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I completely agree with everything you said. That said, the most effective defense I've seen for the seemingly incoherently cautious status quo approach is tha

I completely agree with everything you said. That said, the most effective defense I've seen for the seemingly incoherently cautious status quo approach is that the medical community doesn't operate on the span of one pandemic, but is rather in a perpetual struggle. So even if the short-term expected value of an excessively cautious approach is negative, resulting in more deaths and a longer pandemic, it might be outweighed by reducing the chance of damaging public faith in medicine long-term by an erroneous more aggressive move. I still don't agree, but that very long-term view is the only defense I see for the approach given what we knew at the time.

wutbrodo 5y ago
Thank you for bringing that up. That makes a lot of sense, and public health absolutely does need to consider mass psychology and their credibility. The theory that they're overindexing on protecting that credibility doesn't really comport with their behavior the rest of pandemic, however. Leaving aside all of the blood on the hands of mindless bureaucracy (like effectively banning testing for Covid in the early pandemic when it was most crucial), there has been decision after decision that prioritized status quo bias and RCT-worship even when the long game suggests it would damage their credibility (the fervent anti-mask recommendations in the early pandemic is a great example, as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late). More importantly, "public health is misleading you at the cost of your health/life because they're playing the long game" doesn't actually preserve much credibility. It certainly casts public health figures in a more positive light, but I'm not really thinking in terms of blaming individuals over institutions/cultures anyway. It doesn't really matter _why_ public health advice is wrong in obvious and significant ways. What matters is the ultimate conclusion: if you have basic scientific literacy and an IQ over 105, form your own broad understanding of the science. This isn't a call to jettison epistemic humility: you're not going to be able to understand things anywhere close to as well as an individual epidemiologist can. But the point is that listening to the science as filtered through public health advice _is even worse_, in the same way that getting nutrition advice from the USDA will.
- Scoundreller 5y ago
  > as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late I watched Contagion for the first time last week, and they had the same attitude toward fomites, where it was spread through knobs and cash registers. I’m convinced that the movie was interpreted as a documentary on what to do rather than science. Now I question how much hand-washing helps prevent the spread of other respiratory viruses. Looks like, for flu, in this study, fomites were responsible for 4% of cases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/ … and > Mask wearing is much more useful than hand washing for control of influenza A in the tested office setting. Regular cleaning of high-touch surfaces, which can reduce the infection risk by 2.14%, is recommended and is much more efficient than hand-washing. But I’m just a guy that spent 2 minutes searching studies on Google of respiratory viruses, why make decisions so easily based on that when you can base decisions on a movie on Netflix.
  - wutbrodo 5y ago
    Very interesting, thank you. Call it Gell-Mann Amnesia, but I had not thought to extend my skepticism of the basic competence of public health authorities to flu recommendations. I suppose my model is that they were bad in the fast-moving epistemic environment of the pandemic, and that this wouldn't extend to relatively stable and well-understood cases like influenza.

wutbrodo 5y ago

Thank you for bringing that up. That makes a lot of sense, and public health absolutely does need to consider mass psychology and their credibility. The theory that they're overindexing on protecting that credibility doesn't really comport with their behavior the rest of pandemic, however. Leaving aside all of the blood on the hands of mindless bureaucracy (like effectively banning testing for Covid in the early pandemic when it was most crucial), there has been decision after decision that prioritized status quo bias and RCT-worship even when the long game suggests it would damage their credibility (the fervent anti-mask recommendations in the early pandemic is a great example, as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late). More importantly, "public health is misleading you at the cost of your health/life because they're playing the long game" doesn't actually preserve much credibility. It certainly casts public health figures in a more positive light, but I'm not really thinking in terms of blaming individuals over institutions/cultures anyway. It doesn't really matter _why_ public health advice is wrong in obvious and significant ways. What matters is the ultimate conclusion: if you have basic scientific literacy and an IQ over 105, form your own broad understanding of the science. This isn't a call to jettison epistemic humility: you're not going to be able to understand things anywhere close to as well as an individual epidemiologist can. But the point is that listening to the science as filtered through public health advice _is even worse_, in the same way that getting nutrition advice from the USDA will.

Scoundreller 5y ago
> as is the bizarre insistence on recommending precautions against fomites over aerosols until extremely late I watched Contagion for the first time last week, and they had the same attitude toward fomites, where it was spread through knobs and cash registers. I’m convinced that the movie was interpreted as a documentary on what to do rather than science. Now I question how much hand-washing helps prevent the spread of other respiratory viruses. Looks like, for flu, in this study, fomites were responsible for 4% of cases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/ … and > Mask wearing is much more useful than hand washing for control of influenza A in the tested office setting. Regular cleaning of high-touch surfaces, which can reduce the infection risk by 2.14%, is recommended and is much more efficient than hand-washing. But I’m just a guy that spent 2 minutes searching studies on Google of respiratory viruses, why make decisions so easily based on that when you can base decisions on a movie on Netflix.
- wutbrodo 5y ago
  Very interesting, thank you. Call it Gell-Mann Amnesia, but I had not thought to extend my skepticism of the basic competence of public health authorities to flu recommendations. I suppose my model is that they were bad in the fast-moving epistemic environment of the pandemic, and that this wouldn't extend to relatively stable and well-understood cases like influenza.