It was a maddening year. I lived in Quebec until October 2020, and there the public health director was an active source of disinformation. I believe he still argues against aerosols.
To have all the correct info available right from the getgo, and to have public health authorities actively spread wrong information. Maddening.
One of the things that has agonized people is not knowing what is safe. There’s been basically no documented outdoor transmission. You can see friends and family outside fairly safely. Just keep a little distance. If you hug, hold your breathe. Knowing the mechanisms you can gauge what is likely to spread and what isn’t.
I still know of people washing groceries and avoiding hugs but not so worried about removing masks to eat in a group indoor setting.
I am yet to understand why Quebec is doing curfew. How does not going outside after 8pm till 6am somehow make the situation better? Their own health officials said curfew won’t help.
It's really not. People definitely can and do have parties without the curfew. They just do it during the weekend or overnight. Besides, data shows that Quebecers already followed the measures pretty well, and only a small fraction of overall infections came from unknown causes or illegal gatherings, much dominated by schools and work (healthcare before vaccination).
Data from the public health agencies suggested it would not and had not had any impact.
Ah, this requires a bit of knowledge of Quebec politics.
The quebec premier is a pro-business populist. So, his leadership method can be accurately summarized as, doing what's best for business, and covering up for the issue this causes using populist issues (law 21, for example) or aesthetics.
Well, as cases started increasing in Montréal, he wanted to act though. But he didn't want to implement an actual lockdown, as that would hurt the economy (much like fumbled the first lockdown where cases almost went to zero, but instead of continuing slightly longer and implementing mass tests and tracing, he lifted it right before tracing was up to capacity and cases went to zero, but I digress). For the same reason, he didn't want to close down schools, which are a large driver of infection here according to public health data.
So, he implemented somthing he knew would look though to his base outside of Montreal, without actually impacting the economy, which is an 8pm curfew. Obviously, everyone with a bit of knowledge knew this would be useless, but there goes. As the curfew went on, vaccination of the health sector picked up, and the healthcare system went from a large driver of cases to non-existent, allowing Montreal to bring R under 1 and cases to go down. He obviously acted as if the curfew contributed, and pushed the curfew to 9:30.
Then, he had the brilliant idea of : putting back schools to full-time learning instead of one-day-on, one-day-off, even as the schoolboards and teachers didn't want to - supercharching a large infection driver, but also, outside of Montreal, opening back up indoors dining for restaurants and indoors gyms (without masks!).
Unsurprisingly, this led to an explosion of cases outside of Montreal, while Montreal kept stable amounts of infections despite a delayed curfew and full classrooms. So, he rolled back those measures, and to look though again, he put an 8pm curfew in the high infection periods.
Despite the fact that cases weren't increasing much in Montréal, afraid that the lack of increase despite a delayed curfew would show plainly that his curfew, flagship measure, was useless, he put it back to 8pm in Montréal. Nicely, this means that people now only have two hours or so to do their groceries, supercharging the mass of people there, indoors.
So there it is, it's really just aesthetics. If it helps or not doesn't matter, as long as it doesn't annoy his base too much and looks flashy, it's good for Mr. Legeault.
Also, he added a mandate to wear masks in outdoor parks, while almost no infections at all were recorded outdoors.
I live in Quebec and would summarily disagree with this assessment.
Your statement about the failure curfew policy and closures is definitely not true.
Have a look at the data [1] (Select: Quebec and change the timeframe to include 'all time'.
The original closures in January had a radically positive effect in reducing spread, and there were many more measures in place than merely curfew.
You directly contradict yourself by indicating 'opening up restos schools was a bad decision' when in the preceding statement you literally said that the policies 'had no effect'. They clearly did.
Schools have been opened in many places in the world, and are generally not considered to be superspreading locations - the difference 'now' is not COVID v1, rather, it's COVID v1.1 and v1.2 (i.e. other variants) which seem to be affecting young people at considerably higher rates.
The policy here is not hugely different than most places in the world.
>The original closures in January had a radically positive effect in reducing spread, and there were many more measures in place than merely curfew.
I never disputed the good effects of the closures in January. I disputed the impact of the curfew solely. You will alos notice in the data after January that the category of infection sources that fell the most is actually "Living and care environemnts", which is where healthcare is placed - a major driver of infection that was eliminated via vaccination.
Except you could see cases went down in a very similar way in places with no curfew around that same time period. It's asinine to credit the curfews for that. Unless you also don't mind blaming the current uptrend on... Curfews too? Because otherwise it's just an unfalsifiable hypothesis :
1) if cases go down it's thanks to Legault and his "audacious measures" like curfews
2) if cases go up the population is to blame but the measures still work and we just need more of them
There were curfews all over Quebec, and Quebec's Jan 1. policies had the most precipitous drop in cases in any province in Canada at any time except the 'shelter in place' orders.
Your '1 and 2' points are not relevant speculation - and I don't care one bit about Legault or his government, it's besides the point.
The policies across Canada and most of Europe for that matter are not dramatically different.
Why are you only comparing to the rest of Canada? The drop also happened in the US. And in Europe. Also why aren't the curfews working anymore?
Also, I'm not sure how attributing any benefit to completely unproven NPI that the government literally admitted to putting in place because it "sounded good and it sent message" rather than based on any scientific data isn't the actual speculation here.
You're batching together policies to make the curfew look good by proxy.
All analysis that isolates the curfew as a singular NPI show no discernible advantage, and the government admitted to having no evidence it's useful at all.
It's partly a social signal. I live in Quebec and the notion of 'curfew' has a very eerie and ominous 'feel' like nothing ever in my life.
I feel it's more powerful than the time we were seeing NYC hospitals blow up in COVID disaster.
It's 'over there' when it's on TV ... but when you 'have to get home by 8' it a visceral effect.
To the point wherein never before have I truly contemplated the authoritarian nature of the order - though I'm fully sympathetic to the Provincial Leaders trying to stop mass death, it's pretty scary that this can happen and the Supreme Court ruling on the case that was brought before them was really scant. Basically, the Judges said 'it's for the good of the people and proportional so it's ok' - but there's basically zero in the way of parameterized logic, precedence, or specific legality to all of it.
As far as the Health Officers supposedly miscommunication information, I suggest that these are intelligent people, and that obviously there's still not as much consensus as the comment implies.
'Gaslight of Science' I think is better exemplified by those denying COVID or vaccines.
>'Gaslight of Science' I think is better exemplified by those denying COVID or vaccines.
The Quebec governmnent's refusal to publish public health guidance on decisions that experts think are ineffective while insisting that they are based on evidence definitely qualifies as gaslighting science.
>It's partly a social signal. I live in Quebec and the notion of 'curfew' has a very eerie and ominous 'feel' like nothing ever in my life.
It was also a strong social signal to everyone I know that the handling of the crisis was aestheticized and politicized as there was no evidence of it's efficacy. Certainly for some it had a chilling effect, for many it led to a complete loss of trust in a government that was already playing fast and loose with rigor and trustworthiness.
The government of Québec mismanaged the crisis to a phenomenonal level. Literally thousands of deaths were directly caused by that mismanagement (from the catastrophic handling of nursing homes) even with a population that was (and still is) one the most compliant to the restrictions.in the world . But we still are blamed and pusnished by the government for "slipping up" and not being responsible while we all know no one in the government will be held accountable for the CHSLDs collapsing and Quebec having some of the worst outcomes in the world. That's who's gas lighting here, not a very tiny group of fringe weirdos with almost 0 impact denying covid.
"Quebec having some of the worst outcomes in the world"
This is completely false, Quebec actually has some of the better outcomes in the civilized world. [1]
Better than US, France, UK, Poland, Spain, Sweden - it's about the same as Switzerland and a little worse than Germany.
Where is your evidence of mismanagement?
The initial pandemic broke out and given that Quebec is the place in NA with the highest degree of 'socialized elderly care' - it's not unreasonable that the initial shock was higher, but after that 'first wave' of deaths in LTC - since June - the rate has been about the same as Canada, which is among the best in the world.
The populist blame is ridiculous - everyone whines about their own governments without providing any material evidence, because frankly in most cases there is none.
Please, are you actually comparing us to sweden? Yeah I hope we have better numbers than an open country. And even then the numbers are only slightly different and they were mostly from long term care too. But why not compare us to Norway or Denmark? Shouldn't we also be running circles around those unruly, not locked down freedumbz loving floridians or science denying Swedes after a year of never ending "mesures de santé publique" ?
Are you actually denying that the CHSLD system completely collapsed? Dude. What? People were left to die in their feces and from hunger, the army was called to help out, bodies of abandoned covid deaths were just left there for a while. Private CHSLDs like Herron got literally ghosted by the healthcare agency overseeing them and stopped replying to emails begging the for help. Healthcare staff had to work without PPE, hospitals were left to their own for the first few weeks back in March. Like I'm not even sure here if you have any clue of what has happened in early March because there's no way you could the CHSLD system didn't collapse and weren't mismanaged otherwise. That's something even Legault admits. But since we are on HN I'll assume good faith and address your other points
Okay so no it's absolutely unreasonable that the shock was that much higher. You are repeating more government talking points. because that's just what it is: depending on what week it is we always get a different excuse. It's either young people or spring break or people travelling or Christmas parties or a uniquy old population or the elusive covid deniers driving infection numbers up. It never ends. The truth is nothing about our situation was truly unique or unique enough to explain what we saw.
Also FWIW, Florida has an older population and is doing either better or pretty similar to us so yeah that doesn't make sense either. Why does it matter if the elderly care is socialized or not? Can't the government protect its patients more than the private sector in Florida can?
> Their own health officials said curfew won’t help.
I’m no longer following quebec public health’s announcements closely, but did they seem credible? They’ve been wrong on most everything so I’d need their reasoning rather than their authority to believe them here.
A curfew makes gatherings substantially harder. You have to buy food and drink in advance, and people have to be able to sleep over and be comfortable doing so.
Contact tracing won’t detect many clusters at private gatherings if people don’t say they were violating rules. Public health’s data may not be accurate here.
If I were in charge I wouldn’t use a curfew mind you. I would instead fix public health’s rules: emphasize ventilation, mandate open windows, require masks at work while seated, etc. But I suspect the curfew actually achieves its purpose. Quebec is doing better relative to other provinces than it did pre curfew, iirc.
[citation needed] - anecdotally all of the people I heard of that partied before still party after, either on the weekends eariler or they stay over.
>another major cause of spread.
[citation needed] - The "activities and events", which includes legal events, is 285 out of 11 158 in the sum of outbreaks collected by Quebec public health. "Other environments", which is where they put clusters that they can't identify is even lower at 46 out of 11 158. All other categories are verified using hard data, and one couldn't lie to classify the cluster somewhere else. So no, this isn't a data issue : https://www.quebec.ca/en/health/health-issues/a-z/2019-coron...
By far the dominating sources of infection are work and school, and it's not even close. Followed then are places of commerce.
What curfews actually do though, is force much higher concentrations of people indoors and in public transit, which strongly contributes to the infections in work, "other establishments", and legal "activities and events". Which has a big impact on infection, unlike the other factors.
Politicians had many other tools they chose to relax or not to use right as they enforced the curfew. For example, restrictions on schools were relaxed, a major driver of infection - places like gyms and so on were opened, which already infected hundreds of people, rapid tests were not used in outbreak environments, schools were not outfited with basic ventilation (even just an air purifier would help!), contact tracing is in a horrible state, etc...
Most of all, the politicians could actually release the data behind their decisions, going a long way to increase goodwill and compliance, but chose not to.
They chose the curfew because it would placate those who asked for stricter restrictions and get people to disagree with them, because it would be flashy and hard to ignore, because once restricted to Montreal it wouldn't cause issues to their voterbase, and because it's very easy to implement and doesn't hurt businesses with which the current government is incredibly cozy.
I think public health estimated actual infection rates are 5x the reported case counts. Where are cases easy to measure? In schools and work where you can easily know who was there. Where are they hard to measure? In informal social gatherings among rule breakers.
You’re looking only at the extreme case. Hardcore parties will still party. But regular people who just want to have a dinner party of ten, won’t. There is no data on overall gathering changes (no one tracks that), but you have to assume casual gatherings drop off. And anecdotally I know people are cancelling plans.
As it gets brighter late at night I think the argument against curfew will be stronger. People do go outside on late summer nights and that is safe.
I agree with you on ventilation, and rapid tests etc. If I were in charge I’d do that and not a curfew. But Arruda doesn’t believe in aerosols or rapid tests. So I understand why the politicians reach for the tool they can actually use.
As for data: there’s an easy way to settle this. Find infection per capita in quebec vs ontario vs bc before the first curfew, and after. It’s the only major difference. I think Quebec’s relative numbers improved post curfew, but I don’t have good time series on hand. Know of any?
I know the curfew is psychologically brutal! I’m merely arguing it probably works, too.
Also I’m from New Brunswick originally and there in the Edmundston region they have the same policies as the rest of New Brunswick, except that people disobey the rules and have private parties. They’ve had constant outbreaks, but it doesn’t show in the stats because those people don’t go for tests and they don’t share full info with contact tracers. Public Health officials have described the rule breaking in their briefings. We know it is the case as New Brunswick doesn’t normally have local cases so the virus only enters by rule breaking.
