> Specifically, once the proportion of recovered in the population reaches 1/(1-R_0), there are no longer enough vectors (infectable indviduals) remaining for a serious outbreak to occur. It’s worth noting that this is the same principle that vaccination relies upon; vaccination is just an artificial way to build immunity without having to undergo a full infection.

I should learn to never read anything from random people working in areas they don't have any expertise in. This whole section is wrong.

The idea that vaccination and epidemics need the same percent of immunity is completely 100% wrong. An active epidemic is going to infect way more people before dying out than the simple, naive herd immunity calculation will give you. In fact, while an r0 of 2 indicates that you get herd immunity with just 50% of the population, a typical active epidemic with the same r0 would infect 80+% before dying out.

This is clear when you think for about 1 second about it. The `1/(1-R_0)` value gives you the point where infected people infect 1 more person, it doesn't give the point when the infection stops spreading.

> I should learn to never read anything from random people working in areas they don't have any expertise in.

This is one clear lesson that can be drawn from the pandemic.

I don't think so.

Consider that many governments with professional public health departments, including those of the richest countries in the world, downplayed the unfolding disaster, completely blew it on containment as a result, and are now reduced to using _extremely_ expensive lockdown measures to try to buy time until someone can come up with a better idea.

Meanwhile, plenty of randos on the internet did the straightforward epidemiological math in January/February and correctly deduced what was coming.

I think a clearer lesson is that, sometimes, the designated professional experts will fail to outsmart a fairly simple and very well known system of differential equations.

If you find this conclusion terrifying, well, I agree.

> Meanwhile, plenty of randos on the internet did the straightforward epidemiological math in January/February and correctly deduced what was coming.

Plenty of epidemiologists did the math and were talking about the situation on Twitter in January and February. I know because I was following them before China locked down. There were articles and interviews in the press from actual experts (Marc Lipsitch, Neil Ferguson, Michael Mina, Michael Osterholm) during that time.

There were science journalists (Helen Branswell, Kai Kupferschmidt) writing back then who were great at contextualizing the emerging information about the epidemic.

Dr Nancy Messonnier at the CDC warned that "Disruption to everyday life might be severe" on February 25th.

Meanwhile, randos were racking up karma across the internet with their back of the napkin bullshit.

When you have enough people throwing guesses around, inevitably some are bound to get it right.

What is the probability that my guess is going to be right?

I did some little thinking and modelling of my own late Feb, and reached the correct conclusions by following a simple exponential model, having very basic understanding of epidemiology, and being mindful of error bars (mostly ones created by me being a layman in the field).

On the other hand, I trusted WHO and CDC on masks around February; even posted things to HN to that extent. I now regret it and consider it a failure of not doing enough first-principles reasoning, and not digging into the feeling of confusion I had when reading the official advice.

What I got blindsided by was supply chain impacts. I read the daily updates on /r/supplychain with fascination; while I realized things are interconnected, I didn't realize just how much and in what non-obvious ways.

Bottomline, the lesson I draw from the pandemic is to trust myself a bit more, and attempt to carefully reason from first principles more often.

What did you get right in late Feb that the WHO and such were still wrong about? I feel like by that time it was already fairly clear from their communications that this was going global and heavily affect everyone.

Where WHO and others were mistaken in their communication was where they were discouraging use of facial covering. And I meant only that here. AFAIR, they were very correct about the severity of the disease. Unlike ECDC[0]; I read their reports too, and AFAIR, they were still only predicting moderate risk for Europe as late as second week of March.

--

[0] - https://www.ecdc.europa.eu/en

>Consider that many governments with professional public health departments, including those of the richest countries in the world, downplayed the unfolding disaster, completely blew it on containment as a result

Governments are ultimately run on a day to day basis by politicians. Proactive measures to prevent a crisis are a much tougher action to justify, especially if they negatively affect people in a way more direct than just spending their tax dollars, than reacting to a crisis. If anything I think this crisis should teach us something about how governments make choices.

