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Three coronavirus quickies

1. Charles Horton writes:

The existing research into ivermectin doesn’t generally strike me as very strong, with much of it showing up in non-peer-reviewed journals, or having other major flaws (i.e., the Hill study presents itself as a meta-analysis but of the 18 trials it collects, it only claims that two are high-quality—then analyzes all 18). With that said, though, the drug seems to be attracting attention outside of people doing “research” via Google and social media: Chest, which is Kinda Somebody in the research journal world, recently published an ivermectin study, and the EVMS team (now FLCCC—the “Front Line” part strikes me as hokey, but historically it had been a pretty decent collaboration of ICU docs and pulmonologists; this is not at all the same as the silly “America’s Frontline Doctors” outfit) seems to be promoting it very strongly.

I feel like we’ve only gotten far enough with it to say that it deserves further research, but the EVMS/FLCCC guys seem pretty much sold on it. Do you think I’m missing something here? Or is it just a matter of wanting to have something, anything, in the toolbox before variant Covid makes the existing mess even worse? It’s an ancient generic drug that costs very little, so there’d be little financial incentive to say what a given drug company wants to hear, and unless I’m missing something it’s also been largely outside of the political drama that surrounded hydroxychloroquine research.

If the answer is that the EVMS group (which was just a team of docs developing a protocol, and which didn’t buy into the HCQ hype) has morphed into something less profitable as it became “FLCCC”, then I’m sad to hear that. The link makes me wonder that, with its pop-up window advertising that one of the main docs appeared on so-and-so’s radio show. That was definitely not the sort of thing it would have had in its earlier (as in, until becoming FLCCC in December) days.

More critical commentary here.

2. Aleks Jakulin writes:

WHO says: “This means that the probability that a person who has a positive result (SARS-CoV-2 detected) is truly infected with SARS-CoV-2 decreases as prevalence decreases, irrespective of the
claimed specificity.”

The test doesn’t care about prevalence. Trying to adjust individual tests this way before publishing results is statistically unsound and adds biases in an opaque way. Instead, we need to think in terms of how to interpret test results.

We should recognize that tests are fundamentally probabilistic and take into account other information about the person in addition to the test result: symptoms, date of onset of symptoms, age, contacts, travel, reason for testing, previous tests, type of test. Prevalence is an extremely superficial piece of information to be used for such a purpose, and mixing such interpretations with the test outcomes adds biases into the data that disrupt subsequent analysis and comparison.

The persons getting tested should receive guidance on how to interpret test results and inherent uncertainty, what is the progression of the disease in this spirit—while also investing in understanding risk at an intuitive level.

The health agencies should publish “deeper” data for each test, instead of just publishing aggregate data. Consider, for example, the detailed data for each test published in Singapore.

Such an approach to data would allow a detailed interpretation of each case for epidemiological purposes (when was the case most infectious?)—as well as a better understanding of prevalence in general (are we getting mostly false positives in screenings, or do we have a rapidly expanding community spread with symptomatic patients coming in to be tested).

3. Someone writes:

What’s wrong with **? I am intrigued by the mindset of [this eminent scientist] apropos the coronavirus pandemic – he has exerted a huge amount of time and energy over the last year trying to prove that epidemiologists and public health experts are over-estimating its scope, and that their exaggeration of the pandemic is the real problem. Why?

I wonder what drives him, and what it means for statistics, data analysis, and science in general. Perhaps I am overreacting to find his behavior so disturbing.

By chance, I saw him on a panel of discussing the pandemic back in the spring. He complained bitterly that he was working 20 hours a day analyzing data that showed that Covid19 was no worse than the flu, but that his contribution was not appreciated, and worse, he was under attack for telling the truth. Another member of the panel gently schooled him that while Covid and the flu looked similar in that they both manifested in the respiratory system and both could lead to pneumonia, Covid was also a blood disease, and thus much more complicated and serious. ** then backed off and denied that he was equating Covid to the flu. He subsequently seems to have forgotten about that.

Now that the US has surpassed 400,000 deaths, I checked back in on his stance today. He’s very active online trying to rescue his theory and still maintains that he is a martyr to the cause. . . .

My replies:

1. I have no idea. I’ve never heard of this one.

2. Yes, it’s a challenge, and I agree that even if the agencies can’t solve the problem, they should acknowledge it.

3. Here’s my take: based on surveys, it appears that some large fraction of people in their seventies in this country believe in outlandish conspiracy theories. If you think of a simple additive model, you might say that given this person’s scientific expertise you think he’d be more grounded in reality, but his demographics would suggest otherwise. Put it together and you’ll find that some nontrivial proportion of scientists in their seventies in this country will believe all sorts of theories unsupported by the facts. Hmmm, I guess this sounds ageist, so let me say that people of all demographic groups can be resistant to facts. Why do we hear from this guy? It’s selection bias. If he were saying the same thing that more sane scientists were saying, then he wouldn’t need to scream on twitter, and nobody’d be talking about him, more than they’re talking about various other people with general scientific credentials who have conventional opinions on topics on which they have no particular expertise.

P.S. Zad shares the above picture of Ace, who would be happy to revise views in light of data.

145 Comments

  1. jd says:

    >based on surveys, it appears that some large fraction of people in their seventies in this country believe in outlandish conspiracy theories

    What surveys are these?

    • Andrew says:

      Jd:

      I’m thinking of surveys showing that a large proportion of Republican voters think that Trump won the election, which implies belief for widespread election fraud, which is an outlandish conspiracy theory—I think it’s fair to call this outlandish given all the effort that has been spent trying to gather and publicize evidence of fraud, followed with the lack of any good evidence. Given the age distribution of Republican voters in this country, it’s safe to say that a large fraction of Americans in their seventies believe in this theory. But I don’t have direct polling on this; the only age breakdown I could find in a quick google search was this poll, which just gives age as less than or more than 45.

      • jd says:

        I must have overlooked something, but all I saw on this survey was something like ‘do you think the results of the election are accurate?’
        That’s a bit different than believing a conspiracy theory…
        A better question would have been something that pertained to conspiracy theories like ‘do you believe the election was stolen?’ or something like that.

        In any case, you may be right, I don’t know. But that is quite a statement, and I don’t quite see that it is based very substantially on surveys.

        When I read the statement, I was thinking you must know of surveys where large fractions of people in their 70s believe in conspiracy theories in general https://en.wikipedia.org/wiki/List_of_conspiracy_theories

        • Andrew says:

          Jd:

          Here’s an example: “Half of Republicans say Biden won because of a ‘rigged’ election: Reuters/Ipsos poll.” No breakdown by age, but, again, given the correlation between age and vote preference, I think it’s safe to say that a large fraction of Americans in their seventies hold this belief.

          • Dale Lehman says:

            Andrew – I do think your “safe to say that a large fraction of Americans in their seventies hold this belief” is an overstatement, at best. Perhaps it is not even justified. If we are to take voting for Trump as a proxy for belief in conspiracy theories (it is a stretch, but as you suggest not too much given that a large percentage of those voting for Trump did feel the election was rigged), then the age group over 65 voted 52/47 in favor of Trump (from the CNN exit polls, https://www.cnn.com/election/2020/exit-polls/president/national-results, which I can’t speak to the accuracy of). A number of other demographic factors are similar, if not more slanted towards Trump: 53/45 among males, 51/47 among those working full-time, 54/44 among veterans, 54/42 among those with incomes > $100K. So, you could have said that males or veterans or the rich believe in outlandish conspiracy theories. I’m not saying they don’t, just that singling out the people in their 70s seems unjustified to me. Of course, that’s probably because I will be 70 in 3 months.

            • Andrew says:

              Dale:

              By “large fraction,” I don’t mean a majority. I’d consider 25% to be a large fraction. My point is that if you take this rich white guy in his 70s and ask why he believes in nutty conspiracy theories, I’d say, well, yeah, a lot of rich white guys in their 70s believe these things, so it’s no surprise that this belief is held by some rich white guys in their 70s who are prominent scientists.

              • Dale Lehman says:

                Perhaps someone will research this more thoroughly – but here is what I found for a sample size of 2. I looked at the Congressional districts served by Marjorie Taylor Greene and Lauren Boebert. Both are conspiracy believers – or at least promoters. Both were recently elected to Congress. I looked at the population of their districts compared with the rest of their state. Economically, they serve relatively rural parts of their states, with incomes levels a bit lower and also somewhat lower poverty levels. Both serve relatively white districts. Most notably, the % of population with a BA degree or higher is extraordinarily low in both of their districts (I don’t recall exactly, but it was around 18% in Greene’s district and 34% for Georgia as a whole).

                I don’t think age is the factor that stands out. Rural vs urban perhaps. White vs non-white perhaps. Education – absolutely. The appeal of conspiracy theories to the uneducated seems glaring to me. Sure there are educated people who believe in conspiracy theories, and sure there are other commonalities to those believers. But the educational discrepancy seems too large to ignore and seems to have a reasonable causative mechanism. There is plenty wrong with university-level education, but it does at least expose people to some degree if critical thinking.

              • Andrew says:

                Dale:

                I agree that age is not the most important variable, it’s just one of many variables one could look at.

          • kj says:

            Andrew,

            I’m perhaps a little sympathetic because I have a couple family members who fall into this group. So while I don’t buy any of it, I think some models of “rigging” are less conspiratorial than others, and surveys don’t discern.

            One person says the election was unfair for reasons like (the incredibly tedious) Senator Josh Hawley: states changing election rules for covid without going through proper lawmaking. The other believes in poll workers “finding more ballots”, or people submitting others’ mail-in ballots. I guess partisanship makes them believe such mechanisms favor one side, and that poll watchers are ineffective.

            Neither support the “Stop the Steal” folks who believe things like vote machines being hacked by Venezuela or whatnot. But they’d still answer yes to the survey.

