Covid 11/​19: Don’t Do Stupid Things

Link post

There is very good news. We have a sec­ond vac­cine! Both Pfizer and Moderna’s vac­cines have now shown 94%+ effec­tive­ness in treat­ing Covid-19. Not to be out­done by Moderna’s re­port of 94.5% effec­tive­ness, Pfizer has its fi­nal re­sults and they are ex­cel­lent. 95% effec­tive, 94% effec­tive in peo­ple over 65, no ma­jor safety con­cerns. They plan to ap­ply for emer­gency use au­tho­riza­tion within days and likely already have done so by the time you read this. Es­ti­mates are that we can vac­ci­nate 20 mil­lion peo­ple by year’s end.

There is also very bad news. We have more pos­i­tive test re­sults than ever be­fore, more hos­pi­tal­iza­tions than ever be­fore, and a sub­stan­tially in­creased pos­i­tive test rate. Deaths lag tests, but are on track to rise pro­por­tion­ally to the rise in tests.

Within that bad news there is good news. There are signs that the Mid­west in par­tic­u­lar, where things are max­i­mally bad right now, is get­ting ready to peak. My es­ti­mate for how bad things will get be­fore they get bet­ter, and how long it will be be­fore that hap­pens, have both ten­ta­tively gone down some­what. Bad news can still be good news if you ex­pected even worse news.

There is also an im­por­tant note be­fore we get to busi­ness.

Last week in my weekly post, I said some things about the elec­tion that did not re­late to Covid-19. Do­ing so broke the norms of my per­sonal blog and the norms of LessWrong, where these up­dates are re­posted. I felt it was the least bad op­tion un­der the cir­cum­stances. I could have ex­e­cuted it bet­ter, but I stand by my de­ci­sion, and ac­cept the con­se­quences.

I do not in­tend to let it hap­pen again.

One of the con­se­quences of break­ing this norm is that it is even more im­por­tant for me to strongly re­assert the norm go­ing for­ward. Tempted as I may be­come, I will be ex­tra care­ful not to dis­cuss poli­tics ex­cept as it di­rectly re­lates to Covid-19 or re­quires us to take pre­cau­tions for our own safety. I also plan to en­force the rule strongly in the com­ments.

If you feel I have crossed that line in this or a fu­ture post in this se­ries, once you have ver­ified no one else has yet called me out, please do not hes­i­tate to call me out on that.

If you feel I have crossed that line in a post not in this se­ries, and I didn’t ex­plic­itly ac­knowl­edge that I was do­ing a poli­tics-nec­es­sary thing like a pre­dic­tion mar­ket post, call me out on that too.

Thank you. Let’s run the num­bers.

The Numbers

Deaths

DateWESTMIDWESTSOUTHNORTHEAST
Sep 17-Sep 2310168932695399
Sep 24-Sep 309349902619360
Oct 1-Oct 779711032308400
Oct 8-Oct 1478212172366436
Oct 15-Oct 2180415912370523
Oct 22-Oct 2889517012208612
Oct 29-Nov 495619772309613
Nov 5-Nov 11108927122535870
Nov 12-Nov 181255293428181127

Deaths are ris­ing ev­ery­where. That’s baked in for at least the next few weeks. Deaths gen­er­ally con­tinue to re­li­ably fol­low cases pro­por­tion­ally af­ter a 14-21 day de­lay, and case counts have yet to sta­bi­lize. The Mid­west num­ber here is good news af­ter last week’s gi­ant jump, but mostly there are no sur­prises here.

Pos­i­tive Tests

DateWESTMIDWESTSOUTHNORTHEAST
Sep 17-Sep 23540258538112773223342
Sep 24-Sep 30554969293210630027214
Oct 1-Oct 7567429724311017034042
Oct 8-Oct 146828412574411799538918
Oct 15-Oct 217557114985113323843325
Oct 22-Oct 289498318188115812357420
Oct 29-Nov 411268425291716709870166
Nov 5-Nov 11157495387071206380108581
Nov 12-Nov 18211222452265255637150724

Things are still get­ting worse ev­ery­where, but the rate at which the Mid­west in par­tic­u­lar is get­ting worse is slow­ing down. Hope­fully peo­ple there are start­ing to get the mes­sage. It’s also likely that herd im­mu­nity effects are hav­ing an im­pact. With pos­i­tive test rates in the dou­ble digits, there’s lit­tle doubt a large ma­jor­ity of cases are be­ing missed, and parts of the Mid­west now have pos­i­tive test counts im­ply the ac­tual case counts should be very high, in some cases high enough that herd im­mu­nity should be rapidly ap­proach­ing. If any­thing, there is the worry that the Dako­tas are pro­vid­ing ev­i­dence that the herd im­mu­nity thresh­old is on the higher end of its po­ten­tial range, be­cause we are already at or near the lower end.

Pos­i­tive Test Percentages

Per­centagesNorth­east­Mid­west­SouthWest
910 to 9162.41%5.99%11.35%4.49%
917 to 9232.20%5.96%7.13%4.11%
924 to 9302.60%6.17%6.18%4.27%
101 to 1072.61%6.05%6.74%4.23%
108 to 10142.57%8.14%7.09%4.75%
1015 to 10222.95%8.70%7.85%5.36%
1022 to 10283.68%9.87%8.58%6.46%
1029 to 1144.28%12.79%8.86%7.04%
115 to 11115.56%17.51%9.89%8.31%
1112 to 11186.99%18.90%11.64%10.66%

Per­centages and test counts tell the same story. A small rel­a­tive in­crease in the Mid­west that bodes rel­a­tively well, signs that aren’t great in the other re­gions.

