site banner
PaperclipPerfector  1mo ago (text post)   2808 thread views

Small-Scale Question Sunday for September 29, 2024

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

1
Top Bottom Old Controversial Comments
Jump in the discussion.

No email address required.

At this point, the medical establishment and government don’t (or at least, I really, really hope they don’t) have enough credibility left to enforce anti-pandemic measures. Even if avian flu does become a human pandemic and is widely acknowledged as such, it’s probably just going to have to rip through the population like any other transmittable disease. Those who get sick, get sick; those who die, die; and those who survive eventually reach herd immunity.

It's nice to meet an optimist. Unfortunately, I can not concur. I am still seeing a lot of people wearing masks in public, and I am sure the establishment and the press are capable of creating a panic that would easily provide democratic supermajority for virtually any measure short of mass executions, if they want to. My only solace is that the elections are in 2 months and they don't have enough time already to use it (and also probably don't need it really as they already have passed all the laws they needed the last time) so there's no real incentive to do it again right now.

At this point, the medical establishment and government don’t (or at least, I really, really hope they don’t) have enough credibility left to enforce anti-pandemic measures.

I'd like to note that it isn't just the medical establishment or the government (in the USA) that has lost credibility: the public has as well. Going into Covid lockdowns in March 2020, I might have thought that everyone would play along, now I know that there is no chance everyone will play along.

Even if you assume Lockdownism is ultimately correct on the facts, it is a classic prisoner's dilemma: my sacrifice of locking down and not going out is only worth anything if everyone else does as well. If I know in advance that everyone else is not going to lockdown, there is no societal value in my locking down.

And there is no way that anyone will convince me that the American public is gonna do shit-all about it.

I'd like to note that it isn't just the medical establishment or the government (in the USA) that has lost credibility: the public has as well. Going into Covid lockdowns in March 2020, I might have thought that everyone would play along, now I know that there is no chance everyone will play along.

It's fascinating and banging-my-head-to-the-wall inducing to read peoples comments here regarding lockdown and particularly those who assume that the Western response was universaly the same, or at least very similar, as the American response.

Finland never had a lockdown. Not a single one. When the pandemic hit in mid March, the only things forcibly closed were bars and restaurants (after massive public pressure). Yet everything shut down because 1) people voluntarily stopped going out, 2) many facilities owners didn't want the risk of spreading the infection (of which a lot was uncertain back then) and 3) many of the rest didn't want the bad PR. I personally skipped town for two months because I preferred having views like this instead of being stuck in the city with absolutely nothing happening. Apparently nature parks have never been as popular as during that time (and no, nobody even suggested restrictions to that - there's shitloads of open space in Finland, might as well let people enjoy it when it's especially useful).

So, in some places people do play along. It just seems that US is not one of those.

Playing along with "don't go to crowded pubs" and playing along with "you are going to be arrested if you go alone to an empty beach, but please please go to a massive protest where people around you scream in your face for hours" is playing two entirely different games.

It's fascinating and banging-my-head-to-the-wall inducing to read peoples comments here regarding lockdown and particularly those who assume that the Western response was universaly the same, or at least very similar, as the American response.

So, in some places people do play along. It just seems that US is not one of those.

Seems like you're making the same mistake as he is? All he said was "there is no chance everyone will play along", and Finland is not "everyone" any more than the US is. Europe made plenty of insane COVID-era decisions, and I think he's right that even pro-covid-measures people lost appetite to redo them for anything short of an airborne ebola-cancer-aids outbreak.

People in Medicine are really nervous, you are right that public health entities burned through basically all the credibility they had last time, but at current expectations this Avian flu would be be worse than COVID and U.S. healthcare (and likely everywhere else) has basically burned through every ounce of slack it had including things like people's willingness to work and mental health. A lot of COVID-denier types were able to miss just how close we were to total collapse because everyone was locked up at home but this could be really, really bad.

Is the anxiety about the 1st few months? How much do the existing antivirals and the approved vaccine temper their perception of things? Sequiris has been groomed for a few years by ASPR to be in a position to rapidly scale up their manufacturing, and they already have (a very small) global distribution of it. BARDA is probably going to announce and grant them a treasure trove if there's actually a pandemic.

