Open Thread 152.5

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1,369 Responses to Open Thread 152.5

  1. Plumber says:

    UPosting to subscribe to this thread.

  2. Edward Scizorhands says:

    I tried to make this comment 888,888. But I missed the timing. It’s 888,889.

    We are approaching a million comments here.

  3. rumham says:

    Justin Amash would be the first libertarian US Senator.

    Given that he’ll be the only one running with national recognition who isn’t in the pandemic high risk group, do you think they can break 5% this time if he runs?

    (personally, I hope so)

    • Matt M says:

      I doubt it. 2016 was probably the best case scenario for the LP and they only got like 4%. Maybe Amash is a somewhat better/more famous candidate than Gary Johnson, but I’m not certain that’s true.

      Also it’s not a foregone conclusion that Amash will receive the LP nomination. He probably will but various other contenders have been campaigning for some time, and some prominent libertarian personalities have been holding party sign-up drives specifically to get people to support Jacob Hornberger. The LP nomination is very much an insider deal with delegates and not primaries, so it’s pretty hard to predict.

      • rumham says:

        True. He just announced it yesterday and a lot of libertarians are already writing about how pissed off they are that he waited til now. And there’s a large group that is still mad they went with Gary last time, preferring an ideologically purer candidate.

        The biggest hope here is that this time around both of the front runners are showing signs of mental degradation. These may be the most confusing televised debates ever aired for a US presidential election in history.

        • John Schilling says:

          The Libertarian party will almost certainly do better with a demonstrably-electable moderate libertarian than with an ideological purist, and if they’re not smart enough to get with that program then it’s time to split the party into the relevant one and the whining-idiot one.

          But the bit where they’re considering going with a guy who didn’t even enter the race until the tail end of primary season, that does look bad. It’s an open admission that they select their candidates in smoke-filled rooms, disregarding what the voters have to say on the subject. The lesson of 1968 is, you don’t win elections that way. Even if, being libertarians, the smoke is mostly cannabis.

          Since they weren’t going to win anyway, I expect it won’t hurt them too much and that going with Amash is probably the best move. But what is driving Amash’s move now, that he couldn’t have known three or six months ago?

          • Jaskologist says:

            Straightforward from here:
            1. Biden steps down due to the Tara Reade accusations.
            2. This shames Trump into stepping down due to his own allegations.
            3. President Amash

          • rumham says:

            But what is driving Amash’s move now, that he couldn’t have known three or six months ago?

            The Biden sexual assault allegations and Trumps falling poll numbers, maybe? And there’s the wildcard factor of the pandemic. That one alone might have swayed the balance.

          • John Schilling says:

            Trump’s numbers are oscillating around the same 40% mark they always have (and always will). And Biden being a dirty old man is not a new thing, as is the bit where the Democratic party is not going to even marginally abandon him over that.

          • Matt M says:

            The Libertarian party will almost certainly do better with a demonstrably-electable moderate libertarian than with an ideological purist

            And who is that supposed to be? Amash? Is he obviously more “demonstrably-electable” than the multi-term Republican governor from a purple state who had all the right “economically conservative, socially liberal” positions? The guy who got 4% against the two most hated mainstream candidates of all time?

            If you’re running as a libertarian, you have already conceded that you are not electable and are not going to win and are not even close to being able to win. There’s no sense in diluting the message for palatability – you’re already unpalatable to the vast majority of the voter base.

            But the good news here is that Amash actually is pretty pure. Policy wise I’m not sure there are too many things he and Hornberger (who was the favorite before Amash announced) would actually disagree on.

            It’s an open admission that they select their candidates in smoke-filled rooms, disregarding what the voters have to say on the subject.

            Well… yeah. But they already admit this. The libertarian party does not have primaries. There are no “voters” as such. The state conventions (open to all registered members) elect delegates (and from what I’ve been told, in all but the biggest states, it’s less of an “election” and more “if you want to be a delegate, you can be one”) and then the delegates meet at the national convention and vote for the nominee.

            A few states do conduct non-binding “straw polls” but these are not primaries in any real sense.

          • Edward Scizorhands says:

            From my watching, it was Trump’s behavior during the daily briefings that pushed Amash.

            You can debate whether or not those briefings really gave anyone any new information.

          • Matt M says:

            And there’s the wildcard factor of the pandemic. That one alone might have swayed the balance.

            It would if Amash was going to come out as strongly anti-shutdown. But there’s no indication he’s willing to do that.

            And even the obscure, ideologically pure guys currently leading the LP presidential nominee race are terrified of saying anything on that, because “the shutdowns are pretty popular.” At least that’s the excuse people keep making when I go in libertarian facebook groups and shout “WHY ARENT ANY OF THESE PEOPLE OUT THERE IN PUBLIC PROTESTING THE SHUTDOWNS???”

          • albatross11 says:

            The thing is, the federal government’s early involvement in the pandemic response was actively harmful–they delayed the availability of testing for about two months, during which we had community spread of the virus and could possibly have gotten out in front of it, and they repeatedly tried to make that one lady in Washington State stop finding out that there was community spread. We continue to have dumbass regulations making it more difficult or impossible for breweries to make and sell hand sanitizer, and feds seizing shipments of PPE for murky reasons. This is all a really great story for Amash to tell if he wants to make a case for libertarianism.

            The lockdowns are a less clear case. As John Schilling has said, they made sense with the assumption that the authorities were going to buy time to take other actions, and I’m not seeing a lot of evidence that they have done that[1]. But quarantine and closing down public events in time of a disease outbreak are actually pretty standard, traditional powers of the government. Someone like Amash (who is very into the literal constitution and traditional limits on government) may just think that this is within the purview of the government, even if he thinks it’s often been done poorly.

            Also, I suspect the lockdowns have at least sometimes been a useful excuse for everyone to do what they needed to do anyway. Movie theaters with 10% of their seats sold are going to close either way, but maybe the lockdown gives them an excuse and a story to tell their creditors and employers.

            [1] By now, OSHA or CDC should have extensive guidance for safety protocols for reopened businesses out in draft and being commented on by the public, we should be flooding the world with masks and face shields and hand sanitizer, we should be ramping up for massive testing, experimental vaccines should be getting ready to do challenge trials, and there should be hundreds of thousands of people being trained to do contact tracing. I’m not seeing evidence of that happening, but I hope I’m wrong.

          • LadyJane says:

            The Libertarian party will almost certainly do better with a demonstrably-electable moderate libertarian than with an ideological purist, and if they’re not smart enough to get with that program then it’s time to split the party into the relevant one and the whining-idiot one.

            This.

            Personally, I’d be very tempted to vote for Amash if he gets the Libertarian Party nomination, but his stance on abortion is a potential deal-breaker for me. He’s consistently described himself as “pro-life” and voted against federal funding for abortion (on the basis of pro-life arguments rather than fiscal ones), and I’m incredibly worried about what kind of people he’d appoint to the Supreme Court. I’ve seen a lot of libertarians asking him to ‘clarify’ his position, which seems to be a coded way of saying “here’s the deal, just change your position to pro-choice now and we’ll completely forget about your bad track record on this issue.”

            Still, he has solidly libertarian positions on fiscal and civil issues, and I’m cautiously optimistic about his stance on LGBT rights: He supported the Defense of Marriage Act back in 2010, but he changed his mind and backed the repeal of DOMA in 2013. He maintains that he only supported DOMA out of support for states’ rights and wasn’t aware of the law’s full implications and ramifications at the time; in 2018, he said that he considered his support for DOMA to be the biggest mistake of his political career. So basically, he’s no better or worse than Biden, who had a similar heel-face turn on gay marriage around exactly the same time. Amash also voted “Present” on the House resolution to condemn Trump’s transgender military ban; he was not among the five Republicans who joined Democrats in denouncing Trump’s decision, but he didn’t vote against the bill like the vast majority of Republicans did.

          • Matt M says:

            I should clarify – my demand that LP candidates denounce the shutdowns is less “because that’s what I believe should happen” and more “because I think it would be a very smart political move.”

            There are a lot of people out there right now who are *very* angry about the shutdowns. No, not a majority (or even close to it). But those who oppose them seem to oppose them a lot, COVID in general will likely be the defining issue of the November election… and right now both candidates support shutdowns.

            I personally know many lifelong Republicans who are furious at Trump, at Republican governors, and absolutely anybody who is promoting shutdowns right now.

            To do some quick high-level math, over 20M Americans have already become unemployed because of the shutdowns (and this number will surely grow). If the LP ran an anti-shutdown candidate and got even 1/4 of those people to vote for them, that would already be more votes than Gary Johnson had in 2016, even assuming those are the only votes they get…

          • matkoniecz says:

            And there’s the wildcard factor of the pandemic. That one alone might have swayed the balance.

            It would if Amash was going to come out as strongly anti-shutdown. But there’s no indication he’s willing to do that.

            I thought that it was meant as “maybe both Trump and Biden will die”.

          • rumham says:

            @matkoniecz

            That and more. Shifting data, mortality, public opinion. We’re in relatively untraveled waters here. Could be something we have yet to anticipate.

    • Christophe Biocca says:

      Senator

      Article is about an attempted presidential run and he’s currently a congressman.
      I’m more worried about him losing his seat in the house despite his relative popularity, now that he’s broken with the Republican party.

      • rumham says:

        Sorry, in the house, yes. Still would be the first.

        I’m more worried about him losing his seat in the house despite his relative popularity, now that he’s broken with the Republican party.

        That is probably a factor in him considering whether to run. He may feel like he’s got nothing to lose.

      • Edward Scizorhands says:

        Amash broke with the Republicans a while ago[1], and has been an Independent.

        His re-election chances have been dim for a while.[2] From what
        I remember my relatives in Michigan saying, by the time he left his party he was looking likely to lose Republican primary before he left the party.

        [1] I thought it was forever ago, but only 9 months. Still, from the beforetimes.

        [2] https://reason.com/2019/12/27/key-election-forecaster-switches-justin-amashs-house-seat-to-lean-republican-in-2020/

    • Gary Johnson ran a very watered down campaign. I’m not sure if the reason is that those are really his views or that he thought the unpopularity of the major party candidates made this an opportunity for the LP to actually get a significant number of votes and didn’t want to blow it by admitting to unpopular views.

      If Amash gets the nomination, the question will be whether he does the same thing for the same reason. I have heard him speak once and was positively impressed, but I don’t know much beyond that.

  4. MisterA says:

    Question for folks here who think the lockdowns are just postponing the inevitable and we should just reopen.

    Is that still your view if it turns out economists are right, and having the virus run wild actually is even more destructive to the economy than the lockdowns are?

    If I understand the position right, it’s that since the virus starts spreading again whenever we reopen, and we can’t stay locked down until there’s a vaccine, it’s silly not to just reopen now. Is that accurate?

    What I’m stuck on is, if a world where we’re open and the virus is spreading causes even more economic damage than an 18 month lockdown, why can’t we lock down until there’s a vaccine? It will be terrible in lots of ways, but what is the basis for saying it’s worse than the alternative?

    • Faza (TCM) says:

      The problem here is knowing what world we’re living in.

      If it is indeed a world where lifting lockdowns is worse in terms of life outcomes than staying locked down, then staying locked down is the correct choice. If not, it isn’t.

      Unfortunately we cannot know this in advance.

      COVID-19 is not a completely unknown quantity at this point. We have had a number of sizeable outbreaks in different countries, so we can make some guesses as to what is likely and isn’t.

      The lockdowns also aren’t a completely unknown quantity, given that many countries have locked down to a greater or lesser extent. We have at least some idea of what the pain points are.

      At this point it becomes a matter of picking your poison.

      • MisterA says:

        I mean, I agree with all of this, except that the consensus among experts seems to be that one of those two worlds is the one we live in and the other isn’t.

        Maybe all the experts are full of it – this is a novel situation so that wouldn’t be super surprising even if you normally have a high opinion of experts – but in the absence of a better source of information, how else do you pick?

        • Faza (TCM) says:

          In a novel situation, the approach I find most fruitful is to see what the data is telling you as it evolves over time.

        • baconbits9 says:

          Which experts? Macro economist ‘experts’ have a terrible track record of predictions going into a crisis, find me one who had a good record of prediction from 2007-2012 and I will give their opinion a strong weight but virtually everyone making predictions in that time frame had a record riddled with massive mistakes, and they are more or less the same individuals and organizations making predictions now.

        • Subotai says:

          I’m a little more willing to trust the experts than some other commenters. If someone did a survey asking directly whether the total cost of an 18 month lockdown (as measured by QALY loss + economic damage) is worse than letting the virus run wild (assuming, say, an 0.4% IFR and that wearing masks and cancelling large events is enough to prevent hospitals from being overwhelmed), and a representative sample of leading economists overwhelmingly agreed that the epidemic was worse, I would update my opinion. But I think that’s highly unlikely.

        • rumham says:

          What I’m stuck on is, if a world where we’re open and the virus is spreading causes even more economic damage than an 18 month lockdown, why can’t we lock down until there’s a vaccine?

          Is anyone making policy arguing that? I thought that even the lowest bounds of the antibody testing contradicted that.

          • Matt M says:

            Gavin Newsome said on Twitter yesterday that concerts, sporting events, and conventions would not return to California until “therapeutics have been developed.”

            This sounds like a plan to continue lockdowns until a cure or vaccine has been developed.

          • Rob K says:

            @Matt M

            Concerts, sporting events, and conventions are massive gatherings of people, which is to say probably the highest risk activity in ordinary life for viral transmission.

            Do you consider literally any restrictions on activity to constitute a lockdown? If so that’s a non-standard use of the term, to my understanding. If not, you seem to be extrapolating substantially beyond what was said.

            Do you consider a resumption of most normal activity with restrictions on the highest-risk activities to be an unreasonable course of action?

          • Matt M says:

            I would consider a permanent and indefinite ban on music, sports, and professional gatherings to be an unreasonable course of action, yes. Even though these activities are high risk for virus transmission.

    • Matt M says:

      What I’m stuck on is, if a world where we’re open and the virus is spreading causes even more economic damage than an 18 month lockdown

      I think most of the economists are still relying on assumptions that re-opening would lead to a massive increase in cases, everywhere at once, which would then overwhelm hospital capacity, leading to excess deaths. This was the original fear that prompted the original meaning of “flatten the curve.” As far as I can tell, this is the only scenario in which perpetual lockdowns could possibly do less economic damage than “open up and go for herd immunity.”

      Like, it’s pretty much impossible that a barber shop would get less business in a scenario where they are allowed to open, but customers avoid them because they are scared of the virus than in a scenario where the government says “you have to stay closed, nobody can come to your business, even if they aren’t scared.”

      So pretty much the only way you could see “more damage” from re-opening than from lockdowns is by seeing more deaths, which will only happen in the “hospitals overwhelmed” scenario. As far as I can tell, most people seem to no longer believe that’s a serious risk in most locations (note that the government is actively dismantling emergency field hospitals it built in Seattle, Houston, and other places – the Navy medical ships are leaving, etc.)

      • JPNunez says:

        But…the economy being closed won’t cause deaths. The barber does not need to die because he is closed. The government can provide for him. Suicides may rise, but I find hard to believe the extra suicides will go way above-the-vietnam-war deathcount.

        I think the case for “extended lockdowns will be worse” is very thin.

        • A Definite Beta Guy says:

          Exactly how long do you think the federal government can run $4-5 trillion annual deficits?

          • JPNunez says:

            Honestly? a few years.

          • Randy M says:

            Even if so, not wise to take all the slack out of the system at once.

          • albatross11 says:

            It will keep on working just fine until the day it stops. That day will probably be a memorable one.

          • Edward Scizorhands says:

            Seeing how close we can get to financial disaster is like seeing how close we can get to our health system being overwhelmed.

            You can’t just say “oh, that’s happening now. Well, let us change course, and it shall stop happening.”

        • EchoChaos says:

          But…the economy being closed won’t cause deaths.

          The economy being closed will ABSOLUTELY cause deaths. And not just suicides. There are lots of things that will be affected by such long-term closures.

          This doesn’t mean that it isn’t the right answer to lock down, but this is naively optimistic at best.

          • JPNunez says:

            AFAIK life expectancy actually rose during the Great Depression.You may argue that this will be different, but I think the priors are against your case.

        • baconbits9 says:

          But…the economy being closed won’t cause deaths.

          It won’t? Why would you think that? Do you think that modern medicine exists without the supporting structure of the broad economy?

        • Faza (TCM) says:

          The barber does not need to die because he is closed. The government can provide for him.

          Unless the government is out there growing grains, milling flour and baking bread – it cannot.

          The government can give him money, but that’s only useful if there’s something that money can buy, which depends on the economy actually functioning to some extent.

          Besides, the barber is just the tip of the iceberg. I work in accounting. My job isn’t threatened. Except that if enough barbershops close they’ll stop paying my company to do their books, so I’ll be out on the dole.

          If non-essential businesses are closed, that barber isn’t spending his gov-bucks on anything else either, so the people who own/work in those places are now in trouble. Which has knock-on effects all throughout the system.

          It is happening right now. You can watch it in real time.

          You may think you can solve this by throwing even more money at the problem, but that only works as long as someone grows the grain, mills the flour, bakes the bread, sells the bread.

          • JPNunez says:

            The government needs to act to keep essential industries going.

            Even Trump is declaring pork production as essential, and while I’d like this kind of policy to be created predictively instead of reactively, this is a step in the right direction. It needs to be accompanied for more testing for these workers, but we will probably move in that direction. China did this! It’s not a crazy notion.

        • Matt M says:

          Sorry, I realize I left out an important clarification in my above post.

          I’m ruling out, from the start, the notion that lockdowns can/should be maintained until a vaccine is developed.

          I am assuming that herd immunity is the only way out of this, meaning that the only relevant question is one of timing. In a binary sense, our options are basically “Get herd immunity quickly and end the lockdowns quickly” or “Get herd immunity slowly and maintain the lockdowns for much longer.”

          In that sense, Option 2 is preferable only to the extent that it results in less overall deaths because in Option 1, the hospitals would become overwhelmed and people will die who otherwise might have been saved.

          But both options assume the same amount of people get infected on net, in the long run.

          In that sense, lockdowns are only worth doing if they are successfully pushing your hospital capacity down to 100% or lower, when otherwise it would have been over 100%. But given that right now, in the vast majority of the country, hospital capacity is well below 100%, the lockdowns currently in place are causing us to incur a cost without a corresponding benefit. Any spare capacity in the hospital system in any place with a lockdown can be thought of as a giant waste of resources.

          • matkoniecz says:

            In that sense, lockdowns are only worth doing if they are successfully pushing your hospital capacity down to 100% or lower

            It is also worth doing if new treatment appearing in near future will be better than currently available.

            But I am skeptical about new treatment that would be so effective that it justifies until it will happen.

          • JPNunez says:

            First time I see someone arguing we should adjust contagion until hospitals ride the thin line of being overwhelmed.

          • Matt M says:

            That’s literally what “flatten the curve” meant for the first month they were telling us it was the strategy we were pursuing.

          • JPNunez says:

            While technically true, everyone who was asking to flatten the curve would have preferred to not reach the limit at all if possible.

            This is not really flatten the curve but…rise the curve?

            I mean, you may argue that the economy being closed will cause more deaths or not, but you are literally asking that states that are controlling the infection intentionally _kill_ more people. That’s the predictable outcome of your proposal.

          • albatross11 says:

            If you can flatten the curve for long enough to matter, it’s probably also possible to hammer the curve so that R drops below 1 and the disease stops spreading.

          • Edward Scizorhands says:

            Failing to lower the highway speed limit to 25 is literally killing people.

            Literally. Literally literally.

        • matkoniecz says:

          But…the economy being closed won’t cause deaths.

          That is ridiculous. There are already first deaths from starvation in India, caused by lockdown. It is low number, and USA has bigger reserves but sufficiently long lockdown will cause collapse of critical supply chains including food production.

          Even with direct food production active sooner or later for example farm machinery needs to be repaired/replaced.

          (BTW, over 50 deaths in India were attributed to closure of alcohol shops – https://gulfnews.com/world/asia/india/the-human-cost-of-indias-coronavirus-lockdown-deaths-by-hunger-starvation-suicide-and-more-1.1586956637547 )

          —-

          Also, economic damage will make harder to avoid next serious shock (whatever it will be).

          • rumham says:

            BTW, over 50 deaths in India were attributed to closure of alcohol shop

            Anecdotally, I know two people who found out they were physically dependent on alcohol after the lockdown went into effect. One carefully and slowly detoxed (is that the right word?) with what he had on hand. The other did not. Thankfully, for her, they kept the liquor stores open. I’m worried about her, but it would be difficult for most people to lower their drinking in a time of stress such as this.

          • baconbits9 says:

            Even with direct food production active sooner or later for example farm machinery needs to be repaired/replaced.

            This is one completely neglected aspect of the lock downs. The % of the economy that is ‘essential’ is in proportion to the length of the lockdown. If we need a 1 day lockdown then to prevent a bunch of deaths we need to keep hospitals staffed and electricity and water running. Extend it out a few days and you have to start making food deliveries, extend it further and you need to open up the the longer portions of the supply chains and food production. Eventually you will have folded almost the whole economy back into play and the lockdown won’t be effectively slowing the spread. If you are talking 18 months then you had better start opening schools pretty soon as you don’t want a shortage of Doctors/Nurses as people who would have been recently qualified are pushed a year+ back. You definitely don’t want to do this when your medical staff are being disproportionately hit by the virus while also working the most stressful period in their lives.

          • JPNunez says:

            This is one completely neglected aspect of the lock downs. The % of the economy that is ‘essential’ is in proportion to the length of the lockdown. If we need a 1 day lockdown then to prevent a bunch of deaths we need to keep hospitals staffed and electricity and water running. Extend it out a few days and you have to start making food deliveries, extend it further and you need to open up the the longer portions of the supply chains and food production. Eventually you will have folded almost the whole economy back into play and the lockdown won’t be effectively slowing the spread.

            These are good points but they only reinforce the idea that the lockdowns should be stricter early on. Other countries are already recovering because they acted early.

      • matthewravery says:

        As far as I can tell, most people seem to no longer believe that’s a serious risk in most locations

        This is statement ranges from completely untrue or plausible depending on what you mean by “re-open”.

        Currently, most places in the US have an R(t) modestly below 1 (0.75 to 1.1 captures most every state). In places where there aren’t many cases, that’s fine. There are few, and they’ll die out quickly if that’s where the transmission rate stays. In places where there are more cases, it’ll take longer but still not a big deal.

        Depending on what gets opened up and how much people actually start going out and doing things, those values will most likely peak over 1.0. Perhaps this will be offset by higher temperatures, but that’s a guess. If lots of things open up and people are eager to re-engage with the economy, they’ll shoot well above 1.

        If things get back above 1, that means cases are growing exponentially. If you start from a small group and only have a R(t) modestly above 1, it grows exponentially but with long doubling times. If that’s all you do, then you’re screwed in 3 months instead of three weeks, but you’re still screwed.

        I don’t think anything above is remotely controversial. You can open up some things in some places, but you should still be careful and closely monitor the rates of new infections at the local level. If left unchecked, local medical resources will still get overwhelmed. Nothing we’ve learned since February has changed any of this.

        • Christophe Biocca says:

          How is this Rt calculated? Do the really low values for NY really make sense given antibody testing showing 1/5th of NYC residents have had the virus?

          This matters because if the true values are +1 from the old values, then we’re already above the threshold and seeing exponential growth, just a slower one.

          • Edward Scizorhands says:

            The assumption I get from “1/5th of NYC has already had it” is that we would expect NYC to go through what it’s already gone through about 3 more times before we have herd immunity.

            There’s a decent argument that “the most vulnerable people, who weren’t obeying social distancing, have already caught it.” But then the other 80% are still going to continue being careful, which means avoiding a lot of participation in the economy.

          • matthewravery says:

            R(t) calculations are explained at the link above.

            I think they’re completely reasonable. They’re measuring the rate of transmission, not the base total. So the only assumption you make when you discover your base rate is different is that the delta (percentage-wise) has been relatively constant over the duration.

            The link above notes that when they began accounting for testings totals and positive rates, the local R(t) estimates generally went down a tick.

        • Subotai says:

          None of this shows that hospital capacity will be overwhelmed. Of course if R(t) is above 1, the number of cases will grow exponentially at first, but it will eventually reach a limit set by population size. Since the hospitals were not overwhelmed in New York City even though around 10% of the population was probably infected near the peak, I don’t agree that we will be as “screwed” as you seem to think. Obviously many people will die, but I don’t think the death rate will be worse than it would be if we spread the cases over many months instead.

        • If that’s all you do, then you’re screwed in 3 months instead of three weeks, but you’re still screwed.

          What assumption are you making about lethality? If you believe the result of antibody tests it’s something like .1%, which means that going all the way to herd immunity only results in about 200,000 deaths, perhaps two million infections serious enough to require hospitalization. If people continue to do a good deal of social distancing, with many old people self-quarantining until the virus is close to extinct, fewer than that.

          The U.S. hospital system has about a million staffed beds, so spreading most of that out over three months shouldn’t overwhelm it.

    • baconbits9 says:

      It is not binary, and we are not in ‘lock down’, and presenting it as such prevents the proper disucssion.

      Lockdown is what happened in parts of China- everyone is ordered to stay indoors with government’s trying to meet the most basic needs (ie food delivered to doors by military personal, and hospitals open but you have to get permission to go to the hospital), what we have is called lock down but is far more partial and fragmented than that. The adult discussion is do we have a mandate from a higher goverment level that decides things or do we have behavioral changes made by individuals, and where in that range do we fall. You could have mandates for the whole country, or state by state, or locality by locality. You could have minimum national standards, and then have localities implement their own higher standards if they chose, or have a national policy about cross border travel and then have local policies for the rest, etc, etc, etc, and framing it as ‘lock down vs nothing’ avoids all the actual issues involved except for a simplistic ‘liberty vs tyranny’ angle.

      Is that still your view if it turns out economists are right, and having the virus run wild actually is even more destructive to the economy than the lockdowns are?

      The broader view is not one vs the other, it is a comparison of scenarios. The way that you have phrased it here implies that lockdowns will work to stop the virus, but that isn’t a given you can very easily have the lockdown damage and then the virus damage when you reopen, and that has the potential to be much, much worse than either would have been on their own.

      The basic ignorance behind ‘flatten the curve’* is that it assumes we have a static or rising ability ability to deal with the virus and that means that we can just spread out infections over time and get better or the same results at worst. This is economically illiterate, our ability to contend with the virus depends on our ability to produce goods and services which is taking a major hit right now, and also with whatever other crisis we have to deal with. This sets up the worst case scenario where an attempt to come out of lock down leads to a resurgence of the virus simultaneous with a massive economic hit as the reopen fails to invigorate the economy.

      *as it was presented to the public

    • The Nybbler says:

      Is that still your view if it turns out economists are right, and having the virus run wild actually is even more destructive to the economy than the lockdowns are?

      Please don’t ask loaded questions like that.

      What I’m stuck on is, if a world where we’re open and the virus is spreading causes even more economic damage than an 18 month lockdown, why can’t we lock down until there’s a vaccine? It will be terrible in lots of ways, but what is the basis for saying it’s worse than the alternative?

      This world is simply not plausible, given what we know about the virus.

    • Purplehermann says:

      I’m pretty sure the economists don’t think this

    • baconbits9 says:

      why can’t we lock down until there’s a vaccine?

      Very serious question. Why would you assume we could? What historical evidence would suggest that we can close a large chunk of the economy and just wait it out without severe issues on reopening? What theoretical evidence? Status quo bias exists for a reason, you don’t just assume that you can do something radical to the system and assume it won’t be so bad.

      • Matt M says:

        It’s also entirely possible that the date at which a successful vaccine will be developed is never.

        Saying “we should lockdown until a vaccine is developed” is basically saying “I’m comfortable with the idea that life might continue on like this forever.”

    • edmundgennings says:

      I can not conceive of a possible path where rona operating as we now think it operates causes anywhere near that much economic damage by running rampant (once and by rampant I mean as fast as possible without systematic overwhelming of hospitals) as an 18 month lockdown would. In the spirit of fermi calculations or it is better to pull numbers out of the air than one’s decision, let us do math with plausible numbers. Let us say we get herd immunity at 70% of the population. I have a hard time buying Rona as having a working age fatality rate of higher than .5. So we would lose .35 of the working age population. That is less than how many people retire every two months(100/(65-22)/6=.38 ) and given assorted people moving for family reasons etc, let us guess that is about the undesired employee loss of a random normal month.
      In terms of sick employees; some where between most and the vast majority of the working age population (which seem closest to prisoners as a population in terms of populations that we have data on) would be totally asymptomatic. The best data suggests that 93% of this group would be asymptomatic. That seems a bit high so let us say 10% of the working age population gets sufficient symptoms that they stay home for a week. And 5% stay home or a ta hospital for a month. We spread these infections over a 3 month period. Having roughly 5% of ones workforce out for a few months and permanently lose .35% would not be great for a company but that strikes me as about as bad as 1 to 2 weeks of lockdown. Now having cautious consumers again is not great, but cautious consumers are way better than no consumers. Further if we get social buy in or at least resignation to everyone getting infected especially once people has been infected, there is no reason for consumers to be particularly cautious. Also a month or three of consumer caution only directly impacts a smallish range of businesses. Factories making goods do not care if the public orders them online.
      These numbers would have to be massively wrong for this being less than an order of magnitude less damaging economically than an 18 month shutdown and my guess would be that it would be closer to two orders of magnitude less damaging economically.

    • John Schilling says:

      Is that still your view if it turns out economists are right, and having the virus run wild actually is even more destructive to the economy than the lockdowns are?

      If having the virus run wild is actually more destructive to the economy(*) than the lockdowns are, then yes, that would change my recommendation substantially. But that’s independent of whether or not “the economists are right”, and your argument is not improved by trying to smuggle in argument by authority like that.

      What I’m stuck on is, if a world where we’re open and the virus is spreading causes even more economic damage than an 18 month lockdown, why can’t we lock down until there’s a vaccine?

      I don’t think it is plausible that we are living in that world. I also don’t think that there is anywhere near a consensus among economists that we are. I think most of the economists recommending that we continue the lockdowns, envision them being continued for a few more months, not for a year or more. And I think that any economists who are recommending a year of lockdowns, are operating from an unrealistic model of the virus’s spread and lethality under non-lockdown conditions, in which case they are not in fact arguing from a position of authority because that’s not an economic question.

      The most commonly heard economic argument in favor of lockdowns is that people are still so scared of the virus that even if we lift the lockdowns they won’t go back to working and spending. There’s certainly some truth to that, but even so lockdowns are strictly worse than not-lockdowns in simple economic terms. And the more true it is that the not-lockdown case would still see everybody hiding out at home, the less difference the lockdowns make in terms of disease propagation.

      The less common but more valid argument is that, absent the lockdowns, the disease will kill a lot of people and that’s economically destructive. Which is qualitatively true, but numbers matter. COVID-19 has a lethality of <1% among the working-age population, mostly skewed towards the higher end of that population. Even assuming that the lockdowns result in nobody being infected and the no-lockdown case results in everybody being affected, and that working-age mortality is a full 1%, that comes to maybe 0.15 GDP worth of lost productivity, spread over decades. We're currently seeing I think a 20-30% decrease in productivity, despite some very expensive government interventions. Six months or so of lockdown would cause as much economic harm up front, as an unchecked epidemic would over a generation.

      And both the "lockdowns result in nobody being infected" and "no lockdowns result in everybody being infected" assumptions are gross exaggerations. People are being infected under the current lockdown regime, and that's only going to get worse as compliance falls off. And the alternative to the current lockdown regime isn't Italy-in-February, it's voluntary social distancing plus tailored government actions plus better treatment plus this isn't Italy where everybody lives with their grandparents plus summer vs. winter probably matters somewhat.

      If there's a credible argument for the middle ground between apathy and lockdown resulting in more economic harm than a full year of lockdowns, I haven't seen it. And I don't think most economists are making that argument with those qualifiers.

      * and to social trust and institutions, public mental health, etc.

    • ana53294 says:

      The economy is one of the reasons why we should lift the lockdowns. But there are other reasons too: preserving our democracy (elections have already been cancelled), our liberties, our privacy, our sanity, our religious freedom, our freedom of expressions (no protests against lockdowns are allowed).

      I worry about the power trip the government is taking and the complete ignoring of our Constitution very seriously. For some reason, the Spanish Constitution only matters when it comes to the matter of an independence referendum; the Supreme Court seems to always side with the government.

      I’d say that even if the deaths from coronavirus inflict an equal pain to our economy than the lockdowns*, I still believe that people should be able to make a decision for the level of risk they find acceptable on their own, without it being forced on them. We do allow people to ride motorbikes, don’t we?**

      *Which I don’t belive, by the way. The death of elderly people in care homes, however regrettable, is not something that will affect the economy at large that much.

      **And please don’t tell me about externalities; motorbikes also cause negative externalities, and we don’t ban them.

      • VoiceOfTheVoid says:

        **And please don’t tell me about externalities; motorbikes also cause negative externalities, and we don’t ban them.

        The vast majority of the danger re: motorbikes is to the rider. A much larger part of the danger re: a young, healthy person flaunting the lockdown is them spreading the disease to those at risk.

        • baconbits9 says:

          To who? I can’t spread it to someone obeying the lockdown order.

          • Edward Scizorhands says:

            1. Essential workers who can’t stay home.

            2. Separately, people who were taking risks that would be prudent if the overall spread is low, like going to the grocery store. If a bunch of people start spreading a lot, those people have to resort to other methods. You can model this as a finite amount of risk to go around, and if several people start eating up extra shares of the risk, it takes away the amount available to others.

    • bv7bd says:

      Have you got a good link for economists saying the virus will cause worse economic damage if we end the lockdown?

      I found https://insight.kellogg.northwestern.edu/article/economic-cost-coronavirus-recession-covid-deaths, but I don’t find it very convincing. The paper argues (I think correctly) that millions of people would die if we abandoned all attempts at controlling the virus. But then it tells us that we should value each lost life as worth 9.3 million dollars of damage to the economy, and using that number it reaches the conclusion that ending the lockdown would cause horrible damage to the economy.

      I agree that lost lives are very bad, but I don’t agree that lost lives can be directly converted into economic damage. Taking this paper’s argument to an extreme, we could notice that 0.7% of the US population dies every year; if we convert that into economic damage, it’s roughly the size of the US economy, which means that the US economy is destroyed every year.

      Also missing from the article was any discussion of whether, at the end of the lockdown, we would see fewer deaths when we finally reopened.

      I think that, if the paper wants to argue that millions of people will die if we don’t lockdown, they should just make that their argument. They should avoid using made-up numbers to convert the deaths into “economic damage”.

      • emdash says:

        They should avoid using made-up numbers to convert the deaths into “economic damage”.

        I think ‘made-up numbers’ is a pretty harsh characterization of this. Estimating the value of a statistical life is an important thing to do and is basically what underlies almost all modern safety regulations (i.e. anything that doesn’t stem from a moral panic). Every safety measure will have some cost (both real and opportunity) and you need to have some way of comparing that cost against the gained value in lives saved, so you need a number. That number (9.3M) seems about consistent with every other number I’ve seen (around 10M in the US).

        Taking this paper’s argument to an extreme, we could notice that 0.7% of the US population dies every year; if we convert that into economic damage, it’s roughly the size of the US economy, which means that the US economy is destroyed every year.

