What did we learn from the COVID-19 pandemic? What should we be doing now to prepare for the next pandemic? Which measures (aside from vaccination) were most effective?
We still don't know for sure, but there's enough evidence to make educated guesses about a lot of interventions. I did this same exercise last year and not much has changed since then. Here's a brief rundown.
| Intervention | Good idea? | Details |
|---|---|---|
| Masking | Yes, but... | Masks are required only indoors and need to be well-fitted N95 masks. Cloth masks and medical masks are only minimally effective. |
| Better ventilation | Yes | We should be working right now on a Manhattan Project to install better ventilation universally to prepare for a future pandemic. This is especially true in schools, workplaces, and other high-traffic areas. |
| Close schools | Probably not | This is a little tricky. The evidence suggests that school closures reduced the spread of COVID, but only moderately and only for the first couple of months. However, this is largely because COVID didn't affect children much, and this might not be true of the next pandemic. Also, learning loss was the same everywhere, even in places that re-opened schools quickly. Remote learning wasn't the culprit. |
| Remote work | Yes | Most of the evidence suggests that "essential workers," who couldn't stay home, died at 2x higher rates than others. |
| Far-UVC lighting | Yes | This deserves more attention. Far-UVC lighting has been well studied and turns out to be effective at killing viruses without affecting humans. We should have a crash program to install them in workplaces and other public places everywhere. |
| Restaurant shutdowns | Yes | Studies show that food service workers died at fairly high rates during COVID. Outdoor dining is OK. However, we might make exceptions for indoor dining at restaurants with good ventilation and Far-UVC lighting. |
| Ban on large gatherings | Yes | Crowded indoor gatherings seem to have frequently acted as superspreader events. |
| Surface cleaning | No | There were approximately zero cases of COVID that were traced back to touching an infected surface. |
| Handwashing | Yes | It's not clear how effective this was, but it's low cost and does no harm. |
| Border closings | No | There's little evidence that these helped. You can't keep viruses 100% out, and even a few cases are enough to eventually infect a whole country. |
| Social distancing | Yes but.... | It helps, but most countries adopted a 3-foot rule that seems to have worked fine. |
| Contact tracing | No | It's a good idea in theory, but in practice it's all but impossible to implement well. This is especially true in a country like the US, where so many people are skeptical of government bureaucrats calling on the phone to ask personal questions. |
| Lockdowns | Maybe | Lockdowns were moderately effective but came at a large economic cost. The right balance is more a political question than a scientific one. |
Learning loss was the same everywhere:
was it that the national controversy surrounding expertise, and distrust of expertise, distrust in conventional wisdom, and the sheer fantasies prioritized over learning and serious interest creating a sense of distrust of education and aptitude among the young?
Shocked! I was just shocked to learn that Australia has been running remote schooling for a couple of generations in the Outback and has not yet devolved to the stone age.
Maybe Americans should have turned to them for tips? They did this by radio,mail, etc ... in the pre-internet era!!
So do some rural states like Alaska and Oregon. And no one thinks it is ideal.
They have practice, we did not. For the few months my kids had to do remote learning (March to May of 2020) they were often online for less than two hours a day. Some of their classes only met a couple times a week.
Tracing apps were very useful when you actually had to work or when reopening attending events. It made it easier to know and contact people you were near but may not have continued social contact with.
I think there was a surface event of an elevator in Aotearoa but that's also an enclosed space. Surfaces are the major vector for say, norovirus, so it's not entirely a bad idea. Especially for high traffic surfaces like shopping carts.
I can see why Closing Schools received a “probably not” from Kevin. “However, this is largely because COVID didn't affect children much, and this might not be true of the next pandemic. Also, learning loss was the same everywhere, even in places that re-opened schools quickly.” So the negative effects were meh compared to schools that didn’t close, and the next pandemic might hit kids worse. But it pissed off Republicans because teachers must be opposed at all times regardless of reason, and pissed off parents who lost their free daycare, so that’s good enough for Kevin to deem it probably a bad idea.
The chefs kiss is the next item Remote Work which Kevin deems a good idea for everyone - except teachers I suppose? - because “Most of the evidence suggests that "essential workers," who couldn't stay home, died at 2x higher rates than others.” I guess teachers should’ve cheerfully signed up to die at twice the rate that they actually did, eh?
Teacher here.
Every pandemic is going to be different and only rhyme with the last one. But school closures were frankly more about the adults the children:
The teachers (many of whom are older and in the prime dying age for COVID) and also family members. Many children (especially poor children) live in multi-generational households with elderly relatives in close proximity. Schools would be a vector to spread disease home to millions of vulnerable elderly who have no where else to go.