As demonstrated elsewhere in this thread, support for lockdowns/masks/precautions is very low, and even traditional supporters are going to be banging the economic drum.

This will likely kill much more young people before whatever crazy new technology we have gets approved and rolled out. At least thats the feeling.

I think it may be a bit doomer but the worse than COVID and COVID exhaustion bits are very real.

Ok, I understand where you're coming from now. I think if there's a pandemic it will be hellish for anyone working in healthcare. On the other hand Audenz was already approved by FDA and updating the formulation with antigens for new strains doesn't require new clinical trials to be reviewed by the agency before the supplemental formulation is approved. The rollout preparedness is (relatively) good already. They've just spun up manufacturing a 40 million dose stockpile of only the adjuvant from a $121 million BARDA grant, but that's mostly just to get Sequiris' manufacturing flywheel started. Probably 6 months until vulnerable populations start getting administered a vaccine from whenever a pandemic is declared, with a 1 month margin of error. So if the vaccine actually works that writes off the most apocalyptic outcomes.

I think if there's a pandemic it will be hellish for anyone working in healthcare.

I'm not concerned about the apocalypse, even without any further technology changes but I am concerned about stuff like people dying at their homes of heart attacks because ambulances are overstretched and we don't have the resources in the ED or hospital to handle otherwise treatable problems.

Like with COVD damage to the complex systems involved will take a long time to clear, if ever.

Not to mention medical professionals getting sick at a (much) higher rate than the general population, further decreasing the capacity. That already had an effect here in Finland during Covid.

This still isn’t the Black Death 2.0. Literal worst case scenarios are still nowhere near what the virus was sold as.

Society didn't end and wasn't going to, but we did almost lose access to healthcare which is quite a bad outcome.

We weren’t going to lose access to healthcare, we were going to get healthcare rationed. Not that bad, or anywhere near bad enough to justify the lunatic reaction to it.

More comments

A lot of COVID-denier types were able to miss just how close we were to total collapse because everyone was locked up at home but this could be really, really bad.

I don’t think the Covid-deniers did miss that; it’s everyone else who failed to see the issue. Opposition to lockdowns was the single thing that united all the various types of skeptics.

I think you misunderstand, even with the reduction in cases because of lockdowns our hospital infrastructure almost collapsed (and would have without them, at least initially).

Denier/skeptic types don't realize how bad it was in the beginning. I've seen plenty of people here doubt the seriousness of COVID, call complaints of full hospitals etc as fake news, and so on.

Just from my own perspective, I don’t think the problem was the initial reaction. The problem was that there was no real thought into what was going to be the sustainable solution to the need to slow spread while still giving people freedom and not destroying the economy. There were no end dates or mitigation mechanisms, no advice on what kinds of activities were high or low spread, or what types of environments were conducive to spread. So they just locked everything up indefinitely just to be sure and lied about the dangers so that the people were too scared of Covid to make rational decisions.

And to me that damned the whole thing. Nobody will trust a system that cannot be honest or upfront about dangers and trade offs and how the economy could actually function when nobody can leave the house without government permission. It further gave no criteria or end dates to the emergency. 2 weeks to flatten the curve became 2 months, than nearly 6 months. Because of all of this, the government simply lost all credibility, not just in health (and being Frank, no matter how bad the next pandemic gets, lockdowns are off the table, and good luck with vaccines) but in almost everything else. If the government lied about this in a power grab, what else are they lying about. (I personally think at least some of the popularity of Qanon and later election denial is down to the loss of trust that came out of the lockdown experience. People felt abused and lied to by their own government, and as such, conspiracy theories telling them the government was lying about other things and using its power to manipulate them into things that benefit them). That trust is unlikely to come back for at least a generation and maybe longer than that.

When I argue with my coworkers and other pro-Lockdown types its all about how it was poorly defined, blew our load on an important public health intervention, failure of implementation and buy in etc etc.

When it's the anti-Lockdown types its almost always "bruh, you know COVID was real right?"

