[sbuttgereit]

Reading this I was expecting the same knee-jerk, panic response that has become the "acceptable" public health response to the problem the pandemic places before us.

While I detect a hint of futility in this statement, I am nonetheless deeply heartened to know some public health officials are themselves questioning some of the simplistic premises that have been driving policy to this point at all levels of government. Really there at least three attributes that I see in this statement that I don't typically see in utterings of our bureaucrats:

1) I actually get the sense of outright honesty from this statement. Not some overly messsaged, PR driven/reviewed statement by some spokes-hole. I actually think this statement is really what this guy believes... a public statement that even expresses some vulnerability. Despite the subject, very refreshing and I'd be more likely to listen seriously to what he has to say in future.

2) Struggling with right and good uses of power and seeing not using one's power as itself a public good. Good heavens... this guy should run for President! I expect I'd disagree with much of his politics, but I'd vote for him just for having such thoughts and expect the nation would be better off no matter his other leanings.

3) Questioning the mandates, their effectiveness, and whether they might be causing more harm than good. And not doing so from some artificial posturing to show "the right politics", but honest, genuine questioning.

Whether you agree or not... I wish more of our public officials were this thoughtful on critical issues such as face us in this pandemic.

[heleninboodler]

I agree wholeheartedly with all three of your points. I disagree strongly with one of his positions (I don't think we should be opening schools while the rest of us are locked down), but I too find it very, very encouraging to have a public official obviously using his brain and being honest about the fact that nobody really knows the right answer.

And especially in the context about the use of power, the acknowledgement that imposing a lockdown doesn't actually necessarily change people's behavior all that much is a really good point. We've definitely seen that there are some that will intentionally do the opposite if they feel their freedoms are being impinged upon, so if it's not going to actually make an improvement, the gesture could be a huge mistake.

[snickms]

As some people are claiming doubt as to the effectiveness of lockdowns, let me point you to the Australian stats: https://www.abc.net.au/news/2020-03-17/coronavirus-cases-dat...

It worked particularly well in Victoria, where a second lockdown turned a ~700 case per day nightmare into 38 straight days of no deaths or locally acquired cases.

New Zealand also used a lockdown strategy. stats: https://www.health.govt.nz/our-work/diseases-and-conditions/...

Suicide rates in the most affected Australian states were surprising: https://www.theguardian.com/australia-news/2020/nov/09/suici...

The lockdowns were terrible for many people - for all the reasons you can imagine. On the other hand, I doubt anyone here would now argue that those crazy times were a mistake.

[heleninboodler]

I think it's fairly clear that lockdowns that actually lock people down are undeniably effective. The question is really whether or not imposing a lockdown in any given population will actually result in people cooperating, which I think is debatable for a lot of parts of the US, where we are taught to take a lot of pride in our inability to be controlled. I think the acknowledgement that a lockdown doesn't necessarily have the effect you think it will is a recognition of that cultural phenomenon.

[sdoering]

Yesterday there were some interesting stats shown for Germany. Before the 2nd soft lockdown in November the age bracket of 20 - 35 was the 2nd highest in terms of infections per 100k (within the last 7 days). Only topped by the age bracket 80+.

During our second lockdown the increase in cases did slow down a bit, but only a bit. One could argue, that the soft lockdown didn't really work that well, as it didn't turn the ship around.

The interesting part of the statistics was, that the age bracket of 20 - 35 was the only one with reduced infection numbers during the 2nd (soft) lockdown. So all positive effects from this age group were totally negated by every other age bracket - be it school children (massively increased numbers due to open schools), of kinder garden kids (same with open). Or also older people seemingly (no idea of the reasons) contracting Sars-CoV-2 at an increased rate during the soft lockdown.

I have no idea for why these other age brackets have increased numbers. Could be that these are also the age brackets were you find the most critics, but that is just a totally unproven hypothesis of mine.

Could be that behavior changed in regards to the first lockdown and people do not keep their social distancing as much as they did (that is just anecdotal evidence from encountering people not keeping their distance while grocery shopping).

[yorwba]

At least in Berlin, it was the same during the first lockdown: infections among younger people peaked one or two weeks earlier than among older people.

You can see this very well in the heatmap of cases by age group here: https://www.berlin.de/corona/lagebericht/desktop/corona.html...

[remote_phone]

Places like UK did a hard lockdown for 6 weeks and kept schools open. It completely worked. Yes, kids can transmit the virus, but it appears that as long as the ADULTS limit their interaction with other adults, kids have only a limited way of encountering infections.

[jeffbee]

Didn't UK have either the worst or second-worst outcome among all European nations?

[AlphaSite]

Yes, but it doesn't really disprove the assertion that lockdown's work. It more proves that the other approaches they tried either dont work or weren't applied effectively.

