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Episode 217: Coronavirus Part 5, Math clarification
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dr lyle dr hawk how are you both doing this evening well how are you jen pretty much the same how are you guys exciting life here cats cat food jamba juice delivered acai bowls it's all the same it's a groundhog day all over again it's very it's very groundhog day except it's escalating my neighbors are getting worse by the day well that's that's just awful i can't tell how much of that is perspective and how much of it is reality i've lost track i've i've lost lost touch with reality oh my there must be a full moon somewhere in there we've quarantined long enough yes uh yeah today is part five uh we have done a couple of parts here on the podcast a video with dr lyle dr hawk part three part four last week today is part five um well we're going to spend a few minutes on coronavirus then we're going to take some other questions as well because uh dr lyle dr hawk you have some some more interesting things to say about this coronavirus thing so uh well let's just start there and then we can take some questions yes jen do you want to just offer any things that you've observed or how do you feel um i can i can jump in i know you have some new uh new statistical analysis to offer people which i think is a good place to get us started and so then we can talk about the social stuff and anything else that comes out of that but let's let's get grounded with just where we are with the numbers first i think that makes it all right great the uh and we don't want to talk about the coronavirus this whole hour just because i think enough you know by the time you've eaten 37 peanut butter sandwiches in a row it's time for something else yeah all right now there's a the thing that has frustrated me the most has been a an incredible lack of discussion about really what i consider to be the most important parameter in this entire problem which is the death rate the um they've talked about how many people have been infected uh this is only important in so far as it um it it would help sort of uh indirectly try to come up with the death rate now i've been super frustrated and i was convinced a couple weeks ago that they knew the death rate um because it would be quite easy to establish the upper boundary of the death rate by taking a a population where there's been a lot of testing and take a cohort out of that population of a few you know a few thousand people follow them for three weeks find out how many died and then you've got you have the uh the worst case scenario is if those people that had been tested were on average worse off than average members of the infected population because they went to the trouble of being tested then it would be the case that that whatever number you would find would be the upper boundary so my example would be is if you took 5 000 people out of germany in mid-march uh that had you knew their names and you had them on a database which i'm sure they do and then you just simply follow them for the last three to four weeks we would see how many of those 5 000 people had died if it had been 50 people we would know that we were in deep trouble that we had a one percent type of a killer possibly well as 50 over 5000 is one percent if we had six seven eight nine ten eleven people died out of those five thousand we'd be down there somewhere at a tenth of a percent or two tenths of a percent this is a completely different order of magnitude of the problem so i have been very frustrated that that that there has been no clarity that i have seen anywhere in the news about that issue the only uh death rate estimates i've seen have come from absurd publications coming out of the chinese data indicating you know 0.66 1.2 3.4 2.8 1.7 everybody's scrambling around talking about one percent as if it's nothing and happy if it's .66 or the wuhan data's re-analysis look like it's 0.7 those are astronomical numbers people .7 times 330 million americans is over 2 million americans dying uh if the if there was a full penetration of the infection which we would expect to ultimately happen so this is beyond belief uh important to know whether we're dealing with something that's closer to one percent or something that's closer to a tenth of a percent now the uh jen like knocked my head around a few days ago so in case you're tired of hearing about this you have no idea what what jen's put up with so jenna's put up with if you get tired of this kind of just me rambling about numbers you just imagine what this is like for an hour a day i deserve i deserve a no bell you deserve a nobel prize so she finally cleared me up by explaining that we i it would be useful to talk in different numbers so that we numbers that that people actually use yeah numbers that people use so a one tenth of one percent death rate means that if you are infected there is a 99.9 chance that you will survive so that's what that is okay if it's a 0.2 percent duct rate it's there's a 99.8 percent chance that you will survive okay that's that's what those numbers mean if there's a one percent death rate then if you're infected there's a 99 chance that you'll survive now i couldn't believe my ears the other day i a couple days ago i heard ben carson talking and he was i think i was on the internet i poked a link and ben carson in his in his you know we we all know how sort of steady this guy is emotionally and he's uh he's almost sleepy and he says you know people just can't be hysterical you know if you get this infection there's a 98 chance you'll survive god god coming from a brain surgeon utterly astounded that the the head of health and human services in the united states is off by an order of magnitude okay it better not be two percent chance of death then it had better be 