You live in a roughly Dunbar-sized group. This does not mean that you live in a small village, but it does mean that your actual personal contacts, the number of people that you have direct social contact with, is about one hundred. One day, a respiratory illness starts to circulate among your social group. At first it seems just like a bad cold; later it becomes clear that it's a really bad cold.

You catch it, and you spend four days in bed with fever, muscle aches, chills, and nausea. Your sense of taste and smell go away. Once the fever breaks and you get out of bed, you deal with another week of sinus headaches and persistent dry cough. This is way longer than a typical cold, but it does eventually abate, and you get back to your normal life. [1]

In the aftermath, you take stock with your friends and acquaintances. It seems that about half of everyone you knew got the supercold; the rest avoided it by good luck or had such mild cases that they didn't notice. One person had a fever for ten days and almost had to go to the hospital, but they did eventually recover.

Nobody that you know died, though you did hear about a friend's elderly great-uncle who caught the cold and died of complications.

One day shortly after this, a mysterious man in a gray suit approaches you.

"I see that you and your friends have survived the passing of the great and terrible novel respiratory virus," he says.

"Uh, yes," you said, wondering why he refers to it in such an obtuse manner. "Who are you?"

"I am a concerned bureaucrat," the man says. "It also so happens that I am in possession of a time-travel device."

"Whoah, what? How does that work?"

"Never mind that. The point is: I can make it so that your friends do not suffer from the supercold."

"Okay. What's the catch?" You are genre-savvy and know that there is always a catch.

"Well, you'll have to close down many of your businesses for several months."

"Okay... so how will my friends who are waiters or small business owners avoid bankruptcy??"

The man shrugs. "We'll send them a check for a few thousand dollars."

"That's not nearly---"

The man cuts you off. "Also you'll have to give up in-person socializing for the same period. Especially you have to stop big social events like church and synagogue meetings, holiday parties, and weddings."

"But my sister is getting married---"

"And you will be required to wear uncomfortable masks whenever you leave the house for the same time period."

You are starting to have doubts. "But if we do this you promise it'll stop the disease?"

The man shrugs. "Well... maybe. For a little while."

"That's not very comforting. I'm really not sure that this is a good deal. Listen, the disease was about a week of discomfort for most people, nobody died, and if you hadn't showed up to make this pitch to me, I would have been well on my way to forgetting the whole thing. Is this really worth it?"

The bureaucrat begins to get upset. "How can you say nobody died?"

"I don't know a single one. My case was among the worst ones out of my friends, and it was unpleasant but not life-altering."

"What about your friend's great-uncle?"

"He was already quite old. And while his family surely grieves, it's still a fact of life that old people die a lot."

"And so you're going to throw him to the wolves in order to save your friends livelihoods!"

"Honestly... maybe. Really, though, shouldn't we be able to do something to protect the elderly or other vulnerable people without causing everyone else six months of financial hardship and lost relationships?"

"Six months..." the man squirms. "I might need you to do this for a year or two."

"And you said that I still might eventually catch the cold anyway."

"Aren't you listening to me? People died of this disease."

"People die every day of a thousand different things. It is good to save lives, but there is such a thing as a price which is too high. And this price is too high, at least under the terms that you're offering."

"Bah," the time-traveling bureaucrat says. He scowls at you. "I don't need your permission anyway." He pulls the time-travel device out of his pocket and pushes the button, leaving behind only the slightest whiff of brimstone.

There is distinction between COVID "skeptics" and COVID... it's not clear that there is a term for a COVID non-skeptic, but you know what I mean. (This lexical lacuna itself is something interesting, but I don't have time to go into that here.) It is typically proposed that the reason for COVID skepticism is some version of anti-scientific bias, exacerbated by partisanship. In other words, the problem with COVID skeptics is assumed to be one of epistemics: they refuse to believe the clear scientific data about COVID, preferring to believe conspiracy theories and medical cranks.

This view is false. Or rather: conspiracy theories and partisanship abound, but they are downstream phenomena, consequences of a more fundamental reality, and combatting them directly is useless unless and until the underlying cause is addressed. The underlying cause is the conjunction of two things:

  • COVID is a non-life-threatening for almost everyone
  • The harms caused by COVID suppression were larger than the harms of COVID itself for most people

These facts create a scenario in which a great many people, if they had been given a free choice between getting COVID or putting up with COVID restrictions, would have chosen to just get the disease. But of course they weren't given that choice. The choice was taken from them and made instead by politicians and bureaucrats working with murky legal justification, and thus the very real harms of COVID suppression were felt by everyone while the harms of the disease itself remained abstract, or were experienced and found to be small.

That latter point is important. I have a family member who lives in the rural Midwest, with all that that implies. They mostly complied with COVID restrictions in the early parts of the pandemic, but stopped doing so around summer of 2020 and were in open (if informal) rebellion against such things during the wave of winter 2020 and beyond. As one might predict, their community was hit with an enormous COVID Delta wave. Their entire family was infected and fell ill, as did the majority of their friends and acquaintances, with their church (which continued holding services unmasked this entire time) being a major hub of infection.

And the end result?

There were zero fatalities of anyone actually known to them. Not a single one. Not even a hospitalization.

It's important to point out that this is not an anomalous result. Given the total CFR of COVID (~0.5%), the expected number of fatalities in a Dunbar-sized group is less than one. The modal experience of COVID is that nobody you know dies. The next most common experience is that only one person dies, probably somebody elderly.

