Stanford Professor Calls Covid-19 Response a Severe Overreaction - Printable Version
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Stanford Professor Calls Covid-19 Response a Severe Overreaction - martyup - 03-20-2020
https://www.dailywire.com/news/stanford-professor-data-indicates-were-overreacting-to-coronavirus?itm_source=parsely-api
Quote:In an analysis published Tuesday, Stanford’s John P.A. Ioannidis — co-director of the university’s Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health — suggests that the response to the coronavirus pandemic may be “a fiasco in the making” because we are making seismic decisions based on “utterly unreliable” data. The data we do have, Ioannidis explains, indicates that we are likely severely overreacting.
Quote:The woefully inadequate data we have so far, the meta-research specialist argues, indicates that the extreme measures taken by many countries are likely way out of line and may result in ultimately unnecessary and catastrophic consequences. Due to extremely limited testing, we are likely missing “the vast majority of infections” from COVID-19, he states, thus making reported fatality rates from the World Health Organization “meaningless.”
Quote:Ioannidis then zooms in on the “one situation” where “an entire, closed population was tested”: the Diamond Princess cruise ship’s quarantined passengers. While the fatality rate was 1.0%, he points out, the population was largely elderly, the most at-risk demographic. Projected out onto the age structure of the U.S. population, he calculates, the death rate is more like 0.125%, with a range of 0.025% to 0.625% based on the sample size
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - ChicagoCard - 03-20-2020
He is also quoted among others by Nicholas Kristof in his latest NY Times piece...
https://www.nytimes.com/2020/03/20/opinion/coronavirus-outcomes.html
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - 2006alum - 03-20-2020
Since this was first posted a few days ago, it has been somewhat widely refuted. As someone noted when his article first came out a few days ago (I can't find it now), his one datapoint is also aberrant in a number of respects. In addition to being elderly, the Diamond Princess Cruise population that was symptomatic had rapid testing and intervention early on, with no shortage of respirators and critical care beds for those who needed it. And there was no concern about testing and contact tracing, because everyone was presumed to be at risk, and they were totally isolated, so no concern about spread.
None of those assumptions hold true for the population at large, and as Italy is showing us, widespread transmission coupled with an inadequate supply of medical treatment leads to a CFR that is much higher than .025% to .625%. What's incredible in Italy is that they are doing fairly wide testing and 3/4th of those tested are negatives. So it's not like there some vast number of probably infected people who aren't being tested.
In other words, what he should look at is if every cruise ship had the same problem happen at the same time and had to rely on the same hospital for treatment. This is as much a public health problem as it is one of simple epidemiology.
Here's a few other hot takes:
[tweet]https://twitter.com/nntaleb/status/1239967206579908609?s=20[/tweet]
[tweet]https://twitter.com/HelenBranswell/status/1240286173446184960?s=20[/tweet]
[tweet]https://twitter.com/NAChristakis/status/1239969810496098306?s=20[/tweet]
https://www.statnews.com/2020/03/18/we-know-enough-now-to-act-decisively-against-covid-19/
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - BostonCard - 03-20-2020
I have great respect for Ioannidis, and we should all hope he’s right, because in that case we will feel foolish for overreacting but we will almost all be alive. But I don’t think we should under respond for that reason. If we follow his advice, and he’s wrong, we are looking at millions of preventable deaths. I keep saying it that we actually can fight this pandemic and we can keep it under control, but doing so requires taking action rather than awaiting perfect data.
BC
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - martyup - 03-20-2020
There will be severe long term damage to the US and world economies based on decisions being made by local, state, and federal bureaucrats. Taking the approach most likely to save the most lives isn't always the best approach. If it was, we wouldn't be driving cars. I am not a medical doctor or a scientist of any kind, so I will defer to Stanford's co-director of Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health.
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - chrisk - 03-20-2020
(03-20-2020, 07:17 PM)martyup Wrote: There will be severe long term damage to the US and world economies based on decisions being made by local, state, and federal bureaucrats. Taking the approach most likely to save the most lives isn't always the best approach. If it was, we wouldn't be driving cars. I am not a medical doctor or a scientist of any kind, so I will defer to Stanford's co-director of Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health.
