This thread points to some intractable misunderstanding about what's happening. It's the effect of the myth, I think. — frank

Yes, definitely is far gone into myth of American exceptionalism and doesn't understand the situation. I agree with you there.

However, in NOS4A2's defense, it's really difficult to understand the political significance of the virus, that people are unlikely to simply continue as normal as fast as possible. It is the change of psychology, both within the US and how the world views the US during this situation, that is of historic significance.

It is very tempting to have the fallback position of the friendly platitude "we've always had pandemics", which is true, but that is not really a comforting historical parallel, as pandemics have nearly always brought profound social and political change; the very thing the right in America fear most. So it is quite understandable that denial is preferred over inconvenient truths.

That’s just untrue. No one has ever said nor implied such an idea, and such a dangerous straw man is an incitement to violence. — NOS4A2

I backup my assertion with explaining a high-profile argument for the pile of dead bodies.

Texas Lt. Gov Dan Patrick, and many on the internet and beyond, are exactly arguing for the pile of dead bodies.

“As a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that all America loves for your children and grandchildren?” And if that’s the exchange, I’m all in. — Dan Patrick

Is an argument for "let's have a pile of dead bodies" in no uncertain terms.

But I'm glad you're not taking such a position, I'm sure you'll go ahead and educate yourself on the science of this issue and realize all the governments are doing the same thing for a reason: the deaths from the pandemic are simply way higher than indirect harm to small business and jobs for a significant amount of time. People who lose their business can survive (likely only with government handouts and free retraining and free health-care, yes) but can survive and go on to do something else; relatively few would actually die from the loss of livelihood (when people lose their livelihood due to "technology disruption" or "triple A junk mortgages blowing up the financial system" it's just "creative destruction", nothing to lament, no reason to keep those jobs around because people "bounce back", and those that don't aren't the general rule). One small business bankruptcy or livelihood gone does not equal one death, whereas one death from the virus does equal one death; this is the basic math you are missing; while "affected individuals" are larger in magnitude in the economic category, they are not equal to deaths.

Secondly I don't think that by relaxing the social distancing measures now imposed by most countries, the depth of the recession would be reduced. We don't know yet how far the health crisis will go and as it is an exponential contagion, halting that growth will mitigate the worst effects of the rapid increase in infection. This is the reason why these countries have adopted these measures. Presumably their governments have been advised by specialists as to how bad it could be without action. — Punshhh

There's just 1 missing detail in this, which is that recession won't be less because you end up in the same situation of hospitals (even more) overrun, lot's of bad stories (from health care workers, from people who lose a loved one), and demand from the people that politicians do something.

However, in theory, you could just lift the quarantine and have that "pile of dead bodies in the corner" as Bill Gates says. Notice that he's saying to his follow oligarchs why you "can't" just lift the quarantine, which obviously you can, what's left unsaid is that the mechanism of why you "can't" is because other people care about those dead bodies; he's not telling his fellow oligarchs why you "shouldn't" have a pile of dead bodies, just that, for circumstances out of their control, he's trying to explain why they really can't (broken cookie syndrome vis-a-vis the economy).

I add this precision, because lot's of people arguing for lifting the quarantine are genuinely arguing for the pile of dead bodies and genuinely don't understand why people have a problem with that.

Notice, in Texas Lt. Gov Dan Patrick now famous interview he addresses what he perceives as the obvious criticism when he says "And I want to live smart and see through this" because the obvious rebuttal in his mind is "you're old, aren't you worried" to which he has a perfectly good answer with "I won't have buyers remorse here, I'll use my wealth to protect myself personally; obviously". He follows this thought immediately with "but I don’t want the whole country to be sacrificed" to cut off the other followup question of "you really ready to sacrifice all the other grandparents you're talking about, if you're not actually talking about yourself". For, it's you sacrificing the country, it's you destroying something not him!

At no point in the interview does he address people losing their grandparents unnecessarily, he insists the grandparents themselves are asking to bravely face death. Why? because he's clearly a psychopath: attributing his fearlessness in the face of the virus to every other grandparent (creating a noble "great generation" in the mind), while simultaneously bragging about his ability to use his "smarts" to avoid getting the virus; i.e. he's emotionally manipulating people to want to get the virus while displaying his ability to manipulate his own environment to not get the virus.

The trouble I have with this is that it's not always clear how you would separate out the two opposing views from each other when it comes to making concrete decisions relating to the economy. In case of early Trump and Johnson reactions to the crisis, they probably did have the economy as monetary value for a certain class in mind rather than the interests of the society at large. We know their ideologies.... — ChatteringMonkey

Definitely we agree here.

One might say, that's fine, it's just a bunch of traders, banks and the rich loosing out on making more money, who cares... but wouldn't this also have consequences for the rest of the economy so that in the end it has real consequences for the general public and the poor? And I understand that this is a 'designflaw' in the system to put it euphemistically, and that it could and should be otherwise in a number of ways... but until it is actually otherwise, it doesn't really matter right, because it still will have real consequences that are bad for the general public. — ChatteringMonkey

When people are structurally placed on the brink; i.e. precarious living as a form of social control, then indeed at any given moment it seems people need to live to die, later.

The problem we are witnessing in the United States is that people need to die now to die later. And all the kings men and all the kings horses can't put the propaganda back together again.

The "tension", previous to this crisis, seemed to be between the elites and the masses of poor that might "break free" at any moment, do something "revolutionary" like, oh I don't know, just go and start occupying things or something. Obviously, the problems that arise from poverty are solved by more poverty, at least a little while.

Ultimately a society that weakens itself to keep up an elite and keep down the poor and "the ethnics" is simply not able to withstand a real crisis. Yes, serfs of days past might depend on a corrupt liege to at least keep a fierce enemy with a penchant for genocidal at bay, and reason things just have to be this way, but if that same corrupt liege appoints corrupt and incompetent generals and admirals and taxes the poor into malnutrition, when the enemy is breaching the gates and streaming through the streets, this theoretical interdependence is no longer relevant.

True, this isn't the largest calamity that can be imagined (not a literal nuclear strike or environmentalists seizing power in a surprise Bolshevik-Nazi cultural-Marxist coup and immediately mandating large bonfires of all capital equipment and a "back to the woods, hunter-gathering collectivist suicide pact" to satisfy the most viscous of id's in the most extreme of all identity politics: self reliance) but rather the societies' I am referring to do not break due to facing something truly great, rather a fairly normal tempest sinks faster a ship already sinking. When the keel is rotten, new paint only lasts so long to keep things afloat. When the water pours over, and cold grips the heart, the time to fix the organizational problems that led to the crisis ... well, that boat has sailed.

For, it is not just coronovirus. The world in general, and the post-WWII Breton-Woods pax Americana in particular, has already lot's of problems, and it is within this context that the US has already even more problems.

And it is not simply Trump. Advancing Jeb Bush and Hillary Clinton was already a sign that the American elite are no longer able to replace themselves cognitively. Advancing Biden clearly shows the disease is terminal.

The first parallel geopolitical analysts had when it was clear "things would be bad" is that this maybe the US's Chernobyl. A large and costly crisis in itself, yes, but more importantly a fatal blow to the faith that underpins the entire system. The virus pops to many illusion in too short a time. It is a "the invisible hand has no clothes" moment.

Future generations will say the Soviet Union fell due to an insane ideology detached from reality unable to fulfill its self appointed prophesy, and so too the USA.

22 days ago, March 4th (aka 7 to 10 doubling periods yonder):

The virus may survive on surfaces up to 9 days (compared to 2 hours for the flue ... which means you can get this disease in the mail ... which in turn means if you test a Amazon warehouse you may find coronavirus, so you don't as to not make such a massive economic disruption so instead you just keep online the most efficient way to spread the virus exponentially through, perhaps low probability but super high impact, totally random infections that make entirely unexpected and unexplained clusters), — boethius

Today, March 24th:

Amazon on Monday evening had informed employees of the Shepherdsville, Kentucky, warehouse that the facility would be closed for 48 hours for cleaning after it identified three workers sickened by the disease caused by the coronavirus. On Wednesday, hours before the warehouse -- called SDF9 -- was scheduled to reopen, Amazon told workers it would be idled until further notice for more cleaning, the first known case of Amazon shutting a U.S. facility due to the pandemic without a scheduled end date. — Bloomber news

(use noscript with firefox to defeat paywall, only epistemologicaly of course )

Not unless NATO has a bunch of respirators lying around somewhere. The issue is specialised equipment and medical personnel. And what makes it worse is that the neighboring countries cannot afford to help (some token gestures have been made) since they need to husband their resources to avoid the same fate. — Echarmion

Also a big problem that needs to be added to the specialized skills needed to keep someone alive on a respirator, is a large majority of respirator patients have other health conditions which need to be treated too. There are really a lot of limiting factors to trying to scale adequate care when the details start getting looked at.

