Was the response driven by epidemiology, though? I'd argue it wasn't.
They threw out actual consensus science on pandemics, as well as the appropriate response to one. The 6' rule was reached by haggling. Masks aren't effective. The CDC knew early on this was airborne, yet everywhere the official message was mask-mask-mask instead of urging the vulnerable to absolutely isolate. The non-vulnerable - at least half the public - didn't need to isolate at all.
I think it's a mistake to say we focused only on science. We did no such thing.
3 years later and they still haven't given a remotely plausible reason why they abandoned all the many pre-2020 pandemic plans in place, which eschewed lockdowns, were skeptical to negative on masks, had school closure as a VERY limited-time measure of last resort, etc...
Which is why people understandably assume the people who were supposed to provide the scientific expertise, were either incompetent or malicious actors, or some of both.
Scott Sumner has always made a very similar point about 2008: there was a standard theory available in macroeconomics textbooks, events failed to contradict it in any way, but the theory was completely abandoned in favor of random alternative approaches.
It's probably a mistake to believe that the same thing happened for different reasons in these two completely different areas.
I have not read Blindsight is 2020 so forgive me if I'm making points that have been already been addressed.
When it comes to the initial lock downs (March 2020), I believe we did the right thing in being a little over cautious. At that time, as far as I can tell, I think it's fair to say we didn't know much about the virus or what the worst case scenario might be. It seems prudent to err on the side of caution, given that if the worst case scenario is as bad as it theoretically can be for a highly transmissible influenza, we would be in deep trouble.
I am in full agreement that public debates and honest discussions should have been going during this time, allowing us to fully weigh the costs and benefits of continuing to extend lock down. That said, one of the initial reasons I recall for the lock downs in the first place was to "flatten the curve" to avoid overwhelming our healthcare system. As someone with dozens of friends and acquaintances working as doctors, nurses and in healthcare IT, it seems they had their hands full even with the lock downs in place. If the healthcare system collapses, we all lose.
I guess my questions for Gabrielle are, do you think it's fair that we weighed the opinions of public health officials more? And perhaps more broadly, when it comes to tackling problems at this scale, how do we decide which voices that should be amplified (if at all)? Lastly, I'd be interested to hear your take on if and how the information landscape made this whole problem worse?
Normally I would be tempted to say that freaking out in March 2020 was a reasonable decision at the time. Provided:
1) You were a normal person that just heard of COVID and had access to no special information and didn't know who to trust.
There were some people with more information that should have known better and didn't or didn't care.
2) You felt that, once we knew more, such measures could be turned off like a light switch is appropriate. For instance, by summer 2020 we clearly could have just moved on. Schools should have opened in the fall. Etc.
#2 really fell apart with hindsight, and I will never trust in it again. Once a moral panic gets going and powers have been enacted, it's not going to end, so you can never let it start.
Is that a bad equilibrium? Sure. COVID could have been x10 or x100 deadlier. It could have killed children instead of the elderly. Such a pandemic would have warranted March 2020 lockdowns, at least for a time.
But next time I'm not even waiting to find out of that is the case. I'm going to risk it. I'd rather take that risk then repeat COVID over a disease that didn't deserve the response it got.
COVID also dramatically increase how much I care about politics/culture wars. Normally I would say "that stuff doesn't effect me enough to spend much time on it". After COVID I can empirically say that it definitely can affect my life in fundamental ways.
1) Some bloggers I followed started talking about a deadly airborne virus out of China that I never heard of. They said different things but thought it was serious.
2) The country it originated in, China, had locked down their entire society.
3) The first European country to encounter it, Northern Italy, collapsed almost immediately. I had a doctor friend who had visited America for awhile that was in Milan and said it was a nightmare. They also shut down.
4) New York City, where I was from, was undergoing some kind of pandemic.
5) I told this to my father, hoping he would skip going to chorus practice that week, but neither he nor anyone in my family listened. The "news" hadn't told him to worry yet.
6) A couple days later the NBA cancelled a game over COVID and all of a sudden it was serious.
7) The sources I was consulting held open the possibility that it transmitted on surfaces, which if true would have been impossible to deal with. Many of the countries that the pandemic hit early were acting as if surface transmission was real.
With time, or with the king of knowledge a professional following this should have had, this could all be sorted out. But in March 2020 I just didn't want my Dad to go to chorus practice and die.
This is not correct. The "we didn't know" claim does a lot of dishonest work. We knew a lot.