Test Counts

DateUSA test­sPos­i­tive %NY test­sPos­i­tive %Cu­mu­la­tive Pos­i­tives
Sep 10-Sep 164,636,1405.8%559,4630.9%2.00%
Sep 17-Sep 235,737,9195.2%610,8020.9%2.09%
Sep 24-Sep 305,833,7575.1%618,3781.1%2.18%
Oct 1-Oct 76,009,8455.2%763,9351.3%2.28%
Oct 8-Oct 146,322,8655.7%850,2231.1%2.39%
Oct 15-Oct 216,439,7816.5%865,8901.2%2.52%
Oct 22-Oct 286,933,1567.5%890,1851.4%2.67%
Oct 29-Nov 47,245,6008.6%973,7771.6%2.86%
Nov 5-Nov 118,285,49510.6%1,059,5592.4%3.13%
Nov 12-Nov 188,924,33812.3%1,155,6702.9%3.47%

My pre­dic­tion last week was 12.9% pos­i­tive rate on 9 mil­lion tests. We got a 12.3% pos­i­tive rate on 8.9 mil­lion tests. Which is still way worse than last week’s rate of 10.8%, but bet­ter than my ex­pec­ta­tions due to things sta­bi­liz­ing some­what the last few days of this week.

For next week my best guess is 13.4% pos­i­tive rate on 9.5 mil­lion tests. That’s still headed in the wrong di­rec­tion, but at a slower pace. One must con­stantly re­define what counts as good news.

The ba­sic facts are un­changed and worth re­peat­ing. It is bad out there and is con­tin­u­ing to get worse. Cases will likely in­crease for a while longer, deaths for a month longer than that. You need to de­cide whether you are will­ing to hold out un­til the vac­cines are available.

If you do not wish to get Covid-19, and I do not think you want to get Covid-19, then un­less you have already had it, now is the time to be even more cau­tious than ever be­fore (with the ex­cep­tion of the greater New York re­gion in March/​April). That means among other things: mask up, do ev­ery­thing out­doors when­ever pos­si­ble and es­pe­cially don’t spend 15+ minute pe­ri­ods to­gether with oth­ers in­doors un­less they’re in your pod, so­cially dis­tance, avoid be­ing in the di­rect path of any­one talk­ing let alone yel­ling or singing, sup­ple­ment Vi­tamin D. Most of all don’t do stupid things, like large in­door gath­er­ings with­out masks such as a tra­di­tional Thanks­giv­ing. En­courage oth­ers to do the same.

Ma­chine Learn­ing Project

They have re­launched (hat tip: Nate Silver) af­ter a hi­a­tus, and in this new iter­a­tion the site is fo­cused en­tirely on now-cast­ing, to an­swer the ques­tion of how many peo­ple are cur­rently in­fected or have been in­fected.

Here is their best guess.

For the United States, their an­swer comes back 631k in­fected yes­ter­day and 560k in­fected five days ago (ver­sus 164k pos­i­tive test re­sults yes­ter­day). That is less cases than I would have ex­pected, and un­for­tu­nately if true it im­plies both that herd im­mu­nity is not de­vel­op­ing slower than I was guess­ing, and that the in­fec­tion fatal­ity rate is higher and re­mains around 0.5%. I still think the IFR is lower than that at this point, but this up­dates me some­what to­wards less un­no­ticed in­fec­tions. It’s plau­si­ble we are now bet­ter at know­ing who to test, and we have more tests, so even though the pos­i­tive rate is go­ing up, the per­centage of cases de­tected might not be go­ing down.

Their guess for to­tal in­fec­tions so far is 16.9%, with num­bers in the high 30s for the Dako­tas and 22.3% for New York. That also seems on the low end of plau­si­ble to me.

Europe

Not pic­tured for usual rea­sons is Belgium, among oth­ers. If you look at Belgium, you see both a gi­ant peak and now a gi­ant rapid de­cline. What they are do­ing is work­ing, and work­ing fast. Pos­i­tive test per­centages are still trou­bling ev­ery­where else, so there is worry that late re­port­ing is mak­ing things look bet­ter than they ac­tu­ally are.

Deaths are climb­ing, but that was already baked in be­fore lock­downs started.

This tweet alerted me to this web­site that gives ex­cel­lent vi­su­al­iza­tions of Covid-19 in Europe. The effects of lock­downs are un­mis­tak­able. Again, we need to worry about late re­port­ing, but the bor­ders tell the story.

Swe­den is no longer the con­trol group. An odd time to end such a valuable sci­en­tific ex­per­i­ment, but that’s how it goes these days. I sup­pose there wasn’t that much more to learn.

Go Away Or I Will Taunt You a Se­cond Time

States en­act more Covid-19 rules as in­fec­tions are on the rise.

The prob­lem is that these new rules are both look­ing mostly in the wrong places and be­yond tooth­less.

Much of Europe went into strict lock­down. I was and am still skep­ti­cal that they were right to keep schools open, but it was a real at­tempt that clearly was ca­pa­ble of work­ing, and it seems to be work­ing.

The new Amer­i­can re­stric­tions are not a real at­tempt, and have no chance of work­ing. They pre­sum­ably will make a small im­pact, what try­ing looks like. Con­trast this with Europe, where try­ing is tak­ing place. When the United States turns this wave around, it will not pri­mar­ily be due to im­posed re­stric­tions, but in­stead due to some com­bi­na­tion of vol­un­tary be­hav­ior changes and peo­ple be­com­ing im­mune.

When one sees some­one claiming to ad­dress a prob­lem, one can ask how many lev­els of ‘try’ and ‘pre­tend’ are in­volved.