Of course, that health workers don't even have enough masks is just insane, and that part of the problem could have easily been solved. What I find bizarre is that stocks of masks weren't renewed after SARS-1 even in places that tapped into their mask-stock. The utility of masks seems to be at the top of "what did we learn" lest from the SARS-1 experience.

So you think that in no circumstance when deciding policy, human live can be measured against other values? There was a point to the example. If it can be done in other cases, what's different here? I'm not arguing against lock-down right now, to be clear, I agree that there shouldn't be any doubt. I'm just saying that at some point the question will come... and that could be a question where philosophy could actually be informative. If you don't want to go there, that's fine. — ChatteringMonkey

Many comments previous, I get into this subject when it was clear that containment was being half-asked to protect the stock market, and then containment just abandoned; going to "mitigation". UK was quite explicit about this. Of course, they just didn't really understand what they were doing and they'd just end up like everyone else but with a worse problem.

There are two opposing views about the purpose of the economy that have a an overlapping logic in some sense, but are not the same and give rise to different decisions.

The first view of the purpose of the economy is that its fundamental roll is to keep people alive; it is that which allows us to live. It might have other purposes, but only as a compliment to and not in conflict with this first purpose.

The second view of the purpose of the economy is to give value to owners; it is that which provides dividends to the investor class.

In the first view of the economy, lifting the quarantine is justified because at some point more people really will die than from the virus. Even if we ignore "jobs", which warrants another discussion as could be completely meaningless in this view of the economy in the event those jobs just undermine nature or other social structures we depend on, but self-isolation has mental, physical and educational consequences that in themselves at some point easily compete with a "mild epidemic" -- i.e. one that is not overwhelming the health system. So, if the epidemic is under control, then indeed the argument that further sheltering in place is doing more harm than good can be made, it's what government will say, and everyone will more or less agree. The principle is not really controversial. This is why we don't self-isolate to defeat the flu every year, and we're self-isolating now because this is not the seasonal flu.

However, in the second view of the economy, lifting quarantine measures is not because it will start to save lives, but rather it will get the stock market moving up again. From this point of view, the purpose of self-isolating to slow the spread of the virus was not really sensical to begin with. The virus simply doesn't kill enough people. For instance, if we were all robots working in a factory and a software-virus came through and disabled permanently 1 percent of us, it's really not reason to stop the factor, especially if a cure isn't even guaranteed to work. It would be even more absurd to stop the factory if the virus only permanently disabled obsolete robots in the back. So, viewing people as workers and consumers and something of value insofar as they contribute to the stock market going up -- for the investor class that's on the whole simply diversified into the stock market -- then there would only be alarm if we're talking "real numbers" like 10 - 20 percent, of which the coronavirus is simply an order of magnitude less lethal, and therefore irrelevant, in itself, as a menace to the stock market. So not pursuing the optimum strategy, to just keep factories and everything running as normal and tolerate a few units going offline, is extremely frustrating from this point of view.

As I mention in those previous comments, this second maximize-dividends view of the economy sacrifices peoples lives for increasing stocks all the time. For instance, allowing plenty of toxins in everything, the destruction of the environment, psychologically intolerable work conditions, the debt-to-homeless machine, are all examples of sacrificing people for stock value -- the pushback from trying to reduce pollution or make working conditions compatible with actually enjoying life even at the bottom will create the pushback that it's "bad for X,Y, Z corporations" which really means bad for dividends as that's the purpose of corporations.

The difference with this crisis is that it's on such short a timescale that it's impossible to muddy the water of cause-and-effect with propaganda for enough people to be begging to be abused and exploited and any future for their children corrupted; as per the usual "non-toxic, environmental friendly, psychologically friendly regulations would be bad for the economy, cost jobs, just not work, even if there was evidence of a problem which we flatly deny, and even if there was nothing can be done about it". The logic is exactly the same for the pandemic, and a lot of people swallow it whole, but not enough: there's still too many people that genuinely love their parents, grandparents, in-laws and vulnerable people. The atomization of society is not as complete as necessary for the optimum response in this particular situation.

But, to the position that my criticism of others would have been better received had I acknowledged my hypocrisy and then recited a long long winded self excoriation, I'd just ask that you pretend that happened. — Hanover

Why write an excoriation, why not just acknowledge the hypocrisy and reconsider your world view? Unless your goal is to be a hypocrite: in which case, mission accomplished.

Now that we're working under the assumption I followed your directions, will you now acknowledge that my post was fully correct in substance, or were your above comments just an irrelevant chastisement? My guess is that it's the latter. — Hanover

As I mention in my rebuttal, I see no evidence of the people you think will actually have hurt feelings from @Benkei's analogy. If there is no such person, I don't see what the substance could be. Even if there was such a person, I don't see why I'd accept it is was "hurtful language"; I'd still have to be convinced.

I hate to be repeating myself, but what I described is PRECISELY the approach that every virologist who wants to achieve herd immunity prescribes. — Nobeernolife

No, you are simply wrong and have not bothered to inform yourself of the basic science of what's going on.

The mechanism of protecting the vulnerable is by slowing the spread of the virus to within the medical system's ability to handle it, so that vulnerable people will get adequate care as well as healthy people.

You can try to isolate vulnerable people even more as part of that social distancing policy, but the process of reaching "herd immunity" is going to expose large amounts of vulnerable people to the disease. There's no practical way to isolate them for the entire duration of the pandemic.

Herd immunity is just the end result of everyone getting the disease and recovering or dying, it is not some sort of tactic that can be achieved and then, because there is herd immunity, vulnerable people are now protected.

Now, if you want to change your position to "yes, yes, the heard immunity thing is just social distancing; it's just bad PR to call it a plan to develop herd immunity by people getting the actual disease, rather than just the outcome of people getting the disease, which we obviously want to be a manageable process" then you are on your way to understand why Trump acted too late to have a better path than what is playing out in the US currently.

There is not some sort of bizarre theory and counter intuitive strategy where herd immunity can be "achieved quickly" and that's why actions were late and it's not a problem if even the late actions were completely bungled, like the tests.

Yes, by acting too late and incoherently, Trump put the US on a path to herd immunity sooner rather than later. No, doing so is not clever: the process of that happening quickly and out of control is what many virologists spend their entire lives studying and putting together plans and protocols to avoid happening - advice condensed into various briefings that went ignored.

I think you can, and I think that is what the countries who follow this approach are trying achieve. If there are enough immune people in the herd, the virus will not find enough new targets to spread and fizzle out by itself. The problem is that to keep those who would die from the virus (the sick and elderly) separated, while the virus burns through the herd. — Nobeernolife

No, you're just engaging in fantasy science.

If people are getting the disease they can transmit it to vulnerable people while they have the disease.

Fully isolating the vulnerable, which was sort of pseudo plan for propaganda purposes, is simply not practically possible.

The best that can be done is containing as long as possible, such as stopping flights as I was advocating when I joined this thread, and then slowing the spread so that the medical system is not overwhelmed. This results in many vulnerable people dying, but at least not more than necessary. With an overloaded medical system, lot's of healthy people die as well from lack of care, from the virus and other things.

People developing immunity through getting the disease is how you maximize the chance vulnerable people will also get it
— boethius

Sorry man, I can't deal with you. You make no sense. — frank

This is just basic common sense.

If your strategy of getting herd immunity of a disease is everybody actually getting that disease, you're going to maximize chances of vulnerable people getting that disease.

You can protect vulnerable people either by containing the disease, which doesn't provoke herd immunity, or then creating some artificial way of creating immunity that is not actually getting the disease, and so can't expose vulnerable people to the actual disease because the now immune person didn't actually get the disease.

Herd immunity from getting the actual disease happens in 2 parts:

1. People getting the disease and their immune system learning to deal with it and becoming immune.
2. People getting the disease and dying from it and no longer being part of the herd.

There is no way to have 1 without 2. This is why an epidemiologists thought this idea was satire when he first heard about it.

