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Mar 28Liked by Ben Krauss

This post articulates my feelings better than I have been able to do myself. Arbitrary/stupid rules that are unenforced is the worst of all worlds, and the current situation, in which a significant contingent of people I see in my urban life still wear masks, often cloth ones, even outside, is IMO absurd. Something important with society has broken down, and few people seem interested in understanding it, let alone fixing it.

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That Makari/Friedman article in The Atlantic struck me as startlingly bad, in the sense that I can think of few things better calculated to alienate the voters that Biden needs to convince than attempting to get the country to dwell on its feelings about the pandemic. Neurotic urban liberals really do struggle at times to understand just how unappealing urban liberal neuroticism is to the rest of the country.

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Mar 28ยทedited Mar 28

One of the most baffling things to me was the lack of data during the pandemic about the age of those killed by Covid. This information is now pretty well known, but it was very under-reported and under-emphasized during 2020-2021. Most of the discussion and reporting focused on, well, people like Matt and us readers -- working-age adults, usually part of the PMC.

We now know this was a disease that primarily killed either the "very old" or the "still-old with other problems".[1] Not to dismiss those deaths, but when evaluated on a QALY basis, COVID wasn't as bad as the response would indicate. The lack of an age-targeted effort by health officials and governments should be part of any analysis.

[1]: Those 70 and older were 11% of the population and 66% of the deaths. Those under 50 were 64% of the population and only 7% of the deaths. Source: https://healthequitytracker.org/exploredata?mls=1.covid-3.00&mlp=disparity&demo=age&dt1=deaths#population-vs-distribution

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I found myself very out of touch with Team Blue during Covid, not because I necessarily disagreed with the final policy decisions, but more because there was such a shocking unwillingness to have a semblance of a real cost/benefit debate aboutโ€ฆ*anything* - it still shakes me to the core to remember the utterly loopy things that came out of the mouths/keyboards of people I had previously considered thoughtful, balanced, evidence-driven, grounded, etcโ€ฆ(eg Iโ€™ll never forget when Andy Slavitt - of all people - tweeted in Spring 2020 that what made Covid different was that it could be *infectious without/before being symptomatic*. WOW. Scary! Except with 5 minutes on Google heโ€™d have found dozens of scientific papers describing the reality that most respiratory viral infection act exactly the same wayโ€ฆ)

The fact free irrationality of Team Red was always a given. But discovering that my own team - Team Blue - was just as naive / scientifically illiterate / reactionary in so many areasโ€ฆwas and still is profoundly disappointing.

Covid maximalism became a religion in the left in the same way that Covid denialism became a religion on the rightโ€ฆ.and that makes me very sadโ€ฆ

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I actually think that crisis response can be very revealing. For me, the most depressing thing about supposedly-neutral institutionsโ€™ response to COVID is that they basically adopted a new attitude: theyโ€™ll sometimes be trustworthy, but they might distort things to help Team Blue. As long as they arenโ€™t as bad as explicitly-conservative institutions, this is treated as an entirely unimportant issue.

If I live and work in extremely blue areas, though, why on earth should I care if the NYT isnโ€™t as bad as Fox, or if the CDC isnโ€™t as bad as Trumpโ€™s medical advice? The institutions I rely on are now uniformly a bit worse, and I feel like I can expect exactly the same thing in the next crisis.

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Mar 28Liked by Ben Krauss

Reading through the comments gives me the sense that MY is missing one big component of the public reaction here. Itโ€™s all personal! Matt writes about a few personal moments where he was frustrated but doesnโ€™t connect that to the larger piece about how those frustrations are having an impact years later. Let me offer a few particularly emotional things from that time which stick with me and make it hard to think (or feel) clearly about the first year-ish of the pandemic. In no particular order.

- Dropping my wife off at the hospital for work next to a refrigerated truck being actively loaded with a body. Iโ€™d seen the truck for about a week and never made the connection that thatโ€™s what it was. Scary! This was early enough that we didnโ€™t really know who was most at risk and it was also at the point where the hospital didnโ€™t have adequate PPE so they were reusing the same masks over and over, using homemade masks, etc. It really felt like she was on grave danger and that โ€œthe systemโ€ was failing to do enough to protect those who were trying to save lives.

- Relatedly, senior attending physicians were refusing to come in, refusing re-assignment to the COVID wards, and the hospital had little ability to discipline them. Time and again, residents were left alone on the floor because a certain group of their attendings simply wouldnโ€™t come to the hospital. And the residency directors, to their credit, stepped in over and over to fill in, but talk about feeling abandoned. The message was basically: youโ€™re not a full doctor so you get to be at risk while I stay home. It broke their relationship with these physicians who, until then, had been an important part of their training. Again, lost trust in โ€œthe systemโ€.

