Wednesday, December 29, 2021

Compared To...?

Always ask, even if silently, "Compared to whom/what?"

Shorter version of Scott Lincicome: If we had let the free market regulate our covid response it would have been messy, unfair, initially haphazard and likely dangerous. But what the government did was worse.

Perhaps the biggest of these boondoggles still haunts us today: the continued regulatory blockade of—and executive branch errors regarding—at-home (“rapid”) COVID-19 tests. We discussed the testing situation at length back in September—noting then (1) the dearth of FDA-approved antigen tests (which are cheaper and faster than, and can be just as accurate as, lab-based “PCR” tests); (2) the numerous public health experts and economists begging the Biden administration to deregulate (lawfully) the process; and (3) the ominous-yet-obvious signs of avoidable future shortages. To be clear, I certainly wasn’t alone in making these arguments. Since then, the FDA has approved a few more rapid tests (still far fewer than European regulators, it must be noted), but—with the Omicron variant and holiday travel spiking U.S. demand—the testing situation here hasn’t improved and may have actually deteriorated.

You can bring some disagreements if you like, or build on what he wrote.  That's what discussion is about.


17 comments:

twinkle7 said...

may I join and read your site.
I live in the volcanic crater …Akaroa ..at French farm…
the new doctor thought i would appreciate your site…
I was in Arad Romania in 1990/91..
Lois Bellingham

David Foster said...

Worth reading:

https://marginalrevolution.com/marginalrevolution/2021/12/propublica-on-the-fda-and-rapid-tests.html

Christopher B said...

...it would have been messy, unfair, initially haphazard and likely dangerous.

would have been?

If you've got a half an hour to waste, give a listen to this. (The Chieftain is a former Irish Army trooper, former US Army and current National Guard armor officer, author, and researcher/advisor to the company that produces the World of Tanks game. Great accent, too.)

Keep in mind this is being done by a company with decades of experience building big heavy mobile equipment, in an city that along with Waterloo and Charles City Iowa just up the road were the triumvirate of agricultural tractor and equipment production, at a time when the US faced a clearly existential threat from two sworn enemies that were having considerable success in their military operations, and was supposedly united and galvanized into doing whatever it took to survive. (the TL;DL .. they spent eighteen months and millions of dollars to build and equip a factory that produced a baker's dozen half-completed tanks before it was shut down and the tanks scrapped. The real story is in what happened along the way to that result.)

Assistant Village Idiot said...

@ twinkle - you are certainly welcome to be here - it would be hard to prevent you from reading anyway! I wouldn't know whether you will like it here or not.

I know little about Akaroa. I even had to look it up to learn it is in NZ. I have not been to Arad, RO but my wife may have. She was definitely in Zarand in 1999, and we were both at Deva, Hunedoara. and Timisoara briefly in 2005. We have been to Beius and Oradea several times.

Assistant Village Idiot said...

@ Christopher - "would have been?" - Yes, that was Lincicome's point. What happened instead was messier, at least as unfair, haphazard for a longer period of time and more dangerous.

A lot of my objection to the complaints of conservatives on the issue is that they somehow move from "the government is not handling this well" to "covid is not all that dangerous anyway."

Gavin Longmuir said...

Perhaps the real issue was not the inadequate supply of tests; instead it may have been the over-reliance on tests.

Ask yourself -- How do I know I am sick? The answer is obvious -- I have signs & symptoms of disease -- anything from headaches (a symptom which I report but no-one else can observe) to collapsing in the street (a sign which anyone can observe). A doctor can analyze those signs & symptoms, and make a diagnosis of the likely cause of my sickness. Then the doctor may order tests to confirm that diagnosis, and at some point start an appropriate course of treatment.

The Covid testing extravaganza resulted in a redefinition of "case". Instead of a case being a person with signs & symptoms, a case became a healthy person with no signs & symptoms of disease but with a positive test result. This caused massive amounts of fear and distress for individuals without doing much to slow the spread of the virus.

If Covid had appeared, say, a hundred years ago before testing regimes were available, would the response to a seasonal increase in mortality have caused so much social and medical harm along with so much human distress? One wonders how many Covid-like disease outbreaks did indeed occur back before the availability of testing -- without causing massive government-inspired panic?

Randomizer said...

Lincicome misses the point. It wasn't that there was too much governmental involvement, but that the governmental organizations we have in place are so thoroughly incompetent. We thought we needed the CDC, FDA and county health departments. Didn't we used to have a surgeon general? Jocelyn Elders is the last one I can recall.

The CDC could have been the place to get the latest, unbiased, scientific results and statistics. It's not. The FDA started by slowing things down, then seems to have surrendered. My county health department hasn't been seen, and we get the fiendish Fauci as the federal medical expert.

Yes, Lincicome, of course the free market would have been better. "This vaccine is approved in Europe." Good enough for me. "This vaccine is only approved in China" No thanks, I'm not getting vaccinated at Harbor Freight.

Ivermectin and hydrocloriquine may not help against Covid, but I would stop at the drug store to pick up these cheap and usually safe medications. Maybe my problem was really hook worm and malaria, you don't know. With a free market response, a person who may have Covid, could stop by the pharmacy to get an instant test and a shot of monoclonal antibodies.

The governmental response was wrong about everything, but will double-down, rather than reflect, learn and apologize. The primary goal will be to retain their new power. With a free market response, we might still have had 800,000 dead, but some companies would be rewarded and some punished by the market, but our entire economy would not be wrecked.

Assistant Village Idiot said...

