4 ms·

Also I forgot to address your other points. I was not claiming that H1N1 was as bad or worse than COVID-19, to be clear. Obviously COVID-19 is the worst pande

Also I forgot to address your other points. I was not claiming that H1N1 was as bad or worse than COVID-19, to be clear. Obviously COVID-19 is the worst pandemic we've had in over a century. But that's mostly a function of the fact that we haven't had a truly bad pandemic (the scary ones like SARS-1 fizzled out, presumably because the virus was very symptomatic and very deadly). The point is that, we didn't lose our shit over flu pandemics which actually kill children, and actually cause more significant recurring deaths than COVID-19 will do to what I already explained about COVID-19 targetting the unhealthy/old. If you want my argument in a nutshell: - The most stable solution to the problem of COVID-19 is to build widespread population immunity. Also, banking on vaccines as an artificial way to get to herd immunity is a foolish strategy, because we're relying on a temporally unbounded future event, which is an awful idea. - Lockdown not only increase all-cause mortality by making every other health condition in the world worse (both directly through social isolation and depriving exercise, as well as through suspending elective surgeries, as well as the widespread culture of fear/etc leading to people to not go to the hospital), but I actually believe that it increases COVID-19 mortality. The same factors of social isolation, stress/fear, unemployment and lost sleep are at play, but also particularly the prevention of exercise (which plays an immunoregulatory role besides the other positive effects), and even more particularly, being cooped up outside = no sunlight = no vitamin d. Vitamin D is actually a ridiculously important vitamin as far as respiratory infections go - I didn't realize how strong the effect was, I encourage you to research it. Additionally, nitric oxide, also produced by sun exposure and not provided by a vitamin d supplement, decrease blood pressure so helps cardiac events, and is even being directly studied as a COVID-19 treatment (perhaps due to immunoregulatory effects?) - Because I don't believe in practicing containment, for the above reasons and others I don't feel like going into at this point, I believe that any attempt to artificially slow spread in the general population is counterproductive. So, insofar as universal masking works, we should not be wearing masks. Insofar as lockdowns actually work, we shouldn't be locking down. And if they don't work (and I think the evidence is not there, and thus they likely have either no effect or possibly make spread worse, particularly with masking and school closures) - well, then why are we doing them?

gojomo 6y ago
While I don't agree that the data supports your anti-mask, large-gatherings-are-OK preferences, I appreciate you making the strongest possible case for what has often been mocked as a "let 'er rip" response. It's helpful to see the collected data & reasoning for that idea. In particular, even given much of your argument, I believe it's still wise for most people, and especially those with any extra risk factors, which likely include some yet-unknown among the outwardly-healthy, to avoid getting this for as long as possible. The end point – nearly everyone having an upgrade immunity to the somewhat-novel threat – is the same. But the upgrade is slower, to minimize collateral damage, and involves more conscious processes, including at some point synthesized vaccines, rather than purely natural/chaotic. Every week brings better understanding of risks & treatments. Every week gives more opportunity for the pull of 'optimal virulence' (https://en.wikipedia.org/wiki/Optimal_virulence https://en.wikipedia.org/wiki/Optimal_virulence) to eventually select for even-milder strains. At least partially-effective vaccines for high-risk/front-line workers may arrive before the end of the year. Delays prevent overwhelming health facilities – or increasing average initial infectious loads – which each seem to risk synergistic escalations of mortality rates. That said, it's not implausible that the right strategy for those least-at-risk – the young & very-healthy – is to mostly go about their normal day, and not worry much about getting an mild case from other mild (presymptomatic/asymptomatic) shedders. The risks are offset by the value of adding to their internal (and thus society's) immunity library against Covid-19 & related viruses. But: these people should remain diligent about limiting their interactions with the higher-risk. So even more important than the 'regional' strategies now in place, would be for people to declare & behave consistently with their own personal risk-tolerance. At an extreme, this might include wearing some outward declaration of your risk-profile, and segregating shared facilities, by place or time, to minimize interactions between "let 'er rip" & "avoiding" subpopulations.
