Coronavirus: The Hammer and the Dance explains what everyone should know about governmental and societal policies for dealing with Coronavirus. Millions will die needlessly unless we change policies. (Some Asian countries have good policies. North American and European countries don't.)
Summary: Absolutely don't give up and intentionally let everyone get the disease. And we don't need total lockdown for 18+ months to wait for a vaccine, either. Instead, we must immediately do roughly 4-6 weeks of lockdown to get the disease under control (every day counts against an exponential pandemic). Once it stops spreading exponentially, we can manage it using testing and contact tracing, and ongoing mild and cost-effective lockdown measures while awaiting a vaccine. Any time spent on half-measures right now is condemning people to die and hurting the economy without solving the main problem. If we don't get this right, the hospital system will be overwhelmed and millions will die as hospitals turn them away. We're already on course for disaster, in a matter of days, if we don't make this policy change.
Do we really need to take drastic measures? Yes. Read about how harmful the disease is: A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients (the article is about a hospital in New Orleans, in Louisiana, in USA).
In Wuhan, the disease peaked a month after they did a full lockdown. In Italy today, despite the ongoing disaster (they've passed China in deaths), their lockdown is still inadequate.
It seems to take a lot of fear or force/authority before people change their behavior and isolate. It shouldn't, but as a practical matter for ~everyone it does. Until the force/authority of government compels people to do the right thing the only thing that works is fear.
Suppose someone will listen to enough information to become fearful and self-isolate for now.
Then the fear itself becomes a problem - leading to not just feeling bad but not being able to sleep, loss of appetite, raise in blood pressure, listlessness, hyperventilating, stress-eating, etc. Less fear than that and they would still go out and do dumb shit.
Don't get me wrong: the fear is a better problem to deal with than having the virus. But still a big problem, and one that could cause nasty snap-backs ("fuck it, I'm tired of living this way, if I die I die", "I want to drink to forget all this").
Any suggestions for dealing with that?
#16091 Depends on the person. A few suggestions:
Don't be an emotionalist.
Learn philosophy. Learn anything.
Learn about viruses. Demystify the enemy.
Distract yourself. Books, video games, TV. Find something you can get lost in for weeks, like a new one that sucks you in.
Do stuff you regard as productive, have wanted to do for a long time, and can do at home.
Understand what the dangers are better. You should be scared if you and others are going out like normal. But if you're staying home, your risk is low. The fear should prevent risky activities and get you to do low risk activities, and you should feel fairly safe while you're avoiding the risky activities. Associate the fear with the dangerous stuff not with all of life.
15 Days to Slow the Spread was posted by the U.S. Whitehouse on March 16.
It is *not* the hammer. It's not close. It's half-measures (maybe tenth-measures) which are likely to kill over a million Americans compared to the hammer and dance strategy.
New Zealand about to do the Hammer and the Dance. 102 confirmed cases in NZ.
Massive pressure went on the NZ govt to do the Hammer and the Dance. They should have done it earlier. And it is not being implemented until Wed. But they are at least going to do it. And some of the pressure arose from information posted on this blog. Thank you for doing really good work. The problem now is getting all NZers to treat it really seriously.
Hydroxychloroquine for Covid-19
Hydroxychloroquine is an existing drug that is now being used by some doctors to treat Covid-19 with great results (one NY doctor used it on over 700 patients resulting in zero deaths):
Company awarded $750,000 by US government to do a 1-month study of Hydroxychloroquine for Covid-19:
Hydroxychloroquine is an existing drug, e.g. used for malaria and lupus. So it's already in production and production is now being ramped up.
FDA changed their rules to allow the use of this drug for emergency cases even though no study has been done yet. I hope this policy continues in the future for all diseases.
Originally posted on Discord.
At what point has the mitigation  been in action for such a long time that a hard lockdown (Hammer) is no longer the better strategy? When is it better to do something else?
It is better to use the dance strategies whenever you can. It would have been better to use them initially, as Taiwan did. Once our numbers are low enough that we can use them, it will be better to use dance strategies. That will require the government actually preparing enough & being able to implement them well though.
But I think you are asking when it is better to do something besides the Hammer & Dance - what if the hammer takes too long? Is there a point where it is better to just let the disease run its course, to save the economy?