But the crisis is a result of inaction. The extreme economic damage is a result of that, not something unavoidable. What is the long-term economic damage you refer to? There must be some, but much of the economic shortfall is consumption, which has a much smaller long-term effect than investment. Certain industries, such as airlines and cruises, may be impacted long-term, but there will be other industries that will be stronger and bigger.
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - 2006alum - 03-20-2020
(03-20-2020, 07:40 PM)chrisk Wrote: But the crisis is a result of inaction. The extreme economic damage is a result of that, not something unavoidable. What is the long-term economic damage you refer to? There must be some, but much of the economic shortfall is consumption, which has a much smaller long-term effect than investment. Certain industries, such as airlines and cruises, may be impacted long-term, but there will be other industries that will be stronger and bigger.
Indeed. This bears repeating, endlessly if necessary:
[tweet]https://twitter.com/DrEricDing/status/1241116464746291202?s=20[/tweet]
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - CompSci87 - 03-20-2020
(03-20-2020, 07:17 PM)martyup Wrote: There will be severe long term damage to the US and world economies based on decisions being made by local, state, and federal bureaucrats. Taking the approach most likely to save the most lives isn't always the best approach. If it was, we wouldn't be driving cars. I am not a medical doctor or a scientist of any kind, so I will defer to Stanford's co-director of Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health.
Why "defer" to one expert when other experts disagree?
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - stupac2 - 03-20-2020
(03-20-2020, 08:41 PM)CompSci87 Wrote:(03-20-2020, 07:17 PM)martyup Wrote: There will be severe long term damage to the US and world economies based on decisions being made by local, state, and federal bureaucrats. Taking the approach most likely to save the most lives isn't always the best approach. If it was, we wouldn't be driving cars. I am not a medical doctor or a scientist of any kind, so I will defer to Stanford's co-director of Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health.
Why "defer" to one expert when other experts disagree?
Because that's the one person telling him what he wants to hear.
I wonder what Mr Ioannidis's reaction to this chart would be:
![[Image: ETmaZThXsAIqWdJ?format=jpg]](https://pbs.twimg.com/media/ETmaZThXsAIqWdJ?format=jpg)
That's at about a 40% daily growth rate. Doubling every 2 days. If that doesn't bend we're talking about 500k cases by April 1, and 20 million cases by mid-April. I wonder what the economic damage from millions of deaths would be...
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - magnus - 03-20-2020
(03-20-2020, 08:58 PM)stupac2 Wrote: I wonder what the economic damage from millions of deaths would be...
As a terrible thought experiment, ignoring the ethical/moral/love of humanity dilemmas, theoretically, what would the economic damage be if the virus were allowed to run its course unabated?
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - BostonCard - 03-20-2020
Probably just as bad if not worse. When deaths start piling up and the hospitals are overwhelmed, I’m thinking the government probably doesn’t have to tell people to shelter in place. It’s not a choice between a healthcare calamity and an economic calamity, it’s a choice between an economic calamity with a healthcare calamity and one to avoid a healthcare calamity.
BC
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - burger - 03-20-2020
(03-20-2020, 09:58 PM)BostonCard Wrote: Probably just as bad if not worse. When deaths start piling up and the hospitals are overwhelmed, I’m thinking the government probably doesn’t have to tell people to shelter in place. It’s not a choice between a healthcare calamity and an economic calamity, it’s a choice between an economic calamity with a healthcare calamity and one to avoid a healthcare calamity.I was about to say the same thing. Even if the mortality rate is lower than expected (narrator: it's not), a lot of people are going to die. A lot of health care providers are going to die when their PPE runs out. It's a disaster.
BC
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - cardcrimson - 03-20-2020
(03-20-2020, 09:58 PM)BostonCard Wrote: Probably just as bad if not worse. When deaths start piling up and the hospitals are overwhelmed, I’m thinking the government probably doesn’t have to tell people to shelter in place. It’s not a choice between a healthcare calamity and an economic calamity, it’s a choice between an economic calamity with a healthcare calamity and one to avoid a healthcare calamity.
BC
Well, at least Social Security would become solvent again.