        Except for the fact that most of those 0.7% of people are near or past the end of their prime economic contribution years. That 9.3M is for a hypothetical random person, and 0.7% of middle-aged workers are not dying every year. In any case the 9.3M is also the expected contribution over the rest of that random person’s life, not in a single year, so comparing it with GDP on a per year basis is inappropriate.

        • gbdub says:

          But most of the people who die of COVID are also already near the end of their lives, so if the number is bad to use for one estimate it is bad to use for the other.

        • bv7bd says:

          Here’s my estimate.

          The US GDP per capita is $62K/year. If most people work from age 20 to age 64 then the average lifetime contribution to GDP is $62K * 45 = $2.8 million.

          (The $9.3M number seems to be derived from a metric about how much people will spend to avoid death. That’s a useful number for many purposes, but it’s not related to economic damage.)

          https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ has some rough statistics about the age of people who die. 23% of people who die of coronavirus are on average 55 years old. 4.5% of people who die of coronavirus are on average 31 years old. (Everyone else is over 65 and therefore presumably retired.) Doing some math, people who die of coronavirus lose on average 3.8 years during which they could productively contribute to the economy, so we can estimate the damage to the economy of a coronavirus death at $235K.

          — and, if we wanted to push this further, we’d have to note that the GDP _per capita_ is more important than raw GDP, and GDP per capita tends to go up as a result of coronavirus deaths.

          We should be clear that people dying is horrible. We shouldn’t underestimate how bad it is when people die. It’s really bad! I’m definitely not arguing that we should cancel the lockdown and get a lot of people sick.

          I’m just saying that cancelling the lockdown and getting a lot of people sick would not cause that much damage to the economy.

          • emdash says:

            I think I mostly agree with your line of thinking, which is seems to be that those estimates are probably kind of high since they are based on how people value their own life (in terms of price they demand for increased risk), which might not be the same as their actual economic value in the broad sense. But I think your estimate is still too low, mostly because people perform lots of valuable services for free (especially things like childcare) which have economic value.

            I’m not entirely sure about this, but it seems like the 9.3M estimate is probably high considering the demographic breakdown of those being affected, but your estimate of 235K is probably the absolute lower bound of the value. I guess it depends at what point between those two the damage crosses the threshold of ‘too much economic damage’.

          • Purplehermann says:

            Any idea how to account for the dead are disproportionately those with underlying conditions?

        • Purplehermann says:

          The vsl isn’t about how much people will contribute, at least directly – it’s about how much we’re willing to pay (as noted by Edward, on the margin.)

          This calculation doesn’t actually make an a case based on the economy at all, rather it’s based on how much we usually are willing to pay to save lives because we want people to live.
          It doesn’t take into account the fact that those who die are much more likely to be unhealthy and old.
          It doesn’t take into account the differences between massive economic damage or going into a depression and a bit of cash on the margin.
          It doesn’t make any real case that the economy would be better off with shutdowns.

      • Edward Scizorhands says:

        If you want to value the old less than the young, you can use QALYs instead of raw lives.

        $10M is also the marginal value of an average life. If we could stop one death per year, it would be worth about $10M to us, but that doesn’t mean 1 million more/fewer deaths are worth $10T.

      • I agree that lost lives are very bad, but I don’t agree that lost lives can be directly converted into economic damage.

        I think a lot of people are misunderstanding what economists mean by the cost of a life, possibly because they don’t understand what economics is.

        The issue isn’t how a life affects the economy, it’s what a life is worth to the person living it. The standard way of making the estimate is to find some situation where individuals are making a choice between alternatives that differ mainly in chance of death — driving a truck loaded with sand vs driving a truck loaded with dynamite would be a textbook example, although not, I think, a real example.

        Suppose you discover that you have to pay drivers $10,000/year more to drive a truck loaded with dynamite, and that driving such a truck results in a .1% chance each year of being blown up. You conclude that the driver values 1/000th of his life at $10,000, hence values his life at ten million dollars. Do a lot of such estimates from different real world examples and you produce a value of life.

        There are three things wrong with the argument of the paper, if I correctly understand it. The first is that the people dying will mostly be old, hence have less of their life left, so should value it at less. The second is that the calculation is done with values of mortality that are probably much too high, given the more recent data on how many have been infected. The third is that what matters is not how many people will die without a lockdown but how many more people will die, and there is no good reason to think that is several millions, or even within an order of magnitude of that.

        • Purplehermann says:

          What people want to know is:
          1. How much damage are lockdowns doing to the economy, compared to letting the virus burn through?
          2. How many will die in each case?
          (Obviously it isn’t binary)

          Then we can compare the deltas.

          Slipping in lives lost as an economic cost because we value lives is not helpful. We are weighing lives as lives seperately.
          This double counting is a nuisance.

          As for the defintions, it’s feeling kind of similar to the
          racism = prejudice + power shtick.

          The economists should stop telling us how much to value lives as lives and get down to figuring out how badly the actual economy will be damaged.

          • VoiceOfTheVoid says:

            Well, when you go to compare them, at some point you’re going to need to compare lives lost to dollars saved (or dollars spent to lives saved), and you’re going to need some conversion factor. I agree that this isn’t the most honest presentation, but I don’t think putting a dollar value on lives is in-and-of-itself the problem.

          • albatross11 says:

            Look, the tradeoffs here are between economic well-being and people dying sooner vs later vs not at all. So there is no way to get around making some kind of $/life tradeoff in your analysis.

          • LesHapablap says:

            Voiceofthevoid/ albatross11,

            That’s true but everywhere that I have seen this study mentioned, including by Scott in one of his link posts, interpreted it to mean that the economy would actually be better off by 5T with the lockdowns.

          • Purplehermann says:

            That calculation will have to be made yes. (For an optimalish solution)

            That’s not my problem here.

            This is being presented as damage to the economy itself, not a cost/life saved analysis, which it does badly anyway.

            People are understanding this as : the economy will be better off with lockdowns and we get to save lives.

            What it actually says is: we think the lives saved are more important than the damage done to the economy (and not because of the damage losing workers etcetera directly does to the economy).

          • What it actually says is: we think the lives saved are more important than the damage done to the economy

            A correct description, given your terminology. But the way you use “damage done to the economy” I think reflects a misunderstanding of economics.

            Suppose a tornado destroys a lot of houses. Do you count that as damage to the economy? Presumably you do, because houses are of value.

            So are human lives, so the tornado killing people is damage to the economy in the same sense.

        • LesHapablap says:

          People do not value their lives at 10MM when they are 75+. Consider: if you’re an 80 year old with a disease that has a $10MM cure, would you buy it if it meant saddling all your kids and grand kids with $10MM of non-dischargeable debt for the rest of their lives? How much debt would you be willing to give you an extra few years?

    • A lot of the past analysis assumed that if you got the disease you had something like a one to ten percent chance of dying, depending on age and health. If you believe the most recent evidence on the number infected, that was high by at least an order of magnitude, with an overall ratio of deaths to infected more like 1:1000. If that’s right, then letting the virus run to herd immunity gives you something like 200,000 U.S. deaths. Total staffed beds in U.S. hospitals are about a million, so if half of them are dedicated to coronavirus patients, each patient is in the hospital for two weeks, and a tenth of the patients die, the hospital system can handle all of them over about two months.

      If those numbers are right, it looks as though ending the lockdown while encouraging social distancing to spread things out and quarantine for those especially vulnerable is the best policy, assuming that someone who has had the disease is immune thereafter for at least a year or so. And if most of the particularly vulnerable choose to self-quarantine for a few months, total deaths should be lower than 200,000.

      Whether the newer infection estimates are correct, I don’t know.

      • Edward Scizorhands says:

        If you believe the most recent evidence on the number infected, that was high by at least an order of magnitude, with an overall ratio of deaths to infected more like 1:1000.

        Things move fast so I missed this. What are you citing?

        We’ve had something like an extra 0.1% or 0.15% of NYC die. That right there is a 1-in-1000 chance if they all had it. If about 20% of them had it, then the chance of death is about 1-in-200.

        If that’s right, then letting the virus run to herd immunity gives you something like 200,000 U.S. deaths

        The US is at 60K deaths right now. Do you think we are nearly 30% of the way to herd immunity already?

        • I believe there have been several different studies giving different values, with the N.Y. one the highest.

        • albatross11 says:

          If 20% of New Yorkers got the virus (and have antibodies, so hopefully they got it long enough ago to mostly have progressed to serious illness if that was going to happen), and .1% of New Yorkers have died of COVID, then we should figure that the IFR is around .5%, or 5/1000. But there should be very wide error bars on that, to account for uncertainty in the test results, the death attributions, and maybe the lag between exposure and serious illness. (I think it’s typically about three weeks from exposure to getting really sick and ending up in danger of dying, whereas I think antibodies typically show up sometime between 4-14 days.).

          Some extra error terms I think we don’t really know much about yet:

          We might be overestimating IFR (thinking the virus is *worse* than it really is):

          a. Does everyone who was exposed develop antibodies? [If not, more people have been exposed than we’re counting, so the real IFR is lower than 0.5%]

          b. Do antibodies fade away soon after the infection is cleared? [If so, more people may have been exposed than we’re counting–same effect.]

          c. Are a substantial fraction of people in the population immune? [If so, IFR is around .5%, but unchecked spread will cause a lot fewer than population*IFR deaths.]

          d. Is there some reason the most susceptible people have mostly already been infected? (For example, most of the nursing homes have already been hit. Extensive mostly-hidden spread in the healthcare system would also fit this.). [If so, IFR in the future will be lower than 0.5%, because most people are less susceptible than the ones who’ve been infected so far.]

          e. Is there something about NYC that makes the virus more deadly there than in other places? (Maybe when you get infected you get a big dose because of everyone being so packed together? Or maybe NYC’s hospitals really did get so overwhelmed that the fatality rate went way up?). [If so, the fatality rate from infections will be less in other places.]

          f. Have we gotten much better at treating serious COVID-19 infections without the patient dying? [If so, future infections will be lower fatality rate.]

          Any of those would mean that our estimate of how deadly the virus is was too high, and it’s really less of a threat than we think.

          We might also be underestimating IFR: (Thinking the virus is less bad than it is.):

          g. Does the disease progress slowly in some people and take longer than we expect to put them into the hospital or the morgue? If so, we’re underestimating IFR. [The longer the lag, the smaller the fraction of people had been infected early enough to count in the death total.]

          h. Has the disease been explosively spreading lately, so that most of the growth in cases has happened in the last few days? [Again, that would mean that the fraction of infected people who’ve had time to die yet was smaller than we think, and thus IFR would higher.]

          i. Are there longer-term deaths associated with the virus? Like, you get sick with the flu, recover, and then drop dead from a heart attack a month later? [If so, we haven’t counted all the deaths yet from the infection rate.]

          j. Have the most susceptible people been being extra careful to avoid getting infected? [If so, we’re underestimating IFR.]

          The low rate of detected infection among the USS Teddy Roosevelt and the crew of the Diamond Princess suggests that (c) could be true–maybe some people are immune. (That could be genetic variation, or having had a recent coronavirus cold, or maybe exposure to some other thing that left cross immunity.) I also expect (f) is true–we’re probably better at treating COVID-19 now than we were at the beginning of the NYC outbreak, and that will probably mean that future cases have a better prognosis. I think (g) and (i) are true, but most likely the numbers aren’t that large so they don’t change the whole picture so much. I suspect (j) is true for later cases, and it may be that any apparent fall in lethality of the disease is less because doctors know what they’re doing now than because the 70-year-old diabetics have been holing up in their homes and accepting grocery deliveries with a mask and gloves on for the last month, while 40 year old overweight delivery guys didn’t worry about it till that cold turned nasty and went into their lungs and they started having trouble breathing.

    • DinoNerd says:

      I continue to say “I don’t know” about all this. There’s a lot we don’t know about this virus; there’s also a lot we don’t know about macroeconomics, in spite of those specialists more often claiming certainty (while disagreeing with each other).

      Here are some scenarios; the first group can’t happen in most places because of measures already taken.

      – Everyone gets it; 1% die, skewed towards males, older people, and those with prexisting conditions; maybe other skews as well (race, poverty, local hospital capacity). When the dust clears, folks don’t catch it any more, and we’re all back at work. Lots of trauma, some widows and orphans, and some loss of critical senior people. But the survivors are back at work in let’s say 3-6 months, and after they fire all their political and health leaders for “not protecting them” things are basically back to normal, with more funding for pandemic protection. In two years, GDP has recovered and is climbing normally – setback of maybe 1 year economically, probably less. Or infinite, if you don’t live to see the recovery.
      – Same, with a much lower death rate. Less political turmoil, and sooner recovery.
      – Same except that after let’s say 2 years, those who’ve had it once can catch it again, and face substantially the same risk. No vaccine is possible, or it takes as long to produce one as it did with AIDS. Huge social adjustments, and the economy is more affected by them, in the long run, than by the direct impact. Results unpredictable.

      – “Hammer and the dance” competently executed, with a goal of keeping medical systems from being overwhelmed rather than of having as few as possible catch it overall. As any of the above scenarios, with fewer deaths (those who would have benefitted from treatment not available) and higher economic costs.
      – “Hammer and the dance” competently executed, with a goal of getting R0 < 1 and keeping it there. Travel (even within countries) remains heavily restricted so that localities that successfully reduce their local transmission/case load can enjoy benefits in the form of return to work. I think this is a winner, except it's probably not politically feasible, except for pocket handkerchief-size countries. Probably double the economic hit we've all already taken, and a slower recovery than "let's all get sick right away".
      – lockdown continues "until we have a reliable vaccine", with a few adjustments for things farther out in the supply chain. (Goal: "keep everyone safe".) This takes at least a year, more probably two or three. Horrific economic effects. In some places out of work, desperate, and possibly starving mobs storm legislatures, and are met with lethal force. In many countries, governments pay out much more than they take in and balloon their deficits and debts, then collude on "fixing" this via inflation. Worst case – runaway hyper inflation.
      – Lockdowns get more and more porous. Eventually we have two kinds of people: paranoid knowledge workers, and those who've had the virus. See scenarios above, but with higher economic costs.
      – A place like New Zealand or Prince Edward Island successfully reopens with contact tracing and long quarantines for visitors and travellers. Lost tourism dollars are partly replaced by new local industries, producing what can't easily be shipped in, but there's still significant unemployment etc.

      • The Nybbler says:

        – “Hammer and the dance” competently executed, with a goal of getting R0 < 1 and keeping it there. Travel (even within countries) remains heavily restricted so that localities that successfully reduce their local transmission/case load can enjoy benefits in the form of return to work. I think this is a winner, except it's probably not politically feasible, except for pocket handkerchief-size countries. Probably double the economic hit we've all already taken, and a slower recovery than "let's all get sick right away".

        This is not “double the economic hit we’ve already taken”. This is a “collapse the economy completely” economic hit for the United States. Not to mention spoiling one of the original political reasons for the United States, which is free travel between the several states. To keep R0 below 1 requires you keep measures at least as strict as those now in place in New York until virus extinction, and it’s going to take many months. Then you have to severely restrict international travel indefinitely. This is probably where Australia, South Korea, and New Zealand are going, and I don’t think they’re going to enjoy their newfound isolation.

        • DinoNerd says:

          From where I’m sitting in the SF Bay area, if we had a way to restrict travel in and out of the area, and didn’t have a state governor bound and determined that everyone in the state has to follow whatever rules are needed for LA county, we could have opening-with-social-distancing-measures for most workplaces already. Lots of folks might be working half time, or similar, or still be laid off, but more people would be getting more work. Combine this with good contact tracing, and we wouldn’t be doing as well as e.g. New Zealand at keeping everyone healthy, but OTOH, we’re also less dependent on tourism.

          And I’m OK with a policy that if you come from or visit an area which either has too many cases, or doesn’t provide trustworthy information about the number of cases, you are going into quarantine for 14 days, no exceptions, and you are doing that in a way we can enforce. Even if you come from LA.

          [Edit: with obvious provisions for transportation of goods – basically keep the drivers/crews from risky areas ‘outside’ isolated from the locals, then send them back with other goods. Container trucks/ships/trains/planes make that easier – no need for risk loading/unloading.]

          But as you point out, it’s not politically feasible. Your right to travel from your plague-ridden area, and come spread your disease in less plague-ridden areas, is more important than my right not to have you do that.

          • you are going into quarantine for 14 days

            Are you assuming there aren’t enough tests so we can require testing instead of quarantine?

          • Matt M says:

            I still find it super weird, bordering on unbelievable, that in an era where we’ve completely annihilated any sense that individuals have local rights that might trump “the state needs to prevent a plague”, we still respect these rights between various jurisdictions or what have you.

            Like, the same people who argue that I have no right to go down the block and get a haircut, because it might infect people, will defend to the death my ability to drive from New York City to rural Kentucky, even though that might infect people. It’s just bizarre.

          • DinoNerd says:

            Are you assuming there aren’t enough tests so we can require testing instead of quarantine?

            Yes, that was sloppy of me. If we have adequate tests, that don’t have a worrisome false negative rate, there’s no need for quarantine.

            OTOH, I don’t recall encountering any estimates of the false negative rates for current tests. It’s clearly non-zero, but how high is it?

            I recall that the antibody test used in the Santa Clara study is so prone to false negatives that the headline rate reported was approximately double the rate of positive tests – i.e. if you have antibodies, that test has a 50% chance of saying you do.

        • baconbits9 says:

          Then you have to severely restrict international travel indefinitely. This is probably where Australia, South Korea, and New Zealand are going, and I don’t think they’re going to enjoy their newfound isolation.

          If Australia tries this route they are going to have major economic problems. Their immigration rate over the past 20 years is a major driver of their economic growth (probably worth something like 20-25% of their GDP growth over that period).

          • John Schilling says:

            Yeah, nobody has to do this. Some nations have the option to chose between being a member of the community of nations that have to deal with this pandemic (and the next and the one after that), and being one more hermit kingdom with one less public health problem than everybody else. Australia at least has raw material exports that e.g. China will pay for even if Chinese can’t visit Australia; New Zealand’s material exports are more limited and more tied to New Zealand’s branding.

    • DinoNerd says:

      Addressing this comment more directly:

      What I’m stuck on is, if a world where we’re open and the virus is spreading causes even more economic damage than an 18 month lockdown, why can’t we lock down until there’s a vaccine? It will be terrible in lots of ways, but what is the basis for saying it’s worse than the alternative?

      The economic damage is cumulative over time. Businesses and families can weather a certain amount of reduced income. (Some more than others.) Then they fall off a virtual cliff, and become less able to recover.

      At best, each month without an income increases their debt; at worst, they liquidate everything they have at huge losses (few buyers, many sellers), such that possessions that could have kept them going for e.g. 10 years in better times – and took them 40 years to accumulate – now only keep them for one year.

      The first thought, of course, is that those few buyers will make out like bandits, and rehire everyone else after the end of the shutdown. Except one of the ways people will liquidate their assets is by failing to maintain them. Skipping regular maintenance tends to result in repair costs larger than the costs of the skipped maintenance, with potential for disaters. (PG&E failing to trim trees near power lines comes to mind as a cautionary tale.)

      A real economist could connect the dots better than I can, and find a lot more examples. But I’m sitting here, still employed, safe at home, and stressing about my now-to-be long-postponed retirement date. (My investments have crashed, like everyone else’s.) And I’m one of those in a really good position to weather this storm. Everyone who’s not WFH and not “essential” is already in worse shape than me, and the “Trump bucks” won’t last anyone 18 months. And some quantity of those either WFH or essential are already taking pay cuts or losing jobs, according to headlines I’ve read. I’d expect more next month, and more the month after that, as long as this lasts.

      • albatross11 says:

        It seems clear that a (say) 2 year lockdown can’t actually work. Lots of necessary things are not getting done right now for lockdown reasons, and that can be sustained for awhile, but not for a couple years. Many people are not working right now, and again that can be sustained for awhile out of savings plus stimulus plus side gigs, but it’s not going to be able to go on for all that long. So any plan that says “let’s lock down until a vaccine is available” simply can’t work, and it’s not worth worrying about.

        From the data we’ve seen, it seems like COVID-19 doesn’t actually spread all that quickly or well (most of the people on the Theodore Roosevelt and the Diamond Princess didn’t get it, despite close quarters and communal meals and limited ventilation and such), and it seems plausible (though more data is needed) that a lot of the spread comes from rare superspreader events that have an outsized impact on the world. This makes me think we could actually keep COVID-19 under control until a vaccine comes out, without trying to do something nuts like keeping everything locked down for a year or two.

        One way to approach this is the “hammer and the dance” idea, which is supposed to mean that during the lockdown, we get ready for broad testing and tracing of contacts and quarantines of individuals who are exposed. The whole point of this is that you *don’t* keep everything locked down forever, so I don’t think it’s unbearably expensive. Broad testing and contact tracing are things other countries are doing now, so it’s not like this is impossible.

        The other way to approach this (we need both, IMO) is to work out how to run something close to our normal life with minimal trasmission risk. How do you get back to work in an office building, or a factory floor, or a meat packing house, or a grocery store, or a school? How do we reopen restaurants and theaters and bars and sporting events–can we do that at all, or will some have to stay closed to avoid massive transmission?

        Based on what I understand so far, it seems possible to do this without wrecking the economy or breaking the bank, and it seems like *not* doing it will have high costs–not only sick and dying people, but also people who don’t know whether they’ve been sick yet going out of their way to avoid getting sick. Now, I’m not at all convinced that we will manage it, and it’s quite possible we’ll do some dumb set of policies that give us the worst of all worlds. But this does seem workable in principle.

  5. rahien.din says:

    Registering an error.

    Not to invite debate, but rather to show the form of the argument :
    In a previous thread, I kind of took it to Robin Hanson over his “Buy Health, Not Health Care” article. I accused him of, basically, begging the question. He posits that people would be healthier if they follow health advice, meaning an important cause of unhealthiness is that people don’t follow health advice. If his solution to unhealthiness requires that people follow health advice, then he has assumed that there is no problem. If following health advice is effective, then it should be effective in any health delivery system.

    Subsequently, I expressed incredulity at how a libertarian-leaning person could endorse a system that requires insurers to vet your daily actions. This slid into some further incredulity at libertarianism in general. Eventually I came to the conclusion “So if libertarianism is about anything, it must be about what choices I am permitted to offer to others.” Meaning, if libertarianism is to take positive effect, then our starting point must be our own personal obligations to other people.

    But I am making an error of the exact form that I accused Robin Hanson of.

    Basically, I’m begging the question : if society would work better if people started by thinking of others, then an important cause of societal dysfunction is people not thinking of others. If my solution to the problem of societal dysfunction requires that people be thinking of others, then I have assumed that there is no problem. If our societal/political starting point is “What are my personal obligations to other people?” then this would probably make any societal/political system effective.

  6. matkoniecz says:

    SSC Discord invite continues to be invalid.

  7. johan_larson says:

    Welcome to Hollywood. The studio you work for has secured the rights to a portion of the Lord of the Rings IP, and is figuring out how to monetize it. Specifically, they have the rights to appendices C through F: Family Trees, Shire Calendar, Writing and Spelling, and The Languages and Peoples of the Third Age. What sort of films do you propose to make from this material?

    • Deiseach says:

      What sort of films do you propose to make from this material?

      Murder mystery, perhaps in the style of Knives Out (haven’t seen it but have seen glowing reviews about it) based on:

      Pearl Took – Murderess?

      Indeed, Pearl Took – hired assassin? (The below is all canon, blame Tolkien not me).

      Lalia Clayhanger marries Fortinbras Took, head of the Took Clan and The Thain. After his death, she becomes the Matriarch of the family, (as is often customary amongst Hobbits), despite her son Ferumbras inheriting the position of Thain and being titular head. She waxes in both power and girth, gaining the name of Lalia The Great (or The Fat, by the less-gruntled) and rules with such a rod of iron, nobody is willing to marry Ferumbras (who has been shuffled off to a small set of rooms in The Smials instead of being the lord and master as he should be) and come live under the dominion of Lalia.

      Ferumbras’ cousin Paladin has better fortune, he marries and has four children (including our boy Peregrine). However, it’s Pippin’s sister Pearl that we are interested in.

      She is assigned to be a caretaker for Lalia, who by now is confined to a wheelchair (which does not stop her domineering everyone) and who likes to be wheeled to the door every morning to take the air. One morning, Pearl is a bit careless about this, and oops a daisy oh dear me, poor old Lalia gets tipped out of her chair, falls down the steps, and comes down with a sudden case of death.

      Cue sighs of relief all round.

      Pearl is ‘punished’ for her gross negligence by being forbidden from attending the celebrations for Ferumbras who finally gets to succeed to the role of Head of the Clan in fact as well as name only. Still, poor old Ferumbras dies single and heirless, and cousin Paladin succeeds him as Thain.

      Pearl is also seen, a short while later after Lalia’s death and Ferumbras’ accession, wearing a Took family heirloom necklace of pearls, which provokes a certain amount of gossip (hey, Hobbits are only human after all and they like a juicy scandal as much as the next person). A reward for a job well done? And/or payment for the hit? (Do we think no guv’nor it was an accident honest, she decided to bump off Lalia all off her own bat, or did the family drop heavy hints about quid pro quo?)

      EDIT:
      The Languages and Peoples of the Third Age

      This is more The Silmarillion proper than the Appendices, but Fëanor’s little hissy-fit about The Shibboleth Of Feanor is endlessly amusing to me; that The Greatest Genius Of Elvendom Ever, Past Present Or To Come was so petty makes me laugh every time.

      We speak as is right, and as King Finwë himself did before he was led astray. We are his heirs by right and the elder house. Let them sá-sí, if they can speak no better.

      • cassander says:

        A farce with martin freeman’s bilbo dealing with his various relations, legal wranglings, and neighbors after getting back from his adventure would be an absolutely wonderful movie/series.

        • Nick says:

          There’s got to be just one callback where he’s in a tough spot and uses the Ring to escape.

        • Deiseach says:

          bilbo dealing with his various relations, legal wranglings, and neighbors after getting back from his adventure

          It could give us the backstory behind all the birthday gifts at his going-away party:

          Some of the visitors he invited to come inside, as Bilbo had left “messages” for them. Inside in the hall there was piled a large assortment of packages and parcels and small articles of furniture. On every item there was a label tied. There were several labels of this sort:

          For ADELARD TOOK, for his VERY OWN, from Bilbo; on an umbrella. Adelard had carried off many unlabelled ones.

          For DORA BAGGINS in memory of a LONG correspondence, with love from Bilbo; on a large waste-paper basket. Dora was Drogo’s sister and the eldest surviving female relative of Bilbo and Frodo; she was ninety-nine, and had written reams of good advice for more
          than half a century.

          For MILO BURROWS, hoping it will be useful, from B.B; on a gold pen and ink-bottle. Milo never answered letters.

          For ANGELICA”S use, from Uncle Bilbo; on a round convex mirror. She was a young Baggins, and too obviously considered her face shapely.

          For the collection of HUGO BRACEGIRDLE, from a contributor; on an (empty) book-case. Hugo was a great borrower of books, and worse than usual at returning them.

          For LOBELIA SACKVILLE-BAGGINS, as a PRESENT; on a case of silver spoons. Bilbo believed that she had acquired a good many of his spoons, while he was away on his former journey. Lobelia knew that quite well. When she arrived later in the day, she took the point at once, but she also took the spoons.

      • matkoniecz says:

        Fëanor’s little hissy-fit about The Shibboleth Of Feanor

        This is great

        he saw the growing adoption of s by the Noldor, and especially now by Finwë and Indis themselves, as a deliberate insult to his mother and a plot by the Valar to weaken his influence amongst the Noldor

        also

        According to Christopher Tolkien it is typical of his father’s latest work on the legendarium in that the production of new material resulted largely from discursive attempts to explain anomalies and unanswered questions in his earlier work, usually philological in nature, which often led to treatments of widely varying subjects.

        is really interesting

        • Deiseach says:

          he saw the growing adoption of s by the Noldor, and especially now by Finwë and Indis themselves, as a deliberate insult to his mother and a plot by the Valar to weaken his influence amongst the Noldor

          Yep, that’s our boy. “Self-centred” doesn’t even begin to describe him, and he has more issues than a newsagent’s shelves. He’d think the sun shone out of his own backside, were it not that he existed prior to the Sun and probably looked down his nose at it as shoddy Valar workmanship 😀

          • Evan Þ says:

            He not only existed prior to the Sun but also died prior to the Sun, so he lamentably didn’t get a chance to look down his nose at it. 😀

          • Deiseach says:

            He not only existed prior to the Sun but also died prior to the Sun, so he lamentably didn’t get a chance to look down his nose at it

            If he heard about it in the Halls of Mandos from all his sons (and other family members, and other unrelated Elves) who died following in his footsteps, he would definitely have looked down his nose at it: “Sun? What’s that? Oh, some bodge job those incompetents threw together instead of helping you regain my Silmarils, which are objectively superior as light sources! Typical!” 😀

      • Nick says:

        Not only petty, @Deiseach, but mundane! Fëanor is rather like our own literati issuing jeremiads about linguistic changes. See here for a taste of it, concerning the replacement of the passival with the progressive passive in English:

        [it’s the worst of] those intruders in language … which, about seventy or eighty years ago, began to affront the eye, torment the ear, and assault the common sense of the speaker of plain and idiomatic English

        Liberman links the full text at the end.

    • Bobobob says:

      Assuming the Shire calendar has 12 months and there are at least a dozen family trees, that’s 25 years’ worth of Peter Jackson movies right there.

      • EchoChaos says:

        Assuming the Shire calendar has 12 months

        Don’t forget the days of Lithe and Yule, which aren’t part of any of the months.

      • johan_larson says:

        The chapter in question has four family trees, one for each of the hobbits in the fellowship.

    • Jaskologist says:

      Golden Girls, but it’s hobbits.

  8. sunnydestroy says:

    Has anyone here tried Direct Primary Care?

    I’m considering trying it out and looking for some experience reports or things to be aware of. Also, if anyone can recommend places near San Jose, that would also be very helpful.

  9. ausmax says:

    I have a charity question. My wife wants to give to this charity since she’s from Atlanta and the mayor of Atlanta just recommended it: https://secure.givelively.org/donate/united-way-of-greater-atlanta-inc/atlstrong-fund

    For some reason I have it in my head that united way is a particularly inefficient charity, but I haven’t been able to find my source for that. I found this on givewell: https://www.givewell.org/international/disaster-relief/united-way which suggests that they are at least bad at spending a reasonable percentage of disaster relief funds, but that seems very specific. Does anyone have any thoughts on this? I don’t mind slightly inefficient charities (I’m not a purist by effective altruist standards), but I do lean towards trying to maximize the impact of my giving at least. Appreciate any advice.

    • zoozoc says:

      Isn’t United Way inefficient in the sense that they don’t do any charity work themselves, but simply give the money to other charities? I suppose in some ways it might be more efficient as they can focus on fundraising whereas other charities can focus on their mission. But I don’t think this ends up being the case.

      Donating to United Way basically offloads the giver’s task of having to choose which charity to give to and let’s them choose instead. If you trust that United Way is better at picking charities than you are, then you should give to them.

      • gbdub says:

        In some sense they are a less rationality oriented version of effective altruism – they focus on fundraising yes (so they are probably better and more efficient at it than most of the small charities), but they also have a vetting process where they evaluate charities for effectiveness and alignment with United Way’s broad goals.

        Their other service is frankly distancing / buffering for corporate donors. In a world where the Boy Scouts and Salvation Army can suddenly become 3rd rails, United Way is a good way for companies to generate generic charitable goodfeels without risking controversy.

        • Matt M says:

          Yeah, this is what I was thinking as well. Giving to United Way is like giving to GiveWell, only without all the nerdy math stuff behind it.

      • ausmax says:

        that’s all interesting. It sounds like there isn’t a particularly compelling reason not to give to them. I’m not sure that I’m particularly good at picking charities, so as long as United Way isn’t too misaligned with my values, which they don’t seem to be, this seems like an unwasteful donation.

      • Evan Þ says:

        United Way does do at least a bit of charity work themselves; they organize my chapter of the VITA tax prep volunteer program under contract with the IRS.

    • Douglas Knight says:

      You don’t think that they lie about fundraising and don’t do anything is a generalizable conclusion?

      Like most charities, United Way is simply a patronage network that makes the world worse.

    • VoiceOfTheVoid says:

      Cynical argument: Your prior should be that most charities are mostly ineffective until proven otherwise, so you don’t need specific evidence of inefficiency to reconsider donating; you should need specific evidence of efficiency to consider donation in the first place.

      Even more cynical argument: Despite their years of research, Givewell’s evidence for even their most trusted charities is incomplete and debatable, so no charity has ironclad evidence of effectiveness.

      Actual position: Consider donating to Against Malaria Foundation and/or GiveDirectly as well, but United Way looks pretty fine to me.

  10. Wrong Species says:

    People will make a prediction about why they think some trend is going to start/end, it won’t happen and then people will dismiss them for being wrong and “explain” why they were wrong. A good thing to keep in mind is sometimes the original reasoning is completely valid, it’s just taking longer than they expected.

    • Garrett says:

      “The market can remain irrational longer than you can remain solvent.”

      – Probably Gary Shilling, frequently attributed to Keynes.

      • How long you can remain solvent, in the context of market speculation, depends on what particular bets you choose to make. If you correctly estimate how long the market will remain irrational, you make bets that come due in a longer time than that.

        • DarkTigger says:

          Longer bet’s might be to expensiv for your current bankroll (or at least to expensiv for your risk migitation strategy).

    • Faza (TCM) says:

      Also, “In the long run we are all dead” – which actually is Keynes.

    • Christophe Biocca says:

      A good thing to keep in mind is sometimes the original reasoning is completely valid, it’s just taking longer than they expected.

      That’s also the excuse made for failed predictions. Paul Ehrlich is still at it, half a century later.

      • Wrong Species says:

        I don’t know. That seems like a good claim for something that people have dismissed but could be proven right in the long run. The idea that if you have too many people, you start running in to serious problems is sound reasoning but it is more complicated than “more people=more problems”. Let’s say 100 years pass and then his predictions come true. Wouldn’t he look prescient?

        There’s a good example of this in the movie The Big Short. Christian Bale’s character helps make decisions for this investment firm. He notices some discrepancies in the data, sees a crash coming and bets against the housing market. The deal he makes is that every day the housing market does well, he loses money. It’s only if there’s a crash does he make anything back.

        He makes this deal right when everyone else is extremely bullish about the market. His investors try to pull out but he has the power to lock them in to do his deal. They are continuously losing money this whole time, until they don’t. The housing market crashes and then this investment firm makes a ridiculously large rate of return. He was completely vindicated and focusing on all the times he lost money is missing the point.

        Of course, we only know that from hindsight. You can’t just believe everyone who says they will be vindicated in the end, otherwise your brain will fall out. I’m merely suggesting that you should have more uncertainty over claims that some prediction has been “discredited”.

        • Faza (TCM) says:

          The problem with things that may prove true in the long run is that even a broken clock is right twice a day. If you predict something that is not actually impossible, chances are good it will happen at some point if you wait long enough. That doesn’t actually make you prescient.

          ETA:
          On reflection, it’s a special case of the Texas sharpshooter fallacy.

          • Wrong Species says:

            You probably have to look in to the specifics of the claim itself. The pundit who has spent the last ten years warning about another recession is different from the guy who bet against the housing market back pre Great Recession.

