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An update on a pre-registered result about the coronavirus

214 points by balfirevic 7y ago

simonebrunozzi 7y ago
Oh my. The Japanese government should feel ashamed to have hidden all of this from the public (edit: I mean the real data and the real gravity of the situation, of course). I, for one, fled the US to come to Japan for a few weeks because I mostly believed these numbers. I hate this. I really hate that politicians (all over the world, in this specific case in Japan) can afford to treat us like this, and usually not face any significant consequence.
- kspacewalk2 7y ago
  >I, for one, fled the US to come to Japan for a few weeks because I mostly believed these numbers. SARS-CoV-2 thanks you for your efforts to help it find new populations to replicate in.
  - SketchySeaBeast 7y ago
    Yeah, considering that you can be asymptomatic for quite a few days that was an extraordinarily selfish act. Fear made them a vector. Feels like the guy in a zombie movie who tries to break the door down to get into the safe room.
    - Trasmatta 7y ago
      Or like Charles Campion in The Stand.
  - simonebrunozzi 7y ago
    The prior 3 weeks I was in a remote area with essentially no contact with anyone. I came back to SF, stayed at home for one night, and left. Also, if I feel endangered, I have every right to decide where to go. You might see it as selfish, I see why. At least I am paying my useless and expensive health insurance in the US (out of my own pocket, because you know what? I'm unemployed right now) to support the system, even if I am not taking advantage of it. Sometimes things are a bit more complicated than "SARS-CoV-2 thanks you for your efforts...".
    - smcl 7y ago
      If you can't see the why we're incredulous at the idea of intercontinental travel at the height of a pandemic where an often asymptomatic and incredibly infectious disease is running rampant ... then I honestly do not know what to tell you.
- smcl 7y ago
  Please tell me this is a joke comment
kspacewalk2 7y ago
>We project a true count of over 500,000 infections, including more than 5,000 severe cases, and a breakdown in provision of care (“overshoot”) in Nagoya, Osaka, and Tokyo, before the end of April. The current count is ~21,000 with the number of confirmed daily cases declining for 6 days straight, from 741 to 338 yesterday. So... not only wrong on the numbers themselves, but also on the scale, trajectory and impact on society. Japan's response seems commensurate with the problem, and this reads to me like an excessively verbose illustration of how one can spin even pre-registered falsifiable claims whichever way you want regardless of outcome. 'See? We were mostly right'. Maybe that's too harsh.
- waffle_ss 7y ago
  It's not too harsh. It seems pretty clear to me the blasé conclusion that essentially "things are gonna get much worse in a month" (no duh) was loosely backfilled with numbers after the conclusion was already made. Writing in a circuitous manner may have been necessary due to the author's immigration status but it's also a very convenient smokescreen that makes his group's results look more dramatic. For example, the timeline for March 24th, the day before this epic whitepaper was released: "a sporting event is postponed." This "sporting event" was the Tokyo OLYMPICS! But showing that Japan was already starting to take COVID-19 a lot more seriously than some of their public pronouncements may lead you to believe before the whitepaper release date might undercut the article's implication that his whitepaper changed the public narrative and thus the author would be less deserving of asspats and clout. I've heard people say that this pandemic highlights the (unfortunate) severe lag time of real-life discourse to Twitter's discourse (what is "known" on Twitter versus public narrative).[^1] From that angle this report could be a good thing to try to short-circuit that gap. My opinion is the attempt failed (more accurately their conclusion was already stale), and this writeup brings it right back around to the worst parts of Twitter's discourse - personal brand marketing and clout-chasing. [^1]: While that's undoubtedly true, Twitter also generates a massive amount of garbage takes which are conveniently forgotten through severe selection bias (looking back with hindsight to see who was right is easy). Online takes also have zero cost compared to reality; you can throw infinite virtual darts at a dartboard but in reality you can steer your meat machine down only one path. Thus there will always be a lag between the two.
9nGQluzmnq3M 7y ago
I usually like patio11's writing style, but this is super verbose even by his standards and oddly evasive/defensive to boot. There's a number of important messages here, but they make up perhaps 10% of the content, and I still don't really fully understand the rationale behind the cloak and dagger "hash of report" business.
- simonebrunozzi 7y ago
  Perhaps that's on purpose. Perhaps he wants to avoid being sued, or similar things. Patrick has a ton of credibility and I would give him the benefit of the doubt here.
  - kspacewalk2 7y ago
    Perhaps he wants to avoid being read.
  - joebot123 7y ago
    The purpose of the overall evasiveness could be to prevent personal retaliation of some kind - that would be understandable. But why avoid mentioning the word Olympics and instead call it "the sporting event" repeatedly? Especially now when your connection to the white paper is public.
    - pavlov 7y ago
      Maybe because the virus and Olympics are both sensitive topics of national pride in a country that has turned increasingly nationalistic. Japan has a conviction rate of over 99%. If a prosecutor decides you're guilty of something, it's basically a done deal. You don't want to get on the wrong side of authorities in a country like that.
      - derefr 7y ago
        > Japan has a conviction rate of over 99%. If a prosecutor decides you're guilty of something, it's basically a done deal. I thought that was because the prosecutors are very conservative about choosing what cases to prosecute in the first place, only going after effective slam dunks.
glofish 7y ago
I found the post to be lengthy, lacking focus and specificity. More compelling case could be made in a fraction of its length. Hardly worth reading. The tedious timeline, tweeting hashes as if that meant anything other than: "do you see how I was right all along". The whole concept of tweeting a hash of a whitepaper as form of endorsing it is kind of absurd.
- akavi 7y ago
  I don't think the set of people whose opinions patio11 cares about would forget about him tweeting that hash (especially given the emphasis he placed on it). The hash concept depends on social norms, and it's a fairly strongly enforced in his corner of the internet.
simonebrunozzi 7y ago
> Over a roughly 2 week period, we would expect approximately 64,000 passengers to fly from Japan to Singapore. 3 infections in that population is a rate of approximately 47 basis points, which is 5X the 9 basis points rate of infection in Japan. If one believes the government, the rate with surveilled clusters backed out be a tiny fraction of 9 basis points. This argument is a bit flawed. People that travel from Japan to Singapore are not a perfect sample of Japan's population - they might be more likely to be infected, as they might travel more than the average Japanese person.
- lolc 7y ago
  Three is way too few samples to draw any statistics from anyway. It does suggest untracked transmission in Japan. And that's about it. When I read that part I was disappointed to have been lured into reading another iteration of "I multiply numbers without tracking associated uncertainty". Sigh. That stuff runs rampant at the moment.
