7 ms·

On “Armchair Epidemiology”

67 points by ssklash 7y ago

tjr225 7y ago
If this current situation has taught me anything it is that the internet is a mush of armchair garbage and it’s overwhelming to decipher- yes even what I’m typing now. The whole thing has me desperate to ignore everyone and read a book. What a joke; to think we are all somehow experts.
- arunbahl 7y ago
  Unclear if you read the article and are voicing disagreement with it, but Scott Aaronson is in fact defending armchair epidemiology.
  - tjr225 7y ago
    I did read the article. I'm exhausted by both sides.
- deleted 7y ago
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- threatofrain 7y ago
  Most people don't have a <relationship> with an expert, so they are still left out on their own, having to decipher the world as it comes. When you don't have relationships with a technical community, there's no interesting anchor to stop you from gyrating with the news of the day.
- naringas 7y ago
  I agree, I still cannot make up my mind about masks... It seems like "back in the day" people trusted the experts, becuase well, there weren't many alternatives (?); but now thanks to the internet everyone can google for a while and feel like they have a worthwhile opinion. It seems like now it's possible to find an expert (and/or data) to justify any opinion. I am not saying this is bad, but that it's just different. The game has changed.
  - Gibbon1 7y ago
    After rolling things around my current thought is, what if this isn't the last rodeo? What if there is another outbreak? Because there will be. Of 'something' but we don't know what that will be. Seems to me then what you want to a robust set of responses that do not require people to make decisions based on god knows what. Because in the future you don't know ahead of time what's going to be helpful and what won't be. What you want to public to do is reflexively anything that might help. And then later tell them what measures they can back off on. Not the other way around.
  - btilly 7y ago
    I agree, I still cannot make up my mind about masks.. What's so hard about masks? That's one area that experts seem pretty consistent on, and what they say makes sense. It is slightly complicated but not contradictory. Wearing a mask doesn't do that much to prevent you from getting sick. But it does a lot to prevent you from getting others sick. If there is a limited supply of masks, the best people to give them to are people are at high likelihood of being sick and come face to face with lots of people who get sick easily. Which is to say medical staff. If there were masks to go around, we'd want everyone wearing them as a precaution. So that you're not getting people sick even if you don't yet know that you are sick. Some countries, like Taiwan, already make enough masks that they can actually do that. The USA does not. In time we should fix that. Can you find anyone whose expertise is generally respected who says something that disagrees with what I just said?
- gentleman11 7y ago
  I worry about this in software development. There are so many “experts” posting blogs about whatever is on their mind, and the tide of common wisdom gets caught up in it. Eg, everybody, everywhere said that NodeJS has amazing performance for high io workloads. If you look at benchmarks however, the nodejs systems cannot keep up with older tech, so now the argument is “we use it because it’s a nice environment, not for performance.” I am trying to focus on textbooks now, but with so much self publishing I think that it is only a temporary strategy
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- fragmede 7y ago
  The mush is because we don't actually know, and we're all afraid to admit it. Like, does this thing confer a lasting immunity upon those who survive? We have educated guesses, and can draw some inferences, and cite statistics and cases from countries at each other, but until it's 6-months later and we have incontrovertible proof, it's mush dancing around the honest answer to many of the questions floating around is: We don't know. The second problem is that we're clearly terrible at collectively digesting new information uniformly. New information is evolving our understanding and things said a week or months ago no longer reflect our current understanding. But not everyone's subscribed to the same newsletter, so we're not on the same page. Back in January, based on SARS and MERS, and how much that affected the western world, the comparison to the flu was apt. Was. It's not longer January and that comparison is bad and is liable to get you branded a right-wing capitalism-death-cultist. There's no way to read only what's changed, so either to get into the muck and drink from the firehose, or defer to experts, some of whom are actually paid to deal with this. Go read a book, the muck'll be here waiting for you when you get back. When you do, ask the experts, when you get back and update your knowledge correspondingly.
btilly 7y ago
Looking back at my thinking at the same time I am also ashamed at how slow I was to realize it. I also trusted in our institutions. I knew what lengths that they went to in SARS. I understood how much thought has gone into public health. I found articles explaining why one would rationally ration available tests. Even when it was clear to me that we were in for a pandemic and millions would die, I completely failed to predict that we'd be willing to put Western countries in lockdown - or that lockdown would be as effective as it has been. I probably came to the right conclusion before Scott did. But still the only thing that I did right with my knowledge was to tell my wife to buy a put on the DOW back when it was still rising.
whatever1 7y ago
Let's talk first about the domain experts, professors in prestigious universities, that were reassuring the public that COVID-19 is no way more fatal than the seasonal flu [1]. The same moment that the ICUs in Italy and Spain were already overwhelmed and the physicians could not find the necessary protective equipment to keep saving lives. Are there gonna be any legal repercussions to these? [1]https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464 https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as...
- modzu 7y ago
  what are you talking about? that article is contemporary, they havent been proven wrong.
  - whatever1 7y ago
    Art can be contemporary. Science not. We are currently looking at 200k deaths in the USA [1] from COVID-19, in the good scenario. How is it even compatible with their 0.01% mortality rates? Have we forgotten how to divide numbers? [1]https://thehill.com/homenews/administration/490138-birx-says-us-could-have-up-to-200000-coronavirus-deaths-if-we-do https://thehill.com/homenews/administration/490138-birx-says... P.S. They even make the claim that COVID-19 has 1/10th the mortality of seasonal flu :facepalm:
    - petertodd 7y ago
      "We are currently looking at 200k deaths in the USA" That is a prediction. It is not yet a fact. Right now we just don't have a good idea of how many people 1) how many people are currently infected, 2) how many people have already been infected and recovered without being tested, 3) how many people were already immune and would never have been infected, 4) how the way you are infected changes the outcome of the disease. The mortality rate depends directly on those numbers. Until we know those numbers, we just don't know for sure. With H1N1 initial estimates of the fatality rate per infection were almost two orders of magnitude too high. A similar error may or may not be happening here. The best we have right now is a tiny handful of limited, non-representative, "accidental experiments" like the Princess Diamond, that may or may not represent how the disease spreads in the community (note question #4). This will however soon change as more randomized testing is done, and in particular, anti-body testing to determine who already got the disease and recovered.