            Finally, you could also say there are many Democrats in their 70s as well. A majority of Democrats polled in 2018 answered that “Russia tampered with vote tallies”:
            https://today.yougov.com/topics/politics/articles-reports/2018/03/09/russias-impact-election-seen-through-partisan-eyes

            • On the other hand we have **direct real evidence** that Russia was hacking systems attempting to tamper with vote tallies, and that we owned and used a lot more hackable systems at that time.

              https://www.nytimes.com/2019/07/25/us/politics/russian-hacking-elections.html

              So believe that “russia tampered with vote tallies in 2016” is based on something a lot more than “conspiracy theory” (such as “Senate intelligence committee reports”)

              • Not to mention evidence that Russia was wildly successful with other kinds of attacks: https://www.nytimes.com/2021/01/02/us/politics/russian-hacking-government.html

              • kj says:

                I agree. My point was that binary survey questions like that shouldn’t be used as a proxy for conspiratorial beliefs. It doesn’t discern between believing “Russia had the means and motivation, so it’s possible,” and “the CIA and KGB are in cahoots” or whatnot. I’d only label one of those conspiratorial.

              • Anoneuoid says:

                Not to mention evidence that Russia was wildly successful with other kinds of attacks: https://www.nytimes.com/2021/01/02/us/politics/russian-hacking-government.html

                Yes, basically the entire government was hacked during 2020. This includes CISA itself who is responsible for ensuring government IT security (including the election).

                CISA, which is part of the Department of Homeland Security, is a SolarWinds client. So is the Pentagon, the Federal Bureau of Investigation, and U.S. Cyber Command.

                https://www.newyorker.com/news/daily-comment/after-the-solarwinds-hack-we-have-no-idea-what-cyber-dangers-we-face

                This is why critical infrastructure should not be able to connect to the internet, and especially not wirelessly. And *really* especially not from tens of miles away via cell towers.

              • confused says:

                Yeah, this is basically the comment I was making with regards to “40% of Americans believe the Earth is less than 10,000 years old” below…

                There is a huge difference between “I think X is possible/I am skeptical of X” and “I firmly believe X is true/false” – especially if one is a) not particularly close to the issue and b) inclined to be skeptical of ‘officialdom’ in general (as many Americans are).

                What has really been exceptional about the last few years, IMO, is that we had a President who was not perceived by a huge number of Americans as part of “The Government” and therefore strongly trusted by many of those same people who most strongly distrust “The Government” (and ‘officialdom’ in general).

            • Keith E. says:

              Yeah, even when somebody holds a view I’m convinced is wrong, I’m still a little sympathetic, if for no other reason than:

              “Maybe that other guy holds his incorrect belief because he’s susceptible to conspiracies”

              Could be said by the other party about me. Sure, they’d be wrong. But sure, they’d think I was wrong. Attempted psychological analysis in a debate that should be about fact is not just a fallacy… it feels rude.

          • jim says:

            I agree that ‘rigged’ election ‘fraudulent’ election

            one could construe counting illegal immigrants in the census that determines congressional seats as “rigging”, particularly since numerous progressive states/local governments are taking extreme measures to protect illegal immigrants from deportation and even intentionally disrupting ICE operations.

            It’s dangerous to extrapolate even slightly from people’s beliefs about the election. On both sides of the political spectrum, unprecedented behavior is being treated as normal and justifiable, and that gives people a lot of conspiracy fuel.

            • John Williams says:

              The constitution says congressional seats should be based on the number of “whole persons.” How is that “rigging?”

              • Ken Schulz says:

                And, of course, undocumented persons cannot, and empirically, do not vote. They may perhaps have an effect on redistricting. If there is evidence that this systematically works to the advantage of one political party or the other, I have not seen it.

              • confused says:

                I am not saying this is true, as I do not know… but I think the argument basically is that undocumented immigrants are not equally distributed across the states, so excluding/including them from the census would end up giving less/more representation to certain states.

                I would be surprised if the effect really favored one party very much, though. One would expect undocumented immigrants to be more numerous near the Mexican border; TX is very Republican, AZ is a swing state, CA and NM are blue.

                However, I think it’s likely that many Republicans *believe* that it makes a difference, given how much of politics is essentially the old rural heartland vs the rest of the US these days…

              • jim says:

                “The constitution says congressional seats should be based on the number of “whole persons.” How is that “rigging?””

                The point has nothing to do with the constitution. The constitution is clear on the issue. It has to do with local (state, county, city) progressive governments blocking the Federal government from carrying out it’s legal responsibility of immigration enforcement. It’s not outlandish to *construe* that as a means to increase representation – particularly when the same progressives are arguing for a path to citizenship for all illegals. French Quebecers have long accused Federal Liberals in Canada of doing exactly that.

                Note that I use the word “construe” – I am not implying a cause much less a conspiracy. Nonetheless, it is extraordinary and probably unprecedented for local governments to refuse to cooperate with the Federal government.

                Overall however, my point isn’t even about that. It’s that the idea of “rigged” can have many connotations.

          • Bob76 says:

            Hmm. I searched for the phrase “Half of Republicans say Biden won because of a ‘rigged’ election.” I found a Reuters site containing the following:

            In 2016, 52% of Democrats said Hillary Clinton’s loss to Trump was “legitimate and accurate,” even as reports emerged of Russian attempts to influence the outcome. This year, only 26% of Republicans said they thought Trump’s loss was similarly legitimate.

            This seems to imply that 48% of 2016 Democrats would not say that Trump’s election was “legitimate and accurate” corresponding to 74% of this year’s Republicans.

            It seems to me that there are two concerns here. First, how trustworthy is polling process—is the sample good, adjustments okay, etc? Second, how much weight are we to give to such answers? “legitimate and accurate” is a complicated concept. If the question were more like “do you think the votes were counted reasonably accurately?”, one could at least be fairly confident that the question was more focused. (There’s still a problem with ‘reasonably’.)

            One might believe that factors such as (1) press bias or (2) mind rays from the lizard people, made the election illegitimate even though the votes were counted correctly.

            Bob76
            PS. I’ll try not to rant on evolution. But I will note that I think that if you ask the question “Is it reasonable for racehorse owners to pay a lot to breed their mares to horses that win lots of races?”, I bet fewer than 40% would disagree (modulo those who don’t believe that breeding racehorses is reasonable). You can think of lots of questions about agricultural practices that implicitly reveal a belief in evolution but that avoid making the respondent explicitly say that they believe in evolution. I grew up in a farm town. I knew many kids who were taught during the week in school and at FAA meetings that careful breeding had improved milk yields (lb/cow/year) and were taught on Sunday that evolution was false.

            • Andrew says:

              Bob:

              I agree that talk is cheap, and survey responses are just survey responses. A particular concern after the 2020 election is not just that lots of rank-and-file voters believed allegations of election fraud which were unsupported by any evidence, but that these claims were pushed by major political leaders. In that sense, the views reflected by shallow poll responses were raw material for irresponsible political actors.

              Regarding evolution: yes, there’s been some literature on this, I can’t remember where. In-depth interviews with people such as biologists or farmers who express belief in Biblical fundamentalism while at the same time dealing with evolution in their work. It’s an interesting question and it makes us aware that just about all of us have contradictions between our actions and our stated beliefs.

              • rm bloom says:

                Those allegations were pumped up *before* the election, by that piece of nazi garbage then in high office. A stunt and a foul way for that repulsive creature to hedge its bets (since rational estimates that they’d lose must have been filtering into even their foul ranks).

            • Martha (Smith) says:

              Bob said, “You can think of lots of questions about agricultural practices that implicitly reveal a belief in evolution but that avoid making the respondent explicitly say that they believe in evolution. I grew up in a farm town. I knew many kids who were taught during the week in school and at FAA meetings that careful breeding had improved milk yields (lb/cow/year) and were taught on Sunday that evolution was false.”

              I think there is a semantic problem here. To me, the word “evolution” as used in biology means *natural* selection, while agricultural selective breeding is something that is done deliberately by humans. So I see no contradiction between what the kids “were taught during the week in school and at FAA meetings that careful breeding had improved milk yields (lb/cow/year)” and what they were were taught on Sunday (“that evolution was false”).

              • dhogaza says:

                So when mutations in bacteria allow them to avoid death by antibiotic, and over time replace the original population, that’s not evolution because it’s not natural selection, but selection due to human intervention?

              • confused says:

                Also, even a lot of young-earth creationists these days accept “microevolution” (better cows or corn, antibiotic-resistant bacteria) but not “macroevolution” (e.g. dinosaur to bird).

                Of course, the process is the same…

                But it does seem wacky that you can get huge changes by mutating one gene at a time, most people aren’t really used to thinking in terms of “deep time” – also the highschool explanation of “gene -> protein” doesn’t terribly well account for stuff like homeobox genes, which can cause really dramatic changes.

                (Of course, not everything actually happened by mutating one gene at a time, e.g. the origin of mitochondria by endosymbiosis probably being the most important case. But I doubt that’s terribly widely known to the general public.)

      • Joshua says:

        I don’t think that age or political orientation are very good predictors for who is likely to believe in conspiracy theories.

        I’ve seen some evidence that people who tend towards authoritarianism are more prone towards conspiracy ideology – but I don’t think that the evidence is conclusive.

        Following on, there’s some evidence that Trump supporters are relatively prone towards authoritarianism (see Haidt).

        That said, I still think that the human psychological mechanisms that lead towards conspiracy ideation are more or less universal, and not likely distributed by age and/or political ideology.

        That isn’t to say, however, that IN THIS PARTICULAR CONTEXT, beliefs in conspiracies about the 2020 presidential election aren’t distributed disproportionately across age and or partisan demographics.

        • jim says:

          I’m curious if you’d say that ppl’s individual conspiracy theories tend to support some aspect of their own beliefs? IOW, do ppl generate and believe in conspiracy theories as a means of convincing themselves that their other beliefs are real and justified?

          • Joshua says:

            jim –

            > IOW, do ppl generate and believe in conspiracy theories as a means of convincing themselves that their other beliefs are real and justified?

            That would seem likely to me. To believe in most conspiracy theories, there has to be a willing suspension of disbelief. That’s how they can get past the implausibility aspect. How does one get past the imlausibility of a large group of people conspiring together to do incredibly heinous things (let’s say what “truthers” believe about 9/11) w/o one person having a conscience and stepping forward to blown the whistle? How does someone get past the implausibility of life-long Republicans in Georgia conspiring with Democrats to defraud Trump of tens of thousands of votes? How else to think it’s likely that career public health professionals who have dedicated their lives to public health would conspire to make the pandemic worse (or seem worse) just so they can hurt Trump’s chances in the election?