- __blockcipher__ 6y ago
  I'm happy for people to be able to choose their own risk tolerances. What I'm not happy with is mandating that I or others must go along with what I feel, (not without evidence I might add), is a state of collective delusion. If I can wax philosophical for a bit, I remember learning in elementary school about native american rain dances, how they would dance around and thought that it would cause rain. "How foolish of them", I thought. "It's so obvious that there's no connection between dancing around and precipitation falling from the sky". And yet, when I look around, I see us all participating in an elaborate form of pseudo-medicalized rain-dancing. Take the staggering amount of people walking around all day in nitrile gloves. Let me tell you, if I were a SARS-CoV-2 respiratory droplet, I would love those people; I get to a hitch a free ride on their gloves with my droplet completely intact, preserving the moist environment that all life (and pseudo-life since we've arbitrarily decided viruses aren't alive, which is just silly) thrives in. Uncovered hands at least have commensal bacteria and an acid mantle (well, for those that don't wash their hands like someone with OCD) that make it harder for SARS-2 to persist. But those gloves are the perfect environment. Why do people wear those gloves? Well, in my opinion, they associate the gloves with doctors, they associate doctors with cleanliness and a scientific version of holiness, and thus they essentially believe that the gloves act as a magic totem that ward off evil spirits - I mean, evil viruses. Mask-wearing isn't much better. It is definitely better, and I get the "it protects you, not necessarily me" argument, but when you look at how people actually use the damn things in the real world, I think that's almost certainly false. People touch their face, their mouth, etc way more. Not to mention all the other reasons. Which does lead to the irony: insofar as masks do work to slow spread, that's a bad thing, yet they may actually increase spread, which in my book is a "good thing"...except (a) I hate having to wear a mask, and (b) since the rest of society is not on-board, a healthy increase in cases will be met with further lockdown :( -- Anyway, you alluded to this, but I don't think having a bunch of 20-somethings try to avoid all human contact for [1 year, infinity] makes sense. I think it's a less stable system. Just like how every year in California we have huge wildfires, which we artificially suppress, and so every year there's more and more material waiting to ignite. Well, pandemics work the same way. When we try to keep ourselves in a state of SARS-2-virginity, we create an environment where at any moment infection can rip through us again. Look at New Zealand, which is held up by the ignorant as an example of "doing it right", and yet now they can't allow any foreign visitors without 2+ week quarantine "until the vaccine" (sigh). The laughable thing is in the US we're not really practicing containment, and yet we also kind of are, and that leads to the total ass-backwards metric of "cases must be perpetually in decline otherwise we shut down again". -- Okay, back to serious stuff. > But: these people should remain diligent about limiting their interactions with the higher-risk. So even more important than the 'regional' strategies now in place, would be for people to declare & behave consistently with their own personal risk-tolerance. At an extreme, this might include wearing some outward declaration of your risk-profile, and segregating shared facilities, by place or time, to minimize interactions between "let 'er rip" & "avoiding" subpopulations. See, this is my problem. The moment we stated that it was the problem of those not at risk to avoid anything that might infect an at-risk person, we went down the completely wrong path. When you exrapolate it to its logical conclusion, I think you can see how ridiculous the notion is. I'd note that it's a mentality we never took for the flu, etc (ignoring examples like the 1918 pandemic, etc). If I'm am immunocompromised individual, it's my job to isoalte myself if that's what my risk tolerance leads me to do. It's not my job to screech at the rest of society for living their lives like human beings. It just doesn't make any sense. Containment only works when the entire country is on board. (And by the way, even if that were the case I still think it's a terrible idea, but let's ignore that for now). So, we should have immediately realized that if we wanted to preserve even a shred of freedom and our Western values, containment never should have been an option. In fact, Sweden said as much: their health leader (I forget the name) outright said that they don't have the ability/right to do the type of lockdown that China did. And yet somehow, the rest of us have looked at China and unthinkingly swallowed their recommendations to enact authoritarian policies. And we've actually praised them ("we" meaning basically anyone on the left or in the center) for their response! > The risks are offset by the value of adding to their internal (and thus society's) immunity library against Covid-19 & related viruses. Exactly. It's just a more stable system that way. And as someone who isn't at-risk, it's way easier for me to get exposed and isolate for 2-3 weeks than it is to have to be perpetually on-guard for an indefinite time period (at least a year). The last point I want to make, is that anyone who's ever done work that required sterile conditions (such as culturing fungi), or handled substances active in the microgram range, knows how incredibly difficult it is to avoid breaking sterile protocol. Pathogens live absolutely everywhere, and so you have to exert enormous cognitive effort and skill to basically visualize every possible source of infection and to diligently watch what you're doing with your body, where your breath is going, etc. I mentioned substances active in the microgram range - I've inadvertently dosed myself, presumably by absent-mindedly touching my lips - so I have a very good mental model of what it takes to guarantee a lack of infection. You have to watch your every move, avoid touching any mucuos membrane, wash your hands constantly, etc. It's simply just not possible for your average person, and not possible for a trained professional to do for more than a period of several hours. And yes, we don't literally need perfect sterility to avoid spreading SARS-CoV-2, but it gives a great illustration of the kind of mentality that you need to adopt. Sorry for the meandering and rambling nature of all my posts today, I drank way too much metaphorical coffee. Thanks for actually engaging in discussion, it's these interactions that make the effort worth it, since as you can see I'm already getting downvoted quite significantly - although encouragingly, thus far I have not had a single comment flag, whereas it used to be literally every comment of mine that went against the grain (in a respectful manner) got flagged and I'd have to e-mail dang every damn time.

