6 ms·

Care to name some examples? I mean... the broad arc of the policy choices have been correct, right? Stay home. Wear a mask. That stuff works. We thought it

Care to name some examples? I mean... the broad arc of the policy choices have been correct, right? Stay home. Wear a mask. That stuff works. We thought it worked last April and we were right. There's some genuine argument about the efficacy of specific facilities, like schools. But that's stuff at the margin. I guess I don't see any good candidates for the "drastic policy decisions" based on "biased studies from massive corporations"... Really most of what the world did was pretty textbook disease control stuff. What is it you mean?

neilwilson 6y ago
The reliance on unusual concepts - like asymptomatic transmission and the effect of wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence they do that much good out in the field rather than in the lab (much like hydroxychloroquine which is similarly effective in a lab but not in the field). There is no blow out in Texas et al and Sweden has just tracked the same path as everybody else suffering much less than Belgium for example, and today isn’t anywhere near the top of the charts. There’s an awful lot of curve fitting to beliefs going on - because it is so difficult to do solid experiments.
- watwut 6y ago
  How is symptomatic transmission unusual concept?
  - timr 6y ago
    Asymptomatic transmission is the concept in question. Symptomatic transmission is the typical case -- you cough, sneeze, etc., and give it to others. There's still quite a bit of debate over this question, despite the article's insistence that the matter is settled. The data supporting it comes mostly from modeling studies, and real-world data is thin on the ground. Mostly anecdotes. We have lots of examples of pre-symptomatic (or minimally-symptomatic) transmission for other illnesses, but these tend to be limited (e.g. spread within households), and it's always been a bit of a stretch to make the claim that completely healthy people are spreading diseases widely in "super-spreader" events via casual encounters. Does it happen? Sure. Is it common? Ehhhh. Even with Covid, we know that the majority of transmission (something like 80%) occurs within households. Of the remainder, as TFA notes, there's an "overdispersion", where a few people are responsible for most of the spread. Is it really likely that these "superspreader" people are mostly completely healthy, without symptoms, and yet unknowingly spreading it to vast numbers of people? Or is that just something that we've found a few times, and makes the most memorable anecdotes? It is certainly not the hypothesis you would favor based on parsimony alone. If you were a betting person, you'd probably put your money on the idea that someone is a little bit sick (but not so sick as to stay home in bed), and the disease can spread by aerosol or droplet with low probability. That's a much simpler explanation for the same pattern: someone has a tickle in their throat or a slight fever, but goes to the restaurant/office/wherever anyway. Set the probability of transmission to a low p-value, and let the poisson distribution do the rest. Just by chance alone, you will see rare occasions where large(r) groups of people get infected.
    - watwut 6y ago
      I had typo. But AFAIK, asymptomatic transmission is not novel concept. We have been learning about it in elementary school in the context of other diseases. There is absolutely nothing new about it as concept. It is not something that appeared with covid first time in history of diseases.
      - neilwilson 6y ago
        If it was a concept in this situation we could easily prove it. Get people who pass a lateral flow test or PCR test into a room and measure their pre-sympomatic viral output. Why hasn't that experiment been done?
        dTal 6y ago
        It has? Repeatedly? This is the news from three days ago: https://www.independent.co.uk/news/health/covid-symptoms-report-coronavirus-ons-b1828361.html https://www.independent.co.uk/news/health/covid-symptoms-rep...
        timr 6y ago
        Showing that people with Covid can be asymptomatic is not evidence that asymptomatic people transmit the virus, and the article you linked to just leaps directly to the conclusion. Here's an actual paper from 2021 that shows that -- as you might expect -- that exhaled particles correlate with age, weight and viral load: https://www.pnas.org/content/118/8/e2021830118 https://www.pnas.org/content/118/8/e2021830118 In other words: older, fatter, sicker people are more likely to shed the kind of particles that facilitate transmission. They make a point of noting that nobody in their test under the age of 26 was a significant source of aerosol. Anyway, GP is not wrong. We could do these experiments, instead of just guessing.
- Fomite 6y ago
  Asymptomatic transmission isn't at all an unusual concept in infectious disease epidemiology.
  - henrikschroder 6y ago
    The question isn't whether or not it can happen, I think everyone agrees that this virus can spread through both presymptomatic and asymptomatic individuals. The question is how common is it? How large a percentage of all cases are caused by it? And the whole "always wear a mask" hinges on asymptomatic/presumptomatic spread being high. Because if it isn't high, then we're focusing on the wrong thing, we're needlessly being suspicious of every single random stranger, we're choosing something that's easily virtue-signalable, over things that actually stop the spread.
    - raverbashing 6y ago
      If it isn't high the situation wouldn't have gotten as bad as it got. Especially with people more alert to people showing symptoms
      - xxxxhhhh 6y ago
        So basically you have no direct evidence, this is biased supposition.
- worker767424 6y ago
  > ...wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence My favorite example of how it's become semi-religious is people wearing them on outdoor walks in the suburbs where, worst case, they'll with within 6 feet of someone for a total of 30 seconds. The virus spreads very poorly in those conditions. Ironically, you're more likely to get the virus at home from a family member, but there's been minimal push for masking at home because it's political suicide.