0.2 okay at worst so anyway to again the remarkable uh nonchalance about analyzing this particular most crucial parameter has been just astonishing to me and i can't believe it doesn't dominate all the discussions that i would that i would be hearing out of academically oriented commentators but it's not and so uh so i i had some things bother me and so one thing that bothered me i've been heartened obviously by the bell curves around the world we got some spikes up here on tuesday uh monday was looking good tuesday's not looking as good but it still this thing is behaving in bell curves and it looks like we can get some kind of a guesstimate as how this thing will be circumscribed uh so i i'm not too worried except a couple things have bothered me the first thing that has bothered me has been the total amount of deaths in new york in new jersey specific pacific excuse me specifically new york so new york has 10 000-ish deaths new york has a total of 20 uh 20 million people in new york so if it were 0.1 uh percent then if it's a 99.9 survival rate a 0.1 death rate then the maximum amount that could possibly die in new york state in this thing would be 20 000 and we're already everybody had it if every single person had the infection which of course we're quite confident that is in the word near the case so new york suspiciously looks like it's worse than a 0.1 percent so that that should raise a red flag to to everybody who's doing the math on this thing so it is raised my red flag now the question is how how wildly should it be waving um the second thing that bothered me was a stanford epidemiologist some fancy uh professor woman uh and i i mentioned woman because i i i could be this could be a sexist comment but i expect a woman academic to possibly be less grandstanding than a male so i could i i simply i don't know why but i would expect them to be less uh less looking for the balcony and less looking to make big noise so i don't know if that's true or not the uh but in this case she was commenting that she believes that uh the notion that the the virus is widespread is in the population here is mistaken and she thinks that the infection rates are less than one percent now this was published today if that's true folks that would be a disaster so i'm not you know this is again amazingly sloppy if if she believes that's true then then she should more than just about anybody understand the implications of that that would mean that there's less than 3 million infections in the united states we already have close to 30 000 people deceased and that means we're at a one percent monster so i hope to hell she's wrong and that kind of comment is an amazing comment to make uh in the context of what it is that we're looking at so that created some anxiety in me so as a result i've been comforted by the bell curves all looking perfectly sane and not too crazy at all and now i had to go back and look at world data so let me walk us through the world data that that i have access to that gives me a clue as to where it is that we stand so where i decided to go to was i wanted to go to where there have been a huge amount of tests conducted um with the lowest possible positive rate so the united states conducted more tests than everybody but their their positive rate is huge and uh as a the reason uh why that's a problem is it means that um it means that you're testing a lot of really sick people highly symptomatic people so you actually want to go to where they've they've given a hundred thousand tests out and two thousand of them have been positive uh you want that because that means that they're testing huge amounts of the population so if a hundred people that take the test 98 of the people are negative and only two two percent are positive this tells you that you're actually um not testing a super high concentration of very sick people and this means that your extrapolations from the death rate of the of these in these places is going to be much more accurate so we want to go to where it's the the lowest possible positive rate that gives us the most representative sample uh also if there's a large amount of tests done we know that those tests have taken time to have been completed so you didn't if you've got 500 000 tests done in your society they didn't do them all in the last week so therefore we know that a huge percentage of the people have gone through their infective process and if their if the death rate is uh however many people have died we know that country has been through a huge amount of those infections and they've been completed so that's why we are going to look for big numbers uh generally and low positive rates and then we compute the amount of deaths that have been seen over some estimate amount of how many cases there are so i looked at seven countries germany uh as of today about 1.3 million tests with 130 000 positives so 10 percent now that's pretty high but that's the number that i sort of put on the top end that means they're testing an awful lot of people with snivels coughs and fever to get that high um but but that's okay that's and they have about 3 300 deaths so we have 3 300 deaths over 130 000 confirmed cases which gives us a an official death rate of of 2.7 percent now before we panic because 2.7 is 27 times bigger than we're hoping at 0.1 percent so 2.7 we have to understand that the germans have tested only one and a half percent of their population so we would expect that the total amount of cases is not 130 000 because we got those 130 000 out of a mere 1.3 million we've got another 80 million people to test and so therefore if we've only tested one half percent of the population we at least need to go up 10x so if we multiply the the 130 000 positives by 10 we're going to come up with 1.3 million infections which i would think would be a bare minimum and that's