Censoring discussion in an environment of coercive mandates. Anyone working for Google - how do you justify this? You have great options out there you know?
The problem is that for any major issues you can get attention and money for publishing a contrarian view. Platforms like youtube then can be megaphones for monetizing conspiracy theories which do actual harm. There is some distance between good faith discussion and promoting the opposite of whatever view is popular.
Content distributors are then on a knife edge with moderation, and how to moderate fairly is incredibly difficult. Youtube doesn’t want to be the vaccine conspiracy clearing house so at some point they decided to just ban it all. Making money from peoples attention brings this problem and moralizing won’t make it go away.
All your points are true but they don't lead to the conclusion that censorship is the answer. The problem is the attention algorithms create an echo chamber with little room for distasteful alternatives. The quack content is on page 1 getting all the money from anyone on a particular rabbit hole. There shouldn't be this rabbit hole, the quack content should always be on page 12. And in the earlier days of Google before the heavy focus on personalisation, this is the way it worked.
The problem is that the content is engineered to take advantage of humans and google and becomes the thing on the first page. You might be yearning for the old days of less effective SEO. It's a hard problem how to moderate away though algorithm design or manual intervention things which pull on the strings of human weaknesses.
Is an algorithm designed to de-prioritize content you don't like any better than a human selecting content for removal?
Google isn't the one who wants to cut their ad revenue and get accused for being Big Brother. Social media censorship has always occured because people demanded it. This time, it's not just an angry Twitter mob either. Even the president are saying that they are not doing enough to combat misinformation.
There's still people dying in large numbers, unvaccinated? Eventually people notice the body count against a point of principle. That's how we got to this point.
If they are unvaccinated and they die, so what? They made their choice. The doctors ought to be saying "Well, well, well, if it isn't the consequences of your own actions" not trying to force people to do something in order to save them from themselves.
Then you always hear "well the real problem is that the unvaccinated are taking up ICU beds from non-covid patients that need them, etc."
Ok, how long have we known about this problem now? Why are ICU beds such a fixed resource? Why can't we make temporary wards for unvaccinated covid patients to alleviate ICU beds?
If this problem happened in the tech world it would be lambasted. "Please stop making requests to X website, it makes the server crash and then the people that really need to access it can't". Yeah DDoS attacks happen and are hard to prevent downtime, but if the server loading problem still persisted over a year and a half later people would be outraged that the company did nothing to try to meet the load. In the tech world when servers can't handle its load we start scaling (either automatically or manually) until the server can meet the load (or otherwise take some sort of mitigating action to alleviate the DoS). Hospitals need to innovate a way to do the same, "please don't get sick with covid because we have no way of scaling to meet load spikes" is such a crappy way of operating.
Every infected person is host to the evolution of the virus. It is likely to become vaccine resistant given enough reproduction cycles. And it could become more, or less, deadly. If it starts killing children quickly, like measles, and is vaccine resistant because we let it simmer in 35% of the population, we will be very sorry.
Our best defense against this is to vaccinate as quickly as possible. Measles now rarely kills our children, due to vaccination.
Measles is fundamentally different. Asymptomatic transmission and zootic reservoirs have no impact. It's not a leaky vaccine and we aren't in the midst of a measles pandemic. Long lasting sterile immunity is provided by the measles vaccine. It makes a lot of sense to mass vaccinate for measles.
True, that is one limitation, but there are tons of other things you could do. A little innovation is required here. I do not believe it is an impossible problem. I think what's happening is that hospitals don't really want to innovate and are hoping to just wait for covid to blow over so then can return to "normal" operation and business-as-usual.
But I say they need to innovate because this isn't the last pandemic that will ever happen, and hospitals need a way to deal with loading spikes and denial of service just like every other system susceptible to those things.
Some may argue the medical establishment has done this: they made a vaccine.
Everyone pays for maintained capacity. If you believe in a free market then your hypothetical plague-better is going to go bust well before they get to reap benefits from having 100k ventilators in storage.
Innovation involves working around limitations. I already conceded that medical staff was a limitation. So how do you work around it? Training covid-specialized temps, perhaps? I don't know the answer because I'm not an expert in that problem domain. But I've innovated around similar limitations in my current domain expertise so I believe it is possible.
You can’t. That’s the point. Nursing, even at the lowest level, is not a trivial skill. The only people you could scale up at short notice like that — if there wasn’t also a general all-sector labour shortage — is nursing assistants, who have to generally do their thing under supervision of a registered nurse, which is an Associate degree or a Batchelor degree.
