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A case for ending lockdown

ryankemper.io

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Re: A case for ending lockdown

#361

Post by pinkfoot »

ryankemper wrote: post #336
pinkfoot wrote: post #294

Earlier quoted context omitted.

Why is a intelligent, qualified, experienced team of epidemiologists "only in a position to identify the (medical) benefits of the lockdown and not the costs." After all, you were able to recognise both parameters?

Epidemiologists are not equipped to understand the economic ramifications that occur when large portions of society are forced to halt their business operations. This seems self-evident. Public policy wrt Covid basically occurs at the intersection of epidemiology and economics. The epidemiologists can help tell you what will happen under different scenarios, and the economists can tell you what will happen economical…

They aren't, but you are. Right

Re: A case for ending lockdown

#362

Post by ryankemper »

Balgair wrote: post #349
ryankemper wrote: post #333

Earlier quoted context omitted.

So, I've read the article, and it seems to not support this assertion of yours: > TLDR: We're undercounting deaths due to covid-19 by ~60% nationally, and 40% in NYC. What it does say is this: > “Thus I would probably add about 15% or so to the known death toll,” she wrote to two city officials. “However — no city or state will be factoring this in or reporting it, so I don’t think we should either. We should just as…

See Figure 3. I was off, Nationally were underreporting ~47%, NYC is at ~60%. We can argue the pictures and stats in the Washington Post all day long. But either way, we're likely to be underreporting. Also, though not directly due to the virus itself, the 'avoidable' deaths are kinda due to the pandemic and an over-response-ish factor. This thing is going to take decades to sort out. Kinda like how people that die f…

I see, I think my point of contention was that it's not accurate to say that these are necessarily undercounted covid deaths. That hasn't been proven.

I do agree however that it is very likely that the majority are.

> Also, though not directly due to the virus itself, the 'avoidable' deaths are kinda due to the pandemic and an over-response-ish factor.

Right, the distinction is if they would have occurred in an environment where we weren't locking down and suspending elective surgeries in places that weren't hard-hit. In a place like New York we should definitely assume that the capacity wasn't there until we have evidence otherwise though, so that would be a region where we certainly could not blame overreaction.

Thanks, I'll try to think about this more later on.

Re: A case for ending lockdown

#363

Post by ryankemper »

grumple wrote: post #350
bagacrap wrote: post #329

Earlier quoted context omitted.

the intent of the lockdown measures was to reduce peak need to just below hospital capacity and no more . Reducing it further only increases the duration of lockdown and all its deleterious effects on public health . We did not come anywhere close to healthcare capacity, and what now? We just stay locked down forever? Your argument for lockdown is unfalsifiable. Any good outcome is attributable to lockdown, and any b…

> Your argument for lockdown is unfalsifiable. If you want to get down to epistemological arguments, then we should be clear: we can't know ANYTHING about the real world for certain and all no claim about the natural world is falsifiable; the only claims we can make are those that are tautological or conceptual only. The scientific method itself does not stand on anything more than epistemological sand. Obviously, th…

> This is what a large number of domain experts (including data scientists with domain knowledge) have been doing, and they believe the lockdown has been necessary (and will continue to be, at least in part).

I believe you, but can you cite some domain experts so that we have something to work off of?

Re: A case for ending lockdown

#364

Post by ryankemper »

pinkfoot wrote: post #361
ryankemper wrote: post #336

Earlier quoted context omitted.

Epidemiologists are not equipped to understand the economic ramifications that occur when large portions of society are forced to halt their business operations. This seems self-evident. Public policy wrt Covid basically occurs at the intersection of epidemiology and economics. The epidemiologists can help tell you what will happen under different scenarios, and the economists can tell you what will happen economical…

They aren't, but you are. Right

Thus why I don't engage in gatekeeping. I'm just pointing out the obvious hole in your view.

There's no hole in my view because I believe that experts are right more often than not, but I also believe that they can get things wrong, or fail to see the ramifications of certain policies.

Thus why so much of the discussion seems to be optimizing for a single variable - COVID-19 deaths - while ignoring plenty of other dimensions that we care about (deaths from all causes in the long run, quality of life, etc).

In particular quality of life is absolutely missing from the analysis in many who claim that the lockdown is justified.

Re: A case for ending lockdown

#365

Post by ryankemper »

scott_s wrote: post #209
ryankemper wrote: post #108

Earlier quoted context omitted.

Out of curiosity, to what extent do you feel we successfully flattened the curve in New York? Given that recent serology results showed between 15-20% prevalence, it does seem like it could have been significantly worse. But just to be clear we should note that we ended up having a massive excess of capacity as far as ventilators and beds were concerned (I'm guessing the real bottleneck is trained staff but am not su…

I am unaware of a "massive excess of capacity" in NY; quite the opposite. Where do you make that conclusion from? NY, to my knowledge, has been well over capacity and has had to take severe measures. Hospitals have had more patients than they can deal with and the staff is overworked. Elective procedures have been cancelled, no visitors are allowed, doctors and nurses who ordinarily work elsewhere are working in Covi…

By massive excess I was referring to vents/tents. Estimates of vents needed were far too high due to the models being relied upon (i.e. not because we surprised ourselves with how flat the curve got given the seroprevalence was not expected from policymakers as far as I can tell).

