Swedish update, and which places need to fear second waves?

Your recent question intrigued me. Do you have any new info/opinions on what’s happening in Sweden? Despite no mask wearing, continued indoor dining (at least judging from recent photos on instagram), their case AND death daily counts are plummeting (looks like an inverse exponential). This would also explain excess deaths returning to normal throughout US. Bizarrely, my cursory reading of Swedish newpapers online did not result in any recent articles discussing the dramatic decline in cases there!

One theory circulating is they achieved herd immunity on the math: 10x true seroprevalence (from CDC tests in US) * 2x true immunity (from Tcell things not measured by antibody tests that I don’t fully understand) * 0.75% reported case penetration * 2x for relatively low tests per capita rate = 30% true immunity (likely much higher in densest areas where spread would be much faster resulting in maybe >70% immunity in Stockholm). This puts them r0 < 1.

The nice thing about this hypothesis is that it’s easily falsifiable. If true immunity rates are 20x reported case load (dropping last 2x factor since test rate higher in US), then Florida should have just gotten to the 1.4% necessary to trigger similar immunity in dense cities and from now on, cases per day should follow an inverse exponential.

This would also explain why NYC has not seen a resurgence despite very similar reopening as SF and LA – they achieved dense herd immunity in May and thus the subsequent decline in reported cases was driven by herd immunity rather than more strict closures or mask compliance, reversing either of those factors now doesn’t reverse immunity. To be clear, I’m not disputing that distancing or mask wearing works – they do. But so does infecting everyone quickly. No value judgements on what’s the better policy decision here, just trying to make a predictive statement.

At least, one can hope!

That is my email from Mayank Gupta.  In my view, some version of this view is looking more true with each passing day.  We also are not seeing second waves in hard-hit northern Italy.  Still, many surprises remain and we should not leap to premature conclusions.

To be clear, I was and still am pro-lockdown (without regrets), pro-mask, pro-testing, and I believe Denmark followed a better path than did Sweden.  Long-term damage (rather than death) still may be a significant risk, and furthermore many parts of the world may be far more vulnerable than the United States.  Still, you need to put all of the moralizing and partisanship aside and ask what we are learning from the new data, and I think Mayank Gupta has put it (probabilistically) very well.  And see this related Atlantic piece, though I would have some quibbles with it.  And here is a bit more commentary on the new T-cell results.

In any case, always be prepared to revise!  I believe that within a month we will have a much better sense of these questions.

Addendum: You will note these hypotheses also significantly raise the probability of much earlier animal-to-human transmission, especially in Southeast Asia.  A very good baseline principle for reasoning is simply “Origins usually go back longer and earlier than what you first might think!”

Second addendum: If you go back to March, leading epidemiologist Michael Osterhalm argued: “We conservatively estimate that this could require 48 million hospitalizations, 96 million cases actually occurring, over 480,000 deaths that can occur over the next four to seven months with this situation.”  Covid-19 has been terrible, and the performance of the executive branch (and many governors) absymal, but do those look like good predictions right now?  (Hospitalizations for instance have yet to hit 250k.)  If not, why not?  How hard have you thought about this question?  (Added note: one correspondent suggests that Osterhalm misspoke and in fact meant 4.8 million hospitalizations — note that still would be off by quite a large margin, almost a factor of twenty.)

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On the other hand, Osterholm was brave enough to point out the transmission risks associated with the Floyd protests even as they were going on. This blog, by contrast, had fallen silent.

the washington duckymacsuckfaces

the dallas Suckasses
-I am also of Philly
does not matter where the team is from, dallas sucks

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What is most interesting about the Floyd protests is that CA hadn't opened in general. Remember, mid-May was the pissing match between Elon Musk and Gavin Newsom over whether Tesla could open or not. NYT ran a story on May 19 ("CA is reopening. Slowly. it's complicated") that CA was opening. At that time, 24 counties with stellar numbers (almost all small counties in far NorCal) had been allowed to reopen. In that NYT piece, Newsom promised in the coming weeks that stores could be opening for shopping, and sporting events might happen in June.

In short, CA was still locked down tightly when George Floyd was shot on May 25. The first riots the US happened on May 26 in Minneapolis. CA rioting followed a few days later--while most of the state was still in tight lockdown.

For daily new cases published on Worldodometer, with 7 day average enabled, on April 16 CA had 1000 cases. On June 15, they had 3100. That is a 1.9% daily growth rate. On July 15, there are 8500 cases. Over the last month, that is a 3.4% growth rate. And the 2.5X increase in the slope around June 15 is very clear.

June 15 is two weeks after the riots started.

Texas also shows the June 15 doubling or tripling in daily new case rate. That is 6 weeks after Texas had opened restaurants. So if Texas re-openign was the cause, we'd expect to see their bump in mid May. But we didn't. It occurred in mid June just like CA. Again, 2 weeks after protests began.

The same story repeats again and again. Whether states opened early or never opened, something caused a sharp rate of increase in mid June.

BLM protests are overwhelmingly the source of CA (and every other cities) woes.

https://www.worldometers.info/coronavirus/usa/california/

I'd add that the effect wasn't just the actual going out in a big mob for a Mostly Peaceful Protest, it was the psychological effect. For 10 weeks, the media had been telling everybody that coronavirus was the Most Important Thing Ever. Suddenly, the death of some bouncer in Minnesota was now the Most Important Thing Ever and all that stuff about social distancing vanished. Now the press was encouraging mobs, which had ramifications for those not taking part in them: Oh, I guess the virus thing must be over and we can get back to having fun.

Bouncer's Lives Matter.
Bouncers perform an essential public service.
Imagine a world without bouncers.
OMG.

Floyd was not just a bouncer and putative counterfeit bill passer, he was also part of a rap group. I spent 20 minutes yesterday on Wikipedia looking at this group, headed by "DJ Screw". What was interesting and sad to me is how many in the group, active more than 20 years ago, is now dead. Seems that the Black men in Houston die at an alarming rate. So Floyd's death is not that 'unusual', sad but true. They were actually in the process of doing a film biography on DJ Screw in January of this year, and I'm sure Floyd's death will accelerate this film.

Bonus trivia: SARS-CoV-2 has a huge gain of function, meaning it's likely, man made. It takes 25-50 years to get such huge gain-of-function naturally, and we're to believe it happened, far away from bats, in Wuhan, the same city that the WIV (with lots of lab bats) formerly headed by Dr. Shi, aka BatWoman, lives and works? Nope, not buying it. As for Sweden, since lab-made viruses are seasonal (they are susceptible to warmer weather more than natural viruses), then Sweden cases may be declining due to summer, people outdoors more, temperatures a bit warmer. Same in north Italy. Here in the mountains of Greece we had a heat wave a few months ago and it gets hot here. But good points made by TC's post, and Mr. Gupta's knowledge of Swedish is impressive. @CatInTheHat - quit making up stuff about "undetected". That's speculative. Or, acknowledge I'm also possibly right about SARS-CoV-2 being chimeric and I'll call it even, since my evidence is also speculative (until the find an intermediate host in the wild harboring the virus, which would definitively disprove it)

Rapper Lives Matter.
Imagine a world without rap.
I can't even.
Don't go there.

Its very hot in Los Angeles right now and cases are soaring. Though I think there is a fair bit of monkeying with case definitions, there is no evidence that heat is knocking it down here.

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Regarding the chimeric virus, you can send your theory to Tyler and let him post it for all to critique
I think there are these possibilities:
1. The virus was a chimeric bioweapon engineered at the Wuhan Institute of Virology ( WIV), released intentionally
2. The virus was a chimeric bioweapon engineered at the WIV, released accidentally
3. The virus was a chimeric public health proof of concept experiment engineered at the WIV, released accidentally
4. The virus was a natural unmodified zoonotic virus studied at the WIV and released accidentally
5. The origin of the virus has no link to the WIV ( current established working hypothese)

I do not believe 1 or 2.
I am partial to 5, but 3 and 4 are possible but unproven. I don't see hardly any support in the scientific community for 3 and 4

*6 = a modern version of the Woody Allen character in CASINO ROYALE got miffed at being blocked on TWITTER by arrogant STEM people and designed a proof test of a phenomenon that would make them look really stupid, by making predictions that would be shown to be false within months.

You think I'm kidding?

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+1 on the "protest effect", if there is one, being most likely to mainly be through confusion and dilution of media messaging, not direct effect from protests as superspreading events (as outdoors, even if it's bs that attendees maintained social distancing and wore masks). One of Nate Silver's postulates really (and one I defended as plausible on here to much ire).

I don't know how much of this is specifically the crappy left wingness of the media though. Look back at the forest fires in Australia and deforestation of the Amazon early in the year; they dropped off on both of those (well covid could have "forced" them to) when they weren't "fresh" stories, even though they were still going on (and are in the case of Amazon deforestation).

The bigger effect may be due to the media in general being driven by careerists who want to develop exciting "fresh" angles and stories which will raise their profile, not repetitive plodders who plod along doing their duty and simply reporting without bias or opinion what is important and ongoing, until it isn't. Backed up by a public that is fickle, and whose "Public Choice Theory" response is to buy whatever media are talking about something new and exciting, not something old but more important.

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+1

The psychological effect of the protests is a very good insight.

In VA, people were required to wear masks the same weekend the George Floyd protests began. During the month of June, everywhere I went in VA, nobody wore masks, because why do it? There were protesters out on streets every day. Starting about two weeks ago, when the protests and media BLM hype slowed down, people quickly started wearing masks everywhere, businesses started enforcing the wearing of them, and mask moralizing became common.

"The psychological effect of the protests is a very good insight."

