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1yr ago
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Edited 1yr ago
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Nassim Taleb is likely wrong about IQ and talent
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I’m very against masks (always thought evidence was insufficient to move past priors and believed there were huge downsides). Can you share the Chinese studies though? Would be interested in reading those.
There is no Chinese study I would trust. I based it on observation of great number of infected. It appears that the current Chinese wave is due to lifting lockdown restrictions but from the data Zvi has provided, it seems the opposite. The number of infected was rising and the government realized that it makes them look stupid and they decided to lift lockdown to shift the blame.
Going back to more reliable data – I remember that article on marginalrevolution.com where they showed that good data doesn't need complicated statistics to show that vaccines work. The graph of infected without vaccine was clearly so different from the one for recently vaccinated. It seemed so convincing. And yet, now we know that this conclusion was wrong. The vaccine protection from infection didn't last long, only 3-4 months on average. It might be protecting from severe disease and death (by about 90%) but that wasn't what this graph was trying to prove. It turns out you need a good and thorough statistics and study design even for things that seem obvious.
As a pharmacist I was trained to back up all my assertions by evidence. If you give a recommendation to the patient or a doctor to use a specific drug, they might always ask – what is the evidence? I should be able to answer this questions without delay. But when the masks started to be recommended, the best evidence I had seen was Scott's article. When I tried to ask doctors and others if they have more evidence about effectiveness about masks, they said that you don't need evidence for parachutes. The many reversals in this pandemic showed that many things that initially seemed like parachutes were not like them, therefore the question about evidence remained.
In the UK we usually rely on NICE guidelines. Not all evidence is of equal strength but NICE as the organization put a lot of effort to evaluate and list all available studies for given intervention. I am in favour of regulatory barriers for all new medicines. The only problem is that the regulatory process is too slow and might fail us during pandemics when quick decisions are required. I know that Scott is very critical of regulatory institutions but I cannot share his criticism because pharma companies try to push too many costly medicines with only a marginal benefit (especially for cancer). Sometimes even regulators make mistakes and approve doubtful medicines (like aducanumab) but they err on the opposite side – not approving useful drugs – only in very rare cases. I can only agree that the regulatory process is too slow, cumbersome and inflexible in some cases but the main service they provide is very important.
During covid pandemic nothing of this seemed to matter. Regulators were disregarded, politicians introduced measures without any proof of effectiveness. They even introduced vaccine mandates that we were previously taught to be a bad policy. My native country bought too many vaccines and now they are donating them to poor countries – again we were taught this to be a bad policy. Those countries most likely simply destroyed the donated vaccines. Usually it works much better to donate money so that they can buy what they need and not the excess stock. Other countries are unable to accept donations of medicines because they usually are not in the form their doctors are trained, they might not have labels in their local languages, they might not use the particular brands or strengths and supply chains might not be appropriate. For example, Pfizer had mRNA vaccines to be stored in -70°C. Then they made another variant that could be stored in -20°C, and then again another one to be stored in fridge (2°–8°C). The options in poor countries are more limited and if they have settled for one specific cold chain, all other vaccines that need a different conditions will never make to final recipients. This distribution is hard. We learned this when lockdowns disrupted our supply chains in the west. In poor countries supply chains are even more fragile and simply donating medicines have very little benefit if we don't consider how they will fit in their supply chains. But that didn't matter for politicians, they only needed to save their faces and pretend being good humanitarians.
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