Jul 232020
 


Constantin Brancusi Portrait of George 1911

 

 

Last week, Tyler at Zero Hedge ran an article from a site called Adventures in Capitalism, in which the writer (Kuppy?!) lets his light shine on the CIVD19 situation. He concludes that we’re all going to get it, it’s no use resisting, there will never be a vaccine and herd immunity is all we have left to hope for.

And I was thinking: what if he’s -largely- right? What if the utter lack of preparedness and the glaring incompetence we see displayed before our eyes all across the globe has made escape -almost- impossible? Surely at the very least we should prepare for that, too, even if it’s not the only thing we should prepare for.

Not that I’ve strayed much from my original viewpoints, that it’s very dumb to for instance have lengthy discussions about how efficient facemasks and lockdowns are, as long as they’re the only tools you have. But if nobody has a playbook for such things, including the WHO that gets paid millions for exactly that, you do run the risk of making your only tools obsolete.

It’s been a pretty wild year so far what with the spectacle of all the politicians bending like pretzels to avoid being caught unprepared. So many of them have solemnly declared that masks and testing don’t work, simply because they had no access to either. After decades of warnings that a new virus could pop up at any moment.

But you’re right, we now have to look ahead. So first I’ll give you a few “Kuppy” quotes with my comments on them, and we’ll take it from there. Oh, but first this on the morality of a policy aimed at herd immunity, from a BBC piece on the “achievements” of the British gov’t in the virus crisis. “Anthony Costello, professor at University College London and a former director at the WHO, tweeted”:

“Is it ethical to adopt a policy that threatens immediate casualties on the basis of an uncertain future benefit?”

And then we can turn to Kuppy:

You’re Probably Gonna Get It…

[..] had they stopped this thing in Wuhan, we would be right to use a containment approach to COVID-19. Instead, it’s everywhere and despite your personal opinions on the issue, it isn’t going away until most of us get it. There, I said it; you can hide in your basement, but you’re still probably going to get COVID-19. You can quarantine a whole nation; they’ll just get it next year. We are a global economy and this is now a global disease.


Whether you like it or not, the world is going for “herd immunity.” Unfortunately, there is no other viable option; there will be no vaccine, there will be no miracle cure and besides, the virus isn’t even all that dangerous if you are young and healthy. Simply put, COVID-19 won’t flame out until 50 to 80% of us get it (the precise number is open to debate).

I think a lot of people at this point in time would mostly agree with what he says there. But do they oversee the consequences?

Unlike smallpox or polio, there will never be a vaccine (there has never been a COVID vaccine for a variety of reasons)—therefore, as soon as quarantine ends, we’d all begin to spread it again, as there will always be infected humans. Countries that hermetically sealed their borders would not be immune either—they’ve simply deferred infection.

You can quarantine a village in Africa and stop a disease like Ebola that strikes fast and often kills the host. You cannot stop the spread of something that tens of millions of global citizens unknowingly have, while lying dormant for up to three weeks.

More things many would agree with. But will there really always be infected humans, and will they always spread the virus around the entire planet? Is that true? The virus needs new hosts all the time, and if you keep potential hosts sufficiently separated from each other, it can not spread.

We may have a global economy with global citizens, but we’ve seen plenty evidence that what has caused hospitality and travel to plummet has not been lockdowns, but people’s fear of getting infected. Is that irrational, and will you be able to convince them otherwise?

I think it should be obvious that you cannot stop COVID from spreading, at best, you can slow it down so that hospitals do not become overwhelmed. Instead, governments are passing draconian and arbitrary laws that do little to slow the spread, yet destroy businesses and communities.

Hmmm. How exactly would you slow it down without masks and lockdowns? Does it seem like a good idea to bring people together again in offices, elevators, planes, trains, restaurants and bars? Right now it doesn’t appear to make much difference, most people wouldn’t go anyway.

I read today that in the UK, almost half of workers -well, those that still have a job- work from home, whereas that number was 5% before virustime. And now the gov’t wants them all back in the workplace. Think they’ll go as long as the virus is out there?

Millions of jobs, and there come hospitality and travel again, are lost forever. People are afraid. And no, that has little to do with a media fear-porn campaign, though the media are as clueless as the politicians, and it’s a comforting thought to be able to blame them.

[..] putting your head in the sand and hoping COVID-19 goes away is foolish. It is time for everyone to accept the inevitable and figure out what that means for themselves and their countries. The current checker-board approach in the US where each state and even each county takes a different approach—is simply making a mess of things.

