“Here’s what that looks like in the context of exponential growth:”True but actually it is worse than this. As places like Australia are finding, it is not just a matter of a different growth rate. Measures that stopped the pandemic in its tracks before fail completely in the face of delta.I would also point out that this is looking a bit like the Spanish Flu (which apparently actually started in the US midwest). Later variants were more infectious and attacked younger people more severely. I can attest from personal experience that you do not want to get long covid. There is a view that either you die or you are fine—nothing could be further from the truth.This is a long way from being over.
“I worry that recently I’ve lacked sufficient skin in the game. Everyone I personally care about is vaccinated or young enough that they don’t need vaccination, so the real sense of danger is largely gone.”
[Quotes because editing after using “>” for quotes is totally broken here.]The strategies being employed at the moment in countries partially but not sufficiently vaccinated are to a close approximation the optimum for evolving viruses that are more transmissible to vaccinated people. We have a huge number of infected and a huge number vaccinated in the same population thus the maximal evolutionary pressure and opportunity.So it is somewhat likely—hard to tell how likely—that variants that are resistant to the vaccines will appear. When a disease is only slowly transmissible there is an evolutionary incentive for it to become less ( and less quickly) fatal. However diseases that are easily transmitted have far less incentive to become less quickly fatal e.g. cholera in some parts of the world.My conclusion is that given the risk that a more transmissible, more vaccine resistant and more deadly variant will appear, everyone has skin in the game.Not to mention the “long covid” syndrome which is very nasty and fairly prevalent in young people. And that we really have little idea of the long term consequences of non-fatal infections in young people. I remember when Chicken Pox was considered a mild and harmless illness. Tell that to people who have suffered years of excruciating pain from shingles as a result of Chicken Pox later in life.
This was, I think, a reasonable characterisation of wikipedia in the early days. Things are very different now. You have to navigate a gauntlet of deletionistas, poorly defined rules, gatekeepers, and political biases. I gave up a couple of years ago. The most difficult aspect is the arbitrary rules about what sources are authoritative and what are not.One small example: You are (or were when I looked) required to refer to male genital mutilation as “circumcision” and are not allowed to refer to it as “male genital mutilation”. The female version may not be referred to as “circumcision” and must be called “female genital mutilation”. The opinions of the doctors who make money from this operation on males must be deferred to as definitive. Basically I found everything was like this. You are not allowed to refer to primary sources such as journal articles but must only refer to secondary sources such as textbooks or newspapers, which are often out of date, biased or wrong. You have the ridiculous situation where people have tried to correct their own date of birth by supplying a copy of their birth certificate and this was rejected. In at least one case, the person had to arrange for their date of birth to be mentioned in a newspaper and then it was accepted. In fields where there is no political controversy things are not so bad. But you are still subject to the deletionistas who will find any possible reason to nuke your hard work. And wikipedia’s view that there is a definitive version of the truth on any given issue makes it utterly hopeless at covering anything that is controversial. I am certain that wikipedia of the early C17 would be presenting the geocentric view of the universe as definitively true.
Well worth reading the linked material—quite damning.
I read the negative paper (I had already read the positive one). The positive one concludes, rightly I think, that there is evidence falling short of proof that IM is likely to be useful. I am not at all happy with the negative paper. 1. Lots of highly emotive language against IM suggesting a lack of objectivity. Another thing suggesting lack of objectivity is that they put <did not find IM useful> in their list of strengths. I wonder who would find this a strength and why? Also sneering about studies done in low income countries did not endear them to me.2. They really went all out, above and beyond the call of duty, trying to exclude papers. Again it did not seem like they were humbly and objectively seeking the truth. It seemed to reek of motivation. Having reduced the papers that qualified to a tiny number, then surprise surprise the result is N.S. Which they can then misrepresent (see next point).3. Misstatement of the conclusion. Lack of statistical significance does not mean you showed the thing doesn’t work, especially given P=13% and RR=0.37. Given the small numbers the reduction in deaths would have had to have been enormous (~80%) to achieve significance. 4. I could not find a design of the study, published before they started. This is a concern, because they excluded studies of prophylaxis (prevention of infection), which is reportedly the strong point of IM. No convincing explanation was given for why they did this. Ironically they criticise other studies for not having prepublished designs.5. It was interesting that every study that they quoted showed a large reduction in deaths. And they found fault with just about every one of them. Their own study showed a 63% reduction in deaths also, but was N.S.I too would probably take IM if I had CV (or even was exposed) and could get access. ATM it seems likely it would be helpful and the downside seems low. IM has been in use for decades and billions of people—many with poor nutrition and otherwise vulnerable—have taken it. So it is not a great unknown in terms of side-effects.