  - remarkEon 6y ago
    It’s definitely become a semi-religious thing where I’m at. I generally don’t wear a mask outside and people have asked me to put one on from about 10m away. I’ll comply, just to not be combative at that particular moment in time, but remove it once they’ve passed by. I’m fully vaccinated now. I expect this social norm to be semi-permanent and I don’t really have a good idea for how to break it. Even carrying a vaccine card everywhere would, I expect, elicit pseudoscientific retorts that “vaccines don’t affect transmission”.
    - SergeAx 6y ago
      But we really don't have an evidence that vaccine-induced immunity response prevents virus transmission. And we do have evidence that people recovered from COVID-19 months ago can bear high viral load in their respiratory system: https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v1.full-text https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v...
      - wrycoder 6y ago
        Two out of 6,614 previously infected were reinfected and showed documented high viral load. That’s a very low proportion. A prior history of SARS-CoV-2 infection was associated with an 83% lower risk of infection
        SergeAx 6y ago
- Daho0n 6y ago
  >Sweden has just tracked the same path as everybody else That's very much false. You compare apples to apples to get a useable result, not apples to sour grapes. Sweden's policy have caused much much worse results compared to the countries you should compare it to: Norway, Denmark and Finland. For example deaths per 100k citizens is 12 in Norway and 134 in Sweden. Sweden is the perfect counterexample to your point. Nice graphs (Sweden is the yellow line that always stand out): https://www.vg.no/spesial/corona/norden/ https://www.vg.no/spesial/corona/norden/
  - neilwilson 6y ago
    Why not Belgium, Peru, Poland, Hungary, Romania, even Gibraltar or the UK? Why do you want to compare to those specific countries you quote rather than the countries, say, that Sweden has distant transport links to? See what I mean about myths propagating.
    - Isinlor 6y ago
      Because Nordic countries are very similar culturally and compare between each other all the time. I have a Finnish girlfriend and my impression is that first thing that Finnish people do when considering a policy is to ask how it's done in Sweden. They overall rejected Swedish approach with good results. All the other countries you mentioned have vastly different cultures. E.g. I'm Polish and I can say that Polish government doesn't care about law and Polish people are fine with it. It's not to the extent Ukraine or Russia does it, but still. Poles also do not respect authority. This is in exact opposite to how things go in Finland or Sweden. It's almost a taboo to question authorities in Sweden or Finland.
  - mike_hearn 6y ago
    There's no biological theory underpinning cherry picking of a handful of Sweden's neighbours. It's not like Sweden is ground zero of some genetically identical but non-deadly strain of SARS-CoV-2 that inexplicably can only spread within physical proximity of Stockholm. So not surprisingly, if you do the cherry picking honestly by including all Sweden's neighbours, including Latvia, Estonia, Lithuania etc, then Sweden stops being the worst in that little bounding box and we're back to Sweden disproving the models. Which it has done, comprehensively, because no model or theory postulates a Nordic exception.
erostrate 6y ago
The WHO initially said there was no evidence supporting the need for masks in the general public. They only changed their stance in early June. In Europe many politicians were making the same claim, which was convenient because they didn't have enough masks.
- 6gvONxR4sf7o 6y ago
  At the time, I thought the general guidance was “don’t hoard masks, we need them for healthcare workers” rather than “don’t wear masks they don’t work” (which through the game of telephone turned into everything imaginable).
  - EmbeddedLight 6y ago
    The outrage comes from government and other health officials making claims early on that masks were not as effective, and that maintaining social distance and isolation was better (which I agree). But this was merely used as distraction to allow healthcare facilities to snatch up the existing supplies of high quality n95 masks before the public could (see toilet paper apocalypse 2020). Then the government changed their statements and said that masks were effective, and everyone should use them. It's the switching and lying to the public that leads to a lack of trustworthiness. You can argue that they didn't know the efficacy of mask usage, but that isn't the point here. It's that they lied to the American public for an ulterior motive, which is wrong.
- viklove 6y ago
  The WHO is a political organization, not a scientific one.
mike_hearn 6y ago
I've read a lot of public health papers in the past year, probably more than 50. Here are some of the problems that cropped up in papers that were used by governments to support policy decisions. Many of those policy decisions later turned out to be incorrect, like lockdowns and mask mandates, both of which easily count as drastic and neither were textbook. In fact pre-COVID pandemic control plans by the WHO explicitly recommended against lockdowns. By the way, be careful to separate the question of mask mandates from masks themselves. Mask mandates don't work: just look at case curves when mandates were introduced or removed and observe the lack of inflection points. If they worked people would have hundreds of examples by now of case curves which obviously inflected right after a mask mandate was changed, but no such graphs are ever cited because those inflections don't reliably happen. Texas provides a recent example (mandate removed, curve continues prior trend) but this problem was obvious from within a week of the first mandates being introduced. Look at [1] for some case graphs with mandate change dates drawn on them to see the problem. Anyway, errors seen in public health papers: 1. Circular reasoning. 