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Weather obviously correlates with people spending time together indoors, but it’s not the only relevant factor. Government policy and individual choices determi

Weather obviously correlates with people spending time together indoors, but it’s not the only relevant factor. Government policy and individual choices determine to a large extent how many risky exposures people undergo and how risky they are. Notice that e.g. Vermont had very low numbers of deaths, while similarly cold places in the midwest had much higher death rates. The difference is primarily political, not demographic or weather-related. In pre-omicron waves, the virus got to dense exposure in one place then spread geographically outward like a wave or fire (omicron has moved too fast for that pattern to be as visible). For example NYC, Boston, etc. were the initial epicenter in early 2020 (Seattle and the Bay Area also had plenty of early cases but strong reactions flattened the curve); the fall/winter 2020 wave pretty much started at the Sturgis motorcycle rally then spread outward across much of the country from South Dakota; and Florida was the initial epicenter for the Delta variant, which later spread throughout the south, then later on to the northeast, midwest, and west. These geographic waves of infection have perhaps as much to do with epidemic timing as local weather patterns. But severity of each wave has more to do with local social responses than with precise start timing. County by county or state by state comparisons in the USA are pretty stark (>5x difference between best vs. worst results), but are still limited to a large extent by common features of the federal response, American media environment, etc. If you look at international comparisons, there are 20x or 50x differences in outcome between countries caused by more starkly differing policy responses (obviously lower income countries are much more constrained than high income countries, but within each category some countries have had much worse policy response than others). Countries with fast, coordinated responses who empowered health officials, communicated clearly to the public, and dedicated the necessary resources ended up doing very well in comparison to those who made excuses, blamed others, misinformed the public, sat on their hands, and prioritized politics over health.

rossdavidh 5y ago
If you compare, say, Florida and California: - they were about the same in per capita mortality in the first wave - Florida was higher in summer 2020 wave - California was higher in winter 2020/21 wave - Florida was higher in summer 2021 wave - California is higher now The relative policy differences between California and Florida did not switch back and forth. The weather did, and it repeats from year to year. It would be nice to imagine that we always have control, but the actual data suggests that it's mostly a placebo. Other than vaccines, nothing humans have done has had much of an impact on the progress of the disease. The differences you refer to (e.g. Vermont) are largely explained by population density (the population of New Hampshire, for example, is about twice as much in the same area). If policy such as you describe had a big impact, then we would not see Sweden with a lower per capita mortality than France. Actually, while Sweden is slightly less, they've been very close the entire pandemic, and their policies are very different. If you used the same criteria for policy that you would for, say, a vaccine or a treatment, you would reject it as ineffective.
- jacobolus 5y ago
  > California and Florida State policy only goes so far. Both CA and FL have a mix of communities full of careful people with okay-to-good leadership and places full of people fed a steady media diet of misinformation with mostly failed leadership. Florida had every possible advantage going into the pandemic, especially mild weather year around that lets people e.g. eat outside, but the state government completely flubbed the response. CA also had plenty of state failures: the policies about “reopening” were poorly timed, poorly targeted, and not responsive enough to changing circumstances. What ultimately matters is people’s behavior at the individual level. Federal policy, state policy, and local policy can strongly influence this (e.g. by sharing good advice and accurate information, providing financial resources, supplying equipment and services, doing contact tracing, coordinating relief, ...) but in the USA there are plenty of individual people who have failed in their basic duty to society spread throughout the country. > Florida was higher in summer 2021 wave - California is higher now Florida was the literal initial epicenter of the 2021 delta wave in the US. It was seeded there (among other places) because Florida is a major travel hub, but got so bad because Florida is under-vaccinated and people didn’t take basic precautions compared to other initial seed sites. The Bay Area almost completely dodged Delta due to vaccinations and precautions while the under-vaccinated the CA central valley got hammered. Now with omicron, people throughout the US have largely given up on non-vaccine interventions and the vaccine doesn’t perfectly protect against infection, so somewhere on the order of half of the population of both states (and every other) is going to get infected, but the number of hospitalizations and deaths in both states will almost entirely consist of unvaccinated people. Places in both states where people are vaccinated will be fine, while the FL panhandle and the CA central valley will get wrecked. There are a bunch of US states with significantly lower population density than Vermont but significantly worse results. Or if you want somewhere to compare to the US that isn’t Vermont, the Bay Area, or Hawaii, look at most parts of Canada vs. most parts of the US. (Note, population density of Canada as a whole is not really relevant here, as most of the people live in a narrow urban band near the border.) Canada has generally had far fewer deaths than the US, even if we compare areas right across the border from each-other. Sweden has had horrible results compared to its comparable neighbors (Finland, Norway, and Denmark). They backed off of their initial failed policy, but not before costing a lot of lives. Fortunately the Swedish public is generally more cautious than the leadership. And fortunately they ended up getting most people vaccinated (better than Finland which saw most of its pandemic deaths in 2021). Of course, the USA has done about 2.5x worse than Sweden. > nothing humans have done has had much of an impact on the progress of the disease This is empirically nonsense, and also a horrible attitude toward public health crises. What is true is that a public health intervention today that ends after 3 months won’t save someone in 6 months. Vaccination is much more permanent than social distancing. Places where people universally wear masks (the higher quality the better) consistently have lower reproductive rate of the virus. Places where indoor dining was closed dramatically reduced the reproductive rate of the virus. Places where people started working from home, doing virtual school, closing public transit, etc. dramatically reduced the reproductive rate of the virus. Etc. There are hundreds of peer reviewed papers analyzing these trends; they aren’t a mystery. Places where there was initial masking, quick mobilization of testing, a coordinated contact tracing effort, isolation for the sick, quarantine for travelers, support for the out of work, etc. did relatively very well (e.g. China, South Korea, Taiwan, New Zealand, Norway, Denmark, ...). We are talking about >10x fewer deaths than they might have had. The problem in most of the US and most of Europe is that interventions came too slow, and when they were relaxed, in many places priorities have been wrong: useless interventions have sometimes been persisted (sanitizing surfaces, 6 feet of distance, masks outdoors) while the most important ones (esp. the closure of indoor bars/restaurants) were scrapped, and not enough was invested into getting people better masks, improving indoor ventilation, ensuring sick people stay home, etc. The criteria for re-instating social distancing and masking was based on the wrong metrics with thresholds set too high, and so lagged necessary response timing by weeks if not months. Political pressure and misinformation has overridden public health departments.

