As I see it, there have been two major pieces of information that have moved my estimates in a positive direction, one is about the nature of the virus being somewhat less deadly/hard to suppress than the consensus here said in early March, the other about the nature of the response to it. The first piece of news is some good luck we’ve had with the nature and spread of Covid, but the second of these is much more generally relevant, and even applies to X-risks. You summarised both together, but I’m going to separate them for that reason.
All that said, the growing (not total, but mostly shared) consensus among both folks I’ve talked to inside Google and with academic epidemiologists who are thinking hard about this is:
Lockdowns, including Western-style lockdowns, very likely drive R substantially below 1 (say .7 or lower), even without perfect compliance. Best evidence is the daily death graphs from Italy, Spain, and probably France (their data’s a mess): those were some non-perfect lockdowns (compared to China), and you see a clear peak followed by a clear decline after basically one time constant (people who died at peak were getting infected right around the lockdown). If R was > 1 you’d see exponential growth up to herd immunity, if R was 0.9 you’d see a much bigger and later peak (there’s a lot of momentum in these systems). This is good news if true (and we think it’s probably true), since it means there’s at least some room to relax policy while keeping things under control. Another implication is the “first wave” is going to end over the next month-ish, as IHME and UTexas (my preferred public deaths forecaster; they don’t do R) predict.
What we have learned is that Western-style lockdowns work, in a fairly diverse range of governments with a fairly wide range of competence in approaching this situation, R has been driven to some number noticeably below 1, and not hovering around 1.There were several commentators arguing (perfectly reasonably, based on the one data point we had in mid-March) that only Wuhan-style lockdowns with case isolation, soldiers welding people into their homes and thousands of door-to-door contract tracers were sufficient to turn R substantially below 1. Luckily, we do not live in that world, and for that we should be grateful. This may connect to the other weird finding—that in many places (basically everywhere except NY, Italy, Spain), hospitals haven’t been overwhelmed the way they ‘should have’ based on our best knowledge in early March.
London hasn’t exceeded its hospital or ICU capacity (though its capacity was recently doubled with the new Nightingale hospital, it has hardly been used), and it has about half of the infection rate of New York—with one estimate here being that the infection rate was 7% in London on the 2nd of April—those cases should have long since progressed and made their way to the hospitals, yet the Nightingale still stands mostly empty (for the love of all eternity, I hope the NHS doesn’t shut the place down because ‘it wasn’t needed’). Probably, London could take New York infection rates and that would just about hit its new capacity. That fits with anecdotal evidence—I know a nurse who works in a big local hospital, and she told me that although things got pretty dicey over Easter time, with PPE being reused, operating theatres etc. being converted to beds and ICUs, and everyone working incredibly long shifts, nobody was being turned away from the ICUs like in Italy or Spain. The hospitals in London have started to empty out in the last week, as they’re ahead of the rest of the UK, and still it never reached the new capacity with a 7% infection rate before the peak (that came on April 8th, not April 2nd). Perhaps uncertainty in the Infection hospitalization rate is a better candidate than uncertainty in the IFR—has anyone checked out that 20% figure recently?
The second piece of good news is what I’d call the ‘Morituri Nolumus Mori effect’ - western governments and individuals repeatedly deciding to do the unthinkable in the face of the overwhelming threat, usually reactively, usually at the very last minute, has become a reliable pattern—one we can hopefully rely on in the future as the minimum standard for response. This isn’t mood affiliation, it has become a reasonably consistent pattern, at least in Europe and through large parts of the US.
The states, as I noted last time, will not simply reopen. They will legally partially reopen, and people will continue to take precautions above and beyond what is required of them. It will be fascinating to see what will actually happen when people are given permission to return to work. How many will do so? What would fully voluntary behavior look like? And of course, would that behavior work to contain the virus?
