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   Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:24 JST Siderea, Sibylla Bostoniensis

   This was a painful example of motivated reasoning and a whole bunch of other psychological nonsense that leads people, people who should be in some sense scientific and rational, to glom onto a paradigm and not let go in the face of evidence.

   At the point that aerosol physicists are telling you, *No, really, what you believe doesn't make any sense*, and you are telling the aerosol physicists, *You're not medical professionals, what could you possibly know?* you are at the point – if not long, long past it – to notice something has gone COMPLETELY off the epistemological rails.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:14 JST Siderea, Sibylla Bostoniensis

     in reply to

     That's Donald Fucking Trump, in an interview he was giving to Bob Woodward on ⭐February 7th⭐ 2020.

     And here he is on ⭐March 19th ⭐ 2020:

     Quote:

     DT: Now it's turning out it's not just old people, Bob. But just today and, and yesterday, some startling facts came out. It's not just old, older...

     [...]

     Young people, too. Plenty of young people.

     [...]

     Well I think, Bob, really, to be honest with you–

     BW: –Sure! I want you to be.

     DT: I wanted to, uhhh... I wanted to always play it down. I still like playing it down–

     BW: Yes, I–

     DT: – because I don't want to create a panic.

     End quote. (See https://siderea.dreamwidth.org/1655431.html for cites, links to the audio)

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:14 JST Siderea, Sibylla Bostoniensis

     in reply to

     Meanwhile, as captured in that STAT article from Feb 25:

     Quote:

     Department of Health and Human Services Secretary Alex Azar said the government is committed to “radical transparency” in keeping the public informed about its response and preparedness planning. [...]

     “Transparency is being candid with people about what the continuum of potential steps are, so they can … start thinking about, in their own lives, what that might involve. Might. Might involve,” Azar said.

     End quote.

     So it seems pretty clear that various members of the Trump administration were knowingly, at his behest, "down playing" the incipient pandemic while assuring the American public of their "transparency".

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:15 JST Siderea, Sibylla Bostoniensis

     in reply to

     (As a side note, I do want to focus this on bad medicine and bad medical science, as opposed to the widely attributed bad governance, but I want to acknowledge – while I have that STAT article open – that this happened:

     Quote:

     It goes– It goes through air, Bob. That's always tougher than the touch, you know, the touch– you don't have to touch things, right? But the air, you just breathe the air and that's how it's, uh, passed. Aaaand so, that's a very tricky one. That's a very delicate one. It's also more deadly that your, you know, your– even your strenuous flus. You know, people don't realize: we lose twenty-five thousand, thirty thousand people a year here. Who would ever think that, right?

     [...]

     And then I said, well, is that the same thing? This is more deadly. This is five per... you know, this is five percent versus one percent and less than one percent, you know? So, this is deadly stuff.

     End quote

     You know who said that?

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:16 JST Siderea, Sibylla Bostoniensis

     in reply to

     The earliest scientific article (to the best of my knowledge) that reported on the possibility there was asymptomatic transmission of COVID was a case study published ⭐February 19⭐, 2020, in the scientific research journal The Lancet Infectious Diseases:

     Pan X, Chen D, et al. (2020) "Asymptomatic cases in a family cluster with SARS-CoV-2 infection"
     https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30114-6/fulltext

     This was very quickly followed by another case study, published ⭐February 21⭐, 2020, in the Journal of the American Medical Association (JAMA, a very high-prestige medical research journal):

     Bai, Y, Yao, L, et al. (2020)
     "Presumed Asymptomatic Carrier Transmission of COVID-19"
     https://jamanetwork.com/journals/jama/fullarticle/2762028

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:16 JST Siderea, Sibylla Bostoniensis

     in reply to

     These were followed ⭐March 5th⭐ – two weeks later – by another case study, this one in the high-prestige scientific journal The New England Journal of Medicine (NEJM):

     Rothe C, Schunk M, Sothmann P, et al. (2020) "Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany."
     https://www.nejm.org/doi/full/10.1056/NEJMc2001468

