In a recent post, David Henderson contrasts the views of Neil Ferguson and Jay Bhattacharya:
The first was Tyler’s praise early in the pandemic of “expert” modeler Neil Ferguson, and his related action, with his Emergent Ventures project, of sending a large check to Ferguson and Ferguson’s Imperial College team. If you check the link just above, you’ll see that Tyler thought, correctly, that Ferguson had a huge impact on the U.K. and U.S. governments’ responses to Covid. Because Tyler is so well respected, not just in the United States but also internationally, that large payment put the imprimatur on some very bad modeling. It was that modeling that led Boris Johnson and Donald Trump to recommend lockdowns, and Johnson and many U.S. governors to impose lockdowns. Would they have done that without Tyler’s support of Ferguson? Probably. But if Cowen had recognized how little we knew at first and taken more seriously the early seroprevalence studies, such as that done by Jay Bhattacharya, that showed that the infection fatality rate from Covid was a small fraction of the case fatality rate, and if Tyler had publicized that, there might have been more pushback early against the lockdowns.
I have a different impression of the debate, one in which the pessimists were correct and the optimists were wildly off base. David links to a post by Tyler Cowen, which itself links to this NYT story from March 16, 2020:
Sweeping new federal recommendations announced on Monday for Americans to sharply limit their activities appeared to draw on a dire scientific report warning that, without action by the government and individuals to slow the spread of coronavirus and suppress new cases, 2.2 million people in the United States could die. . . .
Dr. Birx’s description of the findings was consistent with those in the report, released on Monday by an epidemic modeling group at Imperial College London. The lead author of the study, Neil Ferguson, an epidemiology professor, said in an interview that his group had shared their projections with the White House task force about a week ago and that an early copy of the report was sent over the weekend.
Two years later, it looks like Ferguson’s estimates were basically correct. The official US Covid death toll is over 900,000 (although if unreported Covid deaths were included it would be well over a million dead.) But that’s not what Ferguson was estimating. Rather, his claim was that 2.2 million would die without precautions and without a vaccine. That seems quite plausible. No one died of Covid in the large retirement complex where my 95-year old mom lives in Arizona, whereas without social distancing and without a vaccine they would have experienced many Covid deaths as the virus quickly spread though our population. Of course, that’s not to say all Covid avoidance strategies were wise; in my view many were unwise on a cost/benefit basis, and some were absurd. But the pessimists were correct on the specific point that the death toll would be horrific if people didn’t try to avoid Covid until a vaccine came along.
Of course even the optimists favored protecting the very old, but how accurate were their estimates of the death rate for the rest of us? Consider the views of Jay Bhattacharya, expressed in a Nov. 20, 2020 interview with Russ Roberts:
First you find that there’s a very steep age gradient in the survival rate. People who are under 70–if now, there’s now there’s like 50-some of these studies–so you can criticize mine but now you got to go after 49 other people–if you’re under 70, the infection survival rate is something like 99.95%. 99.95%, for under 70.
Bhattacharya had an extra 8 months to make a better estimate than Ferguson and instead made a ridiculous claim, unless I am misreading what he is saying. He seems to be claiming that only 0.05% of people under 70 who get infected with Covid end up dying from the disease. The actual figure is not known with precision. But given that roughly 0.10% of Americans under 70 (about 300,000) have already died of Covid, with thousands more dying every week, and given that this occurred despite widespread social distancing and despite widespread use of vaccines after 2020, I think we can assume that the actual infection fatality rate in an unvaccinated population would be at least 3 or 4 times higher than Bhattacharya suggested. And again, he benefited from an extra 8 months of data beyond what Ferguson had to work with.
PS. If someone wants to say that Ferguson should have said, “without action by the government and/or individuals” instead of “without action by the government and individuals”, I would not disagree. But again, David’s discussion is of infection fatality rates, and it seems Ferguson was pretty accurate on that point. Bhattacharya was not.
READER COMMENTS
Thomas Strenge
Feb 17 2022 at 4:21pm
This is an interesting piece, but how do you square the case of Sweden which appeared to follow a traditional epidemiological response to what everyone else did?
Scott Sumner
Feb 17 2022 at 5:16pm
The IFR was also very high in Sweden. Total deaths were not so high because the Swedes practiced social distancing in ways not too dissimilar from their neighbors. (Their recession was comparable to the other Nordic countries, their death rate per capita was far higher.)
I have a number of previous posts that discuss Sweden.
raja_r
Feb 17 2022 at 5:21pm
IIRC, Ferguson’s 2.2 million deaths were for the time period from 4/2020 to 9/2020. And that was not including deaths due to the hospital systems being overwhelmed.
Marc
Feb 17 2022 at 6:07pm
I was going to point out the same thing, but also add died of COVID has changed, it is now died with COVID. This is a big distinction, as someone that works with medical, I am very familiar with coding deaths and issues of coding people that have died with many potentially fatal illnesses. Picking which illness pushed the deceased over the edge is a judgement call, coding everything as COVID was political.
This was politicized with Trump, now it is being handled better, but because of this, people don’t trust the data.
Scott Sumner
Feb 17 2022 at 10:55pm
That’s right, but without social distancing the pandemic would have swept through the population like wildfire.
raja_r
Feb 18 2022 at 9:07am
One of the references I use for this claim is the social distancing in India – there wasn’t any. There certainly was no “wildfire” like spreading there. The excess deaths (not the govt. estimates) aren’t any higher than other countries.
Reece
Feb 18 2022 at 12:10pm
This is completely wrong. India had a nationwide lockdown for months, and targeted ones until December 2020. The Indian government was far stricter than the US government in the first year of the pandemic. Even in 2021, many states did lockdowns. A 2020 survey (“Lockdown of 1.3 billion people in India during Covid-19 pandemic: A survey of its impact on mental health”) found *98.2%* following social distancing measures, vastly higher than the US. It’s true that in 2021 this was greatly relaxed (and covid spread like wildfire through India after this), but by this point medical treatment was better and many were vaccinated, so it isn’t surprising that excess deaths aren’t higher.
Reece
Feb 18 2022 at 12:15pm
This is completely wrong. India had a nationwide lockdown for months, and targeted ones until December 2020. The Indian government was far stricter than the US government in the first year of the pandemic. Even in 2021, many states did lockdowns. A 2020 survey (“Lockdown of 1.3 billion people in India during Covid-19 pandemic: A survey of its impact on mental health”) found *98.2%* following social distancing measures, vastly higher than the US. It’s true that in 2021 this was greatly relaxed (and covid spread like wildfire through India after this), but by this point medical treatment was better and many were vaccinated, so it isn’t surprising that excess deaths aren’t higher.
raja_r
Feb 18 2022 at 1:31pm
Reece –
I’m from India. Yes, the government came up with many rules. No one followed it beyond the first few weeks. Government rules don’t mean much in India.
Reece
Feb 18 2022 at 1:59pm
It doesn’t matter if you’re from India. I have numerous Indian coworkers who have social distanced… which also doesn’t matter. Anecdotes are extremely weak evidence. Distancing can differ vastly depending on location, class, etc. Survey data is thus vastly more reliable, and it directly contradicts your experiences.
