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.
I honestly haven't seen anyone wear a cloth mask outside in a few years, but I agree with the general point here. And it's just sad that so many comparative countries have publicly conducted bipartisan investigations and reflected on their COVID response and the United States hasn't. Another pandemic will happen, and there's no reason to think our government or public health officials will be ready for it.
I still see this all the time as well, which I think is an example of Matt's point #10. People had (and continue to have) just massively different experiences over the past five years. There were a few moments in, say, 2021, where I'd go out to the suburbs literally three miles west of where I live and it almost felt like a sci-fi movie.
I'm willing to bet a lot (though I'd never collect) that by the time any pandemic as threatening as COVID happens again in the US, any such investigations we conduct and lessons drawn will be only the vaguest of memories and of no practical importance.
I suspect that the benefit of mRNA vaccines (and their far more impressive successors) *will* be present in that situation, however.
Well, I am still seeing it in bougie Red Line NW! Not as much as before, but still. Even in 2024, I have been walking (or even riding my bike, in the street) in the residential environs here and had people ostentatiously mask up when passing. Outside!
I totally agree that there are situations where masks are appropriate. I had a really bad respiratory thing last fall and wore an N95 when I went to the doctor and drugstore. But - like almost everything else in the world - it seems to have mutated into a political flag, and I am *so* tired of them.
I take the points about the likely efficacy of "bipartisan investigations," assuming a bizarro US in which such a thing could happen. But as you note, it's extremely unlikely, given the movement of people and goods, that the next pandemic will take 100 years to hit, and we have not only learned nothing, we've gone in the wrong direction.
Three days ago, caught cycling in a hailstorm, I made it to within 100 feet of my home and on the final turn went down hard, with my right hip landing bone-first on the asphalt, seemingly whipping my head to the ground in turn. My well-fitted, certainly expensive helmet absorbed the blow and my head is the only thing currently not hurting. Not the first time. I’m intrigued by data if anyone will offer it, but my guess is that it will say helmets will not protect from all, and may encourage risk taking, but that well-worn, well-fitting ones* do the job for which they’re intended. Prudence and fortune rule the rest.
I’m happy to say that my head is fine, my memory is in tact.
By the way, you guys have to hear about a spill I took on my bike the other day. See, there was this hail storm…
There are 2 branches of “helmets don’t matter” thought.
Branch 1: the thing that kills cyclists is cars traveling over 30mph, not whoopsies on the street. Helmets don’t help against getting hit by cars.
Branch 2: the number 1 thing that makes cyclists safer is more cyclists. Mandatory helmet laws and/or a culture of safetyism with cycling prevents the growth of cycling and makes the activity more dangerous in the medium to long term. The best thing for cycling safety would be a cycling culture like Amsterdam where it’s considered as safe and normal a thing to do as walking and it doesn’t require extra safety gears everyone does it.
As far as data goes, the data proves points 1 and 2, and it also proves that if a cyclist is falling/crashing their outcomes are better with a helmet than without.
I believe the studies about this are fraught with selection effects, but I actually am not sure.
But I am sure that the likelihood of crashing on a bike is serveral hundred magnitudes larger than the likelihood of being exposed to Covid contagions.
If helmets made head injuries *worse* I can't imagine you would see them as common equipment for professional cyclists, as they are.
The thing about helmets is, asking whether helmets work to protect you from head injury against, say, getting hit by a semi-truck, is the wrong question. In that case, someone with a helmet and someone without would probably both fare poorly. But in the case of hitting a pothole and going headfirst over the handlebars? Feels like you'd much rather have a helmet there.
Hopefully by the time the next pandemic comes around America will be less stupidly partisan and polarized. There will always be crazies and ideologues for sure, but perhaps they can be reduced to 20% of the population rather than 50%.
Correspondingly, I think there's no reason to think our government or public health officials will be made more ready for it by publicly-conducted bipartisan investigations.
So while I like a lot of what Matt wrote today, I think the core thesis falls paper-flat.
Seriously...just keep the politicians and politicized public scrutiny away.
Despite their poor showing during the pandemic, I am fairly certain that the CDC, NIH, and FDA (et al.) have a pretty good idea of what they f***ed up and what (smaller list) they got right, and have personnel with the necessary expertise and competence to fix what needs fixing.
They just need to be properly motivated to overcome bureaucratic inertia and actually make the needed changes.
Hmm, YMMV. I see it all the time. Some people are just really afraid of getting Covid and wear them practically all the time even when driving!
I'm guessing but I don't think they're doing it "performatively", i.e., as a "blue" signifier. They are just really paranoid. That said, I live in SF so they don't likely get called out for it at all.
IMO at least on the left people are just looking for meaning. Religiosity is down, the struggle for survival has mostly been won, so what’s left to be inspired by? Making a difference is hard so people are latching onto some weird things.
It’s not unrelated to numerous corporations advertising their “mission” or “purpose”.
Hmm... So I'm someone who considers himself cautious and well-informed. Not a prepper, but because I had read about SARS a few years earlier, I kept some packs of N95 masks around just in case. Knew a pandemic would come at some point - Bill Gates and others had been warning about it, after all.
Pre-2020, I could mostly go through my life "my way" and not have to actually deal with how other people live their lives. I would argue with anti-vaxxers online, but honestly the stakes felt low since my kids were vaxxed and overall compliance was high.
The pandemic forced my beliefs on "living properly" into conflict with what other people value. And to pick an example that doesn't paint me as a hero, I was furious that people were choosing to go to church during a pandemic. Yes yes, in normal times we can pretend religion isn't just some made-up BS, but the stakes are REAL now - stop screwing around and stay home!
And this tension existed throughout life at that time, y'know? So much disagreement because suddenly other people's choices were creating risk for MY family. Couldn't stop seeing how wrong all their lifestyles were - most people are not nearly as utilitarian and rational as they should be.
For me, this is the "PTSD" that is hard to unwind - how to get back to living our separate ways after actually getting entwined with how other people choose to live.
And even if those who do allow that it is or may be made-up BS can benefit from the community aspect of church. Gathering in church was crazy to me during the early weeks/months the way any voluntarily gathering was, but the long-term social distancing ethic was (is) not a great look for us (secular blue America).
Yes, I've become a churchgoer since I moved to Tennessee (and got vaccinated), and the community has been wonderful, and a nice change from the isolation of NYC under Covid. The church seems to do a lot of good locally, too. Keeping church congregations from meeting is not without costs.
rationally I know that, but it became harder to empathize during a public health emergency, when I felt the choices of others were leading to risks to my family.
In fact I think better than using the term PTSD would be just to say that the pandemic caused serious rifts in the nation's empathy, because the stakes of other people's actions suddenly became higher.
The collapse of once-dominant mainline Protestant religiosity in American life has been replaced with wokism/COVID hawkishness (*). We're all wired to believe intensely in something, whether it be a metaphysical being or not.
(*) What MY gloriously called "lizardism" in a post on Israel/Palestine a couple months back
This isn't right. Contrary to poplar understanding, religiosity has fallen much more in the working class than in the professional class, but the latter is the focus of "wokism."
IMO the turning point where Blue America lost the plot and the trust of others wasn’t the 2020 protests. it was spring 2021 when the vaccine was widely available and yet many health officials, local governments and individuals said thank you but I’m still doing all the NPIs. CDC didn’t help by flip flopping on masks.
My other pet theory is that things started to break when we went into the second year of social distancing. If we had mostly emerged in spring 2021, I think people would have looked back and said wow that was a weird year. But when it kept going, then it’s like, oh I guess this is how we do Easter now. This is how we do Memorial Day. It becomes the new way rather than a crazy outlier. I really think that’s when things broke.
Officials got spooked by Delta, but not nearly enough was being made about the antivaxxers suffering from it much more, because the vaccines were working. That definitely got me very angry at NPIs still existing/being brought back.
Biden did have his 'pandemic of the unvaccinated' line, but the public health crowd got mad at him for it. Another time they should have just let Biden be Biden.
I think the flip flop on the masks was huge and really fed vaccine hesitancy. Unfortunately, I also think it was part of a broader issues with experts having failed ethically and being too arrogant.
I was hugely pissed early on when Fauci started back peddling masks in an attempt to monopolize the existing masks for medical/public safety/fire/ems etc. (and I was one of the ones who needed the masks due to my job). Anyone with a brain would have looked at how Asia saw them wearing masks after things like SARS (not just for SARS-COVID but wearing masks at Disney Land), thought about germ theory, and decided that the prior probability should be that masks probably did something (this is regardless of their true efficacy but just as common sense). We did not need peer-reviewed probability and effect size tests on masks at that point...just common sense.
Even then, It was also evident that the CDC would have to walk back the idea that masks might not be effective once they became available. However, Fauci fed the anti-NPI hysteria of the right for the short-term gain of making more masks available for healthcare/emergency workers. Of course, some people would not trust him later.
Medicine then doubled down on stupid NPIs (not being able to attend events outside) while simultaneously exempting their favorite political causes (see all the medical professionals and institutions that decided it was ok to protest in large groups but not go to outdoor church - I am not religious but saw this as hypocritical and can only image how religious people felt). In retrospect it appears that outside activities were not a huge issues, but you really need to be consistent when messaging in an emergency (see the issues with Fauci and masks).
Giving exemptions to causes you support (i.e. protests) while not making similar concessions to causes you may not support (i.e., religion) makes some people feel like a double standard is being applied. I am not religious and did not go to church during COVID, but I still thought it was fairly biased. I can only guess how a truly religious person would feel.
Finally, highly respected scientists were untruthful to reporters in terms of the possibility of lab leak, and it appears they did so to protect "science." This does not mean that COVID was due to lab leak (it appears not) or that they Proximal Origins paper was deceitful (it may or may not have been...timing is odd but scientists change their minds all the time when they get new information). What they did do (and you can read the Slack conversations and see this) is mislead the press about the possibility of a lab leak. Again, this does not mean they believed the lab leak...but they clearly tried to create an impression that i was much less likely (near impossible) than they thought at the time. I mean, they talk about deceiving the guy in the Slack messages.
Ostensibly, this was done to protect "science," but that is like Fauci saying attacks on him were attacks on science. It was arrogant and short-sighted. All experts have is their credibility, and the only thing they accomplish when conflating their views with science or when they lie (even to protect emergency workers or science itself) is to destroy that credibility.
If you destroy your credibility and later need it to be broadly credible, like to get people to take a vaccine that was developed quickly and in a non-standard manner (creating some basis for legitimate concern), you are screwed. You are not viewed as credible because you have lied, been seen as taking sides for political reasons, and, been incredibly arrogant (which turns many people off).
It took me a while to experience this, because I was still vaxxed and relaxed in rural Michigan most of the time until November 2021, when I moved back to NY. I went back to my previous bureaucrat job in January 2022, and we were required to wear masks (any kind, including cloth) in the office. Even when the requirement was lifted a few months later, a lot of people (especially very young people!) continued to wear them. The NPIs - masks, distancing, not going anywhere - had become an article of faith, and it seems as if a surprisingly large number of (not immunocompromised) people are just going to hang on to them forever.
There was a brief moment in the first half of 2022 (when blue America really started shedding NPIs) when the most-masked people in my community were, like, 30-to-45-year-old women. But that's passed; I no longer notice any particular demographic commonality among the people I see who still wear masks.
It was multiple fuckups that was a total comedy of errors. It went from "don't wear masks, we need to save them for frontline medical workers" to "you can make up cloth masks, and save the N95s for frontline medical workers" to "cloth masks don't work, you MUST wear an N95 at ALL TIMES!". All while they had no consideration at all for how anti-social and impractical this was going to be as the overarching mitigation. The funny thing is, I think they were closest to correct at the beginning, which was "N95s or GTFO, but in limited circumstances".
On the one hand, I agree with you. On the other hand, the period you're talking about what was, what, like...nine months? I kind of vacillate back and forth as to whether that actually mattered.
I do think it would be good if governments tried to systematically learn from Covid so we could do better next time, though. And that doesn't seem to be happening, at least in the US.
Wearing cloth masks is absurd, agreed. But I see no harm in wearing a well-fitted one if you want to reduce your odds of picking up a virus such as influenza, common cold or, yes, covid. People have been doing this in Asia for decades. I personally dislike masks and haven't worn one in a couple of years, but at this point I barely notice when I see another person doing so. And the "outdoors" aspect probably means they find it easier to simply leave it on.
Fair enough - but I think that a number of people have put masks in the “one weird trick” category- that the ONLY downside of wearing a mask is personal comfort. A well-fitted mask WILL stop you from contact with any number of normal viruses/ common cold etc. Which means that your immune system isn’t going to learn about them and when you do let your guard down you probably are going to be sicker than you otherwise would have been. This is a case where people would be well advised to step back and think about what they are trying to accomplish. Yes, masking makes sense in a pre-vaccine world where you have no immunity to COVID and you don’t particularly want to gamble on gaining that immunity the natural way. And sure- if you know you are going to be visiting someone soon who is genuinely immune compromised, masking up for the week before your visit makes sense as well. But I don’t think that is what is happening in most of these cases.
Turning masks into a political signifier has been terrible, especially for people who actually need them (immunocompromised) or people who benefit from wearing masks outdoors, i.e. people with bad pollen allergies. And as global warming continues to turn summer into “fire season” we’re going to have occasions where everyone needs a mask to go outdoors.
True! Last summer in NYC, wildfires in Canada increased the particle matter and pollution in the air to actually dangerous levels. And while this had nothing to do with COVID, the mask wearing breakdown I noticed in my immediate social circle fell right on partisan lines.
FWIW I spend large portions of every summer in rural Eastern Washington, not exactly COVID hawk territory. When there have been fires that impact the air quality, people still wear masks at about the same rate as pre-COVID (and almost everyone has them in their emergency kit, if not a full on respirator), mostly because it's not uncommon to be, be related to, or otherwise know someone who directly works on fire prevention and they were trained on the advantages of masks vs. smoke long, long ago.
Also, when there is smoke everywhere in the air that close to a forest fire, it only takes a few minutes of breathing it in to realize that smoke and fire couldn't give a shit about your political beliefs, and will screw up your ability to breathe real quick anyway.
Whereas contacting an illness isn't something you are going to notice in real time.
I saw a headline, "'Yellowstone' Actor Kicked Off Plane for Refusing to Sit Next to Masked Passenger." My first thought was, yeah, you don't get to make those decisions as a passenger. My second was, how did we get to the point where the masks are even annoying to people who aren't wearing them, let alone unacceptably obnoxious?
I don't say anything or make a scene about it, but seeing it does annoy me and make me anxious due to losing key visual cues in interacting face to face.
Do you feel that way with sunglasses? Sincere question!
Also, regarding the actor on the plane, isn't not interacting face to face with one's seatmate not only acceptable, it's actually probably many people's preference?
Getting sick is not binary. Reducing viral load makes a huge difference. Even reducing only 30% could be the difference between I feel shitty and I can't breathe and have to go to the hospital
"A well-fitted mask WILL stop you ... you probably are going to be sicker than you otherwise would have been."
I don't see why this is necessarily true as an adult. Suppose without a mask you get a particular strain of cold every 3 years, but with a mask you only get it every 5 years. You might end up with the same level of symptoms either way.
Or not, but I have no idea, and it doesn't seem like anyone does.
The Koreans have this pretty well figured out (not for covid specifically - they’ve done this for decades). Wear a mask when you have a respiratory disease to protect others, not yourself.
I'm annoyed that so many people are politicizing masks like this. Wearing a mask in certain situations is a perfectly reasonable choice.
-When you get a cold, sometimes you have to be near people. There's also a period after the peak where you're not sick enough to isolate, but may still be contagious. I wear a mask in these situations when I go to the grocery store, and I do it for you. I don't need you to celebrate me for it, but at least don't sneer at me.
-My mother is currently getting radiation therapy for cancer. Getting sick would be bad for a number of reasons, but she doesn't want to completely isolate. She's started wearing a mask in a lot of situations. Sometimes I wear a mask around her too.
-I used to take the bus to work and I was getting sick all the time. I don't really take public transportation anymore, but if I did, I think it'd be reasonable for me to wear a mask on-board so I didn't get 8 colds a year. Maybe [gasp!] I'd even leave my mask on the walk from the bus station to my office, because it's cold outside and it keeps my face warm.
Nothing about any of this is political until you decide it is. Nothing about it is political signaling except your post declaring it political signaling.
For an individual choosing to wear a mask, there may well be a non-political reason for doing so. But as I pointed out in another comment here, look at pictures of the audience at a meeting of the San Francisco Board of Supervisors. They're mostly wearing masks! That is undoubtedly political signaling. Even the loons protesting in Vanderbilt recently all had masks on.
Yes, there definitely is some political signaling in wearing masks, as there is with many other decisions (driving a pickup, etc.)
The trick is to get the political rot out of our brains - if you have some negative reaction to a person at the grocery store with a mask on, you should try to recognize that as your problem.
Yes, it's stupid political signaling. It's also about the most innocuous form of signaling. Who cares if they put a mask on to show some kind of "virtue"?
Serious question: are people actually getting eight colds a year from commuting on public transportation? I've commuted on public transportation for almost my entire adult life and have typically gotten like one cold a year, maybe two. (I've gotten sick somewhat more than that in the past year because I have a little one at home, but that's different.)
If this is true, it would explain why I see people masking on public transit WAY more than anywhere else.
I was the one who said this - I believe I got eight colds in one year when I was taking the bus, but it's possible I've exaggerated in my own memory. I also saw a big increase when my kid was in day care.
The good news is that I know keep an excel record of my colds.* When this comes up in a decade, I'll have the receipts.
*Common colds are the thing that I am wussiest about relative to the general population. I hate them so much and am always surprised when other people get them and manage to seem to carry on more-or-less pleasantly.
8 colds certainly sounds like a lot. But the period of fewest colds in my adult life (no sick days in 3 years) corresponds with the job where I walked to work instead of taking the subway.
In practice I think of it less as political signaling and more as wearing a shirt with big block letters:
"Hey, remember [name of the first boy/girl] you really fell for? Remember that breakup? Wasn't that a heck of a time? Let's put [him/her] front of mind for a minute"
Some of us have ME/CFS, which for some of us is debilitating. It can last for the rest of one's life. I've had my case for 10 years; I assume I'll always have it. Further viral exposure can make it worse. So when people started talking about Long Covid, those of us with post-viral illnesses knew what they were going through.
I can function with my ME/CFS, but if it gets worse I may be housebound. It's already life-altering in so many ways. It's rough!
So when I wear a mask in public, like in a classroom, it's not political signaling. You don't know why people wear masks. Your assumption shouldn't be that it's a case of frivolous signaling.
Many pathogens are relatively new to humanity after jumping from other animals we domesticated. These pathogens are extremely dangerous and have a likelihood of breaking rather then improving our immune system.
Also, the common cold changes its antigens so fast I dont think it matters if you skip a few years.
“ when you do let your guard down you probably are going to be sicker than you otherwise would have been.”
This is not clear at all. Especially since a mask won’t fully stop all contact with all viruses, but will often mean you have small enough contact that your body can prevent the infection but still learn the immunity.
The harm is that it's dehumanizing. It's harder to empathize with someone if you can't see their face. It's a subtle effect but it compounds over time.
The only time it really makes me angry is when I see young children masked, usually in the company of their mothers. These kids are having their social/emotional development stunted, and they're going to become part of the professional managerial class right around the time I retire.
Social media is a bigger problem along these lines, but it's all contributing
How much time are you spending empathizing with random people walking down the street or riding the subway? Our level of contact with the average passerby is 0.
It's funny you ask this, because in addition to a sitting meditation practice I'm trying to practice metta meditation (as often as I can remember to) with eyes open, walking around doing stuff, and I find it's most fruitful when I'm around strangers in public.
I'm tracking my efforts in a spreadsheet so I could give you a very precise answer, albeit one that doesn't apply to people in general.
I will day declining social trust, or a general unwillingness to think charitably about strangers, is a really huge problem that is probably at the root of a lot of other huge problems. Yes, empathizing with strangers is very important. Eye contact, small smiles, and polite nods to the people who live in your community are important. It shouldn't be dismissed so casually.
I just think if this was something that really bothered people in and of itself, we would hear from more people who are put out by sunglasses. (Poker players wear sunglasses, not face masks, to keep others from reading their faces.) But I don't believe I've ever heard someone say it's annoying when people walk around wearing sunglasses.
Anyway, sincere wishes for continued progress in your efforts to think charitably about strangers, including those wearing masks.
Yes, I need metta specifically because I'm too often a bitter angry judgmental person. Thanks for the encouragement. I still feel bad for the children of virtue-signaling hypochondriac parents, though. I have definitely heard others remark that sunglasses make people seem aloof or unfriendly, and I've noticed that reaction in myself.
But is that the case vs that a mask reduces the likelihood that you will transmit?
As for liberals that need a purpose, work for taxation of net CO2 emissions, merit based immigration, lower deficits, less protectionism in supply security policy, reform of land use regulations and building codes, more effective public education, better crime control (including gun regulation). There are so MANY things to be done to make the world a better place!
I think the best thing for avoiding catching anything is hand-washing, and when leaving the restroom, I use the paper towels with which I dried my hands to turn the door knob. Since I started doing that my frequency of colds has come way down.
Cloth masks are not absurd. I don't know why or how that became a thing but it's just wrong. If everyone wore a mask properly it would almost completely prevent the spread, and on an individual perspective it definitely still offers some percentage of protection
Well, non-fitted masks mainly work via a "herd" effect (if everyone is masking, the exhalation of virules into the surrounding air is minimized). So yes, if "everyone" wears one we'll see a large benefit. But the point is, at this juncture only a very small portion of the public is masking, so if one chooses to mask, it's vastly more effective to go with a high quality, fitted mask, because the herd protection of near-universal masking is absent.
A real shitty pure cloth mask (there were really nice ones with better filtering than surgical) probably doesn't protect the wearer but still benefits public health by blocking droplets going out
Are droplets actually relevant? The public health establishment had convinced themselves that droplets of the size filtered by cloth, and that fall to the ground within six feet, were relevant. But that’s because they over-learned the lesson of Semmelweis and then had a miscalculation in the 1920s.
Just like 6 ft obviously wasn't binary but they had to pick some semi arbitrary distance to advise. Everything comes out of your mouth as a droplet but then it turns into smaller particles after. If you block what's initially coming out it doesn't matter whether it's a droplet afterwards. And even if it only blocks 50% well that's still 50% less virus you're putting into the world which makes a big difference
I agree that the incoherence was a big problem. It drove me crazy in the fall of 2020 when the old man dive bars were open but my kid's school was going to start remote (despite the local teacher's favoring being in person).
On the other hand I don't really get the rage/trauma thing. And I am skeptical that a post-mortem would be particularly helpful for whatever the next infectious pandemic is. Part of our problem seems to have been incorrectly applying studies from the 1920 flu .
"And I am skeptical that a post-mortem would be particularly helpful for whatever the next infectious pandemic is. Part of our problem seems to have been incorrectly applying studies from the 1920 flu ."
There was a really big fuckup around testing --- first trying to centralize it in the CDC (which decided to roll their own, over-complicated test despite being given instructions for making a working test, and then they fucked up manufacturing of their own tests to boot [1, 2]) while banning private labs from running tests, and then not approving at-home tests until pretty late in the game. (EDIT: some would say that they were opposed to the *concept* of at-home tests.) This wasn't the first time the CDC made similar mistakes with making tests available [3], so covid wasn't a one off.
My hope is that "the government" has learned its lesson with this because it was such a disaster. However, I'm not sure they have, and I'd really like to see a statement from the CDC along the lines of "Next time there is a pandemic, we will push for private testing and at-home tests to be approved and made available ASAP." My fear is that the lesson they learned is that they shouldn't fuck up manufacturing their tests --- not that they shouldn't monopolize testing.
I'm told that the existing flu LFT test is lousy, technically, compared to the COVID one. Much worse statistics on sensitivity and specificity. Tolerable for population surveillance but lousy for individual diagnosis.
(I did try to import a combo COVID/fluA/fluB/RSV quad-strip test from Germany, but Customs was paying attention and did not allow it in).
Actually, it looks like they did approve at-home flu tests (not sure about RSV) back in February 2023 [1]. You can get one on Amazon [2] (altho the price seems kind of steep).
Well, yes, in the sense that "all" CDC/DFA need to do is in the future let their action and recommendations be guided by cost benefit analysis. But I think seeing exactly how the COVID actions and recommendations failed the test would be useful
I agree with most of what Matt said but I think he lets Republicans off the hook too much for how adamantly anti-vaxx they were, resulting in so many needless deaths.
I remember Matt posting during Covid about how he was "Vaxxed and Relaxed" which struck me as the right mentality after we gained a basic understanding of the virus.
I think if people want to wear masks, that's fine. It's flu and RSV (as well as COVID) season and we have no idea why they're wearing masks. Maybe they're immuno-compromised.
You can laugh at me all you want with my mask but I’m trying to avoid colds, which can condemn me to inactivity for as long as a week. Masks are simply a new tool for avoiding the common cold, not to mention the flu.
I do understand it indoors for people who have respiratory issues or are immunocompromised. There is a bookstore near me where the owner has issues so they still require masks.
I suspect the use of "immunocompromised" has increased as the use of "fibromyalgia" has decreased. Though both are real conditions, the venn diagram of those using both terms probably has a lot of overlap.
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.
Here's my thing: During the pandemic, there were many, many, many times I wanted to scream in conservatives' faces "JUST DO AS YOU'RE FUCKING TOLD," followed immediately by doing an about-face and screaming in progressives' faces "STOP FUCKING TELLING PEOPLE TO DO SILLY THINGS."
I would add to that by telling conservative politicians and pundits to stop lying to people for political gain and telling liberal politicians and pundits to stop lying to people because they are arrogant and believe they know what is best for everyone, all the time, under any circumstance...
It was less the rule following and more the absolute faith in the experts.
If Fauci said walking backwards looking thru your legs would reduce transmission due to some made up scientific sounding thing people would have done it.
(And I live near a hospital in a large suburb of NYC and there were lots of ambulances going by and long lines of cars backing up to get into the hospitals—it was scary and made worse by the gruesome media cover of the city itself.)
I want to underline the word "visualize"—whether or not that's actually how a liberal-dominated world *would* be, don't casually hand your political opponents such a trivially easy talking point.
And no mention of the people who suffered as a result of some of the Covid era restrictions! Having a family member die alone because the hospital does not allow visitors is really awful. So is watching a family member go back to drinking because they can’t go to their AA meetings and the zoom AA meetings aren’t the same.
How interesting to blame the restrictions rather than the fact of the pandemic itself. Maybe humans were actually more realistic about society when they could just blame the gods for everything.
Hospitals refusing to allow the dying to have visitors is a policy decision and there's nothing about the virus that forced hospitals to do this. They could have handed visitors an N95, made sure that they had a good seal, had them sign a waiver saying they won't sue the hospital and then allowed them to go in. Instead they had healthcare workers do things like fill gloves with warm water and stick them in the hands of dying people so that they didn't feel as alone.
It's better to "blame the gods" because blaming human institutions without understanding them from the inside is pretty much futile. Yes, they "could have done this or that" but they didn't. Why didn't they? Why would we even expect them to do "what they could have done" in the midst of the chaos?
My personal psychological discipline has always been to avoid blame and instead seek understanding, partly because I tend to feel unproductively guilty about my own unintentional mistakes. But also because I've worked in a complex system, and was aware of the extent to which it was a ultimately black box to my understanding. Blame goes nowhere. Might as well come up with some gods to blame.
In the meantime, looking forward pro-actively is more crucial than wallowing in blame. It's possible that the healthcare system in general, not very resilient in 2019, is now deteriorating in the wake the pandemic and experiencing its own Boeing moments, in my city seen in the mass resignation of burned out PCPs , the impossibility of finding docs and getting appointments, the closures of local urgent care centers, etc.
My speculations about the chaos and what "they" "could have done" -- during the chaos, N95s were precious and more important for just keeping people alive. Who was supposed to "make sure they had a good seal"? Who was supposed makes sure all the relatives of the dying got a phone call? Who was supposed to handle all the visitors? The hospitals were in deep triage mode that extended to their operations across the board.
Real questions going forward: where are the pressure points in our power that can help healthcare institutions resist late-stage capitalism and become more resilient for whatever comes next?
