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Culture War Roundup for the week of September 9, 2024

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are you seriously proposing that Australia ought to have kept its borders shut to immigrants and tourists permanently?

The claim was "COVID was too infectious to be controlled", and here we have a very clear example of controlling it.

More generally, my point was that it's absurd to say conservative policies had nothing to do with the death toll from COVID, which @FCfromSSC seems to be rather rigorously denying ("I don't think Conservative behavior had any significantly disproportional impact on spreading the Covid plague.")

It's impossible to discuss trade-offs if one side refuses to acknowledge that there was any actual price. We can absolutely discuss freedom -vs- death! But you have to acknowledge that it's an actual tradeoff, and not just freedom for free.

The vaccines were very effective at preventing serious illness, but practically useless at preventing transmission.

Fair enough, but that's a radically different claim from the broader "the vaccine wasn't very effective."

From what I understand, the initial vaccine approval didn't require any testing for preventing transmission, but later testing did in fact reveal that there was a significant drop in transmission: https://www.reuters.com/fact-check/preventing-transmission-never-required-covid-vaccines-initial-approval-pfizer-2024-02-12/

Can you provide a source for a near-zero effectiveness there?

Thus your comparison fails from a QALY perspective.

First off, I don't think people really reason via QALY that much. If elderly lives are worth radically less, why does murdering someone in their 80s carry the same penalty? Why do people spend so much money buying a year or two of life when they get cancer?

Second, AIDS largely killed people that took voluntary risks that exposed them to infection, whereas COVID was a routine workplace risk that people were forced to endure.

Third, AIDS hit in an area where our medical and communication technology was vastly worse - it took a year just to work out that it was sexually transmitted, and you couldn't just post that information on a website because the internet didn't really exist. Conversely, for COVID, we had a vaccine available to the public in like a year and a half!

"the actions taken to spread the disease were straightforwardly more objectionable" (FCfromSSC)

With AIDS, avoiding it would have required not having any relationships for the next decade or two, because we had no clue how it was transmitted or when it would end. Failure to do so only risked your own health.

With COVID, you were asked to wear a mask and avoid big parties for a few months. Failure to do so placed everyone around you at risk.

I don't really see much of a meaningful distinction between "Covid was too infectious to be controlled" and "it is possible to control Covid, provided your country is a geographically isolated island nation without land borders and you keep your borders shut indefinitely". It's so telling that "zero Covid" types always fall back on the examples of Australia and New Zealand to demonstrate that of course lockdowns work at controlling Covid (and it's just a complete coincidence that both countries are geogprahically isolated island nations without land borders). Show me an example of a country which isn't a geographically isolated island nation with land borders which was able to control Covid with vaccines and NPIs. I'm going to assume you can't. Given that most countries are not geographically isolated island nations without land borders, it seems perfectly reasonable to argue that, for 90%+ of countries on earth, Covid is too infectious to be controlled.

And insofar as you're labelling the decision to reopen the Australian borders a "conservative" one, we both know full well that if Anthony Albanese (Labor party) had taken office a few months earlier, he would have made the same decision. In point of fact, Albanese did take office in May 2022, and did not immediately reverse the previous administration's decision to reopen the border. New Zealand reopened its borders a few months after Australia did, a decision made by a Labor prime minister (who was previously, consistently praised for her aggressive response to Covid and "girlboss" energy throughout the Anglosphere), and saw the same dramatic spike in Covid deaths. Are you just defining "conservative" policies as any policies which do not pursue the minimisation of Covid deaths as a terminal goal, at the expense of all other considerations? Or are you only interested in discussing the relative rates of Covid deaths when you can blame conservative decisions for them, and studiously ignoring progressive politicians who make almost identical decisions in almost identical circumstances?

If elderly lives are worth radically less, why does murdering someone in their 80s carry the same penalty?

I never said elderly lives are worth radically less. You claimed that Covid is more lethal than AIDS, but this is obviously untrue for the simple reason that it is much easier to kill a sick elderly person than a young healthy person.

it took a year just to work out that it was sexually transmitted, and you couldn't just post that information on a website because the internet didn't really exist

TIL the Internet was the first ever medium for disseminating medical information. In point of fact the CDC (among other bodies) ran massive nationwide campaigns throughout the 1980s intended to raise awareness of the disease and how to avoid catching it, as did various governmental bodies in the UK. There was a very brief window, only a few years, in which a person who'd contracted AIDS could legitimately plead ignorance and say they didn't now better.

With AIDS, avoiding it would have required not having any relationships for the next decade or two

Or, you know, wearing a condom.