scythe 7y ago
Must the conclusion be all one way or the other? Maybe cluster containment was a bad strategy, but not horrible? Maybe masks and voluntary distancing had a little effect, but not enough? Maybe cases were undercounted, but not to the tune of 90-99%?
grosales 7y ago
This is just my 2 cents but according to https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries Japan has only done 923 tests for 1M of their population. That's much lower than any developed nation. One thing the article claims is the spread of the virus by asymptomatic infected people. Given this low level of testing - it's hard to gauge the true level of infection in the country - although the continuous decrease on daily cases is good, it doesn't mean it cannot spike back up. We just have to wait and see what happens.
- SyneRyder 7y ago
  To give an indication of how low that testing is, on that site Japan is ranked #119th country in the world in terms of testing.
- m_mueller 7y ago
  What I find confusing though is Japan's low death numbers. I was assuming that spikes in mortality couldn't be hidden, but recent comments from inside sources in Japanese hospitals are starting to make me doubt this assumption. Still, there is not a crisis on Lombardia-level going on, which one would expect given the relative inaction of Japanese government. I'm guessing the truth is somewhere in the middle - Japan's reported numbers are underestimating the issue, but at the same time Japanese society is as a whole more resistant than at least Southern Europe.
  - EE84M3i 7y ago
    One theory is that people are dying but it hasn't been discovered yet because of people staying inside. see https://en.wikipedia.org/wiki/Kodokushi https://en.wikipedia.org/wiki/Kodokushi Having just ridden the Yamanote today though, it's unreal how empty it is.
    - aikinai 7y ago
      I doubt there's much overlap in people who have so little human contact that no one knows they're dead and people who catch viruses that are still present in only a tiny fraction of the population. Oh, and a third condition that these people be such recluses that they don't even call a doctor when deathly ill.
sneak 7y ago
It would be exceptionally difficult—if not outright impossible—for me to write something like this and not once make even a passing attempt to imply blame or culpability for a core dishonesty that may well end up causing thousands of deaths. Patrick, I admire your professionalism and restraint in service of your goals.
deleted 7y ago
[deleted]
sdffdsfdsfsddsf 7y ago
Assuming the ratio of cases with symptoms to cases without symptoms usually remains the same, I must admit I don't immediately understand why it would be important to determine the amount of asymptomatic cases to determine the risk. It seems to me the growth rate of (symptomatic) cases would be the major indicator for that. (Obviously it would be of general interest, but I mean specifically with respect to gauging the risk). It all seems to hinge on the assumption that with the implemented "strategy A", nobody with pneumonia would be tested for Covid19 unless they have a known connection to a symptomatic case. That of course would be a mistake. But were people really that complacent that it would never occur to them to test for Covid19, even as the rest of the world is talking about nothing else? (Availability of tests is of course a factor here, but should only be a temporary impediment). I am interested in it, because here in Germany there also is currently a discussion of the virus spreading silently, only to come back in full force in fall if we become complacent. I must admit I don't fully understand the logic behind that, as surely when it spreads silently, it also has a proportion of symptomatic cases in its wake, so that in the end, it doesn't spread silently after all.
- vikramkr 7y ago
  The asymptomatic cases can also spread the disease, and a single individual is enough to trigger another outbreak if they slip through the cracks, so for contact tracing and everything you need to know how many asymptomatic cases there might be and where they might be. And the wake might not be spread evenly throughout the population, you could end up with younger individuals being asymptomatic and creating a breeding ground for the virus to spread and mutate in a college town before, even though it seems to be under control, it spreads back to vulnerable populations where everyone is symptomatic. That's one extreme of this but we don't know without random testing how bad it is towards that end
- PeterisP 7y ago
  It's not important to determine the amount of asymptomatic cases, but it's important to detect asymtomatic individuals so that their contacts can be traced and tested as well. This was not done, and "strategy A" failed because of that.
seemslegit 7y ago
There is no way Japan's faux-success is due solely or even dominantly to asymptomatic cases, they had to be turning a blind eye to symptomatic ones as well and attributing them to pneumonia, flu etc. The fact that the reported rates began rising only after the Tokyo Olympics were announced cancelled is almost a USSR-era farce. Japan has a leading hospital-bed-per-capita capacity in the OECD which could help them conceal this but I believe if occupancy of those beds was graphed for the last two months we'd see a curve indicating an epidemic comparable with US and Europe.
- twblalock 7y ago
  Then where are the overwhelmed hospitals? Where are the bodies?
  - seemslegit 7y ago
    They're not overwhelmed yet because they have capacity (NYC hospitals are struggling but are not over capacity either), deaths happen all the time especially in a country with aging population like Japan and are just not counted as covid19, like the author says it will probably be visible in excess deaths statistics once those are published.
lalaland1125 7y ago
This article frankly sounds like the rambling of a crazy person with all of the attempts of secrecy and defensiveness. > A distant secondary consideration, but a real one, was that choosing to publish could bring down heavy sanctions, through predictable pathways. Why is the author afraid of "sanctions" in a first world democracy with strong freedom of speech protections? A much more interesting and useful article would be an examination of the authors exact fears and why he feels afraid of publishing publically in Japan. > Some have advanced a theory which starts from the observed timeline and assumes the behavior of very many people was motivated by a sporting event. Normal people simply directly state their arguments about what is obviously the Olympics. Why is the author playing a game by pretending to be circumspect? > I will broadly refrain from comment regarding that organization, for predictable reasons. Oh please.
- ceejayoz 7y ago
  > Why is the author afraid of "sanctions" in a first world democracy with strong freedom of speech protections? https://en.wikipedia.org/wiki/Criminal_justice_system_of_Japan#Confession_in_Japanese_criminal_investigation https://en.wikipedia.org/wiki/Criminal_justice_system_of_Jap... "Many Western human rights organizations alleged that the high conviction rate is due to rampant use of conviction solely based on confession. Confessions are often obtained after long periods of questioning by police as those arrested may be held for up to 23 days. This can at times take weeks, during which the suspect is in detention and can be prevented from contacting a lawyer or family." https://www.tofugu.com/japan/sued-in-japan/ https://www.tofugu.com/japan/sued-in-japan/ alleges truth isn't an affirmative defense in a libel/defamation suit like it would be in the US. I'm pretty suspicious of any system with a 99% conviction rate.