            You have to be pretty “motivated” to get past such obstacles of basic logical incoherence. It’s not like they’re all idiots. My guess is that while particular ideology doesn’t predict a tendency towards conspiracy ideation, strength of ideological identification does. That’s why we see more conspiracy ideation towards the extreme ends of the political spectrum.

            • jim says:

              ” To believe in most conspiracy theories, there has to be a willing suspension of disbelief. “

              Oh I don’t think that’s true at all. Educated people routinely believe things like:

              ‘ “Big Food” is trying to get us hooked on Kraft Dinner’ and such. Another I’ve heard from educated people is that advertisers know exactly how to make you, Joshua, buy whatever candybar/car/vacation etc they want. It’s also widely believed – not so much among educated people – that certain people or traders can control the stock market, or make it go this or that way etc.

              I don’t think

            • Martha (Smith) says:

              Joshua said,
              “To believe in most conspiracy theories, there has to be a willing suspension of disbelief. That’s how they can get past the implausibility aspect. How does one get past the implausibility of a large group of people conspiring together to do incredibly heinous things (let’s say what “truthers” believe about 9/11) w/o one person having a conscience and stepping forward to blown the whistle?”

              Methinks you are assuming that the way you see things is the way others see things. There is no a priori reason to believe that what you see as implausible is implausible to others.

              • Joshua says:

                Martha –

                >Methinks you are assuming that the way you see things is the way others see things. There is no a priori reason to believe that what you see as implausible is implausible to others.

                Well yes, that’s the crux of the bisquit.

                But I”m talking like the plausibility of believing that the Bush administration planted explosives to blow up the Trade Towers and then had the planes crash into the buildings to cover it up, and prevented any of the many people who must have been involved from coming forward with evidence of said conspiracy.

                Now it is indeed true maybe some of the people who believe in that conspiracy don’t think it is an implausible theory. My guess is that another group would agree that it’s implausible but answer with something like “sometimes implausible” happens.

                But I’m pretty comfortable with a general statement that conspiracies where large groups of people commit heinous acts, or acts that stand in contrast to their lifelong behaviors, without any of them coming forward to blow a whistle, could fairly be called implausible. Yes, implausible things do happen, but that doesn’t mean that they aren’t implausible.

                Is there a purely subjective determination of what is and what isn’t plausible? I guess not. But I’d say that there are some reasonable situations where the adjective fairly applies. And the 9/11 truther theory is one that I think fits. I’d say the vast majority of people agree that the theory is implausible.

              • confused says:

                I wonder if part of the issue is that these people don’t really realize how many people would have to be involved.

                It’s easy to imagine some faceless sinister Big Government type giving the orders, but thousands of everyday people working regular 9 to 5 jobs, not so much.

                Not sure about 9/11, but I think this largely accounts for the “COVID deaths are massively overstated” conspiracy theory. People just see numbers from “the CDC” and it could just as well be some bureaucrat in Washington writing down whatever numbers come to mind; they don’t realize that these come from tens of thousands of individual doctors writing death certificates, thousands of counties and all fifty states collecting data, etc.

  2. Anonymous says:

    > He complained bitterly that he was working 20 hours a day analyzing data that showed that Covid19 was no worse than the flu,

    The panelist who shall remain nameless was right. Analyzing data that shows that Covid19 is no worse than the flu is a lot of work! You have to wade through mountains of inadequate data looking for those golden nuggets.

  3. Daniel says:

    2. Indeed, the test doesn’t care about prevalence, so it doesn’t affect the alpha or beta, but prevalence affects the PPV and NPV. That’s just good ole Bayesianism for you. It would be nice to use other, more specific information in lieu of prevalence to get the base rate, but I don’t expect that to happen in a systematic way. It would be great, for instance, to adjust the subjective probability based on date since onset of symptoms, which is pretty easy to get. Not happening in a quantitative way, just WHO noting that PCRs are diagnostic aides, that in addition to all that other information, prevalence can help doctors (or sophisticated patients) interpret results from a probabilistic standpoint (caveat: prevalence estimates themselves are…estimates). If you were to adjust in a quantitative way, it would add bias in an opaque way about as much as ‘defining your prior.’

    It would be even better to adjust the test’s calibration based on specific information like date since onset of symptoms, but then by definition the test WOULD care about that info.

    Anyway, WHO says prevalence affects PPV? Correct. Jakulin says using other info would be nice? Correct.

    • Specifically when prevalence is high, contamination of a test is more likely. This is basically the only way you can get a false positive PCR, but it’s a nontrivial risk. My wife suggested that about 2% of PCR tests used to genotype mice are contaminated by ordinary technicians. This is a situations similar to COVID testing with widespread COVID, but in a situation where you’re trying to genotype mice and none of them have the gene of interest, even if you contaminate the test it won’t be with a positive sample. That’s similar to testing for COVID in a region with near eradication, like New Zealand.

      So prevalence DOES matter. It is in fact one of the major drivers of whether contamination results in a false positive

      • Anoneuoid says:

        In that WHO document it tells you the other big way. If prevalence is believed to be high, the lab is supposed to change the threshold be more sensitive and less specific.

        If it is believed to be low, they are supposed to make the threshold more stringent.

        This is the same as using alpha = 0.1 as the significance cutoff if you really think your null hypothesis is false but 0.001 if you think it must be true.

        • Anoneuoid says:

          I see, this update removed the previous version which said more clearly:

          The design principle of RT-PCR means that for patients with high levels of circulating virus (viral load), relatively few cycles will be needed to detect virus and so the Ct value will be low. Conversely, when specimens return a high Ct value, it means that many cycles were required to detect virus. In some circumstances, the distinction between background noise and actual presence of the target virus is difficult to ascertain. Thus, the IFU will state how to interpret specimens at or near the limit for PCR positivity. In some cases, the IFU will state that the cut-off should be manually adjusted to ensure that specimens with high Ct values are not incorrectly assigned SARS-CoV-2 detected due to background noise.

          https://web.archive.org/web/20210120083427/https://www.who.int/news/item/14-12-2020-who-information-notice-for-ivd-users

      • Joshua says:

        Prevalence does matter, however there’s some interesting info in this podcast regarding just how many “false positives’ there are in a situation of low prevalence. Specifically, in Australia they’ve had many tests given, with very few positives – and it has been confirmed that those few positives were not “false positives.”

        https://soundcloud.com/senscipod/episode-32-pcr-and-covid-19-testing-with-dr-angie-rasmussen

        Of course, part of the problem is that there’s a lot of political posturing about what comprises a “false positive” – whereby tests results were people who tested positive but weren’t infectious are being labeled as “false positives” as a political rhetorical tool.

        • This just reiterates what I was saying I think. In Australia, where the prevalence is very low, when you accidentally contaminate a well (which is inevitable) it’s very very unlikely that you contaminate it with a positive sample. Therefore you don’t create a false positive.

          on the other hand, when 10% of the tests you’re doing are true positives, then if you contaminate a well, there’s ~ 10% chance you create a new false positive. There’s also a certain chance that you contaminate your plate with aerosols settling onto it or such, and this could contaminate tens of wells etc.

          If there isn’t much RNA around then it’s hard to contaminate with that RNA, if there’s lots of RNA around then it’s easy to contaminate with that RNA.

          • Joshua says:

            Daniel –

            > This just reiterates what I was saying I think.

            Agreed. I thought that it does as well, if indirectly. I thought I made that clear.

            In a situation with very low prevalence there were very few positives and after confirmation, vanishing few “false positives.” They do speak to the issue where contamination is a prominent issue w/r/t “false positives” – and logically you’d expect more contamination when there’s a higher prevalence.

    • rm bloom says:

      This is how one should see the generic situation — sandwiched in between two limiting cases:
      [a] if the prevalence is zero, and I get a positive test, then it is necessarily a false positive.
      [b] if the prevalence is 100% and I get a negative test, then it is necessarily a false negative.

      The doctors see it in this way:
      [a] if in his view the index of suspicion that I am a case is low, he accepts a negative without further question.
      [b] if in his view the index of suspicion that I am a case is high, and my test is negative, he will test again.

  4. Julien says:

    What should we change in the way science works or interacts with the public to reduce the incentives to behave like ** and cause lots of damage? I wouldn’t want to punish the ** of the world for having wrong opinions, but at the same time this pattern of older scientists saying outrageous things to remain relevant has been seen times and times again (besides ** that shall remain unnamed, I can think of Didier Raoult or Luc Montagnier in France).

    • Ken Schulz says:

      Journalists on the science beat of course have a responsibility to represent scientific consensus as such, and to present heterodox views as such, even if they are held by credentialed scientists. There is no obligation to give a platform to scientists who are opining outside their area of expertise.
      I think as a society in an increasingly complex world, we need to do a better job of educating youth in critical thinking skills. As a psychologist, I see a place for teaching about cognitive biases and heuristics. There is always room for improvement in the teaching of scientific method, empirical inquiry, observation and experiment. There are problems which are most severe in the social sciences, of measurement, data quality, signal and noise, which need to be taught, because so many public-policy questions involve research findings from these disciplines. (I include economics as a social science)

    • jim says:

      “What should we change in the way science works or interacts with the public to reduce the incentives to behave like ** and cause lots of damage?”

      The answer is nothing. I don’t know or care who ** is, but he has as much right to his opinion as you have to yours. I doubt that his opinions did much damage to the COVID response. The US is doing poorly but most other western countries aren’t doing that much better. Despite the virtual certainty of a pandemic emerging at some time, most of the world was caught totally off guard. The response of every major health organization and government in the world – a few Asian countries excepted – has been a disaster.

      What we should change, if anything, is not the way science interacts with the public but the way science is practiced and what it demands internally for verification.

      • Andrew says:

        Jim:

        ** is influential enough that it’s actually possible that he did some real damage. I agree that he has the right to his opinion, and I guess that some of his influence came because he was saying things that some people wanted to hear. Just to go back to the above post, my correspondent was asking not what could be done to stop **, but, rather, what were the motivations of ** in bumbling around with theories that didn’t make a lot of sense and were being contradicted by data. My guess is that ** is living in an information bubble and is discounting contrary indications. Also he might well enjoy the attention. And of course we do need some contrarians as part of our societal mixed strategy of pursuing all hypotheses, even those that seem not to make sense.