And under such circumstances, what are they supposed to think about the supposed dire consequences of failing to comply with COVID regulations? They already endured the full brunt of an unmitigated COVID wave and lived through the worst-case scenario that the government was trying to save them from. At this point, no amount of "believing experts" or "following the science" could possibly dislodge them from their belief, formed by direct personal experience, that COVID is no big deal. And with regards to future precautions, they're not even wrong. Their whole community now has natural immunity which reduces the likelihood of future reinfections and severe complications. It's unlikely that they'll even notice Omicron when it passes through.

I believe that this pattern holds up at larger scales. I do not know of any source which directly compares beliefs about COVID severity with opinions on restrictions, but there was this fairly famous finding reported by the NYT:

COVID severity estimates by party affiliation

If we accept that party affiliation is a rough proxy for one's opinions on COVID restrictions, then we see that having accurate beliefs about COVID severity is correlated with opposition to such restrictions. (I would be interested in any studies which directly measure this.)

This is the scenario which breeds conspiracy theories. People observed the government, media, and large corporations acting in apparent unison to prevent a disease which barely kills anyone, and concluded that something fishy was going on. Conspiracy theories about COVID existed from the very beginning, but I have observed firsthand their spread from a conspiratorial fringe to... basically everyone who is even slightly right-of-center. Even people who are themselves vaccinated have bought into conspiracy theories about vaccines, with their resentment and suspicion only increased by the fact that they were coerced into getting a medical procedure that they did not want.

But it's important to note that this is an ulterior consequence of the way that the pandemic has played out, not the underlying cause. People don't oppose COVID restrictions because they believe conspiracy theories; they believe conspiracy theories because they oppose COVID restrictions.

Now let's return to our poor time-traveling bureaucrat.

The bureaucrat has a spreadsheet which aggregates death rates from thousands of Dunbar-sized communities. His frustration arises because while every individual in these communities may find the costs of COVID to be bearable, they collectively add up to hundreds of thousands of excess deaths, which does not seem to be bearable. Thus, he finds it necessary to do something, and as a bureaucrat his only tool is to pass regulations. Furthermore, while he might notice the financial costs of his policies, the emotional and social costs aren't captured on a spreadsheet at all, and so might as well not exist. So he implements a policy which seems like an obvious win, only to meet something which seems to him like irrational opposition.

The community itself, meanwhile, suffers from the opposite problem of scale. They feel the economic and social costs of COVID regulations directly, but the weight of the hundreds of thousands dead is spread so thin that they barely notice it.

I don't know if there is a general way to reconcile these views. Mostly, I blame the bureaucrat, who is allowing himself to think that his spreadsheet captures all relevant information, and the history of COVID response over the past two years is like a parable about the Goodhart's Law implications of treating COVID case counts as a target to optimized. I do think that the main way to accomplish both the community's and the bureaucrat's goals is to simply reduce the cost of COVID suppression. Here I speak more tentatively, but the following seem to me to be generally true:

  • Lockdowns are almost certainly net negative
  • Masks are not very effective, but they are cheap and easy, so they're probably worth it. It is probably sufficient to recommend them without mandating them.
  • Prevention measures should have been focused on the elderly and otherwise vulnerable. Case counts among the young and healthy population should have been treated with indifference.
  • More speculatively, we should have positively encouraged non-diabetics under 30 to catch COVID. They are vanishingly unlikely to need hospital care but still contribute to herd immunity. Every healthy college student who gets COVID is basically a free vaccination. [2]

Can we learn these lessons in time for the next pandemic? Unfortunately, if the next pandemic is less than forty years away, I fear that we cannot. At this point a big chunk of the population is pre-radicalized against heavy-handed intervention, and conversely the bureaucratic-managerial class seems to have learned exactly the wrong lessons. Somehow restoring a functional relationship between these classes strikes me as a much higher priority than any specific policy change.

This is, to put it mildly, a hard problem, because the existing dynamic is frankly abusive. The past two years have seen the state and elite institutions inflict harmful regulations... and claim that it's for our own good... then the "good" of ending the pandemic never actually materialized... then the continuing pandemic was blamed on us for not obeying hard enough. This is the classic pattern of an abusive parent. Is it any wonder that so many people have taken the tack of vocal rebellion or quiet non-compliance?

And can you honestly claim that any of the FDA, the CDC, the WHO, or your state government actually deserve our deference and respect at this point?

So the real task of pandemic preparedness may not be to think up good policies that our institutions can implement, nor to somehow educate people out of conspiracy theories, nor (worse) to simply suppress such conspiracy theories. The real task is to have institutions worth listening to in the first place.

  1. This is almost exactly how it went when my wife got COVID. I caught it from her a few days later, but I never developed a fever and suffered only sinus headaches and a persistent cough. ↩︎

  2. In the summer of 2020 I wanted to write an article along these lines called "You Should Get COVID". Unfortunately I never got around to it, and at this point it's moot. ↩︎

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This story makes sense for describing how people might believe conspiracy theories because they oppose lockdowns, but I don't think a similar story would apply for opposition to vaccines. Following this line of thinking, I think the sequence of events is:

  1. Disease breaks out.
  2. Public health authorities respond to the disease with high-cost preventative measures.
  3. People respond to those preventative measures by becoming hostile to public health measures.
  4. People's hostility to public health measures oppose vaccines even though they're much lower cost and much more effective than the measures that led to them becoming hostile to public health measures in the first place.