With COVID, you were asked to wear a mask and avoid big parties for a few months.

Yes, we were asked to do that. But even getting massive buy-in from the public on both counts had virtually zero demonstrable impact on the rate of transmission of the virus. China was unable to control Covid even using vastly more punitive measures (like literally locking people inside their apartment buildings) than any Western government, even in 2022 after 90%+ of their adult population had been vaccinated. I mean, even in your preferred example of Australia, even while their borders were shut, people still died. Or are you claiming that Australia really could have gotten its Covid death rate down to zero if literally everyone had always worn a mask outside the home?

Failure to do so placed everyone around you at risk.

Well, no: it placed every old and immunocompromised person around you at risk. Most people are neither, and Covid poses little more threat to them than the flu.

You claimed that Covid is more lethal than AIDS, but this is obviously untrue

I feel like "killed twice as many people" is pretty obviously "more lethal"? This is just basic words-having-meanings stuff. From the person who is so gung-ho about "female" only having one meaning, you sure seem eager to redefine words all of the sudden.

But eh, that's pedantry.

Straight up, the important question: do you really think Covid would have had the same death toll if we had never imposed any restrictions, never asked anyone to mask up, etc.? To me, it feels really obvious that it would have gone up. Maybe we're talking 5%. Maybe we're talking 50%. But can you acknowledge the very basic idea that at least one (1) extra person would have died? I'm looking for a simple "yes" or "no" here.

If "yes", I'd love to hear more details - do you think masking helped? Do you think lockdowns helped? How much?

I feel like "killed twice as many people" is pretty obviously "more lethal"?

There were 16,000 murders in the US in 2018, but "only" 3,340 murders in El Salvador. I guess this means the US was "pretty obviously" 5 times as dangerous as El Salvador?

No, because DUH, the US population is fifty times the size of El Salvador.

Even more pertinent example: millions of people have been killed with guns since they were invented, but nukes have only killed a quarter-million people. I guess this means guns are "pretty obviously" more lethal than nukes?

No, because DUH, hundreds of millions of bullets have been fired in combat situations, but nukes have only been deployed in combat situations a grand total of twice.

It's so obnoxious that you're just pretending you don't know what the phrases "per capita" or "case fatality rate" mean. Or pretending that you don't know that an older population will always have a higher death rate than a younger population, because that's what "life expectancy" means. Or pretending that you don't know that one can easily end up with worse health outcomes from contracting a moderately severe illness in a developing nation vs. contracting a very severe illness in a developed nation, because of differences in the standard of medical care. Or pretending you don't know the difference between "an otherwise healthy person contracts an extremely lethal disease and dies" vs. "an old person who has been in out of hospital for years as their body slowly breaks down picks up an opportunistic infection which finishes them off (when a young healthy person would have shrugged off the same infection without even needing to be hospitalised)". I mean, you obviously do understand all of the above. No one thinks a disease which only kills 1% of people it infects is more lethal than one which kills 10%. To spell it out, in case it wasn't already abundantly clear:

  • Case fatality rate and infection fatality rate are the key metrics for gauging how lethal a disease is. Covid has killed 7 million people, but there have been at least 7 hundred million confirmed cases, meaning its case fatality rate is 1%. Its infection fatality rate might be 0.5% or even lower. By contrast, 90% of people who contract HIV ultimately die from it, generally because of an opportunistic infection they're unable to fight off because they're immunocompromised.
  • Per capita death rates also matter, just like when comparing murder rates between countries. The global population has increased by 2.5 billion people since the start of the HIV crisis. Had there been 7 billion people on the planet in 1981, the death toll from HIV would have been proportionately higher.
  • As above, but also consider the fact that the total population of the most at-risk demographics for HIV (homosexual males, heroin addicts etc.) is vastly smaller than the total population of the most at-risk demographics for Covid (old people mainly, plus immunocompromised people). In 2020, there were 735 million people aged 65 or older. In 1981, I doubt there were more than 200 million homosexual males and heroin users in the entire world.
  • Older people are more likely to die than younger people - this is what the term "life expectancy" means. All things being equal, an older country will have a higher all-cause death rate than a younger one. At the start of the HIV crisis, the median age in the US was just shy of 30 years; at the start of Covid, it was 37. If the world population had been younger in 2020, the death toll from Covid would have been far lower. This is plainly demonstrated by the fact that many countries which had unusually low rates of Covid deaths per capita also have median ages far below the global average.