rossdavidh 5y ago

If you compare, say, Florida and California: - they were about the same in per capita mortality in the first wave - Florida was higher in summer 2020 wave - California was higher in winter 2020/21 wave - Florida was higher in summer 2021 wave - California is higher now The relative policy differences between California and Florida did not switch back and forth. The weather did, and it repeats from year to year. It would be nice to imagine that we always have control, but the actual data suggests that it's mostly a placebo. Other than vaccines, nothing humans have done has had much of an impact on the progress of the disease. The differences you refer to (e.g. Vermont) are largely explained by population density (the population of New Hampshire, for example, is about twice as much in the same area). If policy such as you describe had a big impact, then we would not see Sweden with a lower per capita mortality than France. Actually, while Sweden is slightly less, they've been very close the entire pandemic, and their policies are very different. If you used the same criteria for policy that you would for, say, a vaccine or a treatment, you would reject it as ineffective.

jacobolus 5y ago
> California and Florida State policy only goes so far. Both CA and FL have a mix of communities full of careful people with okay-to-good leadership and places full of people fed a steady media diet of misinformation with mostly failed leadership. Florida had every possible advantage going into the pandemic, especially mild weather year around that lets people e.g. eat outside, but the state government completely flubbed the response. CA also had plenty of state failures: the policies about “reopening” were poorly timed, poorly targeted, and not responsive enough to changing circumstances. What ultimately matters is people’s behavior at the individual level. Federal policy, state policy, and local policy can strongly influence this (e.g. by sharing good advice and accurate information, providing financial resources, supplying equipment and services, doing contact tracing, coordinating relief, ...) but in the USA there are plenty of individual people who have failed in their basic duty to society spread throughout the country. > Florida was higher in summer 2021 wave - California is higher now Florida was the literal initial epicenter of the 2021 delta wave in the US. It was seeded there (among other places) because Florida is a major travel hub, but got so bad because Florida is under-vaccinated and people didn’t take basic precautions compared to other initial seed sites. The Bay Area almost completely dodged Delta due to vaccinations and precautions while the under-vaccinated the CA central valley got hammered. Now with omicron, people throughout the US have largely given up on non-vaccine interventions and the vaccine doesn’t perfectly protect against infection, so somewhere on the order of half of the population of both states (and every other) is going to get infected, but the number of hospitalizations and deaths in both states will almost entirely consist of unvaccinated people. Places in both states where people are vaccinated will be fine, while the FL panhandle and the CA central valley will get wrecked. There are a bunch of US states with significantly lower population density than Vermont but significantly worse results. Or if you want somewhere to compare to the US that isn’t Vermont, the Bay Area, or Hawaii, look at most parts of Canada vs. most parts of the US. (Note, population density of Canada as a whole is not really relevant here, as most of the people live in a narrow urban band near the border.) Canada has generally had far fewer deaths than the US, even if we compare areas right across the border from each-other. Sweden has had horrible results compared to its comparable neighbors (Finland, Norway, and Denmark). They backed off of their initial failed policy, but not before costing a lot of lives. Fortunately the Swedish public is generally more cautious than the leadership. And fortunately they ended up getting most people vaccinated (better than Finland which saw most of its pandemic deaths in 2021). Of course, the USA has done about 2.5x worse than Sweden. > nothing humans have done has had much of an impact on the progress of the disease This is empirically nonsense, and also a horrible attitude toward public health crises. What is true is that a public health intervention today that ends after 3 months won’t save someone in 6 months. Vaccination is much more permanent than social distancing. Places where people universally wear masks (the higher quality the better) consistently have lower reproductive rate of the virus. Places where indoor dining was closed dramatically reduced the reproductive rate of the virus. Places where people started working from home, doing virtual school, closing public transit, etc. dramatically reduced the reproductive rate of the virus. Etc. There are hundreds of peer reviewed papers analyzing these trends; they aren’t a mystery. Places where there was initial masking, quick mobilization of testing, a coordinated contact tracing effort, isolation for the sick, quarantine for travelers, support for the out of work, etc. did relatively very well (e.g. China, South Korea, Taiwan, New Zealand, Norway, Denmark, ...). We are talking about >10x fewer deaths than they might have had. The problem in most of the US and most of Europe is that interventions came too slow, and when they were relaxed, in many places priorities have been wrong: useless interventions have sometimes been persisted (sanitizing surfaces, 6 feet of distance, masks outdoors) while the most important ones (esp. the closure of indoor bars/restaurants) were scrapped, and not enough was invested into getting people better masks, improving indoor ventilation, ensuring sick people stay home, etc. The criteria for re-instating social distancing and masking was based on the wrong metrics with thresholds set too high, and so lagged necessary response timing by weeks if not months. Political pressure and misinformation has overridden public health departments.