  - fomine3 7y ago
    Unlikely. Japan is fine about freedom of speech (just not arrested), unlike Germany.
- aikinai 7y ago
  > Why is the author afraid of "sanctions" in a first world democracy with strong freedom of speech protections? A much more interesting and useful article would be an examination of the authors exact fears and why he feels afraid of publishing publically in Japan. I completely agree. Where is all this weird expectation of political persecution in Japan coming from? Both from Patrick and a lot of comments in this thread.
jeffreyrogers 7y ago
This seems a bit over-the-top. Sure, maybe Japan isn't testing and is just treating pneumonia cases as pneumonia cases instead of the cornavirus cases they actually are, but if that is allowing society to function mostly normally and isn't changing death rates all that much I don't see the harm. Arguably that is a better response than shutting down your economy and creating massive debt problems that will need to be resolved later.
- XorNot 7y ago
  The death rate from COVID-19 is a constant: about ~1% of all cases, so far as is currently known. If the R0 of the virus is about 2 (which from evidence is about the case for uncontained spread, possibly higher) then half of your entire case load is discovered in the last increment. That period is (roughly) 14 days from infection to the onset of symptoms. We cannot build a hospital, nor train doctors and nurses, in 14 days. But here's the thing: the hospitalization rate - which is what keeps the death rate at 1% - is around 10 - 15%. And both those numbers are constants, multiplied against an exponential factor. And hospital stays are around 3 to 4 weeks long. By the time your hospital beds are 50% full, you're already out of capacity - the next wave is going to be being denied treatment. And in fact, anyone else who has an otherwise treatable but potentially life-threatening condition is also going to be denied treatment. At which point a lot of your deaths aren't going to be directly due to COVID-19...but that's really not going to matter.
  - jeffreyrogers 7y ago
    Okay, but this appears to not be happening in Japan. Why not? If your answer is, it's going to happen, then why hasn't it happened already if things are truly as dire as the original essay is saying? Edit: It also appears to not be happening in Sweden. I think a lot of the modeling of this is flawed.
    - XorNot 7y ago
      I'll be a lot more interested when it hasn't happened 2 weeks from now.
porker 7y ago
Near the top patio11 writes: "Our choice to be anonymous was a considered one and is discussed in more detail below.". I cannot find where it's discussed in more detail below. Can someone point me to it?
weinzierl 7y ago
I love Patrick's posts but this is long, even for his standards. Can someone summarize the main points?
- HackOfAllTrades 7y ago
  No. It's well worth your time to read the whole piece.
rmccue 7y ago
The clearest communication about the use of hashes rather than direct publication is laid out quite simply in patio11's original memo: > I have concerns about saying this loudly because I have an immigration status and because Japan has previously shot the messengers in times of national emergency, including in the wake of the 2011 disaster. As someone who has spent their entire adult life in Japan, who lives here with my wife and children, and who has family on the front lines, I pray daily that I am wrong.
- sneak 7y ago
  At which URL did you find that text? I can't locate it on his site. I can confirm, though, as an expat, that there is a special kind of fear/restraint involved in needing an opt-in, discretionary permission from a government to be permitted to physically return to your home (which you already paid for) and your family. It causes a lot of security-conscious people to err far on the side of caution, which, indeed, may not even be an error at all. Immigration policies generally affect a very small minority of people in a country, so strengthening the rights around them simply isn't a priority in most societies, and risks/chilling effects like this fall out as a result.
  - rmccue 7y ago
    http://media.kalzumeus.com/covid-19/japan-covid19-memo-202003221115.md http://media.kalzumeus.com/covid-19/japan-covid19-memo-20200... - linked from “I did not publish the memo at the time.” just before the “ Why did you publish the hash and not the memo?” title.
BerislavLopac 7y ago
> There are few conspiracies in the world. There are many systems with complicated decision-making processes, internal data flows, and incentive structures for actors within them. The second sentence here is absolutely correct, but it directly contradicts the first one. Because a "conspiracy" is nothing more than having a group of those actors, with aligned incentives, coordinating to work together while hiding that coordination with other actors whose incentives are in opposition.
- robocat 7y ago
  I disagree. The second sentence is about uncoordinated actors making decisions, without anyone conspiring together. The emergent behaviour may look like a conspiracy, which is what he is pointing out.
  - BerislavLopac 7y ago
    What is the difference between "looking like a conspiracy" and "being a conspiracy"?
    - NateEag 7y ago
      The actors' intent. Actual conspiracies involve deceit, misdirection, and ill will. "Never attribute to malice that which can adequately be explained by incompetence." It's not a perfect rule, but it is a helpful idea to keep in mind.
ohazi 7y ago
Most of this seemed blindingly obvious to me and my peers (in the US) at the time that Patrick tweeted his hashes. Several of the replies to his tweets correctly guessed the topic, and most came to similar conclusions. Anybody with half a brain knew what was going on. Maybe Japanese culture really is "different" and things really did need to be done this way, but I find myself agreeing with other comments here that this whole effort seems puzzlingly labrynthine with relatively little to show for it, other than providing an opportunity to tweet hashes.
- davidw 7y ago
  Yeah, I think it didn't take much to put two and two together, even without much familiarity with Japan: https://twitter.com/davidnwelton/status/1241556680833298434 https://twitter.com/davidnwelton/status/1241556680833298434
- joe_the_user 7y ago
  Yeah, making a secret prediction seems only justified when your position is in the extreme minority and when it contains fairly surprising and/or specific claims. When your claim is just supporting a "strong minority viewpoint", doing so secretly ridiculous.
  - wglb 7y ago
    I think the article points out the justification as a counter point to the likely official statements everywhere that "Nobody could have known".
mherdeg 7y ago
Cool. Did you trade on it?
AnonC 7y ago
> I felt, while my subjective confidence was 90%, that I was likely miscalibrated. The likelihood that one non-expert, doing casual sleuthing in his spare time, had scooped not just any expert but almost all the experts and almost all the parties in formal authority felt infinitesimally small. So...was it just a coincidence that the results seem vindicated? Or is the above statement just too much modesty? Or both?
- AgentME 7y ago
  There's a whole section at the end with his theories about why you could expect someone like him to get this better than the experts (the experts were too busy managing the intricacies of Plan A instead of constantly rigorously checking that its assumptions still held and whether it was time to give up and switch to Plan B, etc), and he makes a point against having too much modesty like he did if you have good data.