2. Invalid citations. 3. Programming errors in models. 4. Use of extremely out of date numbers. 5. Absurd or obviously invalid assumptions and results in models being ignored. That's not a comprehensive list. Unfortunately these aren't rare problems. Virtually every public health paper I've read has had at least one of these issues, often multiple. Circular logic in particular is mind-numbingly common, to an extent I've never seen before. For example, a common "validation" technique for models is to compare them to other models and declare their outputs to be similar (e.g. [2] or [3]). It's almost unheard of to compare model outputs to actual observed data, probably because doing validation right would invalidate virtually all public health models (this problem was admitted in a 2012 paper [4]). For a specific example of these problems see the paper by Flaxman et al from Imperial College London [5]. This paper argued that lockdowns work using a statistical model, but they actually don't work, so to get this result required a combination of: 1. Circular logic: the model took as a starting assumption that case curves could only be changed by government intervention. In other words the paper encoded its own conclusions in its assumptions. The assumption epidemics can only be affected by lockdowns has no rational basis given the long history of epidemics starting and ending naturally. 2. The paper included Sweden in its data set, which attracted attention because Sweden appears to prove that the models generating the counterfactual were wrong. It managed to conclude lockdowns worked despite this because it concluded Sweden was a freak coincidence with an only 1 in 2000 chance of existing at all; in the graph that showed the different per-country fudge factors the model was allowed to calculate, Sweden was simply hidden to obscure what had happened. The truth was discovered later by people who studied the tables of prior probabilities uploaded to GitHub. 3. The paper admitted half way through that its scenario was "illustrative only" and that "in reality" the results would be different. There were other problems too, but none of them stopped the authors telling the press that lockdowns had "saved millions of lives" (i.e. the drastic policy pushed for by that very same research team). Nor did it stop international press agencies citing this paper in "fact checks". After reading so many papers with really basic and blatant problems, it's hard not to conclude that open access is going to seriously damage academia's credibility. Being able to just download and read the output of academic scientists is a very new thing, and one of the few highlights of the time I've spent reading COVID research is that open access is real now: I've hardly ever hit paywalls. Only for old papers. Unfortunately open access is a double edged sword. Now we can all read what we're paying for and observe the dangerously low quality. The outcome will probably be a large expansion of the battle between "science believers" and "science skeptics". Up until now that has been mostly restricted to debates on climatology, but now I think it will widen considerably. There's just no way to read the literature and retain your confidence in academic science when so much of it is entirely un-scientific. [1] https://rationalground.com/mask-charts/ https://rationalground.com/mask-charts/ [2] https://github.com/ptti/ptti/blob/master/README.md https://github.com/ptti/ptti/blob/master/README.md (see the paragraph starting with "Formalism-agnostic"). [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001435/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001435/ ("There is agreement in the literature that comparing the results of different models provides important evidence of validity and increases model credibility") [4] ibid; ("few models in healthcare could ever be validated for predictive use. This, however, does not disqualify such models from being used as aids to decision making") [5] https://nicholaslewis.org/did-lockdowns-really-save-3-million-covid-19-deaths-as-flaxman-et-al-claim/ https://nicholaslewis.org/did-lockdowns-really-save-3-millio...
vondur 6y ago
I’m pretty skeptical at this point that masks made any difference. Here in Southern California where everyone wears masks indoors, and even the majority of people wear them outdoors. Yet we still ended up with some of the highest infection rates in the country. I’d wager if we gave the people who are most susceptible to the disease N95 masks, we’d have seen a much lower hospitalization and death rates.
- higeorge13 6y ago
  It might have made a difference, but we do not have a stable reference case to observe the difference. It might have reduced 1, 2, 10, 20% the number of infections, who knows? In the end it's just a piece of paper/cloth in our faces; i personally don't get this anti-mask sentiment as if we are placing something really bad in our mouths.
  - xxxxhhhh 6y ago
    > In the end it's just a piece of paper/cloth in our faces Humans are social creatures as the result of millions of years of evolution. There’s profound effects when facial social cues are erased and people are widely deprived of socialization.
- hello_moto 6y ago
  I observed many people around me use ineffective mask or don't wear it properly. Basic health hygiene requires discipline that may take years to develop if not mandated and enforced/practiced. Too many variables to be a mask skeptic given Cali situation...
graeme 6y ago
Some mistaken policy choices: * Not requiring masks at workplaces or schools once seated (common in many areas) * Not aiming for ventilation and denying aerosol spread * Denying asymptomatic and presymptomatic spread. Giving health/testing advice mainly based on symptoms * Not using and blocking rapid tests * Not scaling testing capacity with cases Japan had a more coherent approach on some of these with their three C’s approach: avoid closed spaces, crowded rooms, and close contact. The West generally just emphasized the latter. (The west did have capacity limits, but only to space people out within rooms, not for aerosols)

