COVID topic vol 2

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tonyedgecombe
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Re: COVID topic vol 2

Post by tonyedgecombe »

jacob wrote:
Mon Nov 16, 2020 3:11 pm
Therein lies the problem of specialization.
To be fair to Chris Witty he does have several post graduate economics qualifications and likes to dabble in economics in his spare time.
jacob wrote:
Mon Nov 16, 2020 6:28 pm
For COVID it's the unwillingness to admit wanting to sacrifice the freedom of the old for the freedom of the young so instead [the dichotomy] becomes economics vs health.
At least in the UK we are turning into a gerontocracy, we have a government run for old people. I can see this becoming a big problem in the developed world as there is nothing more resistant to change than a septuagenarian and we are creating a lot more of them.

Hristo Botev
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Re: COVID topic vol 2

Post by Hristo Botev »

Riggerjack wrote:
Mon Nov 16, 2020 6:49 pm
Harder still, when the variables get filled in by experts in crossword puzzles. :shock:
I saw that! Problem is, “fauci” makes for such a useful crossword answer—so many vowels; it’s like why I see “melee” in every other cw I do.

7Wannabe5
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Re: COVID topic vol 2

Post by 7Wannabe5 »

“nomadscientist” wrote: like family formation
Is that what the kids are calling it these days? :lol:

Seriously, I am at high risk and my 80 year old mother is at even higher risk, so I have only visited with my DD29 twice and my mother once and my DS32 zero times since March, and we wore masks. Therefore, I don’t fret about my adult kids and how tight or loose they are keeping their pods for my benefit. However, the problem with simple trade off of freedom between the old and the young is that the old are often already hobbled in that regard. Many senior citizens, including my mother, live in situations of semi-independence. They need helpers to do their cleaning, cooking, laundry or they need regular medical visitations. They can’t isolate themselves as completely as an independent middle aged asthmatic like myself, so rising levels of infection in the general population will increase their risk and likelihood of earlier death.

UK-with-kids
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Re: COVID topic vol 2

Post by UK-with-kids »

jacob wrote:
Mon Nov 16, 2020 6:28 pm
I wonder how much of the SNAFU is due to humans not wanting to have that uncomfortable conversations that nature is increasingly forcing us to have. I happen to think that drives most of the conversation.

For COVID it's the unwillingness to admit wanting to sacrifice the freedom of the old for the freedom of the young so instead [the dichotomy] becomes economics vs health.

For CC it's the unwillingness to admit to sacrificing the welfare of future generations for the welfare of Boomers and GenXers so instead it becomes about whether the science is true.

Humanity just keeps finding a way to type-cast individual/tribal interests into simplistic frameworks no matter how fundamental.
There's a lot of truth in this, although perhaps it's not just humans not wanting to have the conversations, but western democratic structures disincentivising politicians from speaking the uncomfortable truths that might swing the next election against them? Or maybe it isn't that at all - the Netherlands managed to take long-term action against tidal flooding, whereas China isn't particularly interested in stopping climate change for example.

I'd also say the reality that isn't being faced up to is more basic than old versus young and economy versus health - after all, we're all young at some point in our lives. A couple of realities spring to mind:

1. Human mortality rate = 100%
- The longer we manage to keep elderly and/or unhealthy people alive, the higher the cost (which young people have to work harder to fund) and the higher the risk becomes that lots of people will die all at once if something quite minor comes along. For the majority of Covid victims we're talking about people who've reached the stage where they'd probably die just from falling over.

2. Risk remains >0%
- The more we try to eliminate all risks, the more shocking they become when events catch up with us. Kids being exposed to fewer germs in childhood. Safer roads that try to eliminate the human error factor. Clothing the elderly in impact detecting airbags using technology borrowed from cars. And now almost the whole population being kept apart to stop diseases spreading. I think we can all see the potential adverse consequences of all this, even if all the individual measures seem to make sense at the time.

nomadscientist
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Re: COVID topic vol 2

Post by nomadscientist »

chenda wrote:
Tue Nov 17, 2020 4:12 am
What would you do instead ? If you were benevolent dictator.
Given where we are, I would have ended the social restrictions several months ago as not cost* effective. Specific interventions to support shielding high-risk persons would probably remain cost effective. Essentially, the Great Barrington Declaration.

The pandemic could also have been shut down cost effectively early by imposing quarantine on all** inbound travelers.