In this case, I be­lieve that the at­tempts are pre­tend­ing to pre­tend to try to try to solve the prob­lem. They are not try­ing to try, but they are pre­tend­ing that they are do­ing some­thing that could plau­si­bly pre­tend to be try­ing to try. Their hope is that this sym­bol­i­cally trans­lates as ‘do­ing some­thing’ and pre­vents the cre­ation of com­mon knowl­edge that there is no at­tempt at all. Ideally, it will al­low those who do pre­tend to pre­tend to try to try to mark those who do not do this as blame­wor­thy when things go badly, or even al­low the meta-pre­tenders to claim credit when things im­prove. Ah, the joys of liv­ing in a high level simu­lacrum.

The one ex­cep­tion might be Cal­ifor­nia, which may be try­ing to try or even out­right try­ing. That would be con­sis­tent with their ap­proach so far.

If I don’t write a post within a few months break­ing down var­i­ous meta lev­els of try­ing and pre­tend­ing, please re­mind me to do so. It’s definitely worth do­ing.

In the mean­time, be un­der no illu­sions that we are do­ing any­thing as a na­tion other than giv­ing up and let­ting peo­ple fend for them­selves, while hop­ing that enough peo­ple will be suc­cess­ful enough that the hos­pi­tal sys­tems will re­main in­tact.

And again, I am not con­vinced that this is the wrong de­ci­sion. I am es­pe­cially not con­vinced it is the wrong de­ci­sion given the pub­lic choice prob­lems in­volved. We lack the ca­pac­ity to do enough to solve the prob­lem be­fore the vac­cine ar­rives. So what is the al­ter­na­tive?

That ar­ti­cle from CNN also in­tro­duced me to a great new line.

Our New Motto: Don’t Share Your Air and Don’t Do Stupid Things

Ex­actly.

That’s a motto be­ing used by Los An­ge­les Mayor Eric Garcetti, and I for one am here for it. I’ve been say­ing ‘don’t do stupid stuff’ but I am not good at mar­ket­ing and stupid things is clearly bet­ter. Share your air also rolls nicely off the tongue and sum­ma­rizes the most im­por­tant sec­ondary point (even if it is tech­ni­cally log­i­cally un­nec­es­sary, since it is a stupid thing to do).

This cor­rectly boils things down to their essence, in the style of You Have About Five Words, pro­vided peo­ple can con­nect ‘don’t share your air’ to not do­ing things in­doors. If they can also con­nect it to ‘wear a mask’ that might be a reach, but it is both at least plau­si­ble and even bet­ter.

If there was more band­width available, next up in my pri­or­ity queue would be tel­ling peo­ple to sup­ple­ment Vi­tamin D, but the Amer­i­can peo­ple’s available band­width is, shall we say, not high.

I can­not em­pha­size enough that peo­ple do­ing stupid things are most of the prob­lem.

Our failure to con­tain this pan­demic is not about peo­ple mak­ing care­ful in­formed trade-offs and choos­ing slightly too much risk slightly too of­ten. Nor is our prob­lem an in­suffi­ciently de­tailed un­der­stand­ing of ex­actly how to go from some­what safe to ab­solutely safe, or ex­actly how many feet apart to be or which di­rec­tion to face or how long to in­ter­act, or wear­ing the wrong kind of mask, or any other such de­tails.

Those de­tails mat­ter! They es­pe­cially mat­ter to you per­son­ally if you want to get the most out of life while tak­ing the least risk. The differ­ence be­tween get­ting those de­tails right or wrong can eas­ily be an or­der of mag­ni­tude of risk.

But here’s the thing. If you’re even think­ing about those ques­tions, you’re not tak­ing that much of the risk. You have already cut out most of your risk com­pared to your pre-pan­demic be­hav­iors. Cut­ting your risk fur­ther could be worth­while for you but that’s not how we win. It is like wor­ry­ing about whether you are go­ing to con­tribute to cli­mate change be­cause you used a pa­per bag that was slightly too large while look­ing up at a coal power plant. You are not the is­sue here.

And let me tell you. In what might be the ul­ti­mate ev­er­green state­ment, peo­ple are do­ing a lot of stupid things.

There’s a whole sec­tion called Thanks for the Hypocrisy later in this post about Thanks­giv­ing plans, where 40% plan to have a gath­er­ing of 10 or more peo­ple.

One nurse’s tale from South Dakota, treat­ing pa­tients that don’t be­lieve Covid-19 is real. A huge por­tion of the pub­lic con­tinues to treat Covid-19 as not be­ing real, or no worse than the flu.

It seems Magic play­ers in Ok­la­homa are try­ing to gather to­gether for large tour­na­ments on the same day their state ran out of ICU beds? Come on, ev­ery­one, we’re bet­ter than this.

First cruise ship to set sail since the pan­demic has five peo­ple test pos­i­tive for Covid-19. I am Jack’s ut­ter lack of sur­prise.

Masks con­tinue to be seen as a poli­ti­cal state­ment, and are slightly an­noy­ing to wear, so huge per­centages of peo­ple re­fuse to wear them.

In­door din­ing con­tinues in most of the coun­try be­cause of ‘the econ­omy’ and be­cause we don’t want restau­rants to go out of busi­ness nor can we agree to give those restau­rants money to not go out of busi­ness. So this week, Mary­land did some­thing about its in­door din­ing… and went from 75% to 50% ca­pac­ity.

The New York Times re­ported on a wed­ding that had 200 guests and the fact that they had 200 peo­ple at an in­door wed­ding was both barely men­tioned and also ex­cused be­cause the 200 peo­ple were ‘so­cially dis­tanced.’

Others think that small groups and daily rou­tines don’t count, so they felt like they were ‘do­ing ev­ery­thing right (WSJ).’ So they gather with­out masks out­side of their home pods like it is noth­ing.

Most peo­ple think that cer­tain types of ac­tivi­ties are ‘safe’ and ‘don’t count’ in some im­por­tant sense. That’s how peo­ple in­stinc­tively think and it is also the lan­guage au­thor­i­ties are us­ing. One can fol­low all the guidelines and still have a two-house­hold ten-per­son Thanks­giv­ing, and in most places dine in­doors with oth­ers sev­eral times a week, and so forth.