(There is an intermediate level of Licensed Practical Nurse who can be unsupervised but can’t supervise others, which is “just” a one year vocational course).
> But I've innovated around similar limitations in my current domain expertise so I believe it is possible.
Unless you’ve innovated around a crippling multi-state demand spike, during a general labour marked supply shortage, in a sector where getting things wrong is literally lethal and where people sue for malpractice even for sub-lethal errors despite the government mandated minimum qualification levels, I think you are making an error in thinking your experience is transferable.
(If you do have that experience, please share, as that sounds like one heck of an anecdote!)
That said: One thing you could “innovate” that would technically work is making a roving vaccination drone that hunts down and forcibly vaccinates people that don’t want a vaccine. Even ignoring medical ethics, I don’t think that’s a great idea. But technically…
Hmm, funny. I'm pretty sure I could train a non-programmer to do a specialized type of programming task in a few months if it were a crisis even though that person doesn't have a computer science degree. I don't see why healthcare is so much more difficult to train temporary specialists. Didn't we do it during WW2 (rapidly train medical specialists in a matter of months, aka medics, without a 4 year degree)?
> Unless you’ve innovated around a crippling multi-state demand spike, during a general labour marked supply shortage, in a sector where getting things wrong is literally lethal and where people sue for malpractice even for sub-lethal errors despite the government mandated minimum qualification levels, I think you are making an error in thinking your experience is transferable.
Yeah that's the real problem. Any innovations that alleviate the problem are going to run afoul of some bureaucratic, regulatory, and legal red tape put in place over the last century. So let me rephrase - I could probably innovate and solve this problem if I were a medical professional. But not without running afoul of some red tape somewhere. But I say red tape is meant to be broken in times of crisis.
> I'm pretty sure I could train a non-programmer to do a specialized type of programming task in a few months if it were a crisis even though that person doesn't have a computer science degree.
Then you’re either underestimating the complexity of programming or overestimating general skill level:
"""One of the difficult tasks was to schedule a meeting room in a scheduling application, using information contained in several email messages."""
"""Level 3 = 5% of Adult Population
…
The meeting room task described above requires level-3 skills. Another example of level-3 task is “You want to know what percentage of the emails sent by John Smith last month were about sustainability.”"""
People here are unusually good with computers.
I have no reason to think intensive care of respiratory illnesses is easier than code.
I don’t know enough medicine to say what typical treatment is, but a quick search says the entire USA has 93k ICU beds, that the number occupied by COVID patients went from 3500 in June to 26,000 in September, that the total number of COVID patients (including non-ICU) peaked at 97800 in September (and 133,250 in Jan) and that there are oxygen shortages in various hospitals worldwide because too many patients need the same treatment at the same time.
Given how easy it is to make oxygen — and to make something that makes it — a shortage of it can only happen when there are enough other things that also need to be fixed that it isn’t the limiting factor.
As someone else said elsewhere on this thread, the actual innovation is the vaccine.
> Then you’re either underestimating the complexity of programming or overestimating general skill level
The more specialized a task is, the narrower the range of skills you need to do that task. I could certainly train someone on how to do a specialized programming task such as cleaning CSV files in python in a matter of months. They wouldn't be able to do much else, but they would be able to do that fairly well.
Being a general practitioner is hard because the knowledge and skill pool is huge. Being an ultra-specialist easy by comparison.
Very often patients of rare diseases (including cancer types) know much more about their specific type of disease, known treatment methods, etc. than a general practitioner. How is this possible? The scope of their study is very narrow, so they can quickly go much deeper than a general practitioner on that one topic.
So yes, I still think it would be possible to train ultra specialized covid caretakers in a matter of months given how much we know about how the disease progresses. They don't need to know anything outside of specifically covid and they can flag any cases falling outside of their training to a more qualified person.
Think of it this way: you basically just train people to learn flow charts. The flow charts cover 90%+ of what typically happens to an ICU patient with covid. If they encounter something not in flow chart, they stop and escalate to a real nurse or doctor. You're saying such a scheme wouldn't be effective at all? I think it would free up tons of medical personnel.
> I could certainly train someone on how to do a specialized programming task such as cleaning CSV files in python in a matter of months. They wouldn't be able to do much else, but they would be able to do that fairly well.
After a few months? Average user might still be copy-pasting the # symbol, and need help every time they tried to edit and run a script because they mixed tabs and spaces.
> Very often patients of rare diseases (including cancer types) know much more about their specific type of disease, known treatment methods, etc. than a general practitioner. How is this possible? The scope of their study is very narrow, so they can quickly go much deeper than a general practitioner on that one topic.