        This gets back to our discussions of junk science. I would not want societal investment in research on ESP, ages ending in 9, air rage, himmicanes, ovulation and voting, beauty and sex ratio, etc., to be zero—I say this not because I think any of these topics is worth studying but rather because many people are evidently interested in these topics and I think people should be free to study what they want to study if they’re not harming people—but I do have a hunch that societal investment in these topics is higher than it should be. That’s just a hunch, though, as I don’t have any good measure of societal investment in these topics. Back in the 1970s, lots of the attention economy was wasted on the purported science of Noah’s Ark, Shroud of Turin, ancient astronauts, Loch Ness monsters, the Bermuda Triangle, and the like. The favored topics of junk science have shifted. Anyway, it’s a lot easier to do what I do, which is to point to specific areas of junk science and explore what went wrong, than to make a systemic argument that PNAS, for example, devotes too much space to it.

      • Ken Schulz says:

        jim – What elements of “the way science is practiced” contributed to the unpreparedness of European and North and South American governments? It seems rather, that swine flu, Ebola and Zika had sensitized the scientific community to the risks of novel infectious disease. Science journalists like the Pulitzer Prize winner Laurie Garrett had written books and articles. Obama administration staff developed a playbook for pandemic disease; Trump administration staff carried out a simulation exercise. Unfortunately, when the pandemic came, political appointees did not follow expert advice or apply lessons learned in earlier events. Was this the consequence of “the way science is practiced and what it demands internally for verification”?

      • Joshua says:

        jim –

        > The response of every major health organization and government in the world – a few Asian countries excepted – has been a disaster.

        Not just a few Asian countries did better.
        There are a lot of other countries also that have handled this considerably better than we have.

        Of course, there’s an element where outcomes in various countries, including ours, are a function of structural or other factors that political officials can’t control, but there were a series of obvious mistakes made, though deliberate policy choices.

        Comparing to other countries that did poorly as a basis of comparison is weak rationalizing. The mistakes we made can’t be rationalized away by saying outcomes in other places were as bad. You can’t improve going forward if you don’t explicitly acknowledge (consequential) errors that were made. Hand-waving them away is counterproductive.

  5. Joshua says:

    > What’s wrong with **?

    Methinks said scientist’s initials may be M. L.

    If so, he made a string of errors where he mis-estimated the trajectory of the pandemic. All in the same direction towards underestimating illnesses and deaths.

    If you make a series of such errors, all going in the same direction, doesn’t that suggest a basic analytical flaw? Some were off by more than one order of magnitude. Yet no explication of an analytical flaw has been forthcoming. This despite said scientist saying that it’s important to learn from errors and priding himself on being open to feedback.

    He’s even throwing shade on the advisability of vaccines (with the lame argument that the vaccine is more dangerous than the disease).

      • Andrew says:

        Amy:

        Wow—what is it with Stanford?

        • anonymous says:

          I thought J.I. Stanford has a “deep bench” in this arena, evidently.

        • Amy says:

          Interesting question – what is it about Stanford? The old saw is: follow the money ——->Peter Thiel?https://en.wikipedia.org/wiki/Peter_Thiel
          “A co-founder of The Stanford Review, he is a conservative libertarian who is critical of high government spending, high debt levels, and foreign wars. He has donated to over 50 political figures on the American Right, including Donald Trump and Meg Whitman. He also maintains a political action committee, Free Forever.”
          Free Forever vs. pandemic lockdown?

          • Andrew says:

            Amy:

            The Hoover Institution predates Thiel. But I hadn’t heard much about Stanford Medical School before all this coronavirus stuff. I was guessing that the medical school people were hired without reference to Thiel or the Hoover Institution, but it could be that all the big money floating around has had some influence, as with the study that was funded by the Jet Blue guy. I really have no idea.

            • Amy says:

              Andrew:
              These are some pieces that may or may not fit together to form a picture of how big money could have an influence:
              1. Dr. Birx says that someone was providing data different from hers to the White House, and that other data was presented rather than hers.
              2. **, a famous scientist, says he spends 20 hours a day analyzing data and claims that his analysis shows that coronavirus is no more dangerous than the flu, and that preventative public health measures are worse than the disease itself. He advocates for a let-it-rip policy that will result in natural herd immunity.
              3. Scott Atlas is special adviser to the president on the White House coronavirus task force and advocates for a herd immunity policy. He does not personally have any relevant expertise. (How did he come to be appointed?)
              4. ** and Atlas are both in the scientific advisory board of pandata.org, an analytic group formed for this self-proclaimed mission: “We see in lockdown and it’s related intrusions on civil liberties a serious threat not only to lives but to civilization itself. This treat must be resisted.”
              5. ** and Atlas are also both at Stanford.
              6. Peter Thiel, a libertarian and major donor to Stanford, his alma mater. He is a strong proponent of the Pandata stated mission. He is also a major donor to Trump, so presumably he has the president’s ear.

              Q: Who finances Pandata?

              • Andrew says:

                Amy:

                I was curious so I googled Pandata. First thing I found is there are several Pandata companies or organizations:

                pandata.co: “Pandata: Approachable AI for Humans”

                http://www.pandata.org: “Pandemics ~ Data & Analysis (PANDA) is a multidisciplinary initiative seeking to inform policy relating to the Covid-19 pandemic and lockdown”

                http://www.pandatagroup.com: “Pandata Group | Snowflake Implementation and Consulting”

                pan-data.eu: “PANdata – the Photon and Neutron data infrastructure initiative”

                pandatatech.com: “Pandata Tech | AI and ML Data Quality Solutions”

                pandata.de: “Pandata is your agile task force for data strategy and solutions across the entire data value chain”

                I guess it’s http://www.pandata.org that we’re talking about. I clicked through and it says it was founded by two people from South Africa. The members include some doctors, some people in the finance and public relations fields, an economist, a corporate lawyer, a statistician, and a voice actress, among others.

                I could not find anything on the webpage about how the organization is financed, or what its expenses are. It says it’s a “volunteer non-profit organisation” but that’s it. Maybe it’s registered in South Africa, or maybe nonprofits there don’t need to be formally registered, I don’t know.

              • Carlos Ungil says:

                Andrew,

                I’m not sure if this answer your question but the “About Us” page ends with “is funded by its members, speaking engagements and the public.”

                Seems to be registered in SA (2018/364043/08) according to the details in this document: https://www.pandata.org/wp-content/uploads/201123-Application-Panda-Knowledge-Factory-NPC-amicus-curiae-compressed-min.pdf

              • Dale Lehman says:

                This is the first I’ve heard of Pandata. They clearly subscribe to a particular view – one that I don’t hold – but it is certainly legitimate to analyze the costs of our pandemic response and the costs of COVID itself. The Pandata people appear to have good credentials (and we know how important those are) – educated with good credentials, but certainly with their own biases.

                But here is what I find inexcusable. I looked at one of their studies – released this month – concluding
                “Conclusion SARS-CoV2 is not a “killer virus”.”
                Their analysis looked at age distributions of deaths with positive COVID tests compared with the prior 2 years, by country. The most notable standouts where deaths in the over 80 age group were actually lower in 2020 than 2018 and 2019 was in Italy. Their study refers to the first wave of the pandemic and the Italy data is from mid-March. But if you look up the deaths in Italy, mid-March was at the beginning of the first wave. Given that the study is released in January 2021, why didn’t they use all the data from the first wave? Why stop just when the first wave was beginning? The whole study smells of writing the conclusion (above) first, and then cherry-picking the data to support it. Forked paths everywhere. I think they have taken a legitimate question to analyze and committed analytical malpractice. What we need is some appropriate punishment for analytical malpractice. Perhaps it should be a sentence to a lifetime of TED talks.

              • rm bloom says:

                What do those savants who think it’s no more dangerous than the flu say to explain the remarkable demand for ICU beds lately? Is it because of some *other* illness which masquerades as or hitchhikes along with cov ?

                Or do they think that the hospitals are concocting the whole story — to (?) pump up their building-funds?

          • Joshua says:

            I will say this.

            In resonse to a query about material at PANDA that says a vaccine is more dangerous at all age levels than COVID, our scientist friend did a tweet out that he and his very elderly mother have both been vaccinated recently.

            • Joshua says:

              Actually, how I described it really doesn’t quite convey the full message – which was:

              -snip-
              “Currently, there is no one for whom the befit would outweigh the risk of these vaccines – even the most vulnerable elderly, nursing home patients.”

              • confused says:

                Uh, wow, that is *totally insane*.

                COVID mortality rate for nursing home patients over 80 has got to be double-digit percentage.

                What is the vaccine risk even supposed to be? We know there’s not a meaningful acute risk from Phase III trials with pretty large sample sizes — and a lot of the supposed other possible effects (still baseless, but I guess at least not *actually disproven yet*) like infertility would be meaningless in this population.

              • Anoneuoid says:

                COVID mortality rate for nursing home patients over 80 has got to be double-digit percentage.

                What is the vaccine risk even supposed to be? We know there’s not a meaningful acute risk from Phase III trials with pretty large sample sizes

                Which trial was that?

              • Amy says:

                Re: “In response to a query about material at PANDA that says a vaccine is more dangerous at all age levels than COVID, our scientist friend did a tweet out that he and his very elderly mother have both been vaccinated recently.”

                Interesting: When I went to show friends the anti-vaccine statement on the pandata.org website last night, it was gone. Is that a result of the query to our scientist friend? He doesn’t seem to be completely aware of what he is endorsing by lending his name on the scientific advisory board. Instead of disassociating himself, the evidence is removed.

              • confused says:

                I think the Moderna or Pfizer one (or both) was like 30,000 sample size.

                That’s already enough to show that the risk is much less than COVID even for relatively young adults (the USS Theodore Roosevelt, which is a population of overwhelmingly healthy relatively-young adults, had one death in about 1100-1200 infections) much less the elderly.

                I actually think it was pretty questionable to wait for the Phase III trials before vaccinating nursing home patients – the actual death rate from COVID in that group has been high enough that I don’t buy that any side effects would be relevant in comparison. (IE, Phase I and II wouldn’t spot a 1 – in – 1,000 side effect; but that wouldn’t be relevant compared to several percent of the total nursing home population dying of COVID).