+1, agreed

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The timing and locations don't support the BLM protest theory very well. In Washington, for example, the big boom has been in the Yakima area which had few protests while there has only been a relatively minor increase in the Seattle area with its CHAZ or CHOP or CHOAD or whatever. Similarly for NYC which had major protests running for weeks, but no major outbreak.

The usual causes for the outbreaks are family gatherings, going to church services, parties and other social activities. Our town had a boom after high school graduation. There were a lot of parties. July 4th got us another pop. Contact tracing indicates that the usual new case is someone going somewhere to see family or friends and bring COVID home with them or someone from elsewhere coming to our area for a get together.

If no one noticed, Memorial Day was held this year in late May, and parks and beaches started reopening around the same time. Sure, there were BLM protests, but protesters were usually masked and most of the ones I saw were keeping their distance, unlike the folks out for the fireworks or family picnics.

Memorial Day was May 24, 2020, Day Zero of the Post-George Floyd Era.

By the way, my impression is that the current spread is disproportionately among Hispanics. They tend to live in more crowded conditions than whites, Asians, or blacks.

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This underestimates the difference between indoor events (especially if air is recirculated) and outdoor events.

If everything that happens outdoors is zero risk, even piling on top of each other in a mob shouting, why are so many outdoor activities illegal under the quarantine?

one way ratchet. Early on people didn't know what was dangerous (confusion over airborne vs surfaces) and most safe outdoor activities are "low value" so they are not being prioritized in reopenings even if they would be completely safe. Opening playgrounds doesn't help the economy but reopening indoor dining does.

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Looting a Target is an indoor event.

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Looting a chain of stores like JCPenny or Payless or Sears or JCrew is also an indoor event. Private equity people wear masks when they can't teleconference.

There is a big difference between indoor and outdoor transmission. There's a lot more ventilation outdoors, so there is a lot more aerosol dilution.

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But Tyler did report Trevor Bedford's tweet from June 7: "My (updated) best guess is that each day of protests involving 600k people will result in between 200 and 1100 eventual deaths."

The tweet is still up. Cancellation imminent? But he's not notable enough to warrant a Wikipedia page, so maybe no one cared.

https://marginalrevolution.com/marginalrevolution/2020/06/u-s-a-estimate-of-the-day.html

Now do the Tulsa rally equivalents.

And whenever he gets out of the hospital, will undoubtedly be pleased to say that personally. Currently, this is his status as of 6:02 PM, Jul 15, 2020 - "If he continues to progress at the same pace, they will probably get a little more proactive today about moving him to some new treatments. Also, he was irritated they wouldn't let him have a Snickers bar. That's our boss! Please keep praying for him."

So, considering that the Tulsa rally had 1% of 600k people, the result would be 2 to 11 deaths, leaving inside the fact that it was held indoors, with most people not wearing masks nor social distancing. We can all sincerely pray that Herman Cain will not end up representing 50% of that low end estimate of that rally's increased death toll. Leaving aside the fact that it is impossible to pinpoint how he became infected, as would be the case of all those protesters.

There's a big difference between half a dozen 20 year old boys crammed into an 800 square foot apartment smoking weed from shared bongs and playing video games and 6000 people in a arena designed to hold 20,000.

There are probably 3-4 orders of magnitude between the "humans per cubic meter" metric.

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A simple "No, I won't" would suffice. Ah prior_approval, always thr logorrheic.

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Tyler Cowen is absolutely downplaying the role of the protests in spreading the virus for political reasons. It's his blog, he can spin these stories however he wants.

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I posted about herd immunity many times. All you need is ~ 20% that got infected. There is another 15% + of people with quasi immunity ( hardly susceptible, hardly infectious) that mount a quick T cell response and don't get sick and with some social distancing ( R ~ 1.5) then 33 % is enough for an effective immunity.
This has been reached in Stockholm and Gothenburg and NYC and probably other infected places like Northern Italy and that's why we have had a dramatic slowdown in these places.

goddammit, stop bothering DR. FAUCI
or else
he is trying to work

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Note that this is not new. Michael Levitt had had this idea for a long time that 20% is enough to reach herd immunity because of an hidden immune cohort but generally his analyses have unfortunately not been taken seriously.

It's likely that there is a large immune cohort in East Asia - just look at the numbers. So hidden immunity is possible. But we simply do not know whether there is one in the U.S. Remember that East Asians have been exposed to many more coronaviruses and may have developed immunity that way.

That said, Michael Levitt is usually pretty much spot on.

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Herd immunity and mitigation strategies aren’t mutually exclusive- in fact they are additive-ie “herd immunity” occurs at lower levels of recovered infection levels when masks & social distancing are used. The so called “herd immunity” target is unknown & many are hoping it is only 20% but it is risky to act like we are near herd immunity

Nobody is making this assumption. Social distancing is still in place in NYC. I said if R goes to ~ 1.5. That implies something social distancing just not everyone locked tight

Most people are still scared out of their gourds in NYC. I can't blame them. My niece took the subway to Brighton Beach and had a subway car for herself and her roommate for much of the trip. She had a great time at the beach which was, not surprisingly, far from crowded.

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Sorry : hit send button too soon
Nobody is making this assumption. Social distancing is still in place in NYC. They're in phase 3 and i believe indoor dining is til not permitted.
I said if R goes to ~ 1.5. That implies some social distancing just not everyone locked tight.

There's also the fear factor. Social distancing started before the formal orders and is likely to continue afterwards. The kinds of people who have enough money to spend to make an economic difference are also the kind who are used to doing stuff they might not like to maintain their health. They're the ones who quit smoking, endure kale, work out at the gym, eschew good tasting food, get that under or grad degree in a hard subject, choose a challenging career and so on. They aren't going to piss it off for a sweet sixteen party.

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if
herd immunity is at 20%
then
what percentage of cases occur after "herd immunity"

New infections start to decline at a rate that depends on the local R.
Cases are usually not well defined as they depend on testing availability and protocol.

"Cases are usually not well defined as they depend on testing availability and protocol."
do you see any problems with this assertion?
we are by no means the best /even bright but this sounds like
a tiramisu of bull dust&circular speech

There is no problem with the assertion. You can’t take the number of cases as face value most of the time. Variation in number of cases can reflect testing activity rather than variation in infection rates. This has been discussed a million times on this blog.
Here’s a nice thread that demonstrates this for Sweden

https://twitter.com/jacobgudiol/status/1283308801043636231?s=21

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Not quite. R0 in a purely susceptible population without and public health measures was estimated at about 3, from whence we get 2/3 as the herd immunity threshold. If it is true that many people had de facto immunity already, and the virus was still spreading as fast as it was, then the ‘true’ R0 must’ve been significantly higher than 3, and the actual herd immunity threshold would be higher as well, so 33% wouldn’t be enough.

that would suggest the number of cases after reaching "herd immunity" might be equal to the number of cases it took to reach herd immunity?

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No, effective herd immunity depends on R which changes over time. Ro is just the static initial R.
When it’s quoted with Ro, it’s for a population that that doesn’t take any precautions and is oblivious of the virus.
In practice that doesn’t happen.
And the most common number for Ro in papers was 2.4 to 2.6.
HT doesn’t occur everywhere at once. It can exists in NYC but not in Fl or Houston. New infections can decline in one part of the country but rise in another. That’s what has been happening

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That 2.5 - 3 value for R0 was based on studies in China. I don't think anyone believes China is being honest about their infection rate, so it's long been thought that the real R0 is higher for that reason too, 4 - 5.

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This is true. R0 is estimated by the growth rate of infections early in the pandemic. If, say, X fraction of the population is naturally immune, then you need to multiply the R0 you would have estimated from the initial growth rate assuming 100% susceptibility by 1/(1-X). Herd immunity is reached when Rt = S(t) R0 < 1. If R0 = 2.5/(1-X), then this occurs when S(t) < (1-X)/2.5. If X=.5, this means herd immunity is reached when 80% of the population is immune, either immune from the beginning or by going through the disease process. So if 30% of people get through the disease, if you add in the 50% naturally immune, you have herd immunity. If X=.75, herd immunity is reached when 90% are immune, which means you need 15% to actually go through the disease.

It’s a dynamic situation . R is a function of time and place R(t). I was careful to use the word “ effective”, effective immunity. Ro is for a naïve population that is oblivious of the virus and takes no precautions. Whether you correct it for the hidden immune fraction ( which is unknown at the beginning) is not relevant to the argument.
The argument is only that given some fraction immune that I believe is of the order of 20%, and a fraction infected of the order of 20%+ ( NYC/Stockholm, etc…) , then if R(t) drops below 1.5 ( due to masks and some social distancing), then “effective “HT is reached at 33% ( past infected + immune) and we passed that point in some places.
This doesn’t mean that if everything is relaxed and people are allowed to crowd in bars, HT will be maintained.
From the data in Germany, getting R to stay below 1.5 is not too hard for this virus.

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Ok, but that would imply that the fact that NYC streets were empty and that New Yorkers had stopped interacting with each other had no effect on Rt and thus on the herd immunity threshold. NYC right now is not really open: you can't eat indoors at restaurants, and most people keep their distance and wear masks, and yet the decline in new cases has already stopped. What this tells me is that of you make an estimate of herd immunity threshold based on a particular set of behaviors, you shouldn't assume that if people start behaving differently, that threshold will be unchanged.

I said R ~ 1.5. That implies some social distancing. NYC qualifies under that scenario.
R would be higher if everyone was oblivious of the virus and taking no precautions.

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The supposition that the Swedes didn’t mask & social distance is false- a recent look at Swedish behavior shows that most Swedes EXCEEDED the government’s recommendations by a considerable margin.