gregmac 7y ago
> A long time ago I did a bit of work on disaster alert systems. They’re not dissimilar to fire alarms. The engineered purpose of a fire alarm is not merely to let people know there is a fire. Many will have already perceived the fire. The alarm, buttressing training delivered far before the alarm rings, gives you unquestionable and immediate permission to evacuate. We know that otherwise some people, smelling smoke and feeling uneasy, would look around the room, see other people not moving, and conclude “Who am I, to disrupt everything going on by shouting ‘Fire! Fire! Fire!’?” The history of humanity has seen far too many rooms where no one shouted ‘Fire!’ early enough. This alone is a pretty interesting point. Can apply to many other systems that are much less significant than literally "life or death."
- throwawayiouyt 7y ago
  This novella was worth reading just for this gem. It is equally applicable in "boiling frog" scenarios as in the "fire" cases.
throwawayiouyt 7y ago
This thread is full of people who, never having been immigrants in societies hostile to immigration, dismiss the tone of the article as ridiculous. Those people are simply wrong. Speaking up in places where you are not lucky to have that societal right has consequences. Some of those are legal, but some are not. Criticizing the author for the politeness and secrecy of all things is a statement of immense privilege. Criticizing falsifiability, on the other hand... One usually expects more precise estimations for a hashed prediction.
timerol 7y ago
I really appreciate this post. It's hard to read, but this seems very intentional. There are a number of salient points that are very specifically not stated. Some questions deliberately not answered: Who was on the Working Group, other than Patrick? Dr. Tyler Cowen spread the results, but no one is mentioned as working in the group other than Patrick. This seems designed to limit potential social fallout to other parties. The whole "Someone read between the lines" section would be much easier to read with the relevant person named. Also consider that Patrick may be limiting fallout to himself here, with the bold statement early on that "I instigated the Working Group and I was the primary author of its white paper." Did the NYT article writer correspond with the Working Group? The white paper was published with plenty of time before the article was written, and the explicit goal of the Working Group was to "leverage a news organization." Also consider that the NYT article was published on Thursday. And when discussing the goals of the working group, "This implied a publication deadline of Thursday. We assumed media organizations would need our work by Wednesday to check it and produce reporting informed by it." Note that Dr. Cowen's quick post was also published on Thursday, possibly to increase deniability when referring to that goal date. What Japanese organizations failed to respond to this crisis? The most damning prose in the entire article is "May all judgments be just and merciful." Patrick does not identify any Japanese organization or government by name, but says that the Working Group spoke to many of them. Also, both memos are listed in the timeline immediately before a announcement by Governor Koike. Patrick even convolutes his prose to the point where he never mentions the Olympics. I wouldn't be surprised if he had another sporting event in mind that also matched the specifics of what he wrote. How much influence did the Working Group have in Japan's response? The NYT article is definitely one potential point of influence, but it seems that the memo itself was shared widely. Consider the difference between this humble ending to the article: "I am a responsible professional. I have no relevant expertise or authority. I have avoided unproductive criticism. I might have made some guesses, during a year when many people were guessing on many topics. I quietly told some people about them. Some guesses may, perhaps by happenstance, align with official guidance and credible published reporting." and his tweet confirming the memo (option 1): "I am materially wrong about the most consequential thing I've had to have a view on in 15 years. You should probably degrade your estimate of my ability to think through complex problems." Interpreting things through an aggressive lens, I read this as a scathing diatribe against the Japanese government, where a non-expert foreigner living in Japan has to get the Western media involved before the government would admit to there being a problem. Props to the governor of Tokyo for being more on top of this than anyone else (perhaps with the Working Group's involvement), but the national government completely dragged its feet until it was forced by international pressure to start asking real questions. But I'm probably reading too much into it. Patrick's too humble of a guy to say all of that.
knolax 7y ago
Another dilettante intellectual techie trying to play epidemiologist. This time with melodramatic secrecy to boot!
glandium 7y ago
Random comments in this frame of context: - I've seen/heard some doctors saying publicly, on Japanese TV, mid-March, "I think there are 10 times more cases than reported" - There's an average of 270 deaths per day from pneumonia on a normal year in Japan (100k). - The largest number of deaths announced from COVID-19 in a single day was, I think, yesterday, and it was 20. - Deaths from pneumonia that aren't tested could very well appear to be in the noise of normal pneumonia deaths, easily hiding the real death toll. It doesn't take malicious intent for this to happen, just people following the rules (see below). - Generally speaking, Japanese institutions have a very difficult time moving outside the box. If they have a written plan that is to be followed, that is what happens. - The plan was to test people who had 4 consecutive days of fever (2 for older people) and close contact with people already diagnosed, and that's what happened. - It took prefecture governors starting to do things on their own for the central government to start moving. That happened for school closures (Hokkaido leading the way, then Osaka, IIRC), and sending mild cases to hotels or making them stay at home, rather than occupy beds in hospitals (started in Osaka, IIRC) - Hospitals have a shortage of equipment, and beds. Some prefectures have ramped up the number of available beds for infectious diseases. The government finally changed the rules to allow mild cases to be isolated out of hospitals (I think about a week ago, but it's hard to keep track of time these days). - Some hospitals have closed their doors completely. The reason? Clusters of COVID-19 in staff and patients. Not because they were treating COVID-19 patients as COVID-19 patients. But because they were treating patients that turned out to have COVID-19. Or people with COVID-19 going there for consultations. Which is not all that surprising when you know people are reportedly going from hospital to hospital to try to be tested for COVID-19. If anything, I'm surprised there aren't more clusters in hospitals. - There have been reports of ambulances having to try a large number of hospitals before finding an ER able to attend to their non-COVID-19 patient. I wrote this on April 4: "the political response to covid-19 in Japan is pissing me off now. It now feels like watching a 100 km/h car running into a wall in slow motion, and the car is already in contact with the wall and absorbing kinetic energy." Almost 3 weeks later, I think we're seeing the engine entering the passenger cabin.

