Friday, January 1, 2021

Soho Forum Debate on the Great Barrington Declaration

 I wrote a post a couple of months ago outlining a path toward herd immunity. Two days later, the Great Barrington Declaration (GBD) was released, authored by three epidemiologists (from Harvard, Oxford, and Stanford, so presumably they have some credibility). It outlines basically the same argument that I made: young, healthy people are relatively robust to the virus and should be living their lives freely (there is something like a factor of 1000 difference in mortality for the youngest versus oldest Covid patients), while the older and more vulnerable among us should be sheltering. The freely mixing population will get a lot of cases of Covid and develop some kind of herd immunity, at which point the virus will dissipate and the elderly can eventually get back to normal lives. 

My feeling is that the opponents of the Great Barrington Declaration don't really have a case. As in, it's not even close. This recent Soho Forum debate between Martin Kulldorff and Andrew Noymer increased my confidence. Watch the entire thing. I was slightly surprised that that the debate was a tie. The exact proposition was:

Coronavirus lockdowns should be lifted and replaced with a targeted strategy that protects the old and other high-risk groups.

Kulldorff, one of the authors of the GBD, is in favor and Noymer against. Kulldorff was not as articulate as I'd have liked. His performance is slightly choppy, which might have something to do with his accent. But the substance of his argument is right on. Noymer's arguments were terribly disappointing. I was hoping Noymer would at least articulate a clear reason for all-inclusive lockdowns that include the non-vulnerable. Some kind of cost-benefit analysis or something. In previous posts I've laid out the three main reasons why I could be wrong. 1) The risk to young people, while statistically quite small, should worry us. Or 2) There is no reliable way to keep this  teeming mass of young people separate from the vulnerable. Or 3) There are long-term consequences of a Covid infection that aren't revealed in the death figures. I was hoping to get a more thorough treatment of these possible arguments. Maybe a philosophical defense of 1), which I regard to be innumerate or irrational. Perhaps a formal treatment of 2), which I also find unreasonable. (How many elderly people would even say, "Yes, I want my adult children and grandchildren to go to such lengths for my sake." Would you, if you were a vulnerable person in your waning years?) Maybe a thorough fleshing out of 3), based on known hangover effects of prior infection. (As I've said before, appeals to "unknown" long-term after-effects, which aren't strict extrapolations from known after-effects, are a form of Pascal's Mugging.) 

None of this was on offer. Noymer suggests replacing the term "lockdown" with "public health orders." So that's his solution: replace an ugly term for an ugly policy with a revolting euphemism. I'm always a fan of more precise language, but this seemed like a cynical deflection to me. Noymer also repeatedly cited a statistic from his home community (Orange County, California I believe) that attempted to quantify the risk to young people, implying that it's larger than the GBD people presume. Maybe I missed his point, but I was left wondering "Why not use nationwide or international figures?" Was he cherry-picking an example of a community with an especially high death rate for young people? 

Perhaps most bizarre, Noymer repeatedly emphasizes that you don't know for certain whether you're in the low-risk group or not. Which suggests he doesn't know how to think seriously about risk. What you don't do is note that there is a non-zero risk and then catastrophize that you could be a casualty. What you should do is quantify the risk as best you can for your demographic, and treat such a risk as you would any numerically similar risk. (As in, Is it a numerically large enough risk for me to worry about it at all? Are particular efforts to mitigate the risk worth it in a cost-benefit sense? Am I using a cost-benefit calculus that is calibrated similarly to other hazards I face in my life?) Of course there could be some unseen variable working against you. Some genetic predisposition that magnifies your risk tenfold, the sheer bad luck of getting a very high viral load, a weakened immune system due to stress (possibly due to severe social isolation). You don't throw up your hands and say, "Gee, I don't actually know if I'm in the 'probability of death = 1' group or the 'probability of death = 0' group, so I'd better assume the former." You treat unknowns using the concept of probabilities, with lower probabilities warranting less concern. Hazards with probabilities below some threshold should be totally ignored, and the same goes for probabilities that are beyond your ability to control. Someone who is so terribly confused about basic concepts relevant to public health (or so confusing that he leaves listeners baffled about his point) should have no influence on important public policy decisions. Their commentary should be ignored.

I apologize for being such a broken record on this issue. In fairness to myself, I've been posting much less frequently than I used to. These thoughts occur to me about ten thousand times as frequently as I write about them. I admit it's making me rather grumpy. I feel like I do a decent job of understanding contrary viewpoints. There are three main reasons for failing to do so. One is that you fail to seek out such viewpoints. The second is that you observe such viewpoints but the topics and arguments are too subtle for you to understand. The third reason is that the viewpoint is hopelessly confused or poorly defined. I don't think the first or second apply. I am positively swimming in the standard "everyone must treat this as a deadly catastrophe" narrative. Having listened to Noymer's blather for about 45 minutes, I can safely say it's not the second. What I am seeing is a refusal to think seriously about how to quantify and respond to risk. I think I am seeing bad arguments being back-fit to foregone conclusions, and it comes out looking like a confused string of non sequiturs. This is a deadly serious disease, which threatens some people very close to me who qualify as "vulnerable." It needs to be treated with clear-headed thinking. 

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