Michael Rulle
Feb 18 2022 at 10:24am
Excellent catch. It is virtually impossible to know what deaths would have been under different policies. Scott punted on his response to your comment. One thing that seems certain is the death rate is still the same as it was 2 years ago. Just look at total deaths. The 2 million number appears to have been a bad prediction. We are now predicting we are coming to the “end”—which I interpret as a new equilibrium. Omicron cases are rapidly declining. Deaths seem to be following the predicted lag. I do think our economic condition is in part related to our reaction. But it is easy to say that in hindsight. When all is said and done, maybe we will be able someday analyze what really happened and why.
Scott Sumner
Feb 18 2022 at 12:55pm
“The 2 million number appears to have been a bad prediction.”
You don’t seem to understand the difference between a prediction and an estimate. It was an estimate of the number of deaths if all 330 million of us did absolutely NOTHING to avoid Covid. Not sure why so many people don’t understand that.
Michael Rulle
Feb 19 2022 at 9:35am
I agree. 2 million appears to have been a bad estimate.
Michael Rulle
Feb 19 2022 at 9:47am
PS. My reasoning for this is total deaths have been a virtual constant for two years. Granted, we never did “nothing”, hence we do not know what nothing would have produced. But we did many different things (e.g., created vaccines, created masking policies in some states but not in others, worked from home, went shopping as usual). Yet total deaths have remained a virtual constant. Hence, the 2 million (which was stated as a maximum) estimate was 8 times the rate that occurred. It appears to have been not just a bad estimate——but an exaggeration. See, I can say Trump screwed up—-on purpose—-or perhaps ignorance.
Scott Sumner
Feb 19 2022 at 1:30pm
“My reasoning for this is total deaths have been a virtual constant for two years.”
This is completely false. I have no idea what you are talking about.
David Henderson
Feb 17 2022 at 5:40pm
Thanks, Scott, for entering the discussion.
The Neil Ferguson model that you and I refer to was his 2006 flu model. He specifically excluded nursing homes. As you know, a large fraction of the U.S. deaths occurred in nursing homes.
Also, Ferguson’s model predicted a single-peak pandemic where the death toll hit a maximum at around July 2020 and rapidly declined. He didn’t release exact dates, but from the graphs it basically means almost all deaths should have taken place roughly by the Summer of 2020 plus or minus 3 months. That clearly didn’t happen. If you just keep the clock running indefinitely you’ll eventually cross almost any prediction that’s made….which is what you appear to be doing here.
Mark Z
Feb 17 2022 at 5:56pm
Related to my comment below, he seems to have run the simulation for 2 years (a couple of his tables refer to this as the timeframe), so I assume his total fatality estimates are for the first 2 years (which we’re about to cross). The number thus seems reasonable while the distribution of deaths is way off. I’m not sure many points one gets for that. One could argue that measures taken to suppress spread have the effect of spreading out deaths across time though.
Scott Sumner
Feb 17 2022 at 10:57pm
I think you missed the point. He was predicting the death toll without social distancing. It’s now clear he was basically right about the IFR and Bhattacharya was way, way off.
Covid was roughly as deadly as Ferguson estimated.
Phil Magness
Feb 18 2022 at 10:17am
Ferguson ran models for several different scenarios, covering a range of policy responses. This may be seen in both the US/UK paper from 3/16/20 and the paper extending their modeling to almost 200 countries on 3/26/20.
The 3/26 paper is interesting because it also came closer to approximating the range of policy responses we saw in practice. On 3/26/21 – the one year mark after it was released (keep in mind that this model predicted a summer 2020 peak, meaning that almost ALL of the deaths under it were supposed to take place before the early fall of 2020) – I tabulated the performance of 3 of Ferguson’s policy scenarios in 189 different countries.Scenario 1 was unmitigated spread. Ferguson overestimated deaths compared to reality in 189/189 countries. His median overestimate death count was 1,983%.Scenario 2 was a population-wide social distancing model that roughly approximated what most countries ended up doing. Ferguson overestimated deaths compared to reality in 189/189 countries. His median overestimate death count was still 1,041%.Scenario 3 was a China-style suppression model that assumed a 75% curtailment in human contacts, maintained in place for a year or more until a full vaccine rollout was achieved. Keeping in mind that few countries other than China went to that extreme, Ferguson still overestimated deaths compared to reality in 170/189 countries. The median overestimate even under this suppression model was 535%, and the 19 countries that passed Ferguson’s threshold only did so slightly even though none of them used such severe suppression techniques.The bottom line: Ferguson’s models performed abysmally in the specified period that they were supposed to model (i.e. a single-peak pandemic that took off in spring 2020, topped out in summer 2020, and dissipated by the early fall). The clear pattern from all of his modeling scenarios for different policy interventions is a propensity to vastly overstate the predicted number of casualties.
Scott Sumner
Feb 18 2022 at 12:59pm
Even if all of that is true, it has no bearing on my post. I pointed out that Ferguson was roughly correct as to the IFR and Bhattacharya was way off, despite having 8 more months of data to work with.
Todd Moodey
Feb 18 2022 at 2:03pm
Scott–
Since it’s not explicitly mentioned in your post, I gather you’re inferring Ferguson’s IFR from his estimate of 2.2 million deaths in the absence of any countermeasures across the entire U.S. population of approximately 300 million. If so, then doesn’t the accuracy of his model–as the source of the numerator in the IFR–bear crucially on your point?
Regards,
Todd
Scott Sumner
Feb 19 2022 at 1:33pm
Todd, I don’t understand what you are asking. If you are asking whether all aspects of his model were correct, my response is that I don’t know but I highly doubt it. But he was roughly correct about the IFR.
Phil Magness
Feb 20 2022 at 1:49pm
Scott Sumner –
Did you not state in your original post that “Two years later, it looks like Ferguson’s estimates were basically correct. The official US Covid death toll is over 900,000…”
This is an unambiguous misreading of Ferguson’s model, as I have documented along with several others on this thread.
Now you switch gears to IFR, yet your claim as quoted above was clearly about the death projections – which, once again, you misinterpreted.
The appropriate thing to do here would be to admit your mistake, correct your assessment of Ferguson going forward, and move on.
Reece
Feb 18 2022 at 3:14pm
To be clear, Phil is the one claiming “China-style suppression”, not the researchers. Obviously 75% reduction does not remotely require that level of suppression – the US managed 82% suppression of contact rates in the first wave and 74% in the second, despite much of the country not locking down and no part of the country being as strict as China (see: “Quantifying population contact patterns in the United States during the COVID-19 pandemic”).
The model also gives different triggers for when the suppression happens. Phil used the higher one, 1.6 deaths per 100,000 per week. In actuality, the suppression in the US happened below even the lower one, 0.2 deaths per 100,000 per week. The model gives *vastly* different numbers based on the triggers – 1.6 shows 474K deaths, 0.2 shows 84K.
Other measures, such as masks, also helped reduce spread.
