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The author, Marty Makary, is a surgon. He does not have any expertise regarding viruses or epidemiology. He's completely ignoring all other reasons why infecti

by rawfan 6y ago

The author, Marty Makary, is a surgon. He does not have any expertise regarding viruses or epidemiology. He's completely ignoring all other reasons why infection might go down, the most important one being effective countermeasures, like wearing masks and social distancing. He's also ignoring that the case rates are stagnating due to the British variant. Germany is in that phase now. Cases of the British variant are in exponential growth, current lockdown measures are not effective against it.

throwaway8581 6y ago
The author’s point is that by now, something at least 50% of the US population has had the virus and 15% have had the vaccine. And that for some reason, the official sources are just putting their hands on their ears and saying “LALALALALALALALALA” at the mere mention of herd immunity. There is a resistance to accepting that this pandemic is soon going to end the way that just about every pandemic in the entirety of human history and pre-history has ended: enough people have had the virus and developed some level of immunity to prevent pandemic-level spread. The only difference is that we are giving the natural process a little boost through vaccination (but not by much since we got a late start because we refused to do challenge trials, so the vaccine that was done in May was not distributed until December because more tedious and less accurate non-challenge trials had to be done). I think there will be a hesitancy to accept this because lockdowns[0] and universal vaccination, reasonable ideas, have moved on from being points of pragmatic policy to being points of political dogma, such that they are resistant even to changing facts. And after being fed the nonsensical “if it saves even one life” line by their political heroes, it will be difficult for many people to accept that the real calculation involves accepting some “advanced” deaths (a strange concept because old folks on their death bed succumbing to the next common cold are usually not considered to have died earlier than they “should have”) for the sake of getting on with life, just like we do every year with all sorts of diseases in circulation. It also represents of failure by the public health officials and experts. Because the vaccine was needlessly delayed, not many more lives were saved than if the virus was just allowed to run its course sometime last summer (once we discovered that ventilators were actively harmful in many cases) along with some basic precautions for vulnerable populations. We were held back by rigid medical ethics requirements banning challenge trials. So while individual cities could have hundreds or thousands of new cases per day, deliberately infecting a few hundred healthy people for the purpose of testing the vaccine was PROHIBITED. We lost half a year to this, trillions of dollars, hundreds of thousands of lives, and millions of livelihoods. All because we let a bunch of medical ethics theorists in ivory towers told us that we couldn't run common-sense low-risk trials.
- sgt101 6y ago
  When you say "the vaccine was done in May" do you include building the manufacturing system that would create it and put it into a supply chain? This is a physical thing, not a website, scaling a website to cope with 100m requests is helluva job - scaling a physical product to 100m items is much, much, much harder. Especially when it is a medical product. I think you have forgotten this small detail. Another detail : yes we found that ventilators were harmful, but we also found that other forms of assisted breathing like high nasal flow oxygen were effective. Additionally we found that giving steroids was effective. There are other treatments coming online now in addition to this - so when we look at delaying the pandemic and the benefit there of we need to understand that the survival rate for patients has improved over that time. You seem to have forgotten this small detail. When we talk about this as a natural process in a population and allowing it to happen the people it happens to in the summer rather than the winter live 6 months less. They may have written a book or a play or helped their grandchildren become the people they need to be in that time span. You seem to have forgotten this small detail.
  - throwaway8581 6y ago
    The vaccine could have been rolled out to the most vulnerable groups much sooner than it was. If you vaccinate only those groups (and the vaccine works), you prevent the vast majority deaths. >When we talk about this as a natural process in a population and allowing it to happen the people it happens to in the summer rather than the winter live 6 months less. They may have written a book or a play or helped their grandchildren become the people they need to be in that time span. As for your last point, that's not how it works. To the extent that the disease runs its course through the population anyway, then there's also people aging (and infirming) INTO the vulnerable group too, who would have lived if they caught it in the summer but upon catching it six-months later die. Another way to look at it is that it's not any better or worse that a pandemic hits one year or the other (putting aside population growth). A flu pandemic in 1905 is no better than a flu pandemic in 1904. It just kills a different set of people. And actually, by extending the period where the virus is in pandemic circulation, and to the extent that it will spread through the population anyway, you probably kill more people by stretching the pandemic out. Virus survivors die for other reasons, "wasting" their immunity, and like I said above, more people become newly vulnerable to the virus.