going to take our death rate to 0.27 percent instead of 2.7 so that at worst i would back up a little bit go ahead yeah how did um okay so i understand how you got from the 130 1.3 million total test to 130 000 positives to right but germany total total deaths in germany are 3 300. that's correct um and so why do you say we have to get to 12.5 million extra tests oh or you know no in other words we're gonna we're gonna we know that if we've only tested 1.3 million people we have not tested 80 million okay so we can we can imagine that if they found 130 positives out of a measly 1.3 million then surely we're going to find 10 times more in the remaining 80 million people that we haven't tested okay if we if we've only tested a tiny little fraction of people we've we've tested 1.5 of the population we have not tested 98 and a half percent of the population right therefore it is incredibly unlikely that the hundred and thirty thousand positives that we've seen is anywhere close to the total okay yeah got it but i guess just saying that if we do multiply it by ten that would would that be a more representative sample is that no no but 10 is just a wild guess that if we that if we uh essentially what it's saying is that if you've got 80 million people and you took a little subset of those and 10 of them are positive then it's very likely that the overall in the overall society at least one percent of them or a couple percent of them are positive okay so it's basically saying that that um it is saying that they've probably got 2 million infections in that country if we manage to find 130 000 of them by only testing a tiny amount of people surely there's going to be quite many more and that's what the german scientists that's what they said is they said that's a likely fifteen percent yeah infection right yeah i doubt that actually so i think that's bad data but it's certainly likely that they've maybe had three percent infection rate so if they've had a three percent infection rate and they've had two and a half million people infected which would be extremely reasonable uh then then we have 3 300 deaths over two and a half million people and we're down there at about point one five okay far less than one percent we're talking about one-seventh of that level so that's germany okay now let's look at another country because we don't want to be too excited about germany because germany has a remarkably low amount of deaths uh relative to some other countries so you know let's try to look at something else and i the next one i looked at was canada so canada has run 440 000 tests which is a lot of tests which means it's taken them quite a bit of time to get that done so most of those people that were ever found infected have been through their process there were 27 000 positives which is means six percent of those were positive tests now canada has 37 million people so that means they also have only tested one and a half percent of their population just a tiny fraction of their population this this uh this group is more representative than germany because only six percent are positive so clearly they're not quite as sick as the people on average that have been been tested in germany 900 people have died okay so uh that also is very similar to germany around three percent of the people that are positive have died so once again we take that number of about three percent and we realize we've only tested one and a half percent of the population or about one out of 75 people so we're going to multiply that and figure that canada has at least 10 times that many infections and so once again if we we we take that down by a factor of 10 we're down at 0.3 i i would say that would be the worst case scenario so everywhere i look um let's let's skip over let's go to a very simple data set which is israel so israel has tested um 117 000 people they've had 12 000 positives i.e 10 are positive so you can see these countries where they have tested a lot of people they're getting about 10 positive whereas america is running a lot higher about a fourth okay so we're just testing the really sick people which means our our data is going to be skewed the um they have 123 deaths in israel out of those 12 000 which is right at about one percent so essentially that's one percent and they've only tested 1.3 percent of their population so we have to assume that if they've only tested one percent of their population if they were to test all of them we would probably go up by 10x in the amount of total infections so it's probably not 12 000 infections in israel there's probably 120 000 and we've seen 123 deaths so we're that's looking at estimated at 0.1 so we're down there in those kind of numbers again now a couple of other uh really good data sets one south korea looks like this here's australia so australia has has run 366 000 tests they've had 6400 positives which is only 2 percent positive rate let me explain how useful that is that means they test a 100 people 98 of them come back negative two of them come back positive what does that tell you that tells you they're not out there hunting people that are symptomatic okay so it tells you that this is uh pretty close to a random sample so of that random sample they had 6400 positives and they've had 61 deaths which is about one percent now that's super encouraging so the the that literally the australian data at this moment sets the upper possible boundary of the of the lethality of this disease at one percent but we of course have to realize that they've they've gathered these 61 deaths and we're comparing them across the the 366 000 people that have tested but there are 25 million people in the country so therefore once again this represents only one and a half percent of the country so it isn't it isn't uh there aren't going to be 6 400 positives because we only pulled