Prior to it hitting the US, we already had perfect (closed!) natural experiments in the form of the cruise ships, closed systems with a population that skewed old. As I recall, the death % was around 2%, affecting the old not the young. So we had good hard data in February of 2020) that suggested that the overall population death rate, which is much, much younger, would be much, much lower than 2% and also that the old and sick were vulnerable, not others.
We also had in April 2020 the two CA studies that put the fatality rate at about 0.2%-0.4%, worse than flu but not the crazy single digit percentages that all the journalists were hoping for. The studies turned out to be accurate, but the study authors were all pilloried as charlatans in the press because no one wanted to provide good news.
These data were readily available on the web at the worldometers coronavirus tracker site that most people who were doing any tracking of the pandemic were using.
I'm in agreement that the media handled much of this very poorly and the silencing of contrarian opinions is shameful. That said, relying on two studies to inform policy on this scales seems like a weak argument amidst the potential fallout.
Again, even if we knew that fatality rate was under 1%, 1% of 350 million people will definitely wreck the healthcare system assuming we did nothing.
I can't claim to be an expert in any of these areas so I'm working with the best information I have (and have time to absorb). I get the feeling that the lesson many people took away from the past 3 years is that no one can be trusted and that all intuitions (media, public health, etc) are to be torn down. We all can't be experts in all area, let alone experts in a fraction of the actually important areas. I'm not sure what the path forward looks like but everyone doing their "own research" can't be the single solution.
"Again, even if we knew that fatality rate was under 1%, 1% of 350 million people will definitely wreck the healthcare system assuming we did nothing."
If we knew the fatality rate was under 1%, it was important for us to figure out what it actually was and who was vulnerable. Not assume 1% and panic. This is the problem with starting from panic and only ceding ground, rather than proceeding from established science and plans.
I think you have to take seriously how chaotic and disorienting the response would have been if all heterodox opinions were given a voice. In a complex situation you need a leadership structure that puts its foot down on certain things that will not be discussed. In hindsight, this always looks dictatorial, arrogant, and disrespectful of free speech, but imagine trying to storm a beach, put out a burning building, or save a gun shot victim while listening to every subordinate chime in with all their, "actually, the evidence says...actually, did you see the new paper on...actually, that study failed to replicate". I know in this instance the public health leadership was particularly bad and probably leaned too far in the "we gotta put our foot down on this" column (see:the Francis Collins email to Fauci about the Great Barrington declaration), but just imagine trying to run this shitshow and think of how quickly it could spiral out of control if you let all these voices have a fair hearing. Granted, in the end, this strategy probably ended up causing more harm to peoples faith in the public health establishment, but my overall point is that I dont think there was any way in which they were gonna come out of this thing unscathed. If they were adaptable and malleable during the pandemic they would have lost the trust then because every time they changed the guidance people would've said, "These clowns have no idea what theyre doing. They keep changing theyre mind every two weeks" So lose the trust during the pandemic or lose it after when its revealed that you stifled debate in order to maintain control.
Things we knew right away were vulnerability by age groups and rough mortality for those. Things we didn't know immediately, but learned quickly, were things like being less aggressive in using ventilators, and confirming this was airborne. But the vast majority of the damage happened way after all of this stuff was well known based on evidence.
Good question. Perhaps it made sense to give public health experts' opinions a bit of extra weight, but IMO it wasn't appropriate to give them ALL the weight and ignore expertise from other fields. It's something that struck me on the very first day the lockdowns were announced. Why were we expected to "listen to the scientists," when we were clearly facing not just a scientific problem but a human one?
Here in California the primary (and maybe even the only) stated justification for lockdown policies was to prevent medical facilities from being overwhelmed. Do you think enforcing temporary lockdowns for this reason had any merit?
Thanks for your question. I think most jurisdictions, including my province of Ontario, used a similar justification.
I'm not an anti-lockdown absolutist, so (with some reluctance) I concede that a SINGLE and SHORT-LIVED lockdown may have been warranted. But it should have been a one-shot deal. Extending the restrictions and mandates caused a lot of destruction and misery (not to everyone, of course) and breached the foundational principles of liberal democracy.
Those of us who place a high value on freedom despaired at the lack of allowable discourse about the trade-offs between safety and freedom. My book gets into these nuances. It doesn't position lockdown skepticism as the "correct" view -- just raises many of the questions we were not allowed to talk about.