Gibbon1 6y ago
Part of my current out of my butt theory why cases are going down is all the dummy's have partial herd immunity. The reasoning is simple. If you listen to what people that actually know what they are talking about they say in the US total cases are about 20%. Lets consider Gallant. Gallant does all the things to stay safe. Is the infection rate among Gallants 20%? Hell no. It's probably a 1/3 that or 6-7%. Consider Goofus. Goofus is a dummy. He does nothing to protect himself. And hangs out with other Goofus's. Is the infection rate among Goofus's 20%? No, it's probably 3-4 times higher. Or 60-80%. 60-80% means the Goofus's have herd immunity. 6-7% infection rate means Gallants don't.
- parrellel 6y ago
  The "stupid people" demographic reaching saturation and there being a depression in transmission as a result does make a lot of sense just from observed behavior. Then we'd expect the next surge when people start to relax safety measures.
  - Gibbon1 6y ago
    Collections of goofus's are likely important because covid tends to burn out without super spreading events. One can imagine that the collections of dummies that continued to hold large gatherings would have even higher infection rates. Highlights an issue with a lot of thinking about this. Population profiles aren't homogeneous but people make that assumption when drawing conclusions from simple statistics.
Izkata 6y ago
> He's completely ignoring all other reasons why infection might go down, the most important one being effective countermeasures, like wearing masks and social distancing. If those measures are so effective, why did they take nearly a year for an effect to be seen?
- parrellel 6y ago
  Because the virus is too slow and people are idiots, clearly.
- chasd00 6y ago
  I agree, cases are falling so fast and so dramatically in Texas that it looks like a data error. I see no way masks and social distancing resulted in the drop off happening now. We're at levels not seen since the mins in Sept/Oct which outruns the holiday wave. I can't make heads or tails of it. https://apps.texastribune.org/features/2020/texas-coronavirus-cases-map/ https://apps.texastribune.org/features/2020/texas-coronaviru... edit: the past weather has certainly had an effect on testing but the drop off predates the storm.
  - Izkata 6y ago
    There's more: * The WHO updated their guidelines for PCR tests in a way that could cause this (because the tests were being misused, the new guidelines clarify how they're supposed to be used in a way the previous ones did not), except the update also happened after the drop started. * The drop is worldwide, it seems like only a handful of countries aren't experiencing it. In most places it started at various parts of January, but here in Illinois it started in November (minus spikes that correlate to Thanksgiving/Christmas/New Years). * There is no correlation in the US between "lockdown states" and "reopened states". It's just dropping everywhere. My personal belief: We already hit herd immunity in most of the world a month ago. There's a few possibilities for why this would be (underestimating cross-immunity or how far the virus has spread, for example), but it's really hard to say for sure.
    - chasd00 6y ago
tonyedgecombe 6y ago
Cases of the British variant are in exponential growth, current lockdown measures are not effective against it. Not in Britain. https://coronavirus.data.gov.uk https://coronavirus.data.gov.uk
- xhedley 6y ago
  The daily growth in Britain is -6% to -3% with current British lockdown measures which I believe are stronger than average worldwide. Certainly stronger than pre-Christmas 2020 British measures. In England (Wales Scotland and Northern Ireland have similar but different rules because of devolution): * All schools are closed bar vulnerable children and children of key workers. * All non-essential retail, hospitality and leisure is closed. * Everyone should stay at home except for allowed exceptions like work, medical appointments or local exercise. * You can meet one person from another household for local exercise outside if you stay 2 metres apart. Variant B1.1.7 surged in Kent (South East England) in December 2020 despite "UK Tier 4" lockdown. The transmission increasing by 70% from the initial variant overwhelmed the reduction from reduced social mingling given that rule set.
  - tonyedgecombe 6y ago
    South East England was in tier 4 lockdown in December but I don't think there was much compliance. This was fairly typical: https://youtu.be/K_tQCW_abjo?t=1993 https://youtu.be/K_tQCW_abjo?t=1993

