Today people started losing their jobs because of Crazy Nancy Pelosi, Cryin’ Chuck Schumer, and the Radical Left, Do Nothing Democrats, who should immediately come back to Washington and approve legislation to help families in America. End your ENDLESS VACATION!
— Donald J. Trump (@realDonaldTrump) April 17, 2020
Crazy Nancy Pelosi deleted this from her Twitter account. She wanted everyone to pack into Chinatown long after I closed the BORDER TO CHINA. Based on her statement, she is responsible for many deaths. She’s an incompetent, third-rate politician! pic.twitter.com/uWNI7DCG3o
— Donald J. Trump (@realDonaldTrump) April 16, 2020
Crazy “Nancy Pelosi, you are a weak person. You are a poor leader. You are the reason America hates career politicians, like yourself.” @seanhannity She is totally incompetent & controlled by the Radical Left, a weak and pathetic puppet. Come back to Washington and do your job!
— Donald J. Trump (@realDonaldTrump) April 16, 2020
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258 comments:
«Oldest ‹Older 201 – 258 of 258CS: "Herd immunity by definition"
But it is not (only) a matter of definition. It also depends on susceptibility. Though I am no expert, I imagine there are also different levels--you may not need complete immunity across the population to avoid most of the nasty complications.
We don't know the actual level needed yet in this case.
New York and New Jersey together have 44% of the cases in the. US and 57% of the deaths. Remove those from the numbers and the “models” and you have a so so flu year
People are beginning to notice.
I think Newsome was just lucky.
Yes. Political people tend to credit politicians or government, and since the media are political people that's what we hear (and many believe). But politicians have far less impact on literally everything than is generally believed. They have more impact on this type of activity than other types (say, general economics) but it's still far less than generally beleived.
Ioannidis vs. daskol: tough choice.
But he called BS early: an "epidemic of false claims." As did we amateurs right here on the Althouse blog.
you may not need complete immunity across the population to avoid most of the nasty complications.
We don't know the actual level needed yet in this case.
Fine, but anyone who argues that the 2.5%-4% range found in the Santa Clara study is likely to be effective herd immunity should recognize that this would be completely unprecedented. For most diseases around 80% is needed (for measles IIRC it’s 95%.) I’ve seen 40% thrown out as perhaps the lowest threshold known to work for some diseases.
A reminder of the WHO:
Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China🇨🇳. pic.twitter.com/Fnl5P877VG
— World Health Organization (WHO) (@WHO) January 14, 2020
Blogger CStanley said...
Herd immunity by definition requires a large percentage of people to have antibodies..
--
FWIW,
Antibodies are not required for immunity against some viruses
I propose we offer limited $$ to WHO if they change it to WUH
"anyone who argues that the 2.5%-4% range found in the Santa Clara study is likely to be effective herd immunity should recognize that this would be completely unprecedented"
It would be, I agree. Is anyone arguing that right now?
A quick question: I haven't seen a word on this blog about testing, though everyone agrees it is the critical roadblock to reopening.
Testing has been held up due to CDC incompetence and FDA standard procedures. Early batches were ineffective. The whole world wanted the limited amount of reagents available. Ab testing will be interesting for statistics. PCR testing will be important for diagnosis. ARM was assuring me a month ago that every molecular biology lab had PCR machines and there was no issue.
We cannot wait for perfection and watch the economy die, much as Democrats would like to do so. Nancy knows that small business owners vote R and she is perfectly willing to see them all go bankrupt.
And the reason people like Ioannidis succeed in life is credulous people who think that March 12 piece of "science" he published is some brave statement calling out BS. In fact, read carefully, it's clearly a load of BS itself, using a lot of words to invite the credulous to believe he's taking a strong position when all he's doing is stating the obvious--there's not enough data for an evidence based approach--and taking a weak, but utterly defensible from a science perspective, position. People love bullshit.
But he's as much a part of our "expert problem" as the fools who run around shrieking because some model is projection 10M dead. Other side of the same coin.
Walter, that is an interesting link and there is another interesting one there, on a peptide that inhibits Zika virus replication that sounds a bit like the EK1C4 in this article about SARS.
These are not antibodies and could be engineered.
@Sebastian: your 2:19 comment quoted me and then responded...
"But those levels of immunity in the community are much, much lower than what is needed for herd immunity."