those out of a measly 366 000 australians we have to understand that there's 75 times more australians than that so therefore we're gonna need to go up at at least 5x if not 10 to cover that we've got we've got 75 times more people to test certainly we can reasonably say we think there's 10 times more people infected than the 6400 people that you found on that continent it's very likely that it's sick at least 64 000 infections those 64 000 infections then have resulted in 61 deaths which is about one in a thousand if it was 64 deaths over 64 000 it's one in a thousand so australia and israel um uh and other places they are looking they are looking way closer to point one than anything that would look like 0.5 or nowhere near 1.0 now the last data set this one a little longer than i thought but so be it is the united arab emirates now this is a unique country so it's a small smallish country they have about 9 or 10 million people they have tested 650 000 people in that country this is the best data set in the world uh that i can buy a wide margin so they have tested an extraordinary um you know seven percent of their population which is just vastly more than anybody else has tested the um their infection rate we would expect to be extremely low because this is effectively a random sample it turns out that they have 5 000 positives out of 650 000 tests which is less than one percent positive easily the lowest rate of testing in the world so they have now tested as i said they've tested about a little over they've tested less than 10 of their population so it's reasonable to expect that even though they will have cherry-picked you know some people who have lined up at the testing booth because they had some sniffles so even though 99 of the people are coming back negative uh the the few positives may be over represented in that 650 000 so it's possible that we cannot take the 60 650 000 over the 9 million in the country and say we got we we can't multiply the 5 000 positives by 12 to make up for that and say that we think there's 60 000 cases in the united arab emirates um there probably are not however there's probably 25 or 30 000 cases so uh there's probably several times more cases than than they they see because they've only tested 650 000 over 9 million the there are 28 deaths in that country so if it turns out so that right now they are at 28 deaths over 5 000 identified cases that folks is about 0.5 percent that represents the upper boundary of how lethal this thing could possibly be um assuming that everybody that was currently affected at this ratio has gone through their process which is maybe not fair however you've only tested seventy percent seven percent of that population so it's exceedingly likely that we would have to multiply this by at least five you know at least 3x so we should honestly be able to multiply it by close to 10x but three times would be extremely conservative that would give us 15 000 cases today in the uae and we have 28 deaths which would take us around 0.2 so the best data in the world to me is is now bouncing somewhere you know a 0.1 to 0.2 um new york is the scariest data it's looked like it looks like it could be pointing to the upper boundary of that some other places are pointing closer to 0.1 but this looks to me where the debate is not up at 1.0 so it looks like the truth is this is not 99 chance of survival it's either 99.8 or it's 99.9 this is for for our listeners hopefully this puts this into perspective uh people that are looking at big numbers are extremely should be terribly worried and concerned about the difference between 98 99.8 and 99.9 let me explain why it is this is incredibly important to know this number and it should be the all-consuming pursuit of everybody that's looking at this problem and it doesn't appear to be okay the 99.8 would leave .2 of infected people dead which would mean potentially 750 000 americans which would be a catastrophe if everybody was infected 99.9 leaves at worst case three and a half 350. that is also huge but you know it's not looking like we're heading into those numbers so however if it were possible in future generations of this disease even occurring in the next 12 months that if it was 0.2 you understand that's a massively greater catastrophe than 0.1 so anyway hopefully this explains my frustration and consternation at as the numbers slowly percolate in uh why you know why don't we know this number because quite frankly folks we should and uh i i'm i'm looking at databases that are not as accurate and sophisticated and not as not able to be parsed in piecemeal the way that people in charge should be able to do this there's really to me no excuse for for the kinds of discussions that i've been hearing uh between and among these the the reports of scientists and their discussions i don't understand why this parameter isn't all-consuming and that these uh that the the estimates here aren't being aren't being triangulated by the best minds in the world working on this problem into very very narrow intervals of possibility does that make that make sense i'm mostly talking to jen because that's who i usually talk to about this yeah yeah well i think a big i think people are having the discussion but people are are like ben carson just sort of recklessly conflating the the two percent in point two they're just not it's it's and that's being echoed by the media as well so you have um just really a lot of inconsistency of reporting and a lot of incoherence around the discussion and nobody knows um what expert to latch on to when it seems like experts are in more disagreement than maybe they are because of misreporting and and number um transmogrification curious about the methodology of the stanford epidemiologist and how she got how she came to that conclusion the first thing that occurs to me i don't