elchief 7y ago
Who should we believe, then, the WHO? They told us China had it under control, and not to wear masks
- empath75 7y ago
  The math. We had the fatality rate and r0. As soon as it was obvious that it spread out of control on China, it was just a matter of time. You didn’t need to be an epidemiologist, you just needed a high school maths education.
  - zozbot234 7y ago
    The thing is, it didn't quite spread out of control on China. There were a heck of a lot of cases in Wuhan and Hubei, and markedly fewer cases elsewhere. We might guess that this is perhaps just a side-effect of exponential dynamics, but I'm not quite sure about that.
    - makomk 7y ago
      At a guess, this is perhaps a consequence of the fact that the entire rest of China has been treating everyone from Hubei like a plague carrier since January regardless of whether they've even been there in years. Any country that didn't, at the very least, quarantine people who'd been in Hubei plus their close contacts back then probably can't expect the same results, and even that plus contract tracing and testing plus social distancing only seems to hve delayed the inevitable.
  - elchief 7y ago
    Which math to believe, the 4.8% CFR, or the 19% deaths/completed?
- knzhou 7y ago
  The WHO has been urging everybody to get prepared for 10 weeks now, while constantly giving the same good advice (test, trace, lockdown, social distance). People are pretending this is all WHO's fault because they said some wrong stuff in early January, when the correct conclusions were not at all obvious. And they've been completely correct and transparent since late January. It's almost April now. At this point, it's just a worn out excuse.
darawk 7y ago
What's particularly impressive about this situation is that all the institutions on all sides got it wrong. Trump and his administration downplayed it, and Vox, Wapo, NYT et al downplayed it. You would think these two would act as a check on one another, but they completely failed to do so. The one time we needed them to disagree with each other, they agreed forcefully.
modzu 7y ago
this is borderline terrorism, imo. right from the into, "Dr. A..." which to a layman would reasonably interpet as meaning "M.D" rather than professor of computer science. the one thing i have noticed in all this is the utterly astonishing abandonment of science, reason, and rationality. that scares me much more than disease.
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zozbot234 7y ago
Hindsight is always 20/20.
alexandercrohde 7y ago
This is a topic that seems to be in a perverse conflict of interests. A. Politicians have interests representing themselves as well as their country, and thus have given dishonest advice (masks don't help) with an ulterior motive (save them for hospital), downplayed the problem, and covered up the number of cases. B. I think a lot of actually qualified experts (doctors, scientists) to think the public can't handle the truth perhaps? I still have yet to see anybody in any position of respect or authority simply say the bald truth: "A few million Americans will die, at least, unless some radical cure happens. Social distancing is a drop in the bucket, ventilators make a tiny difference. The vast majority of young people will be totally fine" I'm disappointed in our society for failing to bubble up and synthesize good information quickly.
- zozbot234 7y ago
  > Social distancing is a drop in the bucket Sorry, but look at how China, South Korea, Taiwan etc. are doing right now - this doesn't jive at all with "social distancing is a drop in the bucket". Even Western countries/places which started social distancing early in their local outbreaks look like they'll be a lot better off than places which didn't. > The vast majority of young people will be totally fine This is also quite wrong, unfortunately. A sizeable minority of young people will need hospital treatment for COVID, and perhaps intensive care. Given overwhelmed healthcare systems, they won't be "totally fine" at all. Of course, older folks are at increased risk.
  - JimTheMan 7y ago
    I highly recommend this video from Korea (Professor Kim Woo-joo from Korea University Guro Hospital) that gives a Korean perspective on the disease and the western response to it: https://www.youtube.com/watch?v=gAk7aX5hksU https://www.youtube.com/watch?v=gAk7aX5hksU A few points of interest: (He is a very respectful fellow so apologies if the summary seems a bit to the point) - Masks help and he is slightly puzzled why the west hasn't adopted that culture - Their testing and tracing helps and they doubt the US would allow their level of privacy invasion - Korea is doing well because they have had to respond to pandemics and were prepared (as are Taiwan, Singapore etc)
hirundo 7y ago
"A viral article implores us to ... to listen only to authoritive sources like the CDC, not random people spouting on social media. This was notable to me for being the diametric opposite of the actual lesson of the past two months" This is the opposite sentiment to "there are no libertarians in pandemics." Keen perception of reality is unlikely to be concentrated at the top of political hierarchies. Competent Authority isn't an oxymoron but it's distressingly unreliable.
empath75 7y ago
There are people still, in every thread here about it, downplaying it. I’m sure someone will be along momentarily to tell us that it’s no worse than seasonal flu.
naringas 7y ago
this whole covid19 debacle is exposing a very real change brought about by the internet. we are being forced to adapt and to develop new ways to relate to information, to asses it's trustworthiness, etc... it's an epistemic phenomenon. perhaps another facet of this phenomenon are the filtered information bubbles. But this pandemic really puts the pressure on us to face the reality of our current information society.
jasonhansel 7y ago
> A viral article implores us to “flatten the curve of armchair epidemiology”—that is, to listen only to authoritive sources like the CDC, not random people spouting on social media. > This was notable to me for being the diametric opposite of the actual lesson of the past two months. So, because some (unspecified, unnamed) experts weren't able to predict the future with perfect accuracy, we should give equal credence to "random people" instead? Medical professionals, scientists, and public health experts are still the best available source of knowledge about preventing the growth of this pandemic. Spreading the message that we should ignore epidemiologists is wrong at best and dangerous at worst.
- jasonhansel 7y ago
  (I'm sure that epidemiologists reading posts like the OP feel a lot like software devs reading opinion columns about cybersecurity or cryptocurrencies.)
- fiblye 7y ago