I’m an epidemiologist. When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire — William Hanage, epidemiologist

If we accept the pandemic cannot be contained, then herd immunity is just the inevitable result of the pandemic playing out, but the build up herd immunity from people getting the disease does not protect the vulnerable from also getting it, as for the time you have the disease you are able to transmit it to vulnerable people, that how the disease spreads.

I agree. That's pretty much what we're doing. — frank

The argument is the timing. That lot's of policy measures were available before.

It's like you have a bucket of water to put out a camp fire; you're too lazy and don't bother; you cause a forest fire and then go throw the bucket on the forest fire and say "see, I did".

Timing matters. In an a process that grows exponentially, timing matters a lot.

My point was that closing businesses should not be done in excess of what's absolutely necessary to slow the spread. We want it to spread. We need people to get it and recover from it. Until we have either a cure or a vaccine, people developing immunity to it is our only way of protecting the vulnerable.

I know this is a tricky thing to grasp. — frank

This is not tricky, you are simply flat out wrong.

People developing immunity through getting the disease is how you maximize the chance vulnerable people will also get it. If it's too late to contain the virus, then slowing down the spread is the only way to make it manageable for vulnerable people, and healthy people where the disease takes a bad turn, to get medical care. Slowing down also buys more time for health systems to prepare and for treatments to be worked on.

I see just posted the point about the spread needing to be manageable, as I say above, but this is not reaching herd immunity as a way of protecting the vulnerable; herd immunity is just the outcome of any endemic process regardless of how it's managed.

Even if one believes the US response under Trump is inept, the response I'd think should be sympathetic as opposed to ridiculing — Hanover

Isn't an inept response by definition ridiculous, and deserving of ridicule? How is society going to learn without signals such as ridiculing the inept?

I though we wanted to debate what's true and what's false. The important proposition being "is Trump inept or not"; which, if factual, clearly far outweighs in terms of merit for discussion people's feelings about "strong language" that points in the direction of Trump's ineptness.

So, what's with the feelings police?

And, if you want to play feelings police, why aren't you criticizing Trump and his followers for making light of the situation before? Shouldn't you at least preamble your criticism of with "Yes, Trump and a lot of his followers weren't really sympathetic to the idea this pandemic is a problem nor with the people who died 'due to something no worse than the flu', and ridiculing people on the left who were concerned about it, and not simply in the form of words, but taking actions designed to spread the disease faster in order to virtue signal their lack of sympathy for those that disagreed with Trump's message it was a hoax and will go away or is in any case no worse than the flu and plenty of people work through it and get better; and so not only hurt feelings but have and will cause many deaths", then, having recognized this and the hypocrisy of Trump and his followers having "hurt feelings" now with regard to criticism of Trump's inept handling of the crisis (assuming it's inept as you say), go on to make your point that analogies should be carefully selected to not hurt anyone's feelings, and not just actual people with hurt feelings about the analogy but also people who aren't themselves really hurt by it, but can understand the point being made, but nevertheless could imagine someone else, who isn't here, who could maybe be hurt by it, if they were here.

Maybe an exercise in Bayesian statistics? I.e., a concern with false positives? — tim wood

Out of 20,338 people tested in Britain for covid-19 164 people have the disease. The test itself is 97% accurate. You take the test and it comes back positive. What's the chance you actually have it based on this single test?

Apparently the answer is something like 21%? — Michael

Good point. 97% accuracy isn't great. — Baden

These observations are correct on an individual level.

The reason for mass testing is systemic. Even ignoring how to increase the accuracy of the tests (multiple tests etc. which could even be counter productive, see below); having more positives than what's expected from false-positives is going to inform that community transmission is happening in the region, first of all and some policy response is needed (obviously, we'd want to save tests until community spread, and so it's more random sampling than mass testing in this "mode").

Second, some of the positives are going to be true-positives, but even if these are 20% of all positives (true and false positives), you can still just quarantine all positives anyways. Since the course of action of asymptomatics is to just self-isolate until there are symptoms, there's not really much cost to the false-positive (to society).

Furthermore, if society is going into lockdown anyways, then asymptomatic false positives just end up with "more motivation" to lockdown. So it actually makes the situation marginally better with some percentage trying to "super lockdown", thinking they have the virus even if they don't (mind trip, both not harmful to society).

Of course, false-negatives create the exact opposite behaviour, so the above benefits only arise if the chance of false-negatives are significantly lower than false-positives.

So, mass testing can still have a systemic policy effect even if results of positive tests are not used as a basis of diagnosis; diagnosis could be based on symptoms if and when they develop.

By diagnosing based on symptoms rather than serial testing the positives to identify the fasle-positives, this makes more tests available for the mass-testing policy. More mass testing without diagnosis can be more effective use of tests than trying to diagnose (to separate true-positives from false-positives through more testing, which if chances were only 20% for the first test a second test may still be inadequate to be highly confident).

In otherwords, there's the Bayesian statistics for the case of the individual, but also Bayesian statistics for policy. Mass testing will give better information on the sate of the outbreak than no mass testing, even if each individual positive is only marginally more informed. Isolative measures of all positives, both true and false, is going to significantly slow the spread of the virus even without diagnosing anyone until they have symptoms, as well as inform and track the effectiveness of policy measures sooner than the ultimate evidence of deaths.

Indeed, considering all this, the argument can be made that testing symptomatics "who want to know" is less informative (as the outbreak progresses there's less and less chance it's going to be something else) than mass testing to find asymptomatics in a large net that catches both true and false positives.

There is always some time frame in which data fits an exponential growth curve! Or logarithmic. Or linear. Or better yet polynomial — SophistiCat

Yes! You finally get it. If we're interested in a time frame where exponential growth is accurate (or accurate enough for our purposes) it's perfectly valid to say the phenomenon has grown exponentially from A to B points in time.

Such as biologists saying bacteria grow exponentially when there is enough food.

What you don't seem to get is that your criticism of using the term "experiential growth" is the same for all curves (and continuous curves themselves don't "match" any phenomena because all measurement is fundamentally discrete).

If you say "oh, it's not exponential it's logistic" I can say "ahh, it's only logistic until it isn't, what if the virus doesn't behave in a logistic curve due to reinfection, or what if we wait long enough for new generations to be born that aren't immune and the virus re-emerges as a pandemic; see, haha, only logistic until it isn't!! hahaha".

What would your answer be? Logistic is a good curve to approximate infection growth on the time scale we're interested in, of this first wave of infection.

And, by the same logic "exponential" is a good curve to approximate the first phases of an outbreak, as other factors that reduce exponential growth are insignificant on the time scale of the initial outbreak.

Why are we interested in this time-scale? Because that's when the medical system is overwhelmed and governments decide on a policy response to stop the exponential growth that would occur if no action is taken.

Why is exponential a good description? Because the corrective terms and factors on this time scale would make no significant contribution to predicting the initial outbreak, so the equation can just be simplified to an exponential one, and it's useless pedantry to keep terms that simplify to zero.

- it can be made to fit any curve over any time scale. But no scientist in their right mind would propose an exponential growth model just because you can fit an exponential curve to two consecutive points. This is not how scientific modeling works. — SophistiCat

No where did I say we only have two data points, so I don't know where this strawman comes from, but it's not even a correct argument against the strawman you've created!

Scientists fit curves to small amounts of data, even 2 data points, all the time, and then debate which projection is justified based on either the trend in the data (as more data comes in) or proposed mechanisms.

Yes, no scientist would insist it's one projection rather than another without some argument, but fitting different curves to data and then debating what is "overfitting" and what isn't, what is the clear trend in different time frames, what mechanisms might change the trend in different time frames, is basically the second lesson of data analysis (after how to fit curves to data to begin with).

Which is exactly what I'm proposing!

Maybe growth will reduce close to zero soon in Italy, follow such a logistic projection (still not projected "forever" but only a good prediction insofar as quarantine measures are maintained, virus doesn't mutate to be more virulent to defeat quarantine; still only "logistic until it isn't" as you say) where new cases start to approach zero.

Maybe not! Maybe it will follow a projection where growth continues to be some significant percentage of the population, under the previous policy measures, and a exponential curve is a predicts accurately the future states over the time frame we're interested in (corrective terms to the logistic function are insignificant). Maybe the new policy measures, of marshal law, will get it under control ... maybe not!