know about i don't know about females being less prone to balcony and certainly some can be just as if not more so um but it may be it may be an internal balcony seeking um status face off with um ionitis depending on whether they are in great disagreement since they're in the same department and both sort of being the uh the mouthpiece of you know stanford's official position on the question so they may be sort of incentivized to over-exaggerate their respective positions if they have a big long-standing tension in their their professional analyses of this kind of thing so that just occurs to me as a possible social dimension of that question but i'm curious because that is is so far out of what you're talking about and uh where we would expect somebody with access to that kind of data to be yeah i don't know so that's what uh that that'll probably keep me up a little late tonight crunching some more numbers and waiting for more numbers to come in the uh yeah the numbers yeah yeah and i i saw two today that the the u.s death rate is up um you know not not climbing nicely down the bell curve like we would like to see so the daily the daily count is up so it shook up that curve shape a little bit but yeah that's um you know we don't want to get too attached it's not with it's not outside of the the realm of possibility for a curve on the decline so unless we see that steadily climbing for a while it's also nothing to be alarmed about but those those two factors together i can see being just giving giving people some pause just like okay let's make sure we know what's going on here but um i i think you've nicely comprehensively uh gone through every available reasonable data set and they seem to all be pointing in exactly the same direction so yeah yeah that's the best we can do right now they're pointing at least to that order of magnitude we're at 99.8 or we're at 99.9 or something at 10. and um maybe yes if you're dealing with a really high risk population and new york might be i mean we don't there's so many things that we can't control for with density and uh you know travel patterns and the fact that new york had a lot of flights coming in from europe and the west coast did not have flights coming in from asia may account for a big big part of the difference there there's a lot of people that are rushing to sort of give social distancing a lot of credit in this process and social distancing may deserve some of the credit maybe it deserves all of the credit we don't know we don't know until we really figure out what all of these potentially compounding variables are and and what makes certain populations more vulnerable there's so many hypotheses floating around air quality i mean we we know that age smoking other other pre-existing health conditions are all individual risks and vulnerabilities but there there may be some population level ones that haven't been identified yet um that are going to come out too so there may be very good reasons that new york's numbers are so much higher and we just we we haven't begun to get to a position where we're really able to pin all of that stuff down because as you're as you're saying we can't even get clear on the exactitude of the death rate yes well yeah all right nathan yeah i'm cutting any any questions because i'm i'm i'm thirty-three i'm about ready to walk away from this uh i will say i had it i had an interesting conversation today with a good friend of mine and um she lives in germany and she had had a friend who had uh a young guy healthy guy that had this infection and went through a very rough two weeks and the this this would not be typical uh certainly as we we look at most of the infections particularly of younger people most of the infections are reasonably mild and uh but his was rough and it just gave me just even hearing this that a non-smoking healthy intelligent behaves himself perfectly good immune system athletic guy could could go through a tremendously rough couple of weeks it wasn't it was not like the normal flu it was a he it was a hell of a lot worse it's like okay well guess what i mean even though it's uh something of an outlier uh wash your hands yeah wash your hands this is no joke it's worth repeating you know we i think we sometimes um are getting lumped in with some of the more cavalier interpretations of this whole situation as we've gone along we've we've never said we've we've never said don't worry about it don't bother washing your hands to you know go ahead and violate social distancing norms like we're fans of all of those things so um and you wanna you wanna be reasonable and be prudent about this kind of thing we're just also trying to take a um a wider view of the of the whole big picture outliers and all yeah i was wondering i was wondering dr lyle dr hawk if you think that the numbers uh being so low out of the united arab emirates was due the fact that you know i guess the women have to wear the burqas that cover their face i mean that's another there's there's so many different um you know depending on your discipline i've seen a bunch of different hypotheses floating around that could explain all of these little micro differences in these different places and they're a lot some of them are very interesting um you know in italy you've got parents living at home with a lot of proximity so there's there's a bunch of people that are chasing down that a whole research agenda associated with that whether the sort of more vulnerable population of the older parents were getting exposed more more rapidly and more intensely by their working children who were coming home and bringing bringing disease home to them um so it's like there's there's sort of social scientists working on this from social science kind of perspectives and then you've got more epidemiologically oriented questions about air quality