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Scott briefly observes, "The only thing about COVID nobody talks about anymore is the 1.2 million deaths.
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?)
When has policy ever been about the numbers ? It's about sex appeal.
Utilitarians can be surprisingly blind at times. Covid wasn't sexy. No spectacle, no myth building, no clear narrative. Deaths were slow, honorable & blameless. Ofc people don't care in proportion to the numbers.
No movie or even harrowing video to speak of. Hell, there wasn't even an iconic photo. Statistically, I know the Bengal famine killed a lot of people. But viscerally, my emotions are tied to the photos of piled up bodies, literally (not figuratively) looming vultures and 1st hand stories of families prostituting themselves for food. There is a villain (Churchill). There is intrigue ( what if they hadn't diverted reserves to Australia). There is a story.
Plane crashes are sexier than car accidents, which causes disproportional worry. Tuberculosis, a 'CURABLE DISEASE' !! kills 1.25 million every year. No one cares. Malaria kills 600k every year. Yet, the most visceral image of it is Bill Gates releasing non-viral mosquitoes to a room of white people. Covid is no exception.
The Ukraine war went from being sexy urban warfare 'Hordes of migrants, tanks built up in front of Kyiv, hot women crying and destroyed cities' to more conventional unsexy warfare in the woods. No one cares anymore. Israel and Palestine keep producing visceral imagery at an unheard-of rate, and it stays sexy.
Tragedy has pretty privilege. It's all that matters.
This surprised me a bit: worldwide those deaths are from about 10M new cases every year, so you've got better than 10% odds of dying if you're infected ... but in the USA we still have 500-600 deaths from about 10K new cases every year, so you've still got better than 5% odds of dying if you're infected! Has antibiotic-resistant TB gotten that bad? Do people let TB infections get bad enough to be untreatable before seeking treatment?
It looks like most of our progress against TB predated the cure, too. 10K/340M cases per year is about 3/100K for the US, vs 10M/8B = 125/100K for the world as a whole, so at least we've had incredible success at making TB an avoidable disease... In 1900 the US death rate was nearly 200/100K, from God only knows what infection rate, but it steadily dropped to a fraction of that even before streptomycin was invented ... apparently mostly from better living conditions (less overcrowding and more ventilation, better quarantine of infected patients, less malnutrition making people vulnerable)?
These statistics from 2023 indicate that it's mostly among immigrants/non-native born people in the USA. Included with that are the risk factors associated with poverty, homelessness, and unhealthy behaviour. Plus they're including places like Guam and Micronesia, which you'd expect to have much worse outcomes anyway:
As regards drug resistance:
So at a glance it looks like "be immigrant, be poor/in bad circumstances, don't get diagnosed immediately, don't get put on treatment immediately, more likely to contract TB and to die from it". Again, drug-resistant TB seems to be slightly higher amongst non-US born than US natives. And smoking/vaping is the big risk factor.
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