E.g. the UK government said lockdowns were infeasible, and then implemented one a couple of weeks later—or the fact that compliance with the lockdown measures in Europe has been generally high and is showing no signs of slackening off—or most of the simple measures that will probably happen anyway, that were mentioned in on R0 - or that concerns about contact tracing privacy and stimulus spending have evaporated in most treasuries. Combined with the key empirical fact about the virus—that reactively turning a western-style lockdown on is enough to suppress the virus in most places, we can see the shape of the next year.
We (Europe, some USA) will try to implement a test-trace-isolate scheme to suppress the virus long term without any more lockdowns. That’s the plan, but it will be incredibly difficult to implement. It might work (I’d give Europe a 50⁄50 shot, the USA as a whole somewhat less), but we will simultaneously be ‘reopening’ with heavy social distancing, both legally enforced and through individual behaviour.
If there is another acceleration, it will be slower, we will have more time to react, and we will do another lockdown in the worst case when numbers are about as bad as what prompted the first lockdown, and that lockdown will do what it did this time around except with better treatment, bigger hospital capacity (and a smaller economy).
This rough schema was suggested as what would likely happen in early March, but then it was possible to claim governments and individuals were literally asleep at the wheel and voluntarily choosing to die—that now looks much less likely (leaving aside Trump). I recall several posters responding to that claim with ‘we’re too incompotent to even make a lockdown work’ or similar—that didn’t seem impossible given what we knew then. It’s interesting to see how speculations in March about whether the Morituri Nolumus Mori effect would pull through or not. Wei Dai notably updated in the direction of thinking it would, after reading this prescient blogpost:
The interventions of enforced social distancing and contract tracing are expensive and inevitably entail a curtailment of personal freedom. However, they are achievable by any sufficiently motivated population. An increase in transmission *will* eventually lead to containment measures being ramped up, because every modern population will take draconian measures rather than allowing a health care meltdown. In this sense COVID-19 infections are not and will probably never be a full-fledged pandemic, with unrestricted infection throughout the world. It is unlikely to be allowed to ever get to high numbers again in China for example. It will always instead be a series of local epidemics.
Toby Ord summed up the Morituri Nolumus Mori effect in a recent interview:
Learning the right lessons will involve not just identifying and patching our vulnerabilities, but pointing towards strengths we didn’t know we had. The unprecedented measures governments have taken in response to the pandemic, and the public support for doing so, should make us more confident that when the stakes are high we can take decisive action to protect ourselves and our most vulnerable. And when faced with truly global problems, we are able to come together as individuals and nations, in ways we might not have thought possible. This isn’t about being self-congratulatory, or ignoring our mistakes, but in seeing the glimmers of hope in this hardship.
It is possible to reconcile this hopeful picture of our response, and this model of how we will deal with things going forward, with the very, very obvious civilisational inadequacy we have when addressing Covid—the lesson seems to be that reactivity is strong (when it’s legally allowed to be) even if availability bias, ignoring expected value and the rest make advance planning incredibly weak.
Of these two very general lessons, the first (massive inadequacy in preparation) is clearly known to all of us. But the second (reactive actions being strong) clearly came as a surprise to some people (I put significant weight on a total lockdown failure and explosive first wave, which isn’t happening) - partly because of the good luck that we’re in the timeline where R goes under 1 with an imperfect lockdown, but also because we didn’t attribute enough weight to the Morituri Nolumus Mori effect. I see it as the counterbalance to the meme of ‘civilisational inadequacy’ - both are good heuristics for predicting what is and isn’t going to be done by governments and individuals, both are important if you want to get your predictions right.
I’ve tried to tease out those general lessons because I think they can apply to any other rare, catastrophic risk, including X-risks. I note that Will Macaskill made reference to the Morituri Nolumus Mori effect in a pre-covid interview, explaining why he puts the probability of X-risks relatively low. Gates also referred to it.