      • Joshua says:

        Just to fill that in a little bit…M.L.said:

        He made a general calculated assessment where infections would “burnout” at 15% -20% of the population. In the US we are at 25 million cases. Given a 4/1 ratio of undetected cases to detected cases (low end of CDC estimation) we’re at @100 million cases and still accumulating at a very high rate (even if it’s short-term dropping at a rate faster than it has previously during the pandemic).

        Europe was experiencing 2k/day when he said there were “no deaths.”

        He projected that Brazil would see 98k deaths, they’re at 216k deaths now, and adding 1,000 a day.

        He projected that Iran would be “past halfway” at 24k cases, they’re at 1,367k cases now.

        He said Israel would likely see 10 deaths, they’re over 4,300.

        He projected Italy would see 17k-20k deaths, they’re at 85k now.

        He said the pandemic would be over on 8/22 in US.

        Worst of all, IMO, he perpetuates the “lockdown death” assertions when he’s made no accounting for his previous errors. And he fails to support his counterfactual assumptions about what would have been absent interventions. How does he disaggregate the impact of interventions from the impact of the pandemic itself?

        It’s mystery wrapped up in an enigma.

        • Navigator says:

          Joshua,
          Cumulative cases mean nothing. By definition, they grow with every passing day. Counting cumulative for something that passes within a week or so doesn’t make sense. Not to mention that PCR testing was self-selection, convenience sampling from day one. Forget specificity/sensitivity. There’s no control whatsoever over who, why, when and how often gets tested.

          If proper cluster sampling with limited tests had been deployed early on, we would have ended this pandemic long ago.

          If you really want to get an idea of what’s going on, analyze hospitalizations and deaths, which overwhelmingly show that this is a dangerous disease, but really affecting those 75+ the most, when all is said and done (end points assumed). They constitute the majority of fatalities.

          • Joshua says:

            Navigator –

            I’m not sure of the relevance of your comment. The person I’m referring to has made many scientific assertions with little accounting for related uncertainties and shown little to no accountability for the erroneous nature of his analyses. He/she made statements about cumulative numbers, and was systematically wrong.

            As for your comment – hospitilaztioms, ICU admissions, and deaths track with cases. Of course the ratio changes somewhat, but in the US since about August the ratio has been pretty stable: with deaths, for example about 1.3%-1.6% of cases predict deaths about a month out

            So yes, the PCR testing as a public surveillance tool has significant deficiencies (see Mina for discussion in that). There could have been better methodologies for that. But rates of positive PCR tests is not irrelevant.

            • rm bloom says:

              “The person I’m referring to has made many scientific assertions…”

              Are you sure you should call these assertions “scientific assertions”? Is it because the bearer of the assertion has various letters after his name?

        • paul alper says:

          Why is everyone fearful of mentioning his name, Michael Levitt? Wikipedia claims
          —–
          Levitt has been outspoken on the ongoing COVID-19 pandemic and made several claims that turned out to be wrong.[41] In February 2020, Levitt made a number of predictions about China’s COVID-19 trajectory,[42] including one on February 7 which claimed that “by 14-Feb. we will have reached 95% of the eventual death count of 928”.[43] In March, the Los Angeles Times reported that Levitt forecasted in February that the COVID-19 pandemic in China would soon peak and that China would end up with around 80,000 cases and 3,250 deaths from COVID-19.[44] As of September 2020, China had reported around 85,000 cases and 4,600 deaths.[45]

          Other notable statements made by Levitt during the COVID-19 pandemic include his belief that Israel would suffer no more than 10 COVID-19 deaths[46] and his belief on July 25, 2020 that COVID-19 in the United States would be over “in 4 weeks with total reported deaths below 170,000”.[47] As of November 2020, there were more than 270,000 reported deaths in the United States[48] and more than 2,800 reported fatalities in Israel.[49] About Israel, Levitt clarified that “The problem was that I should have said excess deaths.”, and that he made a mistake with that statement.[50]

          Levitt also has stated his belief that achieving natural herd immunity to the virus is possible[51] and has spoken against lockdown orders.
          ———
          Levitt is associated with
          https://www.pandata.org/scientific-advisory-board/
          which includes Scott Atlas, also famous for getting most things wrong about Covid-19. Similar to astrology, forecasting disease numbers is hard.

          • Andrew says:

            Paul:

            Without commenting specifically on the identity of **, let me just say that sometimes I feel that these discussions can go in more interesting directions if we focus on the arguments and situations rather than on the specifics of who’s making the arguments. Not always—sometimes the person is the story—but in this case that’s where I was coming from.

      • jrc says:

        From the Panda legal disclaimer, after the part where they say if you take their advice and die they aren’t responsible for it:

        “No warranty is given that any files, downloads or applications available via this website are free of viruses which may have the ability to corrupt your system.”

        https://www.pandata.org/disclaimer/

        As a wise man once said: Black X6, Phantom. White X6, Panda.

        Panda panda panda panda panda panda….

  6. MaximB says:

    Somebody put together a list of studies on Ivermectin, together with a short synopsis
    https://c19ivermectin.com/
    The same for hidroxychloroquine, https://c19study.com/
    I only browsed through (quite a lot to read) but it appears both ivermectine and HCQ (after all) are effective against coronavirus.
    Unless the majority of these studies are poor/wrong/biased etc.
    They also gathered studies on zinc, vitamin C, Remdesivir etc. What puzzles me is that most/all treatments listed here seem effective. But could they be wrong in the same direction?

    • Anoneuoid says:

      For HCQ all the RCTs I saw gave very high doses late in the disease process (so the mechanism as an antiviral wouldn’t make sense). They also didn’t monitor for methemoglobinemia which is an expected side effect of chloroquine overdose (especially in patients already undergoing/elevated oxidative stress) and mimics symptoms of covid.

      The treatment for methemoglobinemia is, guess what? Vitamin C. So even if vitamin C didn’t benefit covid patients originally it definitely would have the 70% that were getting HCQ.

      These were some of the most unethical studies I have ever seen. Also, early on Trump worked together with Cuomo to create this situation. Trump touted HCQ then Cuomo banned the distribution to outpatients (when it made sense) and ordered inpatients (when it had no expected benefit and expected danger) to receive it.

    • Charles Carter says:

      Low quality studies + publication bias/ file-drawer problem + selection. Yes, they could all be wrong in the same direction. And when I say low quality, a scan of the titles reveals many if not most just do not have clinical applicability.
      NIH says “…insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19.”

      https://www.covid19treatmentguidelines.nih.gov/statement-on-ivermectin/

      • Anoneuoid says:

        And what was the data for early intubation, lockdowns, etc?

        That is the problem here.

        • rm bloom says:

          The “data” my friend is what is learned *after* — in circumstances with little precedent — actions are taken; for better or for worse. If what they tried at first failed to make a difference, that is one thing; they were only ER docs, not fortune-tellers. If they did not learn from their experience at all — well that is another matter. Now go have this discussion with an ER doc on the ward and see if he or she has time for your asinine and tendentious complaining.

          • Anoneuoid says:

            But you don’t need to be a fortune teller to correct vitamin deficiencies with vitamins.

            For some reason they *do* require some data on that safe and cheap intervention, but not the expensive and dangerous interventions they have chosen to implement.

            • rm bloom says:

              Let me try to tease apart the main strand of the argument.
              The expensive and dangerous interventions that they “chose” to implement are choices made under duress and influx of numbers in hospitals under — and this is a great understatement — fairly remarkable circumstances. Have the ER and ICU physicians learned *nothing* in over the succeeding six to nine months? No. They have learned much. Do I need to quote chapter-and-verse to “prove” that? Nonsense. Those folks delight in sharing their discoveries, their pearls! Insights simple or complicated. Like the small but not insignificant improvements had by “proning” the patient. Under what can only be likened to wartime conditions, they have struggled and they have improvised; and some improvisations are recorded because they are helpful. It is a process as far from the pole of laboratory science or academic orthodoxy as can be gotten.

              • Martha (Smith) says:

                Very well put.

              • Anoneuoid says:

                Well, this is what happens when we do what you recommend:
                https://www.sciencenews.org/article/coronavirus-covid-19-brazil-city-manaus-herd-immunity

                Hopefully, you will care more about saving lives than being right in the future.

              • rm bloom says:

                “Hopefully, you will care more about saving lives than being right in the future.”

                Et tu, Brutus. Or is it Miss Nightengale?

              • Anoneuoid says:

                You say hospitals were under stress so the health experts chose the most expensive and dangerous interventions and that is ok.

                They also avoided the cheapest and safest interventions.

                They did what you want… and how many people died?

              • rm bloom says:

                “You say hospitals were under stress so the health experts chose the most expensive and dangerous interventions and that is ok.”

                You hear what you want to hear — you project your daemons on others’ shadows.

                I said that hospital doctors under stress do the best that they can under remarkable conditions; and that sometimes something is learned; but it is learned in hindsight. They are medics, dealing with the bodies as they come in; they are not wizards or fortune tellers. But neither are they academics of the orthodox high-church as you seem endlessly, obsessively to wish them to be (so you may paint them with your ugly, obsessive suspicious accusations, over and over and over). If they discover a trick or a pearl that makes a damn bit of difference, that gets propagated through the community *fast*. But not good enough for you.

                You seem to insist that they play some “role” — the role of the obdurate and useless orthodox. You are the playwright and you can write your play anyway you wish; and assign the roles as you wish. But if one day you yourself end up in an ER, and god-willing you will not, you will see the difference; between what you imagine they are and what they actually are. It is remarkable, but there are people in this world who put their lives on the line to help others in the most remarkably tense and dread-filled situations. Some of those are doctors.

              • Anoneuoid says:

                I think doctors are mostly people trying to do their best making decisions based on what millions of fog brained people trained in NHST came up with.

                If you require higher standards for cheap and safe interventions than expensive and dangerous interventions, as has been made obvious to anyone paying attention in the last year, you will not make good decisions. This will harm many, many people.

              • rm bloom says:

                “I think doctors are mostly people trying to do their best making decisions based on what millions of fog brained people trained in NHST came up with.”

                Really! Their practice, their clinical experience, that of their colleagues, the reports of their patients, the world about — it all counts for nothing in your conspiratorial view. The only thing that counts, on this view, is the pervasive, disseminated conspiracy of the academy, its stubborn and obdurate orthodoxy. The academy that awaits its Luther; or its Chairman Mao; to awake its sleepers from their fog of hypocrisy; to shatter it asunder.