Now, you can say "oh, well, I still don't like the word exponential here", but I'm just using the terminology epidemiologists and biologists use; you asked for a source, I provided you a citation of such language under the heading "exponential growth" in wikipedia. Why do scientists talk like this? Because the same kind of criticism can be brought in for everything, you could walk into any math class explaining exponential growth in terms of interest payments "gotcha! exponential interest growth is impossible because eventually no ledger could keep track of the numbers, so it's really an exponential added to a step function that reduces growth to zero when the entire accessible universe has been filled up tracking this number; why is this a foolish criticism? Because that time-frame is of no interest to the phenomena being discussed".

Why this is relevant (that we don't know yet what projection will actually be true; and we don't know which policy measure contributed exactly what amount in controlling the virus) is because it informs risk analysis.

A lot of people assumed Wuhan was a "worst case scenario" and that therefore Italy will follow a projection similar to Wuhan ("Italy is X weeks behind Wuhan" is a phrase that would pop up) essentially implying that Wuhan presented a upper-bound on "how bad it can be". However, Italy has now broken with the Wuhan pattern (of leveling off in growth about now). This could be due to the Wuhan scenario being mostly fraudulent numbers by the Chinese, or it could be that Italy didn't do a good enough policy response or, even with a similar policy response, conditions are more favourable to the virus in Italy or it has mutated to be more virulent (lack of adequate protection of health care workers creates the conditions of evolutionary pressure for the virus to become more virulent).

So Italy is now becoming the new worst case scenario.

Other places with an even later or even weaker, or both, response can make an even worse case scenario compared to Italy.

Yeah, the scientific community describes things as growing exponentially for as long as they grow exponentially. — SophistiCat

This is exactly what I explain in the sentence you reference. If in some time frame of interest (such as "until now"), the data fits an exponential growth curve, scientists will say "it is growing exponentially".

You may insist on exponential growth if you think you have a good handle on the causal mechanism, and can account both for the function and for the changing exponent, without having to make retrospective adjustments after each new measurement. — SophistiCat

Did you even bother reading my comments?

I'm not insisting things will continue to grow exponentially in Italy, I'm saying it's not ruled out by the current data.

17% daily growth rate this week could mean 17% growth rate next week and the week after that and the week after that, until 50% of the population is infected and growth rate reduces due to running out of hosts.

Or, it could indeed mean 5% growth rate next week and then approaching 0% growth rate week after that.

Since we don't know which scenario we are in (precisely because we cannot know for sure all the mechanisms of transmission and how many need to be cut to approach 0% growth rate), is why, once this situation is reached the risk management conclusion quickly becomes "maybe what we're doing now is enough ... but we can no longer risk being wrong, so we need to do even more social distancing and enforce compliance with the military".

If it was "certain" that growth rate was decreasing to zero, it's unlikely marshal law would be implemented (it is quite a big step for civilian authorities to take).

I can't really be bothered continuing this. — fdrake

Sorry I missed this. This is good news since you're just being facetious for nothing, in my opinion, but I'm in self isolation so have plenty of time to go into minute detail.

Here's your source though:

The number of microorganisms in a culture will increase exponentially until an essential nutrient is exhausted. Typically the first organism splits into two daughter organisms, who then each split to form four, who split to form eight, and so on.

Because exponential growth indicates constant growth rate, it is frequently assumed that exponentially growing cells are at a steady-state. However, cells can grow exponentially at a constant rate while remodeling their metabolism and gene expression.[1]

A virus (for example SARS, or smallpox) typically will spread exponentially at first, if no artificial immunization is available. Each infected person can infect multiple new people. — Wikipedia - Exponential Growth

Does this satisfy your doubts that the scientific community describes things as growing exponentially if, in some time frame their interested in, the phenomena does grow exponentially?

Or do you want more sources of this language being used.

Do you want me to explain again why your statement:

The growth of coronavirus isn't exponential in Italy. The acceleration of the number of new positive cases has steadily been declining since the quarantines were imposed in Italy, and has now levelled off to around 0. — fdrake

Cannot be assumed to be true (in the sense biologists might use the word "exponential" in the context of organism growth).

The current policies may support more doubling times in the whole of Italy, which is perhaps why we see more measures. Italy is not similar to South Korea nor Wuhan in terms of situation and policy response, and we simply don't know if the strategy there has or will work controlling the virus on a short time scale of a few weeks (i.e. if Marshal law was necessary, and if so we cannot know if Marshal law as currently implemented solves the problem that the civilian authorities could not solve) , which is the policy objective (large cities, basic services that need to run, building designs, compliance, may not be sufficient to have an outcome similar to Wuhan, assuming for the sake of argument, those numbers are correct).

The reason to be concerned about policy failure in Italy, is because it indicates we may likely see policy failure to control the virus all over the globe; that even with the enormously disruptive measures of mass-quarantine, the virus may still easily overload medical systems.

Though I will ask for sources on this use of local exponential trend? Genuinely curious. I can see the appeal of having a model that splits the time trend like that. — fdrake

This is just how scientists talk. I can provide plenty of examples of scientists using implied domain of validity in talking about fitting curves to data or modeling some phenomena.

Epidemiologists and ecologists talk in terms of exponential growth of a population, to explain infestation, invasive species, plagues. They say "bacteria will grow exponentially"; they then explain in the theory that "as long as there's enough food, no toxins and no predation". So, when they observe something growing exponentially they say "this is growing exponentially" like a virus replicating from cell to cell or from person to person.

Nuclear explosions are also described in terms of exponential reactions, yet, again, physicists aren't saying the reaction will grow exponentially until the nuclear bomb weighs more than the universe.

It's a useful estimate of what happens in the next relevant time step and so describes well the reaction in the starting phase.

In the outbreak phase of an epidemic, an exponential function is the best description of what's going to happen next, so they call it "exponential growth". Just like interest payments are exponential as that best describes what happens next, even though it is impossible for any bank to represent numbers that exponential growth will eventually attain.

For the situation in Italy, policy makers want to know if the measures have really gotten (or will get soon) things off an exponential growth curve in the next coming weeks or not; since the policy objective is to get the rate of infection below the health care capacity; due to this context, it doesn't matter to them that the virus would anyways start to burn out as they want to put in place policies that stop exponential growth right now.

So, if the growth rate isn't actually decaying, but still has a sustained doubling period (even 2-3 doubling periods is a significant change to the situation policy makers maybe trying to avoid; maybe even 1 doubling period they are trying to avoid), then policy makers want to put even more social distancing measures.

Of course, the true rate of infection can only be known in hindsight, as there's lag between infection and diagnosis and a sampling bias in who get's diagnosed (unless there's enough testing to have an accurate model overall).

I'm simply making the simple point that going from 3 days doubling time one week to 7 days doubling time, does not necessitate that the next week would be a 2 week doubling time time and soon no doublings at all. At any point in the "slowing down" the infection growth rate could be the new normal (until simply running out of hosts slows the virus, approaching herd immunity, or then even more extreme measures are put in place).

In terms of just empiricism generally, it's completely valid to characterize some data as growing "so far" as "linearly" or "quadratically" or "exponentially" or "sinusoidally". It may simply be true that the data follows such a trend so far and that it's the best function to estimate the next observation. No scientists would understand such a statement to imply the scientist therefore concludes it would continue for ever. Making a better prediction (for instance when it will break with the observed trend) requires a theory and justification. Since data is noisy, there's almost always opportunity to jump on some variation to justify a given model.

Likely, right now in Italy they have a few models of what's happening and don't know what's correct. Since delayed action has proven costly so far they are switching to assuming the worst model: that they are still in an exponential growth regime on a time scale that is intolerable to deal with, so, time to call in the army to maintain a stricter compliance.

There was an uptick in growth today and yesterday in Italy, it doesn't swamp the downward trend in new case number acceleration when averaging. — fdrake

That's what I explain: it maybe going towards linear growth, but right now it's still exponential growth, some percentage of the population is growing each iteration.

We cannot "know" which case it is. I'm not arguing against the hypothesis that it's downward trending.

I'm just presenting the fact that we cannot assume it's downward trending, it could be a new local (in terms of time) equilibrium of a new growth rate.

What has happened: number of new cases per day's rate of increase has been trending toward 0. You simply don't get that behaviour from an exponential function applied to the entire case number trajectory. — fdrake

No, I get it. That's why I peppered my statements with "local in time", and I've explained multiple times that exponential growth in this context is short hand for acceleration phase of a logistics function which itself maybe only part of a bigger function on a longer time scale (such as several mass quarantine, relaxing mass-quarantine and peak phases).