It can go both ways; here in Portugal the government closed stuff like schools despite the National Public Health Council saying that was disproportionate.

> The `1/(1-R_0)` value gives you the point where infected people infect 1 more person

Right: it's (after you correct the typo) the point where the number of active cases does not increase over time.

I'm sure you're getting weary at this point, but I really need your help understanding what you're saying here, because to me it seems supremely untrue.

First, `1/1-R_0`. This is exactly what Wikipedia says: https://en.wikipedia.org/wiki/Herd_immunity#Mechanics

And it makes intuitive sense that once you infect <= 1.00 people, growth is no longer exponential. So I don't think that point is wrong at all.

> The idea that vaccination and epidemics need the same percent of immunity is completely 100% wrong. An active epidemic is going to infect way more people before dying out than the simple, naive herd immunity calculation will give you. In fact, while an r0 of 2 indicates that you get herd immunity with just 50% of the population, a typical active epidemic with the same r0 would infect 80+% before dying out.

This doesn't make any sense to me. Vaccination is just an artificial way to build immunity. So I don't understand your active epidemic point at all. Or put another way, as the proportion of % recovered goes up, we start approaching the eventual limit where `1/1-R_0`->1. That is to say, in your example we start with R_0 = 2, then as people recover that value slowly starts decreasing until it hits 1 at the herd immunity threshold. It's not clear to me what the discrepancy you're detecting is here.

This is called 'overshoot'.

See here for a good explanation https://twitter.com/CT_Bergstrom/status/1252077930286444545

Thanks. That was helpful.

So then, it does seem that if we successfully contained the virus, and then avoided infection spread until a hypothetical future vaccine is developed, that we could avoid the number of infections required by some amount.

Just to tie it back to the broader lockdown vs not lockdown debate, we could probably say that a successful full containment strategy+vaccination could decrease the net area under the curve. As far as policy is concerned I still think the costs of locking down for that long (particularly given that the time is unbounded) is not worth it, but that is a very valid point that I will need to circle back and weave into the document.

Well, here's the problem: The statements your making are quantifiably incorrect throughout the article, and by large amounts. The article sounds authoritative, but it's not. It's the definition of Internet misinformation.

I think getting your opinion out there is important, but to be honest, the article needs a heck of a lot more in terms of disclaimers, and much less in terms of confident statements and grandstanding.

I've worked through the best available data. My conclusions:

1) The economic costs of ending the lock-down may be astronomical. This is especially true with what we learn about COVID19 and lung damage (or potentially other organ damage). If even a small fraction of the population is on long-term disability, the costs go up super-quickly.

2) The fundamental costs of the lockdown are cheap. With reasonable economic mitigations, the costs should be that everyone upgrades their car, computer, or similar maybe 6-18 months later, plus an extra 1-5 percent of the GDP.

3) Most of the economic damage of the lockdown, like a cytosine storm, is self-inflicted: bankruptcies, defaults, layoffs, etc. There are reasonable way to manage most of those (and the rest require a very modest stimulus). We haven't taken those steps because we're stupid.

4) If we don't put in systems to manage the economic costs, we'll be super-vulnerable to the next pandemic.

5) This is something which will come up again, and it's also something which is a national security issue. Engineering something like the next COVID19 as a bioweapon is, at this point, within the scope of even poor countries (North Korea, most countries in Africa, etc.), and there's a Moore's Law where the resources go down super-quickly (larger organized crime organizations could probably do this as well now). The point isn't that poor countries are more likely to do this (they're not), but that with 200 countries in the world, the odds that SOMEONE is likely to do this are increasingly high.

> 1) The economic costs of ending the lock-down may be astronomical. This is especially true with what we learn about COVID19 and lung damage (or potentially other organ damage). If even a small fraction of the population is on long-term disability, the costs go up super-quickly.

I have a feeling a lot of people advocating ending the lockdown are doing so on the basis that only old and infirm people die, as if the other option is either an asymptomatic infection or a quick recovery from something flu-like.