neilwilson 6y ago

The reliance on unusual concepts - like asymptomatic transmission and the effect of wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence they do that much good out in the field rather than in the lab (much like hydroxychloroquine which is similarly effective in a lab but not in the field). There is no blow out in Texas et al and Sweden has just tracked the same path as everybody else suffering much less than Belgium for example, and today isn’t anywhere near the top of the charts. There’s an awful lot of curve fitting to beliefs going on - because it is so difficult to do solid experiments.

watwut 6y ago
How is symptomatic transmission unusual concept?
- timr 6y ago
  Asymptomatic transmission is the concept in question. Symptomatic transmission is the typical case -- you cough, sneeze, etc., and give it to others. There's still quite a bit of debate over this question, despite the article's insistence that the matter is settled. The data supporting it comes mostly from modeling studies, and real-world data is thin on the ground. Mostly anecdotes. We have lots of examples of pre-symptomatic (or minimally-symptomatic) transmission for other illnesses, but these tend to be limited (e.g. spread within households), and it's always been a bit of a stretch to make the claim that completely healthy people are spreading diseases widely in "super-spreader" events via casual encounters. Does it happen? Sure. Is it common? Ehhhh. Even with Covid, we know that the majority of transmission (something like 80%) occurs within households. Of the remainder, as TFA notes, there's an "overdispersion", where a few people are responsible for most of the spread. Is it really likely that these "superspreader" people are mostly completely healthy, without symptoms, and yet unknowingly spreading it to vast numbers of people? Or is that just something that we've found a few times, and makes the most memorable anecdotes? It is certainly not the hypothesis you would favor based on parsimony alone. If you were a betting person, you'd probably put your money on the idea that someone is a little bit sick (but not so sick as to stay home in bed), and the disease can spread by aerosol or droplet with low probability. That's a much simpler explanation for the same pattern: someone has a tickle in their throat or a slight fever, but goes to the restaurant/office/wherever anyway. Set the probability of transmission to a low p-value, and let the poisson distribution do the rest. Just by chance alone, you will see rare occasions where large(r) groups of people get infected.
  - watwut 6y ago
    I had typo. But AFAIK, asymptomatic transmission is not novel concept. We have been learning about it in elementary school in the context of other diseases. There is absolutely nothing new about it as concept. It is not something that appeared with covid first time in history of diseases.
    - neilwilson 6y ago
      If it was a concept in this situation we could easily prove it. Get people who pass a lateral flow test or PCR test into a room and measure their pre-sympomatic viral output. Why hasn't that experiment been done?
      - dTal 6y ago
        It has? Repeatedly? This is the news from three days ago: https://www.independent.co.uk/news/health/covid-symptoms-report-coronavirus-ons-b1828361.html https://www.independent.co.uk/news/health/covid-symptoms-rep...
        timr 6y ago
        Showing that people with Covid can be asymptomatic is not evidence that asymptomatic people transmit the virus, and the article you linked to just leaps directly to the conclusion. Here's an actual paper from 2021 that shows that -- as you might expect -- that exhaled particles correlate with age, weight and viral load: https://www.pnas.org/content/118/8/e2021830118 https://www.pnas.org/content/118/8/e2021830118 In other words: older, fatter, sicker people are more likely to shed the kind of particles that facilitate transmission. They make a point of noting that nobody in their test under the age of 26 was a significant source of aerosol. Anyway, GP is not wrong. We could do these experiments, instead of just guessing.
Fomite 6y ago
Asymptomatic transmission isn't at all an unusual concept in infectious disease epidemiology.
- henrikschroder 6y ago