However, insofar as the growth is best described as some percentage of the population, then we are still in the exponential growth regime (locally in time).

The quibble that it will eventually stop growing exponentially and be part of another curve is really ridiculous.

It's like saying orbits are not ellipses because eventually a black whole might come through the solar system and make the planets all go in a different curve. Or saying "exponential interest on loans" isn't a real thing because eventually the computer disk space to represent the loan would be heavier than the universe.

All curves describing some real phenomena have a explicit or implied time domain where the observation is valid and some argument why over-fitting the data with a "better curve" would be worse than the proposed curve.

Exponential growth describes how it's "growing now on a timescale we care about".

If we just want to quibble about terminology, I could say "axxuuually, individual viruses and individual infections are discrete events and not described by any curve at all, and anyone not talking discrete mathematics is misrepresenting the situation!" See, it's true, but no productive because the people with the knowledge to understand a mathematical description of what's going on should have the knowledge to put things in context. No one has ever claimed viruses would outweigh the universe (as Elon Musk has pointed out won't happen, or do you think that's like "totally valid criticism of the talk around epidemiology right now"?).

Maybe it's A. decaying towards zero shortly, but maybe not, it might be just representing B. testing no longer keeping up with the growth rate (that testing cannot scale as fast as infections due to logistics problems), or then C. a new steady growth rate for "a while" that requires more policy measures to reduce during that "while" we care about.

Once this situation is created, it becomes very difficult to know what's actually happening, so eventually policy makers just "do everything" when they realize what a single doubling period actually means to the system. Was it needed to barricade people into neighborhoods in Wuhan? Maybe not, or maybe it's essential to get out of the exponential regime. We don't really know.

date Diagnosed Deaths
2020-03-14-----------21,157(+20%)-----------1,441(+175 +14%)
2020-03-15-----------24,747(+17%)-----------1,809(+368 +26%)
2020-03-16-----------27,980(+13%)-----------2,158(+349 +19%)
2020-03-17-----------31,506(+13%)-----------2,503(+345 +16%)
2020-03-18-----------35,713(+13%)-----------2,978(+475 +19%)
2020-03-19-----------41,035(+15%)-----------3,405(+427 +14%)
2020-03-20-----------47,021(+15%)-----------4,032(+627 +18%)
2020-03-21-----------53,578(+14%)-----------4,825(+793 +20%) — wikipedia - coronavirus pandemic in Italy

Although this week has reduced the growth rate compared to the week previous which was consistently above 20%, this could represent testing decoupling from new infections, or just a new growth rate that would be sustained until the critical 60-70% of the population is infected (and inflection would occur just because the virus is running out of hosts).

Maybe measures are working and we'd be below 10% next week, and then start to get towards linear growth the week after and then decay the week after that.

Or maybe more measures are needed to get it under control, such as marshal law to enforce the quarantine, as happened today.

No one's calling it marshal law, but that's what it is:

Martial law is the imposition of direct military control of normal civilian functions by a government, especially in response to a temporary emergency such as invasion or major disaster, or in an occupied territory. — Wikipedia - Marshal Law

The Italy case is not cause for too much optimism.

Exactly 1 month ago, there were 21 cases diagnosed in Italy. Now there is marshal law.

The growth of coronavirus isn't exponential in Italy. The acceleration of the number of new positive cases has steadily been declining since the quarantines were imposed in Italy, and has now levelled off to around 0. — fdrake

This is still exponential, in a local region of time, just that the doubling time is getting steadily longer according to official diagnosis[/].

Since the system is starting to collapse, the growth of cases could be limited by testing.

Of course, hopefully the exponential growth rate, on a local time scale, is slowing towards inflection in a larger logistics functions (sometime soon).

Although it seems reasonable to assume the measures "are surely working", cause they seem pretty extreme, to get to linear or even exponential-decaying growth rate soon, it is possible the social distancing measures are still maintaining exponential growth, certainly slower than everyone going to restaurants and work and so on, but still exponential.

Effective measures, in a numerical sense, could still mean extending the doubling time, such as to weeks instead of days is still effective. However, doubling the cases in a month rather than 3 days is still pretty effective, numerically speaking; a lot of effort could be needed simply to go from 3 day doubling time to 3 week doubling time, and we don't know if that effort is above or below what Italy has done.

They are having their doubts too, why they have now called in the army to enforce the quarantine better (rather than just help with logistics, such as taking away dead bodies, as they've been doing up until now).

For instance, in China there was observed cases that seem to have spread through pipes. It could spread through vents too, or perhaps even balcony to balcony when the wind is right. There's also just the spread due to movement that is still happening: essential services, going to grocers, etc.

Where exponential growth has been stopped, we saw either earlier measures (such as with South Korea with a classic containment strategy implemented by competent individuals before it was too late to do), or then more extreme (such as China barricading people into neighborhoods and doing a "gate hand-doff" for delivering supplies, and that's assuming their numbers are some basis of what's been going on, which I don't want to just assume because I trust China but experts seem to agree they could not hide continued exponential growth, just hide a lot of the cases and deaths that did happen; such as just letting whoever dies in barricaded neighborhoods and not counting those in the statistics and then passing "no negative opinion about the government" laws to cover it up). Italy was neither early like South Korea nor as extreme as Wuhan, so we cannot conclude Italy measures are "enough" until they actually work.

I definitely hope they are enough, because all of Europe seems passed the "South Korea uses initiative and foresight to get on-top of the problem strategy". Europe has lot's of apartment blocks with old pipes and air ventilation systems. Oh, and still no one's bothered to check if you can get the virus in the mail.

All of this drop in rate of new cases can't be attributed to the quarantine measures; people would have probably isolated themselves regardless. But the effect of cutting off as many transmission vectors as possible should not be underestimated. — fdrake

I don't understand this. For me "quarantine measures" are basically being used to refer to all measures to cut off transmission vectors.

Though technically, quarantine is isolation a potential cases to see if they become cases, whereas all things that cut down transmission vectors is called social distancing. However, in this technical sense, quarantine is the most effective social distancing measure we have.

Are you trying to say something different?

There is a food crisis in the UK today, the PM announced yesterday that all pubs, restaurants, cafes, etc must close Friday night. Also the schools closed the same day, resulting in panic buying. — Punshhh

Literally 5 days ago:

UK will do the same as ssu reports Finland is doing. These "changes in strategy" is simply propaganda to walk from "oh, crap, it is a problem I should have realized will hurt the stock market much more by downplaying it compared to being proactive" to the inevitable position of "all hands on deck! to prevent more spread and get this under control! for queen and country lads!" without admitting to any mistakes and pretending it was "people's loved ones" that were the center most priority all along, just a few understandable course corrections along the way — boethius

Just as predictably, the real world outcome of this "PR delay" is to make the situation that much worse.

Your math is wrong. The spread is exponential, not the death rate. The spread doesn't discriminate. The death rate does, based upon current medical condition. — Hanover

No, your math is wrong.

The spread does discriminate, based on social distancing measures. It's exponential, during the first outbreak phase, if those measures aren't effective or not even tried.

The death rate is some percentage of the infection rate, without discrimination, not detached from it, for one part. Medical conditions, the discriminatory part, get worse as the system overloads, increasing the death rate.

coronavirus update: — frank

We'll see if this update, whatever it's supposed to mean, will stay accurate for long.

275 US deaths from coronavirus.

Current % of US cases of coronavirus considered severe: 0. — Hanover

You're saying the deaths weren't considered severe before they died?

Or that currently there are no severe cases because the severe cases died and no new ones have developed to severe yet or then data hasn't been updated yet?

You do realize the argument is deaths will double, and then keep doubling until it burns through the population or then is brought under control by social distancing measures?

That doubling something many times results in very big numbers. Yes, it's physically impossible that the virus keeps doubling until it outweighs the entire universe; Elon Musk is certainly good to criticize any doctor that was worrying about such a possibility in talking about exponential growth. However, it's not impossible the infection keeps doubling until it causes severe problems for the medical system; so severe that actions are needed because people don't accept just letting people die where actions can do something about it (some people don't mind this, but the fact is most people do mind and that's why government after government is taking actions to either contain or bring their outbreak under control).

That the argument is about what numbers we'll see in the future, and that the present numbers and how things have gone elsewhere is the basis for that argument about the future.