>I think public health estimated actual infection rates are 5x the reported case counts. Where are cases easy to measure? In schools and work where you can easily know who was there. Where are they hard to measure? In informal social gatherings among rule breakers.
A large part of why infection rates are higher is because a lot of people simply don't get tested, be it because their workplace doesn't want them to (happened to a lot of people I know), or because they have light or no symptoms. Otherwise, people who were infected in a party and then infect other people that do get tested have a high likelihood to get traced as sources of infection too. Besides, there is no obligation to cooperate with contact tracing, if you go get tested after going to a party you can simply not say anything, so I don't really see why people that get infected at a party wouldn't get tested. On the converse, the one party-goer I know of apparently gets tested weekly, but hey that's anecdotal and low quality.
>As for data: there’s an easy way to settle this. Find infection per capita in quebec vs ontario vs bc before the first curfew, and after. It’s the only major difference. I think Quebec’s relative numbers improved post curfew, but I don’t have good time series on hand. Know of any?
The issue for this is that sadly the curfew was not implemented alone.
That said, one can look at when the curfew was extended to 9h30PM, and indeed there is no significant difference.
Have a look at the CTV stats. Quebec peaked at 30 per capita, fell to less than 10 with the curfew. And having kept a version of it, now is less than 15 per capita.
Ontario was 25/7/25. BC was 16/10/23.
Roughly. My prediction would be that Quebec has a lower peak than these two provinces and spends less time with max restrictions. Ontario issues a full stay at home order, and did so before Quebec’s curfew announcement.
Also Montreal is the only place that kept the curfew at all (9h30 vs none until recently) and it has markedly lower per capita case counts than the rest of quebec or other BC/Onatario.
Do you have an alternate explanation for this data?
Of course. The curfew being imposed in January also came with harsh restrictions on schools and with workplace closures, and at the same coincided with the wrapping up of the vaccination of the healthcare system, which together account for 80-90% of cases.
Montréal is also the only place that kept many, many other other restrictions and that had accelerated vaccination before cases popping off everywhere.
So we really have to limit observation to curfew only changes.
>That’s a hard comparison as there many variables during past case declines too when curfew lifted
Certainly, but if the curfew was the determinant factor, then we would not see the decline persist past it's relaxation or removal.
>However, right now Ontario has had a total lockdown for a while, but no curfew.
Even the implementation of the major measures in January 1st did not have much effect outside of healthcare until around 2 weeks afterwards. It's only been four days since Ontario implemented similar measures. The earlier "lockdown" was a lockdown in name only and even allowed gyms and indoor-dining to be open. For this comparison to be made we will still have to wait at least ten days.
As it stands, the only conclusion we can take from this data we have so far is that the curfew is likely not the decisive, as case declines persisted after it's removal and relaxation.
The priors we have from expert opinions and even government officials is that the lockdown is not expect to be effective.
From this, I can't conclude anything except that the lockdowns are likely not effective.
> From this, I can't conclude anything except that the lockdowns are likely not effective.
Wait you’re expanding this to not just curfew, but any lockdown is ineffective?
I’d invite you to check out the recent outbreak on Newfoundland. Large undetected outbreak, lots of spread, 100% UK variant, totally eliminated in a month due to a lockdown with high compliance, return to zero cases.
I should add I do have some doubts about the curfew with warm weather. Outdoor socialization isn’t harmful, and people will feel more deprived now than during the winter one, when many people hibernate anyway.
Oh fuck sorry I totally got mixed up, I absolutely meant curfew and not lockdown. I was debugging a really hairy algorithm at the same time and I got distacted. Of course, lockowns are incredibly effective, by far the most effective tool, and I wish we had let the first lockdown continue until completion.
Sorry, I made a mistake here. In the last sentence, I mean "curfews are likely not effective", not lockdowns, which definitely are extremely effective.
A lot of trouble originated in advice being adjusted to market availabilities rather than science (e.g. don't recommend masks so people wouldn't stockpike them).
> If you hug, hold your breath
Does this still hold with B117?
If outsides are so safe why are curfews still a popular measure?
Yeah, people believe B117 still transmits via aerosols, not fomites. If so, how could you possibly transmit it if you aren’t breathing while hugging?
The curfew’s intention is to block people from having social gatherings. You can’t so easily go to dinner at a friend’s if you have to sleep over for the night, and all the stores are closed to buy stuff.
It’s fascinating to me that a scientist would look at the Diamond Princess and it’s 14 deaths of almost entirely 80+ year olds (no one under 65 died) and see evidence to justify mask mandates and school closures and firing half of the people of color from their jobs. Why not, say, quarantine for senior citizens or any sort of coordinated response to protect and provide for the elderly? When people talk about a covid hoax, it’s not denying the virus exists. It’s denying that the popular mitigation strategies don’t do anything but drive value for Amazon share holders.
We unfortunately had (and in many places are still having) both an emotional and fear-driven reaction to the spread of the virus.
A lot of people understand the risk is much lower than the measures used to contain it, such as full school closures and closing parks and playgrounds. In retrospect I hope we can admit at least those preventative measures were a mistake.
My fear is that if another more serious virus lands on the scene, there will be no credibility to do it again.
The park closures made very little sense. The playground closures made sense when people were worried about fomites, and the early lab studies (that largely measured the wrong thing) suggested that fomites were an issue.
A school is neither a park nor a playground. Schools are mostly indoors, mostly in inexpensive buildings with correspondingly poor ventilation and/or air filtering, and have a lot of people talking and breathing the same air. This is a totally different situation.
Is this science driven or emotion driven from the other side? If virus is airborne and can spread without symptoms, are you saying younger age group does not get the virus or does not show the symptoms? If they do get the virus, then they can spread it. The closures were to prevent the virus from spreading and I do not understand why the measures used to contain it are a mistake.
From the OP, it seems clear that virus is airborne, spreads in clusters and people spread it before showing any symptoms. I am open to suggestions on what are the alternative ways of stopping the spread?
It's not about whether the current restrictions are the best or not. It's about whether anything should be done at all as evidenced by critics' lack of concrete proposals of what they would do instead. Presumably nothing.
So doing something so disruptive is better than doing nothing even if we end up with the same result anyways because... At least we did something?
Even if that's true, I keep hearing that argument and I think I'll keep hearing it a lot in the future which makes sense as we try to justify what happened. But it's not based on reality considering that the anti lockdown side had a pretty clear plan: quarantine those most vulnerable, spend any fraction of the enormous resources we spent on locking down everything on making sure to provide for those people. That way we could've also focused the testing capacity & PPE on a lot less people, making it that much easier to isolate them from the virus. Instead of allocating thr same amount of resources regardless of how at risk someone was.
You can disagree with the position but I'm not sure how you could argue that it's "doing nothing".
Suppose, for the sake of argument, that you are right to the extreme: Covid kills a non-negligible fraction of people 65 and up and has zero mortality or long term consequences for people under 65. [0] Even if this were true, doing nothing to control the spread among under-65-year-olds would result in absolutely enormous numbers of cases over a fairly short period of time. Do you really expect that the large majority of people over 65 could be protected effectively when the considerable majority of under-65 people to whom they are exposed (caregivers, food providers, relatives, etc) get covid?
I do not believe that most of the world has responded in a particularly useful way to covid, but I do believe that masks are quite effective (especially N95 or comparable masks) at reducing the spread of covid in indoor spaces. So yes, mask mandates, at least indoors, make quite a lot of sense.
The school closure issue is harder. There seems to be surprisingly little data on the degree to which covid spreads among children compared to adults and the degree to which covid spreads from children to adults. But most schools consist of students indoors, in a poorly ventilated space, often crowded, talking, for hours a day. Read the article: this is prime covid-spreading conditions. Perhaps schools could have been allowed to remain open to the extent that they could move outdoors or drastically improve ventilation, but doing nothing seems likely to have been a very bad idea.
To me, in the absence of data, we should default to using best-guess models and not just throw up our hands and say "whatever, nobody knows for sure, just keep on keepin' on". Anyone who has children knows that pretty much any disease rips through schools. If COVID-19 were to eventually be proven to not transmit between children in meaningful numbers, it'd be a huge irregularity. But so many people treat this "no proof of transmission" situation as "proof of no transmission".
> Anyone who has children knows that pretty much any disease rips through schools. If COVID-19 were to eventually be proven to not transmit between children in meaningful numbers
If? We already know that it doesn't. Yes, other viruses rip through schools rapidly, but this virus simply doesn't. Your gut feeling is wrong.
"Younger children (<10 years of age) may be less likely to be infected than adolescents. This possibility is supported by contact tracing studies; test positivity data from children, adolescents, and adults; and population screening studies using seroprevalence data. Susceptibility to SARS-CoV-2 infection and the proportion among those infected experiencing symptoms both generally increase with age."
>Even if this were true, doing nothing to control the spread among under-65-year-olds would result in absolutely enormous numbers of cases over a fairly short period of time.
I don't think this is something you can claim without backing. I fail to see significant logic/empirical observations that make it seem futile to you that stopping the spread to a subset of the population is significantly harder than for the whole population.
>Do you really expect that the large majority of people over 65 could be protected effectively when the considerable majority of under-65 people to whom they are exposed (caregivers, food providers, relatives, etc) get covid?
Exposing the not-at-risk population would likely increase the short-term risk (all measures constant) but decrease the long-term risk to people over 65. Having a smaller population to focus on protecting would likely make their protection easier.
Even if you were right in that you would have more casualties from selective locking down (which I am unconvinced), would the increased death toil justify the freedom being messed with for the whole population?
Asymptomatic spreaders are the biggest risk to vulnerable populations and there wasn't a way to detect that before the pcr tests, nor a foolproof way (even now) to test everyone at-risk populations might come in contact with.
A substantial risk of passing a deadly virus on to vulnerable people is not a freedom, it's negligence.
>A substantial risk of passing a deadly virus on to vulnerable people is not a freedom, it's negligence.
Stay-at-home orders/curfews are affronts to freedom. Derailing this to imply wanting to go outside at all is negligence is disingenuous. Preventing people from seeing other people over long period of times is known to be psychologically bad for human (and is a form of torture, see [1]. Although it is different in some ways, it seems clear its not good for the population well-being).
>nor a foolproof way (even now) to test everyone at-risk populations might come in contact with.
Don't let perfection hinder practicality. Keeping at-risk population away from infected people at a good rate is very feasible. It doesn't have to be foolproof (nor is it right now). It does not seem either harder or worse than what we are doing right now.
> Stay-at-home orders/curfews are affronts to freedom. Derailing this to imply wanting to go outside at all is negligence is disingenuous. Preventing people from seeing other people over long period of times is known to be psychologically bad for human (and is a form of torture, see [1]. Although it is different in some ways, it seems clear its not good for the population well-being).
I only have experience with the U.S. orders in California specifically. I spent a lot of time outside in parks and nature reserves instead of inside buildings. From what I saw, a lot more people than usual were also doing the same. It's quite possible that countries that restricted people to their own houses went overboard, but e.g. New Zealand had an optimal outcome with a very quick lockdown and contact tracing.
There are some similar situations: curfews and blackouts during world war II bombing raids, and laws against shooting firearms into the air. Both restrict "freedom" in a general sense but are examples of legitimately limiting individual freedom because it causes undue risk to others. I don't have a solid threshold for where restrictions make sense, but a starter might be the total net QALYs. Wars are often supported despite reducing net QALYs for everyone, for example, but that's hopefully an outlier.
According to [1], an estimate of 810,000 discounted QALYs were lost by July 2020 in the U.S. This number would likely have been significantly higher with uncontrolled spread. Dividing that out into the U.S. population means the lockdowns would have to reduce everyone's life expectancy by about a day due to the 3-4 months we were in lockdown to reach the threshold where I'd start to consider scaling the lockdowns back. As the U.S.'s failed attempt to control the spread continued for the entire year, the cost/benefit changed. Extrapolating from about 150k covid deaths in July/August 2020 to the 560k now linearly we'd be up to four lost days balanced against QALY losses from covid. Suicide rates seem to have decreased in 2020, so the losses would have to come from delayed effects or adverse health from lack of exercise, etc. I can be convinced that the lockdowns were too extreme, but it'll take solid analysis and it probably won't be fully measurable until a few years from now when we see follow-on effects.
> Don't let perfection hinder practicality. Keeping at-risk population away from infected people at a good rate is very feasible. It doesn't have to be foolproof (nor is it right now). It does not seem either harder or worse than what we are doing right now.
To keep vulnerable people healthy, we have to keep everyone they interact with healthy or at least non-contagious. If covid had unrestricted spread through everyone under 65 that's 80% of the population being a vector within a couple months. We didn't have test infrastructure or certainty on mechanism of spread by May 2020, so quite likely most vulnerable populations would be in contact with contagious people and get sick as well.
I agree we're basically at the tipping point but it's because vaccines are getting us closer to herd immunity. Attempts at "opening up" in the past were misguided because they only resulted in a large spike of new infections and deaths, the latter the key indication that despite best efforts the vulnerable populations were not well protected.