The biggest cat­e­gory of ‘stupid stuff’ has been iden­ti­fied, and au­thor­i­ties seem to be con­verg­ing on in­for­mal gath­er­ings of friends of fam­ily, in­doors, in their homes. This is the new thing to blame, which is the wrong fram­ing to think about al­most any­thing, but is also prob­a­bly the big rea­son things are out of con­trol. Peo­ple don’t think of their friends or fam­ily as risky, they let down their guard, and then they’re wrong.

The new stupid thing is do­ing in­tertem­po­ral sub­sti­tu­tion ex­actly wrong. Lots of peo­ple see that the vac­cine is on the hori­zon, that the end is near, and they start tak­ing more risks rather than less.

This is of course ex­actly back­wards. An end to the pan­demic raises the value of stay­ing safe, and it low­ers the cost of stay­ing safe. So you should be safer and take less risk. But peo­ple’s minds largely don’t work like that. I’m not sure ex­actly what they do think in­stead. One pos­si­bil­ity is that they im­plic­itly have an idea for how much risk they are will­ing to take, and now that they won’t have to ‘spend out of their bud­get’ for that much longer, they are free to take more risk now. Another is that they get the mes­sage ‘things are bet­ter’ and act like things are bet­ter, with­out pro­cess­ing any im­pli­ca­tions at all, and that seems closer to the cen­tral thing go­ing on to me. But I don’t un­der­stand and in­sights here are ap­pre­ci­ated.

All I Want For Christ­mas are a Covid Vac­cine And a PS5 But They Un­der­priced Them And Now They’re All Sold Out

Moderna’s vac­cine is 94.5% effec­tive in pre­limi­nary re­sults, with 90 symp­tomatic cases in the con­trol group ver­sus 5 in the treat­ment group. Con­sen­sus seems to think the re­sults are ideal and very good news. Here is the offi­cial press re­lease. Moderna’s vac­cine is similar to Pfizer’s, but has the ad­van­tage of not re­quiring stor­age to be in su­per cold freez­ers. Hence the build­ing of gi­ant freez­ers already un­der­way. We could be do­ing much bet­ter on vac­cine lo­gis­tics and timelines, but we also are do­ing some things right.

I have not seen it pointed out ex­plic­itly by any­one, but we have far more effi­cacy and safety data on both vac­cines than we think that we do, be­cause they are very similar vac­cines. Many did re­al­ize this enough to note that they ex­pected the Moderna vac­cine to be effec­tive due to the re­sults we got from Pfizer, but it goes fur­ther than that. To a large ex­tent, we can use the re­sults from each vac­cine trial as ad­di­tional ev­i­dence about the other, and gain even more con­fi­dence that both vac­cines work. Re­mem­ber, we haven’t had a few failed at­tempts and two suc­cesses. Noth­ing has been put in a file drawer. We have two similar suc­cess sto­ries and zero failures.

The rea­son I am not mak­ing a big­ger deal about ‘dis­tribut­ing these vac­cines yes­ter­day’ is that my un­der­stand­ing is that dis­tri­bu­tion and pro­duc­tion have dis­tinct bot­tle­necks, and pro­duc­tion is already at the max­i­mum reg­u­la­tions and our limited will­ing­ness to pay ex­tra (along with any other bot­tle­necks) will al­low. Thus, we are mov­ing Novem­ber vac­ci­na­tions into De­cem­ber and Jan­uary, but April vac­ci­na­tions stay in April.

There are con­cerns that states do not have enough money for vac­cine dis­tri­bu­tion (Wash­ing­ton Post). Ob­vi­ously this is in­sane and the fed­eral gov­ern­ment should give states far more money than they ac­tu­ally need to avoid even slight de­lays in dis­tri­bu­tion. But it also shouldn’t mat­ter. I know states are in fi­nan­cial trou­ble, but the vac­cine is the way to make that stop, so states should spend the money if they have to, no mat­ter what it takes, whether or not the fed­eral gov­ern­ment picks up the check later. Money is fun­gible.

One odd thing is that pro­jected timelines did not seem to move at all when we went from one vac­cine to two. That could mean that the sup­ply chains both have the same bot­tle­neck, or it could mean that ev­ery­one was as­sum­ing Moderna’s vac­cine would work and it was already sched­uled in. Or it could mean that we are scal­ing up by or­ders of mag­ni­tude, so one dou­bling now ac­tu­ally does not change the timeline much.

“Vac­cine chief Mon­cef Slaoui says there will be enough vac­cines to im­mu­nize 20 mil­lion Amer­i­cans in De­cem­ber.” My un­der­stand­ing is now that this is from a com­bi­na­tion of both vac­cines.

An im­por­tant part of my model has been that when peo­ple be­come in­fected, they provide much more effec­tive im­mu­nity than you would ex­pect at ran­dom, be­cause peo­ple aren’t in­fected at ran­dom.

With the vac­cine, it de­pends on who gets the vac­cine. If we base our de­ci­sions on who is most vuln­er­a­ble and/​or who is most ea­ger to get the vac­cine, im­mu­nity from vac­ci­na­tion is go­ing to be much less effec­tive at pro­vid­ing herd im­mu­nity than one would ex­pect from ran­dom vac­ci­na­tions. Those are ex­actly the peo­ple who are already be­ing care­ful, so them be­ing im­mune won’t make as much differ­ence as we might like. The pan­demic won’t end as quickly.

If we go for those who have jobs that put them at high­est risk, the op­po­site hap­pens. Every time we im­mu­nize an es­sen­tial worker who has not already caught Covid-19, or some­one who is oth­er­wise tak­ing a lot of risk, we are bring­ing things closer to a con­clu­sion faster.

