Steve Kirsch is AFAIK not a rationalist, but he was banned from Medium for claiming the effectiveness of a specific drug in treating Covid-19 was 100% based on two trials. Personally I think his claim is overstated (confidence intervals and so on) but the main thrust of his argument is reasonable and definitely not even close to ban worthy. https://www.skirsch.io/medium-ban-for-life/
Thanks for the answer, and I understand where you are coming from. But concluding that “we need to do more studies” is not useful in this case, when most of the future damage of the pandemic will happen in the next few months, and publishing new studies takes close to a year.
Thanks for the explanation. I do not understand the formula however. As I read your explanation, if both strains had the exact same doubling time of 6.5 days, one strain would still be ln(2) *6.5/6.5 = 0.69 more infectious than the other one, so I must be misunderstanding.
Very well written post, although I disagree with the main conclusions. But first of all, I agree that both in the original and in the updated version of the essay Kelly seems to imply that if an average artist goes for his strategy, they can expect (>= 50%) to be able to live off their work:
I don’t know the actual true number, but I think a dedicated artist could cultivate 1,000 True Fans, and by their direct support using new technology, make an honest living.
Having said that, I do not think your conclusions about the EMH hold here, or that they are somewhat inconsistent with your other statements. First of all you agree with the author regarding the superiority of the “1000 true fans” strategy over the broad appeal strategy.
However, then you assert that according to the EMH it is impossible that one job is much easier than the other. But that would also mean that the “1000 true fans” path cannot be superior to the normal path, so both of your assertions are (somewhat) in conflict with each other.
But the EMH brings it all together in a much bigger way. It says:Is this author suggesting that it’s much easier to do one job than another and make the same money?THEN THIS AUTHOR IS WRONG!!!!
But the EMH brings it all together in a much bigger way. It says:
Is this author suggesting that it’s much easier to do one job than another and make the same money?
THEN THIS AUTHOR IS WRONG!!!!
Personally, I both believe that the 1000 true fans strategy is indeed more superior for many/most creators and in that sense a 20 dollar bill that is lying on the ground for a long time. If one believes in the EMH here, one would also need to explain why it took >10 years for OnlyFans and Substack to emerge.
I have also been experimenting with mind palaces for books this year, and have a slightly different experience. This is not meant to contradict your experience, just pointing out that it can vary for different people:
1)”Constructing a memory palace makes textbook reading more engaging and focused.”
While I am indeed more focused while memorizing boring content, I would not necessarily say that it is more engaging, in part because I have to mentally switch between reading/listening and visualizing. Furthermore, despite long experience, visualizing does not feel effortless for me, so unlike you I cannot study a textbook this way longer than when I am just studying it.
3) A memory palace helps you relate and understand concepts.
True, and a very important point. My biggest gripe with Anki/Flashcards is how split up the knowledge becomes after atomizing the pieces of information.
4) Visualization practice and memory palaces make you more able to see and manipulate 3D structures.
My loci in the memory palace are fairly generic, in that they would work just as well as 2D pictures, which is maybe why I do not feel like I got better at manipulating 3D structures. Certainly, I have never used a complex 3D structure in my mind palaces, it would just take too long in the first place.
I also think that visualization/mind palaces would be tremendously worthwhile in school or/and work. They are great for deeper mastery of concepts, because they allow for longer recall AND building links between topics, but also for stupid grinding of facts before an exam.
This is a very important topic and question, but I fear that you generalize too much and your assessment of Western politicians’ understanding lacks subtlety. In particular, my opinion is that the obviously good strategies were just not politically feasible. In the beginning of the pandemic, I used to treat arguments of the form “The successful strategy of country A is just not possible in country B” as defeatism and status-quo bias, but I now believe that the South Korean model is indeed not possible in Western democratic countries. This can be seen by creative and smart initiatives of some Western countries that nevertheless failed.
You mention that the government holds the following misconception:
It’s fine to hover just below the point where hospitals get overwhelmed—it’s not important to bring down the number of active cases as low as possible
However, the German government is perfectly aware of the meaning of exponential spread, here is chancellor Angela Merkel explaining what R means and why a value of 1.1 would be too high.
While hand-washing was an important recommendation in the beginning here as well, our public health messaging has been focused for some time now on droplet and aerosol transmission. School and university classrooms are often required to be ventilated at regular intervals (which for most schools is not doable, but that’s a different topic). Hand sanitizer is also much easier to implement than any ventilation measure in Winter.
