Following the Science - Printable Version

Following the Science - Printable Version

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Following the Science - Goose - 11-24-2020

https://www.medpagetoday.com/blogs/vinay-prasad/89856?xid=nl_secondopinion_2020-11-24&eun=g1475875d0r

Not sure what other thread to put this in, so I made a new one. I like what this blog says, and I think it is important we consider the points it makes.

RE: Following the Science - OutsiderFan - 11-27-2020

This:

"Some scientists fault the public for not heeding public health recommendations, but these folks miss the point. How you communicate your message and the sustainability and uptake of your message are part of the intervention itself, and you must be judged by what is achieved."

Like judging the person who puts out the punch for it being undrinkable, after someone else goes and pees in it.

RE: Following the Science - DocSavage87 - 11-27-2020

I often feel like those who support Atlas or champion views not in the mainstream (e.g., masks don't really work, we can get herd immunity by letting virus rip without major loss of life by "protecting the vulnerable") fall back on philosophical straw men arguments or cherry-pick particular decisions as as exemplars of "don't follow science."

Take this quote from the blog: "Scientists can help define these trade-offs, but scientists have no special ability to speak about values on behalf of all citizens. In other words, science is necessary but not sufficient to deal with COVID-19. Thinking otherwise is a dangerous view that steals political power from people and gives it to scientists under false pretenses."

I hear a lot about "values", but the major conflicts in decisions don't really seem about values, they are about scientific facts. A large part of the population still think (1) masks don't work and could possibly be harmful, and (2) COVID-19 is similar to the flu. There is no way we agree on policy if we can't agree on the baseline facts, and if the "people" make decisions based on a fake reality, then they shouldn't be making the decision. And that is especially true of the political leadership.

Let's be clear: the doctors and scientists aren't the ones who have massively failed during this pandemic, it's been the political leadership. If the political leadership had been mute, actually not making things worse, we'd have less death in this country. So it's particularly galling to hear forum posts saying how the real problem is letting epidemiologists / scientists take over policy. News flash: Scientists have never been in charge of the policy. If they were, we'd have taken over factories for manufacturing PPE, rolled out brobdingnagian grants for parallel efforts on research & deployment of new tests (particularly rapid ones), prioritized opening K-6 significantly over bars and football stadiums, etc.

Instead we have people who briefly heralded healthcare workers like they ordinarily adulate military personnel, and now won't even change their behavior though it puts the healthcare workers in harm's way. What part of "follow the science" is packing airports and gathering groups from across the country in small indoor areas?

RE: Following the Science - Goose - 11-27-2020

(11-27-2020, 11:16 AM)OutsiderFan Wrote: This:

"Some scientists fault the public for not heeding public health recommendations, but these folks miss the point. How you communicate your message and the sustainability and uptake of your message are part of the intervention itself, and you must be judged by what is achieved."

Like judging the person who puts out the punch for it being undrinkable, after someone else goes and pees in it.

I don't think that example is a good one. I also don't totally agree with the idea that the presenter is totally responsible for the uptake of the message. I do think the communication from the scientists has been muddled by the normal and healthy disagreements that exist among them. However, I think it has also been much damaged by the presentations "talking down" to the American people. Presenting strategies for mitigation with little or no explanation of "Why this strategy" has been very destructive. When things don't work for perfectly understandable reasons, people lose trust if they don't know those reasons. Why are the color tiers in California what they are? Nobody knows, including the County Health Officers who have complained about that fact. Things like this are a self-inflicted wound. However, it is also not a presentation by scientists. It is a political policy. Are the scientists at fault here for not insisting on full disclosure? I think they are, but it isn't entirely their call.

In short, we are often asked to believe Fauci and ignore Trump because of who they are, not because of the reasoning presented in what they say. That is never a good thing.

RE: Following the Science - DocSavage87 - 11-27-2020

(11-27-2020, 01:36 PM)Goose Wrote:
(11-27-2020, 11:16 AM)OutsiderFan Wrote: This:

"Some scientists fault the public for not heeding public health recommendations, but these folks miss the point. How you communicate your message and the sustainability and uptake of your message are part of the intervention itself, and you must be judged by what is achieved."

