Discussions of Book of Mormon issues and evidences, plus other topics related to The Church of Jesus Christ of Latter-day Saints.

Saturday, April 25, 2020

Science-based vs. Faith-based Policies for Coping with the Corona Virus

Are we using faith or science to cope?
Though I am open about my faith and often welcome steps that allow faith to play a more visible role in society, I prefer to let faith be a personal matter and not a basis for government policies. Unfortunately, I fear that an abundance of faith,, perhaps even blind faith, is behind many policies and plans being pursued by government leaders these days, especially when it comes to dealing with the novel Corona virus. 

Here in Wisconsin, we have a popular governor, Tony Evers, who is a man of great faith. His faith was on display in his recent announcement that Wisconsin's "Safer-at-Home" slockdown policy would be extended for at least another month. In a touching and poignant expression of his faith, Governor Evers said:
"I want to be honest with you folks, things won't get back to normal until there's a vaccine and treatment for this disease and even then our new normal will not be the same as our old normal," Evers said. "This will be a slow and gradual process."
I fully support Governor Evers' right to have faith that unpredictable future events may happen, even miraculous ones. I would love to have a successful cure and a safe, effective vaccine, preferably both. But my personal faith on this matter is not as strong as his.

This novel Corona virus, which is closely related to the old-fashioned Corona viruses that have been part of the viral group causing common colds for millennia, might be conquered in a year or two with a vaccine. If so, we'll have yet another reason to shout hosanna (be sure to use a white Kleenex tissue instead of a handkerchief for that occasion)! But we can't base that hope on a reliable prediction grounded on firm science, only our faith in what might happen, if we are very lucky. 

Scientists have not been able to develop successful vaccines or cures for the common cold after all these decades of trying. Scientists have been working on a vaccine for HIV for almost 40 years. We are closer than ever and perhaps need to keep spending money based on the belief that a vaccine will solve that problem, and this could happen, but so far our faith has not been rewarded. Fortunately, scientists have had much more success in developing vaccines for influenza, which have been administered to people since the 1940s. The faith-promoting success stories from the battles that science has won in fighting influenza with vaccines may (and even better stories for polio and other diseases) be the source of Governor Evers' deep faith that similar success might be seen with the novel Corona virus and COVID-19. But just how successful have influenza vaccines been? There is too much misinformation about vaccines on the web (I am not an anti-vaxer and have stayed current on many vaccinations, even getting several vaccine shots while I was in China), so let's turn to the US government's CDC website, "Vaccine Effectiveness: How Well Do the Flu Vaccines Work?":
  • Flu vaccination can keep you from getting sick with flu.
    • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2017-2018, flu vaccination prevented an estimated 6.2 million influenza illnesses, 3.2 million influenza-associated medical visits, 91,000 influenza-associated hospitalizations, and 5,700 influenza-associated deaths.
    • During seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
That's wonderful news. The 2017-18 flu season was perhaps the biggest in the past decade, but thanks to vaccines, 5,700 lives were saved and over 6 million people were prevented from becoming ill. Wonderful! Sadly, skeptics (there's always one in every crowd!) might try to cast doubt and create distraction at this point with cheap shots like, "Yeah, but how many people actually died from influenza that season? How many got ill anyway?" Fortunately, the CDC also has provided documentation on this so there's no need to turn to negative fake-news sites.  On the CDC's tersely titled page, "2017-2018 Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths and Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths Averted by Vaccination in the United States," we find the facts:
CDC estimates that influenza was associated with 45 million illnesses, 21 million medical visits, 810,000 hospitalizations, and 61,000 deaths during the 2017–2018 influenza season. 
Wait, 61,000 died? Over ten times as many as the lives saved? And 45 million still became ill? OK, not everyone gets the flu shot, but a flu shot is no guarantee of success. Not even close. One problem is that there are many viruses and viruses mutate. A vaccination based on one virus might not work on another strain. The CDC makes this point in its assessment of vaccine efficacy against influenza:
During seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
In other words, under favorable circumstances when the influenza virus that is circulating happens to be similar to the virus used in creating the vaccine, the risk of needing to seek medical help is reduced by about half. Will be any luckier with the novel Corona virus?

"Fortunately," you may say, "we're dealing with just one novel Corona virus, not a host of variants like we have with influenza, so there's no problem. One virus, one vaccine, one hope for all! That vaccine will work and will come on schedule, soon!" Thank you for that expression of faith. But please recognize that it is a view based on faith, not real science. Science might offer a different perspective. A study from one of the top universities in China, Zhejiang University in beautiful Hangzhou (one of my favorite cities in the world) examined the virus in 11 different patients in that city and found over 30 mutations. See "Coronavirus has mutated into at least 30 different strains new study finds" at The Jerusalem Post.

The large number of mutations that are probably occurring with this virus could make it more difficult to control with a vaccine. Even before this new data, Dr. William Haseltine for Scientific American explained why we really don't know if we can develop an effective vaccine for this disease. So how long do we need to keep roughly 30 million people unemployed? How long do we need to suspend the Bill of Rights and let governors exercise vast power over their people and decide which businesses can live and which must die? Well, how long has it taken to successful prevent and cure the common cold from other Corona viruses (and other families of viruses as well)? How long has it taken to cure AIDS with a safe, successful HIV vaccine?


We may see a miraculously swift and effective vaccine come out soon and be ready for widespread use in a year or two. But policies that rely on such hope are not really "science based," no matter what our politicians and medical celebrities tell us as they justify the need for more control and more spending, with more billions going to their friends in Big Pharma and Wall Street. 

At this point, you may be feeling your blood pressure rise and a wave of righteous indignation sweeping over you. "This fool sounds like he's about to question the wisdom of the lockdowns! They are working and saving our lives. He must be a vile person who doesn't care about other people and puts money over lives!" If so, please understand that this reaction is not based on the scientific method. In principle, at least, the scientific method does not lead scientists to become angry when someone asks if there is solid evidence to support an assumption. Science is based on questioning assumptions and considering new evidence to test our hypotheses. Science should welcome, not condemn, data that points to weaknesses in understanding, for that may be an opportunity to advance our knowledge, if the data is accurate. It is in the realm of faith, especially blind or immature faith or religious zealotry, where reasonable inquiries may cause believers to feel threatened or angry, and where the response is to shout down or denounce the infidel who dares ask questions. The "science-based" approach some people support may be more faith-driven than they realize.