I mean sure a lot of people ended up believing it was fake, but to take their perspective, the government was pretty much lying about everything all the time. They said as a slogan that it was “2 weeks to flatten the curve.” After 3-4 months with no end in sight, the people saw that as a lie. The messaging on masks did two complete separate 180s. Masks don’t work until they do, except ooops they were wrong and it actually doesn’t work. The vaccines will prevent you from getting Covid, until it was obvious they didn’t, at which point they protected other people, until it was obvious that this wasn’t happening either. Then the vaccines were supposed to be based on a place that didn’t mutate much. Except that that section does mutate a lot and now you need a booster every year for the new variant. And so after the fourth or fifth obvious falsehood, it’s not really that surprising to me that people who lost their freedom because they obeyed a government that lied to them a lot might start questioning the virus that’s at the bottom of this whole thing. They’re under arbitrary rules that are quite often not only making them miserable, but costing them money and opportunities, with no end in sight, with moving goalposts and lots of guilt tripping over any questioning or noncompliance.

If the government wants the trust of the people, it must be trustworthy.

When you say collapse, what exactly do you have in mind? Are we talking about a triage situation or something more long-term damaging? If it’s the former, I would consider the situation deeply unfortunate, but it’s also something that would resolve itself in relatively short order.

Take the issue of ventilator shortages, which I recall being a real problem in some areas in early to mid-2020. It’s horrifying if you’re a Covid patient who needs a ventilator but who can’t get one, but I wouldn’t consider the deaths that resulted from such shortages to constitute collapse of the hospital infrastructure.

Also, on the topic of lockdowns, it seems to me that we went about it in exactly the wrong way. Assuming we were going to do some kind of lockdown regardless, it seems to me that we should have forced the at-risk portions of the population to isolate, directed the fountain of free federal money to “reward” those who stayed on the job, let the disease rip through the healthy population, then rescinded all lockdown measures once the number of cases was low enough that there was little risk of overwhelming the hospital systems. You’re still running rough-shod over some people’s freedoms, but that seemed to be inevitable by March of 2020, and at least this plan seems like it would have been less destructive and more effective.

The purpose of the original management of masks and the overall lockdown approach was to buy time for hospitals and other aspects of healthcare to adjust and to do things like "smooth out the curve." This was mostly a success. Messaging around this was terrible, and public health and governmental identities (and the media) couldn't stop themselves from lying and misunderstanding.

These policies overstaying their welcome has nothing to do with the early need. You of course also have other nonsense like trying to prevent people from staying outside away from each other in a park. The damage from overzealous, unscientific, and downright retarded policy decisions is immense.

But the lockdown was still a good idea.

Hospitals had to shut down elective procedures. They had ophthalmologists and dermatologists managing critical care patients. Routine medical activity and screening shut down in a way that will increase mortality and morbidity for decades. Medical education, which is expensive, complicated, and slow was paused or had quality go down for years. Many doctors and other staff died, retired, moved out of clinical practice, or dramatically reduced their hours, and the shortages and other problems caused by this are only growing worse and have a tremendous lagging effect. It's taking time and a multifactorial problem but hospitals are shutting down all over the U.S. and it's becoming increasingly impossible to get certain types of care in some states or regions.

Multiple things can be true at the same time.

Lockdowns were a violation of freedoms. They were absolutely a necessary violation of freedom for a time. They were not a necessary violation later, but persisted anyway.

Most lockdown deniers types seem to realize they were right about lockdowns being misused and then leverage that into thinking that COVID was just as bad as a regular flu, that everything was fine or a hysteria, or that because we didn't load up some random ship with COVID patients that everything was fine, or that running out ventilators will cause some people to die but cause absolutely no other problems.

It's a massive Dunning-Kruger issue that seems tremendously over represented in the population of rat-adjacent people.

Hospitals had to shut down elective procedures. They had ophthalmologists and dermatologists managing critical care patients. Routine medical activity and screening shut down in a way that will increase mortality and morbidity for decades. Medical education, which is expensive, complicated, and slow was paused or had quality go down for years.