Like judging the person who puts out the punch for it being undrinkable, after someone else goes and pees in it.

I don't think that example is a good one. I also don't totally agree with the idea that the presenter is totally responsible for the uptake of the message. I do think the communication from the scientists has been muddled by the normal and healthy disagreements that exist among them. However, I think it has also been much damaged by the presentations "talking down" to the American people. Presenting strategies for mitigation with little or no explanation of "Why this strategy" has been very destructive. When things don't work for perfectly understandable reasons, people lose trust if they don't know those reasons. Why are the color tiers in California what they are? Nobody knows, including the County Health Officers who have complained about that fact. Things like this are a self-inflicted wound. However, it is also not a presentation by scientists. It is a political policy. Are the scientists at fault here for not insisting on full disclosure? I think they are, but it isn't entirely their call.

In short, we are often asked to believe Fauci and ignore Trump because of who they are, not because of the reasoning presented in what they say. That is never a good thing.

We're in this situation because of a lack of national leadership. There was a brief effort to roll out some national plan, back when there was such a thing as a federal coronavirus task force, but the CDC and fed policy making is absent for this whole pandemic. You complain about the presentation when the game plan for the pandemic was always to have a unified national front and get all the people on board with strong CDC recommendations reinforced and tailored by each state. That was the game plan. Nobody gamed out that POTUS would be actively undermining the effort. You could run a billion simulations and never consider that possibility. Nobody gamed out that POTUS would actively champion HCQ+AZM as a cure so COVID-19 was no big deal. All of this nit picking about how scientists failed and not considering the order of magnitude worse problem caused by the White House is frankly incredibly flawed analysis.

When it comes to public health care that requires the support of the people, having a unified public message is the NUMBER ONE priority. There is no way we could've succeeded during this pandemic with the Trump administration. It was a non-starter. Even if the scientists had done everything 100% by the book, there would be chaos and conflicting messages, which has been a hallmark of this Administration.

RE: Following the Science - Goose - 11-27-2020

(11-27-2020, 01:43 PM)DocSavage87 Wrote: Nobody gamed out that POTUS would be actively undermining the effort. You could run a billion simulations and never consider that possibility. Nobody gamed out that POTUS would actively champion HCQ+AZM as a cure so COVID-19 was no big deal. All of this nit picking about how scientists failed and not considering the order of magnitude worse problem caused by the White House is frankly incredibly flawed analysis.

Not surprisingly, I will argue that you analysis is the one that is flawed. While it is certainly true the POTUS has been a catastrophe in terms of a messenger for a rational approach to the outbreak, the idea that his response determines the narrative is flawed. If the scientific community (possibly as constituted in the department of HHS) had clearly spoken out, backing up their statements with data or at least a plausibility argument, I doubt may people would be listening to the man who recommended drinking bleach. That didn't happen. Instead the CDC issued contaminated test kits and it was all downhill from there credibility wise. Trump didn't cause that. Furthermore, the state level was unaffected by Trump's incompetence. They could say and do what they wished. Yet, as I pointed out, we still don't know why tracking and tracing failed, and we still don't know why the color tier is what it is. We do know (after some serious pushback forced the disclosure) that in fact the LA County Health Department has no data justifying stopping sales of liquor at 530 PM. Trump didn't cause that either.

IMHO, the concept that Trump was the problem and if not for him things would be fine is dangerously false. Tony Fauci himself has repeatedly pointed out that the lack of investment and reduced budgets at the State and County level is a primary cause for our failed response. The number of staff people at the County level has fallen steadily for many years. Note that despite Trumps attempt to reduce the CDC budget, Congress has always kept in constant in dollar value. Any reduction has been due to inflation and the transfer of some responsibilities to other departments (eg. national stockpile to Homeland Security). The CDC also got a brand new 700,000.000+ lab in 2017. That said, as far back as 2008 the CDC was publishing papers outlining their inability to provide adequate testing to the country in the event of an epidemic. Trump wasn't elected until 2016. So yes, Trump was a problem, but demonstrably he wasn't THE problem.

