I think Zvi is (still) overly confident in pessimism (or, at least, headline-Zvi, as opposed to actual-content-Zvi, which is somewhat more hedged). The new variant is probably pretty bad and the distribution of predictions should look worse compared to what it did a week ago—but there is a ton of uncertainty still, and the headline is unjustified.
Sidenote on predictions: Zvi previously predicted that social distancing would be a thing of the past by the time summer ended, that COVID-19 would cease to be the dominant news story (which would remain the case indefinitely), and that we would have given up to the point of approaching herd immunity by now. Social distancing, though weaker than it once was, is still very much in effect, COVID-19 continues to be the dominate our collective attention, and we have limited the pandemic to the point where we can still potentially save millions of lives with the vaccines.
Zvi and many others on LW (including myself in this) totally failed to predict how people in the US would react to this virus. From this, I’ve updated that we’re bad at predicting how politics and humans will respond to novel unexpected events, and probably a bit overly pessimistic about other humans’ ability to be persuaded by rational argument and Real Bad Stuff happening.
I think that predicting the course of the disease or predicting whether a certain variant is more infectious is mostly a different kind of prediction from predicting people’s behavior.
Unfortunately, people’s behavior in response to the new strain is also really important for how bad it will get, so ¯\_(ツ)_/¯
a bit overly pessimistic about other humans’ ability to be persuaded by rational argument and Real Bad Stuff happening.
I am surprised that you say “overly pessimistic”? It seems that the outcome we got of hovering around R=1 with the economy being shut down in large parts for almost a full year was basically the worst-case outcome, with nobody I know being pessimistic enough about how bad it went (it appears to me that the costs of runaway heard immunity would have been drastically less, especially given that we are likely to reach something like 40% prevalence anyways before the vaccine).
Depends on what you mean by “pessimistic,” I guess. I think my model back in March was that basically everyone would dismiss COVID as being “like the flu”; tons of people would die; but no one would really pay much attention to it.
Instead, people actually freaked out about it and lots of people actually got overly into enforcing quarantine restrictions on each other. I was expecting that people would fail to even parse the small chance of death by COVID as sufficiently important to be worth worrying about, and that didn’t turn out to be true.
I agree that the real outcome is much worse than we could have done overall, with e.g. mass testing or challenge trials—though I don’t agree that this is clearly worse than runaway herd immunity. Back-of-the-envelope calculation: if 1% of the US population died of COVID, that’s around 3 million deaths, which in VSL terms is around $30T. The US’s GDP for one year is around $20T. My error bars on the validity of VSL at that scale are pretty large, as is my uncertainty about comparing GDP to VSL, and other non-GDP considerations of lockdown… but the two certainly seem comparable in magnitude, and I weakly think that lockdown is better in terms of total social utility.
(edit: of course we’re at ~300k deaths now, which changes the analysis by 10% or so; still seems like the calculation comes out about the same as of right now. The effect of another huge wave could change this calculation substantially.)
It is very unlikely that we would have gotten to 100% prevalence in any world, which would be necessary for 1% of the U.S. to die. With all the superspreader dynamics, you would likely reach heard immunity at something like 50% prevalence, maybe even less than that, and we are about 40% of the way there. This also completely ignores age-related effects. The average life-years lost per covid death is ~10-15, since the average person who dies of COVID is much older.
This all results in a VSL closer to 1/10th of the value you cited (~2 for only getting to 50% prevalence and a factor of 5 for age-related effects). Then, if you take into account that we aren’t actually on track to prevent most of the relevant deaths (we are already at 20% historical prevalence and are likely to reach 30%-40% before widespread vaccine adoption, suggesting that we are likely to end up with 60-70% of the relevant deaths, compared to the world with zero lockdowns), the numbers really aren’t looking good.
This makes the total calculation come out to more something like a counterfactual $1T in VSL terms. I think with that, it’s looking pretty unlikely to me that the lockdowns we had were worth it, even just taking into account the economic effect of this year (not to mention that the total impact and length of lockdowns is likely to extend substantially into 2021). I also think this year will have a large number of highly negative long-run effects on institutions, political tension and long-term health for lots of people that will make the overall cost of the lockdown greatly exceed the deaths that were prevented.
Back in March, there was a lot of concern that uncontrolled spread would overwhelm the medical system and some hope that delay would improve the standard of care. Do we have good estimates now of those two effects? They could influence IFR estimates by a fair amount.
Also, my understanding is that the number of infections could’ve shot way past herd immunity levels. Herd immunity is just the point at which the number of active infections starts declining rather than increasing, and if there are lots of active infections at that time then they can spread to much of the remaining people before dwindling.
Habryka’s point is that roughly the same number of people would’ve died either way, because in both situations the same number of people will get it – something like 40%. But in one of them we *also* shut down the economy for over a year. That’s why it’s the worst of both worlds – worst of deaths, worst of economy.