People can figure what things may mean without first accepting them as inevitable. Many are doing that right now. But yes, the US has been a mess and still is. It’s too large for a one-size-fits-all approach, especially if that has to be made up on the spot.

But the “leaders”, whether in politics, health care or elsewhere, have a fool-proof take on that: they blame each other. Still, the US debacle is something that has grown over years, decades, it hasn’t suddenly appeared, you just didn’t see it before. And it’s not only the US; the entire rich world has the exact same problem.

Here in Miami Beach; we have a 10pm curfew, we have fines and jail time for not wearing masks in public, bars are closed, restaurants can only have outdoor seating and the beach was closed last weekend. It is not clear what any of these measures actually accomplish if tens of thousands are marching around in protests without masks.

As an aside, the stupidest thing around must be people who wear facemasks outside, unless they’re in close proximity to others. Still, there are gov’ts that demand they do. Closing a beach falls in that same category. Unless people get close together. As for the protests, the most cynical remark I can muster is that at least the rioters cover their faces.

 

 

As I made my rounds at some of my favorite restaurants this week, owners finally broke down the brave façade; they confessed that they’re financially bleeding to death. Dozens of prominent restaurants have already shut their doors for good—some of these restaurants have been around for decades and survived multiple economic cycles. If the laws are consistent, you can manage your business—if the government changes the rules every few days to combat a bad cold, what are you supposed to do?

Darn, Kuppy, you were doing just fine, and now you have to bring up the dead “just a bad cold” idea? Read on. It’s not.

I think it is time for everyone globally to finally admit that COVID-19 is here, that we are powerless to stop its spread and that most of us are going to get it. The focus should be on protecting those who are elderly or compromised from a health standpoint. When you start from that framework, you can then think through the consequences and adapt policy appropriately.

We haven’t protected the elderly and health compromised during the lockdowns. What makes you think we will when things are supposed to “return to normal”? We locked up the elderly in the petri dishes we call carehomes, and we let kids and the poor stew in their own misery.

You think we’ve learned something from that? I think when outbreaks flare up again, as they do right now all over Europe, they’re going to isolate the old and the young again, and let the poor rot some more.

If you hope you can protect everyone from it, you’re going to postpone the inevitable, while destroying the economy. Once again, I don’t know what the right approach is, but I know that what’s being done today is asinine. It’s time for global leaders to wake up.

I’m pretty sure that’s what we call a false dichotomy. Lockdowns don’t destroy economies, the virus, and people’s fears of getting infected, plus seeing their loved ones be infected, does. Opening everything up is not going to change that for the better.

 

From there it’s just a small step for man and giant leap for mankind towards Kuppy’s only solution left: herd immunity. The idea has already been burned to the ground by numerous parties, but since it’s the only thing he has left, let’s humor him, shall we?

Here’s from a recent BBC piece on the topic, which seems sort of based on the notion that it’s all Britain has left as well. Interesting article though, I must say, they tried to make something out of the whole minestrone :

Did ‘Herd Immunity’ Change The Course Of The Outbreak?

“Herd immunity” is a concept describing the point at which a population has developed protection against a disease. There are two ways to do this. Vaccination is one route. But with any new virus it’s impossible to say how long it will take to develop a vaccine, if ever. The other way is for people to catch the disease and build up some form of immunity. If exposed to the virus again, it is assumed they have protection. If most people in a population are protected then the virus cannot spread.

But there are two problems. One is that with a new virus – like this particular coronavirus – it’s not always clear how much protection having had the disease, particularly a mild case, gives you or how long it lasts. And if most of the population catches the disease, many thousands might die. On 13 March, Sir Patrick stated that about 60% of the population would need to become infected for society to have “herd immunity” – effectively some 40 million people in the UK.

“Communities will become immune to it and that’s going to be an important part of controlling this longer term,” he told Sky News. These comments sparked an immediate backlash. Anthony Costello, professor of health and sustainable development at University College London and a former director of maternal and child health at the WHO, tweeted: “Is it ethical to adopt a policy that threatens immediate casualties on the basis of an uncertain future benefit?”

And from Britain we can go seamlessly to Sweden, perceived as the -internationally heralded- poster child of herd immunity policy, though they never officially endorsed it. A group of 25 Swedish doctors and scientists sounds the alarm on the entire approach, and even suggest it is a “secret goal”.

Sweden Hoped Herd Immunity Would Curb COVID19. Don’t Do What We Did. It’s Not Working.

The motives for the Swedish Public Health Agency’s light-touch approach are somewhat of a mystery. Some other countries that initially used this strategy swiftly abandoned it as the death toll began to increase, opting instead for delayed lockdowns. But Sweden has been faithful to its approach.