It looks like we are go­ing to do a com­bi­na­tion of these ap­proaches. Some es­sen­tial work­ers will be at the front of the line, and our most vuln­er­a­ble will be there as well. Those who want the vac­cine the most and value it the most will mostly have to wait, but will likely com­prise the ‘sec­ond wave’ that I will join.

When will things be nor­mal again? Some ex­perts say sur­pris­ingly quickly: Fauci cau­tions ‘grad­ual re­turn’ to nor­malcy by ‘sec­ond, third’ quar­ter 2021. To me, that’s sur­pris­ingly quick. As an in­di­vi­d­ual, I might be ready for nor­mal life in May, but that doesn’t mean nor­mal life is ready for me. If we are less than a year from things seem­ing mostly nor­mal, I will ab­solutely take that re­sult. One could plau­si­bly re­spond that the av­er­age per­son will hear ‘vac­cine available’ as ‘pan­demic over’ so any re­al­is­tic timeline will sound pes­simistic. It is also pos­si­ble that this is a case of giv­ing an op­ti­mistic pre­dic­tion, but fram­ing it as pes­simistic be­cause Very Se­ri­ous Peo­ple only al­low pes­simistic pre­dic­tions. One must con­stantly be cau­tion­ing.

Im­mu­nity to Covid-19 For Some, Mi­ni­a­ture Amer­i­can Flags for Others

I talked about this last week, and now have found some hard data.

A new Gal­lup poll finds that 58% of Amer­i­cans would take a Covid-19 vac­cine, up from 50% pre­vi­ously but lower than be­fore vac­cine safety turned into a par­ti­san is­sue. That seems about right for ‘would get the vac­cine if it was offered in­ci­den­tally dur­ing a check-up.’ And it is far worse in other places, such as in Spain where only 24% of peo­ple want to get the vac­cine right away. My guess is that ‘will­ing to go out of one’s way to get it’ is lower than that, and ‘will­ing to put in effort to se­cure part of a limited sup­ply, maybe even wait on a line’ is lower still, and that it will be even lower once ev­ery­one starts talk­ing about the side effects. Which are mild, but still mean there’s a sub­stan­tial chance you spend the next day in bed feel­ing bad. A lot of peo­ple aren’t down for that.

Many sources, even well-in­ten­tioned ones, are not helping mat­ters. Joe Ro­gan, on the na­tion’s most pop­u­lar pod­cast, openly ques­tioned whether one day feel­ing bad to get the vac­cine wasn’t worse than get­ting Covid-19 if you are healthy, be­cause his as­sis­tant and oth­ers he knows have had mild cases they barely no­ticed, and he no­ticed that Trump is out of shape, got Covid-19 and didn’t die.

I even see how he got to that place, and it shows how hard it is to get a good model even when one is try­ing, as I be­lieve that he is. Joe Ro­gan’s pod­cast is so pop­u­lar for many rea­sons, but in part it is be­cause he ac­tu­ally tries to use rea­son and his ex­pe­riences to build up a full-of-gears model of phys­i­cal re­al­ity in a way reg­u­lar peo­ple can re­late to. Peo­ple are starved for that. I hope he is helping in­spire oth­ers to think for them­selves. He clearly has some im­por­tant pieces of the puz­zle that the peo­ple I know mostly lack, and he clearly lacks many im­por­tant pieces that the peo­ple I know have mas­tered. I strongly dis­agree with him a lot. He gets a lot of things im­por­tantly wrong, but at least he is wrong, and I have no doubt I am fre­quently wrong too. An ex­change of knowl­edge would be highly valuable.

De­spite all the prob­lems con­vinc­ing peo­ple to take the vac­cine, as I noted last week, I do not ex­pect this to im­pact dis­tri­bu­tion of the vac­cine any time soon. Half the peo­ple are plenty of peo­ple un­til half the peo­ple are vac­ci­nated, at which point we will know it is safe and we will pick up an­other 10%, at which point we will be at or near full herd im­mu­nity and we will have had plenty of time to use other meth­ods to con­vince the re­main­ing peo­ple, in­clud­ing re­quiring vac­ci­na­tion to par­ti­ci­pate in var­i­ous ac­tivi­ties if that proves nec­es­sary.

In the mean­time, this only makes it eas­ier for those of us who ac­tively want the vac­cine yes­ter­day.

Thanks for the Hypocrisy

Govern­ment offi­cials rise as one to urge us to limit or can­cel our Thanks­giv­ing plans. They are, of course, cor­rect. By that time things will prob­a­bly be sub­stan­tially more dan­ger­ous than they are even now. Din­ing and talk­ing in­doors for much of the day in large groups is one of the riskiest ac­tivi­ties in terms of Covid-19 in­fec­tion. Com­bin­ing it with stu­dents re­turn­ing from col­lege will make it even worse, and many gath­er­ings in­clude our most vuln­er­a­ble. It’s not a good idea.

If you have thanks­giv­ing plans out­side of your pod and do not want your fam­ily to be in­fected with Covid-19, ei­ther ev­ery­one com­ing needs to quaran­tine for two weeks be­fore­hand, or you need to can­cel your thanks­giv­ing plans.

The peo­ple do not seem to be listen­ing. “Nearly 40% of US res­i­dents plan to par­ti­ci­pate in gath­er­ings of 10 or more peo­ple this holi­day sea­son de­spite con­cerns over the spread of COVID-19”. Here are some other num­bers:

How­ever, 73% of re­spon­dents said they would prac­tice so­cial dis­tanc­ing dur­ing the holi­days and 79% sug­gested that they would cel­e­brate or gather only with peo­ple with whom they live, the data showed.

Just over 80% in­di­cated that they would ask fam­ily and friends in­vited to events not to come if they had symp­toms of COVID-19.