  The question isn't whether or not it can happen, I think everyone agrees that this virus can spread through both presymptomatic and asymptomatic individuals. The question is how common is it? How large a percentage of all cases are caused by it? And the whole "always wear a mask" hinges on asymptomatic/presumptomatic spread being high. Because if it isn't high, then we're focusing on the wrong thing, we're needlessly being suspicious of every single random stranger, we're choosing something that's easily virtue-signalable, over things that actually stop the spread.
  - raverbashing 6y ago
    If it isn't high the situation wouldn't have gotten as bad as it got. Especially with people more alert to people showing symptoms
    - xxxxhhhh 6y ago
      So basically you have no direct evidence, this is biased supposition.
worker767424 6y ago
> ...wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence My favorite example of how it's become semi-religious is people wearing them on outdoor walks in the suburbs where, worst case, they'll with within 6 feet of someone for a total of 30 seconds. The virus spreads very poorly in those conditions. Ironically, you're more likely to get the virus at home from a family member, but there's been minimal push for masking at home because it's political suicide.
- remarkEon 6y ago
  It’s definitely become a semi-religious thing where I’m at. I generally don’t wear a mask outside and people have asked me to put one on from about 10m away. I’ll comply, just to not be combative at that particular moment in time, but remove it once they’ve passed by. I’m fully vaccinated now. I expect this social norm to be semi-permanent and I don’t really have a good idea for how to break it. Even carrying a vaccine card everywhere would, I expect, elicit pseudoscientific retorts that “vaccines don’t affect transmission”.
  - SergeAx 6y ago
    But we really don't have an evidence that vaccine-induced immunity response prevents virus transmission. And we do have evidence that people recovered from COVID-19 months ago can bear high viral load in their respiratory system: https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v1.full-text https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v...
    - wrycoder 6y ago
      Two out of 6,614 previously infected were reinfected and showed documented high viral load. That’s a very low proportion. A prior history of SARS-CoV-2 infection was associated with an 83% lower risk of infection
      - SergeAx 6y ago
Daho0n 6y ago
>Sweden has just tracked the same path as everybody else That's very much false. You compare apples to apples to get a useable result, not apples to sour grapes. Sweden's policy have caused much much worse results compared to the countries you should compare it to: Norway, Denmark and Finland. For example deaths per 100k citizens is 12 in Norway and 134 in Sweden. Sweden is the perfect counterexample to your point. Nice graphs (Sweden is the yellow line that always stand out): https://www.vg.no/spesial/corona/norden/ https://www.vg.no/spesial/corona/norden/
- neilwilson 6y ago
  Why not Belgium, Peru, Poland, Hungary, Romania, even Gibraltar or the UK? Why do you want to compare to those specific countries you quote rather than the countries, say, that Sweden has distant transport links to? See what I mean about myths propagating.
  - Isinlor 6y ago
    Because Nordic countries are very similar culturally and compare between each other all the time. I have a Finnish girlfriend and my impression is that first thing that Finnish people do when considering a policy is to ask how it's done in Sweden. They overall rejected Swedish approach with good results. All the other countries you mentioned have vastly different cultures. E.g. I'm Polish and I can say that Polish government doesn't care about law and Polish people are fine with it. It's not to the extent Ukraine or Russia does it, but still. Poles also do not respect authority. This is in exact opposite to how things go in Finland or Sweden. It's almost a taboo to question authorities in Sweden or Finland.
- mike_hearn 6y ago
  There's no biological theory underpinning cherry picking of a handful of Sweden's neighbours. It's not like Sweden is ground zero of some genetically identical but non-deadly strain of SARS-CoV-2 that inexplicably can only spread within physical proximity of Stockholm. So not surprisingly, if you do the cherry picking honestly by including all Sweden's neighbours, including Latvia, Estonia, Lithuania etc, then Sweden stops being the worst in that little bounding box and we're back to Sweden disproving the models. Which it has done, comprehensively, because no model or theory postulates a Nordic exception.