  >So, because some (unspecified, unnamed) experts weren't able to predict the future with perfect accuracy, we should give equal credence to "random people" instead? That wasn't my takeaway. My takeaway is that if you have some intuitive sense that shit's about to hit the fan and authorities keep telling you to stay calm and don't take any special precautions, all while danger is clearly growing, it's best to lean towards following your intuitions gradually just in case things ramp up. You shouldn't buy 10000 rolls of toilet paper, but all those people who thought, "Hmmm, maybe I should buy some masks and a couple extra bottles of hand sanitizer. Maybe not visit the movie theater anytime soon as well" while authorities were saying "Go to work and be normal. Masks are useless"... well, they were right and it would've been better to take those then "unnecessary" precautions. Reminds me of people talking about government surveillance pre and post Snowden. If you wanted to encrypt all your messages and avoid Facebook, etc, you were a conspiracy nut because it was impossible to surveil everything. Overnight it became "Of course they monitor everything. Why wouldn't they? But we have end-to-end encryption now and we can completely trust it."
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knzhou 7y ago
This whole mess has been a repudiation of business-as-usual politics, but it has not been a repudiation of scientific experts. Scientific experts across the world have been alarmed for months now. The only problem is that, as with any new and uncertainty situation, the error bars started absolutely enormous, so the range of expert opinion has been wide. This is the case in any crisis. With the benefit of hindsight, you can always find an expert who was wrong, but that doesn't mean anything. It's important to say this because later, you're going to start to hear bloviating from politicians who failed to act for months. "Nobody knew this was coming." "Everything that went wrong was solely the fault of $enemy_country or $rival_party."
- professorgerm 7y ago
  It has been a repudiation of the communication layers between experts and average people, as well, which I think might be more of Aaronson's ire than experts qua experts (it's certainly more of my ire, but I don't have his platform). A standard of "scientists dabbling in journalism to improve communication" instead of "journalists dabbling in communicating science" would likely have gone a long way to improving the civilian response and trust in experts. There's also the factor of the "Noble Lie" dishonesty around wearing masks. I suspect intellectual-ish contrarians (like Aaronson et al) are more angered by this than the average person, but we ended up with shortages and sellouts anyways: a significant number of non-experts didn't buy into that noble lie so the experts/organizations that pushed it (not to be confused with ALL experts) burned a lot of good will to basically no effect. ETA: I considered replying to your comment about the Harvard epidemiologists but would rather edit it in here to avoid two replies to one person: I think that's a great example of my point. The story wasn't broken by bloggers, but bloggers were more likely to be amplifying the concerned experts than our "traditional media powerhouses."
screye 7y ago
What has struck me most about Epidemiology, are the qualifications needed to be someone pursuing a career in it. It seems like an Epidemiologist is most likely to be a doctor with some knowledge of statistics. On the contrary, I would have thought that a statistician/operations research person with domain knowledge of medicine would be a lot better suited to study epidemiology. A lot of the existing models also seem really naïve for something an entire field depends on. Tradeoffs between human life lost due to the disease and effective human lives lost due to economic downturns seem entirely unstudied. Czechia's actions of forcing people to using masks seems to have worked amazingly well for flattening out the curve. The "science" not seems to support it, and official recommendations are now moving back to recommending masks for all. The popular hypothesis for this, is that it stops nonsymptomatic carriers from being spreaders. Now this sounds like a fairly obvious thing to realize, and to an extent, existing models should have caught this a lot earlier. I grew up as a kid with an almost religious belief in Science. Over time, I have come to realize that a lot of our sciences are at best empirical and at worst entirely unverifiable. I am a 100% certain, that in a 100 years, we will look at medicine and nutrition of the 2000s, the way we look at humors and blood letting.
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- mdp553 7y ago
  Speaking as an infectious disease epidemiologist - epidemiology is a broad field and includes people from many different backgrounds. The type of epidemiology I do (dynamic modeling of epidemics) leans more towards people with backgrounds in statistics, physics, math, and engineering when compared to the more "traditional" types epidemiology (if there even is such a thing anymore).
- Engineering-MD 7y ago
  There is benefit to a team with diverse backgrounds. Mathematical and statistical knowledge is vital, but so is understanding how hospitals and humans react to disease and interventions. As for looking back at medicine in 200 years as blood letting and humours, I think that is to misunderstand medicine in its entirety. Modern medicine is evidence based where it can be, mixed with a high level of uncertainty and best application of basic science. This has predictive power, but is obviously limited due to the complexity of the system. A better analogy would be industrial era engineering vs modern day engineering: the same aim with similar attempts but much better understanding of the system at a higher level of resolution achieved by improvements in technology and base understanding.
apatil 7y ago
I sent a similar text to a medically vulnerable friend on Jan 25 saying I thought it was "scary, but not the scariest thing in the world right now", despite having spent some time working with an epidemiology research group. In hindsight, I knew enough to take the risk much more seriously. This article: https://virologydownunder.com/past-time-to-tell-the-public-it-will-probably-go-pandemic-and-we-should-all-prepare-now/ https://virologydownunder.com/past-time-to-tell-the-public-i..., plus the rising mortality numbers, spurred me to start warning the medically vulnerable people in my life on Feb 23. I am very grateful to the authors for helping me do the right thing. At this point, it seems to me that our experts are still letting us down in two important ways: 1. They aren't rebutting this implicit notion that any mortality risk below 1% can be rounded down to zero. As a consequence, the idea that it might be a good idea to let younger, healthy people just go out and get the virus and get immune seems to still have currency, and this is really dangerous. We can't open things back up until we have a credible plan for driving the infection rate toward zero. Leaving aside the risk of life-changing injury, a mortality risk of eg 0.5% applied to eg half of young adults would still be by far the most dangerous thing that happens to most of them this year, and a huge personal tragedy for many of us. Do the math and work out how many people you know would die. 2. Simple, inexpensive measures like widespread masking, handwashing, gloves and eye protection will clearly be important components of any credible plan for driving the infection rate toward zero, unless we get an early vaccine. The experts should be hammering the point that we all need to be fastidious about those things whenever we open back up again.
