Covid-19: My Current Model

post by Zvi · 2020-05-31T17:40:00.945Z · score: 189 (94 votes) · LW · GW · 69 comments

Contents

  Risks Follow Power Laws
  Sacrifices To The Gods Are Demanded Everywhere
  Governments Most Places Are Lying Liars With No Ability To Plan or Physically Reason. They Can’t Even Stop Interfering and Killing People
  Silence is Golden
  Surfaces Are Mostly Harmless
  Food Is Mostly Harmless
  Outdoor Activity Is Relatively Harmless
  Masks Are Effective, And Even Cloth Ones Are Almost Enough
  Six Feet Is An Arbitrary Number, People Aren’t Treating It That Way, And That’s Terrible
  Herd Immunity Comes Well Before 75% Infected and Partial Herd Immunity Is Super Valuable
  Yes, We Know People Who Have Been Infected Are Immune
  Our Lack of Experimentation Is Still Completely Insane
  We Should Be Spending Vastly More on Vaccines, Testing and Other Medical Solutions
  R0 Under American-Style Lockdown Conditions Defaults To Just Under One, Which New York Escaped Via Partial Herd Immunity
  The Default Infection Fatality Rate (IFR) Is 0.5%-1%, Depending on Conditions
  Typically in America, 33% of Deaths and 90% of Infections Are Missed
  People Don’t Modify Behavior In Response To Re-Openings All That Much, When Given a Choice
  Thus, Schools Are Going To Be a Huge Problem
  But, Saying “Reopening” Doesn’t Do Much
  It’s Out of Our Hands
  Predictions Updates
  Support Longevity Research
None
69 comments

The post will be a summary of my current key views on various aspects what is going on, especially in places where I see many or most responsible-looking people getting it importantly wrong.

This post is not making strong evidence-based arguments for these views. This is not that post. This is me getting all this out there, on the record, in a place one can reference.

Risks Follow Power Laws

It is impossible to actually understand Covid-19 if you think of some things as ‘risky’ and other things as ‘safe’ and group together all the things in each category. And yet, that’s exactly how most of our thinking is directed.

Instead, think of risks as following power laws.

The riskiest activities are indoors, involve close physical proximity with others, while those for extended periods of time others cough, sing, puff or otherwise powerfully exhale, or talk directly at us, or we are in actual physical contact that then reaches one’s eyes, nose or mouth.

Activities missing any of those components are much, much safer than activities that share all those components.

Then other actions, such as masks and hand washing and not-face-touching, can reduce that risk by further large percentages.

Slight reductions in the frequency and severity of your very risky actions is much more important than reducing the frequency of nominally risky actions.

The few times you end up talking directly with someone in the course of business, the one social gathering you attend, the one overly crowded store you had to walk through, will dominate your risk profile. Be paranoid about that, and think how to make it less risky, or ideally avoid it. Don’t sweat the small stuff.

And think about the physical world and what’s actually happening around you!

Sacrifices To The Gods Are Demanded Everywhere

A sacrifice to the Gods (post of this topic to be linked in when finally written) is an action with physical costs but with no interest in any meaningful physical benefits, taken in the hope that it will make one less blameworthy. Things are bad because we have sinned. The Gods demand sacrifice. If we do not act appropriately repentant and concerned, things will surely get worse.

Once we act appropriately, we are virtuous and will doubtless be saved. We can stop. There is no need to proceed in a way that would actually work, once the Gods have been placated. Everything will work out.

If you don’t make the proper sacrifices, then anything that goes wrong means it’s your fault. Or at least, you’ll always worry it is your fault. As will others. If you do make the proper sacrifices, nothing is your fault. Much better.

If the action is efficient and actually were to solve the problem in a meaningful way, that would invalidate the whole operation. You can either show you are righteous and trust in the Gods, or you go about actually solving the problem. For obvious reasons, you can’t do both.

A steelman of this is that Complexity is Bad and nuance impossible. If we start doing things based on whether they make sense that sets a terrible example and most people will be hopelessly lost.

Thus, we sanitize packages. We stay exactly six feet apart. We wait exactly two weeks. We close all ‘non-essential’ businesses, but not ‘essential’ ones. We issue stay at home orders and give huge checks to the unemployed. Then we turn around and ‘reopen’ at which point that unemployment is voluntary, the state doesn’t have to pay, and so people are forced to go back to work. We lie to ban masks, then we try to mandate them, and wonder why people don’t trust the authorities. We hail our health care workers as heroes but don’t let them run experiments or gather much data. And of course, we enforce regulations enforce regulations enforce regulations, while shouting about how great and flexible we are that we waived a tiny number of them.

We must choose one individual intervention that solves our problems, rather than combining their effectiveness, because math is not a thing. And herd immunity is 75% infected, because math is exactly that much of a thing, but no more of a thing than that.

We also commit ritual suicide in the form of refusing to permit market forces, or to appropriately compensate those who would produce things for the things we need produced. But that’s more about general insane sacred values than it is about a true sacrifice to the Gods.

Yeah, I’m not thrilled with our completely dysfunctional civilization. Thanks for noticing.

A lot of what follows is spelling out exactly what these demands are, and why they fall into this category.

Governments Most Places Are Lying Liars With No Ability To Plan or Physically Reason. They Can’t Even Stop Interfering and Killing People

The police directly lying, attacking, restraining and killing innocent people rightly has gotten people very, very angry.

But the response to the pandemic hasn’t been that different, other than the lack of protests.

The WHO has lied repeatedly, to our face, about facts vital to our safeguarding our health and the health of those around us. They continue to do so. It’s not different from their normal procedures. WHO delenda est.

The FDA has interfered constantly with our ability to have medical equipment, to test for the virus, and to create a vaccine. All of this continues. It’s not different from their normal procedures. FDA delenda est.

Almost all government officials in America, and most other countries (I won’t get into which ones are the exceptions) have done the same. They’ve joined in lying about everything. They mostly act to demand sacrifices to the Gods, striking down actions until some of those restrictions will somehow have sufficiently appeased the Gods and they’ll look responsible and pious, and maybe everything will be all right.

Discussions don’t even consider telling citizens the truth about what’s happening, or giving them choices about how to react. It’s assumed that of course we should tell them whatever will cause the actions we think are right.

All such people are doing, is attempting to find the incantations that will move them away from being blameworthy in the next week or two. That’s it. Seriously. That’s it.

It’s all they still have the ability to do. Almost no one with the ability to model the physical world, or who would care about the implications of their model if they did have one, has any power or authority at this point. See the moral mazes sequence. Ironically some corporations (I won’t speculate on which ones here, but I try to hold their stocks) are the most powerful exceptions.

Hold them all in the contempt they deserve. Maybe even do something about it.

Silence is Golden

All the data I’ve seen, and my physical understanding of the virus, lead me to the conclusion that people who are not talking (and also not sneezing or coughing or singing or what not) are not going to give off much virus. They’re an order of magnitude or more less risky than someone who is talking.

Direction matters, too. Don’t talk facing someone else, don’t face them when they talk to you. Our ears can handle it. Same with volume, which should be kept to the minimum necessary under the circumstances. Singing or yelling is especially terrible.

This is a primary reason why when we finally look at the data, mass transit has not been anywhere near as dangerous as it looks, and many cities with extensive mass transit around the world have had reasonable outbreaks.

Surfaces Are Mostly Harmless

Early on, it made sense to be paranoid about surfaces. It was established that the virus could ‘survive’ for various periods of time. So if you want to be ‘safe’ you need to clean in some form, or wait that period of time. That reduces the risk to almost zero, if done properly.

Absent that, we are sent into a constant frenzy of ‘deep cleaning’ and viewing surfaces as deadly weapons that infect anyone they touch. Jobs are mentally ranked largely by the number of surfaces they require people to touch, and economic activity prevented if too many surfaces might be involved.

That level of paranoia might continue to make sense if this was ‘if one zombie slips past the line everyone dies.’ The precautionary principle is a thing. That’s not what we’re dealing with.

It’s been months. We don’t have concrete examples of infection via surfaces. At all. It increasingly seems like while such a route is possible, and must occasionally happen, getting enough virus to cause an infection, in a live state, via this route, is very hard. When you wash your hands and don’t touch your face, it’s even harder than that.

Meanwhile, those who refuse to touch surfaces like a pizza delivery box end up in more crowded locations like grocery stores, resulting in orders of magnitude more overall risk.

And yet, despite being this certain, it’s damn hard to stop sanitizing packages. And it’s even harder to be this forceful in writing. Because what will happen if I don’t make the sacrifices?

Screw it. Until I get very unexpected evidence, surfaces are mostly not a thing anymore. If lots of people touch stuff and then you touch it, sure, wash your hands after and be extra careful to not touch your face in the interim. Otherwise, stop worrying about it. Save that worry for where it counts.

Food Is Mostly Harmless

You do have to worry about eating meals, because it is something we do socially. It is an easy way to end up spending an hour indoors, in close proximity to others, while talking and otherwise interacting. That’s risky.

The food itself is at most minimally risky, even if it doesn’t get heated enough to reliably and fully kill the virus. You don’t have to ruin all your food. People are often avoiding foods that seem risky. Once again, it makes sense that it could be risky, but in practice it’s been months and it does not seem to work that way. The precautions people are taking will incidentally be more than good enough to guard against contamination of food at sufficient levels to be worth worrying about. I mean, sure, don’t eat at a buffet, but it’s not like any of them are going to be open, and even then the (also mostly safe) surfaces are likely scarier than the food.

As we covered in the section above, surfaces are also not very risky. Dishwashers treating restaurant plates like toxic waste is not based on a risk calculation, it’s based on our moral principles regarding purity.

