The day before yesterday night (24/03/2020 at 20:00 hrs IST) PM Modi announced a 21 day lock down. Under most circumstances, erring on the side of extra caution is the conservative thing to do, and I am conservative in that aspect on this matter. However, one must also ask the question, to err by how much? You see? And the moment one puts such a question, quantitative analysis is brought into action. But on what basis does one do QA? On DATA, you might say. Rightly so, but there is a catch. You must have not only data, it must be reliable data; and further the models you use to analyze data must also be sound and robust. Hmm, unreliable data, not so sound models, deja vu? Yeah. Recall "hockey stick curve", Michael Mann? Recall Climate-Gate? Go figure.
NaMo has asked citizens for full cooperation, and more importantly, exhorted us not to fall prey to panic etc. All very sound advice. However, there is a big catch. In the past (and continues till date) he has fallen for the Climate-Gate trap. That shows that he is vulnerable there.
Notice one more thing, all the opposition which was baying for his blood for "failing economy", is now exhorting him to take sterner and sterner measures re' COVID-19, despite knowing full well that these measures will screw the economy even further (assuming it is screwed [I don't believe so!]). Smell a rat? If not, you must!
ICMR head Dr Balram Bhargava has been quite calm and sensible for most part. ICMR's assurance that nearly 80% get well with no or mild symptoms, remaining 20% develop more than mild to severe symptoms, about 5% need hospitalization, etc etc (please check recent news for his accurate statements) have been music to the ears of we the people.
You might be wondering, what is this guy doing? Supporting the action, or opposing the action? We will come to that in due course.
First a nice joke. Recall 8th Nov 2016? Or was it 2017? Yeah, the demonetization announcement night? After that, someone had made a funny but an apt statement. "Until now India had 1 billion plus Cricket Experts, now we have 1 billion plus Economists". I would add to that, and say now we have 1 billion plus Epidemiologists. The asshat Amartya Sen calls Indians "the argumentative people". May be true, may not be true. I often find the case to be like "Dumb asses pretending to be Extra Smart asses". Okay, you could include me in that group if you wish, no harm. But you get the drift I suppose.
Consider making a few thought experiments. There will be a lot of hand-waving here, but bear with me. Let us simplify the cases we want to handle by considering four types of diseases.
(a) Certain to Infect (100% sure contagious), Certain to Cause Death, (b) No contagiousness, non fatal (does not cause death) (c) Limited contagiousness, Significant likelihood of causing death (d) Nearly certain to infect, some likelihood of causing death.
Please keep in mind that I have not been exhaustive in the number of possibilities. Now let us imagine what the outcomes would be:
(a) Nothing can be done, and we all await certain death. Covid-19, almost surely is NOT of this type.
An Aside: Please keep in mind that philosophically (and in experience) it is true that we all are going to die certainly sometime, however our deaths are staggered in time and as many humans die many new healthy human births also keep taking place and we as humans continue to live on. But we are not talking in this sense here.
(b) Nothing needs to be done, go watch whatever. Covid-19 seems not to be as nice as this.
(c) Great care needs to be taken to isolate patients, have/administer treatment, and yet we also need to be prepared for the worst. But this is doable. For example Small Pox etc were somewhat worse than this, but we got over it. Covid-19 does not seem to be in this category.
(d) AFAICT, Covid-19 seems to fall in this category. What does that mean? That notwithstanding the fatality ratio, number, etc whatever, it will be nearly impossible to restrict the infections to only a small number of people. Meaning, that over a period of time, we all will eventually get it. Fortunately, the good news is, as Dr Bhargava assured us, most of us will get well, recover, whatever. So NO NEED to panic.
Now you may ask, then what is the point of taking these "drastic" measures? A very prudent question indeed. This is where, real and reliable data, and real and reliable models come into play.
Since, it seems a given that most of us will indeed encounter this virus, and will likely get infected, the pertinent question reduces to: How rapidly will this happen? And how many people might not recover and will die? Further, these deaths need to be "from Covid-19" and not "with Covid-19", a subtle but important difference. For example, a large number of people die every year "with Flu", but not "from Flu". Whereas other large numbers of people die "from cancer, from tuberculosis, etc" and not merely "with cancer, with TB, etc". This is where the "disagreements" begin.