            If you predict something that is not actually impossible, chances are good it will happen at some point if you wait long enough.

            Bill Gates spent years warning about a global pandemic. It took a while but here we are. Would you not say he has been proven right?

          • baconbits9 says:

            This assumes your prediction stays static, which isn’t a necessary one.

          • Faza (TCM) says:

            Bill Gates spent years warning about a global pandemic. It took a while but here we are. Would you not say he has been proven right?

            No, that’s the Texas sharpshooter fallacy to a tee.

            We know epidemics happen. Saying that we’ll have an epidemic on a global scale at some unspecified point in the future doesn’t tell us anything we didn’t know already.

            Worse still, all we’ve learned so far is how woefully unprepared we are to deal with a proper global pandemic* – starting from the UN/WHO and working on down. Nobody’s gonna come out of this smelling of roses, except – maybe – the Swedes.

            * ETA: When we actually have a proper, existential-threat level pandemic, I mean.

          • Wrong Species says:

            @Faza

            You say that epidemics just happen so no one gets any points for predicting that. But clearly few people were taking it seriously enough to do anything about it. This is clearly a point where we can say that if we had listened to him, we would have been better off. It looks like South Korea took the idea seriously and look how much better off they are.

            It sounds like you are saying no prediction can ever be vindicated, and anyone who thinks otherwise is committing a “fallacy”. When exactly do you think a prediction coming true should be considered validated?

          • matkoniecz says:

            We know epidemics happen. Saying that we’ll have an epidemic on a global scale at some unspecified point in the future

            Surprising number of people were claiming that pandemics of any serious illness are nowadays impossible, or were acting like that.

            “serious pandemic will sooner or later happen” is not an obvious claim

            doesn’t tell us anything we didn’t know already.

            It tells us that there should be some basic level of planning and preparation and serious signs of new one should not be ignored.

            No, that’s the Texas sharpshooter fallacy to a tee.

            It would be if for 20 years he would predict “pandemic will happen within next 12 months”. Or if he would claim “I predicted years ago that in 2019/2020 we will have a pandemic”.

            “I predicted this pandemic” is still true for him.

            —–

            Similarly, I predict that sooner or later we will be devastated by a serious solar flare. It is prediction based on facts, and it is actionable. And it is not Texas sharpshooter fallacy to predict something that will sooner or later happen.

            Once serious solar flare will happen (with serious economic damage – many satellites gone and/or power grid failures) I will be able to claim that I predicted this (hopefully it will not happen in my lifetime). But unable to claim that I predicted solar flare happening on a specific date.

            “We will be hit by a severe solar flare on 2025-09-12” is a blatant crackpottery, “Sooner or later we will be hit by a serious solar flare and risk is high enough to treat it seriously” is a prediction.

            And once will have over, for example, 10 000 death caused by solar flare everyone will claim that (s)he predicted this or that it was impossible to predict.

          • Faza (TCM) says:

            You say that epidemics just happen so no one gets any points for predicting that. But clearly few people were taking it seriously enough to do anything about it.

            No, I’m saying that for a prediction to be worth anything it must be actionable.

            Bill Gates doesn’t get any points for predicting global epidemics years in advance, unless he said specifically that there will be a coronavirus epidemic in early 2020 and I don’t believe he ever said anything of the sort.

            It looks like South Korea took the idea seriously and look how much better off they are.

            South Korea reacted to an epidemic that was already confirmed, right next-door, as it were. It appears they reacted wisely.

            The rest of the world had roughly the same time to react as South Korea did, but chose to act differently. It was, in my opinion, a poor choice and the results could be – and were – predicted in advance. We can look back on the predictions and see who got it mostly right and who got it mostly wrong.

            Where this differs from an unbounded prediction is in identifying the specific set of circumstances for which the prediction will be held to be true.

            If I predict a 50% drop in GDP over the next six months (being fanciful here) and the actual drop is only 5%, my prediction will have been horribly wrong even if at some hitherto unspecified point in the far future GDP does, in fact, drop 50%. Any decisions made with the assumption of a 50% drop – when GDP is only set to drop 5% over the time frame – will be actively harmful.

            Surprising number of people were claiming that pandemics of any serious illness are nowadays impossible, or were acting like that.

            “serious pandemic will sooner or later happen” is not an obvious claim

            It is obvious. The fact that people choose to ignore the obvious doesn’t make it any less so. Living in the same country as me (and hence, facing the same issues of the day) you shouldn’t be surprised at this.

          • HeelBearCub says:

            No, I’m saying that for a prediction to be worth anything it must be actionable.

            “A pandemic will occur at some point, and here are likely sources of that pandemic, and here are things we can do to prepare for it” is an actionable prediction, though.

          • matkoniecz says:

            I’m saying that for a prediction to be worth anything it must be actionable.

            It is actionable. For example laws allowing doing some things remotely, possible activated only in an emergency would be useful.

            For example allowing to conduct parliament session remotely. That would fix stupidity of choosing between spreading infection among member of parliament and breaking law by conducting session in a way that breaks set rules.

            Or basic plans for handling pandemic.

            Or testing effective methods for controlling spread of typical pandemic vectors. Look at previous pandemic, look at transmission vectors and design emergency method for controlling that in case of unusually deadly or unusually infectious virus/bacteria/.. will appear.

            Or provisions in law allowing to postpone elections (due to epidemic) not bundled with permission to activate censorship. Upcoming elections in Poland will be a ridiculous shitshow, in small part due to bundling all serious emergency overrides in one package.

            Bill Gates doesn’t get any points for predicting global epidemics years in advance, unless he said specifically that there will be a coronavirus epidemic in early 2020 and I don’t believe he ever said anything of the sort.

            All of that what I mentioned is not requiring such ridiculously specific prediction.

          • albatross11 says:

            Yep. Indeed, to the extent we’ve had a functional response, it was largely because when H1N1 flu arose a decade or so ago, lots of people wrote up pandemic plans, stockpiled supplies, etc. In subsequent years, it looks like not so many people were maintaining those supplies (some were left to expire, some were consumed to save a little money in this year’s operating budget), and not so many people were keeping those plans updated and such.

            Planning for foreseeable crises is one of the core things that the management of any organization is supposed to do. That ranges from keeping a rainy-day fund to having plans written down for how to deal with stuff you know might happen–hurricaines, ice storms, whatever. The problem is, this is a function of management that is seldom tested, and so it’s easy for today’s management to ignore it on the theory that the crisis is unlikely to come during their watch, or for the plans for responding to the crisis to be completely screwy and nobody notices until the crisis happens.

        • Christophe Biocca says:

          The distinction I’d make is that the housing market short had a time horizon over which it would either be vindicated or lose so much money that it would clearly be wrong.

          If you tell people to sell their stock in 1985 because there will be a crash, the fact that there is one in 1987 does not vindicate you if it still ends up above were you told people to sell.

          Ehrlich’s position isn’t merely “We might one day have a population problem”, it’s:

          [i]n the 1970s hundreds of millions of people will starve to death in spite of any crash programs embarked upon now.

          This did not happen. The actual trend ended up that we’re feeding more people better with essentially flat agricultural land usage over the last decades, and population growth is slowing with each passing year. So not only did the prediction not come true, it’s getting further away from happening with each passing year.

          • Anteros says:

            Spot on.
            He makes his case even worse by currently claiming he was too optimistic

          • matkoniecz says:

            He makes his case even worse by currently claiming he was too optimistic

            Wat? How he reconciles it with facts that clearly falsified “in the 1970s hundreds of millions of people will starve to death” prediction?

            Is he lying about his predictions, claiming conspiracy that hid millions of starvation deaths or what?

          • Christophe Biocca says:

            Wat? How he reconciles it with facts that clearly falsified “in the 1970s hundreds of millions of people will starve to death” prediction?

            Is he lying about his predictions, claiming conspiracy that hid millions of starvation deaths or what?

            No he’s saying we’ve taken steps that stopped those deaths at the cost of causing even more deaths in the future, because we’re now above the long-term sustainable population limit. There’s a reason I picked the guy as an example of saying “I will eventually be-vindicated” to avoid admitting you’re wrong.

          • matkoniecz says:

            Thanks for reply!

            OK, this is both less chemtrails-level stupid and even more arrogant.

            And he would probably claim to be vindicated by any tragic even that would cause global population to be lowered.

        • There are two different questions:

          1. Will overpopulation eventually become a problem? The answer is that we don’t know.

          2. Is Ehrlich someone whose views about the future should be taken seriously? The answer is no. He made a prediction with great confidence, it turned out to be wildly wrong. Hence he is either incompetent or, if he didn’t really have the confidence he claimed to have, dishonest, and in either case his predictions are worthless.

          Ehrlich himself, of course, isn’t very important. The important conclusion is that a public perception that all the experts agree about some impending catastrophe is only weak evidence it is true, even weaker if most of the sources of that perception are people who would approve of the things that are proposed necessary to prevent the catastrophe even if they did not believe in the catastrophe.

          Which is the connection between the population issues of fifty years ago and my views on the current climate debate.

  11. BBA says:

    Today was supposed to be the day of the New York presidential primary. But for the same reason as everything else, the primary was postponed until June 23, to coincide with our state’s congressional and local primaries. Fair enough.

    There were eleven candidates who jumped through all the necessary hoops to get their names on the ballot way back in the Paleolithic, but ten of those eleven candidates have since dropped out, so yesterday the State Board of Elections ruled that those ten candidates should be removed from the ballot, and since the primary will be uncontested, as provided in Article I, Section 1 of the state constitution it will not be held at all. Biden has been awarded the 274 delegates from New York by default.

    Cue endless screams of “RIGGED!!!” from rabid Bernie Sanders supporters – never mind that Sanders himself has dropped out and endorsed Biden, he hasn’t quite been mathematically eliminated yet! This does mean that Biden only needs 1/3 of the remaining delegates to lock the nomination down. It’s all over but the shouting, but oh, will there be shouting.

    Personally I’m a little miffed that I won’t have a chance to cast a protest vote for Elizabeth Warren, but that’s neither here nor there.

    • EchoChaos says:

      Embarrassing. New York should be ashamed of herself. Cancelling elections is the most un-American thing I can possibly think of.

      Yes, it’s a primary, but it’s still offensive.

      And for all the CW folks, yes, I will be this angry at Republicans who do the same.

      • Clutzy says:

        Again, the problem with the theory that this is an extraordinary time, is that it is an empiraclly untrue claim. Hong Kong and Asian flu in the 50s and 60s were probably equal in virulence given world interconnection and populace, 1918 Spanish flu was much worse. If Polio, Measels, or whooping cough mutates to not be stopped by current vaccines, they will all be much worse, etc etc.

      • broblawsky says:

        And for all the CW folks, yes, I will be this angry at Republicans who do the same.

        Including the Kansas, Nevada, and SC GOPs? Also Alaska and Arizona, I think. That was all pre-coronavirus, too.

        Edit: I recognize that this is whataboutism, but @EchoChaos did kind of ask for it.

        • EchoChaos says:

          Yes, that’s embarrassing, although somewhat less so with an incumbent. I believe not holding a full primary against an incumbent is at least understandable.

          • broblawsky says:

            And that seems like special pleading.

          • EchoChaos says:

            @broblawsky

            No, it’s still embarrassing. Just somewhat less so.

          • meh says:

            can you expand on why it is less embarrassing with an incumbent?

            from what i can see, one uncontested primary was cancelled, and many contested primaries were cancelled.

          • meh says:

            previous comments have often insinuated that new yorkers aren’t ‘real americans’. why is the distinction simply not a result of this bias?

          • EchoChaos says:

            @meh

            I have been part of real-life protests against the Republican party for not holding primary elections properly, while I’ve never protested the Democrats for doing that, just called them an embarrassment.

            Not holding elections, for either party and in primary or general is an embarrassment. I understand it somewhat with an incumbent, but it’s still an embarrassment.

      • m.alex.matt says:

        None of the other candidates are running anymore. There’s nothing embarrassing about it.

    • Edward Scizorhands says:

      Haven’t candidates done other things than “cancel” their campaigns, like “suspended” or “paused” them?

      It seems wrong that they should be removed from the ballot. If someone wants to cast their vote into the void, I will always support them in that. It’s your vote, do what you want with it.

      • BBA says:

        The relevant portion of the Election Law provides:

        if a candidate for office of the president of the United States…publicly announces that they are no longer seeking the nomination for the office of president of the United States, or if the candidate publicly announces that they are terminating or suspending their campaign, or if the candidate sends a letter to the state board of elections indicating they no longer wish to appear on the ballot, the state board of elections may determine…that the candidate is no longer eligible and omit said candidate from the ballot

        So legally, at least for purposes of the 2020 New York Democratic primary (as the state has separate laws for D and R primaries and they’re completely rewritten every four years to comply with DNC and RNC requirements, ain’t Calvinball fun), “suspending” and “terminating” a campaign are one and the same.

        Note also that there is no Republican primary in NY because none of Trump’s challengers for the nomination qualified for the ballot.

        • Aapje says:

          This seems undemocratic. Firstly, legally there doesn’t seem to be any such official status that should be registered with the state, nor a requirement that makes a campaign suspended. So legally, there doesn’t seem to be a difference between the candidate declaring the campaign ‘magnificent’ or declaring it to be ‘suspended.’

          In fact, as far as I can tell, the entire concept of suspending the campaign was invented so politicians could tell the electorate something, without it having legal consequences.

          Secondly, what business is it of election law what candidates do to get votes? Should Biden be removed if he thinks that he can coast on the campaigning he’s done so far and stop active campaigning? Does this then even mean that he suspended his campaign or can some people then just arbitrarily decide whether he did? Should candidates be removed that never had the means for a campaign or that simply decided to run without one?

  12. salvorhardin says:

    CA governor Newsom just announced California’s reopening plan. The next phase, which he says is coming in “weeks not months” though with no precise date, includes reopening of childcare and summer camps, and he also said they’re going to try and start the 2020-21 school year early. As a parent, this is extremely good news to me, though of course much could happen to frustrate it. Outdoor restrictions also get relaxed in the next phase, so less public health theater. Hair salons, gyms, movie theaters etc are lower priority and probably months out, and it sounds like dine-in restaurants probably are as well; concert and sporting venues explicitly will not reopen until there’s an effective therapy or vaccine.

    Overall sounds like a relatively sane and cost-benefit informed approach. Any bets on what other states will follow the CA example and how soon we’ll actually get to the next phase?

    • John Schilling says:

      I’m going to question the “cost-benefit informedness” of keeping the concert venues and dine-in restaurants closed; the best evidence I’ve been able to find suggests that those are mostly low-risk if reasonable precautions are taken. And I was hoping for more detail on when offices, factories, and retail sales outlets would reopen.

      • albatross11 says:

        John:

        We have at least one documented superspreader event in a restaurant. We also have documented superspreader events in churches, which seems not all that different from an indoor concert venue assuming the church sings some songs. (Probably more cheering and yelling than singing from the audience in a concert venue, but those both seem about as well-suited to launching big droplets across the room as singing.) Based on what we know now, it seems like those should both stay closed, to me. What am I missing?

      • Radu Floricica says:

        From your link a couple of threads ago I got an image that “loud speaking towards somebody is high risk of infection”. I have no problem imagining this scenario many times a day between waiters and patrons – some are bound to be noisy with one person raising voice and the other moving the face a bit closer to hear.
        Plus yeah, in the super spreader restaurant in China people downstream an aircon airflow from an infected person were at high risk. Obviously no masks when eating.

      • John Schilling says:

        There were an awful lot of restaurants open in February and early March, and quite a few superspreader events observed. If the intersection between those two is a single restaurant-related event, then the takeaway should be “let’s look at what this restaurant may have done wrong”, not “we must close all restaurants for the next year”. And if your idea of modal or even two-sigma restaurant behavior involves waitstaff and patrons shouting at each other at any significant fraction of e.g. Mardi-Gras level intensity, you maybe need to patronize different restaurants.

        Regarding concerts and churches, those aren’t exactly one-size-fits-all either. If the argument is, “I’ve heard that churches have singing, so we should treat them like rock concerts and shut them down”, no way does that pass strict scrutiny in the US and you’re going to need to look at more targeted solutions. And then apply them to the concerts as well.

        And then there’s the bit about the schools. There’s been one superspreader incident I know of traced to a restaurant, and one to a school. But we’re committing to reopening the schools early and the restaurants not at all? Children don’t seem to develop COVID-19 symptoms, true, but since much of the current public health theater is based on the concern of asymptomatic spreading, this is a curious deviation from that norm – and also curious that I haven’t seen much of any actual investigation of transmission dynamics in school settings. Newsom committing to reopening the schools early, is practically an admission that this policy is being driven by what will have Democratic voters yelling at him the loudest, not by relative danger.

        • Matt M says:

          Newsom committing to reopening the schools early, is practically an admission that this policy is being driven by what will have Democratic voters yelling at him the loudest, not by relative danger.

          Just for the record, it is my belief that this is absolutely true, for all politicians, in both parties, at federal, state, and local levels. Everyone is doing what they think will get them the most votes.

        • salvorhardin says:

          Agreed that this is not driven by relative danger but by voter anger/impatience. But in this case it’s at least plausible that a cost/benefit calculation would give the same result: schools are more “essential” than dine-in restaurants in a lot of ways– even if you discount any human capital development effects and think only of the childcare provision for the parents now trying to juggle childcare and work.

        • albatross11 says:

          John:

          I don’t think we have nearly enough data to feel like we’re getting a representative sample of superspreader events, nor of more low-number spread. I think it’s really a bad idea to work from the assumption that if we don’t have a documented case of transmission in exactly this situation (say, a rock concert) that therefore that must not be a place where transmission happens.

          As best I can tell, we have probably only traced a really tiny fraction of transmission events. Probably more superspreader events, but even there, I bet we’re missing a large number, probably a majority, even of those. So I think it’s nuts to try to make arguments that because we haven’t documented a transmission in environment X that therefore transmissions must not happen in environment X.

          • John Schilling says:

            OK, but that brings us back to why are we reopening the schools? It’s just as plausible that there are lots of unrecorded school-superspreaders as there are for restaurants, so if the standard is “we’re not sure this is safe…”, then the schools should stay closed.

          • Edward Scizorhands says:

            1. California schools aren’t opening today. Newsom said that might happen by July.

            2. This gives time to work on plans to design schools to be less likely to be spreader environments, such as avoiding many students traveling at once. I’m sure someone will complain that these plans aren’t happening / aren’t happening fast enough / should have already happened / are lies and okay.

            3. Schools are an essential part of the economy because they enable parents to work and many of those parents are working at things we need running to keep the food, power, and internet flowing. The daycare aspect is very significant here. Like keeping a pork plant running despite the increased risks to workers because its output is needed so much. (I’m not saying you necessarily need to agree with the trade-off there, but you can see that’s the argument.)

          • baconbits9 says:

            2. This gives time to work on plans to design schools to be less likely to be spreader environments, such as avoiding many students traveling at once. I’m sure someone will complain that these plans aren’t happening / aren’t happening fast enough / should have already happened / are lies and I just can’t with that any more.

            To reduce the likelihood of something being a spreading environment you actually need a good model of what a spreading environment is and a good model of how people are going to react to the shift in policies. It won’t do a damn bit of good to have students not show up at the same time if it causes a knock on effect that makes other more dangerous behaviors common.

            California schools aren’t opening today. Newsom said that might happen by July.

            From what we do know of the virus it appears that being outside in high humidity, high sunlight places should give you the lowest transmission rates. Why would we reopen schools in July, when we have hot, humid weather with lots of outdoor activities for kids (in many places) and instead put them in air conditioned buildings and think this is a good idea?

          • Schools are an essential part of the economy because they enable parents to work

            A lot of people say things like that. It makes an odd contrast with the usual argument for a public school system, which has something to do with education.

            In the case of small children, it makes some sense. But I don’t see why someone of high school age shouldn’t be able to be home alone, or doing things in a park, or socializing with friends, during his parents’ working hours. Probably true for an eleven or twelve year old as well. Most parents nowadays have cell phones, so if there is some emergency, which is unlikely, they can be reached.

            Suppose they reopened the primary schools alone. Would most parents of kids older than that feel they had to stay home to watch them? Should they?

          • Purplehermann says:

            @David Friedman I’ve heard talk of sending only 3rd grade down back to school.
            I think people feel that once kids are in school, might as well just send all of them. The infection will spread anyway.

          • Edward Scizorhands says:

            I know we aren’t supposed to say that schools are day cares, but this is SSC and we’ve repeatedly acknowledged that. Seattle closed the schools because it would make parents stay home. It was the region-wide trigger.

            Elementary school kids are the easiest to manage. They usually all stay together in one room. They have bad hygiene, especially as you get younger. You can throw more manpower at this. Smaller class sizes is another way.

            Older teenagers without supervision are typically a major societal problem. (David Friedman looking at his super-competent children is probably not seeing a good model of what most teenagers would do.) Maybe we don’t need to worry about them criming so much if lots of people are staying at home and watching things.

    • zoozoc says:

      My only quibble with the plan is that there are a lot of businesses (like hair salons), where instead of forcing the businesses to be closed, you could instead require masks to be worn instead. Masks might not be as effective as having no activity, but on the other hand, you are essentially forcing businesses to operate under the radar if they want to survive. So in some scenarios it would actually be more effective than the status quo.

      • salvorhardin says:

        The implicit assumption with salons, AIUI, is that having the stylist’s hands on the client’s head for that long, and the stylist themself in physical proximity sufficient to let them get their hands on, is such a large risk that masks can’t mitigate it enough. Probably this needs more study to understand if it’s really that bad, but it plausibly might be.

        • baconbits9 says:

          Your implicit assumption is that things have to be proved to be safe before they can resume, since we can’t particularly prove things to be safe then the logical extension is that we shouldn’t open anything.

          • Matt M says:

            Right. Think of the “known to the state of California to potentially cause cancer” labels. They put those up on everything. But notice that they don’t actually ban any of those things. Because it turns out that proving something absolutely 100% is guaranteed to never cause cancer is near impossible, and because voters don’t actually want to live without everything that cannot satisfy such a demand.

            The notion that we’re going to ban everything that cannot be 100% proven to not promote the spread of COVID is simply absurd.

  13. FLWAB says:

    My state is easing it’s lockdown to allow some non-essential business to reopen on a restricted bases (restaurants are reservation only, only household members can eat together, 20% capacity, etc) and one of the restrictions is that for retail stores all customers need to be wearing masks (exact wording is a “cloth face covering” so DYI masks must count). I’m happy to be able to buy some stuff I’ve been waiting on, but I don’t have a mask. I went to Wal-Mart (sans mask! I’m a criminal!) looking for masks or mask substitutes, but found nothing. My wife has told me in strong terms that she has no interest in sewing a mask herself, and I must admit I’m not exactly champing at the bit to try to sew one myself.

    However, when I’m out and about I’d say the majority of people I see are wearing masks. Where are they getting them from? How am I supposed to comply with the new mask restrictions when nobody is selling masks? I could order one online, but I don’t think one will arrive for several weeks. I’m I just supposed to wear neckerchief as a piece of public health theater? Where is everyone getting these masks?

    • I have seen descriptions online of ways of making a mask that does not require any sewing.

    • matkoniecz says:

      However, when I’m out and about I’d say the majority of people I see are wearing masks. Where are they getting them from?

      In Poland (and also other European countries) many people started small scale production (making less than 40 masks) in home and either were gifting them to friends/family or selling them.

      Maybe someone bored/looking for cash is doing something like that nearby?

      • FLWAB says:

        A lot of them do seem like they might be home-made. Too bad all the craft markets were banned, I’m sure some nice ladies could be making a mint right now! It would help me too.

    • Lambert says:

      A kefiyyeh, bandana or kerchief over the mouth and nose ought to either absorb droplets or redirect them downwards.

      • beleester says:

        The CDC has instructions for cutting a T-shirt into a mask, and for turning a bandana into a mask with the help of a pair of elastic bands.

        You could probably also use a T-shirt ninja mask, if you don’t want to cut up your shirt.

        I’ve tried using a scarf, but without a way to hold it over the ears it had a bad tendency to slide off of my nose. Something that ties tightly around your head is a better option.

        • AG says:

          Last OT someone mentioned a study showing that tying a pantyhose over a cloth mask strongly ups its effectiveness by making a better seal.

    • AlesZiegler says:

      In Czechia, government declared sewing shops, where one can buy supplies for homemade production, to be an essential business which has an exception from retail lockdown.

      I got my homemade mask for free as a gift from an acquitance. But surgical masks are more comfortable for outdoor activities (in addition to being better from health perspective), so now I am using those instead.

    • VanBuren says:

      If your town has a local Facebook group or some kind of mailing list, check there. My town’s Facebook list has frequent posts by crafters who make masks and sell them or give them away, and occasional posts by people seeking masks. There are also a lot of homemade masks available on Etsy, though they probably cost more and have higher shipping times than something made locally.

    • zoozoc says:

      I am (or was) seeing a lot online with people sewing masks. And there are small businesses that can be found on Facebook and elsewhere that are women who will sell home-sewn masks.

      Sadly, it seems like the fast majority of the volunteer mask-sewing was simply donating their masks to hospitals, where I think they will remain unused. People just don’t seem to think that masks are necessary for themselves or their local communities.

  14. mrjeremyfade says:

    I have a history podcast. Hanging With History, available most everywhere. There are 6 episodes online so far, coming out at a weekly pace. With 14 episodes written.
    The theme is the Industrial Revolution, (That Miracle that Happened That One Time) so the focus is on Britain. And I’m approaching it slowly, because why not? There are many possible contributing causes and many circumstances made Britain unique. And I’m trying to have some fun with it. I hope you enjoy it.

  15. DinoNerd says:

    Deep in a thread, where reply no longer works, Matt M posted:

    Noble lies backfire, especially when they’re about observable things.

    [This is a brief snippet – the comment is long and probably worth reading.]

    He’s discussing in particular statements by “mainstream US media and mainstream politicians”.

    There’s no question that much of what I’m reading about Covid-19 and the public health measures intended to contain it is variously inaccurate, incomplete, misleading, and sometimes incoherent.

    My question is whether it’s any worse than what I get to read about other topics, from news media, politicians, advertisers and net.randos, both mainstream and otherwise. Or if it’s worse in any checkable way.

    Advertising is a particular pet peeve of mine – while it often includes nothing falsifiable, it’s usually intentionally misleading. I’d argue that it’s the leading edge of post-Truth, aka “believe whatever you want, and if you assert it loudly enough, and appear high status enough, others will come to share your belief.” But all those other categories – including first politicians, then media – are eagerly following in the advertisers’ footsteps.

    In general, the mainstream varieties of all these (including ads) are a bit less blatant than those farther out on the fringes, though to the extent a person has strong beliefs not acceptable to the mainstream, that tends to seem a bit less true. (Check mainstream sources for something you are neutral about; you may be surprised.)

    So what do folks think:
    1) Is the CV-19 coverage any worse than what supporters of a politician you hate were saying in the course of getting that politician elected ? Is it worse than what you’ve seen from the media about any topic where you have an unusual level of knowledge (software in my case)?
    2) Look back to predictions that didn’t work out in the real world. Do you know anyone who’s stopped listening to the expert who made them, or the media that published them?
    3) Just how visible would it be to you if either:
    (a) 10 * as many deaths were occuring as being reported, and the PTB was underreporting for [conspiracy theory here]?
    (b) 100 times fewer deaths and illnesses were occurring as being reported, for similar [conspiracy theory] reasons?

    My guess is that everyone is at least somewhat tolerant of post-Truth, except perhaps a few institutionalized people with severe autism, and many people are so tolerant of post-Truth that they think the word “true” means something like “believing this makes me feel good”.

    The set of people who are even angry about the flip-flop on mask wearing seems tiny, and its pretty blatant. The set who aren’t sure which one was false, let alone whether it was a lie – and also aren’t sure whether anyone can currently determine which one was wrong – seems even smaller than the set who are (still) angry.

    I’m expecting I’ll come to believe some things that aren’t true as a result of this, but less than average, such that I’ll be perceived as even weirder – and possibly dangerous – that I already was pre-Covid. (Disbelievers in (some) local Truths are often regarded as thereby probably inclined towards all possible evil, in my experience.)

    • HeelBearCub says:

      The set of people who are even angry about the flip-flop on mask wearing seems tiny

      I don’t believe there was a flip-flop on mask wearing. It’s my understanding that they still don’t say that you wearing a mask will aid in preventing you from catching the disease.

      They do say that everyone wearing masks will reduce individuals from spreading. This is not a distinction without a difference.

      • albatross11 says:

        Yeah, the flip-flop here was from health authorities. The common line in the US from the CDC et al was that mask wearing didn’t really do much good in preventing spread; in Asia the common line was that of course it did some good and everyone ought to wear masks. IMO, one thing that probably changed peoples’ minds was that the countries that got reasonable control over the spread of the virus were overwhelmingly the ones where people wore masks.

        • Matt M says:

          To me the biggest problem here is the degree of confidence combined with the flip flop.

          It’d be one thing if the media had been saying “We aren’t really sure, but it seems as if masks don’t work” and now is saying “We still aren’t quite sure, but after looking at it more, it looks like they might work and the low cost of wearing them probably makes it worth trying even if they don’t.”

          But that’s not how it went. The actual authorities went from “It is not recommended that you wear a mask” to “Masks are required and you will be fined $1000 for not wearing one” within a month. The media went from “People who buy masks are paranoid hoarders depriving our health care workers of needed supplies (and probably racist)” to “People who are out in public without masks are reckless idiots who are contributing to the continued spread of a pandemic which will kill millions” even more quickly.

          • Clutzy says:

            Indeed, this is the most disturbing part, and its clearly translated to the people who listen to these authority figures. Perfectly healthy 30 year olds have been screaming in a discord server about how someone passed them on the sidewalk without a mask on.

          • JPNunez says:

            I thought we approved people from changing their ideas when proven wrong?

          • Matt M says:

            And the proper way to communicate that you have done that is what I lay out in the second paragraph, not the third.

            What happened to “prove” them wrong in the last month? Did I miss some new study that now proves that home-made cotton coverings strapped to people’s faces definitely prevent you from catching the virus?

            No. That didn’t happen. There has been no new evidence. It’s dishonest to act as if there is (and new evidence would be a precondition to change your opinion from “people who buy masks are actively harming society” to “people who don’t buy masks are actively harming society” so quickly).

          • Nick says:

            @JPNunez
            Changing your mind is a mark of epistemic humility; overweening confidence before and after is not. Which is obviously what Matt was saying. Reread the thread or stop asking bad faith questions.

          • Clutzy says:

            I thought we approved people from changing their ideas when proven wrong?

            Its possible to be wrong in both directions, which is what has happened. Its like if there was a bridge over the Mississippi river and the first time you were too far North and drive into the drink, then the next time you were too far South and drove into the river. Still wrong, just wrong for a new reason.

          • albatross11 says:

            The way I understand it, the “masks for the public are a waste of time” idea was received wisdom in the US medical community–I heard this same perspective on TWIV months before there was any issue of mask shortages in the US or anything, so this wasn’t an attempt at a noble lie. And at that time, I already had a couple N95 masks and a few surgical masks I’d bought as pandemic prep before. (I was wearing a mask in public before the received wisdom changed, because I could reason about the risks and benefits myself.).

            But it’s important to recognize that this was about using a mask to avoid getting infected by someone else. A makeshift mask or even a surgical mask isn’t all that helpful there–it can stop big droplets landing on your mouth or going directly up your nose, but does nothing for very small droplet nuclei, and it’s easy for you to mishandle the mask and infect yourself later. (Everyone talks about how healthcare workers are trained to avoid this, but I bet they often infect themselves this way too.).

            An N95 (especially with a valve) or P100 mask is probably a lot better at protecting you, but a necessary consequence of that is that you’re having to do more work to breathe and it’s uncomfortable and you can’t do a lot of normal daily life (drinking, eating, smoking) with one on.

            Getting the public to wear masks to avoid spreading to others seems very likely to lower the probability of infecting someone. But just having an occasional person wear such a mask isn’t all that beneficial, unless they’re known to be infectious. (Thus, even since the H1N1 flu, you see masks in doctors’ offices that are given to anyone who’s coughing or sneezing.).

            The thing that changed was the ability to get almost everyone, including asymptomatic people, to wear masks. If we could get it together enough to give everyone a surgical mask to wear every day, we’d be better off, but even a makeshift mask is probably doing some good. The whole point of this is to decrease the probability that you will infect someone you come in reasonably close contact with, by:

            a. Lowering the number and size of droplets that make it to them, and thus the load of virus they get. (You can think of this as decreasing the probability of transmitting the virus to someone given that they’re close enough to be in contact with you.).

            b. Shortening the range of the droplets, so when you speak, cough, etc., you don’t fire those 100 micron droplets of mucus and virus across the room. (You can think of this as decreasing the number of people with whom you have contact.)

          • albatross11 says:

            TL;DR version:

            Old CDC guidance was about whether the public should wear masks to protect themselves. I think they were slightly wrong there, but not hugely wrong–a surgical or makeshift mask is probably a little protection, but not a lot.

            Current CDC guidance is about whether the public should wear masks to protect others. Everyone already agreed that making likely-contagious people wear a surgical mask was a good way to keep them from spreading their infections. But they didn’t advise this for the whole public, probably because they didn’t think they could get everyone to do it at once. If the most careful 10% of the public wear surgical masks to avoid spreading the virus, it’s probably not doing much.

            Now, we can get everyone or nearly everyone to wear a mask. That can be via a law requiring it, or a social norm that gets you the stinkeye if you don’t wear one, or private businesses requiring a mask to enter their store or office. In a world where we can get everyone to wear a mask in public, and where there are substantial numbers of asymptomatic or presymptomatic carriers, the current guidance makes sense. Ideally, we’ll work out our production problems and everyone will have a pretty good mask (surgical, N95, KN95, or at least a high-quality makeshift mask) they wear in public indoor spaces until the pandemic is no longer an issue.

          • But they didn’t advise this for the whole public, probably because they didn’t think they could get everyone to do it at once.

            Can you point at any statement by the CDC prior to their reversal that implies that? My impression was that they strongly advised against wearing masks, not that they said “wearing a mask won’t much protect you, but it will protect other people.”

            And why would you have to get everyone to do it for it to be worth doing? Each person wearing a mask is one more person whose chance of spreading the virus is reduced. If the CDC believed what you claim, shouldn’t they have been advising people that they should wear masks, rather than advising people that they shouldn’t?

          • Edward Scizorhands says:

            How much of the change in conventional wisdom has to do with coronavirus having asymptomatic transmission? (Honest question: I don’t know the expectations the CDC works with.)

            If you assume that people who aren’t visibly stick aren’t spreading, they don’t need masks. And you might worry that people who are visibly sick think they can go out if they just wear a mask.

          • albatross11 says:

            Well, just about every doctor’s office I’ve been to for the last few years has asked people to put on a surgical mask if they were sick, so it seems like mainstream medical opinion was pretty clearly on the side of masks preventing spread of illness. OTOH, it seems like the mainstream medical opinion in the US was also that the public wearing masks during flu season or outbreaks wasn’t helpful–that was what the TWIV people were all saying, and it mirrors WHO and CDC guidance. Trying to make a sensible worldview of those two things, the best one I can come up with is the idea that surgical masks mostly won’t protect you, and that we probably won’t be able to get very many people to wear them so they won’t slow the outbreak much.