Your risk is from the waiter, or from the other diners, being in that room with you for a while. Thus, takeout, delivery and/or eating outdoors.

Outdoor Activity Is Relatively Harmless

Note the downgrade from mostly to relatively. One cannot simply do whatever one likes as long as they are getting fresh air.

Outdoor activity does seem like a large drop in risk relative to doing the same thing indoors. My best guess is there is something like 5-10 times as much risk indoors versus the same activity outdoors. That’s with huge uncertainty, but it seems clear on multiple levels that this makes a huge difference. Whenever you can, if there are things that will happen outside your quarantine pocket, move those things outdoors.

The combination of quick and outdoors and not-in-your-face probably effectively adds up to safe, especially if you add in masks. During the peak epidemic in New York things were so intense that it would have been reasonable to worry about miasma. Now, I would do my best to keep my distance and avoid talking at each other, but mostly not worry about incidental interactions.

I do expect there to be a spike in cases as the result of protests and civil unrest.. To not see one would be surprising, and would update me in favor of outdoor activities being almost entirely harmless.

Also, we should be testing police officers every few days wherever there are protests and capacity allows it, and tracking which officers had how much close contact during those protests and which officers did things like wearing masks. No matter its other features, this is a natural experiment we should not waste, and also it will be important that the police not spread Covid-19 to the protesters or each other if such events continue. If we track carefully we can learn many things, like how much it matters for spread which protests were silent versus vocal.

Doing a block party, or otherwise socially interacting extensively, whether for fun, business or justice, is again vastly safer than doing it indoors, but still something to look out for. Nominally doing distancing during the event will help, but only partially. If it’s packed and you can’t distance, or people are talking at each other a lot without a lot of distance, or yelling or singing a lot, I’d worry.

Masks Are Effective, And Even Cloth Ones Are Almost Enough

Surgical are better and N95s are better than that, but even cloth masks on both ends of an interaction are almost certainly good for a 25% reduction in risk and probably 50%-75%. We need to reduce risk by about 75% on average to beat this thing, so such masks by themselves are close to being good enough.

This is one reason I’m optimistic about us getting a handle on things. Mask politics are a mess, because of the way it was botched, but I expect this to get sorted out gradually over time. Mask requirements are also a good way to tell which places are taking reasonable precautions in other ways.

Six Feet Is An Arbitrary Number, People Aren’t Treating It That Way, And That’s Terrible

A six foot rule is way, way better than nothing. It’s easy to remember and follow. If you had to choose a boolean ‘exactly this close’ rule, six feet apart seems about right. It balances ‘risk falls according to what is likely an inverse square law’ with ‘at some point people won’t obey the rule.’ And yeah, maybe people are not equipped to handle anything other than a boolean risk switch.

But then people go completely insane and think the six foot rule is real.

By people here, I mean almost everyone. Including when it counts.

Biden and Sanders debated with platforms exactly six feet apart. Waiting lines are six feet apart. Las Vegas marked out places to sleep in parking lots six feet apart. Restaurants will have to keep people six feet apart. Constantly, people do their best to stand six feet apart like they’re playing The Distance Is Right and trying to get as close as possible without going under. Sometimes with a tape measure.

If you think this is a straw man, and Everybody Knows the rule is only a rule of thumb, I assure you that you are wrong. It is creating a paradigm of magical safe-versus-unsafe binary thinking. Thus it is crippling our ability to think about the physical world.

Herd Immunity Comes Well Before 75% Infected and Partial Herd Immunity Is Super Valuable

See On R0 for details. Here’s the summary version.

People’s rate of exposure to others correlates super highly to their rate of exposing others to infection.

Different people take and create different orders of magnitude of infection risk.

Those taking more risk are proportionally more likely to get infected.

Therefore, it would be shocking if a 50% immunity rate via random infections didn’t by itself cut down on future risk by 75% or more, which is sufficient for herd immunity in most places. If anything it’s probably closer to 25% in most places.

Even if you don’t fully get there, such effects are additive with our efforts elsewhere. So if we’re close to the critical point in general, which seems right, even a little bit of immunity goes a long way – the first 5% infected has to cut down future risk by far more than 10%.

This is the most important reason why New York and the Northeast are doing so well. Our policies need that extra boost to get over the finish line.

That doesn’t mean we should use a ‘herd immunity strategy’ but it does mean that everyone trying to scare us with ‘we’d need 75% infected’ is either straight up wrong or a fear-mongering liar.

Yes, We Know People Who Have Been Infected Are Immune

Everyone saying we don’t know this is doing so to scare people, or doesn’t know how knowledge actually works. Usually both.

It’s true we don’t know how long this lasts, and it may expire relatively soon (e.g. a year from now). But anyone, such as the WHO, who claims to be an expert and says we don’t know this? Delenda est.

Our Lack of Experimentation Is Still Completely Insane

I don’t even see the need to bother explaining, at this point, why running experiments on willing subjects is a moral imperative and everyone standing in the way of it deserves a slow and painful death. That is all.

We Should Be Spending Vastly More on Vaccines, Testing and Other Medical Solutions

In addition to being the right thing to do to save lives, if you look at the stock market, it would obviously be the right thing to do purely to collect capital gains taxes and use that to pay off the additional costs. Again, we’re completely dysfunctional, and go around repeating rituals like ‘give away a few trillion dollars to help the economy’ without doing the things that would actually physically help, and worrying about ‘wasting money’ or ‘overpaying’ and other concepts that don’t matter even a tiny bit right now.

We can’t even, in a legal sense, get out out of the way of those actually doing the thing.

If we actually cared we’d have a vaccine within a few months. We don’t, so we won’t.

R0 Under American-Style Lockdown Conditions Defaults To Just Under One, Which New York Escaped Via Partial Herd Immunity

This Is Not A Coincidence Because Nothing Is Ever A Coincidence.

Whenever something lands almost exactly on the only inflection point, in this case R0 of one where the rate of cases neither increases nor decreases, the right reaction is suspicion.

In this case, the explanation is that a control system is in play. People are paying tons of attention to when things are ‘getting better’ or ‘getting worse’ and adjusting behavior, both legally required actions and voluntary actions.

When things are ‘getting worse’ we take ‘action’ by forbidding and forcibly stopping actions, and privately taking a mix of arbitrary and more sensible precautions, until we plausibly have things under control and cases shrinking. Anything beyond that, people won’t support.

When things seem to be ‘getting better’ there is escalating pressure to loosen up, to ‘reopen,’ regardless of current levels, until once again equilibrium is reached.

New York broke out of this, at least until Memorial Day, due to a combination of herd immunity and the memory of things being so bad. For a while its R0 has been around 0.73. We’ll see if that can be maintained.

The Default Infection Fatality Rate (IFR) Is 0.5%-1%, Depending on Conditions

A lot of things matter.

Age and comorbidities have huge effects.

Initial viral load probably matters. Small risks are even less risky than they appear, especially if you wouldn’t expose others who are high risk.

Vitamin D matters. Potentially quite a bit. But you probably have to take it before being infected, you can’t wait and then macro-dose, it won’t work the same way. Supplements are a good idea for basically everyone until this is over, especially if you might be deficient. You’re indoors all the time, it’s a problem, fix it with a pill.

Zinc probably matters once you’re infected.

Medical care matters. Total breakdown of medical care in practice leads to several times the fatality rate under regular circumstances. High quality treatment at current knowledge levels can probably drive death rates down further, so the ratio between full success and complete breakdown can be rather large – something like an order-of-magnitude difference between 0.2% and 2%.

I don’t have a strong opinion at this point about particular medical treatments beyond the above.

I’ve been using 1% death rates in my projections and calculations in order to be conservative, especially when dealing with New York. New York’s hospitals were at least somewhat overwhelmed at the peak. The death rate probably trends to be somewhat lower than 1% otherwise, but it’s not clear. America in general could be as high as 1.2% IFR without making the data stop making sense. Beyond that, a lot of things get confusing and other data needs to be increasingly off. New York’s data stops making sense below about 0.6% IFR, whereas in other places it could get much lower without anything breaking.

Typically in America, 33% of Deaths and 90% of Infections Are Missed

Those two numbers move in lockstep, of course, once you pick an IFR that you believe, and a model for how delayed are deaths and how delayed are infections.

Anyone who claims an over-count has an agenda to minimize things. Most who merely doesn’t believe a substantial under-count merely put stock in official numbers without thinking to adjust them, or think that without knowing the proper adjustment one should adjust zero, even if one knows direction and can guess at magnitude.

People Don’t Modify Behavior In Response To Re-Openings All That Much, When Given a Choice

Thus, Schools Are Going To Be a Huge Problem

Because that last bit of the first bold statement is important. When given a choice.

School is prison. Prisons do not simply release prisoners because they choose not to be there.

The good news is, while we did not have the compassion or good sense to release our (mostly completely unnecessary) prisoners, we did at least close the schools. But they are not happy about it and tried to fight back.

Even under lockdown, many students I know about are buried under mountains of ‘homework’ and forced to ‘attend’ ‘classes’ that take their entire day and lead to eye strain, so that this prison atmosphere can be approximated while we wait for the actual prisons to reopen. Even now, schools threaten students with life ruination, should they not spend the bulk of waking hours signaling their compliance to arbitrary authority.

When schools re-open, they won’t be optional. Kids will be forced, at the barrel of a gun, to return to their cells. So decisions about this matter a lot.

Also, the idea that ‘six feet equals safe’ is combining with reopening schools to create a future disaster, because if you’re in a confined space all day then six feet totally won’t save you. Splitting the class in two means the morning class infects the teacher who infects their afternoon class, and so on. Magical thinking has replaced thinking about the world, and we’re going to pay dearly it.