I have read your response and I will leave your words to justify your intention. — ArguingWAristotleTiff

Yes, I think that's how philosophy works: people argue their case.

However, I disagree with your implication that I am arguing "my intention was good" and so excuses an act that is "in fact harmful" according to some definition of harm that can be automatically assumed.

My intention is to make a true argument and persuade people on a personal level, not some abstract version of a person where nothing said is ever permitted to be discomforting to the real person the abstraction represents.

Debate is very personal, and as much an emotional struggle than a logical one.

My goal is to bring my A game to debate, not simply to completely demolish my opponents arguments, as construed in some neutral abstract language, but to crush their will to continue to present such arguments.

There can indeed be casualties in such an exchange, people who can't "take it" (finding out their world view isn't as solid as they thought), maybe Frank is such a person and maybe not, and so maybe he can learn and grow if I'm right (or then prove me wrong if I'm wrong, to give me the chance to learn and grow in that case), and I justify my intention on the grounds that finding the truth, not simply abstractly but in real terms that only exist in a personal way, is necessary for society to avoid the kinds of mistakes we are seeing play out in a very personal way for everyone impacted by the crisis.

To remove the personal, is, in my view, to abandon personal responsibility.

It is the Republicans that are the snowflakes according to their own definition, hiding behind what they believe are leftest standards of discussion whenever they don't have an answer for their beliefs, such as excusing Trump's actions.

It was uncalled for and unappreciated. — ArguingWAristotleTiff

Uncalled for by whom? Unnapreciated by whom?

The people I disagree with here and am in debate with?

An insult is an insult because it's factually incorrect, in basically every world view that can be credibly entertained. Pointing out people will live the consequences of believing wrong things (unless they have enough wealth to insulate themselves from the consequences of their actions) is not an insult. It's simply true, and serves the purpose of inviting people to reflect on how what's true and false impacts their personal lives. It's fun to play the denial game, send "serious analysis people" running in circles, until it's not fun anymore because the problem being denied has a personal impact.

And this is what's fairly unique about this crisis: it affects also affluent Westeners that respond well to denialist or "we can't be sure" argument, and impacts them on a massive scale; it's not even "just some Westerners" over there dealing with a forest fire or a hurricane or a job loss or medical bankruptcy (where people can say: "well, don't live there or don't work there! dummy dum, don't rely on the government for a competent response!!"), it's everywhere. The same propaganda tactics have been used to ignore plenty of other crisis in terms of human or other creatures suffering; those tactics work because the people who believe them don't suffer the consequences of those policies.

What's so interesting in this crisis, philosophically to me anyway, is that people are believing the same propaganda tactics yet it's clashing with the consequences appearing in their personal lives on the time span of days. There's no time to put a new face to the same lies or recruit new fools as old fools wise up.

People downplaying until a few days ago were basically saying "ha, Europe, snowflakes; Trump knows that it's not so bad and no reason to overreact and stop entire economies! It's hysteria whipped up by the left to try to damage Trump, don't believe it!".

Now those same people are saying "Trump took it super seriously, did everything he could!". It's wild. Even on this forum, not to mention conservative pundits and social media echo chambers.

The only good thing that can come out of this immense tragedy is excising this mental disease carefully nurtured by propaganda over decades, and not just Trump supporters but the general framework of neoliberalism that permeates academia, bureaucratic policy making circles and the rich and powerful.

I dont have any authority. I'm a respiratory therapist who used to sell medical equipment and now is back in the clinical setting. — frank

This is still more medical authority compared to someone who knows nothing about medicine.

Of course you believe you did the best you could with the information you had, as you believe that about everyone it seems. I am predicting you will see in this crisis why such an assumption is erroneous.

If we assume people above us in authority are "doing the best they can" then there's no reason to challenge them, nor mitigate bad decisions that we see happening.

Even if you don't perceive you have any authority at all to persuade about respiratory illness or the consequences of running out of respiratory equipment, sharing correct analysis with colleagues who do have "authority", as you would consider it, could have better informed them if they were otherwise busy resulting in the best decisions according to your social theory, as well as informing your close circles and social media circles, doing your part to fight misinformation that the crisis can be downplayed (of course, assuming my analysis is largely correct; if the crisis is overblown, then there are no lessons to learn).

You can state what you believe to be fact without personal attacks. Saying you get what you deserve was stated in a personal way to Frank. — ArguingWAristotleTiff

It's not a personal attack. It's a personal prediction, but I have strong arguments for why the prediction will come true.

If my prediction is untrue, then can come back and say "nope, didn't encounter any unusual difficulties due to corona virus; I was completely right to downplay the threat, whatever small mistakes the administration made in failing to contain or prepare seriously in February didn't really have much impact on how things played, we should move on from those small details, can verify myself all doctors who were super concerned and crying wolf feel silly now".

It's only a "meany attack" if my analysis is right in which case a medical professional that downplays my analysis will suffer the consequences personally.

Ignoring a danger and then suffering the consequences of that danger is a textbook definition of "getting what you deserve". As someone with some sort of medical authority, could have had much higher impact on helping to prepare himself and his colleagues as well as shape public opinion.

certainly assumes he's done the best he can with the information I've provided here and, more importantly, medical professionals around the world. Again, if that premise is wrong, and he could have done better with the information he's had access to, he'll get what he deserves in not doing his best for himself and his patients.

So, my conclusion follows from my premise. What matters is the premise.

In terms of the medical system, political leadership and society as a whole, excusing all the mistakes that have been made, means keeping people who are not acting in the public interest or not competent (or both) exactly where they are, not learning anything and so inviting the same mistakes next time or for some other crisis (which could be tomorrow).

I understand all of this is being done.

I fail to see what he could have done differently in concrete terms, He reacted quickly, and as I pointed out, quicker than other European countries (although not as quick as Taiwan and Singapore, I give you that. — Nobeernolife

You provide the counter examples to your own argument. That's not a good debate tactic.

South Korea is also a great example of what competence looks like.

The problem grows exponentially in the outbreak phase. Every doubling time matters a whole lot; indeed doubles the problem. Doing the things that should have been done, only later, is not at all the same thing as doing them on time. This will take some math to explain (and any leader we expect to be running at an above kindergarten thinking level would be able to understand), so I will fully develop it in my full response to your previous comment.

I have no idea who you are but remaining humble is my suggestion for a start on how to deal on an interpersonal level with others. — ArguingWAristotleTiff

It's not an attack. It's a prediction. I predict you can't avoid the consequences of an overloaded medical system if you are a medical professional. It's essentially a mathematical certainty at this point.

So the 0% is bad? — Hanover

It's like starting a fire in your house. In the beginning it's just a candle and the fire is "contained" so nothing to worry about, then the candle falls over due to making a half-asked effort to put the candle correctly in the candle holder. The fire starts to spread, but at first it's only "0%", if rounding to 1 digit, of the house, not to mention the county or the state or the entire world (most of the world's ocean anyways, immune to wood-based fires!).

Then the fire grows, consumes the house, jumps to the woods, causes a massive forest fire that is some meaningful percent of the state, burns down whole towns ... but because people aren't flying this fire all over the world, it's stilled contained to it's geographic area due to the physical dynamics of how fires spread, it doesn't become a significant percent globally ... so I guess this analogy doesn't lead to something you would actually consider a problem.

However, for the sake of argument, imagine people do fly the fire all over the world, well now there's a global problem, very expensive, all started from a mismanaged candle. If you want a "natural" trigger, just replace the candle with a lightening strike in a field and the town fire department saying "well, it's not a whole percent of the world yet, so we will wait to act".

The most cost-effective time to stop the fire is before it's out of control. Once it becomes out of control, "not everyone will die" isn't really relevant to people and governments dealing with the fire.

So in other words you can not give a concrete example of what Trump should have done that he did not. Figures. — Nobeernolife

Did you even read to the end of the sentence?

Why would saying I'll do something later imply I am unable to do it?

I can't go into this now, because the layers of denial are so thick that it will take more work to fully explain every reasoning mistake you are committed to.

But to give one simple example, so you don't live in some illusion in the meantime that I'm delaying because "I can't deliver", Trump could have seen that relying on a single test process was a large risk; that "diversification" is a key risk reduction strategy.