But I’ve witnessed some very serious infections, so this colors my perception and pushes me toward continuing lockdowns. To your point, the disease can be debilitating foR relatively young, healthy people. Have you ever gotten the flu and then had to re-learn how to swallow after spending a month in the hospital?

Yes corona is mostly deadly to older people, but even for those who do not die there are negative health outcomes which impact their ability to work and take care of themselves. What is the economic impact of that? Why is it not factored into the cost/benefit analysis of opening up?

> Yes corona is mostly deadly to older people, but even for those who do not die there are negative health outcomes which impact their ability to work and take care of themselves. What is the economic impact of that?

We need to know the incidence of these issues. Response needs to be completely different in case they're the majority of cases, or if they happen in the minority.

So far the evidence collected from what I've seen is case reports, so nothing clear or definitive.

Overshoot is also a function of rates of infection. If each infection results in 0.5 new infections and 16 people are infected, that falls off to ~8, 4, 2, 1 so about doubling. On the other hand if 16,000 people are infected per day it’s still falling off at the same rate, but you get 1000x more infections before it ends.

So you are telling me, that you write an article with misstakes and think you should be the person making statements because you are able to write an article?

And you also think, that politicians are doing an economycal suicide just because they like it?

Srsly, wouldn't you assume and shouldn't you assume, that there are experts calculating and estimating that shit on every single day and trying there best to find a reasonable way out of this?

> So you are telling me, that you write an article with misstakes and think you should be the person making statements because you are able to write an article?

Yes, I am a person that makes and is currently making mistakes.

> And you also think, that politicians are doing an economycal suicide just because they like it?

I analyzed the "game theory" of this a bit here: https://www.ryankemper.io/post/2020-04-29-the_case_for_endin...

> Hanlon’s Razor is very relevant here; we think it is not reasonable to assume that they were trying to usher in a techno-totalitarian state. Rather, they were trying to prevent mortality, but their incentive structure is such that it is much worse to have done nothing and later find out that the virus was worse than we thought, than what actually happened, which is to have undertaken actions that were self-destructive and then discovered that the virus was way less deadly than we thought.

You know, i'm an expert in developing software. But i'm an expert in this because i spend years mo-fr 40h min. with time on weekends and after work.

There are plenty of people coming to me and say stuff like 'uh why does that take so long' 'i can do that quickly in an hour' etc. and at the end of the day they are wrong.

In those cases, i would just love for people to accept my expertise and let me do what i'm good at because it costs time dealing with this stuff.

And you know, all those speculations of people who are sitting down for a few hours, writing something, gathering a little bit of data left, a little bit of data right THIS IS RIDICULOUS.

You are not an economist, you are not a doctor, you are not a virologist, you are not the statistics guy. Apparently you are a SRE.

What do you think, your statement actually does? I tell you what it does, if it even does anything: It works against all the experts trying to actually do their fucking job on estimating and deciding on a daily bases about human lives.

Do you know what i decided when corona started? I will, this time, just try to be as undisruptive to the society as i can. I don't have to argue against or for it, i will trust the experts and politicians on this one.

Not everyone needs to form an opinion and also state it.

And yes it might be harder for you to believe in your president right now, i do get that. But let me give you a tip: Whenever everyone would love to stop quarantaen today, i will try to avoid public spaces as long as i can, because the risk of having corona, is actually for me, a bigger problem then just staying low for a few month.

> First, `1/1-R_0`. This is exactly what Wikipedia says: https://en.wikipedia.org/wiki/Herd_immunity#Mechanics

I have no expertise in this area, but Wikipedia does not say:

    1/(1 - R_0)

It's:

    1 - (1/R_0)

Which makes much more sense to me on a math footing. You should probably fix that in your article so it doesn't confuse other pedants like myself.

Doh! Thanks for catching that. That is a really glaring mistake on my part.

(The irony in me having said it was "exactly" what Wikipedia says is not lost on me :P)

https://gitlab.com/ryankemper/writings/-/commit/093ade629447...

