Tuesday, September 29, 2020

Belgian Doctors' open letter on covid-19

A correspondent sent me a link to the Belgian Doctors' open letter on covid-19. I found it original, documented, and worth reading and thinking about. It is at least an important contribution to a debate -- and one of its big points, we should be having a debate. Science is still quite uncertain about much regarding this disease, and science never did know much about economic and public policy. I'm not totally convinced, but it has several interesting ideas that I had not considered before. 

The headline

We ask for an open debate, where all experts are represented without any form of censorship. After the initial panic surrounding covid-19, the objective facts now show a completely different picture – there is no medical justification for any emergency policy anymore.

The current crisis management has become totally disproportionate and causes more damage than it does any good.

We call for an end to all measures and ask for an immediate restoration of our normal democratic governance and legal structures and of all our civil liberties.

A history 

The WHO originally predicted a pandemic that would claim 3.4% victims, in other words millions of deaths, and a highly contagious virus for which no treatment or vaccine was available....This led to a global alarm situation, never seen in the history of mankind:...a lockdown that shut down the entire society and economy and quarantined healthy people...

Being doctors, they don't mention  the steepest fall in economic activity since.... well, I can't think of a steeper one. 

Gradually, the alarm bell was sounded from many sources: the objective facts showed a completely different reality. ... The course of covid-19 followed the course of a normal wave of infection similar to a flu season.

The use of the non-specific PCR test, which produces many false positives, showed an exponential picture...

Our immune system...

I've cut this part short for blog review, but to the nonspecialist it is the most interesting. Short version: The doctors claim that many people who test positive are in fact not sick, and not in danger of getting sick. Nor, most importantly, are they infectious for anybody else. It is perfectly normal for us to have bits and pieces of viruses all over us. 

It appears that most people already have a congenital or general immunity to e.g. influenza and other viruses. This is confirmed by the findings on the cruise ship Diamond Princess, which was quarantined because of a few passengers who died of Covid-19. Most of the passengers were elderly and were in an ideal situation of transmission on the ship. However, 75% did not appear to be infected. So even in this high-risk group, the majority are resistant to the virus.

A study in the journal Cell shows that most people neutralise the coronavirus by mucosal (IgA) and cellular immunity (T-cells), while experiencing few or no symptoms...Most people who test positive (PCR) have no complaints. Their immune system is strong enough....

On the catastrophic over-estimate of death rate. (Which to be fair nobody knew -- there are lots of diseases with much larger death rates. A failure to adapt to new knowledge is, however, a valid criticism.) 

Mortality turned out to be many times lower than expected and close to that of a normal seasonal flu (0.2%). 

The number of registered corona deaths therefore still seems to be overestimated.

There is a difference between death by corona and death with corona. ..

Propagation

Spreading occurs by drip infection (only for patients who cough or sneeze) and aerosols in closed, unventilated rooms. Contamination is therefore not possible in the open air. Contact tracing and epidemiological studies show that healthy people (or positively tested asymptomatic carriers) are virtually unable to transmit the virus. Healthy people therefore do not put each other at risk.

Transfer via objects (e.g. money, shopping or shopping trolleys) has not been scientifically proven.

These are bombshells. "not possible" seems like a stretch -- if you're 3 inches apart in the open air, you can catch covid. I presume they meant "not likely at sufficient distance in open air." I also think "healthy" means asymptomatic. 

According to the good doctors, the widespread fear of transmission by asymptomatic people is false, and the massive wiping down effort wasted. 

Masks

...Oral masks in healthy individuals are ineffective against the spread of viral infections. 

Wearing a mask is not without side effects. Oxygen deficiency (headache, nausea, fatigue, loss of concentration) occurs fairly quickly, an effect similar to altitude sickness. .... In addition, the accumulated CO2 leads to a toxic acidification of the organism which affects our immunity. Some experts even warn of an increased transmission of the virus in case of inappropriate use of the mask....

Hospitals have a sterile environment in their operating rooms where staff wear masks and there is precise regulation of humidity / temperature with appropriately monitored oxygen flow to compensate for this, thus meeting strict safety standards. ...

All this seriously calls into question the whole policy of social distancing and compulsory mouth masks for healthy people – there is no scientific basis for this. 

(As some commenters point out, an essay is as strong as its weakest point, and dangers of mask wearing seem pretty weak. Construction workers wear N95 masks all day.)