214 points by balfirevic 7y ago

Oh my. The Japanese government should feel ashamed to have hidden all of this from the public (edit: I mean the real data and the real gravity of the situation, of course). I, for one, fled the US to come to Japan for a few weeks because I mostly believed these numbers. I hate this. I really hate that politicians (all over the world, in this specific case in Japan) can afford to treat us like this, and usually not face any significant consequence.

kspacewalk2 7y ago
>I, for one, fled the US to come to Japan for a few weeks because I mostly believed these numbers. SARS-CoV-2 thanks you for your efforts to help it find new populations to replicate in.
- SketchySeaBeast 7y ago
  Yeah, considering that you can be asymptomatic for quite a few days that was an extraordinarily selfish act. Fear made them a vector. Feels like the guy in a zombie movie who tries to break the door down to get into the safe room.
  - Trasmatta 7y ago
    Or like Charles Campion in The Stand.
- simonebrunozzi 7y ago
  The prior 3 weeks I was in a remote area with essentially no contact with anyone. I came back to SF, stayed at home for one night, and left. Also, if I feel endangered, I have every right to decide where to go. You might see it as selfish, I see why. At least I am paying my useless and expensive health insurance in the US (out of my own pocket, because you know what? I'm unemployed right now) to support the system, even if I am not taking advantage of it. Sometimes things are a bit more complicated than "SARS-CoV-2 thanks you for your efforts...".
  - smcl 7y ago
    If you can't see the why we're incredulous at the idea of intercontinental travel at the height of a pandemic where an often asymptomatic and incredibly infectious disease is running rampant ... then I honestly do not know what to tell you.
smcl 7y ago
Please tell me this is a joke comment

kspacewalk2 7y ago

>We project a true count of over 500,000 infections, including more than 5,000 severe cases, and a breakdown in provision of care (“overshoot”) in Nagoya, Osaka, and Tokyo, before the end of April. The current count is ~21,000 with the number of confirmed daily cases declining for 6 days straight, from 741 to 338 yesterday. So... not only wrong on the numbers themselves, but also on the scale, trajectory and impact on society. Japan's response seems commensurate with the problem, and this reads to me like an excessively verbose illustration of how one can spin even pre-registered falsifiable claims whichever way you want regardless of outcome. 'See? We were mostly right'. Maybe that's too harsh.

waffle_ss 7y ago
It's not too harsh. It seems pretty clear to me the blasé conclusion that essentially "things are gonna get much worse in a month" (no duh) was loosely backfilled with numbers after the conclusion was already made. Writing in a circuitous manner may have been necessary due to the author's immigration status but it's also a very convenient smokescreen that makes his group's results look more dramatic. For example, the timeline for March 24th, the day before this epic whitepaper was released: "a sporting event is postponed." This "sporting event" was the Tokyo OLYMPICS! But showing that Japan was already starting to take COVID-19 a lot more seriously than some of their public pronouncements may lead you to believe before the whitepaper release date might undercut the article's implication that his whitepaper changed the public narrative and thus the author would be less deserving of asspats and clout. I've heard people say that this pandemic highlights the (unfortunate) severe lag time of real-life discourse to Twitter's discourse (what is "known" on Twitter versus public narrative).[^1] From that angle this report could be a good thing to try to short-circuit that gap. My opinion is the attempt failed (more accurately their conclusion was already stale), and this writeup brings it right back around to the worst parts of Twitter's discourse - personal brand marketing and clout-chasing. [^1]: While that's undoubtedly true, Twitter also generates a massive amount of garbage takes which are conveniently forgotten through severe selection bias (looking back with hindsight to see who was right is easy). Online takes also have zero cost compared to reality; you can throw infinite virtual darts at a dartboard but in reality you can steer your meat machine down only one path. Thus there will always be a lag between the two.

9nGQluzmnq3M 7y ago

I usually like patio11's writing style, but this is super verbose even by his standards and oddly evasive/defensive to boot. There's a number of important messages here, but they make up perhaps 10% of the content, and I still don't really fully understand the rationale behind the cloak and dagger "hash of report" business.

simonebrunozzi 7y ago
Perhaps that's on purpose. Perhaps he wants to avoid being sued, or similar things. Patrick has a ton of credibility and I would give him the benefit of the doubt here.
- kspacewalk2 7y ago
  Perhaps he wants to avoid being read.
- joebot123 7y ago
  The purpose of the overall evasiveness could be to prevent personal retaliation of some kind - that would be understandable. But why avoid mentioning the word Olympics and instead call it "the sporting event" repeatedly? Especially now when your connection to the white paper is public.
  - pavlov 7y ago
    Maybe because the virus and Olympics are both sensitive topics of national pride in a country that has turned increasingly nationalistic. Japan has a conviction rate of over 99%. If a prosecutor decides you're guilty of something, it's basically a done deal. You don't want to get on the wrong side of authorities in a country like that.
    - derefr 7y ago
      > Japan has a conviction rate of over 99%. If a prosecutor decides you're guilty of something, it's basically a done deal. I thought that was because the prosecutors are very conservative about choosing what cases to prosecute in the first place, only going after effective slam dunks.

glofish 7y ago

I found the post to be lengthy, lacking focus and specificity. More compelling case could be made in a fraction of its length. Hardly worth reading. The tedious timeline, tweeting hashes as if that meant anything other than: "do you see how I was right all along". The whole concept of tweeting a hash of a whitepaper as form of endorsing it is kind of absurd.

akavi 7y ago
I don't think the set of people whose opinions patio11 cares about would forget about him tweeting that hash (especially given the emphasis he placed on it). The hash concept depends on social norms, and it's a fairly strongly enforced in his corner of the internet.

simonebrunozzi 7y ago

> Over a roughly 2 week period, we would expect approximately 64,000 passengers to fly from Japan to Singapore. 3 infections in that population is a rate of approximately 47 basis points, which is 5X the 9 basis points rate of infection in Japan. If one believes the government, the rate with surveilled clusters backed out be a tiny fraction of 9 basis points. This argument is a bit flawed. People that travel from Japan to Singapore are not a perfect sample of Japan's population - they might be more likely to be infected, as they might travel more than the average Japanese person.

lolc 7y ago
Three is way too few samples to draw any statistics from anyway. It does suggest untracked transmission in Japan. And that's about it. When I read that part I was disappointed to have been lured into reading another iteration of "I multiply numbers without tracking associated uncertainty". Sigh. That stuff runs rampant at the moment.

scythe 7y ago

Must the conclusion be all one way or the other? Maybe cluster containment was a bad strategy, but not horrible? Maybe masks and voluntary distancing had a little effect, but not enough? Maybe cases were undercounted, but not to the tune of 90-99%?

grosales 7y ago

This is just my 2 cents but according to https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries Japan has only done 923 tests for 1M of their population. That's much lower than any developed nation. One thing the article claims is the spread of the virus by asymptomatic infected people. Given this low level of testing - it's hard to gauge the true level of infection in the country - although the continuous decrease on daily cases is good, it doesn't mean it cannot spike back up. We just have to wait and see what happens.

