[toss1]

Yes, it should be strongly encouraged in crowded places, not discouraged.

As to "You First", I still do avoid random crowds and I wear an N95 when I do go out in random crowds, including the last time I went to the grocery store. I'm not the only one I see doing that ('tho it is far less common than a year ago).

But sure, you do you, because evidently your approach to life prioritizes your immediate gratification, and doing nothing that might help the general welfare, or help everyone (even you) in the longer term.

[s1gnp0st]

I am disgusted by the totalitarian urge which has been normalized by the pandemic. Your trauma is not my problem, and I will not permanently alter my behavior to satisfy your ever-escalating urge to dominate me.

[jMyles]

Well put. Though I suspect that the overwhelming majority of the sentiment to which you are referring is being carried by bots and not real humans.

It's a difficult time to be empirically-driven, though hopefully we will come out better for it.

[toss1]

You think that having no public health measures is data driven? Go read some data. Seriously. Or, just go to pre-1950s graveyards and gather data on how many dead children there were before public health measures. Or look at the data on how the public health measures ran extinct a strain of flu so it is no longer being included in the vaccine formula.

[jMyles]

I don't see anybody advocating for no public health measures - perhaps you might consider that the views of others are as nuanced as yours.

> Or, just go to pre-1950s graveyards and gather data on how many dead children there were before public health measures.

Indeed! But this doesn't mean that every measure undertaken was reasonable or evidence-based. Germane to the thread at hand: at the height of the polio epidemic, some states sprayed DDT in a bizarre and mistaken belief that it was likely to reduce transmission of the virus. As with lockdowns and masks and surface 'disinfectants' and other unproven measures today, this happened over the objection of a chorus of experts who had already begun to unearth the fecal-oral route of transmission of polio.

Yes, in retrospect, this seems silly and trivial. But at the time, it must have been very frustrating to spend your life (or even your hobby time, as I do) studying public health only to have a hairbrained idea with no empirical basis become the framework on which policy was decided.

> Or look at the data on how the public health measures ran extinct a strain of flu so it is no longer being included in the vaccine formula.

I... presume you are talking about the B/Yamagata lineage of Influenza B?

Nobody knows why this lineage disappeared, and anybody who claims to is trying to sell you something or influence you.

One exciting prospect is that it is the result of viral interference, a phenomenon frequently observed but not yet understood, and potentially the basis of future immune therapy.

In any case, the disappearance of a particular lineage of Influenza B or of H3N2 (which of course is the current endemic influenza, but began as an epidemic subtype in the 1960s) is not an overall public health win or loss; it just means that other lineages (in this case, B/Victoria) will present the endemic strains in future years unless B/Yamagata re-emerges.

[toss1]

Yikes, Pandemic public health measures are NOT totalitarian in any way, shape or form.

Totalitarian measures are "TOTAL"; i.e., they encompass all aspects of govt and society.

Public health measures are LIMITED to the scope of the public health threat.

Being unwilling to take even small measures that not only help you but also help your fellow citizens does not make you some kind of 'free-thinking libertarian'.

It simply shows you like to behave like a sociopath, and your statement that a policy idea is a result of "trauma" is an uncalled-for insult, as you intended it (which again shows your drive to prioritize feelings over facts). Seriously, no one is trying to "dominate" you. As if you were that important. Sheesh.

[throwway120385]

It's not totalitarian. How do you feel about having a sewer hookup or a septic system in your house? Because those things were largely mandated and not by grassroots. With that kind of attitude we'd all be crapping in outhouses and standing in our own poop within a decade.

I agree with reasonable limits to public power, but I think data driven public health approaches are an area where the public should have a lot of power. We've eradicated things like hookworm in part because we have asked people to put shoes on their children and stop pooping in holes in the ground.

[jMyles]

In an unlikely turn of events, you appear to be an actual human and not a bot (from a cursory look at your comment history). So I say, gently:

> because evidently your approach to life prioritizes your immediate gratification

Do you genuinely believe that this is a fair characterization of the sentiment of the person (or position) to which you are responding, giving the benefit of the doubt?

