Why COVID-19 prevention at the margin might be bad for most LWers

COVID-19 isn't that bad for the vast majority of young and otherwise healthy people (no worse than a bad flu).

I disagree with this and disagree that it is the consensus. The risk of serious sequelae is uncertain but potentially quite high- certainly much worse than the flu.

We are quickly learning how to treat the virus. Your grandparents chances of survival if they get COVID-19 are likely significantly higher if they get it in three months than today. As the virus is new to humans there are likely a lot of "low-hanging fruit" mutations for evolution to find, and the more people the virus is in the more chance it will stumble upon a mutation that makes it better at invading the cells of young people. We don't have a good estimate of how much long-term harm it does to people it doesn't kill. While if you get the virus this year, you will probably be safe from it next year, we don't know this for sure. We don't yet know if viral loads matter and it could be that the rapid initial exponential growth of the virus once it is in you means it really isn't important what your initial exposure is.

I agree with many of your points, but have a few areas of disagreement that lead me to different conclusions:

• There is considerable evidence of permanent lung damage, even in cases with no noticeable symptoms.
• A one-time ten percent decrease in lung function will barely inconvenience a 20-year old. If the same person gets the same disease every year, (s)he won't live to 30.
• The linked article quotes studies indicating potentially permanent lung damage in 77% to 95% of the test subjects.
• The virus is mutating in ways that complicate the development of treatments and vaccines.
• Each person infected has a tiny chance of becoming host to a problematic mutation, and passing it on.
• The fewer infected people, the less of a problem this will be.
• I do not know (at this time) whether we will have a vaccine in a year, or ever. AFAIK we've never created a vaccine for a respiratory coronavirus before (we have some veterinary vaccines for intestinal coronaviruses, but not respiratory ones). Some vaccine trials for the related SARS-1 coronavirus made the disease worse, not better.

To me, this adds up to "coronavirus is potentially much more serious than you think, even for young people, and it would be better to be very cautious until the uncertainties are resolved". I understand that the economy is doing very poorly, but I think the risks, at this time, militate against opening up. I strongly support measures to help those who've lost jobs because of the situation, though.

Note: This represents my opinion as of a particular time. As new information comes in, I expect to update my opinion accordingly.

One difference is that people on LW are more likely than average to be able to almost-entirely self-isolate for long periods of time, given the slant towards work that is doable online, being relatively well-to-do, and are more able to fulfill their socialization needs digitally. Personally, I'm planning to avoid any public spaces, aside from short tasks like getting groceries (with a mask on), until I can get a vaccine. Of course not all of those apply to everyone, and the first two of those are examples of privilege, but it still explains people on LessWrong.

According to most predictions I've seen, the very worst of the peak where I am has hit at this point. Perhaps it could get worse in a resurgence after opening up, but it seems likely to go down from here. Therefore, I want to get infected as late in this curve as possible. This is doubly true since as James_Miller points out, the methods for treating the virus are getting much better over time.

In addition, I'm willing to take a lot of personal sacrifices to avoid the chance of having significant long term damage to my lungs. I've seen some evidence online that even young people who get it and don't seem to have negative symptoms still sustain lung damage that could take years off of their lifespans as well as lower long term quality of life.

Given all of that, it doesn't make personal sense to get exposed now. Looking at the cost/benefits to the general community, I think it also makes sense for me to not get exposed. If I get sick, it's an additional on local medical resources. My job is valuable enough that it wouldn't make sense for me to work in that category of jobs where I would be interacting with vulnerable communities, especially since I don't have any training as a healthcare worker.

1. Most people tend to be right about 60% of the time when they feel fairly certain. If we apply this logic to your assumptions, the chance that they are all correct is approximately 0. Many things we were told about CV2 turned out to be wrong. That is a bit simplistic, but your analysis should take into account that your assumptions may not all be correct, and the consequences of this. For example what if young people have silent organ damage, as has been reported? What if immunity is limited, uncertain, or short-lived, as if often the case with corona viruses? Such errors could be very costly. In general the strategy of "pick the most likely scenario and bet erh farm on that one scenario" is a poor strategy.