None of what I'm saying is controversial or in dispute: this is all extremely basic medicine. When ranking how dangerous diseases are, we take all this into account, which is why no one would take you seriously if you claimed that AIDS is less dangerous than pneumonia, even though pneumonia kills around 4 million people every year - because, duh, in many if not most cases pneumonia is just the straw that broke the camel's back, the illness that finally finished off an old person (or indeed a person with AIDS!) who was bound to die soon anyway, and even for old people the case fatality rate is less than 50%.

From the person who is so gung-ho about "female" only having one meaning, you sure seem eager to redefine words all of the sudden.

I cannot believe my gender-critical opinions are now being used as ammunition with which to rubbish my apparently controversial claim that "diseases which kill a higher proportion of those infected with them are more lethal than those which kill a lower proportion". I look forward to the day when I tell someone that murders/100k of population is a more accurate gauge of how violent a country is than absolute number of murders, and they scoff and tell me how can they believe that, coming from someone who thinks Trump isn't Literally Hitler™?

Straight up, the important question: do you really think Covid would have had the same death toll if we had never imposed any restrictions, never asked anyone to mask up, etc.?

The meta-analysis from Johns Hopkins estimated that NPIs probably prevented 0.2% of Covid deaths, which seems near enough to zero as to make functionally no difference.

And NPIs were not costless actions: they caused thousands of additional deaths both in the short-term (suicides, drug overdoses and other deaths of despair) and long-term (many health services deemed "nonessential" were shut down for extended periods of time during Covid, meaning there are tens of thousands of people in the world right now who have cancer and don't know it, or who know it and would have received treatment for it several years earlier if not for the hysterical overreaction to Covid). It's rather telling that the only country in the EU which never imposed a lockdown, Sweden, actually ended up with fewer Covid deaths per capita than the EU average, suggesting that whatever effects lockdowns etc. can be completely dwarfed or negated by local factors (population density, climate, age of population etc.). I think most of the deaths from Covid were baked in as soon as it left Wuhan, and even if NPIs prevented a few deaths on the margin (or, more accurately, allowed a few old people to live a few extra months before something else finished them off) they did not come close to passing a cost-benefit analysis.

But can you acknowledge the very basic idea that at least one (1) extra person would have died?

This is such an obnoxious and emotionally manipulative way of phrasing a question. Governmental policies are supposed to pass a cost-benefit analysis. "One person who would've died didn't die as a result of this policy, ergo it's a roaring success" is a standard which literally any government policy in the world could meet with ease, ergo it's meaningless.

Rabies kills 70,000 people per year, with a 100% lethality rate. Does that make rabies worse than the black plague (a pathetic 30-50% lethality)? If you could trade rabies for a new black plague, do you think that would be a good deal? Would you rather 70 thousand people die of rabies, or 30 million people die of the black plague?

I do understand the difference between absolute lethality and lethality percent. But despite what you say, they are both valid measures. The really vicious stuff with 100% lethality tends to burn itself out. The lower the lethality, the higher the transmissibility, because dead people are terrible vectors. That means the most damage is done somewhere in the middle, where a disease has a bunch of hosts to help it spread

Governmental policies are supposed to pass a cost-benefit analysis.

And you don't find it all odd that your proposed policy is 100% benefit, 0% cost? Do you think I'm arguing that we should just leave money on the table?

NPIs probably prevented 0.2% of Covid deaths

Did you read the article you linked? It's really not that supportive of your case. The 0.2% is just lockdowns. They go on to say: "The study did give partial credit to policies that shut down “non-essential” businesses — which they concluded could bring down COVID death rates by as much as 10 per cent." Then there's the bit about which studies got excluded, etc.. Also the bit about it being done by economists with major political ties. But even if we take it at face value, it's saying there's easily a 10% difference to be made here.

To say nothing of, again, Australia: which managed a very clear 90% reduction in deaths the first two years.

This is such an obnoxious and emotionally manipulative way of phrasing a question.

I mean, it's pretty obnoxious having someone try to engage me in a cost-benefit analysis and then refuse to acknowledge the "cost" half of that equation. It's one thing to say "70 deaths is nothing to the 487 suicides" - we can have a conversation there. But if your stance is really "there is absolutely nothing anyone in the entire world could possibly have done that could have reduced Covid deaths in any way", then obviously I can't argue with that, because there is no argument for leaving free money on the table.

Heck, your link did a decent job convincing me that lockdowns were probably a bad policy: 0.2% is a real number, unlike zero. But again, the article also discusses how closing bars and restaurants probably cut deaths by 10%. That's an intervention worth talking about! How does the suicide rate compare to that? If we had just focused on the interventions that worked, wouldn't the suicide rate have been much lower?