There's no point where it would be better to just let the disease run its course (without already having vaccines, treatments, etc). The death rate is too high. It would kill millions of people and overwhelm the healthcare system. People would die of other things too, not just covid, because the hospitals would be overwhelmed. We would lose healthcare workers to exhaustion and covid and suicide and PTSD. These things are *already happening* even though we have mitigation strategies. Things in Italy, Spain, NYC would be SO much worse if they hadn't shut down. Things would get bad enough that people would be afraid to leave their houses.
One way to stop from overwhelming the healthcare system would be to just stop admitting covid patients. We'd not want to admit ANY covid patients, since any positive patients could transfer it to other patients. We could maybe set up extra hospitals just to take covid patients, but we wouldn't have the capacity to take ALL of them - we'd have to just take young people with no pre-existing conditions or something. The people we are most likely to save. Even offering comfort care to higher risk patients would overwhelm the system. We don't have enough doctors & nurses to deal with that. But then where would those patients go to die? Home with their families to die there, gasping for breath? I know if anyone who advocates letting the disease run its course has thought through the reality of this.
One idea people have is to just segregate all the old people & those with health conditions. One thing to consider - that's already what nursing homes ARE. They are segregated old people. And those have led to really high death rates because once it gets into a nursing home, a lot of people die. There is no way to fully segregate nursing homes - they need staff. I don't think we would be able to get enough people to volunteer to leave their families & work in a nursing home for the next 18 months or whatever. And even if we could, they also need healthcare, food, supplies, people to come and fix things that break, etc. We can't just fully segregate them. All it takes is one person bringing it in, and a bunch of people die.
Another problem with that idea is that 40% of the US population is "high risk". 40% of people are either over 65 or have a health condition. How could we segregate 40% of the population? Where would we put those people even if we COULD segregate them? (Which, as I said above, we can't - they will still need food, healthcare, etc.)
There is no reasonable way to just let this run its course. We don't even know the death rate yet - we know that it's too high for the healthcare system to deal with. And we know that if we let it overwhelm the healthcare system, it will be even higher because people with covid won't get proper treatment, and neither will anyone else.
Are the people who want to just let it run its course willing to just let 1-5% of the population die? Do they think that will somehow save the economy?
It is possible that there will be other things we could do that would help.
Like, maybe it would work to infect healthy people with really low amounts of the disease - maybe healthy people could volunteer to become infected & quarantine, and that could help us build up towards herd immunity.
But that is basically a type of treatment. That's an old-fashioned way to do something like a vaccine. We would need some research to even figure out how well it works.
I wouldn't call that an alternative to the hammer & the dance. It is a type of medical treatment. A crude one, but still medical treatment that requires research to even figure out if it works well, how safe it is, etc.
One of the things that we are currently buying time for is more medical research. If we can figure out some kind of treatments that would work, that would be great, and could change our dance strategy.
We can also learn more about how the virus actually spreads, what kills it, what we need to be careful of, when people are contagious, etc. Those things would all also help us with a more successful dance strategy.
None of those things are really alternatives to what I would consider the dance strategy - they are part of it.
> At what point has the mitigation been in action for such a long time that a hard lockdown (Hammer) is no longer the better strategy? When is it better to do something else?
(written and posted before reading ingracke's replies)
Very roughly, it's too late when 50% of the population has already been infected. Before that it's still plausible and worthwhile to (mostly) stop the spread by doing hammer.
It depends on speed of spread too. If 60% have been infected but only 2% are currently infected and 48% are recovered, then definitely do hammer to save the other 40%.
But if 50% have been infected and 40% are currently infected, that sounds like probably too late. If people would actually listen and do everything right, and all start the hammer today, it'd still be good to save a lot of people from infection. But with disobedience, carelessness, some spread due to essential business, spread to family members while staying at home, etc., maybe it'd be time to give up on stopping it.
Actually no wait, I think that's wrong. That was my first thought and I won't edit, but there's a major issue I didn't factor in. If 40% are currently infected, the hospitals are overwhelmed. That's really bad. It's still quite possibly worth it to hammer, even if it doesn't exactly work and everyone ends up infected, just to flatten the curve some. Like if the last 10% of the population (that get infected) get infected late, at least they'll have hospital resources available and therefore only have maybe a 0.66% death rate instead of the 4%.
