[CriticalCathed]

Absolutely. One of the worst consequences that we may have to deal with at the end of this is that public trust will go down. In the beginning our leaders failed to act on the guidance of the scientific and medical communities -- almost two months wasted. And now, our leaders are flailing around implementing policy that is not based on reliable data or scientific evidence. They've both failed to react and then when they did react they are in many ways failing to act prudently.

Take a look at this editorial written by John Ioannidis. Excerpt that is relevant, though the whole thing is a worthwhile read:

>If COVID-19 is not as grave as it is depicted, high evidence standards are equally relevant. Exaggeration and over-reaction may seriously damage the reputation of science, public health, media, and policy makers. It may foster disbelief that will jeopardize the prospects of an appropriately strong response if and when a more major pandemic strikes in the future. [0]

Quick BIO rip from wikipedia:

>Ioannidis studies scientific research itself, especially in clinical medicine and the social sciences. He is one of the most-cited scientists in literature. His 2005 paper "Why Most Published Research Findings Are False" is the most downloaded paper in the Public Library of Science, and has the highest number of Mendeley readers across all science."

>Ioannidis is a Professor of Medicine, of Health Research and Policy and of Biomedical Data Science, at Stanford University School of Medicine and a Professor of Statistics at Stanford University School of Humanities and Sciences. He is director of the Stanford Prevention Research Center, and co-director, along with Steven N. Goodman, of the Meta-Research Innovation Center at Stanford (METRICS). He is also the editor-in-chief of the European Journal of Clinical Investigation. He was chairman at the Department of Hygiene and Epidemiology, University of Ioannina School of Medicine as well as adjunct professor at Tufts University School of Medicine.

[0] https://onlinelibrary.wiley.com/doi/pdf/10.1111/eci.13222

[wool_gather]

Ioannidis had [a similar opinion article][0] published last week.

It's worth reading [the rebuttal that followed][1] (as long as we're doing credentials: "Marc Lipsitch, D.Phil., is professor of epidemiology at the Harvard T.H. Chan School of Public Health and director of Harvard’s Center for Communicable Disease Dynamics."):

It agrees that the basic lack of good information is a failing and also certainly creates risk. But we have seen at least twice now the outcomes of doing nothing or almost nothing:

> First, the number of severe cases — the product of these two unknowns — becomes fearsome in country after country if the infection is allowed to spread.

> So acting before the crisis hits — as was done in some Chinese cities outside Wuhan, and in some of the small towns in Northern Italy — is essential to prevent a health system overload.

There are clearly no truly good choices available right now.

---

[0]:https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...

[1]:https://www.statnews.com/2020/03/18/we-know-enough-now-to-ac...

[CriticalCathed]

I had read that rebuttal. The odd thing about it is as the author himself wrote, I'm not sure that Ioannidis is advocating inaction. Neither would I. Things must be done. It's that it's completely unclear that the "lockdown" stuff that is going to cause a new depression is actually worth it, or effective. And because lockdown is so vague, I mean not allowing people to go outside under threat of imprisonment and fines, or needing papers to travel somewhere. It may be an extreme overreaction, and I personally believe the cure would be worse than the disease. There are other things we can do.

Here's speculation based on data:

I can't help but see the demographics of those who are dying and come to the conclusion that this is not a threat to the general population in the direct sense. No one aged 0-9 has died worldwide to date. No one in Italy under 30 has died. Of those that have died in Italy, 88% had one or more serious comorbidities; only 12% can be directly attributed to COVID-19. It seems that this is killing people who are already sick or in fragile health; it just so happens that the elderly of course dominate those categories. Consider this: nearly 3,000,000 people die every year in the USA. How many of those who will die this year from COVID-19 will overlap with that 3,000,000? In other words, could it be that the excess mortality rate of COVID-19 when amortized over the next two years isn't actually that high? Does it make any sense to throw ourselves into a depression because of this? Remember, the effects of eceonomic downturns affect every single aspect of peoples lives including their health. If we do this wrong even more people may die or have significant, long lasting, hardship because of an ill-considered and potentially unnecessary intervention.

I read a paper this morning that suggested some things that I believe need more attention:

> For example, we are learning that hospitals might be the main Covid-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients. Patients are transported by our regional system,1 which also contributes to spreading the disease as its ambulances and personnel rapidly become vectors. Health workers are asymptomatic carriers or sick without surveillance; some might die, including young people, which increases the stress of those on the front line.

>This disaster could be averted only by massive deployment of outreach services. Pandemic solutionsare required for the entire population, not only for hospitals. Home care and mobile clinics avoid unnecessary movements and release pressure from hospitals.2 Early oxygen therapy, pulse oximeters, and nutrition can be delivered to the homes of mildly ill and convalescent patients, setting up a broad surveillance system with adequate isolation and leveraging innovative telemedicine instruments. This approach would limit hospitalization to a focused target of disease severity, thereby decreasing contagion, protecting patients and health care workers, and minimizing consumption of protective equipment. In hospitals, protection of medical personnel should be prioritized. No compromise should be made on protocols; equipment must be available. Measures to prevent infection must be implemented massively, in all locations and including vehicles. We need dedicated Covid-19 hospital pavilions and operators, separated from virus-free areas.[0]

[0] https://catalyst.nejm.org/doi/pdf/10.1056/CAT.20.0080

[Kaze404]

> In the beginning our leaders failed to act on the guidance of the scientific and medical communities -- almost two months wasted.

Some of them still are. Bolsonaro went on TV to downplay the virus and is actively trying to reduce state agency because state governors aren't waiting on the federal government to protect their citizens.