Why? Gaining herd immunity, where large numbers of the population (preferably younger) are infected and thereby develop immunity, has not been an official goal of the Swedish Public Health Agency. But it has said immunity in the population could help suppress the spread of the disease, and some agency statements suggest it is the secret goal.

Further evidence of this is that the agency insists on mandatory schooling for young children, the importance of testing has been played down for a long time, the agency refused to acknowledge the importance of asymptomatic spread of the virus (concerningly, it has encouraged those in households with COVID-19 infected individuals to go to work and school) and still refuses to recommend masks in public [..]

Several authorities, including the WHO, have condemned herd immunity as a strategy. “It can lead to a very brutal arithmetic that does not put people and life and suffering at the center of that equation,” Dr. Mike Ryan, executive director of WHO’s Health Emergencies Program, said at a press conference in May.

Regardless of whether herd immunity is a goal or a side effect of the Swedish strategy, how has it worked out? Not so well, according to the agency’s own test results. The proportion of Swedes carrying antibodies is estimated to be under 10%, thus nowhere near herd immunity.


And yet, the Swedish death rate is unnerving. Sweden has a death toll greater than the United States: 556 deaths per million inhabitants, compared with 425, as of July 20.

Sweden also has a death toll more than four and a half times greater than that of the other four Nordic countries combined — more than seven times greater per million inhabitants. For a number of weeks, Sweden has been among the top in the world when it comes to current reported deaths per capita. And despite this, the strategy in essence remains the same.

7 months of pandemic without a lockdown, under 10% have antibodies, and the death toll is 7 times that of their neighbors. Something’s not working right?! But Kuppy said it was our only remaining option…

Then again, something that did pique my interest is this very recent development. I could see this concept becoming more potent than any vaccine, if only because as Kuppy rightly notes, there has never been a vaccine for any coronavirus.

New Antibody Mix Could Form ‘Very Potent’ COVID19 Treatment

Researchers have identified a potent cocktail of antibodies that may help doctors treat Covid-19 infections and protect people at risk from falling ill with the disease. The antibodies were collected from patients hospitalised with severe Covid-19, and they could be manufactured at scale by pharmaceutical firms and transfused into the blood to fight the virus or prevent it from taking hold. Scientists at Columbia University in New York screened antibodies from 40 Covid-19 patients and identified 61 types from five individuals that effectively wiped out coronavirus.

Among them were nine that displayed “exquisite potency” for neutralising the pathogen. Tests on cells showed that the antibodies killed off the virus, while experiments with hamsters revealed that an infusion of one of the more potent antibodies protected the animals from disease. “It shut off infectious virus completely in the lung tissue of the hamsters we treated,” said David Ho, a professor of medicine at Columbia who led the research.

[..] Professor Sachdev Sidhu at the University of Toronto also has plans to take neutralising antibodies into clinical trials later this year. “In my opinion, the more antibodies the better, as scaling up antibodies, although standard, still requires time,” he said. “Having multiple options will be good to ensure as many patients as possible can receive the therapies.”

He said every country that is capable of doing so “owes it to their population” to manufacture therapeutic antibodies, and that countries should work together to ensure they can be made available to as many patients as possible at affordable cost.

Then again, antibodies do not come without their own risk. There’s always the risk of a cytokine storm in some form or another. No exception in the case of SARS-CoV-2.

Study Sees Harmful Effect Of Coronavirus Antibodies In ICU

Antibodies generated by the immune system to neutralise the novel coronavirus could cause severe harm or even kill the patient, according to a study by Dutch scientists. Immunoglobulin G (IgG) is a fork-shaped molecule produced by adaptive immune cells to intercept foreign invaders. Each type of IgG targets a specific type of pathogen.

The IgG for Sars-CoV-2, the virus causing Covid-19, fights off the virus by binding with the virus’ unique spike protein to reduce its chance of infecting human cells. They usually appear a week or two after the onset of illness, when the symptoms of most critically-ill patients suddenly get worse. A research team led by Professor Menno de Winther from the University of Amsterdam in the Netherlands said they might have found an important clue that may answer why the IgG appears only when patients are ill enough to be admitted to the intensive care unit (ICU).

The scientists found that the blood from Covid-19 patients struggling for their life on ventilators was highly inflammatory. They observed during a series of experiments that it could trigger an overreaction of the immune system, destroy crucial barriers in tissues and cause water and blood to spill over in the lungs.

