[Mick]

So, to recap: My family and close friends have:
1) had to doubt their safety on public transportation, basic road infrastructure, domestic travel, and international travel because the state has been unable to manage this pandemic.
2) We/they have been concerned about maintaining access to safe groundwater and power, because the state has been unable to safely provision basic public utilities. 
3) And we have had food and prescription drug supply chains significantly disrupted because the state cannot provide sufficient security and public access for those businesses to remain open.

Interesting.  I agree with you with respect to any kind of mass transportation.  It isn't economically feasible for any mode of transportation to safely socially distance people.  Not trains, planes, buses or ships.  But that's strictly a COVID-19 situation.  I wouldn't take mass transportation in any country in the world.

The rest of it...I haven't experienced, nor would I expect to experience food and drug supply chain interruptions.  That goes for my friends and acquaintances in Detroit, Washington DC, Arlington and San Jose, the places I've lived in the last few years. Ditto, safe groundwater (although I filter my water in every city, and I agree what happened in Flint was a travesty).  Ditto safe power (although I think PG&E could and should repair rather than replace, and I think they should build more nuclear power plants). As for basic road infrastructure, it's definitely a problem in Michigan, but not in the other places.  And Governor Whitmer ran on a platform of repairing the roads and dramatically increasing the funding to the schools.  And then she reneged on both promises.  And then she made everyone stay home, except for her husband who wanted a boat ride.  And she raise-fisted in person with the protestors, and spoke...and she later claimed that she never took off her mask, except for, you know, those unfortunate multiple photos of her without a mask.  C'est la vie.

If America is a failed state, I'm genuinely trying to imagine another society that I'd rather be in.  Not trying to pick scabs here, but I'd be curious as to your list of countries in which none of the above are at issue.

[Mick]

So, to recap: My family and close friends have:
1) had to doubt their safety on public transportation, basic road infrastructure, domestic travel, and international travel because the state has been unable to manage this pandemic.
2) We/they have been concerned about maintaining access to safe groundwater and power, because the state has been unable to safely provision basic public utilities. 
3) And we have had food and prescription drug supply chains significantly disrupted because the state cannot provide sufficient security and public access for those businesses to remain open.

Interesting.  I agree with you with respect to any kind of mass transportation.  It isn't economically feasible for any mode of transportation to safely socially distance people.  Not trains, planes, buses or ships.  But that's strictly a COVID-19 situation.  I wouldn't take mass transportation in any country in the world.

The rest of it...I haven't experienced, nor would I expect to experience food and drug supply chain interruptions.  That goes for my friends and acquaintances in Detroit, Washington DC, Arlington and San Jose, the places I've lived in the last few years. Ditto, safe groundwater (although I filter my water in every city, and I agree what happened in Flint was a travesty).  Ditto safe power (although I think PG&E could and should repair rather than replace, and I think they should build more nuclear power plants). As for basic road infrastructure, it's definitely a problem in Michigan, but not in the other places.  And Governor Whitmer ran on a platform of repairing the roads and dramatically increasing the funding to the schools.  And then she reneged on both promises.  And then she made everyone stay home, except for her husband who wanted a boat ride.  And she raise-fisted in person with the protestors, and spoke...and she later claimed that she never took off her mask, except for, you know, those unfortunate multiple photos of her without a mask.  C'est la vie.

If America is a failed state, I'm genuinely trying to imagine another society that I'd rather be in.  Not trying to pick scabs here, but I'd be curious as to your list of countries in which none of the above are at issue.

[OutsiderFan]

list of countries in which none of the above are at issue.

Though the Scandinavian countries and Canada are high up there, my list begins and ends with New Zealand. 

On a related note, you’ll find a direct correlation between happiness of citizens and ranking of country on the worldwide democracy rankings. At this time 4 years ago, the United States ranked #17 in the world. Today, it is #25. Utterly disgusting and embarrassing. Anyone want to claim Americans are happier now than when we were ranked #17?