Poor people who are forced back to work for financial reasons already are a problem in many places, and with the end of extended unemployment and with reopening, it will get much worse. But businesses mostly will act mostly responsibly for other reasons, even then, so I believe it mostly won’t be that bad.

But, Saying “Reopening” Doesn’t Do Much

Where is the spike in places like Georgia and Texas?

There wasn’t one, because the activities people resumed as a result of the ‘reopening’ aren’t important. The places that reopened seem like crazy things to open, like tattoo parlors and gyms, but they aren’t getting much activity, aren’t packed and are taking precautions.

What’s dangerous? Again, social interactions, and super-spreader events. Super-spreader events are still not allowed. Social interactions mostly are private decisions that can’t be stopped under our current level of willingness to enforce law, even before loss of social order. Our ability to enforce law certainly isn’t going to increase any time soon.

The people decide how locked down they actually are going to be. The message ‘you are not safe’ is the key part of the lock down message. People heard it, and what they hear next isn’t going to change their perception of safety much. They’ll say ‘screw it’ and do stuff anyway mostly on the same schedule regardless of government decisions. This war is going to be fought elsewhere, unless and until there’s a major second wave, and likely even then.

Right now, the people are saying ‘not as much as before’ even before the effects of demonstrations and loss of civil order. We’ll see what happens, but control systems are definitely in place. I’ve already adjusted my path of behavior based on my expectation that things will follow a worse path in June than I previously expected. That won’t matter much because I’d be taking little risk either way, but it’s representative of others.

Again, the problem is when people must be open, for reasons of government mandate or economic need, or other obligations, that we have danger. The other obligations are real. Not looking at them won’t make them go away or stop them from having effects.

It’s Out of Our Hands

There was a window where people in authority could do things, and those things would matter a lot. That is, they could have done things if they had the ability to do things. Which they didn’t. So they didn’t do them, instead trying to avoid blame from week to week in the hopes it would all work out somehow. Which it almost did, in some important senses, and still almost might in general.

But what little political capital and will there was or might have been is long gone, now. Even before the protests, in the face of the economic pain, there was little ability to stand in the way of reopening. Either we do it smart, which we’re not capable of doing, or we do it dumb and hope individuals and private corporations find ways to make it smart, and/or that dumb is good enough. And they might make it smarter! And it might be good enough!

Maybe. We hope. But it’s clear that we’re not going to do any of the things that have worked elsewhere. Nor we can we keep our dumb closings going. It’s over.

Where do we go from here? I think that’s still up in the air. Largely it comes down to the physical situation. If it turns out the dumb strategy works, then it works. We can still slowly scale up our testing and other efforts, immunity can slowly increase, and we hope we can sustain enough modifications to bring it home. Or we might have a lot more infections and deaths left than that, until the herd immunity effects bring it home mostly on their own.

There are worse things. Staying locked down for another year, for example, because we won’t accept that bad outcome, would be far worse. Robin Hanson talks about this extensively, how we should be preparing a plan B to do pure mitigation. And of course he’s right, if it’s do that or do what we’re doing. It’s an odd choice, though. Because if we could do the things he suggests, then we could also do the first best solutions, and we wouldn’t need to follow his suggestions.

Predictions Updates

Pattern is that the percentages in the statements are Scott Alexander's original predictions. When I say I bought, sold or held, that's what I did in the linked-to post.

1. Bay Area lockdown (eg restaurants closed) will be extended beyond June 15: 60%

I sold to 40%. I almost certainly lose, unless there’s something I don’t know. I don’t know what they are thinking locally, but given recent events, I’m guessing there won’t be any lifting of any restrictions of anything, any time soon. Given how many other places are lifting similar restrictions, and how little Bay Area infection there ever was, I’d still say this could have gone either way based on what we knew at the time. But given how slowly everything is moving, I was too aggressive.

2. …until Election Day: 10%

I held. I still think hold this.

3. Fewer than 100,000 US coronavirus deaths: 10%

I sold a lot and it’s over. This is 0% now.

4. Fewer than 300,000 US coronavirus deaths: 50%

I sold this to 30%. For most of May I was losing marked the market, since the news was overall very good. There will be a period where the rolling average won’t get us to 300k. But recent news is turning around, we are seeing upticks, and no will to do much about it, and not much margin to stay under 300k even if control systems cause adjustments. I’d say this is back to about where it was before. I’m guessing our baseline scenario is now 500k or so, with of course huge error bars.

5. Fewer than 3 million US coronavirus deaths: 90%

I held. Again, we saw very good news early, so to get to 3 million now we’d need full system collapse to happen quickly. It’s definitely still possible, but I’m guessing we’re now more like 95% to avoid this than 90%.

6. US has highest official death toll of any country: 80%

I bought this to 90%. Logic seems to hold, the potential other candidates aren’t in trouble, so I’d now buy a little higher.

7. US has highest death toll as per expert guesses of real numbers: 70%

I bought this to 80%. Given China continues to keep things under control, and the 10% difference was coming from China, this has to be closer to the answer to #6 than a month ago. Probably buy it to 85% or so now.

8. NYC widely considered worst-hit US city: 90%

I bought to 95%. Is there a world where this becomes Minneapolis? I think no, although attempts to frame it that way might be possible. Things got really bad in New York, and the communities that might break down in Minneapolis aren’t that big a portion of the city by population. Los Angeles maybe? I don’t see it. I still like the 95% level, despite New York’s recovery, because time passed.

9. China’s (official) case number goes from its current 82,000 to 100,000 by the end of the year: 70%

I sold to 40%. I’d sell slightly lower now, again because time passed and there’s no movement, and the clock is ticking.

10. A coronavirus vaccine has been approved for general use and given to at least 10,000 people somewhere in the First World: 50%

I sold this to 40%. From what I’ve seen news has been good and I’d no longer be willing to sell below 50%. As much as we’re totally failing to do what a real civilization would do, we’re making progress.

11. Best scientific consensus ends up being that hydroxychloroquine was significantly effective: 20%

I sold to 15%, given studies are actively being halted let’s knock that down to 10% now.

12. I (Scott Alexander) personally will get coronavirus (as per my best guess if I had it; positive test not needed): 30%

I sold this to 20% ‘at least’ and that ‘at least’ was doing a lot of work. Still is. Not selling this to 10% or lower seems wrong at this point.

13. Someone I am close to (housemate or close family member) will get coronavirus: 60%

I sold this to 40%, time passes and I’d sell it further.

14. General consensus is that we (April 2020 US) were overreacting: 50%

15. General consensus is that we (April 2020 US) were underreacting: 20%

I sold the 50% to 30% and held the 20%. If anything it seems like consensus is even less likely now than the 50% that left for it before. There won’t be a consensus. There will be a “consensus” that media types like to claim but it won’t be real.

16. General consensus is that summer made coronavirus significantly less dangerous: 70%

I held because this is so vague, so that isn’t an endorsement of the number so much as a desire to stay away from ambiguous markets. In any case, we’re definitely about to find out!

17. …and there is a catastrophic (50K+ US deaths, or more major lockdowns, after at least a month without these things) second wave in autumn: 30%

I sold to 20% based on this being a parlay of many things. Will June count for this, if current trends continue? Chances are it will come in under 50k deaths, we had 40k in May and are still declining. By the time the spike from reopening matters enough for deaths it’s late June or we’re into July, so we likely beat 50k in June on official numbers. And if the resurgence starts in July or August does that count? Either way, chances here have clearly gone up under any reasonable definition. I wouldn’t still sell this.

18. I (Scott) personally am back to working not-at-home: 90%

I sold this to 80%. Still seems reasonable – again, events seem to have sort of cancelled out.

19. At least half of states send every voter a mail-in ballot in 2020 presidential election: 20%

I sold to 15% or so. I am not following the details, but I’m guessing chances have gone up a little but not a lot.

20. PredictIt is uncertain (less than 95% sure) who won the presidential election for more than 24 hours after Election Day. 20%

This is more politics than Covid-19, and I don’t think the answer changed much.

Support Longevity Research

I’ll end on a note I keep meaning to get to. Which is that if we care so goddamn much about Covid-19, there’s an elephant in the room.

The planetary death rate remains stable at 100%. There is a force that kills everyone. It mostly kills older people, with risk increasing steadily with age. Even before it kills you, it has various only partly known and devastating effects on your body, your mind and your quality of life.

That force, of course, is aging.

If we think Covid-19 deaths are bad, well, they look a lot like deaths from ‘natural causes.’ Yet those are considered good and right and proper, and not like the horror that they are. We’re all going to die. When someone suggests this might stop, or it is bad, we get thinkpieces about the ecological horrors of overpopulation or the psychological tortures of living too long.

Which is complete nonsense.

Can we substantially delay or even prevent aging through scientific research? We don’t know. We’re not making much of an effort. My guess is yes, we absolutely could improve our lifespans and slow down the negative effects of aging. Perhaps we could halt it mostly or entirely, given enough time. There’s lots of low-hanging fruit that isn’t being picked, because we don’t think that it’s all right to pick it. It’s fine to fix being worse than the baseline of ‘everyone dies at this rate’ but not to try and lower that rate.

We are no different than the crew of the Enterprise-D, who mourn individual deaths greatly and go to great lengths to find cures and safeguard innocents, but who constantly discover ways to radically delay or end human aging, just lying there, and no one even bothers to point them out. As in, oh look, this primitive society has found a cure for aging that they’re using to stay alive longer to seek revenge, and maybe the lead is that they cured aging and we should look into that?

Nah. That’s not the moral of this week’s story.

No wonder all good things must come to an end.

