While new medical treatments proposed to cure COVID-19 cases are required to be validated through controlled double blind studies, the benefits and risks of social distancing strategies are not subject to any comparative tests
we show that the available data exhibit no evidence for any effects of the full lockdown policies applied in Italy, Spain, France and United Kingdom in the time evolution of the COVID-19 epidemic. Using a phenomenological approach, we compare the evolution of the epidemic before and after the full lockdown measures are expected to produce visible results. Our approach … is focused on incident rather than cumulative data, and it compares pre-lockdown and post-lockdown trends. However, here, no positive changes are noticed in the trend of the daily death growth rate, doubling time, or reproduction number, weeks after lockdown policies should have impacts.
That is certainly the case with U.S. data on death rates.
Lockdowns have achieved a theatrical purpose. They allow politicians to pose as powerful leaders implementing a cure for the virus.
Pointer from John Alcorn.
2. A study by R.E. Field and others of a cohort of 500 COVID-19 patients at a London hospital. Many interesting findings, including
When the outcome of the ventilated patients is viewed by age and gender … no female over the age of 60 has yet left the intensive care unit alive and nomale over the age of 50 has left the intensive care unit alive.
Another pointer from John Alcorn.
“Another pointer from John Alcorn.”
Lol…what a resource. Thank you John. Build your own blog already.
“Lockdowns have achieved a theatrical purpose.”
Hate to say it, but it’s the 2001 security theater all over again.
Appearance over substance. Feel good over the best available evidence.
Wife and I were literally talking about this a few days ago.
Totally agree. It’s healthcare theater instead of security theater now. I’ve also heard it called the cult of safety-ism. Seems it’s the unintended consequence of valuing life and safety more than we used to, so not unambiguously bad but still worth pointing out and striving against.
Agree. But, can call it “hygiene theater” instead?
Just returned from a beautiful meal out. The wait staff was in full garb much like a surgery room. Felt so sorry for them, but we were so grateful for the great service and excellent food.
Thx for the compliment and encouragement! Blogs require steady commitment, and effective blogposts should always have a punchline. Is that me? In any case, I trust Arnold Kling to separate the wheat from the chaff in my barrage of pointers.
Yes, sir. No pressure, just a suggestion. Very difficult to hit the 1% like ASK, but something to seriously ponder as you progress. In the meantime, please continue with the links and commentary 🙂
1. The reproduction rate table at https://rt.live/ now list 8 states with R greater than one. In addition to NE, WY, KS, MN, and IA listed yesterday, they have added NH, WI, and IN. NH has been in lockdown since 3/26, WI since 3/25, and IN since 3/24. So there is some evidence that lockdowns may not be the miracle panaceas their supporters claim.
Agree, and I would go even further in saying that many people who support the shut downs don’t even understand what they are for, which is to say they don’t get the whole flatten the curve rationale—not saving lives so much as to spread out deaths into something our healthcare system and economy can handle.
There area lockdowns and then there are “””lockdowns”””.
One of my personal maxims is “If you can’t half-ass it, don’t even bother.” If people are going through the motions of trying to do some kind of Zoom substitute for normal activity, and can’t get at least half the intended effect out of it, then it would be better to just drop it altogether until you don’t need an alternative.
And the US (the West in general) can’t half-ass this lockdown.
China genuinely locked down Wuhan and surrounding areas, and nuked R0 and stopped the spread of the virus. Had they not done so, there would be millions dead there now. Other Asian countries isolated suspected infected people and quarantined them away from their homes and families.
American (and I presume European) lockdown is far too loose to do anything but delay and drag out the pace of infections and deaths. Once we thought there might be a good reason to do that, but now we know there is no benefit in dragging things out, and it’s too late to do anything to stop everyone from getting it. So might as well let it rip and let people get back to producing.
I’m in a place with above average tightness of lockdown, at least officially. Yesterday I went to the hardware store, which is ‘essential’ because people might have to make an emergency repair of a leaking pipe or something. But of course everyone is there doing their spring yardwork shopping, getting landscape stones or huge stacks of mulch, soil, grass seed. Essential!
Maybe one person in fifty was buying pipe-repair type stuff. Some half-assed attempts at ‘mitigation’, but about half the people not wearing masks, and not that much leery distancing. Any big retail store with even one item out of a thousand that is of an ‘essential’ character, gets to be fully open and sell everything to everyone, and while they are doing things that probably lower the rate of spread a lot, none of that is enough to reduce the reproduction rate below 1.