It looks like it’s high time, in fact it’s long overdue, that we stop calling COVID19 a respiratory disease. The SARS-CoV-2 virus may enter the body through mouth and nose, but once it’s in, the lungs are merely the first organ it reaches. But it’s through the vascular system that it spreads all through the body.

What we see even in patients that have been declared “recovered”, and we see this time and again, is crippling fatigue, lung damage, heart damage, brain damage, nerve damage, multiple organ damage. And, as a recent report spelled out, blood clotting was found in every organ in the body, including veins, during autopsies.

Many “recovered” patients report symptoms, such as debilitating fatigue, that can last for at least months. We simply don’t know for how long, because it’s only been around for 7 months.

These are things to consider when you say we must surrender to the virus and let it run its course. Even if it doesn’t overwhelm a certain area’s health care system today, we may well be left with huge amounts of people who carry its scars, and need medical assistance, for the rest of their lives.

That appears to be the minimum price you’re going to pay for letting the virus run its course. Is that worth it? Well, not for the girl who’s unlucky enough to catch it, I tell you. For society as a whole then? What’s the price we’re willing to pay for keeping a bar open? I don’t have to answer that question, I only have to ask it. But we as societies do need to come up with an answer.

Is large scale infection inevitable, as Kuppy claims? If so, the consequences look dire. But yes, so do more lockdowns. Agreed. Totally. You tell me. What’s the price you’re willing to pay? A closed bar, a facemask in a store, or a friend’s body crippled for life? You tell me.

To wrap this up, a last study, this one conducted in 69 countries across six continents. I don’t think I’ve seen anything over the past 7 months that I find scarier than this. You see, heart surgery is a life saving procedure for many people, who would be gone without it.

So what happens to your health care system if you let half the population catch the virus, and half of those end up with heart damage in one form or another, to one degree or another? And that’s just the heart, that’s not lungs or brain or nerves or blood vessels.

 

“55 per cent of patients had an abnormality. One in seven patients were found to have severe abnormalities..”

More Than Half Of All COVID19 Patients Found To Have Damaged Hearts

An international survey of heart scans in people treated for COVID-19 found that 55 per cent of patients had an abnormality. One in seven patients were found to have severe abnormalities. The study adds further evidence to the emerging picture of COVID-19 as a disease of the vascular system in a significant number of cases, and not always primarily a respiratory disease.

It also suggests that a significant of COVID-19 patients will need to be monitored and assessed for permanent damage to the heart. And it raises questions about the extent to which COVID-19 is a disease you may not fully recover from. The research is from a team at the Centre for Cardiovascular Science, University of Edinburgh, UK. They studied echocardiograms from 1216 patients, aged 52 to 71, 70 per cent of them male.

The patients came from 69 countries across six continents. They were all presumed or confirmed cases of COVID-19 when the echocardiograms were taken (between April 3 and April 20, 2020). An echocardiogram uses ultrasound to show how your heart muscle and valves are working. About three-quarters of the patients (901 of them) had no pre-existing cardiac disease. But 46 per cent of their echocardiograms were abnormal, and 13 per cent were found with severe disease.

According to the study: Left and right ventricular abnormalities were reported in 479 (39 per cent) and 397 (33 per cent) patients, respectively. There was evidence of new myocardial infarction in 36 (three per cent), myocarditis in 35 (three per cent), and takotsubo cardiomyopathy in 19 (two per cent). Sixty percent of the scans were performed in an ICU unit or emergency room. About 54 percent of the patients had severe COVID-19. Abnormalities were often “unheralded or severe, and imaging changed management in one-third of patients.”

Study co-author Marc Dweck, consultant cardiologist at the University of Edinburgh, U.K., said in a statement: “COVID-19 is a complex, multi-system disease which can have profound effects on many parts of the body, including the heart. “Many doctors have been hesitant to order echocardiograms for patients with COVID-19 because it’s an added procedure which involves close contact with patients.

“Our work shows that these scans are important—they improved the treatment for a third of patients who received them.” Dr Dweck continued: “Damage to the heart is known to occur in severe flu, but we were surprised to see so many patients with damage to their heart with COVID-19, and so many patients with severe dysfunction.”

Really, you tell me. But don’t tell me only old people die of it. We’re way past that point. And don’t tell me younger people are not affected. That’s like 19th century wisdom. If you want to argue for herd immunity, by all means, but don’t just blurt out something. Let’s see what you got.

 

I’ve always, as noted before, disliked the wartime, military talk when it comes to this virus, the “we must beat this enemy because it’s out to get us”. This is not the -real- German nazis or the -imaginary- Russians of today. A virus is smaller than you can imagine and it’s not even alive according to science.