You want real infrastructure and a high functioning state, fix the foundation that underpins its functions. One look at our political system tells you it is an absolute cancer on society as currently constructed. I guarantee you even hinting the USA is a failed state would be a fool’s errand with a stronger democracy.

[OutsiderFan]

list of countries in which none of the above are at issue.

Though the Scandinavian countries and Canada are high up there, my list begins and ends with New Zealand. 

On a related note, you’ll find a direct correlation between happiness of citizens and ranking of country on the worldwide democracy rankings. At this time 4 years ago, the United States ranked #17 in the world. Today, it is #25. Utterly disgusting and embarrassing. Anyone want to claim Americans are happier now than when we were ranked #17?

You want real infrastructure and a high functioning state, fix the foundation that underpins its functions. One look at our political system tells you it is an absolute cancer on society as currently constructed. I guarantee you even hinting the USA is a failed state would be a fool’s errand with a stronger democracy.

[BostonCard]

There has also been a slew of incorrect information.  Masks are a great example. Early of the Health leaders were saying not necessary.  Now that’s changed. Mortality rate.  Heard very high numbers early on. About 4.3 percent.  Now looking like 0.2 to 0.4. Still higher than flu.  But (fortunately) much less deadly.  Transmission rate.  Early on said 4 to 1.  Now believed closer to 1 to 1.  Transmission from objects - wipe down everything they said.  Now, risk from surfaces very low.

Couple quick points:
Transmission rate (R0) has been estimated in the 2-3 range the whole time.  This is one of the parameters about the virus that was estimated early and more or less correctly, whether you look at the data in China, Italy, or New York.  Since that time infectiousness (Rt) has fallen to about 1, but it has fallen due to our actions (social distancing, lockdowns, etc).  The CDC's "best estimate" right now is that R0 is 2.5, in line with earlier estimates.

Early in the epidemic, there were warnings not to take the "naive" case fatality rate seriously.  Since not all outcomes had been fully adjudicated (not everyone who was going to die had died yet) the numerator couldn't be determined correctly.  Moreover, since we expected that very sick and dying patients were more likely to be tested, while less sick patients were not, the denominator couldn't be determined correctly either.  Furthermore, there is a distinction between the case fatality rate (proportion of all people who get sick with COVID-19 who die) and the infection fatality rate (proportion of all people who test positive, regardless of symptoms, who die).  The CFR is not as high as the WHO's initial estimate of 3.4%, but it is close to 1%.  The IFR is lower because of the number of asymptomatic people.  Based on deaths and serology prevalence in New York, the IFR is 0.86%; it is higher (1.4%) if you use total excess deaths rather than confirmed covid-19 deaths.  This is about what I had estimated earlier based on the Spanish seroprevalence data (the study, which was a randomized sample of the Spanish population showed 5% of Spaniards with antibodies to COVID-19; in a population of 47 million, that translates to 2.35 million infected; given 27,100 deaths, the IFR is 1.1%; if you go with excess deaths, the number of COVID fatalities is more along the lines of 44,000 and the IFR is closer to 1.9%).  I think in the end, the IFR will probably settle out to about 1%, lower than the original estimates of CFR, but higher than some of the other studies (like the one from Bhattarcharya and Ioannidis) have found.

I think with regards to the two other items you mentioned (masks and surfaces), I agree that messages have changed over time.  I think mostly this has to do with a better understanding of the disease and new information.  I will admit that I was one of those skeptical about the efficacy of masks, though there have been staunch supporters of it from the beginning here (I'm thinking of OutsiderFan).  For masks, a bit of it was influenced by a desire to preserve PPE for healthcare workers.  That shouldn't affect the interpretation of the data, but when data was still being developed, it was reasonable for recommendations to take that into account.  For transmission via fomites (surfaces), in the early periods of the pandemic, guidelines were based on limited data; basically analogies to other viruses such as influenza, and the persistence of COVID-19 on surfaces.  It was a reasonable extrapolation, and the messaging was more like "it could be transferred via surfaces" but that gets understood as "it is transferred via surfaces".  And, of course, while such transfers are rare, it is still reasonable to say that it "can" be transmitted by fomites, even as data has shown that the the dominant form of transmission is person to person.  More importantly, this is exactly what science is supposed to do.  As new data comes in,  underlying assumptions have to be questioned and our understanding of "the truth" has to change.  So, I get that the evolution of messages over time can be confusing, but I honestly don't know what can be done to prevent that, given the hunger for information early in the pandemic, before a full understanding of the data is available.