That's not clear. Wittkowski speculates that Korea achieved herd immunity at seemingly low levels of infection.
If by that you didn’t mean that 2.5-4% might be enough, then I misunderstood.
"to invite the credulous to believe he's taking a strong position"
No, we did not believe he took a "strong position." That's what the pro-sanity faction did here on this blog. But on balance Ioannidis was right to inspire the right kind of skepticism when that was in short supply. He was one of the gooder guys when most of his colleagues were egregiously bad. Let's focus our attention there.
@walter, that is interesting, thanks. We were taught that the innate immune system plays a small role but it’s possible that isn’t always true. The other side of that coin though is that it’s the same part of the immune system that causes damage in the lungs and such, so even if we get really lucky and find that a lot of people fight this off through that type of immunity, it would be difficult to create therapies for those who don’t without the treatment causing more harm than good.
CS: "then I misunderstood."
No, my bad. I meant to say "what is needed for herd immunity" is not yet clear in this case, not to make a claim about the 2.5-4.0.
That's a very charitable way to regard Ioannidis. Too charitable. I would characterize his paper more harshly: when there was a need for "experts" to provide useful guidance on what actions to take and what framework to use to evaluate what actions to take and how to measure whether they were useful or not, Ioannidis sat back in his comfy chair in an ivy covered tower, puffed his pipe, and wrote a paper saying how all this action and talk was rather unscientific.
"Inspiring skepticism" is not the same as, say, saying that the lockdown is a mistake. It's not the same, or nearly as useful, as suggesting what actions we might reasonably take, you know, marshaling one's deep expertise and prestige to actually put a little skin in the game and offer something useful. He problematized, and he did it so that he could point it out in a few months and persuade the credulous that he's the big old expert. But did he really use his expertise in a beneficial way (beneficial for others than himself)?
@daskol,
You repeat yourself over and over and over again. You don't like Dr. Ioannidis, got it.
Stanford University likes him. BMJ likes him.. JAMA likes him.
Nature likes him.
He's a "meta-data" dude who wrote one of the best papers in the literature in decades, "Why Most Published Research Findings are False
Your criticism of him is weak, but it is noted.
So, let folks read his work and watch his one big video and let them judge for themselves.
Video on Covid-19 by Dr. John Ioannadis
If 5 million people were dead now in the US from COVID-19, Ioannidis' "conclusion" would still be correct.
Ok Sebastian I see.
"Chris Lopes said…The Russia thing though seems to have been a Cold War style disinformation campaign launched by the Russians to mess with the election process."
The previous stories they fed you went rancid, Chris. Why are you believing the new one?
BAG, you seem apt to confuse credentials with expertise and usefulness. I have no doubt that Ioannidis is good at getting published, good at getting cited and good at cultivating his good name with the grandees of his field and environs. And if I seem harshly critical of him, it's mostly because I had thought very highly of him for the role he played in publicizing the replication crisis in the social sciences: that phenomenon has had a profound impact on the way I look at many things, including all those fancy journals you mention and what's in them. So it is a major disappointment to me that Ioannidis has revealed himself as foremost a bullshit artist: if 5 million people were dead of COVID-19 in the US, his paper would still be correct. He said nothing meaningful.
Ioannidis doesn't actually bother me. What bothers me is when intelligent people can't spot a bullshit artist.
I hope Pelosi's ice cream moment will be juxtaposed with her inaction in an ad.
I just wish she would do a daily review of various flavors.
And oh, maybe a tour of her vineyard.
Ice cream and wine? Ladies will swoon.
I did not have any particular issue with anything Ioannidis wrote. But near the end of his paper, he says: "If COVID-19 is indeed the pandemic of the century, we need the most accurate evidence to handle it. Open data sharing of scientific information is a minimum requirement. This should include data on the number and demographics of tested individuals per day in each country. Proper prevalence studies and trials are also indispensable."
Where is this "most accurate evidence" supposed to come from? On what basis were we to draw conclusions about the virus given the relative lack of such data and the inherent difficulty in collecting such data while a pandemic is unfolding? On what basis do we determine that social distancing won't be effective? Ioannidis cites a single paper, "Physical interventions to interrupt or reduce the spread of respiratory viruses." The conclusion from the paper regarding distancing was: "There was limited evidence that social distancing was effective, especially if related to the risk of exposure."