No worries - it was clearly just a typo :-)

It is fun to imagine the negative herd immunity threshold implied by the erroneous form of the equation though :P

Say R0 is 2, 1/(1 - R0) means that we already hit herd immunity before SARS-CoV-2 even existed!

The frightening one for me was R0 == 1: Basically, we'd need a positive or negative infinite percentage of people to be infected depending on which direction you approach it from.

Even when the R0 reaches 1.0 those who are infected will still infect one more person (on average). Infections continue to happen after the R0 is below 1.0.

Thanks, that does make intuitive sense. I wonder for a virus like SARS-CoV-2 that has a high R_0 and thus requires maybe 80% of the population to be immune for full herd immunity, if that means that the overshoot would be pretty mild?

It would mean the overshoot would likely go close to 100%, but it is complex to model as not everyone is equally likely to be infected - basically the population is not uniform. Epidemiologist do model this, but it requires relatively complex models.

Here's more random stream of consciousness about this:

> Pareto Mitigation: An evidence-based approach

I love how this uses "evidence-based" as a dogwhistle followed by proposing an approach without providing any sort of evidence about the efficacy of the approach.

> Those who have lost their jobs tend to be those workers who are in a lower socio-economic bracket and have jobs that do not allow one to “work from home”.

This is presented without evidence. I think there's a reasonable chance this is the case, but many essential businesses/industries employ primarily lower socio-economic classes so who knows. This is just presented like you should agree with it.

It's also not clear that those that are more disadvantaged are actually worse off here. There has been a very large increase in the amount and accessibility of unemployment benefits.

There seems to be excessive use of bolding random segments of sentences. I don't know if this is just a stylistic thing, but ¯\_(ツ)_/¯.

On suicides, it seems like most of the argument should be verifiable from data (i.e. by its claims, we should be able to see an actual increase in suicide deaths). Is that data not available yet?

> A preventable decline in preventative care

Even the (supposedly evidence-based) proposed approach would likely lead to exactly the same decline in preventative care. This error is repeated throughout the document where there's this idea that the changes that we've seen are due to lockdown and will just go away otherwise (except, of course, for when the change is positive and, clearly, the not-quite-lockdown approach recommended would continue that positive change).

> Be wary of “hero culture”

This is maybe the strangest section. Why does this just talk about a hero culture related to real scientists? Do we think that people are more likely to think some nerdy scientist is a hero rather than our heroic manly president? This seems like it should be a point in support of lockdown to me (tbh, it seems like it shouldn't be a point at all, it's just an attempt to discredit experts).

> The Soul of the Country is at Stake

OMG. I skipped this in first skim. Yeah, this makes me think I've wasted my time even thinking about this thing, this is clearly a plea to the emotions of a specific subset of the population. I'm done.

> This is maybe the strangest section. Why does this just talk about a hero culture related to real scientists? Do we think that people are more likely to think some nerdy scientist is a hero rather than our heroic manly president? This seems like it should be a point in support of lockdown to me (tbh, it seems like it shouldn't be a point at all, it's just an attempt to discredit experts).

Sorry to bombard you with replies, but I realized I never addressed this.

I think you might have a different idea of what "hero" means, basically all I meant is that we tend to elevate these figures (Fauci in this case) up as "heroes" and therefore act like they are infallible and thus you cannot express an opinion that contradicts them. That is what I was arguing against.

It's not about "hero" in the sense of, like, what a young child would imagine a hero is. So in the sense I'm using it, people totally do view the "nerdy scientist" (Fauci) as a hero. And I understand why they do.

> This seems like it should be a point in support of lockdown to me (tbh, it seems like it shouldn't be a point at all, it's just an attempt to discredit experts)

No, it's not discrediting them, it's just saying: evaluate policies and statements on their merits, not based on simply who said them.

I hope that makes sense.