69 comments

Comments sorted by top scores.

comment by Rob Bensinger (RobbBB) · 2020-05-31T20:56:52.110Z · score: 19 (3 votes) · LW(p) · GW(p)
It’s been months. We don’t have concrete examples of infection via surfaces. At all. It increasingly seems like while such a route is possible, and must occasionally happen, getting enough virus to cause an infection, in a live state, via this route, is very hard.

On April 23 I wrote on Facebook:

For most things, I'm just leaving it to air out for 3+ days. If I need to put it in the fridge or freezer, I disinfect it first.

My gestalt amateur sense is that surface transmission from people you aren't spending a bunch of in-person time with seems really low. (Do we even know of any clear examples of this, for COVID-19?) But I'm in a dusty/moldy house in a remote area with no nearby ICUs, so I'd rather err on the side of caution.

(The dust thing seems less important to me now that I'm thinking of COVID-19 as disproportionately endangering people who have cardiovascular issues, not so much people who have respiratory issues.)

Eloise Rosen replied:

> Do we even know of any clear examples of this, for COVID-19?
Yes!
"A woman aged 55 years (patient A1) and a man aged 56 years (patient A2) were tourists from Wuhan, China, who arrived in Singapore on January 19. They visited a local church the same day and had symptom onset on January 22 (patient A1) and January 24 (patient A2). Three other persons, a man aged 53 years (patient A3), a woman aged 39 years (patient A4), and a woman aged 52 years (patient A5) attended the same church that day and subsequently developed symptoms on January 23, January 30, and February 3, respectively. *Patient A5 occupied the same seat in the church that patients A1 and A2 had occupied earlier that day (captured by closed-circuit camera)* (5). Investigations of other attendees did not reveal any other symptomatic persons who attended the church that day."
https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm

I haven't seen other examples, though, so I remain skeptical that surface transmission is a big deal. Erin Bromage previously claimed that the South Korean call center outbreak occurred "roughly 6% from fomite transfer" but then retracted the claim; not sure what happened there.

comment by Zvi · 2020-06-01T13:47:21.532Z · score: 7 (4 votes) · LW(p) · GW(p)

OK, so if true we have one hard example, so presumably it is *possible*. But I also haven't heard of a second one, and also asymptomatic transmission is a thing, etc etc.

It would be weird if we didn't have one case somewhere that has a plausible surface vector even if they were completely safe.

comment by Owain_Evans · 2020-06-01T08:57:57.021Z · score: 5 (3 votes) · LW(p) · GW(p)

A detailed investigation of outbreak in a South African hospital found pretty good evidence for transmission by surfaces or indirect contact (nurse touches infected person A and then later touches susceptible person B). Doesn't mean risk from deliveries is significant but worth being wary of surfaces in general.

https://www.sciencemag.org/news/2020/05/study-tells-remarkable-story-about-covid-19-s-deadly-rampage-through-south-african

According to current evidence, SARS‐CoV‐2 is transmitted between people through respiratory droplets and contact routes. Droplet transmission may also occur through fomites so transmission of the virus can occur by direct contact with an infected person or indirect contact with surfaces in the immediate environment of that person or with objects used on the infected person (e.g. stethoscope or thermometer). The spatial distribution of cases and exposed individuals who became infected on the wards suggests that indirect contact via health care workers or fomite transmission were the predominant modes of transmission between patients in this outbreak. Direct droplet or contact transmission would be plausible where the people that were exposed were located in close proximity to an infectious case, e.g. P4 in the bed directly opposite P3 on MW1 between 13 ‐ 16 March (Figure 7); or X1 and X3 sharing a four‐bedded bay with P7 on MW1 between 27 March ‐ 2 April (Figure 10). However, in other examples the exposed individuals were located in different rooms and different areas of the ward, making indirect contact via health care workers or fomite transmission more plausible. We also present evidence suggestive of direct droplet transmission from a symptomatic health care worker to two patients on the neurology ward.
comment by Zvi · 2020-06-01T13:46:00.206Z · score: 4 (2 votes) · LW(p) · GW(p)

The surface being a person seems important in that example. Reduces the number of steps, if nothing else.

comment by gwillen · 2020-06-01T18:47:28.770Z · score: 7 (4 votes) · LW(p) · GW(p)

Right, I was thinking the same thing -- not just a person, but medical personnel. So you're going from patient 1, to someone's hands, who is then directly touching patient 2, plausibly even patient 2's mucous membranes. That's much more direct than a typical fomite contact, which is more like face-hands-fomite-hands-face (or if you sneeze on a doorknob, face-fomite-hands-face.)

comment by habryka (habryka4) · 2020-06-05T05:55:52.242Z · score: 13 (8 votes) · LW(p) · GW(p)

Promoted to curated: This feels like the best summary of all the key Covid updates to make over the last month or so, and generally just a post with a lot of good points.

I generally don't want all of LessWrong to become about Covid, but creating common knowledge of things like this feels like the right tradeoff in handling the visibility of Covid stuff, though I am not super confident.

comment by jacobjacob · 2020-06-05T19:20:19.039Z · score: 8 (6 votes) · LW(p) · GW(p)

I don't think "too much Covid content" is the major problem here. Rather, the major problem with this essay is that it mostly states Zvi's updates, without sharing the data and reasoning that led him to make those updates. It's not going to convince anyone who doesn't already trust Zvi.  

This is perhaps an acceptable trade-off if people have to move fast and make decisions without being able to build their own models. But it's an emergency measure that's very costly long-term. 

And for the most important decisions, it is especially important that the people who make them build their own models of the situation. 

(For the record: I think Zvi's thinking on Covid is mostly extremely sensible, and I disagree with Sherrinford's comment below. So this is not about whether he's right or not. I'd bet he is, on average.)

comment by Rob Bensinger (RobbBB) · 2020-06-05T20:44:07.108Z · score: 9 (5 votes) · LW(p) · GW(p)

I think it's relevant that this isn't Zvi's first COVID-19 post on LW; it's his seventeenth, and he's been showing his work to an exceptional degree.

Since some important stuff isn't hyperlinked in the post itself, putting it all in a sequence (or the mods just picking out a few of the relevant past discussions of these topics and linking them in a pinned comment) might be helpful.

comment by Zvi · 2020-06-05T21:09:38.819Z · score: 8 (4 votes) · LW(p) · GW(p)

Indeed, the goal of this post is that long post is long in order to cover all the ground and I'm explicit that I'm not showing my work here. I tried to put up hyperlinks to the previous posts in the relevant places, where work is shown, but that's definitely not covering all bases.

I'm not up for extensive additional hyperlinking work at this time, but if others have suggestions I will likely accept them.

comment by Sherrinford · 2020-06-05T09:42:01.366Z · score: 7 (10 votes) · LW(p) · GW(p)

I am a bit worried about the fact that an essay that depicts "governments most places" as "lying liars with no ability to plan or physically reason" and, based on similar assessments, calls for the dissolution of the WHO while not providing evidence (as stated in the second paragraph) is considered "the best summary of all the key Covid updates to make over the last month or so".

comment by Zvi · 2020-06-05T11:01:42.690Z · score: 21 (10 votes) · LW(p) · GW(p)

Believe me, I am also very bothered that I can produce useful Covid-19 content. And also that these statements seem appropriate. But here we are.

comment by Rob Bensinger (RobbBB) · 2020-06-05T15:17:16.757Z · score: 7 (7 votes) · LW(p) · GW(p)

Would you feel similarly concerned about a hypothetical curated essay that instead said 'the WHO has done a reasonably good job and should have its funding increased' (in the course of a longer discussion almost entirely focused on other points) while providing just as little evidence?

If so, then I disagree: in a dialogue about world affairs with people I respect, where someone has thirty important and relevant beliefs but only has time to properly defend five of them, I'd usually rather that they at least mention a bunch of the other beliefs than that they stay silent. I think it's good for those unargued beliefs to then be critiqued and hashed out in the comments, but curation-level content shouldn't require that the author conceal their actual epistemic state just because they don't expect to be able to convince a skeptical reader.

If not, then I think I'd disagree a lot more strongly, and I'm a bit confused. Suppose we have a scale of General Institutional Virtue, where a given institution might deserve an 8/10, or a 5/10, or a 1/10. I don't see a reason to concentrate our prior on, say, 'most institutions are 8/10' or 'most institutions are 3/10'; claiming that something falls anywhere on the scale should warrant similar skepticism.

Perhaps the average person on the street thinks the WHO's Virtue is 7/10; but by default I don't think LessWrong should put much weight on popular opinion in evaluating arguments about institutional efficacy, so I don't think we should demand less evidence from someone echoing the popular view than from someone with a different view. (Though it does make sense to be more curious about an unpopular view than a popular one, because unpopular views are likely to reflect less widely known evidence.)

comment by Sherrinford · 2020-06-05T18:46:31.302Z · score: 7 (5 votes) · LW(p) · GW(p)

You disagree with both answers I could possibly, in your view, give to a question that you ask. But the hypothetical alternative you give is not the mirror image of Zvi's essay, nor is it the mirror image of what I referred to from Zvi's essay.

Zvi claims that governments are "lying liars" and they have "no ability to plan or physically reason". In the reasoning for your first disagreement possibility, you effectively say that your prior about any of Zvi's statements being right is high because you respect him and also because he properly defends some of the many statements he makes. By contrast, my own prior of the quality of Zvi's less political assessments in this text are lower because the statement that governments have "no ability to plan" is false. Concerning the WHO, Zvi's statement about the response to the pandemic is that it is "not that different" from "attacking, restraining and killing innocent people". This is far from my understanding of what governments or the WHO are doing. So my priors on other statements in the essay are not high after reading the politics sections, and this does not depend on the average person on the street's opinion, or on what Zvi writes in other texts.