The compromise in my mind would be to consider school closures UNTIL vaccines are available and then accelerate vaccine approval. We apparently had the mRNA vaccines invented within weeks of the arrival of COVID back in March 2020 but it took a year to get approval. If you want to keep schools open, make vaccines available to teachers at least on a voluntary basis much earlier in the process. I'd have taken an untested vaccine way back in March 2020 if I was being asked to keep teaching in person. Most of my colleagues would have.
There is frankly not all that much we can do about kids spreading the virus even if they don't get sick themselves. But the solution to that is accelerated vaccine approval.
The biggest solution in my mind is to greatly shorten the vaccine development and approval process. Even if that takes billions and new AI technologies or whatever to pull off. That will be the biggest bang for the buck and vastly more useful than all the other stuff put together.
mRNA vaccine subject here
"We apparently had the mRNA vaccines invented within weeks of the arrival of COVID back in March 2020 but it took a year to get approval."
I was a subject in the Moderna phase III trial and didn't get my first jab until August. Phase I, a small scale trial for safety, and Phase II, a small trial testing efficacy, had been done by then. But it requires a much larger trial to be confident about the morbidity and mortality of vaccine side effects. The Moderna Phase III trial was 30,000 and the Pfizer Phase III was 45,000. I was particularly prized as a subject since I was over 65.
Yes, enrolling and carrying out large double-blind placebo-controlled clinical trials at multiple sites is tedious, but trust is paramount. Even today, there are still (specious) claims that the vaccines have killed millions.
I salute you for your service. Not every hero wears skin tight body armor.
You've also got to make sure you close the rest of the town, too, or you've just displaced the children among the rest of the town.
See also when they close schools at norovirus events you end up spreading it at museums, zoos, restaurants, etc. as parents and children continue on.
Yeah, I really don't understand the whole "We probably shouldn't have closed schools since COVID didn't affect kids so much" line. First, what other infectious disease would we be so sanguine about had it killed 2,000 kids over a period of 2-3 years? Can you even imagine the cacophony of screaming that would have ensued had politics not demanded we minimize that cost?
And second, who is it, exactly, that people think are staffing these schools? More kids? Do we believe that teachers and counselors and custodians and other staff should die so that test scores can stay high?
YES! for the concerns about the school staff. Here in New Mexico, reports noted that the state had a very high percentage of elderly teachers. The exact demographic that was most vulnerable, and that was given priority.
The families are perhaps just as big of an issue.
Even if children don't die of COVID or get particularly sick. They are still vectors of the disease. And a program in which we take all the youth in a community, put them into very close contact with each other every day, all day long. And then send back home every evening into homes where they are often elderly and vulnerable people? That goes against every principle of pandemic management.
It would be hard to invent a more efficient method of spreading disease within a community than that. Even if children are themselves unaffected.
The age group with the highest Covid mortality was 85+, followed the 74-84 year olds. How many teachers are that old?
This obviously doesnt make any sense.
Lets make the exact same argument:l to highlight how bad it is:
The age group with the highest Covid mortality was 88+, followed the 86-87 year olds. 85 year olds need to stop their complaining because they arent in either of these groups!
Brilliant.
Firearms killed over 2500 kids in 2021 alone. I bet we could find a way to ignore 2,000 dead kids over the course of 3 years, especially if we shout "freedom!" often enough.
This is important, but we must remember that the lever pullers for the scientific community probably weren't willing to sit by when they could conceivably pull the levers that would reduce risk and save lives.
While elsewhere those lever pullers that could conceivably pull the levers to reduce risk with firearms have other priorities that outweigh the deaths of children...
There is the difference. And that difference may have the been source of the friction that caused such a haphazard response to the pandemic.
"what other infectious disease would we be so sanguine about had it killed 2,000 kids over a period of 2-3 years? Can you even imagine the cacophony of screaming that would have ensued had politics not demanded we minimize that cost?"
Influenza has killed 1 to 200 children each year since 2013. Why not shut down the schools each flu season to "save" them? Maybe because closing the schools wouldn't have saved one of their lives?
In a 2-3 year period over 2000 children are killed in traffic accidents. We don't seem to freak out much over that.
Closing schools probably would decrease flu deaths. We don't do it because the benefits are outweighed by the costs.
This kind of rational cost benefit analysis suddenly became verboten during the political and moral panic that formed due to COVID and TDS.