Actually, the correct response to COVID was no response at all. First, modern medicine & hygiene etc ensure that viruses are NOT going to kill us all - they haven't managed to do so before & there's even less chance of viruses killing us all now, so we shouldn't be so worried about this largely imaginary problem. Second, no one could possibly know what to do, so diversification beats managed portfolios always. Third, any "good" solution has "bad" consequences, but how to distribute those consequences? Generally, the powerful consider a "good" solution to be one that hurts the powerless, even if the total cost to society is larger than the benefits or the alternatives'. Long and short, we cannot rationally respond to pandemics anyway, so we shouldn't try. The government should have published truthful information, encouraged & facilitated research into successful responses, but nothing else. There are no specialties or combination of specialties that can do anything about such problems for the same reasons & in the same way that specialists can't cure recessions.
The information required to manage pandemics does not exist, could not be processed if it did exist, & couldn't be processed in time if it could be processed. It's just a fool's errand that always & everywhere results in disaster (or succeeds purely by chance).
If there's a killer virus out there, we should each respond as best we can given our knowledge & circumstances - no management req'd because such management cannot work.
How would breakdown resistance to Covid policies? It seems there were some people who were bound to oppose any and all restrictions from the outset due to personality and basic psychological reactance. But others seemed to have various breaking points throughout the pandemic. Do you agree? How would you categorize these people and the forces that caused them to break?
No, I got that part. The hindsight play on words is not subtle.
"Blindsight" is also a feat (special ability) in D&D where things without eyes (or eyes that don't work in the circumstances) can "see" what is around them. There was a whole question of how good it was, how it works, etc., and the official rules were basically "it is perfect barring magic." Hiding was impossible, etc. It became a bit of an in-community joke that the best way to see was to not have eyes in the first place.
I was wondering if the title was an ingroup nod, or if it was just the play on hindsight.
"Blindsight" is also a name for an unconscious response to visual stimuli by someone who is blind, i.e. can't consciously process the stimuli, due to brain damage: https://en.wikipedia.org/wiki/Blindsight
Was the response driven by epidemiology, though? I'd argue it wasn't.
They threw out actual consensus science on pandemics, as well as the appropriate response to one. The 6' rule was reached by haggling. Masks aren't effective. The CDC knew early on this was airborne, yet everywhere the official message was mask-mask-mask instead of urging the vulnerable to absolutely isolate. The non-vulnerable - at least half the public - didn't need to isolate at all.
I think it's a mistake to say we focused only on science. We did no such thing.
3 years later and they still haven't given a remotely plausible reason why they abandoned all the many pre-2020 pandemic plans in place, which eschewed lockdowns, were skeptical to negative on masks, had school closure as a VERY limited-time measure of last resort, etc...
Detailed here: https://twitter.com/SwedenTeam/status/1406736935687753730?s=20
and here: https://twitter.com/TrishtheDish_7/status/1429550428891619345?s=20
Which is why people understandably assume the people who were supposed to provide the scientific expertise, were either incompetent or malicious actors, or some of both.
Scott Sumner has always made a very similar point about 2008: there was a standard theory available in macroeconomics textbooks, events failed to contradict it in any way, but the theory was completely abandoned in favor of random alternative approaches.
It's probably a mistake to believe that the same thing happened for different reasons in these two completely different areas.
I have not read Blindsight is 2020 so forgive me if I'm making points that have been already been addressed.
When it comes to the initial lock downs (March 2020), I believe we did the right thing in being a little over cautious. At that time, as far as I can tell, I think it's fair to say we didn't know much about the virus or what the worst case scenario might be. It seems prudent to err on the side of caution, given that if the worst case scenario is as bad as it theoretically can be for a highly transmissible influenza, we would be in deep trouble.
I am in full agreement that public debates and honest discussions should have been going during this time, allowing us to fully weigh the costs and benefits of continuing to extend lock down. That said, one of the initial reasons I recall for the lock downs in the first place was to "flatten the curve" to avoid overwhelming our healthcare system. As someone with dozens of friends and acquaintances working as doctors, nurses and in healthcare IT, it seems they had their hands full even with the lock downs in place. If the healthcare system collapses, we all lose.
I guess my questions for Gabrielle are, do you think it's fair that we weighed the opinions of public health officials more? And perhaps more broadly, when it comes to tackling problems at this scale, how do we decide which voices that should be amplified (if at all)? Lastly, I'd be interested to hear your take on if and how the information landscape made this whole problem worse?
Thank you!
Eskild
Normally I would be tempted to say that freaking out in March 2020 was a reasonable decision at the time. Provided:
1) You were a normal person that just heard of COVID and had access to no special information and didn't know who to trust.
There were some people with more information that should have known better and didn't or didn't care.
2) You felt that, once we knew more, such measures could be turned off like a light switch is appropriate. For instance, by summer 2020 we clearly could have just moved on. Schools should have opened in the fall. Etc.
#2 really fell apart with hindsight, and I will never trust in it again. Once a moral panic gets going and powers have been enacted, it's not going to end, so you can never let it start.