Certainly this study does not show IM does not work, but it will be quoted as though it does. There have been studies of vitamin D and CV that are also poorly conducted and seemingly rigged to produce a N.S. result. E.g. you give vitamin D when people are late in the disease, knowing full well that it takes a couple of weeks for it to be metabolised into the fully active form.
Is there any kind of resource that reliably turns up high-quality papers?
No you just have to filter. In any particular field you get to know the agendas and limitations of many of the researchers. X is a shill for company Y, A pushes the limits for p hacking, B has a fixed mindset about low fat diets. etc. Some researchers also tend to produce me-too and derivative papers, others are more innovative.Also you do get quicker at spotting the fatal flaw. In finance there are blogs that pick out recent good papers; these are a huge time saver (e.g. Alpha Architect which I have mentioned before).
Some general comments about medical research. Source: I have studied the statistics books in detail, and have read several cubic meters of medical papers and learned most of the lessons the hard way. When reading medical papers look for 1. Funding sources for the study or for the authors of the study (e.g. “speaking fees” and “consulting fees”). He who pays the piper calls the tune. 2. Statistical incompetence, which is rife in medical research. For example, you routinely see “lack of statistical significance” interpreted as “proof of no effect”. 3. Pre publication of the study design, end points and intended statistical analysis. There is a lot of scope to move the goalposts and engage in p-hacking and other nefarious activities. 4. Differences between the abstract and the text. Often you can read the abstract and wonder if it refers to the same paper .5. In meta-analyses look for whether the selection criteria were adhered to or not or whether subjective criteria were used to exclude inconvenient studies. 6. Financial interests. For example it is notable that countries like India, that make generic drugs, appear to be more favourable to generic drugs. Meanwhile in the US, there seems to be a strong bias in favour of drugs in patent. 7. Read the methods section very carefully. Once you have read enough papers this will become instinctive. 8. Be ready for the vast majority of papers to be of low quality and worthless. 9. I routinely see studies rigged to deliver a predetermined outcome. For example, if you want to find a non-statistically significant effect which can be misrepresented as “no effect”, then run a small study, for a short period, and use suboptimal doses or take other measures to minimize differences between the groups compared.
and other says “is not proven”
In the abstract they make a definitive statement that IM is not useful. This goes well past any rational or reasonable interpretation of the evidence. This raises the question of bias / motivated reasoning. I will read the paper in full today and may comment further.
Bear in mind a lot of studies are for me-too drugs i.e. slight variants of existing drugs that have the tremendous advantage of being patentable, even if they are no better. Such trials provide little benefit to humanity.As a fellow member of the reluctant brotherhood I have seen many friends enter trials only to suffer greatly with no, or even a negative, effect on survival. (Sometimes, I suspect, people will have treatment because it allows them to avoid facing The Horrible Truth*). *That they are indeed mortal.
heart disease deaths are a third of what they were in 1950, (thanks to innovations like statins, stents, and bypass surgery.)
I had a look into this a while back. My conclusion was that two big factors in the reduction in heart attack death rates (not numbers) was in large part due to the reduction in smoking rates particularly in older people and the dramatic reduction in the use of toxic trans fats in processed foods and butter substitutes. The evidence for the life-saving qualities of the 3 items listed was not very strong in the studies I ciykd find. Bear in mind in particular that studies started on or before 2003 and meta-analyses incorporating such studies were conducted under lax rules that allowed all sorts of shenanigans e..g changing the end-points, “run-in periods” etc.I don″t really want to get into a debate about this but be aware at least that the conclusions in the quote above are controversial.
You don’t mention which libertarian works you consulted in forming your views on the topic. A very accessible introduction is “What it means to be a libertarian” by Charles Murray.This point of view is very old e.g. the early Daoist works have libertarian threads. So you don’t have to imagine what libertarians think, and they have been thinking hard about the issues for a long time. One thing that surprises many people is the enthusiastic support among many libertarians for collective action and for cooperative organisations. The caveat being that they are not mandated by overbearing people with guns.Another thing that often surprises is the realization of how well people are able to coordinate among themselves without too many people who are from the government and here to help.