2. By getting infected now, you are giving away much by way of option value. The value of getting immunized later, of having better treatment later, of having better and less costly methods of limiting infection, etc.

3. You are falling for the false dichotomy of lockdown versus uncontrolled pandemic. I suggest you have a close look at Taiwan, which has had approximately 1/700th the death rate of the US for example, and which did not have a lockdown. While Taiwan did make a fast start, Australia got down into the Taiwan range of active cases within about 5 weeks, and other countries could also do this with a brief lockdown.

Techniques used by Taiwan include contact tracing, strict controls on entrants to the country, enforcement of quarantine of cases, use of soft metrics like temperature and cold/fever symptoms with exclusion from schools/work/transport for the symptomatic, and others. They have selectively closed some high risk businesses like "hostess bars".

This problem of becoming fixated on one aspect of a problem or one one thing generally, "Einstellung" in German, is an important cognitive bias that is not talked about often enough IMHO. A common example these days is the notion that the USA has one problem, Donald Trump, and with him gone all would be right with the world again.

having the disease as soon and in as safe a manner as possible so as to become immune to it would allow them to act as firewalls towards the disease and help vulnerable populations

Note that preventing yourself from getting it also acts as a firewall.

If there are no long-term effects, then I'd think the ideal would be to get the virus and then not pass it to anyone else. So, following your argument, one might want to marginally increase their chance of getting it. But it seems hard to do that w/o also marginally increasing your chance of passing it to someone else.

You'd want to find a way to get a little bit of exposure for yourself, w/o exposing anyone else to you. So, if you live alone and are completely isolating from other people, maybe it would be a good idea to go ahead and lick all your delivery packages. (See also Robin Hanson's variolation proposal.)

But unless you can find a way to make the exposure profile asymmetric like this, marginally increasing your exposure doesn't seem net beneficial. (And that's even after assuming there are no harmful long-term effects and that one's personal risk is low enough not to matter.)

I get the impression that you might be thinking about this in terms of a false dichotomy. It seems correct to me to note that much longer lockdowns are politically infeasible in large parts of the US, but this doesn't mean that most states will just let their entire population catch the virus. Maybe there'll be a second wave and then states that are similarly badly hit as New York and New Jersey will change their stance. Or maybe some states succeed at lessening the restrictions in a smart way, with masks and so on. Maybe the people are sufficiently afraid to catch the virus that they socially distance themselves of their own accord, even when businesses reopen.

Expert predictions say that there have been between 4.8M—28M infections in the US so far (80%) confidence interval. Those infections are responsible for 73k+ deaths so far, and predictions say the median number of deaths will be below 300k in the US (probably even below 200k but I think there was an upward trend in the latest survey, and some chance they're now between 200k and 300k).

I've been doing predicting as well and I agree with those predictions (I'm saying this because it can be justifiable to not always trust experts). Therefore I don't think it makes sense to assume you'll likely be exposed to the virus anyway. (The case for this is even stronger if you live in Germany or the UK; the upward trend in predictions about the US is a bit concerning.) For those who want to avoid low-ish but non-negligible risks of becoming sick for sometimes quite a long time, with a virus that in some instances can do do all kinds of strange and scary things that we don't fully understand yet (see also Elizabeth's comment above), it's good to have the advice available! (Of course, I'm not necessarily saying I endorse all of those pieces of advice.)

No, you're not missing anything. This should be obviously true to anyone who's observing. Hints of vaccine or treatment-magic-bullet just around the corner, anecdotal scary nonfatal effects, false hope of keeping sub-1% US-wide infected, etc have simply been upvoted in media for political reasons (esp. sunk cost fallacy, but it's complicated - no lockdown leader wants to be blamed for even one death caused by their decision to relax even partially). People have taken sides for/against lockdown and are digging in (there's also phony stuff on the open-up side - overexuberance for mostly-false-positive antibody results suggesting widespread infection so lower severity per infection).

What changed my mind was the argument that it is good practice for a worse pandemic.