[PaulDavisThe1st]

> the next pandemic may be just as bad as this one.

or worse. Keep the aerosol vector, but make it even more effective. Increase the effectiveness of surface transmission. Throw in greater resistant to surfactants (soap) and hand sanitizers.

boom!

[raisedbyninjas]

Your scenario only increases infectiousness. Many viruses are more deadly than covid 19. H5N1 is about 60% fatal, more deadly than ebola. It's quite difficult to contract at least until researchers genetically modified it to be airborne. They didn't need permission for this research and didn't even perform it in the highest safety level labs.

[PaulDavisThe1st]

As I indicated in another post, the fatality rate of COVID-19 isn't the big issue with the disease. Extremely deadly diseases don't tell to do well in the long run, so although they may have a huge impact within a short time, they tend not to pose long term threats. COVID-19, however, is a glimpse into what would be a perfect storm of high infectiousness with high levels of required hospitalization/medical treatment for good recovery. COVID-19, with its relatively low death rate and moderate hospitalization levels, has already managed to somewhat overload public health systems in many parts of the world. The death rate doesn't have to increase to make a future pandemic much, much worse.

[lamontcg]

That high level of virulence though works against it just due to being identified much quicker. You're not going to get cryptic spread of a virus which is 60% fatal.

This coronavirus might have spread to ~10,000 people and already jumped to Italy before anyone was aware there was a brewing medical crisis.

[mxcrossb]

I always try to use HIV as my point of reference for COVID-19. We got off lucky by that measure. So maybe my pessimism is unfounded, but I really wish we had learned more lessons from HIV.

[PaulDavisThe1st]

From what I understand, HIV is fairly difficult to transmit, requiring an exchange of infected body fluids. This makes it deeply traumatic because the people you're most likely to infect will be people extremely close to you. To some extent this is true of almost any transmissable disease, but HIV added the twist that infection is very, very unlikely to happen between two individuals that are not physically intimate with each other.

In this sense, HIV doesn't seem like a particularly good model for anything like a coronavirus pandemic. Aerosol transmission just totally changes almost every aspect of the resulting pandemic.

What lessons do you wish we had learned from HIV?

[krrrh]

I’m not who you’re asking but I wish we had learned that a robust debate is necessary and we shouldn’t just assume tha Anthony Fauci has read the latest research.

https://www.econlib.org/great-moments-in-epidemiology/

He did enormous damage in 1983 by speculating about casual transmission of HIV within households even though he admitted to not having read the paper. He was slow to get up to speed on aerosol transmission this time around.

The comment at the bottom of that page also contains this gem from Oprah Winfrey in 1987:

> Research studies now project that one in five—listen to me, hard to believe—one in five heterosexuals could be dead from AIDS at the end of the next three years. That’s by 1990. One in five. It is no longer just a gay disease. Believe me.

Obviously that never happened. I was 12 that year and this sort of stuff terrorized us, even though it was based on highly dubious modeling, plus belief by public health officials in the promulgation of nobel lies.

I think we should have learned that groupthink and motivated reasoning can lead to all sorts of ancillary damage not just to psychological health, but to reduced trust in institutions, heightened political polarization, massive misallocation of resources, and putting focus on the wrong places.

We should have learned that being honest about what is known and what isn’t known and placing trust in the public leads to the public placing trust in public health authorities when it really matters. Credibility is extremely important to maintain, and protecting and encouraging a robust debate is paramount to discovering the truth and making better decisions.

[PaulDavisThe1st]

I would be suspicious of any claims that we should believe any particular individual about anything. Tearing down a particular individual for their mistakes (rightly or wrongly) is essentially a strawman.

I don't hear or read people saying "we should follow what Dr. Fauci says". I hear and read saying "we should follow the science", and that necessarily means (for a novel disease, whether that's HIV or COVID-19) entering into a process in which things are not certain, opinions differ, new information emerges. "The science" isn't a single, fixed answer for any situation, and even less so for a novel disease. Pretending that "the science" can essentially be identified with a single person is tremendously foolish, both for those who want to believe that person and those who want to tear them down.

[krrrh]

I think that one thing the pandemic has demonstrated is that groups of experts are just as prone to groupthink as non-experts. Thomas Kuhn may argue that they are even more prone to groupthink.

Yet we've also seen intelligent non-experts rise to the occasion. An entrepreneur like Balaji Srinivasan who was sounding the alarm about how serious this was a month or two ahead of public health officials and was mocked for stepping outside of his lane[0], a programmer/sociologist like Zenep Tufecki who has written a series of important analyses over the last year and who later admitted that she felt like she was risking her career by advocating for masks when all the public health authorities were lined up against it [1], or economist Emily Oster who has done a better job of clear communication to the public about how to balance risks and understand the different levels of certainty we had on any given COVID related topic and published clearer analyses of school safety that many states' policies still flatly ignore.[2]

These are all people who have a wide range of experience and interests but were able to make timely contributions that experts may have been too blinkered to develop.

It's not about tearing down any individual, and I apologize if comment went too far in that direction. But we should be concerned about institutions that reject well-argued analysis of available evidence because its coming from the wrong place, or failing to even consider counterarguments and their full slate of implications. One concept that I recently learned about is the 10th man rule which Israeli intelligence adopted after the surprise attach that led to the Yom Kippur war. Essentially that if there are 10 people in a room and the first nine all express the same opinion, it becomes the duty of the 10th man to argue the opposite case regardless of what he or she believes. There are a lot of 10th men out there who had their opinions or voices excluded for too long.

Whatever it is that filters intelligent arguments from outside of the establishment is something that should be addressed before we need to go through something like this again. We would also do well to find ways to include a role for smart dissenting outsiders in conversations like these early.