But staying with that war talk for a moment, are you sure you want to surrender to it regardless? Or do you want to go with: it’s not that bad, and it’s not that deadly, and those old folk would have died anyway? So open up the bars and everything will be just hunky dory! You sure? Surrender?!

 

 

 

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Apr 152020
 


Henri Cartier-Bresson A visitor to the Forbidden City, Beijing 1948

 

Today, I’m going to try to show you how and why we know that in the case of a pandemic like the one we’re in, surrounded by doubts and uncertainties, there are still a series of measures that we can and, more importantly, must take. But also, how these measures are hardly ever taken, and if they are, not in the correct fashion. This has to date led us into a ton of preventable misery and death. If only we would listen. And there’s still more we can do to prevent more mayhem, there is at every step of the process.

It took me a while to get this together. But in the end I wound up with the only COVID19 analysis that makes sense. It doesn’t leave much room for discussion, at least not in the steps needed to be taken in order to tame the virus (I despise the war analogies everyone uses, taming sounds much better). How to fill in those steps once they have -kind of- been taken is another matter.

I’ve been reading up on this for a while, adding -much- more stuff as I went along (this will be a long essay), and at some point realized that the coronavirus is an issue you can’t leave to epidemiologists and virologists, because there are far too many unknowns for them to create a working model, and without such a model they are lost. These fine people are not good at 10-dimensional chess, even if they like you to think otherwise.

These people are useful for the knowledge they possess of past epidemics, not for predicting what will happen in the next one, certainly not if it’s caused by a virus which they -and we- simply don’t know enough about to build a reliable model. In that case, you need to step back and apply more basic principles. Lucky for us, those exist.

 

 

This leads us into a territory that is not familiar to epidemiologists and virologists. Since a virus, and a pandemic, like the one we’re in the middle of, is linked to so many different facets and factors, and so many uncertainties, it takes us into the territory of risk management, assessment, engineering, and from there eventually pretty seamlessly into complex systems.

If you can’t know what will happen next because you can’t oversee the multitude of variables involved, and there are no models that can do so either, the best -only- thing you can do is to halt the growing complexity as soon as you are able to, in order to create a situation, an environment, which the epidemiologists and virologists DO recognize, and can work with.

That is the point where they come in, not before. At present, they are asked to do things beyond their knowledge. And, typical human trait, they don’t tend to acknowledge that. Well, there’s a second reason: some actually think they do understand. The outcome is the same: we- and they- are led astray, away from science and into “scientism” (more on that in a moment).

Which would be fine if this concerned just a hobby, or even if it was only an academic paper left to discuss in classrooms and web forums. But we are talking about 10s of 1000s of deaths, 100s of 1000s of gravely ill people, and in the wake of that an economy as much in need of assisted breathing as the human patients involved.

Lucky for us, we have people who DO understand these things. Unlucky for us, our “leadership” doesn’t listen to them. They think that an epidemiologist or two, three, should be enough. But neither the “leaders” nor the epidemiologists understand the limits every single scientific field has. They don’t understand what happens when scientists venture out of their chosen field. And most of all, they don’t understand what complex systems are.

Please note that the above also means that any and all virus modeling going forward should be taken with an ocean full of salt. We get new examples every day of “qualities” of the virus that are not in any models. Where the virus originated, asymptomatic patients, re-infection, huge discrepancies in ‘modeled’ numbers predicted vs factual ones, Asians vs whites, blacks vs whites, men vs women, smokers vs non-smokers, chloroquine (non-)effectiveness, contagiousness, the list goes on for miles.

There is a way to leave those discussions, based on, we must admit, far too little verifiable information, leaving us groping in the pitchblack, behind for now.

 

Most people who read a site like the Automatic Earth, where finance is a main topic, will know who Nassim Nicholas Taleb is, for instance because he wrote The Black Swan before the 2008 financial crisis. Or because a hedge fund he advises recently announced a 6,000%+ gain in “virustime”. But Taleb is also, and more interesting for this essay, “distinguished professor of risk engineering at New York University’s Tandon School of Engineering”.

For much of his coverage of COVID19, Taleb has been co-operating with Yaneer Bar-Yam, president of the New England Complex System Institute, and Joseph Norman, a postdoctoral researcher at the same New England Complex System Institute. That means “real scientists”, just not from where you might expect. Which in turn means they can help the other guys get out of the ditch they’re in.

