COVID-19 could be pretty bad for you. It could affect your travel plans as countries impose quarantines and close off borders. It could affect you materially as supply chains are disrupted and stock markets are falling. Even worse: you could get sick and suffer acute respiratory symptoms. Worse than that: someone you care about may die, likely an elderly relative.
But the worst thing that could happen is that you’re seen doing something about the coronavirus before you’re given permission to.
I’ll defend this statement in a minute, but first of all: I am now giving you permission to do something about COVID-19. You have permission to read up on the symptoms of the disease and how it spreads. Educate yourself on the best ways to avoid it. Stock up on obvious essentials such as food, water, soap, and medicine, as well as less obvious things like oxygen saturation monitors so you know if you need emergency care once you’re sick. You should decide ahead of time what your triggers are for changing your routines or turtling up at home.
In fact, you should go do all those things before reading the rest of the post. I am not going to provide any more factual justifications for preparing. If you’ve been following the news and doing the research, you can decide for yourself. And if instead of factual justifications you’ve been following the cues of people around you to decide when it’s socially acceptable to prep for a pandemic, then all you need to know is that I’ve already put my reputation on the line as a coronaprepper.
Instead this post is about the strange fact that most people need social approval to prepare for a widely-reported pandemic.
As Eliezer reminded us, most people sitting alone in a room will quickly get out if it starts filling up with smoke. But if two other people in the room seem unperturbed, almost everyone will stay put. That is the result of a famous experiment from the 1960s and its replications — people will sit and nervously look around at their peers for 20 minutes even as thick smoke starts obscuring their vision.
The coronavirus was identified on January 7th and spread outside China by the 13th. American media ran some stories about how you should worry more about the seasonal flu. The markets didn’t budge. Rationalist Twitter started tweeting excitedly about R0 and supply chains.
Over the next two weeks, Chinese COVID cases kept climbing at 60%/day reaching 17,000 by February 2nd. Cases were confirmed in Europe and the US. The WHO declared a global emergency. The former FDA commissioner explained why a law technicality made it illegal for US hospitals to test people for coronavirus, implying that we would have no idea how many Americans have contracted the disease. Everyone mostly ignored him including all major media publications, and equity markets hit an all time high. By this point several Rationalists in Silicon Valley and elsewhere started seriously prepping for a pandemic and canceling large social gatherings.
On the 13th, Vox published a story mocking people in Silicon Valley for worrying about COVID-19. The article contained multiple factual mistakes about the virus and the opinions of public health experts.
On February 17th, Eliezer asked how markets should react to an obvious looming pandemic. Most people agreed that the markets should freak out and aren’t. Most people decided to trust the markets over their own judgment. As an avowed efficient marketeer who hasn’t made an active stock trade in a decade, I started at that Tweet for a long time. I stared at it some more. Then I went ahead and sold 10% of the stocks I owned and started buying respirators and beans.
Before Rationality gained a capital letter and a community, a psychologist developed a simple test to identify people who can override an intuitive and wrong answer with a reflective and correct one.
One of the questions is:
In a lake, there is a patch of lily pads. Every day, the patch doubles in size. If it takes 48 days for the patch to cover the entire lake, how long would it take for the patch to cover half of the lake?
Exponential growth is hard for people to grasp. Most people answer ’24’ to the above question, or something random like ’35’. It’s counter-intuitive to people that the lily pads could be barely noticeable on day 44 and yet completely cover the lake on day 48.
Here’s another question, see if you can get it:
In an interconnected world, cases of a disease outside the country of origin are doubling every 5 days. The pace is slightly accelerating since it’s easier to contain a hundred sick people than it is to contain thousands. How much of a moron do you have to be as a journalist to quote statistics about the yearly toll of seasonal flu given a month of exponential global growth of a disease with 20 times the mortality rate?
Social Reality Strikes Again
Human intuition is bad at dealing with exponential growth but it’s very good at one thing: not looking weird in front of your peers. It’s so good at this, in fact, that the desire to not look weird will override most incentives.
Journalists would rather miss out on the biggest story of the decade than stick their neck out with an alarmist article. Traders would rather miss out on billions of dollars of profits. People would rather get sick than do something that isn't socially sanctioned.
Even today (2/26/2020), most people I’ve spoken to refuse to do minimal prep for what could be the worst pandemic in a century. It costs $100 to stock up your house with a month’s worth of dry food and disinfectant wipes (respirators, however, are now sold out or going for 4x the price). People keep waiting for the government to do something, even though the government has proven its incompetence in this area several times over.
I think I would replace the Cognitive Reflection Test with a single question: would you eat a handful of coffee beans if someone told you it was worth trying? Or in other words: do you understand that social reality can diverge from physical reality, the reality of coffee beans and viruses and diseases?
Social thinking is quite sufficient for most people in usual times. But this is an unusual time.