My wife is a teacher as are many of our friends. They all chose to go back and teach in person because they knew (from the experience at end of the 2020 school year) that remote learning was not effective. This was especially true for my wife who is a special ed teacher. Here in FL, starting in the Fall of 2020, students had the choice of going remote of in person at school. About two-thirds started off in person. By the end of the first semester is was 90% in person. (In our county, anyway. Don't know about statewide.)
I think we'll focus on the wrong lessons when the next pandemic hits. I expect it to be a flu that targets the young, is spread at least somewhat by surfaces, and doesn't require N95 masks.
The error you're making is assuming that the next pandemic's characteristics will match that of COVID. The starting point for any pandemic threat when there's insufficient information on its transmissibility, depends on its virulence. A highly virulent pandemic will force the most conservative assumptions.
I think many far-right people will make the same error, too, using COVID as their starting point.
And you're wrong on surface cleaning. If the next pandemic were a hemorrhagic fever, surface cleaning would be priority number 2 right behind masks.
👍👍👍👍👍
Yes. Nicely put.
Correct. We also learned, which Kevin did not cover, that an alarmingly high percentage of the population are total idiots, and are completely incapable of reading a chart such as Kevin put together, let alone putting one together.
The key with Covid was, and is, that it can be asymptomatic for something like a couple of weeks. That really, is and was the key factor, becuase as D_O says, the method of transmission dictates the measures needed to limit transmission.
There are still people around in the US who think masks are pointless, that's the level of analytical ability they have.
Regarding school closure: Schools are not only made up of children, but of adult teachers and staff, who very much were affected by COVID. Also, although the health of the children itself wasn't so much of an issue, they were still carriers of the virus, and being in enclosed spaces over long periods of time with other people provided ample opportunity to spread the virus to family at home.
Two mistakes:1) As others noted, the next pandemic may differ in mode of transmission, symptoms, risk profile across sub populations, and just about anything else that can characterize a disease;
2) KD continues to ignore the lessons learned by countries in the Asia/Pacific region. Border controls were extremely effective — I believe the key measures were quarantining arrivals to the country at state expense, before testing was available, until individuals could be presumed free of infection. It is true that eventually CoVid-19 breached the borders, but delaying it allowed time to benefit from tests and vaccines.
Well, border controls need to be actual controls. Not just things that scare waves of people to start moving.
Border controls were effective in island nations, and in nations with repressive social controls. Closing the many thousands of miles of US borders would be practically impossible.
The Americas are surrounded by ocean. Coördinating policy with Canada and Mexico reduces the border problem enormously. So negotiating contingency agreements with our neighbors is something we could do before the next pandemic arrives.
The large majority of those entering the U.S. pass through airports or controlled road routes in any case.
Cloth masks and medical masks are only minimally effective
Wrong.
First, hospital personnel wore regular medical masks throughout Covid unless they were seeing respiratory patients. (My son is a physician working in a big city hospital). They clearly thought that their regular masks were useful.
Second, this is a one-dimensional view of what masks do:
Cloth masks help prevent transmission even if they don’t do much to protect the wearer. Fundamentally they’re a partial barrier that reduces the velocity of outgoing breath: if I’m wearing a mask I’m effectively further away from you.
Because of that, if all or most of us wore cloth masks, we’d reduce overall transmission. In particular, we’d “bend the curve downward” (remember that?) and reduce the overwhelming of hospitals that was such a threat in early 2020.
Spread of airborne diseases is exponential; reducing the exponent even slightly integrates to a lot more survivors.
Cloth masks don’t do much to protect the wearer directly but by reducing the number of cases the protection for everyone - including the wearer - can be substantial.
N95s are indeed uncomfortable to wear for any length of time, so the attitude “it’s N95 or nothing” is seriously misplaced. It leads to mask resistance that hurts us all.
Excellent points.
I was no fan of Andrew Cuomo, but his daily news briefings as the crisis hit New York were excellent, and they included a mantra about masks: "My mask protects you; your mask protects me."
He was 100% wrong and barked that slogan without scientific evidence evidence. Many randomized trials have shown that cloth masks and surgical masks have no effect against Covid and influenza. In 2022, randomized trial in Canada showed that N95 masks are also ineffective against Covid.
Wishful thinking is not science.
I only know of one large trial, done in Bangladesh, looking at mask effectiveness. And they helped, even surgical masks, especially if masks are readily available and there was an ad campaign. It mainly helped with the elderly--seemingly people wouldn't always wear their masks, but did so around the vulnerable.
There were many other small studies or even just surveys, and you could pick and choose amongst those.
The Bangladesh study was flawed for a couple of reasons including bias in the masked group. Their conclusion was that cloth masks did nothing and that surgical masks reduced transmission by 20% for those over 50 and 0% if under 50. That makes no sense and where the bias problem enters.