     In case you don't remember, the US has not yet "shut down" at this point. Indeed most people in the United States are at best only vaguely aware that there seems to be some sort of outbreak in China and, by March 5th, Italy. The week in which everything shut down in the US was the week that started Monday March 9th, though most of the businesses that started to shut down did so starting on Thursday March 12th and accelerating through that weekend.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:16 JST Siderea, Sibylla Bostoniensis

     in reply to

     One hero at the CDC – if I understand correctly it was Nancy Messonnier – broke ranks to issue a public statement advising the populace of the US to prepare for the pandemic on Feb 25. https://www.statnews.com/2020/02/25/cdc-expects-community-spread-of-coronavirus-as-top-official-warns-disruptions-could-be-severe/ (But "In a press briefing Tuesday afternoon, other top health officials pushed back on the perception that the public needs to take direct action now to prepare for community spread of the virus. They also doubled down on the message that the U.S. has successfully contained the spread of the virus thus far.")

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:17 JST Siderea, Sibylla Bostoniensis

     in reply to

     Because that is not how science works. That is not how reason works.

     And it most definitely should not be how medical science works.

     The business with 6 ft social distancing was my first inkling that something very bad had taken root and proliferated in the CDC. Something I had first seen as a graduate student studying psychotherapy, and subsequently had started recognizing in the rest of medicine. A kind of epistemological disease.

     A lot of people were invested in the idea that the CDC's..."missteps"... were the fault of the Trump administration. But while some things improved under Biden, many did not.

     I recognized the pathology and knew it was not specific to any presidential administration.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:18 JST Siderea, Sibylla Bostoniensis

     in reply to

     Like I said, my graduate program told us that any research older than five years was not valid to be cited in our assignments, and we were cautioned to assume that all older papers were invalid.

     That immediately struck me as... Odd. And by "odd" I mean bad.

     For one thing, I'm a historian, even if an amateur one, and it is offensive to me to scorn things just because they're old. My area of work in history is in early music, and as a natural consequence of that, I had spent my twenties swimming upstream against prejudices about the artistic worth of pre-classical musics. Assuming older research papers were wrong not because of their contents but because of their date stamp smelled entirely too similar to scorning pre-classical music not due to any exposure to it, but arrogant, ignorant presuppositions about what would be found in it.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:18 JST Siderea, Sibylla Bostoniensis

     in reply to

     But for another and much more important thing, the obvious logical consequence of discarding older research papers as presumed to be invalid, was that all it took for previous research findings to be discredited was the tick of the clock.

     If you just drew a moving line 5 years ago across the scientific corpus, then all you had to do to invalidate a finding is *wait*. You didn't actually have to *prove it wrong*. You could just airly wave your hand and say, Well you know that was from way back when.

     And THAT made my skin crawl.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:19 JST Siderea, Sibylla Bostoniensis

     in reply to

     But nah. There was nothing on the CDC's website to explain why they thought it was 6 ft, when here I am staring at a research journal article from 100 years ago that says 10 ft is not sufficient.

     (For the record, I did reach out to the CDC, asking them, using their contact form, but somewhat understandably given this circumstances – a nascent global pandemic – I never heard back.)

     This was the point at which I began to get a very bad feeling.

     And to be clear, that point was in the middle of January 2020.

     (I posted this https://siderea.dreamwidth.org/1575317.html on Jan 29.)

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:20 JST Siderea, Sibylla Bostoniensis

     in reply to

     Before the CDC had anything to say to the US public about COVID, their influenza page said six feet.

     And I was like ????

     My first assumption was, Hey it's been a century, I bet there's been more science between then and now. Presumably somebody has disproven Doust & Lyon if the CDC thinks it's 6 ft.

     Certainly, as a graduate student in a medical field, I was quite explicitly told not to trust old research papers. My school had a standard that any research paper more than 5 years old was not to be, well, cited for one thing, but really considered valid at all.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:20 JST Siderea, Sibylla Bostoniensis

     in reply to

     So I went looking for the source of the six feet guideline.

     This was the first point at which I noticed that the CDC does not cite its sources.

     I figured, Well this is information about social distancing and influenza is for the general public. Surely on their other pages, the ones for medical professionals, they'll have references. They'll let us know which science they are basing their recommendations on. Because that is how you do in the sciences. And also that is quite literally what the World Wide Web *was invented for*: the dissemination of research papers, with hyperlinked sources, so you could go right to them.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:21 JST Siderea, Sibylla Bostoniensis

     in reply to

     One of the frequent things that was expressed in those circles was that whatever was happening in Wuhan would never be as bad as the flu, so if you wanted to be worried about an infectious disease, be worried about influenza.