I’ll refer to “Taleb” here, nice and short, but that often means his co-operators too. Key terminology you’ll find, and need, is “asymmetry”, “precautionary principle” (“first do no harm”, which is close to the Hippocratic Oath’s “to abstain from doing harm”), and perhaps also “convexity” (a term from the finance world that depicts a relation between interest rates and bond duration).

First, here are a few bits from a piece the three wrote on January 26, to get you familiar with some of the ideas. These are ground rules for approaching a pandemic such as this one, but they are also ground rules for -any- other problems with too many unknown variables.

This is crucial because it denotes that if you have a disease that is both contagious and deadly, you don’t -have to- first wait and (build a model to) see how deadly and contagious it is, as an epidemiologist is wont to do, you can act right off the bat. Of course the scientists at the WHO and various government know this basic stuff, but they still haven’t acted accordingly. On January 26 and after, the ground rules were ignored.

So then you’re forced into the next basic steps. Still -mostly- not an epic disaster, but surely an unnecessary -and potentially deadly- risk. Taleb doesn’t take prisoners, and labels the WHO “criminally incompetent”. And I fully agree: they get paid billions a year to be the world’s ears and eyes in case a new disease pops up somewhere, and they have still let it happen. Here’s that first bit:

 

Systemic Risk Of Pandemic Via Novel Pathogens – Coronavirus: A note

General Precautionary Principle : The general (non-naive) precautionary principle [3] delineates conditions where actions must be taken to reduce risk of ruin, and traditional cost-benefit analyses must not be used. These are ruin problems where, over time, exposure to tail events leads to a certain eventual extinction. While there is a very high probability for humanity surviving a single such event, over time, there is eventually zero probability of surviving repeated exposures to such events. While repeated risks can be taken by individuals with a limited life expectancy, ruin exposures must never be taken at the systemic and collective level. In technical terms, the precautionary principle applies when traditional statistical averages are invalid because risks are not ergodic.

Spreading rate : Historically based estimates of spreading rates for pandemics in general, and for the current one in particular, underestimate the rate of spread because of the rapid increases in transportation connectivity over recent years. This means that expectations of the extent of harm are underestimates both because events are inherently fat tailed, and because the tail is becoming fatter as connectivity increases. Global connectivity is at an all-time high, with China one of the most globally connected societies. Fundamentally, viral contagion events depend on the interaction of agents in physical space, and with the forward-looking uncertainty that novel outbreaks necessarily carry, reducing connectivity temporarily to slow flows of potentially contagious individuals is the only approach that is robust against misestimations in the properties of a virus or other pathogen.

Asymmetric Uncertainty : Properties of the virus that are uncertain will have substantial impact on whether policies implemented are effective. For instance, whether contagious asymptomatic carriers exist. These uncertainties make it unclear whether measures such as temperature screening at major ports will have the desired impact. Practically all the uncertainty tends to make the problem potentially worse, not better, as these processes are convex to uncertainty.

Conclusion : Standard individual-scale policy approaches such as isolation, contact tracing and monitoring are rapidly (computationally) overwhelmed in the face of mass infection, and thus also cannot be relied upon to stop a pandemic. Multiscale population approaches including drastically pruning contact networks using collective boundaries and social behavior change, and community self-monitoring, are essential. Together, these observations lead to the necessity of a precautionary approach to current and potential pandemic outbreaks that must include constraining mobility patterns in the early stages of an outbreak, especially when little is known about the true parameters of the pathogen.

It will cost something to reduce mobility in the short term, but to fail do so will eventually cost everything—if not from this event, then one in the future. Outbreaks are inevitable, but an appropriately precautionary response can mitigate systemic risk to the globe at large. But policy- and decision-makers must act swiftly and avoid the fallacy that to have an appropriate respect for uncertainty in the face of possible irreversible catastrophe amounts to “paranoia,” or the converse a belief that nothing can be done.

 

As you can see, that already contains the next steps in case the initial response is warped (it has been). An expensive failure, but not necessarily an all too fatal one yet. Missing the next steps as well, though, turns this into a whole other story, and one that must be familiar to you, because you’re living it.

Yaneer Bar-Yam on March 23 gave it another try when he wrote in USA Today that “We Need An Immediate Five-Week National Lockdown To Defeat Coronavirus In America”. We know how that went (I don’t really have space to include that piece). According to this little graph I picked up last week, the US is barely 50% locked down. And that’s not going to cut it.

 

 

Two days after Yaneer Bar-Yam’s USA Today article, Taleb and Bar-Yam had a piece in the Guardian, which focused on the UK situation. And guess what? Nobody listened, again. You have to understand, these guys are perceived by the “science crowd” in “epidemic land”, who demand to be seen as the ultimate authorities on the topic, as big threats to their perceived power.