          • JPNunez says:

            @Nick

            Changing your mind is a mark of epistemic humility; overweening confidence before and after is not. Which is obviously what Matt was saying. Reread the thread or stop asking bad faith questions.

            Yeah, but the overweening confidence is less important than actually correcting course. While I place some value on epistemic humility, it’s not higher in value than either the ability to change opinions or actually providing the correct advice.

            This thread is overreacting to the overconfidence too much. It’s not that important. This change is a net positive.

            If the media/authorities flip flop back to masks being bad, then I’d change my opinion, but I haven’t seen that yet, modulo some weird corner case.

        • HeelBearCub says:

          I don’t think they said “it won’t control spread”.

          The health authorities said wearing a mask won’t effectively protect you from being infected.

          Under the covers they may also have been calculating whether asking everyone to wear masks would actually cause 80% of people, rather than 20% of people, to wear masks. But I actually don’t think they knew enough about disease vectors to know that this would be helpful.

          • gbdub says:

            Literally days before the CDC started recommending that people wear masks, the news (this was either a nightly network thing or CNN I can’t recall precisely) had a medical doctor on talking about how masks are somewhere between useless and actively dangerous because no one can wear them properly and they make you touch your face more.

            Now, in the very technical sense, this never got directly contradicted. And also technically, the CDC never “flip flopped” they just went from “we cannot recommend wearing masks at this time because we lack evidence of their effectiveness” to “we now believe we have enough evidence to recommend their use”. They never directly recommended against wearing masks.

            But this is a bit of a cop out. The bottom line is that, for the average joe trying to figure out if he should wear a mask today, that went from “no” to “yes” in a heck of a hurry.

            While I understand why the CDC wants to use language carefully, they seem to have forgotten that they are tasked with communicating to a public that will have a hard time distinguishing between “we do not recommend that you wear a mask” and “we recommend that you do not wear a mask”.

            Missing the potential benefit of mask wearing in reducing community spread (even if the mask wearer is not directly protected) also looks like a huge oversight.

          • HeelBearCub says:

            @gbdub:
            Do you think they should have lied?

            For the umpteenth time, wearing a mask likely doesn’t help you. It likely helps other people, and that only matters if enough people wear them.

            You are right that people don’t like the whiplash and don’t process nuance. That’s why they didn’t recommend wearing masks absent data, because people will insist on misinterpreting why they should wear them.

          • albatross11 says:

            As best I can tell:

            a. Wearing any mask probably provides you *some* protection. Large respiratory droplets full of virus get stopped short of your face, and you’re reminded not to touch your nose.

            b. Wearing any mask very likely provides those around you some protection–not only are large respiratory droplets stopped, but also, when you cough or sneeze, most of the force of your breath is redirected so it’s not launching the droplets across the room so effectively.

            c. The best thing for protecting you is probably an N95 or P100 mask with an outlet valve.

            d. The best thing for protecting others is probably an N95 mask without an outlet valve.

            e. Surgical masks are probably better than makeshift masks, which in turn are better than nothing.

            f. All those masks work better with a cut piece of pantyhose pulled over the outside of them and tied into a knot, because the pantyhose pull the mask tight against your face so you get a better seal.

          • LesHapablap says:

            Mask-wearing is also a reminder for others around you to take the whole thing seriously.

          • Matt M says:

            Mask-wearing is also a reminder for others around you to take the whole thing seriously.

            Which is a bug, not a feature, IMO.

            It’s a propaganda campaign designed to increase fear, that has been launched because the disease isn’t deadly enough to panic the population on its own.

          • Conrad Honcho says:

            Under the covers they may also have been calculating whether asking everyone to wear masks would actually cause 80% of people, rather than 20% of people, to wear masks.

            If so, they were clearly wrong about that, as once they switched to “everyone wear masks” everyone (who can get a mask) is wearing one.

          • gbdub says:

            @heelbearcub – I do not think the CDC should lie. But I do think that, in this situation, they failed to tell the truth in a useful way; this resulted in a practical if not technical flip-flop in recommendations to the public and more importantly delayed the implementation of a probably helpful tool in limiting the spread of the pandemic.

            The job of the CDC in a pandemic is not merely to be technically accurate. They must also convey this accuracy in a manner that the public will understand and translate into correct useful actions.

            “Should I wear a mask” is ultimately a binary question. Now it was true that the most scientifically accurate answer was “maybe”, but the way this was presented to the public was, intentionally or not, rounded off to a definitive “no”. Again, the most mainstream presentation I got was a doctor on the news saying “the CDC does not currently recommend wearing a mask” (technically true, technically a “maybe”) and then going on about all the ways masks might actually be harmful. Of course that is going to be taken as a hard no!

            The other problem is that the CDC seems to have taken far too long to pivot away from individual risk focus and “bias to inaction”. In a pandemic, they need to be more collective risk focused, and recognize that inaction can be just as consequential as action.

            The actual facts about mask effectiveness did not change, the way the CDC (and those disseminating the advice of the CDC) chose to weigh and present those facts did. That’s an error however you look at it.

          • HeelBearCub says:

            @Conrad Honcho:
            “You go to war with the army you have.”

            Any calculation about these kinds of things depends a very great deal on how the population perceives the threat.

            For instance, here are the flu recommendations for 2018-2019 from the CDC. The include the following:

            In addition to getting a seasonal flu vaccine, you can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others. In addition, there are prescription medications called antiviral drugs that can be used to treat influenza illness.

            Now, how many people do you think were actually handwashing in the way that would help prevent the spread of the flu?

            “What will the result of these recommendations be?” is a question you always have to ask.

          • albatross11 says:

            Matt M:

            This is a disease that probably has a 1% or so chance of killing some people in this conversation, on this board, if we’re infected. I agree media spread fear for dumb reasons, but this is something that’s actually pretty dangerous. It’s not the 1918 flu, thank God, but it’s seriously nasty, it’s killed a lot of people, and it stands to kill a lot more. If everyone in the country eventually gets this virus, then we’re probably looking at more than a million deaths (assuming an IFR around 0.3%, which is consistent with what we know right now), many of them people with another 30+ years of life ahead of them, some in the prime of their lives. And probably ten times that number who end up much worse off in terms of lasting lung and heart damage.

            I understand that it would be more convenient for your preferred policies if it were not dangerous to anyone other than 90 year olds already on their last legs. I feel exactly the same way about your attempts to pretend this isn’t so bad and that people claiming it is are all spreading fear as I do about the attempts of a bunch of people on the left to do that w.r.t. black/white IQ differences or differences in crime rates. Trying to shade the truth in a direction more favorable to your desired policies is a lousy way to make the world a better place, and a lousy way to have worthwhile conversations. Please stop.

            None of that tells us whether lockdowns, graduated lockdowns, moderate social distancing, or a big party where we all strip off our clothes and give each other big wet kisses is the right way to respond to COVID-19. But the only way to think clearly about that problem is to be honest about how serious it is, how big the risk is to individuals and to the broader society.

          • The Nybbler says:

            This is a disease that probably has a 1% or so chance of killing some people in this conversation, on this board, if we’re infected.

            So an IFR of 1%

            (assuming an IFR around 0.3%, which is consistent with what we know right now)

            But it’s actually 0.3%? I’m fairly sure the SSC commentariat is not particularly weighted towards high-risk groups.

            And probably ten times that number who end up much worse off in terms of lasting lung and heart damage.

            Any evidence for this beyond anecdote? Not just that there exist cases with such damage, but that they occur at 10x the death rate.

            Trying to shade the truth in a direction more favorable to your desired policies is a lousy way to make the world a better place, and a lousy way to have worthwhile conversations. Please stop.

            Back at you.

          • Subotai says:

            @albatross11, I can’t help but notice your IFR estimate of 0.3%. If it weren’t for people like Matt M pushing back on the widespread panic, do you think you would still have given such a low estimate? Outside of the SSC bubble, the official case statistics and many estimates from the “experts” still show an IFR close to 1918 flu levels. At this point, we know enough to say that this is very unlikely. People who continue to repeat this narrative are not conducting the debate honestly and are absolutely guilty of spreading fear (I recognize that you are not doing this).

          • Matt M says:

            None of that tells us whether lockdowns, graduated lockdowns, moderate social distancing, or a big party where we all strip off our clothes and give each other big wet kisses is the right way to respond to COVID-19.

            OK, but this is the only thing I care about.

            I am all for people “taking this seriously” in their voluntary personal interactions. I put in a request to start working from home before my company mandated it. I had a long phone call with my father where I had to beg him to stop volunteering at a local homeless shelter (which he has done since he retired) in order to minimize his exposure. I advised friends and co-workers to start stockpiling food, TP, and medicine before the panic buying started.

            That said, I still don’t know anybody who has COVID. I know lots of people who have been laid off their jobs. In my area, job loss seems to be a much more clear and present danger than COVID. You can say this is because of the lockdowns, but when I go outside, I still see tons of people out and about. The national media would tell you that my region implemented lockdowns too late, that they didn’t go far enough, and that people aren’t obeying them rigorously enough. And yet, still, COVID is basically a non-factor here.

            I’ve said from the start that my threshold for this being a really serious thing is somewhere around a 1% total population fatality rate. Yes, I understand that would mean 3-4 million American deaths, which is a very large number. But that’s how percentages work when you’re dealing with very large denominators. I think so long as the population fatality rate is below 1%, there will still be tons of people out there who don’t know anybody who has died from COVID. There certainly won’t be “bodies in the streets” as the media has been promising us if we do not repent from our wickedness.

            Look at what people are saying in social media. Not rationalists, not ivy league white collar people, not political partisans. The normal folks you know. Find them and try and get a gauge on what they believe. Based on what *I* see from such people, they believe this thing is far, far worse than 0.3% IFR. They believe that walking within 6 feet of someone who isn’t wearing a crappy homemade mask is basically risking death. These beliefs are wrong, and they are harmful, and they need to be corrected.

          • albatross11 says:

            The Nybbler:

            a. Higher risk people have a higher probability of death given infection. My vague guess at an IFR is somewhere around .3% for the whole population, but it could be fairly different–the data we have so far isn’t really all that great. My current estimate of my own probability of death given infection is somewhere around 1% or maybe a bit lower. There are people older than me and with more serious comorbidities who are regulars on SSC, as well.

            b. If you think I’m lying or being deceptive about COVID-19 facts, please point out where.

            There’s a lot of uncertainty about COVID-19, but I’ve done my best consistently to play straight with the facts as I understand them, including pointing out things that don’t play well with my preferred policies (for example, the possibility that nobody gets long-lasting immunity). I’ve also tried to link to academic papers, popular articles, and blogs/podcasts by experts in the relevant fields.

          • Edward Scizorhands says:

            That said, I still don’t know anybody who has COVID. I know lots of people who have been laid off their jobs.

            I don’t know anyone who’s ever gotten measles. I know lots of people who have had to suffer measles shots.

            I get those two variables are the two most visible to you. But it’s useless to compare them. Seen versus unseen.

            There is another path with less economic devastation and more deaths. And I admit that might be the better world. I’m fine saying there are a certain number of dead grandmas worth a trip to Disneyland.

            But since lots of people are committed to the current path, people who want to flip to the other path need to show their work.

          • albatross11 says:

            We accept more dead grandpas for some disneyland trips every flu season. The question is entirely in what the available tradeoffs are, and deciding what the best choice is among them.

          • HBC:

            It likely helps other people, and that only matters if enough people wear them.

            I don’t understand this. Each additional person wearing a mask reduces the chance of transmission by one person’s worth. I don’t see how the effect of the millionth person wearing one is greater than that of the first. Or the hundred millionth.

          • Edward Scizorhands says:

            If there are 10 people I might meet today that are contagious, and 1 of them is wearing a mask, I have very high odds of catching it anyway. That 1 guy wearing a mask isn’t helping much.

            If 9 of those 10 people are wearing masks, my risk has gone down significantly.

            Like herd immunity from vaccines, society don’t gain much from the first few percentage points of people that are immune, but those last few percentage points are pure gold.

          • John Schilling says:

            If there are 10 people I might meet today that are contagious, and 1 of them is wearing a mask, I have very high odds of catching it anyway.

            If there are ten people you might meet today that are contagious, and none of them are wearing masks, your odds of catching COVID-19 are ~20%. One of them wearing a mask, ~19%. All of them wearing masks, ~10%. Or maybe we’re talking about idealized perfect masks and it goes all the way down to 0% when everybody is masked. But it does so roughly linearly, with the first mask having about the same benefit as the last.

            COVID-19 is not so contagious that a handful of social encounters with unmasked carriers puts you in a risk-saturated regime where nothing else matters because you’re doomed to infection anyway.

          • nkurz says:

            @HeelBearCub:
            > Now, how many people do you think were actually handwashing in the way that would help prevent the spread of the flu?

            My guess would be almost off them. I assume that any attempt at handwashing (especially with soap) significantly reduces the number of active viruses on ones’ hand, and thus helps to prevent the spread of flu. Do you think it does not help at all unless done perfectly?

            If I was trying to quantify it, I’d guess that handwashing with soap probably removes or deactivates viruses at roughly a constant percentage per time. Thus if the CDC recommended 20 second washing leaves something like .01% of the active viruses, I’d guess that an untrained quick 5 second handwashing leaves about 10%. Washing for 1/4 the time multiplies the number of viruses by something like .1, while washing for 4x that time would multiply by (.1)^4 == .0001.

            Do you think these numbers are implausible? Or am I misinterpreting your question, and you are making some other point?

            From some of your other comments, I wonder if one difference in our thinking is that you may think unprotected contact with someone who is infected is almost sure to cause transmission, while I (and others) think there is a relatively low percentage chance of transmission per encounter. If transmission was practically certain, it would make sense that a 90% reduction in number of viruses might have no effect, since it’s transmission is “overdetermined” by a surplus of infectious agent. Whereas if transmission per contact is unlikely, a 90% reduction in virus should imply almost a 90% reduction in risk of transmission, as there is very low “redundancy” of agent.

            I think the fact that the flu has a single digit effective reproduction rate implies that a brief contact with infected individuals is a numerically low risk. If an average infected individual is infectious for several days, encounters dozens of uninfected each day, and only infects a small number of them in total, doesn’t it have to follow that the risk of each encounter is something like R/num_encounters? And if this number is small, doesn’t that imply that even imperfect handwashing should reduce transmission close to as much as perfect handwashing?

          • Edward Scizorhands says:

            One really simple technology I would like to see deployed in lots of places are portable handwashing stations. I imagine something about half the size of a hot-dog cart that you just roll out.

            Subways, airports, schools.

      • Skeptic says:

        The CDC was saying masks to include N95 respirators don’t help prevent infection.

        Which is absurd on its face.

      • John Schilling says:

        I don’t believe there was a flip-flop on mask wearing.

        Going from a nigh-unanimous and -universal “Masks will not help the general public in any way worth mentioning, and you should feel bad for wearing them when our heroic medical personnel need them!” to “This thing that masks might do is so very important that you must wear them, and should feel bad if you don’t and mock people who don’t!”, is absolutely a flip-flop.

        That both the flip and the flop are usually expressed with careful weasel-wording so that they aren’t technically false, counts for nothing in my book. Deliberate misdirection via depraved indifference to the truth, whether you’re using false statements or just carefully chosen half-truths and omissions. Don’t do that, and don’t cheer for people who do that, not if you want me to trust you at least.

        And in this case, it’s flip-flopping to the worst sort of cargo-cult thinking.

        “Look, here’s a thing that technologically advanced professionals can make that has clear and proven benefits. But we can’t have that because they won’t make them for us, only for people more important than us. Hey, maybe if we use our amateur skills and improvised materials to make something that looks like the thing we can’t have, it will work the same way! Never mind the lack of evidence, it looks right and it’s got truthiness, and something must be done and this is something!”

        That’s pretty much literally how cargo cults work. And this is the worst kind, because it’s the kind where the cult leaders make it the civic religion if not actual law of the land, mocking and ostracizing anyone who doesn’t constantly practice their faith in public.

        And, again, it’s a complete flip-flop from the official and media consensus of February and early March.

        • EchoChaos says:

          This is basically my exact feeling on the subject. Thank you for expressing it so clearly.

        • gbdub says:

          I’m a bit baffled why you are so adamant that anything less than an N95 properly fitted is worse than useless, to the point of mocking it as a “cargo cult”. Experiments have shown that homemade masks might be ~half as good at filtering small particles as N95s, and they definitely stop large particles from sneezing / spitting.

          An “N47.5” mask might not be something you’d wear confidently into an infectious area and expect personal protection, but I find it hard to believe that reducing the available infectious particles in circulation by half (hell, even by 10%) would not be a net benefit when applied over the whole population. Any reduction in R0 helps!

          “Something must be done and this is something” is not good logic, but both “wearing masks” and “not wearing masks” are doing something. We should follow the evidence, but we aren’t going to get perfect evidence in either direction in a timely fashion, so in the meantime we ought to go with whatever direction is “probably” right.

          • John Schilling says:

            “Something must be done and this is something” is not good logic, but both “wearing masks” and “not wearing masks” are doing something.

            That is not what “Something must be done and this is something” means, and you know it.

          • albatross11 says:

            I’m pretty convinced that masks make it less likely that you will spread the infection to others, if only by deflecting the airflow from your breaths and sneezes downward and so limiting the distance the virus-laden respiratory droplets are launched. This is the whole point of surgical masks, and while makeshift cotton masks aren’t as good as surgical masks, the best of them are pretty close. And even just a bandana over your mouth is redirecting your breaths down and so limiting your range.

            I think makeshift masks probably provide a little protection from you catching the virus, thanks to having a chance to catch the large droplets before they reach your face. I doubt it’s much protection, though. Think of this like wearing a leather jacket in a swordfight–it might save you from a really marginal cut, but it’s not a lot of protection compared to a mail shirt or some such thing.

            N95 masks and equivalent probably do a decent job protecting you if you get a good fit, but in practice they probably aren’t all that great because they’re usually badly fitted and so you’re sucking air in around the mask pretty often. And similarly, they’re probably better at protecting others from you than surgical or makeshift masks, but leaks around the edges of poorly-fitted masks probably make that worse.

          • John Schilling says:

            I’m pretty convinced that masks make it less likely that you will spread the infection to others, if only by deflecting the airflow from your breaths and sneezes downward

            The improvised masks I’ve got from e.g. Etsy, have mostly been directing the airflow upwards and to the sides. The chin seal seems to be easier to get right than the cheeks and (especially) nose.

          • gbdub says:

            That is not what “Something must be done and this is something” means, and you know it.

            That’s a unnecessarily snippy way of ignoring the meat of my comment, and you know it.

            I agree that we should normally be suspicious of people “doing something” because of the human bias to action, and “wear masks” is the direction that bias is going to go.

            At this point though, it doesn’t matter – the question of mask wearing is in the air, and ignoring it is not really an option. You can either say things that will encourage more people to mask up, or discourage them from doing so. The scales of all things here are large, so it’s an important question. One you can’t really ignore by hiding behind a lack of a perfect randomized controlled trial to answer definitively.

            “The evidence is inconclusive” is one thing. You’ve taken that a step farther into openly mocking mask-wearers as cargo cultists. I think justifying that requires not merely lack of evidence supporting mask use, but definitive evidence against using them, which I don’t think you’ve provided.

            FWIW I think Scott took pretty much the right approach in his post on the subject.

            Anecdotally, I made some simple home sewn masks with a pattern from JoAnn’s. There is definitely some leakage (mostly on the top) but there is clearly a lot of flow going through the mask. Perhaps counterintuitively, “better” filtering material can make things worse (harder to get air through so more leaks out the sides).

    • 1. no.
      2. no
      3a. not visible
      3b visible

    • WoollyAI says:

      1) No, in fact I think the Covid coverage has been slightly better than normal.
      2) Yes, myself for one.
      3) Trivially for either.

      I think you’re discounting the real amount of uncertainty and lack of good information about Covid out there. There are lots of real uncertainties about how many people have been exposed, what the fatality rate is, whether reinfection is possible, how helpful various treatments may be, and a host of other things. This isn’t the media or politicians screwing things up; there are a lot of real uncertainties and a lot of unknowns that are just unavoidable when dealing with a new pandemic. I’m not convinced the media or politicians are actively lying so much as posturing while mired in the same ignorance as the rest of us.

    • The Nybbler says:

      1) No (but that’s a lower bar than the one on the Dead Sea)

      2) Alas, no.

      3) I would notice both — I’m in the NYC area. I know some people who have had COVID and through a short chain, one who has died of it. With 100 times fewer deaths and illnesses, I shouldn’t know any of these; with 10 times more deaths, I should know more.

  16. rumham says:

    So the official CW lines have been drawn. Ending a lockdown is now racist.

    Here’s one.

    Another


    And another (this one from David Frum).

    • Dan L says:

      That’s bait.

      • rumham says:

        Yes, for a discussion. About a brand-new CW topic. On a CW friendly thread.

        • Dan L says:

          If that’s how CW threads optimize for light, you have done me a service in reminding me why I abandoned them.

    • Skeptic says:

      Election can’t come soon enough. Maybe I’m overly optimistic but I hope both Partisan Teams will lower their guns for a moment since the stakes won’t be as high, and maybe we can start to use an actual cost/benefit framework approach towards Corona response.

      But I’m probably wrong, and both sides will instead amp stupidity to 11.

      • rumham says:

        It looked like that was going to be the case. But then anti-lockdown protesters wore some MAGA gear and now we’re right back to where we started.

      • Leafhopper says:

        Stupidity is already at 11. Expect post-November stupidity to be 121 at minimum.

    • broblawsky says:

      Less of this, please.

      • rumham says:

        I don’t expect anyone here to defend the attitude. I figured that I was highlighting an obviously growing sentiment that will likely affect covid policy in an election year. I can understand objecting to a salon link, but we’ve got MSNBC, David Frum and Vox. What about bringing this up for discussion is offensive to you?

        • broblawsky says:

          It’s low-effort self-congratulatory culture war bait. This might be a CW-OK thread, but that doesn’t mean you’re obligated to post everything that offends your sensibilities, especially if you’re not going to put any actual effort into analysis.

          • EchoChaos says:

            We had an entire thread of that from the other side last time with no request for “less of this”.

            Culture war is culture war. This seems imminently fair, since he’s linking to respected news outlets like Vox.

          • rumham says:

            but that doesn’t mean you’re obligated to post everything that offends your sensibilities

            I can assure you that there is not enough time in the day for that.

            especially if you’re not going to put any actual effort into analysis.

            If I had put what I just said there about it being a growing sentiment about covid policy in an election year, in the original post, would that have ameliorated the offense?

            As I previously stated, I honestly felt it would be informative. (edited for tone. apologies)

          • broblawsky says:

            One of those is an actual academic study; the other is a bunch of opinion articles. They aren’t equivalent.

          • rumham says:

            @broblawsky
            I promise you that I didn’t edit that to make your reply not make sense. I honestly thought it sounded too snippy. You are correct that they are not equivalent. But that does not mean that they are not relevant. The press led the lockdowns. Growing narratives fed to large audiences (I mean, Vox and MSNBC aren’t massive, but they’re not negligible either.) would seem to be the kind of thing that could impact policy. You disagree, obviously. I suppose I could have left the salon link out, but it was the one that led me to finding the others.

            Would adding that analysis to the post have ameliorated the offense?

          • broblawsky says:

            Yes, that would’ve been better.

            Edit: Also, please don’t use Google AMP links.

          • rumham says:

            @broblawsky

            Noted. Will correct in the future. Although it looks like I got lucky this time and the discussion mostly proceeded along those lines up and down-thread.

            As to the AMP link, my mistake. I was trying to avoid linking to an autoplay video. I consider it bad netiquette to put one in a list of otherwise articles.

    • matkoniecz says:

      And another

      Domain announcing low quality content (crooksandliars.com) and AMP site. Nice combo.

    • DinoNerd says:

      *sigh* I could wish that every discussion of class/poverty etc. in the US didn’t turn into a discussion about racism.

      Not having read any of those links, one good thing I can see about government mandated lockdowns is that the lower you are on the economic scale, the more likely you have a boss who will fire you if you take the sick days to which you are supposedly entitled, and the less likely you are to have savings that could tide you over if you decided to stay away from work while the epidemic went through, because of being highly vulnerable or living with someone in that category.

      With this lockdown being mandated by the government, it’s harder (not impossible) for your boss to require that you work anyway, with no precautions at all, and fire you if you try to stay home because you are infected. And there’s at least some extra money for those unemployed.

      An official reopening would reduce that effect – while probably also making it significantly less difficult for those who are healthy etc. to find work if that’s what they want or need to do.

      Damned if I know which effect dominates in practice. I’d guess it depends on a lot more than anyone’s going to bother mentioning in any polemic ;-( And for any particular individual, what matters isn’t the statistical effect, but the effect on them personally.

      But who’s going to click on something even as nuanced as what I just said, let alone respond to it ;-(

      • the lower your are on the economic scale, the more likely you have a boss who will fire you if you take the sick days to which you are supposedly entitled,

        Is this true? In the low-paid jobs I worked in high-school, that kind of pressure would be unimaginable: many employees were so incompetent that someone who bothered to call in sick instead of just not showing up was a “good employee.” I saw far more nonsense at my first white-collar job.

        • DinoNerd says:

          Good point.

          I now realize that while I know a fair number of people who complain of illegal bad boss behaviour and they all make a lot less per year than I do – and have more trouble getting another job – not many of those I know count as being on the very bottom. (Though one is “minimum wage + very trivial annual increase”.)

          I don’t recall ever working a job where people would commonly fail to explicitly call in sick, or anyone who did that without a good explanation would keep their job – not even while I was a college kid, doing random minimum-wage temp and part time work.

          On the other hand, I can recall at least 2 cases where something I witnessed or experienced, in my relatively high end jobs more recently, might well have gotten a lawyer salivating. (I knew it wasn’t OK, because my own mandatory annual training in “good business conduct” had told me never to do them. – That “training” is blatantly intended as a CYA, so that when employees get caught doing these mostly illegal things, the company can try to claim “we didn’t tell them to do that; you can’t include us in the resulting lawsuit, fine us, etc.”.)

          And then there’s something like Wells Fargo – lots of employees doing all kinds of illegal/unethical things, because they were the only way they could see to satisfy their bosses. They probably weren’t quite bottom-of-the-heap either.

    • I think one of the main problems that’s causing this is plain old economic illiteracy. My mentality is that production, not consumption or trade, is what creates wealth. So when the barbershops and tattoo parlors are shut down, society is made poorer by having fewer haircuts and tattoos. Doesn’t sound like a big loss to me. Can’t we have a year of no additional tattoos and DIY haircuts? Isn’t that worth it to prevent some people dying and many more being sickened? But the normies look at barbershops and tattoo parlors being shut down and they think that because there’s less greenbacks changing hands, there’s less of every kind of wealth, including less medicine and less food. So my state’s going to let them re-open:

      https://www.reuters.com/article/us-health-coronavirus-usa-reopening/like-test-dummies-as-colorado-reopens-some-see-too-much-risk-idUSKCN2280E6

      What about the distribution of wealth and how that will be affected by the shutdowns? We can change the distribution of wealth. We already do a lot of it, often for reasons which are far stupider. My suggestion is a program to pay small business owners who can show that their businesses were shut down by the government. This is not the same as the bailout that governments are doing now because the payments under my proposal will be made to individuals and will be equal: a standard payment to people put out of work. What about the guy who was counting on a six figure small-business income and has a bunch of mortgages to pay? Declare bankruptcy, give up your expensive house, and be happy at the time you had to enjoy it in the first place.

      • Randy M says:

        I agree with you, but I would, I dislike tattoos and already do my own hair. I imagine there are people who are losing something of value to them in tattoo shops closing down, just as I lose when game shops close down (bad example, because I haven’t actually spent money in one for awhile, but I do on occasion), or, say, churches.

        Obviously it takes far less labor than whatever the most recent best employment figure is to keep our entire nation fed and the lights on. We could, through some hypothetical distribution (that has never really worked before, but nevermind) continue to provide for everyone the same amount of essentials they had before. But those left running tractors are going to feel like chumps, with more free loaders to compare to, and less tattoos (or whatever) to reward themselves with. Nevermind having nothing but Netflix to occupy the rest of the workforce sounds like a problem for a number of reasons.

      • S_J says:

        My mentality is that production, not consumption or trade, is what creates wealth. So when the barbershops and tattoo parlors are shut down, society is made poorer by having fewer haircuts and tattoos. Doesn’t sound like a big loss to me. Can’t we have a year of no additional tattoos and DIY haircuts? Isn’t that worth it to prevent some people dying and many more being sickened?

        That is rather hard on the barbers and tattoo artists, if they need to pay their apartment rent (or mortgage), and they just used their savings to buy groceries.

        Multiply that by hundreds of janitors, waiters, baristas, home-repair contractors [1], landscapers [2], etc., and there are a lot of people who are wondering where their next meal (or rental payment) is coming from.

        And that some of the business owners for places like barbershops and tattoo parlors need some sort of income so that they can make payments on the rental of their business property.

        Even if they aren’t central to the economy, they are hurting for money. Yes, the local pizza place is likely looking for delivery drivers…and Amazon may be hiring. But there are more people seeking those jobs than there are jobs available.

        There wasn’t much warning. Now a lot of people are hurting, economically.

        Yes, there is a potentially better way to line up the economy. But getting from here to there will be very painful for lots of people: including both tattoo artists and home-improvement contractors.

        [1] I had an electrician on tap to do some work on my house when the shutdown was put in-place. He said he was risking a $10000 fine if he was caught.

        [2] I think the governor in my State banned landscape workers from doing their job. Even though that’s one of the few non-essential jobs which can be safely done while respecting rules about social distancing…

      • Christophe Biocca says:

        Why do you assume people are looking at the barbershops and tattoo parlors, as opposed to factories and offices?

        You can always make people sound as dumb as possible by cherry-picking examples, but the tattoo parlors aren’t even mentioned in the executive order, they’re just part of general “Non-Critical Retail”. So are computer and vehicle repair services, but citing those would make the order reopening them sound a whole lot less stupid.

        • Christophe Biocca says:

          Preempting the inevitable “the reopening order is too general, it should exclude obviously-bad choices like tattoo parlors”:

          Colorado (like most places) already had an essential/non-essential division, and as soon as there’s a list of people who can open and people who have to stay closed, everyone plays “defect”, trying to get themselves on the open list while denying others.

          So in Denver cannabis dispensaries (including in-person shopping, not merely curbside pickup) are essential.
          At the national level, the customers for our company (restoration contractors) put together a lobbying effort to get Homeland Security to add them to an essential workers list. I’m sympathetic to why they’re doing it (they’re sufficiently obscure that a random attempt by a county to list who’s essential will probably exclude them without even thinking about it), but it’s still the deployment of lobbying effort that gets you to stay open in a lot of cases.

          Given the relative awfulness of the 2-category list, I’m not exactly hopeful for a large number of categories to suddenly get things right.

          Better to put some rules in place that lower effective R0 and let businesses judge whether staying shut down or reopening under those restrictions is better. That plus consumer reluctance will quickly sort out essential from not.

          • rumham says:

            @Christophe Biocca

            Better to put some rules in place that lower effective R0 and let businesses judge whether staying shut down or reopening under those restrictions is better. That plus consumer reluctance will quickly sort out essential from not.

            It is definitely looking like the Swedish route is the way to go.

        • Clutzy says:

          Exactly. I’m able to work remote (for now), but this depends on my computers running.

      • baconbits9 says:

        So we can live without Tattoos and Haircuts. How about building maintenance repairs for all the places that produce those services? Who is paying for those with a chunk of servicers out of business for the year? What about garbage collectors, police, road repairs etc? Those typically paid through taxes to which the tattoo parlors and barbers and stylists all contribute.

        What about landscapers? We don’t NEEEEEDDDD them, we can cut our own grass and go with a few extra weeds and some overgrown shrubs for a year right? OK the occasional emergency with a downed tree and we need someone, but not necessarily 90% of what a good chunk of people do. How many other jobs could we go without for a year just in theory?

        How about capital structure? How do we make loans and build businesses going forward if a bunch of them can just be shut down for a year with no income? What about construction? Who is building new stuff with all the soon to be empty floor space from businesses you just ordered closed and won’t be reopening?

    • albatross11 says:

      Culture war hot-button issues are a great way of shutting everyone’s brain down so they can’t think clearly about real stuff.

      An honest discussion about the costs and benefits of further lockdowns requires thinking. It requires reasoning about uncertain things, trying to understand mathematical models while recognizing they’re imperfect and may be based on all kinds of wrong assumptions, and trading off important values in ways that are guaranteed to hurt sympathetic people. It’s possible for most people to try to think about this stuff, but it’s hard and unpleasant.

      Yet another bashing-the-outgroup culture-war discussion, by contrast, is easy and fun and appealing. It will make you feel good about yourself because self-congratulation is such a core part of the whole thing. But it will shut down your brain and help you tune out unpleasant facts and questions so you can just shout your side’s slogans at the other side louder.

      Me, I’d rather keep my brain working.

      • Skeptic says:

        Unfortunately, the CW will be a large (maybe largest) determinant of our public policy response.

        So to paraphrase, you may not be interested in the CW, but the CW is interested in the public policy response.

        If the stances are hardening, cost/benefit will have less of an impact, and tribal identity will become the ultimate factor.

      • rumham says:

        Yet another bashing-the-outgroup culture-war discussion, by contrast, is easy and fun and appealing. It will make you feel good about yourself because self-congratulation is such a core part of the whole thing. But it will shut down your brain and help you tune out unpleasant facts and questions so you can just shout your side’s slogans at the other side louder.

        Me, I’d rather keep my brain working.

        I feel like you’re off the mark here. What slogans do you imagine I’m shouting? I’m highlighting a growing media narrative that could very well have an effect on policy. There are Republicans and Democrats saying it in the links provided. They are all anti-trump, however. Do you imagine that I’m on team MAGA?

    • Three Year Lurker says:

      I for one favor a middle ground to ending lockdown.
      Enforce these rules, in order of importance:

      1. No speaking, singing, or shouting.
      2. Carry a whiteboard or memo pad for communication.
      3. Wear a mask.
      4. Sign language is encouraged.

      Do as you please while following those rules.

      The evidence all points toward droplets, so the rules are aimed at the source and provide an alternative.

    • Etoile says:

      It’s like someone gave a writing prompt, “look for concentrations of white people and write an article about it!” And then the students spill out into the world looking for it. It seems like a good formula: it’s pretty easy and gets an audience.

      Honestly, you can write this about any generic hobby that people engage in. I’ve seen it about hiking, about D&D, various types of metal music…. You could probably put in bird-watching, blogging, Quidditch, gardening, and probably virtually any hobby not associated specifically with a different non-white ethnicity.

    • ltowel says:

      I’m surprised that this is the view, and I have to assume it’s because the protesting comes from idiot MAGA groups people the authors don’t agree with. In my mind the key point (as quoted from the vox piece) is:

      Meanwhile, blacks and Latinos also make up the largest number of essential workers, who are most at risk of infection.
      Covid-19 is disproportionately taking lives of black people
      Race and socioeconomics do absolutely play into who is most vulnerable to getting Covid-19 — and who is most likely to die.

      Lock-downs are disproportionately destroying wealth of the poor/working class (waiters, bartenders, barbers), without commiserate pain for much of the middle class or rich, while trading the health of marginalized and poor “essential workers” for the health of wealthy older Americans.