I never made that supposition. I said they achieved herd immunity ( Stockholm/ Gothenburg) given R ~ 1.5. That implies some social distancing.

Social distancing perhaps but masks are the exception, not the rule in Sweden, Norway, Finland, and Denmark.
https://www.economist.com/graphic-detail/2020/07/08/face-off-over-face-masks-europes-latest-north-south-split

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Another possibility to consider, although I don't see how we can really test this in the near term. Perhaps the virus is highly contagious to a small fraction of the population, but most people are naturally immune for some yet to be determined reason?

More likely, it is like polio with most cases asymptomatic and a small handful lethal or with serious consequences. I think polio was 90% asymptomatic or with minor symptoms like sniffles. Still, people were not encouraging their kids to play with friends at the playground or swim in the neighborhood pool. How many people would play the state lottery if the odds of dying from it were the same as the odds of winning it?

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We also have data from the 1918 pandemic that no one seems to discuss: it is estimated that the pandemic ran out after infecting 1/3 of the US, even though epidemiological models keep telling us the pandemic won't stop until you get to 70-80%. Remember that there wasn't a vaccine for the 1918 flu - the virus just ran out on its own after infecting enough people.

Its also funny how people claim that lockdowns helped during the 1918 pandemic, without explaining how they could've possible lowered the number of people who got the virus eventually given that there wasn't a vaccine back then.

Maybe the 70-80% estimate was correct, but the lockdowns made a difference? After all, there were lockdowns, and the epidemic burned out with a much lower infection rate. The trick is to get the transmission growth rate below one, and that can be done with herd immunity or shutting things down or some combination of both.

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Addendum 1
regarding animal to human cross reactivity for coronaviruses, I don't think it's a needed hypothesis. The human coronavirus exposure is enough to explain the T cell activity. Human coronavirus exposure to the 4 HCoV is common. Animal to human transmission of the 14 known animal coronaviruses on the contrary is rare.

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Quite reasonable. Hopefully true!

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I know its fashionable to say Trump has been Abysmal on covid19. But . . . How specifically?

What has he done that has been catistrophic? What specifically, even with the heinsight of a God, should he have done differently?

It's like the mirror image of how everybody in New York decided Rudy Giuliani was a giant hero in the days following 9/11, which made him, in the media's eye, the Republican frontrunner for President in 2008.

In reality, Giuliani didn't _do_ anything, good or bad, during the couple of hours when everybody died in the World Trade Center. It happened all too fast. But lots of people found his briefings over the following week reassuring.

Similarly, the New York media fell in love this year with Cuomo's briefings, even though, it turned out, Cuomo messed up pretty badly (Personally, I don't blame Cuomo that much because this problem is extremely new.)

The press already hated Trump, but interestingly, they also seem to have decided to hate De Blasio too. I don't watch much TV, so I couldn't tell you if Giuliani and Cuomo are objectively better briefers than Trump and De Blasio, or whether this is just a scared audience randomly falling in love with some guys and in hate with other guys.

Most leadership is about perception and the ability to "ride the tiger". Trump did this well when he rode an anti-immigrant trend into the White House, but in terms of messaging and presentation he has been a disaster the entire covid19 crisis. Instead of reassurance he offered ludicrous promises the virus would just go away, makes crazy promises about the economy, gets excited about the stock market while his base is suffering from risk of unemployment, has consistently lied about what he has done (he never barred travel from China for example), has been crazy inconsistent (China is our friend, no China is the enemy, no China is our friend, no China is the enemy...) and has ended up looking weak and out of touch. Trump's lack of professionalism and inability to focus on unpleasant topics has been painfully exposed. He also just won't shut up. It is painful to have a narcissist President demanding so much attention when people have other things to worry about. Biden's number one strength, at this point, is that he will be easy to ignore. People are tired of thinking about politics.

TDS alert!

No, prior_approval. This is the non TDS answer.

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@Peter +1

Trump is one goofy guy.

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Yes, I think Peter nailed it.

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1. Build up the strategic national stockpile
2. Ensure CDC has the resources and expertise in place to develop testing kits. They did not early on and FDA criticized CDC's lack of preparedness sharply.
3. Temporary restrictions on interstate travel. Singapore used the term "circuit breaker" to refer to emergency policies it implemented when certain thresholds in terms of active cases or growth in cases were breached. The federal government should have had similar plans in place and should have been prepared to execute on short notice.
4. The tracing and data collection infrastructure of health authorities is poor and out of date.
5. Taiwan started taking action to monitor arrivals from Wuhan at the border as early as January 1. Various departments of the federal government surely have the ability to communicate with health authorities in Taiwan to share information. Why was this information not acted upon?

TDS alert!

Prior_approval, stop spamming irrelevant comments.

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I think this list is pretty reasonable.

!) no argument there
2) I don't know what this means. My understanding is that critical failure here is was a) CDC botched the test b) CDC refused to use WHO test c) CDC/FDA banned everyone else from conducting their own lab testing
3) this is completely outside the Overton window in the US. Not feasible
4) very true. Don't see how this will ever get fixed in a country like the US
5) no argument there

I think Public Choice wins so far hands down.

The virus that has been winning in America so far, hands down.

The virus is winning as explanation of the policy choices? Interesting circular logic there, prior_approval.

Germany has had more cases in the last 36 hours than Taiwan has had during the entire pandemic. Also Taiwan has about 1,300x fewer deaths.

Here’s a very German headline:
https://www.cnbc.com/2020/07/13/germanys-sex-workers-protest-to-go-back-to-work-amid-coronavirus-ban.html

prior is just in shock that the Germans have done so much worse than the Greeks.

Right ... Why have Greeks done better than Italians and Spaniards?

There is a lot of randomness in the events so far, and the story likely isn't over yet.

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On 3, existing federal law on the topic of public health authorizes HHS to make regulations preventing the spread of contagious diseases between states. The question was not what the overton window is, it was what the government could have done differently. Schengen countries closed their borders with each other and sometimes restricted internal movement. I am not sure how state at home orders are ok but a temporary restriction on interstate travel is beyond the pale.

And what, invoke the insurrection act?

Who is going to magically enforce shutting down interstate travel? The 82nd Airborne? That’s not nearly enough. Activate the entire military to stop traffic on the highways?

Even if it’s legally doable which I seriously doubt, it’s not feasible whatsoever.

This honestly confused me.

For example, Governor Murphy in New Jersey said that people arriving from hotspot states should quarantine themselves for two weeks upon arriving. However, it's not being enforced or checked, partly because Murphy claims we can't.

But New Jersey's borders are mostly water-based. You've got the Delaware River on one side, a bit of the Hudson on the other, and the only land-only border is with New York. It would be simple to set up checkpoints on all the bridges, just to let people know if they should quarantine. You wouldn't even need enforcement or restriction; just someone telling people "Hi, I see you coming here from Florida. Get tested and isolate yourself."

Would you catch everyone? No. Would people find ways to evade the checkpoints? Yes. But people would know they've been seen and whether they're really doing something they shouldn't.

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Shutting down the airports is in Federal power, and has happened in the last 20 years. It's something the White House could probably do by itself without Congress. Yes, people would still drive, but it would have slowed the infections coming out of NYC significantly.

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Another one I forgot:

6. At least supporting states and localities that wished to isolate confirmed cases in quarantine facilities. People criticize Cuomo for his decision on nursing homes but I wonder what the alternatives were. The federal government has the advantage of significant economies of scale and should have the ability to set up field hospitals and isolation facilities at very short notice using the resources of FEMA when states and localities become overwhelmed. The China evacuees were isolated at an Air Force base and the Navy lent a ship to New York City to be used as an emergency field hospital but it otherwise seems as those states have been left to figure things out for themselves.

Are you not from NYC? The national guard built massive field hospitals.

They were never used for the most part.

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I think Trump did one big thing right in NOT nationalizing the response. I don't think any other recent president would have resisted the temptation to declare a national state of emergency and start imposing one-size-fits-all edicts from Washington, which I think would have been a disaster.

Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak - Issued on: March 13, 2020

National Emergency Concerning the Southern Border of the United States - issued on Feb. 15, 2019

A list of these emergency powers being used is at wikipedia - List of national emergencies in the United States

Trump didn't institute nationwide lockdowns. He didn't institute nationwide mask use. He recognized that urban areas face different challenges than rural areas, and that the U.S. is a federated nation.

But he did issue a National Emergency to close the border, which is one of the few issues that fall well within the purview of the federal government.

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From an outside perspective, I recall the US media and politicians went nuts when he did gesture towards taking control from state governors. The usual "Dictator Trump! We R the Resistance!" rhetoric coming out. So it's not totally clear how much could've been done on that score anyway.

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1. Did not model wearing a mask as patriotic duty to reduce transmission from wearer to others.
2. Daily briefings that attracted attention to Federal response, away from what states should have been doing w/o Federal help
3. Politicized the state by state, locality by locality decision about what measures are best and when to reduce spread at lowest cost, as he is doing again wrt school reopening.

That said, his failing wrt the pandemic are far less bad than his policies on trade, immigration, climate change, tax, Israel/Iran, and health insurance.

"his failing wrt the pandemic are far less bad than his policies on trade, immigration, climate change, tax, Israel/Iran, and health insurance."

That only leaves awesome. I think his pandemic response was fine, just not awesome.

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I came to ask the same thing. Everyone has to do their little bow to the left and make sure everyone knows they still hate Trump. The whole world basically followed the same general script, within a range. The results seem unrelated to the response. People who hate Trump will find a way to blame him for whatever happens. For my part, I'm glad he's in office instead of some closet (or not so closet) authoritarian just looking for an excuse to apply federal power and implement their wish list.