It's an article of faith across much of our society that draconian lockdowns in the US and Europe are saving lives and are essential for coping with the virus. But do we really have data to support that? Yes, it's logical that social distancing will reduce the rate of spread of the disease. But Americans were already taking extensive steps to do social distancing on their own before the lockdowns began. Many of us, most of us, were already washing our hands more, being careful about gatherings, and taking other steps that could help protect us. Is there evidence that we are significantly safer now because we have forced many businesses to close and tens of millions to lose their jobs? Is there evidence that staying indoors is safer than going to the public parks? Is there evidence that mass assemblies every day in Walmart make us healthier than going to the gym, to a park, or to a small business? Your faith may be strong and passionate on this matter, but is it really based on science as you have been led to believe?

An important question, though, is not whether or not the lockdowns work, but whether they are justified. Many influential voices are praising the lockdowns for saving many lives, but have they presented careful evidence that a lockdown truly saves lives versus no lockdown? If we compare states without draconian measures to those that ignore the Bill of Rights, can we see clear evidence that a lockdown itself can be credited with saving lives? This is rarely considered, though so far it seems that the data suggests there may not be evidence of a significant benefit to a lockdown. See, for example, Wilfred Reilly's attempt to compare results to see the impact of lockdowns

South Dakota, for example, has come under much heat from the media for the apostate approach of  Governor Kristi Noem, the infidel who claims that she lacks the power to suspend the Bill of Rights and actually must uphold it based on some oath she took long ago when sworn into office. Her approach seems to be "teach people correct principles, and let them govern themselves" -- a concept you may have heard before -- when it comes to social distancing and coping with risks. Tragically, under this reckless approach, there have been 10 deaths in the state as of today. Each death is tragic, but when we consider that this number is barely a blip compared to many other routine causes of death, it might give you pause if you are open to science-based discussions. For example, South Dakota had nearly 200 suicides in 2017, over 20 times the deaths from COVID-19 so far. 

South Dakota is a remarkably safe place to drive, and last year had a record low number of automobile fatalities: 102, ten times their COVID-19 fatalities so far. That number was reported as good news, showing great progress in automobile safety, and was not used to frighten people into staying home and shutting down all non-essential travel, but we certainly could cut those deaths to nearly zero by simply banning travel. So why don't we ban vehicular travel nationwide? Why don't we spend most of each news broadcast talking about frightening automobile accidents and the need to force people to stay home to save lives? For most of us, the ability to travel is viewed as a right and as a necessity for economic well being. It's always risk, a risk that could kill us one day, and while every death is tragic, facing risk and living with risk is part of life. 

But a key question for justification of the lockdowns is not whether they reduce Corona virus deaths. Even if we believe that they are legally justified (that governors can properly suspend the Bill of Rights when they feel there is an emergency and dictate where we can go and which businesses can continue), to be justified, the lockdowns should at least have an overall positive effect on the health and well-being of the people. Even if you believe that one life saved justifies making 30 million people lose their jobs and a nation of school children regress in their education, does the science really show that lives are being saved overall? If one life saved is worth any cost, as one governor seems to think, what if that cost is 10 lives? Is that rational?

If the lockdown saves the lives of a lot of us older grandparents but leads to two suicides of younger people for each of us seniors that are saved, would anyone be arguing that we older people are just worth more than those with mental health issues? (Some mental health professionals are worried about the impact of our response on suicides. Tennessee, by the way, recently reported having more deaths from suicide than COVID-19, a phenomenon that may be true for many other places.) 

If more people will die from failure to see doctors now due to missed cancer detection, missed hypertension treatment, missed warning signs of heart disease -- these are all very big killers, and the impact of lessened "non-essential" health care is a cause for great concern -- or if lives saved from Corona virus proves to be far less that the additional deaths due to the inactivity, poor diet, stress, and poor health care that comes from unemployment among millions of people, are we doing the right thing by crushing the economy now? Should be we be angry at people who are least ask such questions about the overall impact, even if it shakes one's faith to hear such apostate talk?

The only thing that is apparently being considered by most of our politicians and, by his own admission, Dr. Fauci, is the impact of the Corona virus per se. There's no attempt to consider the balance between multiple factors. But the massive steps we have taken will affects tens of millions in adverse ways that will also cost lives. Just the missed diagnoses for cancer alone may result in deaths from lack of early detection that could be as great or greater than the health impact of the Corona virus. On this issue, see: "Professor Warns Cancer Deaths Due to COVID Disruption Will Be Greater Than Deaths From Coronavirus" and the Harvard summary of a study on the 2008-10 economic downturn, "Global economic downturn linked with at least 260,000 excess cancer deaths." What we have down to our economy already may have a far bigger impact than what we faced in 2008-10.