I have no doubt there are, there's a lot of talent in that virtual magazine-room. But they're one of several publications that, to my eye, just completely lost their sense of direction and purpose from the one-two Trump/covid double whammy.
Yeah, it's nice to have a couple of hours of my time back each week now that I'm not marinating in alarmist commentary about all the things I am supposed to worry about. I get it, our society is facing some problems, i don't need to pay you $80/year to rub my nose in it every day. I do miss the film reviews occasionally.
Maybe we shouldn’t get all therapeutic about it, but the idea that we are generally suffering from PTSD with regard to COVID is not an unreasonable heuristic. There were many problems with the pandemic response but I would not call it a failure: we could have done much worse.
Can someone explain to me what this "urban liberal neuroticism" is? Seems like a convenient straw man rather than any real, coherent trend. Fill me in.
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.
Totally agree John. I was always annoyed at how long it took for two basic obvious facts to be understood: COVID was primarily dangerous for the very old and those with respiratory comorbidities, and COVID is airborne. The age factor was obvious almost immediately (and acted on by DeSantis, credit where it's due) and it's incomprehensible to me that it took so long for the CDC to officially acknowledge it was airborne.
The first month of COVID response seemed fairly sane - lock down, flatten the curve, reopen cautiously and keep your eye on the hospitalization rate after that. Then it just went off the rails. Frustrating.
It was obvious to me but I think was purposely hidden in the communication that flattening a curve just means spreading it out over a longer time.
Most non-scientific people I know 100% were led to believe that flattening the curve somehow meant reducing the area under the curve and therefore stopping infections completely as opposed to just making them happen over a longer period of time
I'm pretty confident this is directly attributable to the teachers unions. "Kids don't get sick" was devastating for their quest to get paid for staying at home as long as possible.
I'm always willing to bash Teachers Unions, but I think the causality is backwards here. They responded to how the CDC and other health officials chose to communicate. There was almost nothing in the summer of 2020 in their recommendations or media reports about the relative risk profile based on age. Many teachers were scared. Needlessly, as it turns out.
It's as if the CDC and the media in total weren't interested in providing facts and then let people decide how to respond. Instead, they wanted a particular response then crafted their message and facts presented to support the desired response.
I have two in-laws in the NYC school system. One was a teacher the other a school psychologist. Both reported that many (most?) teachers around them were extremely lax about COVID but also really, really enjoying WFH.
I’m surprised to hear that teachers were lax about Covid. At my DC-suburban school it was the same 5-10% of the kids who just refused to mask properly, and -you can guess - there was no enforcement or consequences of them not doing so. I was pretty much alone in talking about in-person schooling for late spring or fall of 2020, but that’s because I was pretty much alone in reading about the European experience.
I've always thought the persistence of remote school had something to do with the social position of teachers.
If you think about it, most of the jobs that had good reason to continue in person during Covid were blue-collar, with two big exceptions: teachers and medical workers. Medicine has a very strong ethos of sacrifice; if you go into that field you probably know that at some point you may be called to go above and beyond. (Also doctors specifically make a lot of money.)
Teaching isn't really like that. It's just a normal white-collar job. So I think teachers looked around at their peers, lawyers and software engineers and marketing managers and whatever, all of whom were working remotely, and thought "what the hell? I want that, too."
This is just a half-baked theory, and it doesn't excuse the disaster of a policy, but I've always thought that's where it came from.
I want to add one thing to this. I suspect there is a critical mass of teachers who truly mean it when they say "I love teaching and am passionate about it," but mean it in the sense of "I love presenting and explaining information and concepts and am passionate about it," while hating classroom management, which wasn't exactly a cakewalk pre-pandemic, anyway. But working remotely, you don't have to do classroom management anymore! At least, not in the same way.
Another thing is that teachers, especially the types who become union activists, are often very neurotic about their professional position vis a vis other white-collar professionals. They think they aren't valued enough by society. Whereas e.g. lawyers are completely comfortable with their social position--they're generally indifferent to what laypeople think about them. You never see lawyers offended by lawyer jokes.
I suppose I think that in summer 2020 the kinda "precautionary principle" ideological lockstep between public health and education that kept schools closed was more of a preexisting phenomenon than a causal arrow in either direction. At some point, when public health people found the actual data increasingly hard to ignore it was enforced by the unions.
IMO that's one of the biggest failures and least well appreciated aspects to the decline in public trust. As far as I'm concerned everyone gets a mulligan for the spring. Summer 2020 should have been spent preparing for in person, with reasonable precautions. I know this was possible because that's what the Catholic schools did in the Archdiocese of Washington DC.
That's also pretty much how we were at (white-collar, professional) work. Started returning in June, and most everybody back in the office by the end of summer, although I don't think it was mandatory until vaccines came available.
I actually think the case for hybrid models and lots of remote work for office jobs had been pretty strong for years predating the pandemic. It's good for traffic, good for the environment, and good for the workers whose jobs are conducive to it.
Another bad dynamic that got thrown into the mix was a policy that independently had a lot going for it being arbitrarily connected to the severity of covid.
I blame the CDC and the lack of early testing. A bunch of teachers did die early on and so it’s reasonable for them to be scared. Had we had decent testing and tracing - like Europe - we could have demonstrated that those unfortunate deaths were not due to contracting COVID from their students.
The “teachers did die early on” impression comes from massive media amplification of a tiny number of unrepresentative deaths of young teachers as well as unions disingenuously counting elderly retired teachers in their statistics of teacher deaths.
Almost all schools closed in March 2020 and stayed closed through the end of the year. The teacher deaths splashed all over the media in summer 2020 couldn’t have been from teachers catching COVID at school.
A few of anyone/everyone died early on, a common feature of a pandemic. Teachers as a bloc were the only ones that were largely exempted from effectively doing their jobs in response.
I am trying to use "as a bloc" to recognize that a great many teachers were pulling their hair out because they think their job is important and they knew that their pupils were not being served
Kudos to you for acknowledging that many teachers went above and beyond. As someone who currently teaches remotely, I can tell you that it is more challenging than people realize. Think of your last Zoom meeting and then add 30 kids, some of whom have ADHD, and imagine what a nightmare that would be. I do not do many live classes (thank god) but it is tough...
That said, I think a great many teachers let down themselves and the nation. There were people working grocery stores, medical workers, emergency workers, etc. They all went to work...another kudos to people like barristas...Not sure how I would have survived COVID without the barristas
Yes, I know multiple people under 50 who died of COVID in the early days, three of them well under - mid-20s to mid-30s. I am in NY State, but not the city. It was scary, and even if we were given the stats, I am not sure that we would have trusted them.
I also agree with Matt that the school shut downs were often due more to parents than to teachers. When our schools first went back, families had a choice of going back in person or remaining remote. Less than half the students went back in person. It was the opposite of what I initially expected - wealthier parents with jobs that they could do remotely tended to send their kids in person. Poor and blue collar parents with in-person jobs were more likely to keep their kids at home.
"It was the opposite of what I initially expected..."
My guess is this is driven by how much those parents value education combined with access to info on the real risks. Otherwise it doesn't make any rational sense, as the parents with on-site jobs are already exposed.
"Kids don't get sick" logic ignores the fact that lots of people work in schools who are not kids. Of course, those people are unionized and underpaid, so conservatives don't care if they die.
Remember, with pensions, most teachers actually can retire fairly young...Particularly at that point as all the older ones would have legacy pensions from before the more recent trend to reduce the benefits and increase the retirement age.
I do not say that in a snarky anti-pension way (I have a pension and left my first job young) but only as a factual reference. I am not sure of the logic for teacher pensions, but I know many pensions are based on the fact that the work is strenuous. If you were older and concerned, you could leave.
I could have left during COVID and did have to work with the public, but where I worked, there was a lot going and it would have felt like abandoning my team. I do not think it unreasonable to expect the same from educators (which is what I do now).
Also, in terms of pay...the value of a pension is generally in excess of $1 million...so they really are not paid poorly when you take benefits into account.
I don't know why people think closing schools was about kids.
At least pre vaccine it was about not forcing the predominantly elderly teacher population to go work among disgusting disease-ridden kids. And then a side part of it was the fact that kids have older parents and parents always get sick from their kids so again it is about kids as vectors not as patients.
“Kids don’t get sick” was absolutely false though. What was true was “kids don’t get it bad”.
It really was shocking to me though how much my brother and other parents I know were worries about their children when it was quite clear that they were at risk of serious issues but their kids weren’t.
I remember many people that were not going out with their toddlers until they could get them vaccinated. Smart people, mind. Absolutely terrified of their kid getting sick. Fairly convinced most elementary aged kids wouldn't have even known they had it, were it not for the heavy testing.
There is still a lot of uncertainty on long-term outcomes? That hasn't changed. With a lot of the causality in all of it being a nebulous cloud of interactions that are not topologically sortable into a prime mover.
I think it is fair to say there was a lot of fear. And we had a massive hope that we could control the situation to reduce things. Even this retrospective is the hope that we could be better next time. But there is scant evidence that we could have done better this time, or that we will do better next time.
This is not to say we should stop looking. But I would really love it if both sides of the debate weren't so quick to throw out studies that disagree with them.
That's interesting! My partner and I have no kids, and it seemed to us that those months of isolation were great for us, but seemed really hard for people who either lived alone or lived with kids.
I think it depends where you were. The isolation we put kids through was rather high. Literally parks and playgrounds were taped off and they were not allowed to go play with others. It felt excessive at the time, and it feels foolish looking back.
This kind of reminds me of how public health authorities have spoken about AIDS. (I know, but hear me out…)
It is obvious that there are certain populations that have certain behavioral risks that make them much more likely to be at risk for HIV/AIDS (gay men, sex workers, IV drug users, etc). Yet public health authorities historically have not made distinctions and messaged the risk to the population at whole like everyone is equally at risk.
Was this because of A) not wanting to stigmatize those at higher risk or B) Not wanting to make those not in high risk feel like it’s something they never have to worry about? Most likely a little of both but I think both those cases applied to COVID.
Public health authorities were/are reluctant to single out the elderly, but especially obese, etc and didn’t want others to feel 100% immune. I would like to see public health authorities trust us to understand this and not act line everybody is 100% equally at risk for every disease.
This is exactly it. One reason the high correlation between age and covid morbidity wasn’t made ultra clear to the public was many public health officials’ conviction that saying it out loud = it’s ok for old people to die. I definitely saw this stated (on Twitter, ok fine, it was Twitter). The idea was absolutely was that we shouldn’t just be given information and trusted to make decisions.
A lot of public health officials appear have “we’re all in this together” as their operating principle for public health responses. As a practical matter, for COVID, this translated to everyone must do what the most at risk people should do.
It was only around 5 years ago that I learned AIDS is almost exclusively spread through anal sex (plus needles, etc) after I wondered why none of the highly promiscuous straight people I knew/knew of never got it.
Public health absolutely gives incomplete information intentionally to try to affect behavior, and they were caught red handed doing this over and over during the pandemic.
I think it relates to healthcare workers’ universal experience with ignorant patients, which is corroborated by my friends in the industry.
"It was only around 5 years ago that I learned AIDS is almost exclusively spread through anal sex (plus needles, etc) after I wondered why none of the highly promiscuous straight people I knew/knew of never got it."
Maybe in the US. Certainly not in places like South Africa.
Well, no, not if the cultural or health conditions that drive transmission are mostly absent here.
Over the years I've read 3 explanations for why AIDs took off among heterosexuals in Southern Africa (South Africa+ Neighboring countries) far more than anywhere else, including the rest of Africa. I don't know how true each of these are:
1) A greater incidence of other STDs that aid transmission
2) A greater frequency of having multiple long-term sexual relationships concurrently.
3) A trend of men preferring dry vaginal sex. I can't remember what that's about exactly but look it up if you're brave or curious.
I think heterosexual sex accounts for about 10% to 14% of all transmission routes for new HIV cases right now. In King County the group with the highest HIV rates are female sex workers. It is not the primary source of transmission but it isn't not a risk. I do think we need to be more transparent in health care messaging but I do get why folks worry that low risk equals no risk is a frequent reading. In any case you are way more likely to get syphilis from sex workers in King County than HIV and it didn't take long for that to move from that population into the heterosexual population at large. So things can change and jump quick.
"I think it relates to healthcare workers’ universal experience with ignorant patients, which is corroborated by my friends in the industry."
This fits with something my wife encountered (pre-COVID) once while being treated in the ER, where a doctor literally told her they were going to skip giving her a particular medication because they trusted her to do something she had been directed to do, whereas most other patients they would have just gone ahead dosed with the drug. (Being vague here for medical privacy reasons.)
In other words, public health authorities lied their heads off, because they think they know better than you. And that's why their authority was lessened or removed by legislatures across the country.
Before AIDS became treatable, I remember public health and even gay rights groups (who of course are very concerned with stigma) doing a very good job of promoting condom use and emphasizing the high risk to gay men.
HIV is actually a model of how people can put aside political correctness (although to be clear it took a couple of years to really solidify- at first the Left wanted to keep the bathhouses open and the Right wanted to ignore it or quarantine gay people).
We don’t even need to go back that far! This happened with mpox in 2022. I genuinely only found out it was spreading largely among gay male cohorts due to Twitter and WaPo comments sections. And yeah gay advocacy groups were all over it, like, no we want to protect ourselves so we are going to talk about. But they had to push that themselves; health officials and media were going to just keep pretending it was a society wide risk.
OMG don't get me started on mpox. I knew so many gay men running around with their hair on fire in June/July 2022 afraid to even make out with anyone because the official line, amplified throughout the media, was that it was spreading in "the queer community" and you could get it "through intimate contact." No one could find an explanation of what exactly constituted "intimate contact." Fortunately by August, we finally started to get straight talk from other gays working in healthcare/public health, who understood the importance of clear and explicit communication and that the euphemistic language public health officials and media were using was doing more harm than good. Don't say "the queer community" (as if lesbians were getting it!)
when you mean "gay men/MSM and trans women"; don't say "intimate contact" when virtually all cases involved oral or anal sex with a partner who was infected.
Sure, but Healthcare Communication 101 is use plain language, not assume people know what the euphemism means (never overestimate the knowledge of the average person!). All i can tell you is that the correct message, "touching is low-risk, oral and anal sex is high risk," was not getting through to a lot of people.
I don't know about IV users but I definitely disagree that they aren't willing to speak about AIDS as a gay crisis.
Even as a gay teen in the late 80's I was _very_ aware that this was _primarily_ risky to me even if anyone could catch it via intercourse.
That was not hidden.
And even now if I see a PrEP add (the prophylactic HIV medication) it universally features 2 guys in the ad - it's definitely clearly targeted at gay men.
I think this refers more to the messaging towards straight people. I was told as a kid that AIDS was simply a risk from unprotected sex, like other STD’s.
It’s actually remarkable - somehow the societal mix managed to let gay people know that we are at extra risk for hiv and mpox, but didn’t let straight people know that there was this distinction. I don’t know whether this was effective at all for the stigma or for prevention, but it seems like it was effective at getting this state of affairs.
As a non-gay teen it was definitely presented to me as if everyone basically had the same risk. I remember being fairly shocked when I went digging for the actual transmission statistics in my 20s
This was my experience too (I'm almost forty). "HIV is a huge risk if you have sex without condoms" was the message we all got. I didn't learn until shortly before college that HIV transmission via vaginal sex was very, very rare in developed countries.
The stat i remember reading somewhere was a 1 / 300 chance for the woman and a 1 / 500 chance for the man, per incident.
Which isn't zero. But it's not high enough for the disease to spread continuously unless people are having multiple long-term sexual partners at the same time, which I've read is somewhat common in the southern half of Africa.
I've heard the same about southern Africa, I've also heard a few other explanations: prevalence of other diseases increases HIV transmission, "dry sex", populations that weren't historically exposed to the Black Death, and male circumcision. I really have no idea what the answer is.
Yes, as someone who spent the entire 1980s to early 1990s in K-12 schooling, the takeaway I definitely had was that all forms of unprotected sex had nearly the same risk.
As a straight man with a wife that watches a lot of Bravo, I can attest that PrEP adds aren’t coy that their product is for gay men. I swear 1/2 of ads on prime time Bravo are for PrEP. The other 1/2 are for birth control targeted towards young women, haha
I also remember looking at the cdc list of travel precautions in summer 2020 and at first being glad that they mentioned all the relevant points of risk, but then really annoyed that they weren’t doing anything to distinguish the risk of using a gas pump someone else just used vs sitting in an airport with a crowd waiting to board a plane. It’s as though they wanted everyone to be feeling equally nervous and cautious with any mode of travel, rather than wanting to direct people away from more risky modes of travel and towards less risky ones.
Not relevant. The factors that made some people more at risk for AIDS were stamatizable (especially back in the '80's). There is not stigma attached to being old or having a co-morbidity, so there was not reason not to provide that information.
That said, I think the age factor WAS pretty well know, just not acted on.
It's one thing to be a jerk about it, but pretending that obesity is not a preventable risk factor is also not helpful and might even get some people killed.
Maybe not, but you can always make progress. And an obese person is continually at higher risk from infectious diseases other than covid, so it's always a good time to lower your risk factors.
I think the core issue is that covid stopped being approached rationally by any corner within weeks. Trump deduced it was a threat to his re-election and we were off to the races.
We had decent data on mortality rates by age very early. This article was published in March of 2020. The Diamond Princess was an excellent natural experiment, almost a natural challenge trial.
I recall doing analysis in both the initial days of the pandemic as well as over the summer of 2020, and age was so well known to have a huge effect on mortality that we didn't even bother to emphasize it most of the time.
What frustrated me is how people wanted to either round the data down to "if you're under 70, it's basically nothing" or "everyone is at risk". Both of these are bad analysis and bad public health messaging, but I rarely heard anything in between outside of analytically-heavy deep-dives.
Agreed that 70 is probably too high of a cutoff. Below 30 feels very different. Heck, below 50 was already safer than you'd think based on the reactions of everyone.
>> the lack of data during the pandemic about the age of those killed by Covid..
You must have had a dramatically different news feed from me. I could maybe be convinced that some media outfits overemphasized the risk of covid to young people, but there absolutely was not a lack of data about the risk to the elderly.
As I remember it, nearly all of the early reporting on death and hospitalization was broken down by age cohort. Cohort based mortality charts were published everywhere from the start and much of the early discourse on precautions for Covid was centered around protecting the elderly and vulnerable.
Some links to reports and articles from March 2020 from a quick google search:
I don’t think I ever got a sense that there was more than a factor of ten in virus risk for various ages, until I really started digging in March 2021 and realized that my vaccinated parents were actually still at higher risk than then-unvaccinated me, and that when I was vaccinated I would still be at higher risk than my then-unvaccinated nephews.
I tried explaining that to fellow parents. Get your kids vaccinated, but realize that they are at far lower risk without the vaccine than you are with. For those in offices at the time, the 20 year olds that were in the office were in a similar position. They were basically fine if they were keeping decent health otherwise.
Same here...In Oregon, groups like teachers and lawyers (I am not 100% sure about the timing for lawyers) received the vaccine before the elderly...schools and the courts were shut down, but ostensibly, this was to get them open (they didn't).
I remember the reporting being on age, as you are indicating. The response, however, was not. A lot of the writing around it seemed to be waiting for the rest of the age cohorts to catch up.
You can even see it in your headlines. "Older are highest risk, but all must act!"
I read the "all must act" as imploring the young to act to help protect the old, not to act to protect themselves. I don't ever recall reading anything ever that suggested that the age cohorts would catch up. The science was clear from even in March that fatality rate was highly coupled to age and health status.
Fair that I don't remember people directly saying the age cohorts would catch up. However, it made 0 sense for families to start only doing delivery of groceries to protect their family if the grand parents were not nearby.
I hate to harp on the stuff like masking, as we wore them, but the evidence seems clear that worrying about grade school level kids and their masking levels was completely wasted effort? Not letting kids go to playgrounds? The vast majority of "everyone is in a plastic shielded checkout?" Did that do anything?
Covid death tolls are often compared to things like WW2. In the USA there were more deaths from covid in a shorter time and this has been discussed in the sense of traumatic national experiences . I’ve always wanted to see an expected years lost statistic. People who died in world war 2 were overwhelmingly in their 20s compared to the elderly for covid.
If WWII broke out in modern America, the Philippines wouldn't even have had the chance to fall to the Japanese before half the people of the United States had already decided to surrender.
Each year's annual total of fatal drug overdoses (100-110k, average age 40-45 or so) is in the same ballpark as the sum total of covid (1M, average age 75-80 or so)
I wouldn’t say “each year’s annual total” - I don’t think any year before 2015, or maybe 2012, had anywhere near that many. The drug overdose issue is an acute one we haven’t quite been treating as acute.
100k or is the steady state now since 2020 and with no end in sight (it's still trending up), so it feels correct to talk about it in the present tense as an ongoing phenomenon
“COVID disproportionately kills older people” definitely was reported early on, though, even before it came to the US— this fact was pretty clear in, eg: coverage of the first big outbreak in Lombardia in Italy.
I suspect that public health officials might have wanted to under-emphasize it because COVID is contagious and the behavior of people with low death risk also affected transmission rates for the higher-risk population.
I think a lot of people thought “COVID is a lot more dangerous to older people, like 3 or 4 times as deadly”, not realizing that it was more like 100 times as deadly.
But part of that is that I think people have difficulty conceptualizing numbers like 100 - I kept seeing people claim “99% survival rate” as though that is not super scary, and without realizing that even something that is more like 99.9% survival rate is probably on par with drunk driving.
Thank you! When people would tell me that it didn’t kill 99 percent of the infected, I’d be like, that could be 3.3 million Americans if we all get it. That’s bad!
To a person, my fellow army of young new 2020 poll workers signed up "so grandma doesn't have to be here", and this was common knowledge long before November.
I also worked the polls for this reason, but I'm not sure that poll workers are really representative the the general public (and hence what is "common knowledge").
I remember getting into debates about age effects with people on facebook (to be fair, also not representative the the general public), and some smart people's refusal to acknowledge the obvious drove me nuts.
This lack of observation was particularly damaging with the schools. Once this observation was made, and it could have been very quickly, not only should schools have immediately been reopened, they should have been running throughout the entire summer, not only to make up for the time lost before, but to be able to have more outdoor activity, and prepare for the future in case things flared up badly during the winter (which they did).
Twenty years hence, I think our decision to not have all schools fully open by fall *2020* will look worse than every other decision and non-decision put together. Half of a ten-year cohort just deep-sixed.
The only caveat I'll put on the 2020-2021 term is that many school districts had no choice but to close because too many adult teachers and staff were getting sick. But as I said, I think it looks bad enough that schools weren't reopened in *April or May* of 2020, and didn't remain open for the summer.
We did have hospitalization rate issues still in 2020 - we still had bad information(we were cleaning our groceries!) I think it's justifiable that the schools stayed closed in April & May of 2020 due to not having widespread testing yet etc.
Right, where schools were open things weren't exactly normal. My sisters teach and we're back in school Late fall of '20/ spring of 21, but everyone was getting sick, or people were exposed and had to quarantine, it was a mess, and honestly didn't seem like it was doing all that much more than remote instruction.
YES. I think an under-discussed aspect of the COVID policy response is how deeply it was tuned to protecting the lives of working PMC boomers at the expense of everybody else. All the talk of protecting the marginalized--who were mostly still forced to work in person if they weren't just laid off entirely--feels like it was a smoke screen to protect the true beneficiaries.
I'm actually coming to the belief that the whole COVID response (especially post vaccine) may not have been worth it for the few lives saved given the ongoing harms to society and the risks of future politicized pandemics caused by viruses more deadly than COVID.
And this knowledge gap still exists in many circles! It’s still common to insist that people who are immunocompromised are in grave danger from the virus and at even higher risk than elderly people. But your risk of severe Covid doubles with ever 6 years of age and being immunocompromised doubles your risk. So being immunocompromised in the more typical way means you are at the same risk as someone 6 years your senior. The exception is people who are severely immunocompromised, which means people with organ transplants, blood cancers, having no B cells as a result of leukemia treatment, having the genetic disease SCID etc. in all of those cases, covid is not unique. The flu and even a minor skin infection are also really dangerous. Being on Remicade does not raise your risk by a massive amount
I largely agree with this, but it is fundamentally true that most working-age PMC adults do interact with older people (eg their parents) on a fairly regular basis. So the “protect the elderly” tinge to some NPIs is arguably justified (at least pre-vaccine).
I think the QALY analysis is underrated. It needs to be emphasized that any death is important, but it is also essential to understand that life is about trade-offs, and the extremely old and/or individuals with huge health risks are probably in a better position to isolate themselves than, say, school-age children who need to be socialized and to attend school.
I am not an expert on suicides, but my understanding is that this is the reason it is used by epidemiologists for suicides (the nice thing about this forum is that I am sure someone can correct me if I am wrong on this). I worked as a contract analyst with a health department and was amazed at the quality of the people. They can do amazing things but that work seems to take years. It would have been nice to have the analysis in a useful timeframe.
New York had age cohort deaths very early and were releasing them weekly. Though the early pandemic was much more deadly in New York City than it was in other places.
I was wrong. It was New York City Department of Health publishing age related mortality data and it was daily at the beginning of the pandemic. The PDFs are still up.
And school age children even lower. Now there is a hypothetical argument that the coming and going to schools would transmit lots of COVID but CDC never gave schools the information and tools to evaluate that cost to be set against the benefit of in-person schooling. And I'll admit that parents' (and occasionally teachers) reluctance was involved, but, again, CDC did not provide schools with tools to push back.
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 about…*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, etc…(eg I’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 he’d have found dozens of scientific papers describing the reality that most respiratory viral infection act exactly the same way…)
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 areas…was 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 right….and that makes me very sad…
"there was such a shocking unwillingness to have a semblance of a real cost/benefit debate about…*anything*"
I mean, I think that sums up Team Blue pretty well. Just look at your average environmental rule. Team Red isn't much better, but it's less salient when they aren't the ones trying to regulate every aspect of your life.
To be fair, I suspect Kevin is saying that Rs are the ones that fanatically try to regulate a few specific things (abortion, contraception, immigration), because those are things that are passionate enough about (or hate enough) to be "worth it" to violate the core principle that regulation is bad.
Ds, on the other hand, seem to think that regulation is good, and the answer to most things, but then are willing to waive them for things *they* are most passionate about (i.e. the Floyd Protests).
Another example is a lot of social justice stuff. E.g. the push to "ban the box" (limit background checks when hiring) has probably lead to fewer black people getting hired [1], but I don't think this caused the ban the box movement to pause and do a cost/benefit analysis. (Some groups do benefit from the changes, so maybe they would pass a cost/benefit anlaysis.)
Matt actually just recently posted something about that research being incorrect and "ban the box" having fewer negative effects on hiring than previously believed.
Lol, so the conclusion of the paper is that BTB laws have zero impact whatsoever? I'm not sure if that's better than having a mixed impact, but it absolutely doesn't pass a cost-benefit analysis because the resources in advocating for the laws could have been better used elsewhere!
"Results indicate that BTB laws, any type of BTB law or BTB laws covering different types of employers, have no systematic or statistically significant association with employment of low-educated men, both young and old and across racial and ethnic groups."
Lasch likes to talk about a populist notion of "limits." Let's not forget that pre-stim, the EMT people were ascendant, literally arguing that limits did not exist.
I don't understand your comment. I don't know who Lasch is, I don't know what you mean by limits, I don't know what you mean by pre-stim, and I don't know what you mean by EMT. ChatGPT was able to help out with Lasch and had some idea of limits, but not the other two.
Let me try again. "Weirdo Historian of social thought, Christopher Lasch, wrote about the history of the populist movement in America. He believed one of its defining features was an acknowledgement of limits. This resonated with me. Before the inflation caused by the Covid stimulous killed it, modern monetary theory (MMT), argued essentially that there was no limit to what could be spent by government. No cost/benefit necessary.
>Covid maximalism became a religion in the left in the same way that Covid denialism became a religion on the right<
I'm sure your are articulating a sincerely held belief. And you're not alone in this belief. But it strikes me as unjustified bothsiderism. Are there lefties out there who still won't ride planes or go to parties? In a country as large as the US you're going to find some examples of everything, sure, but for the most part the vast majority of liberals/progressives took the "vaxed and relaxed" approach, even if some of them moved more slowly than others. Also, even during the height of the crisis, what harm did covid maximalism cause in the United States? About the only thing I can think of is excessively long school closures. But realistically we weren't going to *completely* escape a period of remote learning. So what kind of "lefty harm" are we talking about on that score, an extra five months? Eight months? In limited sections of the country...