> There's no point where it would be better to just let the disease run its course
If 99% are already infected, we can give up on social distancing, stop staying home, etc.
What about giving up at 95%? 90%?
There is some point. We are nowhere near it and it's not an important or useful issue to more precisely figure out what the point is. But it exists.
Oh, yes, I agree with that.
I was interpreting the question as meaning something more like: Assume the hammer is working, but it is going on too long. After how many months do we just give up and let people die to save the economy.
That is a common question/point I have seen brought up repeatedly, so that's what I took it to mean. There are people who think that waiting 18 months for a vaccine is too long, and as soon as we let up we will have the deaths, so we should just let up now instead of prolonging it. I was arguing against that.
#16235 & #16227
Would it be reasonable to condense it down to something like:
As long as the situation seriously threatens to overload the healthcare system, or keep it overloaded, then the hammer strategy is still the best option?
Healthcare system overload seems to be the key factor to keep in check - for all the reasons given in #16227. Is that a fair assessment?
#16247 Yeah I think hospital overload is the #1 factor to be concerned with and plan around.
I agree that hospital overload is the main concern.
But another issue right now is that we don't even know the death rate or the longterm effects of covid-19. It takes people weeks to die. So in the western countries that recently started getting it, it is possible that there is actually a higher death rate for young people than we realized. It is also possible that many of the survivors have long-term health effects, like reduced lung capacity, or susceptibility to other infections. Maybe some of them will require lung transplants.
So that is another reason to be cautious with plans that involve only letting the young & healthy people get infected. (BTW, one way to let young & healthy people get infected would be to segregate young, healthy volunteers from the rest of the population, and infect them while they are quarantined together. That would be more practical than trying to keep the old people segregated for the next 18 months. The young, healthy people could go be quarantined in groups & for much shorter periods of time. They could also be infected in a more controlled way, with smaller doses. But we can't even consider this until we have a better idea of the death rate & complications, and we wouldn't be able to do it until the situation was more under control - we don't have a lot of resources to spare right now.)
I agree with the hospital overload being the main concern to plan around.
I also agree that there are other issues re covid than hospital overload.
What have been the effects of hospital overload in eg Italy, France, UK? What does eg the non-covid death data look like in these places where hospitals have been overloaded thus far?
I have not been able to find any good data on this.
While I agree on what needs to be stopped (primarily hospital overload) I struggle with the consistency between the tactics used (gov force) and liberalism as explained in Liberalism: Reason, Peace and Property.
I have read the following link, but it is not clear to me that there aren’t other things that could be done besides full lockdown.
FI Google Groups
From *Liberalism: Reason, Peace and Property*
> The /freedom to live/ means being free to keep yourself alive, e.g. by hunting and eating. Being /free/ to think and live doesn’t mean you will succeed (nature may put obstacles in your way like storms or diseases) or that anyone has to help you (but you and others are free to cooperate), it just means you won’t be stopped by violence.
The lockdown stops me (by violence) from going to work —> earning money —> buying food —> living
How do we draw some kind of line re when gov force is needed when this force hinders ppl from living? Amount of lives / lack of other tools / risk degree / solvable within time limit etc?
When is it up to gov to protect? Cf guns ok to protect oneself from physical force - is this not similar in concept to masks to protect oneself from virus prevalence?
I know it’s complex, but it’s too vague for me at my present understanding of this problem. It leaves too much leeway for eg leftists to propagate more power for gov for other issues.
> What have been the effects of hospital overload in eg Italy, France, UK? What does eg the non-covid death data look like in these places where hospitals have been overloaded thus far?
> I have not been able to find any good data on this.
We won't have good data on it right away. Some things are down - there are less car accidents right now because less people are driving. I don't know what's happening with things like heart attacks and other health emergencies - those are still happening, I don't know how it's affecting treatment. One thing that will be difficult to figure out and can't be looked at until later is the difference in cancer deaths. A lot of people are having their cancer treatments delayed right now, even in countries that aren't currently overloaded.