In other words, in several ways the US did a better response than a model they released with less than a fifth of the number of the deaths as Phil used. There are some ways it was worse as well, but it’s not obvious whether a model accounting for all of this would have been above of below this lower estimate. If all countries have a similar story (much higher contact suppression than Phil believes + started at/earlier than 0.2 deaths per 100,000 per week + other measures like masks), his claim that “The median overestimate even under this suppression model was 535%” actually may suggest that the model was roughly accurate.
Phil Magness
Feb 20 2022 at 3:11pm
Reece – There’s no evidence of any western country obtaining a 75% curtailment of *all* contacts for any sustained period of time. The best estimates, which come from things like cell mobility data (and before you dismiss that, note that Imperial’s own modelers – e.g. Report 24 – accept cell data as an accurate proxy for contacts) tended to hover in the neighborhood of a 30-40% reduction, save for a few very short severe panic-induced dropoffs in the days immediately after the first lockdown.
Phil Magness
Feb 20 2022 at 3:16pm
Also, this suggests that you are misreading the Imperial model in another way. The suppression triggers were not deaths per 100K, but ICU beds. See the chart on p. 9.
“The model also gives different triggers for when the suppression happens. Phil used the higher one, 1.6 deaths per 100,000 per week.”
Mark Z
Feb 17 2022 at 5:46pm
One should in general specify timeframes when talking about fatality predictions. ‘X people will die’ doesn’t mean much if you don’t specify over what timeframe. The Ferguson simulations, it looks like, are over a 2 year timeframe, so not too far off from an adequate comparison with the total fatalities thus far, but it’s worth saying explicitly since not everyone is gonna read the link.
JFA
Feb 17 2022 at 10:34pm
Nevermind. I found it. Though it’s unclear when things settle. If it was for two-years, it was a strange choice to only present 8 months of deaths. His bed usage model does go to March 2021, but still, why truncate it?
David Henderson
Feb 17 2022 at 6:45pm
To Mark Z above,
I asked Phil Magness about your point. He has studied the Ferguson model much more carefully than I have, which is one of the reasons (but only one) for my naming him as a generalist who reasoned across various disciplines.
Here’s his answer:
That’s likely a misreading of the report. They stated at some point that they kept the simulation running for a 2 year span, but the results they generated are entirely in spring/summer 2020.
Joseph
Feb 17 2022 at 7:44pm
Ferguson is a hack. He predicted 500K deaths for the UK – and please don’t tell me that without vaccination we’d have been there. Even disastrous first months with terrible death rates in nursing homes didn’t get us anywhere close to this level.
And you really need to look at his later predictions for the UK, the one last summer before “Freedom day” and especially last December for Omicron. The latter had the worst case scenario of 5000 deaths a day. Even their best case was worse than what actually happened i.e. about 200 a day on average. A total disgrace.
As well as the rest of UK “government scientists” – https://www.theguardian.com/world/2021/dec/18/uk-scientists-curbs-covid-infections-omicron-deaths-restrictions-sage
Concentrate your resources on the most important task (also known as 80/20 rule) – what is controversial about this idea, absolutely obvious.
steve
Feb 17 2022 at 9:58pm
No he didnt. Your claim is typical of someone who did not read the actual paper. Link goes to the paper. Note that on page 11 he says the simulation is for 2 years. The predictions cover that time period. Then if you look at page 13 he generates a number of possibilities depending upon R and upon the interventions taken. He predicted about 5,600 deaths if R was 2 and many interventions were taken. You only reach 500, deaths if R was at least 2.4 and no interventions were taken. You ought to read a paper if you are going to make claims about it.
UK sits at 160k deaths and his predictions would have had the UK at about 100k-120k.
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
Steve
Phil Magness
Feb 18 2022 at 12:54am
You are misreading the paper. The model run goes for 2 years, but the pattern it predicts is a single-peak pandemic where the death toll peaks in summer 2020 and quickly dissipates to almost nothing. This is made abundantly clear in the figures on pp. 7-8 of the 3/16/20 Imperial College report, as well as in Neil Ferguson’s press commentaries at the time.
steve
Feb 18 2022 at 12:57pm
The model actually does go for 2 years. If you read his description of that graph it is specifically for the case where there is no intervention. It assumes that at the end of those 4-5 months 81% of the population would have been infected so there would essentially be no deaths for the rest of the 2 years. Table 4 charts expected deaths with varying levels of R and mitigation. So yes, a single peak if no mitigation. Multiple peaks if there is mitigation.
Steve
AMW
Feb 18 2022 at 4:44pm
Phil, you are correct that the figures on pp. 7-8 show single peaks in summer 2020. But on p. 10 there is a figure covering a year, with small peaks in summer 2020 and large ones in winter 2020 after prevention measures are dropped. More pertinent is figure 4 on p. 11, which covers 20 months and shows seven peaks as prevention measures are repeatedly adopted and rescinded based on hospital capacity.
Table 4 on p. 13 contains summary estimates for a full 2-year period with different assumptions on the thresholds at which prevention measures are adopted and rescinded. That table estimates total 2-year deaths anywhere from 5,600 to 120,000 in the UK depending on the measures in place and the threshold for adopting/rescinding them. Actual death numbers in the UK have been ~160,000, as Steve noted. So whatever the faults of the underlying model, it didn’t wildly overestimate the death toll of Covid. (The paper claims the results are qualitatively similar for the US, but doesn’t report any numbers. The baseline scenario with no interventions or behavioral changes estimated ~4.1x as many deaths in the US than in the UK. If we use that as a multiplier for Table 4, it would suggest the estimates for the US would have ranged from 23,000 to 492,000. Again, not a wild overestimate.)
Phil Magness
Feb 20 2022 at 3:03pm
AMW – You are still misreading the report.The figure on p. 10 is *not* a multi-peak pandemic – it’s their estimation of hospital bed capacity under different scenarios. The black line shows their unmitigated scenario, in which case the pandemic hits in spring/summer 2020 in a very steep wave.The other scenarios assume that the steep summer wave of the black line can be averted and delayed by various NPIs, resulting in shallower peaks some time in the fall. The point they were trying to make is that a shallower fall wave after the NPIs would be more manageable than a steep summer wave without NPIs. Hence the “flatten the curve” rhetoric around this model…which, again, was not based in reality.
AMW
Feb 21 2022 at 1:08pm
Phil – On figure 3 (p. 10) I’m not interpreting the black line as a summer peak and the orange/green lines as winter peaks in the same simulation. Take a look at panel B of the figure. The green curve peaks at a very low level in April/May, then accelerates quickly in October. The orange curve hits three peaks in May-August (at relatively low levels), then also accelerates quickly in October. This is what I meant when I wrote:
Beyond this, though, what do you make of figure 4 (p. 12) which unambiguously shows a multi-peak pandemic over a nearly 2-year period?
Joseph
Feb 18 2022 at 8:41pm
Did he predict 5000 deaths a day from Omicron? And what did he predict last summer before freedom day? What were his policy recommendations? Do they make sense in hindsight?
The man is a fraud.