*holistically, i.e. peoples' unhappiness is also a "cost" even though it doesn't subtract from GDP

**politicians still don't get this, e.g. the UK government recently restricting entry of some(!) people from Denmark on the basis of the mink covid mutation. If this mutation bypasses all acquired immunity and current vaccines it will spread to every country and enter the UK just as easily. I can't tell if this dumbass intervention is a deliberate Machiavellian play to appear to be doing something while doing nothing, or a simple reflection of policy made by dumbasses. I guess a misinformation spreader could suggest they want mink covid to spread everywhere to keep this charade going forever...

tonyedgecombe
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Re: COVID topic vol 2

Post by tonyedgecombe »

nomadscientist wrote:
Tue Nov 17, 2020 10:19 am
Given where we are, I would have ended the social restrictions several months ago as not cost* effective. Specific interventions to support shielding high-risk persons would probably remain cost effective. Essentially, the Great Barrington Declaration.
Then what are you going to do in a years time when the virus has mutated and we have all lost immunity. The Great Barrington Declaration is riddled with problems. Meanwhile the health service would be completely overwhelmed. People who could survive it under normal circumstances would die or become incapacitated because the medical system is unable to cope. Are you going to shield all over 55s because that doesn't sound particularly feasible.

Herd immunity is a tool for modelling, not a strategy.

UK-with-kids
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Re: COVID topic vol 2

Post by UK-with-kids »

tonyedgecombe wrote:
Tue Nov 17, 2020 2:35 pm
Herd immunity is a tool for modelling, not a strategy.
Actually herd immunity is a scientific and mathematical fact - it's what has happened when the disease can no longer spread through the population due to immunity which has been acquired for whatever reason, including from vaccines.

If the virus is going to mutate so much that human antibodies (and T cell immunity) don't last then vaccines will have the same problem. So we would need either a clever new type of vaccine that still works against most mutations (maybe some of the candidates are exactly that), or failing that an annual vaccine program like we have for flu.

nomadscientist
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Re: COVID topic vol 2

Post by nomadscientist »

tonyedgecombe wrote:
Tue Nov 17, 2020 2:35 pm
Then what are you going to do in a years time when the virus has mutated and we have all lost immunity.
If that happens what is the merit of anything we are doing? As I understand it the idea of the current policies in Western countries is to minimise deaths before a vaccine. A mutation eliminating immunity would be just as devastating to that strategy, rendering current vaccines worthless.

If your idea is to preserve these measures forever, then my position is that it is preferable to accept the life expectancy loss from the disease. I expect this is consistent with ordinary public health calculations carried out without political pressure to overweight this particular risk.

People who could survive it under normal circumstances would die or become incapacitated because the medical system is unable to cope.
I don't see any evidence that outcomes are significantly altered by intensive medical interventions. If we were faced with say 1% survival without ICU, 99% survival with ICU, then I could see a case for this (but it would also be a case for artificially increasing spread during the troughs, which we didn't do). I expect it's more like 10% vs 12%.

Are you going to shield all over 55s because that doesn't sound particularly feasible.
I'm not going to shield anyone. It would be option just as eating right and exercising is an option. The state may assist to the extent such assistance is cost effective, just as it funds stop smoking programmes to some extent but not to the extent of redirecting all society's resources to stopping smoking.

Crusader
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Re: COVID topic vol 2

Post by Crusader »

More good news:

https://www.nytimes.com/2020/11/17/heal ... unity.html

Immunity to the Coronavirus May Last Years, New Data Hint

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Ego
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Re: COVID topic vol 2

Post by Ego »

Crusader wrote:
Tue Nov 17, 2020 9:45 pm
Immunity to the Coronavirus May Last Years, New Data Hint
What a remarkably drastic swing of the pendulum.

classical_Liberal
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Re: COVID topic vol 2

Post by classical_Liberal »

I had always assumed the powers that be were telling the general public they may not be immune to underscore the point that immunity does not mean reinfection is impossible. IOW, reinfected enough to still shed virus and infect others, but not actually get sick the second (or third) time around in exposure.

I didn't realize anyone was seriously considering that the adaptive immune system was ineffective against COVID. I mean, if it was, vaccinations wouldn't work. This COVID social phenomenon is very weird. Medical science is fine when it serves the purpose of fear, but not when it doesn't? Anyway, at least, it seems, cooler heads are prevailing now wrt medical knowledge behind adaptive immunity. This could mean titers will be accepted in lieu of immunizations, as they are for other infectious diseases that don't shift and drift.

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Ego
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Re: COVID topic vol 2

Post by Ego »

@cL, while science - for good and bad - killed the Noble Lie of religion, Covid has show how the internet has eliminated the ability of scientists to tell their noble lies. In part by revealing the lie and in part by revealing the lack of nobility.