Most of all, 

The role of the media and the official communication plan

Over the past few months, newspaper, radio and TV makers seemed to stand almost uncritically behind the panel of experts and the government, there, where it is precisely the press that should be critical and prevent one-sided governmental communication. This has led to a public communication in our news media, that was more like propaganda than objective reporting.

...The official story that a lockdown was necessary, that this was the only possible solution, and that everyone stood behind this lockdown, made it difficult for people with a different view, as well as experts, to express a different opinion.

Alternative opinions were ignored or ridiculed. We have not seen open debates in the media, where different views could be expressed....

We were also surprised by the many videos and articles by many scientific experts and authorities, which were and are still being removed from social media. We feel that this does not fit in with a free, democratic constitutional state, all the more so as it leads to tunnel vision. This policy also has a paralysing effect and feeds fear and concern in society. In this context, we reject the intention of censorship of dissidents in the European Union! ...

We deplore the role of the WHO in this, which has called for the infodemic (i.e. all divergent opinions from the official discourse, including by experts with different views) to be silenced by an unprecedented media censorship.

We urgently call on the media to take their responsibilities here!

A charmingly old-fashioned view of how media work. 

We demand an open debate in which all experts are heard....we call for an in-depth examination of the role of the WHO and the possible influence of conflicts of interest in this organisation. It was also at the heart of the fight against the “infodemic”, i.e. the systematic censorship of all dissenting opinions in the media. This is unacceptable for a democratic state governed by the rule of law.

With twitter and YouTube removing posts that contradict the WHO, their point is well taken. 

****

Disclaimers: With multiple Stanford letters circulating denouncing our heretic Scott Atlas, let me emphasize that I post this only as an interesting view that I think worthy of discussion. I am not a doctor, an infectious disease specialist, etc. But in a democracy all citizens should think about wise public policy and learn from differing views. We do need a more robust debate. It is sad how this disease has so quickly gotten partisan: masks, lockdowns, and test are D. Vaccines and herd immunity R. Start fighting. 

I also emphasize as always that everything on this blog is a personal view, not the opinion of Stanford University, the Hoover Institution, or anyone else.

The letter does not discuss the reports I have seen of large fractions of people who have long-term consequences from covid-19. Our family is still quarantining. 

***

Update:

To many commenters with thoughtful criticisms of this letter. Well, if you think they are off base, at least we have put to rest the idea that "doctor" = "expert!"

30 comments:

  1. It comes as no surprise that commonly worn masks are ineffective against the coronavirus. Nor does it come as a surprise that the behaviour described by the Belgian MDs from nodding heads is contradictory to best practices in a medical setting. When you're grasping at straws, any straw will do.

    'Asymptomatic' and 'healthy' are not synonomous, but there is no means for the general public to make a quick determination so the public avoids both.

    Panic in government and hospital administration led to the high death rate seen in elderly populations confined to nursing homes in the UK and in the USA. Had the impulse to clear hospitals of patients in anticipation of an boom in coronavirus infections in the general public been resisted, the death tolls in the elderly and infirm segments of the population would have lower and less staggering than they were. By endeavouring to protect one sector of the health care system, they endangered another sector of the system, namely the nursing home sector.

    The toll on the general health of the population has not yet been fully appreciated.

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  2. I have to say that there is a lot of junk in there. Just to point out one very important one where they get mortality wrong, with the most unconvincing of citations:

    Initial estimates of the infectivity of SARS-COV-2 were pretty close to what we currently believe to be true. Initial estimates of the infection fatality rate (IFR) was in the neighborhood of 2-4 times higher than it turned out to be. The IFR of SARS-COV-2 depends on three things that vary over time and population.

    1. How deadly the virus is.
    2. What the demographics are of the infected population (e.g. age distribution).
    3. How effective treatments are.

    A good guess for initial IFR is 0.64% [1]. However, we might be now lower this by 30% with steroid treatment alone, and I have no doubt that it has been lessened by at-risk individuals taking more precautions than young healthy folks.

    This is completely different from the case fatality ratio (CFR), which only counts those sick enough to be caught by our health system. For COVID-19, this is ~2%. You always want to be careful you don’t compare an IFR with a CFR.

    I’m not sure exactly where they got the .2% figure for flu, but the CFR for influenza in the US was about .1% in the 2015-2016 season [2]. The COVID-19 number we should compare this to is it’s ~2% CFR, so on the order of 20 times deadlier. This combined with the fact that it is MUCH more infectious, we don’t have a vaccine, and no-one's immune system had seen the virus, is why 2020 has been so… inconvenient.