by rawfan 6y ago

throwaway8581 6y ago

The author’s point is that by now, something at least 50% of the US population has had the virus and 15% have had the vaccine. And that for some reason, the official sources are just putting their hands on their ears and saying “LALALALALALALALALA” at the mere mention of herd immunity. There is a resistance to accepting that this pandemic is soon going to end the way that just about every pandemic in the entirety of human history and pre-history has ended: enough people have had the virus and developed some level of immunity to prevent pandemic-level spread. The only difference is that we are giving the natural process a little boost through vaccination (but not by much since we got a late start because we refused to do challenge trials, so the vaccine that was done in May was not distributed until December because more tedious and less accurate non-challenge trials had to be done). I think there will be a hesitancy to accept this because lockdowns[0] and universal vaccination, reasonable ideas, have moved on from being points of pragmatic policy to being points of political dogma, such that they are resistant even to changing facts. And after being fed the nonsensical “if it saves even one life” line by their political heroes, it will be difficult for many people to accept that the real calculation involves accepting some “advanced” deaths (a strange concept because old folks on their death bed succumbing to the next common cold are usually not considered to have died earlier than they “should have”) for the sake of getting on with life, just like we do every year with all sorts of diseases in circulation. It also represents of failure by the public health officials and experts. Because the vaccine was needlessly delayed, not many more lives were saved than if the virus was just allowed to run its course sometime last summer (once we discovered that ventilators were actively harmful in many cases) along with some basic precautions for vulnerable populations. We were held back by rigid medical ethics requirements banning challenge trials. So while individual cities could have hundreds or thousands of new cases per day, deliberately infecting a few hundred healthy people for the purpose of testing the vaccine was PROHIBITED. We lost half a year to this, trillions of dollars, hundreds of thousands of lives, and millions of livelihoods. All because we let a bunch of medical ethics theorists in ivory towers told us that we couldn't run common-sense low-risk trials.

sgt101 6y ago
When you say "the vaccine was done in May" do you include building the manufacturing system that would create it and put it into a supply chain? This is a physical thing, not a website, scaling a website to cope with 100m requests is helluva job - scaling a physical product to 100m items is much, much, much harder. Especially when it is a medical product. I think you have forgotten this small detail. Another detail : yes we found that ventilators were harmful, but we also found that other forms of assisted breathing like high nasal flow oxygen were effective. Additionally we found that giving steroids was effective. There are other treatments coming online now in addition to this - so when we look at delaying the pandemic and the benefit there of we need to understand that the survival rate for patients has improved over that time. You seem to have forgotten this small detail. When we talk about this as a natural process in a population and allowing it to happen the people it happens to in the summer rather than the winter live 6 months less. They may have written a book or a play or helped their grandchildren become the people they need to be in that time span. You seem to have forgotten this small detail.
- throwaway8581 6y ago
  The vaccine could have been rolled out to the most vulnerable groups much sooner than it was. If you vaccinate only those groups (and the vaccine works), you prevent the vast majority deaths. >When we talk about this as a natural process in a population and allowing it to happen the people it happens to in the summer rather than the winter live 6 months less. They may have written a book or a play or helped their grandchildren become the people they need to be in that time span. As for your last point, that's not how it works. To the extent that the disease runs its course through the population anyway, then there's also people aging (and infirming) INTO the vulnerable group too, who would have lived if they caught it in the summer but upon catching it six-months later die. Another way to look at it is that it's not any better or worse that a pandemic hits one year or the other (putting aside population growth). A flu pandemic in 1905 is no better than a flu pandemic in 1904. It just kills a different set of people. And actually, by extending the period where the virus is in pandemic circulation, and to the extent that it will spread through the population anyway, you probably kill more people by stretching the pandemic out. Virus survivors die for other reasons, "wasting" their immunity, and like I said above, more people become newly vulnerable to the virus.