      And honestly, it seems like these pieces agree with me about who is suffering, but come to a different approach to fix it – they see racists arguing to end lock-downs, and therefore conclude arguing to end lock-downs is racist, I see poor and marginalized people suffering disproportionately and think that continuing them without some way to equalize the suffering is wrong.

      • Garrett says:

        > Lock-downs are disproportionately destroying wealth of the poor/working class

        I know. It’s great. Is there a good way I can go about encouraging the lockdowns to continue or get more stringent? Trying to phone my governor results in the phone ringing continually without even an option for voice mail.

      • Edward Scizorhands says:

        The lockdowns will harm the lower class, and the virus will harm the lower class.

    • Purplehermann says:

      Vox claims that blacks (proportionately to their population size) die more and have more cases.

      They seem to think this means that blacks are more susceptible(i.e. both more likely to get it and more likely to die if they get it), so getting rid of lockdowns will hurt them disproportionately.

      So first off, if they have more cases they’ll also have more dead. This is pretty obvious, bur spinning this as two seperate issues makes the racism case easier to make.

      (Having poorer health and medical availibility seems plausible to me, but most of the difference in deaths is most likely due to the difference in cases.)

      This also begs the question – why are blacks disproportionately infected (assuming cases track to infections)? There are more white people in the country, and add in economic differences and it is much more likely the disease started with a white or asian than a black, but both of those demographics have much lower case rates.

      This means the virus most likely had more time to spread in non black demographics.

      Culture is probably a big difference.
      This opens up a can of worms, as lefties would not like to discuss any parts of black culture that could be seen in a negative light, regardless of whether the issue is moral, practical, acute or chronic.

      As for ending lockdown hurting them more, there are two parts:

      1. Economic. Someone else shoild handle that, I don’t know.
      I would think economically everyone gains or everyone loses more or less.

      2. Deaths. If a much larger percentage have or had it, they are closer to herd immunity, and should have be less affected by getting rid of lockdowns, even assuming the lockdowns are doing enough to stop it with much higher percentages of infected.

      If blacks are much less healthy (and if the medical thing is relevant) that could change their preferences, but I’m not convinced that this is very important here.

      Even if the health were true in an important way, this is the wrong argument – it should be about ableism, ageism or something, because blacks and whites would all suffer ~proportionately to their lack of health and age, though whites would suffer more at the same health and age (more people/percentage to be infected).

      Medical availability, assuming it is important and the healthcare system doesn’t get overwhelmed might change things as well, but it would still be the wrong argument – rich-poor or class is the distinction, not racism.

      • rumham says:

        This also begs the question – why are blacks disproportionately infected (assuming cases track to infections)? There are more white people in the country, and add in economic differences and it is much more likely the disease started with a white or asian than a black, but both of those demographics have much lower case rates.

        I think it’s probably mostly geographical. Percentage-wise that demographic is in disproportionately crowded cities. Obesity rates are probably an issue as well.

        • EchoChaos says:

          I think it’s probably mostly geographical.

          Doesn’t seem to be. Georgia is hot and humid and blacks are substantially more rural, but blacks are doing way worse in Georgia than whites.

          Underlying risk factors plus culture are more likely.

          One of the major superspreader events in GA was a funeral, for example. Cultural differences in how you mourn at a funeral could explain why it was a superspreader event.

          • Purplehermann says:

            What do underlying risk factors have to do with it?

          • EchoChaos says:

            @Purplehermann

            We know that some percentage of cases are asymptomatic and thus never reported because the victim never shows symptoms.

            If underlying conditions exacerbate the disease, then even if the exact same percentage of whites and blacks were infected, we would see more black cases if blacks have more underlying conditions.

            Just spitballing, but it made sense to me when I typed that.

          • rumham says:

            They are still represented higher in urban areas proportionally than total state demographics, although the difference isn’t that much (4 percentage points or so). So yes, after looking that up, I agree that geography is unlikely to be the predominate factor.

          • Purplehermann says:

            @EchoChaos that makes sense, though I kind of doubt its an important factor- lots of white peole are fat, and I think whites are older on average (less children, larger life expectancy)

          • EchoChaos says:

            @Purplehermann

            Status: Total speculation, but seems reasonable to me

            Just googling about, blacks are much unhealthier than whites in things that we know are major factors.

            For example, 75% of blacks have hypertension by middle age:

            https://www.cardiosmart.org/News-and-Events/2018/08/African-Americans-are-More-Likely-to-Develop-High-Blood-Pressure-by-Middle-Age

            Blacks are almost half again as likely more likely to be obese as whites:

            https://www.pbs.org/newshour/health/cdc-obesity-data-reveals-wide-gap-white-black-americans

            As for age, you’re likely thinking of the fact that there are lots of young minorities, but that’s mostly driven by Hispanics. The black age curve and the white are similar.

            https://qz.com/1013714/one-metric-shows-that-race-in-america-is-about-to-experience-a-dramatic-shift/

            There are certainly tons of unhealthy whites out there, but if we’re looking for why blacks are doing relatively worse in terms of COVID cases and severity, lifestyle seems to be a big reason.

          • Jaskologist says:

            Is there still evidence that blood types matter? There was a link here a while back that had B as significantly higher risk and O as significantly lower. This alone would produce racial disparities, and w’re not normally used to treating bloody type as an “underlying risk factor.”

            (African-Americans have a higher proportion of both B and O relative to Caucasians, so I don’t know how that would shake out prediction-wise.)

          • rumham says:

            @Jaskologist

            It was type A that was the high risk group.

            Current theory is that it is tied to ace2 receptors. So it dovetails with the smoking being preventative theories and the blood pressure meds causing worse outcomes theory.

          • Purplehermann says:

            @EchoChaos
            The hypertension is interesting.

            The obesity article is from 2014, there isn’t much of a difference between black men and and white men, though black women do have a higher rate. The average is 1/6 again for blacks vs whites.

            I would re-read the quartz article and look carefully at the charts, blacks are definitely younger by a good bit, though hispanics are even younger.

            I was baing it on most black families I’ve met having a bunch of kids, whole the average is 2.3 or something in the US.
            A quick Google search shows black kids are the same percentage of the US children now as years ago while white children are a noticeably smaller percentage.

        • Purplehermann says:

          I don’t understand what obesity has to do with infection rates.

          If the intent is that obesity difference are responsible for death rate differences, I’d like to see some sources for both a higher infection:death rate among blacks, and that blacks have more obesity.

          Blacks (and even more so hispanics) have more kids in a household, for an example of a cultural risk facor

          • rumham says:

            Obesity rates

            Non-Hispanic blacks (49.6%) had the highest age-adjusted prevalence of obesity, followed by Hispanics (44.8%), non-Hispanic whites (42.2%) and non-Hispanic Asians (17.4%).

            and deaths:infection

            The effects of COVID-19 on the health of racial and ethnic minority groups is still emerging; however, current data suggest a disproportionate burden of illness and death among racial and ethnic minority groups. A recent CDC MMWR report included race and ethnicity data from 580 patients hospitalized with lab-confirmed COVID-19 found that 45% of individuals for whom race or ethnicity data was available were white, compared to 55% of individuals in the surrounding community. However, 33% of hospitalized patients were black compared to 18% in the community and 8% were Hispanic, compared to 14% in the community. These data suggest an overrepresentation of blacks among hospitalized patients. Among COVID-19 deaths for which race and ethnicity data were available, New York Citypdf iconexternal icon identified death rates among Black/African American persons (92.3 deaths per 100,000 population) and Hispanic/Latino persons (74.3) that were substantially higher than that of white (45.2) or Asian (34.5) persons.

            Obesity is probably just a good metric for cholesterol lining the arteries. I think that is the more accurate risk factor, given what we know about covid causing unusual blood clotting. In fact, I probably shouldn’t have mentioned obesity at all, as although it’s more likely causative than race, it’s less precise than high cholesterol. But I have seen mentioned that there are other explanations as well, such as reduced lung capacity.

          • 2181425 says:

            Not speaking to the ethnic issue, but obesity appears to play a big role in case severity:
            link text

          • Purplehermann says:

            @rumham I checked the link for infection:death rate, and this is the source for the black hospitalization rate. I didn’t see any source for community infection rates and am fairly skeptical that they would have good data on that.

            conducts population-based surveillance for laboratory-confirmed COVID-19–associated hospitalizations among persons of all ages in 99 counties in 14 states (California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah), distributed across all 10 U.S Department of Health and Human Services regions.§ The catchment area represents approximately 10% of the U.S. population. Patients must be residents of a designated COVID-NET catchment area and hospitalized within 14 days of a positive SARS-CoV-2 test to meet the surveillance case definition. Testing is requested at the discretion of treating health care providers.

            Among the 1,482 laboratory-confirmed COVID-19–associated hospitalizations reported through COVID-NET, six (0.4%) each were patients aged 0–4 years and 5–17 years, 366 (24.7%) were aged 18–49 years, 461 (31.1%) were aged 50–64 years, and 643 (43.4%) were aged ≥65 years. Among patients with race/ethnicity data (580), 261 (45.0%) were non-Hispanic white (white), 192 (33.1%) were non-Hispanic black (black), 47 (8.1%) were Hispanic, 32 (5.5%) were Asian, two (0.3%) were American Indian/Alaskan Native, and 46 (7.9%) were of other or unknown race. Rates varied widely by COVID-NET surveillance site (Figure 2).

            The results speak for themselves – unless you think <14% of hospitalizations in general are asian or hispanic combined, while blacks are ~33%, something is weird there.
            Maybe n=580 is too small for accurately measuring this of thing.

            The New York data just shows that there is higher population:death rate, not a higher infection:death rate as far as I can tell.

            As for obesity, I looked your link and it's source.

            Among men, the prevalence of obesity was lowest in non-Hispanic Asian (17.5%) compared with non-Hispanic white (44.7%), non-Hispanic black (41.1%), and Hispanic (45.7%) men, but there were no significant differences among non-Hispanic white, non-Hispanic black, and Hispanic men (Figure 2). The prevalence of obesity was lowest among non-Hispanic Asian women (17.2%) compared with non-Hispanic white (39.8%), Hispanic (43.7%), and non-Hispanic black (56.9%) women, and prevalence among non-Hispanic black women was higher than all other groups.

            This is for adults. I don’t know how the age adjustments affect things.

            Blacks have an age adjusted 49.6% obesity to white 42.2%.

            It mostly plays out in fat black women, the men are not significantly more likely to be obese apparently.

            So obesity is not a reason to expect more black men to have cases than any other male demographic, and we should expect relatively larger amounts of black female severe cases.

          • rumham says:

            @Purplehermann

            Interesting. Thank you for the breakdown. I keep looking and every link has “age adjusted”. More granular would be better, as we could rule it out with male vs female. Age sex and race data would be the best. As it stands, you are still probably correct. But if it’s the result of a wider community spread, we should know in a month or so.

      • John Schilling says:

        Culture is probably a big difference.
        This opens up a can of worms, as lefties would not like to discuss any parts of black culture that could be seen in a negative light, regardless of whether the issue is moral, practical, acute or chronic.

        A potentially relevant observation: In the past week or so, I’ve noticed a greatly increased number of not-just-family social gatherings in my suburban neighborhood. These have been predominantly among black families, some hispanic, and almost no whites. And for that matter, the whites are mostly working-class rather than professional-class.

        Pre-lockdown, conducting one’s social life through the internet I think fell largely in the SWPL category. It is quite plausible that willingness to maintain strong social distancing during (and for that matter after) the lockdown is going to be significantly higher among the professional white people demographic and diminish with cultural distance from that demographic.

      • Almost nobody seems to be talking about the fact that males are also substantially more likely to die of it than females — about twice as likely from the data for my area as of a while back.

  17. salvorhardin says:

    After 9/11, the phrase “security theater” became widespread to refer to anti-terrorism measures that naively look protective but have little if any evidence of effectiveness. Why haven’t we seen “public health theater” get traction yet? Or has it (or some similar phrase) done so already and I missed it? There’s no shortage of examples to point to– banning low-contact outdoor activities and services as “nonessential” is my current pet peeve; I imagine Europeans might regard official permission forms to leave the house similarly.

    • Clutzy says:

      I don’t doubt eventually there will be, but pro-shutdown is really an overwhelmingly dominant position right now with people who control most of the news. My sister in law who is a stereotypical NYT junkie was arguing with me forcefully about the merits of shutdown being 100% the thing supported by science. She knew nothing of the antibody studies, that most models have been amended, etc.

    • Matt M says:

      This kind of talk is pretty common in the various “reopen” groups populated by hardcore shutdown opponents, but as Clutzy points out, this is still a pretty small/fringe group…

      • salvorhardin says:

        Well, the other commonality is the lack of nuance. ANSWER, Code Pink, etc were and are pretty crazy back in the day: I would say both similarly crazy and similarly unpopular to today’s “reopen now” protester groups. But they saw and publicized aspects of the essential ridiculousness and immorality of the establishment response to 9/11 much more loudly than most others were able. Which meant, unfortunately, that if you raised what now in retrospect look like moderate and reasonable concerns about that establishment response, you got lumped in with the ANSWER types.

        Similarly, those of us who think that Sweden looks to have about the right balance– which, note, is way way stricter than “do nothing”– and that moving stricter lockdowns to the Swedish level would have a nonzero but acceptably small public health cost and very large benefit find it hard to articulate that position without being lumped in with the stupidest claims and antics of the “reopen everything” protest crowd.

    • Edward Scizorhands says:

      Michigan making it illegal to buy seeds for vegetables was pretty clearly public health theatre.

      • albatross11 says:

        Security theater is where you do things that are unproductive but look productive, to reassure people. Having the national guard send soldiers (with unloaded guns, apparently) to stand around in airports was security theater.

        Michigan making it illegal to buy seeds for vegetables sounds more like plain old dumb policy–more like banning nail clippers from airplanes. Nobody feels more secure (rightly or wrongly) knowing that nail clippers were kept off the plane.

    • j1000000 says:

      I like the term. Some of the stuff seems outright counterproductive.

      The outdoor activities bans you mention are, I’m assuming, motivated by fear of being accused of discrimination. Allowing tennis and golf but not basketball is the sort of stuff that gets into New York Times op eds.

      In the park near me the baseball field was locked up. That’s about 33% of the park. Before it was locked people were walking around it at a safe distance. Now they’re packed tighter.

      • DinoNerd says:

        Locally, we saw families playing tennis together for the first few days of the lockdown; then they locked the tennis court area. (I’d say they were obviously families – usually one adult and 1 or 2 children.)

      • matthewravery says:

        Seems that way now that we have mounting evidence that, while surface transmission can be a thing, outdoor surface transmission is mitigated quickly by exposure to heat and UV, and airborn droplet transmission is the larger risk.

        A month ago, when the playgrounds were roped off near where I live, it seemed clearly within the realm of reasonable, if a little severe.

        • j1000000 says:

          Yeah the park’s basketball hoops are zip tied and playgrounds are closed, but I don’t mind either of those decisions. But the baseball field is mostly just space. Around me we need as much space as we can get — every street is crowded if the weather is remotely nice

    • DinoNerd says:

      I’ve been using the term “security theater” to refer to some of the measures put in place supposedly to protect us all against Covid-19.

      It didn’t even occur to me to try “public health theater” instead.

  18. meh says:

    so georgia restaurants were allowed to reopen, and contrary to some predictions here, everything did not go back to pre covid levels. many places chose not to reopen, and many customers were hesitant to eat out

    • John Schilling says:

      I don’t think anyone here or elsewhere was predicting significant gone-to-hellishness being observed in less than a week or two, so this is very premature.

      • Edward Scizorhands says:

        I wrote up a whole comment saying meh’s comment was dumb, but it turned out I misread it, and I deleted it immediately after posting.

        People’s behavior isn’t going back to pre-covid behavior, just because lockdowns end.

      • Wrong Species says:

        +1

        We need at least another two weeks, before we can get anything from the data, and even then it will be really noisy. But honestly, I think as long as curve isn’t obviously trending exponential again, we don’t need to close things again.

    • John Schilling says:

      There is of course a huge middle ground between “normal economy” and lockdown. Almost certainly the sweet spot is somewhere in that middle.

      • Edward Scizorhands says:

        “Normal economy” is not a choice even if we wanted it to be, just like “no extra deaths” is not.

        • Matt M says:

          Exactly. I agree with you both. Even if no government anywhere in the nation had implemented any restrictions, there’d still be a huge economic downturn because of some/most people voluntarily limiting exposure.

          What if no government anywhere had implemented restrictions and the news media insisted that COVID was no big deal and most people didn’t have to take any extraordinary measures to protect themselves from it?

        • Edward Scizorhands says:

          Even if we were in complete ignorance of the coronavirus, we were still going to take an economic hit from the surplus deaths.

          And I guess it’s conceivable that meat-packing plants would continue to operate when so many workers keep getting mysteriously sick. But not likely.

        • albatross11 says:

          Matt M:

          Noble lies backfire, especially when they’re about observable things. Let’s imagine the mainstream US media and mainstream politicians had continued the “it’s just the flu, go out and party, the real problem is racism in thinking Chinese people are more likely to have it” line until the present day. New Yorkers and anyone in that area would notice with their own eyes that hospitals were overwhelmed and morgues were overloaded–with nobody taking any precautions and no official above-the-table preparation, that situation would be way worse. Imagine that line persisted up until today, two months into a terrible outbreak that killed a big pile of people.

          Who still believes anything those media organs say at that point? Even the normiest of normies is treating the NYT as slightly less reliable than RT and the Weekly World News. Who will believe any pronouncement from the mayor of NYC or the governor of NY or the president, after they’ve visibly lied in ways that have huge personal consequences for lots of people, and got a bunch of people killed in the bargain. The best outcome available for them would be all those politicians permanently out of power, and the media organs out of business. The worst outcome would involve several of those political leaders dangling from trees and perhaps a civil war, because at the end of that process, once again, even the normiest of the normies would have zero faith in their government, and would see them (correctly) as people who’d put their own citizens into mass graves rather than be off-message and risk harming the economy.

          My family supports three news sources–WSJ, Washington Post, and NPR. If they lied to us about something like this, gave us intentionally bad information to stay off message, when do you suppose we’d be sending any of them any more money? About a week after hell freezes over.

          Later on, suppose the virus had been dealt with–we’d acquired herd immunity, or a vaccine was available. The respectable media organs of your society assure you that the vaccine is safe, and the political leaders all agree. How are you feeling about trusting them? Last time you trusted them, your mom died of pneumonia and you spent a month deathly ill and still can’t walk up a flight of stairs without being winded. Are you getting that shot? Are you believing them when they tell you it’s safe to go back to restaurants and stores? Nope, not ever.

          Mainstream information sources already do some of this, and it has cost them and us as a society. Every time someone in a mainstream media outlet complains about antivaxers or online conspiracy theorists, I want to email them links to the NYT’s coverage leading into the war in Iraq, their coverage of IQ and educational issues, their coverage of the shooting in Ferguson, MO, and similar stuff, with the subject line “reap as you sow.” But that’s mostly about stuff that’s not so immediately observable. Do it in a way that gets a whole bunch of people killed, visibly, and you’ll spend those sources’ credibility forever.

        • Matt M says:

          Noble lies backfire, especially when they’re about observable things.

          I agree. The problem is that the media switched from one noble lie “it’s just the flu” to another “it’s a horrible plague that will definitely kill you even if you’re young and healthy and it will spontaneously appear in any place where two or more people gather in its name”

          The current media coverage of COVID isn’t any less wrong than what they were saying in February. It’s just as wrong, but in the other direction.

        • DarkTigger says:

          @Matt M
          (I know I will regret that question because you will have an example)
          But who said it will defenitly kill you?
          Everything I read is: It can kill you even if you are young.
          And if it don’t kill you it can give you lung fibrosis to a degree that you need to visit a doctor regularly, rises your chance to get a stroke, fucks with your ability to taste and smell, and might even attack your brain, all of which might leave permanent damage.

          We could just as well ask: Why do we ut billions into stroke medicin if it mainly hit’s old people?

        • Matt M says:

          DarkTigger,

          I don’t have an example of a news organization saying “If you get COVID it will definitely kill you.”

          What I do have are thousands of examples in various social media comments of people saying things that only make sense if you believe that is true.

          Consider the recent example of a teacher who, encountering two kids playing on a playground, was reported to have said “I hope you catch COVID and die.” Is it reasonable to assume this person understands that the IFR for COVID is somewhere between 0-2% (and significantly less for the teenagers she was specifically berating)?

          The hysterics among us seem to be making a lot of very incorrect assumptions about this disease. They got them from the mainstream media. Not by the mainstream media literally saying “this disease kills everyone who gets it” but by saying more general things like “stay at home, save lives” which could probably be evaluated as “not entirely false” by a neutral fact checker, but still gives a very misleading impression (that if you don’t stay at home, someone will probably die as a result).

        • John Schilling says:

          Everything I read is: It can kill you even if you are young.

          So can lightning bolts. Numbers matter.

          Well, they ought to. The insistence that everything has to fit into either the “Absolutely Safe” bin or the “Intolerably Dangerous” one has caused no end of stupidity, and COVID-19 only amplifies that.

        • Matt M says:

          I’ve read that in many jurisdictions, the median COVID death is actually higher than the life expectancy (no I do not have a link/source handy, feel free to not believe me).

        • DarkTigger says:

          @Scoop
          A third of USAmericans are obese. Obesety is an privious health problem that is known to be a risk factor for covid. This might affect the 0.5-2% number of people with out previous health risks.

          In Europe EuroMoMo has reported an rise in the exess deaths in the group of the 15-65 year old in the last few weeks, so it does hit people who we exepct to live and work for at least a couple of more years.

        • Matt M says:

          In the US so far, the population fatality rate for Americans under 45 (all health conditions) is about 1-in-375,000

          Which makes “COVID can kill young people too!” the exact sort of “technically true but unbelievably misleading” statement that modern media seems to be almost exclusively built around.

        • Randy M says:

          So can lightning bolts. Numbers matter.

          News lady on some channel as I walked past the break room just now said something like “No matter how much you want to go out, remember, it’s still safer inside.”

          It’s always safer inside, barring an earthquake, fire, hurricane, etc. The percentage is highly relevant.

        • Matt M says:

          The fact that the mainstream media is completely unwilling to put COVID risks in context by comparing them to fatality rates from other things (whether it’s the flu or automobile crashes or lightning strikes or whatever) should, itself, speak volumes.

          The only thing they are willing to do is repeat ad-nauseum “this thing is dangerous and can kill you.” Once again, not technically false. But chairs can kill you too and we haven’t banned those (yet).

        • DarkTigger says:

          How can the prevalence of a health risk affect the death rates for people with no health risk?

          Sorry, I was unclear. What I wanted to say was: The prevalence of people with health risks puts the death rates for people into an perspective. Yeah your chances are really good if you are under 65, and have no previous condition, put the precondition isn’t true for a lot of people.

        • Edward Scizorhands says:

          Various thoughts:

          1. There is no policy that gets us no economic damage, and no policy that gets us no additional deaths. Either extreme still has big losses in the thing it’s trying to save.

          1.1 There are side-effects from both kinds of losses that spillover into the other. Economic harm will lead to health harm; health harm will lead to economic harm.

          2. The best policy is probably between the two extremes.

          2.1 But many policies between the two extremes might be strictly worse than either extreme. The “even with no law against murder we still won’t have a lot of murder” example elsewhere illustrates this. If something is banned, it might be better to really be banned [1] for everyone rather than letting your altruists take one for the team and be destroyed.

          3. Even where the virus is serious, if people have stuck with the social distancing guidelines, they need some visible reward and signs that things are getting better. So nearly everywhere that has gone through some lockdown should be opening up some things, relative to where they are now. This doesn’t mean you have to let everything go. But look at the places where you can get the biggest economic bang and/or put in the best precautions and/or the least marginal unit of risk is created, and give it a go.

          3.1 The messaging on this needs to be clear. “Despite the continued danger, we think this is a prudent risk we can afford to take.”

          3.2 Different places should open up different things, based on what they think is best. All models are wrong, but some are useful. And we can get real-world data showing what really is and what really isn’t safe to open up by watching the people making their best decisions and the results of that.

          [1] This doesn’t mean 100% compliance. But it might mean 99% compliance and the cheaters aren’t flaunting it.

        • Matt M says:

          Yeah your chances are really good if you are under 65, and have no previous condition, put the precondition isn’t true for a lot of people.

          FWIW, I fully agree with this.

          The statement of “healthy people are at low-risk of dying from COVID” is true, but there is an issue with it because most people don’t realize just how many things technically count as “unhealthy” and they don’t see “manageable diabetes” or “top quintile of BMI” or “high blood pressure” as unhealthy, even though it is.

        • Matt M says:

          2.1 But many policies between the two extremes might be strictly worse than either extreme.

          I’ve said this before too.

          I wonder if people would agree or disagree with the following statement:

          The worst case scenario here is not “millions die from COVID” or “we suffer a huge economic depression.” The worst case is that we get both.

          My worry is that current policy of lockdowns, but with minimal enforcement and huge exceptions, practically guarantees we’re going to get both.

          Unless you seriously believe we can keep this level of lockdowns in place until a vaccine is discovered (which might possibly not ever happen), then the lockdowns are doing damage, but are not saving any lives in the long run (excepting the sense in which we are preventing hospital capacity overloads, in the original meaning of “flatten the curve”).

        • DarkTigger says:

          @Matt M
          So okay let’s play:
          In the US
          – the flu season 2019/2020 killed according to the CDC 24,000 – 62,000 people (remember those numbers are an estimate compared to the CFR we have for Covid-19)
          – Car crashes killed 38800 people according to the NSC
          – Lightning killed 0 people according to the National Weather Service.

          In the last two months Covid-19 killed 58,123.
          So despite massiv interventions this deases killed about as much people in two months as the flu did in seven, and moce than car accidents in 12.

          (Also car accidents in Wuhan does not cause deaths in NYC just saying)

        • matkoniecz says:

          @DarkTigger Thanks for bringing data into it!

          I so overestimated how many people are directly killed by lightning.

        • albatross11 says:

          Matt M:

          But that’s true of all risks ever. Your kid was never likely to be molested by a stranger or a priest, you were never likely to be killed by a terrorist, etc. That’s just the way most media sources are, both because of incentives and because of statistical innumeracy.

        • The Nybbler says:

          @Scoop

          The Census estimates under-44 NYC population at 5,097,000. COVID deaths for those ages are 487 confirmed, 112 probable. So the mortality risk in Plaguetown, USA for COVID-19 if you’re under 44 is about 0.012%. Or 1 in 8509. About the same as the (all-age) risk of dying in a car accident in a year. Or, looking at that same chart, not as likely as dying of poisoning in a year. But about that one: you may recall that calls to poison control centers are up by a considerable amount….

        • Edward Scizorhands says:

          There are a lot of ways the virus can fuck you up short of killing you.

        • The Nybbler says:

          There are a lot of ways the virus can fuck you up short of killing you.

          Same goes for poisons and car accidents. Leave the goalposts where they were.

        • JPNunez says:

          Granted, all that math is pretty rough, but I think it’s still safe to say that we’d have to lose many times as many times more people to C19 to make it have a worse health toll than we see from annual traffic deaths.

          Gotta keep in mind that the various levels of lockdowns _probably_ lowered traffic accidents, tho.

    • Matt M says:

      I’m pretty sure this is mainly directed at me, and my general anti-lockdown stance.

      I feel like I’ve acknowledged the circular nature of this debate many times, but I’m not sure that you have. All I’ll say is that “even if the lockdowns are lifted, people will still stay at home” seems to me to be an argument in favor of lifting the lockdowns, not opposed to it.

      If you can achieve similar social distancing results without heavy-handed government policy that restricts the basic rights of individuals, that’s probably the best bet. If you don’t think that will happen, then you agree that lockdowns are altering behavior.

      • Evan Þ says:

        It’s an argument, but I don’t think it’s a sufficient argument.

        If the government repealed the law against murder, most people probably wouldn’t kill anyone, but a few would, and they’d cause a lot of problems for the rest of us. Similarly, supposing that most people would still stay at home in the absence of lockdowns, there’d still presumably be some who wouldn’t. If those some then get the disease and spread it to many other people (maybe at grocery stores?), that would cause some problems.

        I maintain that it’d cause fewer problems than continued lockdowns, but that’s a longer argument.

        • albatross11 says:

          Further, if the government repealed the law against murder, people would take private measures to avoid being murdered–probably including every adult walking around armed all the time and maybe including a contract with some criminal gang to go kill the SOB who knocked me off if I turn up dead.

          • Evan Þ says:

            Yes. The bother of taking those private measures is among the problems that it’d cause.

      • HeelBearCub says:

        IIRC, you and several others have rather vociferously argued that economic woes were the result of a failure of supply (lockdown order) not a failure of demand.

        • baconbits9 says:

          This doesn’t contradict his position at all.

        • Matt M says:

          Just to be perfectly clear, my position is not that even if everyone did exactly as I demanded, there would be zero economic impacts associated with COVID.

          My position is that the economic impacts would be far less severe than they will be in a reality where people order huge swaths of the economy shut down, for everyone.

          How much less severe? I don’t have an exact number handy, but I’d be willing to say at least 2x.

          • Edward Scizorhands says:

            How are places like Sweden or Nicaragua doing, economically?

          • Matt M says:

            I wish I knew! It seems like economic statistics are one of those things that tend to lag by at least a quarter, if not longer.

            I suspect we won’t really be able to answer the “which approach was best” question until at least a year from now, at the earliest…

          • silver_swift says:

            @Scoop, you’d also have to compare it to data from before and to other countries with strict lockdown measures.

            This is the first hit I found for Swedish unemployment rates, which is somewhat up from last year, but not significantly. Then again, neither are the same graphs for Belgium, Germany or France.

        • John Schilling says:

          Lockdown orders produce a reduction in supply (factories and businesses closed) and a reduction in demand (fewer consumers for many goods and services).
          Ending the lockdowns, or not implementing them in the first place, would result in more supply, more demand, and a stronger economy from whichever direction you look.

          Not all the way to pre-coronavirus normal, insofar as people are still apprehensive about going out. Maybe 50% of normal. And since this predictably didn’t turn out to be the one-month temporary measure that was first promised, odds are pretty good that’s close to where we want to be and maybe ought to have been all along.

          • HeelBearCub says:

            Lockdown orders produce a reduction in supply and a reduction in demand

            Yes, I completely agree. I made that point at the time.

            And, also, Covid-19 itself does both of these things (not as much as lockdowns though).

            Maybe 50% of normal. And since this predictably didn’t turn out to be the one-month temporary measure that was first promised, odds are pretty good that’s close to where we want to be and maybe ought to have been all along.

            We are well above 50% of normal already. 2nd quarter US economic activity is estimated to drop 20% to 30%. This is unprecedentedly large.

            But I don’t know how you can be at all sanguine about what the “right” level is.

          • John Schilling says:

            We are well above 50% of normal already

            50% of the economic activity impacted by the lockdowns, if that wasn’t obvious. And if it was 50% of the total economy, we wouldn’t be having this discussion because we wouldn’t be having lockdowns.

      • meh says:

        if the lockdowns are lifted, people will still stay home is an argument in favor of lifting them.

        if the lockdowns are lifted, the economy will still be hurt is an argument in favor of keeping them.

        this was just showing that the argument that we can return the economy to normal is wrong.

    • Clutzy says:

      For someone like me, restaurants and beauty salons were never my problem with the lockdown. Its the other things that look just like a grocery store, but sell other things, like an Iphone store, or repair shop. And the various “nonessential” factories that actually are quite essential, particularly in electronics.

      • Mark V Anderson says:

        I currently work for Best Buy (for another two months). It is my understanding that Best Buy is still open everywhere, but providing curbside service. Are there some states that have forced Best Buy down completely? The stores are certainly open in my state of Minnesota. I agree that electronics is essential in the lockdown economy.

        • Clutzy says:

          The best buy nearest me is shut down. I don’t know if that is a choice or a requirement (they don’t have a good spot for curbside), but I couldn’t run over there to get new headphones when my mic stopped working.

        • Garrett says:

          Annoying thing: big-box stores near me which have gone to curbside-only won’t allow the curbside purchase of ammunition or firearms.

  19. matkoniecz says:

    PTSD in ancient times – https://news.ycombinator.com/item?id=22990296 points out https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_there_any_indications_of_combat_ptsd_in/cbbvfib/ that in turn has claim that PTSD manifested in a different form in ancient times rather than not existing.

    Cross-cultural psychologists have observed that, regardless of cultural background, people who suffer persistent emotional disturbances in the wake of a traumatic event exhibit intrusive memory symptoms in some form. Here in the US, these are closely related to what we commonly call “flashbacks.” For the Romans, people experiencing intrusive memories were said to be haunted by ghosts. These individuals show up in historical, philosophical, and even medical texts.

    Josephus, who was an outsider to Roman culture, also describes this phenomenon in his history of The Great Revolt. Those haunted by ghosts are constantly depicted showing many symptoms which would be familiar to the modern PTSD sufferer. Insomnia, depression, mood swings, being easily startled, frequent eye movement, alertness all day and night, paranoia, avoidance of crowds, suicidal thoughts/attempts, loss of appetite, shaking/shivering, self-hatred, and impulsive violence have all turned up in association with these individuals.

    Since in almost every case the person experiencing these things had made himself an object of public shame, the “ghosts” in question often came in the form of those he had killed or wronged in the past. These would either appear spontaneously to the sufferer, or would come in the form of vivid, frightening nightmares.

    The key component to these experiences, as with modern cases of PTSD, was that the sufferer had no control over his own symptoms. Thoughts or vivid memories would occur unexpectedly and uncontrollably. It is easy to see why the Romans, who were religiously superstitious to begin with, would attribute such things to the foul play of malicious spirits.

    • Le Maistre Chat says:

      What I find most interesting is that the first (?) materialist explanation, “shell shock”, turned out to be false just like ghosts. We didn’t get a more accurate understanding of war trauma by the early 20th century, just an anti-supernatural paradigm.

      • LadyJane says:

        The early 20th century explanation was still much closer to the truth than “ghosts did it,” though, and paved the way for the actual truth to be discovered. In much the same way that “the Earth is round” is vastly closer to the truth than “the Earth is flat,” and paved the way for us eventually discovering that the Earth was actually an oblate spheroid. The flat-Earth hypothesis never could’ve led to the oblate spheroid hypothesis, just like the ghost hypothesis never could’ve led to a nuanced understanding of post-traumatic stress.

        • Randy M says:

          The early 20th century explanation was still much closer to the truth than “ghosts did it,” though

          Is that true? The “Shell Shock” theory was that it was due to the physical trauma of brains rattling around skulls due to concussive force, wasn’t it?

          Whereas PTSD is actually caused by the psychological feeling of helplessness and prolonged dread and repeated and unexpected terror? Correct me if I’m wrong on either count.

          Given the above, ghosts, despite not actually existing, sound closer to the explanation than shell shock.

          • HeelBearCub says:

            I believe that TBI and PTSD related to each other, though.

            … evidence has accumulated that PTSD can develop following mild TBI. Intriguingly, both case studies and cohort studies have noted the existence of PTSD developing following severe TBI. In many of the latter cases, these individuals suffer very significant periods of retrograde and anterograde amnesia, such that they do not recall any episodes of the traumatic experience.

            Note that blast wave pressure can cause TBI on its own.

          • Randy M says:

            Correction noted!