    Their citation around their mortality statement is just a bunch of junk showing that the progression didn't follow a SIR curve. Obviously it didn't. Individuals, businesses and governments all took extraordinary steps to reduce infection and hence death. Despite all of those efforts, which completely eradicated the flu season in the southern hemisphere, we still have a million people dead. If it wasn't so predictable, I'd be amazed at the lengths some people will go to to downplay this pandemic.

    p.s. I really liked your infection model with individual response to risk built in. I pointed a few modeling colleagues to it.

    [1] https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v3.full.pdf
    [2] https://www.cdc.gov/flu/about/burden/2015-2016.html

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    1. "but the CFR for influenza in the US was about .1% in the 2015-2016 season [2]. The COVID-19 number we should compare this to is it’s ~2% CFR, so on the order of 20 times deadlier."

      - we have flu vaccines which obviously help a great deal with making that less deadly.

      "This combined with the fact that it is MUCH more infectious, we don’t have a vaccine, and no-one's immune system had seen the virus, is why 2020 has been so… inconvenient."

      - we are exposed to coronaviruses each year, albeit not this one, if this particular one was deadly enough to warrant the measures that have been put in place we would see a lot more deaths across all the age groups but we're not, we're seeing most deaths occur where they usually occur, in people over 70 with existing health conditions relating to respiratory or cardiovascular illness or cancer, so they're people who have a relatively high likelihood of dying anyway. There is nothing unusual in the demographics of who this is killing.

      Even the rise in cases over the past few weeks here in the UK have coincided with schools reopening - most of the cases are in primary & secondary schools and among people aged 20-29, the number of cases in the older 70+ groups has actually fallen (generally) yet most of the hospital admissions are overwhelmingly in the 60-70+ age group which given the temperature drop due to Autumn arriving is nothing new.

      After Schools, the next biggest place of Covid cases is care homes (again), most likely due to our NHS sending people who are still infected back to their care homes - full of other elderly people who likely have existing health conditions - far too early when they should be isolated for some additional time to protect those other vulnerable people.

      Same thing happened with the 'Spanish' flu, a lot of the initial victims were soldiers in cramped, squalid conditions with fatigue and malnourishment (not good for your immune system I'd imagine...) who were then sent to field hospitals full of other sick people.

      So it seems like we haven't learned from history at all.

      Delete
  3. The cure is worse than the disease.

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  4. The letter cites multiple Youtube videos as sources for masks being ineffective ������

    The majority of their other sources are equally dubious, e.g. blogs with no legitimate references of their own.

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  5. Here Cochrane starts by putting "Science" itself in scare quotes. Frankly, this one word innuendo made my blood run cold. How else to read this but as a veiled assertion that because he isn't pleased with the message coming from Science right now, it's time to question the discipline itself. Have I misunderstood here?

    Also, does Cochrane misunderstand that most medical practitioners are not professional scientists? For this reason an open letter signed by a group of caregivers carries little scientific weight, if any.

    Finally, I wonder if Cochrane is offering this as a counterweight to the recent open letter signed by genuine scientists at Stanford University, which he so despised? If so, he's seeking an equivalence where there is none.

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    1. To answer your question, yes, you have indeed misunderstood. Regardless of whether the Belgian doctors have got all their details exactly right, their basic points are irrefutable:
      • many aspects of covid infection and transmission remain uncertain, and so policy has been based on modelling predictions rather than scientific evidence;
      • the covid pandemic, while serious, has turned out to be nowhere near as bad as predicted by these modellers (even in Belgium);
      • any attempts to challenge the official view based on these obviously false predictions is publicly excoriated.
      To which I would add:
      • the economic cost of following policies based on false predictions looks like being enormous and long-lasting.

      Anybody who claims to be motivated by science should be very concerned about all of these points. But instead, most equate the 'science view' with the 'official view', despite the latter being characterized by next to no scientific evidence.

      Delete
    2. I don't see the "scare quotes" on the word "science" in this piece; maybe they've been removed? In any case, I think many people might nowadays express the word "science" in quotes as a nod to the reader or listener (via "air scare" quotes??) that they are aware of the overuse and ambiguity of the now-pervasive (and regrettable) use of the term "the science".

      Delete
    3. Yes, I removed the scare quotes. I freely edit blog posts when people point out infelicities. There was a point to them. The parts of science that we really know, validated by replicated controlled experimentation, don't say much about public policy. The political call to let scientists decide based on science has a lot of problems where science just doesn't know. As you point out. But all this is clearly too subtle for one set of quotes.