Compare that to the extra couple of hundred thousands deaths we got from our shambolic, MAGA-led "response" to the pandemic. And, unlike liberals who have gone back to living normal lives, GOP-backed vaccine denialism is *still* a very potent force here in 2024. Google "measles Florida" for proof!
The school closures are going to turn out to be far, far, far worse than you are portraying them when we get all the statistics 15 years from now, and should have been ended much earlier and weren't because the Teachers Unions are in our coalition.
I agree with you about the terrible longterm costs of right wing vaccine denialism though. That could kill us all in the next pandemic.
We are absolutely seeing this in the universities now. The students are much less prepared. And they were so coddled during Covid (late assignments were forgiven, standards were lowered, nobody was flunked or disciplined) that they expect easy As and make excuses for everything (mental health in particular is opportunistically wielded). It’s much worse than five years ago.
Even little weird things. Librarians at a selective college in my area have had to change their library instruction - moving to sophmore year what they would have taught in the first year - because students come in not even knowing how to check out a book since 1) libraries did curbside/desk pickup and 2) high school libraries were often closed because they were used for extra space for students to spread out, places for students to do online learning when too many teachers were out sick, etc.
Yes, the demand for As is the worst I've ever seen (and it was already pretty bad). The people claiming to need some sort of accommodation is also off the chart. Once in a while, a student will just start crying in your office because they don't know how to process anything challenging. This wasn't unheard of before but definitely became more common in the last few years. I think it might be getting better now, but I don't deal with as many students as some of my colleagues to know for sure.
But again, is it the case that we realistically could have *completely* avoided remote learning? In the face of a deadly outbreak caused by a (at the time) still not completely understood virus? I think that's not tenable. So what we're >really< debating is the >marginal< additional harm caused by whatever malign left-wing influences >prolonged< school shutdowns. And that varied from place to place. There's also a legitimate debate about what indeed was necessary. Children were at highly limited risk to covid. But that risk wasn't zero (nor was this very clearly understood in the early days). And needless to say a 59-year old math teacher doesn't have the same risk profile as a nine year old. So, while we know remote learning is inferior to in-school learning*, there's still the question of what (if any) reduction in education outcomes is justified to achieve a reduction in health risk or mortality to school employees and students. I get the impression many believe that no reduction whatsoever in education outcomes is acceptable (I'm not suggesting this is your position). But again, to me this seems unrealistic.
*We also, needless to say, didn't know as much about the impact of remote vs. in-school learning as we do now. I find this debate, like so much of the pandemic discourse, to be redolent with an air of Monday morning quarterbacking. Hindsight is always 20/20.
2. Significant learning loss that cascades through later life.
3. Significant increases in drug abuse
4. Significant increases in serious mental health disorders, from PTSD to eating disorders.
5. Significant increases in deaths of despair.
6. Significant increases in loneliness and anti-social behavior.
The numbers of people affected by this, in some cases the entire rest of their lives, and the severity of the effects are going to be awful. We basically experimented with a generation of children and that generation is going to be paying the consequences of our decision to do this for the rest of their lives. You are just going to turn out to be completely wrong about this and we are already seeing lots of signs. (Indeed, there were signs AT THE TIME we followed the teachers unions' demands and didn't reopen the schools sooner.)
I am not sure about this. Almost all of the things you list - perhaps all of them, except number 2 - were already on an upward trajectory before the pandemic. It will take some study to determine how much the pandemic influenced this and how much was the already existing trajectory.
How big of a cohort are you thinking will be adversely affected in this regard? Approximately which birth year can we start looking at after the range to compare and contrast with?
This is where we need an education expert with no dog in the fight. Because that depends on what ages kids are most susceptible to disruptions in schooling, which is an empirical question that I cannot answer.
But I am quite sure that in person schooling is important not only for educational outcomes but also for social development. Indeed, I don't think this would have ever been controversial on the Left pre-COVID. Imagine if someone had argued pre-COVID that we needed to close or get rid of public schools for some reason and could replace it with homeschooling and remote instruction! What would ANYONE on the Left had predicted would happen?
I fear we are going to indeed see all those things. I think it will hard to parse out to what extent that was from excessively long school closures vs. school closures at the worst of transmission vs. just living through a pandemic where there was both major social transitions and excess death. The kids I know who are suffering the most right now are the ones who lost multiple family members. That happened on top of isolation and loss of structure etc but it was a bigger factor that I think we discuss. Not a lot of kids died. A lot of kids were impacted by death in their family.
No we couldn't have completely avoided remote learning. The spring of 2020 was a lost cause. But my school required all faculty to be back in the classroom in Fall 2020 unless we were over 60 or had a specific medical excuse. Now, this was a university and not children, so it was much easier to enforce distancing and masking rules. Everyone got through fine - faculty and staff and students alike. I contrast this to SO many universities that stayed remote for all of 2021, and it just doesn't seem like that was necessary.
The cost/benefit curves are very different for different ages of school and different subject matters. I think a Zoom class of 700 college students is probably better than an in-person lecture of 350, and we should probably have been doing that even pre-pandemic. Small discussion classes at the college level work better in a traditional setting, but it’s hard to know whether doing it over zoom or doing it socially distanced with masks is better. (My inclination is to think Zoom is less bad, but I can’t tell how much that is me just being happy I could live in Austin for a semester rather than College Station, TX).
I don’t know how anyone thought that Zoom-based class for first and second graders would ever work.
I have no idea which side of the line high school classes would tend to fall on.
Even for university students, zoom class kinda sucked. The students were much less engaged and learned far less than in person. You could tell they were all doing other stuff. Maybe I’m a crappy zoom instructor, but I hear this from many other faculty as well.
My daughter was in high school, and Zoom classes/isolation seemed like it was pretty rough on her and her classmates. No doubt they did better than elementary school students, though.
I think that there were a couple of different factors of impact (1) actual lost substantive learning; (2) developmental delay in terms of lack of in personal socialization; and (3) loss of socialization in the norms of school in terms of attendance, behavior, and basic study skills. I think each grade cohort and some but in some cases one was bigger than the other. For my middle schooler and her peers I would rank that from most extreme to least as #2, #3, and #1. But at younger grades I think that #1 was a bigger piece of it.
We stayed remote through the end of Spring 2021, and I felt that was a reasonable compromise. Some of the staff screamed bloody murder when we were summoned back to campus in just a 3/2 in-person/remote format, though.
Same as my nephews in Boston (suburban public school). They went back in April, 2021. So they did at-home schooling for about a year. Which sucked in some ways (especially for low SES students; the data suggest the impact was far more marginal in higher income households). Basically, once the vaccine queue was eliminated, teachers had to go back to school.
Regarding hindsight, there were a lot of countries that didn't close schools, or keep them closed as long as we did, so they apparently had foresight. But also it was obvious to any parent watching their kids in remote school that it was a total failure, and it must have been obvious to the teachers as well. Within a month or two of trying, the correct move was to say, "Well, we tried it and it's not working, time to try something else."
"for the most part the vast majority of liberals/progressives took the "vaxed and relaxed" approach"
Look at pictures of the audience at a meeting of the San Francisco Board of Supervisors, and then say that again. Even the loons protesting in Vanderbilt recently all had masks on.
Nearly my entire NYC office refused to return to in-person work for a solid year after being vaccinated because of "fear of COVID". There are still many holdouts. Yes, it's a convenient "fear", but yeah, it's there and real.
"Excuse"? Not exactly. I think they are genuinely, conveniently afraid in a way that wow! just so happens to require they work from home. I noticed that Disney trips resumed among many. They don't seem to see a tension there.
A friend who teaches at a CUNY school said that the further a person's commute, the greater the resistance. But even this is complicated. She can walk to work. If you are spending a long time on trains and subways, it makes sense that you will be more afraid.
I didn't see any of that, though. People who lived in walking distance of our office refused to come in, just the same as those out in Westchester. I'm on Long Island and I made it in, along with one person who had a long subway ride from Brooklyn. We were pretty much it, more or less, out of around 40 people who were told to head back. That number seems impossible to me now, but yeah, it's about right. And like I said there are still holdouts, all of whom live in Manhattan.
>Yes, it's a convenient "fear", but yeah, it's there and real.<
Is it real or is it just far more pleasant to avoid a commute and work from home? I don't blame workers from trying to get the best possible deal and working conditions they can. But the freedom to work from home is in rapid retreat. (Predictably so in my view).
Doesn't seem to have hurt the US economy much, though. Easily the highest expansion in GDP per capita among the G7.
“GOP-backed vaccine denialism is *still* a very potent force here in 2024. Google ‘measles Florida’ for proof!”
Yes, do that. And search for party affiliation in Broward County, the epicenter of elementary school measles. (Of, if you can’t be bothered, it’s a very blue area.)
I don’t care about the average party affiliation of an area where 5-10% of people are unvaccinated. I want to know the party affiliation of that 5-10%.
Before Covid I would find vaccine resistance at the 5% fringe of the Left and Right. Now it seems to be 7% left and 20% right. The overlap between extremism and conspiracy thinking is high and most anti-vaxx stuff is at its heart conspiracy thinking.
Exacerbated the teen mental health crisis, learning loss, delayed healthcare, increased substance abuse - I lost a loved one to cancer that could have been treated had it been found in routine screening, she died alone because of Covid precautions. I lost people to overdoses, and I myself ended up in the hospital for mental health reasons. Delays in government work left tens of thousands in a lurch for immigration and public benefits - my best friend ended up separated from her wife in Canada for over a year. Limited shelter capacity forced thousands of people to sleep in the street. This is all just stuff I experienced directly.
What harm did COVID maximalism cost? I can tell you! It caused some people to be encouraged not to go to the doctor in person, which in turn resulted in serious health problems and potentially death - ask me how I know.
Myopically focusing on one issue, COVID deaths, without being adult enough to see the big picture is actually a really dangerous way to do public health!
And I'm telling an anecdote, but consider that above Matt posted COVID deaths comparing Sweden to other Nordic countries. But the point isn't to prevent deaths specifically, it's to prevent all deaths! Nobody cares what they died from when they're dead! And you could argue that COVID deaths actually mattered less than the average death because they largely occurred in people who actuarily didn't have a lot of years of life left.
So look up the "all cause" death statistics over the last four years. You'll find that Sweden wins in a landslide.
I found this site that charts excess deaths, and it seems to show a few points in the first year of the pandemic when Sweden had far more excess deaths than Denmark or Norway, and no point after that where the countries are significantly separated. (Maybe Norway is significantly higher than the other two in 2022, but they all bounce around in overlapping lines.)
I would argue that some portion of our ongoing and high homicide and drug overdose rates are related to the left's maximalism generally. Both of those grew out of a quasi-religious adoption of left-leaning ideas during COVID. \
While I agree with many of these ideas when applied in moderation (I voted to legalize marijuana but thought de-criminalizing opioids was stupid). However, post-COVID, it was like every left-leaning idea needs to be taken to the absurd. It really was a quasi-religious period for many on both sides of the political aisle...it's just that the right will justify their crazy with religion, while the left will point and snicker without realizing they do the same thing.
True, but you ought to expect malicious irrationality from the Right. You ought not (but you have to) expect irrationality from the Left. For me, resistance to cost benefit analysis of problems is the distinction between "Liberal" and "Progressive."
I really don’t see that. What I see is a set of things where one group has views that are more out of line with cost-benefit analysis, but I don’t see the other group having any different reliance on cost-benefit analysis generally - they just don’t care as much about this set of things.
You see it even in this post, where Sweden’s number of COVID deaths is presented as evidence they did worse than their Nordic neighbors. Sweden’s overall excess deaths were lower than their Nordic neighbors because they avoided the deaths from overdose, suicide, neglect of elderly folk in nursing homes, etc. that lockdowns caused.
>Sweden’s overall excess deaths were lower than their Nordic neighbors<
That's not what the data suggests. Here's an archived article from an English language Danish periodical (from last spring) if you feel like drilling into the data.
Excess mortality in 2020-2022 appears to be slightly higher in Sweden than in either Denmark or Norway. And confirmed covid deaths were sharply higher in Sweden. What this almost certainly means is that in Sweden, a substantial number of old people who would have died in late 2021 or 2022 died in the first eighteen months of the pandemic, due to covid.
Sweden possesses a strong public health service and a robust state capacity that delivered an admirable response to the pandemic. That response doesn't appear to be better than those of Denmark or Norway, though, and perhaps was marginally inferior.
I can never get archive.ph to work, but here's an article that does the calculation with three different methods. In two, Sweden ends up better than Denmark and Norway, In one, Sweden ends up slightly worse.
The point is that COVID deaths aren't the only deaths that need to be considered when judging a COVID response, and only Sweden seemed to realize that fact in spring 2020. Even just counting deaths is poor methodology; the standard in public health is disability-adjusted life years. If a public health intervention saves two 99-year-olds from death at the cost of the death of one nineteen-year-old, most people would agree that the public health intervention is a failure.
The article is about excess deaths, I asked you about evidence for your claim that lockdown policies led to higher numbers of suicides and overdoses in Denmark compared to Sweden.
The main challenge with doing cost-benefit analysis in the early days of Covid was that Covid was a novel virus and there was extreme uncertainty around what the virus did to the human body and what the long term implications of an infection might be.
Consider that Scarlet Fever killed its victims in 2 waves, the first at initial infection, with a second wave of death 10-20 years later due to the heart damage caused by that initial infection. Epstein Bar virus causes MS decades after infection. Chicken Pox causes Shingles years later. Calculating the true cost of getting a novel disease is impossible early on.
IMO, for at least the first several months of Covid, and maybe up to the vaccine, making these decisions using the precautionary principle made a lot of sense, even as we now know that Covid didn't turn out as bad as some scientists feared it might. (not to diminish the costs of long covid on some people, but I think it's fair to say even that is not as bad as some feared it could be).
I mostly agree with this - just not the timetable - Taking extreme care early on - making some policy mistakes along the way, overreacting in some cases in the first in 6-8 weeks were all forgivable…but it emerged early that a) it was going to be around for a long time, b) that the *vast* majority of people recovered, and c) the old/fat/sick were most vulnerable. Yes - we didn’t know longterm effects, but this thing didn’t come from space - we have lots of experience with similar bugs - could have made inferences that severe issues would be pretty rare . (Another fact that came as a surprise to many people…that ALL infections - cold, flu, strep, whatever - cause tissue damage…and in the worst cases could shorten your life)
“If we prevent one child dying it’s worth doing XYZ intervention!!” was the refrain - but - well…no. That’s just not the way the world works. And again that seemed to be a shock to many people.
Policy is always about balancing benefit and risk. We all implicitly accept that a certain number of people *will* die or get injured in the course of every day life…on the highways, in swimming pools, from food-borne illnesses…and we tolerate that risk because roads and pools and ski lifts and playgrounds and canned food and medication are part of living in this world. Risk is a part of living.
But that basic idea seemed completely foreign to some very smart people in my tribe - and out of their naïveté Covid became this weird bete noire - we must not get it. No measure to fight it was enough. People who couldn’t be bothered to get a flu shot for their kid said: who needs school? Who needs friends? One mask? Why not two!? No cost was ever too high , no burden was too great to bear….and they pushed that childlike approach on to the rest of us.
TRUST SCIENCE until science says you don't need to wear a mask anymore, then "FUCK SCIENCE, I'll keep wearing this mask anyway because it's how I show people I'm a good person."
Covid is still spread decently well by asymptomatic people. I don't know if your point is that covid isn't unique in that, which it isn't, but I initially read your comment as saying it doesn't spread asymptomatically. Just wanted to clarify that for anyone else eho read it the same way
I actually think that crisis response can be very revealing. For me, the most depressing thing about supposedly-neutral institutions’ response to COVID is that they basically adopted a new attitude: they’ll sometimes be trustworthy, but they might distort things to help Team Blue. As long as they aren’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 isn’t as bad as Fox, or if the CDC isn’t as bad as Trump’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.
That open letter about the Floyd protests did a ton of damage to our public health system because it was so obviously politically motivated lying.
You have to have institutions that don't get involved in politics. Everyone wants to use their position to influence politics but if they all try to you have no trust in institutions.
> You have to have institutions that don't get involved in politics.
As a scientist, this is something that has infuriated me to no end. For example, two of the most esteemed scientific journals (Nature and Science) now weigh in on political matters when it suits their editors (in a predictable direction of course). They're collectively throwing away *our* legitimacy with half of the country for nothing but a little dopamine rush from tweeting the articles out.
Yes, I agree that the open letter was bad, but as far as I know it was put out by a bunch of epidemiologists and health care workers; it wasn't the official statement of any institution. And I had no idea what percentage of epidemiologists signed on to it. The worst thing about it was that it was so transparently political is that it gave people who wanted to disbelieve anything any government body said a pretext for doing so.
The key problem is that they got so much publicity for it. In other words, sure they weren't the people actually in charge of COVID policy, but they portrayed themselves as subject matter experts and signed something that was such a transparent piece of non-scientific political hackery that they gave all of academia and all of public health a bad name.
And yes, it just became Exhibit A for anyone inclined to distrust public health in the first place.
Yes! I started out the pandemic basically believing that CDC and other govt officials were fundamentally honest and acting in good faith, even if they made big mistakes sometimes, or were subconsciously beholden to certain ideologies I don’t share. I ended it reading their statements much more cynically, calibrating by the political affiliation/goals of the speaker, their understanding of pop psychology, and a bunch of other factors I don’t understand well. Basically, I now have much less confidence that these people are telling me the truth as they privately understand it.
Fauci’s statements regarding herd immunity goalposts are a particularly striking example of this:
‘ “When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent,” Dr. Fauci said. “Then, when newer surveys said 60 percent or more would take it, I thought, ‘I can nudge this up a bit,’ so I went to 80, 85….. We really don’t know what the real number is.”’
Translation: “A large percentage of my public statements are outright lies, and there is no way for you to know which ones.”
I also think that many of us who were drifting left, or very moderate because we were disgusted with how Republican institutions behaved post Trump, this was a frightening revelation.
Basically, the right is crazy and will kind of admit it...it might be couched in religious terms or other ways, but it is fairly obvious. The scary thing about left-leaning crazy is that they like to frame it as "science" or "expertise." Given that I rely on science and cannot have a high degree of expertise in every field that I might need to have an opinion on, I find the hidden bias more frightening. I cannot easily tell if it's crazy or if I am being misled by my primary source of information. It is much worse than having someone point to a bible verse that I can interpret on my own.
I am kind of like this right now with search and AI. I am wondering what is being guided, influenced, withheld, etc. in tools I rely on to make sense of the world around me.
Reading through the comments gives me the sense that MY is missing one big component of the public reaction here. It’s all personal! Matt writes about a few personal moments where he was frustrated but doesn’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. I’d seen the truck for about a week and never made the connection that that’s what it was. Scary! This was early enough that we didn’t really know who was most at risk and it was also at the point where the hospital didn’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 “the system” 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 wouldn’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: you’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 “the system”.
- 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 they’re older and we knew by then older people were at greater risk. For “interesting” reasons I’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 who’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. They’d just bought a house in the Villages. And look, maybe it was a false positive but, like, you’re going to the oldest place on earth and you have good cause to believe you’ve got a virus we know is pretty bad for old people. Why be that jerk? And of course the lie, but that’s something I’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 we’re sick, they ask why we got the vaccine if it’s didn’t work) and even told my wife, at that point a fully board certified practicing physician, that she didn’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 they’re afraid of vaccines and don’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 SB’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. You’d think we killed somebody they were so furious. And look, maybe that’s the wrong call. Maybe we should have just asked if they were feeling sick and that’s good enough but, you know, they lie about that kind of thing. Again, we patched things up and they’ve had many lovely visits from the baby since she’s been six months old but this is still part of that weird pandemic hangover.
Yeah, this is all just one guy’s experience it’s you can’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. It’s often interpersonal, familial, or related to careers people care about. Some congressional report isn’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.
Two points related to the senior docs not being willing to come into the hospital or work on COVID wards:
1) I staffed a board where one of the members was the CEO of a major university hospital system. The first week of March 2020 he was asked to give an update on what was happening, and what the hospital was doing. Essentially, he said it was going to be bad but they had been preparing since January when word first started to come out of China about what was happening there. But what still sticks with me from his remarks is saying that by the second week of February they had to put all PPE and disinfectants under lock and key because it was being stolen in mass. The only people with access were doctors and nurses.
2) My friend started a surgical residency at the same hospital beginning in 2020. He ended up staffing the COVID ward--very very far outside of his residency and expertise--because the docs who normally would have been assigned refused. He ended up meeting a fellow resident in the same situation, who eventually became his husband. To this day, he is deeply angry about the behavior of those older docs and won't talk much about it.
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.
The ACLU fired a woman who complained about sexist and toxic work culture at the ACLU. They are claiming she was fired for racist behavior but the cherry picked examples they use are so absurdly stretched. The woman has protections under the NLRA and the ACLU is trying to broadly argue that their selected arbitration process should be used in place.
Look it up if you want an example as to why the ACLU has gone off the deep end. (For me it was their leadership claiming that all these groups OTHER than women are disparately affected by the overturning of Roe v Wade. And yes the ACLU list includes groups that cannot give birth.)
To rephrase your latter bit somewhat, it feels like it turned "trust the experts for narrow advice" (good) into "trust the experts to make broad policy" (not their wheelhouse).
Hundred percent, yes. All interesting questions involve tradeoffs, and to become a true expert in a field, you are almost foreclosed from learning deeply about other things just because there are only so many hours in a day.
I agree with this whole heartedly. The main issue is that domain experts usually have little or no training in public policy or in real-time decision making under conditions of great uncertainty. This deficiency is often exacerbated by domain experts having lots of unjustified hubris or at least a lack of humility about the inherent unreliability and incompleteness of their data and their models.
This stuff reminds me of an economics problem called the Annuity Puzzle. Basically, economists built a complex model using something called Utility Theory to predict how often consumers should buy income annuities to fund their retirement. The model has a bunch of assumptions about consumer behavior and preferences. When real world data showed consumers buy annuities much less than their model projected, they spent decades trying to figure out why consumers were so irrational, rather than focusing mainly on the reliability of the model and their assumptions.
I'll bring up my (probably non-representative) experience with a Floyd protest. There were a few thousand people, and as far as I could tell, virtually everyone was wearing a mask and making some effort to not bunch up. Organizers walked around offering masks and hand sanitizer, and asking people to pull the mask over their nose and to stay home if they were sick. Overall, it was pretty well organized.
I imagine that the Twitter public health types would've seen it as an example to be followed. I don't know how representative this kind of demonstration was, compared to others around the country. However, that reflects such a disasterous feature of our discourse. Because of our fragmented and social media-dominated news landscape (and I place some but certainly not all blame on Trump), there's very little room for either nuance or a unifying message. Both dynamics feed into each other as people get angrier and angrier.
It wasn't that the Floyd protests were a covid problem (and in retrospect, it seems clear they weren't). It was the medical establishment saying that going to a protest is okay because racism is also an epidemic that was the problem.
I think that it's nuanced messaging being impossible on Twitter. People's nuanced opinions get flattened into tweets, and people equate everything you're saying with whatever sound bites come from the same vaguely described group, even if you don't agree with those people in something.
How much of the discourse around Floyd protests was driven by this flattening of nuance and how much was genuine cognitive dissonance? Idk, I'm sure you can pull up a few examples, but how much did that matter in our disintermediated media? I don't think that it's possible to say. I agree that people should try not to be hypocrites, and they should be nudged away from it, but people who like to argue about things online focus on it way too much. It's very easy to confuse these other trends with hypocrisy and blow that up. "Listening to experts" is a lot more useful when you don't use stuff like Twitter.
The letter, signed by over 1,000 health professionals, wasn't on Twitter. It was a real statement that has this lovely section:
"We support [the protests] as vital to the national public health and to the threatened health specifically of Black people in the United States. We can show that support by facilitating safest protesting practices without detracting from demonstrators’ ability to gather and demand change. This should not be confused with a permissive stance on all gatherings, particularly protests against stay-home orders."
The problem with anti-lockdown protests wasn't just that people were gathering outdoors, and importantly, it took a little while for people to notice how much harder outdoor transmission was than indoor transmission. The problem was that the goal was to make it easier for people to interact indoors. That's not inconsistent!
Public health experts did a bad job communicating cost-benefit thinking. I agree. I don't think that it's weird to see protesting racism as more important than protesting restrictions on in-person gatherings. You can disagree, but that's not necessarily cognitive dissonance.
The problem is, even with masks and sanitizer, and doing the protests outside, participants are still raising the potential spread of COVID by a non-trivial amount. That's fine - it's an acknowledgement that some public policy benefits outweigh the costs of greater COVID spread.
The issue is this logic was not applied to any other public policy domain, nor was the CBA done in way that appeared neutral or at all systematic. A bunch of bureaucrats reflexively decided that racial justice was the one area we could eat the potential costs of COVID, not for any well-reasoned or justified public policy reasons but based on supercharged, emotional rhetoric.
There really were two George Floyd protests...the ones while it was light was generally consistent with your view (and probably the ones the health experts viewed). The ones after dark were like rave having a baby with an anarchist convention. A bunch of young people who could not go the bars and decided to trash the city instead...
I agree no one MADE anybody else into a conspiratorial loon, but I don't see how it can be disputed that a tendency toward conspiracism is influenced by the social environment people are in. (E.g., it's been observed for decades that rates of belief in conspiracy theories are much higher in societies without free media.)
Actually, they can influence conspiracy. When trusted experts behave dishonestly, they create ambiguity that can then make it more difficult for people to distinguish between conspiracy and fact. Even when experts are honestly just wrong (a lot of what happened during COVID) it can feed conspiracy.
When doing public information work on high-profile incidents, a lot of professionals go to great lengths to avoid releasing statements until they are sure they are accurate. The main reason for this (including withholding information that would have helped us) was that they do not want to release anything and then later retract it. If retracted it, it would create conspiracy theories and feed the beast...
Nope—it doesn't—but it offers a path toward limiting that tendency. I am guessing we are of the same age, and I can remember a time when the left was the big conspiracy club. Some groups will always have more conspiracy-minded folks. It's just important to remember that it's not binary. Things we do influence the size and power of that group.
For me the biggest surprise was CDC incompetence. Since I watched Contagion a decent number of times it was always jarring the gap between “movie CDC” and real CDC. These people had supposedly been preparing for a flu pandemic for the last 20 years but didn’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.
Ronald Reagan gutted CDC leadership. It used to be independent like the Fed but Reagan pushed to make leadership political appointees rather than medical experts because the CDC tried to combat AIDS and prevent it from becoming endemic.
That may be true but it’s irrelevant to their performance during pandemic. It’s not like some dumb political appointee cut the resources to develop COVID tests. They had the resources they just screwed up.
I am not a huge Fauci fan, but I have wondered if the stress of moderating Trump's crazy is one of the reasons he did so many stupid things. We can all only take so much stress, so when he saw Trump saying/doing stupid things, I wondered if the "Trump Derangement Syndrome" influenced him to do go in the opposite direction. I thought the same thing with travel restrictions...because Trump was being racist about them, a lot of people just disregarded the policy...
No, it really isn’t. Masks have moderate effectiveness for flu and covid, and both are airborne, and even though we’ve had many decades to study flu, the public health establishment failed to do that right, and this shaped their poor response to COVID.
Covid isn't flu. But it is a Coronavirus and we have had hundreds of years of experience with those about half of the viruses that cause "common cold" are old Coronavirus. (Interestingly, it appears that many of them can be traced back to localized outbreaks when they were new that causes a lot of death.) We do know quite a bit about how these spread and it is similar to the flu. What I think we didn't expect was that Covid mutated a lot more than most coronaviruses normally do now and acted more like flu in that way. It is possible that our current coronaviruses actually mutated a bunch early in their introduction to humans and then stablized and Covid will do the same but at this point, its mutation and what that means in terms of vaccine effectiveness at stopping infection vs. reducing severity is limited.
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.
I always thought zoonosis was the most likely, lab-leak (or, more accurately, lab-mediated zoonosis since I figured it was a wild virus) was plausible. The extreme reaction against it was frustrating.