There was also the Danish mask study for Covid and previously 10 random controlled trials that showed no significant effectiveness against influenza.
Three hand washing RCT showed no effectiveness against influenza and one RCT in a grade school in Egypt showed a little effectiveness.
He was 100% wrong and barked that slogan without scientific evidence evidence. Many randomized trials have shown that cloth masks and surgical masks have no effect against Covid and influenza.
You're the one who's 100% wrong. While it is true that individual use of cloth/medical masks does little good to protect the wearer, widespread or near universal use of these masks provides significant and useful group protection to everyone in the room (by reducing the quantity of virules breathed into the air).
The scientific minded follow random controlled trials not politician's slogans no matter what a warm fuzzy feeling they might give.
A 2015 RCT trial in hospitals showed that cloth masks let 97% of the virus through while surgical masks let 50% of the virus through.
Your (as always) complete lack of citations is noted. Also, not sure what you think you're attempting to provide by citing a trial five years before the covid virus arrived on the scene.
Lab studies have shown that masks are effective ie they reduce the amount of virus to which you are exposed. If you read the RCTs nearly all acknowledge that they have significant shortcomings.(It sounds like you are mostly citing stuff from the big Cochrane meta-analysis. The most obvious one and the one that makes studies, RCT or not, largely useless is that of compliance. We dont have good studies that account for people actually using masks when and how they should.
Most spread was among family members. If you have 5 in a family and 4 are 100% compliant but one is not you can end up with 100% infected.
Steve
Holy shit, if that's true, why wear any PCP in an operating room at all!? It's all completely ineffective! The germ theory of medicine has been disproved!
You need to improve your knowledge of the scientific evidence. Conveniently enough, a massive meta-analysis and review of the subject was published in Clinical Microbiology Reviews last month (https://journals.asm.org/doi/10.1128/cmr.00124-23). Their conclusions include "Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens."
Which was exactly the sentiment cited by the extreme-magas for NOT wearing masks: why would they want to "protect" anybody but themselves? Why should they inconvenience themselves for another's benefit?
And they're good Christians! Never forget that! Unlike all you librul heathens!
I agree with your points here except...Kevin may be taking into consideration the fact (and let's be real, it is a fact) that Americans aren't thorough enough about masking to get the desired herd effect from medical or cloth masks (without which they do little good).
You're right that the "N95 or nothing" approach is wrong, but certainly, to the extent that a population engages in masking, the higher the percentage of N95s the better.
I’d really like to see a study based on ‘instrumented’ masks, i.e. incorporating some miniature apparatus that traps particles in the inflow and outflow airstreams. Analysis could determine attenuation factors for various masks in actual use.
The last few cloth masks I sewed had multiple layers of cotton and polyester; I was hoping that friction as the mask flexed would create an electrostatic charge, which is an important mechanism for trapping very small particles in N95 masks.
Modern N95s are more comfortable than surgical masks. I really don't understand the comment.
Heck, I prefer my P100 half-face, honestly, because it's soft, has a good seal, and I can wash it. Of course, people complain they can't understand me through it which baffles me, who has a hard time understanding people normally I can hear people in them just fine.
I do not understand why Kevin has been saying that medical masks don't do anything. I recall last year - I forget exactly what the study was or if it was a meta study - reading about how medical masks weren't as good as N95s, but were pretty close. It got a lot of press and I didn't hear a bunch of people debunking it.
As others have said, if medical masks really did nothing then why would they wear them in hospitals? Seriously, why? I don't care about percentages or some other study I never heard of. Kevin and any commenting skeptics out there (I was going to write stupid commenting skeptics, but that would be mean), if medical masks don't do anything why do they wear them in hospitals?
Lessons learned? Don’t develop a vaccine. No good deed goes unpunished.
June 17 (Reuters) - The U.S. state of Kansas on Monday sued Pfizer accusing the company of misleading the public about its COVID-19 vaccine by hiding risks while making false claims about its effectiveness.
Except Pfizer did mislead about the safety and efficacy about its mRNA vaccine.
Anyone remember when the left was normal and fought for sound regulations for the pharmaceutical industry instead of being in its Amen corner?
Everyone: do NOT feed this troll.
Citation not included.
I'd state the obvious: measures depend on the means of transmission. Face masks won't limit cholera but clean surfaces will. With airborne viruses it's the other way around.