Ioannidis mentions distancing once again in context of the Spanish Flu and writes: "Retrospective data from that pandemic suggest that early adoption of social distancing measures were associated with lower peak death rates. However, these data are sparse, retrospective, and pathogen-specific. Moreover, total deaths were eventually little affected by early social distancing: people just died several weeks later." He cites in support of this the paper " Public health interventions and epidemic intensity during the 1918 influenza pandemic."
From that paper: "Consistent with this hypothesis, cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves. Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (≈20%) and less statistically significant than that for peak death rates. This finding was not unexpected, given that few cities maintained NPIs longer than 6 weeks in 1918. Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic. These findings support the hypothesis that rapid implementation of multiple NPIs can significantly reduce influenza transmission, but that viral spread will be renewed upon relaxation of such measures."
Unless I am missing something, isn't this the exact rationale given for social distancing?
"put a little skin in the game and offer something useful"
Well, going against 98.5% of your colleagues takes a little bit of guts.
But brave commenters here did have skin in the game, their exalted reputations as blog commenters no less, and they drew threats of "vengeance" from Mr. Meade himself, and they did offer something useful, not only the correct call on the expert BS but also the correct policy position on limiting the WuFlu fallout while avoid economic ruin. And look how "useful" that turned out to be.
Anyway, criticizing Ioannidis is beside the point. The problem was the other 98.5%.
"We need more/better data to make evidence-based decisions" is entirely complementary to what the rest of his profession, the modelers were saying, which was either there isn't enough/quality data for projections or the projections are really, really scary! They're all of a piece, and what you will not find from any of them is a useful framework for taking action and evaluating the benefits of that action under conditions of uncertainty. That's our expert problem in a nutshell.
100s of thousands or millions dead was never a probably outcome. It was, and is, a possible outcome. Given what we do know--novel virus, no immunity, apparently highly contagious and dangerous to humans--and what we don't know, it is sensible to take action to mitigate the spread of the virus. It's the asymmetry of the situation that dictates that, same as it dictates why a clinician would prescribe Zpak and Hydroxychloroquine to an ill patient while a health bureaucrat can't say it's proven effective: the cost of prescribing it is relatively understood and risks are low, while it could help when nothing else seems to help. This does not mean that every action taken to mitigate virus spread is justified or effective. It is merely a useful framework for evaluating whether to take action and on what basis, something you won't find in the work of too many experts.
but the most extreme measures, probably shouldn't have been applied, if half measures could do, we have erred toward the most drastic measures, which at the end of the day,
"but the most extreme measures, probably shouldn't have been applied, if half measures could do, we have erred toward the most drastic measures, which at the end of the day,
If you get a paper cut on your finger, there is always the risk of a fatal infection. That doesn't mean your first choice of action should be to amputate your arm.
@Sebastian:
But brave commenters here did have skin in the game, their exalted reputations as blog commenters no less, and they drew threats of "vengeance" from Mr. Meade himself, and they did offer something useful, not only the correct call on the expert BS but also the correct policy position on limiting the WuFlu fallout while avoid economic ruin. And look how "useful" that turned out to be.
How can we possibly make that determination at this point? There is not enough data to say one way or the other? Even the research Ioannidis cites in support of his positions is inconclusive at best. Further, if we are to make decisions on the basis of "the most accurate evidence," what was this source of this evidence in early March, given that the world was first alerted to the existence of the virus 5 weeks earlier and given the reliability of data coming from China? How could anyone say with any degree confidence what the correct response was?
"she has proven quite adept at outmaneuvering and goading him into avoidable blunders" Oh prunella, that's a good one. You are talking about the person who ineffectually helped impeach Trump over nothing and then had to watch as Trump's approval and campaign donations soared. Trump was stronger after the impeachment than before. May Pelosi continue to "outmaneuver" Trump again and again.
@daskol,
I watched an interview of your boy, Harry Crane criticizing folks.
He's a clueless fray boy. way out of his league. You kinda sound a bit like him.
There are two risks: (1) the risk of the virus and (2) the risk of economic damage caused by the government lockdown in response to Risk 1. Two separate risks that have to be evaluated. Yes, that vexes people.
Your boy Crane is clueless on Risk 1, he just assumes the virus is dangerous and will spread, and doesn't pay any heed to Risk 2.