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Trump downplayed the threat, even while the case count was rising. He dismissed expert advice. He politicized our response - it took over 100,000 dead to convince him to put on a damned mask - and we now have idiots in and out of power doing what they can to encourage the spread of the disease. He failed to coordinate the manufacturing and provision of protective gear. He was willing to invoke federal powers to force meat packers to work in dangerous conditions but failed to use federal powers to increase the local manufacturing of protective gear.

There's no way Trump could have stood up and stopped COVID anymore than Canute could stop the tides, but there were a lot of things that should have been done that were not. We know they should have been done because the places that did them have much less of a problem with the epidemic. It isn't all the genetic superiority of Dravidians.

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Addendum 2: way off the mark . 96 M cases and 48 M hospitalizations !
That's in 2 hospitalized. In reality , it's less than 1 in 20 if we consider the undetected.
Even in January from the Wuhan reports , you could see this disease was very similar to SARS.
children are spared, comorbidities predict a more severe outcome., people die mostly from an overactive immune response.
Basically if Covid-19 makes its way to the lower respiratory tract, it has a similar mortality as SARS but for most people it doesn't get there.
Covid-19 is more infectious because it can infect the upper respiratory tract but it usually doesn't proceed to the lungs from there.

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TC writes: "and the performance of the executive branch (and many governors) absymal"

What specifically should the federal gov have done differently? At the 130 days after first death, Obama had managed to deliver 1M tests. Trump was a 30M tests. PPE is moving as fast as humanly possible. People are wondering if vaccines are going too fast. Money is flowing like wine. Travel policies are widely viewed as being too restrictive.

What SPECIFICALLY could the exec branch have done better? More soothing words, OK, I'll grant that. But would that have changed?

If Obama had stayed for a 3rd term and have delivered what Trump delivered in terms of tests, PPE, border closure aggressiveness and big bets on virus, it'd be widely viewed as a massive home run.

And if in that bizaro universe Obama also closed the boarder with China in January, he would rightly be hailed as having done almost everything right.

Anyone see the latest on HCQ? TDS has turned lethal.

Could you share it here, please?

https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093/5847586

American Journal of Epidemiology

Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities......These medications need to be widely available and promoted immediately for physicians to prescribe.

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Treatment with Hydroxychloroquine Cut Death Rate Significantly in COVID-19 Patients, Henry Ford Health System Study Shows

https://www.henryford.com/news/2020/07/hydro-treatment-study

The link you posted notes that randomized controlled trials are necessary to validate whether hydroxychloroquine is an effective treatment. So far, the RCTs have not validated any such thing. Despite this lack of evidence, I imagine doctors are perfectly free to prescribe hydroxychloroquine, dexamethasone, remdesivir or any number of other anti-viral drugs available on the market according to their best reading of the available evidence.

The Henry Ford study is seriously flawed. The pts in the HCQ arm received dexamethasone at over twice the rate as those in the arm that did not receive HCQ.

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Lancet, New England Journal retract Covid-19 studies, including one that raised safety concerns about malaria drugs

https://www.statnews.com/2020/06/04/lancet-retracts-major-covid-19-paper-that-raised-safety-concerns-about-malaria-drugs/

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Let’s take a look at the period when hydroxychloroquine was banned in Switzerland, i.e. from May 27th till June 11th, 2020.......... Looking at the evolution curve of this index for Switzerland, we note a “wave of excess lethality” of two weeks from June 9th to 22nd, with a lag of a dozen days compared to the period of suspension of the use of hydroxychloroquine by WHO. This demonstrates, without possible rebuttal, the effect of stopping the delivery and use of this drug in Switzerland (country which follows the recommendations of the WHO, based in Geneva). During the weeks preceding the ban, the nrCFR index fluctuated between 3% and 5%. Some 13 days after the start of the prohibition, the nrCFR index increases considerably to be between 10 and 15% for 2 weeks. Some 12 days after the end of the prohibition, the lethality falls back to a lower level.

http://www.francesoir.fr/societe-sante/covid-19-hydroxychloroquine-works-irrefutable-proof

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Look at the graph in this link below. The French had been using hydro-whatever (HQ) for a long time to treat covid, and then the Lancet article came out claiming it was killing people. So they French stopped. But then deaths clearly rose 3-15X. Then the Lancet article was retracted, so the French resumed giving HQ. And then the deaths fell again.

Seldom do you see a graph so clearly showing something. But the US media couldn't have this.

The French data suggests that if NYC had administered HQ, the death rate there might have been 5-10K instead of 33K.

http://www.francesoir.fr/societe-sante/covid-19-hydroxychloroquine-works-irrefutable-proof

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And what about the universe where Trump closed the border with China? Rather than the one where he just imposed a racist restriction on Chinese nationals after the airlines had already cancelled all the flights? How about the world where he closed the border with Italy which seeded the New York outbreak?

Yes, that would have been better. But already Trump was an outlier on shutting travel from regions in China. Because every single dem argued that was unnecessary. Biden said closing travel from Europe was dumb. Biden wouldnt' have restricted ANY travel.

So, you are arguing Trump wasn't being Trumpian enough?

It wasn’t called dumb, it was called dumb and xenophobic.

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Specifically, he could have done the following:

--Avoided false comparisons to the flu.
--Avoided distracting blame games against the Chinese (regardless of their other faults).
--Avoided pushing Republican governors toward pollyanna reopening targets.
--Been clearer about the role his Administration would play. (Because logistics are largely state and local issues, he could have simply said that.)
--Not publicly doubted the reasonable, defensible responses of Democratic governors, especially given that state politics are not his territory.
--Noted that freedom includes not punching your fellow citizen in the nose with a virus and. so, supported mask use.

Not pushing for reopenings?

Did you read TFA about Sweden?

www.government.se/articles/2020/06/social-distancing-and-markedly-reduced-travel-in-sweden/
Swedes are largely following the government agencies’ advice and recommendations. This has been shown through surveys and data concerning movement patterns. Now travel within Sweden is permitted again – but if the guidelines are not followed, the Government is prepared to take measures.

More than eight in ten Swedes are keeping a greater distance from others than they normally would. Just as many are avoiding shaking hands and are washing their hands more often than usual. Over 60 per cent are taking part in social activities outside the home to a lesser extent and are avoiding public places where there are lots of people. This is clear from a survey on behaviour during the COVID-19 pandemic conducted by analysis company Kantar Sifo on behalf of the Swedish Civil Contingencies Agency. In other words, Swedes are largely following the advice and recommendations issued by the Public Health Agency of Sweden.
Travel decreased by over 40 per cent

The travel advice of the Public Health Agency of Sweden has also been heeded. When the Agency advised against non-essential domestic travel at the end of March, travel in the Stockholm region decreased by over 40 per cent.

Data on movement patterns from telecom company Telia’s mobile network shows that, in Sweden as a whole, travel decreased by more than 20 per cent. Since 13 May, when the advice was changed to permit travel corresponding to one to two hours by car from home, travel in the country has gradually increased again.

According to the Public Health Agency of Sweden, it is not travel per se that spreads the virus, it is personal hygiene and social contact. Now that fewer Swedes are receiving care in hospital and tracing and testing have got under way, as of 13 June it is permitted for people with no symptoms to travel freely within Sweden.

A number of restrictions remain in place. These include the ban on visits to homes for older people, the ban on gatherings of more than 50 people and the rules concerning crowding in restaurants, bars and cafés. Businesses that do not follow the regulations may be closed after an inspection; so far, this has happened on some ten occasions in Stockholm and Gothenburg. The tourism and hospitality industry is also covered by the guidelines on crowding. The situation remains serious and if the curve indicating the number of seriously ill people turns upwards again, new restrictions may be issued.

“Although some restrictions are lifted, this does not mean that life can return to normal. Important restrictions will remain. It is important to hang on, otherwise the spread of infection might take off. We all need to continue to take great personal responsibility,” Deputy Prime Minister Isabella Lövin says.

who you gonna believe. ⬆⬆⬆ or your lying eyes?

https://www.youtube.com/watch?v=PFxfs5X126M

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" PPE is moving as fast as humanly possible."

Really? I heard there are still lots of factories mothballed because they have no guarantees of buyers. How hard can it be to make surgical masks?

It's not the masks. It's the layers of material that are required. Each layer has a different property. Layer 1 blocks particles >100um, layer 2 block particles >10 but less than 100 um, etc.

The raw materials world wide are the problem.

Given that PPE is currently selling for about 5X its normal price, anyone that can make a mask that meets a specification will find a buyer. There is zero reason for ANY factory to be shut down for lack of buyers. If they are shut down, ti's because they can't get raw materials.

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American deaths/7 day rolling average
July 3 626/555, July 4 265/518, July 5 262/515, July 6 378/516, July 7 993/556, July 8 890/585, July 9 960/625

July 10 849/657, July 11 731/723, July 12 380/740, July 13 465/753, July 14 935/743, July 15 997/760

Another update from Trinh of death plot vs case plot, latest data; https://mobile.twitter.com/Trinhnomics/status/1283575629846212608

Deaths and cases both have a fairly clear inflection point upwards, with linear growth in new cases, but it's clear the rate of growth is very different post inflection point. Still rate of change is much lower for deaths.

They remain just as dead regardless of inflection points or rate of change.

sigh. prior approval everybody.

He's a troll and thus when he can't make a logical rebuttal he goes for a blatant appeal to emotion. But he's too autistic to do it right. He's seen other people do the same tactic and doesn't realize it worked for them, because they did it in moderation. He just assumes that if doing it once is effective, then doing it 10x is even more effective.

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I'm not sure the criticism of Osterhalm in the last paragraph is right, at least as far as total deaths go. if NY rates of cases / deaths are needed to get herd immunity... tell me wehre my maths is wrong.