- My parents are quite conservative and anti-vax before it was cool. Still, up through late 2020 they were fairly cautious in red-state adjusted terms mostly because theyโ€™re older and we knew by then older people were at greater risk. For โ€œinterestingโ€ reasons Iโ€™ve explained here a few times, they moved to Florida in Jan/Feb 2021. The Villages. Just before they were going to drive down and check out a home, my mom was called by a member of her tennis team whoโ€™d tested positive for Covid. My mom got tested and she was positive. She told me she would stay home and quarantine. Two days later I got a picture of her our having drinks with the dad at a bar. Theyโ€™d just bought a house in the Villages. And look, maybe it was a false positive but, like, youโ€™re going to the oldest place on earth and you have good cause to believe youโ€™ve got a virus we know is pretty bad for old people. Why be that jerk? And of course the lie, but thatโ€™s something Iโ€™m used to. Again, emotional stuff. How do you separate that feeling to get a more objective view of things?

- Later that summer my wife and I visited and they had a huge falling out because we got vaccinated. They assured us this was going to cause us health problems (to this day, any time they hear us coughing or know weโ€™re sick, they ask why we got the vaccine if itโ€™s didnโ€™t work) and even told my wife, at that point a fully board certified practicing physician, that she didnโ€™t understand medicine and that she was being tricked by Fauchi et al. (Okay, the other thing they were mad about is that my wife would not write them prescriptions for ivermectin.) Again, emotional! It sucked to see my family take their anger out on my wife just because theyโ€™re afraid of vaccines and donโ€™t like that we were vaccinated. It took a long time for us all to come together and agree to disagree so we can enjoy being family. (Though I still get regular forwarded emails from dad from FLCCC recommending weird shit.)

- We had a kid last year (largely because of a conversation with David R and John from FL in SBโ€™s comments, thanks guys, you were right and a second is on the way). Parents, o course, refused to get any of the shots recommended for people who are going to be around babies. We decided to wait and not let them meet the baby until the baby could get her shots and get out of the more dangerous immune-naive newborn window. Youโ€™d think we killed somebody they were so furious. And look, maybe thatโ€™s the wrong call. Maybe we should have just asked if they were feeling sick and thatโ€™s good enough but, you know, they lie about that kind of thing. Again, we patched things up and theyโ€™ve had many lovely visits from the baby since sheโ€™s been six months old but this is still part of that weird pandemic hangover.

Yeah, this is all just one guyโ€™s experience itโ€™s you canโ€™t generate from these experiences specifically but what this plus what the comments here say plus what Matt says makes me want to point out that everyone had a bunch of weird shit happen to them and some aspects of it are *still happening* to them. Itโ€™s often interpersonal, familial, or related to careers people care about. Some congressional report isnโ€™t going to fix that, even if we somehow de-politicize the thing because much of what we lost was trust in institutions, workplaces, and even each other.

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Matt made a similar point on twitter but with major institutions becoming more activist and hypocritical during covid/Floyd has been a disaster for both sides epistemically.

It has made appeals to expertise common on the left, and (much more problematically) it has made the right turn into a bunch of conspiratorial loons.

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For me the biggest surprise was CDC incompetence. Since I watched Contagion a decent number of times it was always jarring the gap between โ€œmovie CDCโ€ and real CDC. These people had supposedly been preparing for a flu pandemic for the last 20 years but didnโ€™t realize (1) quality masks were effective against flu and other respiratory viruses (2) we needed a lot of masks (3) travel restrictions were incredibly effective if not done in a half-assed way.

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Mar 28ยทedited Mar 28

As a biomedical PhD who with nothing else to do wrote several blog posts and carefully followed all aspects of the pandemic (including concluding early on that a lab leak was by far the most likely scenario and correctly predicting that omnicron would help end the pandemic), several points:

1. Trump actually gets way too much shit for the pandemic. This article kind of touches on that but literally no one was saved and making an analogy to literally the island of Australia is pretty pointless. There were things that could have made a 10% difference on the edges but everyone was going to get it and there was nothing we could do. Obviously making it cool to be safe and not uncool could have helped but still only on the edges.

2. Similarly, The Biden administration keeping restrictions in place through freaking 2022 was insane. They were not based in science or logic and he was so afraid to be a dictator figure like Trump that he would let his off the rails God awful agency heads like Walensky go crazy and negatively impact the perception of his entire administration.

