is better than you think" yet it was happening.

So I guess that's the point I became a serious lockdown skeptic. The disparity between what people consuming regular media believed vs what the raw (often non English) data was saying just became too wide. And after that I believe everyone has been catching up, especially now with this "protests against health policies are dangerous but protests against racism aren't" nonsense.

Re: Tribalism comes for pandemic science

#113

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 o…

> 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.

I am not the one saying this. Trevor Bedford (Associate Professor in the Department of Epidemiology at the University of Washington) noted that the protests will add 200-1100 deaths per day of protests: https://twitter.com/trvrb/status/1269533303536664576. This is based on his mathematical modeling of the protests.

> 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.

My point is that if one [demographic or political] subset of people gets to evaluate the tradeoffs and decide for themselves that yes, protesting is worth it even with the risks of the coronavirus, then everyone should get to exercise that choice. You and I should get to exercise that choice when we visit a business or take on some outdoor activity or whatever. It seems to me that personal discretion is allowed only for favored groups and causes, and that seems in itself, unjust.

> The reason both sides talk past each other is because they have different values and different assumptions.

I think this is probably correct. So to rephrase my question, can a society with two big groups holding such divergent values survive? Or is it inevitable that is splits apart?

Re: Tribalism comes for pandemic science

#114

Earlier quoted context omitted.

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 da…

In my state we have leaders looking at data on county and zip code levels, and assigning "stages" to counties that affect how open the businesses can be, based off of how stable their numbers are looking. What's it like in yours?

Re: Tribalism comes for pandemic science

#115
post #107

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 right has been pretty consistent about tailoring the response according to risk Have we forgotten that "this is all a liberal hoax"? Remember HCQ is a cure-all? That's not being consistent--that's completely ignoring science. The right in the US has been consistent about tailoring its message to AI driven talking points that drive social media engagement. Nothing more. How about a "free market" solution? Give e…

This, and so much more of this.

Re: Tribalism comes for pandemic science

#116
post #97
post #43

Earlier quoted context omitted.

The main problem youi'll have with that is that many people assume that the value of a human life is infinite and we must expend all resources possible to save individuals. Neither of those makes for good economics, so folks who include economics and balanced risk into their equations often conflict with folks who want to take the "safest possible action with respect to human life".

The safest possible solution would be for the super wealthy pay to keep the population fed and housed while we wait for a vaccine or improved treatments. Otherwise, the virus will continue to propagate, the poor will have to risk their lives and the virus will inevitably reach the rich and their families in a later wave anyway as was the case with the 1918 flu. Addendum: I posted this fully understanding how unpopula…

I can't tell if this is sarcastic or not, but I will assume it is not.

It is not this simple. You can't, in our current system, shift wealth that readily and quickly. Even if you could, how would you approach possibly selling this in a democracy? And assuming it was feasible, and we could get popular support for it, how would it be implemented? Rationing cards? Government ran food stores?

This is NOT the Spanish Flu. It is very different in its behavior. There is currently no evidence to expect a more deadly, virulent second wave. Please remember that the Spanish Flu was anomalous because it had a more deadly second wave. Almost all viruses, as a function of evolution, become less deadly over time.

And this ignores all of the vast improvements in our understanding of sickness and hygiene, our availability of clean, sanitary conditions etc. Hell, even the change in density between 1918 and 2021 is massively changed.

Re: Tribalism comes for pandemic science

#117
There's almost certainly a lot of safe opening up we could do. What would make it dramatically safer would be pro-social behavior from people on the right. The protesters are all wearing masks and doing their best to maintain social distance outside of the actions. They calculate that it is worth the risk. Time will tell, but the calculus isn't merely do the protests increase the spread? but also will they achieve political goals that have a large bearing on public health, specifically the health of people whom the US Coronavirus response is already systematically failing (black people, whose lives matter).

Re: Tribalism comes for pandemic science

#118

Earlier quoted context omitted.

This is nuts. Large portions of the response were absolutely in the hands of the Federal government, which failed catastrophically. These range from the elimination of our pandemic response team [0] to the early testing debacle, which resulted from bad tests distributed by CDC (and early failures to scale up private testing using Federal powers and expedited FDA approval) [1], to the lack of coordination between stat…

I totally agree with you, that the Federal response was pretty terrible. And I understand and am aware of the topics you provided. However, that does not change where we are today. It would have probably helped us get to "today" a lot earlier, and it would have probably saved many, many lives which were unfortunately lost. But my argument is how we respond _today_ to new information, and how the partisanship endemic…

> If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did.

I don't know how to respond to that - I technically agree with you, the loudest least educated voices probably wouldn't have wanted to lock down. The lack of info and the panic level probably positively contributed to saving more lives. I'm totally okay with that. I believe that knowing then what we know now, we absolutely should have done what we did, and then some. We didn't have enough testing capacity. We know that if we had locked down even earlier, we would have saved a significant number of additional lives.

It's true that part of the argument was based on hospital capacity. But the models today are still consistent with the view that the capacity in many areas would have been overwhelmed in many places had we done nothing. I think the key there is that civilians were going to "do something" and stay at home even if the government didn't tell them to, no matter what.

> But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science"

It's best to step away from that kind of absolutist language (none, all) - it just tends to bait people.

Re: Tribalism comes for pandemic science

#119

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 o…

I don't think number of deaths (from whatever cause) was the primary point of the post you're replying to. The concern is pretty clearly the destruction of trust, the widespread lack of logical consistency amongst people we're supposed to defer to due to their expertise, etc.

Re: Tribalism comes for pandemic science

#120
post #40

There are times I'm glad I left health science/biology/medicine as a field and it's interesting to watch people slowly realize just how badly structured the entire human health field is organized (from academic research to research hospitals to profit hospitals to world health organizations) and how all the incentives are messed up. The closer you get in biology to human health, the more ego, tribalism, and assholery…

I will second this as I am currently working in the biotech field. The amount of short sighted thinking and opportunism from small start ups to the most massive CMO's in the world is staggering.

My take is that the whole field is extremely underfunded and that breeds levels of competition and short term profit seeking, but that's probably a biased opinion.

I'm sure if the field had the level of VC support that traditional software/computing gets we would be making huge strides with our humanity.

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