MikeP
Feb 17 2022 at 8:11pm
As others have noted, Ferguson’s estimates ran only through the summer. So his prediction of 2,200,000 dead needs to be compared against the actual end of September US death toll of 200,000.
Similarly, Ferguson predicted 90,000 dead in Sweden if they did not follow his lockdown advice. They of course didn’t, and their death toll at the end of September was 6,000 while their death toll today is 17,000.
Ferguson was wildly wrong, whether or not a country followed his advice — much more wrong than Bhattacharya. Incidentally, Sweden’s estimated IFR for those under 70 is not high: it is 0.1%.
Also, saying that death rates are lower than they would be if people didn’t take precautions is off base in three ways. First, the complaint I and others have is not against recommendations to distance and wait for vaccines, but rather against mandates and shutdowns and lockdowns. You seem to evade that distinction, but it is the cardinal issue here. Sweden recommended. Most everyone else mandated. Second, the astonishing heterogeneity of responses and homogeneity of results would seem to say that it doesn’t matter whether precautions are mandated or not. And, third, Sweden has the lowest excess deaths in 2021 in all of Europe. It is very likely that their laissez faire policy will end up costing fewer deaths in toto than harsher means employed by most every other nation that took out of the hands of individuals their own ability to decide what risks they most need to take and what risks they most need to avoid.
steve
Feb 17 2022 at 10:12pm
As I note above, it says on page 11 the simulation is for 2 years. This is confirmed at the top of page 13 whichI have copied below. Link to the article is in response to Joseph above. If you can find it I will be glad to link again. In case you have trouble finding it in the section below it says “deaths seen in a 2 year period”.
“Table 4. Suppression strategies for GB. Impact of three different policy option (case isolation + home quarantine + social distancing, school/university closure + case isolation + social distancing, and all four interventions) on the total number of deaths seen in a 2-year period (left panel) and peak demand for ICU beds (centre panel). Social distancing and school/university closure are triggered at a national level when weekly numbers of new COVID-19 cases diagnosed in ICUs exceed the thresholds listed under “On trigger” and are suspended when weekly ICU cases drop to 25% of that trigger value. Other policies are assumed to start in late March and remain in place. The right panel shows the proportion of time after policy start that social distancing is in place. Peak GB ICU surge capacity is approximately 5000 beds. Results are qualitatively similar for the US.”
Steve
MikeP
Feb 18 2022 at 12:46am
Egad. The simulation may have been for 2 years, but the deaths ran through August of 2020.
Look at Figure 1A. The deaths rise from April and taper back to zero in August. In case there is any doubt that maybe there is some hidden curve somewhere that isn’t included in the “US (total=2,200,000)”, you can estimate the area under that per-day death rate curve as a triangle from May 1 to July 15 that peaks at 17. That’s 0.5 * 75 * 17 = 640 deaths per 100k. 640 * 330M / 100k = 2.1M total deaths.
Ferguson was wildly wrong. The fact that the total deaths are finally of the same order of magnitude as Ferguson’s estimates doesn’t excuse the prediction.
steve
Feb 18 2022 at 12:52pm
To be honest I never calculated that out, but not sure it matters if you actually read the paper. That graph is only applicable if there were no interventions and it also assumes that at the end of that time period about 81% of people would have been infected ie there would be essentially no new cases after that period. (Copied below from page 6) In fact we did mitigate and even if we did not it was a big, but maybe not unreasonable, assumption that you would reach herd immunity.
So if you look at Table 4 he clearly carries the simulation out for 2 years. He even says so. You just dont see any difference as time goes by for the non-mitigation group since they had all of their deaths up front in the first few months.
Ferguson did what we would hope an epidemiologist would do. He estimated deaths for a wide range of situations. For widely varying R values and for widely varying levels of intervention. His actual death estimates ranged from 5600 to 550,000. With eh UK now at about 160,000 deaths and his highest value with any intervention was at 120,000 he clearly under predicted a bit but given that it was a new virus not badly.
Steve
“In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we would expect a peak in mortality (daily deaths) to occur after approximately 3 months (Figure 1A). In such scenarios, given an estimated R0 of 2.4, we predict 81% of the GB and US populations would be infected over the course of the epidemic.”
AMW
Feb 18 2022 at 4:49pm
The pertinent graph is Figure 4 on page 12. Multiple peaks over 20 months. The results in Table 4 reflect that simulation.
Zeke5123
Feb 18 2022 at 7:50am
It is also almost largely unfalsifiable. My prediction is X if they don’t do Y. The country didn’t do Y, but had less than X.
Response: well sure there wasn’t an official policy of Y, but Y happened nonetheless.
One problem — cellphone data seems to suggest there was much less social distancing in Sweden compared to more lockdown heavy states.
Scott, as is his normal off baseness in all covid discussions, discounting the one failure of the Swedish response: the centralized nursing homes fiasco. Add that to the relatively higher dry tinder in Sweden and you get the higher deaths per capita (though still really low rates). Scott also ignores the lowest excess deaths in Sweden this year.
The Swedish policy has been vindicated.
Scott Sumner
Feb 18 2022 at 1:04pm
I’ve already responded to all the innumeracy about Sweden coming out of the right in other posts. And no, the nursing home fiasco doesn’t explain the Swedish data.
And Sweden’s recession was just as bad as in the other Nordic countries. So much for the theory that mandates “destroyed” the economy.
Scott Sumner
Feb 17 2022 at 11:00pm
Mark, You said:
“First, the complaint I and others have is not against recommendations to distance and wait for vaccines, but rather against mandates and shutdowns and lockdowns”
Utterly no bearing on this post, which is about the IFR for Covid.
Mark Z
Feb 17 2022 at 11:19pm
I think that one belongs to Mike.
Scott Sumner
Feb 18 2022 at 1:04pm
Yes, my mistake.
Scott Sumner
Feb 17 2022 at 11:10pm
Everyone, I see lots of people misread the post, and lots of people are focusing on unrelated issues. This post is not about government policies.
Again, the post is about the IFR for Covid, which was at least 0.6% in the US back in 2020, maybe higher. Looking at when actual deaths occurred in the US completely misses the point. Of course they were delayed relative to what would have occurred with no precautions. Without social distancing the deaths would have come much faster and in far greater numbers.
A year ago we were at 500,000 deaths and when I suggested we’d have had 2 million deaths without social distancing, people in this comment section complained I was way off base. People were telling me the IFR was only 0.25%. Still think so?
Jerry Brown
Feb 18 2022 at 1:22am
Didn’t think .25% then, and without vaccines, would not think so now. I like old guys like you and the even older David Henderson and it is worth making some sacrifice that might increase the chance both of you are still around. Even if he wouldn’t agree.
You got it right here Scott. More than 0.25% of the entire population has already died from this and probably not everyone has gotten it.
Scott Sumner
Feb 18 2022 at 1:07pm
Yes, and more importantly a large proportion of the old have been vaccinated. Imagine how many would have died without vaccines! Without any social distancing they would have died in 2020.
MikeP
Feb 18 2022 at 2:02am
Yes.