bJGVygG7MQVF8c 7y ago
> I sent a quick reply two minutes later: > For now, I think the risk from the ordinary flu is much much greater! But worth watching to see if it becomes a real pandemic. Nope. Lost all credibility right there. Do not pass GO, do not collect 2 minutes of attention. Sorry. Oh, you've learned something from the error and you've updated your priors? Great, good for you. You're still unreliable.
- AlexMennen 7y ago
  This seems overly harsh. Few people took COVID-19 seriously on Feb 4, so this standard makes almost everyone have no credibility, including people who don't admit to the error. All humans are unreliable.
  - defen 7y ago
    Here's a blog post from February 6 by Greg Cochran, one of the people mentioned. Looks pretty good in retrospect https://westhunt.wordpress.com/2020/02/06/strategy-not-the-flu/ https://westhunt.wordpress.com/2020/02/06/strategy-not-the-f...
  - bJGVygG7MQVF8c 7y ago
    > Few people took COVID-19 seriously on Feb 4 Plenty who were paying attention took it seriously
fellowniusmonk 7y ago
Caveat Emptor is one of the deepest truths, whether shopping on amazon or listening to experts of different stripes, there has been enough information on the internet to come to accurate conclusions at every step, enough historical info from sars and spanish flu to see what could have been coming down the pipe, enough social media leak from China to tell that this was not contained, the choice is not between obliviousness or panic it's about prudent low cost risk mitigation. The fact is, that many people's internal information filtering algorithm is lacking, small preparation is sufficient 90% of the time as long as you are looking at slow moving historic signals, it's about small risk mitigations early. As played out as it is, this is further proof that the medium is the message, people engaging in unidirectional or bidirectional firehose messaging (cable tv, twitter, facebook) have tended towards panic or dismissiveness, people following historical information and slowly changing documents and global forums have been able to take prudent low cost risk mitigation, and by doing it early have operated comfortably on a different wavelength than people panic buying. Unstructured messaging and it's cognitive overhead is a problem, unstructured messaging means that even if the inbound message is about the issue currently in your head, the design of "alerts" trigger a disruptive near context switch, like a digital doorway effect that sabotages deep thinking, deep thinking is required for prudence. People still don't understand how bad this is though, for Americans, I'm only just now seeing a few people and articles connect the dots on bio warfare preparedness and how our asymmetrically weak and discordant response puts the U.S. at increased risk from a national security and power projection perspective. These aren't truths per se, just probability curves. As an example, since mid December I've been gently decreasing my downside risk, divesting and putting a few dollars here and there into things like masks and non perishables, already had a bidet, water filter, UV lamps, etc. No special preparation just things I already have around the house for my aquarium, camping, spray painting, hot ones challenges, etc. I haven't had to wait in any grocery lines or experience any personal discomfort or anxiety, and my slightly early social distancing was subtle enough most people didn't even notice. I was telling people who asked "These might be historic times, low cost preparation is in order." All this is from an individuals perspective, businesses should already be operating with risk management plans.
wwweston 7y ago
Relate to a lot of this (and it's especially worth noting there is something about identity contempt especially on social media but also IRL that hobbles our ability to coordinate understanding and action) but... let's also not forget it wasn't only contrarians and autodidacts who were making concerned noises -- there are plenty of professional epidemiologists and other specialists who were beating the warning drums.
- knzhou 7y ago
  Exactly. For example, back on February 3 we had this from Harvard epidemiologists: > “Many epidemiologists and people who are following this outbreak closely are assuming that it’s probably quite a bit more widespread than the case counts suggest,” said Michael Mina, assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “Many people also think that there’s probably over 100,000 in reality out in mainland China, for example. We just don’t capture all of those through the case reporting we have. … We can assume that this is growing at somewhat of an exponential rate, and it will continue increasing in scale.” This story wasn't broken by bloggers! Source: https://news.harvard.edu/gazette/story/2020/02/as-confirmed-cases-of-coronavirus-surge-path-grows-uncertain/ https://news.harvard.edu/gazette/story/2020/02/as-confirmed-...
notacoward 7y ago
There are two things seriously wrong with this article. (1) It treats authorities and non-authorities as monolithic. Far from it. There were plenty of serious, well qualified epidemiologists who were warning of the danger, and they were right. There were even more non-serious people using their popularity in completely unrelated fields to minimize the danger, and they were wrong. Sadly there still are, most definitely including here. Yes, the people in the actual seats of US federal power got it wrong, and plenty of amateurs got it right, but it's more complicated than the "don't trust experts" narrative. (2) Sample of one. Even if it weren't for the above, and the two groups were monolithic, this is just one case where the authorities were wrong and others were right. Yes, it's a very prominent case because of the consequences, but prominence is not the same as statistical significance. Treating it so is a form of cognitive bias/error. The real lesson here is not to distrust experts or authorities. It's not to trust conspiracy theorists or people with whom we empathize more because they're in our own industry. It's to trust science itself - empirical facts and analysis applied to facts. Both experts and others can help us to interpret those facts, put them in perspective, correct common errors in analysis, but ultimately it should be the facts that rule. The reason so many authorities and non-authorities were wrong is because they rejected the scientific approach, not because of who they are.
- OrderlyTiamat 7y ago
  good points, though I'm a bit bothered with your second point here. First of all, I think calling this a single event is reductionist. We're talking about weeks- months, even- of experts and non experts warning about this, and the systems of authorities failed completely to react in time. We're not talking about failing to heed an important warning once, we're talking about a long string of choices here. Secondly, This isn't just a prominent case, it is a very important case. Treating this as a series of bernoulli trials with a single (statistically irrelevant) failure is an extremely reductionist model of the reality here. While your conclusion of trusting science, empirical facts and analysis rings true to me, I think we should be wary of overly simplifying the subject matter.