I respect your view on this because it seems well researched, but I have a few qualms about it:
1. Using QALYs seems ok w/r to covid, but not in relation to lockdowns. You say 4 days of QALYs lost per person and I'd argue that being unable to see your friends & family or do most activity is alike to being sickly (which is what is used to calculate QALYs). Maybe its not a 1:1 correspondance but lockdowns for 8 months (I'm not sure USA, I'm more familiar with Canada) have (imo) exceeded 4 days of QALYs per person by a long margin.
2. I have major issue with this line of thinking:
>I can be convinced that the lockdowns were too extreme, but it'll take solid analysis and it probably won't be fully measurable until a few years from now when we see follow-on effects.
It's a strongly held belief of mine that, in order to restrict the freedom of people (ala blackouts during WW2), you have to have a solid argument that what your doing not only outweigh the disadvantages, but far outweigh them. Restricting people's freedom is not like an economic decision. I believe this is what the general society has come to accept too (e.g. civil law has preponderance of evidence vs penal code which has abundance of evidence).
I agree that we can grant an "emergency response" where we are unsure of the risks, but I disagree strongly that this emergency response can last this long without a very strong case/public discourse that this is significant enough to restrict freedom.
It's always hard to argue that we should do less when it comes to saving lives, but perhaps a better way to look is whether we're focused on the right thing.
In 2019, heart disease killed 18.6 million people whereas Covid has taken 2.9 million lives. Heart disease is also a major factor in severe Covid cases. Couldn't we save more lives if we took all this governmental effort that we are putting towards tiered business closures and mask mandates and instead focused it on national, maybe even mandatory exercise programs?
On average, people were about 6x more likely to die of heart disease than covid over this last year, yet we take comparatively little if any action.
> people were about 6x more likely to die of heart disease than covid
Could you add a link to where you get those numbers from. What the link below says is that "Covid-19 is the Number One Cause of Death in the U.S. in Early 2021".
If Covid-19 is the number one cause of death, how could heart-disease be 6x more likely cause of death?
Take care when interpreting this kind of data. Even if it were true that Covid-19 is the number one cause of death for 2020, you can make a strong case that this number contains a significant number of unhealthy people which would have died from heart disease & al in the near future. This means that covid effectively "steals" death from a category in the short term. Which would mean that heart disease is still a bigger long term/overall issue than Covid.
Plus this doesn't take into account the reporting bias that seems to have been (be?) prevalent in 2019.
(Although it seems heart disease was still bigger than covid for 2020 [1] if compared to 2019 [2] in the us)
I mean you can do the opposite. People who die from heart disease might be more at risk of other things (obese, etc) and are also likely to be old, no?
Yes, but it's not a short-term boost like with Covid.
I mean it in that Covid will look worse and heart disease better on a short scale, but in the grand scheme of things Covid will die down and heart disease come back, since you don't have immunity or vaccines against heart disease. That means that comparing (for the same year) covid vs heart disease is somewhat useless (since covid is an exceptional and short-lived event).
Fixing both problems will probably move deaths to another category (since that is the purpose of having categories), but the argument was that addressing covid has less benefits than addressing heart disease (mostly because covid addresses itself over time, whatever lockdown/mask wearing we do, but heart diseases do not).
So it's NOT like all those half-million people who died from Covid-19 in the US would have died anyway and we would just call their cause of death something else. No. They died because of Covid-19 and many of them because some people publicly downplayed the danger of it and made fun of people wearing masks.
If you consider US only then it's not quite as dramatic but heart disease is still the #1 killer, especially since this happens every year and there's no vaccine for heart disease. 647,000 US deaths due to heart disease in 2019 vs 575,615 deaths due to Covid in 2020/2021. https://www.singlecare.com/blog/news/heart-disease-statistic...
As others have pointed out however, heart disease is a major factor in Covid deaths, for example, a history of heart failure ramps the Covid case-fatality rate from something like 2% for the general population up to 49%, so it's very difficult to fully separate out heart disease vs. covid for those 575k US deaths.
Old people die. Sorry, the world is made in a way where old people die and young people live. If you don't like it - take it up with the way the universe works.
I don't know when it's been decided that we're going to prevent young people from living, so that people who are going to die soon anyway get a few more years.
I mean, the entire system is made up of exploiting young people so that old rich scum get richer but uh, how long can this go on? Young people don't even have children anymore, while the profits of old rich scum are record high. This trend obviously can't continue so I'm waiting for a voice of reason to say 'enough of this shit already, you're not going to live forever and we're not going to walk on egg-shells for the rest of our lives to appease your irrational fear of death'.
Oh, one more thing - if you give a shit about people not dying of viruses world-wide - try not letting virus carrying things travel world-wide because it's 'fun'. I mean, what kind of games are we playing here? This is a self inflicted wound by stupid rich people that everyone else now has to pay for.
Enough of this shit already, you're not going to live forever and we're not going to walk on egg-shells for the rest of our lives to appease your irrational fear of death.
" I do believe that masks are quite effective (especially N95 or comparable masks) at reducing the spread of covid in indoor spaces."
Why do you believe it rather than know it from solid science?
The problem is that the whole mask thing has dubious impact, much like Vitamin D, or washing hands and the rest, but has become a symbol of political allegiance, not medical impact. What was predicted to happen in Texas hasn't happened.
There has been absolutely no evidence anywhere of children in schools being vectors for transmission. They suffer very little sickness from the disease and don't seem to spread the virus until they start showing actual symptoms - both of which directly contradict the prevailing narrative.
Yet these glaring anomalies seem to be dismissed by the prevailing belief. Even simply mentioning them has become verboten as the response to this post will probably show.
I don't believe anybody has looked into whether different types of people from different ages 'leak' the virus differently. That would go some way to explain the difference between the Diamond Princess experience (full of older people), and schools (full of younger people).
We know very little and humility in the face of that is called for. What we're doing now is going to look foolish in the future once we know more.
Are you serious? Even if you don't know/believe an actual paper, you can always look at first principles:
1) If N95 masks didn't work, all doctors and nurses in ICUs treating covid patients would get sick quite quickly. But that didn't, and in fact they got sick at a similar rate to other doctors (this is from Peru where they had lots and lots of covid)
2) These masks literally stop the virus from passing into your respiratory system. So why would you be surprised if they prevent disease transmission?
"all doctors and nurses in ICUs treating covid patients would get sick quite quickly."
But that's doctors and nurses in a highly controlled environment where we know there is an awful lot of virus particles around. That controlled environment doesn't occur elsewhere, so you are comparing apples and pears.
Leakage round the side, not wearing the masks fully, not changing often enough, etc. all apply in the field not the hospital, and even then the network effects can outstrip the filtering effect. Concentrations matter - as it does with radiation where high radiation areas damage the body and then when it drops below a certain level there is little impact at all.
Extrapolating from hospital to elsewhere is problematic and simply not supported by the evidence.
" These masks literally stop the virus from passing into your respiratory system."
Again in controlled environments, not in the field where that level of protection isn't available nor is it managed, changed or worn properly in all cases.
The reality on the ground shows that. There is no detectable effect outside really controlled environments without a high degree of curve fitting and bias. Texas has not exploded has it.
The downvotes say it all. People no longer wants to discuss rationally the possibility that they may be mistaken. It has become a religious crusade to do with identity.
The motto of the Royal Society is "Nullus in Verba" - take nobody's word for it. The essence of science is to question, not censor.
> I don't believe anybody has looked into whether different types of people from different ages 'leak' the virus differently.
We absolutely have, and non-surprisingly, the sicker a person is, the more virus they spread around them. And since children are much less likely to develop symptoms or get sick, they spread the disease less, which is why spread among students in schools is much, much smaller than among the community at large.
I will always, always value the right of children to go to school and the right of Americans to run a small business over the completely hypothetical notion that a novel corona virus has intense long term side effects. Schools are open in Florida and the kids are fine. There have been a billion, probably two billion, infections so far and near zero evidence of widespread long term effects. If one percent are “long haulers” there should be 10-20 million of them. Where are they? What there is indisputable evidence of is a dramatic increase in drug overdoses, suicides, stroke and heart attack deaths at home (which are callously and cravenly classified as excess mortality due to Covid). I am supposed to chant BLACK LIVES MATTER in the street when police kill 250 black people/year but am supposed to clap and cheer when the Teachers Unions demand that 40 million Children of Color are locked at home with no equipment for distance learning. Please stop pretending that a disease with 99.95% survival rate (99.999% under age 50) justifies ten trillion dollars of self imposed economic disaster. Please stop telling me I need to cover my face when walking my dog outside, Dr Biden. The threat of this virus has been drastically exaggerated to influence politics, undermine property rights, bail out failing corporations, and enrich a select few.
> If one percent are “long haulers” there should be 10-20 million of them. Where are they? What there is indisputable evidence of is a dramatic increase in drug overdoses, suicides, stroke and heart attack deaths at home (which are callously and cravenly classified as excess mortality due to Covid).
I would love for you to be right. Sadly, if you actually try to look up the incidence of long covid (or post covid syndrome, etc), you will find estimates ranging from 5-25% incidence. Optimistically divide by five (I’m giving you the benefit of the doubt here) if you want to estimate the incidence among total infections instead of symptomatic infections. Divide by 10 if you think that 90% of patients will recover fully and quickly enough that you should discount them. You’re left with 0.1% to 0.5%. You appear to be a couple of orders of magnitude off in your calculation.
I've spent a lot of time reading the science over the last year and a half or so. These claims of gaslighting go both ways. I've seen numerous studies passed off as fact and that have been used to guide policy with unacceptably low sampling sizes or other sampling problems.
I've seen very little 'good' science being conducted over the last year. You've got inadequately sampled studies throughout the duration of covid that have led to drastic policy decisions, I've seen biased studies coming from massive corporations being used to guide policy decisions and not one step along the way have I seen anyone who's gone...
'Hey wait a second, maybe we should check this data before we take drastic action'
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?
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.
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.
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.
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.
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:
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.
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.
> ...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.
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”.
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/10.1101/2021.01.13.21249642v...
I understand and hope that vaccination/natural immunity will prevent virus from spreading. But currently we only have evidence of decreased risk of sickness. Virus may still live in respiratory system and spread asymptomatically. BTW, vaccination strengthens lymph/blood system immunity, but not nose/throat lining, where viral aerosol producing.
>But we really don't have an evidence that vaccine-induced immunity response prevents virus transmission.
What I have a problem with here is how the goalposts for going back to normal just continue to push out like this. First it was just reducing R0 to a certain level. Then it was vaccination. Now it's something else that is yet undefined. It's impossible to come up with a rule because someone will always bring up some extreme edge case and say "well we don't really know with P99 certainty". This isn't a reasonable way to manage a society. At some point we need to acknowledge and ingest the remaining risk so that, for mental health reasons and others, our society can return to something that resembles normalcy.
So... while I accept the premise that mask wearing in a situation where you are also distanced, outside and vaccinated is probably a needless optimization, it's still an optimization. People wearing a mask are less likely to get sick. People wearing a mask are less likely to spread disease. That is true whether their base chance was 50% (a sick person eating across a table in an indoor restaurant for half an hour, say) or 0.01% as it is in your hypothetical. The difference is only in the calculation of the absolute, not relative, protection.
It's not "pseudoscientific" to or "religious" to make a different risk analysis decision. People just have different tolerances.
Broadly: be nice. You're not as right as you think you are, you're just braver.
What's more, no one else can tell you're vaccinated. It's polite to be visibly making every attempt to prevent transmission to other people.
There's also an argument that it's safer to have an easy, blanket rule, rather than permit everyone to editorialize on why they are super special and should be given a pass. There's a solidarity angle as well. Just wear the mask, darn it!
Maybe. Once you get to measures that have a negligible effect, weird things start to take over. Behavior change (feeling safer in a mask) is probably a bigger factor than the mask, itself, at that point.
> Maybe. Once you get to measures that have a negligible effect
No, always. Masks are mechanical, they reduce risk by some fraction, period. Some fraction of particles that would enter or leave the lungs and into the environment don't, because they get trapped in the fabric. That doesn't have anything to do with how many particles there are.
I think your logic mistake here is that you're assuming that all these mitigation strategies are correlated, that you need to stay distanced OR outside OR masked, etc... But that's not the way this works. All of those strategies help INDEPENDENTLY, and doing them all leads to less risk.
Now, if you're 40' away from the nearest person and outside, it's true that your absolute risk is almost certainly so negligible as to make a mask irrelevant. But believing otherwise isn't "pseudoscience" or "religion", it's just a calculation error.
>But believing otherwise isn't "pseudoscience" or "religion", it's just a calculation error.
I think you're assuming that these people who want mask compliance at a 40' distance are doing the statistics like you are making the same conclusion about what behavior should be normal (a conclusion I disagree with). Some might be, but I doubt it's any non-trivial percentage. It's just a social norm now that's based not on science, but on a particular person's or group of persons' feelings.
That is pseudoscience. Being "nice" is a, well, "nice" platitude but it isn't science. And after being lectured for more than a year about how "we need to follow the science" I find it more than a little annoying, but not unsurprising, that we're going to do otherwise.