Mitigating actions of a test failure would have been:

1. Had one or two parallel test-kids developed by other companies to increase the odds one is successful at scaling quickly in the critical first outbreak phase (where all reductions in infection rates have the highest return on investment; Tump's a business mad so surely understands that concept).
2. Negotiate to fly-in some tests short term (maybe in exchange) if testing is delayed, perhaps in exchange for money as well as promise to fly back even more tests when things are sorted out in the US. Because, you know, he's the president and can phone up other leaders and "make a deal".
3. Invest and re-organize in scaling tests as quickly as possible once the problems were solved.

Sure, it was also bad PR to claim the "Anybody that needs a test gets a test; they're there, they have the tests, and the tests are beautiful" and "The tests are all perfect, like the letter was perfect, the transcription was perfect, right? [...] This was not as perfect as that, but pretty good.", but it was also terrible decision in the real world of managing the test situation.

As the "doctor" I criticize above points out, it's difficult to make decisions without good information, so anyone managing this crisis at a first or second grade critical thinking level would have been very focused on the tests and making sure they happen quickly.

What obvious logic? I agree that Trumps initial response was bad PR, he went all out to claim the problem was under control while it was not. However, I do not see a problem with the actions he took. He quickly (much more quickly than e.g. European countries) introduced travel restrictions, and appointed a Corona Tsar to coordinate further actions. What exactly should he have done that he did not?

I feel the strong smell of TDS here again.... orangeman bad, no matter what. — Nobeernolife

I'm just going to appreciate this beautiful exercise in mental gymnastics, let it stand a bit as a refined and advanced example of the double-think talent, and then completely demolish it.

It's not clear to me what your point is. If it's that somebody should have done things differently, I dont see a lot of value in that kind of 20-20 hindsight. People always do the best they can with what they know. People make mistakes. Move on. — frank

This is just insane. There's so many things wrong with this I don't know where to start. It seems that reality has caught up to the "I'm a contrarian for style" attitude towards reasoned discourse.

First, this sentence "people always do the best they can with what they know" only makes even any descriptive sense if you assume people are doing their best according to the same ethical scale, which is obviously not true. The serial killer might be doing his best and the police trying to catch him might be doing his best too, but the detective is unlikely to reason "well, he's doing his best with the information he has about how to kill people and get away with it, but people make mistakes, time to move on". It is obviously the ethical difference of what "doing one's best is" which creates the conflicting situation for the detective.

I have made it quite clear in my analysis that there is an ethical difference with Western leadership in this situation, that they wanted to protect the stock market over people's lives. We can go into the evidence for this if you really want to be that cool a contrarian. I have a lot of time on my hands ... but something tells me you may not have time to go into it in the weeks to come.

So, even if I admitted the premise that "everyone's doing their best with the information they have" in a sort of kindergarten playground view of politics where as long as a politician is just as reasonable as the stupidest member of their base, we should empathize with their hurt feelings for being called out on starting a war based on "intelligence fixed around the policy", or giving trillions of dollars to their corporate friends, or passing or defending existing laws making corruption legal -- even if I admitted that premise, if such people have an incompatible ethic to mine, if their goal is to create a crony system to line their pockets, then it's an even greater problem for me if they indeed are "doing their best".

But of course the premise isn't true. Criminal negligence exists as a crime precisely because people don't "always do their best with the information they have". Are you really defending the position that criminal negligence has never occurred? People have always done their best and perceived victims and the justice system should always just "move on" in such situation?

What's worse than throwing down some truisms, that aren't even really good truisms, is the implication of your argument that people should therefore not be held responsibility for mistakes and everyone should move on.

The whole premise of democracy is to get better management in place, not continuously excuse bad management, so, if they are "just mistakes" clearly they're pretty big mistakes and the argument could be made that maybe a first or second grade level of learning ability and critical thinking should be aimed for.

This is not a joke, I'm pretty sure I could explain exponential growth to a precocious first grader or your average second grader (at least in countries with evenly funded, high standards, public education), as they know basic addition and multiplication, and so explain why the disease will propagate really quickly, hurt a lot of people if nothing's done, why containment is important early on, and the basis of social distancing so doctors can help everyone. These are all really simple concepts and all that's needed to understand to make good decisions.

The idea decisions couldn't have been better really is premised on the idea that leadership shouldn't be expected to have an analysis more sophisticated than a kindergarten child. Either, literally the case with Trump who a first and second grader would be able to tell is not making any sense, or then in a sort of plausible deniability "no one saw this coming" sort of way to indeed cover for mistakes (but not the mistake of trying to save people's lives but just not having information about that, the mistake of thinking inaction would be good for the stock market and being disastrously wrong so, now that that's clear, pretending to be an idiot sounds better than explaining what information was known when, and why inaction was chosen over action).

That way you have energy to deal with with what you've got. I'm in an emergency room now preparing for a 12 hour shift. Wish me luck. — frank

I wish your patients luck. As for you personally, you'll get what you deserve in this situation.

We also know that for every positive test, there are about 10 asymptomatic infections. That's

1. Why the wave of sick people ramps up so high so quickly, and
2. Why herd immunity takes over so quickly after that.
— frank

This is not a correct analysis, even if the premise "there are about 10 asymptomatics" is true.

Asymptomatic's refer only to people who do not have symptoms when they are tested. They do not include people who were asymptomatic when they were tested and then went on to develop symptoms.

1. In an exponentially expanding phase -- an acceleration phase of a logistics curve of total past-and-present-infected, for those who think Musk has a meaningful contribution to the conversation -- it is to be expected to find lot's of asymptotics as the population of newly-infected is much larger than the population where the disease has progressed to a state of symptoms. So statistics will point in this direction, but it is an illusion.

2. Herd immunity will take over at some point; true, but not necessarily quickly. It is not guaranteed it would take over after the first wave. The first wave may setup a second, third, fourth, and n'th wave that can be as bad or worse than the first wave. Some diseases do not provide long term immunity even if you get them and recover, and mutation can get around immunity.

It's a bump in the road, not a plague. — frank

I have never even used the word plague, so great straw man.

But in anycase, a pointless truism. If your standard is the "black plague"; sure, not a plague on that scale; if you want to move the goalposts to the black plague, go ahead; no one's being saying it's as bad as the black plague here.

What matters, in terms of policy response, is if the fatality rate is higher than society's willingness to just tolerate it and just go about its business. And the ecological definition of a plague fits what's happening and why we're seeing severe policy responses.

Now, if you think society should just "tolerate it" then make that argument. If you think, well no something must be done, but it's just a "bump", in terms of deaths and economic disruption, on a larger historic timescale, then explain what size bump it is and why things will normalize quickly on the time-scale you're considering.

Yes, I'm sure his work is bad but I guess my point was that even if he was right it still didn't matter. So the whole discussion becomes a distraction from the fact that the Trump administration dropped the ball. — Benkei

Normally this is the case for the kind of comment the author makes. But the author does his utmost cleverest to be even stupider, and throws out scenarios like :

If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths. — idiot

So this is why the usual response of "1 percent is still huge" doesn't work for this author.

But we're in agreement, I was writing just the first-order argumentative mistakes for people that would otherwise take it as serious analysis.

I sincerely doubt it but we'll never know. — Benkei

Yes, we may never know, but if the problem was indeed "hyped" by the left-wing, and billions of dollars could be given to the airlines to save "a few lives", I think it would be carried out, a win-win scenario: politicians "acted", airlines and whoever provides the tech stock goes up, people's lives saved.

It's just interesting to me that approaches are discussed in terms of economics and its long term effects. Where was that discussion going into Iraq, Afghanistan, war on drugs etc. Etc.? — Benkei

Definitely, but I think my explanation more or less covers it: wars, including the drug war, are fuel for corruption and has at least some short term economic stimulus of spending cash. They also create groups of people "to blame" for things and achieve these sorts of propaganda objectives over a long time frame.

Yes, granted that the virus came from China creates a little propaganda opportunity, but ultimately the incompetence of managing the crisis at every subsequent point to the Chinese coverup cannot be blamed on the Chinese. It's like if I push you and you then go jump off a cliff 100 meters away; yes I shouldn't have pushed you, but my action isn't related to your self-harming actions later. Even Trump supporters may be able to see this obvious logic considering the time frame is so short; many are impressively immune, updating their beliefs Trump is not to blame for anything in real time, but we will see if this applies to all members of the flock.

But anyhoo, good to see spending a few billions to save lives is more an issue than spending trillions on wars. — Benkei

I don't think this is quite fair. If they could have just given the airlines billions to solve the problem; some expensive device that instantly diagnoses flyers and so you can contain perfectly, then they would have spent that money gladly.