Similarly what I have seen from by my friends and acquaintances is.

  1. Disease breaks out.
  2. Public health authorities/pharmaceutical companies push a new vaccine and claim it is X% effective/prevents the spread.
  3. Later it is found to be less effective than initially promised/new variants make it less effective and boosters are now announced as needed.
  4. People feel lied to, believing they were originally told vaccine was more effective than evidence shows it is/the fact that restrictions are still in place with the vaccine makes reduces its credibility in their eyes.
Opposition to vaccines comes in various gradings and flavors. I think it's pretty clear that initial vaccination has positive expected value for almost everyone. But it's much less clear if a booster shot can claim the same value proposition: it has a much smaller direct benefit to the bostee, so the argument for it is mostly based on solidarity. Is that enough to make it mandatory? You can also be pro vaccines but against public policy about them. There has been some amount of goalpost shifting, e.g., in the scope and duration of covid passes. In some places, there was an implicit deal on the table: get vaccinated and you will be allowed to visit restaurants and bars. But a few months later this was changed to requiring recent vaccination (4 months instead of 12). Regardless of whether you think that's a good motivation to get vaccination, the promise has clearly been broken.
This is exactly right. By the time the vaccine became widely available, resistance to public health measures was already baked in and broke down along culture war lines, so nothing else really mattered at that point.
We live in in a roughly Dunbar-sized group. If no one died of Covid in your group but one or two people were hurt by vaccines, you will be scared of vaccines.
If you compare deaths to harms, you can end up scared of vaccines or Covid, depending on which you compare. If no one died of a vaccine in your group but one or two people were hurt by Covid, you will be scared of Covid. The question is, where does the framing come from? If no one died of Covid or a vaccine in your group (which seems to be the most likely case for a given group), which do you become scared of, and why?
Let's say you are a man in his 20s. in USA You believe (perhaps mistakenly) that if you get sick with covid, the government will foot the bill. On the other hand, if you get the rare myocarditis from the vaccine, you will be stuck with the bills. Does this create a weird incentive for a young man to avoid vaccination on the grounds of financial risk of ruin?
Why would you believe that?  Long-COVID can give you long-term medical costs that are very unlikely to be paid for by the state.
How long is that long term? We don't know yet but it could be fairly short compared to a condition that can permanently damage one's heart.
i'd bet at at least 1:20 that lung scarring and brain damage are permanent.

Excellent post, but there is one aspect you are missing:


"People die every day of a thousand different things. It is good to save lives, but there is such a thing as a price which is too high. And this price is too high, at least under the terms that you're offering" you say.

A journalist appears beside the bureaucrat. "You want people to die," he sneers. "What a horrible person you are."

"No, I'm just saying that government actions should pass a cost-benefit analysis. It's a basic principle of good governance."

The bureaucrat sighs. "I see we need to do more to combat the spread of misinformation."

"Anti-vaxxer!" shouts the journalist. "Far-right crazy!"

"Far right?!" you exclaim. You're getting annoyed now. "I'm a registered independent. I'm a climate change activist. And it's incredibly unfair for the older generation to stick the younger one with another gigantic bill on top of the costs of decarbonisation. Don't you think we should at least debate that?"

The bureaucrat shakes his head sadly. "There's no getting through to some people. They're just immune to facts."

"Neo-nazi!" shrieks the journalist, his face going purple. "Science denier!" He picks up handfuls of mud and flings... (read more)

9Dumbledore's Army2y
Following on from the above: All the restrictions come to pass as the bureaucrat threatened. You’re angry about your lost social life and your deteriorating mental health and your friends who lost their jobs and your other friend whose cancer treatment has been delayed but there’s nothing you can do about it. You have no political power. You hardly even dare comment on the internet. Every time you try to speak out you are met with abuse or censorship. And you’re worried you might lose your job because once you used your real name when you posted a polite suggestion that maybe the world could have found a better way to handle the virus.* Then one day you meet a man who also opposes lockdown. You’re having your first pleasant conversation for months when you realise he’s from [Country] Nationalist Party. “Um,” you say. “I thought they were far-right racists.” Your new friend smiles at you. “That’s just media exaggeration. The woke lefties hate anyone who wants to have a grownup conversation about immigration.” You aren’t completely happy, but you remember the journalist shrieking insults at you for views you don’t hold. You remember months of every media site and internet commenter acting like ‘lockdown-sceptic’ is a synonym for ‘anti-vaxxer’ and sneering at those terrible people. You have lost all faith that the mainstream media can accurately represent reality, and your previous impressions of the Nationalist Party were based on what you read in the media, so you give your new friend the benefit of the doubt. You try lurking on Nationalist forums, just to see for yourself. You meet a few Nationalists in real life, thanks to your friend. It’s nice. You can vent about the stupid restrictions and no one calls you names. You can have an illicit beer with friends and it’s so much better than going insane with loneliness. Yes, one of your new friends makes politically incorrect jokes, and sometimes people on those forums have some very odd views, but so what. You don
I'd be interested to hear more about this? I'm also a member of the lib dems, but I'm sufficiently inattentive that I couldn't tell you any of the party's positions on covid.
4Dumbledore's Army2y
I’m not sure if the Lib Dems are keeping quiet about it or if the BBC, Guardian etc are carefully ignoring them because the Lib Dems don’t fit the narrative of lockdown-opponents being crazy right-wingers. I haven’t been fully attentive, and I think Lib Dems were on board with the 2020 lockdowns but they voted against extending the Coronavirus Act from March 2021, and they voted with the Tory rebels against vaccine passports this December. I wouldn’t say the Lib Dems have made a brave stand, or even that they’re anti-lockdown, but they do seem to be aware of some of the negative consequences, and also nervous of the government’s abuses of its powers. At the very least they’re more open to debate on the subject than Labour.