Some examples of possible misinterpretations would add value to your post.With the climate emails part of the problem was the use of language in a different sense from its normal meaning. In scientific fields, trick is often used in the sense of a nifty hack, with nothing sinister implied. Just as in common parlance “theory” means something far less definite than it does in scientific discourse, more like what scientists would call a hypothesis.I would add two other comments: 1. As pointed out in the article, the fact that the lan leak was artificially suppressed does not mean it is right. 2. Just because government officials chronically lie does not mean that any given thing they say is definitely true. It just reduces the information content of what they say.
There is a whole hierarchy of incentives to medical people at different levels in the system. At the bottom1. Free samples2. Free education. 3. Cute/good looking drug reps...The free education comes with a nice meal and convivial company. You just need to sit through the drug company propaganda, which is duly accredited as good for mandatory training hours. What happens if your prescribing fails to conform to the desired profile? You don’t get invited to the next “free” training. At the top (influential professors):1. Funding for studies 2. “Speaking fees”. 3. “Consultancy fees”As with the lucrative “speaking fees” paid to ex politicians and the highly paid and often made-up jobs provided to ex-politicians and bureaucrats and their families, everyone knows the score. If you make trouble the “speaking fees” and the like dry up. Completely by coincidence of course.
I have begun to think that the biggest factor in a drug being approved is drug company sponsorship, and thus the potential for drug company profits. Patentability appears to be a big factor. See “regulatory capture”.
“Fit” is vaguer than BMI...
Which is in every way less precise and useful than body shape index (ABSI). BMI fails for: athletes and strong people, people over 50, smokers and ex-smokers, skinny-fat people; in fact it fails for most people. Maximum longevity is in the (mildly) overweight category of BMI.ABSI predicts heart disease mortality far better than blood tests. BMI is not even in the race except at extremes.This is a classic case of medicine’s common practice of persisting with inferior metrics and practices. My suspicion is that this is a result of the excessive power of “great men” and authorities within the field.
See refs at the end of this https://www.fatcalc.com/absi
Wireheading is expanding rapidly.At first it was drugs, with packaging and delivery carefully designed to maximize addictiveness.
Then gambling, social media. More recently...Stock brokers are increasingly leveraging the well-tested wireheading techniques used by casinos to make their customers into gambling addicts.
Quants are bottlenecked by training data entropy.
Very true and often a big surprise to people. This is one reason people focus on high frequency trades—more data.> diversification … free lunchMostly true, but at the risk of pedantry it is not quite free. It is quite hard to find 10 good trades and far harder to find 100. Diversification can dilute alpha.> World conditions change. Competing actors respond to the historical data.Imagine how hard physics would be if the laws of physics changed whenever you got close the theory of everything. Or if mostly when theories were published they stopped working.
Hmmm in order of certainty1. Save and invest more = more total returns. 2. Diversification is the only free lunch in finance.3. A cautious approach to tilting investments in favour of various factors has a lot of evidence around it. See e.g. this blog https://alphaarchitect.com/alpha-architect-white-papers/4. Strict adherence to dollar cost averaging. Much harder to do than it looks.Also all the personal finance rules apply—avoid unprofitable debt, take out insurance. avoid financial catastrophes like divorce, maximize marketable job skills, save hard.In order of certainty, here are the bad ideas1. Thinking that you can easily beat the market. Maybe with 70 hour weeks for many years… read hundreds of books and papers… otherwise assume you have negative skill to the tune of 4-6% per annum. Also going into the markets with psychological weaknesses unresolved and/or cognitive and emotional biases not dealt with—the markets have ways to find and exploit them all. 2. Investing in high cost funds based on recent outperformance.3. Suddenly deciding to invest it all on stocks “for the long run” after a period of outperformance.
I had some exposure to this issue a couple of years ago. I got a speeding ticket, which eventually I got off of. During this process I documented the government making 26 different errors in all. Starting with the speed limit sign that did not comply with their own standards for speed limit signs in 3 different ways....So I suspect that huge numbers of things go wrong in government all the time and are not noticed. What % of prisoners get checked as required? What fraction of video cameras are out of order at any given time? So the argument “Aha! The camera just ‘happened’ to be out of order!” is not as compelling to me as you might expect.Tho’ it would not be surprising that JE was taken out. He seems to have operated a blackmail operation in part and no doubt a few people breathed a sigh of relief on hearing of his fate. But I don’t know.
Good post.I have wondered about this myself actually. The sad thing is that if we mess it up, there is not enough time before the sun renders multicellular life untenable on earth to restore fossil fuels. So for earth we are the last roll of the dice.