NY population: 8.4m. Cases 400k, deaths 32k.
US population: 330m. Same case / death rate = 16m cases and 1.2m dead.

Is 1.2m dead an acceptable cost for herd immunity? idk, up to you guys, i'm not american.

I found the error in my maths (i had the wrong number for deaths in NYC cf state), but the point still stands that the predication wasn't too pessimistic on deaths. Updated maths.

US population: 330m. Same case / death rate = 8.8m cases and 890k dead.

See, it is just like a bad flu season. Why all the hype? It is all about the election.

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You weren't that far off. Most of the deaths were in NYC.

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Also, did Osterhalm's predictions assume masking, lockdowns, etc.? I thought they didn't really model those, which have obviously helped to a significant degree with spread.

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In Northern Italy we have not yet achieved flock immunity, even if it is 20%. In Bergamo, the epicenter, only 21.4% are infected. In nearby towns, where deaths have made + 1000%, they are 35-40%. But the samples they tested are most likely biased.

In the rest of Lombardy probably less than 10% are infected and in the other northern regions even less.

So on NY-style death rates, that's over 1.5m dead to get close to herd immunity.

What even is Tyler's initial post doing? I feel like he's projecting "get to NY-levels of (partial, localised) immunity, but with current US death rates, somehow".

I mean, sure, pull the bandaid off and all that but that's an awfully painful bandaid.

As opposed to what? New York had quite restrictive measures in place, and in spite of that had very high death rates and a curve that seems to indicate herd immunity.

Before saying Taiwan or South Korea, or Japan, there is a possibility they were dealing with either another variant of the virus, or a second wave of a similar one that was more lethal but into a population already immune.

There are very good indications that the deaths come from specific age groups; a not recent statistic said that over 80% of the deaths in Canada were in care homes.

So the only strategies that can work are
1. keep primary care facilities from being sources of infection. That has been done quite well, at high cost.
2. keep elder care homes safe. Done anywhere from catastrophically badly to very good, depending on the quality of the public health officialdom in specific jurisdictions.
3. Work on a vaccine. Being done. There is a distinct possibility that the vaccine will be ready just in time for the pandemic to fizzle out.
4. explore treatments. Being done constantly, and indications are quite well.

The idea that the economy and social life can be shut down for longer than 6-8 weeks has become obvious.

Some policies can help, quick responses to outbreaks, guidelines on how to do retail. In BC no cases were found spread by grocery retail operations. But right now the most vulnerable groups to infection are populations who haven't been exposed.

The idea that the economy and social life is shut down for 6-8 weeks should be enough to control the pandemic is fairly well established.

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New York State's restrictive measures hit on March 22 when it already had about 15,000 confirmed cases, meaning the actual number of infections (and even active infections) was probably closer to 100,000. South Korea, Australia, Malaysia, Thailand, Taiwan and Vietnam don't have 15,000 confirmed cases today.

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I think "let's go for herd immunity" is probably wrong, but it's important that we be able to rationally evaluate the prospect, instead of getting scared when someone asks it and wondering what the neighbors will think.

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what amazes me is that the northern Italy wave was never surpassed or equaled elsewhere. If the herd immunity theory was true you'd expect more severe epidemics in some other province, but to this day, 3 months later, Lombardy still heads the daily death tally.

old people are not valued in Lombardy.

very ignorant people cannot remember those hot summers a few years ago where the vacationing Northern Europeans left the old folks at home and did not return with so much as a gallon of cold water when the news hit that the old people were starting to die in their thousands, back in the cities, in the apartments where the air conditioning was overworked.

I remember.

it is worse in Africa and Asia and South America, of course, but it is pretty bad in Europe too ---- NOBODY TAKES CARE OF OLD PEOPLE WHEN DOING SO INFRINGES ON THEIR RIGHTS TO A VACATION EVERY YEAR.

If you disagree with me, tell me I am an awful person.

you see, I know something you do not know. I know that, out of the billions of us, not a single person can accurately describe why they were right or wrong about herd immunity. The ones who call others imbeciles are FOOLS, for the most part.

And, like I said, I remember the news reports about all those old people left to die in apartments with little air conditioning and nobody there to make sure they drank at least a gallon of cold water every day.

That is all it would have taken - just someone to remind them to drink that gallon of cold water. Just one person who cared. And in so many cases, that minimum level of one person caring simply was too difficult for the Frenchmen or the Italians to meet, even when the lives of their grandparents depended on it.

I hope you agree with me - and you should be ashamed of yourself if you want to insult me, but - all that being said, and left aside, I know, within a ten percent range, exactly how many gallons of salt water there are in all the seas on the surface of the earth (there is some intriguing scientific controversy about underground seas and oceans which neither I nor you are competent to judge, so to be clear, I am only talking about the seas on the surface of the earth, Jules) ---- and I know, within 10 percent or so, how many old people in Europe, left to die in hot apartments while the young people travelled to beautiful locations to ENJOY their summer vacation, would have lived if ONE SINGLE PERSON HAD BEEN THERE TO MAKE SURE they drank just one gallon of cold water every day.

And it was worse in Asia and Africa in similar years, but even fewer people care about that. I care, but trust me, not many other people do.

Why do I bother? I care, but almost nobody else does.

Seriously, you do not want to know what I know.
Scientists are mostly incompetent, literally 99 percent of them are completely unable to describe new phenomena, and most people who are considered humanitarians are decent people who KNOW THEY ARE NOWHERE NEAR AS GOOD AS THE MAGAZINES SAY THEY ARE, and

and

and

you all have no idea that you dodged a bullet
i could be wrong but i am probably right

it was just lucky coincidence that the young lady who walked out of the lab with billions of coronavirus critters on her hands and clothing, because she was late for a date, and thought she did not need to clean up with the full protocol --- (she had looked forward to that date for days, and did not want to be late)

it was just lucky coincidence she walked out with the samples that would kill old people with comorbidities at 100 times the rate of vice versa, rather than the samples that would have killed us all at the higher rate, regardless of age or comorbidities.

Think about it.

I am humble and know I could be wrong, but, seriously, I really do know an awful lot about things that go wrong. True, I know more about things going right - after all, I memorized Proverbs 8 before most of your parents were born ----- but to live in this world is to, whether one wants to or not, understand failure.

So, like I said, be thankful for the lucky coincidence I told you about.
And be nicer to old people than you think they deserve, err on the side of kindness.

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The Federalist is always satire.

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Tony Heller video, "Two Paths to Herd Immunity":
https://www.youtube.com/watch?v=v-YkFyH701Q

Heller's improved, extended version:
https://www.youtube.com/watch?v=uAHVxDBTb7k

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There is no evidence that Sweden has any level of "herd immunity" or that most Swedes have even been exposed to the virus. Swedes have been practicing social distancing voluntarily. Daily life in Sweden has not been that much different than daily life in Germany or Switzerland, where no one is talking about "herd immunity", but deaths are also down to negligible levels. Best guess for the decline of deaths would be

1. spread was slowed significantly in Sweden by social distancing measures and lack of economic activity

2. more importantly, the virus is just not much of a threat to people outside, as long as they avoid soccer stadiums or other very crowded semi enclosed spaces. See also the rapid decline in deaths in the north east USA compared to the air conditioned death traps in Florida, Texas, Arizona, etc.

I also think you cannot underestimate the importance of restricting travel. The Achilles heel of the US really has been the inability of individual states to stop people from coming in and out the way the EU countries were able to do.

This sounds right to me. The Australian state of Victoria had a nasty "second wave" so the military has sealed it off. If it gets worse Melbourne will be subdivided into plague zones just like in the video games.

In Vic our would be totalitarian leader Dan Andrews is using this to indulge his socialist control fantasies, that's all. There are many new infections, usually a couple of hundred a day, he has also greatly increased testing, so of course he will find more infections, this virus is far more common than people like to believe. The important thing is the number of ICU cases and deaths, both of those have barely moved. The few deaths we have had are of people in their 80's and 90's with other serious health problems. For this Diktator Dan has destroyed our businesses, ruined our economy and reduced our social trust in each other. When and how the state will recover is an open question, the only real practical and quick way would be a massive reduction in regulations and taxes, being a socialist who has already put the state into deep debt as well as a tool of the unions means that we will not improve in the foreseeable future. There is also no opposition party in Vic, we are essentially a one party state.

Yeah, we're going going to let you across the border until you get that virus at least close to eliminated. I recommend wearing a mask.

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Vik Grujic, is that you? Love your work, man, but you've got to do a better job of protecting your head. No matter what your coach may tell you, the brain is an important organ. It's definitely in the top 3. Well, let's say top 4 for you.

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Seeding from New York state to everywhere else... Ideally Cuomo and De Blasio really should have voluntarily sealed off the city and state for the greater good of the USA. Other badly hit state NE USA governors and mayors too. If they had the powers to. If they had no legal powers or capacity to, that's a pretty major flaw in US capacity to respond.

If Trump had the powers and capacity to do so but did not, that's a major flaw on him, likewise.

Supposedly, Trump wanted to seal of NYC early but Cuomo was opposed. I'm not sure if this is correct, though.

You are correct - about March 31st or so (is that 'early' ?) Trump proposed this, with the expected firestorm of criticism from Cuomo and others.

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It was already out before people were aware it was becoming a major problem in New York. The answer was to take action to reduce its reproduction rate everywhere.

Of course, that doesn't change the fact that you don't want people spreading it around. But the situation changes once you have the virus eliminated from regions that you want to keep virus free rather than a situation where you are trying to seriously reduce the reproduction rate of the virus everywhere.