Every single one of these consequences were because of the massively extended lockdowns and the medical/governmental apparatus refusing to lose any face. No shit the industry wasn't doing as much routine medical activity when going to urgent care required multiple tests, staying in your car, poorly-developed ass-covering questionnaires, etc. etc. etc.

hospitals are shutting down all over the U.S. and it's becoming increasingly impossible to get certain types of care

And this is explained by some mythical massive death toll in the medical industry, instead of giant healthcare conglomerates and regulatory capture? Come on man. This is just the Obamacare nightmare 14 years in. Buckle up, it's not going to get any better.

I can't take this seriously after seeing the rock-hard erections in the pants of every petty tyrant nurse, doctor, or administrator that lasted 2 years instead of 4 hours. The sanctimonious slow the spread shit that got jettisoned the moment some race riots needed to be sanctioned by the entire industry. Miss me with this gaslighting.

Every single one of these consequences were because of the massively extended lockdowns and the medical/governmental apparatus refusing to lose any face. No shit the industry wasn't doing as much routine medical activity when going to urgent care required multiple tests, staying in your car, poorly-developed ass-covering questionnaires, etc. etc. etc.

No?

You think Ophthalmologists were being pulled to do critical care because of COVID tests requirements at outpatient offices?

It frustrates me how lockdown/COVID skeptics can be more or less directionally correct and still worse than the supporters at the same time. Stop and think about your claims for a second.

I feel like every study I have read has found very little impact on deaths pre-vaccine, with almost all differences being post vaccine. This would seem to go against your thesis?

In addition, you seem to be missing that people would engage on some level of precautions regardless of what is mandated, just by looking around (for example, restaurant reservations dropped drastically in NY while De Blasio was still telling people to go celebrate Chinese New Years)

People in Medicine are really nervous,

Can you say more about this? Do you know anything more than what has been in the MSM so far?

The good news: it's pure "oh shit this could kick of." So far. I don't have any particular special information at this time but haven't seen anything more than all the other times it almost happens and then doesn't.

The bad news: all the revision, hysteria, and poor decisions about COVID has resulted in most people forgetting just how bad COVID was, and this will likely be worse. Our healthcare infrastructure may not survive another hit of that magnitude.

I can’t speak to most people, but I remember how bad it was. It was so bad that New York City had to bring in emergency 1,000-bed hospital ships in order to handle the overflow of cases. Of course, those ships sat virtually empty and unused, and their large crew of medical workers basically got to enjoy a free holiday, but still, they had to bring in ships! It was so bad, Covid-positive patients had to be rehoused away from the hospitals and into empty schools nursing homes, for some reason. It was so bad that nurses were so exhausted, they barely had the time and energy to make TikTok videos to help keep people’s spirits up as they were imprisoned in their homes. It was bad.

You are forgetting the lockdown sex parties. That was the worst of it. People were so scared top health officials had to secretly rent the hotel rooms “just be naked with friends”. Can you imagine?

I mean, it doesn’t sound great. More Joseph Heller than George Orwell, though.

Well, I guess thank you for appearing on command and making my point for me.

And what is your point? COVID was over-sold. Wildly over-sold, and that's the enduring legacy of the pandemic.

It was never that bad, because it was over-sold so completely that nothing short of civilization-ending pandemic could have been that bad.

It was never that bad, because it was over-sold so completely that nothing short of civilization-ending pandemic could have been that bad.

It was oversold, it was also worse than the people complaining about it being oversold think it was.

"It also was looking more like a wolf than you think it was" is not very useful when you cried wolf for 2 years. That account is overdrawn so deeply that it doesn't matter anymore how much was in it initially.

More comments

OK, I can grant that, but the people making decisions and the decisions made were the worst parts, far worse than the actual virus.

In many cases I believe the use of drugs like remdesevir and techniques such as ventilation caused deaths in people that would have survived the virus. I know my greatest fear was not that my dad would die from COVID, but that he would go to the hospital and die from treatment, all while I wouldn't be able to see him.

You're underselling how bad the medical profession acted.

More comments

This seems like an easy thing for a relatively young and healthy person (I assume) to say.