RE: Following the Science - DocSavage87 - 11-27-2020

(11-27-2020, 02:15 PM)Goose Wrote: the idea that his response determines the narrative is flawed. If the scientific community (possibly as constituted in the department of HHS) had clearly spoken out, backing up their statements with data or at least a plausibility argument, I doubt may people would be listening to the man who recommended drinking bleach. That didn't happen.

You probably doubt many people believe Trump's current flawed narrative on the election, despite very clear court rulings, state election certifications (including GOP controlled ones), etc, all saying there is no fraud. You ignore polls and the clear cult-like behavior of a substantial part of his base.

Your comment about testing problems is a talking point from the right that's patently stupid. It's almost like you think in the middle of a pandemic there can't be a massive effort, a war-time effort, to substantially change things. Like what happened with vaccine development. It's the kind of defeatist attitude that goes along with "well the virus will infect everyone".

The only thing I've seen that's "dangerously false" is unchecked apologist crap peddled on these forums.

RE: Following the Science - M T - 11-27-2020

This board spends a lot of time arguing about every one else's arguments.

RE: Following the Science - Goose - 11-27-2020

(11-27-2020, 02:30 PM)DocSavage87 Wrote:
(11-27-2020, 02:15 PM)Goose Wrote: the idea that his response determines the narrative is flawed. If the scientific community (possibly as constituted in the department of HHS) had clearly spoken out, backing up their statements with data or at least a plausibility argument, I doubt may people would be listening to the man who recommended drinking bleach. That didn't happen.

You probably doubt many people believe Trump's current flawed narrative on the election, despite very clear court rulings, state election certifications (including GOP controlled ones), etc, all saying there is no fraud. You ignore polls and the clear cult-like behavior of a substantial part of his base.

As you probably have already noted, I do believe that MOST Trump voters believe that the election was honest. The polls from Nov 7 to Nov 17 were taken before the court rulings and state election certifications etc. During this time, Trump was tweeting up a storm that there was fraud. If his supporters were in doubt before about the result, there is no longer any reason to have such doubts. Yes, I believe that right now most (not all) Trump supporters believe the election was fair and that number is growing with each passing day. Whether the remainder can be defined as "substantial" is probably arguable, but I certainly agree it isn't zero. However, that has little if anything to do with any of the points I made in my reply to your post. My point was and is "the idea that Trump's response determines the narrative is flawed".

Quote:Your comment about testing problems is a talking point from the right that's patently stupid.

I guess I don't keep track of talking points from the right. The only one I am aware of regarding testing is the idea that more testing is bad because it makes things look worse than they are. If that is what you refer to, I agree that is stupid. However, that was not my point. My point was that the CDC shipped a contaminated test, and that that fact (along with the CDC's somewhat confused public response to that fact) undermined public confidence in the CDC. The first part of the above statement is a documented fact, so I doubt you are talking about that. Are you saying that this problem did NOT reduce confidence in the CDC and to say it did is "patently stupid"? I would like to hear you defend that assertion as opposed to just dismissing the notion that the CDC's image suffered from that event.

FWIW, I also don't consider whether some thesis is a talking point of the left, the right, or nobody in particular to be relevant to it's merit. It is either defensible or it isn't. Attributing as a source some particular group as an argument of it's merit is an attempt at poisoning the well. It doesn't make finding the truth easier.

Quote:It's almost like you think in the middle of a pandemic there can't be a massive effort, a war-time effort, to substantially change things. Like what happened with vaccine development. It's the kind of defeatist attitude that goes along with "well the virus will infect everyone".

I am unsure why you would think I believed any of the above. I certainly didn't say anything like that. In fact, I think the fact that vaccine development went so well supports my thesis that Trump doesn't control the narrative. Science has delivered despite Trump being ant-science in many ways. What I have pointed out is that there have been some policy failures (or at least disappointments) and that these policies were supported by scientists, particularly the contact tracking and tracing program. In those cases science is ill-served by not giving the full rationale for the recommendations initially and by not revealing the cause of the problems that ensued. The public thinks it has been misled when this happens. I cited some cases where that has happened. You didn't respond to any of those points.

