I've been critical of the official policies to address the pandemic, but I haven't offered an alternative. That's in part because I'm not an expert, and even the experts disagree. But here's my general impression:
These seem to be the basic strategies. And in some respects these present conflicting strategies:
i) Mass isolation. Impose curfews/lockdowns to bend the growth curve/transmission rate. Social distancing is key.
ii) Mass testing. Test the population to find out who's infected. Quarantine the infected. Treat the infected with promising preexisting drugs while developing new antivirals. Let the uninfected continue business as usual (more or less).
iii) Let the virus naturally spread to cultivate herd immunity in the population. While the virus is highly contagious, it isn't life-threatening to humans in general. High-risk groups are vulnerable, and the virus will kill some healthy individuals in the prime of life, but most folks develop mild symptoms and have the natural ability to recover.
I may have oversimplified the options. There may be no silver bullet.
For what it's worth, if anything, I think that does sound roughly correct:
ReplyDelete1. I think experts talk about (i) and (ii) the most, but they've only entertained (iii) here and there.
2. The idea behind (i) is that it's an extreme mitigation strategy, whereas the idea behind (ii) is that it's a containment strategy.
a. Containment. So for example when the coronavirus wasn't widespread (e.g. when it was only in one or two "hot zones" like Seattle and San Francisco), then they focused on a containment strategy. That meant testing as many people as possible in the hot zone or local area, tracing all their contacts that they encountered during the time they were infected, isolating both the infected and their contacts, then treating all of them. In short, test, trace, and treat.
Personally I think this was and likely still is possible in most of the US. I don't understand why most places have moved away from this option.
b. Mitigation. However, if the coronavirus becomes too widespread, like an entire region is involved, then it's much harder to contain its spread. There are too many people to test, trace, and treat. Hence experts argued for a mitigation strategy. That means curtailing or slowing the spread of the virus. So that it can be manageable. And once it becomes manageable, then we can move to a containment strategy again.
In my opinion, I think some aspects of mitigation may be reasonable, but I think the problem is we've gone way overboard with it. I think if we want to employ this strategy, then we should tailor it, and let it be voluntary, and so on. Basically be reasonable about it. Not have the govt enforce mass lockdowns, etc.
3. As far as (iii) goes, I think the UK entertained it. Basically, just let the coronavirus burn thru the population, and when enough people get it, and herd immunity develops, then it'll protect the rest of the population. However experts don't like this idea because it sounds inhumane not to try to fight the coronavirus.
At first I admittedly reacted against this idea, but to be honest I don't know that it's such a bad idea, per se. At least, I'm not sure. Maybe it is, maybe not. In reality it basically already is burning through certain populations anyway, despite what physicians do, and so we might be "wasting" a lot of limited personnel and resources trying to control an out of control fire. It sounds harsh because it means we are kind of triaging whole groups of people. I guess it's like giving up an entire city to an invading army in order so that we can keep other cities safe. I'm of two minds about this.
4. I guess these aren't necessarily mutually exclusive. We could do two or maybe even all three at the same time. The US is a big country. Roughly as big as the whole of Europe.
5. To be fair, I've been paying way more attention to the medical scientific side of things more than I have the epidemiological side of things or the public health side of things. So maybe I'm not as well informed about all this.
I've seen several people point to an Oxford study that suggests that the "herd immunity" approach they took in England for a while may have benefitted the country.
ReplyDeletehttps://www.dropbox.com/s/oxmu2rwsnhi9j9c/Draft-COVID-19-Model%20(13).pdf?dl=0
https://www.ft.com/content/5ff6469a-6dd8-11ea-89df-41bea055720b
https://nymag.com/intelligencer/2020/03/oxford-study-coronavirus-may-have-infected-half-of-u-k.html
From the Financial Times article: To provide the necessary evidence, the Oxford group is working with colleagues at the Universities of Cambridge and Kent to start antibody testing on the general population as soon as possible, using specialised “neutralisation assays which provide reliable readout of protective immunity,” Prof Gupta said. They hope to start testing later this week and obtain preliminary results within a few days.
On the other hand, there is a link (behind a paywall) to a "Letter in response to this article" with the header "The Oxford Study Figure has no empirical justification".
I guess we will find out, one way or the other.
Speaking of research:
Delete1. Just in case anyone is interested, most if not all the top medical scientific research institutes and academic journals have made all their publications on the coronavirus available for free to the public. This includes NEJM, JAMA, BMJ, Lancet, UpToDate, and many, many, many more.
In fact, it's something of a marvel to see such scientific collaboration around the world. Too bad it took a worldwide pandemic to accomplish this free sharing of information! Personally, I hope it lasts beyond the pandemic, but maybe I'm too idealistic.