An important aspect of this is that it involves a tradeoff between a sacred value (preventing death) and a secular value (avoiding restrictions). When it's not socially acceptable to have a frank discussion of the real costs and benefits of various restrictions, it becomes easier for people who oppose the restrictions to pretend that the benefits of the restrictions don't exist (aka the disease isn't real or isn't serious).

Freedom is a sacred value for many people as well. 

How often do people talk about tradeoffs between multiple sacred values?

I think he means that your argument:

When it's not socially acceptable to have a frank discussion of the real costs and benefits of various restrictions, it becomes easier for people who oppose the restrictions to pretend that the benefits of the restrictions don't exist (aka the disease isn't real or isn't serious).

also applies this way:

When it's not socially acceptable to have a frank discussion of the real costs and benefits of various restrictions, it becomes easier for people who support the restrictions to pretend that the costs of the restrictions don't exist (aka that restrictions to freedom aren't real or serious).

I think both are great points that complete each other.

Even aside the sacred/secular dichotomy, you still need to be able set an exchange rate between different things (mental health, economic damage, hospitalisations, deaths) to establish whether lockdowns are nett negative . Or you could just state your conclusions without showing any workings like the OP did .

You claim lockdowns are almost certainly net negative but plenty of research papers on the cost-benefit analysis of lockdowns come to the opposite conclusion. Lockdowns saved plenty of lives, prevented long Covid and stopped hospitals from being overwhelmed at the costs of ~5% of GDP and decreased mental health. I could see that for certain segments of the population such as young people that lockdowns are a net negative, though a large decision like lockdowns should likely be decided based off the benefits to all of society and for older people lockdowns were definitely a huge net positive. 

Cost-benefit analyses of lockdowns are hard because on one side you have a bunch of reasonably well-defined positives: preventing deaths, and on the other you have a long tail of weird second-order long-term effects like children learning loss, calcification of social relationships because of masks, politicians getting used to exerting this sort of power over the daily lives of normal people, small business closures and all the second-order effects from that, increased videogame addiction, the dramatic increase of Tinder usage instead of face-to-face flirting, increased depression and suicides, that one study that showed babies born during the pandemic had lost 2 standard deviations of cognitive development compared to babies born earlier (babies are likely more resilient than we think and this loss will be temporary, but still). We've had pandemics and old people dying before, so the overall impacts can be better estimated than the impacts of the lockdowns and measures we've taken in the past 2 years, I think people have drastically underestimated the very long-term and far-reaching effects of these restrictions. 

that one study that showed babies born during the pandemic had lost 2 standard deviations of cognitive development compared to babies born earlier

Whoa, that effect size is huge. Too big for me to believe it without more evidence. Seems more likely to be a confounding factor. The discussion section of that paper is pretty good, listing a bunch of hypothesis of what the reason could be, but not finding any obviously good ones.

One thing that stands out to me:

One aspect also not investigated here is the impact of mask-wearing by the study staff during child
visits and assessments [53]. The inability of infants to see full facial expressions may have eliminated
non-verbal cues, muffled instructions, or otherwise altered the understanding of the test questions and instructions.

This seems like it could be a big confounder. (Though it only makes sense if it has a differentially larger effect on younger children, since the cognitive loss supposedly applies to babies born during the pandemic rather than babies tested during the pandemic.)

What makes you think so? My prior is that 'babies are more resilient than we think' is a fashionable idea because the opposite would be tantamount to blaming parents, especially poor ones, and that's unfashionable. I'm interested in learning more about the topic.
Here's a study where they try to predict adult IQ from infant IQ, the correlation is something like 0.32, so about 10% of the variance of adult IQ is explainable by infant IQ, meaning that low-IQ babies can in fact end up with large IQs as adults, which would either indicate that infant cognitive development measures are pretty bad for predicting adult IQ or that it doesn't matter that much what you do to a baby in the first years of life. There's also the existence of periods of historical deprivation where babies have been subjected to much worse conditions than during lockdowns, and they didn't all end up as village idiots like you'd expect from a 2 standard deviation drop. But still, even if most of the effect is going to disappear, something like a 5 point drop in IQ would be a catastrophe, let alone a 30 point one.  
Please note that "infant IQ" is a very non-standard use; the article says "ability to process information" instead. Before three years, things are so difficult to measure that even mental retardation is not diagnosed at that age. I am not surprised by the correlation being low; but from my perspective it simply means "if you try to measure a baby's mental life, you will get a lot of noise". They are probably also pretty bad for predicting IQ at the age of five years. (I don't have evidence for this that I could link; it's just my understanding of how things work.) One of the reasons is that in people 3 and more years old, we can distinguish between someone being generally smart/slow vs someone having a specific talent/disorder (e.g. "a genius kid with dyslexia"); but a baby does not have a sufficiently wide range of specialized activities to diagnose this.