You also invoke the risk society thesis, but this would apply to Asian countries as well, which were able to contain the virus.
In addition, I think “the summer success in Western countries was not due to measures but due too weather effects” is far too strong a claim. European countries had a decent contact tracing system and cancelled mass events, while the US did not have the first part and had far worse numbers in summer.
Why the South Korean model would not work in the West:
South Korea did contact tracing very well, with huge invasions of privacy like checking CCTV data, publishing the whereabouts of infected individuals and using credit card transaction history. In the US and the UK contact tracers are happy if contacted individuals pick up their phone at all. It’s paradoxical, but it seems to me that Western populations would rather accept a wrecked economy, restriction of movement AND hundred thousands of deaths than a temporary surveillance program.
Examples of Non-Asian countries with smart but failed initiatives:
As far as I can tell, there has only been one Western country to try to eradicate the virus, namely Israel which implemented very tight border control policies and a mobile phone surveillance initiative very early. However, my impression is that cooperation of the populace is just not high enough, which is why a second lockdown had to be imposed.
A to me pretty saddening case is the initiative of the Slovak government to test its entire working age population through cheap antigen tests. Testing was semi voluntary, with the other option being mandatory quarantine. New infection numbers fell very rapidly, but because the testing was done in parallel with a partial lockdown it’s not exactly easy to determine causality. However, since many other European countries with similar lockdowns have at best a flattened curve it seems very likely that mass testing was a great idea which is why it’s copied now in parts of England, Austria and Italy. Despite the large success and subsequent reopening, another round of mass testing has in Slovakia been postponed indefinitely, mostly because the mandatory quarantine got many voters angry and popularity of the government has been waning rapidly.
So in conclusion, many smart policies are much harder to implement in Western countries and may actually reflect the preference of the population, and that our current situation is not because of governments “[...] making some silly errors, not updating their information, and not thinking through the long-term effects. ”
However, there was/is room for fairly cheap wins through scientific and regulatory adaptation. This post is already too long, but briefly put the failure seems to be in those two areas. Despite strong theoretical justifications, no country (AFAIK) has so far approved at home, cheap antigen testing.
Does anybody have recommended resources that explain the timeline of clinical trials of interventions? Specifically why they take so long and whether that is because of practical necessity or regulatory burden. Bonus points if Covid-19 is included as a context.
You are applying the incentive heuristic inconsistently. On the one hand you infer that if there was string evidence of long term effects, governments would be very vocal about it. But on the other hand, you ignore that these incentives would also apply to the Vitamin D effects that you cite. Governments would also surely have an interest to publicize an intervention that has a 25 fold reduction in risk. So the estimate is wrong or your conception of how governments work is wrong.
I suggest that it is both. Other answers have already mentioned that a 25 fold reduction in risk would be ridiculous, and governments just do not respond to incentives like that.
This study is a strong reason to fear prevalent long term consequences for cognitive performance after even mild Covid-19 infections.
On the other hand, you do not mention the strongest reason for supporting your view: the relatively underexplored long term effects of mRNA vaccines. However, if you worry about those, you should just get the traditional-style Oxford or J&J vaccines. Since they use the same technology as well established vaccines, taking them should be fundamentally as safe as getting your flu shot.
The Cuomo video does not have the quote “stop the distribution of the vaccine”, the clip says that Cuomo wants to shape or stop Trump’s *plan*. This could mean that an alternative plan would be implemented that would fulfill the Cuomo’s requirements.
I feel that getting the quote right is necessary if one is literally calling for pitchforks.
but I will bet you ANYTHING that those who DO get infected are at least less infectious.
I am less sure, based on the results of the Oxford vaccine trial: “Viral gRNA was detected in nose swabs from all animals and no difference was found on any day between vaccinated and control animals.” Viral load is indeed lower in the lower respiratory tract, but my understanding is that infections spread mainly from the upper respiratory tract. And if you factor in how most infections are detected, namely by an individual experiencing symptoms, it is conceivable that vaccinated and thus asymptomatic Sars-Cov 2 carriers will be in effect more infectious.
Reposting my comment under Zvi’s post:
Due to the online collection method I suspect that most of the positive samples were already quite advanced in their disease progression. Since Covid-19 deposits in the lungs mainly in the latter part of the disease it is easier to identify them at that point, but also not that useful anymore because most of the transmission happens during the earlier part of the infection (both for symptomatic and asymptomatic people).