This seems more like a shallow dunk than an attempt to acknowledge the terrible job pretty much every Westernized government did at responsibly balancing the right of ordinary people to go about their lives versus the actual increased risk to the actually significantly more vulnerable population, rather than pandering to overblown fears stoked by social media culture and letting a bunch of low-information healthcare officials with no accountability to the actual population play tin-pot dictator.

I'd also like to know - many people have stoked fears about supposed healthcare "collapse", but did any healthcare systems anywhere actually do anything that could be described as collapse during the entire Covid era? Exactly what does a "collapse" look like, what are the real consequences of it? I mean things that actually happened, not somebody speculating about what could happen. I think this is a "The optimal amount of fraud is non-zero" thing - if no healthcare system anywhere actually "collapses", then we're being too restrictive and over-cautious, and we should ease up until there are a few.

I'd also like to know - many people have stoked fears about supposed healthcare "collapse", but did any healthcare systems anywhere actually do anything that could be described as collapse during the entire Covid era?

In the west, probably Bergamo and nowhere else. At least in the UK, the politics of the decision to lock down were driven by media coverage of events in Bergamo.

Honestly, I kind of wonder whether the last century of health care have been like the 20th century fire prevention/suppression effort and humanity would be much healthier overall if pandemics were a more regular selection factor in reporduction.

I’m not even sure it’s entirely a reproductive issue instead of a general fitness one. It seemed like every time I heard about some perfectly normal, healthy young person dying of Covid, it turned out he or she weighed 300 lbs.

While I won’t deny that, I’d rather put it that it’s an easy thing for anyone who saw the competency with which almost all Western governments handled Covid to say. After living through 2020–2022, do you really trust the CDC, the WHO, the federal and most state governments, the major medical journals, or any other group to get this one right?

No, but I suspect that the costs of not even trying would be higher than the costs of ham handed attempts at containing it or delaying it. It's not just about the virus itself, but about healthcare system collapse. If you get appendicitis at that point, good luck surviving.

If you get a novel virus for which no good medical treatment exists you’re left to live or die as fate demands, if you come in with acute appendicitis you’re operated on and live. I have just solved this supposedly impossible conundrum.

It probably won't work out as nicely and cleanly as that. There will be several treatments of dubious efficacy that will be given/experimented with on the many virus patients, while all sorts of other types of doctors get drafted in to deal with them.

Refusal to follow triage best practices in order to try to make people care says more about the medical system than it does about anyone victimized by that choice.

What is this place?

This website is a place for people who want to move past shady thinking and test their ideas in a court of people who don't all share the same biases. Our goal is to optimize for light, not heat; this is a group effort, and all commentators are asked to do their part.

The weekly Culture War threads host the most controversial topics and are the most visible aspect of The Motte. However, many other topics are appropriate here. We encourage people to post anything related to science, politics, or philosophy; if in doubt, post!

Check out The Vault for an archive of old quality posts. You are encouraged to crosspost these elsewhere.


Why are you called The Motte?

A motte is a stone keep on a raised earthwork common in early medieval fortifications. More pertinently, it's an element in a rhetorical move called a "Motte-and-Bailey", originally identified by philosopher Nicholas Shackel. It describes the tendency in discourse for people to move from a controversial but high value claim to a defensible but less exciting one upon any resistance to the former. He likens this to the medieval fortification, where a desirable land (the bailey) is abandoned when in danger for the more easily defended motte. In Shackel's words, "The Motte represents the defensible but undesired propositions to which one retreats when hard pressed."

On The Motte, always attempt to remain inside your defensible territory, even if you are not being pressed.


New post guidelines

If you're posting something that isn't related to the culture war, we encourage you to post a thread for it. A submission statement is highly appreciated, but isn't necessary for text posts or links to largely-text posts such as blogs or news articles; if we're unsure of the value of your post, we might remove it until you add a submission statement. A submission statement is required for non-text sources (videos, podcasts, images).

Culture war posts go in the culture war thread; all links must either include a submission statement or significant commentary. Bare links without those will be removed.

If in doubt, please post it!


Rules


Recommended Posts And Communities

Recommended Realtime Chats