erostrate 6y ago

The WHO initially said there was no evidence supporting the need for masks in the general public. They only changed their stance in early June. In Europe many politicians were making the same claim, which was convenient because they didn't have enough masks.

6gvONxR4sf7o 6y ago
At the time, I thought the general guidance was “don’t hoard masks, we need them for healthcare workers” rather than “don’t wear masks they don’t work” (which through the game of telephone turned into everything imaginable).
- EmbeddedLight 6y ago
  The outrage comes from government and other health officials making claims early on that masks were not as effective, and that maintaining social distance and isolation was better (which I agree). But this was merely used as distraction to allow healthcare facilities to snatch up the existing supplies of high quality n95 masks before the public could (see toilet paper apocalypse 2020). Then the government changed their statements and said that masks were effective, and everyone should use them. It's the switching and lying to the public that leads to a lack of trustworthiness. You can argue that they didn't know the efficacy of mask usage, but that isn't the point here. It's that they lied to the American public for an ulterior motive, which is wrong.
viklove 6y ago
The WHO is a political organization, not a scientific one.

mike_hearn 6y ago

I've read a lot of public health papers in the past year, probably more than 50. Here are some of the problems that cropped up in papers that were used by governments to support policy decisions. Many of those policy decisions later turned out to be incorrect, like lockdowns and mask mandates, both of which easily count as drastic and neither were textbook. In fact pre-COVID pandemic control plans by the WHO explicitly recommended against lockdowns. By the way, be careful to separate the question of mask mandates from masks themselves. Mask mandates don't work: just look at case curves when mandates were introduced or removed and observe the lack of inflection points. If they worked people would have hundreds of examples by now of case curves which obviously inflected right after a mask mandate was changed, but no such graphs are ever cited because those inflections don't reliably happen. Texas provides a recent example (mandate removed, curve continues prior trend) but this problem was obvious from within a week of the first mandates being introduced. Look at [1] for some case graphs with mandate change dates drawn on them to see the problem. Anyway, errors seen in public health papers: 1. Circular reasoning. 2. Invalid citations. 3. Programming errors in models. 4. Use of extremely out of date numbers. 5. Absurd or obviously invalid assumptions and results in models being ignored. That's not a comprehensive list. Unfortunately these aren't rare problems. Virtually every public health paper I've read has had at least one of these issues, often multiple. Circular logic in particular is mind-numbingly common, to an extent I've never seen before. For example, a common "validation" technique for models is to compare them to other models and declare their outputs to be similar (e.g. [2] or [3]). It's almost unheard of to compare model outputs to actual observed data, probably because doing validation right would invalidate virtually all public health models (this problem was admitted in a 2012 paper [4]). For a specific example of these problems see the paper by Flaxman et al from Imperial College London [5]. This paper argued that lockdowns work using a statistical model, but they actually don't work, so to get this result required a combination of: 1. Circular logic: the model took as a starting assumption that case curves could only be changed by government intervention. In other words the paper encoded its own conclusions in its assumptions. The assumption epidemics can only be affected by lockdowns has no rational basis given the long history of epidemics starting and ending naturally. 2. The paper included Sweden in its data set, which attracted attention because Sweden appears to prove that the models generating the counterfactual were wrong. It managed to conclude lockdowns worked despite this because it concluded Sweden was a freak coincidence with an only 1 in 2000 chance of existing at all; in the graph that showed the different per-country fudge factors the model was allowed to calculate, Sweden was simply hidden to obscure what had happened. The truth was discovered later by people who studied the tables of prior probabilities uploaded to GitHub. 