If you’re not doing a real lockdown, you’re doing lockdown political theater, which is the worst of all worlds. You get all the pain, and now that we know about the ventilators, none of the benefit.
A few points:
1. It’s becoming increasingly clear to me that aggregating different regions within the US will give terrible data. Combining New York’s data with Minnesota’s makes roughly as much sense as combining Virginia’s with Lombardi or Paris’ with Wuhan. The only intelligent way to do this is to look at the tight regional clusters in which particular outbreaks are occurring.
2. Arnold, I’m getting increasingly concerned that you’re becoming a generator which takes as input “elite consensus opinion”, and which subsequently spits out its inverse as output. This may well be a good model, and I often employ it myself. But its concerning here because it is leading to a complete reversal of your initial opinion. Indeed, you were “two weeks ahead” of most in implementing a personal quarantine. Now, with state-imposed lockdowns, they are mere security theatre.
Three follow-up points
1. You’ve been essential reading during this lockdown
2. If this change is merely the result of detailed consideration of broad-based data, fair enough. Unfortunately, I suspect that the polarization of this issue is pushing you away from lockdowns if for no other reason than that the sources you generally trust more are moving in that direction.
3. Regardless of effectiveness, I agree with your view “anti-fragile Arnold vs Risky Randy” outlook and agree that there should be legitimate cost-benefit questions here. But acknowledging that we need to consider the total cost-benefit picture is an argument distinct from viewing lockdowns as theatrical.
And lastly a question.
If ineffective, then what is the mechanism by which reducing contacts with others does not lead to a reduction in R. Presumably, R is a function of the number of contacts we have, the length of those contacts, the proximity of those contacts, etc. Certainly there are many other variables that it takes in, but it would seem that increased interactions when put into the R-function would lead to greater R as output.
To the extent that lockdowns reduce those contacts, what is the mechanism by which it does not lower R? Is it because we spend more time indoors with others? Is it that we in fact have more contacts because we’re locked in with a small number of individuals?
Or is it alternatively that lockdowns may be effective in comparison to normal living, but if compared to modest social distancing, it brings no additional benefits?
Or is it that our lockdowns have enough leaks that they’re rendered useless and that lockdowns will only work if done in the manner which totalitarian states can carry them out?
Jay, that is some impressive begging of the question. You assume the that the lockdowns lower the contacts/increase social distancing, and then proceed from there.
Read the Meunier paper first, and you will see that Kling is not changing his mind blindly here.
If you need a mechanism- here it is- the lockdowns haven’t had a meaningful effect on contacts/social distancing after people took their initial actions pre-lockdown. In short, the fear of the virus created all the effective social distancing that a lockdown would ever provide.
I see, lockdown refers specifically to government imposed quarantines as opposed to quarantines /isolation that people individually choose to take.
In that case, Arnold is spot-on that the policies are security theatre. He was two weeks ahead. Even the median citizen was probably 2-3 days ahead.
I could make the exact same argument about the utility of homicide laws.
And, of course, most people wouldn’t murder even if there were no laws against it. Fortunately, murder laws don’t imprison everyone who might possibly murder someone.
Like the rain that falls on the just and unjust alike, lockdowns affect alike those who would transmit and those who wouldn’t.
You are changing the argument away from meaningful effect.
The lockdown does not fall on the just and unjust alike, and by the way, that’s kind of a creepy phrase, especially in this context.
The lockdown is not imprisonment, and we have no means of discretion between those who would transmit and those who would not.
I’m not sure what is the creepy phrase. The metaphor is from Jesus’ sermon on the mount:
Mathew 5:43 (KJV) Ye have heard that it hath been said, Thou shalt love thy neighbour, and hate thine enemy.
44 But I say unto you, Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you;
45 That ye may be the children of your Father which is in heaven: for he maketh his sun to rise on the evil and on the good, and sendeth rain on the just and on the unjust.
What I was trying to say was that lockdowns make no attempt to distinguish between people who are likely to get and/or spread the virus and people who aren’t.
In a lockdown, you don’t have to convict anyone of being dangerous. There is no due process. Everyone is a potential danger to society who can be put in preventive detention.
If you think slipping in some occasional unattributed God only perspective when making political points is cool, well, don’t know what to say.