      Delete
  6. I agree completely that the suppression of divergent opinions generally, and related to Covid specifically, is a huge problem right now. There is still a lot we do not know about the virus, and shutting down most debate is not going to help us learn more faster. But, this probably wasn't the best letter to use to make the point.

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    1. Unfortunately most of the "debate" is to pretend the whole thing is an overblown hoax. A more "science-based" take is Cornell's:

      https://www.washingtonpost.com/opinions/2020/09/30/cornell-coronavirus-college-campuses-students/
      --

      "But most important, we took the steps that are at the heart of any public health initiative to control infection: establishing robust programs for testing with rapid turnaround, contact tracing, and isolation and quarantine. We tested every student upon their return to campus. All of our undergraduate students are being tested twice per week, while graduate students, faculty and staff are being tested at varying rates, depending on the frequency and nature of their on-campus interactions.

      Fighting an epidemic means stopping its spread. A student who tests positive is immediately put into isolation in a hotel room that the university pays for and where we provide support. We work with the county health department to conduct contact tracing, and we also immediately test everyone within the student’s social network. We are currently testing more than 30,000 individuals per week."

      --

      Sadly most of the boosters for reopening are so against any suppression of "essential freedoms" that they would consider policies like this a non-starter. I guess in their view, pandemics are things we don't bother to fight unless the bodies pile up high enough.

      Anyway, John, I'm disappointed that you lent your voice to this garbage petition.

      Delete
  7. "According to the good doctors, the widespread fear of transmission by asymptomatic people is false, and the massive wiping down effort wasted."
    I'm a lot more concerned with the people that are symptomatic but don't give a f*ck because Trump said it's just a fake news hoax so they still go to work and stores and bars and wipe their runny nose with their hands and don't wash their hands. Just a few of those could infect quite a few more people since this virus seems farm more contagious than the flu.
    And about the masks causing oxygen deficiency...I'm pretty sure I survived just fine wearing N95 masks all day long while jackhammering concrete in confined spaces for 12 hours a day, so I'm pretty sure people can wear one for an hour when they go to the store.

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    1. I'm against excessively restrictive responses but also against excessively dismissive responses. It's lazy to blame Trump when most of the blame should go to federal agencies and state officials (New York, New Jersey) over which he has little control (at least over a period of months). However, I have to say that people whining over imaginary problems from wearing masks should take a good look at the actual literature and talk to people who wear REAL masks all day long.

      A few months ago, out of an abundance of precaution, I wore an N95 mask just about everywhere, including the gym. Now the gym is open again (here in Arizona), I'm wearing a surgical mask while working VERY hard. Unlike most people, I suffer from chronic congestion and a probably-related phobia to anything that impedes my breathing. Yet, somehow, I get through a workout (shopping is NOTHING by comparison) while wearing a mask. I'm baffled by those who won't wear a mask or just fake it when they think some is watching -- these are people who are panting and blowing their potentially diseased expirations right into others.

      On the positive side, I've observed greatly improved mask-wearing in the last month or two (Arizona has at the same time gone from one of the worst places in the USA to one of the best). But there are still too many people who won't wear a mask (or wear it completely ineffectively) and have an attitiude when asked to protect others in a close space where a lot of strong exhalation takes place. It's almost enough to turn me into a statist/authoritarian. Fortunately, I have deep understanding of why such feelings would only lead to disaster.

      I have seen no evidence that "wiping down" matters much at all. I have seen strong evidence that (properly) wearing a good mask helps. It's clear that the vast majority of people are utterly clueless when it comes to the actual (changing) scientific evidence. They base their behavior on tribalistic identifications. ("Trump doesn't wear a mask, so I don't." "Biden wears a mask, so I do.")

      So: Yes, the "oxygen-deficiency" from mask-wearing is complete rubbish. It's also idiotic to focus solely on the death rate. The evidence for all kinds of nasty long-term damage from COVID-19 keeps accumulating. Personally, I absolutely f'ing dread having a breathing tube forced down my throat, let alone damage to the lungs, heart, etc.

      98% of comments on this issue seem to be driven primarily by ideology. That makes me deeply discouraged for our culture (USA to be sure, but globally too).

