Obviously it's terrible that millions of people died. But then, millions of people died from the black plague, many die from car accidents, and preventable (via lifestyle changes) diseases. As an ex-scientist I work hard to take the long view on disease- that is, billions of years. Once you adopt this perspective and look at COVID, you realize that many aspects of it have been overreported in the press and that led many people to overestimate its relative danger compared to many other things we face on a regular basis.
The current reporting about the newest virus is a great example- the language is scary, but we have absolutely no data to tell us that this will have any global impact, nor that this represents any sort of phase change into a new situation.
Your own comment. 100% - 90% = 10% and that was marked as just a possibility.
> As an ex-scientist I work hard to take the long view on disease- that is, billions of years.
That's fine, but that timescale is not the timescale at which our lives are unfolding.
> Once you adopt this perspective and look at COVID, you realize that many aspects of it have been overreported in the press and that led many people to overestimate its relative danger compared to many other things we face on a regular basis.
Well, even if I take the most conservative figures I end up with millions of 'front-loaded' deaths, and 100's of thousands of deaths where 'premature' is probably an accurate figure. And that's before we get to take into account that this is long from being over.
> The current reporting about the newest virus is a great example- the language is scary, but we have absolutely no data to tell us that this will have any global impact, nor that this represents any sort of phase change into a new situation.
That is absolutely true. But at the same time we also don't have any data for the opposite: that this will not affect things at all. Policy makers are in a bind, anything they do that helps will come with a price tag, the cost of doing nothing is likely political suicide, the cost of doing too much is going to come at the price of a massive global recession (and possibly set the stage for future wars).
So now we get this stretched out slow motion train wreck, which is far from ideal as well. What would you suggest we do instead?
My suggestion (and I strongly recommend nobody takes it) is to immediately go forward with no masking, no vaccination, special triage centers for people with COVID (so they aren't infecting people with comorbidities going to hospitals), accept the catastrophic loss of life, and then watch carefully over the next ten years. My belief is that if this happens, the entire global population will have enough natural immunity that this disease will become endemic.
As I said, nobody should follow my advice. it would be political suicide- in the same way that people who promote "death panels" (to allocate limited resources rationally) get shut down, even though it's the most rational approach that would maximize global health.
Further, everything I suggested above is merely intuition based on several decades of experience working in public health/medical biology, rather than hard epidemiological data. I could be completely wrong and my strategy could instead lead to a black death scenario or existential situation (death rates of 30+% due to virulent variants with high transmission rates and very long infectious periods). Again, I must say that nobody should follow my recommendation because it's based entirely on a lifetime of systems thinking and working with complex biological entities.
It's a bit strange to see a suggestion like that accompanied by the disclaimer that it shouldn't be taken. What scenario would you suggest that is not accompanied by such a disclaimer? In other words, say we put you in charge of public policy tomorrow without the option to abdicate, what would you suggest we do, assuming it would actually be done as you advise?
Build a time machine and invest more in the CDC and the NIH back in 1985?
Seriously though I can't think of a more reasonable strategy than that carried out by the US, Sweden, and China (each represents a different experiment).
China's extreme level of population restriction and high level of testing seems to have greatly reduced transmission and impact (I don't know how to interpret China's published numbers, and I don't really trust them that much). This is probably necessary in any area where population density is high enough that rapid transmission can occur. However, my guess is that it also led to a large number immune-naive people and I don't think that any current vaccine will be useful for more than a year, so I think they're at constant risk of explosive disease growth that they can only address through strict policies.
For countries with fairly small number of dense cities, like Sweden, I think what they did was excellent. They stated their prior beliefs and more or less stuck to them and, in my interpretation, they did not suffer any more than other countries, when population density is considered.
Finally, the US. The US did fairly well even though there is a large noncompliant population for a number of reasons. First, we've invested heavily in disease management infrastructure (research, hospitals, strong public health) which meant that we could deal with (to some extent) the massive surge of patients going to hospitals who then infected others nosocomically, and have industries that developed vaccines and other treatments quickly. Second, we actually have a well organized public health system that is relatively powered to implement unpopular but reasonable policies. But, I worry that our court system moves too slowly (for example I would really like to see the supreme court making an extraordinary decision that the US has full rights to mandate vaccines for its entire population) and we have a large number of people who seem to actively fight reasonable public health measures.
So in short, the best approach is to have a large amount of resources (public health researchers, medical folks) combined with excellent realtime knowledge about spread, a largely compliant population which is willing to suspend civil liberties in emergency situations, and political leaders who are willing to risk their long-term careers by providing cover for the researchers.
Finally, thank goodness that the US had the foresight to make and fund the NIH and CDC for so long, providing us with an excellent foundation with which to respond to diseases like this. I am in awe of the folks who pushed for the creation of a new field (molecular biology) in the 30s and 40s which led to the elucidation of the genetic code and development of structural biology, which ultimately provides the foundation for much of our understanding of viruses.
Fair enough, thank you. I like to keep things grounded in reality, theoretical considerations are fine for after the fact analysis but in a fluid situation decisions need to be made. They'll never be perfect but not deciding is abdication and that isn't really an option.
Where I live the health care system has been weakened to the point that we can't really deal with such levels of calamity in a responsible manner any more, the result of years of neo-liberal cost cutting and attempts to create a market situation around health care. The end result is a terribly fragile mix of high density populations, extreme mobility and very little cushion to absorb mistakes. It remains to be seen if either one of the three scenarios you sketched will work for us in the longer term, so far it's not looking all that good but it also could have been far worse.
Obviously it's terrible that millions of people died. But then, millions of people died from the black plague, many die from car accidents, and preventable (via lifestyle changes) diseases. As an ex-scientist I work hard to take the long view on disease- that is, billions of years. Once you adopt this perspective and look at COVID, you realize that many aspects of it have been overreported in the press and that led many people to overestimate its relative danger compared to many other things we face on a regular basis.