The problem was that effective containment of stopping 10 to 20 percent of world air travel would have depressed the airline and boeing and airbus stock temporarily.

War spending is also short term stimulus and hand outs to a lot of cronies. All pandemic responses are anti-economic stimulus and only permit hand outs to relatively few cronies.

Now that the problem has advanced to a crisis big enough to hand out trillions of dollars to their cronies in every industry, they're pretty quick on the draw. Not that they consciously chose for things to play out until this point, just that there was no visible action points until now.

The fatality rate is actually not even that important at the moment. It's the fact nobody has immunity and enough are sick enough that they require hospital care that will demand all the healthcare capacity a country has. The knock-on deaths because of that will mean deaths that can be attributed to corona will greatly increase. — Benkei

Yes, but only because the rosy scenarios have clearly been essentially ruled out by nearly everyone who's following along. The author is still a hold out for roses literally raining down from the sky upon us.

The author goes to some length to try to show a scenario where the CFR is not so much worse than the flu, as well as a rosy scenario where, even if it wasn't, just "letting it pass" will save more lives as the health system can at least get back to treating everything else quickly.

The CFR not mattering is only above a threshold, that has clearly been passed but this author doesn't accept, since the author still tries to dance under this threshold by making very large range of estimates, based on cherry picking even among the data that's currently available, and then saying: "see, it could be super low, still just in the noise of normal coughs that kill old people all the time".

So, given this advanced state of delusions, my answer focused on the main problem with this reasoning, even just internally assuming his estimates, which is that "well, it could be super high too; obviously", and that equally obviously "not having the information" the author wants is not some necessary fact of the situation we just have to deal with by underplaying things, but a choice by leaders. That we don't have the information is a criticism of the people not going and getting the information, not a criticism of the people worried that things may be on the worse end of the wide estimate windows as well as everything else the author doesn't consider.

There's also the possibility governments aren't flying as blind as the author thinks, but have gotten out and gotten the information, but haven't published it because it isn't good and we can deduce it isn't good because of the policies being put into place.

But yes, there's so much wrong in this "statistician's" analysis that we could go basically sentence by sentence and demonstrating cherry picked data, making factually incorrect statements such as social distancing "we don't know will work", unsupported conclusions from his own premises, not balancing the rosy scenario of "it could be on the low end" with black scenarios of "it could be on the high end".

But some suspect it will be even lower, possibly lower than seasonal flu. Dr. John P. A. Ioannidis Recently wrote: — NOS4A2

What a complete idiot; can't believe this guy is correlated with the word "statistics". That's academia for you.

His reasoning is completely preposterous.

After explaining why sampling bias creates large uncertainties, which is true, that without good estimates of the infection fatality rate, no optimum strategy can be constructed. True. An honest intellectual would have pointed out why it was so critical to contain as effectively as possible during the initial outbreak to buy time to get good information to make good decisions.

But, either due to being a dishonest intellectual or then just a complete idiot, he does not want to inform his readers that people in charge completely dropped the ball during the initial phase where containment was still possible to either contain or at least significantly slow.

He really, really wants to criticize people who don't have an optimistic reading of the numbers, which he himself goes to some length to explain that there's not enough information to get a good estimate on way or another -- but insists on emphasizing only a rosy reading.

This leads up to his key premise which is as follows:

The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections. Sadly, that’s information we don’t have. — John Ioannidis

From this premise the reasonable conclusion is that sort of random testing should be carried out! so that it goes from being information we don't have to information we have. That should then be the end of his reasoning line: if we want better decisions we need better data which will require more testing capability as well as randomized testing. Another example of things that can't be done early on when testing is outsourced to a crony who then does a crappy job.

Instead of informing his readers that the Trump administration does have the power to do this, and therefore should do it, he instead criticizes people for "preparing for the worst scenario".

In the absence of data, prepare-for-the-worst reasoning leads to extreme measures of social distancing and lockdowns. Unfortunately, we do not know if these measures work. — John Ioannidis

Is his next sentence. What the hell is this? Most measures of social distancing are uncontroversial in that they work.

Epidemiologists, which this dufous apparently is, all agree social distancing measures work at reducing transmission rates. "Shelter in place" obviously works at reducing infection rates.

By focusing on one edge case of schools, where there is room for some debate, doesn't cast shade on all the other extreme measures of self-isolation and large scale quarantines. This is just completely dishonest argumentation to imply all social distancing measures have the same uncertainty as school closings; however, a numerical model recently leaked does show school closing as being effective, so, in order to keep "the uncertainty is the same" perspective he would need to at least provide a numerical model showing school closings are counter productive, which he doesn't because he's lazy and stupid.

School closures, for example, may reduce transmission rates. But they may also backfire if children socialize anyhow, if school closure leads children to spend more time with susceptible elderly family members, if children at home disrupt their parents ability to work, and more. School closures may also diminish the chances of developing herd immunity in an age group that is spared serious disease. — John Ioannidis

Maybe, maybe, maybe, maybe.

This is simply wishful thinking analysis.

The expression "Hope for the best, prepare for the worst" he basically wants to change to "Hope for the best, and also prepare the best".

It's completely reasonable to prepare for a worst case scenario if the Trump administration doesn't carry out the randomized testing that the author wants. That's the reasonable conclusions to the "room for doubt" that he brings up: "The administration is completely incompetent, the infection rate is out of control and not tracked correctly, we don't know what will happen, policy reactions will not be optimum leading to high second order risks in terms of economic and social disruption fallout."

Yes, a rosy scenario is still possible, that "it's not so bad".

But a black scenario is also still possible. Health-care workers are disproportionately affected, have much higher infection rates due to close proximity and starting to run out of protective gear already in the first weeks of the crisis, and death rates and "just them older doctors" we should care about dying more than is needed, as they have a lot of experienced their loss represents long term damage to the health system. The capacity of the health care system is not constant through a "acute" overload, but could be significantly damaged leading to a protracted under capacity to deal with other disease anyways; the author does not mention the benefits he points out in his rosy scenario are not assured, but also unknown, since the author is unable to think critically. In an overloaded scenario many more young people may die without treatment; this number is also unknown, extrapolating from the cruise ship numbers is not a valid proxy to the "run wild" hypothesis. Letting it run rampant also maximizes the probability and also evolutionary pressure to mutate into something worse. Long term damage to lungs and other organs is also among the things unknown at this point, especially without treatment which would result from no social distancing. Also critically, re-infection, due to losing immunity in a relatively short time or then mutation, is also unknown; so, letting the virus run rampant cannot be assumed to provide everyone immunity, and the virus may come back as a second wave pandemic putting us back to square one but with a severely damaged health system and maybe a worse virus to deal with.

That the black scenarios can't be ruled out is why all the measures being seen are taken by every country that has an exponential outbreak, and strict quarantine and travel restriction are being put in place by countries that do, as another social distancing measures, and countries that don't in order to carry out the containment strategy competently to buy time to prepare and learn from failed policy cases; including now Trump! is doing some extreme social distancing like stopping planes, and various states individually as well are going more extreme to fill the policy gaps!

The idea of "letting it run its course" was investigated, governments put competent statisticians on the job; no country would be stopping nearly all economic activity if rosy scenarios weren't essentially all ruled out at this point. The author doesn't mention this, because the author wittingly or unwittingly, wants his readers to imagine that government's just listen to lefty snowflake twitter users to make decisions.


Wha't the reasoning for attacking Trump's own decisions now of taking things "super seriously", indeed deciding to have taken it super seriously from the beginning and now implementing severe measures? That the "libs got so loud that Trump was forced to act on the left's snowflake delusions." It's a crazy line of argument to imagine that the left is actually in charge, somehow, now that the stock market it tanking and Trump is no longer "sticking it to the left" by downplaying the pandemic as "just a flu".

It's the most stupendous feet of double think that I have so far witnessed in the political scene.

If you want to criticize the reaction, criticize the administration that is currently in charge of the reaction.

If you want to criticize the lack of data needed to create a optimum strategy in terms of "life lost from the virus" and "life lost due to reactive and overdone policies affecting the economy", then criticize the administration for A. abandoning effective containment and contact tracing so that little time was bought to figure out the information needed B. fumbling the layup "make tests available" to do random sampling as well as track symptomatic cases and C. not doing random sampling testing even now to have a clear idea of what the situation is now.