67 points by ssklash 7y ago

If this current situation has taught me anything it is that the internet is a mush of armchair garbage and it’s overwhelming to decipher- yes even what I’m typing now. The whole thing has me desperate to ignore everyone and read a book. What a joke; to think we are all somehow experts.

arunbahl 7y ago
Unclear if you read the article and are voicing disagreement with it, but Scott Aaronson is in fact defending armchair epidemiology.
- tjr225 7y ago
  I did read the article. I'm exhausted by both sides.
deleted 7y ago
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threatofrain 7y ago
Most people don't have a <relationship> with an expert, so they are still left out on their own, having to decipher the world as it comes. When you don't have relationships with a technical community, there's no interesting anchor to stop you from gyrating with the news of the day.
naringas 7y ago
I agree, I still cannot make up my mind about masks... It seems like "back in the day" people trusted the experts, becuase well, there weren't many alternatives (?); but now thanks to the internet everyone can google for a while and feel like they have a worthwhile opinion. It seems like now it's possible to find an expert (and/or data) to justify any opinion. I am not saying this is bad, but that it's just different. The game has changed.
- Gibbon1 7y ago
  After rolling things around my current thought is, what if this isn't the last rodeo? What if there is another outbreak? Because there will be. Of 'something' but we don't know what that will be. Seems to me then what you want to a robust set of responses that do not require people to make decisions based on god knows what. Because in the future you don't know ahead of time what's going to be helpful and what won't be. What you want to public to do is reflexively anything that might help. And then later tell them what measures they can back off on. Not the other way around.
- btilly 7y ago
  I agree, I still cannot make up my mind about masks.. What's so hard about masks? That's one area that experts seem pretty consistent on, and what they say makes sense. It is slightly complicated but not contradictory. Wearing a mask doesn't do that much to prevent you from getting sick. But it does a lot to prevent you from getting others sick. If there is a limited supply of masks, the best people to give them to are people are at high likelihood of being sick and come face to face with lots of people who get sick easily. Which is to say medical staff. If there were masks to go around, we'd want everyone wearing them as a precaution. So that you're not getting people sick even if you don't yet know that you are sick. Some countries, like Taiwan, already make enough masks that they can actually do that. The USA does not. In time we should fix that. Can you find anyone whose expertise is generally respected who says something that disagrees with what I just said?
gentleman11 7y ago
I worry about this in software development. There are so many “experts” posting blogs about whatever is on their mind, and the tide of common wisdom gets caught up in it. Eg, everybody, everywhere said that NodeJS has amazing performance for high io workloads. If you look at benchmarks however, the nodejs systems cannot keep up with older tech, so now the argument is “we use it because it’s a nice environment, not for performance.” I am trying to focus on textbooks now, but with so much self publishing I think that it is only a temporary strategy
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fragmede 7y ago
The mush is because we don't actually know, and we're all afraid to admit it. Like, does this thing confer a lasting immunity upon those who survive? We have educated guesses, and can draw some inferences, and cite statistics and cases from countries at each other, but until it's 6-months later and we have incontrovertible proof, it's mush dancing around the honest answer to many of the questions floating around is: We don't know. The second problem is that we're clearly terrible at collectively digesting new information uniformly. New information is evolving our understanding and things said a week or months ago no longer reflect our current understanding. But not everyone's subscribed to the same newsletter, so we're not on the same page. Back in January, based on SARS and MERS, and how much that affected the western world, the comparison to the flu was apt. Was. It's not longer January and that comparison is bad and is liable to get you branded a right-wing capitalism-death-cultist. There's no way to read only what's changed, so either to get into the muck and drink from the firehose, or defer to experts, some of whom are actually paid to deal with this. Go read a book, the muck'll be here waiting for you when you get back. When you do, ask the experts, when you get back and update your knowledge correspondingly.

btilly 7y ago

Looking back at my thinking at the same time I am also ashamed at how slow I was to realize it. I also trusted in our institutions. I knew what lengths that they went to in SARS. I understood how much thought has gone into public health. I found articles explaining why one would rationally ration available tests. Even when it was clear to me that we were in for a pandemic and millions would die, I completely failed to predict that we'd be willing to put Western countries in lockdown - or that lockdown would be as effective as it has been. I probably came to the right conclusion before Scott did. But still the only thing that I did right with my knowledge was to tell my wife to buy a put on the DOW back when it was still rising.

whatever1 7y ago

Let's talk first about the domain experts, professors in prestigious universities, that were reassuring the public that COVID-19 is no way more fatal than the seasonal flu [1]. The same moment that the ICUs in Italy and Spain were already overwhelmed and the physicians could not find the necessary protective equipment to keep saving lives. Are there gonna be any legal repercussions to these? [1]https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464 https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as...

modzu 7y ago
what are you talking about? that article is contemporary, they havent been proven wrong.
- whatever1 7y ago
  Art can be contemporary. Science not. We are currently looking at 200k deaths in the USA [1] from COVID-19, in the good scenario. How is it even compatible with their 0.01% mortality rates? Have we forgotten how to divide numbers? [1]https://thehill.com/homenews/administration/490138-birx-says-us-could-have-up-to-200000-coronavirus-deaths-if-we-do https://thehill.com/homenews/administration/490138-birx-says... P.S. They even make the claim that COVID-19 has 1/10th the mortality of seasonal flu :facepalm:
  - petertodd 7y ago
    "We are currently looking at 200k deaths in the USA" That is a prediction. It is not yet a fact. Right now we just don't have a good idea of how many people 1) how many people are currently infected, 2) how many people have already been infected and recovered without being tested, 3) how many people were already immune and would never have been infected, 4) how the way you are infected changes the outcome of the disease. The mortality rate depends directly on those numbers. Until we know those numbers, we just don't know for sure. With H1N1 initial estimates of the fatality rate per infection were almost two orders of magnitude too high. A similar error may or may not be happening here. The best we have right now is a tiny handful of limited, non-representative, "accidental experiments" like the Princess Diamond, that may or may not represent how the disease spreads in the community (note question #4). This will however soon change as more randomized testing is done, and in particular, anti-body testing to determine who already got the disease and recovered.