      Delete
  8. I don't know how to reconcile the claim of 0.2% IFR, or 0.6% for that matter, with the fact that the worst-hit areas (notably Bergamo province in northern Italy, but similar values from some parts of Spain I think) had an overmortality corresponding to 0.5% of the total population in two months. That suggests IFR of at least 1%, up to 2.5% if we trust serological tests to give the correct number of infected. Alternative explanations: (1) unfavorable demographic profile (2) large random fluctuations of IFR between areas (3) genetics (southern europeans get it worse) (4) hospital overcrowding. Notice that even if the general IFR is low-ish in absence of hospital overcrowding, it implies that measures which keep the epidemic under control can half the death toll or more.
    So, yay for "flattening the curve" but "squashing the curve" is overzealous and not cost-effective?

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  9. Prof. Cochrane,
    This letter is correct. Time will tell. It always does. The angry leftist authoritarians claiming that "it is scientific" may learn. They just need to update their beliefs in face of new evidence. They never do, but they may have to, this time.

    The one citing 0.1% as a IFR for flu arguing that it is not 0.2% (in a bad flu season, it is), then resorting to conditional expectations to say it is 2%!, and then dropping at the end a hint that "he models things"... Seriously? As we know since undergrad: garbage in, garbage out.

    Always good to see discussion being created. Congrats!

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  10. Having used, and collected data for public institutions, during 30 years of public service in labor, education, and health programs, I regret to say that errors, and misuse of much data from public sources, is endemic, slanted to cater to political objectives and beliefs. Emotional heat is generated that dissipates slowly, if ever.

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  11. Who are the authors of the letter? The copy at the web link doesn't say.

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  12. One of the links on the topic of masks went to a woman trained by OSHA, working in Michigan, a 20-year PPE expert. She spent very little time actually discussing how/why masks don't work and a lot of time throwing out jargon to impress us with her credentials. She mostly sounded like she was trying to justify her day job and had an inferiority complex with respect to MDs. "You can't all wear N95s! My job is to fit test everyone for N95s! If you can just wear one without my approval then what am I here for!"

    I gave it a true listen, but when she mentioned that Bill Gates "has a patent on the coronavirus" I had to turn it off.

    I didn't have time to dive further into any of the other links but that one was a total dud.

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    1. Although I've heard a lot about PPE shortages (caused by government regulations, although most people don't understand this), today I was grocery shopping in Safeway and picked up a pack of 10 N95 masks for $10. Okay, they don't fit me [too much air leakage from the bottom] as well as ones from a medical supplier but still, that's pretty great. Yay for the market despite all the (invisible to most) state controls.

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  13. Sure all doctors aren't experts on everything. But you should specify what you mean with doctors, because many people have doctoral degrees that are not in medicine, and yes, they may be experts on airflow, particle size and other sciences and disciplines that inform the decision on public health policy. I agree with everything the Belgian open letter has to say except this part below, which is just plain false:

    ...Oral masks in healthy individuals are ineffective against the spread of viral infections.

    Wearing a mask is not without side effects. Oxygen deficiency (headache, nausea, fatigue, loss of concentration) occurs fairly quickly, an effect similar to altitude sickness. .... In addition, the accumulated CO2 leads to a toxic acidification of the organism which affects our immunity. Some experts even warn of an increased transmission of the virus in case of inappropriate use of the mask....

    Hospitals have a sterile environment in their operating rooms where staff wear masks and there is precise regulation of humidity / temperature with appropriately monitored oxygen flow to compensate for this, thus meeting strict safety standards. ...

    All this seriously calls into question the whole policy of social distancing and compulsory mouth masks for healthy people – there is no scientific basis for this.

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  14. Its6comforting to hear of more rational and more well considered approaches to this global blip than we've known in the U.S.

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  15. John, thanks for this analysis and for this forum. Please accept a note from an incorrigible copyeditor (and let me know if I'm wrong): In your sentence above that reads "The valid criticism is a failure to adapt...", I think you meant to write "is of a failure...", yes? Just wanted to alert you.
    --Eric

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    1. Thanks. To all: I appreciate typos, badly written sentences, and other corrections. I don't edit blog posts as well as I should.

      Delete
  16. Does anybody question the fact that most, if not all, doctors/authors are not specialists in viral infections. There is a lot of GPs, psychiatrists and general surgeons. Medicine is Hard, just like economics, there are specialists in sub-fields for a reason.

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  17. Apparently facebook does not even tolerate discussions of any kind that question the validity of the media narrative on this disease. I posted the doctors' letter on a couple of groups for discussion purposes and facebook's "fact checkers" took the posts down within minutes.