The lethal impact of our economic suicide may not be limited to indirect deaths from cancer, heart attacks, and actual suicides,  but could have a more direct lethal impact through widespread famine. This is not something I learned about from random angry anti-big-government sites, but from one of the major pro-government sources of all, the United Nations. David Beasley, UN World Food Programme (WFP) Executive Director in the April 21 virtual session of the UN Security Council on the Maintenance of International Peace warned about the far-reaching impact of poverty arising from the response to COVID-19:
There is also a real danger that more people could potentially die from the economic impact of COVID-19 than from the virus itself. 
In a related article at WFP.org, WFP’s Chief Economist, Arif Husain said:
COVID-19 is potentially catastrophic for millions who are already hanging by a thread. It is a hammer blow for millions more who can only eat if they earn a wage. Lockdowns and global economic recession have already decimated their nest eggs. It only takes one more shock – like COVID-19 – to push them over the edge. We must collectively act now to mitigate the impact of this global catastrophe.
I have been lucky to travel in China, Indonesia, Cambodia, Vietnam, Mexico, and some other parts of the world where real poverty afflicts many people, in spite of great progress in recent years to life the living standards there. It was especially in visiting the homes of a few of those afflicted by poverty in China and seeing what happens to their options, their quality of life, their health care, and other issues, that I came to see how awful the impact of poverty is. It leads to tragedies and unnecessary deaths and despair.  Our self-inflicted economic collapse, one that could be greater that that of the depression, will not just affect many American lives, but will have a wide circle of influence on the global economy and on the lives of those many millions who are now trying to rise out of poverty around the globe. Our nations and their nations need us to have a healthy economy, not one that is shut down unnecessarily. It is my disdain for poverty that makes it impossible for me to relish a trade war with China or other steps that will exacerbate poverty there or in other nations like Indonesia, Vietnam, and Mexico. (And don't get me going on my disdain for war and the global harm caused by our war machine. Some other time we can have a calm discussion, I hope, about the evidence regarding the issue of what our trillions spent for war is doing in terms of making the world a better place or not.)

So many have a passionate faith that they need to stay locked down indefinitely and just trust their prophet-like leaders with their prophetic models of doom, even though the models have been so severely wrong that they should have no credibility by now, though they continue to guide policy and faith. what they have been told and stay locked down in fear. These passionate believers know what to do when someone raises inconvenient concerns about the bigger picture and the possibility that our self-inflicted economic wounds may be doing more harm than good. They will respond with passionate acts of faith to condemn the uncaring infidel. They may ask the social media enforces to deplatform me for spreading "fake news" that challenges the official government position. Perhaps some will eventually pursue an even more flamboyant act of faith, such as the good-ol' auto-da-fé that was a tried and true way in the past to enforce the faith and correct the non-believers. But if such anger is your gut reflex, at least realize that it may not be as scientific and science-based as some would have you believe. 

At least for some parts of the country, sustained lockdowns do not appear to be justified by logic, science, or law (I suggest that the freedom to assemble, free speech, religious freedom, etc. are meaningless if all it takes is one official declaring it's an emergency to nullify those rights without due process). The impact of economic suicide may be far greater than the limited good being achieved. And the fear that has been whipped up in the media with constant attention to this virus may be wildly out of proportion to risks that the US people have been coping with for years, such as a over 60,000 deaths from the flu in a single season a couple years ago, 99,000 deaths last year from hospital acquired infections (easily solved by any politician: just burn hospitals to the ground to stop those infections at their source -- isn't it worth it if only one life is saved?), 40,000 deaths a year from car crashes, etc. But for centuries, we have understood that such risks are part of life, and have chosen to move forward. Now we are surrendering our economy and our Constitutional rights to cower in fear. Is this healthy? The latest scientific data suggest that sunlight is useful in killing the virus, so instead of a "Safer-at-Home" edict for my state and yours, the science-based approach perhaps should be "Safer Outside of Home" edicts that let us get back to our lives, while continuing to take appropriate steps to keep us more vulnerable folks safe, while letting the young have their future back.

COVID-19 is worse than the flu. The death rate for infected cases looks like it's about 0.4% now that we have better data, which is worse than the flu, but not horrifically so.  The death rate in many states has been far less than a typical flu season. In fact, far less than a typical flu season for that state. Flu deaths in South Dakota for the 2017-18 flu season were over 20 times higher than the 10 COVID-19 deaths far, and here in Wisconsin, the flu deaths were nearly 4 times higher than the 262 deaths we've had so far, though we've had a new spike in cases and sadly more deaths are likely. As a reminder to those of you who are saying these lockdowns are needed to save the children, 97% of our deaths in Wisconsin have been in the 60+ age group and zero have been reported for people under 40 years old. It's not the young that we're saving. 

The horror that we see from COVID-19 largely comes from New York City, where severe problems exist. It seems that their crowded subway system was the ideal environment for spreading the disease (woe to the heretics who might opine that maybe driving to work in a car is much safer). But their crisis is not the crisis the entire nation faces. Florida with a greater population and a very high percentage of vulnerable older people was predicted by the experts to be facing even more deaths than New York, but at 1,046 deaths in Florida, they are nowhere close to the 16,599 deaths in New York as of today. New York's panic need not be ours (though almost all our media is from their and their crisis informs every report, contributing to the national panic). The steps they feel they must take need not be emulated everywhere else. Even at this late date, with abundant data showing New York's situation to not be representative of the rest of country, I see intelligent believers declaring that if we lift the lockdowns soon, we will end up having a worse problem than New York. That kind of fear is based on faith in authority figures who have botched their figures; it is not based on science.  

What am I calling for? Science, not misguided faith in technocrats or politicians or media figures, to make informed decisions. Respect of our Constitution and allowing communities to decide what protective measures are appropriate. Teaching the people correct principles and letting us figure out how to live our lives, run our businesses safely, how to exercise in a gym, how to jog or enjoy sunlight without getting a ticket, how to get a haircut without having to be an elite politician (sorry, Chicago!), how to take care of our children and our elderly, and how and where to shop. 

As for education, let communities and families figure that out. But one thing I'll say: we should realize that the people who have done most to help keep school children safe from viruses, safe from bullying, and safe from mass shootings are the parents who have been doing home schooling. Right now, if you know a home schooling parent, chances are they can give you great tips on the resources needed for effective remote education and how to do schooling at home more effectively. In addition to praising our medical care workers for the valiant work they are doing (sorry to the many who are now on inactive or furloughed because of the painful ban on non-essential medical services, resulting in many hospitals being emptier than ever), perhaps we should also spend some time thanking home schoolers for the work they have done to help keep children safe and healthy. Many more families may wish to consider that option for their children. 