I agree that LessWrong should not put much weight on popular opinion in evaluating arguments per se. Though depending on what you mean by your suggestion to be more curious about an unpopular view, I may disagree there. Unpopular views can very well be unpopular because they are wrong. The statement that the moon is made of toothpaste is unpopular for that reason. Of course, Zvi's essay is very popular on Lesswrong, though I would not say that that is sufficient to tell me whether what he states is right.

To my impression, Zvi is not just writing a curated essay that says the WHO should be dissolved, but actually makes many statements that go through on the nod for people that believe them in advance. However, I believe people who do not believe the statements in advance may not even understand them. But probably that is just me not understanding the text, so I'll just list examples of what I find confusing:

The "sacrifices to the gods" section is a description of a perceived behavior of ... whom? The government? People in general? Because all governments do the same, and all people obey (the rules by the government? the rules by society? I don't know what is implied here.)

Zvi implies that the "we" would not choose efficient action even if it could be easily identified ("If the action is efficient and actually were to solve the problem in a meaningful way, that would invalidate the whole operation."), which I find highly implausible, he states that people don't trust "the authorities" (which may be true, but who knows?), and seems to imply (again I don't know who "we" is) that governments or societies are only willing to "choose one individual intervention that solves our problems, rather than combining their effectiveness, because math is not a thing", while actually several countries have combined measures like e.g. masks and distance prescriptions.

Having explained in this whole section that the "we" does only stupid things (while "market forces" could do the good ones), in the next section (about governments) it is the "we" that is lied to by WHO etc. And then "It’s all they still have the ability to do. Almost no one with the ability to model the physical world, or who would care about the implications of their model if they did have one, has any power or authority at this point." Okay, I better don't question whether that is true, I guess it must be self-evident in dystopian America.

So I think a mirror image text may be one that asserts that "the WHO has done a reasonably good job and should have its funding increased because governments, the WHO and similar organizations exclusively and efficiently act based on science, evidence, and altruism". And yes I would be concerned about such a hypothetical curated essay.

So all of this is fine for a personal opinion essay. After all, Zvi says "This post is not making strong evidence-based arguments for these views. This is not that post. This is me getting all this out there, on the record, in a place one can reference." I just don't have the impression it's about "aim to explain". But ok, both of you know the idea of lesswrong much better than I do.

comment by Rob Bensinger (RobbBB) · 2020-06-05T19:12:20.159Z · score: 7 (4 votes) · LW(p) · GW(p)

Sorry, those two weren't the only answers I imagined you might give, I just didn't want to make the comment longer before letting you respond.

My next guess was going to be that your objection was stylistic — that Zvi was using a lot of hyperbole and heated rhetoric that's a poor fit for curated LW content, even if a more boring and neutral version of the same core claims would be fine.

I think that's part of what's going on (in terms of why the two of us disagree). I think another part of what's going on is that I feel like I have good context for ~all the high-level generalizations and institutional criticisms Zvi is bringing in, and why one might hold such views, from reading previous Zvi-posts, reading lots of discussion of COVID-19 over the last few months, and generally being exposed to lots of rationalist and tech-contrarian-libertarian arguments over the years, such that it doesn't feel super confusing or novel as a package and I can focus more on particular parts I found interesting and novel. (Like critiques of particular organizations, or new lenses I can try out and see whether it causes a different set of actions and beliefs to feel reasonable/'natural', and if so whether those actions and beliefs seem good.)

This isn't to say that Zvi's necessarily right on all counts and you're wrong, and I think a discussion like this is exactly the way to properly bridge different people's contexts and priors about the world. And given the mix of 'this seems super wrong' and 'the style seems bad' and 'there aren't even hyperlinks I can use to figure out what Zvi means or where he's coming from', I get why you'd think this isn't curation-worthy content. I don't want to go down all the object-level discussion paths necessarily to reach consensus about this myself, though if someone else wants to, I'll be happy about that.

comment by Ben Pace (Benito) · 2020-06-05T23:23:06.941Z · score: 5 (3 votes) · LW(p) · GW(p)

Summary of what you said:

The conclusions in the post only make sense to people who already believed them, and aren't that useful for most people to read.

Here are some examples of conclusions you disagree with and whose arguments you find confusing: You disagree that the WHO has an inability to plan and is effectively attacking, restraining and killing innocent people; you don't get the bits about sacrifices to the gods; you don't get why he says countries are failing to use multiple measures rather than a single hopeful fix-all, when some countries are using multiple measures; you're confused who 'we' refers to and have some sense that it shifts throughout the post.

It seems totally fine (and good!) for Zvi to write this post, but the mod team curating it as "the best summary of all the key Covid updates to make over the last month or so" seems like a confusing call, because it isn't very helpful to perhaps the majority of people who will read it.

Is that right?

comment by Sherrinford · 2020-06-06T08:56:15.356Z · score: 1 (1 votes) · LW(p) · GW(p)

Thank you very much, Ben. By and large, I think the summary is fine, but I think I would like to clarify the following things.

First, I am unsure about the "useful for most people to read" part. Obviously, many people like the essay, and I am not sure what makes political opinion essays "useful". Of course there will be many people who find it useful to link to the text. Similarly, I am unsure how timeless it is; if it makes a post timeless that it is exemplary for the political sentiment of lesswrong in June/May 2020, then sure this seems to be timeless (which you can see because it is curated). But I am negative about the explain vs persuade part. Admittedly, this essay may be characterized by a third category additional to these two, but I believe as a curated lesswrong post that is explicitly intended to be used as a reference, it will rather be used to persuade on politics without explaining.

Secondly, the WHO having an "inability to plan" sounds a bit different from "no ability to plan". In my understanding, the first is a matter of opinion, the second is absurd as a description of basically any organization. But maybe I am overinterpreting. I think I understand what Zvi is saying about sacrifices, though I am not really sure.

comment by Rob Bensinger (RobbBB) · 2020-06-06T15:20:12.494Z · score: 5 (3 votes) · LW(p) · GW(p)

You say "the political sentiment of lesswrong" and "persuade on politics"; if we replace "politics" with "a model of world affairs" or "a view about the state of the world's main decisionmaking institutions" or the like, that changes my intuitive response to your comment a fair bit.

There are risks to talking about world affairs or the state of the US government on LW, and the risks may outweigh the benefits. But in a relatively utopian version of LW, at least, in a world where it was possible to do so without a bunch of bad side-effects, I think there would be a lot of curated "politics" content in the sense of "content that aids in understanding the current state of the world and its institutions", even though there are other interpretations of "politics" according to which politics doesn't belong on the LW front page.

In this utopian version of LW, I think some curated posts would focus on defending models, while others would focus on presenting new models for evaluation or summarizing previously-defended models.

(This abstract point seems more important to me than the question of whether Zvi's post in particular would be curated in utopian-LW.)

comment by Sherrinford · 2020-06-06T17:10:41.934Z · score: 2 (4 votes) · LW(p) · GW(p)

I think I agree to all of what you say, except that I am unsure whether it is about what I wrote.

comment by Rob Bensinger (RobbBB) · 2020-06-01T18:19:49.916Z · score: 13 (5 votes) · LW(p) · GW(p)
Predictions Updates
1. Bay Area lockdown (eg restaurants closed) will be extended beyond June 15: 60%
I sold to 40%.

Since this section is called "Prediction Updates", I initially thought you were saying you'd predicted 60% on May 1, and are now predicting 40%. You may want to clarify that 60% was Scott's April 29 prediction, and 40% was your May 1 prediction.

comment by Zvi · 2020-06-02T00:44:25.559Z · score: 4 (2 votes) · LW(p) · GW(p)

Yeah, I can see how that is confusing. Will edit.

Added the following to original, mods please reimport or insert it directly at top of section: Pattern is that the percentages in the statements are Scott Alexander's original predictions. When I say I bought, sold or held, that's what I did in the linked-to post.

comment by Paul Crowley (ciphergoth) · 2020-06-02T03:40:59.241Z · score: 2 (1 votes) · LW(p) · GW(p)

You're not able to directly edit it yourself?

comment by Ben Pace (Benito) · 2020-06-02T07:24:06.726Z · score: 7 (4 votes) · LW(p) · GW(p)

Zvi's crossposts are a bit messy to edit (html and other things) so for Zvi we said we would make fixes to his posts when he makes updates, to reduce the cost on him for cross-posting (having to deal with two editors, especially when the LW one is messy).

(I have now made the edit to the post above.)

comment by WannabeChthonic · 2020-06-05T07:07:44.042Z · score: 11 (11 votes) · LW(p) · GW(p)

Thinking about how to act during the pandemic is very important. Tbh I dislike some aspects of this post. Some parts of it seem very emotion-fueled and political.

For example:

Governments Most Places Are Lying Liars With No Ability To Plan or Physically Reason. They Can’t Even Stop Interfering and Killing People

This seems to be a very angloamerican thing. Here in europe things are bad (e. g. Norway, Italy, ...) but overall, our political system seems to apply appropriate force when required. Badly struck areas are in lockdown while other areas have open restaurants and open zoos. Sure, not every decision will be right, but listening to science and cooperating across borders really helps.

So for me, this post seems to spread a lot of FUD, something which is pretty hurtful to some people when they feel lack of control and physical isolation. Maybe we can compile this into a resource on how to understand exponential risk, superspreader theory and how to interpret the current research which is done on the SARS-CoV2 virus. Because let's be honest: most people suck at understanding epidemics (we call the few remaining people "epidemiologist" and there's a reason why they're spend so many years in uni). Let's not make the mistake and become hobby-epidemiologists.

comment by Zvi · 2020-06-05T11:11:16.147Z · score: 13 (4 votes) · LW(p) · GW(p)

One can certainly defend South Korea and other non-Western countries. And certainly one can defend European countries compared to USA/England or to each other. Definitely one can say that some of them, once Italy happened, did a non-insane job of "shut things down across the board until things get better than try opening them up again" if you think that you have no other policy tools to work with.