Is that a bad equilibrium? Sure. COVID could have been x10 or x100 deadlier. It could have killed children instead of the elderly. Such a pandemic would have warranted March 2020 lockdowns, at least for a time.
But next time I'm not even waiting to find out of that is the case. I'm going to risk it. I'd rather take that risk then repeat COVID over a disease that didn't deserve the response it got.
COVID also dramatically increase how much I care about politics/culture wars. Normally I would say "that stuff doesn't effect me enough to spend much time on it". After COVID I can empirically say that it definitely can affect my life in fundamental ways.
Here is what I knew in mid-march.
1) Some bloggers I followed started talking about a deadly airborne virus out of China that I never heard of. They said different things but thought it was serious.
2) The country it originated in, China, had locked down their entire society.
3) The first European country to encounter it, Northern Italy, collapsed almost immediately. I had a doctor friend who had visited America for awhile that was in Milan and said it was a nightmare. They also shut down.
4) New York City, where I was from, was undergoing some kind of pandemic.
5) I told this to my father, hoping he would skip going to chorus practice that week, but neither he nor anyone in my family listened. The "news" hadn't told him to worry yet.
6) A couple days later the NBA cancelled a game over COVID and all of a sudden it was serious.
7) The sources I was consulting held open the possibility that it transmitted on surfaces, which if true would have been impossible to deal with. Many of the countries that the pandemic hit early were acting as if surface transmission was real.
With time, or with the king of knowledge a professional following this should have had, this could all be sorted out. But in March 2020 I just didn't want my Dad to go to chorus practice and die.
This is not correct. The "we didn't know" claim does a lot of dishonest work. We knew a lot.
Prior to it hitting the US, we already had perfect (closed!) natural experiments in the form of the cruise ships, closed systems with a population that skewed old. As I recall, the death % was around 2%, affecting the old not the young. So we had good hard data in February of 2020) that suggested that the overall population death rate, which is much, much younger, would be much, much lower than 2% and also that the old and sick were vulnerable, not others.
We also had in April 2020 the two CA studies that put the fatality rate at about 0.2%-0.4%, worse than flu but not the crazy single digit percentages that all the journalists were hoping for. The studies turned out to be accurate, but the study authors were all pilloried as charlatans in the press because no one wanted to provide good news.
These data were readily available on the web at the worldometers coronavirus tracker site that most people who were doing any tracking of the pandemic were using.
Hi Andre, misinformed - perhaps, dishonest - no.
I'm in agreement that the media handled much of this very poorly and the silencing of contrarian opinions is shameful. That said, relying on two studies to inform policy on this scales seems like a weak argument amidst the potential fallout.
Again, even if we knew that fatality rate was under 1%, 1% of 350 million people will definitely wreck the healthcare system assuming we did nothing.
I can't claim to be an expert in any of these areas so I'm working with the best information I have (and have time to absorb). I get the feeling that the lesson many people took away from the past 3 years is that no one can be trusted and that all intuitions (media, public health, etc) are to be torn down. We all can't be experts in all area, let alone experts in a fraction of the actually important areas. I'm not sure what the path forward looks like but everyone doing their "own research" can't be the single solution.
Okay.
"Again, even if we knew that fatality rate was under 1%, 1% of 350 million people will definitely wreck the healthcare system assuming we did nothing."
If we knew the fatality rate was under 1%, it was important for us to figure out what it actually was and who was vulnerable. Not assume 1% and panic. This is the problem with starting from panic and only ceding ground, rather than proceeding from established science and plans.
I think you have to take seriously how chaotic and disorienting the response would have been if all heterodox opinions were given a voice. In a complex situation you need a leadership structure that puts its foot down on certain things that will not be discussed. In hindsight, this always looks dictatorial, arrogant, and disrespectful of free speech, but imagine trying to storm a beach, put out a burning building, or save a gun shot victim while listening to every subordinate chime in with all their, "actually, the evidence says...actually, did you see the new paper on...actually, that study failed to replicate". I know in this instance the public health leadership was particularly bad and probably leaned too far in the "we gotta put our foot down on this" column (see:the Francis Collins email to Fauci about the Great Barrington declaration), but just imagine trying to run this shitshow and think of how quickly it could spiral out of control if you let all these voices have a fair hearing. Granted, in the end, this strategy probably ended up causing more harm to peoples faith in the public health establishment, but my overall point is that I dont think there was any way in which they were gonna come out of this thing unscathed. If they were adaptable and malleable during the pandemic they would have lost the trust then because every time they changed the guidance people would've said, "These clowns have no idea what theyre doing. They keep changing theyre mind every two weeks" So lose the trust during the pandemic or lose it after when its revealed that you stifled debate in order to maintain control.