But from Covid the big lesson, I think, is to know when you've lost. When the genie is out of the bottle, don't bother plugging it. When a microbe has become endemic, don't shut down the economy and close schools. The response wasn't wrong, considering the unknown. But it went on too long. Except vaccines, of course, but those you want for endemic diseases too. Even then it's ridiculous to require vaccination of visitors from countries wth less Covid than your own.
At a certain point the justification was to not overburden the medical system. But where I live, the hospital was empty. Doctors and nurses complained of the overburdening they'd get later when all the postponed treatments for other ailments would have to be done. So when a disease is endemic, calibrate the response locally, I'd say.
If you keep things open, you increase the number infected, increased the number infected means more in hospitals, and hospitals have a capacity limit.
As other people have said, these lessons aren't useful because the next pandemic won't be COVID-19.
Some things that would be useful:
Try to have a medical scientific presence in or near as many countries as possible
Have an emergency vaccine trial schedule that depends on the size of the pandemic
Develop better mathematical modeling (because the ones during COVID were surprisingly bad)
Develop the ability to step up mask and vaccine production
Develop plans for supply chain disruptions
Amen!
Our pandemic preparedness was really bad. Stockpiles, dry rotted. But that's OK, we'll just buy new stuff from China....
Actually, there was a good article in Daily Kos back as COVID started spreading that pointed out that the Japanese did not create "just in time" scheduling and "lean manufacturing" because they wanted to. Those were, basically, in response to a desperate lack of natural resources.
No one should be aiming for 100% efficiency - in a supply chain that means NO slack to handle emergencies - like a pandemic. The Kos author said that lean manufacturing and JIT scheduling, driven too far turned into "skeletal manufacturing" and almost instant depletion of vital materials.
My wife and I saw that in real time at the beginning of 2020 in Bellingham. Basically every mask in Whatcom county disappeared in 1-2 days. The local hardware stores cleaned out everything and sent a lot of their inventory to local clinics and hospitals. The clinics and hospitals had become reliant on multiple deliveries per day of scrubs, gloves, masks, sanitization supplies. All gone in a (relative) instant.
We had some regular paper medical masks - made do with them until local tailors started turning out multi-layer cloth masks, then cloth masks with a pocket between layers for a more effective replaceable insert, etc. The local distilleries shifted very quickly into making 195 proof alcohol diluted down to an effective hand sanitizer and surface cleaner back when the transmission characteristics of COVID were still not well known.
One missed lesson is that home schooling didn’t work for the great majority of families and children. It failed so miserably that vulnerable home schooled kids came out of the epidemic significantly behind.
Weakening public education is a bad idea.
This isnt consistent with what actually happened. It is however a showcase for the reality of this situation: we will learn almost nothing from the pandemic.
As usual, Kevin provides a good and rational starting position on an issue. Based on my own experience, I would add the following.
1) About the school closing, you have to factor in the panic of lots of people. I live in Chicago where CPS handled this in its typically earnest but bureaucratic way. Here, you are talking about many old schools with bad ventilations, with a cold winter. Chicago in March isn't Florida. Schools were closed and learning was remote. Then it went to hybrid (half the time remote and half the time in-person). Finally, return to in-person with masks and lots of monitoring. I have two kids, and this was not easy to navigate. But there were parents who were extremely scared to send their kids to school, with the hybrid, with mask. They were afraid for their kids, themselves, or grand ma who lived at home. Who knows? also, there were lots of old teachers who were afraid, probably with some reasons. So, I wasn't happy about everything, but this was a really difficult situation to manage.
2) Regulations about outdoors!!!! Generally out city administration was solid dragon the pandemic. But they pissed off everyone. They opened bars, but kept the city parks and beaches closed for the whole summer! If you know the wind speed along lake Michigan on an average day, this is beyond stupid. And so unfair, with lots of kids in poor neighborhood who have no place to go in the summer except to a beach. But oh, she allowed rich people to park their yacht along the shore and have driving parties in view of everyone. The management of these decisions was stupid, insensitive, and unjustified.
Lightfoot's superpower was coming up with compromises that made nobody happy.
Closing outdoor spaces is absolutely asinine. We knew almost from the first that the virus did not spread outdoors except by the most intimate contact.
What the US did right: the CDC has great world-wide infectious disease monitoring.
What the US did poorly: the US had spotty local infectious disease monitoring. And lack of data--ignorance--was used as an excuse for inaction. With post-COVID wastewater monitoring, the US is doing better, let's keep the funding high for it.
Biggest mistake: the federal government responded slowly and ineffectively in the first two months. Faster response that seems like an over-reaction at the time is the best response. If the response is effective, and a disease is slowed or stopped, it should always feel like an over-reaction. Hoof-and-mouth disease is the model.