CS
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Re: COVID topic vol 2

Post by CS »

The people screaming "it's not real" right up to their death from it is a fascinating piece of human psychology. The quote I remember most from the article is "They stop screaming when you intubate them."

Of course, if they had to intubate them, they couldn't have been screaming that loudly.

On the other hand, my mother has cut me some slack now for my frustration with dealing idiots, aka people.

Edit - @Ego, what do you mean by that for scientists? I can't imagine someone truly interested in science politicking like a religious leader. The locus of control is different. Religious leaders = want control of other, scientists = want 'truth' for themselves.

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Ego
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Re: COVID topic vol 2

Post by Ego »

@cs, cL posted what he believed was a noble lie above regarding adaptive immunity. The mask lies told when people were hoarding masks was another. There have been so many examples during Covid that it is prudent to assume every public facing official is telling what they believe to be a noble lie and attempt to read between the lines to divine the truth

Regarding lack if nobility, Neil Ferguson spending time with his girlfriend after he was responsible for forcing everyone else into lockdown was one small example. Omnipotent decision makers profiting from their mandates is another.

jacob
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Re: COVID topic vol 2

Post by jacob »

The Noble Lie works when told to the "unconsciously incompetent". However the "consciously incompetent" realize that there's some game going on only they don't know what it is [due to their lack of competence]. Disinformation (alternative facts, conspiracy theories) is best targeted at this (C-I) group and the usual approach is to generate the impression of uncertainty: "I don't know; Nobody knows".

This predicament seems to describe several modern issues that the "training of senior administrators", who are used to relying on some hierarchy of expertise, hasn't quite caught up with yet.

Unconsciously incompetent and consciously incompetent used to describe 99% of humanity. The previous arranged was to defer to experts. However, now it has been replaced with "doing me research on teh google" which many think is better because they prefer to "make up their own mind" (another word for the dopamine rush of confirmation bias :-P ).

Either way ... you gotta appreciate how difficult it is to craft a public message that gets an entire population to behave in a homeotelic way.

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Ego
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Re: COVID topic vol 2

Post by Ego »

@Jacob, what you say is true but there is a shortcut in determining what the experts and those in power really believe.

You may be the only person i know who adhered to his stated beliefs wrt covid and didn't attend a friends birthday party at the French Laundry, for instance. Do as I say, not as I do... does not work in a world where everyone can see for themselves what a person actually does.

As I've said before, actions speak louder than words.

And for the record, I don't believe there is some great conspiracy. Covid is deadly for some, harmful for others and harmless for most.

Lemon
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Re: COVID topic vol 2

Post by Lemon »

nomadscientist wrote:
Mon Nov 16, 2020 1:28 pm
To my mind he answers these questions like any politician, starting from the very first answer*. More consequentially, his statement that mortality varies "slightly" with age is both false and grotesquely dishonest.

*an independent scientist would've said something like "I'm fine, not that it matters." Both through the mindset, and actually being in a position to not care what anyone thinks of him. This guy is courting a positive public image, and he does it so slickly it's surely deliberate.
I think this is completely uncharitable. He is the CMO. Recognising that his colleagues are working flat out is part of leadership and that is a totally legitimate answer. This is also someone who has worked on the coal face for years, prior to this role he was still doing acute on calls. I would be unimpressed with a scientist that didn't recognise their colleagues when given a platform.
nomadscientist wrote:
Mon Nov 16, 2020 3:21 pm
The UK system (""death panel""/socialised medicine) already judges efficacy of medical interventions generally by the DALY measure (cost per Disability Adjusted Life Year saved) on a national basis, so I don't see any cultural or other difficulties in judging corona interventions by the DALY measure either. It's the standard measure and there would have to be an extraordinary reason to not use it*.

I do not see any DALY calculations justifying the current measures. It seems likely that they would not justify the current measures even given a large range of uncertainty**.

I also do not see any attempt to quantitatively limit the uncertainty in either the "DALYs saved" or the "cost" components of the calculation.

Instead I see curation of facts to justify the current measures endlessly (even, increasingly, attempts to justify them past the end of the pandemic). Chris Witty does not talk like a narrow specialist who refuses to answer non-technical questions outside a narrow range. He talks like a politician intending to make a bundled package of decisions sound appealing to the audience.

The reality is we do not hear anything from working scientists. We hear from science administrators who have been filtered by multiple promotion gateways for political outlook and aptitude.

