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I saw plenty of smart people ahead of institutions and real doctors on masks and to some extents other aspects of the pandemic.

Yes, in general if you don't know much on a topic you'd on average do best if you listen to the experts but you can outperform that if you can identify the right kind of smart people with a good track record.



"Right kind of people" have no accountability to their advice. A doctor can't really just hazard a guess without actual facts to base them in or risk losing their ability to practice and/or reputation. "Right kind of people" can be and are often plenty wrong about things but it fades into obscurity and they are never held accountable.

Of course they are right sometimes but on many issues with a binary choice (should or shouldn't wear masks) that's a 50% chance.

In the long run you want to be able to discern hearsay, opinion, and rumors from facts and accountability to them.

You see it today when inquiring if a pregnant woman should get the vaccine. Doctors won't really advise you because although they maybe feel it's totally safe if you're far enough along, they would be held accountable if something happened. They can be "pretty sure" about things, but that isn't enough. Meanwhile, "very smart person" on Twitter can reference a bunch of content from unaccountable people that says it's safe and come off as an expert when they aren't. It's easy to be "right" when you don't have skin in the game and especially so when no one is going to hold you to account for all the times you were wrong or misinformed.


Last spring I was briefly lectured by a maskless doctor who said I shouldn't bother with the mask I was wearing at an appointment. I shrugged and kept my mask on. A month or two later I saw him again. He was wearing a mask that time and didn't complain about mine.

That doctor didn't just avoid guessing. He gave unsolicited advice, on limited information, that turned out to be exactly wrong and somewhat dangerous.


It sounds like that doctor has lost some reputation to you now. It’s hard for people to say “I don’t know” for some reason.


>A doctor can't really just hazard a guess without actual facts to base them in or risk losing their ability to practice and/or reputation.

No, but one doctor might base advice on one study he saw another on a different one. Having skin in the game helps but it is also well documented that doctors might be overly cautious due to risk of litigation and thus sometimes chose suboptimal courses of action.

>Of course they are right sometimes but on many issues with a binary choice (should or shouldn't wear masks) that's a 50% chance.

No, this isn't a real coinflip. There's evidence for and against things like this, and some people have learned better than others how to evaluate such evidence and can definitely do better than 50%.


I saw plenty of smart people ahead of institutions and experts on hydroxychloroquine here on HN. They were wrong.

Smart people with a good track record are generally called "the experts".


That is the single most frustrating part of the pandemic for me:

* There was preliminary evidence from the experts it might work.

* At some point Trump got wind of this and mentioned it.

* The media, in an effort to portray Trump as wrong, went on a crazy cherry-picking campaign to show HCQ as completely ineffective. "HCQ does not work" was the prevailing sentiment for almost the entire past year because of this, even though evidence was still coming out it does work under certain circumstances.

* Now that Trump is out of office, our understanding of HCQ is shifting back to exactly what that preliminary evidence said that Trump repeated.


* https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9...

"They included 30 569 patients with systemic lupus erythematosus or rheumatoid arthritis who were already taking hydroxychloroquine in the 6 months before what was considered as the start of the pandemic in England and 164 068 patients with these rheumatic diseases who did not use hydroxychloroquine. The study found no significant difference in standardised cumulative COVID-19 mortality associated with hydroxychloroquine use (0·23% among hydroxychloroquine users and 0·22% among non-users) with an adjusted hazard ratio of 1·03 (95% CI 0·80–1·33)."

* https://www.acc.org/latest-in-cardiology/clinical-trials/202...

"Among patients exposed to patients with SARS-CoV-2, hydroxychloroquine, administered within a median duration of 2 days as post-exposure prophylaxis, did not reduce the incidence of SARS-CoV-2 or COVID-19 infection within 14 days, compared with placebo (vitamin C)."

* https://www.nih.gov/news-events/nih-research-matters/hydroxy...

"Researchers assessed each patient’s condition 14 days after being assigned to a treatment group. They used a seven-category scale ranging from one (death) to seven (discharged from the hospital and able to perform normal activities). The results showed no significant difference between the hydroxychloroquine and placebo groups. The scientists also found no differences in any of 12 additional outcomes, which included mortality 28 days after assignment to a treatment group or time to recovery. Based on the data, they concluded that hydroxychloroquine was not an effective treatment."

* https://jamanetwork.com/journals/jama/fullarticle/2772921

"Several published rigorous studies have demonstrated similar findings. In the well-conducted clinical trials published to date, hydroxychloroquine has been evaluated in a wide variety of populations, ranging from patients with severe illness2-4 to individuals at risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, in whom the drug was used as primary prophylaxis5; these studies failed to show any beneficial effect of the drug. This raises the question: How did medicine get to the point where so many studies were conducted assessing the possible benefit of hydroxychloroquine, that led to nearly identical findings, and have been published in major journals?"

* https://www.nejm.org/doi/full/10.1056/NEJMoa2022926

"Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care."

* https://www.cdc.gov/mmwr/volumes/69/wr/mm6935a4.htm

"New prescriptions by specialists who did not typically prescribe these medications (defined as specialties accounting for ≤2% of new prescriptions before 2020) increased from 1,143 prescriptions in February 2020 to 75,569 in March 2020, an 80-fold increase from March 2019."

* https://www.aljazeera.com/economy/2021/1/27/oklahoma-attempt...

"Oklahoma tries to return $2m worth of hydroxychloroquine"

Under what circumstances does it work?




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