But you don't need to wear a mask at home, just open the damn windows and let the air circulate
People's level of actual cognition seems to have gone down and being replaced by dogmatic fervour one way or the other, leading to a competition of who screams their allegiance louder.
If you think a mask don't help you're welcome to volunteer at a Covid ward without one. NPIs (stay at home, lockdowns, etc) have been used since the black death
Sure you won't hurt anybody but yourself by wearing a mask (or two) outdoors with no one around (for prolonged periods of time) or "staying at home" at all costs needlessly, but yeah, you'll still looking like a fool.
>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.
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.
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.
> There's no biological theory underpinning cherry picking of a handful of Sweden's neighbours.
Uh... the whole premise was to cherry pick Sweden and try to make a broad determination based on that one data point! You don't get to demand broad statistics if you didn't do it originally.
Sweden isn't cherry picked because there are only a handful of regions that chose not to lock down and the relevant argument is about the impact of locking down or not. Therefore looking at it specifically follows naturally from the question being investigated.
The converse, attempting to argue that Sweden suffered harshly by looking only at physical neighbours, doesn't follow naturally from any scientific question anyone is actually raising. For that comparison to be useful you'd need a theory of the form, "Nordic peoples are genetically superior to other peoples in ways that makes them naturally resistant to COVID, and thus whilst original models neglected that factor, Nordic Exceptionalism means Sweden should have been identical to Norway and they weren't therefore their decision was a bad one". But obviously such an argument would be nonsense and nobody is claiming that - just implying it.
It's irrelevant for another reason: Sweden only looks like it did "badly" compared to Norway when using percentages. If you look at it in terms of absolute change in excess death, it's small, and depending on how you calculate, you can actually argue COVID had no effect on excess death in Sweden ([1] has an example of such calculations). The impact on Sweden of not locking down, even if you ascribe all differences between these arbitrarily chosen countries to that, is so tiny that it cannot justify the costs of the policy.
At any rate, if you like there are other examples and they all support the same argument. For example, in the USA Florida is a reasonable choice. They released their restrictions relatively early without disaster. Or South Dakota (=identical curves to North Dakota despite very different levels of restrictions), or the recent example of Texas unlocking, or Belarus.
Sweden is a popular choice because it's a very clear counter-example that's been widely discussed in Europe, and because - as I already noted - no model predictions or epidemiological theories make any exceptions for Sweden or Nordic countries. In fact modellers predicted specifically that Sweden would have had 90,000 deaths from COVID by May, but in fact they had about 98,000 deaths in total from all causes by the end of the year. It's therefore sufficient by itself to disprove the models.
This is an outstanding Gish gallop, and I salute you for it.
All those gaggling facts are just being used to obscure.
Really all you're saying here is that the data is noisy (duh). So we can't refute your argument with local data about Scandinavia because that's "cherry picking". But when your argument is about a SINGLE DATA POINT IN ISOLATION (Sweden's results) then... that's totally valid analysis that needs to be accepted without question or worry about confounding noise?
No, that's bad science. It's quite clear that nations with both good mitigation strategies and good compliance (Finland, Germany, Japan) had low case counts, and those that didn't (everywhere else) had bad outbreaks. It's true you can find outliers, but so what?
There seems to be a basic logic issue here. Maybe an example will help. If you argue "all swans are white" then to disprove your theory all I have to do is identify a single black swan. One is enough, and presenting such a black swan is not "cherry picking" because the original theory was total and had no exceptions: it posited the absence of "cherries".
If your response is, "well obviously all swans are white in this part of the lake" then you've lost the argument, because your original theory is the one being debated, not one with a random ad-hoc revision that makes no sense.
Arguments about Sweden and lockdown are like this. The debate in question is whether lockdowns were required. Their justification is entirely based on models that claim to accurately simulate the counter-factual: that not locking down will yield enormous death numbers. To disprove this theory and thus eliminate it as the justification for lockdowns only requires one counter example, because the original theory is total and has no exceptions for proximity to Stockholm/Nordic culture/whatever today's excuse is.
Now as I've pointed out, Sweden is not the only counter-example, there are quite a few in different parts of the world. But that doesn't matter because by the nature of the original claim, a single counter-example is sufficient. To re-establish a justification for lockdowns would require a revised theory that is actually coherent and explains all the exceptions, not just a single one: this is basic logic.
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.
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).
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.
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.
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.
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...
> This paper argued that lockdowns work using a statistical model, but they actually don't work
Sorry, cite for "actually don't work"?! I don't know what you mean by "lockdown". That's not a term of art, it's something used mostly among right wing people arguing against mitigation strategies via hyperbole. Are you talking about mask requirements? Restaurant closures? Hard curfews?
Obviously "lockdowns" (in this sense of "broad covid mitigation strategies") do work. Arguing otherwise is nonsensical. Just look at the data for what is happening in influenza in areas where mitigation was common. Flu cases and deaths fell through the floor. Clearly mitigation worked, just not perfectly (in large part because of poor compliance by people who believe "lockdowns don't work").
I don't know what you mean by "lockdown". That's not a term of art, it's something used mostly among right wing people arguing against mitigation strategies via hyperbole.
The word lockdown has been widely used for the entire past year by people across the political spectrum, to refer to mandatory stay-at-home orders, business closures and so on. You know this already of course, but are determined to view this through ideological lenses.
As for obviously working and being nonsensical to claim otherwise, it's the opposite: the data is extremely clear that they have no effect whatsoever and quite a lot of all-country statistical analyses have been done that show that rigorously. For example, here is one such paper:
"Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people"
But again, to see this, you don't really need sophisticated analysis. You can just look at the case curves for different regions that did or did not use these tactics.
Re: influenza. We're talking about COVID here, so influenza is irrelevant, controlling the flu wasn't the goal of lockdowns. However, there is some evidence that suggests you can't be infected with more than one respiratory virus at once, so it's possible SARS-CoV-2 simply kicked influenza out. But given the extremely lax symptom classification of COVID it's also possible influenza cases have simply been reclassified. Regardless of the explanation it's not actually relevant: neither lockdowns nor mask mandates had any impact on COVID and there is abundant evidence to this effect. The real question we should be asking is why not, and there unfortunately there are quite a few plausible explanations but nothing conclusive. And the people who are paid to figure that out (epidemiologists) all seem to be in denial and still pretending their models were never invalidated, so they're not much help.
* 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)
I think the word “science” itself has lost meaning. Many people I know have yard signs that say “science is real” but in practice these same people can be easily manipulated by bad studies that are cycled through news media and social media. They also often listen to science only when it agrees with their views. I think like what came before, popular science is turning into an act of blind faith.
We certainly see this with blind belief in “scientific authorities” who can get things very wrong (like the WHO). We also see it with fact checkers - as an example, I remember reading a (factually correct) article on Facebook yesterday about COVID lockdowns, which mentioned the infection fatality rate. This post had a fact check content warning, from a fact checker who incorrectly quoted the case fatality rate for COVID-19 as evidence that the article was misinformation.
I’m not sure what the fix is. It feels like there is too much information out there for the public to handle and process properly. Or maybe we need a new word that is not “science”, that captures more of the critical thought that is needed, and moves us away from blind faith.
Scientism is basically a religion nowadays. This has lead to the rise of certain figures, such as Neil deGrasse Tyson, who start talking way beyond their fields - and rarely questioned, and then start judging others and imposing their own morality.
Zeynep is one of the best possible writers out there for a HN crowd, IMHO. Super intelligent, dives deep into the relevant data, and thinks things through.
You have to be careful with her writing. She overgeneralizes quite a bit, and conveys anecdotes as if they're definitive evidence. There's a lot of 20-20 hindsight bias going on.
For example, this article is basically -- when you reduce it to non-redundant claims -- the opinions of a few people, and two examples: the diamond princess, and the Washington choir.
The diamond princess is presented as if it were a definitive example of aerosol spread. But even Japanese experts were debating it at the time, as -- despite the implication of "lockdown" as used in the piece -- the people on the ship were still mingling on a regular basis to eat. It's simply misleading to present this as an obvious-at-the-time counterfactual. In fact, NHK did a whole documentary discussing it (no longer available [1]), and did this re-enactment to show how it might have happened:
The debates about fomite transmission at the choir are simply dismissed as ridiculous by a single researcher -- an aerosol researcher who has been vocal since the beginning of the pandemic that aerosols are responsible. So you have to consider the source. He's entitled to his opinion, but others weren't gaslighting by having the temerity to disagree with him. There were actually legitimate scientific questions at play, and the opinion of a single person doesn't negate those questions, even if that person turns out to be right in retrospect.
If I had to pick a broad "scientific" trend from the pandemic that disturbs me, it's the over-reliance on anecdote and canonizing of opinion. This seems very much like another example of that broader trend: taking opinions, cherry-picking the ones that look right in retrospect, and anointing those opinions as heroic, while all other opinions are somehow deliberately misleading.
Yes! I can clearly remember the early publications on how long the virus can survive on various surface types. In hindsight these might turn out to be not relevant, but if we consider that all public health guidances still emphasize hand washing, I think this really is a failure of science to perform the relevant experiments and ensure results are disseminated properly.
With a lot of pieces of knowledge we got stuck and a follow-up never really happened. Seems as if our capacity for adding more information to a complex area is limited.
Oh, 100% yes. So much of the stuff being tossed around as "fact", even today, is simply lore. Once something gets printed in the New York Times, people just believe it -- even "experts" who should really know better.
But good science takes time, and opinions can be printed instantly, so here we are.
Why do so many people think science is some neat and clean process adhered to by altruistic seekers of knowledge in lab coats?
Science is chuck full of competition, posturing, and political shenanigans - especially for popular subjects where there is fame and fortune on the line. Scientists are human beings. They, just like the rest of us, want to be right and to be rewarded for it. We humans are often not graceful about being challenged or proven wrong.
Worse yet, this messy process is filtered and spun by politicians and political media before being presented to the public.
Really, it's remarkable that things have worked out as well as they have. We have at least three viable vaccines being widely distributed and only a tiny uptick in mortality in the mean time. Things could have been much better, but they also could have been much worse.
> Things could have been much better, but they also could have been much worse.
The question now is what can we learn from how things were handled by the government in power at the time that half-a-million people died of Covid-19 in the US? As relates to the article of discussion the question is: Was there gas-lightning going on that made things worse?
Of course everybody makes mistakes and we should and can learn from them. But, "gas-lightning" is not a mistake. It is intentional.
The article wasn't talking about the government gaslighting scientists. It talked about scientists gaslighting each other.
This is nothing new. Science isn't clean. Just like anything run by humans, it's full of politics and nonsense. We just don't normally pay so much attention to it.
I saw a news clip of a woman getting vaccinated saying she trusts the vaccine because she "likes science." The vaccines appear to be mostly safe, but because you "like science" isn't a reason to trust them. What she means is she likes Mythbusters and thinks that's science.
Mythbusters is (or was, I haven't watched it in a decade) following scientific principles. To quote Adam Savage, "Remember, kids: The only difference between screwing around and science is writing it down.".
Science is a process, and it doesn't need the trappings of pristine lab coats and expensive labs. Those things help, but it's about the core principle.
The core principle of science is trying to prove your belief incorrect. Mythbusters was basically trying to see if some story was plausible, and can we make the test interesting. Unfortunately this is very common even among scientists, but I using that basic principle it’s almost accidental when they learned something was different than they expected.
A great example of this is their sword breaking setup. Take two swords and whack them together seems like a natural test. Unfortunately, the issue isn’t the strength of the sword when new it’s a question of metal fatigue and defects in craftsmanship. But, rather than run the test for say 2 weeks they just increased the swing strength because that looks cool.
That the CDC didn’t update guidelines that the virus was spread in the air until October seems near criminal - how much political pressure was on them to say “it’ll all go away soon”, as was stated by political leadership over and over?
Unfortunately the CDC is doing better than most OECD health authorities that I know of. Canada still hasn’t updated its guidance to my knowledge.
I haven’t checked Europe in a bit, maybe they updated. But judging from their poor showing presently, I doubt it.
There were lots of problems in the US response, but it was far from uniquely bad. And aerosol resistance was ingrained across western health authorities, it didn’t come from the president.
Saying "Europe" in this context is like saying "America" (the continent, not the US). You won't get a useable picture putting Norway, Italy and Russia[1] in the same basket just like you won't with the USA, Peru and Brazil.
1: Did you mean the EU?
EU != Europe. Russia is 40% of Europe's area and 15% of its population. European Russians are 80% of Russia's population.
One note here is that "aerosol" =/= "spread through the air". The debate was not over whether or not the virus was spread through the air, but whether or not it was spread via droplets (relatively "large" particles that spread through the air, but will settle relatively quickly onto surfaces) or aerosols (relatively small particles that are likely to linger for longer).
The evidence for aerosol transmission outside of specific medical procedures (the aptly named "aerosol generating procedures") wasn't nearly as overwhelming, and most epidemiologists I know were more than willing to characterize the transmission of COVID-19 as likely being on a continuum (documents I wrote were discussing this in early May).