I don't think one can defend their performance against the standards of 'did what was likely to actually do the least harm based on physical considerations, and didn't lie about the situation to their public."

I do think that understanding the distinction is vital to understanding our pandemic, including our potential future responses, and therefore what one should do personally. To me this isn't vague FUD, it's predicting that such failures will continue.

comment by timothy liptrot (timothy-liptrot) · 2020-06-05T14:03:02.580Z · score: 9 (2 votes) · LW(p) · GW(p)

I disagree with your last few sentences. We really don’t have infinite resources to spend doing ineffective covid interventions. For example, If the evidence strongly supports that finite transmission is rare that influences my behavior. If the evidence strongly suggests immunity does exist, that changes at least my stock portfolio. We shouldn’t overstate our certainty about complicated issues but it is useful. For example, understanding transmission influenced me not to go to the protests (people packed together chanting high transmission risk) but to start playing frisbee outdoors (fomite in sun low transmission risk).

Part of the problem was revealed by the “we have no immunity until it is proven for this specific strain” articles. A lot of public health info sources are too frequentist, so with limited info they prefer to say nothing. So a little Bayesian reference class and updating can go a long way.

comment by Jay Molstad (jay-molstad) · 2020-06-02T11:04:30.919Z · score: 10 (8 votes) · LW(p) · GW(p)

Dishwashers treating restaurant plates like toxic waste is not based on a risk calculation, it’s based on our moral principles regarding purity.

I agree with most of what you're saying in the post, but this bit strikes me as a bad example. Used dishes are likely to contain significant amounts of saliva, which is the primary transmission vector of the virus. Spraying dishes with water could easily result in a virus-laden aerosol, and infection through small cuts is also a concern. If you handle dishes from hundreds of people a day, the risk starts adding up. Although I agree that surfaces are rarely a significant concern, it seems that a restaurant dishwasher is a worst-case scenario for transmission by surfaces and extra precautions are justified.

comment by AlexSchell · 2020-06-02T10:33:15.386Z · score: 9 (5 votes) · LW(p) · GW(p)

Nice post! Agree on most conclusions except I put more weight on the herd immunity threshold being not much lower than the naive compartment models imply.

Serology data from the 1968 flu pandemic seem to rule out large effects of heterogeneity on the final attack rate. First wave seropositivity was ~35% (mostly 25-50%) with an R0 of ~1.5. R0 increased in the second wave to ~2.5, and seropositivity ended up mostly around 60-70%.

People claiming big heterogeneity impacts seem to have focused on models over empirics. Unfortunately the range of effects implied by different ways of modeling heterogeneity is very wide, with not much to choose between models but actual epidemic data.

comment by ErickBall · 2020-06-02T13:57:20.343Z · score: 9 (2 votes) · LW(p) · GW(p)

Thank you for the dose of empiricism. However, I see that the abstract says they found "little geographic variation in transmissibility" and do not draw any specific conclusions about heterogeneity in individuals (which obviously must exist to some extent).

They suggest that the R0 of the pandemic flu increased from one wave to the next, but there's considerable overlap in their confidence intervals so it's not totally clear that's what happened. Their waves are also a full year each, so some loss of immunity seems plausible. I wonder, too, if heterogeneity among individuals is more extreme when most people are taking precautions (as they are now).

comment by Gunnar_Zarncke · 2020-05-31T21:11:10.953Z · score: 6 (3 votes) · LW(p) · GW(p)

I agree with all points regarding actual risks which match my own actions and the recommendations I give friends and family.

The only point where my probability estimates seems to noticeable differs from yours is with HCQ:

11. Best scientific consensus ends up being that hydroxychloroquine was significantly effective: 20%
I sold to 15%, given studies are actively being halted let’s knock that down to 10% now.

I think it is still relatively likely that there are combinations of HCQ with esp. Zinc that might work. I have updated toward them not working by now but would still give them at least 40%. Pure HCQ obviously not. I would offer a bet between your 10% and my 40% i.e. 1 to 3 that in the end a treatment with HCQ plus other active ingredients turns out to be effective.

Disclaimer: I follow ScottAdamsSays on Twitter and while he is also uncertain the potential upsides seem to be huge. He mentions use as a prophylactic for personell at risk like medical and police. He pushes further looking into it and there are many posts about other countries using combinations of HCQ with Zinc and others. You mention Zinc yourself. It seems plausible that Zinc is the active ingredient and HCQ enables its uptake. I seem to remember that CellBioGuy also wrote something along these lines.

comment by Zvi · 2020-06-01T13:54:23.079Z · score: 22 (9 votes) · LW(p) · GW(p)

Happy to do a small wager at 25% odds if we have someone we both trust to hold the money, or you trust me to do so, up to $100 vs. $300, or we can do $1 vs. $3 symbolically with no trust issues. Judgment would be whatever Scott evaluates to in his prediction evaluation.

Note that I agree that it's >10% that there is a worthwhile way to use HCQ as part of a treatment strategy. But that's different from it being the scientific consensus!

For the disclaimer, I would be very, very wary updating from Scott Adams here. He can be insightful, but when he advocates for things that make the administration look good, he'd do that essentially irrespective of truth value. What you're getting is "here's the best case I could make given I already wrote the conclusion at the bottom of the page." So if you do want to update off such things, you need to compare it to how good an argument you expected him to find!

comment by Gunnar_Zarncke · 2020-06-16T11:19:09.682Z · score: 4 (2 votes) · LW(p) · GW(p)

@Zvi The deeper look by Glen below lets me update back to ~40% that HCQ as prophylactic i.e. taken before the infection works. I'm now willing to take my $10 vs. your $30. We would commit here and transfer by PayPal after Scott has resolved. OK?

comment by Zvi · 2020-06-19T23:22:00.698Z · score: 6 (3 votes) · LW(p) · GW(p)

All right, I accept the wager. Done. Your $10 vs. my $30, PayPal upon Scott's resolution post. Since it's been three days, you can back out any time between now and 6/22, if you update again or my note below wasn't properly factored in.

Note that the bet is about what the "scientific consensus" is, rather than whether it actually works - if it works but there's no consensus, I'd still win. I think a lot of the time, likely more than half the time, that HCQ would work if given correctly, the scientific consensus fails to acknowledge this.

comment by Gunnar_Zarncke · 2020-08-22T21:08:56.818Z · score: 2 (1 votes) · LW(p) · GW(p)

Ongoing trials:

https://www.archbronconeumol.org/es-hydroxychloroquine-as-prophylaxis-for-coronavirus-avance-S0300289620301629

(I don't know where else to post this; last post tagged Coronavirus is months old)

comment by Gunnar_Zarncke · 2020-06-21T20:04:47.078Z · score: 2 (1 votes) · LW(p) · GW(p)

Well, how else would we figure out if it actually works. We are not the experts.

Anyway. I take it. I have seen that it got banned by CDC and that would let me update a bit. But I want to move forward and the main motivator of having a bet is that I will follow it until next year :-)

Update: I expect to get in touch by DM here when results are due.

comment by Gunnar_Zarncke · 2020-06-04T19:04:30.746Z · score: 2 (1 votes) · LW(p) · GW(p)

And Re Scott Adams: I know that he is pushing things. He is actually relatively transparent about that part esp. in his Periscopes. He is basically demoing most of his techniques for his audience (and his audience does a lot of the explaining in the replies). I don't like him as he can be very offending/transgressing but it still possible to learn quite a bit about politics and psychology from him and he is always ahead of the curve.

comment by Gunnar_Zarncke · 2020-06-04T00:34:13.532Z · score: 2 (1 votes) · LW(p) · GW(p)

Thank you for offering the bet. I would have taken it. Unfortunately I see it just now that I have an update on the matter. See below.

comment by Zvi · 2020-06-04T11:44:19.906Z · score: 4 (2 votes) · LW(p) · GW(p)

Entirely fair. Nothing done, then.

comment by Gunnar_Zarncke · 2020-06-04T00:41:30.914Z · score: 7 (4 votes) · LW(p) · GW(p)

Update: An RCT on HCQ as prophylactic is just out (with some evidence on Zinc too) and it is negative:

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

See also the supplementary material which has the details on Zinc:

https://www.nejm.org/doi/suppl/10.1056/NEJMoa2016638/suppl_file/nejmoa2016638_appendix.pdf

So this covers use of HCQ plus Zinc as treatment and the people show the same symptoms (feaver, chills, headache,...; not only positive tests) than the controls.

This really leaves little room for any noticable benefits. I am updating toward lower than 10% now.

comment by Radford Neal · 2020-06-05T14:24:30.813Z · score: 3 (2 votes) · LW(p) · GW(p)

From the abstract: "The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%])"

So the treatment group did have a lower incidence of illness than the control group, but the difference wasn't statistically significant. However, only 107 patients in total became ill. This is a rather small sample, so the results by no means rule out a clinically important benefit of HCQ. Even just taking the observed proportions as a best estimate, there's a 17% reduction of illness in the treatment group, which doesn't seem negligible, and the actual benefit could plausibly be considerably larger. (Of course, given the small sample size, it's also plausible that the real effect is in the other direction.)

comment by Glen Raphael (glen-raphael) · 2020-06-11T16:28:34.337Z · score: 5 (3 votes) · LW(p) · GW(p)

That study made me much more inclined to think HCQ is useful as a prophylactic.

Among the full study group there was a reduction of illness of a bit over 17% but it's better than that: the study's supplementary appendix includes a chart that breaks out various subgroups including a breakout by DAY. The most benefit was found for people who started treatment on day ONE post-exposure. Next best was starting on day TWO post-exposure. By day three there was a negligible benefit and by day four there was a negligible harm - that subgroup actually did a bit worse than the control group.