Quote:The only thing I've seen that's "dangerously false" is unchecked apologist crap peddled on these forums.

I think I have consistently during this epidemic pointed out Trump's shortcomings (OK, I really had lots of help with that). I have also pointed out other situations where I felt there were serious shortcomings (to the point BC has stated that I have harped on our contact tracing and testing failures). I have pointed out that some of these problems predate Trump, and some other problems exist on the State and Local level where the Federal Government is not the controlling agency. My point here and in several other places on this board is that when Trump is gone, all these other problems don't go away, and that most of them Trump did not cause. Can they be fixed? Sure, but they won't be if we just declare victory because Trump is gone. Is there a danger that will happen? Yes, if the narrative is that it was all Trump's fault. That is why I believe that narrative is "dangerously false".

RE: Following the Science - DocSavage87 - 11-28-2020

(11-27-2020, 09:14 PM)Goose Wrote:
As you probably have already noted, I do believe that MOST Trump voters believe that the election was honest. The polls from Nov 7 to Nov 17 were taken before the court rulings and state election certifications etc. ... Yes, I believe that right now most (not all) Trump supporters believe the election was fair and that number is growing with each passing day.

So there was a poll a few weeks ago that you now dismiss and claim that not only have the numbers flipped in terms of the % of his supporters who believe him, but you believe they believe him less every day. I think you are simply postulating based on how you feel and not what we see. You can claim Twitter, Fox, OAN, Newsmax, etc, are all not representative. That's your opinion. I think you are wrong. You have no data to back you up. I at least have some data that show recently, I was most certainly correct. And that's before the echo chamber has plenty of chance to reinforce the lies.

(11-27-2020, 09:14 PM)Goose Wrote:
Whether the remainder can be defined as "substantial" is probably arguable, but I certainly agree it isn't zero. However, that has little if anything to do with any of the points I made in my reply to your post. My point was and is "the idea that Trump's response determines the narrative is flawed".

What is the "narrative" in your mind? A consistent public message from the govt or the health care workers narrative? Because it's patently absurd that the narrative pushed by the vast majority of health care workers hasn't been consistent now for many months. You can use a stopwatch to see how fast people like you immediately reach for anecdotes back in March or April. It's f**king end of November. And the "narrative" has been mixed precisely because Trump has been a second larger channel that not only suppresses the healthcare perspective, but he's got the podium.

If you think Trump's messaging didn't greatly impact public perception, particularly for his base, we have nothing to talk about. Period. We have no common ground.

(11-27-2020, 09:14 PM)Goose Wrote:
My point was that the CDC shipped a contaminated test, and that that fact (along with the CDC's somewhat confused public response to that fact) undermined public confidence in the CDC.

The vast majority of the people, particularly Trump supporters, don't even know the details of the early timeline other than Fox talking points, and the CDC problem on early testing is not a main one. The fact that even now, in November, you cite this as the glaring problem other than the impact of Trump is amazing. The fact you don't think the CEO of our country, POTUS, could've significantly pushed for money and initiatives to shore up all the deficiencies you mention (pre-dating Trump) is incredible. This was a war. Our president, just as he is doing now, plays golf while people die. He'd rather blame prior Administrations than actively fix anything that needed fixing, particularly when he has an incredible mandate and reason to do so.

Nobody -- NOBODY thinks everything was just glorious with the healthcare infrastructure pre-Trump. Nobody thinks the issues will magically resolve when Trump leaves, particularly since he continues to feed disinformation to a large % of population. These are straw men arguments that you and your ilk constantly trot out. The complaint is that NOT ONLY DID TRUMP NOT WORK TO FIX THE ISSUES DURING THE PANDEMIC WHEN HE HAD CLEAR MANDATE, HE MADE THINGS MUCH MUCH WORSE. Not only on the infrastructure, but the key factor -- public messaging to help compliance.

RE: Following the Science - Genuine Realist - 11-28-2020

(11-24-2020, 01:38 PM)Goose Wrote: https://www.medpagetoday.com/blogs/vinay-prasad/89856?xid=nl_secondopinion_2020-11-24&eun=g1475875d0r

Not sure what other thread to put this in, so I made a new one. I like what this blog says, and I think it is important we consider the points it makes.