'Governor Brian Kemp is overruling local governments that have issued mandatory mask laws in a new executive order issued Wednesday.

The 41-page order is mostly a revised extension of guidelines the governor had put in place since the start of the coronavirus pandemic with the addition of the new language regarding mask mandates.

The executive order reads in part:
“State, county, or municipal law, order, ordinance, rule, or regulation that requires persons to wear face coverings, masks, face shields, or any other Personal Protective Equipment while in places of public accommodation or on public property are suspended to the extent that they are more restrictive than this Executive Order.” www.fox5atlanta.com/news/local-mask-mandates-suspended-by-gov-kemps-executive-order

Amazingly, Kemp's order means it is illegal to enforce mask wearing at Hartsfield-Jackson Atlanta International Airport, which handled 110,531,300 passengers in 2019, making it the world's busiest airport.

The U.S. is so, so screwed up.

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"Ideally Cuomo and De Blasio really should have voluntarily sealed off the city and state for the greater good of the USA. Other badly hit state NE USA governors and mayors too. If they had the powers to. If they had no legal powers or capacity to, that's a pretty major flaw in US capacity to respond."

Such a restriction would have made sense but also would have almost certainly required the cooperation of the federal government. States making up their own policies is a recipe for confusion and chaos. New York City, for instance, sits on the border with New Jersey and has two airports within the city limits. Can the city and state close down those airports on their own? Can they stop people just passing through? How will essential workers who live in New Jersey and commute every day be accommodated? These are things that need to be answered and coordinated across a variety of agencies including FAA, Customs and Immigration, state and local health and police departments, and the Port Authority of New York and New Jersey. The feds need to lead an effort like this but, of course, they would need cooperation and engagement from Cuomo and DeBlasio.

I guess that makes sense. Multi-state pacts were insufficient on that?

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How is "sealed off" different from the mandatory 14 day quarantine states are imposing now? I get that enforcement will never be 100% but states are doing it now, so why couldn't they have done it earlier?

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Seems reasonable. Note countries that clearly are doing nothing but a bit of social distancing are lowering the R0 and flattening the curve. Even Egypt (hot weather helps), even Brazil, even Mexico, Russia, Peru & Chile (what's up with their big numbers?!). But strangely, not India, which is exponential still. And look at the second waves in Israel and Iran. If there was "herd immunity" that's 'hidden' as claimed by CatInTheHat, why the sudden second wave in Israel and Iran? It would not have happened so easily. A more plausible scenario is that there's never herd immunity, but if you let your guard down, one case quickly snowballs into a thousand cases. South Korea and China (with imported cases) have proved that. That's why C-19 will take forever to cure, maybe until they ever find a vaccine (and the word on the street, just talking to random Greeks here, is that nobody wants to take the vaccine, that will be a future challenge).

Well, it doesn't look like
a second wave in Israel https://twitter.com/MLevitt_NP2013/status/1282905128887095298

Depends exactly what you mean by second wave, but it's definitely worse than it was before unless these figures are really screwy:

https://www.worldometers.info/coronavirus/country/israel/

Instead of following the successful Swedish model, the Israelis are likely to lockdown instead, even though we all know that lockdowns only cause economic damage without in any way stopping the spread of the virus. "Israel faces the prospect of a fresh lockdown as a new daily record of confirmed coronavirus cases was reached.

The country’s health ministry on Thursday reported 1,898 new cases of the virus, as it registered more than 44,500 total cases."

Whose strawman are you slaying now?

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Once again. The “Swedish model” resulted in just as much economic damage as the “lockdown” with worse mortality. The “Swedish model” also relies on a level of voluntary social cooperation and ethnic homogeneity that would be impossible to replicate in the US. Why do we keep talking about Sweden? Why aren’t we talking about Germany?

'Why aren’t we talking about Germany?' Because the U.S. prefers comparing itself to the worst these days (we are better than Brazil!), not the fairly average, much less the best.

Germany isn’t even close to the best with around 9-10,000 dead.

Taiwan 7
South Korea 291
Japan 985

Germany was clearly an example of the fairly average. Why on Earth would anyone think it is among the best?

+1, nobody should be holding Germany up as an example of excellence here.

True, and yet Germany is still better than Sweden in every respect, including opening the economy. Why the weird insistence in libertarian circles that there is some Swedish model we can learn from?

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"Long-term damage (rather than death) still may be a significant risk."

Something bad might happen sometime in the future, therefore it's better to self-inflict a definite (or higher probability) immediate harm? Is that the theory? Insurance is a good thing, prudence is a virtue likewise, but this theory is unworthy of a Harvard graduate.

I'll take the pubs open and hardly anyone got the Coronavirus for $50 thanks, Alex.

Some places can certainly keep the disease spread at a minimal level, but this remains a holding action.

One familiar from how we contain many animal diseases, but it is still a holding action. You can see this in how hoof and mouth disease flares up.

" Foot and mouth disease (FMD) is a transboundary animal disease (TAD) that severely affect the production of livestock and disrupting regional and international trade in animals and animal products.
The disease is estimated to circulate in 77% of the global livestock population, in Africa, the Middle East and Asia, as well as in a limited area of South America. Countries that are currently free of FMD remain under constant threat of an incursion.
75 % of the costs attributed to FMD prevention and control are incurred by low income and lower-middle income countries. Africa and Eurasia are the regions which incur the largest costs, accounting for 50% and 33% of the total costs respectively.
The morbidity rate may approach 100% in susceptible cattle populations.
A global strategy for the control of FMD was endorsed in 2012." www.oie.int/en/animal-health-in-the-world/animal-diseases/foot-and-mouth-disease/

This is what happened in the UK in 2001 - "The outbreak of foot-and-mouth disease in the United Kingdom in 2001 caused a crisis in British agriculture and tourism. This epizootic saw 2,000 cases of the disease in farms across most of the British countryside. Over 6 million cows and sheep were killed in an eventually successful attempt to halt the disease.[1] Cumbria was the worst affected area of the country, with 893 cases.

With the intention of controlling the spread of the disease, public rights of way across land were closed by order. This damaged the popularity of the Lake District as a tourist destination and led to the cancellation of that year's Cheltenham Festival, as well as the British Rally Championship for the 2001 season, as well as delaying that year's general election by a month. By the time that the disease was halted in October 2001, the crisis was estimated to have cost the United Kingdom £8bn.

Measures to control a disease can be very expensive.

Yeah, but I'm seeing some places paying more and getting less.

And we've never had foot and mouth disease in Australia. Our long term vigilance against it and other agricultural diseases could be why Australia and New Zealand have done so well with the Coronavirus compared to the disastrous responses in so many other countries.

Which was sort of the point - areas enjoying natural isolation are able to control a disease by keeping it away. Other places will simply have to bear the costs of keeping corona in check.

Then there is the U.S., which is clearly in a class by itself by this point.

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Australia and New Zealand have done OK in terms of the Asia-Pacific region. If you look at deaths per capita, Thailand and Malaysia have done slightly better and Singapore and South Korea have done slightly worse.

In terms of cases per capita, Australia looks worse than these four countries except for Singapore. The death numbers might start to unfortunately increase soon due to the renewed outbreak.

Australia was looking good because -- until recently -- the majority of cases were contracted offshore so we could claim they weren't our bloody fault. But now a majority of infections have been acquired onshore, so things are looking less bloody rosey.

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Of course, what people should be wary of is The Last Wave:

https://www.imdb.com/title/tt0076299/

On account of how it's slightly boring.

But it does have a young Richard Chamberlain and David Gulpilil.

Boring

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“To be clear, I was pro-lockdown (without regrets), pro-mask, pro-testing”

I wonder if this means Tyler is no longer pro-lockdown, pro-mask, pro-testing or some combination?

I worry that there has been no pushback against the silly cost benefit some economists used to justify the original lockdown because I worry about activist governors or even Trump caving to liberal pressure to impose more economic restrictions this far into the recovery. I’d love to see realistic cost benefit of any further attempts to re-lockdown.

The counterfactual to the April lockdown would likely have been changes in behavior with a similar economic decline to what actually happened. Although I’d like to think we could have isolated NY and avoided or delayed lockdowns elsewhere: thus lessening the depth of the recession and size of the federal response. But I see no universe where the US locked down as hard as Italy or Wuhan or where the US government provided a response that actually addressed the whole virus problem.

Sure masks—but testing would have to scale impossibly to help now. It seems the least bad of our response options is 1) at-risk individuals taking reasonable precautions and 2) saving the economy for the survivors.

I used to do drugs. I still do, but I also used to.

--Mitch Hedberg

"My friend asked me if I wanted a frozen banana. I said no, but I want a regular banana later, so yes."

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News:

"It’s worth noting that the gap between Sweden and its neighboring countries has grown significantly since May 15, to between 10 and 20 times as many deaths per 100,000 population compared to Denmark, Finland and Norway."

Gupta:

"No value judgements on what’s the better policy decision here, just trying to make a predictive statement."

An odd pairing, IMO, and exactly the time to make value judgements.

As bizarre as it may seem to you, falsifiable hypotheses and predictions are orthogonal to value judgements. As is objective reality.

He’s either correct or incorrect.

https://en.m.wikipedia.org/wiki/Nihilism

Okay Boomer.

You woke up at 4am to spam 'Science is Violence' and objective reality is nihilism.

Carry on

Here's what you could do, rather than getting mad at little old me:

Argue for the policies which you believe will produce the least suffering for your state, country, or the world as a whole.

Public Choice has already won so far, hands down.

Good God.

You don't trust that argument?

I hope you are a parody account.

What is "public choice," our God who wins when we die?

The owner of the simulation?

Either way, that 8:41am comment values it more than us.