I no­tice I am con­fused and a bit bog­gled. That’s a lot of peo­ple who claim to be liv­ing in groups of ten or more.

It’s also al­most 20% of peo­ple not ask­ing those with symp­toms of Covid-19 not to at­tend.

Even af­ter ev­ery­thing that has hap­pened, that last one blows my mind. Peo­ple who are sick should stay home and not at­tend gath­er­ings. This isn’t a new prin­ci­ple. Even if you don’t think Covid-19 ex­ists, even if the year is let’s say 2018, if you are cough­ing up a storm and feel ter­rible, stay home. This is not hard.

Hold­ing the holi­day at all is differ­ent, even done in­doors, with­out masks and with­out so­cial dis­tanc­ing. Yes, that’s crazy risky. You should not do this.

But I un­der­stand. I had to step in to tell some­one in my fam­ily, com­ing to my own Thanks­giv­ing that they had to iso­late or they couldn’t at­tend, be­cause it’s a damn hard thing to say to some­one. That con­ver­sa­tion can go very badly. Even I was tempted to let it hap­pen. No one wants to be the villain who ru­ined Thanks­giv­ing. It has been a long and lonely year. Thanks­giv­ing is to many the sec­ond most im­por­tant holi­day of the year, sec­ond only to Christ­mas which is un­der similar threat. I to­tally, to­tally get it.

Even more than that, I don’t even think the de­ci­sion is ob­vi­ously wrong. From a per­sonal per­spec­tive, the holi­days are valuable to us, and who are we to tell peo­ple they aren’t worth the risk? Peo­ple are choos­ing that risk, they have skin in the game and they are re­veal­ing their prefer­ences to us.

From a col­lec­tive ac­tion stand­point, it would be bet­ter if we were all go­ing to do our part to con­tain the virus. But it is clear at this point that we are not go­ing to do that. How do you tell peo­ple to keep pick­ing Stag when half the coun­try keeps choos­ing Rab­bit, if that’s how you view the pay­off ma­trix?

It’s damn hard! Here’s Ger­many’s re­cent at­tempt, which is worth a spoiler-free watch. On top of the ob­vi­ous things, it’s worth not­ing that the mes­sage is to do some­thing to im­prove the world rather than do some­thing as a sig­nal. Nor did it shame any­one. A sharp con­trast with the Amer­i­can ads I saw in New York, and a wel­come one. Not good enough to get it done, but good show.

So you’re the na­tion’s poli­ti­ci­ans who want to help, and you don’t know what to do. You can’t do lock­downs or re­stric­tions be­cause the pub­lic won’t stand for it or listen to you. That bridge is burned. Phys­i­cal ac­tion like ad­vanc­ing the vac­cine is out of your hands. Espe­cially if he has any­thing to say about it.

I still have an im­por­tant sug­ges­tion for you: Set a good ex­am­ple and don’t be a gi­ant ob­vi­ous hyp­ocrite.

As in, if you want to en­courage peo­ple to be re­spon­si­ble and en­courage ev­ery­one not to en­gage in the one ac­tivity we most need to stop do­ing, in­door din­ing out­side one’s house­hold, it would help to not be a gi­ant hyp­ocrite and hold in­door din­ners for in­com­ing con­gres­sional mem­bers of both par­ties. Peo­ple no­tice. Peo­ple re­mem­ber. As they should. They tend to re­act like this. This ac­count sums up my re­ac­tion. Cancel­ing the event af­ter peo­ple re­act to it won’t help much.

Gover­nor New­som of Cal­ifor­nia re­grets at­tend­ing a 12 per­son din­ner at the French Laun­dry. More re­fusal to set a good ex­am­ple. More ut­ter lack of skin in the game.

You might be a mem­ber of the New York City gov­ern­ment who bragged about not limit­ing the size of your in­door gath­er­ings. Which is ‘ok, fair’ but in his defense there are oth­ers who are also flaunt­ing the rules who aren’t get­ting called out as loudly, which isn’t fair. Fair­ness is im­por­tant.

At least eight mem­bers of congress tested pos­i­tive this past week. Any in­di­vi­d­ual per­son can be un­lucky, but seven in one week makes it clear that good ex­am­ples are most cer­tainly not be­ing set.

That’s only the in­ci­dents on a per­sonal level that I no­ticed this week.

The protests. The hair­cut. The funeral for John Lewis. The Rose Gar­den cer­e­mony. The pres­i­dent re­sumed work in per­son while in­fec­tious. Non-ex­is­tent con­tact trac­ing and no­tifi­ca­tions at the high­est lev­els. The cel­e­bra­tions af­ter the elec­tion. In­door din­ing at up to 75% ca­pac­ity. The list goes on.

Maybe re­mem­ber that the ‘lit­tle peo­ple’ who do the work count as peo­ple, and don’t keep say­ing they’re not there and no one was within six feet at least when we have video or pho­to­graphic ev­i­dence.

While they close play­grounds and schools, and tell reg­u­lar peo­ple not to cel­e­brate holi­days.

This keeps hap­pen­ing. If there is to be any hope of con­vinc­ing peo­ple to do their part, it needs to stop.

New York City Closes Schools

This story is, as usual, the em­bod­i­ment of New York in the age of Covid-19.

Europe has mostly closed ev­ery­thing else but left schools open.

New York City has a teacher’s union.

Unions are not known for their flex­i­bil­ity. When schools re­opened, it was agreed that they would close again if pos­i­tive test rates in the city hit 3%.

They hit ex­actly 3% yes­ter­day, so to­day the schools are closed.

Hours be­fore this, a re­porter asked Cuomo if New York City schools would be closed, which caused him to tell the re­porter they were ‘con­fused’ and gen­er­ally go on a tirate.

Kids can’t go to school any­where in the city de­spite many ar­eas still be­ing at roughly 1% pos­i­tive rates, but they can go to a movie the­ater for ‘en­rich­ment’ in­stead.