          • Le Maistre Chat says:

            Interesting! So to our current knowledge, it has both TBI and geistig (psychological) components.

      • mtl1882 says:

        In the early 1800s, doctors treating the new wave of railway crash victims noticed similar symptoms and diagnosed “railway spine.” The theory was that their spine’s molecules were “deranged” in the crash from being whipped around, and caused problems in the nervous system.

      • Buttle says:

        Before shell shock, we had “soldier’s heart”, or “Da Costa’s Syndrome”, an explanation for the change in Civil War era soldiers based, literally, in their hearts, which were suspected of being damaged by the physical demands and privation of war. One of the symptoms is orthostatic intolerance, that feeling, once one has stood up, of preferring to sit or lay back down.

        https://www.ahajournals.org/doi/10.1161/01.CIR.53.5.749

    • Andrew Hunter says:

      I’ve been reading a *great* blog by a military historian who strongly disagrees with this perspective: https://acoup.blog/2020/04/24/fireside-friday-april-24-2020/

      (This is seriously one of my favorite blogs now, from analysis of armor and armies in all your favorite fantasy books, to coverage of historical war poetry, to chemical weapons…)

    • broblawsky says:

      Some of the argument over ancient vs modern PTSD reminds me of Scott’s observation on reading The Body Keeps The Score that “wizardry” – e.g. ritualized BS – might actually help some people with PTSD. Some people with PTSD seem to respond well to being formally told by someone they trust that all of the ghosts are definitely gone, you’re welcome, please deposit your denarii in the vase by the door.

    • bottlerocket says:

      That was really fun to read – thanks!

      I think part of what I liked about it is that it really lays bare how fungible story outcomes are. I feel like one weird fallacy I’ve run into (not here) is people saying things like “Fictional story X teaches us the dangers of Y.” No it doesn’t! Someone just wrote a story well that happens to resonate with you.

      The best I’ve been able to steelman it is that humans have decent heuristics for evaluating the likeliness of a scenario if it’s presented to them, especially ones they wouldn’t have thought of otherwise. It still seems horrendously vulnerable to bias, though.

      • VoiceOfTheVoid says:

        Reminds me of a youtube video I came across a while ago [content warning: civil but passionate atheism]:
        https://youtu.be/NfyoDgszas0

        • Nancy Lebovitz says:

          Thank you– that was excellent.

          It’s a rare pleasure to see a video– perhaps especially an atheist video– with ideas I haven’t seen before.

          • VoiceOfTheVoid says:

            I’m glad you got something out of it! This channel is a rare specimen of (for lack of a better phrase) atheist propaganda that makes high-effort, well-thought-out content rather than just constantly trying to dunk on Christians.

    • phi says:

      Brilliant! Reminds me of this: https://slatestarcodex.com/2019/03/28/two-wolves-and-a-sheep/

      Sour grapes (starting with the original fable for those who haven’t heard it):

      A fox came across some grapes hanging from a vine. He reached up as high as he could, and even tried jumping, but he could not reach them. He gave up and walked away, saying as he did so, “it’s just as well, those grapes were sour anyway, and not fit for consumption.” Moral: It’s easy to disparage that which one cannot attain.

      A fox came across some grapes hanging from a vine. They were very low to the ground, so he could reach them easily. He began to eat them, and then sputtered and spit them out. A dog had peed on them. Moral: Don’t eat fruit that is below dog-height.

      A fox came across some grapes hanging from a vine. He could not reach them, so he walked away saying “ah, who needs those sour grapes anyway”. A watching raven mocked the fox: “What a fool. He’s just mad that he can’t reach the grapes.” The raven flew up to the vine and began eating the grapes himself. He sputtered and spit them out. Moral: Sometimes the grapes actually are sour.

      A fox came across a grape vine, with many bunches of grapes hanging from it. He gathered all the ones he could reach, and enjoyed a very pleasant snack. Then he continued on his way. Then another fox came along. She tried to pick some of the remaining grapes, but could not reach any of them. “There is no more low-hanging fruit!” she lamented. Moral: Something something, efficient market hypothesis, something something.

      Two foxes came across a grape vine with some grapes hanging from it. It had been a difficult year, and they were both on the brink of starvation. They fought each other bitterly for the right to eat the grapes. Eventually one fox managed to kill the other. He went to pick the grapes, but could not reach them. “Eh,” he said, “the bastard deserved to die anyway”.

      A fox came upon some grapes he could not reach. So he waited, and watched. Soon the farmer came along with a ladder and picked the grapes and brought them into the farm house. Through a window, the fox watched the farmer smash up the grapes and put them into a barrel. Many months went by, and the fox returned often to see what was done with the barrel. One day, he saw the farmer putting the contents of the barrel into bottles, and loading the bottles onto a cart. The fox stealthily approached the cart, and stole a few of the bottles. The bottles were labelled “red wine vinegar”, but foxes cannot read. The fox picked up a bottle, popped the cork out, and took a swig…

    • beleester says:

      That blog has some great spins on a lot of stories, including some incredible extensions to the “Nate the Snake” story (aka The Longest Joke in the World)

      Also from Tumblr:
      Once upon a time there was a city called Omelas…
      There once was a woman who built her house upon the sand…

    • Skeptical Wolf says:

      And one missing variant from one of my favorite game settings:

      “But little frog… I can swim”

      • Edward Scizorhands says:

        Did the frog make it all the way across the road?

        • Skeptical Wolf says:

          No, it did not.

          The version of the story is from the L5R game setting, specifically the Scorpion clan. It is told to the clan’s founder (as a variant of the more common version of the story), who went on to deliberately lose a tournament and found a clan that frequently relies on being underestimated.

  20. LadyJane says:

    You are a German citizen living in Berlin during the height of the Second World War. One of your friends lets slip that he’s hiding Jewish refugees in his attic. Later, the SS come to your door asking if you’ve seen or heard anything about those refugees. You could protect the refugees simply by saying “no,” but that would require lying. On the other hand, giving an honest answer would assuredly result in the imprisonment and likely death of the refugees. What is the ethical course of action here?

    1. Lie to the officers. Lying isn’t morally wrong in this situation, since saving lives is a much higher moral priority.
    2. Tell the truth, even if it results in the refugees being killed. You can’t be responsible for the immoral actions of the SS officers; you can only be responsible for your own actions, and you have a moral responsibility to avoid lying.
    3. Admit that you know the location of the refugees (thus refusing to tell a lie), but refuse to tell the SS officers where that location is (thus refusing to put the refugees in harm’s way). Alternatively, stay silent and refuse to answer their questions at all. You’ll almost certainly be arrested, and likely even tortured or killed, but it’s the only option that doesn’t involve wronging either the SS officers or the refugees, so it would be a worthwhile sacrifice.
    4. Do whatever you want or whatever most benefits you, since morality is a spook and nothing actually matters beyond self-gratification.

    Personally, I’d go with the first option, and I get the sense that most people would do the same, but I’m also a consequentialist and a moral pragmatist. For someone who subscribes to a deontological view of morality, adheres to virtue ethics, or has a religious basis for their moral code (and follows a religion in which lying is considered a sin), would the second or third options seem more ethical? And for an egoist or nihilist who rejects morality altogether, is there any valid reason to protect the refugees? After all, you’d potentially be putting yourself at risk by lying to the officers, without getting anything out of it for yourself.

    • Nick says:

      The best course of action is probably to stay silent. If they give you an out, as far as poor wording or a too specific question (“Have you seen these refugees?”), take it. I think under such circumstances most folks would lie, though, and I can hardly blame them. I probably would, too.

      After all, you’d potentially be putting yourself at risk by lying to the officers, without getting anything out of it for yourself.

      It’s good that you mention this, because lots of people are not very good liars. A lot of these examples are rigged by assuming that when you lie everything turns out perfectly, but that is just not true.

      • matkoniecz says:

        The best course of action is probably to stay silent.

        I am not convinced that it is viable solution in case of someone asking you specifically. In case of addressing crowd – OK. But with “SS come to your door asking”…

        At that point refusing to answer will cause SS to torture you/your family and/or going through the entire building.

        • Nick says:

          I don’t know what you mean by viable solution. Of course it is not likely to turn out well; none of your options is likely to when SS officers bang on your door, although some are more likely to than others. But consequences are not how our actions are judged. In such an extraordinarily terrible situation, I can hardly blame a person for lying, but even less can I absolve it.

    • The Nybbler says:

      A deontological view wouldn’t necessarily preclude lying. The rules don’t have to be simple.

      I lie. No duty of truth is owed to monsters.

      • LadyJane says:

        @The Nybbler: Your answer and Baeraad’s come to closest to my own position. But for the sake of argument, would you apply the principle that “no duty of truth is owed to Nazis” unconditionally, even if no innocent lives were at stake? What if the Nazis were directly harmed as a result of your lie?

        For instance, let’s say you knew some men in the German Resistance. Would it be morally acceptable to give the SS officers a false location with the intent of sending them into a Resistance ambush, where the officers themselves would be the ones facing near-certain death? Or would that be going too far?

        What if you merely knew about an ambush that was going to happen, and didn’t play any part in it yourself? Would you have a moral obligation to save the lives of the SS officers by warning them of the Resistance plot, or is it acceptable to stay silent and allow them to go to their deaths?

        Personally, I think sending them into an ambush would be justified, given the extreme circumstances and the reprehensible actions of the Nazi Party as a whole. But I realize that such a course of action is even harder to justify under traditional morality.

        • Randy M says:

          Would it be morally acceptable to give the SS officers a false location with the intent of sending them into a Resistance ambush, where the officers themselves would be the ones facing near-certain death? Or would that be going too far?

          I have a pretty firm no lying stance.

          I also have a pretty firm “No killing stance.” Honorable combat was nice and romantic, but if you can kill someone, you can probably lie to them. So, given the Nazis in this example being the aggressors and deserving defeat in combat, I think lying to them as a strategem of war is probably merited.

          There may be more difficult cases where the conflict is not so one-sided morally and you as a citizen of polity X have a duty to the armed forces of nation x engaged in honorable combat, with a mirrored perspective on the opposition side.

        • EchoChaos says:

          For instance, let’s say you knew some men in the German Resistance.

          Was there any serious German resistance? I’m not aware of any, and Googling doesn’t turn up anything of any real consequence.

          As far as I know, Germans generally didn’t think of the Nazis as an occupying force, because they weren’t.

          • Matt M says:

            Yeah, while I’m aware of a few small insider plots to remove Hitler specifically, it seems like that was more of a “this guy specifically is nuts and will lead us to ruin and someone else could do a better job at all of this” rather than “this entire system is wicked and immoral and corrupt and needs to be replaced by something entirely different.”

          • John Schilling says:

            Canaris, at least, turned against the Nazis over the scope and official approval of war crimes during the invasion and early occupation of Poland, at a time when Hitler was still leading Germany to victories and seemed likely to continue. I doubt he was the only one, just the most highly placed.

            And I’m not sure, but the Nazis may have set a new record for Evil in being so thoroughly Evil that their own spymaster ratted them out over the evilness. I’m having a hard time thinking of other historical examples.

          • EchoChaos says:

            @John Schilling

            That’s really what I was getting at. While there were individuals who turned on the Nazis (both low and high in the chain), there wasn’t really a capital-R Resistance like there was in France/Denmark/Poland/etc.

          • Nick says:

            Of course there was German resistance! Look up White Rose, led by Hans and Sophie Scholl, for just one example. Other groups are mentioned such as the Kreisau Circle.

            Purely incidentally: Sophie’s boyfriend Fritz, ambivalent about the Nazi regime, nonetheless joined the Wehrmacht, reasoning that he was fighting for Germany and not for Nazism. Sophie wrote to him in 1940,

            In your ideal conception [joining] really accords with the moral demand made on every individual. [But] how can a soldier have an honest attitude, as you put it, when he’s compelled to lie? Or isn’t it lying when you have to swear one oath to the government one day and another the next? You have to allow for that situation, and it’s already arisen before now.

            Odd that this person who cared so much about Jewish lives thought there was something wrong with lying.

          • zoozoc says:

            There was resistance to what Germany was doing. Dietrick Bonnhaufer had relatives who were involved in many attempts at killing Adolf Hitler and Bonnhaufer himself eventually become more involved.

            When Adolf initially came to power there was more resistance. But I believe that he and his cronies spent the time leading up to WW2 purging all internal political resistance.

            The rise and fall of the 3rd Reich highlights many such attempts at usurping Adolf’s power. I think most resistance focused on Adolf because he really was more like a charismatic Dictator than an elected official.

        • The Nybbler says:

          But for the sake of argument, would you apply the principle that “no duty of truth is owed to Nazis” unconditionally, even if no innocent lives were at stake?

          To Nazis? Sure; it’s basically a given that their whole purpose is evil. But it’s wider than that; there are a whole lot of people I simply don’t owe an answer to, and if they won’t accept that or will commit harm if I refuse to answer, there’s no problem with lying to them. As major as Nazis asking about the Jews or as minor as a salesman who won’t stop bugging me until I give him some lie that indicates he’s got no chance of a sale.

          What if the Nazis were directly harmed as a result of your lie?

          Even better, since they’re actual Nazis. At best they are cogs in a murder machine, and if they get broken, so much the better.

    • Evan Þ says:

      I’m reminded of Corrie and Betsy Ten Boom, who were themselves hiding Jews in the Netherlands during the war and disagreed about this question. Corrie said she’d take your first option for the same reasons you give; Betsy insisted the second option was the only ethical choice. Their disagreement persisted until the SS actually came to search their house, with just enough warning for their Jewish guests to hide in the secret cellar.

      The SS demanded “Where are the Jews hiding?”; Betsy – visibly frantic – blurted out “Under the table!”
      They glanced under the table, totally missed the trapdoor to the cellar hiding under the rug, yelled at Betsy for lying, and proceeded to search the rest of the house and leave fruitlessly.

      Betsy would later die in a concentration camp, while Corrie would survive the war to become a famous Christian speaker and author. In her autobiography, she could only conclude from this scene that God would honor whichever ethical choice you make here as long as you’re sincerely trying to do good.

      • Nick says:

        Indeed; Brandon discussed this at Siris a few years ago:

        We don’t have to speculate in the abstract about what good and decent people do about lying in the Nazi-at-the-door scenario. We have accounts by these Amsterdam householders of the moral dilemmas they faced in this context, e.g., in the works of Corrie ten Boom; many of them were pious Dutch Calvinists, who were at least as strongly convinced that lying is wrong as Tollefsen. As such, they did not take the consequences automatically to justify them. Some of them refused outright to lie. Many lied but took themselves to be doing the right thing in a morally defective way, and they asked Christ for forgiveness for that defect and admired those rare souls who were able to face the same circumstances without having to stain themselves with a lie. Others did not know for sure whether they had done something that was strictly wrong, but stilled prayed to Christ to forgive them if they had.

      • zoozoc says:

        Maybe I’m mis-remembering or thinking of another book/person, but I seem to remember a similar incident that Corrie talks about where SS officers come to a house and ask the children of the house where the Jews are being hidden. The child then answers truthfully, but then laughs shortly afterwards. The officer thinks the child is playing a joke on him and doesn’t end up searching the location.

      • Kaitian says:

        I guess “you tell the truth but the soldiers ignore the refugees” is a good outcome, but it’s not one you can plan in advance. If you deliberately tell the truth in such a way that they’ll think it’s a joke, that’s basically the same thing as lying, but riskier. After all, once you’ve stated where the refugees are, the soldiers might decide to look for them any time.

        I also think the ethics of “you are personally hiding refugees” are different from “you know about someone hiding refugees”. After all, in the first case the refugees being found is also very bad for you (and you can’t really claim you didn’t know about them). In the second case, it’s mostly just bad for someone else, although you might conceivably get in trouble for lying about it. So from a purely selfish perspective, in the first case you should lie, and in the second case you should tell the truth.

        • I disagree.

          If you tell the truth, you are telling the soldiers that you knew where the refugees were and didn’t tell anyone until they demanded the information. That’s more likely to get you in trouble than lying, assuming you are a competent liar and the soldiers don’t already know that you have the information.

          • LadyJane says:

            I’d imagine you’d still be in less trouble than someone who was actively hiding refugees in their house, though.

            And for what it’s worth: When I asked the same question on a different forum, one person did indeed respond with “I wouldn’t wait for them to come to my house, I’d tell the SS in advance,” which I suppose is the optimal answer if your only concern is self-preservation. (Though it’s also challenging the hypothetical to a small degree.)

          • Kaitian says:

            @DavidFriedman
            That’s a fair point. But in case they did find out you had the information, you’d probably be better off telling them now rather than never. I guess being selfish is not as easy as I thought.

            @LadyJane

            By that standard, isn’t the person hiding the refugees already lying by hiding them in the first place? That would mean them lying vs not lying at the moment they are asked would barely make a difference. Unless we suppose that lying in response to a question is worse than lying by omission, either morally or in terms of the risk to yourself.

          • chrisminor0008 says:

            @LadyJane Was the forum 4chan? That’s about the answer I would expect there.

          • HarmlessFrog says:

            @chrisminor0008

            Funny, but that’s a legitimate course of action from the assumption that one’s own life and well-being overrides all other concerns.

          • LadyJane says:

            @chrisminor0008: As HarmlessFrog pointed out, I think there’s a difference between “I’d help the Nazis so I don’t get arrested/killed myself” and “I’d help the Nazis because Nazism is awesome.” Though a few people did give pro-Nazi answers: One person argued “The SS wouldn’t come to my door because if I’d been living in Nazi Germany, I’d be in the SS myself, and I’d immediately arrest my friend and kill the refugees he was harboring.” Someone else gave a similar answer, with the caveat that he’d try to “redeem” his friend (by convincing him of the righteousness of Nazism) instead of arresting him or selling him out. On the other side of the spectrum, someone argued that lying to the SS officers was justified because the Jews are the Chosen People, so anything that helps them is inherently justified, even if it harms non-Jews.

          • Nick says:

            @LadyJane
            …Were they all edgelording or something? This forum you’re describing sounds awful.

          • LadyJane says:

            @chrisminor0008, @HarmlessFrog, @Nick: I think it’s worth pointing out that prioritizing self-interest doesn’t necessarily require one to comply with the SS and sell out the Jews. Tarpitz’s answer below is one example; you might choose to protect the Jews because it makes you feel better about yourself, or because turning them in would make you feel guilty, or because you’re personally loyal to your friend, or because you have a sentimental attachment to the people you’re protecting. None of those require a belief in objective morality or even an adherence to any sort of comprehensive ethos.

            Another example comes from a response I got on a different forum: “I would lie to the SS officers because I could never be satisfied living under such an oppressive regime, so it’s in my personal self-interest to sabotage that regime, even if it puts my life at risk.” And, similarly, the old Martin Niemöller poem could be interpreted through the lens of rational egoism; the SS might be rounding up Jews today, but they could just as easily be sending you off to the forced labor camps tomorrow.

        • baconbits9 says:

          I guess “you tell the truth but the soldiers ignore the refugees” is a good outcome, but it’s not one you can plan in advance.

          I take the point of these stories to be that you don’t control outcomes. Most people assume that telling the truth will cost lives and that telling a lie will save them rather than admit that almost everything is out of your control during such times.

          • LadyJane says:

            Honestly, this seems like a cop-out to me. Yes, technically anything could happen at any time, so there’s no way to know for sure what the consequences of your actions might be. Kant brought that up in his axe murderer scenario: Maybe lying to the axe murderer to protect your friend would inadvertently result in your friend’s death anyway (for instance, if the axeman goes in the opposite direction of your friend’s house, but happens to run into your friend on the street while he’s out shopping). Maybe telling the truth would’ve resulted in your friend surviving (e.g. if the axe murderer heads in the direction of your friend’s house and gets picked up by police along the way). We can’t know for sure, so instead we should just stay true to our moral principles.

            But I never found that argument particularly persuasive. Sure, we can’t know for sure what will happen, but we can make some very accurate guesses. “Give up your friend’s location” seems much more likely to result in “your friend gets murdered by the axeman” than “lie to the axe-wielding murderer.” And sure, you can find real life examples where someone told a Nazi officer “the Jews are under the table” and the officer didn’t bother to check for a trapdoor, but I get the sense that those examples are cherry-picked. How many more instances were there in which being honest with the Nazis simply resulted in the Nazis finding and killing the refugees?

            That sort of moral philosophy might be appealing to the devoutly religious, if they have faith that God will ensure that virtuous acts lead to virtuous outcomes (which seems to be the implication of the anecdote about Betsy Ten Boom), or if they’re so unconcerned with the material world that they simply don’t care what happens on Earth so long as they don’t tarnish their immortal souls through sinful behavior. But I can’t really see how a secular version of it would work.

          • baconbits9 says:

            It isn’t a cop out, it is an observation that morality for an individual is about what you can actually control.

            But I never found that argument particularly persuasive. Sure, we can’t know for sure what will happen, but we can make some very accurate guesses. “Give up your friend’s location” seems much more likely to result in “your friend gets murdered by the axeman” than “lie to the axe-wielding murderer.” And sure, you can find real life examples where someone told a Nazi officer “the Jews are under the table” and the officer didn’t bother to check for a trapdoor, but I get the sense that those examples are cherry-picked. How many more instances were there in which being honest with the Nazis simply resulted in the Nazis finding and killing the refugees?

            The cherry picking is being done by the scenario. You do not have a good idea about what would happen in 1943 if the SS came knocking on your door. You cannot with any certainty think that you can alter the chances of the Jews being found by your words*, nor can you confidently predict what happens to your family, friends, neighbors etc in the branching aftermaths of your speech. Pretending that you can say ‘lying will save 0.X lives’ is exactly that, pretense. The real decisions are all in the build up- are you actually the person harboring Jews in defiance of a brutal regime? Are you the sort of person that will inspire others to do good deeds at great personal risk? Not ‘imagine you have a chance to be a hero in your own head, should you take it’?

            *With the exception being specifically showing the SS where the Jews are hiding.

          • The Nybbler says:

            You cannot with any certainty think that you can alter the chances of the Jews being found by your words*,

            That asterisk is hiding a lot. Of course I can. If I tell the SS that I know nothing (keeping in mind that I’m not hiding the Jews, I merely happen to know of someone hiding Jews), that’s going to be a lot better than “Sure, they’re at Bob’s house”, or even “Yeah I’ve seen some Jews sneaking around outside but I don’t know where they’re hiding” (in which case they are likely to search more thoroughly) or “Fuck you SS, I ain’t telling where they are” (in which case they have ways of making me talk that may not be perfect but aren’t worthless either). Maybe I can do better by pointing them to Dantooine (that is, some place where Jews used to hide but no longer do), but it’s likely the SS is as smart as Governor Tarkin and will figure out I lied, and that’s going to go badly for me, and may or may not help the actual Jews.

          • baconbits9 says:

            That asterisk is hiding a lot. Of course I can.

            Only because you are constructing a scenario in your head of a static once off interaction with the Nazi state where you get to control all of the parameters.

          • The Nybbler says:

            I’m using the scenario as given. The SS is at the door, asking if I know about any Jews. I do. In this scenario it is reasonable to believe that my words and actions with respect to the SS will have some effect on what happens to the Jews. Saying otherwise is fighting with the hypothetical.

          • baconbits9 says:

            Saying otherwise is fighting with the hypothetical.

            Oh no, I wouldn’t want to fight the hypothetical, its so smart and deep and penetrating.

            The whole point is that the hypothetical is set up to make it sound easy and predicable but what the ACTUAL STORIES from people who hid Jews show that real life is in fact messy and hard to predict. Setting up hypotheticals with no uncertainty gives you no insight into life or morality.

    • Baeraad says:

      I think I best fit the definition of a virtue ethics, and I’d choose the first option also. Honesty is a virtue, but so is compassion. Lying is bad, but so is being callous to the suffering of others.

      As for why I wouldn’t just refuse to answer the question, well, firstly because then the Nazis would know I knew something, and they might well start looking more closely at my known associates, or torture the information out of me. But also because I consider self-preservation to itself be a virtue. Again, lying is bad, but it’s less bad than allowing myself to be arrested and maybe tortured or executed.

      And yes, that does mean that in a lot of situations I would consider confessing to an actual crime to be the wrong thing for an actual criminal to do, while I would also consider the police trying by any legal means to get a confession out of the criminal to be the right thing for them to do. Which is a bit odd, I’ll grant you, but that’s what’s intuitively feels right to me.

      • Kaitian says:

        +1 I pretty much completely agree with this. I think I value “not lying” much less than most people in the rationalist discussion of ethics. I can understand where they’re coming from: in the fields they care about (communicating science, building an ethics module for our future AI overlords) “not lying” is a very important value. But I think in most everyday situations, the “no telling falsehoods” ethics espoused by people like Eliezer Yudkowsky and Sam Harris are unintuitive and often counterproductive.

      • Randy M says:

        in a lot of situations I would consider confessing to an actual crime to be the wrong thing for an actual criminal to do, while I would also consider the police trying by any legal means to get a confession out of the criminal to be the right thing for them to do.

        I’m not sure it would. Because torture and execution are unjust punishments for almost any crime. If the punishment is grossly unjust, I don’t believe the police are correct in trying to arrest you for it, unless they are doing their best to soften the punishment upon you to prevent worse, I guess.
        And, if the crime you committed was heinous enough to merit the execution accompanying being arrested for it, then you are obligated to confess, beg for mercy, and go to your death.

        There are situations where two people following their duties come into conflict, of course. Lawyers, of course, though neither should lie about it. In some cases soldiers.

    • The Pachyderminator says:

      I wouldn’t hesitate to lie my head off, nor would I expend the tiniest bit of mental energy trying to avoid a direct lie while still leading the SS officers into a false belief. If God has a problem with this choice, too bad. I don’t approve of all of His actions either.

      • The Nybbler says:

        Yes. This isn’t a situation you evaluate according to your moral system. It’s a test vector you use to verify your moral system.

    • Lord Nelson says:

      I’m religious and believe that lying is a very serious sin. I would also have no moral qualms with lying in this scenario, since telling the truth is essentially the same as sentencing innocent people to death.

      Different people have different opinions about whether this particular lie is considered a sin. Regardless, if I must ask for forgiveness, I’d much rather do it for lying than for knowingly getting someone killed.

    • Ketil says:

      5. You tell the truth since, even though you disagree with their politics and sympathize with the jews and your friend, the SS represents the government and rightful authority, and it is your duty to be loyal to it.

      All right, so the SS and nazis are just our current day devil, i.e. pure essence of evil. But I think my case is more relevant. Let’s say there is a ravaging virus going around, and you think it is pretty harmless, and that everybody will get it in the end, so the difference is whether victims suffer now or in a couple of months. Also, you believe that a lockdown has severe consequences economically and socially, and likely costs more lives than the disease could conceivably claim. Yet, authorities institute lockdown. Do you respect it?

      This is pretty much my position, and my answer is “yes”, I pretty much follow the official advice.

      • LadyJane says:

        I think an important distinction can and should be made here. There’s a difference between a broad policy that may cause harm of unknown severity to an unknown quantity of people, and an immediate deadly threat to specific people whose lives directly depend on your actions.

        In the former case, there’s a reasonable justification for obeying the law, even if you think it does more harm than good. After all, virtually any policy decision could potentially cause some amount of harm to somebody, through action or inaction. If we all refused to obey every law that we personally believed was more harmful than helpful, it wouldn’t be long before there were people disobeying every law, and we’d quickly find ourselves in a state of total chaos – not the sort of anarchy espoused by political anarchists, but rather anarchy in the Hobbesian sense, a war of all against all.

        In the latter case, though, I’d argue that the immediate preservation of innocent lives takes precedent over following the law.

        • Ketil says:

          I think an important distinction can and should be made here. There’s a difference between a broad policy that may cause harm of unknown severity to an unknown quantity of people, and an immediate deadly threat to specific people whose lives directly depend on your actions.

          I’m not convinced this distinction is the central one. If it’s a group of armed jews that come knocking on your door, and you have gotten wind that your friend is hiding an SS officer and fromer KZ guard running from justice… you would still lie to the police?

          But clearly, the loyalty argument works as a Schelling point of sorts, it’s the default policy when there are no other strong reasons for going another way. When consequences are uncertain or vague, obedience to authorities becomes the default.

          Is it possible for an authority to not be rightful in your opinion?

          Yes, of course. But this doesn’t depend on whether I agree with some of their specific policies or not. And if people only obey the laws they agree with, we can just dispense with the laws altogether.

      • thisheavenlyconjugation says:

        Is it possible for an authority to not be rightful in your opinion?

      • Well... says:

        Like LadyJane, I don’t think the two situations are analogous.

        Furthermore, I think the rigid pro-authority stance, especially when invoked in the hypothetical WWII scenario, throws a red flag for potential edge-lording. I get that individualism, questioning authority, etc. are often commoditized and cliched past the point of incoherence (not to mention obnoxiousnes) in our society, but that doesn’t make “it is your duty to be loyal to the government and rightful authority” a necessarily true statement, or even meaningful beyond the cheap purpose of shocking people.

    • matkoniecz says:

      Legitimate defense

      2263 The legitimate defense of persons and societies is not an exception to the prohibition against the murder of the innocent that constitutes intentional killing. “The act of self-defense can have a double effect: the preservation of one’s own life; and the killing of the aggressor

      http://www.vatican.va/archive/ccc_css/archive/catechism/p3s2c2a5.htm

      Under Catholic interpretation it would be OK to outright kill this SS officers. Though knowingly burning their house with an innocent child inside would not be OK.

      I am going to assume that lying is also fine.

      —————

      Also, for example, defense against Nazi Germany invading your country is also perfectly fine.

      2265 Legitimate defense can be not only a right but a grave duty for one who is responsible for the lives of others. The defense of the common good requires that an unjust aggressor be rendered unable to cause harm. For this reason, those who legitimately hold authority also have the right to use arms to repel aggressors against the civil community entrusted to their responsibility.

      • Nick says:

        Under Catholic interpretation it would be OK to outright kill this SS officers.

        I am going to assume that lying is also fine.

        Both of these are false. Defense is legitimate only when defending against an aggressor, and you can’t respond with intent to kill or with immoderate violence. Lying is always a sin.

        • matkoniecz says:

          Defense is legitimate only when defending against an aggressor

          Why this part would be relevant here? People coming to my home to murder innocent people certainly qualify as aggressors.

          you can’t respond with intent to kill or with immoderate violence

          As I understand that there is a difference between “I want to kill Foobar, now he is a SS officer so I finally have a reason to murder him” or “I want to kill Nazis” (not OK) and “I want to protect other people and my actions will have side effect of dead SS officers” (OK).

          (If I am wrong, please correct me – and I am likely to be wrong, fortunately I never had reason to check what are recommendation in that case or think deeper what is OK, though my initial thought is that lying in this case is the best solution)

          • Nick says:

            fortunately I never had reason to check what are recommendation in that case or think deeper what is OK

            I would hope not! 🙂 I’ve never had to use lethal force, either.

            Why this part would be relevant here? People coming to my home to murder innocent people certainly qualify as aggressors.

            I don’t think it’s that clearcut. They aren’t coming to your home to murder people, they are coming to your home for information. Of course if you refuse them and they unholster their guns you are justified responding in kind. But I don’t think you can just open the door and blast them away.

            As I understand that there is a difference between “I want to kill Foobar, now he is a SS officer so I finally have a reason to murder him” or “I want to kill Nazis” (not OK) and “I want to protect other people and my actions will have side effect of dead SS officers” (OK).

            That’s true, but you can’t kill them when disabling them would do. Sometimes you have the option of using lethal force or just taking out their kneecaps. Or sometimes you have to use lethal force but you can shoot them in a way less likely to kill them. The point is that you can’t jump straight to cutting off their heads.

          • matkoniecz says:

            They aren’t coming to your home to murder people, they are coming to your home for information.

            I would argue that given their plans at that point it already counts as attempting to murder people. Whatever murder will take place directly in my house or in a different place makes little difference to me.

            Also, I would describe their plans as “go to this home, murder all found Jews and gather info allowing us to murder more”.

          • FLWAB says:

            I would argue that given their plans at that point it already counts as attempting to murder people. Whatever murder will take place directly in my house or in a different place makes little difference to me.

            You’re thinking like a consequential. The point isn’t that these people have a high probability of murdering people in the near future. The rule isn’t “You can’t kill people unless they are probably going to kill someone.” The rule is that you aren’t allowed to kill people at all, and the only exception is that you are allowed to save your own life when it is in immediate danger, which may have the unfortunate but not guaranteed side effect of killing the person trying to kill you.

          • The Pachyderminator says:

            The rule is that you aren’t allowed to kill people at all, and the only exception is that you are allowed to save your own life when it is in immediate danger

            It doesn’t have to be your own life. You can also use lethal force in defense of others, as the quote from the Catechism above says. This applies to civil authorities waging a just war, and also applies at a smaller scale to individuals defending innocent people from Nazis. You just have to stick with the minimum effective level of force, as Nick says.

            Incidentally, Catholic teaching on the death penalty follows the same principle: it’s justified when nothing less will serve to protect the innocent.

          • John Schilling says:

            It doesn’t have to be your own life. You can also use lethal force in defense of others, as the quote from the Catechism above says.

            And you can use it against a threat that is less than immediate, particularly in the Just-War case. “Immediate danger” is the legal standard, for purely private use of lethal force.

      • Deiseach says:

        St Augustine wrote two works about Lying, and from one (“On Lying“) he goes into questions like this.

        23. This did a former Bishop of the Church of Thagasta, Firmus by name, and even more firm in will. For, when he was asked by command of the emperor, through officers sent by him, for a man who was taking refuge with him, and whom he kept in hiding with all possible care, he made answer to their questions, that he could neither tell a lie, nor betray a man; and when he had suffered so many torments of body, (for as yet emperors were not Christian,) he stood firm in his purpose. Thereupon being brought before the emperor, his conduct appeared so admirable, that he without any difficulty obtained a pardon for the man whom he was trying to save. What conduct could be more brave and constant? But perhaps some more timid person may say, I can be prepared to bear any torments, or even to submit to death, that I may not sin; but, since it is no sin to tell a lie such that you neither hurt any man, nor bear false witness, and benefit some man, it is foolish and a great sin, voluntarily and to no purpose to submit to torments, and, when one’s health and life may haply be useful, to fling them away for nothing to people in a rage. Of whom I ask; Why he fears that which is written, You shall not bear false witness, and fears not that which is said to God, You will destroy all them that speak leasing? Says he, It is not written, Every lie: but I understand it as if it were written, You will destroy all that speak false witness. But neither there is it said, All false witness. Yes, but it is set there, says he, where the other things are set down which are in every sort evil. What, is this the case with what is set down there, You shall not kill? If this be in every sort evil, how shall one clear of this crime even just men, who, upon a law given, have killed many? But, it is rejoined, that man does not himself kill, who is the minister of some just command. These men’s fear, then, I do accept, that I still think that laudable man who would neither lie, nor betray a man, did both better understand that which is written, and what he understood did bravely put in practice.

        There has been a lot of debate and development on this; outright lying is always wrong, but things may not be lying even if they are deceptive, such as equivocation. The Jesuits get a bad rap for this kind of hair-splitting but it’s a genuinely difficult problem: tell the truth or save a life?