SyneRyder 7y ago
To give an indication of how low that testing is, on that site Japan is ranked #119th country in the world in terms of testing.
m_mueller 7y ago
What I find confusing though is Japan's low death numbers. I was assuming that spikes in mortality couldn't be hidden, but recent comments from inside sources in Japanese hospitals are starting to make me doubt this assumption. Still, there is not a crisis on Lombardia-level going on, which one would expect given the relative inaction of Japanese government. I'm guessing the truth is somewhere in the middle - Japan's reported numbers are underestimating the issue, but at the same time Japanese society is as a whole more resistant than at least Southern Europe.
- EE84M3i 7y ago
  One theory is that people are dying but it hasn't been discovered yet because of people staying inside. see https://en.wikipedia.org/wiki/Kodokushi https://en.wikipedia.org/wiki/Kodokushi Having just ridden the Yamanote today though, it's unreal how empty it is.
  - aikinai 7y ago
    I doubt there's much overlap in people who have so little human contact that no one knows they're dead and people who catch viruses that are still present in only a tiny fraction of the population. Oh, and a third condition that these people be such recluses that they don't even call a doctor when deathly ill.

sneak 7y ago

It would be exceptionally difficult—if not outright impossible—for me to write something like this and not once make even a passing attempt to imply blame or culpability for a core dishonesty that may well end up causing thousands of deaths. Patrick, I admire your professionalism and restraint in service of your goals.

deleted 7y ago

[deleted]

sdffdsfdsfsddsf 7y ago

Assuming the ratio of cases with symptoms to cases without symptoms usually remains the same, I must admit I don't immediately understand why it would be important to determine the amount of asymptomatic cases to determine the risk. It seems to me the growth rate of (symptomatic) cases would be the major indicator for that. (Obviously it would be of general interest, but I mean specifically with respect to gauging the risk). It all seems to hinge on the assumption that with the implemented "strategy A", nobody with pneumonia would be tested for Covid19 unless they have a known connection to a symptomatic case. That of course would be a mistake. But were people really that complacent that it would never occur to them to test for Covid19, even as the rest of the world is talking about nothing else? (Availability of tests is of course a factor here, but should only be a temporary impediment). I am interested in it, because here in Germany there also is currently a discussion of the virus spreading silently, only to come back in full force in fall if we become complacent. I must admit I don't fully understand the logic behind that, as surely when it spreads silently, it also has a proportion of symptomatic cases in its wake, so that in the end, it doesn't spread silently after all.

vikramkr 7y ago
The asymptomatic cases can also spread the disease, and a single individual is enough to trigger another outbreak if they slip through the cracks, so for contact tracing and everything you need to know how many asymptomatic cases there might be and where they might be. And the wake might not be spread evenly throughout the population, you could end up with younger individuals being asymptomatic and creating a breeding ground for the virus to spread and mutate in a college town before, even though it seems to be under control, it spreads back to vulnerable populations where everyone is symptomatic. That's one extreme of this but we don't know without random testing how bad it is towards that end
PeterisP 7y ago
It's not important to determine the amount of asymptomatic cases, but it's important to detect asymtomatic individuals so that their contacts can be traced and tested as well. This was not done, and "strategy A" failed because of that.

seemslegit 7y ago

There is no way Japan's faux-success is due solely or even dominantly to asymptomatic cases, they had to be turning a blind eye to symptomatic ones as well and attributing them to pneumonia, flu etc. The fact that the reported rates began rising only after the Tokyo Olympics were announced cancelled is almost a USSR-era farce. Japan has a leading hospital-bed-per-capita capacity in the OECD which could help them conceal this but I believe if occupancy of those beds was graphed for the last two months we'd see a curve indicating an epidemic comparable with US and Europe.

twblalock 7y ago
Then where are the overwhelmed hospitals? Where are the bodies?
- seemslegit 7y ago
  They're not overwhelmed yet because they have capacity (NYC hospitals are struggling but are not over capacity either), deaths happen all the time especially in a country with aging population like Japan and are just not counted as covid19, like the author says it will probably be visible in excess deaths statistics once those are published.

lalaland1125 7y ago

This article frankly sounds like the rambling of a crazy person with all of the attempts of secrecy and defensiveness. > A distant secondary consideration, but a real one, was that choosing to publish could bring down heavy sanctions, through predictable pathways. Why is the author afraid of "sanctions" in a first world democracy with strong freedom of speech protections? A much more interesting and useful article would be an examination of the authors exact fears and why he feels afraid of publishing publically in Japan. > Some have advanced a theory which starts from the observed timeline and assumes the behavior of very many people was motivated by a sporting event. Normal people simply directly state their arguments about what is obviously the Olympics. Why is the author playing a game by pretending to be circumspect? > I will broadly refrain from comment regarding that organization, for predictable reasons. Oh please.