So to get an average 17% improvement across the whole group we're combining two start days of positive improvement (days 1 and 2) with two start days that (eyeballing the chart) round off to roughly zero improvement (days 3 and 4). Since the N was pretty evenly spread across days, basic math says if we JUST looked at the benefit for people who start as early as day 1 or 2 we should expect to find about twice as much improvement which is to say a ~34% reduction in illness!

Given the curve on that data, I'm optimistic about prophylactic use; it's possible that starting on day 0 or day -1 does even *better* than 34%. And (contrary to the retracted studies) they found no evidence at all of serious side effects or heart issues.

If this study result replicates then people who obtain HCQ in advance (so they don't have to wait for study enrollment or shipping) and start taking it *immediately* upon known exposure are ~1/3rd less likely to show any symptoms of covid than if they didn't do that. Which could save thousands of lives. (We can't be 95% sure of this result yet because the study was too small, but less-than-perfect knowledge is still knowledge and under the current circumstances probably worth acting on.)

(Caveat: they didn't find benefit for age>50, the group we care most about. Caveat to the caveat: there were only 5 people in the "control" for age 50 - they didn't have nearly enough oldsters enrolled in the study to expect meaningful results for them.)

comment by Gunnar_Zarncke · 2020-06-16T11:12:56.667Z · score: 4 (2 votes) · LW(p) · GW(p)

Thank you for looking deeper into this. A likely 1/3 reduction when taking it on day 1 is amazing. And if people at risk take it routinely ("day zero") it might be even better. I guess I have to update back to 40% likely it works.

comment by Douglas_Knight · 2020-06-10T04:07:51.949Z · score: 5 (3 votes) · LW(p) · GW(p)
The Default Infection Fatality Rate (IFR) Is 0.5%-1%

Why do you believe that? We can only measure IFR in the worst outbreaks, such as NYC and Lombardy, where it was 1-2%. Maybe hospitals that aren't overrun have half the morality rate, but how do you know?

Amer­ica in gen­eral could be as high as 1.2% IFR with­out mak­ing the data stop mak­ing sense.

What about the data wouldn't make sense if the IFR were 2% in America ex NYC? Outside of a massive outbreak, we can measure neither deaths nor infections. Sure, if you assume that only 33% of deaths are missed, then we can measure deaths. But why assume that? Isn't that only true in NYC because there was pressure to record untested pneumonia deaths? Elsewhere there is less attention and less pressure.

comment by Gunnar_Zarncke · 2020-07-29T12:54:52.075Z · score: 4 (3 votes) · LW(p) · GW(p)

@Zvi have you updated your model in the last two months?

comment by Raemon · 2020-06-11T20:07:00.194Z · score: 4 (2 votes) · LW(p) · GW(p)

It'd be helpful to me (and probably others) if the reasoning for why surfaces weren't a common vector was written up more thoroughly as an answer here:

https://www.lesswrong.com/posts/uyb48ttrhzvfLWhsH/can-covid-19-spread-by-surface-transmission

comment by velcro · 2020-06-08T01:46:39.608Z · score: 4 (3 votes) · LW(p) · GW(p)
The WHO has lied repeatedly, to our face, about facts vital to our safeguarding our health and the health of those around us. They continue to do so. It’s not different from their normal procedures.
The FDA has interfered constantly with our ability to have medical equipment, to test for the virus, and to create a vaccine.
Almost all government officials in America, and most other countries (I won’t get into which ones are the exceptions) have done the same. They’ve joined in lying about everything.

Would you be willing to provide examples (and ideally sources) for these claims? They seem extraordinary, at least to me.

With regards to the FDA, I stipulate that they interfere constantly. I disagree that the effect of the interference is a net negative. I personally welcome interference in attempts to provide faulty or dangerous medical equipment, tests and vaccines.

comment by SyntheticYeti · 2020-07-08T17:59:58.584Z · score: 2 (2 votes) · LW(p) · GW(p)
Where is the spike in places like Georgia and Texas?
There wasn’t one, because the activities people resumed as a result of the ‘reopening’ aren’t important. The places that reopened seem like crazy things to open, like tattoo parlors and gyms, but they aren’t getting much activity, aren’t packed and are taking precautions.

Author should update this to indicate they were wrong, as it is clear that spikes in both of these states have occurred since this article was written. See https://www.nytimes.com/interactive/2020/us/texas-coronavirus-cases.html and https://www.nytimes.com/interactive/2020/us/georgia-coronavirus-cases.html. I don't know what parts of the author's model are invalidated by this prediction failure, would be curious to hear how their thinking has changed (or not) by this data.

comment by siclabomines · 2020-06-06T04:32:36.732Z · score: 2 (2 votes) · LW(p) · GW(p)

My intuition is that the effect of the most infectious people getting infected first is even bigger than you suspect. It will not be herd immunity what brings this under control. Herd immunity would be if the infected person has a harder time infecting because some are immune already, and that requires some significant % of people being immune (unless it's juuuuust R=1.04 or something very near 1 but bigger, too much of a coincidence). Yet most countries got it under control at low %s with either lots or little action (even when at first many of the same countries seemed unable to affect the spread with anything short of total lockdown).

It seems much more reasonable that as the virus selectively removes the most susceptible, the R drops below 1 and that's it. The proportion of removed could be at 1%, 0.5%, 5%, no problem here. Argentina is having a spike despite being in lockdown for months, because they locked down too early, I think because the virus refuses to be tamed until it has eaten up "those" communities.


Regarding the rate being ~1, I share the suspicious attitude, but something doesn't feel right in suggesting the control mechanism is people's behaviour. Maybe there's something else. Or maybe there isn't even a control mechanism (one that slows the spread if the "next generation of infected is bigger and viceversa"), but the dynamics are is just not behaving naturally like an exponential. Maybe there's a "cap" of how many peoplee can get infected per 2 weeks because not that many (accidentally?) commit one of the "high-risk" things you suggest. Or the connection graph between people is shaped in a way that tends to this linear thing. I don't know.

comment by SDM · 2020-06-01T13:00:30.456Z · score: 2 (1 votes) · LW(p) · GW(p)
Whenever something lands almost exactly on the only inflection point, in this case R0 of one where the rate of cases neither increases nor decreases, the right reaction is suspicion.
In this case, the explanation is that a control system is in play. People are paying tons of attention to when things are ‘getting better’ or ‘getting worse’ and adjusting behavior, both legally required actions and voluntary actions.

This connects to my older comment about the 'Morituri Nolmus Mori' [LW(p) · GW(p)] (people not wanting to die') effect - it is apparently so predictable that, with short-ish term feedback, it can form a control system with the other end being all the usual cognitive and institutional biases that prevent us from taking these events seriously and actually planning. This is weird and surprising and I don't think anyone expected it back in early March/feb. It may tell us quite a lot about how society reacts to high-risk events with low probabilities in general.

I don't think many of us predicted such a strong and consistent effect back from MNM in early March - as evidenced by updates like this:

5. Fewer than 3 million US coronavirus deaths: 90%
I held. Again, we saw very good news early, so to get to 3 million now we’d need full system collapse to happen quickly. It’s definitely still possible, but I’m guessing we’re now more like 95% to avoid this than 90%.

For Coronavirus, this also means the remaining uncertainties are 'can we do better than the equilibrium position' (sociological and political) and 'how bad is the equilibrium position' (mainly a matter of the disease dynamics). It seems to me, the equilibrium obviously ends in partial herd immunity (nowhere near 75% 'full herd immunity', because of MNM) with some unknown level of healthcare overload along the way, and as you say the US is practically bound for equilibrium, while in Europe there is still a push somewhat away from it (with e.g. national-level tracing and testing programs) but that push is not that strong and also dependent on individuals sticking with social distancing rules. European lockdowns had R between 0.6 and 0.8, noticeably below 1, indicating that they beat the equilibrium to some degree for a while, while Wuhan had r =0.4 as they were even freer of the push towards the R=1 equilibrium.

comment by gwillen · 2020-06-01T19:05:29.617Z · score: 15 (5 votes) · LW(p) · GW(p)

I am still skeptical of the strength of "MNM" effects. Control systems with huge lag times are infamously unstable. Are most people really able to judge whether they should be scared or not based on the R value from a week or two ago, which they don't even know but have to eyeball from the trend in cases?

comment by Purplehermann · 2020-06-02T10:58:04.496Z · score: 3 (2 votes) · LW(p) · GW(p)

People are looking at numbers of infected and dead, the bigger the numbers the scarier it is. When the numbers are down a lot, they believe it's over.

I don't think having a particularly accurate understanding is necessary for this back and forth.

comment by TheMajor · 2020-05-31T20:38:56.417Z · score: 2 (7 votes) · LW(p) · GW(p)

Excellent post, thank you for writing this! I’ve been meaning to write up something similar, about my opinion on the public response to COVID-19 and a few future predictions. I think this comment section is a perfect place for this, and I’ll write my own thoughts as a response to yours. My experiences are not based on the situation in the USA.

As a disclaimer, my predictions are among the most pessimistic of all the ones I’m seeing people discuss. Consider it the bottom pit of the Overton window. Having expectations that COVID-19 will be worse than people are thinking so far can and does have negative effects on your mental health, so be careful (and stop reading). I’d love to be proven wrong.

Risks Follow Power Laws

Amazingly written, I did not give this enough thought. I should stop doing my own grocery shopping, and have it delivered instead.