2. I think a solid repository is PubMed's LitCOVID. Anyone and everyone working in medical science knows it. It's a huge a database linked directly with the NIH. Go there for bleeding edge research on the coronavirus.
Hawk, this is good to know!
DeleteWhen this first broke out there was a lot of hysteria out there (not necessarily on this blog). I watched how the media gave the impression that if we do not come up with a vaccine soon then civilization will end. And those who suggested that natural herd immunity may be the immediate viable solution were shutdown and labeled "anti-vax!" (i.e. Peter Hotez). It is appearing now that those who suggested NHI as a viable solution is being recognized with warmer acceptance as a viable option before a vaccine is brought to the market. Further, there should be questions on the nature and safety-testing to ensure a safe vaccine without being shut down and labeled "anti-vax." The medical establishment and conventional wisdom is not always correct. And questioning the establishment ensures check and balances.
ReplyDeleteWell, when experts like Peter Hotez argue for herd immunity they aren't excluding vaccines and other therapies. They've always said these work in tandem.
DeleteBy contrast, anti-vaxxers generally argue against vaccines (e.g. vaccines contain toxins, vaccines contain aborted fetal tissue, vaccine developers are in cahoots with big pharma, the medical establishment pushes vaccines out of ill will like greed rather than out of good will).
Also, (natural) "herd immunity" among anti-vaxxers isn't equivalent to what medical experts mean by "herd immunity". It's like the difference between how a Catholic uses the word "grace" and how a Protestant uses the word "grace".
DeleteOriginally, the expression "herd immunity" meant "natural herd immunity." The medical establishment eventually appropriated the expression to refer to the high percentage of those who are vaccinated; thus using "natural" is redundant but needs to be in order to distinguish from the vaccination (wrong) sense of the term. And what is ironic is that you are using the expression "anti-vaxxer" sloppily.
Delete"Originally, the expression "herd immunity" meant "natural herd immunity.""
DeleteThe issue isn't what the term historically meant. The issue is what herd immunity means today. What is it. How does a population acquire it. And so on.
"The medical establishment eventually appropriated the expression to refer to the high percentage of those who are vaccinated; thus using "natural" is redundant but needs to be in order to distinguish from the vaccination (wrong) sense of the term."
That just sounds like revisionist history. But you can believe whatever you like.
"And what is ironic is that you are using the expression "anti-vaxxer" sloppily."
Well, you have argued vaccines contain toxins. You have argued vaccines contain aborted fetal tissue. You have argued vaccine developers are in cahoots with big pharma. You have argued the medical establishment is enrichening themselves with vaccines. You have argued parents should not vaccinate their children with common vaccines like the MMR. So you can say "anti-vaxx" is sloppy, but your own position regarding vaccines and vaccination is quite clear.
"thus using "natural" is redundant but needs to be in order to distinguish from the vaccination (wrong) sense of the term.""
DeleteHerd immunity can be acquired in multiple different ways. A population can "naturally" acquire herd immunity simply by being exposed and infected with a disease. Take smallpox. Smallpox devastated Native American populations. However the Native Americans who survived acquired immunity to smallpox. This is what the "natural herd immunity" position advocates. Just letting an infectious disease like smallpox burn through a population. The strong will sruvive, the weak will not. Survival of the fittest.
However one can also vaccinate a population. At its most basic level, vaccination is simply exposing the population to a weakened or killed form of an infectious disease. This way the disease can't harm anyone, but it can still cause our immune system to make antibodies against the disease. This way we don't have to get very sick from the disease since it has been weakened or killed. We might get a little bit sick, but then recover. That's effectively what vaccines do. This way both weak and strong can survive a disease.
Tim McGrew just posted this article on Facebook:
ReplyDeletehttps://fee.org/articles/oxford-based-group-stops-using-who-data-for-coronavirus-reporting-citing-errors/
Breaking: The top epidemiologist of the medical establishment, British Neil Ferguson of the Imperial College, who's highly cited doomsday coronovirus model that all the news networks have been reporting has admitted he was completely wrong. He just did a complete 180 on his model and agrees with what many of us have been saying all along including the sober-minded Oxford epidemiologist Sunetra Gupta.
ReplyDeletehttps://www.youtube.com/watch?v=3yvhmf38vOg
https://twitter.com/neil_ferguson/status/1243294815200124928
DeleteAlan, would you kindly revise or delete your erroneous comment in light of the evidence provided by Hawk or will you let it stand potentially misleading other readers?
ReplyDeleteAlan Kurschner
ReplyDelete"Perhaps Hawk should not be so quick to finger down the comments of Bigtree's youtube comments and copy and paste a link that he is not willing to consider Bigtree's response?"