It’s not racist; there’s not a culture in the world I trust to research exotic animal viruses without the risk of human exposure and transmission. It’s just that normal zoonosis is so, so damn common.
The best I could say about a potential American lab leak is that I would expect less cover-up (or at least less effective cover ups).
It doesn't matter if it happened or not. Any chance beyond 1 percent would have stopped all of this research to a screeching halt and worldwide investigations if it wasn't freaking China
This is awesome. I was at ~15% chance of a lab leak a few years ago and then updated to 1% or less two years ago based on the evidence that I saw at the time (I found my old comment to confirm the numbers). While I wouldn't have had the stomach to bet $100k on it, I still felt like Matt and many others were way too credulous. I think they overindexed on being told "lab leak" was racist (a stupid claim) and then failed to objectively evaluate evidence that came out since.
“ 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.”
I don’t follow the reasoning here. Surely a vaccine that is 70% effective could still be relevant to mandate, even if it’s not 95% effective, right?
Also, even if it doesn't do that much to block transmission it does do a lot to reduce the severity of cases which can matter a lot for hospital loading, etc. which in turn has plenty of knock-on effects.
I think that the difference is that there was hope that a vaccine might be effective enough that being around someone who was vaccinated would dramatically reduce your risk of getting infection to something approaching zero -- like measles. But with a rapidly mutating virus the vaccine worked more like a flu vaccine. It would somewhat reduce your chances of getting sick or spreading the illness but not make that negligible but it would dramatically reduce your changes of becoming dangerously ill. I think the vaccine mandates originally were based on the idea that you were safe as long as you were around all vaccinated people and it quickly became clear that wasn't the case. I personally still supported vaccine mandates because it still made you safer in the sense that would be less likely to get ill and less likely to carry a heavier viral load and I was okay limiting stuff to people who were willing to do reasonable things to make things more safe even if it wasn't a guarantee that it would prevent all spread.
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.
====
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.
I want to signal-boost this: "Masks... 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." 100% agree!
Re: why antivaxxery is so prevalent, one hypothesis I've heard (not sure if true, but sounds plausible) is that lots of people are scared of needles, and "vaccines are a hoax!" may be less embarrassing to say in some circles (not liberal PMC circles, obviously) than "I refuse to get the vaccine because I'm scared of injections." Solution: we need an effective intranasal spray vaccine!
It really bothers me that the medical establishment seems to refuse to consider that fear of needles is something to try to work around! Why have intranasal flu vaccines been restricted to special needs populations for so long?!
They're not very good as vaccines. One could ask why we haven't put more behind making them better, but I think that intranasal vaccines are simply more difficult and less effective.
Thanks! I thought I was losing my mind at times trying to explain the inherent anti-social nature of masks to some people.
Fear of needles is certainly a thing, but I wonder how many of those people are just being quietly averse, instead of using a wacky conspiracy theory that makes them look nuts to mask their aversion. Vaccines seem unusually susceptible to conspiracy theories, and there are a ton of them out there, with at least one out there for every common ideology.
I'm spitballing here, but maybe it's because in order for vaccines to truly obtain herd immunity, you need to have everyone take them, and while in other cases we can just ignore the conspiracy theorists, we can't here, and that causes them to get expectionally riled up over what conspiracy they think is hurting us all.
The thing about masks and Covid is that masking in social situations is horrible and Covid spreads primarily via social interaction. For some reason, lots of people just glossed over this very obvious tension.
Regarding 11-15, I really do think that anti-vaccine mindsets need to be researched. Like drosophilist says I think that fear of needles may be one factor, but I suspect there's something further.
I think two factors were huge:
-Political polarization is bad enough now that anti-COVID measures being slightly left-coded was enough to cause some people to oppose vaccines purely out of spiteful partisanship.
-Conspiracy theories are fun and interesting, and any new, large government program is a fertile place to make up conspiracy theories.
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".
I think a lot of initial COVID coverage, and backlash to that coverage in the US, doesn't really process how bad it was in NYC compared to everyone else in the country. The healthcare system was actually on the brink. Medical staff had to be shipped in, there were trailers full of corpses, and I remember seeing images of (temporary) mass graves. It was bad, but the media is fairly concentrated in NYC, so the world sees that more than what happened in Dayton.
By the time lockdowns became more divisive in the late spring/summer, there was a some idea of how to handle it. Outdoor interaction was a lot less risky than indoor. Masks (if you knew what you were doing) were better and easier to get a hold of. People could choose their in-person interactions more easily in the Sun-Belt than in NYC in March. There was a lot of handwringing over COVID laxness when it moved south over the summer, but that was more of a policy choice than what was sprung on NYC in March.
Yeah, I can rationally understand how it must have been different to be elsewhere... In March/April 2020 though, it was really hard to watch the daily death toll just keep rising, and projecting that chart out, thinking about what that scale of death would look like nationally based on what was happening in NYC - it was really bleak.
And it was frustrating, being inside what was happening in NY, having known what had happened in Italy and in China already, and seeing other parts of the US just pretend it wasn't going to happen to them next.
I feel like a lot of people have gotten revisionist, and what they remember is actually what came later - "vaxxed and relaxed" with some immunity and a weaker (though more contagious) variant. Also, remember we probably had an undercount of how many people were infected, so the mortality rate seemed very high. If you were there in March and April and watching the death toll rise, you had every reason to expect complete disaster if nothing was done.
I agree. I lived in Upstate NY at the time, and it was very scary. I remember telling my partner to stock up on food in early March (I knew somebody in Hong Kong, and he said it was going to be really bad) and the canned food was just gone. Things kind of just came to a halt. Still, I didn't know anyone directly who got seriously ill in those first weeks. My main experience at the time was finishing my thesis and playing Animal Crossing. 20,000 New Yorkers died in 3 months.
I sometimes wonder how different NYC would have been if every resident somehow had their own front door directly out into fresh air, with no other changes.
I remember how surreal it was to see the news out of NY and be in Seattle where we actually got Covid earlier but had a much better run overall than most of the country. I kept waiting for NY like conditions to hit and they never did.
I really do think that one of the differences was testing. It didn't seem to get much national coverage but the University of Washington basically went rouge and tests thousands of flu samples that they had gotten for our annual flu surveillance studies for COVID without prior approval from patients and against the express instructions of the CDC. They found a lot of COVID from people who had relatively mild cases that had not required hospitalization and been misdiagnosed as flu. Those people were all contacted and their contacts put under quarantine. So that there was this weird disconnect where people in Seattle all seemed to know a bunch of people who had already had Covid and been sick but survived and almost no one who had died watching it kill all these people in NY. I still wonder if the virus that hit NY from Italy wasn't mutated to be more deadly than the one that hit the West Coast directly from China.
I think the most plausible difference between the outcomes in NYC verse Seattle is that Seattle shut down many large public and private institutions by March 5th whereas Mayor De Blasio was publically encouraging people to continue as normal on March 10th. NYC's week plus delay in enacting a public health strategy relative to Seattle meant about 2 extra cycles of doubling in NYC before significant action was taken to bend the curve. I think NYC's initial Covid spike reflects that.
In any case, even if a national retro on the pandemic is impractical it is likely worthwhile for large cosmopolitan cities to reflect on what went well and poorly in their early response to Covid so that they can do better next time.
Agreed. That earlier shutdown was directly related to thost UW tests. We knew by March 5th that we had an explosion of cases because we knew about so many mild cases that were going undetected anywhere else. Seattle isn't a huge city and by March 5th pretty much everyone at least knew someone who knew some who had already been infected with Covid. I had already been put on Quarantine because I had spent hours with patient #70 in the US. My cousin had already been quarantined completely independently from an exposure at the building where he was a security guard and was symptomatic with presumed Covid.
If we had only had the information that folks in NY had, neither of them would have been presumed to have anything but a really nasty cold and we would have just thought we had two or three hospitalized cases with no deaths. I can understand how that different is the sense of the size of the threat would really impact the speed at which public health would feel the need to act and the willingness of the public to go along with it. Although to be fair to NY our economic base transferred better to online that NY's in some ways so there was also less industry push back.
My main sense is that some private soul searching has gone on in public health in WA and King County even if there hasn't been a full post-mortem. The main lessons that I think they feel they learned was (1) they cannot count on a fully functional federal government to help in a crisis and should expect to have to go it alone and even break rules (2) They need to maintain good and close relationships with the West Coast Alliance that was put together with Washington and Oregon to have the critical mass necessary to do their own response work including independent vaccine assessments and test protocols (3) They need to be constantly monitoring for virus trends by doing frequent testing and sequencing of representative sample of folks who present as sick and wastewater, (4) they can best build trust with the public by being transparent with data and clear about recommendations, and (5) the local population has the stomach for public health measures that are strict if the results are good. (We had very strict rules and there were small protests but all the officials in charge won against candidates running that challenged them on that and won primarily by pointing out how many more of us would be dead if we lived in anywhere else.)
You can already see some of these changes. The public health "dashboard" that used to provide amazingly detailed data on Covid in a partnership with Tableau that would let you make a chart to answer almost any question you could ask and remained up but expanded to cover RSV and Flu. You can see in real time rates of diagnosis, hospitalizations, and waste water levels for every zip code and the requests that people provide a swab for public health now are offered to everyone who presents at a doctor with any potential virus.
I also think it accelerated a sense that had started in 2016 that most folks trust the State government much more than the Feds and in many ways view State law and State officials as the best way to protect citizens from the federal actions that they view as harmful on reproductive rights, LGBTQ, environmental regulations, and immigration crackdowns. There is pretty constant messaging at the State and Local level that folks don't need to worry about any of those things because the State has its own rules and frankly isn't planning to cooperate with the Feds on anything they don't agree with.
Ironically our incredibly high testing levels which were again supported by a huge testing capacity at the UW also meant that many people had a better sense of what Covid looked like than it seems like was true many places. By March 5th I could have told you that the main difference between how Covid presents and other colds or flus would be (1) loss of taste and smell, (2) cough combined with what felt like decreased overall lung capacity, and (3) fever that came and went but most struck at night. It felt like it took a long time for those telltale signs to be part of the widespread national discussion. Ironically, I also started socializing outside early because it was apparent that it didn't spread well outside because I knew so many people with mild cases and no one had gotten it that way and we were seeing almost no cases in our homeless population despite very intense efforts at regular testing and doing Covid, the homeless were basically not allowed to spend anytime indoors anywhere.
I'm sorry that you have to have that memory. My keenest memory from 2020 is starting my morning at work calling morgues looking for my clients and buying groceries for clients because the foodbanks were empty. What a brutal, horrible year.
My memories are all about life getting so much busier as all my volunteer jobs got so much more intense. My old PTA job of collecting snack packs from the food bank for kids to take home on Fridays because a home delivery service of more than 120 boxes of food all over the neighborhood each week. My volunteer work our our local day shelter on Wednesday evenings turned into an all hands on deck effort to set up distributions of hot food, camping gear, outdoor medical care, PPE, and testing trying to figure out protocols to keep us safe on the fly. Even my job as a salmon steward feeding the fry one a week at the imprint pond got nuts. The afternoon that they closed Seattle Schools, I got a call that me and my 11 year old daughter had been designated as "essential staff" by Washington State Fish and Wildlife and needed to go immediately to the imprint pond because they needed to collect all the hatchery eggs and fry from every Seattle public school by midnight and put them in imprint pond before the schools were locked for a three day deep clean or we risked losing the whole hatchery supported salmon population for the year. I sat in that park with my daughter until 11 pm that night in the pitch black counting individual fry as we released them into the pond. And there were 47,000 of them! It was insane. And then, during the park closure having to hike 3 miles each time I went for a now twice a week feed.
I remember seeing all these people online watching Tiger King or learning to bake bread and thinking who crazy it was that we were having such different pandemic experiences.
I’ve lived in NYC for 14 years now and spent most of my life in the are. I don’t know a single person who died of COVID aside from a family friend’s great aunt who was in her 80s and just had a stroke. My uncle who would die within a year from early onset Alzheimer’s had it and was fine. My friend’s grandma who was terminal with lung cancer had it twice and survived.
Also you could hear the sirens more because there wasn’t any other traffic or background noise. I remember how eerily quiet the city was.
"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 didn’t want to talk about it anymore.”"
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.
Glad to hear this said. I think an intra-CDC investigation undertaken in good faith might yield helpful improvements. Same for the FDA. A government-wide “inquiry” would just be a partisan shit show.
Yeah, this was very odd - but characteristic of what I have come to expect from UK politics, which is unbelievably petty and can be summed up by "no, you!"
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.
The CNN chyron saying to stay indoors unless you are going to a protest is burned into my brain as one of the few times in my life I felt I fully understood Trump voters. I would not underestimate the effect of this laughable hypocrisy.
Sorry if this is obvious/banal, but unless you’re an evil dystopian totalitarian state, you’re going to have a really hard time enforcing any rule that the *majority* of the population disagrees with. This isn’t about federal vs state vs local, this is “what would you do if 50% or more of the people refused to obey the rules.” Like, it’s just not realistic to enforce super stringent measures. Also, even if you did have state capacity, how would you punish people? Put them in jail? Great idea, let’s put them in a place that has the perfect conditions for rapid COVID spread.
> unless you’re an evil dystopian totalitarian state, you’re going to have a really hard time enforcing any rule that the *majority* of the population disagrees with.
While true I think that misses the point a bit. There are tons of rules that the vast majority agrees with but, it turns out, the state doesn't have anything like the capacity to actually enforce. Because it appears no one is willing to pay the price (both in budget for the manpower but also for the curtailed liberties) for that level of enforcement.
Matt mentioned the current school truancy issues, which I don't think are caused by some widespread disagreement with mandatory schooling but simply lack of manpower to aggressively enforce it.
But for even more clear cut examples look at almost everything regarding financial laws, which most people agree with, but no one wants a massive government bureaucracy inspecting all of your financial transactions so we've ended up in this weird situation where we've made every financial institution a kind of deputized extension of law enforcement.
I think Covid (along with the general declining trust levels and turbocharged by social media) has shown how much our society runs on voluntary compliance with laws and how easy it is to get away with not following them.
I don't think it was exactly a secret or anything -- people sped in cars, people cheated on taxes -- but something about Covid put it much more in your face on a daily basis that (IMHO) has resulted in a bit of a step-change.
Anyone worried about an authoritarian America should take great comfort in COVID and the protests. Both revealed how little state capacity exists to enforce anything. Look at a protest in Europe with batons flying and water cannon washing down crowds. In the US the police could not manage crowds of a few thousand people.
Also, just to clarify...I think this is a good thing. If we cannot get a large majority of people to believe/behave in a certain way, it is probably not worth the time to compel them to do so (in most cases). In almost all cases the energy spent on compelling people for short-term, limited compliance would be better spent on convincing people...you would have fewer converts but they would be more likely to comply in a meaningful and long-term way.
I don't see any disagreement we have here--state and local governments likely also lacked sufficient state capacity in this regard, but they have much more of it than the feds do. My main point is that I think the left/right valence on pandemic attitude would have largely been the same regardless of who was in charge in DC or what they did.
Plus, Americans really are not good rule followers. For good a lot of the time and for bad some of the time...People in America do what they want. I think this has become a little more right-coded than left-coded, at least on some issues (i.e., not related to race/gender, etc.)...so I agree that right-wing folks would have been more inclined to fight broad government interventions...while left leaning folks would have fought "The Man." In this case "The Man" presumably would have been Trump, who would have been accused of using the pandemic to advance his authoritarian agenda (which actually would have been a good way for him to do it...not good in an ethical sense but effective).
Most of what you wrote is great, but this was dead wrong: “blue state parents, especially non-white ones, were reluctant to send their kids to school, and that’s an important reason they stayed closed.”
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. That’s why the early FCPS rhetoric was not that they would stay closed until fall 2021, it was “we’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 we’ll open after that.”
When people make the claim that non-white, blue area parents wanted virtual, they’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.
You're right about how things went in Fairfax specifically, but even if most people talking about racial discrepancies are using later surveys, those aren't the only surveys that exist. This article is from July 2020 and it already includes polls showing large racial discrepancies in views on school reopening:
I have always been trying to figure out why it was said that more non-White parents wanted schools to be closed. It never made sense to me intuitively. Thanks for this, and I would also appreciate anyone else who has a good counter explanation as well.
I don't have an explanation, but our school district is mostly poor, and 80% non-white, and parents were definitely reluctant to send their kids back. When given the choice, more families chose to keep their kids at home than send them in-person.
People I talked to gave some reasons - they tend to live in multi-generational homes - especially immigrant families; they felt very exposed in other areas of their lives, so wanted to at least limit exposure at school; some wanted to reduce the chance of getting sick so they could continue to work - many were making decent bank because so many people were out of the workforce. Also they felt as though they wouldn't get good care if they got sick. I don't think any of those are a complete explanation, though.
Fascinating. The way I've been looking at it is that schools are a critical resource for parents to have a place for their kids to be so that they can go make a living. But I likely have this completely wrong, and there's some good clues in there, thanks.
I found that non-white parents were much more likely to be okay leaving their kids home alone or with older siblings while white parents felt like they needed to always have an adult with their kids. I sensed that a lot of white parents wanted their kids in school because it was impossible to watch them and get remote work done. I was running a basic needs drop off program for kids at my daughter's elementary school for the first year. We would drop off two boxes of food from the local food bank for each family along with books, hygiene items, and school work. I was sort of shocked at first by how many times it was a third grader staying home by themselves who answered the door. When I thought about it, I was only in 4th grade when I started babysitting and they were probably just fine. I just knew that the parenting norms among by wealthier white friends would not have felt like an 8 year old home alone all day was okay.
One part that's not talked about much: in many of these households (which are disproportionately lower-income), teenagers became a crucial part of the household income during closures. School is closed, teen is "attending" virtual school while working a cash register at Chipotle. Because of rampant grade inflation during virtual school, teen is getting better grades than ever.
If the choice is the teen going back in person and the family losing their house because they can't make rent, and teen staying virtual and the family keeps making their rent... yeah, I'd send the teen to work too. Many of these teens have now dropped out (officially or unofficially) and entered the workforce, a trend which the labor shortages (and high wages) of the last two years has accelerated.
There's a McDonalds near my house where the kid who is *always* manning the drive thru (including during school hours) looks to be about fourteen years old.
In my limited experience of talking to the families for whom I was doing remote family support for my kid's elementary school, I think part of this was that a lot more of them knew someone who died. As of July 2020, the death rate per capita for different groups was something like Latino people were five times more likely to die than White people, while Native people were four times more likely and Black people were roughly three times more likely. I think these rates probably somewhat reflected different rates of underlying health but mostly whether people's jobs exposed them to the public. I think the trauma of the pandemic lands different if you were a white remote worker who knows someone whose grandma died or a Latino grocery clerk who lost four family members. I also think these families fundamentally didn't believe that schools would care about keeping their kids safe from covid.
Adding on to what another poster said, our schools were open and in Florida we were quite forcefully advocating for kids to return in 20-21 by Winter Break. The thing I heard from my parents who chose to stay online was fear about the elderly members of their household.
Also in my case there were a decent number of these families who were working from home and the elderly were the childcare people so they weren't feeling the need to return to normal for economic pressures in the same way the majority who did return to the classroom (we went from 55-45 in Fall to 70-30 after Winter break.
If 40% of parents don't want schools to reopen, that is a lot of people who are going to panic about their kids dying, cause a big fuss, not send their kids, etc, even if it's not a majority.
11% Black, 17% Hispanic or Latino, 21% Asian. Non-Hispanic whites are a slight minority in Fairfax County, and underrepresented compared to the nation (59% white non-Hispanic.)
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 didn’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 couldn’t really trust the guidance they were getting from the government.
While it was clearly nonsensical even from very early on, I would say the reason for the advice was a bit more complicated than pure concern about mask supplies, though that was absolutely a factor in some cases. The CDC recommendation against mask use by the general public actually long predated the COVID pandemic. This blog writeup from March 2020 discusses anti-mask recommendations from the 2009 swine flu epidemic and from 2015 during MERS:
I think the anti-mask stuff was initially mostly motivated by the same dysfunctional institutional epistemology that also led to them being ridiculously slow to update on the importance of ventilation and the futility of cleaning surfaces.
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.
I think we didn’t get that much of this because there’s been pervasive cultural and state messaging encouraging people to lose weight for decades and it’s done fuck-all for actually changing obesity rates because long-term loss of long-held weight without some kind of surgical or pharmaceutical intervention is super difficult. “Tell fat people to eat less and exercise more” isn’t an effective public health policy.
Similarly to what I mentioned to Kenny, I don't think I'd characterize messaging to be "pervasive."
Also would dispute long-term weight loss being difficult (at least for the majority of people who are currently obese). People just need to eat fewer calories than they consume to lose the weight, and then transition to a maintenance diet once they hit their weight goal. Tracking calories and exercising make this easier.
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.
I honestly haven't seen anyone wear a cloth mask outside in a few years, but I agree with the general point here. And it's just sad that so many comparative countries have publicly conducted bipartisan investigations and reflected on their COVID response and the United States hasn't. Another pandemic will happen, and there's no reason to think our government or public health officials will be ready for it.
I still see this all the time as well, which I think is an example of Matt's point #10. People had (and continue to have) just massively different experiences over the past five years. There were a few moments in, say, 2021, where I'd go out to the suburbs literally three miles west of where I live and it almost felt like a sci-fi movie.
I'm willing to bet a lot (though I'd never collect) that by the time any pandemic as threatening as COVID happens again in the US, any such investigations we conduct and lessons drawn will be only the vaguest of memories and of no practical importance.
I suspect that the benefit of mRNA vaccines (and their far more impressive successors) *will* be present in that situation, however.
Yeah, Obama left a playbook behind. Whole lotta good it did.
Well, I am still seeing it in bougie Red Line NW! Not as much as before, but still. Even in 2024, I have been walking (or even riding my bike, in the street) in the residential environs here and had people ostentatiously mask up when passing. Outside!
I totally agree that there are situations where masks are appropriate. I had a really bad respiratory thing last fall and wore an N95 when I went to the doctor and drugstore. But - like almost everything else in the world - it seems to have mutated into a political flag, and I am *so* tired of them.
I take the points about the likely efficacy of "bipartisan investigations," assuming a bizarro US in which such a thing could happen. But as you note, it's extremely unlikely, given the movement of people and goods, that the next pandemic will take 100 years to hit, and we have not only learned nothing, we've gone in the wrong direction.
Every time I see a bicyclist wearing a mask, but not a helmet, my hope for humanity dwindles to a mere ember.
Three days ago, caught cycling in a hailstorm, I made it to within 100 feet of my home and on the final turn went down hard, with my right hip landing bone-first on the asphalt, seemingly whipping my head to the ground in turn. My well-fitted, certainly expensive helmet absorbed the blow and my head is the only thing currently not hurting. Not the first time. I’m intrigued by data if anyone will offer it, but my guess is that it will say helmets will not protect from all, and may encourage risk taking, but that well-worn, well-fitting ones* do the job for which they’re intended. Prudence and fortune rule the rest.
I’m happy to say that my head is fine, my memory is in tact.
By the way, you guys have to hear about a spill I took on my bike the other day. See, there was this hail storm…
*kinda like masks…
There are 2 branches of “helmets don’t matter” thought.
Branch 1: the thing that kills cyclists is cars traveling over 30mph, not whoopsies on the street. Helmets don’t help against getting hit by cars.
Branch 2: the number 1 thing that makes cyclists safer is more cyclists. Mandatory helmet laws and/or a culture of safetyism with cycling prevents the growth of cycling and makes the activity more dangerous in the medium to long term. The best thing for cycling safety would be a cycling culture like Amsterdam where it’s considered as safe and normal a thing to do as walking and it doesn’t require extra safety gears everyone does it.
As far as data goes, the data proves points 1 and 2, and it also proves that if a cyclist is falling/crashing their outcomes are better with a helmet than without.
I believe the studies about this are fraught with selection effects, but I actually am not sure.
But I am sure that the likelihood of crashing on a bike is serveral hundred magnitudes larger than the likelihood of being exposed to Covid contagions.
If helmets made head injuries *worse* I can't imagine you would see them as common equipment for professional cyclists, as they are.
The thing about helmets is, asking whether helmets work to protect you from head injury against, say, getting hit by a semi-truck, is the wrong question. In that case, someone with a helmet and someone without would probably both fare poorly. But in the case of hitting a pothole and going headfirst over the handlebars? Feels like you'd much rather have a helmet there.
I don't think it is a signifer at all. Those that are doing it are just really paranoid about getting Covid.
Hopefully by the time the next pandemic comes around America will be less stupidly partisan and polarized. There will always be crazies and ideologues for sure, but perhaps they can be reduced to 20% of the population rather than 50%.
Move to Portland. Blue hairs and other progressives in cloth masks in abundance.
Correspondingly, I think there's no reason to think our government or public health officials will be made more ready for it by publicly-conducted bipartisan investigations.
So while I like a lot of what Matt wrote today, I think the core thesis falls paper-flat.
Seriously...just keep the politicians and politicized public scrutiny away.
Despite their poor showing during the pandemic, I am fairly certain that the CDC, NIH, and FDA (et al.) have a pretty good idea of what they f***ed up and what (smaller list) they got right, and have personnel with the necessary expertise and competence to fix what needs fixing.
They just need to be properly motivated to overcome bureaucratic inertia and actually make the needed changes.
Do you? I haven’t seen much at all to suggest they’ve learned anything.
Hmm, YMMV. I see it all the time. Some people are just really afraid of getting Covid and wear them practically all the time even when driving!
I'm guessing but I don't think they're doing it "performatively", i.e., as a "blue" signifier. They are just really paranoid. That said, I live in SF so they don't likely get called out for it at all.
IMO at least on the left people are just looking for meaning. Religiosity is down, the struggle for survival has mostly been won, so what’s left to be inspired by? Making a difference is hard so people are latching onto some weird things.
It’s not unrelated to numerous corporations advertising their “mission” or “purpose”.
Hmm... So I'm someone who considers himself cautious and well-informed. Not a prepper, but because I had read about SARS a few years earlier, I kept some packs of N95 masks around just in case. Knew a pandemic would come at some point - Bill Gates and others had been warning about it, after all.
Pre-2020, I could mostly go through my life "my way" and not have to actually deal with how other people live their lives. I would argue with anti-vaxxers online, but honestly the stakes felt low since my kids were vaxxed and overall compliance was high.
The pandemic forced my beliefs on "living properly" into conflict with what other people value. And to pick an example that doesn't paint me as a hero, I was furious that people were choosing to go to church during a pandemic. Yes yes, in normal times we can pretend religion isn't just some made-up BS, but the stakes are REAL now - stop screwing around and stay home!
And this tension existed throughout life at that time, y'know? So much disagreement because suddenly other people's choices were creating risk for MY family. Couldn't stop seeing how wrong all their lifestyles were - most people are not nearly as utilitarian and rational as they should be.
For me, this is the "PTSD" that is hard to unwind - how to get back to living our separate ways after actually getting entwined with how other people choose to live.
Obviously people who go to church don't think it's made-up BS. Empathy is important during a pandemic just like at all other times.
And even if those who do allow that it is or may be made-up BS can benefit from the community aspect of church. Gathering in church was crazy to me during the early weeks/months the way any voluntarily gathering was, but the long-term social distancing ethic was (is) not a great look for us (secular blue America).
Yes, I've become a churchgoer since I moved to Tennessee (and got vaccinated), and the community has been wonderful, and a nice change from the isolation of NYC under Covid. The church seems to do a lot of good locally, too. Keeping church congregations from meeting is not without costs.
rationally I know that, but it became harder to empathize during a public health emergency, when I felt the choices of others were leading to risks to my family.
In fact I think better than using the term PTSD would be just to say that the pandemic caused serious rifts in the nation's empathy, because the stakes of other people's actions suddenly became higher.
See @AMIDWESTERNDOCTOR
The collapse of once-dominant mainline Protestant religiosity in American life has been replaced with wokism/COVID hawkishness (*). We're all wired to believe intensely in something, whether it be a metaphysical being or not.
(*) What MY gloriously called "lizardism" in a post on Israel/Palestine a couple months back
Huh? This is a vibes-based response. Religiosity has been falling for like 40 years and NOW you have an explanation for it?
This isn't right. Contrary to poplar understanding, religiosity has fallen much more in the working class than in the professional class, but the latter is the focus of "wokism."