You're obviously being trolled by your fellow Boomer, prior_approval. For some reason the fact that Public Choice is predictive triggers him.

Argue for the policies which you believe will produce the least suffering for your state, country, or the world as a whole.

There's a joke about negative utilitarianism here but I'll avoid it. Actual policy is constrained by the public. That's my entire point. But sure:

I'll advocate for the norm of stating falsifiable hypotheses in discourse and the use of prediction markets. I'd even advocate for a fully funded prediction market at the Federal level as part of the CBO requirements.

How does that rubber meet the road?

It sounds like you are saying we should insert a market, and time for it to settle, before unspecified action?

Maybe not really wrong, but not really useful or actionable.

What?

I said using prediction markets will lead to less suffering in the world and in the US. I'm not optimistic, but there's a sliver of hope it would help push incentives in the right direction or at least slow the push in even worse directions.

What are you looking for, a moonshot 'Rona policy that is effective in a low trust society?

I don't think it is very actionable to suggest a completely new and different mode for government agencies, no.

*Within* our system though, I would say we could empower experts and do what they say.

See also:

https://en.m.wikipedia.org/wiki/The_Death_of_Expertise

https://en.m.wikipedia.org/wiki/The_Fifth_Risk

The CDC released its guidelines.

Now we all get to see what that policy looks like in reality when “the rubber meets the road” as you say.

If this is what you believe you can formulate a falsifiable hypothesis that states which more closely follow the CDC guidelines will have fewer excess deaths per capita.

Is that your position?

This is where it's hard for me to take you seriously.

We have an American Administration which is working actively against expertise in many areas but especially in pandemic response.

You can't say "that's bad" right here, right now?

You want to play games, yes games, about falsifiable theories about the future instead?

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You've made this point to anonymous at least half a dozen times. He's never responded in a manner that would indicate he understands the concept in the slightest. I think you've made some good points, but they are wasted on anonymous. He's not going to learn anything that he doesn't want to learn.

The tragedy is that you still hold hopes for Trump-friendly American conservatism, and you don't recognize that Skeptical's Nihilism throws it all under the bus.

He isn't saying "it's all good," he's saying your guy, your administration stink to hell, but expect no better.

I'm saying a few things. But before that Jwatts doesn't own the administration, so that's just blatantly ridiculous. And objectivity is not nihilism, that's also blatantly ridiculous. Objectivity is objectivity. Running away from reality is closer to nihilism than anything else.

1) if you shrink away from falsifiable hypotheses, that's a good indicator you don't believe your own narrative (you don't seem to believe states following CDC guidance has any measurable effect on outcomes? )

2) Who the president is does not affect outcomes in any large sense. Instead, outcomes affect who the president is. We're about to see that in November.

3) Issued policy is words on paper or spoken through a microphone. Policy in practice is the combination of issued policy and your 'rubber meets the road' phrase

4) Low trust societies typically fail on policy in practice for two reasons:
4a) institutional capacity is low and process focused instead of outcome driven (CDC, FDA, TSA, insert agency here)
4b) passive resistance to unpopular policies make them untenable in the medium to long run. either they're ignored or the governor eventually removes them due to unpopularity

"I'm saying a few things. But before that Jwatts doesn't own the administration, so that's just blatantly ridiculous."

Maybe I'll read further than this later on, but here's what I remember:

I've been pointing out flaws in this administration potential (before 2017) and real (after 2017), and you two have been the "TDS" tag team.

lol, that you can't own that now.

You said the POTUS was a Russian intelligence asset simultaneously recruited by Moscow in the 1980s and under KGB sexual blackmail. That was your operative theory for 5 years. That's pretty deranged, whatever the choice of phrase. I still think it's deranged. Let's leave that aside since it's not germane to the discussion.

I say "This president is bad and another could do better."

You say "I don't want to talk about that, so let's make 'falsifiable hypotheses' about this president or his administration."

No, I said I don't believe the president has a large effect on outcomes. I have offered several falsifiable hypotheses on this crisis, all have either been proven correct or are looking correct pending more data.

Part of your issue is inserting your tribal values into a question that has no tribal valence. You're making a value statement "I don't like this president because X" I'm saying "I don't believe the president has a large effect on outcomes. Here's my model, here are my priors, let's test it"

Honestly the fact that when asked for an operative theory of how the president affects outcomes you basically admitted you don't believe he does. As I recall your theory involved the Heisenberg uncertainty principle and alternate timelines. No dice, dude.

You can do that until you are blue in the face, and you haven't answered, or contested, my claim. ALL you've done is move the argument to a terrain where you feel more comfortable.

I'm not contesting your real claim, since I certainly believe you don't like the President! But after all of this digital ink spilled for nothing, you refuse to either offer an operative theory or a falsifiable hypothesis. At this point it's basically untenable that you believe your own internal narrative.

The Fisher King theory of reality is not going to cut it

"You said the POTUS was a Russian intelligence asset simultaneously recruited by Moscow in the 1980s and under KGB sexual blackmail. "

The first sentence is a lie, so forget the rest.

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On 1-4, here's the problem: You are doing question substitution. I won't bother to look up the official name of the fallacy, but in a nutshell:

I say "This president is bad and another could do better."

You say "I don't want to talk about that, so let's make 'falsifiable hypotheses' about this president or his administration."

You can do that until you are blue in the face, and you haven't answered, or contested, my claim. ALL you've done is move the argument to a terrain where you feel more comfortable.

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Worse than that, and for redundancy, by moving the ball to your new questions to be solved in the future, you are ignoring life and death decisions in the here and now.

Your moral framing is tiresome and ridiculous. It's a sign of a weak mind, that your reaction to someone proffering a falsifiable hypothesis is to ascribe moral culpability of the pandemic.

All of this nonsense just to avoid the question:

If this is what you believe you can formulate a falsifiable hypothesis that states which more closely follow the CDC guidelines will have fewer excess deaths per capita.

Is that your position?

Has anyone ever suggested the possibility to you that you might, in fact, be a psychopath?

Fits the available data.

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He's saying "sure Trump is bad, but with 'a low trust society' no one could do better."

Sick epitaph.

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Your insistence that this is the time to make value judgments appears premised on the (naive, in my view) assumption that the relative numbers of deaths from Covid in these countries is now finally determined. Denmark, Norway and Finland now have fully susceptible populations and it was always foolish to presume full containment was achievable. They will be going back to work and sending their children to school in the fall. If they somehow manage to avoid new pandemic deaths and continue to function *then* might be a good time to make value judgments. Even then, when the decisions were made, the assumptions on which Sweden based its policy (that the virus was uncontainable, and community spread inevitable) were far from absurd.

Isn't exactly the opposite?

Swedish plan looks very bad right now, but many people say we can't criticize it because they might look good in the end.

That is actually the argument from missing data.

The argument we simply don't know what the pandemic will look like after one or five years. The data is not missing, it is non-existent.

Come on. "We don't know if someone else will throw a rope to the drowning man, so let's wait and see?"

We have a very clear moral problem before us (pandemic suffering and death), and clear actions to take (social distancing, wear a mask).

We just have a preposterous number of people who don't want to do those things until (they say, hand waving, excuses) they know how it all turns out.

They won't throw the rope.

Saying we know how the pandemic will look in a year is exactly the same as saying we know who will win the Superbowl in 2021. In other words, we don't know. And we cannot know, not because the data is missing, but because it does not exist.

You seem lost in the same stupid partisan arguments as every single other American here. The Swedish model was an attempt to deal with the virus, not an argument about wearing masks or social distancing. It was always seen as a longer term model.

Personally, I think it is a failure as of now, but am more than willing to judge it using the perspective that guided it, which is the several years into the future.

Again, no.

The Swedish plan is demonstrably worse, with data available today.

No future data needed.

The Swedish model has not been demonstrably worse and can't be judged until next summer.

It has been demonstrably worse to date compared to the other Nordic countries. Judging is for the future, but there is absolutely nothing to recommend the Swedish model as of tight now. It was a strategy, and it has not succeeded on its own terms - the number of deaths was far too high in the eyes of the Swedes, and the number of infected people is considerably lower than the projections from March.

We will see, and it may yet turn out that Sweden does no worse than its neighbors over the longer term. The Swedes bought their ticket, so to speak, as noted in the Bloomberg article from below - "Olsen, an early critic of Sweden’s Covid-19 strategy, fears that regardless of immunity levels, it will take a long time for the pandemic to run its course in the country. Though a lockdown would have been the right thing to do when the virus broke out, he says it’s too late now to impose one.

“That train left the station in March, and we dropped the ticket on the platform,” Olsen said. “If we had done it then we would have come out of this very differently.”

I understand why people would compare Sweden with Finland and Norway but the initial conditions weren't the same as Finland managed to almost completely prevent coronavirus from entering in the first place and Norway may have as well. A Norwegian study also concluded that had Norway not locked down under international pressure, the outcome would have been the same through voluntary social distancing as Sweden did. Nobody is mentioning this for some reason.

Most people compare Denmark and Sweden. Finland is not Scandic, and Norway is fairly isolated.

The Norwegians are likely grateful that they did not have Sweden's death rate from Swedish style voluntary social distancing. Which might have been a problem with Sweden that the Norwegians could have avoided by doing a better job than Sweden. However, it seems as if the Norwegians already believe that.

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"can't be judged until next summer"

LOL, there it is, the direct appeal to missing data.

The future is always unknown. It is not missing data, it is non-existent data.

Or do you think saying we will need to wait until July is over to determine July's average temperature is another example of a direct appeal to missing data?