Yeah, it's overconfident to claim that lockdowns are "almost certainly net negative". This stuff is complicated.

But it's also not certain that lockdowns were "definitely a huge net positive" for older people. For example, for my 90 year old grandmother the life-saving benefits are much larger than for younger people. But the costs of a couple years in lockdown has also been huge for her. She's been persistently depressed, and her health has deteriorated a lot. Presumably from not moving around much any more. She's felt really bad about life since the pandemic started.

Especially given that her statistical risk of dying per year is something like 50% pre-covid, it's not obvious whether this is a good trade-off. It all comes down to details about just how big the mental health costs are and the specific number for mortality reduction from covid.

Yeah, I wanted to make much the same point. My grandma died in 2015, but I've talked about it with my family members and we're all pretty certain she would have chosen to die of COVID rather than go into lockdown. In the last years of her life (especially after being widowed in 2008), she was very realistic about the fact that she didn't have much longer to live, and her whole life revolved around her community — she lived alone, but she was an important community fixture in her small town, and had been for decades. Not socializing would have removed her only source of meaning, and there's no way she would have thought that it was worth locking down to buy herself two additional years of life in isolation.

Many cost-benefit analyses (especially early in the pandemic) compared modelled, not actual, benefits of lockdowns - note that epidemiological models have repeatedly proven overly pessimistic - usually with estimated short-term monetary costs of lockdowns. Generally these cost-benefit analyses ignored non-monetary costs, even though they're huge. They also tended to calculate benefits by comparing lockdowns vs doing nothing, ignoring options like supporting the elderly to isolate themselves while letting everyone else go about their lives. 

We now know that lockdowns had minimal-to-zero benefits in terms of preventing short-term excess deaths:  (If you don't have patience to read the paper, just consider Sweden's average-for-Europe performance despite its decision not to lockdown, or the minimal difference between the outcomes of US red states and blue states.) 

So given that the actual factually-demonstrated benefits are statistically indistinguishable from zero (so realistically some small positive), and the costs are immense, I find it hard to claim that a reasonable cost-benefit analysis would support lockdowns. 

Do yo... (read more)

Compared to other Scandinavian countries, the Swedish death rate is very high: Sweden has 1459 covid deaths per million. For Norway that number is 238, for Finland it is 280 and for Denmark it is 559.  The Danish population density is more than 5 times that of the other Scandinavian countries, so perhaps Scandinavia without Denmark is a better reference class. I'm not claiming that Scandinavia (with or without Denmark) is the correct reference class, I'm just saying that Europe is not the only possible reference class and other reference classes paints a completely different picture.  Covid numbers are from  
Population density is entirely the wrong metric to look at here. You could fudge the denmark "population density" count by just including Greenland, and including the empty swathes of land in the nordic countries has the same effect.
5Dumbledore's Army2y
Well said. Eyeballing the chart shows no correlation between population density and covid death rate. Looking strictly at Europe, CSPI has a good chart (halfway down the long detailed post) showing minimal correlation. My take on population density is that the pro-lockdown media in March and April 2020 were predicting bodies piled high in the streets and the total collapse of healthcare systems without lockdowns. Because back then populations hadn’t normalised extreme losses of freedom so you needed to predict Armageddon in order to sell the lockdowns. Sweden, and later the US red states, proved that Armageddon was factually false. So the journalists needed some rationalisations for why Sweden hadn’t turned into a hell-hole and population density was the first thing they thought of.   If you still want to control for population density, compare Stockholm against European cities likeParis with similar population density. I’m pretty sure I read a good report finding that Stockholm was average again, but I seem to have lost the link.
Fair point. The relevant metric might be something like average population density around an average person (or density might not be that relevant at all). Looking at this map of population density, my conclusion is that every country is different, so using Scadinavia without Denmark as a reference class is probably unfair cherry-picking. Still, Sweden has more than 2.6 times as many covid deaths per million as any other Scandinavian country. 
My prior for this is that the population-level differences are probably almost entirely centered around care-homes, and questions related to care-homes (or, more generally, very old people). Since my knowledge on comparisons between care-homes in scandinavian countries is close to zero, I cannot really provide any insight here. But something as banal as "did people who are sick stop going to work in care-homes" will probably bias the results far more than population density. Edit: regarding population density: I don't think there's no effect, I just don't know what the effect is or if it is even monotone. Almost all the people I know who got covid either (a) live in a village and don't trust the government or (b) are highly-connected even for big-city standards. So it could be that there is a sweet spot local-minimum where people in cities feel super at risk because of all the strangers around them and isolate, but the effects of the additional density don't meaningfully lead to more covid.
Hm. I wonder if there's really a " minimal difference between the outcomes of US red states and blue states". From the graph here it looks like red states had  ~40% higher mortality per capita: Maybe that's more from lower vaccination rates, than lockdowns - but it still undermines the argument that´s based on no significant red/blue state differences.

Dumbledore's Army was speaking about excess deaths. The article to which you link is about COVID mortality. 

In addition, it says "Either way, the per capita death toll in blue America and red America was similar by the final weeks of 2020." That suggests that the lockdowns didn't cause a difference in COVID-19 mortality but the vaccines actually did. Sweden is also an example of no lockdown but decent vaccine uptake.