But right now you can't even get reliable statistic on how many people are even dying of coronavirus. Not everyone is being tested. Not every death is actually counted as coronavirus. Lots of nursing home deaths in different countries aren't being counted, or are only being added to the stats later.
As to other effects of overload - they aren't even trying to intubate older people in some hospitals, which will make the death rate for coronavirus higher than it would otherwise need to be. The nurses and doctors are overworked. As of March 30th, 61 doctors in Italy have died of coronavirus.
> it is not clear to me that there aren’t other things that could be done besides full lockdown
There are other things that could have been done besides a government-enforced lockdown.
The government could have taken it seriously early on. They could have told people how to protect themselves. Instead they mostly just told people everything was fine, carry on as usual, keep going to events. The government officials themselves continued going to events, travelling internationally, shaking hands, etc. That is why so many of them ended up with coronavirus.
So of course no one took it seriously. The WHO, the world's governments, the health officials all were not taking it seriously.
If everyone who could work from home had started working from home earlier, and if everyone had stopped most of their unnecessary outings, stopped socializing as much, stopped all large gatherings, wore masks when they did go out, then it would not have spread so quickly.
Once it got bad enough, then extreme social/ physical distancing was needed to stop the virus from spreading so much. If we had done better earlier, I don't know if we would have needed such extreme distancing. We still might have, if we weren't able to do the kind of quarantines & contact tracing they are doing in Taiwan.
Even without government intervention, "social distancing" would really damage the economy. If everyone just stopped going out to restaurants, bars, salons, gyms, etc – which they should have been *told* to do by health officials – that alone would have shut a lot of things down. A lot of businesses would have had to close or cut their hours and lay a lot of people off. Which would prevent a lot of people from going to work even without government force. A lot of people would still lose their jobs.
The problem of the economy being shut down and people lose their jobs and not being able to afford their rent is not actually directly caused by government force. Those problems would happen if everyone were taking the pandemic seriously and trying their best to avoid spreading it, whether or not the government was making them. If people were actually acting responsible in the pandemic, a lot of people would lose their businesses and their jobs. So blaming government force and talking about liberalism vs government control doesn't really address the actual cause of the problem.
#16306 (this message was also written by me, btw)
Another issue is that a lot of people don't take recommendations seriously unless the government actually makes laws and rules. Because that is what the government *does*. It makes laws and by-laws about so many different things. It makes laws about things that don't really matter at all and don't hurt anyone. So people think that surely, if it matters, the government would make a law about it.
If the government just made recommendations, and had almost no laws, people would take recommendations more seriously.
The middle of a pandemic where millions of people will literally die if we do nothing is not the time for the government to all of a sudden just start being hands-off.
It is a bit like a helicopter-parent who micromanages their child and has lots of rules and punishments. Say they read an article about TCS, and decide to start just explaining things to their kid instead of using rules and threats. It would not make sense to start this for the very first time when the child is literally about to walk off the sidewalk into traffic. That doesn't mean that arguments are ineffective or that it is impossible for TCS parents to non-coercively keep their child safe or that punishments and rules are needed.
> Those problems would happen if everyone were taking the pandemic seriously and trying their best to avoid spreading it, whether or not the government was making them. If people were actually acting responsible in the pandemic, a lot of people would lose their businesses and their jobs.
Yes. If everyone was to take the epidemic seriously and try their best to avoid spreading it many would lose their businesses, jobs, and homes. This is voluntary and does not conflict with liberalism.
My concern is not with that. My concern is with those who value their businesses, jobs, and homes higher than the risk of getting - and spreading - the virus. Those who do not want to be under a lockdown voluntarily.
Let’s ignore the ppl who do not care about spreading the virus (I do agree that knowingly spreading disease, as mentioned in (curi’s article)[https://elliottemple.com/essays/liberalism], or acting unreasonably if suspected of having such, is force). But suppose some ppl do take precautions and wear protection to minimise the risk of getting and spreading the virus to others. Is it still consistent with liberalism to force them into a lockdown if they do this? If so, why? I don’t really see how it would be consistent with liberalism. I don’t think anyone suggests 0 risk as the standard btw.
I like the approach by Alex Epstein in *Moral Case for Fossil Fuels*, to look at the downsides of all alternatives. I think we have looked heavily into one (covid downside) and not as much into the other (econ downside - me neither). Maybe someone here has, but it has not been discussed much that I am aware of.