Sacrifices To The Gods Are Demanded Everywhere

I agree fully. Your steelman hits quite close to the mark in my opinion. I want to add that if everybody has internalised that ‘pleasing the Gods’ is the way to respond (to anything, really), then this actually becomes the correct way for authorities to write guidelines – anything else will just add another layer of translation.

Governments Most Places Are Lying Liars With No Ability To Plan or Physically Reason. They Can’t Even Stop Interfering and Killing People

Yes.

Silence is Golden

I am completely unsure on the relative importance of this, compared to other risk factors. How much of the spread are you willing to attribute to this? Have there been studies on this?

Surfaces Are Mostly Harmless

I have been keeping all packages that arrived in a sealed plastic bag for 24 hours before opening (like a Good Boy), I guess that was stupid. Reading this paragraph changed my mind.

Food Is Mostly Harmless

Yeah, this all makes sense.

Outdoor Activity Is Relatively Harmless

As does this.

Masks Are Effective, And Even Cloth Ones Are Almost Enough

I totally disagree with this. Where are the numbers coming from? I consider cloth masks closer to a Sacrifice to the Gods than a real countermeasure.

Six Feet Is An Arbitrary Number, People Aren’t Treating It That Way, And That’s Terrible

You have this one completely backwards. People really really are not able to make risk assessments and benefit analyses. This world you describe, where the rule is taken as a best point estimate, and people interpret the ‘6 feet’ as anything else than a Boolean yes/no question, was never going to happen. I consider the current public awareness of the importance of keeping distance an amazing improvement on the status quo before this rule went public. You mention this (as the opening sentence, in fact). I disagree with any suggestion that we could plausibly do better collectively.

Herd Immunity Comes Well Before 75% Infected and Partial Herd Immunity Is Super Valuable

This is a very good point, but can you explain the numbers you give below? I have no intuition on what typical spread in personal infection risk is (sure, the range is large, but we also need the frequencies with which these high risks are taken).

Yes, We Know People Who Have Been Infected Are Immune

I agree fully.

Our Lack of Experimentation Is Still Completely Insane

Agreed.

We Should Be Spending Vastly More on Vaccines, Testing and Other Medical Solutions

I agree here, except with the last line. With all the regression to the mean the current medical system is experiencing, it is totally unclear to me how we would plausibly create a vaccine on a short (“a few months”) timescales.

R0 Under American-Style Lockdown Conditions Defaults To Just Under One, Which New York Escaped Via Partial Herd Immunity

Another great observation, and I’ll reply in more detail in a separate post..

The Default Infection Fatality Rate (IFR) Is 0.5%-1%, Depending on Conditions

There has been discussion of this on LessWrong before, and I agree.

Typically in America, 33% of Deaths and 90% of Infections Are Missed

This sounds like the correct order of magnitude for both, and also agrees with my estimates for the under-reporting in the official numbers where I live.

People Don’t Modify Behavior In Response To Re-Openings All That Much, When Given a Choice

This title is a very important (positive) remark, because it suggests (contrary to what I personally believe) that it might be possible to resume a lot of activities almost as normal while maintaining R0<1. I agree that the situation for schools is uniquely bad, and unfortunately I can tell you from personal experience this is one of the places completely infected with making Sacrifices to the Gods. This is a disaster waiting to happen.

It’s Out of Our Hands

When was this window for people in authority? Looking back I honestly think we were never capable of dodging this disaster (our society isn’t adequate at the level of saving people during a pandemic).

comment by Kenny · 2020-06-01T00:13:37.469Z · score: 3 (2 votes) · LW(p) · GW(p)

it is totally unclear to me how we would plausibly create a vaccine on a short (“a few months”) timescales.

"Create a vaccine" is somewhat ambiguous. There are already several (dozens?) of vaccines undergoing clinical trials so, in one sense, we've already created vaccines. There are several vaccine technologies that are well understood that can be used to quickly produce a vaccine. In the sense of developing, producing (at scale), and administering a vaccine – to a large number of people – that's (much) less plausible (or possible) given 'civilizational (in)adequacy'.

comment by Rolands · 2020-06-11T16:39:48.601Z · score: 1 (1 votes) · LW(p) · GW(p)

"Silence is golden." Ok, how golden? If two people are staying in a house together, should they actively try to avoid communicating more than what's necessary? That's not exactly easy, and I'm not sure how much benefit it has when we're sharing the same common areas anyway.

comment by DPiepgrass · 2020-06-11T14:38:14.197Z · score: 1 (1 votes) · LW(p) · GW(p)
"The WHO has lied repeatedly, to our face, about facts vital to our safeguarding our health and the health of those around us. They continue to do so. It’s not different from their normal procedures."

Are you sure not providing evidence for your claims is the right call?

comment by Mcmxcog · 2020-06-11T07:43:33.515Z · score: 1 (1 votes) · LW(p) · GW(p)

Nice summary. I would add that there seems to be a correlation between severity of symptoms and outcomes with obesity. Now is probably be an especially good time to change lifestyle to lose weight if obese.

comment by Marielle Volz (mvolz) · 2020-06-11T06:08:57.169Z · score: 1 (1 votes) · LW(p) · GW(p)

In the UK school absences for an unexcused reason (i.e. a vacation during the school year) are fined, so it is more rigid system than in the U.S.

Primary schools have been re-opened here for subset of students last week, and it is not mandatory.

I'd be surprised if you're correct on this, even on average, for the U.S., given that there are so many regional differences from state to state there.

comment by jmh · 2020-06-03T22:02:51.898Z · score: 1 (1 votes) · LW(p) · GW(p)
If we think Covid-19 deaths are bad, well, they look a lot like deaths from ‘natural causes.’ Yet those are considered good and right and proper, and not like the horror that they are. We’re all going to die.

Sounds a bit like Sinclair in his book with LaPlante, Lifespan. We should be looking at aging as a disease, not a natural outcome of life.

With regard to the whole overpopulation fear or bored with living it is worth noting that solving aging doesn't seem to be achieving immortality - at least not anytime soon I sounds. More about increasing the quality of life post 50 or so with perhaps an extra 10 to 30 years. Whether or not that extra time or the less aged middle year would really result in a significant increase in population I'm not sure. Others might have a good idea on how to model that.

comment by dvasya · 2020-06-01T05:37:51.698Z · score: 1 (1 votes) · LW(p) · GW(p)

Regarding HCQ, the recent large-N studies were observational and looks like patients there were given HCQ late and if they were relatively sicker. Using it early on could still work (but now there won't be an RCT for that thanks to numerous delendae).

Regarding schools, did the countries that reopened those already fare particularly worse?

comment by Zvi · 2020-06-01T13:59:56.954Z · score: 10 (2 votes) · LW(p) · GW(p)

I don't have that info regarding schools but also no one is systematically collecting data on anything and everything is confounded, including by control systems.

On HCQ, as I noted in the other comment on it, I'm mostly predicting/observing that the scientific community has decided it's going to reject HCQ, preventing it from becoming a consensus treatment. This is partly for 'good' reasons, partly for not-so-good reasons that have nothing to do with science, partly because they no longer know how or are not allowed to study things in ways that would uncover the information.

This is different from the question of what you should do if you or someone you care about gets sick! To which I reply IANAD and for legal and other good reasons, I have no net useful advice for you here.

comment by Purplehermann · 2020-06-02T11:02:05.160Z · score: 1 (1 votes) · LW(p) · GW(p)

In Israel schools were recently reopened, 31(last I checked) schools have had cases over the last couple weeks. A notable school reportedly had over 100.

Before the country reopened the rate was around 20 infections a day. Currently in the 50-60 infections per day (on most days) area. This seems to support schools being important

comment by dvasya · 2020-06-02T01:18:03.121Z · score: 1 (1 votes) · LW(p) · GW(p)

Here's a (high) schools data point... https://twitter.com/EricTopol/status/1266976828549238785?s=19

comment by Liron · 2020-06-03T16:37:35.893Z · score: 0 (2 votes) · LW(p) · GW(p)

Unfortunately I feel like the whole pandemic will only lead to a very slight overall uptick in preparedness for the next, much worse one. The biggest impact will probably be people’s perception that pandemics can be real threats.

comment by jmh · 2020-06-03T21:43:54.745Z · score: 5 (3 votes) · LW(p) · GW(p)

I've seen this claim that the next time will be worse that this one a few times now (not limiting to LW).

I'm curious about the claim. Is that related to some underlying model or some biologic or virologic reason. Is the claim based on the view the human population will continue growing so population density increases, even if density increase that social interaction will increase relative to today? Something else?

comment by Liron · 2020-06-06T18:08:04.948Z · score: 4 (2 votes) · LW(p) · GW(p)

We simply observe that COVID is not on the convex hull of bad-pandemic-causing parameters. It’s a luckier roll of the dice than the one portrayed in the plausible Pandemic movie.

The “next” pandemic is likely to revert to the mean, but it seems like over 20% chance that on a 30-year timescale there will be a virus with much higher IFR and/or much higher R0, maybe due to much more surface and aerosol spread than SARS-CoV-2 which is apparently mostly droplet spread.

comment by Zvi · 2020-06-06T20:10:02.482Z · score: 8 (4 votes) · LW(p) · GW(p)

It is worth noting that the same virus with a higher IFR doesn't obviously kill more people, especially if it kills children, because there would be a more aggressive reaction. Very possible it gets squashed entirely.

And if we had a similarly deadly disease with much more spread, we'd have been forced into herd immunity strategy quickly. Which again, isn't obviously better or worse as an outcome.

If both were much worse, of course, that would be much much worse.

comment by Liron · 2020-06-06T20:30:44.903Z · score: 4 (2 votes) · LW(p) · GW(p)

If COVID were 3x higher on either parameter, it probably wouldn’t have led to a more effective US federal response. My guess is that it would just have been a much bigger crisis.