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - martyup - 03-21-2020
(03-20-2020, 08:41 PM)CompSci87 Wrote:(03-20-2020, 07:17 PM)martyup Wrote: There will be severe long term damage to the US and world economies based on decisions being made by local, state, and federal bureaucrats. Taking the approach most likely to save the most lives isn't always the best approach. If it was, we wouldn't be driving cars. I am not a medical doctor or a scientist of any kind, so I will defer to Stanford's co-director of Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health.
Why "defer" to one expert when other experts disagree?
He is not the only expert that is more optimistic about this pandemic than others. Here is a NYT opinion piece, posted earlier by ChicagoCard, that cites several experts that don't disagree with Dr. Ioannidis:
https://www.nytimes.com/2020/03/20/opinion/coronavirus-outcomes.html
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - Mick - 03-21-2020
(03-20-2020, 07:40 PM)chrisk Wrote:No disrespect meant, but I don't believe you. Why would you claim that? Goldman Sachs says 2nd quarter GDP will contract 24%. There are 30.2 million small businesses in the USA (defined as fewer than 500 employees). How many of them will survive two months with no revenue and bills piling up? How will they come back? They'll be forced to consume what resources they have left, there will be millions in layoffs.[/url](03-20-2020, 07:17 PM)martyup Wrote: There will be severe long term damage to the US and world economies based on decisions being made by local, state, and federal bureaucrats. Taking the approach most likely to save the most lives isn't always the best approach. If it was, we wouldn't be driving cars. I am not a medical doctor or a scientist of any kind, so I will defer to Stanford's co-director of Meta-Research Innovation Center and professor of medicine, biomedical data science, statistics, and epidemiology and population health.
But the crisis is a result of inaction. The extreme economic damage is a result of that, not something unavoidable. What is the long-term economic damage you refer to? There must be some, but much of the economic shortfall is consumption, which has a much smaller long-term effect than investment. Certain industries, such as airlines and cruises, may be impacted long-term, but there will be other industries that will be stronger and bigger.
Yes, the coronavirus is tragic and people will die. How many people will die because of economic reasons? How many suicides? How many because they can't pay their rent and become homeless? 40% of Americans can't afford an unforeseen $400 expense and 50% of Americans live paycheck to paycheck. You really think America is going to be whole and bounce back economically from this?
To your comment "But the crisis is a result of inaction." Powerful people, people who run countries and states and large agencies have a documented bias towards action, even if it means ruination. And that's where we're headed as a result of this action.[url=https://www.worldometers.info/coronavirus/]
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - 2006alum - 03-21-2020
(03-21-2020, 07:56 AM)martyup Wrote: He is not the only expert that is more optimistic about this pandemic than others. Here is a NYT opinion piece that cites several experts that don't disagree with Dr. Ioannidis:
https://www.nytimes.com/2020/03/20/opinion/coronavirus-outcomes.html
For what it's worth, Chicago Card already cited that piece in the very first response to your initial post up above...
(03-20-2020, 05:15 PM)ChicagoCard Wrote:
He is also quoted among others by Nicholas Kristof in his latest NY Times piece...
https://www.nytimes.com/2020/03/20/opinion/coronavirus-outcomes.html
(03-21-2020, 08:02 AM)Mick Wrote: Goldman Sachs says 2nd quarter GDP will contract 24%. There are 30.2 million small businesses in the USA (defined as fewer than 500 employees). How many of them will survive two months with no revenue and bills piling up? How will they come back? They'll be forced to consume what resources they have left, there will be millions in layoffs.
Yes, the coronavirus is tragic and people will die. How many people will die because of economic reasons? How many suicides? How many because they can't pay their rent and become homeless? 40% of Americans can't afford an unforeseen $400 expense and 50% of Americans live paycheck to paycheck. You really think America is going to be whole and bounce back economically from this?
I guess the problem is that all those things would happen anyway in the event that the pandemic spread widely and unchecked - in places like Wuhan and Italy where they were very slow to identify (and acknowledge, in the case of China) what was happening, they still had to shut down their economies altogether while the virus raged through those regions. It wasn't a question of "if" but "when."