Before we delve further, let me make it clear that while we will analyze as best as we can, it does not at all mean that I am insensitive to "deaths" of human beings, even if they are old, or are with existing conditions, and all that. Human life is valuable But, please also bear in mind that about a lakh people die in road accidents every year, but we never ban driving on roads for "securing lives of people". Don't jump in your seat, but please keep it in your mind. My only point is, let us not make "death" an emotional issue to get hysterical.
The only argument that seems to drive measures like "social distancing" is that it "flattens the curve". What curve? Some bikini clad woman's abs? Not that friend. What it means is that we want to control the speed with which people get infected. I am sure you all have seen people talking of R0 (R nought) and a figure showing high peak (usually on left), a lower peak (usually on right) and a flat dotted line showing "hospital capacity". But also notice that none of them show that picture with "realistic actual numbers".
For example, in some recent news article, ICMR says best case scenario is Delhi will get 1.5 million cases, and Mumbai, Kolkata, Bengaluru will get 5 lakh cases. They do not show the availability of current "hospital capacity" in relation to this. The same article, states that with stringent measures "peak" (the actual value is not given, some percentages are given, but I don't want to go into that here. Author, for example, claims 2% fatality rate; Ishwara knows from where, so let us skip that.) will reduce and will happen after 200 days, and with some other "even stricter measures", further reduced peak will happen in 700 days. Notice that, first of all these "predictions" are speculations (recall Climate-Gate). Model (mathematical) plus Parameters plus some more Data used to plot tables or curves. But, even if so, the table must at least show that with these drastic measures we have (say) 90% plus confidence that we will have sufficient "hospital capacity" when "peak" happens. None of this is discussed. And you will discover that, barring flowery language, it is as hand waving as this blog post that you are reading. I apprehend that their hand-waving is much worse. Excepting pandering to "people are dying" emotion, they accomplish pretty much nothing.
You may ask: Don't beat about the bush mate, get to the point. Ok, let me try that. The fundamental question is, whether the drastic measures taken are proportional to the real risks. Put it differently, the measures we take have associated costs, and produce (expected) outcomes. The question is, whether the expected outcomes justify the costs. My answer is: a BIG NO. And by the way, don't yell "people are dying" - I warned you about not getting hysterical - because the cure, these "drastic measures" will also have HUMAN-COSTS. Factor that in too.
Then the question arises, why are such drastic measures being taken? Who benefits? About this, while presently I have mere suspicions. But since the case looks eerily similar to climate-gate, I guess the beneficiaries must be same or similar. And its initial consequences are already much more than Climate-Gate. Bureaucracy, Officialdom has already got "emergency powers". Did you notice that? Empowerment of un-elected officialdom, and further the un-electables, WAS one of the purposes of Climate-Gate, and here and now, the general population, under mass fear psychosis, has voluntarily surrendered that. If you recall, I have always stated that NaMo however good he may be, is neither infallible, nor immortal. Further, even if he is infallible, he surely is not immortal. So every time such "power accretion" to "government" happens, I squirm in agony. Because, for every NaMo that we have, there are hundreds of Kejriwals lurking around, who will blatantly misuse, abuse such powers. An aside: Just recall how the climate-Nobel-Laureate (now dead?) RK Pachauri was parading "Himalaya will melt by year 2025(?) or thereabouts" as loud as he could. Al Gore became the first billionaire trading "carbon credits". Now, likewise will happen for "ventilators" etc. Don't even get me started re' US-election 2020 etc.
Notice a few other things. All political parties, including those who were mocking NaMo for his "swachchha bhArata" initiative - something that would go a long way towards hygiene, therefore healthcare, blah blah - are unanimously supporting the Govt. Why? What gives?
All the business-class people, who keep screaming about "free markets", "It is not govt.'s business to be in business", are hoarsely demanding "bailout/stimulus" package. Smell a rat? You must.
Now that you know that I disagree with the harsh measures taken by the government, you might ask, what are my recommendations to the govt.?