Essentially, early in the epidemic, that was fueled by two things:
1) Previous studies for flu have shown that masks have very little effect.
2) There was concern about fomite transmission, and for good reason - both from previous coronavirus outbreaks (SARS and MERS) and because of the initial settings (hospitals and the cruise ship). Donning and doffing contaminated PPE is a skill, and an actually fairly difficult one.
The combination of the two led to the active concern that the reduction in transmission due to mask wearing might very well be offset by people self-inoculating via their mouth or eyes.
The shift in thinking came about via two mechanisms as well:
1) The fomite transmission thing appeared to be less of a big deal than initial studies indicated.
2) Previous studies had looked at protecting people by wearing masks. The newer paradigm for masks is primarily focused on reducing the amount of virus asymptomatic or mildly symptomatic individuals are putting into the environment via droplets or aerosols. Hence things like "My mask protects you, your mask protects me."
For point 1 above and point 2 below: to my knowledge this was widely already known by the medical community, and is widely used throughout asia to protect others against any cough or airborne diseases. Did the previous studies for flu only take into consideration the protecting value for the individual wearing it? How does the wearing of masks during the spanish flu fit into that? Was that not effective then?
I guess its hard to say. It seems, well, obvious in hindsight surely, but you'd think that something this obvious in hindsight would be figured out by experts beforehand. Telling people actively to not wear masks seems like they not only missed the shot but were actively harmful.
The biggest gaslighting of this whole affair has been the political adherence to clearly insane propositions like forcing everyone to wear masks (questionable in any case) but allowing cloth masks (which do, at best, ~nothing, unlike actual rated masks, so definitely pointless) or quarantining billions of young people who accumulate less than 25 micromorts of mortality from covid contraction in the name of adding (on expectation) a few life-months for geriatrics who are not contributing to society and are about to keel over anyway.
The unnecessary manmade destruction of utility over the last year is nearly unprecedented, perhaps the most devastating since WW2.
This is an interesting article and here are some broadly relevant points:
1) HN didn't know a lot about COVID at the time it emerged into the world. If nobody was trying to inform HN about COVID, is that a failing? Probably not. It seems highly likely to me that the actual scientists had good research done on respiratory diseases and probably got a handle on the situation quickly. HN getting detailed information like this ~12-18 months after the outbreak is actually pretty speedy.
2) The mass media were and probably will continue to be serially wrong about COVID, which is expected of the media. They aren't in the business of being technically correct. If they were interested in being technically correct they'd be too squeamish to work in the media. Ditto if they had any deep understanding of how to control infectious diseases they'd have gone into careers in epidemiology rather than journalism, they're learning this stuff at the same speed as everyone else.
3) There aren't a lot of new learnings in the pandemic. It shouldn't be a surprise to anyone that governments can't organise themselves to deal with a crisis in less than 6 months, the government isn't a rapid response outfit. Based on the patterns of success and failure of responses it seems recent memory of SARS is a better predictor of outcomes than competence, so a lot of the broad flows of events were probably predictable and predicted in advance. Some new ideas is that this JIT business is madness, and the amount of travel people do spreads diseases in an eyebrow raising fashion (maybe there should be less of it?).
4) I think the real take away from this is that crazy preppers aren't actually crazy, and having some reserves (financial or otherwise) put aside for disasters is still a good idea.
>>4) I think the real take away from this is that crazy preppers aren't actually crazy, and having some reserves (financial or otherwise) put aside for disasters is still a good idea.
There is a difference between being prepared, and being a prepper.
If you have six months of savings in the bank, a few gallons of gas and clean water in the garage and dry food in the pantry, you're prepared. If you have several booby-trapped supply caches in the wilderness that you have marked on your map, you're a prepper.
>If you have six months of savings in the bank, a few gallons of gas and clean water in the garage and dry food in the pantry, you're prepared.
I think most people in my world would use the word "prepper" for this and I didn't think the word had negative connotations. Also that 99% of people don't even have that.
Having 3 months of salary stashed aside is standard financial advice in Germany. This is not saying that everyone or even most people do it (most couldn’t even afford to do it), but no one would ever call someone like that a prepper.
If you only look at the financial side, I'd agree. If you added that a good portion of that should be in cash, and to have a few weeks of fresh water and long shelf-live food stored at your house, I'm pretty sure the majority in Germany would call that person a prepper, even though having two weeks of everything required is in the government's guidelines. It's just that we've gone so long without a major interruption that it seems silly to most people.
Wow, 2 weeks of water is about 20 liters per person! That's a lot of water to have sitting around. Two weeks of food is kind of easy if you shop at Costco :)
An aside: in Germany, “Hamstern” = stocking up on excessively large amounts of something that is feared to be in short supply thereafter, although it can carry negative connotation, as a selfish refusal to share with others (when I lived in Germany, I was always struck by people's general politeness and generosity, so hoarding for no reason would be frowned upon). Also, “Hamsterkäufe” refers to purchases made out of fear of a future shortage.
The article's main complaint seems to be that people were slow to accept that it could be transmitted by asymptomatic people through the air, but I don't recall anyone questioning that, even from the start.
The author is eliding the debate as to whether transmission was aerosol vs. droplet (which was controversial and difficult to settle) with "did it get passed via the air", which was not.
I will say the lack of fomite transmission remains surprising, and one of the few ways we have been fortunate this pandemic.
There was very little debate about asymptomatic transmission. But there's a great deal of difference between "Are there asymptomatic carriers?" and "How many, and how efficiently do they transmit?"
> But there's a great deal of difference between "Are there asymptomatic carriers?" and "How many, and how efficiently do they transmit?"
The greatest tragedy in all of this is that the state of scientific journalism is as crap as it's always been. Science does not deliver neat yes/no answers, it delivers probabilities.
Can asymptomatic people spread the virus? Yes.
Can you get infected by passing a random unmasked stranger on the street? Yes.
Can you get infected by touching a surface that an infected person has touched? Yes.
Can you get the disease more than once? Yes.
Can you die from the disease? Yes.
Can you develop "long covid" after having the disease? Yes.
Can you get infected even though you've been fully vaccinated? Yes.
Can you die from the vaccine? Yes.
The above statements are all true. But their probabilities of happening to you range from very unlikely to microscopic. And that gets completely lost when media reports on it, and when people talk to each other, and when politicians make policies trying to stop the activities that people are most afraid of...
And now we're in this mess where it's practically impossible for anyone to know what the right thing to do is.
No mention of the big 2020 HN crowd aggressively promoting chloroquine as the drug that will save the world? Sad, I'd love to hear what those people have to say today!
Now if only we could have firm studies on Vitamin D deficiency and its relationship with Covid instead of FUD about overdoses and the use of "Mendelian Randomization" for variables with a strong phenotipic variation.
155 comments
[ 2.6 ms ] story [ 215 ms ] threadTo have all the correct info available right from the getgo, and to have public health authorities actively spread wrong information. Maddening.
One of the things that has agonized people is not knowing what is safe. There’s been basically no documented outdoor transmission. You can see friends and family outside fairly safely. Just keep a little distance. If you hug, hold your breathe. Knowing the mechanisms you can gauge what is likely to spread and what isn’t.
I still know of people washing groceries and avoiding hugs but not so worried about removing masks to eat in a group indoor setting.
Data from the public health agencies suggested it would not and had not had any impact.
The quebec premier is a pro-business populist. So, his leadership method can be accurately summarized as, doing what's best for business, and covering up for the issue this causes using populist issues (law 21, for example) or aesthetics.
Well, as cases started increasing in Montréal, he wanted to act though. But he didn't want to implement an actual lockdown, as that would hurt the economy (much like fumbled the first lockdown where cases almost went to zero, but instead of continuing slightly longer and implementing mass tests and tracing, he lifted it right before tracing was up to capacity and cases went to zero, but I digress). For the same reason, he didn't want to close down schools, which are a large driver of infection here according to public health data.
So, he implemented somthing he knew would look though to his base outside of Montreal, without actually impacting the economy, which is an 8pm curfew. Obviously, everyone with a bit of knowledge knew this would be useless, but there goes. As the curfew went on, vaccination of the health sector picked up, and the healthcare system went from a large driver of cases to non-existent, allowing Montreal to bring R under 1 and cases to go down. He obviously acted as if the curfew contributed, and pushed the curfew to 9:30.
Then, he had the brilliant idea of : putting back schools to full-time learning instead of one-day-on, one-day-off, even as the schoolboards and teachers didn't want to - supercharching a large infection driver, but also, outside of Montreal, opening back up indoors dining for restaurants and indoors gyms (without masks!).
Unsurprisingly, this led to an explosion of cases outside of Montreal, while Montreal kept stable amounts of infections despite a delayed curfew and full classrooms. So, he rolled back those measures, and to look though again, he put an 8pm curfew in the high infection periods.
Despite the fact that cases weren't increasing much in Montréal, afraid that the lack of increase despite a delayed curfew would show plainly that his curfew, flagship measure, was useless, he put it back to 8pm in Montréal. Nicely, this means that people now only have two hours or so to do their groceries, supercharging the mass of people there, indoors.
So there it is, it's really just aesthetics. If it helps or not doesn't matter, as long as it doesn't annoy his base too much and looks flashy, it's good for Mr. Legeault.
Also, he added a mandate to wear masks in outdoor parks, while almost no infections at all were recorded outdoors.
Your statement about the failure curfew policy and closures is definitely not true.
Have a look at the data [1] (Select: Quebec and change the timeframe to include 'all time'.
The original closures in January had a radically positive effect in reducing spread, and there were many more measures in place than merely curfew.
You directly contradict yourself by indicating 'opening up restos schools was a bad decision' when in the preceding statement you literally said that the policies 'had no effect'. They clearly did.
Schools have been opened in many places in the world, and are generally not considered to be superspreading locations - the difference 'now' is not COVID v1, rather, it's COVID v1.1 and v1.2 (i.e. other variants) which seem to be affecting young people at considerably higher rates.
The policy here is not hugely different than most places in the world.
[1] https://newsinteractives.cbc.ca/coronavirustracker/
I didn't ever say that any policy had no effects except the curfew.
>Schools have been opened in many places in the world, and are generally not considered to be superspreading locations
You are simply wrong on this point. Quebec contact tracing data shows "Education" to be the #2 category for source of infection in the last two months : https://www.quebec.ca/en/health/health-issues/a-z/2019-coron...
>The original closures in January had a radically positive effect in reducing spread, and there were many more measures in place than merely curfew.
I never disputed the good effects of the closures in January. I disputed the impact of the curfew solely. You will alos notice in the data after January that the category of infection sources that fell the most is actually "Living and care environemnts", which is where healthcare is placed - a major driver of infection that was eliminated via vaccination.
1) if cases go down it's thanks to Legault and his "audacious measures" like curfews
2) if cases go up the population is to blame but the measures still work and we just need more of them
Your '1 and 2' points are not relevant speculation - and I don't care one bit about Legault or his government, it's besides the point.
The policies across Canada and most of Europe for that matter are not dramatically different.
Also, I'm not sure how attributing any benefit to completely unproven NPI that the government literally admitted to putting in place because it "sounded good and it sent message" rather than based on any scientific data isn't the actual speculation here.
All analysis that isolates the curfew as a singular NPI show no discernible advantage, and the government admitted to having no evidence it's useful at all.
I feel it's more powerful than the time we were seeing NYC hospitals blow up in COVID disaster.
It's 'over there' when it's on TV ... but when you 'have to get home by 8' it a visceral effect.
To the point wherein never before have I truly contemplated the authoritarian nature of the order - though I'm fully sympathetic to the Provincial Leaders trying to stop mass death, it's pretty scary that this can happen and the Supreme Court ruling on the case that was brought before them was really scant. Basically, the Judges said 'it's for the good of the people and proportional so it's ok' - but there's basically zero in the way of parameterized logic, precedence, or specific legality to all of it.
As far as the Health Officers supposedly miscommunication information, I suggest that these are intelligent people, and that obviously there's still not as much consensus as the comment implies.
'Gaslight of Science' I think is better exemplified by those denying COVID or vaccines.
The Quebec governmnent's refusal to publish public health guidance on decisions that experts think are ineffective while insisting that they are based on evidence definitely qualifies as gaslighting science.
>It's partly a social signal. I live in Quebec and the notion of 'curfew' has a very eerie and ominous 'feel' like nothing ever in my life.
It was also a strong social signal to everyone I know that the handling of the crisis was aestheticized and politicized as there was no evidence of it's efficacy. Certainly for some it had a chilling effect, for many it led to a complete loss of trust in a government that was already playing fast and loose with rigor and trustworthiness.
This is completely false, Quebec actually has some of the better outcomes in the civilized world. [1]
Better than US, France, UK, Poland, Spain, Sweden - it's about the same as Switzerland and a little worse than Germany.
Where is your evidence of mismanagement?
The initial pandemic broke out and given that Quebec is the place in NA with the highest degree of 'socialized elderly care' - it's not unreasonable that the initial shock was higher, but after that 'first wave' of deaths in LTC - since June - the rate has been about the same as Canada, which is among the best in the world.