[0] https://www.vox.com/recode/2020/2/13/21128209/coronavirus-fe...

[1] https://www.nytimes.com/2020/08/23/business/media/how-zeynep...

> When the Centers for Disease Control and Prevention told Americans in January that they didn’t need to wear masks, Dr. S. Vincent Rajkumar, a professor at the Mayo Clinic and the editor of the Blood Cancer Journal, couldn’t believe his ears.

> But he kept silent until Zeynep Tufekci (pronounced ZAY-nep too-FEK-chee), a sociologist he had met on Twitter, wrote that the C.D.C. had blundered by saying protective face coverings should be worn by health workers but not ordinary people.

> “Here I am, the editor of a journal in a high profile institution, yet I didn’t have the guts to speak out that it just doesn’t make sense,” Dr. Rajkumar told me. “Everybody should be wearing masks.”

[2] Articles in various publications + https://explaincovid.org & https://www.qualtrics.com/news/national-covid-education-dash...

[spankyspangler]

This goes to all politicians and "experts" and journalists.

The slavish subservience to authority and desperate clamor to lick boot sickens me. I mean, Vietnam, Iraq, Afghanistan, Libya, the gun running and drug smuggling and interventions in South and Central America, banking corruption and laundering, the subprime crash, the Panama Papers, Congressional insider trading, corporations paying no taxes while politicians clutch pearls and wring hands about how they're using legal loopholes so there's nothing they can do about it, intelligence agencies spying on congress and on citizens, fabrications of stories about collusion with Putin, the list is endless.

And yet again, like clockwork, once again the "experts" and "journalists" know what is best for us and once again the followers are all falling over themselves to prove their devotion by putting on their big shows of faith, and denouncing and bullying all the heretics and traitors who dare to ask questions.

I have to laugh if it wasn't so sad. For some stupid reason I had some hope, but after seeing it all play out again it seems like old Dick Cheney could come and start talking about Iran and WMDs or denounce the next Gaddafi, and Fox and the NYT and all those other "trusted experts" would duly start regurgitating their lines, and pretty soon everyone would fall in line and anyone who didn't want to go to war (read: send others to war) would be un-American traitors.

[PaulDavisThe1st]

> The slavish subservience to authority and desperate clamor to lick boot sickens me.

Have you considered that the "desperate clamor" might just be a clamor to do the best thing ? And just how would we do that?

Your entire attitude seems to be predicated on the idea that nobody actually knows anything, there's no point listening to "experts" (even putting the quotes around the word is intended to be dismissive), and there's no way to spend time learning more about something.

I thoroughly reject that POV.

Look, you've provided a great list of terrible things that the US (and other) governments have done (though it's necessarily incomplete and mostly rather recent). But in the context of your point, so what?

What about the experts that know how to build bridges properly? What about the governmental policies that actually result in positive changes? What about the doctors, engineers, designers, architects, farmers who actually do have a better understanding of their fields than an average person?

I don't disagree with you about the lamentable actions of our government and the processes/structures that allow them to happen. But I reject the implication that this requires me to just be infinitely cynical about everything.

[spankyspangler]

> Have you considered that the "desperate clamor" might just be a clamor to do the best thing ? And just how would we do that?

I have considered that, and rejected it.

I'm not talking about people who don't really know and genuinely get their information from whatever their TV or internet or friends tell them and they just go along with it but generally live and let live in the face of differing opinions.

I'm talking about the hateful bullying mobs going around attacking people, and the people and corporations who actually look into the information which is quite easy to see those "authorities" are hardly a good source of truth, yet they grovel down on their hands and knees to lick boot.

> Your entire attitude seems to be predicated on the idea that nobody actually knows anything, there's no point listening to "experts" (even putting the quotes around the word is intended to be dismissive), and there's no way to spend time learning more about something.

That's not my attitude.

> Look, you've provided a great list of terrible things that the US (and other) governments have done (though it's necessarily incomplete and mostly rather recent). But in the context of your point, so what?

The context of my point is that journalists, politicians, and other self-proclaimed "experts" are not. It is more the rule than the exception that they are self-interested corrupt liars and manipulators.

I'm not talking about, say, the scientist who develops climate models or the medical researcher developing vaccines. I'm not talking about actual experts.

> What about the experts that know how to build bridges properly? What about the governmental policies that actually result in positive changes? What about the doctors, engineers, designers, architects, farmers who actually do have a better understanding of their fields than an average person?

What about them? None of them are manipulating the populace into going to war, or drumming up their throngs of pathetic subservient bootlickers and brownshirts to attack and bully anybody who questions them. So I'm obviously not talking about them.

> I don't disagree with you about the lamentable actions of our government and the processes/structures that allow them to happen. But I reject the implication that this requires me to just be infinitely cynical about everything.

There was no implication.

[mulvya]

> From what I understand, HIV is fairly difficult to transmit, requiring an exchange of infected body fluids.

Fauci didn't think so in 1983.

"But if ''nonsexual, non-blood-borne transmission is possible, the scope of the syndrome may be enormous,'' writes Dr. Fauci of the National Institutes of Health in an editorial to be published Friday in the Journal of the American Medical Association."

https://www.nytimes.com/1983/05/06/us/family-contact-studied...

[throwaway210222]

The "if" changes the meaning of his statement significantly.

[mulvya]

Innumerably many valid statements of the form 'if P then Q' can be generated.

But dissemination of one by a govt. scientist in a prominent medical journal, however, indicates that they think it likely enough to be true.

[PaulDavisThe1st]

Or it means that they think that were it to be true, it would calamitous, and thus we'd better think and work really hard to establish whether that is the case. And in 1983, it was not known if it was the case.