3. EVERY. SINGLE. LOCAL ADMINISTRATION. ACTED IN A NON LOGICAL, POLITICAL, AND NON SCIENTIFIC WAY. I still remember the insanity when mayor Bowser in DC in May 2021 within literally 2 weeks went from "You need to still wear a mask outdoors in the awful heat" to "We are dropping mask mandates for anyone anywhere". And that was literally right before Delta when it was the most contagious and most dangerous form of the virus. Similarly, once it was clear that Delta could break through vaccines maintaining vaccine mandates more than a few months or nothing beyond political signaling and had no basis in logic.

4. Like most scientific or even policy issues, people are incapable of understanding probability or nuance. The media and public health figures did not help this by trying to overly simplify things to the point where they became absolutist and not logical. Wearing cheap masks DOES reduce your risk of COVID. It reduces it more by preventing spread as opposed to preventing catching it, but neither of those is 0% or 100%.

5. Basically everyone just lost their goddamn minds. Between politicians and regular people, including vehicular homicide going through the roof. Everyone was just angry and wrong all the time.

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Fuck it, here's my own 17 thoughts. Feel free to collapse this subthread (click on the light gray line just under my avatar) if it's TL;DR for you.

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1. It was understandable to have a grace period of misunderstanding in March of 2020, when things were uncertain and scary. But that grace period should have been limited to March 2020.

2. During March 2020, there should have been an all brains on deck approach to best figure out how we're going to proceed. And all brains meant not always deferring to public health officials, who are good hedgehogs at their subject matter, but absolutely terrible foxes on opining on a general societywide basis.

3. Once it was discovered quickly that children were at extremely low risk, it should have been recommended that schools reopen immediately. Furthermore, they should have stayed open through the summer, first to make up for time lost in the past, then when more outdoor activity could have been conducted in the present, and finally to prepare for the future, if things got bad in the winter like it does for other respiratory pathogens.

4. Once it was discovered quickly that outdoor activity was vastly safer, it should have been not only allowed but strongly encouraged, and should have been the centerpiece of pandemic mitigation. Things like putting police tape over playgrounds and zip lining basketball nets pissed me off so much.

5. Transportation agencies should have been encouraged to close off some streets to give people more outdoor space to interact--and particularly to eat and drink, which needed to be done outdoors.

6. If we established a strong centerpiece of outdoor activity being encouraged, it could have allowed for us to do almost everything that we couldn't do remotely, and given us key normal social interaction that we all need. It would have also taken a lot of heat off protests, both for the anti-lockdown ones, and for the George Floyd protests. (If those even still happen, an alternate history could have butterflied away him crossing paths with Derek Chauvin.)

7. Masks were never going to be reliable as a mitigation centerpiece because there were too many exceptions to the rule that needed to be made--eating and drinking being the main one--and they were absolutely miserable to wear, and shut off critically key cues of interaction that we pick up to be social. I thoroughly rejected the notion from some that they were the easiest course of action--there was nothing easy about making us look like threats to each other.

8. So much of the insane mask discourse was a doom loop of both virtue signaling and vice signaliing, because while you couldn't see whether a person was vaccinated or taking other actions, boy oh boy could you see whether or not a person had a barrier over a major portion of what identifies them. Just a completely toxic discourse that should have been sidelined by just being chill outdoors.

9. With all the talk about how whether or not in person interaction going down due to the internet is harming society, I'm surprised there hasn't been much discussion on how much the pandemic aggravated that or not. It felt like we were going to have a major turnaround to correct for what we lost in being remote and nonsocial with each other...but has that happened? Should it be looked into more?

10. It's a shame we blew our load with our one shot at lockdowns in the spring of 2020, because the time we really needed it, as could be forecast with the history of other respiratory pathogens, was in the fall and winter of 2020. When things got so bad then, a better argument then could have been made to go into hibernation--especially with credible news that a vaccine was right around the corner.

11. The complex vaccine distribution prioritization scheme in 2021 was a complete disgrace. Matt had it right from the beginning: only prioritize by age. [https://www.slowboring.com/p/vaccinate-elderly] The only thing I'd add is that I called it among friends that the more complex this was made, the quicker you'd run into including antivaxxers in the prioritization. I don't think I've ever been angrier than seeing them turn down what was offered to me early, while I was sitting on my ass at home waiting my turn.

12. Once it was established that the vaccine was working and enough people had it, NPIs should have been completely junked from there on out. You didn't get vaccinated and got covid, it was on you.

13. I was similarly furious when I was still being asked to comply with NPIs in a post-vaccine world. This was the strongest feeling of unfairness I ever felt--you're punishing me despite having done the right thing, instead of not going specifically after the antivaxxers.

14. Biden's vaccine mandate via OSHA I thought was the most reasonable things that could have been done to coerce people into getting vaccinated, and it's a shame the courts shut it down.