The last thing the “science crowd” want is for a bunch of complex systems guys, who they don’t understand anyway, to upstage them. And granted, the headline alone is ample threat to the UK government’s scientific advisers. But that attitude leads to more entirely preventable deaths; as I said above, the epidemiology etc. crowd simply lack the knowledge that the risk engineers do have, and which could help them prevent those deaths.

 

Something related, before I forget: I’ve been following Nassim Taleb’s opinions on genetically modified organisms (GMO) for a long time, because in that field, too, he applies the same ground rules that he does vis-a-vis the virus. First, precautionary principle (do no harm), and in the wake of that, asymmetry (asymmetric risk). In “Monsanto’s GMO field”, just like with deadly viruses, the risks when something goes wrong are devastating. If you get that wrong, you’re literally talking potential extinction.

And that makes any “normal” cost/benefit analysis obsolete. If you get the preliminary risk assessment wrong, the consequences are so far-reaching that your only realistic option is extreme carefulness (precautionary principle). Ergo: you don’t allow GMO crops until you’re 100% sure they have zero negative impacts on human health. What Monsanto does is use “scientists” who declare that no negative effect has been found so far, so it must be okay.

Taleb asserts that that is not science, but “scientism”. It is obvious that the negative effects can take decades to show, but if they do, things have probably become irreversible (all corn contains GMO traces). In other words, the burden of proof MUST lie with Monsanto; you can’t demand that everybody else proves their GMO crops are harmful. On the one hand, Monsanto gets to make a profit, while on the other billions of human lives can get lost. That’s the asymmetry Taleb is talking about.

Labeling any such deliberation, any such cost-benefit analysis, scientific, is an affront to any- and everybody’s intelligence. There are things that you cannot afford to take risks with. Mankind, the animal kingdom, the planet, are some of these things. You can’t argue that a lockdown might cost jobs if and when a non-lockdown will cost lives; you can’t argue for measures that kill people.

The only thing we can really do is to apply those measures that best mitigate job losses, not the ones that keep jobs but mitigate loss of life. It’s not even an actual choice; it’s a false dichotomy, because the risk of consciously allowing people to continue to infect others who may then die, which you could have prevented from happening, is so much greater than the loss of a job. The risk is asymmetric. A job is not a life.

It’s nuts to argue that we should allow someone to die because his/her neighbor might lose their job or because his/her neighbor beats his wife. In case someone loses their job, a government can issue a bailout or even a UBI. That they don’t do that and/or not properly, is another matter. But not one that justifies murder.

And you can’t take the conscious risk of letting people die because someone married an abusive person either. Yaneer Bar-Yam wrote some good stuff on community efforts with regards to COVID19, to be found at the New England Complex System Institute site, which might help in that regard. But you can’t aim for letting a deadly virus spread in order to prevent joblessness, loneliness or poor -life- choices.

 

Back to Taleb and Bar-Yam’s March 25 piece in the Guardian. I have a hard time selecting only some of it, a general problem with well-written essays.

 

The UK’s Coronavirus Policy May Sound Scientific. It Isn’t

When, along with applied systems scientist Dr Joe Norman, we first reacted to coronavirus on 25 January with the publication of an academic note urging caution, the virus had reportedly infected fewer than 2,000 people worldwide and fewer than 60 people were dead. That number need not have been so high [..] Our research did not use any complicated model with a vast number of variables, no more than someone watching an avalanche heading in their direction calls for complicated statistical models to see if they need to get out of the way.

We called for a simple exercise of the precautionary principle in a domain where it mattered: interconnected complex systems have some attributes that allow some things to cascade out of control, delivering extreme outcomes. Enact robust measures that would have been, at the time, of small cost: constrain mobility. Immediately. Later, we invoked a rapid investment in preparedness: tests, hospital capacity, means to treat patients. Just in case, you know. Things can happen. The error in the UK is on two levels. Modelling and policymaking.

First, at the modelling level, the government relied at all stages on epidemiological models that were designed to show us roughly what happens when a preselected set of actions are made, and not what we should make happen, and how. The modellers use hypotheses/assumptions, which they then feed into models, and use to draw conclusions and make policy recommendations.

Critically, they do not produce an error rate. What if these assumptions are wrong? Have they been tested? The answer is often no. [..] Risk management – like wisdom – requires robustness in models. But if we base our pandemic response plans on flawed academic models, people die. And they will.