Stop calling this a conviction. No one is punishing you. We’re trying to get through something very difficult. You can just disagree.
You’re absolutely right. No one has been convicted. No one is in prison. But everyone has restrictions on where they can go, what they can do, and how they can do it. Because everyone is suspected, and it doesn’t need to be proven that any person is dangerous or not dangerous, that any person is likely to become sick or not become sick.
I tracked down the source of the metaphor for you because you didn’t seem familiar with it. I wasn’t trying to give any “God only perspective”. The metaphor has been used for the idea that bad things can happen to both good people and bad people. Tsunamis, say, don’t ask whether you’ve lived a good or a bad life.
A Wisconsin Supreme Court Justice is thinking along similar lines.
Kind of a first mover advantage. China got the virus first, did lockdowns, and was pretty successful. So everyone assumed some kind of lockdown had to be done.
China did a lockdown of a kind no one else did, or is likely to be able to do at this point in time. The Chinese literally, under gunpoint locked everyone in Wuhan in their apartments for 6 weeks- welding the doors shut if they had to. China could do this because, as you wrote, they got the virus first, reacted fast enough that the rest of the country wasn’t under lockdown and could, thus, support the people of Wuhan with supplies from outside- kind of what happens with natural disasters like hurricanes and earthquakes. Europe and the US had no such luxury- pretty much everywhere in these countries was shut down with no unaffected areas free to offer support to much smaller affected areas.
I agree with your first sentence, but I’m still trying to understand what happened in “Wuhan”. I lived in China in 1994-97 and I worked as an advisor to reform state enterprises and banks. I visited “Wuhan” two times during my stay there.
In my search, yesterday I found a post in which the author claims
“Beyond its analysis of the virus, China opted to impose a massive quarantine around the epicenter in Wuhan encompassing 100 million people – the largest ever imposed globally. While some critics believe China should have relied on individual testing, that approach would have been impractical given the scale of Wuhan – 11 million – and the rate at which the virus spread.”
https://www.peterbwalker.com/perspective-on-the-coronavirus/
The author is Peter Walker, “a Senior Partner Emeritus of McKinsey & Company, Inc., and an advisor, speaker, and author on US-China relations.” I looked and found the reference after reading
https://www.foxnews.com/opinion/tucker-carlson-during-coronavirus-pandemic-totalitarianism-doesnt-shock-us-anymore
In 1995, perhaps the scale of Wuhan was just 11 million, but even at that time “the metropolitan area” was much larger, including millions of immigrants from the countryside. I was not surprised reading in the cited paragraph that China imposed a massive quarantine of 100 million people. I was surprised that the author jumped from 100 to 11 million without saying how the government could confine effectively 100 million people in just a few days. I don’t think the Chinese government could have done that to 11 million people for 6 weeks only at gunpoint, as you say, much less to 100 million. As you may realize to feed 100 rather than 11 million from “the rest of China” was an extraordinary operation that no government could have done.
My point is that we still don’t know what happened in “Wuhan”. I doubt we will ever know it. In particular, we will never know how many millions of people entered and left “Wuhan” before, during, and after the quarantine (remember that the Chinese New Year was in January-February and that “Wuhan” had been integrated directly with “the global economy”, including Lombardy and Tuscany where at least half a million Chinese people were living in December 2019).
How is it plausible that lockdowns have no effect? 0 effect seems implausible. I’m asking this not as a proponent of lockdowns, but in knowledge-seeking mode.
“Lockdowns have achieved a theatrical purpose. They allow politicians to pose as powerful leaders implementing a cure for the virus.”
The obnoxious snarky cynicism again. Do you not think it is possible that the hundreds and hundreds of leaders, governors, mayors who issued the orders were doing the best they could, relying on medical and scientific people doing the best they could? I’m going to get barred from this site but I again plea for some humility from someone who pontificated ‘the worst is over’ 50,000 American deaths ago. Data is good. Analysis is good. Hatred gets old.
Both can be true. Politicians and “medical and scientific” people are doing the best they can, with a lot of inadequate information. But what seems right to a politician can be “to pose as powerful leaders implementing a cure for the virus”. At least until people get restless, at which point “the leader who safely reopened the state/city/county” may become what seems right.
Again, here is the 7DDRR.