But first, I find it incredibly sad that the IFR is such a mystery. The CDC initially estimated it, then made the estimates less frequent, then hid the estimate, then stopped estimating it.
Neither the CDC nor the media want people knowing that COVID is much more prevalent than people think, without being seen, and is therefore less dangerous.
To this day, public health and the media report case counts as though they are actual numbers. They of course aren’t. The comedy of ourworldindata showing 78M US cases is ridiculous. It’s likely over 200M by now. But no one tries figuring it out.
Then we have to question the deaths of COVID versus deaths with COVID. Study after study come up with 40-50% of hospitalizations and deaths being with rather than of.
So between the numerator being ~500k and the denominator being ~200M, we’re back around the tried and true ~0.25 IFR — the number I most often see is 0.27 — that the sane people have been finding since the very beginning.
Scott Sumner
Feb 18 2022 at 1:10pm
Virtually everything you say here is wrong or misinterpreted. More than 0.25% of Americans have already died of Covid, despite an overwhelming majority of the old being vaccinated. In many countries it is far higher. The 0.25% IFR estimate is beyond ridiculous, as I’ve said from the very beginning..
MikeP
Feb 18 2022 at 2:20pm
Which of my numbers is obviously wrong or misinterpreted?
900k/78M gives a calculated IFR of 1.2%. Do you believe those three numbers?
I just did a cursory search for papers producing recent estimates of IFR. I found none over 0.5%, with most closer to 0.27% than 0.5%.
So I fail to understand why 0.25% is beyond ridiculous while Ferguson is the unquestioned sage of truth.
AMW
Feb 18 2022 at 4:53pm
MikeP,
There are 931K deaths so far, and the US has a population of ~330M. 931K/330M = 0.282%. Even if everyone in the country had gotten Covid in the last two years, the IFR would be greater than 0.25%. And we’ve had vaccines for a year of the pandemic.
Todd Moodey
Feb 18 2022 at 6:39pm
What’s so curious to me about this way of conceiving the Infection Fatality “Rate” is that even a very much lower “marginal” IFR, as likely currently prevails at the present time, would lead to a higher IFR under this view by virtue of deaths in the numerator continuing to accumulate. Even if we miraculously eradicated the virus, your IFR would never fall, since the aggregate death count can never shrink.
Regards,
Todd
Todd Moodey
Feb 18 2022 at 6:46pm
Sorry, I meant to say “Even if we miraculously eradicated all deaths from the virus…” in my response above!
AMW
Feb 18 2022 at 8:46pm
Todd, I take deaths/population to be a lower bound for the IFR, not an estimate for it. As a the number of deaths increases, the lower bound of the IFR should increase.
steve
Feb 19 2022 at 8:57am
The other part that keeps getting forgotten is that the death rate for hospitalized people dropped quickly. At medium to large tertiary care hospitals early on the mortality rate for a person hospitalized with covid was about 22%. Within a few months it was 14% and is now under 10%. Ferguson was working with the rates we had early in March. Given our generally poor history of rapidly developing therapeutics it would make sense that the model did not allow for rates to drop.
Steve
JFA
Feb 18 2022 at 6:54am
It seems the main critique is over what timeframe the deaths would occur, and for predictions, timeframes are actually highly relevant to the discussion. You have to specify a time period for your prediction for it to be valid. If everyone in the US got Covid, then an IFR of 0.6% would give you somewhere around 2 million deaths. But you have to specify an end date. Seasonal flu will lead to 330,000 deaths just because it has an IFR of about 0.1%. Eventually, 330,000 people will die of flu, but that doesn’t mean that the a “prediction” of 330k deaths from flu over an unspecified period is any good or has much meaning.
Ferguson predicted 2.2 million deaths in the US through October of 2020 with no mitigation. The US only had 230,000 deaths up to that point. There were mitigations that certainly helped reduce deaths, but I highly doubt the efficacy of the mitigations undertaken in the US were that effective.
I think the onus is on you to say why you think everyone in the United States would have gotten Covid in so short a period of time, because that is the implication of your 2 million deaths prediction. At some point herd immunity would have started to kick in and not everyone would have gotten Covid in the time period specified.
To be clear: I think it is possible that we could have reached ~1 million deaths by January of 2021 without any mitigations.
Zeke5123
Feb 18 2022 at 7:57am
Stated differently, IFR is but one component (transmission is another which the model must account for). Something was clearly off with the imperial model. You can’t claim “one part of my model was right therefore I am right”
I know Scott will also dismiss this but the other problem with our data is we don’t really know what the actual death rate for died due to covid. The definition of a covid death is insane because there need not be a causal connection. The CDC is working on redefining it because it is so insane. So in calculating his IFR Scott is relying on basically bad data.
The response will be “excess deaths.” But it is very hard to separate “excess deaths” to pandemic responses.
JFA
Feb 18 2022 at 9:17am
Excess deaths are highly correlated with measured covid deaths and lagged excess deaths are highly correlated with measured infection rates. The number of measured deaths stays pretty close to the number of excess deaths. I don’t really buy the “excess deaths from pandemic response” narrative. Might there be a few deaths due to pandemic response? Sure. You can control for that by just looking at how excess deaths stack up with measured deaths in states that were much more laissez faire about pandemic response, and you see the same high correlation and similar magnitudes. Overall, excess deaths are a pretty good measure of Covid deaths.
Zeke5123
Feb 18 2022 at 11:55am
But implementation of strict pandemic measures also correlate with increased cases. So not sure how you can tease out the response. I guess to really mail it down you need to look at similar localities that count in similar ways and had different reactions to the exact same number of cases.
Maybe that has been done; would be grateful if someone can link that analysis.
JFA
Feb 18 2022 at 1:16pm
Sadly, I haven’t seen anything published that does this. I did it as an exercise for my own edification recently. I’d say take a look at states that didn’t have many emergency measures even when cases were rising: Florida, Texas, Tennessee, Georgia, South Carolina, etc. Those states have covid deaths and excess deaths that track very closely with each other. I’ve spent significant time during the pandemic in both Georgia, Tennessee, and South Carolina over the pandemic, and they jettisoned just about all mitigation measures back in 2020. My sense from reading and talking with family and friends in Texas and Florida is that those states also jettisoned mitigation measures back in 2020 as well. If you have anything convincing to suggest that they had strict mitigation measures whenever cases rose, please share.
Given that several of the more laissez faire states have excess deaths and covid deaths that track closely together, I’m not inclined to place a whole lot of the weight on pandemic response causing even a large portion of excess deaths.
Also, what’s the predicted mechanism between different types of mitigation causing more deaths? Suicide might be one. I’d probably put a big chunk of the opioid deaths in 2020 in that category. I’d be willing to say that upwards of 5% of excess deaths were caused by pandemic response. But I haven’t seen anything convincing that it would be more than that or what the potential mechanisms would be.
zeke5123
Feb 18 2022 at 3:57pm
I think the mechanism, especially early on, would be people not going to the hospital (or delay going) when they had serious health emergencies. For example, maybe you aren’t sure you are having a heart attack. If you are terrified of going to the hospital (because lockdowns suggested things were really scary), maybe you would think: let’s wait x minutes and see if it improves.
