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…
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.
Covid-19: the harms of exaggerated information and non‐evidence‐based measures
71–80 of 462 posts
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#72Earlier quoted context omitted.
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…
Italy was one of the first countries to ban flights from China. Fat lot of good it did. But I agree that there should have been a stronger reaction, in terms of testing / tracing / isolating.
No "panic" enough.
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#73Ioannidis 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…
But today, governments are responding in the typical fashion of responding to pandemics. Closing borders and quarantines are precisely the measure that dampens the more frequent so-called "superspreader" events, and social distancing is the exaggerated response that decimates the potential impact of these "superspreader" events.
It's obvious and unfortunate that the authors didn't do their research on public health policy, since public health advisors and experts actually already knows the right measures to take; it's a matter of convincing the decision-makers that this is the right way to respond to a new pandemic rather than the risk-assessment models that were tailored to more frequent events.
> Ioannidis' approach fails: "Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission..." [3] Authorities were looking for evidence before taking any action.
I don't think this is the right conclusion. I think many flu strains occasionally transmit from animal to humans, but fail to spread from human to human, and imposing drastic measures upon this is too much of an overreaction, since they aren't usually much worse in public health impact than the seasonal flu. On the other hand, as soon as there is a spike of cases in a local area, that is enough evidence to be wary. That tweet just reads like a poor excuse by Chinese officials that doesn't make sense, something that the rest of the world have come to expect from them.
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. He is advocating for better evidence to be published with higher standards, so that if this pandemic is actually less dangerous than it actually is, decision-makers would continue to trust the public health experts to make decisions should a worse pandemic come about.
[1]
e.g.
> Standard individual-scale policy approaches such as isolation, contact tracing and monitoring are rapidly (computationally) overwhelmed
Computationally ???
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#74Earlier quoted context omitted.
China quarantined 700 million of its citizens for fun and it still killed thousands. I'm sure that they regret the policies they implemented right now as they've finally gotten a hold of the outbreak. Edit: I was being sarcastic here. China messed up the initial response but their draconian tactics worked well.
Yes, only thousands. The point of the quarantine was to avoid deaths of millions. China has flattened thoer curve, no one else has.
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#75Earlier quoted context omitted.
Risk management is the correct way to go when uncertainty is high. Containment was the correct approach at the time. When evidence starts coming in, then you can start applying evidence based approaches. > Mortality rate: Mortality and morbidity rates are also downward biased, due to the lag between identified cases, deaths and reporting of those deaths [1] > Among 3,711 Diamond Princess passengers and crew, 712 (19.…
Right, so do the math. 5% of positives required intensive care. If 197 million Americans get this, That means 10 million people go to intensive care. There are 60,000 ICU beds in the U.S. If 10 million people need the ICU, effectively none get a ventilator and they all die. Now it's true that the cruise ship passengers skewed significantly older, but on the other hand, they were all ambulatory and healthy enough to b…
While yes this is true technically, I'm not sure the bar for "healthy enough" is as high as you're making out it is. In my experience (apologies for the anecdote), significantly obese people are quite capable of going on a cruise almost always.
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#76Ioannidis 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…
I find Taleb's argument specious. The risk inherent in a reaction can be pretty catastrophic as well; for example we are now seeing some project 20%+ unemployment in the next quarter. In addition, we do have data on the possible harms from Coronovirus, since we have more CFR data at this point. This puts bounds on possible harms. For more detail see John's other article in statnews. The results of the Diamond Princes…
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#77Earlier quoted context omitted.
Risk management is the correct way to go when uncertainty is high. Containment was the correct approach at the time. When evidence starts coming in, then you can start applying evidence based approaches. > Mortality rate: Mortality and morbidity rates are also downward biased, due to the lag between identified cases, deaths and reporting of those deaths [1] > Among 3,711 Diamond Princess passengers and crew, 712 (19.…
Right, so do the math. 5% of positives required intensive care. If 197 million Americans get this, That means 10 million people go to intensive care. There are 60,000 ICU beds in the U.S. If 10 million people need the ICU, effectively none get a ventilator and they all die. Now it's true that the cruise ship passengers skewed significantly older, but on the other hand, they were all ambulatory and healthy enough to b…
Also you can't conclude much of anything based on a linear extrapolation, even if you have good data.
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#78Common 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.
(When the curve was way past SARS-CoV-1 outbreak.)
Correct data-driven measures have been taken somewhat too late.
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#79Ioannidis 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…
I find Taleb's argument specious. The risk inherent in a reaction can be pretty catastrophic as well; for example we are now seeing some project 20%+ unemployment in the next quarter. In addition, we do have data on the possible harms from Coronovirus, since we have more CFR data at this point. This puts bounds on possible harms. For more detail see John's other article in statnews. The results of the Diamond Princes…
Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures
#80Ioannidis 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…
I find Taleb's argument specious. The risk inherent in a reaction can be pretty catastrophic as well; for example we are now seeing some project 20%+ unemployment in the next quarter. In addition, we do have data on the possible harms from Coronovirus, since we have more CFR data at this point. This puts bounds on possible harms. For more detail see John's other article in statnews. The results of the Diamond Princes…
Also, how hard is it to understand that if Taleb's argument was turned into action on January 26th (57 days ago!) the number of people being impacted would be an much smaller fraction of what it is today?
Also, today we have a virus that is "only" killing 1% of its people, and you seem to be okay with it. What about the next ones? Do you think we should take a "wait-and-see" attitude for the next epidemic that might turn out to kill 5% of the infected? What if it turns out to kill 10%?