elchief 7y ago

Who should we believe, then, the WHO? They told us China had it under control, and not to wear masks

empath75 7y ago
The math. We had the fatality rate and r0. As soon as it was obvious that it spread out of control on China, it was just a matter of time. You didn’t need to be an epidemiologist, you just needed a high school maths education.
- zozbot234 7y ago
  The thing is, it didn't quite spread out of control on China. There were a heck of a lot of cases in Wuhan and Hubei, and markedly fewer cases elsewhere. We might guess that this is perhaps just a side-effect of exponential dynamics, but I'm not quite sure about that.
  - makomk 7y ago
    At a guess, this is perhaps a consequence of the fact that the entire rest of China has been treating everyone from Hubei like a plague carrier since January regardless of whether they've even been there in years. Any country that didn't, at the very least, quarantine people who'd been in Hubei plus their close contacts back then probably can't expect the same results, and even that plus contract tracing and testing plus social distancing only seems to hve delayed the inevitable.
- elchief 7y ago
  Which math to believe, the 4.8% CFR, or the 19% deaths/completed?
knzhou 7y ago
The WHO has been urging everybody to get prepared for 10 weeks now, while constantly giving the same good advice (test, trace, lockdown, social distance). People are pretending this is all WHO's fault because they said some wrong stuff in early January, when the correct conclusions were not at all obvious. And they've been completely correct and transparent since late January. It's almost April now. At this point, it's just a worn out excuse.

darawk 7y ago

What's particularly impressive about this situation is that all the institutions on all sides got it wrong. Trump and his administration downplayed it, and Vox, Wapo, NYT et al downplayed it. You would think these two would act as a check on one another, but they completely failed to do so. The one time we needed them to disagree with each other, they agreed forcefully.

modzu 7y ago

this is borderline terrorism, imo. right from the into, "Dr. A..." which to a layman would reasonably interpet as meaning "M.D" rather than professor of computer science. the one thing i have noticed in all this is the utterly astonishing abandonment of science, reason, and rationality. that scares me much more than disease.

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zozbot234 7y ago

Hindsight is always 20/20.

alexandercrohde 7y ago

This is a topic that seems to be in a perverse conflict of interests. A. Politicians have interests representing themselves as well as their country, and thus have given dishonest advice (masks don't help) with an ulterior motive (save them for hospital), downplayed the problem, and covered up the number of cases. B. I think a lot of actually qualified experts (doctors, scientists) to think the public can't handle the truth perhaps? I still have yet to see anybody in any position of respect or authority simply say the bald truth: "A few million Americans will die, at least, unless some radical cure happens. Social distancing is a drop in the bucket, ventilators make a tiny difference. The vast majority of young people will be totally fine" I'm disappointed in our society for failing to bubble up and synthesize good information quickly.

zozbot234 7y ago
> Social distancing is a drop in the bucket Sorry, but look at how China, South Korea, Taiwan etc. are doing right now - this doesn't jive at all with "social distancing is a drop in the bucket". Even Western countries/places which started social distancing early in their local outbreaks look like they'll be a lot better off than places which didn't. > The vast majority of young people will be totally fine This is also quite wrong, unfortunately. A sizeable minority of young people will need hospital treatment for COVID, and perhaps intensive care. Given overwhelmed healthcare systems, they won't be "totally fine" at all. Of course, older folks are at increased risk.
- JimTheMan 7y ago
  I highly recommend this video from Korea (Professor Kim Woo-joo from Korea University Guro Hospital) that gives a Korean perspective on the disease and the western response to it: https://www.youtube.com/watch?v=gAk7aX5hksU https://www.youtube.com/watch?v=gAk7aX5hksU A few points of interest: (He is a very respectful fellow so apologies if the summary seems a bit to the point) - Masks help and he is slightly puzzled why the west hasn't adopted that culture - Their testing and tracing helps and they doubt the US would allow their level of privacy invasion - Korea is doing well because they have had to respond to pandemics and were prepared (as are Taiwan, Singapore etc)

hirundo 7y ago

"A viral article implores us to ... to listen only to authoritive sources like the CDC, not random people spouting on social media. This was notable to me for being the diametric opposite of the actual lesson of the past two months" This is the opposite sentiment to "there are no libertarians in pandemics." Keen perception of reality is unlikely to be concentrated at the top of political hierarchies. Competent Authority isn't an oxymoron but it's distressingly unreliable.

empath75 7y ago

There are people still, in every thread here about it, downplaying it. I’m sure someone will be along momentarily to tell us that it’s no worse than seasonal flu.

naringas 7y ago

this whole covid19 debacle is exposing a very real change brought about by the internet. we are being forced to adapt and to develop new ways to relate to information, to asses it's trustworthiness, etc... it's an epistemic phenomenon. perhaps another facet of this phenomenon are the filtered information bubbles. But this pandemic really puts the pressure on us to face the reality of our current information society.

jasonhansel 7y ago

> A viral article implores us to “flatten the curve of armchair epidemiology”—that is, to listen only to authoritive sources like the CDC, not random people spouting on social media. > This was notable to me for being the diametric opposite of the actual lesson of the past two months. So, because some (unspecified, unnamed) experts weren't able to predict the future with perfect accuracy, we should give equal credence to "random people" instead? Medical professionals, scientists, and public health experts are still the best available source of knowledge about preventing the growth of this pandemic. Spreading the message that we should ignore epidemiologists is wrong at best and dangerous at worst.