        • MPG says:

          To be fair, Augustine did say, when he re-read his books near the end of his length, that he would rather not have people reading On Lying, because it was too confusing. There’s a theory by an American scholar, Jason BeDuhn, who is in the process of writing a massive three-volume work (two vols. already out) about Augustine’s Manichaeanism and its ramifications, that On Lying was actually an essay in which Augustine worked out just how much he could bend the literal facts in presenting his heretical days to suspicious catholics. I’m not convinced, but there are famous inconcinnities between Confessions and our other data on Augustine’s early life (most importantly, for BeDuhn’s purposes, the coincidence between Augustine’s trip to Italy, then his retreat from Milan in 386, and imperial anti-Manichaean measures).

          Like I said, I’m not really convinced, and I can see events in my own life that, interpreted by the hostile or by historians 1600 years after the fact, might look like they were due to some political or economic situation that had in fact very little to do with my decisions, save by some subconscious influence. But it is a reminder that Augustine’s worries may not be wholly theoretical.

          I do wonder, though, what’s with the stuff about eating dung in On Lying. (And in case you thought that was the weird book about lying, Against Lying is, in context, absolutely hilarious: it’s his full-broadside rebuttal to this eccentric layman, bored by the lack of intellectuals on the Balearic Islands, who has been trying to get Augustine to teach his incognito heresy-hunting methods to “the most astute and select young men.” I’m planning to start a blog on Augustine among other things, and the first line is going to be my tag….)

        • Nick says:

          Thereupon being brought before the emperor, his conduct appeared so admirable, that he without any difficulty obtained a pardon for the man whom he was trying to save.

          The same was not unheard of even under the Nazi regime. From your buddy Tim O’Neill’s piece on the “Hitler’s Pope” myth:

          As Riebling details, a clique of anti-Nazi officers within the Abwehr, led by the intelligence unit’s chief Admiral Wilhelm Canaris and his chief of staff Hans Oster, began to plot against Hitler soon after the invasion of Poland in 1939. Canaris needed a way of communicating with the Allies to gain assistance and to win concessions for Germany once the Nazis were overthrown. The plotters decided to use the Vatican as their go-between and enlisted a Catholic Abwehr reservist, Josef Müller, as their key conduit to Rome. Müller – a large, gregarious, beer-drinking, charmer nicknamed “Ochsensepp” (Joey the Ox) – emerges as the main hero of Riebling’s story. He was a man who in 1934 faced down an SS interrogation led by Himmler himself and was released because the SS leader admired his courage, faith and principles.

          It would be foolish to count on such an outcome, of course. Nevertheless it irritates me when things like this are treated as impossible or unthinkable.

      • Dack says:

        The catechism says no one is bound to reveal the truth to someone who does not have the right to know it.

        There is a reason that the commandments go out of their way to say “Thou shalt not bear false witness against thy neighbour” instead of “Thou shalt not tell lies”.

    • Tarpitz says:

      Morality is a spook, and I would lie. The fact that my preference for preventing the murder of innocents is ultimately arbitrary and sentimental does not make it any less my preference.

      • Anteros says:

        I’m interested in what you mean by ‘spook’ – I have a suspicion that my way of looking at ‘morality’ is similar to yours, but I may be wrong about that.

        I think also that ‘sentimental’ probably downplays the validity (or depth) of your position – I hear it as superficial, if not pejorative. David Hume used it with some seriousness, but usage has changed considerably since his time.

        • rocoulm says:

          “Spook” is a (translation of a) term Max Stirner used to describe concepts that were only agreed upon because society collectively believed them – he used it for things like “private property”, “the state”, etc.

      • Morality is a system societies use to try and compromise their individual preferences to produce some kind of average everyone can just about live with. I would lie to protect the Jews, both due to my individual preference to protect Jews from being butchered, and due to my individual preference for the kind of society that provides such protections.

    • Well... says:

      I like to think I’d do the right thing, whatever that is, but I agree with Jaybee Lobsterman when he says I’d probably give in to my fear and bloody my hands by cooperating with the Nazis like so many Germans did.

      • Matt M says:

        Isn’t it also the case that the average German did not have verifiable evidence that the Jews were actually being exterminated?

        The Nazi party line was something like “We’re removing them so they can live amongst themselves in peaceful communities that we are generously providing for them out in Eastern Europe.”

        Now maybe you had some reason to be skeptical of that claim, given the general environment, rhetoric, etc. But you couldn’t know.

        Edit: Ninja’d by EC below.

        • Kaitian says:

          How much Germans, or any given group of Germans, knew about what was happening to deported Jews is a very controversial topic in history.

          The thought experiment only works if you assume that you know the refugees will be murdered and you know that they don’t deserve to be killed. If you take these factors away, it’s really no different from “the cops come to your door asking if you know of any undocumented immigrants in your neighborhood”.

          Edit:
          @matkoniecz

          I’m sorry if it came across as me trying to say most Germans wouldn’t have known. I haven’t studied this issue, but it seems plausible that many knew, or at least had a general sense that something extremely bad was happening to the people who got deported.

          But it’s true that the issue is controversial (the Wikipedia paragraph you linked starts “debate continues”). It’s certainly plausible that any given German may have no specific idea about what would happen to refugees who were caught, therefore the calculations you’d make in the hypothetical “SS at your door” scenario would be very different if you imagine it happening in the real world.

          • matkoniecz says:

            Describing Jews, Slavs and many other groups as subhuman was an official ideology.

            Slavery/forced labour and mistreatment of various kinds was done openly.

            Knowledge about mass murders was common, though how common exactly is obviously not clear. But AFAIK it is “15% vs 50% were aware”, not whatever it was information circulating in society. https://en.wikipedia.org/wiki/Responsibility_for_the_Holocaust#German_people

            Mass murder was done openly in occupied countries so it is not a big surprise that this was becoming a common knowledge also in other places.

            Specific details like death camps or gas chambers were probably not known well.

            The thought experiment only works if you assume that you know the refugees will be murdered

            It was completely clear that they will be horribly mistreated. Maybe murder was not obvious to all in say Berlin.

            https://www.theguardian.com/uk/2001/feb/17/johnezard is an article, not a real source but matches my image of the situation (if I am wrong, please correct me)

          • Well... says:

            it’s really no different from “the cops come to your door asking if you know of any undocumented immigrants in your neighborhood”.

            It’s still different from that, because we know that cops looking for undocumented immigrants probably means those immigrants or people they’re associated with are going to get in some kind of trouble, with potential consequences including jail time or deportation.

            Is it possible that many Germans thought the authorities would be searching for refugees for benign reasons? I don’t think so.

          • albatross11 says:

            I think there’s a kind of state of knowledge where it’s knowable if you want to know it, but avoidable if you’d rather not know it.

            An example of this from my childhood: I was in high school in a very small Midwestern town. The best teacher in the school was a woman who had, a few years ago, divorced her husband. She’d later started rooming with the girls’ gym teacher (another woman about the same age).

            Anyone who wanted to know, knew that they were a lesbian couple living together. Anyone who didn’t want to know could allow themselves to believe they were just a couple good friends rooming together (along with children from the divorce). I was a geeky, not-terribly-worldly 14 year old, and I knew the score. Some people were more comfortable not knowing.

            More recently, consider the “collateral murder” video that was released by Wikileaks. That video showed US troops doing stuff that it was pretty clear they had to be doing, from reading the news and understanding the shape of the world–including killing children and killing bystanders who stopped to help the dying and wounded people from the first attack.

            Why was that video classified? It surely wasn’t because the Iraqis didn’t know we were doing that stuff–they couldn’t fail to know. It was to enable Americans who didn’t want to know what our military was doing in Iraq to retain their ignorance.

            There are many more examples along these lines. There’s a lot of uncomfortable information out there that most people would rather not know, because it would make them feel bad or because it would require them to take actions they’d rather not take.

            I assume the murder of the Jews (and lots of other people) in Nazi Germany was the same way–if you were paying attention, you probably had a pretty good idea what was going on when the hated ethnic minority were loaded onto trains and never heard from again, and you probably heard rumors that fit well with the obvious conclusion about what was happening to those folks. But it was probably possible not to know, especially if you really didn’t want to think too much about it and made sure to remind yourself that the enemies of the regime were constantly spreading lies and they shouldn’t be trusted.

          • Aapje says:

            @albatross11

            Even if there are rumors, that doesn’t mean that you know for sure. A big issue in a society where reliable sources are suppressed, is that true rumor becomes very hard or impossible to distinguish from false rumor.

          • EchoChaos says:

            @Aapje

            Doubly so when there is an active attempt by declared enemies to spread propaganda.

            In WWI, there was propaganda that Germany was massacring nuns in Belgium. They weren’t. There were some bad things that the Germans did to nuns, including one instance of strip-searching them, but there wasn’t evidence of rape in that instance.

            https://en.wikipedia.org/wiki/Rape_of_Belgium

            What Germany did in Belgium was bad, but the British stories were outright fabrications.

            It would be quite easy for a German citizen in WWII to believe that the stories of the horrors inflicted on Jews were similarly exaggerated.

          • Lurker says:

            This is completely anecdotal, but:
            My great-grandmother apparently never talked about the time the Nazis where in power, except once she told my mother “everybody knew something bad was happening, not the specifics, but something bad, and those who’re saying they didn’t know are either really stupid or lying”.
            For context: my great-grandmother lived her entire life in a tiny village in the middle of nowhere(very, very rural), the entire population of that particular village was catholic back then since the land used to belong to a monastery, so there weren’t any Jewish citizens living there even before the Nazis came (or protestant or anything else but catholic). So if she was in a position to realize something bad was going on, I’m extremely skeptical of claims to not-having-known-anything of anyone but someone who lived even more remotely in a place that already had no Jews.
            Yes, I realize that it’s just an anecdote, but I do think some conclusions to the general level of knowledge in the population can be drawn from that.

          • Dack says:

            German Catholics were in a better position to know that something was going on:

            https://en.wikipedia.org/wiki/Mit_brennender_Sorge

            Written in German, not the usual Latin, it was smuggled into Germany for fear of censorship and was read from the pulpits of all German Catholic churches on one of the Church’s busiest Sundays, Palm Sunday (21 March 1937).

          • Lurker says:

            @Dack:
            Thanks! Learned something new today 🙂

          • Viliam says:

            @Lurker

            My great-grandmother apparently never talked about the time the Nazis where in power, except once she told my mother “everybody knew something bad was happening, not the specifics, but something bad, and those who’re saying they didn’t know are either really stupid or lying”.

            This is 100% what I believe. And people did not know specifics, because as long as they did not know, they could believe they were decent people despite not doing anything. If you know you are not going to do anything about a problem anyway, it is better for your righteous self-image to believe that the problem does not exist.

            (Also, they knew it was not safe to ask questions. But if merely asking questions can hurt you, the people whose fate you are not allowed to ask about probably get hurt much more.)

            On the other hand, without knowing specifics, it was possible to underestimate the seriousness of the problem. “Something bad” does not necessarily imply genocide.

    • EchoChaos says:

      One of the things that makes this a dilemma depends is your current knowledge of what is going to be done to them.

      Switch it to being an American citizen on the West Coast and your neighbor is aiding a Japanese-American family in hiding from the authorities.

      The internment camps are no picnic, but the American government isn’t going to genocide them, and hiding from the authorities may imply that the Japanese-American family is in fact doing something malicious, as in fact some Japanese-Americans did.

      A mistaken belief about the consequences of betrayal may change your calculus.

      Note that I am a Christian and a deontologist.

      If I were in an occupied country (e.g. Denmark or the Netherlands) I would lie to them because resisting occupying invaders and denying them anything they want is a positive moral good.

      But you’ve stipulated that I am a German, which makes it trickier, since it’s my own government. I assume you don’t want me to suppose myself an active Nazi, since that would mostly make the answer obvious. It would probably depend on to what degree I suspected that actual harm would come to them.

      My understanding is that the average German citizen knew that the concentration camps weren’t happy fun places, but didn’t really believe actual horror and genocide was being inflicted, and that convincing the Germans of this after the war was an intensive campaign.

      But certainly some Germans probably suspected beforehand, and knowing what I know now, I would lie to the SS with a clear conscience.

      • matkoniecz says:

        Decribing Jews, Slavs and many other groups as subhuman was an official ideology.

        Slavery/forced labour and mistreatment of various kinds was done openly.

        Knowledge about mass murders was common – https://en.wikipedia.org/wiki/Responsibility_for_the_Holocaust#German_people

        Mass murder was done openly in occupied countries so it is not a big surprise that this was becoming a common knowledge also in other places.

        Specific details like death camps or gas chambers were probably not known well.

        https://www.theguardian.com/uk/2001/feb/17/johnezard is an article, not a real source but matches my image of the situation (if I am wrong, please correct me)

        • EchoChaos says:

          I am not defending the Nazi ideology, but the question of “is this person going to be sent to forced labor by proper order of the state” versus “Is this person going to be brutally executed” require very different responses.

          Remember that the American government also sent citizens to camps where they were used to harvest beets, for example. This is technically also forced labor.

          As for mass murder in occupied countries, my understanding is that was justified as executing resistance cells, which is very different and justified under the laws of war. It’s certainly possible for a German citizen to believe that the measures were harsh but legal and justified.

          Edit: And note that my final sentence was “some Germans suspected” and that I would absolutely lie to the SS.

          • matkoniecz says:

            my understanding is that was justified as executing resistance cells

            For start, terror executions of random people (100 Poles for 1 German) were an official policy.

    • John Schilling says:

      Later, the SS come to your door asking if you’ve seen or heard anything

      Lie.

      I’m sorry, you were going to ask me to choose, right? Do you want to finish?

      Because why are we even having this discussion? There’s no absolute or general rule against lying. Lying may be a bad habit to get in to, but throwing innocents to the wolves to pave the way for your own escape is a much worse one. Lying leads to an absolutely better outcome, unless you believe that Jews are such an intrinsically dangerous threat that each one should be valued at about -100 QALY or below. Lying is almost certainly safer, if you stick to the Sgt. Schultz technique. It is intuitively obvious that you should be lying here. And when did you ever agree not to? Where, in any of humanity’s multifaceted theories of ethics and morality, is there anything that requires more than a few milliseconds of instinct to respond with a lie?

      But if I somehow ever find myself in charge of an elite SS Jew-hunting unit, or antifa Nazi-hunting unit or any other such thing, boy howdy am I going to be hoping that my prey is being sheltered by a bunch of rationalists. Watching the gears crank behind their eyes as they try to puzzle out the obvious, is as good as proximity sensor.

      • Andrew Hunter says:

        About the only interesting counterpoint I’ve heard to the obvious right answer (lie) was in a discussion of D&D alignments. The poster claimed that a paladin, exemplar of Lawful Good, would be required to not lie, but instead–whether or not he was hiding jews–reply “Your pogrom is despicable and I’ll have no part in supporting it. Come at me.”

        Now, other than in D&D or other lands of narrative causality where heroes win, this results in dead paladins and captured Jews. It clearly produces the wrong results. But this is probably acceptable, on the meta-level, for D&D; lawful good characters, paladins doubly so, are supposed to face consequences for holding to their rules. It makes the game more interesting. And there’s clearly something to be said for strong precommitments; HPMOR has an interesting bit about this.

        But all of this is a distraction from the real world, where you fucking lie. Or better yet, you don’t get there in the first place (though that is harder.)

        • John Schilling says:

          I believe one of the first commandments of every Lawful Good faith or ideology, is to strike down immediately and without mercy anyone who ever makes moral claims regarding the behavior of D&D Paladins. Some will also call for the extermination of the entire gaming group; it’s the only way to be sure.

          Seriously, the whole subject is an open invitation for a generally chaotic group that has only a passing familiarity with the Laws that Good people actually make for themselves, to opine forcefully on the subject. If you believe that Good people have made up Laws that require them to Not Lie About Anything Ever, then sure, you can come up with all sorts of interesting moral dilemmas and impose them on your Sworn To Always Be Lawful and Good fictional characters. But it’s all angels-dancing-on-pinheads level theorizing, because those laws don’t exist.

          • Andrew Hunter says:

            I mean, they manifestly do exist! Kant was a person. People believe him. I get that you don’t agree with him, and neither do I, but it’s unfair to say that these rules and people who think like these are just nerd imaginations.

          • John Schilling says:

            If my theory requires that we count Kant among the imaginative nerds, I think my theory still looks pretty good. Unfortunately, Kant predates D&D, so we don’t know for sure whether he’d have been playing a Paladin or just sniping at Paladins.

          • MPG says:

            Sounds ripe for an Existential Comic (and indeed he is a Level 10 Paladin, Lawful Good).

          • Andrew Hunter says:

            Actually, you know what, I’m going to double down: if you don’t like paladins, how about Superman? As Drew says, this is about being an exemplar. Does Superman lie to the Nazis?

            And before you reply “Superman can win”…I think he does it even if he can’t. My favorite panel in all of Supes (I’m not much of a comic reader, tbh, but I like the concepts) is when he confronts an armed robber while temporarily depowered. Jimmy Olson asks why:

            “You think I only step in front of guns because I’m bulletproof?”

            Yes, in many real world situations, this play loses. It’s probably not the right thing to do. I’d lie.

            Superman is better than us.

          • LadyJane says:

            @Andrew Hunter: Would Superman lie to save a life? The answer is, maybe. Depends how you interpret that last page.

          • This discussion reminds me of nothing more than how characters in Star Trek believe that Vulcans never lie, even though there is absolutely no reason to believe this. They lie when it is logical to do so. Why would they do anything else?

          • Nick says:

            This discussion reminds me of nothing more than how characters in Star Trek believe that Vulcans never lie, even though there is absolutely no reason to believe this. They lie when it is logical to do so. Why would they do anything else?

            This could be true, but vacuously so, if it is never logical to lie.

        • Evan Þ says:

          What John Schilling said: Lawfulness does not require this, unless you’ve chosen to be Lawful in relation to a very specific moral code.

          That said, that would be an ethical response for someone who doesn’t have any dependents (including hidden Jews) and wants to take a good chance of martyrdom. His example might inspire others.

        • Drew says:

          The poster claimed that a paladin, exemplar of Lawful Good, would be required to not lie, but instead–whether or not he was hiding jews–reply “Your pogrom is despicable and I’ll have no part in supporting it. Come at me.”

          I think I agree, but think the duty comes from the “examplar” bit, more than the alignment.

          A lawful good Fighter is a guy who’s trying to do his best for himself and society. The peanut gallery can comment on his decisions. We can like them, or dislike them.

          But, ultimately, when we debate the fighter, the stakes are just how positively or negatively we feel about some guy.

          Paladins are different because they exist to be a living embodiment of some code. They’re expected to be extreme.

          A Paladin who compromises is a Paladin who’s undermining the trust in a broader ideology or movement. That could legitimately have more weight than the survival of some people in a house.

      • Dan L says:

        Where do you see rationalists having trouble with this? Link?

        • John Schilling says:

          Pretty much every response in this thread that isn’t “Lie, obviously, WTF is wrong with you”? And the fact that the question was even considered worthy of serious discussion.

          • Dan L says:

            Not a great example. See also my clarification.

            Definitely not the best description of those having trouble, to my eye.

          • albatross11 says:

            Wasn’t “lie, obviously” the answer of just about everyone? With some side quests into whether or not the people involved would actually know enough to know that the answer was “lie, obviously” or would instead think the consequence of not lying would be Jews being treated badly and made to do forced labor in unpleasant conditions, rather than being gassed.

      • J Mann says:

        But if I somehow ever find myself in charge of an elite SS Jew-hunting unit, or antifa Nazi-hunting unit or any other such thing, boy howdy am I going to be hoping that my prey is being sheltered by a bunch of rationalists. Watching the gears crank behind their eyes as they try to puzzle out the obvious, is as good as proximity sensor.

        JohnShilling: “I can see you calculating, filthy rationalist! You are clearly working through some variation on the Trolley Problem!”

        Rationalist: “No, no, officer! I’m just starting with my priors, constructing the potential alternative scenarios, then working out a Bayesian probability of where the Jews are in this iteration of the Many Worlds Hypothesis! If you press me any harder, I will be forced to tell you a hypothesis that will cause a future AI to re-instantiate, then torture you!”

        (I don’t know enough about rationalism to make that fair or funny, but feel free to Steelman it, then laugh at the best possible formulation of that joke).

    • aristides says:

      I’ll consider this from the Christian perspective. The golden rule is to do unto others as you would have them do unto you. If I tell the SS officers the truth, they would have to follow the lead, and take the Jews to a concentration camp. If I was in their position, I would prefer to be lied to so I wouldn’t have to commit any further sin. In general I’m ok with people lying to me to protect me from bad outcomes, so I believe it would not be a sin. God can correct me if I’m wrong after I die.

      • Evan Þ says:

        I’m surprised you’re OK with people lying to you for that reason in general. I would consider it disrespectful and offensive for people to lie to me to protect me from a bad outcome, in general, because it means they’ve decided I couldn’t reason my way to the same conclusion they’ve reached of knowing the truth and still choosing the good outcome. There’re some exceptions (e.g. if I were somehow conscripted into an SS Jew-hunting squad, I’d want people to keep me as blind as useful), but they’re only exceptions.

        • J Mann says:

          What if future you somehow became convinced that hunting down the Jews was a great thing to do?

          Wouldn’t present you prefer that future people frustrate future you in that goal, or are you convinced that if you came to that conclusion, it would be a good one?

    • JPNunez says:

      I lie, but I probably take into consideration 3, cause maybe I am a bad liar or I am stressed enough that I cannot lie convincingly. It would probably depend on the exact situation and my personal stress levels; if I am a german citizen in nazi germany maybe I am used to the stress and can lie convincingly.

      The chances of being arrested and tortured and killed if my lie is detected are high, but with 3 they are almost sure, so maybe 1 is still my preference.

    • Thegnskald says:

      The correct answer is probably 4, because that’s the option that lets me kill the SS officers and flee the country. Because if they’re questioning me, somebody else has pointed them in my direction, and I put no faith in escaping the situation otherwise.

    • Lambert says:

      Does anyone other than Immanuel Kant himself pick 2?
      Deontologists have been carving out exceptions for when a bad thing prevents a much worse thing since Aquinas.
      (Summa Theologiæ Secunda Secundus Question 64)

      Carpet bombing Germany to take out munitions factories is considered justifiable by Catholics, even though it has the side-effect of harming civilians. (Deliberate de-housing isn’t though)

      • Nick says:

        And yet Aquinas is quite clear that lying is always wrong.

        • rahien.din says:

          This is something I have struggled with. What do you think of the following :

          If you cut me with a knife, that causes me bodily harm. But if you cut me precisely and excise a tumor, you have prevented a greater bodily harm.

          If I lie to the SS officer, I have caused him moral harm. But if I lie to him in the correct manner, and I impede him as he attempts to perform some despicable act, then I have forestalled a greater moral harm. And importantly, the proximate victim I save is the SS officer himself – just as the tumor, his actions would cause him great moral harm. I excise them with the lie.

          So this may be an act of compassion. In a way, I have performed a sort of “moral surgery.” It is a sin – but as you have said, a venial one.

    • HarmlessFrog says:

      What is the ethical course of action here?

      I like that you aren’t asking “what would **you** do?” because that runs into the problem that people don’t always choose the ethical course of action. I can’t say with certainty that this is what I would do, because I fear pain and death as much as any man, but at least I’m pretty certain which choice of those given is actually morally upstanding – which is #3, silence or refusal to cooperate. This is likely to result in your death, but then nobody said that doing what’s right will never kill you.

    • Aapje says:

      @LadyJane

      I would lie, but if I somehow couldn’t lie, I would deceive in a way that can be interpreted as the truth.

      For example, in your case, saying “I don’t know where they are” is technically correct. You actually don’t know, but merely suspect that they are hidden with your friends. Perhaps they were moved to different house after the friends told you. Perhaps they are out. Perhaps the friends lied. Perhaps the Jews were already caught.

      Of course, these kind of deceptive answers can merely ease your conscience, but won’t save you from the anger of the Nazis.

      After all, you’d potentially be putting yourself at risk by lying to the officers, without getting anything out of it for yourself.

      Actually, when the officers are at the door, it is already too late to not run any risks. You already didn’t seek out the SS to tell them, so you are already part of the conspiracy to hide the Jews.

      Also, telling the SS may result in repercussions by the community and/or the resistance, so lying may reduce those risks.

    • Edward Scizorhands says:

      Admit that you know the location of the refugees (thus refusing to tell a lie), but refuse to tell the SS officers where that location is (thus refusing to put the refugees in harm’s way)

      This seems foolish. If you are trying to refuse to lie, they can just ask “are the Jews hiding in the house of one of your friends?” and other binary questions. If you clam up only when you would confirm where the Jews are hiding, you are still giving them information.

      Also, you will fold under torture. You might be able to give them a few lies along the way, but we were trying to avoid that, and they’ll still get to the truth anyway.

      • Evan Þ says:

        What makes you so sure that everyone will fold under torture? Considering how many Christians have refused to recant their faith under torture, it’s possible to hold out.

        (Some did recant; see for instance Thomas Cranmer who later inspiringly recanted his recantation. So, it’s good to plan against that possibility if you’re in a conspiracy against a regime known to torture suspects. But others did hold out.)

        • Edward Scizorhands says:

          If I want to get information out of you, and I have good reason to think you have it, I’ll just give you heroin for a few weeks and then wait for confirmed information before giving you the next dose.

        • FLWAB says:

          I have also heard many stories of martyrs that held up under torture, but I have to believe they did so with the help of divine grace. From all the secular sources I’ve read there is no known technique or training that has been shown to be effective in resisting torture, particularly on a long term basis. As far as I’ve been able to research, even the CIA doesn’t know of any method and trains their agents to understand that almost everyone will crack under prolonged torture.

      • John Schilling says:

        Also, you will fold under torture.

        Citation needed for this alleged 100% efficacy of torture in providing actionable information, because I’m pretty sure that’s an urban legend.

        • Matt M says:

          I definitely believe that torture is incredibly effective in compelling people to say things that they believe will cause the torture to stop.

          Whether or not this information is useful/accurate/actionable/whatever is probably highly dependent on the specifics of the case at hand.

          • Randy M says:

            “Everyone breaks” is a different proposition than “You can reliably find out anything with torture.”

          • Edward Scizorhands says:

            Yes, “will produce actionable information” isn’t true. The SS can’t just torture random people to find out information. You’ll get a lot of “facts” that aren’t.

            But the scenario given was one where someone admitted that they knew the location of the refugees. That’s practically begging the evil people to torture them.

            *EDIT* For some reason I remember this Deep Thought by Jack Handey:

            If you were a poor Indian with no weapons, and a bunch of conquistadors came up to you and asked where the gold was, I don’t think it would be a good idea to say, “I swallowed it. So sue me.”

          • John Schilling says:

            I definitely believe that torture is incredibly effective in compelling people to say things that they believe will cause the torture to stop.

            There was one thing Giles Corey could say that would make the torture stop, and he knew from the start what that was. He never said it.

    • FLWAB says:

      I’d have to go with option 2.5, be clever. I’d probably say “I have seen no Jews, I have heard no Jews!” Which is true. If they pressed and asked further I’d say “I wish I could help you, but I do not know where the Jews you speak of are.” This is also true: I undoubtedly wish I could help the SS (so they don’t kill me!), but I’m morally obligated not to. And it’s also true that I don’t know where the Jews are: I suspect where they are, because I was told where they are, but I don’t know they are there. I have not seen them myself, I only have hearsay.

      Does this all seem like stretching a gnat and swallowing a camel? Well yeah, but it’s a tough situation! You gotta do the best you can.

      In point of fact if it actually happened to me I would almost certainly lie. I have lied out of fear in situations where the stakes were far less. But I consider that a personal moral failing on my part, and the above strategy is what I wish I would do, even if I would likely fail to do so. I am a coward, but I am striving to be brave.

      • Evan Þ says:

        You’re reminding me of the Quakers involved in the Underground Railroad, who would cheerfully tell slave-catchers they weren’t hiding any slaves… without adding that they didn’t consider any man a slave.

    • danridge says:

      5. Lying is (practically) a terminal good in itself because without lying you have almost no tools to effect positive change in the world through the outcomes of conversations! When you lie, you can say anything and just about anything can happen.

    • Ninety-Three says:

      You can have deontology while still lying to the SS. For instance, almost ethical theories grant that if a madman with an axe is trying to kill you, you are entitled to shoot him in self-defense. Many of them also grant that if the madman is ignoring you and trying to kill babies, you can shoot him in defense of the babies. Lying is way less bad than shooting someone, so it follows that if we have self-defense and other-defense exemptions for violence, we should also have them for lying.

    • rahien.din says:

      Even acknowledging that lying is a sin, the answer is #1.

      The standard deontological argument, #2, is Pharisaic selfishness.

      #3 is just a bluff. Violence will turn it into #1 or #2. It’s an unnecessary step.

      #4 is delusion – morality is beneficial.

    • GearRatio says:

      Am I married? Do I have kids? Ailing Grandma? What’s my personal economy like – am I rich? These things might or might not change what I do, but they certainly factor into any real world decision.

    • broblawsky says:

      I can’t understand how anyone who takes moral guidance from the Bible could go with #2, when there’s a very direct example in the Bible of lies being used to protect someone being persecuted unjustly by the state, and being directly rewarded by God for it, e.g. Exodus 1:17-21.

      • Nick says:

        Aquinas responded that what was being rewarded was their fear of God, not their lying.

        • broblawsky says:

          That’s a pretty weak answer, IMO: God didn’t punish them for lying, so either:
          a) He didn’t think their deception was sinful, or
          b) He decided that He didn’t want to punish them right now.

          A implies that deception, when motivated by fear of God, isn’t sinful. B is just a “God moves in mysterious ways” dodge, Book of Job style.

          • Nick says:

            God didn’t punish them for lying, so either:
            a) He didn’t think their deception was sinful, or
            b) He decided that He didn’t want to punish them right now.

            This does not follow. God need not punish anyone and everyone who does something less than perfectly. The lie in this case is clearly venial: they were trying to do good, but used means that are always wrong. It’s perfectly consistent to hold that a) their dedication to protect the children was admirable and worthy of reward but b) it was expressed in a defective act. Brandon stakes out the same position in a post I linked above.

            Incidentally, I think you’re confusing things by introducing the term deception. It’s true that not all deception is sinful, but some deception is lying, and lying is always sinful.

          • Le Maistre Chat says:

            @Nick: So I’d attempt Jesuit mental reservation like “I don’t know where any hidden Jews are! (in the occupied Netherlands)” and if turns out that Jesuitry is a venial sin confess it later in American-occupied Germany.

          • broblawsky says:

            This does not follow. God need not punish anyone and everyone who does something less than perfectly. The lie in this case is clearly venial: they were trying to do good, but used means that are always wrong. It’s perfectly consistent to hold that a) their dedication to protect the children was admirable and worthy of reward but b) it was expressed in a defective act. Brandon stakes out the same position in a post I linked above.

            God still rewards them for their action instead of punishing them for it. I can’t ignore the context of the action itself, which is what I think Aquinas is doing. It’s presented as a pretty simple set of actions and reactions:

            1) Pharaoh commands the Hebrew midwives to kill Hebrew male infants;
            2) Because the midwives fear God, they refuse to do so;
            3) Pharaoh asks them why they failed him;
            4) The midwives lie to Pharaoh;
            5) God rewards them.

            You can say that God rewards them exclusively for fearing him and not killing the Hebrew boys, but if that had been the authorial intention, you’d assume that (5) would be presented after (2), not (4). There’s no reason to present the midwives lying to Pharaoh unless you assume the author’s intent was to say that lying is morally acceptable, maybe even commendable, under certain specific circumstances.

      • Le Maistre Chat says:

        Good catch! I’m Catholic and would try to deceive the SS. (Sorry Nick, but according to Catholic dogms Aquinas wasn’t right on absolutely everything.)

    • sharper13 says:

      If you’re fully aware of the fact that the SS involved are planning to murder the Jews (and likely will succeed), then the moral answer is #5: Kill/disable (If possible) the SS officers who are asking you.
      Otherwise, as others have noted, it’s obviously going to depend on what exact knowledge you have, but if killing to protect them is morally fine, then lying is certainly just as moral, as long as it seems likely to give the same results (you and the Jews are actually saved).

      • Aapje says:

        That will actually cause more deaths than telling on the Jews (or not intervening when they can do so without your help), given Nazi policies.

        • matkoniecz says:

          Total effects depends on how this actions reduce power of nazi regime and increase chance of its removal.

          (yes, it is not really possible to calculate)

    • Matt M says:

      Perhaps we can update this scenario to be a bit more modern and realistic.

      You are a New Yorker living today. Health department authorities knock on your door and ask, “Know of any Jewish weddings going on in the area?” What do you say?

      • Edward Scizorhands says:

        That is the second in a three-tweet series.

        The fact that de Blasio’s comms team doesn’t understand how Twitter works is 100% de Blasio’s fault.

    • Dack says:

      How about #5? Don’t answer the door.

      • Edward Scizorhands says:

        NO HABLA INGLES! POR FAVOR VETE, SENOR!

      • Nick says:

        This occurred to me, too, but remember you’d have to take steps in advance to avoid attracting suspicion. Like, make sure there’s no light visible in your windows if they stop by. You might have to lay low yourself to consistently avoid them.

  21. Silverlock says:

    For your amusement: high-tension power line towers shaped like . . .

    clowns

    A tennis racket (or racquet, if that floats your boat)

    Mickey Mouse (located at Disney World, unsurprisingly)

    Two men doing . . . something. Linking arms? Maybe they’re fighting because they’re under [sunglasses]high tension[/sunglasses].

    • Nick says:

      Two men doing . . . something. Linking arms? Maybe they’re fighting because they’re under [sunglasses]high tension[/sunglasses].

      There’s a giant ball in front of them; I think they’re playing soccer or something and contesting the ball.

      • Silverlock says:

        You’re right. I completely missed the ball. If they’re playing soccer, though, shouldn’t one of them be lying on the ground clutching his shin?

        I kid! I kid! All in jest.

        Mostly.

  22. HeelBearCub says:

    A previous thread had a lot of discussion on whether NYCs hospitals were “overwhelmed” or not.

    Anecdata, but here is the experience of a respiratory therapist who quit her job in Texas to take a temp job in NYC.

    Here is here description of the very first shift that she worked, on April 17th:

    It is Friday, April 17. It’s 02:40 in the morning. I am just now sitting down for my break for tonight. The beginning my shift was crazy. It was like a war room in the respiratory report room – so many people were trying to figure out what assignment to take. I was put with a therapist with a lot of experience in the surgical ICU. We had 14 vents between the two of us. When I first got there, a patient that had just been brought in from the OR went into cardiac arrest. We had to replace the breathing tube. The cuff had a leak in it. So he was not ventilating well. About 20 minutes after that, another patient coded in another room – we got him back. See. After that, another patient in another room coded. He did not make it. And he was only 22 years old. I’m tired – just been running around crazy all night. It’s sad the resident had to call the other family of that patient that died. And she said, I’m just so weary of all of this, having to make these phone calls. It’s just getting to me. And she started bawling at the nurse’s station.

    So, 14 vents, 3 codes, one death in her very first shift as a temp.

    By the Sunday the 19th, things are calmer, but at least partly because all of the temporary staff is now in place.

    In other words, that hospital couldn’t run with normal staffing. One of the things that was necessary was that staffing could be pulled in from other places in the country. One should see that this is not the kind of situation you want to happen everywhere all at once.

    • Anonymous Bosch says:

      An ER medical director for one of their top hospitals just committed suicide.