Whether that is enough to cause a problem, who knows.
Scott Sumner
Feb 18 2022 at 1:12pm
Experts have examined the excess death data with a fine tooth comb, and it’s almost all Covid.
zeke5123
Feb 18 2022 at 3:16pm
Expertise is meaningless in politically charged environment. That is how you get nonsense like the Arizona study put out by the CDC. The incentives to be narratively correct differ from the incentives to be accurate.
Doesn’t even mean the experts are always wrong; it just means that appeal to expertise is hardly a smart thing in this context.
steve
Feb 19 2022 at 9:01am
Which is why you never rely on one study. What happens a lot is what you describe. One bad study so you decide all experts are wrong. What should be done is to look at the totality of the work. In that case it shows that Scott is correct. Heck, even if you do studies well some will always be wrong. Doesnt matter what statistical method you choose if you have enough studies one will be wrong even though the stats say it is good.
Steve
JFA
Feb 20 2022 at 6:32am
Steve,
Though I disagree with Zeke on his stance on what excess deaths can tell us, Zeke is quite right about the reliability of experts in a politically charged environment (which can also affect the studies experts consider).
The CDC has been pumping out crap studies this entire pandemic (see Emily Oster’s comments on the latest masking one: https://emilyoster.substack.com/p/lots-of-studies-are-bad?utm_source=url) (though some of them are good, too). Regarding masking in general, the CDC’s summary of the masking literature includes not one paper that suggests masking is not effective. Given how many papers there are, it seems remiss (if “experts” are actually being honest) to include at least one of those papers (they are usually of the same quality as studies showing mask are effective). Regarding mask in schools, the experts lean pretty heavily on the one study Zeke mentioned. Here is the CDC’s (scientific? expert?) stance on masks in schools: “CDC recommends universal indoor masking regardless of vaccination status at all levels of community transmission.[emphasis added]” Additionally here is a handful of papers (links not added because I want to make it past the spam filter) that “experts” should possibly consider (but don’t) when thinking about masking in schools:
Age-dependency of the Propagation Rate of Coronavirus Disease 2019 Inside School Bubble Groups in Catalonia, Spain (children just below the age cutoff for masking show no higher rate of cases or secondary attack rates than those just above the cutoff)
Mask Use and Ventilation Improvements to Reduce COVID-19 Incidence in Elementary Schools — Georgia, November 16–December 11, 2020 (no measurable impact on student masking)
Coronavirus (COVID-19) and the use of face coverings in education settings (report from the UK showing statistically non-significant effect of face masks)
Reported COVID-19 Incidence in Wisconsin High School Athletes in Fall 2020 (non-significant finding for face mask wearing)
COVID-19 Mitigation Practices and COVID-19 Rates in Schools: Report on Data from Florida, New York and Massachusetts (non-significant finding for face mask wearing)
JFA
Feb 20 2022 at 6:33am
sorry for the poor formatting.
Floccina
Feb 18 2022 at 11:21am
I have to agree. People often make the mistake of comparing what happened with what was projected had we done nothing, but I do wonder if we had made a good effort to protect the old, but otherwise let covid run, like Sweden did, would we have quickly had enough natural immunity that the long term number of deaths would have been about the same as they are.
Scott Sumner
Feb 18 2022 at 1:14pm
Two problems:
Sweden did not “let Covid run”. Their recession was just as bad as the other Nordic countries.
If we’d let it run in 2020, before vaccines, another million would have died needlessly in the US.
zeke5123
Feb 18 2022 at 3:21pm
No.
Maybe the truth is the other Nordic countries also relatively let Covid run or GDP is a poor metric for measuring the quantum of lockdowns (e.g., maybe if the globe locks down, every country is going to suffer regardless of their internal policies). You have made a claim that Sweden didn’t let Covid run (which of course is not a binary statement but one in degree) but your evidence doesn’t support your claim.
MikeP
Feb 18 2022 at 4:47pm
Indeed. Norway and Finland pretty much followed the Swedish model after initial lockdowns. They have been more similar than different.
The Oxford stringency index is awful, but you can see that even that shows all of continental Scandinavia well under, say, the UK.
Scott Sumner
Feb 19 2022 at 1:39pm
“Maybe the truth is the other Nordic countries also relatively let Covid run or GDP is a poor metric for measuring the quantum of lockdowns”
After 2 years people still don’t understand the difference between lockdowns and social distancing? The issue isn’t lockdowns, it’s social distancing. And masks. And vaccines.
I’m not saying lockdowns have no effect on the spread of covid, but the effect is marginal.
steve
Feb 19 2022 at 4:58pm
“After 2 years people still don’t understand the difference between lockdowns and social distancing? ”
Not when they dont want to understand it.
Steve
Knut P. Heen
Feb 21 2022 at 8:45am
The Nordic countries are small and imports/exports are a significant part of the economy. Policies in other countries are far more important than our own national policies for the economy. Volvo had to close down early in the pandemic due to low international sales. Later, Volvo had to close down again due to lack of materials (chip imports). Many Norwegians drive to Sweden to buy cheaper food, tobacco, and alcohol. The lockdown of the border “benefited” the Norwegian economy in the sense that Norwegians had to buy the stuff at higher prices in Norway. The Swedish shopping malls at the border lost a lot of business due to the Norwegian lockdown. It is impossible to attribute the economic outcome to a national policy in such cases.
Invisible Sun
Feb 18 2022 at 2:58pm
Covid is so bad that the state most strident in eliminating Covid restrictions and mitigations – Florida – recorded a record number of visitors in 2021.
Furthermore, in September 2020, the governor dropped all Covid restrictions under state authority. Normal life was then experienced by the vast majority of Floridians, especially so on the more Conservative gulf coast. The Superbowl was then played in Tampa in February 2021.
What does the Florida experience indicate? It appears to show that given a choice, people will behave far less concerned about the Covid risk than what the experts say they should – this truth was also made evident by fan behavior at the Superbowl held this month in LA.
This begs the question of what Scott means by declaring the “Pessimists were right.” The pessimists created fear and imposed policies that carried immense economic, emotional and health costs. If that is being right, what is the measure of being wrong?
What does the common person see about Covid that the pessimists do not? What do they see that makes them eager to live normal life much quicker than the experts wish to allow?
Scott Sumner
Feb 19 2022 at 1:41pm
“This begs the question of what Scott means by declaring the “Pessimists were right.””
There’d be no question as to what I meant if you read the entire post. I meant they were right about the deadliness of Covid.
Invisible Sun
Feb 22 2022 at 12:26pm
Scott,
The pandemic pessimists were disastrously wrong for two reasons in particular.
(1) They did not recognize the age stratification of the threat.
(2) They supported mitigations that were ineffective at changing the course of the pandemic, but were very costly in their social, emotional and financial consequences
Now if your argument is about the true IFR of SARS-COV-2 the focus needs to be on the criteria of what constitutes a Covid infection and what constitutes a Covid death. I hope you are aware that early in the pandemic Dr. Birx publicly explained that the US government was taking a very liberal approach to counting deaths. An approach that did not rely at all on a medical diagnosis of the deceased, only that the person was dead and sometime in the previous 30 to 60 days they tested positive for the virus, regardless of whether the person was actually infected and medically sick from the virus.