Like Kling’s 3DDRR, it compares today’s deaths with the death 7 days ago rather than 3. Much smoother data because it always calculates each day of the week with those days from the previous week, and the ultimate goal is to see the ratio approach 1.
And that is cumulative deaths, but 7 days apart rather than 3.
Thanks for continuing to do this.
https://unherd.com/thepost/nobel-prize-winning-scientist-the-covid-19-epidemic-was-never-exponential/
Another apolitical view that says lockdowns are of little use.
That said, certainly there needs to be international oversight and monitoring of the 70 BSL-4 virology labs on the planet. Perhaps we will never know if a Wuhan lab leak was the source of Covid-19, as seems likely, which alone is an intolerable situation.
But we now know of the fantastic cost of even a mild virus pandemic.
May I add a remarkable item to today’s General Update/Roundup?
Freddie Sayers at UnHerd has published a video interview of Michael Levitt (Stanford U.), Nobel laureate in chemistry: “The Covid-19 epidemic was never exponential.” Here is the link:
https://unherd.com/thepost/nobel-prize-winning-scientist-the-covid-19-epidemic-was-never-exponential/
I’ve transcribed some excerpts to help readers who find the audio quality inadequate:
“We don’t know why R0 decreases. It could be social distancing. It could be acquired immunity. It could be hidden cases.”
“The big test is going to be Sweden. Sweden is practicing a level of social distancing that is keeping children in schools, keeping people at work. They are obviously having more deaths than countries like Israel or Austria that are practicing very, very strict social distancing, but I think it is not a crazy policy.”
“I had the two examples in China to start with, and then we had the additional examples. First one was Korea; then Iran and Italy. The beginning of all the epidemics showed a slowing down; and it was very hard for me to believe that those three countries could practice social distancing as well as China. […] People left Hubei, were very carefully tracked, had to wear face masks all the time, had to take their temperatures all the time, and there was no further outbreaks. This did not happen either in South Korea, Italy, or Iran.”
“Two months later, something else suggests that social distancing might not be important; and that is that the total number of deaths that we are seeing in NYC, in parts of England, in parts of France, in northern Italy, all seem to stop at about the same fraction of the population. So are they all practicing equally good social distancing? I don’t think so.”
“in London and in NYC all the people, who got infected, all got infected before anybody noticed. There is no way that the infection grew in NYC without the infection spreading very quickly. So that one of the key things is to stop people who know that they’re sick from infecting others. And here again China has three very important advantages that are not high-tech, that don’t involve security tracking of telephones. […] (1) the tradition in China for years, of wearing a face mask when you’re sick. As soon as the coronavirus started, everybody wore a face mask. […]. (2) Because of the SARS epidemic […], having your temperature measured [at public entrances] is something completely standard in China. (3) Almost all payments in China are made not using a credit card. […] Of course, in addition they know where people are.”
Q: What do you think of lockdown policies in Europe and in America?:
“It think it is a huge mistake. […] If we were to do this again, we would probably insist on face masks, hand sanitizers, and some kind of payment that did not involve touching.”
“England, France, Italy, Sweden, Belgium, Holland are all reaching levels of saturation that are going to be very close to herd immunity. […] the policy of herd immunity is the right policy. I think Britain was exactly on the right track before they were fed wrong numbers—and they made a huge mistake. I see the standout winners as Germany and Sweden. They didn’t practice too much lockdown. They got enough people sick to get some herd immunity. The standout losers are countries like Austria, Australia, Israel, that actually had very strict lockdown, but didn’t have many cases. They have damaged their economies, caused massive social damage, damaged the educational year of their children, but not obtained any herd immunity.”
“California has now had lockdown for six weeks, and wants another four weeks. They so far have than a hundred deaths. […] That is not enough to give them a significant herd immunity. They didn’t need to do all that lockdown.”
“Everybody panicked. They were fed incorrect numbers by epidemiologists. […] There is no doubt in my mind that, when we come to look back on this, the damage done by lockdown will exceed any saving of lives by a huge factor. One very easy way to see this—I’m getting into sensitive territory—is that economists have a very simple way of looking at death. They don’t count people. They come to the conclusion that if you’re 20 and you die, that’s a greater loss than if you’re 85 and you die.”