Because of this I tried to find out Alex's reasoning on this issue. Unfortunately he looks to have chosen the easy way of arguing against indefinite shutdown, which was not very helpful.
(I posted #16351 as well)
I listened to some, for me, new content with Alex today. I was wrong to cast judgement on his position as fast as I did before looking up newer content with him.
I think that several things that Alex brings up in this podcast are reasonable and are close to my reasoning on this.
Tom Woods show Lockdowns vs. Human Flourishing: Is There Another Approach?
There are mistakes with how you are presenting this.
One issue is that you seem to be conflating the economic impacts of people self-isolating with the issue of government control.
You say your concern is with people who value their businesses, job, and homes higher than the risk of the virus. But even if those people did have total freedom, many of them would still lose their businesses and jobs. And then later you talk about looking at the econ downsides. But it is not the government lockdown policies that are causing the economic harm, it is the coronavirus itself.
(There are government policies that caused economic harm - like lying to people about how bad it was, continuing on as if everything was normal, travelling & shaking hands on tv, which signalled everything was normal, telling people masks do more harm then good, lying to people about how the virus spreads in ways that discourage caution. Those things all made the problem worse.)
Regarding taking precautions, The Hammer & The Dance Article recommends taking precautions are starting to re-open things, once we have it under some control AND have some ideas about what precautions will actually help. But I think your point here is that you disagree with the Hammer & the Dance. But you haven't said exactly how.
I listened to that and was not impressed with Alex.
He didn't give a lot of details about what he thought should be done. His point basically seems to be that indefinite shut downs are bad, smart people should be able to figure out reasonable precautions we could take instead. But that is what the Hammer & the Dance argues for.
Alex isn't even clear about what he thinks should happen - he said that he wasn't against limited government shutdowns. But he doesn't define those. He thinks there should be a timeline to re-open things, but one of the issues is that we don't know enough to make a timeline in advance. We don't know what precautions are reasonable yet. We don't have enough research. We don't even know how exactly this is spreading (e.g., how much is asymptomatic, how much is airborne vs droplets, how fair the airborne/droplets travel, etc).
Alex also thinks the disease isn't as bad as people think. He thinks the worst case scenario isn't as bad as people think it will be. But Italy, Spain, and New York were already really really bad, and that was WITH shut downs. I don't think people are exaggerating how bad this could be. Worse than Italy & Spain would be terrible.
One thing that is not clear – with both Alex's argument and yours – is whether you are arguing against the *current* shut downs and social distancing, or whether you are arguing against 18 months of shut downs (or some other timeframe).
I have tried some different approaches for myself the last week or so to get a clearer view but I think it would be best if we can take some steps back and move slowly. I think my issue is on some early level stuff. Let's try some stuff that confuses me.
Some things that confuse me:
- Does it not conflict with individual rights to lock down ppl that are not sick?
- - And by doing so are we not sacrificing the young for the old and sick (eg about 95% of deaths in Sweden are +60yrs old, and about 87% are +70yrs)
- How do we know if our initial take on the virus was too dark / pessimistic (exponential growth predictions are hard - also see DD quote from BoI ch 9 below)?
- - Death numbers in eg Sweden, with lacklustre actions to deal with the virus are far lower than what I would have expected after such a long time
- - So far no hospital overload
- - - these things are in contrast to Italy & UK (this might all change drastically in the coming months of course)
> The opposite approach, blind pessimism, often called the *precautionary principle*, seeks to ward off disaster by avoiding everything not known to be safe. No one seriously advocates either of these two as a universal policy, but their assumptions and their arguments are common, and often creep into people’s planning.
> - Does it not conflict with individual rights to lock down ppl that are not sick?
Do you think you already got any response to that?
>> - Does it not conflict with individual rights to lock down ppl that are not sick?
> Do you think you already got any response to that?
No. If I did then I did not understand the response well enough to integrate it with my knowledge of individual rights (which also could be mistaken).
You are still mixing up the issues of government force and whether a lockdown is the best way to deal with the virus. Those are 2 different issues, but you are talking about them as if they are the same.