You are starting to bore me. Simple question - do you think Cal Governor Newsome should ease up the lockdown, based on the current imperfect information or not?
If yes, we're cool.
If no, well, I will defer furthe choice comments.
over in Hillsborough county, they have their priorities straight,
Risks 1 and 2 are not separate. For example, in any scenario in which the virus spreads widely, that will have an enormous and potentially long-lasting impact on the economy. As to assuming the virus is dangerous: on the available evidence, back in January and still to date, it is dangerous. There is no assuming necessary. It's dangerous and contagious, and moreover, we know how to contain such a problem. In the bad to worst case scenarios, the virus destroys not just many people, but our economy: that's a possible outcome, and you can mitigate it, so you do according to the precautionary principle. This addresses elements of both risk 1 and risk 2. Acting sooner on this type of framework would likely have been more effective and way cheaper than what we've undertaken.
As to CA, from photos I've seen people have taken it upon themselves to loosen the lockdown. Gov Newsome is now beside the point. It does appear that this is relatively sensible by the people of CA, although if they don't have an effective testing system in place, they may well see numbers go the wrong way. So there's something to the federal program of phases/gates, but noncompliance appears to be breaking out. Newsome should make it official to retain whatever authority he still has.
bringing the pillows
Michael K.,
Yes CDC messed up in January and February. But we are looking forward now. You may be right that we have to run risks to reopen--still, with more testing, those risks could be lower and more clearly understood, so that more reopening could happen, at lower cost in illness and lives lost. Given the costs of shutdown, there is no downside to more testing, the faster the better. Ensuring faster, better, cheaper tests, and adequate supplies, and doing so ASAP is not an individual state problem, it's a national one, like Sputnik, only more urgent. And clearly there are lots of ways that the Federal government could help--it's not an area reserved to the states under the Constitution. But Trump is both denying the problem and punting on it.
Taking personal credit for the checks, but withholding any help on the testing that is essential to a reopening, simply to preserve the ability to blame governors for whatever occurs? Not a pretty picture.
@Gk1:
h prunella, that's a good one. You are talking about the person who ineffectually helped impeach Trump over nothing and then had to watch as Trump's approval and campaign donations soared. Trump was stronger after the impeachment than before. May Pelosi continue to "outmaneuver" Trump again and again.
Well, Pelosi did oversea regaining the House. She secured the Speaker nomination despite a potential insurgency against it. On Trump's shutdown, she got him to take ownership of it (in front of TV cameras), to agree to postpone the SOTU, and he ultimately blinked without getting any border wall funding. She negotiated a deal with Trump where she agreed to support the creation of the Space Force in exchange for Trump's support on 12 weeks of paid family leave for federal employees.
Peloi was obviously reluctant to pursue impeachment and was pushed towards accepting it from parts of her base. I'll grant the failure on impeachment, but even then his approval rating still maxed out at 49%. This is also coincided with a very high approval rating on the economy, so it might be hard to tease out the effect.
very reasonable
very reasonable
When the unbalanced meets the unhinged.
But Nanci (insert smiley face here) is the pipeline for all that beautiful NorCal money.
Given the costs of shutdown, there is no downside to more testing, the faster the better.
The probability of faster testing is low. The two methods, PCR (according to ARM this is easy) and Ab are both topping out way too low. The supply of reagents has peaked at an inadequate level. It is very useful when done in samples, like Santa Clara County, but testing of millions is months away.
I credit Gavin for not being as stupid as some. That said, the rules are still stupid. The police arresting a surfer, surfing alone, stupid. Applying a one size fits all for a state of nearly 40 million, stupid. Closing beaches because some people get too close, stupid.
The past years of Trump economic success have blessed the California tax coffers. Gavin had the good fortune to have a huge surplus when he took office. Item, when Arnold was governer, he set up a program to help in just such a disaster as this one. Jerry dismantled it. Gavin did nothing to restart it with his windfall.
There are some quirky anomalies to the death toll here in peoples' republic. SF, the second densest city in the country has an abnormally low number. This despite all the effort to be politically correct and have the giant Chinese New Year parade in February in SF, and nanny downplaying the dangers.
