Discussion about this post

User's avatar
Michael's avatar

Thanks for the great summary. My wife and I still mask, still wash our hand with alcohol after being in stores. We are still exercising the same level of infection risk minimization as we did in 2020. Are we stupid or have some psychological addiction to feeling ourselves to be at risk? Emphatic no's to both questions. The pandemic is still here, declining leading indicators notwithstanding, could very suddenly jump in severity, has a huge zoonotic pool to breed further mutations that escape our monitoring and early warning systems, and having killed millions of us, still retains the capacity to kill millions more. In our opinion, the risk still justifies taking the minor precautions we do.

And that's not even counting RSV which at our age is a very real danger.

I know everyone is very pandemic weary and interest in infectious diseases is probably dropping off. But consider this: the people who are losing interest, some not inconsiderable fraction of them, have the luxury of going into "back to normal" thinking because large numbers of us did take the pandemic seriously and flattened the curve. [minor spelling correction edit just now,]

Expand full comment
Michael DAmbrosio's avatar

I can't but feel we are stuck in this loop:

"We are seeing these surges because of the measures we took in 2020"

So...

"We need to take the measures we took in 2020 to reduce what we are seeing today"

Can you see why the public has "moved on"? (by that I mean, the 10% ceiling we hit for boosters, the near zero masking rates, the largely return to "normal" in schools, business, etc).

Were it not for reading Twitter and Substack, I don't think I would even realize Covid or Twin or Tripledemics are a thing still. Even Facebook has moved on (no one adding "I got my 4th dose" frames, picturing themselves in masks, etc like the old days). It's not something making the news, not in local papers (Plain Dealer for me). Even the weekend edition of the WSJ's only reference to Covid on the front page was a small blurb "China eased pandemic controls, as the country's leaders seek to lessen the pain of stringent zero-Covid policy that has exacted a heavy economic toll and stoked growing public resentment".

And I want to go back to something you said last week in the RSV is "Back:FAQ" from last week in your commentary on Immune Debt:

>"The pandemic delayed first infections of common viruses, like RSV, due to shut downs, social distancing, masking, etc. We saved thousands of lives doing this until we could get a COVID-19 vaccine. This was the right call."<

A comparison of Excess Mortality - a topic that used to be frequently invoked early in the pandemic - appears to contradict this statement. (I consider Excess Mortality the gold standard of outcome, anyone reading this and disagrees, please discuss with me below.)

If this was true, then we should see correlation between vaccine update, stringency of shutdowns, adoption of masks and excess mortality. Countries like Sweden, Denmark, and Finland which had kids in school nearly the entire pandemic, didn't mask young children, had low mask use relative to the rest of the world, should have poorer outcomes than countries like South Korea, Germany, Israel.

Yet the opposite is true.

Sweden has the second lowest excess deaths the entire pandemic after Norway. Zero excess deaths under the age of 65. South Korea meanwhile is poised to become one of the leaders in excess deaths - already in the first 30 weeks tracked of 2022 they have 215,000 deaths when trends predicted 170,000.

Let that sink in. South Korea, the beacon of masking, vaccination, GPS contact tracing, CCTV surveillance, and icon of "Doing It Right" now has the highest excess mortality in the world.

How can we argue "we saved thousands" doing something, when we can clearly see countries not doing that same thing didn't pay a consequence and even had better outcomes?

Katelyn you have done an incredible job writing, communicating, and building this blog/community the last two years.

I trust your dedication to the scientific process, but I urge you listen to Carl Sagan:

"Science invites us to let the facts in, even when they don’t conform to our preconceptions. It counsels us to carry alternative hypotheses in our heads and see which best fit the facts. It urges on us a delicate balance between no-holds-barred openness to new ideas, however heretical, and the most rigorous skeptical scrutiny of everything-new ideas and established wisdom….. When we are self-indulgent and uncritical, when we confuse hope and facts, we slide into pseudoscience and superstition."

From the data I look at, it appears that multiple hypotheses have failed and continue to fail, but whether it is due to politics, or pride, or hubris, many public health officials are unable to accept they were wrong and update their priors. Don't get dragged down by them. We have entered a phase of gaslighting (see: "we never said the vaccine kept you from getting the thing you are getting vaccinated against" - again, you are one of the few to not be trapped by that like Walensky, Fauci, Bourla, etc) to denial.

All of these hypotheses - masking, social distancing, closing schools, selecting which business can be open, plexiglass at checkouts, Halloween candy chutes for trick-r-treaters... all of this was built from observational studies, models, and opinion pieces - the lowest tier of science. There is no shame in conceding that many of these hypotheses failed real world stress tests and experiments. It's not like these ideas were built from decades of repeated RCTs undergoing critical appraisal. We should have no obligation to continue to support and back claims which have been falsified, less we fall for the sunk-cost fallacy.

Expand full comment
64 more comments...

No posts