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PaperclipPerfector  3d ago (text post)   12019 thread views

Culture War Roundup for the week of May 19, 2025

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Scott briefly observes, "The only thing about COVID nobody talks about anymore is the 1.2 million deaths.

That’s 1.2 million American deaths. Globally it’s officially 7 million, unofficially 20 - 30 million. But 1.2 million American deaths is still a lot. It’s more than Vietnam plus 9/11 plus every mass shooting combined - in fact, more than ten times all those things combined. It was the single highest-fatality event in American history, beating the previous record-holder - the US Civil War - by over 50%. All these lives seem to have fallen into oblivion too quietly to be heard over the noise of Lab Leak Debate #35960381.

Maybe it’s because they were mostly old people? Old people have already lived a long life, nobody can get too surprised about them dying. But although only a small fraction of COVID deaths were young people, a small fraction of a large number can still be large: the pandemic killed 250,000 <65-year-old Americans, wiping out enough non-seniors to populate Salt Lake City. More military-age young men died in COVID than in Iraq/Afghanistan. Even the old people were somebody’s spouse or parent or grandparent; many should have had a good 5 - 10 years left.

Usually I’m the one arguing that we have to do cost-benefit analysis, that it’s impractical and incoherent to value every life at infinity billion dollars. And indeed, most lockdown-type measures look marginal on a purely economic analysis, and utterly fail one that includes hedonic costs. Rejecting some safety measures even though they saved lives was probably the right call. Still, I didn’t want to win this hard. People are saying things like “COVID taught us that scientists will always exaggerate how bad things will be.” I think if we’d known at the beginning of COVID that it would kill 1.2 million Americans, people would have thought that whatever warnings they were getting, or panicky responses were being proposed, were - if anything - understated.1

A better comparison for 1.2 million Americans dying would be the Spanish Flu: An estimated 675,000 Americans died, while the total population was estimated to be round 106,000,000. (The 2020 estimated population was around 331,500,000.)

One problem I have with the online debates about covid policy is there's no clear counterfactual: 2021 deaths were higher than 2020 deaths, which is bad for arguments that containment policies were only protecting the most vulnerable at the expense of the general population, because the most vulnerable had disproportionately died in 2020 and management had improved. It's possible that a different set of policies would have resulted in disproportionately more QALYs lost by lower-risk demographics, due to the non-linear dynamics of disease transmission (don't forget rates of mutation). I don't really care to defend any policy, since there were a lot of avoidable mistakes, but I think the criticism should be more specific and measured.

(Edit: Scott's Lockdown Effectiveness: Much More Than You Wanted To Know, published July 1, 2021 - anyone know if there's been much change in the understanding of NPI effectiveness?)

The thing that gets me--and I will admit my loss of facts over the years-- is there's no counterfactual for how effective the vaccines were. I presume the peak numbers would have come down a little, but vs. what? Overall, it doesn't seem to me there's much evidence that the vaccines did anything as the course of the covid outbreak followed every other pandemic just at a different scale. All I get is, "Of course they worked, it's obvious. You're stupid."

The trials presumably produced adequate estimations of the vaccines' effectiveness. I think the problem with public perception was partly that low rates of other infectious diseases created the misconception that sterilizing vaccines are the norm, such that reports that a vaccine "merely" health risks to the recipient by 90% triggered the confirmation bias of anti-vaccine people. (One person repeatedly told me "They changed the definition of 'vaccine.'")

reports that a vaccine "merely" health risks to the recipient by 90%

Unfortunately we don't even really have enough evidence to quantify conclusively what the 'severity' benefit really was -- the initial trials were underpowered for anything to do with severity/death, and of course were terminated once the companies got their approval. (in that the control arm got real shots)

So there's no RCT to quantify this benefit, and the population-level studies are hopelessly muddled by a mixture of hard to correct for demographic confounders and sheer politics/CW. Plus all the different strains -- it's hard to say for sure, but seems clear that Omicron was very not-severe as compared to earlier strains -- so when a person got Covid is probably even more important than his vaccination status, severity-wise.

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