      • EchoChaos says:

        What is the base rate here? I feel like we may be risking the Chinese Robber fallacy just because NY is under a spotlight.

        This is not saying it isn’t bad in NYC.

        • HeelBearCub says:

          The fact that this particular doctor committed suicide isn’t particularly material. Absent some statistically anomalous signal that suicide risk is indeed correlated with Covid-19 healthcare work, we would have to chalk this up as another personal tragedy that might have been precipitated by many events.

          However, as more anecdata that the situation of providing healthcare in NYC was incredibly impacted (i.e. not merely “whelmed” as some have put it), the particulars of her story are material.

          • Matt M says:

            Her anecdotes are interesting, but they remain anecdotes.

            She talks about a 22 year old dying. That’s sad, and I don’t dispute that it happened.

            But the data show that so far, COVID has killed fewer than 1-in-300,000 Americans under 45. That seems worth pointing out.

          • Conrad Honcho says:

            Keep in mind, when I was talking about the system being “whelmed,” I started saying that two weeks ago after New York was no longer whelmed. And it definitely applies in the rest of the country. There’s no reason for everybody to be staying home in my neck of the woods now because NYC was bad four weeks ago.

            And in fact that’s what’s happening. My boss says everybody has to be back to the office starting Monday, so the dream is over. I pretty much didn’t leave my house for six weeks and it was everything I imagined it could be, but all good things…

          • EchoChaos says:

            @HeelBearCub

            I disagree. This is exactly the sort of anecdote (anecdata) that creates a Chinese Robber Fallacy.

            I am not stating either way whether NYC is overwhelmed. My impression is that in places that COVID is bad it is worse than we expected, but in places where it’s not bad, it’s better than we expected.

            Edit: oops, ended up a bit of a dog pile.

          • HeelBearCub says:

            Your arguments don’t make much sense.

            This is like someone saying that all those campers don’t need to use bear bags and bear vaults, as barely (sic) any food is being stolen.
            (Yes, I know you will break out the anti-tiger charm story. It’s not valid.)

            You can’t just evaluate what is happening under lockdown as if this represents what would have happened absent the lockdown. Not sure the name for that fallacy, but it’s common. Perhaps the composition/division fallacy applies.

            We have lots of evidence that NYC was getting very bad. Three days later and it would been twice as bad. Six days later, 4 times as bad. That’s highly explanatory for how we went from Cuomo preventing De Blasio from locking down to mandating a lockdown in 3 days time.

            Yes, what I am presenting is anecdata, but it’s anecdata in support of data that show that we had 10k excess deaths in a few weeks in NYC. “Anecdata” like body bags being stored in refridgerator trucks and mass graves being dug stop being anecdata when you see enough of it and it starts to be just data.

          • Matt M says:

            You can’t just evaluate what is happening under lockdown as if this represents what would have happened absent the lockdown.

            True.

            But you also can’t just assume that the only possible reason that actual results differ from modeled results is that the lockdowns worked (better than expected).

            Particularly so for those who have also been kicking and screaming this whole time that lockdown measures were implemented too late, that they didn’t go far enough, and that too many people aren’t taking them seriously enough.

          • Aapje says:

            An issue is that there seems to be a fairly long period between infection and being admitted to the hospital. So if you take measures by the time the hospitals are whelmed, there is a substantial risk that they become overwhelmed, before the measured have visible effect.

    • AG says:

      I linked this in the last thread, an account from an Idaho nurse doing the same thing: https://www.wbur.org/hereandnow/2020/04/13/coronavirus-nurse-new-york-overwhelmed-hospitals

      Schneider says a typical nurse-to-patient ratio in most parts of the country 4 to 1 or 5 to 1. But because of the coronavirus and the limited number of health care workers on-site, she says some nurses at the hospital are caring for up to 12 patients at a time, with up to five sick patients crammed into a single room.

      “You can’t do it. These are total care patients. They can’t get up and go to the bathroom by themselves,” she says. “I mean, it’s a mess.”

      A lack of beds is plaguing the hospital, so patients lying on stretchers in the hallways have become a common occurrence, she says.

      “It’s heartbreaking because they’re on these stretchers for days at a time,” she says. “There’s no beds to put them on.”

      You don’t have to have a higher death count to overwhelm the hospital. As the account says, merely being in a total care patient would do it, as it’s not like these people could not go to the hospital. This also addresses some of the arguments from the last thread about labelling any death as COVID-related if possible, as that doesn’t have bearing on whether or not a hospital is overwhelmed or not.

      • EchoChaos says:

        You don’t have to have a higher death count to overwhelm the hospital.

        Sure, that’s been known since early on. It’s exactly what “flatten the curve” meant. And I’m glad NYC is getting help from less brutally hit areas. That’s what we should be doing.

        NYC probably will not be able to open up for a fair bit, but that doesn’t mean that the rest of the States can’t.

        • The Nybbler says:

          NYC hospital visits for influenza-like illness are practically at baseline. There’s no reason NYC can’t re-open now.

          • Edward Scizorhands says:

            This assumes a bunch of stuff that may not be true.

          • HeelBearCub says:

            The key question is “for how long?”

            And one answer is “not long enough, and not as long as we would have if we take time to further decrease infection and increase infection fighting measures”.

            Opening for 3 weeks doesn’t do much good.

          • The Nybbler says:

            Permanently. In NYC ~25% of the population has COVID-19 antibodies. The most vulnerable have likely already survived or succumbed, since most nursing homes have already been affected. Given that, I would not expect any new peak in cases to be as high as the previous peak. Particularly since at least initially, even with a complete opening, I would expect more voluntary distancing than there was pre-lockdown.

            Waiting for unspecified or unlikely measures is just “lockdown until riots”.

      • DarkTigger says:

        Why should the other parts of the hospital be suddenly empty? People did not stop get heart attacks (rather the opposite as Covid-19 makes the blood clumb) and cancer.

        • The Nybbler says:

          Because they’re closed by government diktat. Sure, heart attack patients might still come in. But a lot of those people with cancer surgery (or bypass surgery)… “Sorry pal, that’s elective, you’ll have to wait until the emergency is over, around the fifth of Never according to our governor”. Note that “elective” does not mean “optional”

        • Conrad Honcho says:

          Most (all?) hospitals have postponed non-emergency services, so their total volume is down. The hospital near me is having their staff take one day off a week.

          edit: nynjer’d

      • matthewravery says:

        What makes you think those nurses that can be shifted haven’t been already?

  23. Edward Scizorhands says:

    https://www.newyorker.com/magazine/2020/05/04/seattles-leaders-let-scientists-take-the-lead-new-yorks-did-not

    Excellent article comparing Seattle’s response to New York City’s. De Blasio and Cuomo get called out for their early dithering.

    Take-aways:

    * You need scientists, not politicians, making announcements, because otherwise 50% of the audience tunes out. Obama credited the stuff the Bush administration set up to let this happen for H1N1.

    * You have to show public leaders and visible people following the rules if you want everyone to follow the rules.

    * Trying to get people to listen is difficult. The biggest short-term benefit of closing the Seattle schools is that it forced parents to stay home. You have to change the Common Knowledge quickly, and you can’t necessarily do it just by telling people. But once the schools closed everyone knew this shit was real.

    * Politicians often say the opposite of what their public health experts want them to say.

    • albatross11 says:

      I think the overlap between science and policy is tricky here. You need scientists/technology people to help the political leaders and the public know what tradeoffs are available, to the best of available knowledge. Immunologists and virologists and epidemiologists and public health doctors are in a position to know a lot about the nature of the tradeoffs we face. But it should be the political leaders deciding what tradeoffs between values to make.

      I mean, saying “we’re going to keep running the economy normally and just let the people who are going to die, die” is a tradeoff we can make–and indeed, it’s one we make every flu season. And “we’re going to shut down as much as we can to slow transmission of the virus” is a tradeoff we can make–we’ve made it in most of the US. But while the scientists know their fields pretty well and probably understand more than the politicians what tradeoffs can be made, they are no better equipped than anyone else to decide which end of those tradeoffs we should make. That should be being done by poltical leaders, in the open, with them getting the accountability for the decision.

      Now this runs aground when we have, in general, pretty inept leaders who won’t make those decisions all that well. And also when leaders will (as they definitely will) try very hard to get cover from the experts for any unpopular decisions they make, so that they can just say “yes, we had to {let grandma die of pneumonia, let you lose your job after three months of lockdown} because we were just following the advice of {the economists, the epidemiologists}.” But it’s really important to remember that just because you’re smart and know some technical field doesn’t give you any more right than anyone else to decide what tradeoffs between fundamental values the whole society should make.

      • matkoniecz says:

        That should be being done by poltical leaders, in the open, with them getting the accountability for the decision.

        I would go further. Someone who makes this decision (activating lockdown) is a political leader.

        So it is not “decision made by scientists” vs “decision made by poltical leaders”, it is “somehow selected scientists are political leaders” vs “elected people are political leaders”.

        • Matt M says:

          This is a great point. To the extent that Trump’s policy is “I will do whatever Fauci tells me to do,” then Fauci has become acting President of the United States, and should be seen as a political leader, rather than a scientist.

          • albatross11 says:

            The difference is that Fauci doesn’t actually have the power to enact his preferred policies, and also is only accountable to the president, not to the voters. By contrast, Trump can and does make his own decisions about what policies to pursue, and that’s actually right–he’s the one who’ was elected to make this kind of decision, and he’s the one who is going to face the public in November and account for what choices he’s made[1].

            And the reason this makes sense is that Fauci is a very smart guy and he knows his field, but it’s neither his job nor in his area of expertise to weigh all the different important issues and consequences of a policy against one another. How many saved lives is worth another 1% of unemployment for a year? There’s no reason Fauci’s opinion on that is any better than anyone else’s.

            [1] Trump isn’t at all the person I’d like to see in that position, but he’s the guy we elected president and he’s standing for re-election in a few months, so to the extent anyone in this mess has any democratic accountability or legitimacy, it’s him.

          • Randy M says:

            Agree, as usual, with albatross11.
            Experts should not set policy, because they are focused and not always seeing the full picture. The job of the executive (and I advance to assurance that Trump is particularly suited to this) is to synthesize expert advice, weigh the costs and the benefits, and decide on the policy.

        • Aapje says:

          @matkoniecz

          “somehow selected scientists are political leaders”

          Exactly. The Dutch epidemiologist in chief is not actually limiting himself to science. In fact, causality is so unclear that many choices are more determined by the personality traits of the decider, than how well they base themselves on scientific fact.

      • edmundgennings says:

        Not only will the relevant experts not have any particular expertise in making trade offs, they will have a bias. Everyone thinks that their field is important and an infectious disease expert will likely over emphasize the importance of minimizing deaths by infectious diseases. That is how they have been selected and trained to think. The same thing mutatis mutandi is true for any specialty. Moreover, roles matter for how most people act and think. If I am selected for a committee by virtue of being X, I will prioritize x related things in my actions as a committee member. If an expert from some field is selected for some position by virtue of being an expert in that field then their over emphasis on that field will be even more extreme.
        Should we have some generals and admirals involved in determining the type and magnitude of defense spending? Yes. Should generals and admirals be the only people making these decesions? No. Should admirals and generals be thought of as neutral experts on these matters? No.
        The same thing is true for a wide range of fields.

        • Anteros says:

          Climate science comes to mind. But there’s a further distortion – out of tens of thousands of climate scientists, the ones who will be quoted (and offering up quotes) are the most extreme fraction of 1% of the already activist portion who want to stick their necks out.

          The same is of course true for contrarian voices.

          • The same is of course true for contrarian voices.

            Which may be why those who support the current orthodoxy take it for granted that anyone who doesn’t is someone who doesn’t believe warming is happening, or at least doesn’t believe it is due to human action.

      • JPNunez says:

        While you are not wrong, I think part of the problem is that many politicians saw a third option early on, which was just to take mild measures and let a few people die out (like with the regular flu) and have the best of both worlds, but COVID just doesn’t work like that.

        Most countries switched course after that initial period, but by then it was too late, and they had to go with more restrictive measures than they could have done initially. I think that we haven’t had too many more countries behaving like Italy and Spain is because those two, for whatever reason, were hit too early, but now the rest of the world’s population is scared too into complying with the restrictions, which has made them more effective, regardless of the actions taken by their politicians.

  24. salvorhardin says:

    Good news: Oxford vaccine candidate is still looking promising.

    Bad news: if social distancing works well, the vaccine trials may not work to demonstrate effectiveness, because they aren’t doing challenge trials.

    How might we get our sclerotic, ethically-shortsighted rulemaking establishments out of their torpor long enough to fix this?

    https://www.nytimes.com/2020/04/27/world/europe/coronavirus-vaccine-update-oxford.html?action=click&module=Spotlight&pgtype=Homepage

  25. HeelBearCub says:

    If you have been under the impression that Covid-19 deaths have been over estimated, one should consider that to have been “cast out of the stacked beds”.

    The Financial Times has done a 14 country analysis of all cause morbidity.

    The death toll from coronavirus may be almost 60 per cent higher than reported in official counts, according to an FT analysis of overall fatalities during the pandemic in 14 countries.

    I encourage you too look at the charts to see just how abruptly all cause morbidity rose.

    • Matt M says:

      Is it possible that the lockdowns themselves are contributing to all cause morbidity, by reducing people’s general health, weakening their immune system, delaying needed (but “elective”) medical treatment, or by increasing “deaths of despair”?

      • HeelBearCub says:

        The total deaths in the hard hit places doubled vs. the baseline over the course of two month. I don’t think increased morbidity from suicide and delayed treatment can explain that at all. Especially not when we have plenty of causes of death that should also decrease.

        Basically, I think you are grasping at confirmatory straws there.

        • albatross11 says:

          Sure, but those are going to be marginal cases. If you’re pretty sure you’re having a heart attack or stroke or something, you’re going to call 911. If you’re having very mild symptoms that maybe could indicate those things, you’re probably not calling them. (And most of the time you’ll be right, but some of the time, you’ll pay dearly for not calling early.). And in many of those cases, you’ll just wait and see, and call them a few hours later when the symptoms have persisted or gotten worse.

        • Biater says:

          Yes, but the vast majority oof people aren’t avoiding the hospital because of a lockdown, because visits to the hospital are perfectly acceptable during lockdown. If people are avoiding the hospital, it’s because they’re worried they will catch Coronavirus at the hospital. Because they might.

          Ending the lockdown won’t help with that fear while the pandemic continues.

          Lockdowns might also (and I would expect are) causing fewer deaths, due to fewer cars on the road, and fewer people getting the flu (which does still kill people) etc. Fewer people having heart attacks during extreme exercise exertion.

          Maybe long-term though, the negative effect of lockdown on deaths due will outweigh the positive effect. Not exercising for a couple of months probably doesn’t hurt people much. Not exercising for a year is a different story. Someone will need to write books about that.

        • Matt M says:

          If people are avoiding the hospital, it’s because they’re worried they will catch Coronavirus at the hospital. Because they might.

          If you are having chest pains, avoiding the hospital because you’re afraid of catching COVID is a very bad idea. Particularly if you live in the 95% of the country where COVID cases are minimal and the hospitals are basically empty.

          I count “the media has terrified people into avoiding hospitals who otherwise would go” as lockdown-associated, but you could plausibly argue that sort of thing deserves its own category.

        • FLWAB says:

          Yes, but the vast majority oof people aren’t avoiding the hospital because of a lockdown, because visits to the hospital are perfectly acceptable during lockdown.

          Not true. Just today I talked to a co-worker whose baby has a heart condition. The doctor ordered a CAT scan because of some concerns, but they haven’t been able to get it yet. Why? Because while the CAT scan is considered an essential procedure, getting anesthesia for the CAT scan is not. But they already tried to do the CAT scan without anesthesia and her baby wriggled around too much to get a clear image. The baby needs to be knocked out for the scan, but the hospital has decided that is not essential. Now her doctor is in a complicated bickering process with the hospital and it has been over a week.

          I’ve heard of similar cases from other people. People are being turned away from hospitals because their their care is being determined as non-essential. And I’m sure people will die because of it, though how many is beyond me.

        • Garrett says:

          > If you’re pretty sure you’re having a heart attack or stroke or something, you’re going to call 911.

          Anecdata:

          Pre-Covid, of the likely-preventable cardiac arrests I’ve worked in EMS, all of them presented with fairly typical symptoms ahead of time for hours or days. These symptoms were all dismissed as indigestion or whatever in advance.

          More recently, I had a patient who had a complex medical history and a severe presentation which we wanted to take “into the city” rather than to the local community hospital because … complex medical history. We had to work hard to convince them to go because they were worried about getting Covid-19.

          Getting people to go to the hospital for severe conditions is hit-or-miss in the first place. And being afraid of getting Covid-19 is almost certainly tilting the scales.

        • Garrett says:

          > and delayed treatment

          FWIW, I’ve been hearing from unverified sources that a significantly larger number of cardiac patients in the hospital are going into arrest than usual because the patients are being warehoused rather than getting the otherwise planned surgery. The problem being that not having the surgery increases the risk of further complications, but that you can’t say for sure that it will kill you in the next week or so.

          The problem here is that there is only a limited selection of the total data available from which to synthesize. We don’t have published medical histories for everybody involved to facility good analysis. And we’ll likely only be able to determine excess morbidity in years to come as case-controlled evaluations are capable of being done.

          It also doesn’t account for other just-so stories, such as the staff stressing out about Covid-19 so much that they are making more medical errors than usual, resulting in greater mortality.

        • ana53294 says:

          There is also the issue that ambulances may be busy getting disinfected.

        • albatross11 says:

          Steve Sailer proposed that we should be running public service announcements telling people it’s safer to go to the hospital when you have symptoms of a heart attack or stroke than to stay home and try to ride it out. No idea how much that would work, though.

      • Randy M says:

        After six weeks? I’d like to think we are heartier than that.

        But more to the point, if you go to that level you have to also account for less workplace accidents, traffic fatalities, seasonal flu, and whatever else the distancing/lockdown is preventing.

        (edit: what he said)

      • Conrad Honcho says:

        I would find it extremely unlikely if staying inside for four weeks or so weakened people’s immune systems to the point of death.

        Caveat: everything I say about health and medicine is wrong.

        Edit: ninjer’d

        • albatross11 says:

          One thing I do worry about, though–COVID-19 seems to be worse for people who are overweight, and maybe for people who are in poor shape. The lockdown has probably resulted in lots of people getting much less exercise than usual and gaining some weight. I wonder what the statistical impact of that is on eventual deaths….

          • It’s helped members of my family to lose weight, because our home cooking is healthier than our restaurant meals.

          • AG says:

            I don’t know about people who are currently in poor shape, but by looking at parking lot activity, hiking is way up, as people are able to go during hours that would normally be taken up by the commute and work. They can go walking at their leisure on the weekdays, during daylight, instead of having to wait for after work, get up extra early to go before work, or waiting for the weekends.
            Some are also going out more in order to accompany their kids going out to burn energy.

          • salvorhardin says:

            I’ve lost a fair bit of weight in the past two months. I attribute part of this to better portion control from not eating my weekday breakfasts and lunches in a fancy corporate cafe, and part to the calorie-burning effect of a substantially elevated general anxiety level. The former is probably a good thing for my immune robustness and overall health; the latter almost certainly not.

          • viVI_IViv says:

            I’ve completely stopped eating out since I started voluntary self-isolation in mid-March, and I’ve lost quite a bit of weight.

            I’ve been counting calories quite accurately, but I don’t pay much attention to macros. I’ve stopped going to the gym, obviously, but I walk a lot more, overall I think that my energy expenditure decreased yet I’m losing weight (and according to the fancy scale most of it is fat, although I don’t know how accurate the impedance thing is). I wonder how many calories I was actually eating before.

      • Matt M says:

        To partially answer my own question, the article says:

        Some of these deaths may be the result of causes other than Covid-19, as people avoid hospitals for other ailments. But excess mortality has risen most steeply in places suffering the worst Covid-19 outbreaks, suggesting most of these deaths are directly related to the virus rather than simply side-effects of lockdowns.

        That strikes me as a pretty bogus answer. Countries suffering the worst outbreaks are also the ones that would have the strictest lockdowns, that will have had the longest lasting lockdowns, and will have the highest general fear/anxiety among the population at large.

        Given the COVID situation in Italy, it seems reasonable to me to assume that Italians are far more likely to avoid the hospital out of fear than Danes are.

        In order to reject the hypothesis that some of this is lockdown-related, wouldn’t you also have to reject the hypothesis that “lockdown intensity” is positively correlated with “severity of COVID outbreak?”

        • viVI_IViv says:

          In order to reject the hypothesis that some of this is lockdown-related, wouldn’t you also have to reject the hypothesis that “lockdown intensity” is positively correlated with “severity of COVID outbreak?”

          If people are scared to go to the hospital because they’ve seen mass graves or army convoys moving corpses on tv, then lifting the lockdown isn’t going to make them any less afraid. More likely they’d think that their government has left them to die.

      • albatross11 says:

        I expect there is some non-COVID stuff in there, involving things like people with chest pains deciding they’d rather take their chances that it’s just indigestion than go to a plague-ridden hospital. But I don’t think that sort of thing can possibly explain much of the huge jump in deaths.

        At a guess–lots of people are dying without being tested, probably mostly people who were sick with COVID but decided to ride it out at home rather than go to the hospital. I know one person who is currently sick (the illness having dragged on for three weeks now), and she can’t get anyone to see her or test her–she’s not sick enough or she’s potentially contagious, but in either case, she’s told to stay home. If she keels over from a heart attack next week under the strain of a month of untreated COVID-19, I wonder how her death will be counted.

        ETA: I’ll personally count it the way I count kids in Haiti dying of cholera–they got screwed over by living in a shitty, dysfunctional country that couldn’t deal with reality well enough to keep a bunch of their citizens from needlessly dying. But then, I may be getting a little bitter about the quality of response I see in the US.

    • The Nybbler says:

      They’re showing NYC with 12,700, which comes in nicely between NYC confirmed deaths and NYC confirmed + probable deaths, so I’d say at least in NYC, probably not underestimated by a significant degree.

      For another perspective, there’s the CDC fluview data, which shows pneumonia + influenza mortality as a percent of total mortality. The US is at 14.5%, compared to a baseline of 6.7%. In the 2017-2018 flu season, it hit 10.9%.

      • HeelBearCub says:

        Agreed that NYC is no longer underestimating, at least not to anywhere near the same amount, and probably any underestimation is negligible. It’s not clear to me when the FT data ends, so I’d caution against comparing the raw totals as that may just be an artifact of when the measuring period ends.

    • Statismagician says:

      We know this already. Every single person with any degree of biostatistical or epidemiological knowledge is perfectly aware that current confirmed counts are 100%-confidence missing people. Available numbers are bad. We know they’re bad. I and a bunch of other people have been saying they’re bad on this very site since at least early March.

      • HeelBearCub says:

        Right, that’s why I predicated the statement by addressing it to people who thought things were being overestimated. There are definitely people here in that camp.

        It’s just another data point to add on to the “actually this is a really big deal” pile.

        • Matt M says:

          To be clear, I am quite confident of the following:

          1. Most hospitals (in the developed world) have a strong incentive, both financial and from a PR standpoint, to mark any plausible-COVID death as a COVID death.
          2. There are anecdotal examples aplenty of them actually doing this (one of the most egregious, the Ventura County Star reported one of their numbers included a drug overdose from someone who had formerly tested positive). Yes, I understand that these are anecdotes, not data.

          That said, I acknowledge that it is entirely possible that some COVID deaths are going uncounted, and that on net, the uncounted could theoretically outnumber the “overcounted” I discussed above.

          What I’m not too sure on is the mechanism by which this might happen. I could see it in the developing world examples they give, where someone just dies at home having not gone to the hospital and nobody really bothers to alert the state or give a cause of death – they just bury them and move on.

          But do we really have thousands of people, in the developed west, dying at home, of COVID, having never sought treatment, and then not getting autopsied or anything like that?

          Like, what exactly is the hypothetical scenario in which I could die of COVID without having the death be attributed to COVID? What all would have to take place for that to happen?

          • Conrad Honcho says:

            1. Most hospitals have a strong incentive, both financial and from a PR standpoint, to mark any plausible-COVID death as a COVID death.

            Yes, there is a strong financial incentive to commit Medicare fraud. That is, if you lie to Medicare and inflate the level of service you provided to patients, Medicare will pay you more for the work you didn’t actually do. However, hospitals generally don’t do it because it’s extremely illegal and they’re, on average, not crooks. You should assume COVID-19-related Medicare fraud is about as common as however common you think non-COVID-19-related Medicare fraud is.

          • Matt M says:

            As I’ve said when we debated this before, it’s not fraud if it’s an edge case, or hard to determine. Or even if you have a blanket rule of “everyone who dies with COVID will be recorded as having died of COVID” and you are transparent about it and the Feds don’t tell you to knock it off.

          • Faza (TCM) says:

            Most hospitals (in the developed world) have a strong incentive, both financial and from a PR standpoint, to mark any plausible-COVID death as a COVID death.

            Nobody ever got fired for losing a patient to COVID-19?

          • Conrad Honcho says:

            This is already a known type of fraud in healthcare billing, overcoding or upcoding. Among the reasons medical billing coders are told to not do this is not only because it’s wrong and illegal, but because it’s also detectable. It’s not difficult to look at the distribution of codes at one facility and compare them to a similar facility and say “hey, these people are consistently alleging their patients are one service level higher than other similar facilities! We better check this out.” And they get their documentation audited and they get fines and/or jail time. Eventually, people are going to notice when one hospital had twice as many COVID-19 patients as the hospital down the street and wonder why that was. And the Feds are going to hammer them, and you want to talk about bad PR? “Hospital defrauds Medicare during plague!” is not good press.

            You’re doing an extremely naive first-level pass at fraud here. You forget healthcare fraud has always been a thing, so has healthcare fraud detection, and healthcare compliance education. None of that has changed with COVID-19.

          • Statismagician says:

            Also note that trying to get away with Medicare fraud becomes a worse proposition as both Medicare’s fraction of your patient population and the size of your practice rise, since the penalty for getting caught out is triple damages plus permanent exclusion from billing Medicare for everyone involved, and you have to get a lot more people to go along with it. There absolutely is systematic misclassification of things, especially in fuzzy cases where it could be Thing A with reimbursement rate X or Thing B with reimbursement rate 3X and especially in cases where only your physician and his biller have to conspire rather than multiple hospital departments.

            Or, to a first approximation, generally there’s fudging not fraud, and generally by small private practices and not hospitals. There are papers on this; I’ll dig some up when I have a chance, or if you look around in the ICD-9/ICD-10 validation section of PubMed you should be able to find some.

            EDIT: Yeah, what Conrad Honcho said, basically.

          • Conrad Honcho says:

            Just further thoughts on this. I have done data warehousing work, and once built a data warehouse for a hospital system to analyze their billing data. While I do not know anything about health or medicine itself, I have had a great deal of experience with how medical billing works, CPT codes, ICD-9 and -10 codes, etc. Because I was working with healthcare data, I had to take the HIPAA training and the billing/compliance training everyone has to take, even though I wasn’t working with patients or doing any of the billing myself. And one of the review questions made certain you understand that if you committed Medicare fraud, it wasn’t just the organization that was on the hook, but you, personally. Criminally.

            So the whole, “dude, they could just fudge stuff to get a little more money!” thing is not some kind of new novel idea with COVID-19. It is babby’s first healthcare fraud. They are absolutely aware of this, and the billing compliance training included large sections about not doing specifically this.

            When a doc sees a patient and they bill the visit, there are a range of codes they use to describe the nature of the service. So for instance, codes 99211-99215 are for an office or outpatient visit for an established patient (that is a return visit, not an initial evaluation) with a 99211 being service level 1 (easy) and a 99215 being service level 5 (difficult). There’s similar distinctions for inpatient care, or new/evaluation visits, emergency care, psych care, etc. You get more money for each difficulty level. Obviously babby’s first healthcare fraud is, “gee, why can’t we just bump everything up a level and get more money? Who can say what’s the difference between a level 2 and a level 3?” Well, duh, the statistical analysis.

            As for my work, among the things they wanted in the end dashboards for the providers and administrators was a code mix analysis. They were part of this cooperative where lots of different hospital systems would submit their code counts for different specialties. Then everyone could download the aggregated data, and be able to say things like “a general services pediatrician sees 30% level 1 patients, 40% level 2 patients, 20% level 3 patients, 5% level 4 patients and 5% level 5 patients.” And then each doc or group of docs could look at their code mix and see how well they stacked up with that, to make sure that either they weren’t overcoding or undercoding compared to everybody else (or maybe evaluate whether or not they were a doc who saw a lot of basic patients or one who went after the tougher cases). Part of this was also making sure they don’t have some problem with overcoding they don’t know about that’s going to get the Feds coming down on them.

            The point is that fudging medical billing to make it look like a healthcare provider is doing more work than they are to get some extra cash is not a novel idea. It is a well-known form of fraud, such that health insurers and the government are actively on the lookout for it, and so hospital systems train their employees not to do it, threatening them with jail time, and join voluntary associations to share data to help make sure they and their providers are not doing in it actively or even inadvertently and then they hire people like me to build them complicated data systems so they can make sure they’re not doing this.

            The idea that hospital systems go to all this effort to make sure they’re not going to inflate reporting about services they provide to insurers, including Medicare, even though they have a “strong financial incentive” to do so (until the hammer comes down and they get fined/jailed out of existence), but then as soon as COVID-19 comes around they’re going to say “Remember all that training we gave everyone in the organization about not fudging healthcare services or else you go to jail? pfffft, f that noise, plague time! Make it rain! Who got COVID-19?! I got COVID-19, you got COVID-19, yo mama got COVID-19, Err’rybody got COVID-19!” is not reasonable. If anything, people who were doing this stuff before might pull back during the plague since everyone’s looking at the healthcare system now. A reasonable estimate for how much COVID-19 fraud is going on is…about as much, maybe less than the base rate for Medicare fraud by hospitals (not one-man office shows, because they don’t offer inpatient services). I would guess something like 1%.

          • viVI_IViv says:

            Like, what exactly is the hypothetical scenario in which I could die of COVID without having the death be attributed to COVID? What all would have to take place for that to happen?

            You just die in your bed and your body never gets tested for SARS-CoV-2. The doctor just writes on your death certificate “respiratory failure”, which could be anything from Covid-19 to seasonal flu to heart disease to asthma to lung cancer.

            The real world is not CSI and they are not going to do an autopsy unless they suspect there is something “unnatural” about your death.

        • Statismagician says:

          The thing is, as far as I can tell, that the people who don’t think this is a big deal don’t think that because they’re committed to the official count as it stood whenever the Financial Times did their analysis, but rather because they think current measures are either ineffective or won’t turn out to have had a positive ROI. These are completely different points of disagreement and I don’t think you’re going to change anybody’s mind this way.

    • Faza (TCM) says:

      I think we should approach this data with some caution. We are not exactly operating under normal conditions right now, and COVID-19 isn’t the only difference. The pandemic mitigation strategies employed may also have an effect (in fact, it is currently one of the bigger talking points, at least here in Poland).

      I really don’t like the way FT have chosen to display their graphs, with much of the X axis remaining blank, because it pertains to the future. It doesn’t help us get an idea of the time frame of these mortality spikes, which would be better illustrated if we could look at the year-to-date.

      Fortunately, we have EuroMoMo, who’ve recently improved their display capabilities greatly. Zooming in, we see that the big mortality spikes begin around week 11 (9th to 15th March), which – coincidentally – is around the same time the lockdowns began. Prior to that, excess mortality has tended to be substantially lower than in the previous two years.

      I strongly recommend looking at the charts for the individual contributing countries, as well as the differences among age groups (it is somewhat unfortunate that the middle category is 15-64, which seems way too broad). There are some really major discrepancies between countries. I mean, if you compare Italy (179k confirmed cases as of 19th April*) and Germany (145.2k cases as of the same date*), it’s almost like we were dealing with two completely different epidemics.

      Oxford University’s Centre for Evidence Based Medicine have noticed it too: Six Countries: Three-quarters of the COVID Deaths. Comparing this with EuroMoMo, we see that they haven’t included the Netherlands, which seems broadly comparable to Spain under EuroMoMo metrics (and EuroMoMo doesn’t include the US, for obvious reasons). Sweden and Switzerland also have noticeable peaks, but nowhere near the Big Six (if we include the Netherlands).

      Everywhere else seems pretty much within the normal range of variation.

      We don’t have a great deal of information as to what these people are dying of – other than COVID-19 – but we do have some. CEBM have obtained excess death by cause data from Scotland (whose excess mortality peak is visible on EuroMoMo).

      Looking at the charts, we can see a significant rise in excess deaths due to cancer, dementia/alzheimers and other causes. Interestingly, respiratory disease caused deaths have been below baseline for all but one week (two, if you want to quibble about week 15 which is around baseline) and whilst circulatory diseases have caused a significant uptick in excess deaths in weeks 14 and 15, they seem to be trending back towards baseline.

      The matter of excess mortality over the past couple of months is in no way clear cut.

      * Numbers taken from the JHU dashboard.

      • baconbits9 says:

        Just to get a feel for the numbers (googling and not checking sources in any meaningful way)

        The Us in 2019 averaged almost 8,000 deaths per day and has been averaging 770 deaths/day from Covid since the first case was reported. So a 60% higher rate would be an additional 462 deaths per day.

        Suicides in the US averaged 132 deaths a day in 2009. I think its unlikely that the rate had more than tripled due to Corona virus, even doubling would be surprising to me.

        Heart disease killed 2,300 people a day, a 10% increase from the stresses surrounding the virus, the shut downs, unemployment etc doesn’t sound implausible and that would be half of your increase on its own, 20% sounds high but not ‘no chance, no way’.

        After heart disease you have cancer killing about 2,000 people a day, and after that nothing kills significantly more than 500 a day despite some broad categories (all accidents etc).

        One plausible mechanism I could think of would be the reaction time for causes of death like heart attacks and strokes. Survival rates go way up for those who are around other people when it happens, especially in stroke victims (~300 deaths per day 2019) it is often an observer who notices something is wrong and calls for help. Overall you would need much, much better data but a look at some basic raw totals would make it seem plausible that this is at least a part of the cause of the increase in total morbidity.

        • John Schilling says:

          Heart disease killed 2,300 people a day, a 10% increase from the stresses surrounding the virus, the shut downs, unemployment etc doesn’t sound implausible

          Note that there’s at least 4% increase in cardiac mortality in the week between Christmas and New Year’s Day, even after accounting for climate, for reasons that are not well understood but likely cultural or psychological in nature. Something of similar magnitude for the coronavirus lockdown, and possibly a factor of 2-3 higher, seems quite plausible.

        • it is often an observer who notices something is wrong and calls for help.

          I cannot resist a true story.

          Some years back, I was in a WoW raid led by someone we had interacted with a good deal, although only online. He noticed that I wasn’t responding and called the house. My son took the call, came into my office, found me semi-conscious on the floor. The family took me in to the hospital.

          So an observer can notice that something is wrong via an online interaction, although it’s surely less likely.

          (I had a meningioma, a “benign” tumor between the skull and the membrane around the brain, and it was putting pressure on my brain. Solved by surgery.)

          • Edward Scizorhands says:

            This reminds me: Does anyone know Plumber’s real identity[1] and can see if he’s okay? I know his phone is busted.

            [1] I forget if he’s public or private or secret about this.