                On this view, If a doctor in Indianola, Indiana somehow manages to set a broken finger properly with a splint, that is a revolutionary act against the tyrannical rule of the “hypothesis test”.

                They are that stupid, aren’t they?

                Your extremity distorts and spoils whatever reasonable points you have to make.

              • Anoneuoid says:

                Really! Their practice, their clinical experience, that of their colleagues, the reports of their patients, the world about — it all counts for nothing in your conspiratorial view.

                Just look what happened to Cameron Kyle-Sidell. He was forced to step down from his ICU because he refused to put any more covid patients on ventilators in March. Then he had to turn to social media and thank god was very successful in limiting that harmful practice. If it wasn’t for him there would be 10x higher CFR due to everyone following what the WHO said to do.

                Also, lots of treatments are determined by insurance companies now.

              • Anoneuoid says:

                This video from a terrified ER doctor saved more lives than anything else anyone has done: https://vimeo.com/402537849

                His message was essentially don’t apply the results of large international NHST trials like everyone is trained to do.

              • rm bloom says:

                “If it wasn’t for him there would be 10x higher CFR due to everyone following what the WHO said to do”

                If it wasn’t for him and every other practitioner on the front-lines who’ve been working 18 hours a day for months trying to do make a difference. Go seek one out … call him fog-brained, face-to-face.

              • Anoneuoid says:

                If it wasn’t for him and every other practitioner on the front-lines who’ve been working 18 hours a day for months trying to do make a difference. Go seek one out … call him fog-brained, face-to-face.

                Why would I call him fog brained? I wrote:

                I think doctors are mostly people trying to do their best making decisions based on what millions of fog brained people trained in NHST came up with.

                The fog brains are the researchers and public health organizations that devise treatment recommendations who the doctors rely on.

              • Anoneuoid says:

                “Fog brain” comes from this btw:

                “We are quite in danger of sending highly trained and highly intelligent young men out into the world with tables of erroneous numbers under their arms, and with a dense fog in the place where their brains ought to be. In this century, of course, they will be working on guided missiles and advising the medical profession on the control of disease, and there is no limit to the extent to which they could impede every sort of national effort.”

                Fisher, R N (1958). “The Nature of Probability”. Centennial Review. 2: 261–274. http://www.york.ac.uk/depts/maths/histstat/fisher272.pdf

                That is *exactly* what has been going on here.

              • rm bloom says:

                “The fog brains are the researchers and public health organizations that devise treatment recommendations who the doctors rely on.”

                Plainly we could — if we were so inclined — keep this going at least another 18-36 hours, but the audience is probably already losing interest.

                If you can pick up the emphasis however in my comments, if it does not evade you, I am saying that ER and ICU doctors are working in the field; that what they learn is learned in the bloody field; and it is not accurate for you to assume — because of some axe you wish to grind — that they are in the thrall of the orthodox academic bias you so detest, perhaps not without reason, but to which you attribute influential power akin to witchcraft.

                But because the academic contortionists cannot come through in an emergency does not mean that the truth has been concealed by them or by anyone else. Least of all by the doctors on the floor.

                The truth is a work-in-progress. When the London Blitz was at its worst, they at Whitehall figured out that morale improved when the gravity of the situation was neither exaggerated nor underplayed; but when the situation was described as accurately as they were able to do.

              • Anoneuoid says:

                Nothing you said has anything to do with me.

                Let me know when you have a justification for implementing expensive and dangerous policies before cheap and safe ones.

              • Joshua says:

                Anoneuoid –

                > don’t apply the results of large international NHST trials

                I don’t want to watch the whole video. (I think I may have watched it months ago).

                Can you tell me what he said that “essentially” was what your said? Did he mention large international NHST trials?

        • Meg says:

          As far as data for early intubation–It isn’t so much that they were choosing to intubate them earlier than they would other patients. Part of the problem is that covid presents and progresses differently. Patients are sitting at home not feeling short of breath, with O2 sats at 80%. When they finally get to the hospital they are often already past where most people with respiratory illnesses are getting treated with more than just nasal canulas. And certain alternatives aren’t available because of risk of spreading infection (e.g. constant positive airway pressure). Giving steroids to someone with an infection is it’s own risk and not usually the first thing you do when that person is older.

          My husband is an infectious disease doctor and our good friends run the ICU in his hospital system. They were preparing in mid-Jan and had some of the first cases in the eastern US. They were part of the peak that also hit NYC. At that time there was nothing TO know. No one had any guidelines to offer. The Critical care doctors were sharing information with their colleagues in other busy systems. The ID doctors were familiar with all clotting related complications (which are well known complications of infections, though less common).

          All they knew was what DIDN’T work and that people could be talking to you one minute and dead a few minutes later. It wasn’t on the recommendation of a single vocal person or group that changed how the CC docs were approaching things. It was evidence they gained by watching dozens (then hundreds) of patients die and interacting with other doctors who had spent weeks watching hundreds of patients die. Sharing complications, and findings and alternate treatments and how those worked. Eventually they may have become guidelines that other areas were able to take advantage of, but in the first month or two they were desperately keeping their head above water relying on decades of experience treating other diseases.

          And also, living in fear that they might get sick themselves or get their family members sick (we didn’t spend any time in the same room of our house from Jan – August). He started a Pepys style plague diary.

    • norwood says:

      This family of websites – including c19study.com, c19hcq.com, hcqmeta.com, and hcqtrial.com – is odd on many levels. For one, why have an entire family of websites run by the same person/people to say basically the same thing?

      Version 1.0 of hcqtrial.com (available on Internet Archive at https://web.archive.org/web/20200805140535/https://hcqtrial.com/) purported to conduct a “country-randomized clinical trial.” Needless to say no such thing exists, much less one where country data was being derived from – among other sources – Twitter posts. Subsequent versions walked back that claim.

      The websites are all anonymous, claiming to be published by “PhD scientists” who are published “in journals like Science and Nature,” but who can’t say their names because of some vast conspiracy against hydroxychloroquine. Oh. All righty, then!

      • rm bloom says:

        Some years ago there were raccoons in the yard; and in the basement; and in the attic; and in spite of my assiduous efforts to trap them (they are too clever for that), and my reluctance to shoot them (a shot in the night runs the risk of a police-call, but air-guns are too weak) I decided to look for a trapper (a trappist?). The internet and — this was a while ago — the yellow-pages had numerous listings for animal trappers all around the great county of then our residence. Too many to choose from! Ach! How to decide? Pick a few at random. The calls all go to (this was then a few years ago) various answering service exchanges. As the data collects (call backs and slips of the tongue by the exchange operator) it transpires that this great community of animal trappers, advertising their services for the householder not fleet of knife or trap or rifle — this apparent vast well of talent, and telephone exchanges, full-page advertisements and web-sites … *all* of it (this is not an exaggeration) were but an ephemera — they were a complex, graded web of tributaries all leading to exactly *two* — TWO — trapping operations (trappists?); one in the far south of the metro area and one on the other side of gap in the great range of mountains on the north. Two puny little firms; too overburdened to make firm commitment in time; but with great devotion to cause and with alacrity, promising they and only they are the ones you’d best to trust; and do *not*, mind you, do not take your chances with a raccoon, gun or knife or net or cage or otherwise: They’ll get the best of you yet!

        • Martha (Smith) says:

          Speaking of raccoons: I read or heard somewhere today (but don’t recall where and haven’t been able to find it on the web) that typhus (which is spread by fleas from raccoons and possums, both of which are common here) has symptoms similar to the early symptoms of COVID, so people here who have COVID-like symptoms should be tested for typhus.

          • Martha (Smith) says:

            I found the website. It wasn’t something I found on the web; it was in an email from my neighborhood list serve. It said:

            “my husband was diagnosed with typhus yesterday after 3 weeks of illness, including 3 days in hospital last week :( i have had it for just over a week.

            the doctor said there was an outbreak both in [my neighborhood and another Austin neighborhood], from fleas carried into the ‘hood by possums & raccoons. apparently the previous bad outbreak was in 2009…

            the symptoms are similar to covid except without respiratory issues – one reason the diagnosis took so long.

            the good news is there is an antibiotic that specifically targets typhus and one apparently begins feeling better within 48 hours of taking it.

            thought it might be useful for anyone else in the hood suffering similarly!”

          • rm bloom says:

            I used to have a hell of a problem trying to persuade my mother not to leave the cat-food out for the raccoons. The cats and the raccoons actually got along very well in those days. She looked upon their getting along fondly, idealistically. That’s the model: the lion and the lamb. Or the lion and the bear? In Chinese, they call Raccoons “Huan-Xiong” which means “washing bears” — for the way they like to wash their paws. But I was worried about communicable diseases. Like many things, those worries were superseded by other worries and now it is all safely in the realm of the fireside tall-tale. Or should it be ring-tail?

  7. Joshua says:

    The Ivermectin stuff is interesting.

    There are many related issues that cross over with much of the discussion on this blog

    From my perspective the people promoting that treatment don’t do themselves any good by employing some of the research methods described in the following article:

    https://www.medscape.com/viewarticle/942995

    Also this article is interesting:

    https://www.medpagetoday.com/infectiousdisease/covid19/90

  8. paul alper says:

    Andrew says: “it appears that some large fraction of people in their seventies in this country believe in outlandish conspiracy theories.”

    As it happens, I went through my seventies quite a while ago and I can tell one and all that outlandish conspiracy theories are espoused by a far greater proportion of the U.S. demographic population than readers of this blog might imagine. Try this one on for size:

    https://stevepieczenik.com/2021/01/13/6274/

    Note that Pieczenik is 77, and formerly with the CIA, possesses a Ph.D and an MD. Note too that the interviewer is Alex Jones, who is still in his forties, and even he is dumbfounded by what he is hearing. Jones and his viewers simultaneously believe that the Covid-19 virus is a hoax and is extremely deadly–>it is a beta test by the ChiComs, Bill Gates and George Soros designed to emasculate most of us. And, of course, 9/11 was a put-up job. Ditto the various mass shootings at schools.