IMO the turning point where Blue America lost the plot and the trust of others wasn’t the 2020 protests. it was spring 2021 when the vaccine was widely available and yet many health officials, local governments and individuals said thank you but I’m still doing all the NPIs. CDC didn’t help by flip flopping on masks.
My other pet theory is that things started to break when we went into the second year of social distancing. If we had mostly emerged in spring 2021, I think people would have looked back and said wow that was a weird year. But when it kept going, then it’s like, oh I guess this is how we do Easter now. This is how we do Memorial Day. It becomes the new way rather than a crazy outlier. I really think that’s when things broke.
Officials got spooked by Delta, but not nearly enough was being made about the antivaxxers suffering from it much more, because the vaccines were working. That definitely got me very angry at NPIs still existing/being brought back.
Biden did have his 'pandemic of the unvaccinated' line, but the public health crowd got mad at him for it. Another time they should have just let Biden be Biden.
I think the flip flop on the masks was huge and really fed vaccine hesitancy. Unfortunately, I also think it was part of a broader issues with experts having failed ethically and being too arrogant.
I was hugely pissed early on when Fauci started back peddling masks in an attempt to monopolize the existing masks for medical/public safety/fire/ems etc. (and I was one of the ones who needed the masks due to my job). Anyone with a brain would have looked at how Asia saw them wearing masks after things like SARS (not just for SARS-COVID but wearing masks at Disney Land), thought about germ theory, and decided that the prior probability should be that masks probably did something (this is regardless of their true efficacy but just as common sense). We did not need peer-reviewed probability and effect size tests on masks at that point...just common sense.
Even then, It was also evident that the CDC would have to walk back the idea that masks might not be effective once they became available. However, Fauci fed the anti-NPI hysteria of the right for the short-term gain of making more masks available for healthcare/emergency workers. Of course, some people would not trust him later.
Medicine then doubled down on stupid NPIs (not being able to attend events outside) while simultaneously exempting their favorite political causes (see all the medical professionals and institutions that decided it was ok to protest in large groups but not go to outdoor church - I am not religious but saw this as hypocritical and can only image how religious people felt). In retrospect it appears that outside activities were not a huge issues, but you really need to be consistent when messaging in an emergency (see the issues with Fauci and masks).
Giving exemptions to causes you support (i.e. protests) while not making similar concessions to causes you may not support (i.e., religion) makes some people feel like a double standard is being applied. I am not religious and did not go to church during COVID, but I still thought it was fairly biased. I can only guess how a truly religious person would feel.
Finally, highly respected scientists were untruthful to reporters in terms of the possibility of lab leak, and it appears they did so to protect "science." This does not mean that COVID was due to lab leak (it appears not) or that they Proximal Origins paper was deceitful (it may or may not have been...timing is odd but scientists change their minds all the time when they get new information). What they did do (and you can read the Slack conversations and see this) is mislead the press about the possibility of a lab leak. Again, this does not mean they believed the lab leak...but they clearly tried to create an impression that i was much less likely (near impossible) than they thought at the time. I mean, they talk about deceiving the guy in the Slack messages.
Ostensibly, this was done to protect "science," but that is like Fauci saying attacks on him were attacks on science. It was arrogant and short-sighted. All experts have is their credibility, and the only thing they accomplish when conflating their views with science or when they lie (even to protect emergency workers or science itself) is to destroy that credibility.
If you destroy your credibility and later need it to be broadly credible, like to get people to take a vaccine that was developed quickly and in a non-standard manner (creating some basis for legitimate concern), you are screwed. You are not viewed as credible because you have lied, been seen as taking sides for political reasons, and, been incredibly arrogant (which turns many people off).
It took me a while to experience this, because I was still vaxxed and relaxed in rural Michigan most of the time until November 2021, when I moved back to NY. I went back to my previous bureaucrat job in January 2022, and we were required to wear masks (any kind, including cloth) in the office. Even when the requirement was lifted a few months later, a lot of people (especially very young people!) continued to wear them. The NPIs - masks, distancing, not going anywhere - had become an article of faith, and it seems as if a surprisingly large number of (not immunocompromised) people are just going to hang on to them forever.
There was a brief moment in the first half of 2022 (when blue America really started shedding NPIs) when the most-masked people in my community were, like, 30-to-45-year-old women. But that's passed; I no longer notice any particular demographic commonality among the people I see who still wear masks.
The CDC mask flip flop is specifically where I punched out from being super covid cautious and deferential to the guidance.
It was multiple fuckups that was a total comedy of errors. It went from "don't wear masks, we need to save them for frontline medical workers" to "you can make up cloth masks, and save the N95s for frontline medical workers" to "cloth masks don't work, you MUST wear an N95 at ALL TIMES!". All while they had no consideration at all for how anti-social and impractical this was going to be as the overarching mitigation. The funny thing is, I think they were closest to correct at the beginning, which was "N95s or GTFO, but in limited circumstances".
On the one hand, I agree with you. On the other hand, the period you're talking about what was, what, like...nine months? I kind of vacillate back and forth as to whether that actually mattered.
I do think it would be good if governments tried to systematically learn from Covid so we could do better next time, though. And that doesn't seem to be happening, at least in the US.
Wearing cloth masks is absurd, agreed. But I see no harm in wearing a well-fitted one if you want to reduce your odds of picking up a virus such as influenza, common cold or, yes, covid. People have been doing this in Asia for decades. I personally dislike masks and haven't worn one in a couple of years, but at this point I barely notice when I see another person doing so. And the "outdoors" aspect probably means they find it easier to simply leave it on.
Fair enough - but I think that a number of people have put masks in the “one weird trick” category- that the ONLY downside of wearing a mask is personal comfort. A well-fitted mask WILL stop you from contact with any number of normal viruses/ common cold etc. Which means that your immune system isn’t going to learn about them and when you do let your guard down you probably are going to be sicker than you otherwise would have been. This is a case where people would be well advised to step back and think about what they are trying to accomplish. Yes, masking makes sense in a pre-vaccine world where you have no immunity to COVID and you don’t particularly want to gamble on gaining that immunity the natural way. And sure- if you know you are going to be visiting someone soon who is genuinely immune compromised, masking up for the week before your visit makes sense as well. But I don’t think that is what is happening in most of these cases.
Turning masks into a political signifier has been terrible, especially for people who actually need them (immunocompromised) or people who benefit from wearing masks outdoors, i.e. people with bad pollen allergies. And as global warming continues to turn summer into “fire season” we’re going to have occasions where everyone needs a mask to go outdoors.
True! Last summer in NYC, wildfires in Canada increased the particle matter and pollution in the air to actually dangerous levels. And while this had nothing to do with COVID, the mask wearing breakdown I noticed in my immediate social circle fell right on partisan lines.
FWIW I spend large portions of every summer in rural Eastern Washington, not exactly COVID hawk territory. When there have been fires that impact the air quality, people still wear masks at about the same rate as pre-COVID (and almost everyone has them in their emergency kit, if not a full on respirator), mostly because it's not uncommon to be, be related to, or otherwise know someone who directly works on fire prevention and they were trained on the advantages of masks vs. smoke long, long ago.
Also, when there is smoke everywhere in the air that close to a forest fire, it only takes a few minutes of breathing it in to realize that smoke and fire couldn't give a shit about your political beliefs, and will screw up your ability to breathe real quick anyway.
Whereas contacting an illness isn't something you are going to notice in real time.
I saw a headline, "'Yellowstone' Actor Kicked Off Plane for Refusing to Sit Next to Masked Passenger." My first thought was, yeah, you don't get to make those decisions as a passenger. My second was, how did we get to the point where the masks are even annoying to people who aren't wearing them, let alone unacceptably obnoxious?
I don't say anything or make a scene about it, but seeing it does annoy me and make me anxious due to losing key visual cues in interacting face to face.
Do you feel that way with sunglasses? Sincere question!
Also, regarding the actor on the plane, isn't not interacting face to face with one's seatmate not only acceptable, it's actually probably many people's preference?
Getting sick is not binary. Reducing viral load makes a huge difference. Even reducing only 30% could be the difference between I feel shitty and I can't breathe and have to go to the hospital
"A well-fitted mask WILL stop you ... you probably are going to be sicker than you otherwise would have been."
I don't see why this is necessarily true as an adult. Suppose without a mask you get a particular strain of cold every 3 years, but with a mask you only get it every 5 years. You might end up with the same level of symptoms either way.
Or not, but I have no idea, and it doesn't seem like anyone does.
The Koreans have this pretty well figured out (not for covid specifically - they’ve done this for decades). Wear a mask when you have a respiratory disease to protect others, not yourself.
"A well-fitted mask WILL stop you from contact with any number of normal viruses/ common cold etc."
It will also stop you from contact with any number of normal people who think your political signaling is offputting.
I'm annoyed that so many people are politicizing masks like this. Wearing a mask in certain situations is a perfectly reasonable choice.
-When you get a cold, sometimes you have to be near people. There's also a period after the peak where you're not sick enough to isolate, but may still be contagious. I wear a mask in these situations when I go to the grocery store, and I do it for you. I don't need you to celebrate me for it, but at least don't sneer at me.
-My mother is currently getting radiation therapy for cancer. Getting sick would be bad for a number of reasons, but she doesn't want to completely isolate. She's started wearing a mask in a lot of situations. Sometimes I wear a mask around her too.
-I used to take the bus to work and I was getting sick all the time. I don't really take public transportation anymore, but if I did, I think it'd be reasonable for me to wear a mask on-board so I didn't get 8 colds a year. Maybe [gasp!] I'd even leave my mask on the walk from the bus station to my office, because it's cold outside and it keeps my face warm.
Nothing about any of this is political until you decide it is. Nothing about it is political signaling except your post declaring it political signaling.
For an individual choosing to wear a mask, there may well be a non-political reason for doing so. But as I pointed out in another comment here, look at pictures of the audience at a meeting of the San Francisco Board of Supervisors. They're mostly wearing masks! That is undoubtedly political signaling. Even the loons protesting in Vanderbilt recently all had masks on.
Yes, there definitely is some political signaling in wearing masks, as there is with many other decisions (driving a pickup, etc.)
The trick is to get the political rot out of our brains - if you have some negative reaction to a person at the grocery store with a mask on, you should try to recognize that as your problem.
Yes, it's stupid political signaling. It's also about the most innocuous form of signaling. Who cares if they put a mask on to show some kind of "virtue"?
Serious question: are people actually getting eight colds a year from commuting on public transportation? I've commuted on public transportation for almost my entire adult life and have typically gotten like one cold a year, maybe two. (I've gotten sick somewhat more than that in the past year because I have a little one at home, but that's different.)
If this is true, it would explain why I see people masking on public transit WAY more than anywhere else.
I was the one who said this - I believe I got eight colds in one year when I was taking the bus, but it's possible I've exaggerated in my own memory. I also saw a big increase when my kid was in day care.
The good news is that I know keep an excel record of my colds.* When this comes up in a decade, I'll have the receipts.
*Common colds are the thing that I am wussiest about relative to the general population. I hate them so much and am always surprised when other people get them and manage to seem to carry on more-or-less pleasantly.
8 colds certainly sounds like a lot. But the period of fewest colds in my adult life (no sick days in 3 years) corresponds with the job where I walked to work instead of taking the subway.
In practice I think of it less as political signaling and more as wearing a shirt with big block letters:
"Hey, remember [name of the first boy/girl] you really fell for? Remember that breakup? Wasn't that a heck of a time? Let's put [him/her] front of mind for a minute"
Some of us have ME/CFS, which for some of us is debilitating. It can last for the rest of one's life. I've had my case for 10 years; I assume I'll always have it. Further viral exposure can make it worse. So when people started talking about Long Covid, those of us with post-viral illnesses knew what they were going through.
I can function with my ME/CFS, but if it gets worse I may be housebound. It's already life-altering in so many ways. It's rough!
So when I wear a mask in public, like in a classroom, it's not political signaling. You don't know why people wear masks. Your assumption shouldn't be that it's a case of frivolous signaling.
...sarcasm?
Many pathogens are relatively new to humanity after jumping from other animals we domesticated. These pathogens are extremely dangerous and have a likelihood of breaking rather then improving our immune system.
Also, the common cold changes its antigens so fast I dont think it matters if you skip a few years.
“ when you do let your guard down you probably are going to be sicker than you otherwise would have been.”
This is not clear at all. Especially since a mask won’t fully stop all contact with all viruses, but will often mean you have small enough contact that your body can prevent the infection but still learn the immunity.
👏👏👏👏👏
The harm is that it's dehumanizing. It's harder to empathize with someone if you can't see their face. It's a subtle effect but it compounds over time.
The only time it really makes me angry is when I see young children masked, usually in the company of their mothers. These kids are having their social/emotional development stunted, and they're going to become part of the professional managerial class right around the time I retire.
Social media is a bigger problem along these lines, but it's all contributing
How much time are you spending empathizing with random people walking down the street or riding the subway? Our level of contact with the average passerby is 0.
It's funny you ask this, because in addition to a sitting meditation practice I'm trying to practice metta meditation (as often as I can remember to) with eyes open, walking around doing stuff, and I find it's most fruitful when I'm around strangers in public.
I'm tracking my efforts in a spreadsheet so I could give you a very precise answer, albeit one that doesn't apply to people in general.
I will day declining social trust, or a general unwillingness to think charitably about strangers, is a really huge problem that is probably at the root of a lot of other huge problems. Yes, empathizing with strangers is very important. Eye contact, small smiles, and polite nods to the people who live in your community are important. It shouldn't be dismissed so casually.
I just think if this was something that really bothered people in and of itself, we would hear from more people who are put out by sunglasses. (Poker players wear sunglasses, not face masks, to keep others from reading their faces.) But I don't believe I've ever heard someone say it's annoying when people walk around wearing sunglasses.
Anyway, sincere wishes for continued progress in your efforts to think charitably about strangers, including those wearing masks.
Yes, I need metta specifically because I'm too often a bitter angry judgmental person. Thanks for the encouragement. I still feel bad for the children of virtue-signaling hypochondriac parents, though. I have definitely heard others remark that sunglasses make people seem aloof or unfriendly, and I've noticed that reaction in myself.
But is that the case vs that a mask reduces the likelihood that you will transmit?
As for liberals that need a purpose, work for taxation of net CO2 emissions, merit based immigration, lower deficits, less protectionism in supply security policy, reform of land use regulations and building codes, more effective public education, better crime control (including gun regulation). There are so MANY things to be done to make the world a better place!
I think the best thing for avoiding catching anything is hand-washing, and when leaving the restroom, I use the paper towels with which I dried my hands to turn the door knob. Since I started doing that my frequency of colds has come way down.
Cloth masks are not absurd. I don't know why or how that became a thing but it's just wrong. If everyone wore a mask properly it would almost completely prevent the spread, and on an individual perspective it definitely still offers some percentage of protection
Well, non-fitted masks mainly work via a "herd" effect (if everyone is masking, the exhalation of virules into the surrounding air is minimized). So yes, if "everyone" wears one we'll see a large benefit. But the point is, at this juncture only a very small portion of the public is masking, so if one chooses to mask, it's vastly more effective to go with a high quality, fitted mask, because the herd protection of near-universal masking is absent.
But do cloth masks offer protection? Surgery masks is another thing entirely.
A real shitty pure cloth mask (there were really nice ones with better filtering than surgical) probably doesn't protect the wearer but still benefits public health by blocking droplets going out
Are droplets actually relevant? The public health establishment had convinced themselves that droplets of the size filtered by cloth, and that fall to the ground within six feet, were relevant. But that’s because they over-learned the lesson of Semmelweis and then had a miscalculation in the 1920s.
Yes. Again things aren't binary.
Just like 6 ft obviously wasn't binary but they had to pick some semi arbitrary distance to advise. Everything comes out of your mouth as a droplet but then it turns into smaller particles after. If you block what's initially coming out it doesn't matter whether it's a droplet afterwards. And even if it only blocks 50% well that's still 50% less virus you're putting into the world which makes a big difference
I agree that the incoherence was a big problem. It drove me crazy in the fall of 2020 when the old man dive bars were open but my kid's school was going to start remote (despite the local teacher's favoring being in person).
On the other hand I don't really get the rage/trauma thing. And I am skeptical that a post-mortem would be particularly helpful for whatever the next infectious pandemic is. Part of our problem seems to have been incorrectly applying studies from the 1920 flu .
"And I am skeptical that a post-mortem would be particularly helpful for whatever the next infectious pandemic is. Part of our problem seems to have been incorrectly applying studies from the 1920 flu ."
There was a really big fuckup around testing --- first trying to centralize it in the CDC (which decided to roll their own, over-complicated test despite being given instructions for making a working test, and then they fucked up manufacturing of their own tests to boot [1, 2]) while banning private labs from running tests, and then not approving at-home tests until pretty late in the game. (EDIT: some would say that they were opposed to the *concept* of at-home tests.) This wasn't the first time the CDC made similar mistakes with making tests available [3], so covid wasn't a one off.
My hope is that "the government" has learned its lesson with this because it was such a disaster. However, I'm not sure they have, and I'd really like to see a statement from the CDC along the lines of "Next time there is a pandemic, we will push for private testing and at-home tests to be approved and made available ASAP." My fear is that the lesson they learned is that they shouldn't fuck up manufacturing their tests --- not that they shouldn't monopolize testing.
[1] https://www.washingtonpost.com/investigations/cdc-covid/2020/12/25/c2b418ae-4206-11eb-8db8-395dedaaa036_story.html
[2] https://www.washingtonpost.com/investigations/contamination-at-cdc-lab-delayed-rollout-of-coronavirus-tests/2020/04/18/fd7d3824-7139-11ea-aa80-c2470c6b2034_story.html
[3] https://www.washingtonpost.com/investigations/lessons-unlearned-four-years-before-the-cdc-fumbled-coronavirus-testing-the-agency-made-some-of-the-same-mistakes-with-zika/2020/07/03/c32ca530-a8af-11ea-94d2-d7bc43b26bf9_story.html
They still won’t approve at-home tests for flu or RSV, even though those should be no harder than at-home tests for COVID or HIV.
I'm told that the existing flu LFT test is lousy, technically, compared to the COVID one. Much worse statistics on sensitivity and specificity. Tolerable for population surveillance but lousy for individual diagnosis.
(I did try to import a combo COVID/fluA/fluB/RSV quad-strip test from Germany, but Customs was paying attention and did not allow it in).
Actually, it looks like they did approve at-home flu tests (not sure about RSV) back in February 2023 [1]. You can get one on Amazon [2] (altho the price seems kind of steep).
So, maybe I should be more optimistic.
[1] https://www.fda.gov/news-events/press-announcements/fda-authorizes-first-over-counter-home-test-detect-both-influenza-and-covid-19-viruses
[2] https://www.amazon.com/LUCIRA®-COVID-19-Single-Use-Emergency-Authorized/dp/B0CL7S9F4P/
Oh, that's great!
Good point! A reason for pessimism.
EDIT: there is a semi-at-home test for covid/flu/rsv, but it's expensive and you have to mail it off for processing. But yeah, there are no reason at-home tests. https://www.ondemand.labcorp.com/at-home-test-kits/covid-19-flu-rsv-test-home-collection-kit
"My fear is that the lesson they learned is that they shouldn't fuck up manufacturing their tests --- not that they shouldn't monopolize testing."
If the US government had been in charge of our response to polio, we'd have the world's most state-of-the-art iron lung, and no polio vaccine.
Not sure if that's true, but I'm liking simply for the mental image of a high-tech iron lung... (I'd be curious to see an Apple-designed iron lung!)
iLung?
Breathe different?
https://en.wikipedia.org/wiki/Think_different
Well, yes, in the sense that "all" CDC/DFA need to do is in the future let their action and recommendations be guided by cost benefit analysis. But I think seeing exactly how the COVID actions and recommendations failed the test would be useful
I think outdoor maskers are people suffering from anxiety or PTSD at this point.
There are people who are severely immunocompromised or have serious pollen allergies also.
My favorite maskers are the ones who still wear them but incorrectly - under the nose, etc.
I agree with most of what Matt said but I think he lets Republicans off the hook too much for how adamantly anti-vaxx they were, resulting in so many needless deaths.
I remember Matt posting during Covid about how he was "Vaxxed and Relaxed" which struck me as the right mentality after we gained a basic understanding of the virus.
I think if people want to wear masks, that's fine. It's flu and RSV (as well as COVID) season and we have no idea why they're wearing masks. Maybe they're immuno-compromised.
You can laugh at me all you want with my mask but I’m trying to avoid colds, which can condemn me to inactivity for as long as a week. Masks are simply a new tool for avoiding the common cold, not to mention the flu.
The people I know who wear masks outdoors are generally doing it because of the cold weather…
I do understand it indoors for people who have respiratory issues or are immunocompromised. There is a bookstore near me where the owner has issues so they still require masks.
I suspect the use of "immunocompromised" has increased as the use of "fibromyalgia" has decreased. Though both are real conditions, the venn diagram of those using both terms probably has a lot of overlap.
The two are probably opposite since fibromyalgia is probably a cluster of autoimmune disorders.
Their store, their rules, but that's a great way for me to never go into that store.
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.
Covid reinforced two unfortunate tendencies in the left - neuroticism and moralism.
Yes, and a third, surprisingly: rule-following.
Rules are supposed to be followed.
Here's my thing: During the pandemic, there were many, many, many times I wanted to scream in conservatives' faces "JUST DO AS YOU'RE FUCKING TOLD," followed immediately by doing an about-face and screaming in progressives' faces "STOP FUCKING TELLING PEOPLE TO DO SILLY THINGS."
You, sir, are highly sensible. Please run for office, I'll vote for you!
(I mean that sincerely, not sarcastically.)
I do not propose to run for office for the same reason that I do not propose to be committed to an asylum; namely, that I am not insane.
See, this is exactly the problem with politics!
1. Politics is full of crazy extremists and amoral sellouts
2. Smart, rational, ethical people look at politics and say "F*** no, I'm not touching THAT with a 10-foot pole"
3. Go back to step 1, wash, rinse, repeat.
I'm starting to think David Abbott's idea of sortition has merit.
I would add to that by telling conservative politicians and pundits to stop lying to people for political gain and telling liberal politicians and pundits to stop lying to people because they are arrogant and believe they know what is best for everyone, all the time, under any circumstance...
It was less the rule following and more the absolute faith in the experts.
If Fauci said walking backwards looking thru your legs would reduce transmission due to some made up scientific sounding thing people would have done it.
(And I live near a hospital in a large suburb of NYC and there were lots of ambulances going by and long lines of cars backing up to get into the hospitals—it was scary and made worse by the gruesome media cover of the city itself.)
Yeah maybe that is it. Lol walking backwards.
Implement onerous rules that are mostly about moral signalling...but dont enforce them strictly.
Or even worse, selectively enforce them based on the victim hierarchy or political patronage (Floyd protest).
It was a great way to help conservatives visualize what liberal dominance would look like.
I want to underline the word "visualize"—whether or not that's actually how a liberal-dominated world *would* be, don't casually hand your political opponents such a trivially easy talking point.
And no mention of the people who suffered as a result of some of the Covid era restrictions! Having a family member die alone because the hospital does not allow visitors is really awful. So is watching a family member go back to drinking because they can’t go to their AA meetings and the zoom AA meetings aren’t the same.
How interesting to blame the restrictions rather than the fact of the pandemic itself. Maybe humans were actually more realistic about society when they could just blame the gods for everything.
Hospitals refusing to allow the dying to have visitors is a policy decision and there's nothing about the virus that forced hospitals to do this. They could have handed visitors an N95, made sure that they had a good seal, had them sign a waiver saying they won't sue the hospital and then allowed them to go in. Instead they had healthcare workers do things like fill gloves with warm water and stick them in the hands of dying people so that they didn't feel as alone.
It's better to "blame the gods" because blaming human institutions without understanding them from the inside is pretty much futile. Yes, they "could have done this or that" but they didn't. Why didn't they? Why would we even expect them to do "what they could have done" in the midst of the chaos?
My personal psychological discipline has always been to avoid blame and instead seek understanding, partly because I tend to feel unproductively guilty about my own unintentional mistakes. But also because I've worked in a complex system, and was aware of the extent to which it was a ultimately black box to my understanding. Blame goes nowhere. Might as well come up with some gods to blame.
In the meantime, looking forward pro-actively is more crucial than wallowing in blame. It's possible that the healthcare system in general, not very resilient in 2019, is now deteriorating in the wake the pandemic and experiencing its own Boeing moments, in my city seen in the mass resignation of burned out PCPs , the impossibility of finding docs and getting appointments, the closures of local urgent care centers, etc.
My speculations about the chaos and what "they" "could have done" -- during the chaos, N95s were precious and more important for just keeping people alive. Who was supposed to "make sure they had a good seal"? Who was supposed makes sure all the relatives of the dying got a phone call? Who was supposed to handle all the visitors? The hospitals were in deep triage mode that extended to their operations across the board.
Real questions going forward: where are the pressure points in our power that can help healthcare institutions resist late-stage capitalism and become more resilient for whatever comes next?
I am thinking this morning about how satisfied I am to have cancelled my subscription and no longer be directly paying for that stuff.
Come on, that's not the median article (just as the "cancel Substack" was not.)
You can't really expect a general purpose publication to screen out ALL silliness. And IT owns up to being an opinion piece unlike much of NYT
I think my impressions of what The Atlantic is changed radically during the pandemic. It became ground zero for covid caution.
Maybe. I was not reading it them or before. It do not seem bad now on average. Of course there ARE no neoliberal rags. :)
Say what? I can establish whatever expectations I want *of people I pay for a product*!
One can desire much better than one expects.
There are still occasionally good articles, but it's been a pretty dramatic decline.
I have no doubt there are, there's a lot of talent in that virtual magazine-room. But they're one of several publications that, to my eye, just completely lost their sense of direction and purpose from the one-two Trump/covid double whammy.
Yeah, it's nice to have a couple of hours of my time back each week now that I'm not marinating in alarmist commentary about all the things I am supposed to worry about. I get it, our society is facing some problems, i don't need to pay you $80/year to rub my nose in it every day. I do miss the film reviews occasionally.
Maybe we shouldn’t get all therapeutic about it, but the idea that we are generally suffering from PTSD with regard to COVID is not an unreasonable heuristic. There were many problems with the pandemic response but I would not call it a failure: we could have done much worse.
Can someone explain to me what this "urban liberal neuroticism" is? Seems like a convenient straw man rather than any real, coherent trend. Fill me in.
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
Totally agree John. I was always annoyed at how long it took for two basic obvious facts to be understood: COVID was primarily dangerous for the very old and those with respiratory comorbidities, and COVID is airborne. The age factor was obvious almost immediately (and acted on by DeSantis, credit where it's due) and it's incomprehensible to me that it took so long for the CDC to officially acknowledge it was airborne.
The first month of COVID response seemed fairly sane - lock down, flatten the curve, reopen cautiously and keep your eye on the hospitalization rate after that. Then it just went off the rails. Frustrating.
It was obvious to me but I think was purposely hidden in the communication that flattening a curve just means spreading it out over a longer time.
Most non-scientific people I know 100% were led to believe that flattening the curve somehow meant reducing the area under the curve and therefore stopping infections completely as opposed to just making them happen over a longer period of time
Remember, from 2016 to 2021 things really seamed off the rails in general. Maybe that month was an abnormality.
I'm pretty confident this is directly attributable to the teachers unions. "Kids don't get sick" was devastating for their quest to get paid for staying at home as long as possible.
I'm always willing to bash Teachers Unions, but I think the causality is backwards here. They responded to how the CDC and other health officials chose to communicate. There was almost nothing in the summer of 2020 in their recommendations or media reports about the relative risk profile based on age. Many teachers were scared. Needlessly, as it turns out.
It's as if the CDC and the media in total weren't interested in providing facts and then let people decide how to respond. Instead, they wanted a particular response then crafted their message and facts presented to support the desired response.
I have two in-laws in the NYC school system. One was a teacher the other a school psychologist. Both reported that many (most?) teachers around them were extremely lax about COVID but also really, really enjoying WFH.
I’m surprised to hear that teachers were lax about Covid. At my DC-suburban school it was the same 5-10% of the kids who just refused to mask properly, and -you can guess - there was no enforcement or consequences of them not doing so. I was pretty much alone in talking about in-person schooling for late spring or fall of 2020, but that’s because I was pretty much alone in reading about the European experience.