The populist blame is ridiculous - everyone whines about their own governments without providing any material evidence, because frankly in most cases there is none.
"CHSLDs collapsing" - is plainly false.
[1] https://en.wikipedia.org/wiki/COVID-19_pandemic_death_rates_...
Are you actually denying that the CHSLD system completely collapsed? Dude. What? People were left to die in their feces and from hunger, the army was called to help out, bodies of abandoned covid deaths were just left there for a while. Private CHSLDs like Herron got literally ghosted by the healthcare agency overseeing them and stopped replying to emails begging the for help. Healthcare staff had to work without PPE, hospitals were left to their own for the first few weeks back in March. Like I'm not even sure here if you have any clue of what has happened in early March because there's no way you could the CHSLD system didn't collapse and weren't mismanaged otherwise. That's something even Legault admits. But since we are on HN I'll assume good faith and address your other points
Okay so no it's absolutely unreasonable that the shock was that much higher. You are repeating more government talking points. because that's just what it is: depending on what week it is we always get a different excuse. It's either young people or spring break or people travelling or Christmas parties or a uniquy old population or the elusive covid deniers driving infection numbers up. It never ends. The truth is nothing about our situation was truly unique or unique enough to explain what we saw.
Also FWIW, Florida has an older population and is doing either better or pretty similar to us so yeah that doesn't make sense either. Why does it matter if the elderly care is socialized or not? Can't the government protect its patients more than the private sector in Florida can?
I’m no longer following quebec public health’s announcements closely, but did they seem credible? They’ve been wrong on most everything so I’d need their reasoning rather than their authority to believe them here.
A curfew makes gatherings substantially harder. You have to buy food and drink in advance, and people have to be able to sleep over and be comfortable doing so.
Contact tracing won’t detect many clusters at private gatherings if people don’t say they were violating rules. Public health’s data may not be accurate here.
If I were in charge I wouldn’t use a curfew mind you. I would instead fix public health’s rules: emphasize ventilation, mandate open windows, require masks at work while seated, etc. But I suspect the curfew actually achieves its purpose. Quebec is doing better relative to other provinces than it did pre curfew, iirc.
[citation needed] - anecdotally all of the people I heard of that partied before still party after, either on the weekends eariler or they stay over.
>another major cause of spread.
[citation needed] - The "activities and events", which includes legal events, is 285 out of 11 158 in the sum of outbreaks collected by Quebec public health. "Other environments", which is where they put clusters that they can't identify is even lower at 46 out of 11 158. All other categories are verified using hard data, and one couldn't lie to classify the cluster somewhere else. So no, this isn't a data issue : https://www.quebec.ca/en/health/health-issues/a-z/2019-coron...
By far the dominating sources of infection are work and school, and it's not even close. Followed then are places of commerce.
What curfews actually do though, is force much higher concentrations of people indoors and in public transit, which strongly contributes to the infections in work, "other establishments", and legal "activities and events". Which has a big impact on infection, unlike the other factors.
Politicians had many other tools they chose to relax or not to use right as they enforced the curfew. For example, restrictions on schools were relaxed, a major driver of infection - places like gyms and so on were opened, which already infected hundreds of people, rapid tests were not used in outbreak environments, schools were not outfited with basic ventilation (even just an air purifier would help!), contact tracing is in a horrible state, etc...
Most of all, the politicians could actually release the data behind their decisions, going a long way to increase goodwill and compliance, but chose not to.
They chose the curfew because it would placate those who asked for stricter restrictions and get people to disagree with them, because it would be flashy and hard to ignore, because once restricted to Montreal it wouldn't cause issues to their voterbase, and because it's very easy to implement and doesn't hurt businesses with which the current government is incredibly cozy.
You’re looking only at the extreme case. Hardcore parties will still party. But regular people who just want to have a dinner party of ten, won’t. There is no data on overall gathering changes (no one tracks that), but you have to assume casual gatherings drop off. And anecdotally I know people are cancelling plans.
As it gets brighter late at night I think the argument against curfew will be stronger. People do go outside on late summer nights and that is safe.
I agree with you on ventilation, and rapid tests etc. If I were in charge I’d do that and not a curfew. But Arruda doesn’t believe in aerosols or rapid tests. So I understand why the politicians reach for the tool they can actually use.
As for data: there’s an easy way to settle this. Find infection per capita in quebec vs ontario vs bc before the first curfew, and after. It’s the only major difference. I think Quebec’s relative numbers improved post curfew, but I don’t have good time series on hand. Know of any?
I know the curfew is psychologically brutal! I’m merely arguing it probably works, too.
Also I’m from New Brunswick originally and there in the Edmundston region they have the same policies as the rest of New Brunswick, except that people disobey the rules and have private parties. They’ve had constant outbreaks, but it doesn’t show in the stats because those people don’t go for tests and they don’t share full info with contact tracers. Public Health officials have described the rule breaking in their briefings. We know it is the case as New Brunswick doesn’t normally have local cases so the virus only enters by rule breaking.
A large part of why infection rates are higher is because a lot of people simply don't get tested, be it because their workplace doesn't want them to (happened to a lot of people I know), or because they have light or no symptoms. Otherwise, people who were infected in a party and then infect other people that do get tested have a high likelihood to get traced as sources of infection too. Besides, there is no obligation to cooperate with contact tracing, if you go get tested after going to a party you can simply not say anything, so I don't really see why people that get infected at a party wouldn't get tested. On the converse, the one party-goer I know of apparently gets tested weekly, but hey that's anecdotal and low quality.
>As for data: there’s an easy way to settle this. Find infection per capita in quebec vs ontario vs bc before the first curfew, and after. It’s the only major difference. I think Quebec’s relative numbers improved post curfew, but I don’t have good time series on hand. Know of any?
The issue for this is that sadly the curfew was not implemented alone.
That said, one can look at when the curfew was extended to 9h30PM, and indeed there is no significant difference.
Ontario was 25/7/25. BC was 16/10/23.
Roughly. My prediction would be that Quebec has a lower peak than these two provinces and spends less time with max restrictions. Ontario issues a full stay at home order, and did so before Quebec’s curfew announcement.
Also Montreal is the only place that kept the curfew at all (9h30 vs none until recently) and it has markedly lower per capita case counts than the rest of quebec or other BC/Onatario.
Do you have an alternate explanation for this data?
https://www.ctvnews.ca/mobile/health/coronavirus/tracking-ev...
Montréal is also the only place that kept many, many other other restrictions and that had accelerated vaccination before cases popping off everywhere.
So we really have to limit observation to curfew only changes.
However, right now Ontario has had a total lockdown for a while, but no curfew.
Quebec has similar restrictions (maybe less stringent?) but has a curfew. Case rise nowhere near Ontario.
My bet is we’ll see this divergence continue. The curfew seems to be the biggest point of differentiation Quebec has re: Ontario and BC.
Certainly, but if the curfew was the determinant factor, then we would not see the decline persist past it's relaxation or removal.
>However, right now Ontario has had a total lockdown for a while, but no curfew.
Even the implementation of the major measures in January 1st did not have much effect outside of healthcare until around 2 weeks afterwards. It's only been four days since Ontario implemented similar measures. The earlier "lockdown" was a lockdown in name only and even allowed gyms and indoor-dining to be open. For this comparison to be made we will still have to wait at least ten days.
As it stands, the only conclusion we can take from this data we have so far is that the curfew is likely not the decisive, as case declines persisted after it's removal and relaxation.
The priors we have from expert opinions and even government officials is that the lockdown is not expect to be effective.
From this, I can't conclude anything except that the lockdowns are likely not effective.
Wait you’re expanding this to not just curfew, but any lockdown is ineffective?
I’d invite you to check out the recent outbreak on Newfoundland. Large undetected outbreak, lots of spread, 100% UK variant, totally eliminated in a month due to a lockdown with high compliance, return to zero cases.
I should add I do have some doubts about the curfew with warm weather. Outdoor socialization isn’t harmful, and people will feel more deprived now than during the winter one, when many people hibernate anyway.
> If you hug, hold your breath
Does this still hold with B117?
If outsides are so safe why are curfews still a popular measure?
I think California's curfew in the fall was later seen as ineffective. Why are they popular?
https://en.wikipedia.org/wiki/Politician%27s_syllogism
The curfew’s intention is to block people from having social gatherings. You can’t so easily go to dinner at a friend’s if you have to sleep over for the night, and all the stores are closed to buy stuff.
A lot of people understand the risk is much lower than the measures used to contain it, such as full school closures and closing parks and playgrounds. In retrospect I hope we can admit at least those preventative measures were a mistake.
My fear is that if another more serious virus lands on the scene, there will be no credibility to do it again.
A school is neither a park nor a playground. Schools are mostly indoors, mostly in inexpensive buildings with correspondingly poor ventilation and/or air filtering, and have a lot of people talking and breathing the same air. This is a totally different situation.
From the OP, it seems clear that virus is airborne, spreads in clusters and people spread it before showing any symptoms. I am open to suggestions on what are the alternative ways of stopping the spread?
It's not about whether the current restrictions are the best or not. It's about whether anything should be done at all as evidenced by critics' lack of concrete proposals of what they would do instead. Presumably nothing.
Even if that's true, I keep hearing that argument and I think I'll keep hearing it a lot in the future which makes sense as we try to justify what happened. But it's not based on reality considering that the anti lockdown side had a pretty clear plan: quarantine those most vulnerable, spend any fraction of the enormous resources we spent on locking down everything on making sure to provide for those people. That way we could've also focused the testing capacity & PPE on a lot less people, making it that much easier to isolate them from the virus. Instead of allocating thr same amount of resources regardless of how at risk someone was.
You can disagree with the position but I'm not sure how you could argue that it's "doing nothing".
I do not believe that most of the world has responded in a particularly useful way to covid, but I do believe that masks are quite effective (especially N95 or comparable masks) at reducing the spread of covid in indoor spaces. So yes, mask mandates, at least indoors, make quite a lot of sense.
The school closure issue is harder. There seems to be surprisingly little data on the degree to which covid spreads among children compared to adults and the degree to which covid spreads from children to adults. But most schools consist of students indoors, in a poorly ventilated space, often crowded, talking, for hours a day. Read the article: this is prime covid-spreading conditions. Perhaps schools could have been allowed to remain open to the extent that they could move outdoors or drastically improve ventilation, but doing nothing seems likely to have been a very bad idea.
[0] This is not actually the case, obviously.
If? We already know that it doesn't. Yes, other viruses rip through schools rapidly, but this virus simply doesn't. Your gut feeling is wrong.
https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
"Younger children (<10 years of age) may be less likely to be infected than adolescents. This possibility is supported by contact tracing studies; test positivity data from children, adolescents, and adults; and population screening studies using seroprevalence data. Susceptibility to SARS-CoV-2 infection and the proportion among those infected experiencing symptoms both generally increase with age."
I don't think this is something you can claim without backing. I fail to see significant logic/empirical observations that make it seem futile to you that stopping the spread to a subset of the population is significantly harder than for the whole population.
>Do you really expect that the large majority of people over 65 could be protected effectively when the considerable majority of under-65 people to whom they are exposed (caregivers, food providers, relatives, etc) get covid?
Exposing the not-at-risk population would likely increase the short-term risk (all measures constant) but decrease the long-term risk to people over 65. Having a smaller population to focus on protecting would likely make their protection easier.
Even if you were right in that you would have more casualties from selective locking down (which I am unconvinced), would the increased death toil justify the freedom being messed with for the whole population?
A substantial risk of passing a deadly virus on to vulnerable people is not a freedom, it's negligence.
Stay-at-home orders/curfews are affronts to freedom. Derailing this to imply wanting to go outside at all is negligence is disingenuous. Preventing people from seeing other people over long period of times is known to be psychologically bad for human (and is a form of torture, see [1]. Although it is different in some ways, it seems clear its not good for the population well-being).
>nor a foolproof way (even now) to test everyone at-risk populations might come in contact with.
Don't let perfection hinder practicality. Keeping at-risk population away from infected people at a good rate is very feasible. It doesn't have to be foolproof (nor is it right now). It does not seem either harder or worse than what we are doing right now.
[1] https://en.wikipedia.org/wiki/Solitary_confinement#Torture
I only have experience with the U.S. orders in California specifically. I spent a lot of time outside in parks and nature reserves instead of inside buildings. From what I saw, a lot more people than usual were also doing the same. It's quite possible that countries that restricted people to their own houses went overboard, but e.g. New Zealand had an optimal outcome with a very quick lockdown and contact tracing.
There are some similar situations: curfews and blackouts during world war II bombing raids, and laws against shooting firearms into the air. Both restrict "freedom" in a general sense but are examples of legitimately limiting individual freedom because it causes undue risk to others. I don't have a solid threshold for where restrictions make sense, but a starter might be the total net QALYs. Wars are often supported despite reducing net QALYs for everyone, for example, but that's hopefully an outlier.