ceejayoz 7y ago
> Why is the author afraid of "sanctions" in a first world democracy with strong freedom of speech protections? https://en.wikipedia.org/wiki/Criminal_justice_system_of_Japan#Confession_in_Japanese_criminal_investigation https://en.wikipedia.org/wiki/Criminal_justice_system_of_Jap... "Many Western human rights organizations alleged that the high conviction rate is due to rampant use of conviction solely based on confession. Confessions are often obtained after long periods of questioning by police as those arrested may be held for up to 23 days. This can at times take weeks, during which the suspect is in detention and can be prevented from contacting a lawyer or family." https://www.tofugu.com/japan/sued-in-japan/ https://www.tofugu.com/japan/sued-in-japan/ alleges truth isn't an affirmative defense in a libel/defamation suit like it would be in the US. I'm pretty suspicious of any system with a 99% conviction rate.
- fomine3 7y ago
  Unlikely. Japan is fine about freedom of speech (just not arrested), unlike Germany.
aikinai 7y ago
> Why is the author afraid of "sanctions" in a first world democracy with strong freedom of speech protections? A much more interesting and useful article would be an examination of the authors exact fears and why he feels afraid of publishing publically in Japan. I completely agree. Where is all this weird expectation of political persecution in Japan coming from? Both from Patrick and a lot of comments in this thread.

jeffreyrogers 7y ago

This seems a bit over-the-top. Sure, maybe Japan isn't testing and is just treating pneumonia cases as pneumonia cases instead of the cornavirus cases they actually are, but if that is allowing society to function mostly normally and isn't changing death rates all that much I don't see the harm. Arguably that is a better response than shutting down your economy and creating massive debt problems that will need to be resolved later.

XorNot 7y ago
The death rate from COVID-19 is a constant: about ~1% of all cases, so far as is currently known. If the R0 of the virus is about 2 (which from evidence is about the case for uncontained spread, possibly higher) then half of your entire case load is discovered in the last increment. That period is (roughly) 14 days from infection to the onset of symptoms. We cannot build a hospital, nor train doctors and nurses, in 14 days. But here's the thing: the hospitalization rate - which is what keeps the death rate at 1% - is around 10 - 15%. And both those numbers are constants, multiplied against an exponential factor. And hospital stays are around 3 to 4 weeks long. By the time your hospital beds are 50% full, you're already out of capacity - the next wave is going to be being denied treatment. And in fact, anyone else who has an otherwise treatable but potentially life-threatening condition is also going to be denied treatment. At which point a lot of your deaths aren't going to be directly due to COVID-19...but that's really not going to matter.
- jeffreyrogers 7y ago
  Okay, but this appears to not be happening in Japan. Why not? If your answer is, it's going to happen, then why hasn't it happened already if things are truly as dire as the original essay is saying? Edit: It also appears to not be happening in Sweden. I think a lot of the modeling of this is flawed.
  - XorNot 7y ago
    I'll be a lot more interested when it hasn't happened 2 weeks from now.

porker 7y ago

Near the top patio11 writes: "Our choice to be anonymous was a considered one and is discussed in more detail below.". I cannot find where it's discussed in more detail below. Can someone point me to it?

weinzierl 7y ago

I love Patrick's posts but this is long, even for his standards. Can someone summarize the main points?

HackOfAllTrades 7y ago
No. It's well worth your time to read the whole piece.

rmccue 7y ago

The clearest communication about the use of hashes rather than direct publication is laid out quite simply in patio11's original memo: > I have concerns about saying this loudly because I have an immigration status and because Japan has previously shot the messengers in times of national emergency, including in the wake of the 2011 disaster. As someone who has spent their entire adult life in Japan, who lives here with my wife and children, and who has family on the front lines, I pray daily that I am wrong.

sneak 7y ago
At which URL did you find that text? I can't locate it on his site. I can confirm, though, as an expat, that there is a special kind of fear/restraint involved in needing an opt-in, discretionary permission from a government to be permitted to physically return to your home (which you already paid for) and your family. It causes a lot of security-conscious people to err far on the side of caution, which, indeed, may not even be an error at all. Immigration policies generally affect a very small minority of people in a country, so strengthening the rights around them simply isn't a priority in most societies, and risks/chilling effects like this fall out as a result.
- rmccue 7y ago
  http://media.kalzumeus.com/covid-19/japan-covid19-memo-202003221115.md http://media.kalzumeus.com/covid-19/japan-covid19-memo-20200... - linked from “I did not publish the memo at the time.” just before the “ Why did you publish the hash and not the memo?” title.

BerislavLopac 7y ago

> There are few conspiracies in the world. There are many systems with complicated decision-making processes, internal data flows, and incentive structures for actors within them. The second sentence here is absolutely correct, but it directly contradicts the first one. Because a "conspiracy" is nothing more than having a group of those actors, with aligned incentives, coordinating to work together while hiding that coordination with other actors whose incentives are in opposition.

robocat 7y ago
I disagree. The second sentence is about uncoordinated actors making decisions, without anyone conspiring together. The emergent behaviour may look like a conspiracy, which is what he is pointing out.
- BerislavLopac 7y ago
  What is the difference between "looking like a conspiracy" and "being a conspiracy"?
  - NateEag 7y ago
    The actors' intent. Actual conspiracies involve deceit, misdirection, and ill will. "Never attribute to malice that which can adequately be explained by incompetence." It's not a perfect rule, but it is a helpful idea to keep in mind.

ohazi 7y ago

Most of this seemed blindingly obvious to me and my peers (in the US) at the time that Patrick tweeted his hashes. Several of the replies to his tweets correctly guessed the topic, and most came to similar conclusions. Anybody with half a brain knew what was going on. Maybe Japanese culture really is "different" and things really did need to be done this way, but I find myself agreeing with other comments here that this whole effort seems puzzlingly labrynthine with relatively little to show for it, other than providing an opportunity to tweet hashes.

davidw 7y ago
Yeah, I think it didn't take much to put two and two together, even without much familiarity with Japan: https://twitter.com/davidnwelton/status/1241556680833298434 https://twitter.com/davidnwelton/status/1241556680833298434
joe_the_user 7y ago
Yeah, making a secret prediction seems only justified when your position is in the extreme minority and when it contains fairly surprising and/or specific claims. When your claim is just supporting a "strong minority viewpoint", doing so secretly ridiculous.
- wglb 7y ago
  I think the article points out the justification as a counter point to the likely official statements everywhere that "Nobody could have known".

mherdeg 7y ago

Cool. Did you trade on it?

AnonC 7y ago

> I felt, while my subjective confidence was 90%, that I was likely miscalibrated. The likelihood that one non-expert, doing casual sleuthing in his spare time, had scooped not just any expert but almost all the experts and almost all the parties in formal authority felt infinitesimally small. So...was it just a coincidence that the results seem vindicated? Or is the above statement just too much modesty? Or both?