jasonhansel 7y ago
(I'm sure that epidemiologists reading posts like the OP feel a lot like software devs reading opinion columns about cybersecurity or cryptocurrencies.)
fiblye 7y ago
>So, because some (unspecified, unnamed) experts weren't able to predict the future with perfect accuracy, we should give equal credence to "random people" instead? That wasn't my takeaway. My takeaway is that if you have some intuitive sense that shit's about to hit the fan and authorities keep telling you to stay calm and don't take any special precautions, all while danger is clearly growing, it's best to lean towards following your intuitions gradually just in case things ramp up. You shouldn't buy 10000 rolls of toilet paper, but all those people who thought, "Hmmm, maybe I should buy some masks and a couple extra bottles of hand sanitizer. Maybe not visit the movie theater anytime soon as well" while authorities were saying "Go to work and be normal. Masks are useless"... well, they were right and it would've been better to take those then "unnecessary" precautions. Reminds me of people talking about government surveillance pre and post Snowden. If you wanted to encrypt all your messages and avoid Facebook, etc, you were a conspiracy nut because it was impossible to surveil everything. Overnight it became "Of course they monitor everything. Why wouldn't they? But we have end-to-end encryption now and we can completely trust it."
- deleted 7y ago
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knzhou 7y ago

This whole mess has been a repudiation of business-as-usual politics, but it has not been a repudiation of scientific experts. Scientific experts across the world have been alarmed for months now. The only problem is that, as with any new and uncertainty situation, the error bars started absolutely enormous, so the range of expert opinion has been wide. This is the case in any crisis. With the benefit of hindsight, you can always find an expert who was wrong, but that doesn't mean anything. It's important to say this because later, you're going to start to hear bloviating from politicians who failed to act for months. "Nobody knew this was coming." "Everything that went wrong was solely the fault of $enemy_country or $rival_party."

professorgerm 7y ago
It has been a repudiation of the communication layers between experts and average people, as well, which I think might be more of Aaronson's ire than experts qua experts (it's certainly more of my ire, but I don't have his platform). A standard of "scientists dabbling in journalism to improve communication" instead of "journalists dabbling in communicating science" would likely have gone a long way to improving the civilian response and trust in experts. There's also the factor of the "Noble Lie" dishonesty around wearing masks. I suspect intellectual-ish contrarians (like Aaronson et al) are more angered by this than the average person, but we ended up with shortages and sellouts anyways: a significant number of non-experts didn't buy into that noble lie so the experts/organizations that pushed it (not to be confused with ALL experts) burned a lot of good will to basically no effect. ETA: I considered replying to your comment about the Harvard epidemiologists but would rather edit it in here to avoid two replies to one person: I think that's a great example of my point. The story wasn't broken by bloggers, but bloggers were more likely to be amplifying the concerned experts than our "traditional media powerhouses."

screye 7y ago

What has struck me most about Epidemiology, are the qualifications needed to be someone pursuing a career in it. It seems like an Epidemiologist is most likely to be a doctor with some knowledge of statistics. On the contrary, I would have thought that a statistician/operations research person with domain knowledge of medicine would be a lot better suited to study epidemiology. A lot of the existing models also seem really naïve for something an entire field depends on. Tradeoffs between human life lost due to the disease and effective human lives lost due to economic downturns seem entirely unstudied. Czechia's actions of forcing people to using masks seems to have worked amazingly well for flattening out the curve. The "science" not seems to support it, and official recommendations are now moving back to recommending masks for all. The popular hypothesis for this, is that it stops nonsymptomatic carriers from being spreaders. Now this sounds like a fairly obvious thing to realize, and to an extent, existing models should have caught this a lot earlier. I grew up as a kid with an almost religious belief in Science. Over time, I have come to realize that a lot of our sciences are at best empirical and at worst entirely unverifiable. I am a 100% certain, that in a 100 years, we will look at medicine and nutrition of the 2000s, the way we look at humors and blood letting.

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mdp553 7y ago
Speaking as an infectious disease epidemiologist - epidemiology is a broad field and includes people from many different backgrounds. The type of epidemiology I do (dynamic modeling of epidemics) leans more towards people with backgrounds in statistics, physics, math, and engineering when compared to the more "traditional" types epidemiology (if there even is such a thing anymore).
Engineering-MD 7y ago
There is benefit to a team with diverse backgrounds. Mathematical and statistical knowledge is vital, but so is understanding how hospitals and humans react to disease and interventions. As for looking back at medicine in 200 years as blood letting and humours, I think that is to misunderstand medicine in its entirety. Modern medicine is evidence based where it can be, mixed with a high level of uncertainty and best application of basic science. This has predictive power, but is obviously limited due to the complexity of the system. A better analogy would be industrial era engineering vs modern day engineering: the same aim with similar attempts but much better understanding of the system at a higher level of resolution achieved by improvements in technology and base understanding.

apatil 7y ago

I sent a similar text to a medically vulnerable friend on Jan 25 saying I thought it was "scary, but not the scariest thing in the world right now", despite having spent some time working with an epidemiology research group. In hindsight, I knew enough to take the risk much more seriously. This article: https://virologydownunder.com/past-time-to-tell-the-public-it-will-probably-go-pandemic-and-we-should-all-prepare-now/ https://virologydownunder.com/past-time-to-tell-the-public-i..., plus the rising mortality numbers, spurred me to start warning the medically vulnerable people in my life on Feb 23. I am very grateful to the authors for helping me do the right thing. At this point, it seems to me that our experts are still letting us down in two important ways: 1. They aren't rebutting this implicit notion that any mortality risk below 1% can be rounded down to zero. As a consequence, the idea that it might be a good idea to let younger, healthy people just go out and get the virus and get immune seems to still have currency, and this is really dangerous. We can't open things back up until we have a credible plan for driving the infection rate toward zero. Leaving aside the risk of life-changing injury, a mortality risk of eg 0.5% applied to eg half of young adults would still be by far the most dangerous thing that happens to most of them this year, and a huge personal tragedy for many of us. Do the math and work out how many people you know would die. 2. Simple, inexpensive measures like widespread masking, handwashing, gloves and eye protection will clearly be important components of any credible plan for driving the infection rate toward zero, unless we get an early vaccine. The experts should be hammering the point that we all need to be fastidious about those things whenever we open back up again.

bJGVygG7MQVF8c 7y ago

> I sent a quick reply two minutes later: > For now, I think the risk from the ordinary flu is much much greater! But worth watching to see if it becomes a real pandemic. Nope. Lost all credibility right there. Do not pass GO, do not collect 2 minutes of attention. Sorry. Oh, you've learned something from the error and you've updated your priors? Great, good for you. You're still unreliable.