I've always thought the persistence of remote school had something to do with the social position of teachers.
If you think about it, most of the jobs that had good reason to continue in person during Covid were blue-collar, with two big exceptions: teachers and medical workers. Medicine has a very strong ethos of sacrifice; if you go into that field you probably know that at some point you may be called to go above and beyond. (Also doctors specifically make a lot of money.)
Teaching isn't really like that. It's just a normal white-collar job. So I think teachers looked around at their peers, lawyers and software engineers and marketing managers and whatever, all of whom were working remotely, and thought "what the hell? I want that, too."
This is just a half-baked theory, and it doesn't excuse the disaster of a policy, but I've always thought that's where it came from.
I want to add one thing to this. I suspect there is a critical mass of teachers who truly mean it when they say "I love teaching and am passionate about it," but mean it in the sense of "I love presenting and explaining information and concepts and am passionate about it," while hating classroom management, which wasn't exactly a cakewalk pre-pandemic, anyway. But working remotely, you don't have to do classroom management anymore! At least, not in the same way.
Another thing is that teachers, especially the types who become union activists, are often very neurotic about their professional position vis a vis other white-collar professionals. They think they aren't valued enough by society. Whereas e.g. lawyers are completely comfortable with their social position--they're generally indifferent to what laypeople think about them. You never see lawyers offended by lawyer jokes.
I suppose I think that in summer 2020 the kinda "precautionary principle" ideological lockstep between public health and education that kept schools closed was more of a preexisting phenomenon than a causal arrow in either direction. At some point, when public health people found the actual data increasingly hard to ignore it was enforced by the unions.
IMO that's one of the biggest failures and least well appreciated aspects to the decline in public trust. As far as I'm concerned everyone gets a mulligan for the spring. Summer 2020 should have been spent preparing for in person, with reasonable precautions. I know this was possible because that's what the Catholic schools did in the Archdiocese of Washington DC.
That's also pretty much how we were at (white-collar, professional) work. Started returning in June, and most everybody back in the office by the end of summer, although I don't think it was mandatory until vaccines came available.
I actually think the case for hybrid models and lots of remote work for office jobs had been pretty strong for years predating the pandemic. It's good for traffic, good for the environment, and good for the workers whose jobs are conducive to it.
Another bad dynamic that got thrown into the mix was a policy that independently had a lot going for it being arbitrarily connected to the severity of covid.
Worse than disinterested, they were actively interested in misleading with white lies for "the greater good"
I blame the CDC and the lack of early testing. A bunch of teachers did die early on and so it’s reasonable for them to be scared. Had we had decent testing and tracing - like Europe - we could have demonstrated that those unfortunate deaths were not due to contracting COVID from their students.
The “teachers did die early on” impression comes from massive media amplification of a tiny number of unrepresentative deaths of young teachers as well as unions disingenuously counting elderly retired teachers in their statistics of teacher deaths.
Almost all schools closed in March 2020 and stayed closed through the end of the year. The teacher deaths splashed all over the media in summer 2020 couldn’t have been from teachers catching COVID at school.
A few of anyone/everyone died early on, a common feature of a pandemic. Teachers as a bloc were the only ones that were largely exempted from effectively doing their jobs in response.
I am trying to use "as a bloc" to recognize that a great many teachers were pulling their hair out because they think their job is important and they knew that their pupils were not being served
Kudos to you for acknowledging that many teachers went above and beyond. As someone who currently teaches remotely, I can tell you that it is more challenging than people realize. Think of your last Zoom meeting and then add 30 kids, some of whom have ADHD, and imagine what a nightmare that would be. I do not do many live classes (thank god) but it is tough...
That said, I think a great many teachers let down themselves and the nation. There were people working grocery stores, medical workers, emergency workers, etc. They all went to work...another kudos to people like barristas...Not sure how I would have survived COVID without the barristas
Yes, I know multiple people under 50 who died of COVID in the early days, three of them well under - mid-20s to mid-30s. I am in NY State, but not the city. It was scary, and even if we were given the stats, I am not sure that we would have trusted them.
I also agree with Matt that the school shut downs were often due more to parents than to teachers. When our schools first went back, families had a choice of going back in person or remaining remote. Less than half the students went back in person. It was the opposite of what I initially expected - wealthier parents with jobs that they could do remotely tended to send their kids in person. Poor and blue collar parents with in-person jobs were more likely to keep their kids at home.
"It was the opposite of what I initially expected..."
My guess is this is driven by how much those parents value education combined with access to info on the real risks. Otherwise it doesn't make any rational sense, as the parents with on-site jobs are already exposed.
But FDA would not approve screening tests! So not "test to enter (school)."
If I remember correctly that was a joint effort that also heavily featured FDA.
And I think teachers were less of a problem than parents. But the fundamental problem was CDC messaging.
"Kids don't get sick" logic ignores the fact that lots of people work in schools who are not kids. Of course, those people are unionized and underpaid, so conservatives don't care if they die.
Those people who work in schools usually aren't 75 years old with COPD...
Then how come there wasn’t mass death amongst school workers in Europe, which didn’t close their schools?
Gross comment
Remember, with pensions, most teachers actually can retire fairly young...Particularly at that point as all the older ones would have legacy pensions from before the more recent trend to reduce the benefits and increase the retirement age.
I do not say that in a snarky anti-pension way (I have a pension and left my first job young) but only as a factual reference. I am not sure of the logic for teacher pensions, but I know many pensions are based on the fact that the work is strenuous. If you were older and concerned, you could leave.
I could have left during COVID and did have to work with the public, but where I worked, there was a lot going and it would have felt like abandoning my team. I do not think it unreasonable to expect the same from educators (which is what I do now).
Also, in terms of pay...the value of a pension is generally in excess of $1 million...so they really are not paid poorly when you take benefits into account.
I don't know why people think closing schools was about kids.
At least pre vaccine it was about not forcing the predominantly elderly teacher population to go work among disgusting disease-ridden kids. And then a side part of it was the fact that kids have older parents and parents always get sick from their kids so again it is about kids as vectors not as patients.
Surely it’s not the that the teacher population is “predominantly elderly”?
The fact is that working with disease-ridden kids is the job! It’s a very very important job that no one is obliged to do.
“Kids don’t get sick” was absolutely false though. What was true was “kids don’t get it bad”.
It really was shocking to me though how much my brother and other parents I know were worries about their children when it was quite clear that they were at risk of serious issues but their kids weren’t.
I remember many people that were not going out with their toddlers until they could get them vaccinated. Smart people, mind. Absolutely terrified of their kid getting sick. Fairly convinced most elementary aged kids wouldn't have even known they had it, were it not for the heavy testing.
There was a fair amount of uncertainty about long-term outcomes though. I remember reading about higher risks of diabetes, etc.
In all these discussions it’s easy to forget how much was non-obvious at the time. It was a novel virus!
There is still a lot of uncertainty on long-term outcomes? That hasn't changed. With a lot of the causality in all of it being a nebulous cloud of interactions that are not topologically sortable into a prime mover.
I think it is fair to say there was a lot of fear. And we had a massive hope that we could control the situation to reduce things. Even this retrospective is the hope that we could be better next time. But there is scant evidence that we could have done better this time, or that we will do better next time.
This is not to say we should stop looking. But I would really love it if both sides of the debate weren't so quick to throw out studies that disagree with them.
Are you familiar with the NASCAR driver of the same name? (or are you him?)
No on both counts. Fun to see my name is being made famous out there!
Lol, sure. Though he's only the 2nd most famous graduate of his high school, but that's because he's stuck behind Her Royal Swiftness, Taylor.
That's interesting! My partner and I have no kids, and it seemed to us that those months of isolation were great for us, but seemed really hard for people who either lived alone or lived with kids.
I think it depends where you were. The isolation we put kids through was rather high. Literally parks and playgrounds were taped off and they were not allowed to go play with others. It felt excessive at the time, and it feels foolish looking back.
This kind of reminds me of how public health authorities have spoken about AIDS. (I know, but hear me out…)
It is obvious that there are certain populations that have certain behavioral risks that make them much more likely to be at risk for HIV/AIDS (gay men, sex workers, IV drug users, etc). Yet public health authorities historically have not made distinctions and messaged the risk to the population at whole like everyone is equally at risk.
Was this because of A) not wanting to stigmatize those at higher risk or B) Not wanting to make those not in high risk feel like it’s something they never have to worry about? Most likely a little of both but I think both those cases applied to COVID.
Public health authorities were/are reluctant to single out the elderly, but especially obese, etc and didn’t want others to feel 100% immune. I would like to see public health authorities trust us to understand this and not act line everybody is 100% equally at risk for every disease.
This is exactly it. One reason the high correlation between age and covid morbidity wasn’t made ultra clear to the public was many public health officials’ conviction that saying it out loud = it’s ok for old people to die. I definitely saw this stated (on Twitter, ok fine, it was Twitter). The idea was absolutely was that we shouldn’t just be given information and trusted to make decisions.
A lot of public health officials appear have “we’re all in this together” as their operating principle for public health responses. As a practical matter, for COVID, this translated to everyone must do what the most at risk people should do.
We are all in this together is applicable to taking precautions not to transmit, but not to self-protect.
With a disease that’s transmissible pre-symptoms, those are kind of the same thing though.
It was only around 5 years ago that I learned AIDS is almost exclusively spread through anal sex (plus needles, etc) after I wondered why none of the highly promiscuous straight people I knew/knew of never got it.
Public health absolutely gives incomplete information intentionally to try to affect behavior, and they were caught red handed doing this over and over during the pandemic.
I think it relates to healthcare workers’ universal experience with ignorant patients, which is corroborated by my friends in the industry.
"It was only around 5 years ago that I learned AIDS is almost exclusively spread through anal sex (plus needles, etc) after I wondered why none of the highly promiscuous straight people I knew/knew of never got it."
Maybe in the US. Certainly not in places like South Africa.
"Maybe in the US. Certainly not in places like South Africa."
True, but that's hardly relevant to our public health officials.
But there's nothing special about the biology of South Africans. If you go to sleep on large swathes of the population it can happen anywhere.
Well, no, not if the cultural or health conditions that drive transmission are mostly absent here.
Over the years I've read 3 explanations for why AIDs took off among heterosexuals in Southern Africa (South Africa+ Neighboring countries) far more than anywhere else, including the rest of Africa. I don't know how true each of these are:
1) A greater incidence of other STDs that aid transmission
2) A greater frequency of having multiple long-term sexual relationships concurrently.
3) A trend of men preferring dry vaginal sex. I can't remember what that's about exactly but look it up if you're brave or curious.
I think heterosexual sex accounts for about 10% to 14% of all transmission routes for new HIV cases right now. In King County the group with the highest HIV rates are female sex workers. It is not the primary source of transmission but it isn't not a risk. I do think we need to be more transparent in health care messaging but I do get why folks worry that low risk equals no risk is a frequent reading. In any case you are way more likely to get syphilis from sex workers in King County than HIV and it didn't take long for that to move from that population into the heterosexual population at large. So things can change and jump quick.
"I think it relates to healthcare workers’ universal experience with ignorant patients, which is corroborated by my friends in the industry."
This fits with something my wife encountered (pre-COVID) once while being treated in the ER, where a doctor literally told her they were going to skip giving her a particular medication because they trusted her to do something she had been directed to do, whereas most other patients they would have just gone ahead dosed with the drug. (Being vague here for medical privacy reasons.)
In other words, public health authorities lied their heads off, because they think they know better than you. And that's why their authority was lessened or removed by legislatures across the country.
Before AIDS became treatable, I remember public health and even gay rights groups (who of course are very concerned with stigma) doing a very good job of promoting condom use and emphasizing the high risk to gay men.
HIV is actually a model of how people can put aside political correctness (although to be clear it took a couple of years to really solidify- at first the Left wanted to keep the bathhouses open and the Right wanted to ignore it or quarantine gay people).
We don’t even need to go back that far! This happened with mpox in 2022. I genuinely only found out it was spreading largely among gay male cohorts due to Twitter and WaPo comments sections. And yeah gay advocacy groups were all over it, like, no we want to protect ourselves so we are going to talk about. But they had to push that themselves; health officials and media were going to just keep pretending it was a society wide risk.
OMG don't get me started on mpox. I knew so many gay men running around with their hair on fire in June/July 2022 afraid to even make out with anyone because the official line, amplified throughout the media, was that it was spreading in "the queer community" and you could get it "through intimate contact." No one could find an explanation of what exactly constituted "intimate contact." Fortunately by August, we finally started to get straight talk from other gays working in healthcare/public health, who understood the importance of clear and explicit communication and that the euphemistic language public health officials and media were using was doing more harm than good. Don't say "the queer community" (as if lesbians were getting it!)
when you mean "gay men/MSM and trans women"; don't say "intimate contact" when virtually all cases involved oral or anal sex with a partner who was infected.
Yes to all of that
Sure, but Healthcare Communication 101 is use plain language, not assume people know what the euphemism means (never overestimate the knowledge of the average person!). All i can tell you is that the correct message, "touching is low-risk, oral and anal sex is high risk," was not getting through to a lot of people.
I don't know about IV users but I definitely disagree that they aren't willing to speak about AIDS as a gay crisis.
Even as a gay teen in the late 80's I was _very_ aware that this was _primarily_ risky to me even if anyone could catch it via intercourse.
That was not hidden.
And even now if I see a PrEP add (the prophylactic HIV medication) it universally features 2 guys in the ad - it's definitely clearly targeted at gay men.
I think this refers more to the messaging towards straight people. I was told as a kid that AIDS was simply a risk from unprotected sex, like other STD’s.
It’s actually remarkable - somehow the societal mix managed to let gay people know that we are at extra risk for hiv and mpox, but didn’t let straight people know that there was this distinction. I don’t know whether this was effective at all for the stigma or for prevention, but it seems like it was effective at getting this state of affairs.
As a non-gay teen it was definitely presented to me as if everyone basically had the same risk. I remember being fairly shocked when I went digging for the actual transmission statistics in my 20s
This was my experience too (I'm almost forty). "HIV is a huge risk if you have sex without condoms" was the message we all got. I didn't learn until shortly before college that HIV transmission via vaginal sex was very, very rare in developed countries.
The stat i remember reading somewhere was a 1 / 300 chance for the woman and a 1 / 500 chance for the man, per incident.
Which isn't zero. But it's not high enough for the disease to spread continuously unless people are having multiple long-term sexual partners at the same time, which I've read is somewhat common in the southern half of Africa.
Even lower-- 1/1,250 for the woman, about half that for the man.
https://www.cdc.gov/hiv/risk/estimates/riskbehaviors.html
I've heard the same about southern Africa, I've also heard a few other explanations: prevalence of other diseases increases HIV transmission, "dry sex", populations that weren't historically exposed to the Black Death, and male circumcision. I really have no idea what the answer is.
Yes, as someone who spent the entire 1980s to early 1990s in K-12 schooling, the takeaway I definitely had was that all forms of unprotected sex had nearly the same risk.
As a straight man with a wife that watches a lot of Bravo, I can attest that PrEP adds aren’t coy that their product is for gay men. I swear 1/2 of ads on prime time Bravo are for PrEP. The other 1/2 are for birth control targeted towards young women, haha
I also remember looking at the cdc list of travel precautions in summer 2020 and at first being glad that they mentioned all the relevant points of risk, but then really annoyed that they weren’t doing anything to distinguish the risk of using a gas pump someone else just used vs sitting in an airport with a crowd waiting to board a plane. It’s as though they wanted everyone to be feeling equally nervous and cautious with any mode of travel, rather than wanting to direct people away from more risky modes of travel and towards less risky ones.
Not relevant. The factors that made some people more at risk for AIDS were stamatizable (especially back in the '80's). There is not stigma attached to being old or having a co-morbidity, so there was not reason not to provide that information.
That said, I think the age factor WAS pretty well know, just not acted on.
I think there is lots of stigma with some comorbidities. I saw plenty of jerks saying it was overweight people's fault if they got really sick.
It's one thing to be a jerk about it, but pretending that obesity is not a preventable risk factor is also not helpful and might even get some people killed.
Obesity is not preventable on a time scale that matters for a three year pandemic.
Maybe not, but you can always make progress. And an obese person is continually at higher risk from infectious diseases other than covid, so it's always a good time to lower your risk factors.
I think the core issue is that covid stopped being approached rationally by any corner within weeks. Trump deduced it was a threat to his re-election and we were off to the races.
Both sides came to the same deduction regarding the threat to Trump's reelection. Therefore, Republicans downplayed it while Democrats exaggerated it.
Proving once again that Trump broke our collective brain.
I do not see that as the primary reason for the Left's overaction; it was more "safety-ism."
Agree
We had decent data on mortality rates by age very early. This article was published in March of 2020. The Diamond Princess was an excellent natural experiment, almost a natural challenge trial.
https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/
I recall doing analysis in both the initial days of the pandemic as well as over the summer of 2020, and age was so well known to have a huge effect on mortality that we didn't even bother to emphasize it most of the time.
What frustrated me is how people wanted to either round the data down to "if you're under 70, it's basically nothing" or "everyone is at risk". Both of these are bad analysis and bad public health messaging, but I rarely heard anything in between outside of analytically-heavy deep-dives.
Agreed that 70 is probably too high of a cutoff. Below 30 feels very different. Heck, below 50 was already safer than you'd think based on the reactions of everyone.
For a more fulsome roundup of the coverage from 2020, see The Covid History Project:
https://www.covid19-history.com/timeline/2020/
Thanks for this!
>> the lack of data during the pandemic about the age of those killed by Covid..
You must have had a dramatically different news feed from me. I could maybe be convinced that some media outfits overemphasized the risk of covid to young people, but there absolutely was not a lack of data about the risk to the elderly.
As I remember it, nearly all of the early reporting on death and hospitalization was broken down by age cohort. Cohort based mortality charts were published everywhere from the start and much of the early discourse on precautions for Covid was centered around protecting the elderly and vulnerable.
Some links to reports and articles from March 2020 from a quick google search:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
https://www.nytimes.com/2020/03/14/health/coronavirus-elderly-protection.html
https://www.vox.com/2020/3/12/21173783/coronavirus-death-age-covid-19-elderly-seniors
https://www.who.int/europe/news/item/03-04-2020-statement-older-people-are-at-highest-risk-from-covid-19-but-all-must-act-to-prevent-community-spread
I don’t think I ever got a sense that there was more than a factor of ten in virus risk for various ages, until I really started digging in March 2021 and realized that my vaccinated parents were actually still at higher risk than then-unvaccinated me, and that when I was vaccinated I would still be at higher risk than my then-unvaccinated nephews.
I tried explaining that to fellow parents. Get your kids vaccinated, but realize that they are at far lower risk without the vaccine than you are with. For those in offices at the time, the 20 year olds that were in the office were in a similar position. They were basically fine if they were keeping decent health otherwise.
Same here...In Oregon, groups like teachers and lawyers (I am not 100% sure about the timing for lawyers) received the vaccine before the elderly...schools and the courts were shut down, but ostensibly, this was to get them open (they didn't).
I remember the reporting being on age, as you are indicating. The response, however, was not. A lot of the writing around it seemed to be waiting for the rest of the age cohorts to catch up.
You can even see it in your headlines. "Older are highest risk, but all must act!"
I read the "all must act" as imploring the young to act to help protect the old, not to act to protect themselves. I don't ever recall reading anything ever that suggested that the age cohorts would catch up. The science was clear from even in March that fatality rate was highly coupled to age and health status.
Fair that I don't remember people directly saying the age cohorts would catch up. However, it made 0 sense for families to start only doing delivery of groceries to protect their family if the grand parents were not nearby.
I hate to harp on the stuff like masking, as we wore them, but the evidence seems clear that worrying about grade school level kids and their masking levels was completely wasted effort? Not letting kids go to playgrounds? The vast majority of "everyone is in a plastic shielded checkout?" Did that do anything?
Covid death tolls are often compared to things like WW2. In the USA there were more deaths from covid in a shorter time and this has been discussed in the sense of traumatic national experiences . I’ve always wanted to see an expected years lost statistic. People who died in world war 2 were overwhelmingly in their 20s compared to the elderly for covid.
World War I and the Spanish Flu happened immediately back to back, and the latter likely killed at least half more people than the former did.
Spanish flu also wasn’t as age-stratified as covid.
If WWII broke out in modern America, the Philippines wouldn't even have had the chance to fall to the Japanese before half the people of the United States had already decided to surrender.
Probably a ton of Gen Zers and Millennials would be rooting for Japan for purely oikophobic reasons.
oikophobic?
Xenophobia is an irrational fear and disgust of other societies, oikophobia is an irrational fear and disgust of one’s own society.
Each year's annual total of fatal drug overdoses (100-110k, average age 40-45 or so) is in the same ballpark as the sum total of covid (1M, average age 75-80 or so)
I wouldn’t say “each year’s annual total” - I don’t think any year before 2015, or maybe 2012, had anywhere near that many. The drug overdose issue is an acute one we haven’t quite been treating as acute.
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
Looks like I was about right on the timeline.
100k or is the steady state now since 2020 and with no end in sight (it's still trending up), so it feels correct to talk about it in the present tense as an ongoing phenomenon
“COVID disproportionately kills older people” definitely was reported early on, though, even before it came to the US— this fact was pretty clear in, eg: coverage of the first big outbreak in Lombardia in Italy.
I suspect that public health officials might have wanted to under-emphasize it because COVID is contagious and the behavior of people with low death risk also affected transmission rates for the higher-risk population.
I think a lot of people thought “COVID is a lot more dangerous to older people, like 3 or 4 times as deadly”, not realizing that it was more like 100 times as deadly.
But part of that is that I think people have difficulty conceptualizing numbers like 100 - I kept seeing people claim “99% survival rate” as though that is not super scary, and without realizing that even something that is more like 99.9% survival rate is probably on par with drunk driving.
Thank you! When people would tell me that it didn’t kill 99 percent of the infected, I’d be like, that could be 3.3 million Americans if we all get it. That’s bad!
To a person, my fellow army of young new 2020 poll workers signed up "so grandma doesn't have to be here", and this was common knowledge long before November.
I also worked the polls for this reason, but I'm not sure that poll workers are really representative the the general public (and hence what is "common knowledge").
I remember getting into debates about age effects with people on facebook (to be fair, also not representative the the general public), and some smart people's refusal to acknowledge the obvious drove me nuts.
I'm sure they're not, but it's the best public sample I've got—my median colleague has a STEM master's.
This lack of observation was particularly damaging with the schools. Once this observation was made, and it could have been very quickly, not only should schools have immediately been reopened, they should have been running throughout the entire summer, not only to make up for the time lost before, but to be able to have more outdoor activity, and prepare for the future in case things flared up badly during the winter (which they did).
Twenty years hence, I think our decision to not have all schools fully open by fall *2020* will look worse than every other decision and non-decision put together. Half of a ten-year cohort just deep-sixed.
The post vaccine closures in the 2021-2022 term in particular were unconscionable.
Shoot, and I even meant to write fall 2020, not fall 2021. Edited.
The only caveat I'll put on the 2020-2021 term is that many school districts had no choice but to close because too many adult teachers and staff were getting sick. But as I said, I think it looks bad enough that schools weren't reopened in *April or May* of 2020, and didn't remain open for the summer.
We did have hospitalization rate issues still in 2020 - we still had bad information(we were cleaning our groceries!) I think it's justifiable that the schools stayed closed in April & May of 2020 due to not having widespread testing yet etc.
Right, where schools were open things weren't exactly normal. My sisters teach and we're back in school Late fall of '20/ spring of 21, but everyone was getting sick, or people were exposed and had to quarantine, it was a mess, and honestly didn't seem like it was doing all that much more than remote instruction.
YES. I think an under-discussed aspect of the COVID policy response is how deeply it was tuned to protecting the lives of working PMC boomers at the expense of everybody else. All the talk of protecting the marginalized--who were mostly still forced to work in person if they weren't just laid off entirely--feels like it was a smoke screen to protect the true beneficiaries.
I'm actually coming to the belief that the whole COVID response (especially post vaccine) may not have been worth it for the few lives saved given the ongoing harms to society and the risks of future politicized pandemics caused by viruses more deadly than COVID.
And this knowledge gap still exists in many circles! It’s still common to insist that people who are immunocompromised are in grave danger from the virus and at even higher risk than elderly people. But your risk of severe Covid doubles with ever 6 years of age and being immunocompromised doubles your risk. So being immunocompromised in the more typical way means you are at the same risk as someone 6 years your senior. The exception is people who are severely immunocompromised, which means people with organ transplants, blood cancers, having no B cells as a result of leukemia treatment, having the genetic disease SCID etc. in all of those cases, covid is not unique. The flu and even a minor skin infection are also really dangerous. Being on Remicade does not raise your risk by a massive amount
I largely agree with this, but it is fundamentally true that most working-age PMC adults do interact with older people (eg their parents) on a fairly regular basis. So the “protect the elderly” tinge to some NPIs is arguably justified (at least pre-vaccine).
I think the QALY analysis is underrated. It needs to be emphasized that any death is important, but it is also essential to understand that life is about trade-offs, and the extremely old and/or individuals with huge health risks are probably in a better position to isolate themselves than, say, school-age children who need to be socialized and to attend school.
I am not an expert on suicides, but my understanding is that this is the reason it is used by epidemiologists for suicides (the nice thing about this forum is that I am sure someone can correct me if I am wrong on this). I worked as a contract analyst with a health department and was amazed at the quality of the people. They can do amazing things but that work seems to take years. It would have been nice to have the analysis in a useful timeframe.
New York had age cohort deaths very early and were releasing them weekly. Though the early pandemic was much more deadly in New York City than it was in other places.
I was wrong. It was New York City Department of Health publishing age related mortality data and it was daily at the beginning of the pandemic. The PDFs are still up.
For example:
https://www.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-03272020-2.pdf
And they were releasing all kinds of data
Here is a hospitalization records showing 16% of the hospitalizaed cases were between 17 and 44 years old.
https://www.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-hospitalizations-04092020-1.pdf
And school age children even lower. Now there is a hypothetical argument that the coming and going to schools would transmit lots of COVID but CDC never gave schools the information and tools to evaluate that cost to be set against the benefit of in-person schooling. And I'll admit that parents' (and occasionally teachers) reluctance was involved, but, again, CDC did not provide schools with tools to push back.
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 about…*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, etc…(eg I’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 he’d have found dozens of scientific papers describing the reality that most respiratory viral infection act exactly the same way…)
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 areas…was 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 right….and that makes me very sad…
"there was such a shocking unwillingness to have a semblance of a real cost/benefit debate about…*anything*"
I mean, I think that sums up Team Blue pretty well. Just look at your average environmental rule. Team Red isn't much better, but it's less salient when they aren't the ones trying to regulate every aspect of your life.
If you’re an immigrant, or hire immigrants, it’s a bit laughable to say that Team Red isn’t the one “trying to regulate every aspect of your life”.
To be fair, I suspect Kevin is saying that Rs are the ones that fanatically try to regulate a few specific things (abortion, contraception, immigration), because those are things that are passionate enough about (or hate enough) to be "worth it" to violate the core principle that regulation is bad.
Ds, on the other hand, seem to think that regulation is good, and the answer to most things, but then are willing to waive them for things *they* are most passionate about (i.e. the Floyd Protests).
Both sides are hypocrites, but in opposing ways.
Or a woman...
Another example is a lot of social justice stuff. E.g. the push to "ban the box" (limit background checks when hiring) has probably lead to fewer black people getting hired [1], but I don't think this caused the ban the box movement to pause and do a cost/benefit analysis. (Some groups do benefit from the changes, so maybe they would pass a cost/benefit anlaysis.)
[1] https://www.journals.uchicago.edu/doi/full/10.1086/705880?af=R&mobileUi=0
Matt actually just recently posted something about that research being incorrect and "ban the box" having fewer negative effects on hiring than previously believed.
Interesting. Link?
Here's Matt tweeting about it on Tuesday (link to NBER paper in tweet): :https://twitter.com/mattyglesias/status/1772686895064944927
Lol, so the conclusion of the paper is that BTB laws have zero impact whatsoever? I'm not sure if that's better than having a mixed impact, but it absolutely doesn't pass a cost-benefit analysis because the resources in advocating for the laws could have been better used elsewhere!