     Consequently, people took that in the direction of discussing how to protect oneself from the flu.

     And that was the first thing to come to my attention. All these people sanctimoniously repeating "six feet apart".

     To which I was of course responding in my head, "Six feet? No, at least ten. Doust and Lyon, 1918."

     But that just piqued my curiosity: where the hell were people getting 6 ft from?

     Well, I chased it down.

     It was the CDC of course.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:22 JST Siderea, Sibylla Bostoniensis

     in reply to

     In case you had forgotten this little bit of recent history: at the beginning of the pandemic, US media and *social media* was full of people – left leaning, science prizing, generally sensible and humane people – SCOFFING at the idea that what was happening in Wuhan could possibly come and touch them in their lives, and MOCKING the very idea that anyone should be concerned about it.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:56:23 JST Siderea, Sibylla Bostoniensis

     in reply to

     But that going off the rails didn't just happen during our pandemic. It's been going on for decades.

     And it's not limited to rigidly clung to, fiercely defended wrong beliefs about the range of dispersal of exhaled infectious agents.

     My on-ramp to the pandemic – the point at which that which was going on in Wuhan came to my attention – was a point in January 2020, where all of a sudden people were talking about social distancing in terms of *the flu*.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:57:16 JST Siderea, Sibylla Bostoniensis

     in reply to

     Consequently, when the CDC issued guidance on COVID to health care facilities that said masking was unnecessary except in the case of symptomatic patients who had tested positive for COVID, or that surgical masks were sufficient and n95s unnecessary, what that meant was that hospital systems were free to not provide their staff with PPE. Because it was "unnecessary." The CDC said so.

     Worse, they could even FORBID their staff to wear masks – either at all, or to wear N95s or KN95s. Even if they brought them from home themselves. Since they were "unnecessary", per the CDC.

     And that is in fact a thing that happened:
     https://siderea.dreamwidth.org/1618316.html

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:57:17 JST Siderea, Sibylla Bostoniensis

     in reply to

     So as I was saying:

     There we were, by the first week of March, 2020, there are reputable reports in three very prominent journals that we have reason to believe there is asymptomatic spread of COVID.

     That's just the scientific literature. At the same time, the government of China is quite certain that there is asymptomatic spread, and is behaving accordingly – both in its own infection control measures, and in the warnings they are trying to pass on to other governments around the world, including the US's, as the Trump interview betrayed.)

     At this point, all of the CDC's recommendations are predicated on the notion that one can tell who has COVID by the fact they have symptoms.

     This includes their recommendations to healthcare facilities on using masks.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:57:17 JST Siderea, Sibylla Bostoniensis

     in reply to

     A lot of people have said a lot of unbelievably dumb shit about how the CDC's recommendations must have been to protect the health care system. "Surely."

     But, no, the CDC was also making the same sort of awful recommendations to health care facilities, too.

     It helps here if you understand what CDC recommendations are and how they work – politically, as much as anything.

     As a practical matter, in healthcare, CDC recommendations are no more recommendations than an IETF RFC is an actual "request for comment": it's the medical equivalent of a specification. It establishes the minimum standard of care or practice.

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     Siderea, Sibylla Bostoniensis (siderea@universeodon.com)'s status on Saturday, 28-Oct-2023 13:57:18 JST Siderea, Sibylla Bostoniensis

     in reply to

     One of the things that I recommend you take from this is to note how certain kinds of bad science wind up being excellently congruent with certain powers that are motivated to in some sense *reduce access to medical care*.

     One of the driving engines of bad medical science is the various institutional and governmental payers for medical care. In the US, it's the health insurance industry; in the UK, it's the NHS (or whoever is in charge of it).

     The kind of emotionally motivated irrational bad science I am talking about isn't just a stochastic phenomenon. It constitutes an intellectual movement that is a *faction* in medicine. And that faction makes common cause with illiberal governments, grasping corporations, and any parties who consider themselves to have a vested interest in preventing access to healthcare.

     End digression.)

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