De Bla­sio has no plan for how to re­open the schools, be­cause ’“This day seemed far off, thank­fully.” Isn’t it great when your false im­pres­sions save you from hav­ing to do the work of be­ing mayor?

Th­ese sto­ries always put me in a strange spot, be­cause I am not in gen­eral in fa­vor of schools, but clos­ing schools while al­low­ing in­door din­ing to con­tinue is ev­ery­where and always a stun­ningly ma­jor league screw-up. Schools so far do not seem to be a ma­jor source of trans­mis­sion in the city, and many find them in­valuable. Even if you agree with me that school is ter­rible, re­mote learn­ing as im­ple­mented by schools seems to be far worse, and be de­signed to en­sure kids don’t es­cape any of the tor­tures of at­tend­ing school while not pro­vid­ing what benefits they were get­ting by be­ing around other kids and oc­ca­sion­ally even learn­ing things. It’s al­most as if the sys­tem acts to pun­ish peo­ple rather than solve the prob­lem.

I am con­fi­dent that clos­ing schools while leav­ing other things open is go­ing to dam­age the kids in­volved, given the cur­rent state of re­mote learn­ing, and en­rage the par­ents es­pe­cially those put into lo­gis­ti­cal night­mares, which is a lot of them. They will re­mem­ber.

And re­mem­ber that if re­mote learn­ing is mak­ing the whole class de­pressed, or oth­er­wise de­stroy­ing lives, that is a choice made by hu­mans that can be un­done by hu­mans. Con­sider con­tact­ing the other par­ents in the class, stand­ing as one voice, and say­ing no. Tell them what the new rules are, and dare them to fail the en­tire class over failing to sit there and be tor­tured. Or, of course, con­sider with­draw­ing from re­mote learn­ing en­tirely, and us­ing other meth­ods.

In Other News

You know how you get peo­ple to give up en­tirely and let the pan­demic run wild? One easy way is you say things like this, and tell peo­ple that even af­ter they are per­son­ally vac­ci­nated with a 95% effec­tive vac­cine, and wait the 14 days af­ter the sec­ond shot, they still need to wear masks and so­cially dis­tance. Not only wouldn’t I blame peo­ple for giv­ing up if they thought that was the offi­cial Very Se­ri­ous Per­son line, I’d think that from their per­spec­tive they were ab­solutely do­ing the right thing.

Marginal Revolu­tion re­ports that NY Times re­ports a 30-minute at-home Covid test has been ap­proved, al­though a pre­scrip­tion is re­quired be­cause the car­tel must be paid.

A study came out in Den­mark look­ing at the effec­tive­ness of mask us­age. It was un­der­pow­ered, leav­ing it un­able to con­firm its hy­poth­e­sis that mask use is highly effec­tive, and you can guess how peo­ple are in­ter­pret­ing that. It looks like if you don’t use an­ti­body tests, which in con­text in­tro­duce a ton of noise to an already un­der­pow­ered study, you do find suffi­cient ev­i­dence to con­clude the masks worked. This de­spite low power, highly un­even mask com­pli­ance (which is to be ex­pected in the real world of course), and also ev­ery­one treat­ing ‘what we can show with p<0.05’ as equal to ‘how effec­tive masks are’ when eval­u­at­ing the study. Plus no one can make the other per­son wear a mask, which is where the ma­jor­ity of effec­tive­ness lies. All in all, it seems like even more strong ev­i­dence masks work, and full mask com­pli­ance would be more than suffi­cient to end the pan­demic quickly on its own.

Mayo Clinic has had 900 peo­ple in­fected over the past two weeks, with 93% of them get­ting in­fected while off the job, and the ma­jor­ity of the rest be­ing in­fected in the break room while eat­ing. In­door din­ing is still su­per dan­ger­ous, and we get an­other data point that it is pos­si­ble to take proper pre­cau­tions when pro­vid­ing health care. If you want to do some­thing safely badly enough, you can do it, and the pro­fes­sion­als want it badly enough.

Dolly Par­ton helped fund the Moderna vac­cine. Neat. No idea why any­one needed to do that, but still. Neat.

You re­mem­ber that thing we heard about two weeks ago, that it seems we can mostly de­tect who has Covid-19 for zero marginal cost through anal­y­sis of an au­dio record­ing of a forced cough? And then ev­ery­one for­got about it, pre­sum­ably be­cause reg­u­la­tory bar­ri­ers mean it’s use­less? It’s still there and still looks much more ac­cu­rate than it needs to be in or­der to be the ba­sis of a solu­tion to this whole thing. It would still be a real, real shame if some­one were to find a way to make this available for free on­line to any­one who wants it. A real shame!

There’s also now a pro­posal to use smart­watch data, which can hap­pen au­to­mat­i­cally for ex­ist­ing users. The ques­tion the pa­per does not yet an­swer is how many false pos­i­tives the sys­tem would find. If that num­ber is suffi­ciently low, and reg­u­la­tions don’t get in the way, this seems valuable. Un­til we get that in­for­ma­tion, noth­ing to see yet. But it’s more ev­i­dence for the the­ory that ‘Covid-19 causes a bunch of changes to most peo­ple and you can de­tect those changes in a lot of ways.’

Se­na­tor Rob Port­man (R-OH) has an­nounced he is part of the Janssen-John­son and John­son Phase 3 vac­cine trial. Good for him!

Elon Musk gets tested four times for Covid-19 in one day, gets two pos­i­tives and two nega­tives, shares news with the world with fram­ing that “some­thing very bo­gus is go­ing on” via Twit­ter. As any­one who knows Bayes’ rule can figure out, he al­most cer­tainly had Covid-19. A few days later, he had to watch his lat­est SpaceX launch re­motely. But also he put as­tro­nauts into space so let’s all go easy on him and wish him a speedy re­cov­ery. It’s all right that he has use­ful mod­els of some parts of the world but not oth­ers.