and um and all you know just all kinds of other sort of public health concerns so i think they're the story is going to get really nuanced as we go we've only taken the first couple of steps in that direction yeah my dog is howling in the background yes i'm curious as to why like you know dr lyle you know i i'm used to having you give us revolutionary advice and revolutionary information and so um with something so big it's you know it's not that i don't believe you dr lyles just it's hard to imagine that you're the only one that knows this and i'm trying to cure trying to figure out why like what yeah yeah have you seen nobody seen a movie called the big short nathan no i haven't [Laughter] i i i i'm really i'm just frustrated and uh i'm actually a little frustrated because i wish i would it had a place to hear or hear the thinking of ionitis uh or people like that i i don't want to just hear some contrary in somebody taking a position which he was not he was he gave it extremely well reasoned argument about saying this is going to be a fiasco uh because we don't have good data and i've now been sitting here for a month thinking all we needed to set the upper boundary of how lethal this thing could be was one lousy cohort does not have to be randomly selected all you had to do was get a thousand names out of germany which was the first place that or south korea a place where they tested a lot of people so we weren't just testing the walking dead just give me a thousand people and at the end of that three weeks or whatever it is by april 2nd we would have known how many out of that thousand people had died if it was one or two or three okay that's really good that's down in the 1000 range if it's 12 or 15 we're in the one percent range like complete and four days later we'd have another thousand and four days later we'd have another thousand by now we would have easily been able to follow a cohort of 15 000 people at which point we would know the death rate of this thing unbelievably accurately which would right now that the united states and other places in the world are the the politicians are basically deers in the headlights how could you be anything else it's like how could you know when to open your economy up and when to keep it shut and why and what the risks are how can you know make any reasonable judgment if you don't have a tight estimate of the parameters and they don't so they this the comment that everything just stays just until until someone you know makes it makes a feeling right has a judgment yeah i mean this is this is amazing so apparently what you told me about the surgeon general uh i didn't hear this but surgeon general saying well now we're just we've just following the data now we've got the data forget the models it's like whoa i mean i hear i hear this but it's like the the did we have to wait until piles of data came in and until we have to watch the curves it's like literally they're going to just sit there and watch the curves and wait for the curves to tell us i mean i guess that's one way to do it but it'd be a heck of a lot nicer to know well in advance what was likely to take place so that you could really start making major major decisions right now they're doing it surprisingly uh they're blind in one eye and so god help you i mean i could just hear the the money money quarterbacking on this will be endless like no matter what move you make it's unlikely you made the optimum move and it's likely that further evidence is going to come in later that you could have made better moves and etc but boy to not have the death rate of this thing knocked down to to know the fact that it's either point you know betw between a hair a point one or it's between with hair point two the difference between point one and twenty two is massive and they're not even close to that discussion anywhere that i can see so this is what frustrates me is that by god i could get that information with three secretaries and you know in a database and you could have it in four hours it there's it's inexcusable and i can't i can't believe that that we're flying this blind this late in the i just this has just been my rant well hopefully dr lyle this information that you are giving us hopefully it goes viral and hopefully that's not too early too soon to say that this is this is just chaos during this monday you know what i have to be careful what's going to happen is nathan we're all everybody's just going to sit back and watch the data come in they're going to do what they're doing technically and on the ground just to be as as intelligent and humane and competent as possible in the medical arena but really when it comes to the decision making we're going to have to sit and wait until the evidence comes in and we're going to do it the hard way rather than do it the smart way and that's kind of that's just how it's kind of like this whole kind of like the whole plant-based diet thing where we just had to wait even though a lot of the information all the noises were yes yeah such as life yeah yeah this i i guess what what also bothers me about this you know we're completely off plan we're gonna plan to take other questions but the other thing about this is that um that this is a this truly is ida said this is a fiasco because the truth is i i happen to be pretty confident that this is no probably no worse than a 99.8 or 99.9 survival rate okay what if it was a 98 what if it was disaster true what if it was 10 times worse and you had this kind of fiasco going on yeah go ahead my god yeah oh yeah i mean there's no i mean that's that's just i mean i unbelievably catastrophic consequences yeah yeah yeah i think so dr i think uh last last show i don't know if you mentioned it on air but i know we certainly wanted to talk about is that china's response has been so like i mean not sometimes but