Wow, so many heresies in one blog post! I'm truly a lost soul, I know. But I had to mention the home schooling issue because in the widespread spirit of "never let a crisis go to waste" and "let's use this panic to push through the rest of our agenda," a brilliant Harvard professor just came out with a call to ban homeschooling in order to "protect" our children. As with many things being done to "protect" us in this crisis, the solutions are sometimes more about power and wealth than about actually making life better for Americans. Sorry, but I'm just not a believer when it comes to trusting the elite who always know how to run our lives better. 

Whether you agree or not with my proposals, I hope you will agree that we should ask for wise decisions to be made that will protect our communities in the long run, overall, carefully weighing the multiple factors and risks, not just one. I hope you will also ask that such decisions carefully respect the rights of individuals, rights that should not be summarily suspended without due process regardless of how bad a flu season or how bad any other crisis is or is imagined to be.  Let's rely more on real science and real inquiry, not a faith-based, fear-based approach.

Postscript

At least one faithful member of the Church has accused me of going against the Church in suggesting that the lockdowns might not be helpful. Since the Church has asked members to suspend their meetings to reduce spreading the virus, that supposedly suggests the Church and the Lord think that lockdowns are the way to go. But as I've explained, I'm very much in favor of what the Church has done.  It's a great example of the voluntary steps that organizations can take on their own to reduce risk. The Church and the Lord, as far as I can tell, has not called for businesses to be shuttered and millions to be unemployed. In fact, on the COVID-related Church website, "Keeping Our Employees and Service Missionaries Safe During the Coronavirus (COVID-19) Pandemic," we read the Church is encouraging working from home for its employees when possible, but does not appear to be laying off mass numbers of people or slashing paychecks. Further, regarding Utah offices, "Church offices remain open for the workforce, including stand-alone operations (e.g. Church Office Building, Global Services Department, Joseph Smith Building, Riverton Office Building, Bishops’ storehouses, Beehive Clothing, Granite Mountain Records Vault)." Offices are being kept open. Work is continuing, but being done safely. It's a smart, voluntary move, one that businesses can figure out on their own. Nothing in any of the Church's statements regarding COVID-19 appear to endorse shutting down most of the economy and promoting a nation dependent on a government for sustenance. The principles of provident living and self-reliance still apply.
 

37 comments:

Anonymous said...

This is why I feel religious people make better scientists than the non-religious, because they are at least acknowledging their bias in believing the unseen.

This covid thing going on is all about the diviners and sooth sayers of the world remaking the world in their own image and it's glaring that they couch the terms of this quarantine as a "science" when it has no grounding in the natural world (their models don't match the on-the-ground statistics). Their modeling and statistics are completely theoretical, and it's a religion of destruction. By your fruits you shall know them. False prophets of our day...

Anonymous said...

In addition to diviners and sooth sayers I should have called them the High Priests...Hugh Nibly would have appreciated that reference.

Anonymous said...

When this COVID thing all started, I heard someone on NPR say, if it feels like we over-reacted after this is all over, then we know we did it right. I am not sure that is science. When regardless of outcome, the decision was the right decision ... then we are no longer talking about science. If vitamin C didn't stop you from getting a cold, just think how bad your cold would have been without it!

Managed risk depends on factors like tolerance for risk, operating environment, and value system. Does the value of cars make 40,000 deaths tolerable? How about guns?

Spending on food storage is great if the operating environment of an agrarian society with well known cycles crop failure. Storing a year of food in every residence is great military strategy if you live in a walled city where foreign armies have the practice of laying siege.

If your operating is environment is high density urban settings with a history of tuberculosis outbreaks, then a stockpile of face masks, hand sanitizer, and storage of popup clinics sounds like well managed risk.

This whole covid thing makes the year of food storage paradigm look uninspired and a misplaced priority, unless a year of food storage had nothing to do with temporal outcomes, but was merely a test of random obedience.

Anonymous said...

Jeff, all I would ask is that when you perform the sort of utilitarian ethical calculus you’re describing above — a calculus that is informed by science but is not itself science — is this: that you compare the totality of probable outcomes of the current approach to the totality of outcomes of your recommended looser approach, not to some idealized outcome (much less to the status quo ante). How much economic dislocation might we expect from, say, 500,000 deaths rather than something less than 100,000? How many extra suicides from those overcome with grief or anxiety? How many people will be going out to restaurants or to their jobs? How many more people will die simply because of the greater attrition among medical personnel? Etc. Despite its length, your post doesn’t even come close to exploring all the factors involved.

It seems at least possible that, under a looser regime, we could experience a much greater number of deaths and human misery and just as much or even more economic hardship. It’s even possible it could trigger a level of panic down the road that would engender public support for a much harsher lockdown in the future.

The science, of course, cannot predict these various possible futures with any precision. It can at best give us ranges and probabilities.

I guess I would also ask you to remember that decisions of these kinds can and should be informed by science, but they rest ultimately on values. You and I could agree 100 percent on the science yet still make much different choices. Politics is inevitable.

— OK

Anonymous said...

There's a lot of misleading info out there. Many websites overstate rates for maximal effect. Look at worldometers.info, with a 31% rate in the death column. Hopkins currently gives a 7% rate. The actual rate is well below 1%, and probably below 0.1%. For most, the danger is 0.001% or lower.

Remember media cries against gov't shutdowns? This shutdown's long-term effects are orders of magnitude worse, yet we don't hear cries from most media outlets, who fully support it. Really stupid.

Anonymous said...

Anon 12:55 makes a silly comparison above in writing, Remember media cries against gov’t shutdowns? This shutdown’s long-term effects are orders of magnitude worse, yet we don’t hear cries from most media outlets....

First of all, there’s no “government shutdown” right now in the usual sense of that term, which is that the government has run out of funds because Congress has not approved a budget. Apples and oranges.

Second, even if the two “shutdowns” were otherwise comparable, the reasons behind them are not. To shut things down in order to battle a pandemic is obviously different than doing so because Republicans and Democrats have a disagreement about the federal budget. One might as well say, “You tell me I shouldn’t be injecting this morphine here at this party, but when I was in the hospital you thought it was just fine.”

— OK

Anonymous said...