gojomo 6y ago

While I don't agree that the data supports your anti-mask, large-gatherings-are-OK preferences, I appreciate you making the strongest possible case for what has often been mocked as a "let 'er rip" response. It's helpful to see the collected data & reasoning for that idea. In particular, even given much of your argument, I believe it's still wise for most people, and especially those with any extra risk factors, which likely include some yet-unknown among the outwardly-healthy, to avoid getting this for as long as possible. The end point – nearly everyone having an upgrade immunity to the somewhat-novel threat – is the same. But the upgrade is slower, to minimize collateral damage, and involves more conscious processes, including at some point synthesized vaccines, rather than purely natural/chaotic. Every week brings better understanding of risks & treatments. Every week gives more opportunity for the pull of 'optimal virulence' (https://en.wikipedia.org/wiki/Optimal_virulence https://en.wikipedia.org/wiki/Optimal_virulence) to eventually select for even-milder strains. At least partially-effective vaccines for high-risk/front-line workers may arrive before the end of the year. Delays prevent overwhelming health facilities – or increasing average initial infectious loads – which each seem to risk synergistic escalations of mortality rates. That said, it's not implausible that the right strategy for those least-at-risk – the young & very-healthy – is to mostly go about their normal day, and not worry much about getting an mild case from other mild (presymptomatic/asymptomatic) shedders. The risks are offset by the value of adding to their internal (and thus society's) immunity library against Covid-19 & related viruses. But: these people should remain diligent about limiting their interactions with the higher-risk. So even more important than the 'regional' strategies now in place, would be for people to declare & behave consistently with their own personal risk-tolerance. At an extreme, this might include wearing some outward declaration of your risk-profile, and segregating shared facilities, by place or time, to minimize interactions between "let 'er rip" & "avoiding" subpopulations.

__blockcipher__ 6y ago
I'm happy for people to be able to choose their own risk tolerances. What I'm not happy with is mandating that I or others must go along with what I feel, (not without evidence I might add), is a state of collective delusion. If I can wax philosophical for a bit, I remember learning in elementary school about native american rain dances, how they would dance around and thought that it would cause rain. "How foolish of them", I thought. "It's so obvious that there's no connection between dancing around and precipitation falling from the sky". And yet, when I look around, I see us all participating in an elaborate form of pseudo-medicalized rain-dancing. Take the staggering amount of people walking around all day in nitrile gloves. Let me tell you, if I were a SARS-CoV-2 respiratory droplet, I would love those people; I get to a hitch a free ride on their gloves with my droplet completely intact, preserving the moist environment that all life (and pseudo-life since we've arbitrarily decided viruses aren't alive, which is just silly) thrives in. Uncovered hands at least have commensal bacteria and an acid mantle (well, for those that don't wash their hands like someone with OCD) that make it harder for SARS-2 to persist. But those gloves are the perfect environment. Why do people wear those gloves? Well, in my opinion, they associate the gloves with doctors, they associate doctors with cleanliness and a scientific version of holiness, and thus they essentially believe that the gloves act as a magic totem that ward off evil spirits - I mean, evil viruses. Mask-wearing isn't much better. It is definitely better, and I get the "it protects you, not necessarily me" argument, but when you look at how people actually use the damn things in the real world, I think that's almost certainly false. People touch their face, their mouth, etc way more. Not to mention all the other reasons. Which does lead to the irony: insofar as masks do work to slow spread, that's a bad thing, yet they may actually increase spread, which in my book is a "good thing"...except (a) I hate having to wear a mask, and (b) since the rest of society is not on-board, a healthy increase in cases will be met with further lockdown :( -- Anyway, you alluded to this, but I don't think having a bunch of 20-somethings try to avoid all human contact for [1 year, infinity] makes sense. I think it's a less stable system. Just