Seeing the Smoke
The goal of this article isn’t to get all my readers to freak out about the virus. Aside from selling the equities, all the prep I’ve done was to stock a month of necessities so I can work from home and to hold off on booking flights for a trip I had planned for April.
The goal of this post is twofold. First, if you’re the sort of person who will keep sitting in a smoke filled room until someone else gets up, I’m here to be that someone for you. If you’re a regular reader of Putanumonit you probably respect my judgment and you know that I’m not particularly prone to getting sucked in to panics and trends.
And second, if you watched that video thinking that you would obviously jump out of the room at the first hint of smoke, ask yourself how much research and preparation you’ve done for COVID-19 given the information available. If the answer is “little to none”, consider whether that is rational or rationalizing.
I could wait to write this post two months from now when it’s clear how big of an outbreak occurs in the US. I’m not an expert on viral diseases, global supply chains, or prepping. I don’t have special information or connections. My only differentiation is that I care a bit less than others about appearing weird or foolish, and I trust a bit more in my own judgment
Seeing the smoke and reacting is a learnable skill, and I’m going to give credit to Rationality for teaching it. I think COVID-19 is the best exam for Rationalists doing much better than “common sense” since Bitcoin. So instead of waiting two months, I’m submitting my answer for reality to grade. I think I’m seeing smoke.
Curated. I found this both an object-level-helpful post for the coronavirus situation, as well as a generally relevant rationality post.
I think this is on the edge of how much a post can be "aim-to-persuade" while feeling reasonable to curate, but it served an important function in this case and I don't think I would have suggested Jacob change much about the post in that dimension. I liked that my primary takeaway from the post was not "you should worry about coronavirus" but you have social permission to worry if you think it's appropriate.
For people who are interested in model-driven discussion of how to prepare and what concrete things to worry about (or not), I recommend this thread.
This is partly a test run of how we'd all feel and react during a genuine existential risk. Metaculus currently has it as a 19% chance of spreading to billions of people, a disaster that would certainly result in many millions of deaths, probably tens of millions. Not even a catastrophic risk, of course, but this is what it feels like to be facing down a 1/5 chance of a major global disaster in the next year. It is an opportunity to understand on a gut level that, this is possible, yes, real things exist which can do this to the world. And it does happen.
It's worth thinking that specific thought now because this particular epistemic situation, a 1/5 chance of a major catastrophe in the next year, will probably arise again over the coming decades. I can easily imagine staring down a similar probability of dangerously fast AGI takeoff, or a nuclear war, a few months in advance.
Millions of deaths worldwide would be kind of "meh" to be honest. In emerging economies like China and India it's the price paid yearly (lung diseases due to air pollution) in return for faster economic growth. In first world countries it's a bit more unusual, but even in the most endangered age group the risk is at worst (i.e. complete loss of containment like flu) still only on the same order of magnitude as cancer and cardiovascular diseases.
Overall, not great not terrible. I certainly wouldn't classify it as a "major global disaster".
So in India it doesn't feel like we're paying that price *yearly* because we're also getting more food, more access to better water, healthcare etc for that faster economic growth which reduces the number of deaths?
This one doesn't come with those benefits, I think we wouldn't be "meh" about even thousands of deaths due to a new disease. :)
Edited to clarify: I parsed the "meh" in your original comment as referring to what the general population (in India or China or maybe the world at large) will think about 'millions of deaths', and not your personal opinion on the matter. I figured we were discussing larger societal reaction, because that will impact how the economy does, and (in my mind) make a disaster 'major', separate from the sheer number of deaths.
At no point did I think you were 'for the virus'. Whatever that implies, I expect that to be something very few actual people will be?
Significantly higher than the flu, but not "oh my God, we all gonna die!" high. So,
YOU WILL GET EXPOSED TO COVID-19
virus with 90%+ confidence, within the next year or two. You may well remain asymptomatic, of course and not even know that you have been infected.
Yes, you should stock up and such, but only because of the disproportional auto-immune reaction by the freaking out society. Just like with 9/11, the most harm will came from the people reacting to it. So, a better question is not to how to prepare for the coming pandemic, but how to prepare for the inevitable mass panic and overreaction. It is likely to be bad for a few months, then it will blow over, with some residual long tail dragging on for some time, like it happened with basically every scary event in history, lately including 9/11 and the subprime crisis.
I think the economic impact will also be huge. Businesses are prepared for 2% of their workers being out with the flu on any given day through the winter, but not for 20% to be sick while the other 80% are quarantined as COVID-19 hits their city. And the company who needs the input parts from that first business is not prepared to not have them for a month, and the companies that rely on them are not prepared, and most industries have slim enough cash reserves and profit margins that a pandemic can knock a lot good companies out of business for good. This could all mean just slightly more expensive electronics for two years, or it could mean a decade of unemployment and restructuring.
And this is why I think less and not more permission to panik would be warranted. Our reaction to Covid 19 is likely much more dangerous than the virus itself. So less reaction would arguably be better.
20% Sick is way too much, since that would require everyone to be exposed at once.