Bear Bryant once said there were two kinds of bad, uncoachable football players. One doesn't listen to anything you say. The other doesn't do anything but what you say.

No sensible CEO goes with his experts by rote. They're there to assist and advise, to provide information and ideas - not to make decisions. (If they get into the decision making process, then they've become CEOs.) The expertise is immensely valuable - the value judgments that experts make are no better than those of anyone else. And their objectivity can be warped by their immersion in their own field. I value the medical knowledge of the medicos who post here, and seldom comment on them. But their social and political opinions run the whole gamut, and are too often infected by the elitism that is too often a byproduct of higher education.

The science on covid has gone every which way in the last nine months. Fauci is as popular as he is not because he hasn't backtracked a lot. The public trusts him because he is so obviously in good faith, not because he has always been right. Had Trump as President emphasized his own respect for scientific opinion, while emphasizing that the Administration also had to consider other values - damage to the economy, damage to the education of children at large, damage to society at large, even health matters that are relatively inchoate (e.g., mental health issues such as depression, anomie, domestic stress), he would have done fine, even if the scientific opinions did not always lead the list. It was his compulsive personalization and hostility that did him in.

I also think I'll add one global insight to the compulsive US bashers that populate this board. Whatever the don't-tread-on-me themes in this society that lead to reflexive opposition to authority, the vaccines that might lead us out of this mess have all been produced in the United States (and its recent rival in political oppositionism, the UK) and in a remarkably short period of time. I imagine it's some sort of record. I am wondering what those obedient Germans and docile Taiwanese have been doing all this time.

RE: Following the Science - dabigv13 - 11-28-2020

Wearing your ignorance on your sleeve. BioNTech, the company that will bring the first vaccine to market in the US, and developed the vaccine themselves, is a German company. Pfizer (a multinational corporation that has tried to slip their US taxes with overseas mergers) has partnered with them, luckily for us!

RE: Following the Science - oregontim - 11-28-2020

This thread reminds me how much I miss facts. We used to be able to agree on essential facts and then discuss the meaning. Politicians caught lying were run out of politics. Nowadays we argue what the actual facts are.

That’s a very sad change for the worse, over the last few decades.

I actively ask, for this board, whether anybody is disputing any of the following four points.

Tens of millions of Americans didn’t and don’t cooperate with masks and distancing.
The president of the USA repeatedly, from March through October at least, encouraged that attitude.
Tens of millions of Americans either believe the recent election was flawed or wish it were and don’t mind pretending it was; and would happily have Trump remain in office.
The president of the USA has strongly encouraged that belief and behavior.

Do you agree? Are there posters here who are arguing with any of these four points? I think not, but sometimes I read posts here that make me wonder.

RE: Following the Science - Mick - 11-28-2020

(11-27-2020, 04:46 PM)M T Wrote: This board spends a lot of time arguing about every one else's arguments.

No it doesn't. Jeez, I can't even believe you said that...
;)

RE: Following the Science - oregontim - 11-28-2020

(11-28-2020, 12:18 PM)Mick Wrote:
(11-27-2020, 04:46 PM)M T Wrote: This board spends a lot of time arguing about every one else's arguments.

No it doesn't. Jeez, I can't even believe you said that...
;)

+1 made me laugh.

RE: Following the Science - cctop - 11-28-2020

(11-28-2020, 12:18 PM)Mick Wrote:
(11-27-2020, 04:46 PM)M T Wrote: This board spends a lot of time arguing about every one else's arguments.
No it doesn't. Jeez, I can't even believe you said that...

That's not an argument. That's just contradiction.
[/url]
[url=https://www.dailymotion.com/video/x2hwqn9]That's not an argument. That's just contradiction.

RE: Following the Science - Genuine Realist - 11-28-2020

(11-28-2020, 11:31 AM)dabigv13 Wrote: Wearing your ignorance on your sleeve. BioNTech, the company that will bring the first vaccine to market in the US, and developed the vaccine themselves, is a German company. Pfizer (a multinational corporation that has tried to slip their US taxes with overseas mergers) has partnered with them, luckily for us!