If Covid infections are pervasive then the IFR is low. If infections are uncommon then IFR could be higher. Which is it?
The data and anecdotal observation is that the Alpha and Delta variants were less pervasive and had a higher mortality rate. Omicron was pervasive with much milder symptoms. But due to the method of counting Covid deaths, the death toll from Omicron is also high. From vs With making a huge difference in the analysis.
bb
Feb 18 2022 at 3:40pm
Scott,
I agree with everything you just wrote. Great post.
Ted Durant
Feb 18 2022 at 9:02pm
This thread seems like a bunch of people shouting past each other, but it seems to me there are some basic issues that are crucial, unresolved, and maybe unresolvable.
Scott wants this to be about the IFR, but that’s a ratio of two numbers that are estimates subject to some pretty large variance. We can’t precisely define the fatality count because of co-morbidity, and we certainly can’t precisely estimate the number of infections. And, by the way, what’s the IFR for a person who is infected twice and dies from the second one?
Even if we could measure IFR for the population as a whole, what really matters is conditional probability, and it’s clear that the IFR widely varies across the population (and, apparently, across variants, as well). So, it’s completely reasonable for individuals to make very different decisions about the value – to them – of infection avoidance.
The “herd immunity” strategy seems fraught with problems. First of all, it’s essentially the same (given the IFR slope by age) as putting the old folks on an ice floe and sending them along. Getting to the point of herd immunity means a) getting a huge part of the population to the point of being contagious, first, and b) getting all the weak ones out of the population. That said, it’s not at all clear whether letting it burn through the population as quickly as possible is better or worse than slowing the spread and, as a result, keeping the problem around for longer, aside from the real problem of health care capacity. But even the health care capacity issue isn’t clearcut, given the amount of burnout among health workers as we head toward a third year. Of course, it has reasonably been argued that a significant contributor to that burnout is the amount of cases from people who have not taken reasonable steps to avoid infection.
It also seems that a strategy of encouraging infection in people likely to survive would increase the chances of successful mutation variants, vs a strategy of trying to minimize infections.
Different people have different values. There are plenty of people who think old people jumping on an ice floe, and “letting nature run its course” are the right ways to go. The more people you try to put under the same set of rules, the more difficult it will be to come up with a set of rules that don’t lead to fracture.
Many of the people I hear clamoring about “individual rights and freedom” under the banner of libertarianism seem to be unaware that the great goal of liberty is freedom to do the right thing for yourself, for your family, and for your community.
I’m a numbers guy, but I don’t think the numbers have much to tell us about these things.
Scott Sumner
Feb 19 2022 at 1:51pm
Good comment. I have a lot of problems with both the left and the right on this issue.
I’m getting tired of people on the right yelling for “freedom” on issues like masks when on a wide range of vastly more important issues many of those same people are strongly anti-freedom.
And I’m getting tired of people on the left saying “trust the science” when on all sorts of issues they don’t trust the science, including many aspects of Covid.
That’s not to say the right is wrong about mask mandates being foolish, or the left is wrong about scientists being more trustworthy that vaccine skeptics. But I’d like to see some consistency.
steve
Feb 19 2022 at 5:06pm
“And I’m getting tired of people on the left saying “trust the science” when on all sorts of issues they don’t trust the science, including many aspects of Covid.”
You should do a post on that some time, if you care. My favorite is the risk of Covid spread outdoors. I think the data on that was pretty clear very early and that the risk is very low. So when the left berated DeSantis for opening the beaches I thought they were totally wrong. Of course you then had the right screaming about BLM protests which were also outdoors. Anyway, the masks should have been off while outdoors a long time ago. I actually think they largely were but also pretty sure some laces held on to them.
Steve
Michael Stack
Feb 19 2022 at 3:19pm
Covid has revealed a sharp difference in thinking among libertarian-minded people. I thought all along that a dangerous communicable disease made for a strong case for government, and one of the few types of things that government should actually be working on. I think too many folks on the right dismissed or downplayed the threat of Covid.
Donald Boudreaux
Feb 19 2022 at 4:08pm
Scott misses two important points in his criticism of David’s earlier post. But before I get to these points, I note that I here ignore the debate over the correctness or incorrectness of competing estimates of the SARS-CoV-2’s IFR. I do so because I disagree with Scott’s suggestion that IFR estimates are central to David’s post. What is central to David’s post is his criticism of Tyler Cowen’s early praise of Neil Ferguson’s modeling that prompted governments to lockdown.
Now to the two points missed by Scott.
First, he misses the core reason David publicly took issue with Ryan Bourne’s Telegraph op-ed. In that op-ed, Ryan favorably mentions Tyler as someone who, by thinking on multiple margins, avoids the trap into which so many Covid ‘experts’ fall. Yet as David points out, early on Tyler himself inexplicably fell into this very trap. In March 2020 Tyler praised Neil Ferguson & Co. not so much because they encouraged individuals to beware of the coronavirus but, instead, because Ferguson’s predictions and advice were instrumental in determining policy responses by governments in the U.K. and the U.S. Those responses (in)famously featured lockdowns.
Contrary to what seems to be Scott’s belief, the chief complaint that I and many others – including, I’m sure, David – had about Ferguson was not that Ferguson’s models incited individuals to avoid the virus with measures taken voluntarily. Instead, this complaint was centered on Ferguson’s support for lockdowns, and on the sad reality that governments took this reckless advice.
The second point that Scott misses is David’s discussion of the Great Barrington Declaration. David is correct that the GBD – unlike lockdowns and many other government-imposed Covid measures – takes seriously the inescapability of trade-offs. The GBD, therefore, is a much better example of thinking on multiple margins than were Ferguson’s pronouncements and the resulting lockdowns.
Most governments ignored the GBD. And many people – including Tyler – publicly criticized this document. Yet if its authors are correct, then Covid’s IFR and death toll would today be lower than they’ve turned out to be. The reason is that scarce effort and resources would have been focused on protecting the most vulnerable rather than spent scattershot.
We knew as early as March 2020 that vulnerability to Covid increases steeply with age. We knew also that Covid’s risks rise with co-morbidities. Therefore, identifying the vulnerable was relatively easy. And so it’s fair to ask: What’s so outlandish about a proposal to focus scarce effort and resources on protecting the vulnerable without forcing everyone – most of whom are at very low risk – to spend effort and resources attempting to avoid the virus? After all, effort and resources used to lock down workplaces and schools are effort and resources rendered unavailable to enhance individualized protection of the vulnerable.
How much more effective would mitigation measures have been had scarce effort and resources been focused on the vulnerable? We’ll never know for sure because the counsel offered by the GBD was rejected in all but a few places.