Second then, is just thinking in terms of the rational choice of the main actors. So what’s the willingness to pay from the perspective of the United States to reduce a single percentage point of human extinction whereby that just means the United States has three hundred million people. How much do they want to not die? So assume the United States don’t care about the future. They don’t care about people in other countries at all. Well, it’s still many trillions of dollars is the willingness to pay just to reduce one percentage point of existential risk. And so you’ve got to think that something’s gone wildly wrong, where people are making such incredibly irrational decisions.
I’m not going to update on future evidence I haven’t seen, but if Covid doesn’t kill the 5% of people it ‘should’ kill based on our best knowledge in early march, the Morituri Nolumus Mori effect’s unexpected strength will be one reason, and that should lead us to downgrade our estimate of the chance of genuine X-risks. The first thing I said, the day I became confident this was all really happening (late feb) pointed to that connection.
I think this doesn’t properly consider the counterfactual where it didn’t work—the fact that it did work does imply we’re more the type of people who can make other interventions work as well, and lo and behold it turns out there are Lockdown alternatives that we have more reason to belive will work, given that Lockdown is working.
I also think that the MNM effect is the main reason why both metaculus and superforecasters consistently predict deaths will stay in the low millions. https://goodjudgment.io/covid/dashboard/. They have both heuristics, the MNM effect and inadequacy, and knew from the start.
As I see it, there have been two major pieces of information that have moved my estimates in a positive direction, one is about the nature of the virus being somewhat less deadly/hard to suppress than the consensus here said in early March, the other about the nature of the response to it. The first piece of news is some good luck we’ve had with the nature and spread of Covid, but the second of these is much more generally relevant, and even applies to X-risks. You summarised both together, but I’m going to separate them for that reason.
For the first, see e.g. from Marginal Revolution:
What we have learned is that Western-style lockdowns work, in a fairly diverse range of governments with a fairly wide range of competence in approaching this situation, R has been driven to some number noticeably below 1, and not hovering around 1.There were several commentators arguing (perfectly reasonably, based on the one data point we had in mid-March) that only Wuhan-style lockdowns with case isolation, soldiers welding people into their homes and thousands of door-to-door contract tracers were sufficient to turn R substantially below 1. Luckily, we do not live in that world, and for that we should be grateful. This may connect to the other weird finding—that in many places (basically everywhere except NY, Italy, Spain), hospitals haven’t been overwhelmed the way they ‘should have’ based on our best knowledge in early March.
London hasn’t exceeded its hospital or ICU capacity (though its capacity was recently doubled with the new Nightingale hospital, it has hardly been used), and it has about half of the infection rate of New York—with one estimate here being that the infection rate was 7% in London on the 2nd of April—those cases should have long since progressed and made their way to the hospitals, yet the Nightingale still stands mostly empty (for the love of all eternity, I hope the NHS doesn’t shut the place down because ‘it wasn’t needed’). Probably, London could take New York infection rates and that would just about hit its new capacity.
That fits with anecdotal evidence—I know a nurse who works in a big local hospital, and she told me that although things got pretty dicey over Easter time, with PPE being reused, operating theatres etc. being converted to beds and ICUs, and everyone working incredibly long shifts, nobody was being turned away from the ICUs like in Italy or Spain. The hospitals in London have started to empty out in the last week, as they’re ahead of the rest of the UK, and still it never reached the new capacity with a 7% infection rate before the peak (that came on April 8th, not April 2nd).
Perhaps uncertainty in the Infection hospitalization rate is a better candidate than uncertainty in the IFR—has anyone checked out that 20% figure recently?
The second piece of good news is what I’d call the ‘Morituri Nolumus Mori effect’ - western governments and individuals repeatedly deciding to do the unthinkable in the face of the overwhelming threat, usually reactively, usually at the very last minute, has become a reliable pattern—one we can hopefully rely on in the future as the minimum standard for response. This isn’t mood affiliation, it has become a reasonably consistent pattern, at least in Europe and through large parts of the US.