a lot of the asian response has been uh very coordinated just because they've done this before right and so so so hopefully next if there isn't yes we will be more better fire drill yeah this is a fire drill and um this this may this may have been necessary for this country with its very open and high freedom and non-vertical you know political system yeah yeah i have to go back to that i mean i think it is relevant that they've done it before they they certainly have had a learning process but i think the big part of the story there is that they're able to move very quickly and efficiently because they're so vertically organized and because there's not there's not a um there's not the same kind of contested situation with experts you don't you don't have a debate you don't have uncertainty about who has the numbers right you have like the director of public health you know whatever it's called blah blah blah who says this is what it is these are the numbers that we're looking at no debate no question make your decisions based on this um where here we have this much more open democratic you know free free discussion uh where everybody's welcome at the table to hash it out and and figure it out and you have different people very passionately making very different claims um all over the place different different geographies different um and very different numbers like we're talking about and so i think that that becomes politically the correct choice has to become you sit and you wait for the actual data to come in because otherwise you're taking huge risks aligning yourself with with some intellectual faction that may turn out to be wrong and then you've made a catastrophic error and you lose your election so these are all the kinds of bizarre incentives that exist in the kind of uh kind of system that we happen to live in which has a lot of great benefits of course but has quite a few liabilities particularly in election season when people are very very very risk-averse um and don't don't want to make the wrong step with something like this that's going to haunt them all the way until november so if they can afford to be more cautious and just wait for the data to come in and then make the decision uh the the only other correct thing to do is to exercise um over cautiousness like the the mayor of san francisco is currently enjoying a moment because she's getting lauded for being a visionary for shutting down the city earlier than anybody else um you know and and she she was willing to expend that political capital to do so well she's willing to expend that political capital in a in a city that is going to be uh more more tolerant of that sort of thing in general just politically speaking um and also the the hindsight of this um as doug is saying is is 2020 and it looks like now she was very prescient when really she was maybe just being very um you know acting out of out of more it could have easily gone the other direction if this had turned out to be just a regular flu she would have looked like this authoritarian tyrannical uh scaredy cat who was shutting down the city too early so these are big risks and a lot of politicians most politicians are not willing to take those kind of risks they're just going to sit back and and wait until they have to act wow well it's entertaining yeah go ahead nathan yeah i was just gonna say that uh in the beginning of to uh beginning this uh in january i said that we're gonna start having some bad 2020 jokes this year and dr hawk you i think you're the first one so oh god here they come i i don't i don't want credit for that it's unintentional but i just it's it's it's irritating to me to see that sort of the the these political narratives move so quickly to to vilify or to celebrate political decisions that happen for reasons that have nothing to do with the foresight of these people or nothing to do with even the the information that they're necessarily operating with it's just sheer luck most of the time um and you know san francisco maybe san francisco has been less of a disaster than new york because it adopted social distancing earlier that's entirely possible but we don't know that it could also be because flights from from asia were shut down much earlier than flights from europe to the east coast i think that's going to be a big part of the story um and so could a lot of other factors and so it's very easy to leap to these intuitive inferences and to give politicians credit for them or alternatively to to accuse politicians of making big mistakes or um you know doing things incorrectly when when really there are all kinds of unknown variables and other factors at work and all of this is going to take a long time to unpack wonderful yeah well yeah yeah i wonder doctor dr hawk is there uh i mean you said this is all just kind of luck and the first thing i thought was well isn't it all luck like like if i'm competing you know in one domain uh all things being equal another competitor who's equal with me in all other respects it's really just up to luck right and and so aren't we seeing that playing out you know in politics as well yeah yeah that's whoever can capitalize yeah well we're pattern seeking animals and so we we find patterns in our politics just like we find them in um in our you know what's leading to certain health outcomes and anywhere else that we might find a pattern that doesn't actually mean anything but it looks looks nice makes sense so we go with it um and it's just it's very very often actually not what happened yes uh you're seeing that all over this so you're seeing for example i heard i heard trump sometime in the last few days uh uh bragging about how our essentially our death rates are lower than in europe vis-a-vis how many people we have in the country etc and it's like as if in in getting credit to our great medical