If you had 50%+ pos­i­tive test rates and death tolls to match in the ‘what it takes to get Gover­nor Doug Bur­gum of North Dakota to is­sue a mask man­date’ pool, con­grat­u­la­tions, you’re a win­ner. It can be done.

Last week Cuomo told us he was go­ing to try and stop dis­tri­bu­tion of the vac­cine to New York un­til Bi­den was pres­i­dent. In a rare show of bi­par­ti­san co­op­er­a­tion, Trump won’t de­liver it un­til Cuomo says he’s ready. Cuomo of course re­sponded by threat­en­ing to sue. Bi­den has an­nounced he is go­ing to ap­point a ‘sup­ply com­man­der’ to dis­tribute the vac­cine, which could be quite the point of lev­er­age if one wanted to use it.

Re­mem­ber Fe­bru­ary? When the in­com­ing Chief of Staff Ron­ald Klain was one of many tel­ling us things like “If you want to do some­thing use­ful to­day, go to Chi­na­town — buy a meal, go shop­ping. The virus at­tacks hu­mans, not peo­ple of any eth­nic­ity/​race. Fear is hurt­ing Chi­nese-Amer­i­can owned busi­nesses, base­lessly. Let’s fight the dis­ease AND let’s fight prej­u­dice” or “We don’t have a #COVIDー19 epi­demic in the US but we are start­ing to see a fear epi­demic. Ku­dos to @NYCMayor (and oth­ers) for stand­ing against that”? It’s im­por­tant. We need to re­mem­ber.

Sur­geon Gen­eral backs the ‘pan­demic fa­tigue’ fram­ing of why con­tain­ment has col­lapsed.

Marginal Revolu­tion looks back at Eco­nomics and Epi­demiol­ogy. All points made here seem right to me.

Min­nesota Repub­li­cans test pos­i­tive for Covid-19, alert Repub­li­cans but do not alert Democrats. SFailure to no­tify Democrats in the state leg­is­la­ture of Repub­li­can pos­i­tive tests seems to also have hap­pened in Penn­syl­va­nia. And Ohio.

Thread in which a Very Se­ri­ous Per­son points out things are bad, but also finds new ev­i­dence that an­ti­bod­ies are pro­tec­tive via a case study at a camp. Water is wet, sky blue, ex­perts re­port. Which is valuable when many Very Se­ri­ous Peo­ple are con­tin­u­ously say­ing they are not sure.

More than 80 per­cent of pris­on­ers in Car­son City prison test pos­i­tive for Covid-19. Re­minder that a large per­centage of pris­on­ers have not even been con­victed of a crime.

So this is weird, there’s a pat­tern of peo­ple who have had Covid-19 say­ing Coke no longer tastes good. How many lives will be saved? How many oth­ers im­proved? And pre­sum­ably this wouldn’t only hap­pen to Coke, so what is the gen­eral pat­tern? It would be great if this was a gen­eral awak­en­ing that ar­tifi­cial su­per­stim­uli were not good.

As one of those who fled New York City due to the pan­demic, but who plans to re­turn, I’ve been cu­ri­ous to get a good es­ti­mate for how many peo­ple left the city. My best guess was that a lot of peo­ple left Man­hat­tan, with the ma­jor­ity of some richer ar­eas emp­ty­ing out, based on var­i­ous anec­do­tal sto­ries of empty build­ings, but never found any hard data. The New York Post tal­lies the change of ad­dress forms and comes up with 244k such re­quests from March through July, ver­sus 101k the pre­vi­ous year. So that would be a 143k change of re­quest forms. The Post doesn’t then mul­ti­ply by house­hold size, but I think this is an over­sight and should in­crease this by at least a fac­tor of 2.4? Given that fam­i­lies have greater in­cen­tive to leave than sin­gles, prob­a­bly more. Ris­ing crime cer­tainly isn’t helping but that didn’t hap­pen un­til af­ter June and the spike was al­most en­tirely done by then, so that’s more the Post show­ing its agenda than a ma­jor real cause. I do buy that the spike in de­par­tures from the Up­per West Side zip codes hous­ing new tem­po­rary home­less shelters is not a co­in­ci­dence.

“It is heart­break­ing to see the poli­ti­ciza­tion of sen­si­ble pre­cau­tions. Think how quickly ev­ery­one agreed to take off their shoes in air­ports.” Be­cause of one oth­er­wise failed ter­ror­ist at­tack that re­sulted in zero ca­su­alties, and al­most two decades later, in many places we are still do­ing it. Quite the ex­am­ple that got picked there. Maybe there is a rea­son peo­ple are skep­ti­cal when the gov­ern­ment tells them what they need to do to stay safe.

Conclusion

It’s awful out there. Stay safe. The vac­cine is com­ing, but for most of us not un­til some­thing like April or May.

Google es­ti­mates there are 18 mil­lion health care work­ers in the United States. We will have enough vac­cine doses in 2020 to give to 20 mil­lion peo­ple. Ad­ding in po­lice and fire­men would make it an even 20. As­sum­ing that is in­deed where we start, there won’t be much left for oth­ers, even the most vuln­er­a­ble. There are 49.5 mil­lion Amer­i­cans over the age of 65.

Mean­while, peo­ple are go­ing to keep act­ing ir­re­spon­si­bly and do­ing stupid things. Amer­ica is not go­ing to do what it takes to get things un­der con­trol in the next few months. The mes­sage here hasn’t changed. Time to buckle down. Will the med­i­cal sys­tem hold to­gether? My guess is it prob­a­bly will, but we are about to test it and find out. You don’t want to be part of that test.

Don’t do stupid things.