AlexMennen 7y ago
This seems overly harsh. Few people took COVID-19 seriously on Feb 4, so this standard makes almost everyone have no credibility, including people who don't admit to the error. All humans are unreliable.
- defen 7y ago
  Here's a blog post from February 6 by Greg Cochran, one of the people mentioned. Looks pretty good in retrospect https://westhunt.wordpress.com/2020/02/06/strategy-not-the-flu/ https://westhunt.wordpress.com/2020/02/06/strategy-not-the-f...
- bJGVygG7MQVF8c 7y ago
  > Few people took COVID-19 seriously on Feb 4 Plenty who were paying attention took it seriously

fellowniusmonk 7y ago

Caveat Emptor is one of the deepest truths, whether shopping on amazon or listening to experts of different stripes, there has been enough information on the internet to come to accurate conclusions at every step, enough historical info from sars and spanish flu to see what could have been coming down the pipe, enough social media leak from China to tell that this was not contained, the choice is not between obliviousness or panic it's about prudent low cost risk mitigation. The fact is, that many people's internal information filtering algorithm is lacking, small preparation is sufficient 90% of the time as long as you are looking at slow moving historic signals, it's about small risk mitigations early. As played out as it is, this is further proof that the medium is the message, people engaging in unidirectional or bidirectional firehose messaging (cable tv, twitter, facebook) have tended towards panic or dismissiveness, people following historical information and slowly changing documents and global forums have been able to take prudent low cost risk mitigation, and by doing it early have operated comfortably on a different wavelength than people panic buying. Unstructured messaging and it's cognitive overhead is a problem, unstructured messaging means that even if the inbound message is about the issue currently in your head, the design of "alerts" trigger a disruptive near context switch, like a digital doorway effect that sabotages deep thinking, deep thinking is required for prudence. People still don't understand how bad this is though, for Americans, I'm only just now seeing a few people and articles connect the dots on bio warfare preparedness and how our asymmetrically weak and discordant response puts the U.S. at increased risk from a national security and power projection perspective. These aren't truths per se, just probability curves. As an example, since mid December I've been gently decreasing my downside risk, divesting and putting a few dollars here and there into things like masks and non perishables, already had a bidet, water filter, UV lamps, etc. No special preparation just things I already have around the house for my aquarium, camping, spray painting, hot ones challenges, etc. I haven't had to wait in any grocery lines or experience any personal discomfort or anxiety, and my slightly early social distancing was subtle enough most people didn't even notice. I was telling people who asked "These might be historic times, low cost preparation is in order." All this is from an individuals perspective, businesses should already be operating with risk management plans.

wwweston 7y ago

Relate to a lot of this (and it's especially worth noting there is something about identity contempt especially on social media but also IRL that hobbles our ability to coordinate understanding and action) but... let's also not forget it wasn't only contrarians and autodidacts who were making concerned noises -- there are plenty of professional epidemiologists and other specialists who were beating the warning drums.

knzhou 7y ago
Exactly. For example, back on February 3 we had this from Harvard epidemiologists: > “Many epidemiologists and people who are following this outbreak closely are assuming that it’s probably quite a bit more widespread than the case counts suggest,” said Michael Mina, assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “Many people also think that there’s probably over 100,000 in reality out in mainland China, for example. We just don’t capture all of those through the case reporting we have. … We can assume that this is growing at somewhat of an exponential rate, and it will continue increasing in scale.” This story wasn't broken by bloggers! Source: https://news.harvard.edu/gazette/story/2020/02/as-confirmed-cases-of-coronavirus-surge-path-grows-uncertain/ https://news.harvard.edu/gazette/story/2020/02/as-confirmed-...

notacoward 7y ago

There are two things seriously wrong with this article. (1) It treats authorities and non-authorities as monolithic. Far from it. There were plenty of serious, well qualified epidemiologists who were warning of the danger, and they were right. There were even more non-serious people using their popularity in completely unrelated fields to minimize the danger, and they were wrong. Sadly there still are, most definitely including here. Yes, the people in the actual seats of US federal power got it wrong, and plenty of amateurs got it right, but it's more complicated than the "don't trust experts" narrative. (2) Sample of one. Even if it weren't for the above, and the two groups were monolithic, this is just one case where the authorities were wrong and others were right. Yes, it's a very prominent case because of the consequences, but prominence is not the same as statistical significance. Treating it so is a form of cognitive bias/error. The real lesson here is not to distrust experts or authorities. It's not to trust conspiracy theorists or people with whom we empathize more because they're in our own industry. It's to trust science itself - empirical facts and analysis applied to facts. Both experts and others can help us to interpret those facts, put them in perspective, correct common errors in analysis, but ultimately it should be the facts that rule. The reason so many authorities and non-authorities were wrong is because they rejected the scientific approach, not because of who they are.

OrderlyTiamat 7y ago
good points, though I'm a bit bothered with your second point here. First of all, I think calling this a single event is reductionist. We're talking about weeks- months, even- of experts and non experts warning about this, and the systems of authorities failed completely to react in time. We're not talking about failing to heed an important warning once, we're talking about a long string of choices here. Secondly, This isn't just a prominent case, it is a very important case. Treating this as a series of bernoulli trials with a single (statistically irrelevant) failure is an extremely reductionist model of the reality here. While your conclusion of trusting science, empirical facts and analysis rings true to me, I think we should be wary of overly simplifying the subject matter.