This isn't the black plague. The population is still growing fast, 3,000 more births than deaths a day in the US. We need frequent reminders of the number of unemployed. The longer we have huge numbers unemployed, the more inflation we'll have down the road as the money printing continues. The debt's approaching $25t. Tax revenues are shrinking. Everyone's dollars are worth less than they were at the start of the year. And not too long from now, it's going to really hurt everyone.

Quantumleap42 said...

Jeff, a few things. I am not an epidemiologist, but the math that I use is the exact same as the math used by epidemiologists. Turns out that rates of nuclear reactions and life time cycles of stars is just like modeling diseases spreading.

In your paragraph that starts out "So many have a passionate faith..." you link to a news article about how the University of Washington model is inaccurate in predicting the spread and growth of the virus. Yes the University of Washington model is inaccurate, and the article is correct in its criticism. But the article does not adequately resolve whether the model is too low or too high in its predictions (or mixed), and what other models have been more accurate.

There are two possible ways to interpret the article. Optimistically, meaning the U of W model is too high and the coronavirus isn't as bad as we think it is. This is the rational interpretation you took because it lined up with the other data points you had.

The pessimistic interpretation is that the U of W model is under-predicting the virus so it is worse than we think. Since the article was published on the 17th the data has shown that the optimistic models were too conservative in their estimates. The models that have been the most accurate have consistently predicted more cases and deaths than the U of W model.

Every single one of those models have consistently shown that social distancing and the general lock-down approach taken by many states and countries has been effective in slowing the spread of the virus. When most lock-down measures were taken in mid March the doubling time for the virus in the US was 3-4 days. The doubling time was increasing, but slowly, indicating that the growth of the virus was not being controlled. After the lock-down measures were taken it took 1-2 weeks before the effects could be seen. By the end of March the doubling time was ~5 days, and was growing by about 3/4ths of a day per day. This showed that the virus was then under control in the US. The current doubling time is ~20 days and is still increasing, but we won't know if the increase is still consistent for another 2 weeks.

All data show that we have not reached a peak in the number of daily cases but rather a plateau. They are not decreasing, just staying roughly constant. We still have more new cases than recoveries (or deaths) meaning the total number of infectious people is still going up. This means we have more infectious people than ever before. This makes this moment the exact wrong time to lift social distancing measures.

The models, such as the agent based model from Imperial College, showed that without social distancing and lock-downs the number of deaths would be 2-3 million in the US by mid June and 40-50 million through out the world (not counting China which had locked down at that point). This estimate was consistent with data that showed a doubling time of < 5 days before the middle of March. This is even assuming the number of asymptomatic persons to be 4 times larger than the systematic persons.

Quantumleap42 said...

Also, South Dakota has THE lowest mortality rate in the country. As in, it is 2x lower than the next lowest mortality rate (which is Utah at 1%). Any comparison to South Dakota is comparing to the furthest outlier possible.

Jeff Lindsay said...

OK, thanks, you make an important point about the calculus. Given what we don't know, there are a range of possibilities before us, though they have become more narrow than in the early phase where the panic was more understandable. Initial predictions from those with still questionable incentives to stir panic suggested millions could die, so extreme measures seemed needed to save us older folks, but had we been allowed to have a less fearful discussion, I doubt that Americans would have agreed that we needed to blow up the national economy and create a second Great Depression. As data increasingly suggested that we had been improperly informed about the severity of the disease, more reasonable ranges of possibilities could be offered.

But through it all, why did we abandon science for fear? For example, the very basis of the "Safer at Home" and "Stay at Home" movement has been that we will be safer from the virus if we are holed up indoors, huddled together with our family or in apartment buildings with many families. But apart from new data on the benefit of sunlight in killing the virus, it has long been known in the sciences that confining multiple people in a closed space like an apartment, a home, or a subway carriage is far less safe than having those people be outdoors. Just the open air reduces the risk of transmission if one of those people is infected (and possibly asymptomatic). But it has also long been known that colds and flus (colds include versions of the Corona virus family) spread more rapidly in the winter, when people are indoors more and when it's cold and dry. So what on earth is the scientific basis for telling people they are safer indoors rather than outdoors? Why are we giving fines to people for jogging down the street or along a lake, or even giving fines for people for just driving down the road, when being alone in a care is one of the safest imaginable places to be and a place with virtually no risk of infecting someone else?

We can't even talk about a reasonable scientific response to the calculus of uncertainty when such insane and harmful decisions are being made on the basis of a fearful faith that is utterly non-scientific.

When people say that we need to fear and huddle indoors because that's what the experts say, we need to have the common sense to challenge that. We need to break away from our dependence on a hopelessly dishonest and incompetent media and listen to more sane voices in the medical community. Here are a couple: Dr. Daniel W. Erickson of Bakersfield, California, is a former emergency-room physician who co-owns, with his partner Dr. Artin Massih, Accelerated Urgent Care in Bakersfield. They are experienced medical professionals who have 40 years of hands-on experience in dealing with viruses and respiratory infections. Their observations are critically important for us to consider. See "Open Up Society Now, Say Dr. Dan Erickson and Dr. Artin Massihi," published April 26 at https://www.aier.org/article/open-up-society-now-say-dr-dan-erickson-and-dr-artin-massihi/.

Jeff Lindsay said...

Quantum, mortality rate to be meaningful should be the Infection Mortality Rate (IFR), deaths based on the number of infected people, not the number of reported cases. What we are learning from Iceland, from California, and from New York when testing is done among the general population is that the number of people who have or have had the disease is far greater than we thought before. The best estimate for the IFR, which I believed to be the regularly updated global analysis from Oxford's Centre for Evidence-Based Medicine (cebm.net), now stands at under 0.4%. See "Global Covid-19 Case Fatality Rates," updated April 24, 2020, at https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/:

"Taking account of historical experience, trends in the data, increased number of infections in the population at largest, and potential impact of misclassification of deaths gives a presumed estimate for the COVID-19 IFR somewhere between 0.1% and 0.36%."