[koheripbal]

I suppose, but it also means that the conclusion above (that lockdowns excluding schools works) isn't based on any evidence.

[leoedin]

To be clear, the UK entered a lockdown excluding schools on the 5th of November.

Within a week, positive tests started declining significantly. The lockdown ended on the 2nd of December.

Within a week, positive tests started going up again.

https://www.theguardian.com/world/2020/dec/08/covid-cases-an...

There is plenty of evidence that lockdowns do work. Whether they make sense from an economic or overall quality of life perspective is a separate issue. But they work.

[jacobush]

Sweden did sort of a lockdown excluding schools up to pupils age 16.

[glitchcrab]

Yeah please don't use us as an example - the UK has handled this terribly.

[michaelt]

Take a look at the data here: https://coronavirus.data.gov.uk/details/healthcare - for example, the "Patients in hospital" data.

The UK's number of COVID-19 patients in hospital peaked at 19,500 in mid-April and fell to 800 by the start of September.

That's despite things like the 'eat out to help out' scheme that ran until the end of August.

Schools and colleges re-opened in September [1] and the government started "encouraging" workers back to offices [2] - and admittedly, by the end of September patients in hospital had only risen to 2,400.

But by mid-November we see the second wave peaking at 16,500 hospitalised. Today, as we come out of the second lockdown, there are still 15,000 patients in hospital.

The UK has not demonstrated that schools can safely be kept open.

Unfortunately, as the geniuses in government decided to reopen schools and universities and offices all at the same time, it's difficult to directly attribute the second wave to any single policy decision.

[1] https://www.gov.uk/government/news/schools-and-colleges-to-r... [2] https://www.bbc.co.uk/news/uk-53942542

[disgruntledphd2]

The Irish government kept schools open, moved almost all universities online, and encouraged/required workers to work from home.

From our data, it doesn't appear that schools were a massive driver of transmission.

We know that kids don't spread it as much as they do the flu, so on balance, keeping schools open seems like the better course of action as long as it's not a major driver of infection rates.

[leoedin]

Hospitalised cases lag infections by weeks. For some reason you're completely ignoring the positive test results, which show a very clear correlation with lockdowns.

https://www.theguardian.com/world/2020/dec/08/covid-cases-an...

We shouldn't expect hospitalised cases to fall immediately - although they have been falling for the past week or so. Lockdowns - even excluding schools - clearly are effective at reducing transmission rates below 1. Unfortunately the lesser measures we're currently under don't seem to be - as cases have plateaued and are starting to rise again.

[michaelt]

> For some reason you're completely ignoring the positive test results

For a good reason.

By almost all the statistics, the second wave hasn't been as bad as the first. Comparing peaks, measures like "Deaths within 28 days of positive test" (942 vs 486) and "Weekly deaths with COVID-19 on the death certificate" (9,495 vs 3,371) and "Patients in hospital" (19,518 vs 16,421) and "Patients in mechanical ventilation beds" (3,252 vs 1,461) say the second peak was about half the height of the first one.

On the other hand, "Cases by date reported" peaked at 5,113 in the first lockdown and 25,329 in the second lockdown - making the second wave 5x higher than the first. Presumably due to a lack of test capacity.

If I'd chosen the one metric which makes the second wave look 5x the first instead of 0.5x, that'd be a pretty deceptive way of describing the results of government policy (although technically accurate).

[roenxi]

'Works' is what happened to Ebola - near total containment outside of a rather poor part of the world.

There is a major complaint here against the lockdowns. They have positive and negative outcomes and there is very little evidence that the two sides have been weighed against each other. The scale of the damage done by our response is too great to accept best effort attempts to control the disease. The standard of the response needs to be excellence, not competence.

We also can't discount the possibility that there were easier, less invasive measures than lockdowns that captured a lot of the benefit without the costs. It has been a chaotic year but there is no natural law that says every time there is a pandemic the only option is to scuttle the economic ship.

[bluescrn]

The 2nd UK lockdown wasn’t all that effective. Schools open = all the pain for significantly reduced gain.

[ithkuil]

On italy they only opened schools for children in age groups for which having them at home would be a major burden for working parents (either work from home or essential workers).

Arguably this reduced the pain, while also reducing the effectiveness of the lockdown measures. It's a fine balancing act. It's hard to compute precisely, we're not yet good at it as a society. That said, expecting people to work while having children at home and at the same expecting grandparents to stay isolated, puts people on a very tough spot. How do people cope with that in places that kindergartens are still closed?

[fludlight]

Kid1->Kid2->Parents-of-kid2 transmission sounds like it would lead to a lot of orphans. Did it? What's the lag on the statistics on that subject?

Outcomes are also not binary (life or death). There is also the possibility of a gamut of lifelong health problems from, e.g. scarred lungs, for both kids and parents.

[remote_phone]

Most parents of school kids are younger than the 60. That age group has less than 0.2% death rate.