Your first question is about government force. But all your questions after that are about the best way to deal with the virus.
It would be much easier to just discuss one of them at a time. In this case, I think you should start by talking about the best way to deal with the virus. Then you could discuss the best way to enact those policies later - once you know what the best policies actually would be.
This is a worse post than my original one but good enough. It’s a rough copy from memory. The first one was lost to a 404 error.
> You are still mixing up the issues of government force and whether a lockdown is the best way to deal with the virus. Those are 2 different issues, but you are talking about them as if they are the same.
> Your first question is about government force. But all your questions after that are about the best way to deal with the virus.
You’re right. I see that I am still mixing issues.
(Tangent *post mortem*: I am better at identifying this (talking about different issues) with others than with myself - maybe I should do more discussion trees of my own discussions, especially when I get stuck.)
> It would be much easier to just discuss one of them at a time.
> In this case, I think you should start by talking about the best way to deal with the virus. Then you could discuss the best way to enact those policies later - once you know what the best policies actually would be.
This is a good suggestion. It will help me with structure and enable me to move forward on the issue.
I think that I should start even further back and discuss the endgame / goal first. I now understand that I am not yet clear on even the goal and that might be a reason to my confusion.
I will write blog posts on this and link / paste them here as well for criticism. That way I can catch errors early and fix them along the way.
The time I dedicate to FI / philosophy goes down quite a bit during weekends. My main focus will be towards my main goals so at times posting on this subject may be slow progress.
I will put this on hold for the time being. I have made a note to check in on this issue on a future date.
I thought that I could do this in parallell with other things that I am working on without getting overwhelmed. I was wrong.
Fuck Pueyo's Scholarship
Pueyo is a fraud. He said he was super smart and great at learning, and studying coronavirus all day, *so disregard his lack of credentials*. But then he can't (learn to) do basic stats and outsources that to someone else.
> Thanks to Matt Bell for leading the research in this section.
The material in that section is utterly incompetent and ridiculous, and discredits both Pueyo and Bell.
I looked into it but I don't want to make the effort to write up the details for public consumption (high accessibility) because the error isn't going to be corrected either way because they have no Paths Forward.
Very briefly they assume, for no reason, that 0.1% of ppl coming to a store have COVID. The number assumed here makes a big difference to the conclusion but it gets no discussion. On this premise, plus faulty data that isn't even in their source paper and only applies to young children, they conclude that stores shouldn't use forehead temperature screening.
The paper gives 1.59 as a number for one purpose (outlier rate) and Pueyo/Bell use 1.60 as their number for another purpose (false positive rate). They give zero explanation of where they got 1.60 besides linking the entire paper, and they seem to just be betting that all their readers are even dumber than they are and never check sources. I think they rounded the wrong number and don't know what significant figures are.
The paper has its own major problems like being a chaotic, disorganized mess with poor communication. It was inappropriate to cite the paper without any details or further explanation or quotes. And the paper *isn't applicable to the general public* at stores. They only looked at people aged 1 month to 18 years, and only under limited conditions that'd make the thermometer work better: "2) stable clinical conditions (defined as stable vital signs and blood pressure values, heart rate and oxygen saturation), (3) absence of skin infection, rash, recent topical treatment or abundant sweating in measurement areas, (4) absence of underlying chronic conditions." They were also only looking at people involved with medical care.
#16490 Pueyo can't do basic stats but claims to have read and understood tons of papers related to coronavirus. But many of them involve basic stats. So wtf? Lying bastard.
> This article has been the result of a herculean effort by a group of normal citizens working around the clock to find all the relevant research available to structure it into one piece, in case it can help others process all the information that is out there about the coronavirus.
He cannot in fact do what he's claiming he does if he doesn't know basic stats and can't correctly read an article on forehead thermometers.
> Yes! Although working on this 18h/day so really depends on what can push the message farthest. Feel free to dm
> I deleted that reference because I was sent papers showing there’s still debate on S vs L
He edits out his errors with no retraction notice or change log. And presumably makes a variety of other changes. Fuck him.
I made a note to revisit this today.
I have chosen not to pursue this issue further for now. I need to focus my time on fundamental learning issues that I have been struggling some extra with for roughly the last month.