25 Nov Some Links
At this point, you could protest, “Hey Bryan, I thought you weren’t a utilitarian.” So what if the cost of COVID prevention greatly exceeds the value of life saved? My answer, to repeat, is that I have a strong moral presumption in favor of human liberty. So while I respect individuals’ rights to overreact to moderate risks, I oppose any act of government that does not pass a cost-benefit test with flying colors.
And no, I don’t think that an asymptomatic person who walks down the street unmasked is “aggressing” against passersby in any meaningful way.
Too many doctors have interpreted the term “evidence-based medicine” to mean that the evidence for a treatment must be certain and definitive before it can be given to patients. Because accusing a physician of not being “evidence based” can be a career-damaging allegation, fear of straying from the pack has prevailed, favoring inertia and inaction amid uncertainty about Covid-19 treatments.
For diseases with established treatment options, holding out for certainty may be prudent. But when options are limited and there are safe treatments with evidence for effectiveness, holding out for certainty can be catastrophic. Requiring a high degree of certainty during a crisis may elevate the augustness of medical organizations and appease the sensibilities of medical professionals, but it does nothing for patients who need help.
The penchant for certainty is visible in the frequently updated treatment guidelines for Covid-19 from the National Institutes of Health. These guidelines were developed by scientists around the country, but because of a mentality that is biased toward virtually irrefutable evidence, no distinction is made for treatments with evidence for effectiveness that falls below the mark of certainty. This framework almost certainly has contributed to many avoidable deaths during this pandemic.
Far from increasing, let alone exponentially, the data showed that the wave was faltering if not cresting already. The lockdown came in on a Thursday. The very next day data from three reliable sources – the Office for National Statistics, the government and the Covid Symptom Study – showed slight falls of the number of positive cases or some levelling off. The fall was steep in some places such as Liverpool. The cynic in me wondered whether the haste with which the government had rushed to bring in the national lockdown, at the urging of its questionably sage advisors, was so that lockdown could be credited with the fall that was coming.
Ah, said the government at the time, but hospital admissions are still increasing and so are deaths. Well, sure. Hospital admissions lag cases by two weeks, and deaths lag admissions by two weeks. We now have two more weeks of data and the evidence looks clear. The faltering of the wave in late October and early November was not just a pause but a peak. Hospital admissions appear to have peaked on 11 November and began to fall, implying a peak of infections in late October, well before lockdown began. Even deaths seem to have now stabilised, unexpectedly, with the seven-day average also steady since 11 November.
The same thing happened in April, when in retrospect it became clear that infections peaked before lockdown began, with deaths peaking around 8 April – too soon to credit the lockdown.
People in reliably blue states (California, New York, Oregon) as well as in the states that made Donald Trump a one-term president (Wisconsin, Michigan)—have been standing in line for three and four hours to get a Covid-19 test before traveling this week. These people are perfectly aware that infection rates are rising and that the Centers for Disease Control and Prevention strongly cautions against celebrating the holiday with people outside your household. Alas, many of them don’t seem to care anymore. According to the American Automobile Association, there could be as many as 50 million Thanksgiving travelers this year, only 10% less than in 2019.
This is a form of mass civil disobedience like nothing the country has seen since the 1960s. Some of it is born of Covid fatigue, to be sure. But the endless parade of politicians flouting their own rules surely has also played a role. It began shortly after the spring lockdowns and if anything has become more commonplace, even farcical.
Chicago Mayor Lori Lightfoot and House Speaker Nancy Pelosi violated lockdown orders to get their hair done, which sounds like something a Kardashian would do. Philadelphia Mayor Jim Kenney sneaked out of state to dine at a restaurant in neighboring Maryland because eateries back home were closed to indoor customers. When Washington Mayor Muriel Bowser and members of her staff traveled to Delaware to celebrate Joe Biden’s presidential victory, they violated Covid quarantine requirements. And Sen. Dianne Feinstein of California, who tweeted in July that “wearing masks in public should be mandatory,” has been spotted several times in public not wearing a mask while she was indoors and chatting face to face with others.
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