In one thread someone wrote about one rationalist dying to sepsis because they locked down to the extent that they didn't go to the hospital. I have one friend who said that three acquaintances of hers committed suicide during the lockdowns.

Looking at excess deaths makes a lot more sense because the additional deaths caused by the lockdown matter.

Yeah, I agree that excess death data is preferable when available. For some reason Dumbledore's Army's original link isn't working for me ("page not found"). So I haven't yet seen state by state excess mortality data. But if it actually doesn't find any difference between the red/blue states that would undermine the argument from the NYT article above. Looking at Our World in Data's limited cumulative excess mortality data Sweden has 2-8X higher excess mortality during the pandemic compared to other Scandinavian countries (with similar vaccination rates). That undermines any simple arguments based on Sweden (other than ones with weaker conclusions - such as that avoiding lockdowns don't 10X+ net covid mortality). Ofc there could be some other explanation for excess Swedish mortality. But an argument against lockdowns based on Sweden as a datapoint would need a pretty solid explanation of this.
3Dumbledore's Army2y
Fixed the link, thanks for letting me know it wasn’t working.  If For whatever reason that link doesn’t work, it’s called The Impact of the COVID-19 Pandemic and Policy Responses on Excess Mortality and the authors are Agrawal, Cantor, Sood and Whaley.
No. is the page for excess mortality.  Finland has +19 pp absolute change and +165% relative change while Sweden only has +8 pp and +125%. Norway even has +24 pp and +355%.  Sweden has lower excess mortality than Finland and Norway.
Yeah, precisely that page. Scroll down to the graph: "Excess mortality: Cumulative number of deaths from all causes compared to projection based on previous years, per million people, Dec 19, 2021 "The cumulative difference between the reported number of deaths since 1 January 2020 and the projected number of deaths for the same period based on previous years." Sweden 883 Finland 411 Denmark 154 Norway 110 Iceland 92 Proportions are similar if you check out the economist's data below: Where are you getting your numbers?  
I'm referencing the numbers on Sweden has a higher population than the other countries listed so total numbers are not comparable. That alone doesn't explain all the difference. It's unclear to me why and come to such different conclusions.
"Sweden has a higher population than the other countries listed so total numbers are not comparable. That alone doesn't explain all the difference." The numbers I'm citing above are population normalized. They are total excess deaths per million (and per 100k in the economist link). "It's unclear to me why and come to such different conclusions." Ah, that data isn't cumulative. It is just looking at current excess mortality. A lot of Sweden's excess mortality happened early on (I believe, while the other Scandinavian countries were locking down more). So the cumulative number is higher, but not the current number.
7Dumbledore's Army2y
I think it’s entirely from different vaccination rates. Check the stats for 2020 only ie before vaccines were widely available. Because there were indeed no significant red-blue state differences then. The paper I linked above includes all US states in its analysis as well as 43 other countries. Edited to add: try going through the US states data in this report, written March 2021 ie before the Delta wave with differential vaccine rates.
Funnily enough, I have yet to read a single not-completely-ridiculous cost-benefit analysis that goes this way. We must live in different bubbles.
There has been some evidence both ways, but I think that the best argumentation has been that lockdowns were net-negative by a lot. Dumbledore's Army linked this paper, which is not the same as the one that originally convinced me, but it's also good and I don't have the other link on hand. In particular, analyses in favor of lockdowns tended to make two errors: * They compare a lockdown to a hypothetical situation in which there is no mitigation at all, rather than allowing for private, voluntary mitigation. * They assume that infections which do not occur during the lockdown never occur at all, rather than simply occurring later. Since we never got close to actually eradicating COVID, deaths during lockdown were mostly delayed rather than prevented. (The exception would be the cases where we delayed long enough to get good treatments or vaccines, or where we avoided medical system collapse, but even taking these into account the benefit is still smaller than assumed.) Most importantly: relying on voluntary isolation allows people to choose their level of risk based on their vulnerability, their risk tolerance, and their ability to bear the costs. This is not perfect (you wind up with some people who would prefer to self-isolate but can't do so for economic reasons), but it's still miles better than forcing the same policy onto everyone.
4Dumbledore's Army2y
From earlier this year: Douglas Allen of Simon Fraser University reviews 80 studies, concludes that lockdowns have costs which are 3.6 - 282x more than their benefits. The 3.6 is based on unrealistic extreme assumptions intended to steel-man the case for lockdown. He concludes: “It is possible that lockdown will go down as one of the greatest peacetime policy failures in Canada’s history.” I repeat my request for you to post links to any high-quality cost-benefit analyses which come to the opposite conclusion.

And based on the differential experience people made based on their decisions the lesson they derive from the pandemic will be diametrically opposite:

I’m already looking forward to the 2 pandemic movies playing forever 

  • Thank goodness I masked, vaxed & boosted. Barely made it out alive. 
  • Knew it, the government was lying all along. No vaccine and I’m healthy as a dewormed horse.
1Daniel Kokotajlo2y
The miracle of modern filter bubbles!

I think this grossly underestimates the second tier connectivity. In the hypothetical society, this person has 9900 indirect associates (such as the great uncle of a friend). If a random 0.2% of the population were to die from a disease, then there would not be just one indirect associate that dies, there would be around 20 of them.