Thanks again for all your thoughtful feedback. You clearly put time into it (and a good bit of frustration, understandably :P)

> basically all I meant is that we tend to elevate these figures (Fauci in this case) up as "heroes" and therefore act like they are infallible and thus you cannot express an opinion that contradicts them. That is what I was arguing against.

What you should do is take the time and effort to educate yourself before contradicting them, (such as about basic things like how herd immunity interacts with R0 in a pandemic) and you should present caveats and disclaimers that are online with your own lack of experience, expertise and knowledge.

There might potentially valuable insights in your article, but their value is overshadowed by the way you present all your ignorance with confidence and surity.

Well, being the author I am certainly biased, but I don't think you've wasted your time :)

Thanks for the feedback. I think the dog-whistle part is quite true. I will need to circle back and add citations where I can. Particularly given that one of the thematic elements is that the lockdown is not based upon evidence.

> There seems to be excessive use of bolding random segments of sentences. I don't know if this is just a stylistic thing, but ¯\_(ツ)_/¯.

I was worried about this being distracting. I think particularly bolding segments within a sentence is definitely distracting, so I will (eventually) try to clean that up.

> On suicides, it seems like most of the argument should be verifiable from data (i.e. by its claims, we should be able to see an actual increase in suicide deaths). Is that data not available yet?

As far as I know it's not, but I'm not entirely sure where to go looking for weekly suicide data. I've only been able to find data over much longer intervals. This is where being an actual expert would probably help! :P

> this is clearly a plea to the emotions of a specific subset of the population

Just to bite of a piece of this before I conclude here, I personally think that a shift to censorship on such a wide scale is absolutely something to raise a bit of moral panic about. The new usage of the term "disinformation" has hit a point of Orwellian double-speak.

> This error is repeated throughout the document where there's this idea that the changes that we've seen are due to lockdown and will just go away otherwise

For these, it could be good to compare what has happened in countries or areas with different responses to these. I.e compare sweden vs norway.

The positive externalities is not a bad point. Where I'm having trouble is, it seems that if we wouldn't pass a law ordering people to not drive around in normal times, then it feels wrong to point to it as a positive when it's induced by people not being able to do anything.

That being said, I think it does make sense to account for positive externalities. Can you think of others that are lockdown-specific? The classic ones right now are pollution.

> Or look at one of the following sections "General vaccination on the decline". This is a wonderful example of the only looking at negatives.

I'm not sure if that is a great example of only looking at the negatives. This is one dimension where the effects of the lockdown are basically exclusively negative as opposed to being a mixed bag. So this feels like something that absolutely _should_ be mentioned. Particularly when factoring in the irony of it increasing mortality from other non-COVID-19 infectious diseases.

> Imagine that flu vaccination dropped 90% and that flu cases dropped 99%, this thing would report that as a negative because, "hey, look at how many people aren't getting vaccinated".

I don't think this is at all fair either, but I must admit I chuckled a bit. It is a funny thought.

> And then when actually looking at it, it's full of pleas to emotion and claims without any data backing them. Take "Addiction and Overdose", there's no real data discussed (other than historical data about deaths unrelated to lockdowns or distancing or economy). Is there no data that supports the implication (if not outright claim) that lockdown will increase the cost or deaths from addiction/overdose? For anyone reading this, if it feels like it's a good, thorough examination you should absolutely discount any points like this where there's no supporting evidence presented.

So, this is the biggest hole that I personally see in my argument, so I very much agree here. The trouble I ran into is, this is such an unprecedented situation that it would have felt ridiculous if I just started making up mortality predictions. So it felt like a good balance to highlight the _potential_ for increased mortality. I do think that means I likely need to soften the language around lockdown causing more mortality to accentuate the fact that it's merely _likely_ that it does.

--

Is there anything else you can think of? Thanks for the feedback.

> we wouldn't pass a law ordering people to not drive around in normal times,

We absolutely pass a ton of laws to make driving around safer, including restricting driving around when it's particularly dangerous (for example, when a person has had a bit to drink).