According to [1], an estimate of 810,000 discounted QALYs were lost by July 2020 in the U.S. This number would likely have been significantly higher with uncontrolled spread. Dividing that out into the U.S. population means the lockdowns would have to reduce everyone's life expectancy by about a day due to the 3-4 months we were in lockdown to reach the threshold where I'd start to consider scaling the lockdowns back. As the U.S.'s failed attempt to control the spread continued for the entire year, the cost/benefit changed. Extrapolating from about 150k covid deaths in July/August 2020 to the 560k now linearly we'd be up to four lost days balanced against QALY losses from covid. Suicide rates seem to have decreased in 2020, so the losses would have to come from delayed effects or adverse health from lack of exercise, etc. I can be convinced that the lockdowns were too extreme, but it'll take solid analysis and it probably won't be fully measurable until a few years from now when we see follow-on effects.
> Don't let perfection hinder practicality. Keeping at-risk population away from infected people at a good rate is very feasible. It doesn't have to be foolproof (nor is it right now). It does not seem either harder or worse than what we are doing right now.
To keep vulnerable people healthy, we have to keep everyone they interact with healthy or at least non-contagious. If covid had unrestricted spread through everyone under 65 that's 80% of the population being a vector within a couple months. We didn't have test infrastructure or certainty on mechanism of spread by May 2020, so quite likely most vulnerable populations would be in contact with contagious people and get sick as well.
I agree we're basically at the tipping point but it's because vaccines are getting us closer to herd immunity. Attempts at "opening up" in the past were misguided because they only resulted in a large spike of new infections and deaths, the latter the key indication that despite best efforts the vulnerable populations were not well protected.
[1] https://onlinelibrary.wiley.com/doi/full/10.1002/hec.4208
1. Using QALYs seems ok w/r to covid, but not in relation to lockdowns. You say 4 days of QALYs lost per person and I'd argue that being unable to see your friends & family or do most activity is alike to being sickly (which is what is used to calculate QALYs). Maybe its not a 1:1 correspondance but lockdowns for 8 months (I'm not sure USA, I'm more familiar with Canada) have (imo) exceeded 4 days of QALYs per person by a long margin.
2. I have major issue with this line of thinking:
>I can be convinced that the lockdowns were too extreme, but it'll take solid analysis and it probably won't be fully measurable until a few years from now when we see follow-on effects.
It's a strongly held belief of mine that, in order to restrict the freedom of people (ala blackouts during WW2), you have to have a solid argument that what your doing not only outweigh the disadvantages, but far outweigh them. Restricting people's freedom is not like an economic decision. I believe this is what the general society has come to accept too (e.g. civil law has preponderance of evidence vs penal code which has abundance of evidence).
I agree that we can grant an "emergency response" where we are unsure of the risks, but I disagree strongly that this emergency response can last this long without a very strong case/public discourse that this is significant enough to restrict freedom.
In 2019, heart disease killed 18.6 million people whereas Covid has taken 2.9 million lives. Heart disease is also a major factor in severe Covid cases. Couldn't we save more lives if we took all this governmental effort that we are putting towards tiered business closures and mask mandates and instead focused it on national, maybe even mandatory exercise programs?
On average, people were about 6x more likely to die of heart disease than covid over this last year, yet we take comparatively little if any action.
Could you add a link to where you get those numbers from. What the link below says is that "Covid-19 is the Number One Cause of Death in the U.S. in Early 2021".
If Covid-19 is the number one cause of death, how could heart-disease be 6x more likely cause of death?
https://www.healthsystemtracker.org/brief/covid-19-is-the-nu...
Plus this doesn't take into account the reporting bias that seems to have been (be?) prevalent in 2019.
(Although it seems heart disease was still bigger than covid for 2020 [1] if compared to 2019 [2] in the us)
[1] https://www.google.com/search?q=number+of+death+covid+2020+u... - 561k covid [2] https://www.cdc.gov/nchs/fastats/deaths.htm - 659k heart disease
I mean it in that Covid will look worse and heart disease better on a short scale, but in the grand scheme of things Covid will die down and heart disease come back, since you don't have immunity or vaccines against heart disease. That means that comparing (for the same year) covid vs heart disease is somewhat useless (since covid is an exceptional and short-lived event).
Fixing both problems will probably move deaths to another category (since that is the purpose of having categories), but the argument was that addressing covid has less benefits than addressing heart disease (mostly because covid addresses itself over time, whatever lockdown/mask wearing we do, but heart diseases do not).
So it's NOT like all those half-million people who died from Covid-19 in the US would have died anyway and we would just call their cause of death something else. No. They died because of Covid-19 and many of them because some people publicly downplayed the danger of it and made fun of people wearing masks.
If you consider US only then it's not quite as dramatic but heart disease is still the #1 killer, especially since this happens every year and there's no vaccine for heart disease. 647,000 US deaths due to heart disease in 2019 vs 575,615 deaths due to Covid in 2020/2021. https://www.singlecare.com/blog/news/heart-disease-statistic...
As others have pointed out however, heart disease is a major factor in Covid deaths, for example, a history of heart failure ramps the Covid case-fatality rate from something like 2% for the general population up to 49%, so it's very difficult to fully separate out heart disease vs. covid for those 575k US deaths.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490208/
If we are serious about following the science, it's pretty clear where we should focus our effort.
I don't know when it's been decided that we're going to prevent young people from living, so that people who are going to die soon anyway get a few more years.
I mean, the entire system is made up of exploiting young people so that old rich scum get richer but uh, how long can this go on? Young people don't even have children anymore, while the profits of old rich scum are record high. This trend obviously can't continue so I'm waiting for a voice of reason to say 'enough of this shit already, you're not going to live forever and we're not going to walk on egg-shells for the rest of our lives to appease your irrational fear of death'.
Oh, one more thing - if you give a shit about people not dying of viruses world-wide - try not letting virus carrying things travel world-wide because it's 'fun'. I mean, what kind of games are we playing here? This is a self inflicted wound by stupid rich people that everyone else now has to pay for.
Why do you believe it rather than know it from solid science?
The problem is that the whole mask thing has dubious impact, much like Vitamin D, or washing hands and the rest, but has become a symbol of political allegiance, not medical impact. What was predicted to happen in Texas hasn't happened.
There has been absolutely no evidence anywhere of children in schools being vectors for transmission. They suffer very little sickness from the disease and don't seem to spread the virus until they start showing actual symptoms - both of which directly contradict the prevailing narrative.
Yet these glaring anomalies seem to be dismissed by the prevailing belief. Even simply mentioning them has become verboten as the response to this post will probably show.
I don't believe anybody has looked into whether different types of people from different ages 'leak' the virus differently. That would go some way to explain the difference between the Diamond Princess experience (full of older people), and schools (full of younger people).
We know very little and humility in the face of that is called for. What we're doing now is going to look foolish in the future once we know more.
1) If N95 masks didn't work, all doctors and nurses in ICUs treating covid patients would get sick quite quickly. But that didn't, and in fact they got sick at a similar rate to other doctors (this is from Peru where they had lots and lots of covid)
2) These masks literally stop the virus from passing into your respiratory system. So why would you be surprised if they prevent disease transmission?
But that's doctors and nurses in a highly controlled environment where we know there is an awful lot of virus particles around. That controlled environment doesn't occur elsewhere, so you are comparing apples and pears.
Leakage round the side, not wearing the masks fully, not changing often enough, etc. all apply in the field not the hospital, and even then the network effects can outstrip the filtering effect. Concentrations matter - as it does with radiation where high radiation areas damage the body and then when it drops below a certain level there is little impact at all.
Extrapolating from hospital to elsewhere is problematic and simply not supported by the evidence.
" These masks literally stop the virus from passing into your respiratory system."
Again in controlled environments, not in the field where that level of protection isn't available nor is it managed, changed or worn properly in all cases.
The reality on the ground shows that. There is no detectable effect outside really controlled environments without a high degree of curve fitting and bias. Texas has not exploded has it.
The downvotes say it all. People no longer wants to discuss rationally the possibility that they may be mistaken. It has become a religious crusade to do with identity.
The motto of the Royal Society is "Nullus in Verba" - take nobody's word for it. The essence of science is to question, not censor.
We appear to have forgotten that.
https://medical.mit.edu/covid-19-updates/2020/07/do-cloth-ma...
We absolutely have, and non-surprisingly, the sicker a person is, the more virus they spread around them. And since children are much less likely to develop symptoms or get sick, they spread the disease less, which is why spread among students in schools is much, much smaller than among the community at large.
I would love for you to be right. Sadly, if you actually try to look up the incidence of long covid (or post covid syndrome, etc), you will find estimates ranging from 5-25% incidence. Optimistically divide by five (I’m giving you the benefit of the doubt here) if you want to estimate the incidence among total infections instead of symptomatic infections. Divide by 10 if you think that 90% of patients will recover fully and quickly enough that you should discount them. You’re left with 0.1% to 0.5%. You appear to be a couple of orders of magnitude off in your calculation.
I've seen very little 'good' science being conducted over the last year. You've got inadequately sampled studies throughout the duration of covid that have led to drastic policy decisions, I've seen biased studies coming from massive corporations being used to guide policy decisions and not one step along the way have I seen anyone who's gone...
'Hey wait a second, maybe we should check this data before we take drastic action'
Be listened to or taken seriously.
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?
There’s an awful lot of curve fitting to beliefs going on - because it is so difficult to do solid experiments.
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.
There is absolutely nothing new about it as concept. It is not something that appeared with covid first time in history of diseases.
Why hasn't that experiment been done?
This is the news from three days ago: https://www.independent.co.uk/news/health/covid-symptoms-rep...
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
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.
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.
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.
That’s a very low proportion.
A prior history of SARS-CoV-2 infection was associated with an 83% lower risk of infection
I don’t see that in the paper you referenced.
What I have a problem with here is how the goalposts for going back to normal just continue to push out like this. First it was just reducing R0 to a certain level. Then it was vaccination. Now it's something else that is yet undefined. It's impossible to come up with a rule because someone will always bring up some extreme edge case and say "well we don't really know with P99 certainty". This isn't a reasonable way to manage a society. At some point we need to acknowledge and ingest the remaining risk so that, for mental health reasons and others, our society can return to something that resembles normalcy.
It's not "pseudoscientific" to or "religious" to make a different risk analysis decision. People just have different tolerances.
Broadly: be nice. You're not as right as you think you are, you're just braver.
There's also an argument that it's safer to have an easy, blanket rule, rather than permit everyone to editorialize on why they are super special and should be given a pass. There's a solidarity angle as well. Just wear the mask, darn it!
Maybe. Once you get to measures that have a negligible effect, weird things start to take over. Behavior change (feeling safer in a mask) is probably a bigger factor than the mask, itself, at that point.
No, always. Masks are mechanical, they reduce risk by some fraction, period. Some fraction of particles that would enter or leave the lungs and into the environment don't, because they get trapped in the fabric. That doesn't have anything to do with how many particles there are.
I think your logic mistake here is that you're assuming that all these mitigation strategies are correlated, that you need to stay distanced OR outside OR masked, etc... But that's not the way this works. All of those strategies help INDEPENDENTLY, and doing them all leads to less risk.
Now, if you're 40' away from the nearest person and outside, it's true that your absolute risk is almost certainly so negligible as to make a mask irrelevant. But believing otherwise isn't "pseudoscience" or "religion", it's just a calculation error.
Be nice.
I think you're assuming that these people who want mask compliance at a 40' distance are doing the statistics like you are making the same conclusion about what behavior should be normal (a conclusion I disagree with). Some might be, but I doubt it's any non-trivial percentage. It's just a social norm now that's based not on science, but on a particular person's or group of persons' feelings.
That is pseudoscience. Being "nice" is a, well, "nice" platitude but it isn't science. And after being lectured for more than a year about how "we need to follow the science" I find it more than a little annoying, but not unsurprising, that we're going to do otherwise.
But you don't need to wear a mask at home, just open the damn windows and let the air circulate
People's level of actual cognition seems to have gone down and being replaced by dogmatic fervour one way or the other, leading to a competition of who screams their allegiance louder.
If you think a mask don't help you're welcome to volunteer at a Covid ward without one. NPIs (stay at home, lockdowns, etc) have been used since the black death
Sure you won't hurt anybody but yourself by wearing a mask (or two) outdoors with no one around (for prolonged periods of time) or "staying at home" at all costs needlessly, but yeah, you'll still looking like a fool.
It certainly makes one question the benefit of mandating everyone inside.
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/
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.
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.
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.
Their cultures are very similar so the comparisons are very apples to apples.
Latvia, Estonia, Lithuania are post soviet republics. Vastly different influences.
Uh... the whole premise was to cherry pick Sweden and try to make a broad determination based on that one data point! You don't get to demand broad statistics if you didn't do it originally.
The converse, attempting to argue that Sweden suffered harshly by looking only at physical neighbours, doesn't follow naturally from any scientific question anyone is actually raising. For that comparison to be useful you'd need a theory of the form, "Nordic peoples are genetically superior to other peoples in ways that makes them naturally resistant to COVID, and thus whilst original models neglected that factor, Nordic Exceptionalism means Sweden should have been identical to Norway and they weren't therefore their decision was a bad one". But obviously such an argument would be nonsense and nobody is claiming that - just implying it.