So consensus science on pandemics and the data we actually had are now the ~fringe people saying "actually... did you see the paper"?
Seems to me this is completely mischaracterizing what actually happened. It borders on gaslighting.
By consensus science you mean all the pre Covid pandemic plans from the major public health agencies such as those outlined here: https://twitter.com/SwedenTeam/status/1406736935687753730?s=20
Things we knew right away were vulnerability by age groups and rough mortality for those. Things we didn't know immediately, but learned quickly, were things like being less aggressive in using ventilators, and confirming this was airborne. But the vast majority of the damage happened way after all of this stuff was well known based on evidence.
Good question. Perhaps it made sense to give public health experts' opinions a bit of extra weight, but IMO it wasn't appropriate to give them ALL the weight and ignore expertise from other fields. It's something that struck me on the very first day the lockdowns were announced. Why were we expected to "listen to the scientists," when we were clearly facing not just a scientific problem but a human one?
Here in California the primary (and maybe even the only) stated justification for lockdown policies was to prevent medical facilities from being overwhelmed. Do you think enforcing temporary lockdowns for this reason had any merit?
Thanks for your question. I think most jurisdictions, including my province of Ontario, used a similar justification.
I'm not an anti-lockdown absolutist, so (with some reluctance) I concede that a SINGLE and SHORT-LIVED lockdown may have been warranted. But it should have been a one-shot deal. Extending the restrictions and mandates caused a lot of destruction and misery (not to everyone, of course) and breached the foundational principles of liberal democracy.
Those of us who place a high value on freedom despaired at the lack of allowable discourse about the trade-offs between safety and freedom. My book gets into these nuances. It doesn't position lockdown skepticism as the "correct" view -- just raises many of the questions we were not allowed to talk about.
Most "mental health experts" are "experts" but not experts:
https://westhunt.wordpress.com/2014/10/20/the-experts/
Actually, the correct response to COVID was no response at all. First, modern medicine & hygiene etc ensure that viruses are NOT going to kill us all - they haven't managed to do so before & there's even less chance of viruses killing us all now, so we shouldn't be so worried about this largely imaginary problem. Second, no one could possibly know what to do, so diversification beats managed portfolios always. Third, any "good" solution has "bad" consequences, but how to distribute those consequences? Generally, the powerful consider a "good" solution to be one that hurts the powerless, even if the total cost to society is larger than the benefits or the alternatives'. Long and short, we cannot rationally respond to pandemics anyway, so we shouldn't try. The government should have published truthful information, encouraged & facilitated research into successful responses, but nothing else. There are no specialties or combination of specialties that can do anything about such problems for the same reasons & in the same way that specialists can't cure recessions.
The information required to manage pandemics does not exist, could not be processed if it did exist, & couldn't be processed in time if it could be processed. It's just a fool's errand that always & everywhere results in disaster (or succeeds purely by chance).
If there's a killer virus out there, we should each respond as best we can given our knowledge & circumstances - no management req'd because such management cannot work.
Why didn't Team Reality have more influence on Covid19 policies? Why was it captured by Team Apocalypse?
Gabrielle,
How would breakdown resistance to Covid policies? It seems there were some people who were bound to oppose any and all restrictions from the outset due to personality and basic psychological reactance. But others seemed to have various breaking points throughout the pandemic. Do you agree? How would you categorize these people and the forces that caused them to break?
*sold*
Please make an audio version. It's the only way I consume books these days.
Instead of constantly trying to simply bait liberals to please your audience, I'd be interested in giving space to people like Michael Lewis: https://www.amazon.com/Premonition-Pandemic-Story-Michael-Lewis/dp/0393881555/ref=asc_df_0393881555/
Is the title of this book a subtle D&D joke?
No, its on the saying hindsigt is 20/20
No, I got that part. The hindsight play on words is not subtle.
"Blindsight" is also a feat (special ability) in D&D where things without eyes (or eyes that don't work in the circumstances) can "see" what is around them. There was a whole question of how good it was, how it works, etc., and the official rules were basically "it is perfect barring magic." Hiding was impossible, etc. It became a bit of an in-community joke that the best way to see was to not have eyes in the first place.
I was wondering if the title was an ingroup nod, or if it was just the play on hindsight.
"Blindsight" is also a name for an unconscious response to visual stimuli by someone who is blind, i.e. can't consciously process the stimuli, due to brain damage: https://en.wikipedia.org/wiki/Blindsight