29.8.20

WE DIDN'T UNDERSTAND THE COMPLEXITY OF THE PROBLEM.

That's sociologist Zeynep Tufekci in The Atlantic, a week into the house arrests.
As it turns out, the reality-based, science-friendly communities and information sources many of us depend on also largely failed. We had time to prepare for this pandemic at the state, local, and household level, even if the government was terribly lagging, but we squandered it because of widespread asystemic thinking: the inability to think about complex systems and their dynamics. We faltered because of our failure to consider risk in its full context, especially when dealing with coupled risk—when multiple things can go wrong together. We were hampered by our inability to think about second- and third-order effects and by our susceptibility to scientism—the false comfort of assuming that numbers and percentages give us a solid empirical basis. We failed to understand that complex systems defy simplistic reductionism.

Widespread asystemic thinking may have cost America the entire month of February, and much of what we’d normally consider credible media were part of that failure.
As of that writing, the Wuhan coronavirus still appeared to be scary.
Health systems are prone to nonlinear dynamics exactly because hospitals are resource-limited entities that necessarily strive for efficiency. Hospitals in wealthy nations have some slack built in for surge capacity, but not that much. As a result, they can treat only so many people at once, and they have particular bottlenecks for their most expensive parts, such as ventilators and ICUs. The flu season may be tragic for its victims; however, an additional, unexpected viral illness in the same season isn’t merely twice as tragic as the flu, even if it has a similar R0 or CFR: It is potentially catastrophic.
"Potentially," yes. Five months into "fifteen days to slow the spread," it's clear that the continued quarantine theater is no longer helpful.  Just go read Jeffrey Tucker.  "[S]chools should never have closed, ... [B]eaches should have stayed open, ...[B]ars, dance clubs, and professional meetings should have gone ahead. Calm and normal social functioning were necessary to deal a swift blow to the virus so that the vulnerable populations would not be forced to shelter in place for many months, much less a full year."  I recommend that you read and understand the whole essay, and follow the links to various epidemiologists and other health practitioners, and I concur with his conclusion.  "Lockdowns have done nothing to protect anyone while creating astonishing chaos and confusion all around, with no evidence that they have minimized mortality for any groups."

In addition, note the time series comparing deaths per million among countries, tests per million residents (not surprisingly, the small countries are testing more of their residents), the case fatality rates, and the infections counted.  In the United States, "Not only is the epidemic becoming less deadly, but its spread has slowed."  If, as this essayist suggests, the confirmed infections are a substantial undercount of total infections, the problem might be even less severe.

I note also that the last update of hospital capacity by the Centers for Disease Control was issued in mid-July.  The Institute for Health Metrics are still guessing at future loads on hospitals. but that chart makes no reference to hospital, intensive care unit, or ventilator capacities.

Taken together, dear readers, if the original premiss of the house arrests was to keep the hospitals and intensive care units from being overwhelmed, and the people who have the capability of or the responsibility for keeping track of the utilization rates are not sounding alarms about pressure on that capacity, is it not the case that those house arrests have long since served their purpose?

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