You also get people like my mother, who took Bach flower remedies to boost memory (she died of Alzheimer’s 15 years younger than her mother of the same); or my dad, who insisted he was drinking enough water even though at that exact moment he had a drip in one arm to rehydrate him and another drip in the other arm for kidney medicine because his kidneys had almost failed due to dehydration; or people that think they can cure cancer with quack medicine like Steve Jobs did; or breatharians; or people who violently assault healthcare workers and vaccination teams during a global pandemic as in some American hospitals; or countless other examples.
Don’t get me wrong: I value free speech as a way to reduce groupthink, and that can affect experts too, but the experts are still, on average, much less wrong than non-experts. (Also applies to experts being plain wrong without groupthink, as they are humans not angels: still less wrong in their domains than the rest of us).
If medical science is anything like physics — easy to misunderstand, lots of Dunning-Kruger effect — the only people who genuinely become experts in their own diseases are unusually gifted, or already doctors (MD or PhD) or have enough other knowledge to separate real science from half-baked stuff that fails (or never entered) peer review. The rest are lucky they found real science and got close enough to understanding it too make a difference, and lotteries are not sound investment strategies for national growth.
If it’s like computer science, how many battles does the tech sector have to have with the government about cryptography? Or, heck, I’ve had clients and bosses who wanted things which aren’t even coherent, like a view remaining the same size on different sized and different aspect-ratio screens without adding borders, moving widgets, or resizing anything.
If it’s like politics, how many people want tax cuts without cutting government services, completely convinced it’s just a question of improving efficiency?
Or denigrate Media Studies as a “Mickey mouse degree”?
Or think they can beat olympian athletes?
Those are most of the personalities that go to GPs saying they know better. Only a tiny fraction are correct.
> Think of it this way: you basically just train people to learn flow charts. The flow charts cover 90%+ of what typically happens to an ICU patient with covid. If they encounter something not in flow chart, they stop and escalate to a real nurse or doctor. You're saying such a scheme wouldn't be effective at all? I think it would free up tons of medical personnel.
What makes you confident they don’t already do that? Because I think they already do that, with a separate flow chart for every condition.
Thing is, almost everything in medicine has a side effect. I just went onto Google to construct an example with commonly used painkillers, and to my mild surprise, guess what? WHO says no paracetamol for the side effects of the COVID vaccines. I was looking for which ones can’t be taken with alcohol. Untrained people, even smart and eager ones, are likely to not even know how to recognise the right moment to call in outside help.
But even if they could — let’s say an AI tricorder-esq app that can run on their phones — which sector would you deprive of much-needed workers to supply these temps?
And then you need to manufacture a few tens of thousands of sets of specific intense care equipment…
There is merit in your points. How does the world discover these alternatives when everything outside the current treatment regime is heavily censored?
Because there are only a limited number of trained nurses and doctors available. "ICU beds" as a metric actually means the number of patients the staff is able to care for, not the literal number of physical beds.
Not to mention, even if you have some extra to handle variable demand, exceptional circumstances are by their nature exceptional. It's irresponsible to carry that much more capacity when you'll only need it once a century.
Take for example the recent Hurricane Ida. There's still trash and debris to pick up. There's still damage to be fixed, houses to be rebuilt, etc. Insurance claims to process and pay out. Why?
Because there's going to be over 2 million cubic feet of vegetation to dispose of. Just in my parish. That's not considering the other parishes. Or other types of debris. There are trucks from several states and they've been working most days. And we still need to get rid of downed trees.
Because every house is going to have a claim. Every house is going to need some form of repair. Thousands of houses. All at once.
We aren't prepared to handle that sort of scale. And having the resources to handle that sort of scale is just going to languish when its not needed. It'll be waste.
Same deal with COVID. COVID is filling ICUs at a scale that is wasteful to keep on hand during normal operations.
And I'm sorry, saying they "need to innovate" is just the laziest criticism one can make. It exposes the fact that you have not thought of the problem at all beyond noticing the obvious lack of resources. Congratulations for noticing the obvious. How are they supposed to innovate? How do you know they haven't created temporary wards (they have where they could)? What does it take to make a site appropriate for an ICU ward? Etc, etc. There are problems that you don't even know exist because you don't know the problem domain. And that's ok. You're not expected to. But don't armchair quarterback the domain experts who have been working on this problem for the past year. It's not as smart as you think it is.
Okay, then why are hospital resources more finite than non-hospital resources that can scale?