It's irrelevant for another reason: Sweden only looks like it did "badly" compared to Norway when using percentages. If you look at it in terms of absolute change in excess death, it's small, and depending on how you calculate, you can actually argue COVID had no effect on excess death in Sweden ([1] has an example of such calculations). The impact on Sweden of not locking down, even if you ascribe all differences between these arbitrarily chosen countries to that, is so tiny that it cannot justify the costs of the policy.
At any rate, if you like there are other examples and they all support the same argument. For example, in the USA Florida is a reasonable choice. They released their restrictions relatively early without disaster. Or South Dakota (=identical curves to North Dakota despite very different levels of restrictions), or the recent example of Texas unlocking, or Belarus.
Sweden is a popular choice because it's a very clear counter-example that's been widely discussed in Europe, and because - as I already noted - no model predictions or epidemiological theories make any exceptions for Sweden or Nordic countries. In fact modellers predicted specifically that Sweden would have had 90,000 deaths from COVID by May, but in fact they had about 98,000 deaths in total from all causes by the end of the year. It's therefore sufficient by itself to disprove the models.
[1] https://softwaredevelopmentperestroika.wordpress.com/2021/01...
Really all you're saying here is that the data is noisy (duh). So we can't refute your argument with local data about Scandinavia because that's "cherry picking". But when your argument is about a SINGLE DATA POINT IN ISOLATION (Sweden's results) then... that's totally valid analysis that needs to be accepted without question or worry about confounding noise?
No, that's bad science. It's quite clear that nations with both good mitigation strategies and good compliance (Finland, Germany, Japan) had low case counts, and those that didn't (everywhere else) had bad outbreaks. It's true you can find outliers, but so what?
If your response is, "well obviously all swans are white in this part of the lake" then you've lost the argument, because your original theory is the one being debated, not one with a random ad-hoc revision that makes no sense.
Arguments about Sweden and lockdown are like this. The debate in question is whether lockdowns were required. Their justification is entirely based on models that claim to accurately simulate the counter-factual: that not locking down will yield enormous death numbers. To disprove this theory and thus eliminate it as the justification for lockdowns only requires one counter example, because the original theory is total and has no exceptions for proximity to Stockholm/Nordic culture/whatever today's excuse is.
Now as I've pointed out, Sweden is not the only counter-example, there are quite a few in different parts of the world. But that doesn't matter because by the nature of the original claim, a single counter-example is sufficient. To re-establish a justification for lockdowns would require a revised theory that is actually coherent and explains all the exceptions, not just a single one: this is basic logic.
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.
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.
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...
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...
Sorry, cite for "actually don't work"?! I don't know what you mean by "lockdown". That's not a term of art, it's something used mostly among right wing people arguing against mitigation strategies via hyperbole. Are you talking about mask requirements? Restaurant closures? Hard curfews?
Obviously "lockdowns" (in this sense of "broad covid mitigation strategies") do work. Arguing otherwise is nonsensical. Just look at the data for what is happening in influenza in areas where mitigation was common. Flu cases and deaths fell through the floor. Clearly mitigation worked, just not perfectly (in large part because of poor compliance by people who believe "lockdowns don't work").
https://www.aier.org/article/lockdowns-do-not-control-the-co...
I don't know what you mean by "lockdown". That's not a term of art, it's something used mostly among right wing people arguing against mitigation strategies via hyperbole.
The word lockdown has been widely used for the entire past year by people across the political spectrum, to refer to mandatory stay-at-home orders, business closures and so on. You know this already of course, but are determined to view this through ideological lenses.
As for obviously working and being nonsensical to claim otherwise, it's the opposite: the data is extremely clear that they have no effect whatsoever and quite a lot of all-country statistical analyses have been done that show that rigorously. For example, here is one such paper:
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...
"Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people"
But again, to see this, you don't really need sophisticated analysis. You can just look at the case curves for different regions that did or did not use these tactics.
Re: influenza. We're talking about COVID here, so influenza is irrelevant, controlling the flu wasn't the goal of lockdowns. However, there is some evidence that suggests you can't be infected with more than one respiratory virus at once, so it's possible SARS-CoV-2 simply kicked influenza out. But given the extremely lax symptom classification of COVID it's also possible influenza cases have simply been reclassified. Regardless of the explanation it's not actually relevant: neither lockdowns nor mask mandates had any impact on COVID and there is abundant evidence to this effect. The real question we should be asking is why not, and there unfortunately there are quite a few plausible explanations but nothing conclusive. And the people who are paid to figure that out (epidemiologists) all seem to be in denial and still pretending their models were never invalidated, so they're not much help.
* 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)
Pro tip: there wasn't any science to read.
Pro tip 2: when a pandemic's origin contains a lab that studies and publishes that virus, it's from the lab.
We certainly see this with blind belief in “scientific authorities” who can get things very wrong (like the WHO). We also see it with fact checkers - as an example, I remember reading a (factually correct) article on Facebook yesterday about COVID lockdowns, which mentioned the infection fatality rate. This post had a fact check content warning, from a fact checker who incorrectly quoted the case fatality rate for COVID-19 as evidence that the article was misinformation.
I’m not sure what the fix is. It feels like there is too much information out there for the public to handle and process properly. Or maybe we need a new word that is not “science”, that captures more of the critical thought that is needed, and moves us away from blind faith.
https://zeynep.substack.com/p/lessons-from-a-pandemic-annive...
https://zeynep.substack.com/p/critical-thinking-isnt-just-a-...
For example, this article is basically -- when you reduce it to non-redundant claims -- the opinions of a few people, and two examples: the diamond princess, and the Washington choir.
The diamond princess is presented as if it were a definitive example of aerosol spread. But even Japanese experts were debating it at the time, as -- despite the implication of "lockdown" as used in the piece -- the people on the ship were still mingling on a regular basis to eat. It's simply misleading to present this as an obvious-at-the-time counterfactual. In fact, NHK did a whole documentary discussing it (no longer available [1]), and did this re-enactment to show how it might have happened:
https://www.youtube.com/watch?v=kGQEuuv9R6E
The debates about fomite transmission at the choir are simply dismissed as ridiculous by a single researcher -- an aerosol researcher who has been vocal since the beginning of the pandemic that aerosols are responsible. So you have to consider the source. He's entitled to his opinion, but others weren't gaslighting by having the temerity to disagree with him. There were actually legitimate scientific questions at play, and the opinion of a single person doesn't negate those questions, even if that person turns out to be right in retrospect.
If I had to pick a broad "scientific" trend from the pandemic that disturbs me, it's the over-reliance on anecdote and canonizing of opinion. This seems very much like another example of that broader trend: taking opinions, cherry-picking the ones that look right in retrospect, and anointing those opinions as heroic, while all other opinions are somehow deliberately misleading.
That isn't how science works.
[1] https://www3.nhk.or.jp/nhkworld/en/tv/documentary/20200509/4...
With a lot of pieces of knowledge we got stuck and a follow-up never really happened. Seems as if our capacity for adding more information to a complex area is limited.
But good science takes time, and opinions can be printed instantly, so here we are.
Science is chuck full of competition, posturing, and political shenanigans - especially for popular subjects where there is fame and fortune on the line. Scientists are human beings. They, just like the rest of us, want to be right and to be rewarded for it. We humans are often not graceful about being challenged or proven wrong.
Worse yet, this messy process is filtered and spun by politicians and political media before being presented to the public.
Really, it's remarkable that things have worked out as well as they have. We have at least three viable vaccines being widely distributed and only a tiny uptick in mortality in the mean time. Things could have been much better, but they also could have been much worse.
The question now is what can we learn from how things were handled by the government in power at the time that half-a-million people died of Covid-19 in the US? As relates to the article of discussion the question is: Was there gas-lightning going on that made things worse?
Of course everybody makes mistakes and we should and can learn from them. But, "gas-lightning" is not a mistake. It is intentional.
This is nothing new. Science isn't clean. Just like anything run by humans, it's full of politics and nonsense. We just don't normally pay so much attention to it.
I saw a news clip of a woman getting vaccinated saying she trusts the vaccine because she "likes science." The vaccines appear to be mostly safe, but because you "like science" isn't a reason to trust them. What she means is she likes Mythbusters and thinks that's science.
Science is a process, and it doesn't need the trappings of pristine lab coats and expensive labs. Those things help, but it's about the core principle.
A great example of this is their sword breaking setup. Take two swords and whack them together seems like a natural test. Unfortunately, the issue isn’t the strength of the sword when new it’s a question of metal fatigue and defects in craftsmanship. But, rather than run the test for say 2 weeks they just increased the swing strength because that looks cool.
I haven’t checked Europe in a bit, maybe they updated. But judging from their poor showing presently, I doubt it.
There were lots of problems in the US response, but it was far from uniquely bad. And aerosol resistance was ingrained across western health authorities, it didn’t come from the president.
1: Did you mean the EU? EU != Europe. Russia is 40% of Europe's area and 15% of its population. European Russians are 80% of Russia's population.
The evidence for aerosol transmission outside of specific medical procedures (the aptly named "aerosol generating procedures") wasn't nearly as overwhelming, and most epidemiologists I know were more than willing to characterize the transmission of COVID-19 as likely being on a continuum (documents I wrote were discussing this in early May).
1) Previous studies for flu have shown that masks have very little effect.
2) There was concern about fomite transmission, and for good reason - both from previous coronavirus outbreaks (SARS and MERS) and because of the initial settings (hospitals and the cruise ship). Donning and doffing contaminated PPE is a skill, and an actually fairly difficult one.
The combination of the two led to the active concern that the reduction in transmission due to mask wearing might very well be offset by people self-inoculating via their mouth or eyes.
The shift in thinking came about via two mechanisms as well:
1) The fomite transmission thing appeared to be less of a big deal than initial studies indicated.
2) Previous studies had looked at protecting people by wearing masks. The newer paradigm for masks is primarily focused on reducing the amount of virus asymptomatic or mildly symptomatic individuals are putting into the environment via droplets or aerosols. Hence things like "My mask protects you, your mask protects me."
I guess its hard to say. It seems, well, obvious in hindsight surely, but you'd think that something this obvious in hindsight would be figured out by experts beforehand. Telling people actively to not wear masks seems like they not only missed the shot but were actively harmful.
The unnecessary manmade destruction of utility over the last year is nearly unprecedented, perhaps the most devastating since WW2.
1) HN didn't know a lot about COVID at the time it emerged into the world. If nobody was trying to inform HN about COVID, is that a failing? Probably not. It seems highly likely to me that the actual scientists had good research done on respiratory diseases and probably got a handle on the situation quickly. HN getting detailed information like this ~12-18 months after the outbreak is actually pretty speedy.
2) The mass media were and probably will continue to be serially wrong about COVID, which is expected of the media. They aren't in the business of being technically correct. If they were interested in being technically correct they'd be too squeamish to work in the media. Ditto if they had any deep understanding of how to control infectious diseases they'd have gone into careers in epidemiology rather than journalism, they're learning this stuff at the same speed as everyone else.
3) There aren't a lot of new learnings in the pandemic. It shouldn't be a surprise to anyone that governments can't organise themselves to deal with a crisis in less than 6 months, the government isn't a rapid response outfit. Based on the patterns of success and failure of responses it seems recent memory of SARS is a better predictor of outcomes than competence, so a lot of the broad flows of events were probably predictable and predicted in advance. Some new ideas is that this JIT business is madness, and the amount of travel people do spreads diseases in an eyebrow raising fashion (maybe there should be less of it?).
4) I think the real take away from this is that crazy preppers aren't actually crazy, and having some reserves (financial or otherwise) put aside for disasters is still a good idea.
There is a difference between being prepared, and being a prepper.
If you have six months of savings in the bank, a few gallons of gas and clean water in the garage and dry food in the pantry, you're prepared. If you have several booby-trapped supply caches in the wilderness that you have marked on your map, you're a prepper.
I think most people in my world would use the word "prepper" for this and I didn't think the word had negative connotations. Also that 99% of people don't even have that.
Or if you use bottled water anyways just keep a larger stash that you rotate through. Less work, but takes a bit more space
https://www.theatlantic.com/health/archive/2020/04/coronavir...
I will say the lack of fomite transmission remains surprising, and one of the few ways we have been fortunate this pandemic.
There was very little debate about asymptomatic transmission. But there's a great deal of difference between "Are there asymptomatic carriers?" and "How many, and how efficiently do they transmit?"
The greatest tragedy in all of this is that the state of scientific journalism is as crap as it's always been. Science does not deliver neat yes/no answers, it delivers probabilities.
Can asymptomatic people spread the virus? Yes.
Can you get infected by passing a random unmasked stranger on the street? Yes.
Can you get infected by touching a surface that an infected person has touched? Yes.
Can you get the disease more than once? Yes.
Can you die from the disease? Yes.
Can you develop "long covid" after having the disease? Yes.
Can you get infected even though you've been fully vaccinated? Yes.
Can you die from the vaccine? Yes.
The above statements are all true. But their probabilities of happening to you range from very unlikely to microscopic. And that gets completely lost when media reports on it, and when people talk to each other, and when politicians make policies trying to stop the activities that people are most afraid of...
And now we're in this mess where it's practically impossible for anyone to know what the right thing to do is.