This makes it more dangerous than the flu for senior citizens, while for children the mortality rate is "nearly zero," as they report. We vulnerable people can be sheltered without a need to rob the rest of you of your future and health. This disease does not need draconian lockdowns in the United States. The lockdowns are faith-based, and while they may have been done in good faith, they cannot be sustained in good faith on any kind of a scientific or logical basis if one considers the overall physical and mental health impacts, child and spouse abuse impacts, economic impacts, and social impacts due to arbitrary loss of fundamental liberties.

Anonymous said...

"When people say that we need to fear and huddle indoors because that's what the experts say, we need to have the common sense to challenge that. "

When did any scientist with a credential and any sort of official platform tell anyone to be afraid and huddle? That overstatement is beyond irresponsible and logically laughable.

In CA which was an early adopter of the Safer at Home strategy we have prevented what happened in NYC from happening in Los Angeles, the second largest city in the country. And yet, I don't know anyone in Los Angeles who's been advise to be afraid or who is actually afraid. In fact, the overwhelming voluntary cooperation has given people a degree of comfort and confidence that we'll get past this crisis.

Life here continues in an orderly if less rushed pace. No one I'm aware of has been arrested for jogging or for not wearing a mask for that matter. We just voluntarily mask up and distance and act like responsible citizens of a large communitarian city in an effort to keep the pace of diagnoses within the capacities of our hospitals and their beleaguered medical professionals.

Anonymous said...

If you are afraid for your physical or your economic health, aren't you betraying a lack of faith in your god and your food storage?

C T said...

One thing Jeff didn't get into is that we now know far more about how to treat severe COVID-19 cases than we used to. That's a good argument in support of the initial shutdown. Further, we now have evidence that most people who get this virus are asymptomatic or only have mild symptoms. That's also important information we didn't have initially.

Further, we can now look at fatality rates for the various countries of the world and narrow down possible environmental factors that interact with COVID-19 infections to exacerbate or ameliorate symptoms. For example, the cytokine interleukin-6, which is the main one implicated in the "cytokine storm" COVID-19 apparently brings on in severe cases, can be decreased or increased by things in the diet. It's fascinating to note that ginger, turmeric, and glucosamine (found in shrimp paste) consumption correlate extremely well with lower country/regional death rates, for all three of those items have been researched and found to decrease interleukin-6 production. And, hamburger (ground beef) and coffee, which tend to increase interleukin-6 levels, are eaten in large amounts by the areas that have been getting hit hardest with COVID-19 deaths.

India, where turmeric and ginger are the order of the day, while beef and coffee definitely are not, still has under 900 COVID-19 deaths despite having cases all over the country. No, it's not due to their shutdowns, for they are a crowded country of 1.35 billion people, over 100 million of which still practice "open defecation." It's absurd to think that India is doing shutdowns that are more effective at preventing transmission than, say, France.

Jeff Lindsay said...

Wait, Quantum, can you please clarify your comment on South Dakota and Utah? I must be misunderstanding because as I read your words, it sounds like you are saying those two states have such low death rates that they can't be fairly compared to the lockdown states with higher death rates. Isn't the low number of cases and the low death rate part of why they are important to consider and why they might have something to teach us? According to many fear mongers, the states that don't do lockdowns should soon be falling into apocalyptic horror. When I first noted South Dakota's example, I had voices on the Left saying that South Dakota's graveyards would soon be full and nobody would be left to enjoy their healthy economy. Those predictions remain wildly incorrect (10 deaths for South Dakota so far, 41 for Utah, both tragic, but tiny compared to typical flu seasons - Utah have 341 deaths in the 2017-18 flu season for example).

The fact that South Dakota and Utah have low mortality rates from COVID-19 doesn't mean that they are irrelevant. In fact, to me, it helps give the lie to the predictions that have been made for those who refuse draconian lockdowns and shows that states can stay healthy economically and physically. Sweden's has had more trouble, but they have still avoided a crisis like New York or Italy by relying on social distancing. Vietnam has done remarkably well without economic suicide as have other states.

What is the scientific evidence that a lockdown should have been in South Dakota -- or anywhere else? Progress was being made already from natural social distancing before lockdowns were imposed, or would have been realized if lockdowns were not imposed. Models were already considering lockdowns in predictions that were wildly off. The gurus tells us that the numbers came way down from what was predicted thanks to the American people submitting to their recommendations, but had no lock downs been done, would the numbers be any worse? Is there scientific evidence that by crushing small shops and sending everybody flocking to Walmart, we are safer than if we were deciding where to shop on our own? Is there evidence that by shutting down gyms and parks and forcing people to stay home while crushing most businesses, that we are better off than doing social distancing on our own? And is there evidence that by the government lying to us about face makes, telling us that we don't need them because they are ineffective, and then later telling us in April that, "oh, we just learned that there are asymptomatic spreaders so now face masks should be worn" (something the government knew much earlier than that!)?

What is the actual scientific evidence that the draconian policies are doing any good overall? Or that they are even doing better than we were doing by social distancing and hand washing already before they were imposed? Showing that numbers slowed or came down does not prove that any aspect of the draconian policies were helping. It could all be due to natural social distancing, as was occurring all over the US and continues to occur even in places like South Dakota, or it could also have been due to other factors such as weather, decreased influx of sick people from overseas, or factors we don't know yet.

If there is not evidence that the lockdowns themselves are necessary, and if there is no clear evidence that their overall impact on America is a net positive rather than the stupidest national economic decision in history that will set us back decades and cost tens of millions their jobs and lead to hundreds of thousands of deaths, then what is the scientific basis for taking such a horrific step? Fear, panic, and blind faith in anointed leaders, or sound science? I respect faith in many cases, but not this one. It's time for science.

Quantumleap42 said...

A few other things.

Excess deaths. The number of deaths officially attributed to COVID-19 does not include everyone who dies from the virus. If the person has not been officially tested then they are not included in the official count. One way to account for this is to measure the number of "excess deaths", that is the number of deaths above the average for the past 10 years. The number of excess deaths potentially doubles the number of deaths from COVID-19, while in other cases it can raise it by a factor of 20 (in Indonesia). Details from The Economist.