Of course it’s possible that the lockdowns and other one-size-fits-all coercive measures that most of us actually endured outperformed – on the death-toll front – what would have occurred had the GBD been followed. But this possibility is hardly a certainty. Indeed, I believe it to be highly implausible. Regardless, we’ll never know.
Either way, the death toll that we have today, and that Scott uses to calculate Covid’s IFR, is one that arose under policies that were influenced far more by Neil Ferguson than by Jay Bhattacharya, Sunetra Gupta, and Martin Kulldorff- the co-authors of the GBD.
Scott defends Ferguson’s unrealized extreme estimates of Covid fatalities by pointing out that these were made for what is now a counterfactual – namely, a world of no measures, voluntary or mandatory, taken in response to the coronavirus. This same mindset should cause Scott and others to be more favorably disposed to the GBD by prompting them to ask: What would the death toll have been in another counterfactual world, namely, a world in which the GBD’s counsel was heeded?
steve
Feb 20 2022 at 9:11am
Just on principle if people want to smear someone else’s work they ought to have at least read it and quote it correctly. As we have shown, if anything Ferguson under predicted deaths. As to your other points I know for a fact that at least in the medical field no one really paid that much attention to the Ferguson paper. The thing that motivated us was Italy. No one really trusts China, but in the wealthier part of Italy where they had good hospitals they were overrun. People were really dying in hallways with a lack care. We were talking directly to the Italian docs (I was in some of those groups) so as much as the medical profession had any influence that was what was driving us. We did reach that breaking point in parts of Ny and NJ. No matter what you read in the press it was worse that you think in some areas. A lot was being held back.
In retrospect you are convinced that in March we knew everything about the mortality and and other outcomes from covid. We certainly didnt know for sure who all were at risk. The co morbidities were pretty vague. Open up an EPIC chart and nearly everyone over 40 has co morbidities. Which ones mattered and how much was not clear. We did not know long term sequelae.
“What would the death toll have been in another counterfactual world, namely, a world in which the GBD’s counsel was heeded?”
That is a fair question, but then you have to remember that no one had ever tried doing what they suggested. No one knew how to do it. To date no one still does. There is no place where anyone has made an effort, at least successfully, of which I am aware. The UK initially was going to try for herd immunity but they took no special precautions for those at risk and then they went into panic when the deaths climbed so high. What we do know is that in areas that have made more of an effort to mitigate death rates have been lower.
Steve
Don Boudreaux
Feb 20 2022 at 12:30pm
Steve:
Who do I misquote? And who do I “smear”?
As for your claim that I’m mistaken to believe that Neil Ferguson’s modeling played a major role in pushing governments to lockdown, remember that it was Tyler Cowen who credited Ferguson with this effect. I simply take Tyler here at his word – a word that, on this count, I believe to be accurate. (The fact that you and other practicing physicians paid little attention to Ferguson’s predictions is irrelevant to the question of whether or not those predictions played a significant role in prompting governments to lock down.)
Further, you repeat here a mistaken claim that you’ve made earlier about the Great Barrington Declaration – namely, you claim that “no one had ever tried doing what they [the GBD’s co-authors] suggested. No one knew how to do it. To date no one still does.”
I can do no better here than to repeat my response from a few months ago to you on this very point:
I submit that humanity had in 2020, and has in 2022, far better knowledge of how to identify the vulnerable and focus protection on them than it had for how to lockdown in a way that possessed even a remote prospect of passing a cost-benefit test.
steve
Feb 20 2022 at 4:22pm
I dont claim you smeared anyone. I am responding to your first paragraph. While you wanted to “ignore the debate over the correctness or incorrectness of competing estimates ” others were making very incorrect statements about Ferguson’s claims. It actually is important to debunk this widely held belief about what he wrote.
2) ” Jay Bhattacharya of Stanford, Sunetra Gupta of Oxford, and Martin Kulldorff of Harvard – did indeed offer details on what Focused Protection would look like. The fact that these measures would not have worked perfectly and with 100 percent certainty is true.”
Yup, a bunch of academics threw out some ideas they thought might work. No evidence, no prior experience with similar illnesses. As I noted no one had ever tried what they suggested and no one has yet to try it. If people really think this stuff would work then we have left the $20 bill on the ground you guys like to talk about. The fact that no one anywhere has even tried that suggests to me that no one really thinks it would work, at least not strongly enough to try. I looked at their ideas and was pretty doubtful. But, it is a big country. Perhaps you academics should try to convince an area of the country that would be sympathetic to try next time.
As to your suggestion, it looks like the risk increase at about age 50-55. You think everyone older than that should wear a hazmat suit? During Desert Storm I was a lecturer on biological warfare and a Hazmat instructor. Have you every worn a hazmat suit? Lets just set aside the fact that we didnt have remotely enough hazmat gear for 20% of the country to wear. I bet we still dont. A lot of those vulnerable need care assistance, when do they eat, how do they sleep, how do you handle eating? Old people dont thermoregulate all that well sometimes and you do realize you get hot in those suits?
Look, I am sure you mean well but from the POV of someone who has worked with these suits what you are suggesting is akin to me suggesting to you the economist that if we want more widgets they way to do that is to put a really big tax on them. Things just dont work that way.
Steve
Don Boudreaux
Feb 21 2022 at 8:57am
Steve: You miss my point about hazmat suits. I don’t actually believe that their widespread use would have been advisable compared to other possible measures, including the ones recommended by the authors of the Great Barrington Declaration. Your dismissal of their recommendations is based on nothing more than an ad hominem.
The relevant comparison is one of measures such as those recommended by the authors of the GBD with the lockdowns. I submit again that, however imperfect those GBD-recommended measures are (and they of course are imperfect), when compared to the full consequences of lockdowns, they are far the better option. Indeed, as inadvisable as would be putting the vulnerable all in hazmat suits, such a measure would have been better than lockdowns.
You keep writing about lockdowns as if they are a tried and true practical measure. They are not. They are highly impractical and dangerous. We human beings have a long history of isolating the ill and the vulnerable without imposing many, if any, constraints on the actions of the vast majority. We human beings have no history of lockdowns of the sort that were imposed in the Spring of 2020.
steve
Feb 23 2022 at 11:51am
Calling them academics was probably unfair but the point still stands that their recommendations have not been tried. Limitations on movement including quarantines and local lockdowns have been tried with success as well as other mitigation efforts like distancing and masking. Those were used fairly recently with Ebola and were used in smaller areas with MERS.
Also, just to be clear, I have never advocated for continuous lockdowns. (Actually I dont think anyone has.) They should be limited to brief periods when local hospital systems are overrun. Early in the pandemic when we didnt understand everything and we saw what was going on in Italy it was the right thing to do. After that the focus should have been on more sustainable mitigation efforts.
Steve
AMW
Feb 20 2022 at 12:29pm
This is an honest question, not a gotcha question. What policies could have been put in place that would have effectively sealed off the vulnerable from infection while case numbers soared among the young and healthy? It seems to me that in the current world – with vaccines and therapeutics – the GBD advice is quite sensible. We can largely protect the vulnerable, so it’s time to get back to business as usual. But pre-vaccine, I don’t see how that was a feasible option.
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