Still, I _don't_ know about how we are doing in terms of healthcare workers. That's almost certainly the bottleneck and it may be that it's still a bottleneck. I'd have to do some research to say for sure. It's very possible my statement was not correct in that light.

Meta: I'm currently constrained to using one arm since I had a not-so-fun ER visit today, so I'm not really firing on all cylinders right now. So, if you happen to look into the NY capacity matter on your end, I would love to hear your findings.

Re: A case for ending lockdown

#366

Post by ryankemper »

shkkmo wrote: post #357
ryankemper wrote: post #342

Earlier quoted context omitted.

> Credentials are not the only way to acquire or demonstrate expertise. You say you are a "dude that likes to read research papers", how many epidemiological research papers have you read? How much time have you spent discussing those papers with epidemiological experts? Did you reach out to any of those experts to have them take a first pass as fixing any mistakes you made before you decided to post it publicly > In…

> This is not a fair characterization; I was very clear that this represented my "first draft" and that I was looking for feedback specifically to have people poke holes in it. Where was this made clear? The closest I can see is at the very end where you call it a living document and will accept pull requests that match the "style and intentions of this document" which to me sounds like you are only interested in mee…

Okay, I half concede your point. I expressed the desire to have holes poked in my top-level comment contextualizing HN submission / thread comments itself, but did not make clear reference to it in the document itself. So the external dependency means that you are by-and-large correct.

The part I don't concede is this notion:

> Instead you decided to broadcast your ignorance with confidence about an area already ripe with misinformation that is costing people their lives.

In that, it strays far too close to the dangerous notion of "advocating for ending the lockdown, however flawed, is killing people". Which is a notion I cannot and probably never will be able to get behind.

Re: A case for ending lockdown

#367

Post by ryankemper »

mdemare wrote: post #332
ryankemper wrote: post #328

Earlier quoted context omitted.

That's the case fatality rate, not the infection fatality rate. As you can see in your quote, I was talking about IFR. In general - and this is a theme of the writeup BTW - we should be looking at IFR and not CFR. With IFR we can reasonably extrapolate how many deaths we'll have before new infections halt, whereas CFR is borderline impossible to use because we'd need to know how many cases we would expect per infecti…

That article is from early March. It’s May now, no need to estimate anymore. I agree that CFR is fairly useless. But if you test everyone, as was the case on the Diamond Princess, IFR = CFR.

Ah, I see. You are completely right. Thanks for pointing that out.

Re: A case for ending lockdown

#368

Post by ryankemper »

UncleSlacky wrote: post #233
hkai wrote: post #201

Earlier quoted context omitted.

I've read the whole thing and I have these comments: - I think the part about the freedoms is unnecessary because I feel the vast majority of the pro-lockdown people do not share your enthusiasm for freedom and public discourse. While your main argument may shift their opinion, the part about liberty may cause them to stop reading and discard your other arguments. - I think some claims would sound more persuasive if…

I laughed at this: > Other countries do not even have the concept of freedom of speech/assembly embedded into their founding documents. as it was clear that the author hadn't done any research on this - many countries explicitly or implictly have these in their founding documents.

Circling back:

https://gitlab.com/ryankemper/writings/-/commit/6daa56a4a05f...

Re: A case for ending lockdown

#369

Post by fluffything »

pbhjpbhj wrote: post #325
fluffything wrote: post #238

Earlier quoted context omitted.

In the EU there are graphs showing the "daily deaths / day" over the last 2 years. One can pretty easily see the impact of COVID-19 there, even on countries that are not testing and therefore not reporting any cases... Unfortunately I haven't been able to find that data for the US.

https://www.worldometers.info/coronavirus/country/us/ They include "deaths per day" in one of the charts. Early on I found their stats to be consistent with other trusted sources; but I've not confirmed that recently.

That only counts "deaths of COVID-19 positive people".

For countries that don't test, that number is zero. Quite the useless metric to report.

Much more meaningful would be: "(actual deaths/day) - (avg deaths/day of 2019)"

Re: A case for ending lockdown

#370

Post by lbeltrame »

pinkfoot wrote: post #361
ryankemper wrote: post #336

Earlier quoted context omitted.

Epidemiologists are not equipped to understand the economic ramifications that occur when large portions of society are forced to halt their business operations. This seems self-evident. Public policy wrt Covid basically occurs at the intersection of epidemiology and economics. The epidemiologists can help tell you what will happen under different scenarios, and the economists can tell you what will happen economical…

They aren't, but you are. Right

Well, the problem that at least where I live the experts make statements on public policy outside their domain (e.g., organization of public transport) that are barely practical, if not down right impossible to carry out.

OTOH, someone well versed in economy but not in epidemiology or medicine would fail to understand some of the health implications of the current epidemic.

It's not a problem per se, but that's where the discussion on public policy comes in, weighing all the opinions from the stakeholders, then making a decision (right or wrong, but taking responsiblity for it).

That's why I'm wary of statements like "we will reopen when the scientists say so": it's a deflection of responsibility (they don't carry the burden, rightly so, for their decision, but politics does), and for the politics, a serious step back from its duties.

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