E.g. the UK government said lockdowns were infeasible, and then implemented one a couple of weeks later—or the fact that compliance with the lockdown measures in Europe has been generally high and is showing no signs of slackening off—or most of the simple measures that will probably happen anyway, that were mentioned in on R0 - or that concerns about contact tracing privacy and stimulus spending have evaporated in most treasuries. Combined with the key empirical fact about the virus—that reactively turning a western-style lockdown on is enough to suppress the virus in most places, we can see the shape of the next year.
We (Europe, some USA) will try to implement a test-trace-isolate scheme to suppress the virus long term without any more lockdowns. That’s the plan, but it will be incredibly difficult to implement. It might work (I’d give Europe a 50⁄50 shot, the USA as a whole somewhat less), but we will simultaneously be ‘reopening’ with heavy social distancing, both legally enforced and through individual behaviour.
If there is another acceleration, it will be slower, we will have more time to react, and we will do another lockdown in the worst case when numbers are about as bad as what prompted the first lockdown, and that lockdown will do what it did this time around except with better treatment, bigger hospital capacity (and a smaller economy).
This rough schema was suggested as what would likely happen in early March, but then it was possible to claim governments and individuals were literally asleep at the wheel and voluntarily choosing to die—that now looks much less likely (leaving aside Trump). I recall several posters responding to that claim with ‘we’re too incompotent to even make a lockdown work’ or similar—that didn’t seem impossible given what we knew then.
It’s interesting to see how speculations in March about whether the Morituri Nolumus Mori effect would pull through or not. Wei Dai notably updated in the direction of thinking it would, after reading this prescient blogpost:
Toby Ord summed up the Morituri Nolumus Mori effect in a recent interview:
It is possible to reconcile this hopeful picture of our response, and this model of how we will deal with things going forward, with the very, very obvious civilisational inadequacy we have when addressing Covid—the lesson seems to be that reactivity is strong (when it’s legally allowed to be) even if availability bias, ignoring expected value and the rest make advance planning incredibly weak.
Of these two very general lessons, the first (massive inadequacy in preparation) is clearly known to all of us. But the second (reactive actions being strong) clearly came as a surprise to some people (I put significant weight on a total lockdown failure and explosive first wave, which isn’t happening) - partly because of the good luck that we’re in the timeline where R goes under 1 with an imperfect lockdown, but also because we didn’t attribute enough weight to the Morituri Nolumus Mori effect. I see it as the counterbalance to the meme of ‘civilisational inadequacy’ - both are good heuristics for predicting what is and isn’t going to be done by governments and individuals, both are important if you want to get your predictions right.
I’ve tried to tease out those general lessons because I think they can apply to any other rare, catastrophic risk, including X-risks. I note that Will Macaskill made reference to the Morituri Nolumus Mori effect in a pre-covid interview, explaining why he puts the probability of X-risks relatively low. Gates also referred to it.
I’m not going to update on future evidence I haven’t seen, but if Covid doesn’t kill the 5% of people it ‘should’ kill based on our best knowledge in early march, the Morituri Nolumus Mori effect’s unexpected strength will be one reason, and that should lead us to downgrade our estimate of the chance of genuine X-risks. The first thing I said, the day I became confident this was all really happening (late feb) pointed to that connection.
Notably, the Tyler Cowen of a week ago thinks ‘social distancing is working well’ is not a cause for optimism: https://marginalrevolution.com/marginalrevolution/2020/04/social-distancing-is-working-so-well.html
I think this doesn’t properly consider the counterfactual where it didn’t work—the fact that it did work does imply we’re more the type of people who can make other interventions work as well, and lo and behold it turns out there are Lockdown alternatives that we have more reason to belive will work, given that Lockdown is working.
I also think that the MNM effect is the main reason why both metaculus and superforecasters consistently predict deaths will stay in the low millions. https://goodjudgment.io/covid/dashboard/. They have both heuristics, the MNM effect and inadequacy, and knew from the start.