3. The paper admitted half way through that its scenario was "illustrative only" and that "in reality" the results would be different. There were other problems too, but none of them stopped the authors telling the press that lockdowns had "saved millions of lives" (i.e. the drastic policy pushed for by that very same research team). Nor did it stop international press agencies citing this paper in "fact checks". After reading so many papers with really basic and blatant problems, it's hard not to conclude that open access is going to seriously damage academia's credibility. Being able to just download and read the output of academic scientists is a very new thing, and one of the few highlights of the time I've spent reading COVID research is that open access is real now: I've hardly ever hit paywalls. Only for old papers. Unfortunately open access is a double edged sword. Now we can all read what we're paying for and observe the dangerously low quality. The outcome will probably be a large expansion of the battle between "science believers" and "science skeptics". Up until now that has been mostly restricted to debates on climatology, but now I think it will widen considerably. There's just no way to read the literature and retain your confidence in academic science when so much of it is entirely un-scientific. [1] https://rationalground.com/mask-charts/ https://rationalground.com/mask-charts/ [2] https://github.com/ptti/ptti/blob/master/README.md https://github.com/ptti/ptti/blob/master/README.md (see the paragraph starting with "Formalism-agnostic"). [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001435/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001435/ ("There is agreement in the literature that comparing the results of different models provides important evidence of validity and increases model credibility") [4] ibid; ("few models in healthcare could ever be validated for predictive use. This, however, does not disqualify such models from being used as aids to decision making") [5] https://nicholaslewis.org/did-lockdowns-really-save-3-million-covid-19-deaths-as-flaxman-et-al-claim/ https://nicholaslewis.org/did-lockdowns-really-save-3-millio...

vondur 6y ago

I’m pretty skeptical at this point that masks made any difference. Here in Southern California where everyone wears masks indoors, and even the majority of people wear them outdoors. Yet we still ended up with some of the highest infection rates in the country. I’d wager if we gave the people who are most susceptible to the disease N95 masks, we’d have seen a much lower hospitalization and death rates.

higeorge13 6y ago
It might have made a difference, but we do not have a stable reference case to observe the difference. It might have reduced 1, 2, 10, 20% the number of infections, who knows? In the end it's just a piece of paper/cloth in our faces; i personally don't get this anti-mask sentiment as if we are placing something really bad in our mouths.
- xxxxhhhh 6y ago
  > In the end it's just a piece of paper/cloth in our faces Humans are social creatures as the result of millions of years of evolution. There’s profound effects when facial social cues are erased and people are widely deprived of socialization.
hello_moto 6y ago
I observed many people around me use ineffective mask or don't wear it properly. Basic health hygiene requires discipline that may take years to develop if not mandated and enforced/practiced. Too many variables to be a mask skeptic given Cali situation...

graeme 6y ago

Some mistaken policy choices: * Not requiring masks at workplaces or schools once seated (common in many areas) * Not aiming for ventilation and denying aerosol spread * Denying asymptomatic and presymptomatic spread. Giving health/testing advice mainly based on symptoms * Not using and blocking rapid tests * Not scaling testing capacity with cases Japan had a more coherent approach on some of these with their three C’s approach: avoid closed spaces, crowded rooms, and close contact. The West generally just emphasized the latter. (The west did have capacity limits, but only to space people out within rooms, not for aerosols)