  9. oncodoc says:

    I’m 75, and I slept 7.5 hours last night. Influenza is an RNA virus whose first outbreak in human populations caused the 1918-1920 pandemic that killed somewhere between 17-100 million people. Additionally, it appears to be responsible for the development of Parkinson’s disease in some of the survivors. Saying that the current airborne respiratory RNA virus pathogen is no worse than the flu does not comfort me. This research took me 4.8 minutes.

  10. Fred says:

    40% of Americans believe humans were created within the past 10,000 years or so.
    I imagine most readers of this blog find that to be outlandish, if not a conspiracy theory.
    But of course to those 40% of Americans, the belief that humans evolved over millions of years must seem pretty outlandish.
    Really, one thing we can all agree on is that a substantial portion of Americans hold outlandish beliefs.

    • confused says:

      I actually wonder about that “40% of Americans” statement (which I’ve seen repeatedly, with slightly different percentages). I would *love* to see what the actual wording of the survey question was, because I think that could give huge variations in response.

      I would think that there are rather a lot of Americans who are neither committed young-earth creationists, nor know enough about how evolution actually works to be really convinced *they* know why it is true, as opposed to simply being told it is true (the high-school explanation of evolution is IMO not well suited to countering arguments against it).

      • Martha (Smith) says:

        I remember being taught when I was thirteen that “Evolution is the slow and orderly process by which God has created all things and still is creating new things”.

      • Fred says:

        https://news.gallup.com/poll/261680/americans-believe-creationism.aspx

        Which of the following statements comes closest to your views on the origin and development of human beings?

        1) Human beings have developed over millions of years from less advanced forms of life, but God guided this process

        2) Human beings have developed over millions of years from less advanced forms of life, but God had no part in this process

        3) God created human beings pretty much in their present form at one time within the last 10,000 years or so

        —————————————–

        In my opinion, this is a pretty well-worded survey with minimal ambiguity.

        • confused says:

          Ok, thanks. That does look pretty good.

          Although I know some people whose position is essentially “I believe God was involved, I don’t know or care about the details or whether it took six days or a billion years” – I wonder what they would have answered…

        • Anoneuoid says:

          What is with “less advanced forms of life”? This question assumes a pretty standard misconception/fallacy:

          Finally, the whole idea of “progress” doesn’t make sense when it comes to evolution. Climates change, rivers shift course, new competitors invade — and an organism with traits that are beneficial in one situation may be poorly equipped for survival when the environment changes. And even if we focus on a single environment and habitat, the idea of how to measure “progress” is skewed by the perspective of the observer. From a plant’s perspective, the best measure of progress might be photosynthetic ability; from a spider’s it might be the efficiency of a venom delivery system; from a human’s, cognitive ability. It is tempting to see evolution as a grand progressive ladder with Homo sapiens emerging at the top. But evolution produces a tree, not a ladder — and we are just one of many twigs on the tree.

          https://evolution.berkeley.edu/evolibrary/misconceptions_teacherfaq.php#a3

          In fact once you make that judgement then you need to explain why evolution seems directed to produce ever more “advanced” life forms.

          • Martha (Smith) says:

            I tend to think of “progress” (with accent on the first syllable) as implying some sort of “improvement” (or getting closer to a goal), but “progress” (with accent on the second syllable) as just describing change, with no implications of improvement.

            • Anoneuoid says:

              Humans are about 0.01% the biomass of the earth and mammals 0.4%, while plants are ~81% and bacteria ~13%:

              https://www.pnas.org/content/115/25/6506

              The question is: by what measure are humans (and presumably mammals) “more advanced” than plants and bacteria?

              • Martha (Smith) says:

                Anon said “The question is: by what measure are humans (and presumably mammals) “more advanced” than plants and bacteria?”

                The only way I can consider mammals as “more advanced” than plants and bacteria is in the sense that they evolved later. Otherwise put: organisms evolved later than their predecessors. I think “advanced” is a poor choice of word, since it may have the connotations of “better”, but I don’t see any reason why “later in the chain” should imply “better”.

              • @Martha Sorry, but this doesn’t make sense. First of all, mammals diverged from other organisms around 300 M years ago. Flowering plants — about the same, or *later.* (“Another possible whole genome duplication event at 160 million years ago perhaps created the ancestral line that led to all modern flowering plants” https://en.wikipedia.org/wiki/Flowering_plant#Evolutionary_history).

                Second, none of this means anything evolved sooner or later than anything else; everything has been evolving before and since. The bacterium has a chain of ancestors that goes back exactly as long as your chain; the processes of variation and natural selection didn’t pause for either of you.

              • However, humans are bacterial/chemical/electric organisms (machines) while plants and bacteria just feed/live on us?

            • It’s hard to really pin down what is meant by progRESS but it’s clear what is meant by progROCK, and it’s obviously the pinnacle of symphonic musical achievement. The solution is perhaps to ask a Moonchild, or Talk To the Wind, or have enough Discipline to find a Fallen Angel.

    • Joshua says:

      Fred –

      > Really, one thing we can all agree on is that a substantial portion of Americans hold outlandish beliefs.

      Funny.

    • Andrew says:

      Fred:

      Sure. If my correspondent had asked me why scientist X was a Biblical fundamentalist, I would’ve said something like, 40% of Americans are Biblical fundamentalists, so it’s no surprise that many scientists hold this view too. I pointed toward political conspiracy theories because my correspondent was asking me about a prominent scientist who had beliefs that were bordering on political conspiracy theories.

  11. Thomas Lumley says:

    There was good reason for initial skepticism on ivermectin. In contrast to some of the other repurposed drug candidates, ivermectin has a well-understood and very specific action (in its usual use), blocking glutamate-gated chloride channels that arthropods and worms have but vertebrates don’t. This selective action gives it an incredible therapeutic index, but would also make one a bit dubious that it would work anywhere near as well on coronaviruses as on worms. On top of that, the first published in vitro experiments showing effects against SARS-2-CoV were at much higher concentrations than the usual treatments would achieve in humans (orders of magnitude higher) but still were being quoted as supportive, which is a bit of a red flag. Derek Lowe wrote about it here: https://blogs.sciencemag.org/pipeline/archives/2020/05/11/whats-up-with-ivermectin

    Now, just because there were reasons to be dubious doesn’t mean it *couldn’t* work in real life, and maybe it does, but the doubts were at least reasonable at the time.

  12. Charles Carter says:

    It is difficult enough to use statistics to make clinical decisions when good science is available- generally RCTs in applicable populations.
    Sadly the current pandemic has revealed just how little practitioners and academics alike actually concern themselves with good evidence. Not a new problem, we see immense numbers of missed opportunities wherein academics seem to each operate in their own silo. Lots that may be fascinating to a very few, lots that pads one’s CV and possible h-index. Relatively little that can be applied with confidence to patients. Some practitioners seemingly act out of desperation which more often than not is a formula for trouble.

    • Martha (Smith) says:

      Charles Carter said,
      “It is difficult enough to use statistics to make clinical decisions when good science is available- generally RCTs in applicable populations.”

      But one also needs to take into account the quality of those RCT’s. Many are poor quality; many practitioners do not have the statistics background to evaluate the quality of the RCT’s. And, as I think many of us reading this blog are aware, having results published in a peer-reviewed journal is not evidence of high quality — the quality of the paper depends on the quality of the author’s (and of the peer reviewer’s) understanding (or lack of understanding) of experimental design, statistical analysis, and interpretation of statistical claims.

    • Martha (Smith) says:

      Sad, but likely often true.

  13. Renzo Alves says:

    Statistics isn’t enough.

    Recommended reading. “Survey Questions: Handcrafting the Standardized Questionnaire”, by Jean M. Converse and Stanley Presser, 1986, Sage Publications.

    The meaning of the answers depends on the questions and the context.

  14. Joshua says:

    Andrew –

    > If you think of a simple additive model, you might say that given this person’s scientific expertise you think he’d be more grounded in reality, but his demographics would suggest otherwise.

    I’m really not feelin’ the “demographics” thing. I’d say his age demographic is not very informative at all. Are scientists over 70 more likely to believe in conspiracy theories than younger scientists? Maybe in the margins but I’d say all in all it wouldn’t work very well as a predictive variable. At most, I’d say it might be more likely to be some kind of a moderator variable.

    What I see is an accomplished scientist who is very confident in his analytical skills, who looked at a bunch of lines on a graph on his computer screen, and thought he could fit him some curves. So he decided that infections would burn out at less than 20% of a population infection rate. And then he worked backwards from that to fit a lot of other evidence to conform to his theory. And he began to see himself in a position of saving millions of lives by reducing fear and panic and showing how views of widespread death from the pandemic were alarmist and unfounded. Now there was a moral imperative to standing behind his scientific viewpoint.

    The problem is that in not having much of any previous relevant expertise, he also had no theory of mechanism for what would move those lines on his screen up and down. So really, he was just guessing. And then once he made his guess and began to fit other evidence to conform to his guess, he had to defend his position. So criticism wasn’t incorporated into his hypothesis, but seen as a sort of personal threat to his status and sense of self, as well as a moral threat. From there you get to a belief that there is some larger alignment that discredits the people who disagree with him as some kind of collective block of “others.” And from there it’s just a short step to conspiracy ideation (said individual has expressed sympathies for the “follow the money”, profit motive skepticism regarding vaccines).

    There was a breakdown in his scientific process.

    In a similar vein, I see no reason why someone’s age would supply some kind of explanation of causal mechanism for his scientific views. I think that in some way finding a meaningful causal explanation in his age is following in a similar line of mistake as that he made: avoid suggesting causality if you don’t have a good causal mechanism. Now maybe you do have a good working theory as to why age would be causally associated with conspiracy ideation. If you do, what is it?

    > Why do we hear from this guy? It’s selection bias. If he were saying the same thing that more sane scientists were saying, then he wouldn’t need to scream on twitter, and nobody’d be talking about him, more than they’re talking about various other people with general scientific credentials who have conventional opinions on topics on which they have no particular expertise.

    That, I agree with. What’s funny to me is that many of the people who look to this fella as a go to on the pandemic very often push back against references to the credentials of “experts” they disagree with as being fallacious “appeals to authority.”