Second, the number of available ICU beds. If someone gets adequate medical care their chances of survival goes way up. The mortality rate for those who get full care is below 1% and is only 5-10 times worse than the flu. But once ICU beds are full and resources are depleted the mortality rate can go up by a factor of 20-50. Even in a bad year for the flu the number of hospitalizations and the number of ICU patients is below the total number of available beds.

Because the coronavirus spreads faster than the flu it has a greater capability to overwhelm hospitals in a very short amount of time. This is what happened in Italy, Spain, and New York City. This just doesn't affect COVID-19 patients, but everyone. If someone is in a car accident but the hospital is full of coronavirus patients, then the accident victim will not survive because of the coronavirus. No resources for coronavirus patients means no resources for anyone else.

No matter how high the number of undetected coronavirus cases is, the number of known cases and hospitalizations has to be kept low enough during any one week or the case-fatality ratio will go up.

Jeff Lindsay said...

When did anyone tell people to be afraid and huddle? Maybe you've missed a lot of the media recently with constant focus on death and disaster from COVID-19. Maybe you've missed the dramatic campaigns of celebrities, politicians, and healthcare workers telling us over and over "STAY HOME. STAY HOME. STAY HOME."

I'm glad this is not having much impact on you and that things seem voluntary in your part of California. I'm not sure others in your state would agree, though, such as the 7 people were were fined $1000 for going to 7-11 to buy some drinks. See "7 people issued $1,000 tickets for violating COVID-19 shelter-in-place order, Santa Cruz police chief says" or the case of a paddleboarder and also a surfer who were arrested or fined for going into the water contrary to the COVID-19 lockdown orders, when the risk of spreading or catching COVID-19 while out alone in the water would seem to be zero. People in San Diego have received $1,000 tickets and could face up to two-years in prison for sitting in a car near the beach, more than 6 feet away from others. Glad you haven't had any trouble, but it looks like they really do want you to huddle at home and not go get drinks at 7-11, enjoy a sunset near the beach, or do anything in the water. Is there science behind this? Logic? Or an unjustified deprivation of the fundamental freedom to travel, to assemble, and to, uh, get sugary beverages at 7-11? OK, the Founding Fathers might not have been thinking about that last one, or the right to surf, but seriously, the crackdown on citizens has become ridiculous and unreasonable.

Anonymous said...

I've heard that COVID-19 cases are perhaps overreported, since the default is to put COVID-19 when in doubt, in the absence of testing. Can you provide a source, QL42, so we can find out which is accurate?

Anonymous said...

Jeff, I agree that a $1,000 fine is ludicrous. Should be something more like a first-offense warning, like for driving 74 in a 65 mph zone, followed with maybe $100 fine on second offense. Tens of thousands of Californians have been hitting the beach anyway (see https://www.ocregister.com/2020/04/25/eager-early-risers-hit-the-beach-in-san-clemente-as-closure-lifts). That’s in Orange County; next door, in LA and San Diego counties, beaches are apparently closed and deserted. Local control, an American tradition.

— OK

Jeff Lindsay said...

OK and others, regarding the calculus of economic dislocation from disease, a wise friend whose Ph.D. involved virology just shared a thought with me. He pointed to this article: Liang Miao et al., "Annual economic impacts of seasonal influenza on US counties: Spatial heterogeneity and patterns," Int. Journal of Health Geographics, 11/16 (2012); https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479051/. He observed that the economic impact of COVID19 alone (deaths, loss of work days, medical costs, etc, not counting the societal response) can be estimated based on estimates of economic impact of flu. For example, if you think COVID-19 will infect and kill 5x as many as seasonal flu you can multiply these numbers by 5 for a ballpark order of magnitude estimate. Turning to the cited article of Liang Miao et al., for seasonal flu, it looks like an annual cost of $27-$87 billion (so maybe multiply that by 5 for a worst case, or let's say 6 to factor in inflation). For a more extreme pandemic flu season, they cite estimates as high as $170 billion. These can give order of magnitude estimates for economic impact. Then let's compare that to the many trillions of costs that we are facing (6 trillion impact just in terms of the money being thrown to the Fed and others, plus many trillions of harm to the GDP for this year and probably for years to come because so much is being broken). It may be that the treatment (definitely not a "cure") is far more harmful economically than the disease.

That's not to say that strong mitigating measures of some kind in crowded hotspots don't help -- simply stopping subway travel or greatly increasing rather than decreasing the number of trains to allow people to have more distance -- would have probably done much to lessen the spread in New York City. Sadly, as with many aspects of this disease, what the government in New York chose to do by cutting down the number of subway trains was probably the worse possible, most foolish and dangerous step they could have taken. Either close the trains for a while or greatly expand the number so that fewer people will be breathing the same air.

Anonymous said...

Jeff, you’re assuming a linear relationship between number of deaths and total economic impact. I suspect that’s a very dubious assumption.

— OK

Jeff Lindsay said...

OK, we're not yet at the number of deaths from the 2017 flu season, but getting close. So what multiple of that year's economic impact do you propose? If we get four times as many deaths from COVID-19 as flu brings, what do you propose for the mathematical relationship between the economic cost of the disease? Is there any plausible analysis that can make it worth gutting 25% of the GDP and sending tens of millions into poverty, especially when the health impact of doing so may be more lives than were allegedly saved?

Jeff Lindsay said...

""If you are afraid for your physical or your economic health, aren't you betraying a lack of faith in your god and your food storage?"

I take it you didn't read my post and my comments, Anon. I am full of faith and have total trust in my God. My trust in politicians, celebrities, and the media is less absolute. Since I don't think you read much of what I wrote, I'll explain that I was not expressing concern about my economic situation, though there has been pain, nor the amount of boring foodstuffs I have obtained in the past couple of weeks since moving back to Wisconsin. I am doing OK and have a stash of oatmeal, rice, and some bland canned foods. I may be OK. It's others I am worried about.