I'm totally on your side that this is going to have a catastrophic economic impact, but I guess I'm not sure what the alternative is. Whether or not London Breed tells me to shelter in place, if half my friends are coming down with COVID-19 and 1/5th of those need hospitalization, I'm still not going to go participate in the economy. And those who would end up getting very sick would be unable to participate in the economy, all the while straining our hospital system even further. I'm fairly confident the reason universities and large corporations went online and WFH so quickly was in part legal liability and costs to business of doing nothing -- they did this voluntarily, in many cases a week or two before any sort of shelter in place order went into effect. Even if all government authorities had said "carry on as usual," Stanford had already determined the risks of doing so were not acceptable.
So I guess the question is what you think the alternative would be, from the governmental actor standpoint. As the Kristof article notes in the "best case scenario model," the only viable model that seems to have reduced the economic impact has been the model of Korea, Hong Kong, Taiwan, and Singapore, which involves rapid and widespread (and free) testing, invasive and effective contact tracing and isolation, and a very willing and cooperative population. And in this respect, that is what I think chrisk was referring to as "inaction," for well over a week after the promise that "anyone who wants to be tested can get tested," the vast majority of Americans can't. Now as we roll out tests, we lack reagents. We're also critically low on PPE. At every step, the feds have seemed to overpromise and under-deliver, despite having clear warnings weeks to months in advance of what needed to be done. We also have limited infrastructure in place for contact tracing, and as everyone has been noting, we don't seem to be great at the isolation part. So I'd say we're 0/3 on the testing, contact tracing, and isolation. That, to me, is inaction of the highest order.
So what I'd love to hear is, what's the proposed alternative?
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - BostonCard - 03-21-2020
With coronavirus, life comes at you fast. The situation in Italy has already disproven Ioannidis theory. At this point, the death rate in Italy due to coronavirus is 600 per day and still rising (and it may be an underestimate):
https://www.reuters.com/article/us-health-coronavirus-italy-homes-insigh/uncounted-among-coronavirus-victims-deaths-sweep-through-italys-nursing-homes-idUSKBN2152V0
Total deaths in Italy last year were about 600,000 (death rate of about 1%), so if you do the math the daily background death toll is about 1,600. For Ioannidis theory to be right, the Covid-19 death toll would have to be in essence produce a rounding error (<10% increase) in the number of daily deaths. And yet if you have a background rate of 1600/day, the 600/day would be 27% of all the deaths in Italy. Even if some deaths that would have happened anyways are reclassified as Covid related because patients test positive even though they would have died anyways, there’s the fact that as the article I linked shows, a lot of people may be dying from Covid-19 without anyone knowing, and in the most affected areas, the number of deaths may be three times expected.
I have a lot of respect for Ioannidis, and his skepticism has been very important for the field of medicine (not to mention genetics and nutritional science). But even well-respected scientists can be wrong during a fast-moving pandemic, and I think in this case, John is going to regret having written that.
BC
RE: Stanford Professor Calls Covid-19 Response a Severe Overreaction - burger - 03-21-2020
(03-21-2020, 10:39 AM)BostonCard Wrote: I have a lot of respect for Ioannidis, and his skepticism has been very important for the field of medicine (not to mention genetics and nutritional science). But even well-respected scientists can be wrong during a fast-moving pandemic, and I think in this case, John is going to regret having written that.This times 1000.
BC
A bigger issue is that there is a TON of "science"* coming out, and some of it is going to be wrong, for a variety of reasons. Reasons like:
- bad analyses in non-peer reviewed papers
- people projecting their own biases onto data
- small sample sizes (e.g. comparison between Italy, China, and US mortality is essentially an N of 3; crappy choloroquine study, etc.)
- generalizing from early cases
My advice is to ignore the outliers. When you see one scientist expresses an extreme opinion (like the virus outbreak is no big deal, or that the fatality rate from the virus is 0.05%), check and see what others are saying. See what various country's health departments are saying. And if the outlying opinion does not have support of a substantial number of scientists, ignore it.
*I'm using this term super generally to include all manner of papers, analyses, commentary, etc from scientists