  15. Amy says:

    Joshua and Andrew,

    Here’s some detailed evolutionary history: https://liorpachter.wordpress.com/2020/09/21/the-lethal-nonsense-of-michael-levitt/

    You know, I started this discussion to better understand the mentality of this one scientist, but what I have learned since has shifted my interest to the pandemic-denial movement among so-called intellectuals as a whole. **’s motivation may be sui generis, and he may be mostly a useful fool. More important is the role of libertarians such as Peter Thiel, who fancies himself a superior intellect, but whose influence is a result of the vast sums of money he can throw around at Stanford and elsewhere, a la Jeffrey Epstein. Even the literature department at Stanford is in on the game: Thiel evidently cites the literature department as a source of his investment acumen, and he actually teaches a course in the department! (Happened on that plum here: https://podcasts.apple.com/us/podcast/entitled-opinions-about-life-and-literature/id81415836?i=1000474016870)

    I am sensitized to the role libertarians play in the tech world because of the experience of a college student I know. He entered college intending to major in computers/AI, but found the department full of rabid libertarians who he couldn’t bear to spend his time with.

    If Thiel was able to influence the disastrous Trump administration coronavirus policies through Scott Atlas and the other pandata “scientists” that’s horrifying, and a major story of our times.

    Thiel’s wikipedia page is downright scary. Here’s an example: “…I no longer believe that freedom and democracy are compatible… The 1920s were the last decade in American history during which one could be genuinely optimistic about politics. Since 1920, the vast increase in welfare beneficiaries and the extension of the franchise to women—two constituencies that are notoriously tough for libertarians—have rendered the notion of “capitalist democracy” into an oxymoron… In our time, the great task for libertarians is to find an escape from politics in all its forms… Because there are no truly free places left in our world, I suspect that the mode for escape must involve some sort of new and hitherto untried process that leads us to some undiscovered country; and for this reason I have focused my efforts on new technologies that may create a new space for freedom.”

    These are his favorite causes: Through the Thiel Foundation, Thiel governs the grant-making bodies Breakout Labs and Thiel Fellowship, and funds nonprofit research into artificial intelligence, life extension and seasteading. WTF?

    • Joshua says:

      Amy –

      He really is quite something.

      > is to find an escape from politics in all its forms… Because there are no truly free places left in our world,

      “No truly free places left.” Which implies that there once were some. So as a world we were more “free” with serfdom? Or maybe when people handled the distribution of caves by hitting each over the head with clubs?

      In my experience in talking online with people who identify as libertarian, their thinking is often based on a view that Shangri-la exists somewhere, and that place is heaven-like because no one pays taxes (other fundamental beliefs include binary thinking and the belief that there are worse unintended consequences than indented in everything government does except what they want government to do).

      That quote is very much in line with my experiences.

      • confused says:

        I have to say that I’m not even sure what that is trying to say.

        The “no truly free place left” comment isn’t necessarily out of line with classic libertarianism (though I think in *that* case the people saying it would mean something more like “no place not part of an existing government, where new structures can be created” — not necessarily that “perfect freedom” had existed in the past) — but ‘not compatible with democracy’ and that bit about women gaining the franchise? wtf???

        I always thought the libertarian ideal in terms of *form* of government was something like the early New England town-hall democracy or something (though without the blue laws & other restrictive laws that existed then)?

        • Joshua says:

          confused –

          > I always thought the libertarian ideal in terms of *form* of government was something like the early New England town-hall democracy or something (though without the blue laws & other restrictive laws that existed then)?

          But wouldn’t that be an idealized, and unrealistic illusion? For whom was an early New England town-hall democracy more “free?” Obviously not women or African Americans or gay people or Muslims or atheists or I’d guess even poor people or anyone other than wealthy land-owners?

          My point is that there always seems to me to be an unrealistic idealization of some real world Shanrgi-la that never has existed and never will. It’s like they think it’s a mere coincidence that on the entire planet there is no place that protects things they want like “property rights” and that also meets their criteria for being free;

          I will say that having gone to some zoning meetings to apply for a variance at the town hall in my smalliah/ruralish town in the Hudson Valley, its a pretty inspiring form of democracy. But there’s certainly the potential for petty fiefdom types to wield power in a way that certainly doesn’t look like the epitome of “freedom” in my eyes.

          Just to point out, I’m not talking about a lot of libertarians – say a Bill Weld type, and indeed I share a lot of concerns with libertarians about “government overreach.” I”m more talking about what I consider to be extremist ideologues who happen to call themselves libertarians. Seems to me that Thiel falls into that category.

          • confused says:

            >>But wouldn’t that be an idealized, and unrealistic illusion? For whom was an early New England town-hall democracy more “free?” Obviously not women [etc..]

            Well by saying “form” I was trying to separate the structure of the government (a democracy with low bureaucracy and a mix of direct-democracy and representative-democracy elements) from things like what laws are in fact passed or who gets the franchise etc.

            I mean some towns in New England still use that structure and now everybody has the franchise, so there is nothing specific to the structure which is incompatible with a broad franchise.

            In fact rural New England, “interior Northwest” places like South Dakota and Montana, and Alaska have some fairly strong libertarian trends to them and are in some ways less “binary” politically than the rest of the US — the two Independent senators are from Vermont and Maine, and Senator Murkowski from Alaska though currently a Republican once was re-elected on a write-in when someone else won the Republican primary.

            One of the odder things to me is that more wealthy libertarians in the US don’t move to these places and focus their efforts/money on strengthening the already-existing libertarian-like trends there. As much as the federal government has genuinely become much larger since (say) FDR’s time, state governments still have huge power.

            >>Just to point out, I’m not talking about a lot of libertarians – say a Bill Weld type, and indeed I share a lot of concerns with libertarians about “government overreach.”

            Yeah, my major problem with libertarianism per se is that I think there are some problems it’s just not well equipped to deal with (environmental issues being probably the largest, but also I think many libertarians would tend to think of other “long-term planning” aspects of the government as wastes of money).

            I do think that since increases in government power tend to be very hard to reverse, there ought to be a fairly high bar/burden of proof to creating new government programs/giving governments more power. But I think more things have met that bar than a libertarian would agree to.

            >> I”m more talking about what I consider to be extremist ideologues who happen to call themselves libertarians. Seems to me that Thiel falls into that category.

            Well the “democracy incompatible with freedom” quote sounds even weirder than standard libertarianism taken to an extreme, IMO.

      • rm bloom says:

        There is “free space” in a hole in the ground; where they who suppose their lives depend upon no one else but themselves may go to live — to prove the point. There, underground, they may live and die, subsisting on roots and rotting tree stumps in their imaginary mole-world. All so they may say in the end they did it “their” way. But when they decide they want to drag the others in the company down the mole-hole with them … that is an entirely different proposition.

        • confused says:

          I think the idea is that “back when”, you could just go out into the wilderness and set up a new community outside existing structures, like a bunch of ‘utopian’ planned towns from the 19th and early 20th centuries; but now everything is nailed down.

          But I’m actually not sure how much this is true. I don’t know what would really keep someone rich enough from setting up a utopian planned town like the Post cereal company guy did with Post, TX, for example.

          I mean, I guess the issue is that they’d still have to deal with income tax and OSHA and stuff whereas none of that existed in 1900.

          But I think this also implies is a very superficial view of US history. The 1910s actually had some trends in government which we’d now see as pretty totalitarian-leaning – eugenics, free speech much more restricted than would now be considered Constitutional, etc.

          It is true that the *size* of government has generally grown over US history, which may be a problem, but is not the same thing as decreasing freedom.

  16. Brent Hutto says:

    confused said: “It is true that the *size* of government has generally grown over US history, which may be a problem, but is not the same thing as decreasing freedom.”

    For a fundamentalist libertarian, being taxed one single dollar that ends up paying for something you disagree with means you are not free. So by that reckoning, any increase in the size or scope of government is equated to a decrease in “freedom”. Because any real-world government is going to do something that someone disagrees with.

    • confused says:

      Sure – but even accepting that axiom, if that increase in size is happening simultaneously with the removal of actively oppressive government actions, that doesn’t mean a *net* decrease in freedom over time — even if the increase in size itself does ultimately reduce freedom.

      So I don’t think even a consistent fundamentalist libertarian could really say the US was “more free” immediately before 1920 or whatever, because there was more outright oppressive stuff even if the federal government had less expansive reach.

      However – if one is talking specifically about the *federal* government, maybe. Espionage Act, sure, but most of the really oppressive stuff (Jim Crow, Eugenics, etc.) was state level.

      But the thing that really strikes me as paradoxical/inconsistent is the “incompatible with democracy” bit, what other form of government would be better in that regard? I would think that if one thinks the US is sliding toward less freedom, that would imply a desired form “kind of like the US but with much stronger constitutional limitations on government and without the ability for the Supreme Court to use judicial review to weaken the limitations”.

      • Brent Hutto says:

        But again, a fundamentalist libertarian is not thinking about what you categorize as “oppressive” government actions. They feel just as “oppressed” by being taxed to pay for someone else’s health insurance as they are by subject to a Eugenics order.

        • Anoneuoid says:

          Libertarians think there will always be a biggest gang, and government is an attempt to have some control over that. So whatever you are talking about is a strawman.

        • confused says:

          Perhaps. I guess I’m thinking of somewhat less “fundamentalist” libertarians.

          But I do think that a lot of this history is genuinely not well known — probably because US history tends to be taught in terms of an inevitable march of increasing freedom. But this narrative requires a lot of things between Reconstruction and the 19th Amendment, and between the 19th Amendment and the Civil Rights Era, to be skipped over quickly.

        • rm bloom says:

          There must be a nesting of these categories along a certain continuum.

          So I suppose there are those who on high principle will not accept the shame of using public sewers, roads; and who’d rather die in bed then let the fire-department put out the fire that’s consuming ’em.

          Thirty or forty years ago or more, family members often had one of these figures living out his days in a third-floor apartment. When the old folks passed, they’d generally end up wards of the public trust; free to complain about the bolsheviks round the corner; while of course the state looked after them.

          Now they live their days out parked in cars, or trailers. But the guns make ’em feel like *they* call the shots.

          • Joshua L Brooks says:

            rm –

            > So I suppose there are those who on high principle will not accept the shame of using public sewers, roads; and who’d rather die in bed then let the fire-department put out the fire that’s consuming ’em.

            Government is only awful when other people get stuff, not when they get stuff. And they’re fine if a store owner relies on a black cop to protect his/her store, but won’t allow the cop to be a customer because he’s black.

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