"Results indicate that BTB laws, any type of BTB law or BTB laws covering different types of employers, have no systematic or statistically significant association with employment of low-educated men, both young and old and across racial and ethnic groups."
that doesn't quite sound like your paraphrase. Matt's being pretty sarcastic there, IMO.
Just ask a pregnant woman!
Lasch likes to talk about a populist notion of "limits." Let's not forget that pre-stim, the EMT people were ascendant, literally arguing that limits did not exist.
I don't understand your comment. I don't know who Lasch is, I don't know what you mean by limits, I don't know what you mean by pre-stim, and I don't know what you mean by EMT. ChatGPT was able to help out with Lasch and had some idea of limits, but not the other two.
Sorry. I got an acronym wrong.
Let me try again. "Weirdo Historian of social thought, Christopher Lasch, wrote about the history of the populist movement in America. He believed one of its defining features was an acknowledgement of limits. This resonated with me. Before the inflation caused by the Covid stimulous killed it, modern monetary theory (MMT), argued essentially that there was no limit to what could be spent by government. No cost/benefit necessary.
That makes much more sense, thank you!
>Covid maximalism became a religion in the left in the same way that Covid denialism became a religion on the right<
I'm sure your are articulating a sincerely held belief. And you're not alone in this belief. But it strikes me as unjustified bothsiderism. Are there lefties out there who still won't ride planes or go to parties? In a country as large as the US you're going to find some examples of everything, sure, but for the most part the vast majority of liberals/progressives took the "vaxed and relaxed" approach, even if some of them moved more slowly than others. Also, even during the height of the crisis, what harm did covid maximalism cause in the United States? About the only thing I can think of is excessively long school closures. But realistically we weren't going to *completely* escape a period of remote learning. So what kind of "lefty harm" are we talking about on that score, an extra five months? Eight months? In limited sections of the country...
Compare that to the extra couple of hundred thousands deaths we got from our shambolic, MAGA-led "response" to the pandemic. And, unlike liberals who have gone back to living normal lives, GOP-backed vaccine denialism is *still* a very potent force here in 2024. Google "measles Florida" for proof!
The school closures are going to turn out to be far, far, far worse than you are portraying them when we get all the statistics 15 years from now, and should have been ended much earlier and weren't because the Teachers Unions are in our coalition.
I agree with you about the terrible longterm costs of right wing vaccine denialism though. That could kill us all in the next pandemic.
We are absolutely seeing this in the universities now. The students are much less prepared. And they were so coddled during Covid (late assignments were forgiven, standards were lowered, nobody was flunked or disciplined) that they expect easy As and make excuses for everything (mental health in particular is opportunistically wielded). It’s much worse than five years ago.
This. I see this every single day as an academic advisor.
Even little weird things. Librarians at a selective college in my area have had to change their library instruction - moving to sophmore year what they would have taught in the first year - because students come in not even knowing how to check out a book since 1) libraries did curbside/desk pickup and 2) high school libraries were often closed because they were used for extra space for students to spread out, places for students to do online learning when too many teachers were out sick, etc.
Yes, the demand for As is the worst I've ever seen (and it was already pretty bad). The people claiming to need some sort of accommodation is also off the chart. Once in a while, a student will just start crying in your office because they don't know how to process anything challenging. This wasn't unheard of before but definitely became more common in the last few years. I think it might be getting better now, but I don't deal with as many students as some of my colleagues to know for sure.
>The school closures are going to turn out to be far, far, far worse than you are portraying them when we get all the statistics 15 years from now<
I don't think so. Harmful? Sure. "Far far far worse?" (3 fars!). I'm skeptical.
https://jabberwocking.com/remote-learning-during-covid-was-harmful-but-limited/
But again, is it the case that we realistically could have *completely* avoided remote learning? In the face of a deadly outbreak caused by a (at the time) still not completely understood virus? I think that's not tenable. So what we're >really< debating is the >marginal< additional harm caused by whatever malign left-wing influences >prolonged< school shutdowns. And that varied from place to place. There's also a legitimate debate about what indeed was necessary. Children were at highly limited risk to covid. But that risk wasn't zero (nor was this very clearly understood in the early days). And needless to say a 59-year old math teacher doesn't have the same risk profile as a nine year old. So, while we know remote learning is inferior to in-school learning*, there's still the question of what (if any) reduction in education outcomes is justified to achieve a reduction in health risk or mortality to school employees and students. I get the impression many believe that no reduction whatsoever in education outcomes is acceptable (I'm not suggesting this is your position). But again, to me this seems unrealistic.
*We also, needless to say, didn't know as much about the impact of remote vs. in-school learning as we do now. I find this debate, like so much of the pandemic discourse, to be redolent with an air of Monday morning quarterbacking. Hindsight is always 20/20.
Yes, absolutely, three fars.
You are going to see:
1. Significant increases in youth suicide.
2. Significant learning loss that cascades through later life.
3. Significant increases in drug abuse
4. Significant increases in serious mental health disorders, from PTSD to eating disorders.
5. Significant increases in deaths of despair.
6. Significant increases in loneliness and anti-social behavior.
The numbers of people affected by this, in some cases the entire rest of their lives, and the severity of the effects are going to be awful. We basically experimented with a generation of children and that generation is going to be paying the consequences of our decision to do this for the rest of their lives. You are just going to turn out to be completely wrong about this and we are already seeing lots of signs. (Indeed, there were signs AT THE TIME we followed the teachers unions' demands and didn't reopen the schools sooner.)
I am not sure about this. Almost all of the things you list - perhaps all of them, except number 2 - were already on an upward trajectory before the pandemic. It will take some study to determine how much the pandemic influenced this and how much was the already existing trajectory.
How big of a cohort are you thinking will be adversely affected in this regard? Approximately which birth year can we start looking at after the range to compare and contrast with?
This is where we need an education expert with no dog in the fight. Because that depends on what ages kids are most susceptible to disruptions in schooling, which is an empirical question that I cannot answer.
But I am quite sure that in person schooling is important not only for educational outcomes but also for social development. Indeed, I don't think this would have ever been controversial on the Left pre-COVID. Imagine if someone had argued pre-COVID that we needed to close or get rid of public schools for some reason and could replace it with homeschooling and remote instruction! What would ANYONE on the Left had predicted would happen?
I fear we are going to indeed see all those things. I think it will hard to parse out to what extent that was from excessively long school closures vs. school closures at the worst of transmission vs. just living through a pandemic where there was both major social transitions and excess death. The kids I know who are suffering the most right now are the ones who lost multiple family members. That happened on top of isolation and loss of structure etc but it was a bigger factor that I think we discuss. Not a lot of kids died. A lot of kids were impacted by death in their family.
No we couldn't have completely avoided remote learning. The spring of 2020 was a lost cause. But my school required all faculty to be back in the classroom in Fall 2020 unless we were over 60 or had a specific medical excuse. Now, this was a university and not children, so it was much easier to enforce distancing and masking rules. Everyone got through fine - faculty and staff and students alike. I contrast this to SO many universities that stayed remote for all of 2021, and it just doesn't seem like that was necessary.
The cost/benefit curves are very different for different ages of school and different subject matters. I think a Zoom class of 700 college students is probably better than an in-person lecture of 350, and we should probably have been doing that even pre-pandemic. Small discussion classes at the college level work better in a traditional setting, but it’s hard to know whether doing it over zoom or doing it socially distanced with masks is better. (My inclination is to think Zoom is less bad, but I can’t tell how much that is me just being happy I could live in Austin for a semester rather than College Station, TX).
I don’t know how anyone thought that Zoom-based class for first and second graders would ever work.
I have no idea which side of the line high school classes would tend to fall on.
Even for university students, zoom class kinda sucked. The students were much less engaged and learned far less than in person. You could tell they were all doing other stuff. Maybe I’m a crappy zoom instructor, but I hear this from many other faculty as well.
My daughter was in high school, and Zoom classes/isolation seemed like it was pretty rough on her and her classmates. No doubt they did better than elementary school students, though.
I think that there were a couple of different factors of impact (1) actual lost substantive learning; (2) developmental delay in terms of lack of in personal socialization; and (3) loss of socialization in the norms of school in terms of attendance, behavior, and basic study skills. I think each grade cohort and some but in some cases one was bigger than the other. For my middle schooler and her peers I would rank that from most extreme to least as #2, #3, and #1. But at younger grades I think that #1 was a bigger piece of it.
We stayed remote through the end of Spring 2021, and I felt that was a reasonable compromise. Some of the staff screamed bloody murder when we were summoned back to campus in just a 3/2 in-person/remote format, though.
As the father of a kid who was in elementary school in 2021, I disagree that waiting until then to resume was a reasonable compromise.
Same as my nephews in Boston (suburban public school). They went back in April, 2021. So they did at-home schooling for about a year. Which sucked in some ways (especially for low SES students; the data suggest the impact was far more marginal in higher income households). Basically, once the vaccine queue was eliminated, teachers had to go back to school.
Which on the whole I find...reasonable?
This article is from today: https://www.nytimes.com/interactive/2024/03/29/us/chronic-absences.html. Given that we're 4 years on from the beginning of remote learning and still seeing these effects, I think three "far"s is, if anything, modest.
Regarding hindsight, there were a lot of countries that didn't close schools, or keep them closed as long as we did, so they apparently had foresight. But also it was obvious to any parent watching their kids in remote school that it was a total failure, and it must have been obvious to the teachers as well. Within a month or two of trying, the correct move was to say, "Well, we tried it and it's not working, time to try something else."
Yes. I read the article. Then I read Kevin's Drum. I found his critique measured but compelling. YMMV:
https://jabberwocking.com/remote-learning-during-covid-was-harmful-but-limited/
This link is the same one you posted yesterday, but the link I shared is from an article published today. Did he respond to that article already?
"for the most part the vast majority of liberals/progressives took the "vaxed and relaxed" approach"
Look at pictures of the audience at a meeting of the San Francisco Board of Supervisors, and then say that again. Even the loons protesting in Vanderbilt recently all had masks on.
Those two examples are textbook nutpicking - not representative of Dem voters broadly.
People who show up to the SF BOS and college protesters are definitionally nutty.
Nearly my entire NYC office refused to return to in-person work for a solid year after being vaccinated because of "fear of COVID". There are still many holdouts. Yes, it's a convenient "fear", but yeah, it's there and real.
Are you sure they aren't just using this an excuse to continue working from home?
"Excuse"? Not exactly. I think they are genuinely, conveniently afraid in a way that wow! just so happens to require they work from home. I noticed that Disney trips resumed among many. They don't seem to see a tension there.
A friend who teaches at a CUNY school said that the further a person's commute, the greater the resistance. But even this is complicated. She can walk to work. If you are spending a long time on trains and subways, it makes sense that you will be more afraid.
I didn't see any of that, though. People who lived in walking distance of our office refused to come in, just the same as those out in Westchester. I'm on Long Island and I made it in, along with one person who had a long subway ride from Brooklyn. We were pretty much it, more or less, out of around 40 people who were told to head back. That number seems impossible to me now, but yeah, it's about right. And like I said there are still holdouts, all of whom live in Manhattan.
>Yes, it's a convenient "fear", but yeah, it's there and real.<
Is it real or is it just far more pleasant to avoid a commute and work from home? I don't blame workers from trying to get the best possible deal and working conditions they can. But the freedom to work from home is in rapid retreat. (Predictably so in my view).
Doesn't seem to have hurt the US economy much, though. Easily the highest expansion in GDP per capita among the G7.
“GOP-backed vaccine denialism is *still* a very potent force here in 2024. Google ‘measles Florida’ for proof!”
Yes, do that. And search for party affiliation in Broward County, the epicenter of elementary school measles. (Of, if you can’t be bothered, it’s a very blue area.)
I don’t care about the average party affiliation of an area where 5-10% of people are unvaccinated. I want to know the party affiliation of that 5-10%.
Yeah. And in any event I was referring to the dangerous ant-science crank and RDS appointee Joseph Ladapo (FL Surgeon General).
https://www.washingtonpost.com/health/2024/02/22/florida-measles-outbreak-ladapo/
Note that it was Charles R who was making the hasty generalization.
Before Covid I would find vaccine resistance at the 5% fringe of the Left and Right. Now it seems to be 7% left and 20% right. The overlap between extremism and conspiracy thinking is high and most anti-vaxx stuff is at its heart conspiracy thinking.
Exacerbated the teen mental health crisis, learning loss, delayed healthcare, increased substance abuse - I lost a loved one to cancer that could have been treated had it been found in routine screening, she died alone because of Covid precautions. I lost people to overdoses, and I myself ended up in the hospital for mental health reasons. Delays in government work left tens of thousands in a lurch for immigration and public benefits - my best friend ended up separated from her wife in Canada for over a year. Limited shelter capacity forced thousands of people to sleep in the street. This is all just stuff I experienced directly.
What harm did COVID maximalism cost? I can tell you! It caused some people to be encouraged not to go to the doctor in person, which in turn resulted in serious health problems and potentially death - ask me how I know.
Myopically focusing on one issue, COVID deaths, without being adult enough to see the big picture is actually a really dangerous way to do public health!
And I'm telling an anecdote, but consider that above Matt posted COVID deaths comparing Sweden to other Nordic countries. But the point isn't to prevent deaths specifically, it's to prevent all deaths! Nobody cares what they died from when they're dead! And you could argue that COVID deaths actually mattered less than the average death because they largely occurred in people who actuarily didn't have a lot of years of life left.
So look up the "all cause" death statistics over the last four years. You'll find that Sweden wins in a landslide.
>And I'm telling an anecdote<
Yes.
You could keep reading for like one more sentence.
I suggest you Google for figures of cancer diagnosis rates over the Covid period and return to tell me about anecdotes.
I don’t actually see that. Can you show me?
I found this site that charts excess deaths, and it seems to show a few points in the first year of the pandemic when Sweden had far more excess deaths than Denmark or Norway, and no point after that where the countries are significantly separated. (Maybe Norway is significantly higher than the other two in 2022, but they all bounce around in overlapping lines.)
https://ourworldindata.org/grapher/excess-mortality-p-scores-projected-baseline?country=SWE~NOR~DNK
I would argue that some portion of our ongoing and high homicide and drug overdose rates are related to the left's maximalism generally. Both of those grew out of a quasi-religious adoption of left-leaning ideas during COVID. \
While I agree with many of these ideas when applied in moderation (I voted to legalize marijuana but thought de-criminalizing opioids was stupid). However, post-COVID, it was like every left-leaning idea needs to be taken to the absurd. It really was a quasi-religious period for many on both sides of the political aisle...it's just that the right will justify their crazy with religion, while the left will point and snicker without realizing they do the same thing.
True, but you ought to expect malicious irrationality from the Right. You ought not (but you have to) expect irrationality from the Left. For me, resistance to cost benefit analysis of problems is the distinction between "Liberal" and "Progressive."
I really don’t see that. What I see is a set of things where one group has views that are more out of line with cost-benefit analysis, but I don’t see the other group having any different reliance on cost-benefit analysis generally - they just don’t care as much about this set of things.
You see it even in this post, where Sweden’s number of COVID deaths is presented as evidence they did worse than their Nordic neighbors. Sweden’s overall excess deaths were lower than their Nordic neighbors because they avoided the deaths from overdose, suicide, neglect of elderly folk in nursing homes, etc. that lockdowns caused.
>Sweden’s overall excess deaths were lower than their Nordic neighbors<
That's not what the data suggests. Here's an archived article from an English language Danish periodical (from last spring) if you feel like drilling into the data.
https://archive.ph/Zucbp
Excess mortality in 2020-2022 appears to be slightly higher in Sweden than in either Denmark or Norway. And confirmed covid deaths were sharply higher in Sweden. What this almost certainly means is that in Sweden, a substantial number of old people who would have died in late 2021 or 2022 died in the first eighteen months of the pandemic, due to covid.
Sweden possesses a strong public health service and a robust state capacity that delivered an admirable response to the pandemic. That response doesn't appear to be better than those of Denmark or Norway, though, and perhaps was marginally inferior.
I can never get archive.ph to work, but here's an article that does the calculation with three different methods. In two, Sweden ends up better than Denmark and Norway, In one, Sweden ends up slightly worse.
https://www.spectator.co.uk/article/sweden-covid-and-excess-deaths-a-look-at-the-data/
The point is that COVID deaths aren't the only deaths that need to be considered when judging a COVID response, and only Sweden seemed to realize that fact in spring 2020. Even just counting deaths is poor methodology; the standard in public health is disability-adjusted life years. If a public health intervention saves two 99-year-olds from death at the cost of the death of one nineteen-year-old, most people would agree that the public health intervention is a failure.
That article specifically shows Sweden doing worse than Norway and Denmark on excess deaths compared to trend.
"because they avoided the deaths from overdose, suicide, neglect of elderly folk in nursing homes, etc. that lockdowns caused"
We don't know this, or do you have evidence to present? A bit ironic to complain about irrationality and then claim things without evidence.
Btw I agree about Sweden's response in general.
https://www.spectator.co.uk/article/sweden-covid-and-excess-deaths-a-look-at-the-data/
The article is about excess deaths, I asked you about evidence for your claim that lockdown policies led to higher numbers of suicides and overdoses in Denmark compared to Sweden.
That seems to show that Sweden performed worse than Norway and Denmark on excess deaths overall.
The main challenge with doing cost-benefit analysis in the early days of Covid was that Covid was a novel virus and there was extreme uncertainty around what the virus did to the human body and what the long term implications of an infection might be.
Consider that Scarlet Fever killed its victims in 2 waves, the first at initial infection, with a second wave of death 10-20 years later due to the heart damage caused by that initial infection. Epstein Bar virus causes MS decades after infection. Chicken Pox causes Shingles years later. Calculating the true cost of getting a novel disease is impossible early on.
IMO, for at least the first several months of Covid, and maybe up to the vaccine, making these decisions using the precautionary principle made a lot of sense, even as we now know that Covid didn't turn out as bad as some scientists feared it might. (not to diminish the costs of long covid on some people, but I think it's fair to say even that is not as bad as some feared it could be).
I mostly agree with this - just not the timetable - Taking extreme care early on - making some policy mistakes along the way, overreacting in some cases in the first in 6-8 weeks were all forgivable…but it emerged early that a) it was going to be around for a long time, b) that the *vast* majority of people recovered, and c) the old/fat/sick were most vulnerable. Yes - we didn’t know longterm effects, but this thing didn’t come from space - we have lots of experience with similar bugs - could have made inferences that severe issues would be pretty rare . (Another fact that came as a surprise to many people…that ALL infections - cold, flu, strep, whatever - cause tissue damage…and in the worst cases could shorten your life)
“If we prevent one child dying it’s worth doing XYZ intervention!!” was the refrain - but - well…no. That’s just not the way the world works. And again that seemed to be a shock to many people.
Policy is always about balancing benefit and risk. We all implicitly accept that a certain number of people *will* die or get injured in the course of every day life…on the highways, in swimming pools, from food-borne illnesses…and we tolerate that risk because roads and pools and ski lifts and playgrounds and canned food and medication are part of living in this world. Risk is a part of living.
But that basic idea seemed completely foreign to some very smart people in my tribe - and out of their naïveté Covid became this weird bete noire - we must not get it. No measure to fight it was enough. People who couldn’t be bothered to get a flu shot for their kid said: who needs school? Who needs friends? One mask? Why not two!? No cost was ever too high , no burden was too great to bear….and they pushed that childlike approach on to the rest of us.
TRUST SCIENCE until science says you don't need to wear a mask anymore, then "FUCK SCIENCE, I'll keep wearing this mask anyway because it's how I show people I'm a good person."
I don't recall this "mask science" saying one thing or another since it's just a method.
"Just as"... come on now.
Covid is still spread decently well by asymptomatic people. I don't know if your point is that covid isn't unique in that, which it isn't, but I initially read your comment as saying it doesn't spread asymptomatically. Just wanted to clarify that for anyone else eho read it the same way
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8654597/
I actually think that crisis response can be very revealing. For me, the most depressing thing about supposedly-neutral institutions’ response to COVID is that they basically adopted a new attitude: they’ll sometimes be trustworthy, but they might distort things to help Team Blue. As long as they aren’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 isn’t as bad as Fox, or if the CDC isn’t as bad as Trump’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.
That open letter about the Floyd protests did a ton of damage to our public health system because it was so obviously politically motivated lying.
You have to have institutions that don't get involved in politics. Everyone wants to use their position to influence politics but if they all try to you have no trust in institutions.
> You have to have institutions that don't get involved in politics.
As a scientist, this is something that has infuriated me to no end. For example, two of the most esteemed scientific journals (Nature and Science) now weigh in on political matters when it suits their editors (in a predictable direction of course). They're collectively throwing away *our* legitimacy with half of the country for nothing but a little dopamine rush from tweeting the articles out.
Yes, I agree that the open letter was bad, but as far as I know it was put out by a bunch of epidemiologists and health care workers; it wasn't the official statement of any institution. And I had no idea what percentage of epidemiologists signed on to it. The worst thing about it was that it was so transparently political is that it gave people who wanted to disbelieve anything any government body said a pretext for doing so.
The key problem is that they got so much publicity for it. In other words, sure they weren't the people actually in charge of COVID policy, but they portrayed themselves as subject matter experts and signed something that was such a transparent piece of non-scientific political hackery that they gave all of academia and all of public health a bad name.
And yes, it just became Exhibit A for anyone inclined to distrust public health in the first place.
Yes! I started out the pandemic basically believing that CDC and other govt officials were fundamentally honest and acting in good faith, even if they made big mistakes sometimes, or were subconsciously beholden to certain ideologies I don’t share. I ended it reading their statements much more cynically, calibrating by the political affiliation/goals of the speaker, their understanding of pop psychology, and a bunch of other factors I don’t understand well. Basically, I now have much less confidence that these people are telling me the truth as they privately understand it.
Fauci’s statements regarding herd immunity goalposts are a particularly striking example of this:
https://www.nytimes.com/2020/12/24/health/herd-immunity-covid-coronavirus.html
My favorite quote from the article:
‘ “When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent,” Dr. Fauci said. “Then, when newer surveys said 60 percent or more would take it, I thought, ‘I can nudge this up a bit,’ so I went to 80, 85….. We really don’t know what the real number is.”’
Translation: “A large percentage of my public statements are outright lies, and there is no way for you to know which ones.”
I also think that many of us who were drifting left, or very moderate because we were disgusted with how Republican institutions behaved post Trump, this was a frightening revelation.
Basically, the right is crazy and will kind of admit it...it might be couched in religious terms or other ways, but it is fairly obvious. The scary thing about left-leaning crazy is that they like to frame it as "science" or "expertise." Given that I rely on science and cannot have a high degree of expertise in every field that I might need to have an opinion on, I find the hidden bias more frightening. I cannot easily tell if it's crazy or if I am being misled by my primary source of information. It is much worse than having someone point to a bible verse that I can interpret on my own.
I am kind of like this right now with search and AI. I am wondering what is being guided, influenced, withheld, etc. in tools I rely on to make sense of the world around me.
Reading through the comments gives me the sense that MY is missing one big component of the public reaction here. It’s all personal! Matt writes about a few personal moments where he was frustrated but doesn’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. I’d seen the truck for about a week and never made the connection that that’s what it was. Scary! This was early enough that we didn’t really know who was most at risk and it was also at the point where the hospital didn’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 “the system” 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 wouldn’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: you’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 “the system”.
- 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 they’re older and we knew by then older people were at greater risk. For “interesting” reasons I’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 who’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. They’d just bought a house in the Villages. And look, maybe it was a false positive but, like, you’re going to the oldest place on earth and you have good cause to believe you’ve got a virus we know is pretty bad for old people. Why be that jerk? And of course the lie, but that’s something I’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 we’re sick, they ask why we got the vaccine if it’s didn’t work) and even told my wife, at that point a fully board certified practicing physician, that she didn’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 they’re afraid of vaccines and don’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 SB’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. You’d think we killed somebody they were so furious. And look, maybe that’s the wrong call. Maybe we should have just asked if they were feeling sick and that’s good enough but, you know, they lie about that kind of thing. Again, we patched things up and they’ve had many lovely visits from the baby since she’s been six months old but this is still part of that weird pandemic hangover.
Yeah, this is all just one guy’s experience it’s you can’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. It’s often interpersonal, familial, or related to careers people care about. Some congressional report isn’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.
Congratulations on your future baby! Happy to have helped. And I'm saddened to hear how poorly your parents are acting.
Congrats on your kids! And what a lovely thing to hear that it was inspired in some part by comments here.
Two points related to the senior docs not being willing to come into the hospital or work on COVID wards:
1) I staffed a board where one of the members was the CEO of a major university hospital system. The first week of March 2020 he was asked to give an update on what was happening, and what the hospital was doing. Essentially, he said it was going to be bad but they had been preparing since January when word first started to come out of China about what was happening there. But what still sticks with me from his remarks is saying that by the second week of February they had to put all PPE and disinfectants under lock and key because it was being stolen in mass. The only people with access were doctors and nurses.
2) My friend started a surgical residency at the same hospital beginning in 2020. He ended up staffing the COVID ward--very very far outside of his residency and expertise--because the docs who normally would have been assigned refused. He ended up meeting a fellow resident in the same situation, who eventually became his husband. To this day, he is deeply angry about the behavior of those older docs and won't talk much about it.
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.
You now have the ACLU trying to broadly undermine labor rights because they want to defend an illegal retaliatory firing.
To what do you refer?
The ACLU fired a woman who complained about sexist and toxic work culture at the ACLU. They are claiming she was fired for racist behavior but the cherry picked examples they use are so absurdly stretched. The woman has protections under the NLRA and the ACLU is trying to broadly argue that their selected arbitration process should be used in place.
Look it up if you want an example as to why the ACLU has gone off the deep end. (For me it was their leadership claiming that all these groups OTHER than women are disparately affected by the overturning of Roe v Wade. And yes the ACLU list includes groups that cannot give birth.)
I never recalled the ACLU ever being ardently pro-labor.
And yes, bowdlerizing the word women out of Ginsburg's opinion was ridiculously bad.
It was baffling.
The ACLU represented the NRA at the Supreme Court last week.
To rephrase your latter bit somewhat, it feels like it turned "trust the experts for narrow advice" (good) into "trust the experts to make broad policy" (not their wheelhouse).
This applies to Climate Change experts equally as well.
Hundred percent, yes. All interesting questions involve tradeoffs, and to become a true expert in a field, you are almost foreclosed from learning deeply about other things just because there are only so many hours in a day.
I agree with this whole heartedly. The main issue is that domain experts usually have little or no training in public policy or in real-time decision making under conditions of great uncertainty. This deficiency is often exacerbated by domain experts having lots of unjustified hubris or at least a lack of humility about the inherent unreliability and incompleteness of their data and their models.
This stuff reminds me of an economics problem called the Annuity Puzzle. Basically, economists built a complex model using something called Utility Theory to predict how often consumers should buy income annuities to fund their retirement. The model has a bunch of assumptions about consumer behavior and preferences. When real world data showed consumers buy annuities much less than their model projected, they spent decades trying to figure out why consumers were so irrational, rather than focusing mainly on the reliability of the model and their assumptions.
https://popstudies.stanford.edu/news/solving-annuity-puzzle
I'll bring up my (probably non-representative) experience with a Floyd protest. There were a few thousand people, and as far as I could tell, virtually everyone was wearing a mask and making some effort to not bunch up. Organizers walked around offering masks and hand sanitizer, and asking people to pull the mask over their nose and to stay home if they were sick. Overall, it was pretty well organized.
I imagine that the Twitter public health types would've seen it as an example to be followed. I don't know how representative this kind of demonstration was, compared to others around the country. However, that reflects such a disasterous feature of our discourse. Because of our fragmented and social media-dominated news landscape (and I place some but certainly not all blame on Trump), there's very little room for either nuance or a unifying message. Both dynamics feed into each other as people get angrier and angrier.
It wasn't that the Floyd protests were a covid problem (and in retrospect, it seems clear they weren't). It was the medical establishment saying that going to a protest is okay because racism is also an epidemic that was the problem.
I think that it's nuanced messaging being impossible on Twitter. People's nuanced opinions get flattened into tweets, and people equate everything you're saying with whatever sound bites come from the same vaguely described group, even if you don't agree with those people in something.