These researchers had a much better sample procedure, cough samples were mostly acquired at testing sites, where participants did not know yet whether they have Covid (much less risk of subconscious bias) and were presumably at an earlier stage of their disease. They also had much worse results, which I suspect are more realistic for a real world setting.
What actually needs to be done is to do a longitudinal analysis, i.e. you record your baseline cough when you are healthy. Then if you want to check if you are infected, you cough again and compare that “potentially sick” cough against your baseline “non-covid cough”. The potential of this approach is much higher since baseline characteristics of the cough can be accounted for (smoker, asthmatic, crappy mic in phone).
I have been thinking that it should be possible to gather training data for this quickly by identifying a subset of people that are somewhat likely to get sick in the near future like e.g. people participating in big parties, and acquire coughs from them prior and subsequent to infection. If somebody has ideas how to collect such data quickly, feel free to share.
Regarding the cough identifying AI: Due to the online collection method I suspect that most of the positive samples were already quite advanced in their disease progression. Since Covid-19 deposits in the lungs mainly in the latter part of the disease it is easier to identify them at that point, but also not that useful anymore because most of the transmission happens during the earlier part of the infection (both for symptomatic and asymptomatic people).
I have been thinking that it should be possible to gather training data for this quickly by identifying a subset of people that are somewhat likely to get sick in the near future like e.g. people participating in big parties, and acquire coughs from them prior and subsequent to infection. If somebody has ideas how to acquire such data, feel free to share. As an aside, I am somewhat surprised that we as a community interested in AI and out-of-the box thinking have not focused/discussed AI for Covid detection much earlier.
We need more discussion of Slovakia’s approach: Mass testing everybody with cheap antigen tests, testing is semi voluntary, if you don’t have a negative test result you have to quarantine.
I maintain that the Slovak government has shown extraordinary competence here, when compared against an admittedly low international baseline. Even more astonishingly, the Lancet article makes it seem like they went against the advise of their scientific advisors who pushed for a 45 days lockdown.
Before doing nationwide testing, they implemented a successful local test run.
They understand what an incubation period is, and are therefore doing two runs, last weekend and this weekend.
With antigen tests they settled for a good enough solution, understanding that they will catch the vast majority of infectious people who PCR tests would have caught as well.
They managed to mobilize this whole initiative seemingly in a span of 2-3 weeks, with soldiers making sure distances are kept in waiting lines.
What I find most surprising is how discerning the government was in picking out the right advice and ignoring the bad scientific advice (at best governments follow one set of advisors completely, mostly they implement their recommendations in a worse than random way). Why bad? Because most epidemiologists only consider medical harm but not economic, and let the perfect be the enemy of the good:
The bad advice included: Antigen tests are less reliable than PCR tests, that there would be high infection risks at the testing sites, that not enough doctors would be available, that it would be immoral to forcibly quarantine people who do not want to be tested (apparently much better to effectively quarantine everybody in a lockdown), that a lockdown that would crush the economy was the better approach( what comes after the lockdown when the numbers will most likely rise again?)
This is not to say that each individual point was wrong or unlikely to happen, just that the epistemic standard when trying something new should not be “this will definitely work without any problems” but “this is worth a shot”, particularly when the other alternatives have huge downsides as well. Neither am I saying that everything was done perfectly (I am unsure whether it is best to exclude 65+ citizens, citizens could maybe also do the swab testing supervised but themselves)
The jury is still out on whether this will flatten the numbers, but we should all hope that it works out for them so we have a viable alternative.
Any remark on the recent reports of reinfections? In previous pieces you were quite critical of such reports, IIRC you estimated a minimum of 4 months of immunity. However, the US reinfection case seems to have been reinfected after less than two months, and with a much more serious reinfection to boot.
Your quoted cost for training the model is for training such a model **once**. This is not how the researchers do it, they train the models many times with different hyperparameters. I have no idea, however how hyperparameter tuning is done at such scales, but I guarantee that the compute cost is higher than just the cost for training it once.
Given that Steven Pinker retweeted Scott’s deletion post and this news article , this issue will probably keep getting publicity for better or worse. Given this, some people will start looking for Scott’s real name, and thus it would be a great idea to increase the entropy here by promoting a value for Scott’s real name that is not ahem entirely accurate. Thoughts?
Evidence for surface transmission seems to exist: according to this article + report, staff in a hospital did not get infected themselves, but probably caused transmission between patients via non disinfected medical tools https://www.sciencemag.org/news/2020/05/study-tells-remarkable-story-about-covid-19-s-deadly-rampage-through-south-african