The Trump administration kept trying to zero out the CDC, which I'm guessing really killed morale. The CDC also has monitoring stations world wide. There was even one in Wuhan that was closed down prior to the pandemic.
Early on the TFG maladministration cut the CDC's monitoring station budget by 80%. They didn't completely shut down monitoring in China, but at one point there were only about a dozen people covering a vast amount of territory. They also cut the NSC(?) pandemic preparedness team completely. (Claimed they "didn't fire anyone" - but they were no longer doing an important early warning and preparedness function.)
Lockdowns: Drum thinks lockdowns are "maybe" a good idea after studies in 2020 and more in 2021 overwhelming showed they had zero effect on slowing coronavirus not just in the U.S. but around the world.
Closing schools: Studies in Scandinavian countries showed by May 2020 that children almost never spread coronavirus. Still, Fauci panicked and tried to instill more fear to the public, the left MSM was in a frenzy and so parents on the left freaked out and insisted on false information that they should keep their children out of school for 18 months.
You are likely a troll, and not even a very good one at that.
"Lockdowns: Drum thinks lockdowns are "maybe" a good idea after studies in 2020 and more in 2021 overwhelming showed they had zero effect on slowing coronavirus not just in the U.S. but around the world."
Proof is always welcome here. Personal opinions should play very little part in science.
"Closing schools: Studies in Scandinavian countries showed by May 2020 that children almost never spread coronavirus. Still, Fauci panicked and tried to instill more fear to the public, the left MSM was in a frenzy and so parents on the left freaked out and insisted on false information that they should keep their children out of school for 18 months."
Again, proof please. Your personal "opinion" is silly and ignorant. Sweden, at first, ignored the virus until they ran out of hospital space. I was there and have the charts. Sweden reversed that pathetic attitude within months.
BTW, it appears Pakistan is undergoing the beginning of a polio epidemic. If unvaccinated, why don't you go there and keep us all up to date.
For lockdowns, read the Johns Hopkins meta study published in 2022.
The Scandinavian school closure and children papers are online. They were widely discussed in Europe but America's left MSM was as usual silent.
Those of us who work with pediatric patients were aware of the "Scandinavian studies". A good critique is at the site linked below which notes that Sweden really didnt do the studies which would have been helpful. The study most often cited was just someone looking at a lot of papers and noting that there didnt seem to be a lot of kids infected and he concluded kids probably wouldn't be a source of infection*. This completely misses asymptomatic infection and spread. Plus, in May we still didnt know the long term effects of kids who did have asymptomatic infections.
Steve
* In Ludvigsson's paper he claimed there were no outbreaks among school kids but there were actually contemporaneous reports in newspaper accounts.
https://www.science.org/content/article/how-sweden-wasted-rare-opportunity-study-coronavirus-schools
'Studies in economics' is not, actually, a meta study on the spread of the disease.
Would that be this "Johns Hopkins study"? The one that a working paper, not a study, was not published by Johns Hopkins, was not peer reviewed, and was written by economists?
https://www.snopes.com/news/2022/02/03/johns-hopkins-study-on-lockdowns/
I begin to understand why you never cite your sources.
Also, from one of the authors of an analysis from Imperial College London, most from the MRC Centre for Global Infectious Disease Analysis.The writer notes that the ‘Johns Hopkins’* paper
(Quoted at Snopes)
Uh-oh. I’m pretty skeptical about studies that apply ‘the methods of economics’ to issues of economics, let alone issues in other fields …
*the study was not endorsed by JHU, with which only one of the authors was affiliated.
No citation included. That's pretty normal for your misinformation.
How hard is it for you to type "Johns Hopkins lockdown study"?
Imagine going "we should keep schools, which are plague pits on a GOOD day, open."
Imagine writing a whole list of lessons learned with not one word, not ONE, about how plague rats will emerge who actively take the side of the virus, and how we might or might not deal with them.
Imagine writing that same list without a single word about vaccines, either.
Imagine making an argument without contributing something.
Schools can't close outside of context.
Can somebody please carve this knowledge into stone in some obvious place so it's not forgotten like all the painful knowledge lost from Spanish flu, polio, and all the previous pandemics? Mount Everest maybe?
This seems highly debatable to me:
“Lockdowns were moderately effective but came at a large economic cost. The right balance is more a political question than a scientific one.”
Pandemics are hard. People and economies will suffer. But lockdowns and school closures risk turning into the cure that’s as bad as the disease.
I live in a blue area that jumped early into lockdowns and maintained them longer than other parts of the country. It’s no exaggeration to say that this area remains visibly devastated, with some downtown streets entirely emptied of businesses and filled with literally nothing but empty storefronts.