First of all, I am NOT a statistician, mathematician, doctor, epidemiologist, academician, whatever. So take what I say with a pinch/sackful of salt. Still, FWIW, my suggestions are as follows:
1. The lock-down should in no case exceed 21 days. I recommend, strongly consider relaxing it much earlier.
2. Go for fast tracked NPR targeting elderly people first, so we know the "target" population of Covid-19. Make arrangements to secure them. India has a much smaller "elderly" population percentage, and we can get much larger number of younger volunteers.
3. Screw any thoughts re' Economic Package and such non-sense. Think about it, if at all, after 3 months.
4. Popularize ayurvedic, home-medicines, for immunity etc. This obsession with "modern medicine" should not be like "Abrahamic Religion". We must focus on getting patients recovered, and not "medical ideology".
5. In longer term, decentralize mega cities, they are health risks, in such scenarios. Screw all this "metro-train" madness in every city. All the infrastructure investments that lead to further increase in population density must be a strict no-no. If possible, try breaking big cities!
I don't want to write too many of these suggestions off-hand. I would rather list a small list of recommended reading with a few quotes from them. You could read such/similar articles and draw your own analysis/conclusions.
1. A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data.
Quotation: "The current coronavirus disease, Covid-19, has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco."
2. COVID-19: Updated data implies that UK modelling hugely overestimates the expected death rates from infection.
Quotation: "In practice, a high proportion of people killed by COVID-19 will have serious underlying health conditions, and would be much more likely than average to die from non-COVID-19 causes."
3. Climate Denial is like Covid-19 Denial.
Quotation: "...When scientific questions become political issues, he added, people’s beliefs become statements of identity. 'To some extent we see that with the coronavirus.'”
4. The Italian Connection.
Notice a few other things. All political parties, including those who were mocking NaMo for his "swachchha bhArata" initiative - something that would go a long way towards hygiene, therefore healthcare, blah blah - are unanimously supporting the Govt. Why? What gives?
All the business-class people, who keep screaming about "free markets", "It is not govt.'s business to be in business", are hoarsely demanding "bailout/stimulus" package. Smell a rat? You must.
Now that you know that I disagree with the harsh measures taken by the government, you might ask, what are my recommendations to the govt.?
First of all, I am NOT a statistician, mathematician, doctor, epidemiologist, academician, whatever. So take what I say with a pinch/sackful of salt. Still, FWIW, my suggestions are as follows:
1. The lock-down should in no case exceed 21 days. I recommend, strongly consider relaxing it much earlier.
2. Go for fast tracked NPR targeting elderly people first, so we know the "target" population of Covid-19. Make arrangements to secure them. India has a much smaller "elderly" population percentage, and we can get much larger number of younger volunteers.
3. Screw any thoughts re' Economic Package and such non-sense. Think about it, if at all, after 3 months.
4. Popularize ayurvedic, home-medicines, for immunity etc. This obsession with "modern medicine" should not be like "Abrahamic Religion". We must focus on getting patients recovered, and not "medical ideology".
5. In longer term, decentralize mega cities, they are health risks, in such scenarios. Screw all this "metro-train" madness in every city. All the infrastructure investments that lead to further increase in population density must be a strict no-no. If possible, try breaking big cities!
I don't want to write too many of these suggestions off-hand. I would rather list a small list of recommended reading with a few quotes from them. You could read such/similar articles and draw your own analysis/conclusions.
1. A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data.
Quotation: "The current coronavirus disease, Covid-19, has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco."
2. COVID-19: Updated data implies that UK modelling hugely overestimates the expected death rates from infection.
Quotation: "In practice, a high proportion of people killed by COVID-19 will have serious underlying health conditions, and would be much more likely than average to die from non-COVID-19 causes."
3. Climate Denial is like Covid-19 Denial.
Quotation: "...When scientific questions become political issues, he added, people’s beliefs become statements of identity. 'To some extent we see that with the coronavirus.'”
4. The Italian Connection.
Quotation: "So let’s end this crazy ... lockdown, there’s a whole raft of work
to be done shoring up our medical sector to withstand the coming wave,
and it can’t be done at home with our heads in the sand, hundreds of
thousands of people not working,.., and our
economy in a shambles …"