This was the case with the disastrous “herd immunity” thesis. The idea behind herd immunity was that the outbreak would stop if enough people got sick and gained immunity. Once a critical mass of young people gained immunity, so the epidemiological modellers told us, vulnerable populations (old and sick people) would be protected. Of course, this idea was nothing more than a dressed-up version of the “just do nothing” approach.

Individuals and scientists around the world immediately pointed out the obvious flaws: there’s no way to ensure only young people get infected; you need 60-70% of the population to be infected and recover to have a shot at herd immunity, and there aren’t that many young and healthy people in the UK, or anywhere. Moreover, many young people have severe cases of the disease, overloading healthcare systems, and a not-so-small number of them die. It is not a free ride.

This doesn’t even include the possibility, already suspected in some cases, of recurrence of the disease. Immunity may not even be reliable for this virus. Worse, it did not take into account that the duration of hospitalisation can be lengthier than they think, or that one can incur a shortage of hospital beds.

[..] No 10 appears to be enamoured with “scientism” – things that have the cosmetic attributes of science but without its rigour. [..] Social science is in a “replication crisis”, where less than half the results replicate (under exact same conditions), less than a tenth can be taken seriously, and less than a hundredth translate into the real world. So what is called “evidence-based” methods have a dire track record and are pretty much evidence-free.

[..] when one deals with deep uncertainty, both governance and precaution require us to hedge for the worst. While risk-taking is a business that is left to individuals, collective safety and systemic risk are the business of the state. Failing that mandate of prudence by gambling with the lives of citizens is a professional wrongdoing that extends beyond academic mistake; it is a violation of the ethics of governing. The obvious policy left now is a lockdown, with overactive testing and contact tracing: follow the evidence from China and South Korea rather than thousands of error-prone computer codes.

 

If that’s not sufficient, here’s Taleb in a March 31 Bloomberg interview. Please watch:

 

 

And just in case it’s still not clear, I have collected a series of Taleb tweets that should make his position that much clearer. That is, after we failed to halt the virus while we could, thanks to China, the WHO and your own government, in that order, mass mask wearing is inevitable -because not doing so involves an asymmetric risk: even the worst mask reduces infection rates by 30%, and if both people involved in an interaction wear one, that may be 90%.

In that same vein, you need mass testing. And reliable testing, which is still not a given. These are things that people like to question, but those people are in the wrong time capsule. The proper time for that was December in China, and perhaps January in Europe and the US. Not now. Now you can only save what you can save, and that inevitably means taking measures that appear drastic. But which will look walk-in-the-park-ish compared to what follows if you don’t take them.

Tweets first; please do read them all. Note: Fat Tony is Taleb’s best friend and alter ego, and there’s controversy about whether he actually exists. For what it’s worth, I agree with Fat Tony that we don’t need a conspiray theory to explain COVID19, we have a virus that is deadly and highly contagious, and 1000s of scientists and politicians who have no idea what they do.

Those are all the basic ingredients you need for absolute mayhem. Not that all theories, whether it’s glyphosate or 5G, China lab or US lab, intential release or not, are necessarily wrong or baseless, but because in the face of a virus that doesn’t need any of these things to replicate the way COVID19 has, you need to come up with very solid proof. And I have seen none, just plenty theories.

 

 

 

 

I don’t know about you, but where I am right now, Holland, there are no masks available on a grand scale. There is so little testing going on in large parts of the West that even medical personnel often go without testing. I would love to be tested, if only so I know I either can or can’t infect people, but who am I to take away a test from a nurse, even if I could?

And this happens 3+ months after all our governments should have made testing and masks for everyone their no. 1 priority. And that was onnly after they failed to crush the curve when they could have.

Donald Trump was talking over the weekend about the “biggest decision of his life”, referring to the moment the US economy could be re-opened. Trump, as well as all the other “leaders”, even if their science advisers don’t like it one bit, or maybe because of it, should contact Nassim Taleb and the risks scientists he works with, within the next 5 minutes.

What is happening right now is not because all the epidemiologists and virologists around the world are wrong, but because they’re asked to make decisons and construct models about something they don’t know nearly enough about.

Call Taleb, Donald, Emmanuel, Shinzo, Angela et al. If you care enough about the lives of your people. I see a lot of rational-looking measures today, in all the lockdown variations, but I also see many countries and states clamoring for peaks to be called, and subsequent calls galore for less stringent lockdown measures. Decisions prone to be taken by politicians and epidemiologists who are -way- out of their league.

Please be careful. Call Taleb. You have nothing -more- to lose.

 

 

 

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