A possible reason for a lower California death rate: We prisoners of the people's republic do get outside more often that others, where going out in February without a coat results in hypothermia. The San Jose high February 7th was 67. We are not trapped indoors in winter. Almost every morning we go out to visit the ducks, coots and Canada Geese at Santa Clara's central park. It has broad 10 foot wide concrete walkways, polite people with cute dogs, who observe the wear masks and stay away rule. This month we have the added attraction of cute baby ducks and geese. A combination of warm weather, and less time indoors will reduce infection rates. That is a final irony of the "shelter in place" rule: People spend more time indoors, rather than outdoors.
Michael K. I may be mistaken, but I think you are dodging the question.
Would we be better off if Trump used his undoubted power to mobilize federal resources in support of expanding testing.
Answer: yes we would, because it would help both expand testing--which would allow for much safer reopening--and allocate it to areas of greatest public health need and greatest reopening value.
So why is it OK for Trump to deny the problem and punt on solving it? Avoiding responsibility is not an acceptable answer.
Don't pick on Pelosi's fancy fridge. Remember that Althouse has five figure fridge as well and has defended it vigorously in the past.
Would we be better off if Trump used his undoubted power to mobilize federal resources in support of expanding testing.
What is the goal of expanding testing.
The whole testing gambit is is sounding like a scape goat to keep the economy crippled.
So what is the end goal of testing?
(((DeanObeidallah)))
✔
@DeanObeidallah
LIBERATE AMERICA from Trump and Trumpism. After we defeat Trump this November we next must root out and eradicate Trumpism wherever it is found. Our nation depends on it!
If you're feeling froggy, jump! But you won't defeat President Trump this November, so I guess you won't have the opportunity to lose a civil war.
@iowan2:
So what is the end goal of testing?
Identify the sick and isolate them from the rest of the population. Trace who they have recently been in contact and quarantine them. This will slow transmission and hopefully get the R0 below 1. It was the lack of testing that made widespread social distancing the remaining option to slow the spread. But it is obviously not a viable long-term solution. Basically the difference between carpet bombing and surgical strikes.
finally a republican, of sorts, that will fight back - the commies have never had a real opponent!
J. Farmer said...
@iowan2:
So what is the end goal of testing?
Identify the sick and isolate them from the rest of the population. Trace who they have recently been in contact and quarantine them.
The throat swab for the virus or serology for the antibodies?
There are a significant number of false positives and negatives either way.
Don't fetishize testing. If you are going to fetishize a thing, make that thing a thing that will work.
Don't fetishize testing. If you are going to fetishize a thing, make that thing a thing that will work.
I’m always open to considering alternatives. For what it’s worth I put myself in an agnostic category. I don’t think we have enough information yet to make definite claims one way or the other.
Not enough information?
How about 22 million people on unemployment?
And a disease that is not nearly as lethal as was feared.
As for predictions, I like mine.
I took the under on deaths.
And the over on economic destruction.
Sebastian did well, also.
@Birkel:
Not enough information?
How about 22 million people on unemployment?
And a disease that is not nearly as lethal as was feared.
Feared by whom? Anyone making definite claims about lethality was a fool. There is not enough information available to determine that. And even if we could determine with a great deal of accuracy the lethality in one data set, it may not be the same in another data set given confounding variables. The point of distancing wasn't based on lethality but the
to strain healthcare resources with a large cluster occurring within a short period of time.
Getting people back to work in an efficient, effective way is important. Expanding testing capacity is part of that.
How can we possibly make that determination at this point?
How about elementary common sense?
There is not enough data to say one way or the other?
Actually we do have plenty of data. Start by opening up rural areas with low death rates. Stop trying to pretend that inner cities and densely packed inner suburbs are no more dangerous than places where the nearest neighbor is a half mile away. (My rural county has had few hospitalizations and zero deaths.)
Blogger Stephen said...
"Michael K. I may be mistaken, but I think you are dodging the question.
Would we be better off if Trump used his undoubted power to mobilize federal resources in support of expanding testing.
Answer: yes we would, because it would help both expand testing--which would allow for much safer reopening--and allocate it to areas of greatest public health need and greatest reopening value.
So why is it OK for Trump to deny the problem and punt on solving it? Avoiding responsibility is not an acceptable answer."
Trump never denied the problem and made such federal resources as we had available to the various state governors. See New York.
What did you want him to do? mobilize the army? How would that help?
How could he expand testing when there were no test available?
Smug,
Really, sincerely, fuck off.
If you don't know anybody who has been scared by this nonsense, then you live in a really tight bubble.
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