**for example, it's far gone beyond a simple tradeoff of "health vs economy", a dichotomy that both imposes ideological factions on each view and also paints one as the bad guy; it's disrupting all sorts of non-monetary functions like family formation that are ultimately far more important to most people than either monetary or health considerations.
1) We don't use DALYs we use QUALYs. Which are similar but different.
2) He isn't a 'narrow specialist' and has worked extensively in other epidemics and also isn't the only person calling the shots SAGE includes come economists too and there has been a recognition they were initially underrepresented.
3) I have no idea what you mean by hearing form working scientists because we do in the form of publications and increasingly pre prints.
4) He literally says it isn't a tradeoff between health/economy and both are intertwined. There has also been mentions on mental health and long term impacts of closing schools from the beginning to. It might not be perfectly balanced but these are things that are hard/impossible to measure and haven't needed to be measured in a situation like this before, ever.
nomadscientist wrote:
Tue Nov 17, 2020 3:36 pm
If that happens what is the merit of anything we are doing? As I understand it the idea of the current policies in Western countries is to minimise deaths before a vaccine. A mutation eliminating immunity would be just as devastating to that strategy, rendering current vaccines worthless.

If your idea is to preserve these measures forever, then my position is that it is preferable to accept the life expectancy loss from the disease. I expect this is consistent with ordinary public health calculations carried out without political pressure to overweight this particular risk.

I don't see any evidence that outcomes are significantly altered by intensive medical interventions. If we were faced with say 1% survival without ICU, 99% survival with ICU, then I could see a case for this (but it would also be a case for artificially increasing spread during the troughs, which we didn't do). I expect it's more like 10% vs 12%.
The current polices are to stop healthcare overwhelm and yes to avoid excess deaths, but that isn't just COVID deaths. The exit strategy being vaccine currently, but decent drugs/therapies would be another.

In terms of medical interventions we now know in those on Oxygen Dexamethasone drops mortality by 30% so, no healthcare now is ATLEAST that lethal in terms of survivability odds. That doesn't include O2 itself or any ICU stuff.
jacob wrote:
Mon Nov 16, 2020 6:28 pm
I wonder how much of the SNAFU is due to humans not wanting to have that uncomfortable conversations that nature is increasingly forcing us to have. I happen to think that drives most of the conversation.
Oh absolutely. It happens in health all the time too.
jacob wrote:
Wed Nov 18, 2020 1:42 pm
Unconsciously incompetent and consciously incompetent used to describe 99% of humanity. The previous arranged was to defer to experts. However, now it has been replaced with "doing me research on teh google" which many think is better because they prefer to "make up their own mind" (another word for the dopamine rush of confirmation bias :-P ).
But it works so Well!

nomadscientist
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Re: COVID topic vol 2

Post by nomadscientist »

I deleted a long reply to Lemon, because I am not sure it is useful.

The key question is whether on a reasonable estimate according as much as possible to pre-pandemic standards (granting some estimates will involve large uncertainties) the cost efficiency of these interventions would fall within the previously acceptable range. As far as I am aware, SAGE has not done this, and other non-Asia-Pacific industrial countries have not either.

On other points, such as the duty of the CMO to do public and staff relations, or DALY vs QALY, I concede.

Campitor
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Re: COVID topic vol 2

Post by Campitor »

jacob wrote:
Wed Nov 18, 2020 1:42 pm
... The previous arranged was to defer to experts. However, now it has been replaced with "doing me research on teh google" which many think is better because they prefer to "make up their own mind" (another word for the dopamine rush of confirmation bias :-P )...
I can't blame the average layman for wanting "DA GOOGLE" for several reasons:
  1. Those with intellectual depth and expertise are sometimes politicized.
  2. Google portrays itself as the modern Oracle of Delphi and arbitrator of truth. The reality is they will feed us whatever keeps us using Google. If you love tinfoil hats then tinfoil hat search results will be happily supplied.
  3. The cost of expertise is high in money or time or both.
  4. The good stuff is often behind paywalls.
  5. There's no roadmap to expertise without a robust intellectual/expert to point the way otherwise bullet# 1 & 2 applies. Some people can be self taught but it requires an exceptional individual to self educate in a manner that produces a deep understanding and mastery of a complex subject.
  6. Most of American education is centered on listening to those in authority ergo anyone perceived as an authority becomes you're echo chamber of choice.
  7. Independent thinking via vigorous questioning is discouraged.
  8. Listening to opposing viewpoints is discouraged.
  9. Strawman attacks are SOP for even the smartest among us - we focus on the personality and not the facts.
  10. Pareto

Lemon
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Re: COVID topic vol 2

Post by Lemon »

@nomadscientist

That sort of thing has so many variables it is inevitably political, which is what politicians are for.

There have been talks about trying to value these sorts of things, but it is essentially a new way of looking at this sort of problem, not surprising given it is pretty unprecedented.

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