> Yes, it should be strongly encouraged in crowded places, not discouraged.

It boils down to this: encouraging an intervention in public places needs to be based on unambiguous evidence, supported by genuine, authentic science and presented in a way that is convincing to a scientifically-literate society such as ours.

Consider, for example, the evidence in favor of the use of seatbelts, condoms, traffic-calming infrastructure, or hard hats (the latter of which I acknowledge don't require RCTs to be validated).

These products have produced a reliable, measurable, significant change in outcomes to the extent that no reasonable person questions their efficacy impact (though even with these, there is some reasonable dispute regarding trade-offs in each case).

The intervention in question has fallen way, way short of this standard - so much so that it's difficult to make a viable comparison. Despite mandates across a literal majority of geographic landmass of the country, there is still no evidence of any benefit with regard to community transmission rates. And on the research side, only nine RCTs - and none at all regarding source control - have been conducted.

We've watched as a huge chorus of the world's experts have called for RCTs, and have been told by charlatan bureaucrats and profiteers that such a venture is comparable to a parachute RCT. Do you think that's likely to be convincing?

Meanwhile, the (typical, expected, obvious) extrapolation in the Cochrane review has been singled-out, and the waters muddied, for pointing out in sober terms what the RCTs actually said.

It has been reduced to "well, absence of evidence isn't evidence of absence", creating an obvious catch-22 as the same data is puzzlingly used as an excuse not to perform further science on the matter.

Believe me when I say: we care about you. I wish you good health and am happy to take evidence-based steps to ensuring that the world is a healthy, vibrant place for you and people like you. But you go too far when you ask that others to ignore their own good-faith assessment of the facts at hand. And the facts are unambiguous: respiratory pathogens emerge every so often and infect nearly all members of many animal species. There does not appear to be a viable intervention to stop this, and it's not even obvious is stopping it is desirable, as these pathogens confer immunity to those infected. It's an equilibrium and part of a broader ecology in which we live.

You are loved, even by this stranger. Please don't see commitment to data-driven approaches to public health interventions as a hunger for immediate gratification; this is nearly the opposite of the reality of the situation.

[toss1]

What data do you have that say that my comment is likely to be a bot? (genuinely curious)

As I first mentioned, Random Controlled Trials are unlikely to be the best measure for this.

>>encouraging an intervention in public places needs to be based on unambiguous evidence, supported by genuine, authentic science and presented in a way that is convincing to a scientifically-literate society such as ours.

>>These products have produced a reliable, measurable, significant change in outcomes

Yes, true for those products and also for the intervention of wearing N95 masks (I fully agree that other masks are basically placebos).

Again, the most convincing evidence of the effectiveness of mask intervention is that despite crazy levels of anti- and poor-compliance, and limited availability of N95 masks, we drove extinct an entire lineage of another airborne disease, simply by taking small measures that reduce R0 of airborne pathogens. It was not even the target, just collateral damage.

>>to the extent that no reasonable person questions their efficacy impact

This is a nice to have but definitely not necessary qualifying criteria. And, with every one of the measures you mentioned, there were and still are people who claim to be unconvinced. It is kind of what leadership is about - moving the comfort zone to a better place.

>>hunger for immediate gratification

Watching the anti-mask / anti-vax attitudes, especially when they are expressed as some kind of fear of state power over the individual, I'm sorry to say that the most fundamental basis I've seen for that is freeloading and entitled hostility to inconvenience or needing to care about others in society.

They refuse to undertake a minor inconvenience to what will help them and everyone else in society, and in doing so, freeload on the herd immunity or reduction in R0 maintained by their smarter peers. Valuing your own convenience over everyone else's health maybe isn't best called "instant gratification", but it isn't far off. If you have a better suggestion, let me know.

Thx for the love; same to you. I'm all for data-driven approaches to public health interventions; sadly many of those who oppose them are not data driven, but have other motivations, and disguising those as "data driven" does not make it so.