In a small isolated community many of these would overlap, maybe even just in one person in extreme cases, but then it still wouldn't be just one "friends' great uncle" who died, it would also be "my boss's friend" and "my co-wo... (read more)

In practice, your second-tier connectivity has a lot of overlaps so it's not actually the square of the size of your Dunbar-sized immediate group. Additionally, by definition these are people that you don't have direct relationships with, so your knowledge of what's going on with them may be hazy. Anecdotally, I know about 30 people who have gotten COVID, which includes one hospitalization and no deaths: a statistically average outcome. In my second-tier contacts I know... 4 or 5 deaths? I'm unsure, because the only way I can know about this at all is by hearing "[Person I don't know] from [social activity I don't go to] died of COVID", and this makes it easy to never hear about it and to forget.
The number of connection paths to the person who died, and therefore the average number of connections via which you find out about their deaths, is basically just proportional to the square regardless of overlaps. In a "small world" you might find out about the same person's death more than once via these connections, but the number of people you directly associate with who have someone close to them die is the same as in a "large world" so I don't think degree of overlap matters much. I do agree that the impact of deaths decreases with the indirectness of the connections. I was only commenting on the numbers in the example.
Also there is a lot of confirmation bias. I don't remember hearing any friends telling me someone they know died of Covid, but I have heard one say someone they know died right after getting the vaccine and another complaining about what they think are symptoms of vaccination and say their PCP has not been treating them seriously. I bet there have been covid deaths of a friend of a friend, but that is a lot less notable to them or me compared to a potential death due to the vaccine. I wish I had recorded every covid/vax death/problem so I wasn't just relying on my faulty memory.

One important thing to mention, that I feel you may have glossed over, is that contrary to (some) misconception, Covid-19 restrictions were broadly popular. That is, it is inaccurate to view pandemic restrictions as merely a battle between the elite power hungry politicians and bureaucrats, and everyday citizens. 

Politicians are indeed power hungry. And the non-compliance among everyday citizens is indeed quite high. But broadly speaking, we (as in, the general population) did this to ourselves. Or at least, the politicians are clearly acting on behal... (read more)

I think the perspective is very valuable. Nonetheless, some thoughts. Maybe my non-American perspective influences my views here.

  1. The stereotypical bureaucrat is not the one who decides about lockdowns. Governments do, in democracies they are elected by the population and parliament has a say.
  2. I recall media discussions about emotional costs of isolation and economic costs for small business and many similar things. They are noted by people in the bureaucracy as well. Emotional costs include those you get if you have infected your grandparents, and the f
... (read more)

Somehow you managed to transcribe my experience almost exactly.

I probably got Covid in March 2020, despite being more careful about it than most people around me. It was almost inevitable due to the place I lived. My symptoms were even milder than the ones you describe, I didn't lose the sense of smell or taste. When I called the doctors, I was told to stay home unless (or until) I was in need for hospitalization.

Now we're 2 years in. Nobody in my Dunbar-sized group died or needed hospitalization due to Covid. The overwhelming majority of the impact of the... (read more)

Masks are not very effective, but they are cheap and easy, so they're probably worth it. It is probably sufficient to recommend them without mandating them.

Sadly, it doesn't work like this. You can say "yes" to the masks, but then your boss says "no"... and you either remove the mask or lose your job. And the bosses will say "no" for all kinds of reasons; maybe they are antivaxers, or maybe some Karen complained about feeling uncomfortable not seeing your face.

This seems like a fully general argument against optional things.

Do you have estimates of the rate at which that happens (and subsequent harms), vs people who don't want to wear masks being forced to do so (and subsequent harms)?

It is a general argument against workplace safety being optional. And we already have many regulations against traditional dangers in various jobs. The difference is that covid is new.

Do you have estimates of the rate at which that happens (and subsequent harms), vs people who don't want to wear masks being forced to do so (and subsequent harms)?

I can't provide high-quality estimates, only anecdotal evidence. Calculating harm would also be difficult, because a lot of it is indirect. For example, for me the greatest worry about getting covid was not that I would die of it, but that I would unknowingly infect my old relatives with whom I am in frequent contact.

Intuitively, "killing my mother" feels more important than "the mask is annoying". But this is speaking from the position of work-from-home privilege. If I instead had to wear a mask 8 hours a day, every day, I would probably either find some rationalization, or reduce the contact with my mother to phone calls and leaving the groceries in front of her house.

I don’t think it’s fully general. Masks cover your face. Vaccines are invisible. If vaccines are optional, people can get them and they won’t impact daily job performance. Masks will.

And can you honestly claim that any of the FDA, the CDC, the WHO, or your state government actually deserve our deference and respect at this point?

I can honestly claim South Korean CDC showed itself to be worthy of respect in every way. South Korean government less so, but on the net, its work was positive.

Do you have a link that gives a good summary of the performance of the South Korean CDC equivalent?

It seems that about half of everyone you knew got the supercold; the rest avoided it by good luck or had such mild cases that they didn't notice. One person had a fever for ten days and almost had to go to the hospital, but they did eventually recover.

Nobody that you know died, though you did hear about a friend's elderly great-uncle who caught the cold and died of complications.