@ randomizer - I would note only that the CDC's statistics have been pretty good throughout. Having worked for a government agency, I am familiar with some parts of it working fine and others not functioning well at all. Lincicome, being rather libertarian - his essay is something of "why I returned to my previous thinking" - is that you might be technically correct, b ut he believes that government is always going to screw up more than it fixes, as here. I don't think that's quite my argument, as I think I am closer to your perspective, but it's his.

@ Gavin - you might run your interesting theory about what is a "case" past any of the doctors and other professionals you know. I'd be interested what decade they identify as the last time this was true. In fact a great many diseases, and nearly all in some professions, are noticed first via tests, before you are showing any symptoms. It's why your doctor schedules routine bloodwork for you. Lots of people didn't know they had a disease which could have been more easily treated if it had been detected earlier. If it was contagious, they might have exposed and infected their whole circle before they knew they had it. You might argue that early detection has so failed to deliver on its promise that it's not worth it - some have - but that's not the same thing. If your bloodwork says you have diabetes or hypertension, or high cholesterol, you have a "case," even if you haven't been aware of symptioms.

Gavin Longmuir said...

AVI: "If your bloodwork says you have diabetes or hypertension, or high cholesterol, you have a "case," even if you haven't been aware of symptioms."

In theory, people go to the doctor regularly to get complete physicals. In reality -- at least as far as I can see from my keyhole -- that applies only to older people in the Upper Middle Class. People in their 20s, 30, even 40s rarely go to a doctor unless they first have symptoms, or are required to do so as a condition of employment.

It would be reasonable to suggest that most of the younger healthy people who got tested for Covid would not have seen any need to go to a doctor unless they had been frightened into it by the media storm. But maybe things are different in your part of the world.

Gavin Longmuir said...

Randomizer: "It wasn't that there was too much governmental involvement, but that the governmental organizations we have in place are so thoroughly incompetent."

That is an excellent point -- and one with ramifications far beyond medicine. Unfortunately, thorough incompetence is not a government monopoly. Just think about J C Penny and Sears losing their place to Walmart and Amazon. Even within government, incompetence is not a universal factor. Think about the high competence of NASA in the 1960s versus the woke NASA of today.

Everything seems to come back to Prof. handy's "Sigmoid Curve" -- every human organization grows, plateaus, and then decays. Eventually, the Mongols come over the hill and the organization dies. In the US today, we seem to be waiting for the Mongols to arrive, but that is going to be painful & destructive.

What's to be done? There have been suggestions such as hiring senior bureaucrats and corporate officers on relatively short-term (3-year?) contracts, with a strong bias against renewing those contracts. There have also been ideas about "sunsetting" every organization after, say, 20 years and requiring any replacement organizations to be rebuilt from the ground up. Prevention of creation of monopolies and monopsonies could also be part of an answer. However, all of those approaches are likely to create the same kind of chaos and inefficiencies as the arrival of the Mongols.

It is not an easy problem, and history tells us no civilization has ever found an answer. That will presumably ultimately include us.

Assistant Village Idiot said...

@ Gavin - first sentence, and I wasn't even looking for it. https://amp.theatlantic.com/amp/article/621114/ If a test says you've got a case, you've got a case, even with no symptoms.

Gavin Longmuir said...

"If a test says you've got a case, you've got a case, even with no symptoms."

Surely most of us can see there is a difference between:
(a) a situation where an asymptomatic older Upper Middle Class male gets a test showing he has 100% fatal cancer developing in his heart muscle and
(b) the situation where a healthy asymptomatic young person gets a test saying that he may have a viral infection which carries a negligibly small risk of mortality for persons in his age group.

One is absolutely a "case", even without current symptoms; the second, not so much.

Assistant Village Idiot said...

I didn't say there was no difference - don't put words in my mouth. I said they are both a "case" and attempts to pretend otherwise is manipulating the data. Words can have varieties of meanings, formal and informal, but in this case the formal definition of what is a case, which you challenged, is what is at issue. It's like the conversation "Have you ever been to Spain?" "Well, I've been to Madrid." "Oh my dear, you haven't been to Spain." One is a reality, the other is a pose for effect. There has been no convenient redefinition of case for covid. The longstanding standard definition is being applied. It is you who are attempting to insert some redefinition for your own political convenience. I am refereeing that out. You have challenged, I have reviewed, and you are still just wrong. If you want to find some better authority from medical fields who agrees with you, fine. But simply reasserting variations of your original argument, which I fully grasped the first time, isn't going to convince anyone who wasn't already thrilled to find a convenient redefinition themselves.

You seem to think it is all those other people doing the manipulating.

Gavin Longmuir said...

AVI: "I didn't say there was no difference"

Then we agree -- there is a difference.

Assistant Village Idiot said...

Oh please. If that's the victory you want to claim after all this, you are welcome to it. what a waste of time.

Assistant Village Idiot said...

Those still reading might recognise that as a motte-and-bailey fallacy https://en.wikipedia.org/wiki/Motte-and-bailey_fallacy.

Gavin Longmuir said...

Well, let's simply agree to disagree.

From what I can tell, your assessment of the "pandemic" is driven by being closely involved with sick people; and that is understandable. My assessment is driven by being closely involved with people who are losing their businesses, their savings, their jobs, their education, even their joy in life due to Lock Downs and other inappropriate government responses.

It may be that we are like the fabled blind men touching an elephant - what we are each experiencing is real, simply different aspects of a singular phenomenon.

Let me leave you with this final thought -- the "pandemic" will come to an end, and we will go back to a world in which every winter the flu closes out the lives of many old people and people with serious pre-existing medical problems. However, long after the "pandemic" has sunk into history, we will still be suffering from the social & economic consequences of the Lock Downs.