BC

[BostonCard]

There has also been a slew of incorrect information.  Masks are a great example. Early of the Health leaders were saying not necessary.  Now that’s changed. Mortality rate.  Heard very high numbers early on. About 4.3 percent.  Now looking like 0.2 to 0.4. Still higher than flu.  But (fortunately) much less deadly.  Transmission rate.  Early on said 4 to 1.  Now believed closer to 1 to 1.  Transmission from objects - wipe down everything they said.  Now, risk from surfaces very low.

Couple quick points:
Transmission rate (R0) has been estimated in the 2-3 range the whole time.  This is one of the parameters about the virus that was estimated early and more or less correctly, whether you look at the data in China, Italy, or New York.  Since that time infectiousness (Rt) has fallen to about 1, but it has fallen due to our actions (social distancing, lockdowns, etc).  The CDC's "best estimate" right now is that R0 is 2.5, in line with earlier estimates.

Early in the epidemic, there were warnings not to take the "naive" case fatality rate seriously.  Since not all outcomes had been fully adjudicated (not everyone who was going to die had died yet) the numerator couldn't be determined correctly.  Moreover, since we expected that very sick and dying patients were more likely to be tested, while less sick patients were not, the denominator couldn't be determined correctly either.  Furthermore, there is a distinction between the case fatality rate (proportion of all people who get sick with COVID-19 who die) and the infection fatality rate (proportion of all people who test positive, regardless of symptoms, who die).  The CFR is not as high as the WHO's initial estimate of 3.4%, but it is close to 1%.  The IFR is lower because of the number of asymptomatic people.  Based on deaths and serology prevalence in New York, the IFR is 0.86%; it is higher (1.4%) if you use total excess deaths rather than confirmed covid-19 deaths.  This is about what I had estimated earlier based on the Spanish seroprevalence data (the study, which was a randomized sample of the Spanish population showed 5% of Spaniards with antibodies to COVID-19; in a population of 47 million, that translates to 2.35 million infected; given 27,100 deaths, the IFR is 1.1%; if you go with excess deaths, the number of COVID fatalities is more along the lines of 44,000 and the IFR is closer to 1.9%).  I think in the end, the IFR will probably settle out to about 1%, lower than the original estimates of CFR, but higher than some of the other studies (like the one from Bhattarcharya and Ioannidis) have found.

I think with regards to the two other items you mentioned (masks and surfaces), I agree that messages have changed over time.  I think mostly this has to do with a better understanding of the disease and new information.  I will admit that I was one of those skeptical about the efficacy of masks, though there have been staunch supporters of it from the beginning here (I'm thinking of OutsiderFan).  For masks, a bit of it was influenced by a desire to preserve PPE for healthcare workers.  That shouldn't affect the interpretation of the data, but when data was still being developed, it was reasonable for recommendations to take that into account.  For transmission via fomites (surfaces), in the early periods of the pandemic, guidelines were based on limited data; basically analogies to other viruses such as influenza, and the persistence of COVID-19 on surfaces.  It was a reasonable extrapolation, and the messaging was more like "it could be transferred via surfaces" but that gets understood as "it is transferred via surfaces".  And, of course, while such transfers are rare, it is still reasonable to say that it "can" be transmitted by fomites, even as data has shown that the the dominant form of transmission is person to person.  More importantly, this is exactly what science is supposed to do.  As new data comes in,  underlying assumptions have to be questioned and our understanding of "the truth" has to change.  So, I get that the evolution of messages over time can be confusing, but I honestly don't know what can be done to prevent that, given the hunger for information early in the pandemic, before a full understanding of the data is available.

BC