In the contrafactual world where the pandemic just spreads in full force (without vaccines and without special measures to avoid contagion), I claim that your experience will be fa... (read more)

Did you miss the second part where I point out that an unmitigated COVID pandemic played out in my brother's town to almost no consequence? "Everyone got COVID and survived" was not a hypothetical scenario. Even in the 80+ category, the fatality rate is only 15%.
I didn't miss the second part, I just reported another scenario which also was not hypothetical. How many people live in your brother's town? If the whole community is 500 people (and does not include a retirement home), then I've no problem believing that literally everyone got COVID and survived. But the Italian data from 2020 points to a very different direction. For example, in this article, they report the total number of deaths per town (every death, not just covid-related) and compare 2020 to 2019: * Town of Alzano Lombardo (~13.000 people): 123 deaths in 2019, 239 deaths in 2020. * Town of Nembro (~11.000 people): 121 deaths in 2019, 263 deaths in 2020. * Town of Albino (~18.000 people): 182 deaths in 2019, 292 deaths in 2020. Approximately +100% deaths in one year is just not something I can ignore. Regarding fatality ratio in retirement homes, I was basically citing the worst case lingering in my memory (this, also from Nembro, with 39% deaths).

Poll inadequancy: zero is not right, but I think the answer to P(hospitalized|covid) is <1%

That depends on age and comorbidities. That probability is highly stratified. There are some population where P(hospitalized|covid) is >5%
It is an interesting research idea, but after skimming the paper I don't really trust their methods. 1. If I understand it correctly, then they are adjusting their results based by the deaths from 2020. Contrary to their claim I think it does not make sense to do that to control for seasonality. In 2020 Covid deaths in the US only became an issue by the end of March. And the countermeasures against Covid in 2020 could have changed typical behavioral patterns (e.g. travel) associated with possible deaths. 2. Their analysis methods don't seem to be adequate for this kind of panel data. They are running separate regression models for each month and each age group (table 2) - I don't think this is the way panel data should be analyzed (but I am no expert in that - one could ask someone with a background in econometrics about that). 3. If I understand it correctly, they ran multiple models and for aggregating the predicted vaccine deaths they have picked the submodel supporting their claim, which would be a big red flag from my perspective [see notes to table 3, "If a model using same (not previous) month vaccinations was significant and the equivalent models using previous month was not, then death estimates from those models were used instead (light gray boxes). Similarly, if a model using age-specific vaccination (i.e. doses administered to people >65 yrs) was significant and the equivalent model using all vaccine doses administered was not, then death estimates from those models were used instead (dark gray boxes)"]. 4. One problem with their basic approach could be that vaccinations change behaviour and this changed behaviour could lead to deaths (that are unrelated to the vaccines). To control for that one would need e.g. the number of accident deaths (to subtract them from the total numbers before running the analysis).
Would you expect a fairly large noticeable nocebo effect in populations which are scared by vaccination but forced into it by government or employer vaccine mandates?
That depends on the outcome measure. For self reported health I think that is quite possible. However, for all cause mortality (as in the paper) as an outcome measure I don't think a nocebo effect to be likely.

Really, though, shouldn't we be able to do something to protect the elderly or other vulnerable people without causing everyone else six months of financial hardship and lost relationships?"

"Six months..." the man squirms. "I might need you to do this for a year or two."

Not exactly a fair description of what the public health measures have been. What country has been in lockdown for "a year or two" (besides China)?

> The harms caused by COVID suppression were larger than the harms of COVID itself for most people.

Possibly, but I doubt the same can be said... (read more)

In terms of hedons, many old people live in retirement homes under horrendous conditions. Some lose their marbles, I remember one who every day tried to escape while claiming "I have to take care of my goats!" Some forget that their loved ones are dead, only to relearn it and be sad again. Some have chronic pains. Some shit themselves because they can't control their sphincters anymore, then stay in their shit for hours while waiting for the single nurse who has 10 other residents to treat before them because the house is criminally understaffed. Their only joy besides the family's monthly visit is to eat shitty food and watch shitty TV. No, believe me, nobody would spend extra to provide better food for an elderly who might have lost their sense of taste and has no leverage anyway. There is something like negative hedons. There are things worse than death. Can we be real? The average year of an elderly doesn't have nearly as many hedons as the average year of a young adult.
Is there an end in sight? What country hasn't had covid-related public health measures - especially on entry and exit of the country - for the last year? It may not have been a full lockdown (whatever that means) for most of the time, but public health measures have certainly been in place.
Vaccinating to herd immunity proved impossible
If you look at what people who actually care about vaccine effectiveness do because they are mainly driven by personal benefits instead of trying to get a drug approved you can look at examples. Stöcker gave more then two vaccine doses in the first months to build more immunity and on the other hand it seems that the official approved vaccines restricted the amount of doses that were given to make people more likely to sign up for the vaccine.  The other is the RaDVaC project that focused on vaccinating in a way that gives muscosal defense (the first line defense against infections) and also focused on building antibodies in a way that makes the vaccine more effective against variants.  More dakka would have been possible.

There are a number of flavours of covid scepticism, and some of them are definitely unscientific. For instance the claim that covid has never been isolated.

5Dumbledore's Army2y
Downvoted for strawmanning. You are ignoring all of jaspax’ actual points while raising the most extreme flat-Earth view that’s vaguely related to what he said and pretending that it’s somehow relevant. 
[+][comment deleted]2y50