1. This sentence barely makes sense. I guess you're trying to say I should deal with the arguments in Del Bigtree's YouTube video.
2. Well, I've already dealt with Bigtree's arguments in the past, which you know about, or should know about, since you were the one who sent me Bigtree's arguments in the past and asked me to respond to them. Not to mention other videos you've sent me.
3. Also, I've told you I don't have the time to respond to every single 1-2+ hour video you send to me. I've dealt with what I deem to be the best arguments, but I don't have the time or inclination to respond to Bigtree every single time he releases a new 1-2+ hour video.
4. Moreover, Bigtree isn't a medical expert. He's a popular media personality. It'd be better for me to deal with arguments and evidences from medical experts, which I have.
5. Other medical experts who know far more about vaccines and infectious diseases than a nobody like me does or ever will have already dealt with the best arguments from anti-vaccination proponents (e.g. Paul Offit, Peter Hotez, David Gorski).
6. However, whenever I mention medical experts to you, you immediately wave them away rather than engage their arguments. Yet ironically you tout people like Paul Thomas who is indeed a physician, but you don't even seem to know what his arguments are based on. You're just citing him because he has an MD and makes statements favorable to your anti-vaccination position.
7. As far as experts go, Dr. Oz is a physician, but do you believe everything he says, even if it's about a health-related topic? There are plenty of quacks out there.
8. The same goes for practically any field. There are biblical scholars who are "quacks" despite being professing Christians who hold doctoral degrees. Even world-renowned physicists like Stephen Hawking believed absurd things.
9. A better question is how do you distinguish between the quacks and the sound scholars? You've never addressed this fundamental question when it comes to vaccine experts. You just cherry pick the medical experts who happen to side with your beliefs, but ignore the other experts.
"Incidentally, I called this one nine days ago: https://www.alankurschner.com/2020/03/18/will-christians-be-blamed/ https://video.foxnews.com/v/6145346605001/"
Of course, secularists were already ridiculing Christians back in early March (around Mar 2nd) when Mike Pence prayed with his coronavirus emergency team. However I guess it took your keen sleuthing abilities to figure out that a secular liberal rag like the NYT would be so bigoted against Christians.
"I responded, but the bigot police deleted my response."
I didn't delete your original comment, but I would have if I could have. That's because this post isn't about vaccines or vaccination, but you always find a way to shoehorn your anti-vaccination cause into every discussion.
"I responded, but the bigot police deleted my response."
DeleteActually, your comments (which are quoted in full in my response to you) didn't respond to Coram Deo's point.
I don't know if either Hawk or steve (or another active T-blogger) would be willing to take up the question, but both here and elsewhere I'm seeing what I perceive as rampant confirmation bias swirling amidst the current coronavirus pandemic and I'm wondering if it's possible to implement guards or filters in our critical thinking to avoid this to some extent.
ReplyDeleteThis assumes of course that folks wish to avoid or mitigate this feature, indeed many seem to rush to pick out this or that expert, model, or theory which bolsters their preconceived notions.
CD, I think we will all have the opportunity to see this play out, and a year of so from now, there will have been 500 million global deaths or 10 million global deaths or 150,000 global deaths, and proportionally similar numbers in the US, and we can go back and check the records and see who was saying what. I think that’s what he best we can do at this point. Otherwise, we all have our opinions, and we are all playing wait and see.
DeleteAuto correct typo ... “that’s the best we can do at this point”.
DeleteHi CD! I was going to respond here, but my response kept getting longer and longer, so I posted it here instead. :)
DeleteWhile that's an obviously true statement it's also a totally non-responsive statement, John. But thanks for the interaction.
ReplyDeleteI was thinking of tools or techniques that might be deployed rationally *now* as we collectively work through the matter at hand. To be honest my sense is that we actually *won't* all look back when it's all over and agree who was right and who was wrong, instead our confirmation biases will rewrite the facts to match our preferred narrative.
"See, I told you so! If we had followed the social lockdown advice from the experts we wouldn't have had 500M, or 150M, or 10M deaths! But they priortized the economy over human lives!"
"See, I told you so! The number of global deaths was always going to be relatively low - around 150,000 - and if we had followed the advice of experts we could have restarted the economy much earlier and avoided this global recession!"
"See, I told you so! By following the advice of the experts we were able to bend the curve and reduce what would have been 500M, or 150M, or 10M deaths globally to just 150,000!"
I'm no trained philosopher, but I highly value reason and logic, both of which seem to have gone out the proverbial window so to speak to a large degree when the topic at hand is a once-in-a-generation global pandemic.
As far as confirmation bias tools I guess I was thinking along the lines of, perhaps, attempting to disprove one's own hypothesis, for example.
Maybe it's pointless.