AgentME 7y ago
There's a whole section at the end with his theories about why you could expect someone like him to get this better than the experts (the experts were too busy managing the intricacies of Plan A instead of constantly rigorously checking that its assumptions still held and whether it was time to give up and switch to Plan B, etc), and he makes a point against having too much modesty like he did if you have good data.

gregmac 7y ago

> A long time ago I did a bit of work on disaster alert systems. They’re not dissimilar to fire alarms. The engineered purpose of a fire alarm is not merely to let people know there is a fire. Many will have already perceived the fire. The alarm, buttressing training delivered far before the alarm rings, gives you unquestionable and immediate permission to evacuate. We know that otherwise some people, smelling smoke and feeling uneasy, would look around the room, see other people not moving, and conclude “Who am I, to disrupt everything going on by shouting ‘Fire! Fire! Fire!’?” The history of humanity has seen far too many rooms where no one shouted ‘Fire!’ early enough. This alone is a pretty interesting point. Can apply to many other systems that are much less significant than literally "life or death."

throwawayiouyt 7y ago
This novella was worth reading just for this gem. It is equally applicable in "boiling frog" scenarios as in the "fire" cases.

throwawayiouyt 7y ago

This thread is full of people who, never having been immigrants in societies hostile to immigration, dismiss the tone of the article as ridiculous. Those people are simply wrong. Speaking up in places where you are not lucky to have that societal right has consequences. Some of those are legal, but some are not. Criticizing the author for the politeness and secrecy of all things is a statement of immense privilege. Criticizing falsifiability, on the other hand... One usually expects more precise estimations for a hashed prediction.

timerol 7y ago

I really appreciate this post. It's hard to read, but this seems very intentional. There are a number of salient points that are very specifically not stated. Some questions deliberately not answered: Who was on the Working Group, other than Patrick? Dr. Tyler Cowen spread the results, but no one is mentioned as working in the group other than Patrick. This seems designed to limit potential social fallout to other parties. The whole "Someone read between the lines" section would be much easier to read with the relevant person named. Also consider that Patrick may be limiting fallout to himself here, with the bold statement early on that "I instigated the Working Group and I was the primary author of its white paper." Did the NYT article writer correspond with the Working Group? The white paper was published with plenty of time before the article was written, and the explicit goal of the Working Group was to "leverage a news organization." Also consider that the NYT article was published on Thursday. And when discussing the goals of the working group, "This implied a publication deadline of Thursday. We assumed media organizations would need our work by Wednesday to check it and produce reporting informed by it." Note that Dr. Cowen's quick post was also published on Thursday, possibly to increase deniability when referring to that goal date. What Japanese organizations failed to respond to this crisis? The most damning prose in the entire article is "May all judgments be just and merciful." Patrick does not identify any Japanese organization or government by name, but says that the Working Group spoke to many of them. Also, both memos are listed in the timeline immediately before a announcement by Governor Koike. Patrick even convolutes his prose to the point where he never mentions the Olympics. I wouldn't be surprised if he had another sporting event in mind that also matched the specifics of what he wrote. How much influence did the Working Group have in Japan's response? The NYT article is definitely one potential point of influence, but it seems that the memo itself was shared widely. Consider the difference between this humble ending to the article: "I am a responsible professional. I have no relevant expertise or authority. I have avoided unproductive criticism. I might have made some guesses, during a year when many people were guessing on many topics. I quietly told some people about them. Some guesses may, perhaps by happenstance, align with official guidance and credible published reporting." and his tweet confirming the memo (option 1): "I am materially wrong about the most consequential thing I've had to have a view on in 15 years. You should probably degrade your estimate of my ability to think through complex problems." Interpreting things through an aggressive lens, I read this as a scathing diatribe against the Japanese government, where a non-expert foreigner living in Japan has to get the Western media involved before the government would admit to there being a problem. Props to the governor of Tokyo for being more on top of this than anyone else (perhaps with the Working Group's involvement), but the national government completely dragged its feet until it was forced by international pressure to start asking real questions. But I'm probably reading too much into it. Patrick's too humble of a guy to say all of that.

knolax 7y ago

Another dilettante intellectual techie trying to play epidemiologist. This time with melodramatic secrecy to boot!

glandium 7y ago

Random comments in this frame of context: - I've seen/heard some doctors saying publicly, on Japanese TV, mid-March, "I think there are 10 times more cases than reported" - There's an average of 270 deaths per day from pneumonia on a normal year in Japan (100k). - The largest number of deaths announced from COVID-19 in a single day was, I think, yesterday, and it was 20. - Deaths from pneumonia that aren't tested could very well appear to be in the noise of normal pneumonia deaths, easily hiding the real death toll. It doesn't take malicious intent for this to happen, just people following the rules (see below). - Generally speaking, Japanese institutions have a very difficult time moving outside the box. If they have a written plan that is to be followed, that is what happens. - The plan was to test people who had 4 consecutive days of fever (2 for older people) and close contact with people already diagnosed, and that's what happened. - It took prefecture governors starting to do things on their own for the central government to start moving. That happened for school closures (Hokkaido leading the way, then Osaka, IIRC), and sending mild cases to hotels or making them stay at home, rather than occupy beds in hospitals (started in Osaka, IIRC) - Hospitals have a shortage of equipment, and beds. Some prefectures have ramped up the number of available beds for infectious diseases. The government finally changed the rules to allow mild cases to be isolated out of hospitals (I think about a week ago, but it's hard to keep track of time these days). - Some hospitals have closed their doors completely. The reason? Clusters of COVID-19 in staff and patients. Not because they were treating COVID-19 patients as COVID-19 patients. But because they were treating patients that turned out to have COVID-19. Or people with COVID-19 going there for consultations. Which is not all that surprising when you know people are reportedly going from hospital to hospital to try to be tested for COVID-19. If anything, I'm surprised there aren't more clusters in hospitals. - There have been reports of ambulances having to try a large number of hospitals before finding an ER able to attend to their non-COVID-19 patient. I wrote this on April 4: "the political response to covid-19 in Japan is pissing me off now. It now feels like watching a 100 km/h car running into a wall in slow motion, and the car is already in contact with the wall and absorbing kinetic energy." Almost 3 weeks later, I think we're seeing the engine entering the passenger cabin.