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The data is future data, but the consequences of an active economy of interacting people vs lockdown are known and certain. I still can't understand the critics of re-openings who claim that in certain circumstances it is "too soon." Absent an effective vaccine and vanquished virus (or herd immunity from infection), isn't it always "too soon"?

How can anyone possibly look at Florida and think this is an open question?

Unless, as I say, they think the future/missing data will ride in to save them.

But that's the real tragedy. If they are wrong about that future/missing data, they have lost the opportunity for action.

Or is that the agenda?

That depends on whether you believe that what is holding back outbreaks in places like France, or the Netherlands, or NJ, are the re-opening rules, and not fewer susceptible people. What's your basis for that conclusion? Florida is having a problem because they had almost no prior infections.

No, I do not need missing data on what is happening in "places like France, or the Netherlands, or NJ"

What you need is to establish the cause of low case numbers in those places. I'm not sure it's strict re-opening guidelines because I have no evidence that that is the cause.

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I cannot understand why you seem unaware that much of Europe reopened by the beginning of June.

Obviously, in a large number of countries (basically all of Western Europe), it is not "too soon." There are restrictions on large public gatherings (particularly indoors) and mask wearing inside buildings is often mandated, but no one thinks that their country reopened too soon. Something reflected in the actual infection numbers, which people do pay attention to.

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As of mid-June, using antibody testing, around 92% of Sweden's population are as fully susceptible as Finns, Danes, and Norwegians.

You are correct to point out that the Finns (end of April), Danes (mid-April), and Norwegians (end of April) have already sent their children back to school, and will also do so next school year.

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Down here in the South folks don't take the coronavirus very seriously (the flu), and they will latch on to any optimistic projections. It's striking the difference in tone between Cowen and Tabarrok on this subject. Both have done great work, Cowen with Fast Grants and Tabarrok in promoting a more robust government and industry response. But Cowen has repeatedly linked the most optimistic projections, and accounts (such as in Sweden) that defy observation and scrutiny. It's true that, like this blog post, he qualifies everything by pointing out the uncertainties, but folks don't read the qualifications. What we are learning is that small actions can have enormous differences in outcomes, actions (wearing a mask, social distancing, etc.) that are discouraged by the most optimistic projections and accounts, even if qualified. As for an action that will defeat the coronavirus, the development of a vaccine, it's already a flash point, the focus shifting to the profits the drug companies may realize for a vaccine that doesn't yet exist! This is discouraging what should be an all-out government effort, including massive amounts of funding. It's 1943 and we are already declaring victory!

Perspective: in Atlanta, there have been nearly 400 Part One offensives every week this year. These offenses include murder, rape, assault, Robbery. There are 417 people hospitalized with COVID in the whole state of Georgia today and there have been 2700 COVID related ICU admissions in the whole state since March.

Do the police take the criminal complaints in a tent in the parking lot, and then send the victims back home to self-adjudicate?

Oh wait, for rape, maybe they do.

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It's 1943, and we are denying that the Germans are much of a threat; we are picking fights with the British; we are giving billions to arms manufacturers without strings attached or clear orders; we are telling the individual Army Divisions to do whatever they hell they want; and we are issuing press releases listing the previous failures of our generals.

+1

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Really to summarize this page: if letting people die works just as well as saving them, you need new definition of "works."

2.6 million people die every year in the US. Covid has yet to reach the numbers of people who die from heart disease every year.

No one is 'letting people die'. Don't be an idiot.

Not even the people who demand their "no mask" freedom in stricken areas?

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Well, sixty million people on earth die every year. But that's not the point. Are you actually too dumb to understand that?

It's funny that generally the same people who demand protection from any and all forms of violent death at the hands of immigrants, Islamic fundamentalists, and minorities, cannot grasp the concept of excess preventable deaths.

Remember 9/11? How many people died from those attacks? Or were you too young to notice?

Let's hope Derek is not trapped in this endgame:

https://twitter.com/BettyBuckley/status/1283517522264948739?s=19

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Fortunately, Trump has commandeered the infection reporting system and is going to replace it on the fly, without consulting experts or stakeholders, with a secret group that will surely be composed of his Best People (or his son in law and some hedge fund ghouls).

So, information quality is sure to improve going forward.

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Because of the scale free nature of the numbers (the population size of settlements follows a power law), it might even be useful to extend this kind of calculation globally. I don't quite follow the calculation in the email, but if Sweden has reached herd immunity then we could use its confirmed cases percentage, which is 0.76% of the population (76,000 out of ten million).

Just less than 0.76% of the world population is 60 million, and we have 14 million confirmed cases. If the global testing rate is the same as Sweden's, we're only a quarter of the way through this thing, but I guess the testing rate globally is much less than Sweden's. We might be nearly there.

The fact that the question raised in the opening of this email is not being discussed at all in the popular media is worrying.

The Swedes themselves don't think they are near herd immunity.

https://www.bloomberg.com/news/articles/2020-07-15/sweden-says-latest-covid-immunity-not-enough-to-protect-citizens

What a ridiculous article. It says "Sweden remains a long way off achieving so-called herd immunity, according to the latest data" and then just reports a seroprevalence number as though that proved that herd immunity hasn't been reached. We've known for weeks that's not the full story! And, where are "The Swedes" you're referring to in that article who say that they are not near herd immunity?

Weird that you call it ridiculous when it quotes health experts in Sweden on their opinion, and certainly not me on mine.

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More accurate to say some Swedes in Sweden do not think they are near herd immunity. I think it only matters if it's true or not, not whether they think it's true.

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I know why, but why use the word "fear" in the headline? Why not expect?

Because fear sells better than expect. But why should the great majority of us fear a second wave when the first wave itself (save for the policies enacted) didn't harm us?

I'll note that the only time fear appears in the comment section is this comment, so a second wave doesn't seem like something readers of the blog "fear."

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Wisdom, thank you, very appreciated:
***“Origins usually go back longer and earlier than what you first might think!”***
-Cowen
"If I have seen further it is by standing on the shoulders of Giants."
-Newton

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not that it necessarily matters but christopher balding was reasoning a fair amount of what’s in this post from china evidence and first principles in march.

finding it convincing, i offered everyone i knew an even money bet that american deaths by january 1st, 2021 would be sub-400k. at the time, this was a shockingly low number considering imperial college was touting deaths in the millions. fwiw, only one person took the other side. too bad for me.

oh yeah, imperial college... remember those guys? the news cycle has cleansed us of any memory of how we got here. i remember very vividly being furious that none of the architects and proponents who drove is into the iraq war were held accountable once everyone realized it was a monstrous mistake. being young(er) at the time, it was more difficult to appreciate that in order to hold the powers that be accountable you also need to reckon with your own complicity.

this whole affair makes me very sad and disappointed.

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what many fail to notice is that the transmission data don't make much sense either

i am not really going to present a detailed argument in the comments when i'm 150 or whatever, and also no one cares, but the simplest explanation is that corona is spreading via droplets and feces. the latter could have a *much* higher r0 in some settings, which would explain many anomalies, like the staggering attack rates in nursing homes, the recent outbreak on that Venezualan ship, and scattered other oddities such as this from February: https://www.cnn.com/2020/02/12/asia/hong-kong-coronavirus-pipes-intl-hnk/index.html :

"The two initial cases set off alarm bells among health officials that the virus could have been transmitted through pipes in the building. In densely populated Hong Kong this could lead to hundreds of people becoming infected in the supposed safety of their own homes.
In Hong Mei House, the two initial patients with coronavirus lived 10 floors apart, but were on the same vertical block of apartments -- number seven. Health authorities evacuated residents living in apartments numbered seven on all 30 floors of the building because their toilet discharge pipes were linked."

some people forget, but not me.

aerosols produced by the mouth are not likely a significant source of transmission. if they were, rallies, specifically trump's rally in tulsa, would have caused measurably larger outbreaks. here is a recent paper from JAMA in which the authors mention that, you know, the transmission data actually don't add up given what we know about droplet and aerosol transmission:

https://jamanetwork.com/journals/jama/fullarticle/2768396

"Notwithstanding the experimental data suggesting the possibility of aerosol-based transmission, the data on infection rates and transmissions in populations during normal daily life are difficult to reconcile with long-range aerosol-based transmission."

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SNL skit ... Covid prevention
kissing family
https://www.youtube.com/watch?v=uEbzD1bBlTQ
need air

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This is the kind of overly cute analysis that you need to take with a whole shaker of salt.

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It's not a completely implausible claim, but most places that have seen a major outbreak are also the kind that hasn't gone back anywhere near to business as usual. We are just not well aware of what specific behaviors pre-covid have changed and are slowing down R0. How much can be attributed to masks? A high percentage of the population dealing with fewer people in person? Just taking any and all respiratory symptoms very seriously, instead of going to work anyway?

We aren't sure, and it's going to take a while to have any certainty.

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Osterholm will likely be off by a factor of 2 when it comes to 7 month deaths totals. Not too bad considering the difficulties inherent in making forecasts that involve unpredictable humans behavior, technology change (redemsivir, dexamethasone), and and clinical expertise.

Osterholm's weekly podcast is a breath of fresh air. He is very informative, humble and goes out of his way to avoid partisan bickering.

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"There are three kinds of lies: lies, damned lies, and statistics."

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The Swedish model may lead to more deaths or it may end up the same, who knows. But so what? Safety does not always trump freedom, and lockdown sucks.
Most of the population are not likely to die of this virus and don’t want to be locked down.
If 0.1 - 0.2% of the population (mostly old) have to die to achieve herd immunity and return life to normal, then we should just go for it.

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Doesn't the surge in Louisiana, which got hit almost as hard as New York or Sweden, throw cold water on this idea? Or are the cases mostly coming from counties in Louisiana that were spared the first wave?

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