> It's irresponsible to carry that much more capacity when you'll only need it once a century
But you need it for at least 2-3% of the century it seems, so the current model of "please don't overload our beds for 2-3 years" doesn't seem very sustainable either. It's almost like you want Amazon-style "elastic" resources that only kick in when you need them.
> Same deal with COVID. COVID is filling ICUs at a scale that is wasteful to keep on hand during normal operations.
So don't keep them on hand. Figure out a way to mobilize the resources when you need them.
> What does it take to make a site appropriate for an ICU ward?
For one thing, maybe making "a site appropriate for an ICU ward" is too stringent a requirement in times of crisis and overloading?
My solution: Setup circus tents in the parking lot reserved for unvaccinated covid patients where they can sleep on army cots with fewer ICU resources and where they die at higher rates than the normal ICU.
Bam, problem solved. Now the normal ICU is at normal capacity again and unvaccinated covid patients can still receive some limited form of care. If they die at higher rates, oh well, that's a consequence of not getting vaccinated and the direct result of their own choices. And it's better than letting vaccinated heart attack patients die because their unvaccinated comrades took up all the beds and it's also better than taking away everyone's freedom and forcing the vaccination upon everyone. Because now everyone is happy. The unvaccinated still have their freedom, the vaccinated still have their ICU beds.
I'm sure people more familiar with the problem domain could come up with something much better than circus tents in a parking lot. My point was that everyone seems to have accepted that hospitals are inflexible and that the only way to solve the problem is to flatten the curve indefinitely and I don't accept that. Sure, flatten the curve initially, but only until you figure out a better long term solution to dealing with loading spikes.
I just gave you a recent real-life example where non-hospital resources were finite. Did you not read about the on-going problems due to the recent hurricane I mentioned?
Also your solution would pretty much kill all those people. People are in an ICU ward for a reason, moving them to a parking lot tent is not the same. Now, they're not just battling COVID, but also everything else that's out there.
By your logic, putting a bullet in their heads would also solve the problem.
But the problem isn't "getting rid of COVID patients", it's "making sick people well".
> It's almost like you want "elastic" resources that only kick in when you need them.
No. I'm saying that doesn't exist. That it's folly to think that.
> So don't keep them on hand. Figure out a way to mobilize the resources when you need them.
This is you literally suggesting the solution is ""elastic" resources that only kick in when you need them". The thing I said doesn't exist and is an impossibly difficult problem.
This ignores the aspect of personal responsibility. Nobody is forcing these people to refuse the free and widely-available vaccine - they do so by choice and an adult consciousness, and it follows that you bear the consequences for your personal decisions.
The recent vote against boosters by the expert CDC committee and the resulting overturn by the head of the CDC highlights the need for broader free and uncensored discussion.
I read a lot of studies and get help parsing them from YouTube occasionally. Watching videos of more competent people poking holes in videos of quacks talking about the same studies is quite useful and persuasive.
Content like what you're describing is expensive to make, usually very boring and gets no views. You have to pay experts, read studies, interview government officials, maybe even read some science papers. Later you have to dumb it down enough so the common man can understand it. Content like this makes me want to defer the matter immediately to actual experts so I can stop thinking about it.
Now contrast this to viral content claiming that Bill Gates is conspiring to implant 5G chips, vaccine induced magnetism, government hiding thousands of deaths from COVID vaccines and all other conspiracy theories that are easy to manufacture from the comfort of your home, require no expert opinion and get tons of views. Content like this is super addictive, exploits my fears, sows doubt and leaves me less informed. This content wins is the economy like this.
I had a reply about attention algos promoting content higher than it deserves being the root problem. In the old days content with more credible links to it made it to the top for all regardless of your preconceived notions. Now everything is gamed out to your existing profile with God like precision.
They aren't credible, but for other reasons. Remember when covid wasn't airborne and thus masks didn't do anything unless worn by professionals? And border closures wouldn't be necessary and only xenophobes would call for them? And then how they banned corona tests by anyone but the CDC? And the approval delays?
They're playing politics, worry about second-order effects before first-order ones and do 180° turns instead of focusing on the core mission of assessing whether something is a) safe b) likely effective. The same situation happened again with the booster approvals, they dragged their feet again and decided that only those above 65 should be allowed to get them when in practice some international travelers already are forced to get more than two shots due to inconsistent regulations.
More nuanced policy, communicating uncertainty and "currently not recommended but allowed" middle grounds would help their credibility.
Any statistics and numbers need to be scrutinized carefully given the past year of the media and our institutions showing a clear bias in trying to inflate numbers for mass hysteria and scaring people into taking the vaccine.