like how every year in California we have huge wildfires, which we artificially suppress, and so every year there's more and more material waiting to ignite. Well, pandemics work the same way. When we try to keep ourselves in a state of SARS-2-virginity, we create an environment where at any moment infection can rip through us again. Look at New Zealand, which is held up by the ignorant as an example of "doing it right", and yet now they can't allow any foreign visitors without 2+ week quarantine "until the vaccine" (sigh). The laughable thing is in the US we're not really practicing containment, and yet we also kind of are, and that leads to the total ass-backwards metric of "cases must be perpetually in decline otherwise we shut down again". -- Okay, back to serious stuff. > But: these people should remain diligent about limiting their interactions with the higher-risk. So even more important than the 'regional' strategies now in place, would be for people to declare & behave consistently with their own personal risk-tolerance. At an extreme, this might include wearing some outward declaration of your risk-profile, and segregating shared facilities, by place or time, to minimize interactions between "let 'er rip" & "avoiding" subpopulations. See, this is my problem. The moment we stated that it was the problem of those not at risk to avoid anything that might infect an at-risk person, we went down the completely wrong path. When you exrapolate it to its logical conclusion, I think you can see how ridiculous the notion is. I'd note that it's a mentality we never took for the flu, etc (ignoring examples like the 1918 pandemic, etc). If I'm am immunocompromised individual, it's my job to isoalte myself if that's what my risk tolerance leads me to do. It's not my job to screech at the rest of society for living their lives like human beings. It just doesn't make any sense. Containment only works when the entire country is on board. (And by the way, even if that were the case I still think it's a terrible idea, but let's ignore that for now). So, we should have immediately realized that if we wanted to preserve even a shred of freedom and our Western values, containment never should have been an option. In fact, Sweden said as much: their health leader (I forget the name) outright said that they don't have the ability/right to do the type of lockdown that China did. And yet somehow, the rest of us have looked at China and unthinkingly swallowed their recommendations to enact authoritarian policies. And we've actually praised them ("we" meaning basically anyone on the left or in the center) for their response! > The risks are offset by the value of adding to their internal (and thus society's) immunity library against Covid-19 & related viruses. Exactly. It's just a more stable system that way. And as someone who isn't at-risk, it's way easier for me to get exposed and isolate for 2-3 weeks than it is to have to be perpetually on-guard for an indefinite time period (at least a year). The last point I want to make, is that anyone who's ever done work that required sterile conditions (such as culturing fungi), or handled substances active in the microgram range, knows how incredibly difficult it is to avoid breaking sterile protocol. Pathogens live absolutely everywhere, and so you have to exert enormous cognitive effort and skill to basically visualize every possible source of infection and to diligently watch what you're doing with your body, where your breath is going, etc. I mentioned substances active in the microgram range - I've inadvertently dosed myself, presumably by absent-mindedly touching my lips - so I have a very good mental model of what it takes to guarantee a lack of infection. You have to watch your every move, avoid touching any mucuos membrane, wash your hands constantly, etc. It's simply just not possible for your average person, and not possible for a trained professional to do for more than a period of several hours. And yes, we don't literally need perfect sterility to avoid spreading SARS-CoV-2, but it gives a great illustration of the kind of mentality that you need to adopt. Sorry for the meandering and rambling nature of all my posts today, I drank way too much metaphorical coffee. Thanks for actually engaging in discussion, it's these interactions that make the effort worth it, since as you can see I'm already getting downvoted quite significantly - although encouragingly, thus far I have not had a single comment flag, whereas it used to be literally every comment of mine that went against the grain (in a respectful manner) got flagged and I'd have to e-mail dang every damn time.