Pfizer is a US company founded in 1849 in the United States by a couple of German immigrants, if that pleases you. It's multinational in the same way that Apple is multinational.

Clinical trials were conducted in the US, and the relevant applications made to the FDA. If the locus was in Europe, I'd have expected trials to be there and the evaluations to be done by the EU.

So I'll stick with my point about US impetus and locus. However, it wouldn't be the first time I'm wrong.

The major point about the US bashing being somewhat misplaced I will stick with.

RE: Following the Science - DocSavage87 - 11-28-2020

(11-28-2020, 01:11 PM)cctop Wrote:
(11-28-2020, 12:18 PM)Mick Wrote:
(11-27-2020, 04:46 PM)M T Wrote: This board spends a lot of time arguing about every one else's arguments.
No it doesn't. Jeez, I can't even believe you said that...

That's not an argument. That's just contradiction.
[/url]
[url=https://www.dailymotion.com/video/x2hwqn9]That's not an argument. That's just contradiction.

No it wasn't.

RE: Following the Science - Goose - 11-28-2020

(11-28-2020, 12:13 PM)oregontim Wrote: This thread reminds me how much I miss facts. We used to be able to agree on essential facts and then discuss the meaning. Politicians caught lying were run out of politics. Nowadays we argue what the actual facts are.

That’s a very sad change for the worse, over the last few decades.

I actively ask, for this board, whether anybody is disputing any of the following four points.

Tens of millions of Americans didn’t and don’t cooperate with masks and distancing.

The president of the USA repeatedly, from March through October at least, encouraged that attitude.

Tens of millions of Americans either believe the recent election was flawed or wish it were and don’t mind pretending it was; and would happily have Trump remain in office.

The president of the USA has strongly encouraged that belief and behavior.

Do you agree? Are there posters here who are arguing with any of these four points? I think not, but sometimes I read posts here that make me wonder.

I for sure agree totally with 2,3, and 4. I basically agree with 1 as well, but I think it is more of a vector. There are varying degrees of compliance. Some people don't wear masks but do distance. Many more do both some of the time. Are there tens of millions that do neither ever? That I don't know, but it is probably a detail. They substantially don't. So, with these things I agree, FWIW.

RE: Following the Science - Genuine Realist - 11-28-2020

(11-28-2020, 09:45 PM)Goose Wrote:
(11-28-2020, 12:13 PM)oregontim Wrote: This thread reminds me how much I miss facts. We used to be able to agree on essential facts and then discuss the meaning. Politicians caught lying were run out of politics. Nowadays we argue what the actual facts are.

That’s a very sad change for the worse, over the last few decades.

I actively ask, for this board, whether anybody is disputing any of the following four points.

Tens of millions of Americans didn’t and don’t cooperate with masks and distancing.

The president of the USA repeatedly, from March through October at least, encouraged that attitude.

Tens of millions of Americans either believe the recent election was flawed or wish it were and don’t mind pretending it was; and would happily have Trump remain in office.

The president of the USA has strongly encouraged that belief and behavior.

Do you agree? Are there posters here who are arguing with any of these four points? I think not, but sometimes I read posts here that make me wonder.
I for sure agree totally with 2,3, and 4. I basically agree with 1 as well, but I think it is more of a vector. There are varying degrees of compliance. Some people don't wear masks but do distance. Many more do both some of the time. Are there tens of millions that do neither ever? That I don't know, but it is probably a detail. They substantially don't. So, with these things I agree, FWIW.

I don't think the numbers are anything more than guesstimates. Then you have to try to determine the degree of conviction, from offhand opinion to absolutely certain belief. What seems to be quite true is that both the numbers and degree of certainty are diminishing rapidly over time as lawsuits collapse and are revealed to be wholly unfounded. Like Goose, I'm a fairly firm believe in the rationality of the public.

Also, in general, it's a lot better to focus on freeing yourself from your own illusions than concentrate too much on someone else's.