15. Antivaxxery in general is so pernicious and yet it still lingers and worryingly might have become stronger. We really need to figure out why it's lingered for so long, and figure out a way to get rid of it.

16. Continuing to be paranoid about SARS-CoV-2 in particular, and escalated to germaphobe paranoia in general, is not good, and I really worry for those few people that when the pathogens do enter their body, they will suffer more due to not priming their immune system more often.

17. It sucks that all of this still in my head and easy to write--it's not fun to still have it in there. A thoroughly terrible time to be living in.

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As someone who lived in Brooklyn at the time, I definitely remember the incessant sirens.

I was working from home, in a different room than usual because the whole family was home, and at first I thought it was just weird acoustics. Took a couple days to realize, oh no, that's just ambulance sirens nonstop.

Also remember sneaking out for a morning jog & accidentally coming up on one of the freezer trailers outside a nearby hospital - the ones they put out because they needed more space to store bodies. That hit me pretty hard.

It's an uncomfortable time period to remember even now, which I suppose is what some people mean by "trauma".

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Mar 28Liked by Ben Krauss

"Since the Biden administration never conducted an investigation of the crisis...the administration basically left the impression that it accepted that the government had failed, but just didnโ€™t want to talk about it anymore.โ€"

If it makes you feel any better, the UK did have a lengthy expensive investigation, and it almost entirely failed to address any of the actually relevant policy questions (this blog post contained more substantive discussion of policy than hours of covid inquiry), instead digging endlessly into whether officials' swearing at each other was acceptable workplace behaviour.

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I strongly disagree with Matt that a more covid hawkish Trump would have been able to flip the partisan valence. Something that the pandemic exposed is that the US federal government has very little state capacity to enforce rules on a nationwide basis. State and local governments take on the lion's share of that. At the beginning, almost all states had imposed lockdowns--yet the only exceptions were a spattering of Plains states, plus Utah and Wyoming--all Republican controlled. And circa early May, before Floyd's murder, the in person protests that were happening were pretty much all anti-lockdown protests coming from the right. I think it was baked in that the right wing was going to be more dovish than left wing, regardless of who was President or what orders were given.

And I more lightly disagree with Matt in that the Floyd hypocrisy by the public health set really cannot be overblown. It was a major breach of credibility to everything that they were saying, and people saw it as such and blew them off.

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Most of what you wrote is great, but this was dead wrong: โ€œblue state parents, especially non-white ones, were reluctant to send their kids to school, and thatโ€™s an important reason they stayed closed.โ€

Fairfax County in northern Virginia is as blue as it gets, as you know. They surveyed parents in June and early July 2020 about whether they wanted in person or virtual, and 60% wanted in person for their own kids. Thatโ€™s why the early FCPS rhetoric was not that they would stay closed until fall 2021, it was โ€œweโ€™re just delaying a few weeks to get ready. And now a few more weeks. And now a few more weeks delay, but pinky swear weโ€™ll open after that.โ€

When people make the claim that non-white, blue area parents wanted virtual, theyโ€™re basing it on surveys from early 2021. By that point, parents had been bombarded with a propaganda campaign that schools were particular death traps even as everything else in Virginia was open. Even Biden ran a campaign ad along that theme, and many parents were dumb enough to believe it.

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In terms of the impact for the election, I think the main effects from COVID are a lowering of social trust and a lot of lingering unprocessed mental health damage caused by the stress COVID brought with it.

Both of those have made the electorate much more pessimistic, and Biden needs people to be optimistic.

I think one of the biggest failures was the way that the government was giving obviously inaccurate guidance because they didnโ€™t trust people with the full story. The early guidance on masks was that you should NOT wear a mask unless if you knew you had COVID, but this advice was given back when it was nearly impossible to get tests, and when it was already clear that people could spread COVID without showing serious symptoms.

The reason for that advice was because there was fear that people would panic buy masks and make it so that healthcare workers would run out. But instead of making that motivation clear, it was an obvious subtext behind inaccurate advice being given. Which means that the guidance suddenly changing later, combined with the incoherence of the original advice, meant people couldnโ€™t really trust the guidance they were getting from the government.

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One thing that I was disappointed by was the lack of a push to get society healthier after realizing that obesity and other health conditions contributed greatly to one's likelihood of having a severe case of Covid or even dying of Covid.

It's interesting because I know that some of the conservatives who mocked Michelle Obama's "Let's Move" initiative look upon that with regret, whereas many liberals I know now would think that initiative is harmful because suggesting an obese person should lose weight is akin to "fat shaming" by the far left.

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