people and blah blah blah well first of all first of all you have to control for the age of the population second of all you have to control for the smoking rate of the population third of all you have to control for the fact that we are not as far along in the counting process and the head count as they are right so you've got like three three massive factors that that can completely change this picture once any kind of intelligent analysis is done the um another thing is that which just speaking to jen's uh talking about the differences between us and and asia and how many countries of asia have handled this so well i i look at the the political um meltdown in the last couple days about trump claiming i have the rights to do whatever and then the states everybody's screaming at him that no that's not the constitution this is hilarious if you're an asian if you're if you're in singapore you're like this is how these people run the country that that the head cheese says he's in charge when it comes down to it but he'll work with the governors etc and then everybody's saying no the governors have the right it's right here in the constitution they would just be rolling their eyes and shaking their head like you people are all on lsd of course that you you just do what the man says so it's fascinating and of course this is we are now staring at an unusual uh kind of a problem where a literally potentially a reasonably good decision made by a centralized government even if it's not the best decision could be a better decision than the decision made by an open free society where there's all a bunch of cacophony just big bunch of debate and screaming match and difference of opinion and a wild press corps all of that going on uh decentralized much decentralization and even if that ultimately arrives at a better decision it turns out that maybe it's too late and a lot of damage was done and so this is you know i am no favor of strong central governments myself being a libertarian so however this is one of these times that will will test you know this this is actually an in an interesting and curious tests for libertarian scholars it's like okay let's just imagine that we didn't slither out of this with a .15 or 0.2 or 0.1 infection rate let's just suppose it was a lot worse and now we we look at a freer society maybe even freer than the one that we have now which would be very uh a very smiling thing a very happy place for a lot of libertarians if we took the shackles of the government off and didn't have our civil liberties clipped and everything else under the sun that they might very reasonably complain about and make an argument for but what do you do now what do you do in the face of an airborne ebola type thing that's coming after and it's going to wipe out 10 of the population well i'll tell you what if you're in singapore or you're in hong kong or you're in south korea or you're in japan there's a very good chance you and everybody you love and most of your society survives because a very central dominant decisive government takes immediate action and those actions whether they may be unpleasant and surprising and disturbing they are so this is a this is the ultimate fire drill i think uh i don't think you know go ahead jen oh just that it's also worth noting that the people who are most concerned about some sort of authoritarian power grab from the center when it comes to this question from from the white house are generally not coming to that position out of a fear of centralized government per se because they're the same people who are lining up to behind the the governors who happen to align with their um their vision of how things should be managed and and they're they're you know praising the decisive leadership of those governors of cuomo and of newsom and whoever else it is so it's it's not that it's like this libertarian source diversion to central authority it's it's an aversion to trump specifically um and so people who are people who are crying foul about centralized decision making but but okay with it from the states there's actually a very there's a there's a very disturbing to me also as a as a you know sort of emerging libertarian someone someone forced into libertarian thinking by evolutionary psychology who used to be a card-carrying marxist but there is there's definitely um like for me just as a scholar of history and and of authoritarian movements in general my i mean my advisor uh my dissertation advisor wrote a book called how democracies die the guy the guy is very familiar with this question and we've spent a lot of time talking about it but uh the there's there's really like a uh energetic embracing of authoritarian decision-making in general when people are in a crisis um and every authoritarian movement throughout history has generally started on the back of a crisis and and i am seeing that on the left absolutely it's just not not vis-a-vis trump um they there are many many calls for bigger government stronger decision making more rules longer shutdowns more draconian social distancing policies all coming from the states not from dc and to me there's not a big um intellectual difference or even a big constitutional difference between those two things uh it's all about the personalities involved in the fact that we have a rather unusual president that a lot of people really very much dislike so i would just invite people to kind of interrogate their position on this question uh with a little more intellectual honesty uh and really really discover how how much of it has to do with centralized authority and how much of it has to do with who's in charge and how comfortable you would be if the if the person making the decisions was if if all of it was reversed and you found yourself on the outside looking in
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