Not surprisingly, given the loss of revenue, this area is looking at enormous budget deficits that may further erode quality of life in general.
I’m well aware of economic updates indicating that the USA is doing well after the pandemic. And yet broad trends may nevertheless conceal genuine economic harm that specific areas are still grappling with.
So if, as Kevin says, lockdowns were only “moderately” effective at halting the spread of Covid, that seems to raise genuine questions about whether they should have been implemented.
Lockdowns would need to have a solid gold record of impeccable effectiveness to justify their otherwise harmful side effects. And those side effects are still out there. We may now have vaccines for Covid, but we have no vaccines for post-Covid budget shortfalls.
And then there’s the endless, and highly politicized, debate over Sweden and its decision to avoid a Covid lockdown. Scanning through news on Google, I cannot find a single liberal media outlet praising Sweden’s approach nor a single Conservative outlet criticizing it. So, to me, that indicates that the debate is very much open and remains something to consider.
But, on the whole, I personally remain skeptical of lockdowns. Perhaps they were briefly necessary to prevent our medical facilities from being overwhelmed. But they should only be embraced with eyes wide open as to how profoundly risky they are.
Many places did not find “the right balance” that Kevin references. And as a result those places are still suffering years after their medical systems were briefly under strain.
And then there’s the endless, and highly politicized, debate over Sweden and its decision to avoid a Covid lockdown.
Lockdown simply means "mandatory social distancing."
Sweden is a bit like Japan: a well-educated, affluent, high trust society where expert/scientific opinion is widely respected and followed.
In other words, countries where lockdowns aren't necessary are the same countries where social distancing practices are widely and voluntarily followed.
If the "trust" and "follow science" factors are lacking (as in, say, Arkansas), lockdowns don't do you much good, because people who are skeptical of standard public health instructions are unlikely to adhere to rules enforcing the same.
In short, what ought to be "praised" isn't Sweden's lack of lockdowns, but the presence in Sweden of common sense attitudes with respect to the advice of public health officials.
Also, for the record, the evidence suggests that Denmark and Norway did modestly better at keeping people alive with no extra price paid relative to Sweden in terms of economic costs.
" So, to me, that indicates that the debate is very much open and remains something to consider."
The WHO strongly advised against lockdowns in 2009 and again restated that in 2019 - just months before people panicked in 2020.
Drum mentioned lockdowns "came at great economic cost" but didn't mention the horrible psychological impact they had on hundreds of millions of people around the world or that they pushed over 100 million into near starvation in 2020 according to the UN.
Citation not included, again.
Places like San Francisco put people ahead of commerce. So people like you can say it was done wrong after the fact. The city of San Francisco and the State of South Dakota have approximately the same number of people. San Francisco had 1,300 deaths to South Dakota’s 3,200. Everything about SF (dense population, lots of Chinese Americans returning from holiday visits to China) would lead you to believe those numbers would be reversed or even worse for SF. If the United States had San Francisco’s death rate our Covid response would be considered a gigantic success.
Yes, part of it is that San Francisco's population was generally accepting of the science around Covid and did their best to comply with mitigation efforts. South Dakota was filled with a bunch of MAGAts yahoos who were like "fuck you, government! YOLO!" But you also have to account for the fact that the vast majority of SF office workers were able to move to remote work and stay home relatively easily and that made a huge difference (compared to, say, LA or NYC).
A better comparison would be between South Dakota and Vermont, which are both small, rural states with kinda similar populations, but whose public officials took diametrically opposed approached to managing Covid. Again, way, way fewer deaths in Vermont (per 100,000) -- under 1000, vs. over 3000 in SD
(source: https://countryeconomy.com/countries/usa-states/compare/south-dakota/vermont?sc=XOC4)
Clarification: I think those nrs are per 1 million, not 100k. Sorry for the discrepancy.
South Dakota and Vermont are quite different.
South Dakota's largest cities have populations of 200,000, 75,000 and 30,000 whereas Vermont's largest cities have populations of 45,000 and 20,000 and 20,000.
38% of South Dakota is obese compared to only 27% in Vermont.
We know lockdowns and masks didn't slow the spread so other factors explain the difference. A third difference is likely denser nursing homes in South Dakota in Sioux Falls and Rapid City.
You 'know' these things but you never cite anything that supports your evidence.
I wonder why that is?
For the slow...
http://www.wikipedia.com
10.5 of South Dakota's population are Native American, many living in abject poverty on the rez. That's the fourth highest fraction of Native American population among the states (after AK, OK and NM).