Epidemics tend to be exponential at first and then become subexponential way before saturation. Seasonal flu does this for example. Do you have any reason to expect Covid 19 to behave different?
That is currently the worst case scenario death rate. The absolute ceiling to our estimates. The actual death rate will very likely be much much lower. Becuse we have no good figures on how many people are actually infected. How many infected have very mild responses and dont even show proper symptoms and so they wont seek help and wont get tested? That information will only be available months if not years later.
Swine flu has estimated 0.02% death rate now. When the 2009 pandemic hit, the panic was also great. The media reported death rate in the first weeks was also much higher than the actual rate turned out to be.
For an example lets say 10 people are hospitalised in a very serious condition. They get tested and turns out it is some sort of a new virus never seen before. 5 of them die before any new cases are discovered. The death rate will be 50%. But you have no idea yet if we have a world threatening pandemic on our doorstep or a very mild case of a 99.999% of the times an asymptomatic virus.
disproportional auto-immune reaction by the freaking out society
Sadly this is indeed the pandemic we need to react to time and time again. There however are some conflicting and potentially worrisome reports about the possibility of being re-infected, some concerns about long term complications and etc which should raise the severity of our response to this outbreak but not to the level of panic we are having now.
It is a good thing to move when seeing smoke but you dont want to start evacuating skyscrapers and hospitals every time someone smells something that could be smoke(er)
I think this is false. There's some strong but circumstantial evidence available about how many cases are asymptomatic or only very mild. That evidence is factored into the most recent death rate estimates. The media continues citing the wrong stuff in lots of places, but people who search carefully can find somewhat robust information about the death rate by now, and even though I haven't checked the source for the 1 in 500 number closely, it for several reasons seems unlikely to me that it's based on the naive calculation.
If anything 1 in 500 is more likely to be an optimistic scenario because it doesn't factor in that 5% even of healthy people will still require hospital attention, and in true pandemic conditions, hospitals won't have enough room. The hospital in Wuhan were overcrowded, and yet only very roughly 5% of Wuhan's population got the virus. (And yes those 5% include mild or asymptomatic cases; confirmed cases was only 0.5%.)
I believe this is in reference to the changes in European economies during/after the Black Death, where typical incomes rose significantly. However, my understanding is that this happened mainly because most capital was in the form of land, which of course was unaffected by the plague. Thus, the ratio of capital to labor went up and the value of labor increased. In the modern world where agriculture is a relatively small part of the economy, it's not at all clear that a reduction in population density would cause individual incomes to increase.
If you live in a nation that has universal and free healthcare, then there is in fact very little reason to worry.
Wash your hands and practice good hygiene.
As you should anyway, because that reduces the spread of other diseases inc. flu and colds, which are already endemic.
If you live in a nation like the USA, then you should worry, for several reasons:
Many workers cannot afford to take any time off, and cannot afford to go to their doctor for any treatment until it is already life threatening to them.
By that time they are likely to have spread it to customers and colleagues.
Many people cannot afford immunizations. Their insurance doesn't cover them, or their co-pay is high.
These workers also work physically closely with colleagues, and are more likely to travel on buses due to the cost.
Full-service restaurants are commonly extremely low pay (below minimum wage) with little to no health coverage.
Yes, there are laws/regulations about food service, but they are routinely ignored - staff can't afford time off and managers turn a blind eye.
There is currently no vaccine and no cure - only general support.
So no amount of money will save you from death if you are one of the unfortunate few whose immune system cannot destroy the virus before multiple organ failure.
The group with the highest risk of death (~15%) from Covid19 are old men with heart problems, esp. if they have further co-morbidities.
We can thus predict that quite a few old, rich men are going to die because of the US healthcare system.
If Covid19 worries you, then campaign for free healthcare for all because it is the only way to protect yourself from it - and the future viruses that will inevitably follow.
In the USA, the Affordable Care Act made the flu shot free for most people who have health insurance, and for some groups without insurance.
Approx. 10% of US citizens have no health insurance at all, these are of course those who either don't work or have low-paid jobs.
If the total number of people who have been infected by coronavirus doubles every five days, then doesn't that mean that a normal person infected with coronavirus infects one other person in five days? It's not very transmissible.
By all means sell off your stocks (I have) and maybe stock up a bit on food (I haven't) but the Rational person wouldn't panic. We're not all going to die of water lily poisoning.
Not exactly. There's an incubation period, and people eventually stop being infectious. A longer incubation period slows the doubling rate, but makes containment harder rather than easier. The majority of infected people won't infect anyone; they'll be quarantined or self-isolated before they get the chance. The 5-day doubling time is an empirical observation, made in contexts where significant efforts are already being made to limit spread; if we make less effort than the cities which generated that data, the doubling time will be faster.
The parameter typically used for estimating infectiousness is R0, which determines the fraction of transmissions which would have to be prevented in order to contain an outbreak. Estimates of R0 range from high to very high.