You can consider it, but you cannot get it in most Western countries. Either way, it doesn’t change Habryka’s point that we’re currently in the worst possible world.
Have a look at the state of Victoria in Australia, which went from close to 700 cases a day in early August to zero in about 8 weeks. https://www.covid19data.com.au/victoria
Anonymous comments from Dec. 26:
Zvi and many others on LW (including myself in this) totally failed to predict how people in the US would react to this virus. From this, I’ve updated that we’re bad at predicting how politics and humans will respond to novel unexpected events, and probably a bit overly pessimistic about other humans’ ability to be persuaded by rational argument and Real Bad Stuff happening.
I think that predicting the course of the disease or predicting whether a certain variant is more infectious is mostly a different kind of prediction from predicting people’s behavior.
Unfortunately, people’s behavior in response to the new strain is also really important for how bad it will get, so ¯\_(ツ)_/¯
I am surprised that you say “overly pessimistic”? It seems that the outcome we got of hovering around R=1 with the economy being shut down in large parts for almost a full year was basically the worst-case outcome, with nobody I know being pessimistic enough about how bad it went (it appears to me that the costs of runaway heard immunity would have been drastically less, especially given that we are likely to reach something like 40% prevalence anyways before the vaccine).
Depends on what you mean by “pessimistic,” I guess. I think my model back in March was that basically everyone would dismiss COVID as being “like the flu”; tons of people would die; but no one would really pay much attention to it.
Instead, people actually freaked out about it and lots of people actually got overly into enforcing quarantine restrictions on each other. I was expecting that people would fail to even parse the small chance of death by COVID as sufficiently important to be worth worrying about, and that didn’t turn out to be true.
I agree that the real outcome is much worse than we could have done overall, with e.g. mass testing or challenge trials—though I don’t agree that this is clearly worse than runaway herd immunity. Back-of-the-envelope calculation: if 1% of the US population died of COVID, that’s around 3 million deaths, which in VSL terms is around $30T. The US’s GDP for one year is around $20T. My error bars on the validity of VSL at that scale are pretty large, as is my uncertainty about comparing GDP to VSL, and other non-GDP considerations of lockdown… but the two certainly seem comparable in magnitude, and I weakly think that lockdown is better in terms of total social utility.
(edit: of course we’re at ~300k deaths now, which changes the analysis by 10% or so; still seems like the calculation comes out about the same as of right now. The effect of another huge wave could change this calculation substantially.)
It is very unlikely that we would have gotten to 100% prevalence in any world, which would be necessary for 1% of the U.S. to die. With all the superspreader dynamics, you would likely reach heard immunity at something like 50% prevalence, maybe even less than that, and we are about 40% of the way there. This also completely ignores age-related effects. The average life-years lost per covid death is ~10-15, since the average person who dies of COVID is much older.
This all results in a VSL closer to 1/10th of the value you cited (~2 for only getting to 50% prevalence and a factor of 5 for age-related effects). Then, if you take into account that we aren’t actually on track to prevent most of the relevant deaths (we are already at 20% historical prevalence and are likely to reach 30%-40% before widespread vaccine adoption, suggesting that we are likely to end up with 60-70% of the relevant deaths, compared to the world with zero lockdowns), the numbers really aren’t looking good.
This makes the total calculation come out to more something like a counterfactual $1T in VSL terms. I think with that, it’s looking pretty unlikely to me that the lockdowns we had were worth it, even just taking into account the economic effect of this year (not to mention that the total impact and length of lockdowns is likely to extend substantially into 2021). I also think this year will have a large number of highly negative long-run effects on institutions, political tension and long-term health for lots of people that will make the overall cost of the lockdown greatly exceed the deaths that were prevented.
Back in March, there was a lot of concern that uncontrolled spread would overwhelm the medical system and some hope that delay would improve the standard of care. Do we have good estimates now of those two effects? They could influence IFR estimates by a fair amount.
Also, my understanding is that the number of infections could’ve shot way past herd immunity levels. Herd immunity is just the point at which the number of active infections starts declining rather than increasing, and if there are lots of active infections at that time then they can spread to much of the remaining people before dwindling.
I agree
Well, the financial costs would have been. How much value are you assigning to a life?
Habryka’s point is that roughly the same number of people would’ve died either way, because in both situations the same number of people will get it – something like 40%. But in one of them we *also* shut down the economy for over a year. That’s why it’s the worst of both worlds – worst of deaths, worst of economy.
You mean it’s a comparison between no shutdown and ineffective shutdown? Why not consider effective shutdown as a further alternative?
You can consider it, but you cannot get it in most Western countries. Either way, it doesn’t change Habryka’s point that we’re currently in the worst possible world.
For some value of “we”.
(Sharing because I wanted this comment to be part of the centralized discussion on LW, not because I endorse the comment.)