10.5 %, that is
This, like literally everything, is debateable.
Your opening argument that a strong economic recovery that also includes minor, localised, budget shortfalls that also existed before the pandemic is as bad as millions of Americans dying from a virus is a really bad entry into the debate.
Bit this is your typical approach. Very bad entry into the debate.
We should be working right now on a Manhattan Project to install better ventilation universally to prepare for a future pandemic.
While everyone would like to see the best and most protective ventilation systems in every building in every shared structure in the country, I'd want to see some figures before leaping into a Manhattan project. How many shared buildings are would need state-of-the art ventilation systems? Basically everything that's not a single family home, right? We're surely talking about millions of structures. What's the cost, twenty billion? One hundred billion? A trillion? It might be cheaper to simply upgrade building codes and let this process proceed slowly, with time, and/or use lockdowns (as hated as they are) to keep people out of crowded indoor spaces until the worst is over. Or maybe not! But again, what's the cost?
Heck, here in Albuquerque when my offspring were K12, it was typical for schools to have roofs that leaked massively during every rain. The only bright spot was, we only get 8" a year, less during the widespread droughts. And that was the school buildings. Many classes were held in trailers parked outside the school buildings, because the space was needed but no money for constructing new or expanded buildings was available.
Upgrade the ventilation? Sounds good! With what funds? With what legislation? In what world?
You forgot one.
Intervention: Vote wannabe dictator out of office.
Good idea? Yes.
Keeping schools closed was largely a local and state controlled issue. It was a new virus and it takes a while to develop data on a new virus. If you are going to worry about long term effects it will take longer to accumulate data. Closing schools and not opening until fall of 2020 made some sense. After that I would let communities decide upon the level of risk they want to bear. Future pandemic decisions will need to be based upon the virus that causes the pandemic.
Steve
I think Kevin has fallen into the classic error of fighting the last war. He assums that the next virus will be transmitted the same way thatr COVID is. Many health authorities, including the WHO, did the same in reverse, thinking COVID was transmitted through droplets as the last big virus was. The biggest thing Kevin is missing is that we need to understand the mode tof transmission as quickly as possible so we can put in effect the correct measures.
What exactly is meant by the Far-UVC lighting suggestion, or the claims that it doesn't affect humans?
Far-UVC is invisible places (eg duct-work) seems like a fine idea -- but you have to take into account practical realities when bulbs have to be replaced.
Far-UVC light in visible places (ie the ceiling) seems like it could be problematic. I could very easily believe that there are no IMMEDIATE effects, but important long term effects. The one I would be most worried about, just at an intuitive level, is cataracts, but maybe long term melanomas might also be an issue.
This is one of these things where, sure, only one in a hundred thousand are affected -- but maybe only one in a hundred thousand were protected...
I want us to get this right because I think the basic idea is sound (I have a UV light I had installed in my duct work...) but I don't want it to be destroyed by incompetent implementation that leads to more harm than good.
This is probably a bad post because there's no reason to think that the next pandemic is going to be identical to COVID, there are all kinds of ways it could be different and setting these kind of expectations is only going to confuse and bother the more easily confused and bothersome members of society.
Even COVID wasn't similar to COVID. It broke all the rules for coronaviruses. That's why things we thought would work early on sometimes turned out to be useless, because all we had to go on at the time was what works with other coronaviruses.
Surface cleaning: No, but … : The next pandemic virus may or may not survive on and spread via surfaces.
The thing that has really shocked me is that Democrats have not at the local level tried to pass building codes requiring better ventilation (<700 CO2 ppm) for new construction.
Fucking lowest hanging fruit ever.
Also my understanding is Far UVC isn't confirmed to not cause humans problems because it causes a MASSIVE ozone spike. And that it may actually kill just as many lives as it saves.
https://www.vox.com/the-highlight/23972651/ultraviolet-disinfection-germicide-far-uv
Far UV is a yes but. UVC can cause blindness, either temporary (photokeratitis aka snow blindness which is painful to boot) or permanent (increases the incidence of age related macular degeneration). You can't just hang them from the ceiling and call it a day.
But what if the next pandemic is only minimally transmitted via aerosols, but is highly contagious via contaminated surfaces and interpersonal contact, and is far more serious in children than adults?
We've learned some things for a new pandemic that looks like Covid, but the real answer to all of your suggestions is "maybe."
> Lockdowns were moderately effective but came at a large economic cost. The right balance is more a political question than a scientific one.
It's not really political. When the hospitals were about to overflow, we locked down. Once the lock down helped slow the spread of covid and hospitals had room again, we reopened.