[p4coder]

My daughter's school has 2000 kids. 4000 parents. In Santa Clara county the death rate for 40-60 is .5% [1] That would mean 20 parents dead if everyone gets it. Many of the households in immigrant families are multi generational. That will have a multiplying effect.

[1] 12.7% deaths and 29.1% cases https://www.sccgov.org/sites/covid19/Pages/dashboard-demogra...

[nkurz]

While it's still going to be a very real number, I think you are overestimating the number of deaths considerably. I appreciate that you provided a link, but I don't think that source includes the information you would need to make the estimate you are looking for.

First, I think that you are implicitly assuming that there are an equal number of people in each age category. In addition to the percentages you quote, you also need to know the percentage of the population per age range. Second, the "case" rate is the not the same as the "infection" rate, as it only includes confirmed cases. It's usually assumed that for each confirmed case, there is some unknown multiple of this number of infected individuals.

Eyeballing the chart here (and realizing that Santa Clara might not match these numbers, and guessing equal number in the relevant 5 year age ranges) a better estimate of the death rate for the 40-60 year old group is probably something around .15%: https://www.acsh.org/news/2020/11/18/covid-infection-fatalit...

[shostack]

If you go back and read his earlier statements, you can clearly see the evolution of his frustration. He's been a straight shooter on this from the start.

[bsder]

Quoting the man, himself:

> I think people should stay at home, avoid all non-essential activities, wear masks, and not gather with anyone outside their households. I’ve been saying this for about 10 months now. If you didn’t listen to my (and many others) entreaties before, I don’t think you’ll likely change your behavior based on a new order.

I disagree with this wholeheartedly.

People are getting a LOT of pressure to see family right now. Strong messages from people in authority absolutely will cause some people to think more about this. It also gives them an external authority to appeal to when resisting peer pressure.

Yes, you're not going to get the dipshits.

However, being able to tell family, that you maybe didn't even want to see all that much anyway (a lot of people only do the extended family thing out of obligation at the holidays), that there is an "Official Order(tm)" to "Don't gather" helps.

This is similar to official "mask mandates". This helps because a store can now say "Sir, the city/county/state has issued official orders to wear masks and we will have to ask you to leave if you don't wear it." An official mandate gives the store political cover. It also gives the average citizen the ability to ask the store to kick someone out who is non-compliant.

The "Bully Pulpit" is a real thing.

[wnissen]

I agree that there are difficult tradeoffs here. Essentially ever official has said that there will be no enforcement, so the order effectively only applies to the persuadable.

My kid's scout troop is still meeting, kinda sorta complying with the letter of the order. I have advocated multiple times with the leadership to stop the meetings or at a minimum restrict them to small, stable groups, but I am the only one who feels that way. Perhaps a more severe shutdown would persuade them, but perhaps not. I wonder if just a few token enforcement actions, such as pulling people over and asking if they are complying, or modest fines for the local megachurch with 95 cars in the parking lot on Sundays, would go a long way toward making people think twice. There's a common feeling that if something is legal, it's OK, and I find that's rarely true. It's legal to fart in an elevator, but that doesn't make it right.

BTW, the "bully pulpit" specifically

[AnimalMuppet]

95 cars sure doesn't meet my definition of a megachurch. That's rather small, actually.

[interestica]

https://www.nytimes.com/2020/03/12/us/coronavirus-san-mateo-...

From March

"The Silicon Valley Doctor Who Doesn’t Mince Words on Coronavirus Threat"

[deeviant]

People only tend to appreciate thoughtfulness and restraint when said thoughtfulness and restraint benefits and/or agrees with their own positions.

[vmception]

the bay area finds it easier to govern when nobody is doing anything.

they are using the pandemic as convenience to an extent. they don't have a holistic solution and they don't know what they are doing.

yes, it does keep case numbers lower and lagging.

the health official here is right though.

[KorematsuFred]

Indeed. A very rare instance where a government official questions his own wisdom. Wish more california officials were like him.

Not only mandates are completely ineffective (compared to the other much better alternatives) some of the folks like me feel compelled to call BS on many of the "dictats" and make it an ideological issue. At that stage, states credibility reduces even further.

[ketzo]

Okay, I’ll bite — what would be better (from a public health perspective) than government mandates for masks, social distancing, and reduced/restricted indoor gathering?

And, to be clear, what makes you say they are ineffective? Because literally everything I’ve seen everywhere says that those three things are basically the only things that have been effective.

[sokoloff]

Those actions are helpful. The question read to me as whether the mandate to do them was the maximally effective course.

Education, facts, and increasing public consciousness seem like they’d be more effective than mandates for private gatherings. People who would follow the mandate in private would likely also follow educational campaigns. Voluntary compliance based on understanding works everywhere. Mandates only work where you can be seen.