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  18. I'm stunned that you would post something like this and then still bang on about rapid testing. If this is only as serious as seasonal flu (and I believe there is overwhelming evidence in medical journals to support this) then we have ask ourselves are we wrong about how we deal with Covid-19 or were we wrong all along in how we deal with seasonal flu. Anyone with some ability for sound judgment would say the former. People need to learn to live with the disease.

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  19. I agree that lockdowns, taken from the experience of a tightly controlled, tech happy, authoritarian government was a blunt instrument and an inappropriate one for a free society. Some of the remarks about the virus itself and our limited understanding also square with some research from Europe and Japan. But, looking at the list of the doctors and their specialties is not encouraging: many are from orthopedics, others from a raft of irrelevant specialties, and few for virology, immunogenetics, vaccines etc. This was troubling to see. Further, looking at the references, the YouTube video referencing some controversial claims, didn't play, and it said the author had removed it. A paper I read was off the topic and irrelevant. Have you been spoofed, John? I found a similar group claiming to be Dutch doctors, but that site also seemed to be not worth citing. You should either say that you stand by this and explain why, or take your name off this. I very much like your work, but this is embarrassing.

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  20. Even if we:

    1.- knew everything about Covid19
    2.- had an economic model that would allow us to predict the precise consequences of any "public policy" measure down to an individual level (indeed a remarkable achievement)

    It would still be impossible to define an optimal "public policy" that would reflect the aggregated preferences of all the US citizens (much less of the World citizens)

    Arrow's theorem shows that impossibility.

    So, when somebody says, "Science should guide our policy response to Covid19", what he has just said simply has no meaning at all.

    Add to that that:
    a) we know that we do not know a lot of things about this virus and that we have and informed suspicion that there are many relevant aspects that we do not know that we do not know

    and

    b) We do not have anything that slightly resemble a reliable model that allow us to estimate the impact of any policy measure on the most basic aggregated macro variables.

    and you can only concuded that saying "We should do what science recommend us to do" is very well positioned to win the "most meaningless sentence of the year" contest.

    The respond to Covid19 ONLY can be political ... and political has been and will be.

    The calls to "public policy measures based on science" just show that "politics" has a negative connotation and "science" a positive one in our very particular modern "Pantheon" (and maybe rightly so ... or not). But does not move us an inch in the direction of getting the "right" answer to Covid19. At least if we understand “to be correct” the same way that when sending a space probe to Mars.

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  21. The suppression of debate --- and the enlisting of YouTube, Facebook, Twitter, etc. to help enforce it --- are commonplace now. Progressive elites blame "too much" open debate on climate change in the 90s for enabling opposition to solidify against their preferred policy prescriptions. They think their strategy of just yelling "The Science (TM)" started too late. In their mind, if only they had started sooner, then we would already have the Green New Deal. When Covid hit, they were determined to not repeat their "mistake" by trying to nip dissent in the bud before it had a chance to form. Hence, claims of "following The Science (TM)" before actual science (no scare quotes) was formed. Wokeness/PC, of course, is another area where dissent is not tolerated, albeit with accusations of racism/sexism/homophobia/transphobia replacing shouts of "The Science (TM)". Unfortunately, I think we will see more topics beyond these three where progressive elites try to stifle future debate. It's their standard playbook now.

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  22. Hi,
    It has been 7 months since the pandemic was declared and we learned a lot and developed treatments. Now of course it's not like at the beginning.Now it's easy to say it should have been like this. Of course, one should be careful when it comes to human life. No policy or strategy is perfect, it cannot be. I think we should draw lessons instead of criticizing what has been done in this pandemic and apply it in the future. None of my physician and nurse friends have died of the flu yet, but I lost 2 physicians and 2 nurse friends from this disease, and in 7 months, so in 7 months 4 healthcare professionals who where my friens died of this disease. I am a physician for 35 years. During this time, I lost only one physician friend in a traffic accident and the other from a heart attack. These are not coincidental. To say this disease is like the flu and to make the already unhappy and restless society even more unhappy and annoyed is not a behavior befitting scientists. These issues should be discussed in large boards and scientifically examined. I do not believe in the accuracy of immediately sharing such raw information with the public. Real scientific results should be shared.
    Thank you.

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Comments are welcome. Keep it short, polite, and on topic.

Thanks to a few abusers I am now moderating comments. I welcome thoughtful disagreement. I will block comments with insulting or abusive language. I'm also blocking totally inane comments. Try to make some sense. I am much more likely to allow critical comments if you have the honesty and courage to use your real name.