“the number of excess deaths in Europe is around 130,000. […] In some of the worst flu epidemics we get to those kinds of numbers. […] I’m not saying flu is like coronavirus, I’m simply saying that the burden of death for flu is like coronavirus, especially when we correct for the fact that people who die from coronavirus are older on average than people who die from flu. […] Flu kills 2 or 3 times more people under 65 than does coronavirus. […] Another factor that has to be considered are all the cancer patients who aren’t being treated, all the cardiology patients who aren’t being treated. I’ve heard estimates of tens of thousands of people who are going to die because of lack of treatment. […] The age group who die of cancer are younger than the age group who die of coronavirus.”
“The amount of deaths you need to reach saturation — I’m not going to call it herd immunity — where the virus by itself stops, in on the order of 4 weeks of excess deaths. […] The European area will reach around 200,000, or 4 weeks’ worth.”
“If we could protect the old people perfectly, then the death rates would be very, very low. For example, in Europe, I said that there were about 140,000 excess deaths in the last 9 weeks. The number of those excess deaths who are younger than 65 is about 10%.”
“The key thing is to have as much infection for as little possible death; and also do whatever you can to keep the hospitals full, but not overflowing. It’s a difficult calculation. It’s one, which a country like Sweden can do, where there’s essentially no political concerns. The trouble is that in Israel, what I know well, in the US, everything is political; and therefore, nobody could say something like this. They would say: ‘Ah! You’re not valuing death.’”
Re: co-morbidities. “The news should be stressing this, and maybe they should be counting it as a 0.1 Covid death. Countries seem to be racing to have as many Covid-19 deaths as they could.”
Re: Prof. Levitt’s early efforts (in February) to correct Neil Ferguson’s analysis: “people over 80 have a certain fraction of the deaths, people between 70 and 80 have a different fraction. Just using that data from almost anywhere — It could be South Korea, it could be Wuhan, it could be anywhere — and just simply saying, we want the number of deaths that occurred on the Diamond Princess to be at the same number […] If you apply that proportionality to Britain and the to USA, you find that for Britain the half a million drops to about 50,000, and in the US the 2,000,000 drops to 200,000—essentially a year dropping to a month.”
“The WHO, and epidemiologists in general, can only go wrong if they get a number that’s smaller. If I say, ‘There’s going to be one billion deaths from coronavirus,’ and then, ‘Oh, sorry, you guys have done what I said and there’s only going to be 100,000;’ that is considered good policy. […] They’re scaring people into doing something. I can understand that, and there’s something to be said for it — If you could practice lockdown with zero economic costs and zero social costs, let’s do it. But the trouble is that those costs are huge. […] You need to balance both of these things. That’s what I don’t think is responsible. In my work, if a number is too small and I’m wrong, or a number is too big and I’m wrong, both of those errors are the same. If I’m 10% too high, or 10% too low, that is ok. It seems that being a factor of 1,000 too high is perfectly ok in epidemiology, but being a factor of 3 too low is too low.”
“A football game would be a really bad idea right now because people shout and therefore spray saliva on everyone around them, and they could infect a lot of people.”
“this is another foul-up on the part of the baby-boomers. […] we’ve really screwed up. […] We’ve caused the problems of global warming, and now we’ve left your generation with a real mess in order to save a relatively small number of very old people. If I was a young person now, I would say, ‘Now you guys are gonna pay for this.’ […] This is a virus designed to get rid of the baby-boomers.”
J,
IMO, it’s the last of your suggested explanations.
And T, I agree with you.
As states and regions within them formally loosen lockdown restrictions — and as people stop complying with them without formal authorization to do so — there will be a lot more data to collect and analyze. I pray that the news turns out to be good, but I’m not betting that will be the case.
Over 70 and with two underlying conditions and no financial incentive to do anything else, until there’s a vaccine I plan to enjoy the view from my apartment balcony and make only infrequent trips out for groceries and for prayers in groups of ten or less at church.
Lockdowns have achieved a theatrical purpose. They allow politicians to pose as powerful leaders implementing a cure for the virus.
—
Worse, actually. They allow politicians to subsidize programs and ear marks having nothing to do with the virus.
“Lockdowns have achieved a theatrical purpose.” Paging Murray Edelman!
https://www.amazon.com/Constructing-Political-Spectacle-Murray-Edelman/dp/0226183998/ref=sr_1_2?crid=3TSZFYGNWVQ57&dchild=1&keywords=murray+edelman&qid=1588518461&s=books&sprefix=murray+edelman%2Cstripbooks%2C199&sr=1-2