How much of the discourse around Floyd protests was driven by this flattening of nuance and how much was genuine cognitive dissonance? Idk, I'm sure you can pull up a few examples, but how much did that matter in our disintermediated media? I don't think that it's possible to say. I agree that people should try not to be hypocrites, and they should be nudged away from it, but people who like to argue about things online focus on it way too much. It's very easy to confuse these other trends with hypocrisy and blow that up. "Listening to experts" is a lot more useful when you don't use stuff like Twitter.
The letter, signed by over 1,000 health professionals, wasn't on Twitter. It was a real statement that has this lovely section:
"We support [the protests] as vital to the national public health and to the threatened health specifically of Black people in the United States. We can show that support by facilitating safest protesting practices without detracting from demonstrators’ ability to gather and demand change. This should not be confused with a permissive stance on all gatherings, particularly protests against stay-home orders."
The problem with anti-lockdown protests wasn't just that people were gathering outdoors, and importantly, it took a little while for people to notice how much harder outdoor transmission was than indoor transmission. The problem was that the goal was to make it easier for people to interact indoors. That's not inconsistent!
Public health experts did a bad job communicating cost-benefit thinking. I agree. I don't think that it's weird to see protesting racism as more important than protesting restrictions on in-person gatherings. You can disagree, but that's not necessarily cognitive dissonance.
In the law, that is called "viewpoint discrimination".
I do disagree, but more critically: health care professionals should not attempt to pick and choose among motivations for demonstrating.
The problem is, even with masks and sanitizer, and doing the protests outside, participants are still raising the potential spread of COVID by a non-trivial amount. That's fine - it's an acknowledgement that some public policy benefits outweigh the costs of greater COVID spread.
The issue is this logic was not applied to any other public policy domain, nor was the CBA done in way that appeared neutral or at all systematic. A bunch of bureaucrats reflexively decided that racial justice was the one area we could eat the potential costs of COVID, not for any well-reasoned or justified public policy reasons but based on supercharged, emotional rhetoric.
There really were two George Floyd protests...the ones while it was light was generally consistent with your view (and probably the ones the health experts viewed). The ones after dark were like rave having a baby with an anarchist convention. A bunch of young people who could not go the bars and decided to trash the city instead...
Agrees as he folds up his tin hat
Nobody made anybody else into a conspiratorial loon. That is a choice made freely.
I agree no one MADE anybody else into a conspiratorial loon, but I don't see how it can be disputed that a tendency toward conspiracism is influenced by the social environment people are in. (E.g., it's been observed for decades that rates of belief in conspiracy theories are much higher in societies without free media.)
OK but conservatives live in the same social environment as the rest of us.
They don't!
If you watch "blue" media you will get VERY different information than if you watch "red" media. Its a big part of the problem.
Actually, they can influence conspiracy. When trusted experts behave dishonestly, they create ambiguity that can then make it more difficult for people to distinguish between conspiracy and fact. Even when experts are honestly just wrong (a lot of what happened during COVID) it can feed conspiracy.
When doing public information work on high-profile incidents, a lot of professionals go to great lengths to avoid releasing statements until they are sure they are accurate. The main reason for this (including withholding information that would have helped us) was that they do not want to release anything and then later retract it. If retracted it, it would create conspiracy theories and feed the beast...
None of that explains why conservatives were uniquely prone to conspiracism.
Nope—it doesn't—but it offers a path toward limiting that tendency. I am guessing we are of the same age, and I can remember a time when the left was the big conspiracy club. Some groups will always have more conspiracy-minded folks. It's just important to remember that it's not binary. Things we do influence the size and power of that group.
For me the biggest surprise was CDC incompetence. Since I watched Contagion a decent number of times it was always jarring the gap between “movie CDC” and real CDC. These people had supposedly been preparing for a flu pandemic for the last 20 years but didn’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.
Ronald Reagan gutted CDC leadership. It used to be independent like the Fed but Reagan pushed to make leadership political appointees rather than medical experts because the CDC tried to combat AIDS and prevent it from becoming endemic.
That may be true but it’s irrelevant to their performance during pandemic. It’s not like some dumb political appointee cut the resources to develop COVID tests. They had the resources they just screwed up.
You are missing the point. The role of the CDC changed from disease prevention to managing optics for POTUS.
The decisions made by leadership are political due to the reform, not public health related.
No I am specifically referring to their botching of COVID tests which had nothing to do with any political leadership decisions: https://www.npr.org/2020/11/06/929078678/cdc-report-officials-knew-coronavirus-test-was-flawed-but-released-it-anyway
Solid point—all the more reason to have the COVID commission as Matt mentions.
I am not a huge Fauci fan, but I have wondered if the stress of moderating Trump's crazy is one of the reasons he did so many stupid things. We can all only take so much stress, so when he saw Trump saying/doing stupid things, I wondered if the "Trump Derangement Syndrome" influenced him to do go in the opposite direction. I thought the same thing with travel restrictions...because Trump was being racist about them, a lot of people just disregarded the policy...
Seems relevant that covid is not a flu virus.
No, it really isn’t. Masks have moderate effectiveness for flu and covid, and both are airborne, and even though we’ve had many decades to study flu, the public health establishment failed to do that right, and this shaped their poor response to COVID.
Covid isn't flu. But it is a Coronavirus and we have had hundreds of years of experience with those about half of the viruses that cause "common cold" are old Coronavirus. (Interestingly, it appears that many of them can be traced back to localized outbreaks when they were new that causes a lot of death.) We do know quite a bit about how these spread and it is similar to the flu. What I think we didn't expect was that Covid mutated a lot more than most coronaviruses normally do now and acted more like flu in that way. It is possible that our current coronaviruses actually mutated a bunch early in their introduction to humans and then stablized and Covid will do the same but at this point, its mutation and what that means in terms of vaccine effectiveness at stopping infection vs. reducing severity is limited.
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.
Just an FYI, this writeup from Astral Codex Ten today presents a convincing (to me) argument for zoonosis:
https://open.substack.com/pub/astralcodexten/p/practically-a-book-review-rootclaim
I always thought zoonosis was the most likely, lab-leak (or, more accurately, lab-mediated zoonosis since I figured it was a wild virus) was plausible. The extreme reaction against it was frustrating.
It’s not racist; there’s not a culture in the world I trust to research exotic animal viruses without the risk of human exposure and transmission. It’s just that normal zoonosis is so, so damn common.
The best I could say about a potential American lab leak is that I would expect less cover-up (or at least less effective cover ups).
It doesn't matter if it happened or not. Any chance beyond 1 percent would have stopped all of this research to a screeching halt and worldwide investigations if it wasn't freaking China
This is awesome. I was at ~15% chance of a lab leak a few years ago and then updated to 1% or less two years ago based on the evidence that I saw at the time (I found my old comment to confirm the numbers). While I wouldn't have had the stomach to bet $100k on it, I still felt like Matt and many others were way too credulous. I think they overindexed on being told "lab leak" was racist (a stupid claim) and then failed to objectively evaluate evidence that came out since.
“ 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.”
I don’t follow the reasoning here. Surely a vaccine that is 70% effective could still be relevant to mandate, even if it’s not 95% effective, right?
Also, even if it doesn't do that much to block transmission it does do a lot to reduce the severity of cases which can matter a lot for hospital loading, etc. which in turn has plenty of knock-on effects.
I think that the difference is that there was hope that a vaccine might be effective enough that being around someone who was vaccinated would dramatically reduce your risk of getting infection to something approaching zero -- like measles. But with a rapidly mutating virus the vaccine worked more like a flu vaccine. It would somewhat reduce your chances of getting sick or spreading the illness but not make that negligible but it would dramatically reduce your changes of becoming dangerously ill. I think the vaccine mandates originally were based on the idea that you were safe as long as you were around all vaccinated people and it quickly became clear that wasn't the case. I personally still supported vaccine mandates because it still made you safer in the sense that would be less likely to get ill and less likely to carry a heavier viral load and I was okay limiting stuff to people who were willing to do reasonable things to make things more safe even if it wasn't a guarantee that it would prevent all spread.
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.
====
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.
Lots of great stuff here, City of Trees!
I want to signal-boost this: "Masks... 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." 100% agree!
Re: why antivaxxery is so prevalent, one hypothesis I've heard (not sure if true, but sounds plausible) is that lots of people are scared of needles, and "vaccines are a hoax!" may be less embarrassing to say in some circles (not liberal PMC circles, obviously) than "I refuse to get the vaccine because I'm scared of injections." Solution: we need an effective intranasal spray vaccine!
It really bothers me that the medical establishment seems to refuse to consider that fear of needles is something to try to work around! Why have intranasal flu vaccines been restricted to special needs populations for so long?!
They're not very good as vaccines. One could ask why we haven't put more behind making them better, but I think that intranasal vaccines are simply more difficult and less effective.
Thanks! I thought I was losing my mind at times trying to explain the inherent anti-social nature of masks to some people.
Fear of needles is certainly a thing, but I wonder how many of those people are just being quietly averse, instead of using a wacky conspiracy theory that makes them look nuts to mask their aversion. Vaccines seem unusually susceptible to conspiracy theories, and there are a ton of them out there, with at least one out there for every common ideology.
I'm spitballing here, but maybe it's because in order for vaccines to truly obtain herd immunity, you need to have everyone take them, and while in other cases we can just ignore the conspiracy theorists, we can't here, and that causes them to get expectionally riled up over what conspiracy they think is hurting us all.
The thing about masks and Covid is that masking in social situations is horrible and Covid spreads primarily via social interaction. For some reason, lots of people just glossed over this very obvious tension.
Regarding 11-15, I really do think that anti-vaccine mindsets need to be researched. Like drosophilist says I think that fear of needles may be one factor, but I suspect there's something further.
I think two factors were huge:
-Political polarization is bad enough now that anti-COVID measures being slightly left-coded was enough to cause some people to oppose vaccines purely out of spiteful partisanship.
-Conspiracy theories are fun and interesting, and any new, large government program is a fertile place to make up conspiracy theories.
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".
I think a lot of initial COVID coverage, and backlash to that coverage in the US, doesn't really process how bad it was in NYC compared to everyone else in the country. The healthcare system was actually on the brink. Medical staff had to be shipped in, there were trailers full of corpses, and I remember seeing images of (temporary) mass graves. It was bad, but the media is fairly concentrated in NYC, so the world sees that more than what happened in Dayton.
By the time lockdowns became more divisive in the late spring/summer, there was a some idea of how to handle it. Outdoor interaction was a lot less risky than indoor. Masks (if you knew what you were doing) were better and easier to get a hold of. People could choose their in-person interactions more easily in the Sun-Belt than in NYC in March. There was a lot of handwringing over COVID laxness when it moved south over the summer, but that was more of a policy choice than what was sprung on NYC in March.
Yeah, I can rationally understand how it must have been different to be elsewhere... In March/April 2020 though, it was really hard to watch the daily death toll just keep rising, and projecting that chart out, thinking about what that scale of death would look like nationally based on what was happening in NYC - it was really bleak.
And it was frustrating, being inside what was happening in NY, having known what had happened in Italy and in China already, and seeing other parts of the US just pretend it wasn't going to happen to them next.
I feel like a lot of people have gotten revisionist, and what they remember is actually what came later - "vaxxed and relaxed" with some immunity and a weaker (though more contagious) variant. Also, remember we probably had an undercount of how many people were infected, so the mortality rate seemed very high. If you were there in March and April and watching the death toll rise, you had every reason to expect complete disaster if nothing was done.
I agree. I lived in Upstate NY at the time, and it was very scary. I remember telling my partner to stock up on food in early March (I knew somebody in Hong Kong, and he said it was going to be really bad) and the canned food was just gone. Things kind of just came to a halt. Still, I didn't know anyone directly who got seriously ill in those first weeks. My main experience at the time was finishing my thesis and playing Animal Crossing. 20,000 New Yorkers died in 3 months.
I sometimes wonder how different NYC would have been if every resident somehow had their own front door directly out into fresh air, with no other changes.
I remember how surreal it was to see the news out of NY and be in Seattle where we actually got Covid earlier but had a much better run overall than most of the country. I kept waiting for NY like conditions to hit and they never did.
I really do think that one of the differences was testing. It didn't seem to get much national coverage but the University of Washington basically went rouge and tests thousands of flu samples that they had gotten for our annual flu surveillance studies for COVID without prior approval from patients and against the express instructions of the CDC. They found a lot of COVID from people who had relatively mild cases that had not required hospitalization and been misdiagnosed as flu. Those people were all contacted and their contacts put under quarantine. So that there was this weird disconnect where people in Seattle all seemed to know a bunch of people who had already had Covid and been sick but survived and almost no one who had died watching it kill all these people in NY. I still wonder if the virus that hit NY from Italy wasn't mutated to be more deadly than the one that hit the West Coast directly from China.
I think the most plausible difference between the outcomes in NYC verse Seattle is that Seattle shut down many large public and private institutions by March 5th whereas Mayor De Blasio was publically encouraging people to continue as normal on March 10th. NYC's week plus delay in enacting a public health strategy relative to Seattle meant about 2 extra cycles of doubling in NYC before significant action was taken to bend the curve. I think NYC's initial Covid spike reflects that.
In any case, even if a national retro on the pandemic is impractical it is likely worthwhile for large cosmopolitan cities to reflect on what went well and poorly in their early response to Covid so that they can do better next time.
Agreed. That earlier shutdown was directly related to thost UW tests. We knew by March 5th that we had an explosion of cases because we knew about so many mild cases that were going undetected anywhere else. Seattle isn't a huge city and by March 5th pretty much everyone at least knew someone who knew some who had already been infected with Covid. I had already been put on Quarantine because I had spent hours with patient #70 in the US. My cousin had already been quarantined completely independently from an exposure at the building where he was a security guard and was symptomatic with presumed Covid.
If we had only had the information that folks in NY had, neither of them would have been presumed to have anything but a really nasty cold and we would have just thought we had two or three hospitalized cases with no deaths. I can understand how that different is the sense of the size of the threat would really impact the speed at which public health would feel the need to act and the willingness of the public to go along with it. Although to be fair to NY our economic base transferred better to online that NY's in some ways so there was also less industry push back.
My main sense is that some private soul searching has gone on in public health in WA and King County even if there hasn't been a full post-mortem. The main lessons that I think they feel they learned was (1) they cannot count on a fully functional federal government to help in a crisis and should expect to have to go it alone and even break rules (2) They need to maintain good and close relationships with the West Coast Alliance that was put together with Washington and Oregon to have the critical mass necessary to do their own response work including independent vaccine assessments and test protocols (3) They need to be constantly monitoring for virus trends by doing frequent testing and sequencing of representative sample of folks who present as sick and wastewater, (4) they can best build trust with the public by being transparent with data and clear about recommendations, and (5) the local population has the stomach for public health measures that are strict if the results are good. (We had very strict rules and there were small protests but all the officials in charge won against candidates running that challenged them on that and won primarily by pointing out how many more of us would be dead if we lived in anywhere else.)
You can already see some of these changes. The public health "dashboard" that used to provide amazingly detailed data on Covid in a partnership with Tableau that would let you make a chart to answer almost any question you could ask and remained up but expanded to cover RSV and Flu. You can see in real time rates of diagnosis, hospitalizations, and waste water levels for every zip code and the requests that people provide a swab for public health now are offered to everyone who presents at a doctor with any potential virus.
I also think it accelerated a sense that had started in 2016 that most folks trust the State government much more than the Feds and in many ways view State law and State officials as the best way to protect citizens from the federal actions that they view as harmful on reproductive rights, LGBTQ, environmental regulations, and immigration crackdowns. There is pretty constant messaging at the State and Local level that folks don't need to worry about any of those things because the State has its own rules and frankly isn't planning to cooperate with the Feds on anything they don't agree with.
Ironically our incredibly high testing levels which were again supported by a huge testing capacity at the UW also meant that many people had a better sense of what Covid looked like than it seems like was true many places. By March 5th I could have told you that the main difference between how Covid presents and other colds or flus would be (1) loss of taste and smell, (2) cough combined with what felt like decreased overall lung capacity, and (3) fever that came and went but most struck at night. It felt like it took a long time for those telltale signs to be part of the widespread national discussion. Ironically, I also started socializing outside early because it was apparent that it didn't spread well outside because I knew so many people with mild cases and no one had gotten it that way and we were seeing almost no cases in our homeless population despite very intense efforts at regular testing and doing Covid, the homeless were basically not allowed to spend anytime indoors anywhere.
I'm sorry that you have to have that memory. My keenest memory from 2020 is starting my morning at work calling morgues looking for my clients and buying groceries for clients because the foodbanks were empty. What a brutal, horrible year.
My memories are all about life getting so much busier as all my volunteer jobs got so much more intense. My old PTA job of collecting snack packs from the food bank for kids to take home on Fridays because a home delivery service of more than 120 boxes of food all over the neighborhood each week. My volunteer work our our local day shelter on Wednesday evenings turned into an all hands on deck effort to set up distributions of hot food, camping gear, outdoor medical care, PPE, and testing trying to figure out protocols to keep us safe on the fly. Even my job as a salmon steward feeding the fry one a week at the imprint pond got nuts. The afternoon that they closed Seattle Schools, I got a call that me and my 11 year old daughter had been designated as "essential staff" by Washington State Fish and Wildlife and needed to go immediately to the imprint pond because they needed to collect all the hatchery eggs and fry from every Seattle public school by midnight and put them in imprint pond before the schools were locked for a three day deep clean or we risked losing the whole hatchery supported salmon population for the year. I sat in that park with my daughter until 11 pm that night in the pitch black counting individual fry as we released them into the pond. And there were 47,000 of them! It was insane. And then, during the park closure having to hike 3 miles each time I went for a now twice a week feed.
I remember seeing all these people online watching Tiger King or learning to bake bread and thinking who crazy it was that we were having such different pandemic experiences.
I’ve lived in NYC for 14 years now and spent most of my life in the are. I don’t know a single person who died of COVID aside from a family friend’s great aunt who was in her 80s and just had a stroke. My uncle who would die within a year from early onset Alzheimer’s had it and was fine. My friend’s grandma who was terminal with lung cancer had it twice and survived.
Also you could hear the sirens more because there wasn’t any other traffic or background noise. I remember how eerily quiet the city was.
I also lived in NYC in Spring 2020, and I have the same memories of constant ambulance sirens. It was a really grim time.
"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 didn’t want to talk about it anymore.”"
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.
Glad to hear this said. I think an intra-CDC investigation undertaken in good faith might yield helpful improvements. Same for the FDA. A government-wide “inquiry” would just be a partisan shit show.
Yeah, this was very odd - but characteristic of what I have come to expect from UK politics, which is unbelievably petty and can be summed up by "no, you!"
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.
The CNN chyron saying to stay indoors unless you are going to a protest is burned into my brain as one of the few times in my life I felt I fully understood Trump voters. I would not underestimate the effect of this laughable hypocrisy.
Sorry if this is obvious/banal, but unless you’re an evil dystopian totalitarian state, you’re going to have a really hard time enforcing any rule that the *majority* of the population disagrees with. This isn’t about federal vs state vs local, this is “what would you do if 50% or more of the people refused to obey the rules.” Like, it’s just not realistic to enforce super stringent measures. Also, even if you did have state capacity, how would you punish people? Put them in jail? Great idea, let’s put them in a place that has the perfect conditions for rapid COVID spread.
> unless you’re an evil dystopian totalitarian state, you’re going to have a really hard time enforcing any rule that the *majority* of the population disagrees with.
While true I think that misses the point a bit. There are tons of rules that the vast majority agrees with but, it turns out, the state doesn't have anything like the capacity to actually enforce. Because it appears no one is willing to pay the price (both in budget for the manpower but also for the curtailed liberties) for that level of enforcement.
Matt mentioned the current school truancy issues, which I don't think are caused by some widespread disagreement with mandatory schooling but simply lack of manpower to aggressively enforce it.
But for even more clear cut examples look at almost everything regarding financial laws, which most people agree with, but no one wants a massive government bureaucracy inspecting all of your financial transactions so we've ended up in this weird situation where we've made every financial institution a kind of deputized extension of law enforcement.
I think Covid (along with the general declining trust levels and turbocharged by social media) has shown how much our society runs on voluntary compliance with laws and how easy it is to get away with not following them.
I don't think it was exactly a secret or anything -- people sped in cars, people cheated on taxes -- but something about Covid put it much more in your face on a daily basis that (IMHO) has resulted in a bit of a step-change.
Anyone worried about an authoritarian America should take great comfort in COVID and the protests. Both revealed how little state capacity exists to enforce anything. Look at a protest in Europe with batons flying and water cannon washing down crowds. In the US the police could not manage crowds of a few thousand people.
Also, just to clarify...I think this is a good thing. If we cannot get a large majority of people to believe/behave in a certain way, it is probably not worth the time to compel them to do so (in most cases). In almost all cases the energy spent on compelling people for short-term, limited compliance would be better spent on convincing people...you would have fewer converts but they would be more likely to comply in a meaningful and long-term way.
I don't see any disagreement we have here--state and local governments likely also lacked sufficient state capacity in this regard, but they have much more of it than the feds do. My main point is that I think the left/right valence on pandemic attitude would have largely been the same regardless of who was in charge in DC or what they did.
Plus, Americans really are not good rule followers. For good a lot of the time and for bad some of the time...People in America do what they want. I think this has become a little more right-coded than left-coded, at least on some issues (i.e., not related to race/gender, etc.)...so I agree that right-wing folks would have been more inclined to fight broad government interventions...while left leaning folks would have fought "The Man." In this case "The Man" presumably would have been Trump, who would have been accused of using the pandemic to advance his authoritarian agenda (which actually would have been a good way for him to do it...not good in an ethical sense but effective).
Most of what you wrote is great, but this was dead wrong: “blue state parents, especially non-white ones, were reluctant to send their kids to school, and that’s an important reason they stayed closed.”
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. That’s why the early FCPS rhetoric was not that they would stay closed until fall 2021, it was “we’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 we’ll open after that.”
When people make the claim that non-white, blue area parents wanted virtual, they’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.
You're right about how things went in Fairfax specifically, but even if most people talking about racial discrepancies are using later surveys, those aren't the only surveys that exist. This article is from July 2020 and it already includes polls showing large racial discrepancies in views on school reopening:
https://www.chalkbeat.org/2020/7/14/21324873/school-closure-reopening-parents-surveys/
I have always been trying to figure out why it was said that more non-White parents wanted schools to be closed. It never made sense to me intuitively. Thanks for this, and I would also appreciate anyone else who has a good counter explanation as well.
I don't have an explanation, but our school district is mostly poor, and 80% non-white, and parents were definitely reluctant to send their kids back. When given the choice, more families chose to keep their kids at home than send them in-person.
People I talked to gave some reasons - they tend to live in multi-generational homes - especially immigrant families; they felt very exposed in other areas of their lives, so wanted to at least limit exposure at school; some wanted to reduce the chance of getting sick so they could continue to work - many were making decent bank because so many people were out of the workforce. Also they felt as though they wouldn't get good care if they got sick. I don't think any of those are a complete explanation, though.
Fascinating. The way I've been looking at it is that schools are a critical resource for parents to have a place for their kids to be so that they can go make a living. But I likely have this completely wrong, and there's some good clues in there, thanks.
I found that non-white parents were much more likely to be okay leaving their kids home alone or with older siblings while white parents felt like they needed to always have an adult with their kids. I sensed that a lot of white parents wanted their kids in school because it was impossible to watch them and get remote work done. I was running a basic needs drop off program for kids at my daughter's elementary school for the first year. We would drop off two boxes of food from the local food bank for each family along with books, hygiene items, and school work. I was sort of shocked at first by how many times it was a third grader staying home by themselves who answered the door. When I thought about it, I was only in 4th grade when I started babysitting and they were probably just fine. I just knew that the parenting norms among by wealthier white friends would not have felt like an 8 year old home alone all day was okay.
One part that's not talked about much: in many of these households (which are disproportionately lower-income), teenagers became a crucial part of the household income during closures. School is closed, teen is "attending" virtual school while working a cash register at Chipotle. Because of rampant grade inflation during virtual school, teen is getting better grades than ever.
If the choice is the teen going back in person and the family losing their house because they can't make rent, and teen staying virtual and the family keeps making their rent... yeah, I'd send the teen to work too. Many of these teens have now dropped out (officially or unofficially) and entered the workforce, a trend which the labor shortages (and high wages) of the last two years has accelerated.
There's a McDonalds near my house where the kid who is *always* manning the drive thru (including during school hours) looks to be about fourteen years old.
Another fascinating angle, thanks.
In my limited experience of talking to the families for whom I was doing remote family support for my kid's elementary school, I think part of this was that a lot more of them knew someone who died. As of July 2020, the death rate per capita for different groups was something like Latino people were five times more likely to die than White people, while Native people were four times more likely and Black people were roughly three times more likely. I think these rates probably somewhat reflected different rates of underlying health but mostly whether people's jobs exposed them to the public. I think the trauma of the pandemic lands different if you were a white remote worker who knows someone whose grandma died or a Latino grocery clerk who lost four family members. I also think these families fundamentally didn't believe that schools would care about keeping their kids safe from covid.
That makes sense.
As Milan pointed out, the only pro-mask, anti-vaccine segment in reality in America seems to be segments of the non-white population.
It’s definitely true. The only people I see still wearing masks on public transit are disproportionately older Black people.
Of all the places to continue wearing masks, public transit seems to be the most reasonable to me.
Do you know why?
Lower social trust in vaccines, age-related health concerns? Not really sure.
Yeah, I'm trying to figure it out as well, particularly in the context of whether or not to close schools.
Adding on to what another poster said, our schools were open and in Florida we were quite forcefully advocating for kids to return in 20-21 by Winter Break. The thing I heard from my parents who chose to stay online was fear about the elderly members of their household.
Also in my case there were a decent number of these families who were working from home and the elderly were the childcare people so they weren't feeling the need to return to normal for economic pressures in the same way the majority who did return to the classroom (we went from 55-45 in Fall to 70-30 after Winter break.
Early reporting also emphasized racial disparities in risk for serious complications and deaths.
If 40% of parents don't want schools to reopen, that is a lot of people who are going to panic about their kids dying, cause a big fuss, not send their kids, etc, even if it's not a majority.
Fairfax County is white liberals though
11% Black, 17% Hispanic or Latino, 21% Asian. Non-Hispanic whites are a slight minority in Fairfax County, and underrepresented compared to the nation (59% white non-Hispanic.)
https://www.census.gov/quickfacts/fact/table/fairfaxcountyvirginia/PST045223
Facts usually lose to the narrative.
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 didn’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 couldn’t really trust the guidance they were getting from the government.
While it was clearly nonsensical even from very early on, I would say the reason for the advice was a bit more complicated than pure concern about mask supplies, though that was absolutely a factor in some cases. The CDC recommendation against mask use by the general public actually long predated the COVID pandemic. This blog writeup from March 2020 discusses anti-mask recommendations from the 2009 swine flu epidemic and from 2015 during MERS:
https://slatestarcodex.com/2020/03/23/face-masks-much-more-than-you-wanted-to-know/
I think the anti-mask stuff was initially mostly motivated by the same dysfunctional institutional epistemology that also led to them being ridiculously slow to update on the importance of ventilation and the futility of cleaning surfaces.
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.
What are you talking about? When has there ever *not* been an intense society-wide push to get people healthier and cut obesity?
I really only hear about fat-shaming from people who are angry that anyone uses that term.
I'm not sure I would characterize any efforts/pushes as "intense" but willing to hear arguments/evidence to the contrary.
Either way, I personally was hoping that there would be more beyond what's currently being done
Legitimately curious -- what do you think needs to be done that isn't being done?
Something like ¼ of American doctors are obese, and they're certainly aware of the health dangers of obesity and the importance for diet/exercise.
I think we didn’t get that much of this because there’s been pervasive cultural and state messaging encouraging people to lose weight for decades and it’s done fuck-all for actually changing obesity rates because long-term loss of long-held weight without some kind of surgical or pharmaceutical intervention is super difficult. “Tell fat people to eat less and exercise more” isn’t an effective public health policy.
Similarly to what I mentioned to Kenny, I don't think I'd characterize messaging to be "pervasive."
Also would dispute long-term weight loss being difficult (at least for the majority of people who are currently obese). People just need to eat fewer calories than they consume to lose the weight, and then transition to a maintenance diet once they hit their weight goal. Tracking calories and exercising make this easier.
Coincidentally, Wegovy got FDA approved Jun 2021 in the middle of the vaccination drive.