Gibbon1 6y ago

Part of my current out of my butt theory why cases are going down is all the dummy's have partial herd immunity. The reasoning is simple. If you listen to what people that actually know what they are talking about they say in the US total cases are about 20%. Lets consider Gallant. Gallant does all the things to stay safe. Is the infection rate among Gallants 20%? Hell no. It's probably a 1/3 that or 6-7%. Consider Goofus. Goofus is a dummy. He does nothing to protect himself. And hangs out with other Goofus's. Is the infection rate among Goofus's 20%? No, it's probably 3-4 times higher. Or 60-80%. 60-80% means the Goofus's have herd immunity. 6-7% infection rate means Gallants don't.

parrellel 6y ago
The "stupid people" demographic reaching saturation and there being a depression in transmission as a result does make a lot of sense just from observed behavior. Then we'd expect the next surge when people start to relax safety measures.
- Gibbon1 6y ago
  Collections of goofus's are likely important because covid tends to burn out without super spreading events. One can imagine that the collections of dummies that continued to hold large gatherings would have even higher infection rates. Highlights an issue with a lot of thinking about this. Population profiles aren't homogeneous but people make that assumption when drawing conclusions from simple statistics.

Izkata 6y ago

> He's completely ignoring all other reasons why infection might go down, the most important one being effective countermeasures, like wearing masks and social distancing. If those measures are so effective, why did they take nearly a year for an effect to be seen?

parrellel 6y ago
Because the virus is too slow and people are idiots, clearly.
chasd00 6y ago
I agree, cases are falling so fast and so dramatically in Texas that it looks like a data error. I see no way masks and social distancing resulted in the drop off happening now. We're at levels not seen since the mins in Sept/Oct which outruns the holiday wave. I can't make heads or tails of it. https://apps.texastribune.org/features/2020/texas-coronavirus-cases-map/ https://apps.texastribune.org/features/2020/texas-coronaviru... edit: the past weather has certainly had an effect on testing but the drop off predates the storm.
- Izkata 6y ago
  There's more: * The WHO updated their guidelines for PCR tests in a way that could cause this (because the tests were being misused, the new guidelines clarify how they're supposed to be used in a way the previous ones did not), except the update also happened after the drop started. * The drop is worldwide, it seems like only a handful of countries aren't experiencing it. In most places it started at various parts of January, but here in Illinois it started in November (minus spikes that correlate to Thanksgiving/Christmas/New Years). * There is no correlation in the US between "lockdown states" and "reopened states". It's just dropping everywhere. My personal belief: We already hit herd immunity in most of the world a month ago. There's a few possibilities for why this would be (underestimating cross-immunity or how far the virus has spread, for example), but it's really hard to say for sure.
  - chasd00 6y ago

tonyedgecombe 6y ago

Cases of the British variant are in exponential growth, current lockdown measures are not effective against it. Not in Britain. https://coronavirus.data.gov.uk https://coronavirus.data.gov.uk

xhedley 6y ago
The daily growth in Britain is -6% to -3% with current British lockdown measures which I believe are stronger than average worldwide. Certainly stronger than pre-Christmas 2020 British measures. In England (Wales Scotland and Northern Ireland have similar but different rules because of devolution): * All schools are closed bar vulnerable children and children of key workers. * All non-essential retail, hospitality and leisure is closed. * Everyone should stay at home except for allowed exceptions like work, medical appointments or local exercise. * You can meet one person from another household for local exercise outside if you stay 2 metres apart. Variant B1.1.7 surged in Kent (South East England) in December 2020 despite "UK Tier 4" lockdown. The transmission increasing by 70% from the initial variant overwhelmed the reduction from reduced social mingling given that rule set.
- tonyedgecombe 6y ago
  South East England was in tier 4 lockdown in December but I don't think there was much compliance. This was fairly typical: https://youtu.be/K_tQCW_abjo?t=1993 https://youtu.be/K_tQCW_abjo?t=1993