I am expressing concern not for me but for the tens of millions who have become unemployed, possibly unnecessarily. I am expression concern for the millions struggling with mental health issues who may not be receiving visits, professional help, or opportunities to do meaningful work, and may not even be allowed to go outside for a life-sustaining walk along the beach or lake. I am expressing concern for the children and women who have to be cooped up all day with an abusive man who is angry over his lost job and is increasingly drinking. I am expression concern for the harm and pain caused by the decreased respect of personal rights, such as the traumatic scene faced by some mothers giving birth who find that hospitals won't allow their husband to be there to comfort them and make sure the baby is safe, some of whom face the risk of having staff decide against the mother's will to take the baby away if the mother tests positive for COVID-19. I am expressing concern for the millions of small business owners and innovators who have put their fortune, their family's fortunes, their friends' fortunes, and their lives into a successful business, only to have it suddenly shut down by a bureaucrat whose paycheck is secure and who is unwilling to hear any second-guessing of their imperial decree that the business is somehow not "essential" and this must be shut down. Unnecessary, illogical, utterly non-scientific decrees that abuse their power, deny Constitutional rights, and cause oppression and harm to people who are striving to build our nation while the elite rulers shut it down.

The pain is terrible, the long-term impact is harmful and deadly. I'm so very sorry that you and millions of others are unable or unwilling to empathize with such great pain as we begin our Second Great Depression. It's time we stop yielding to media fear and the manipulations of elite leaders to reclaim our rights and get America started again. If we surrender our rights now, what will be left for our children?

Anonymous said...

Jeff, I obviously can’t specify the mathematical relationship between additional deaths and economic impact, but I’m pretty sure it’s not linear (because, e.g., of the decreasing quality of treatment as medical personnel get sick, supplies run out, ICU space gets overrun, etc.).

Also, you seem to be confusing “risk” with “outcomes,” a bit like the guy who plays Russian roulette, survives, and then says “See, there was no risk!” But of course, regardless of that particular outcome, playing Russian roulette is risky, and it’s certainly not good public policy.

— OK

Anonymous said...

Jeff writes, If we surrender our rights now, what will be left for our children?

One could revise this to read as follows: If we surrender our rights to spread infection during the extraordinary circumstances of a pandemic, what will be left for our children?

Not all slopes are slippery. Given where we are right now, the real job for those of us concerned with rights is to begin discussing the creation of a better legal/constitutional groundwork for emergencies such as this one. How can we empower governments to effectively deal with real threats to public health without also empowering them to permanently erode our rights? This discussion could do with a little less rhetorical posturing, a little more seriousness and patience and willingness to engage with civic minutiae, and a little more faith in our institutions. For most of us, a good first step might be to read the state laws concerning emergency declarations, with a critical eye to whatever safeguards they might contain. It’s all available online.

— OK

Jared* said...

The basic principles here are simple:

- You must be near someone who is infected in order to become infected yourself (or touch something they did, etc).
- Neither you nor (asymptomatic) infected people know who is infected and who is not.
- Therefore, in order to stop spreading disease, we need everyone to stop getting near other people. Translating this into public policy is the tricky part, but given that nobody thinks they are the problem until it's too late, I don't know how you drive compliance without lockdowns. (That's not to defend every single application.)

I think the piece you are missing, though, is that this doesn't have to be the only strategy. Testing is the great medium-term liberator, because if we can figure out who is infected and who isn't, then the number of people who need to be isolated drops dramatically. Instead of agitating against restrictions, maybe agitate for more testing!

Anonymous said...

If the mortality rates was truly 2%, as we were originally told, then Jeff would be wrong. But now the mortality rate is know to be 0.5%, Jeff is right, this was a over reaction. Knowing real mortality rates a priori is something that is nearly impossible with current science. It would be nice if mankind had some kind of living oracle that could tell us these things ahead of time.

With regards to legal frameworks, the subway mistake on the local government, but local governments are not expected to have the resources to know such things ahead of time. The State of NY should have given the local government better info.

But the State did not necessarily have the legal power to ban flights from Europe, the federal government did.

Anonymous said...

Yes, local governments should have been getting information and guidance from higher up. It is of course the federal government that the requisite information-gathering capability and expertise. History will not look kindly on the current administration. Hopefully voters won’t either.

— OK

Anonymous said...

Life is so precious it should be worth sacrificing everything to save it. None should be lost. There won't be any costs to this proposal if we say counting those "potential costs" are a sign of lack of compassion. That will give us the moral authority to be so thorough and absolute in our plan. We will only measure our successes. Said Satan.

Anonymous said...

When I talk to my older friends from eastern Europe all they do is roll their eyes and say that Americans have no understanding of how destructive communism is and how it's now our turn to learn this lesson.

Anonymous said...

Anon 1:19, don’t be silly. The United States is not on the brink of going communist. Instead of talking to your friends in Eastern Europe, try talking to some people in Scandinavia.

— OK

Anonymous said...

youtube : Stossel: Sweden is Not a Socialist Success

Anonymous said...

It’s also not communism. Words have meanings.

— OK

Anonymous said...

The reference to socialism and Scandinavia is probably not because of educational vouchers, but universal health care coverage. An apples and oranges comparisons for America. The health care systems involved entirely different making “medicare for all" way to simplistic of a solution to any major American concern.

An under discussed item is American Mennonites and healthcare. I would find Jeff’s research and analysis on the subject interesting. The Mennonites do not reject modern medicine, but they definitely have a faith-centered and nongovernmental approach.

Anonymous said...

No one should believe anything Stossel has to say on any matter.

Anonymous said...

I thought this was a good explanation (from an actual epidemiologist) of how much more dangerous the coronavirus is than the seasonal flu, and how easy it is for us non-epidemiologists to get the numbers wrong:

http://blog.deonandan.com/wordpress/2020/04/covid19-lets-talk-about-the-bakersfield-duo.html

— OK

Anonymous said...

Great article. Thanks for the link.