Tuesday, April 28, 2020

TANSTAAFL and TANSTAALWUC

You may know Heinlein's TANSTAAFL - There Ain't No Such Thing As A Free Lunch - but I bet you don't know the second one because I just made it up:  There Ain't No Such Thing As A Law Without Unintended Consequences.  At least the first one is more pronounceable.  (Tahns taffle vs. tahns tahl wook?)

Heinlein's TANSTAAFL is often stated as being roughly equivalent to the second law of thermodynamics.  You can't get something for nothing.  No perpetual motion machines.  In The Moon is a Harsh Mistress, where Heinlein first used this phrase, the protagonist talks about the free lunch in a bar and tells another character to consider hidden costs.  Where I'm going with this is for you, gentle readers, to recognize that everything that our leaders think they're doing with their management or government policies has a cost and if they care at all about whether they're doing more harm than good, they should analyze all of the costs and do a Cost Benefit Analysis.  Often, perhaps usually, many of those costs are hidden or unknown unknowns

When they decide that we're going to put the country into shutdown to keep from overwhelming the medical system, they're fooling themselves if they think there are no other costs to putting millions of people out of work.  Further, if the only thing they're tracking is the number of people taking up beds in Intensive Care Units, they're lying to themselves about the epidemic by tracking one cost and ignoring scores of others.  Not only is the medical system not overwhelmed, they're literally laying off, furloughing and otherwise shedding thousands of workers because millions of the so-called elective surgeries aren't getting done.  How many people have had a cancer diagnosis but had their treatment halted because they couldn't get the tumor removed or some other elective procedure?  How many of those people will die because of the delay?  We know by comparing American survival stats to those of the British NHS with its ordinarily much longer waits for that sort of procedure that there will more cancer deaths than usual in the US and our survival rates will look more like theirs.

Dr. Nicole Saphier, a radiologist from Memorial Sloan Kettering Cancer Center and a medical analyst on Fox News put some example numbers out in a tweet recently, picked up at 90 Miles From Tyranny:


Considering how bad every other set of numbers that's been tossed around has been, I'm skeptical of this, too, but it's better than estimating how many cases of an illness we haven't had. 

No policy, no law can save lives.  All that a policy can do is trade one group of lives for another. 
Good policies result in a net positive tradeoff. But we have no idea whether the tradeoff is a net positive until we take a sober look at the cost of saving lives. And we can’t do that until we stop with the “if it saves just one life” nonsense.
TANSTAALWUC.



18 comments:

  1. Yep.
    The two things politicians and bureaucrats cannot grasp-
    The Law of unintended consequences
    The Law of diminishing returns.

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    1. The Law of diminishing returns.

      The central bankers ought to understand this one, they call it the marginal utility function, but same thing. If I give a broke person $100 it makes an enormous difference in their life. If I give them another $100 it makes less difference.

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  2. The suicide nonsense is pure undiluted crap, top to bottom.
    The last genius who tried that pulled some WHO study out of someone's hindquarters, which showed suicides spiked all the way to the middle of the margin of error, and peaked six months before the phenomena they were supposedly caused by.

    That's pretty good science magic when the cause happens six months after the effect, but that was exactly what they stated in the summary.

    But yes, there are always cause and effect.
    the problem is, the kids who learned science/STEM didn't go into either government nor journalism (both traditionally the repository of the dumbest lids in any college), so both are the native domain of post hoc, ergo propter hoc fallacious logic by the metric f**kton.

    Cutting off all patients kills healthcare.
    Overwhelming it with critical patients does too.
    End result identical in each case: no health care for anyone.
    Thus a reasonable and rational public policy would be to try to fly at some point between those two goalposts, without clanging into either one.

    Total number of peer-reviewed, vetted, and statistically valid rationales showing anything done accomplishes either goal, to date: approaching absolute zero.

    Here be dragons.

    And the plural of anecdotes is not, never was, nor ever will be "data".
    And thus far, 99.9999% of everything I've seen or heard that isn't obvious bad analysis on the whole situation is purely anecdotal, known in actual science as garbage, and by the average man in the street by the common trade name at the garden center, bullsh...er, rose fertilizer.

    When you start pointing these realities out to people to the left of the IQ bell curve, their first instinct is to start digging in their underpants for their rebuttal. then they go looking for a rope, or wander off with both index fingers jammed into their auditory canals to the second knuckle.

    Ask me how I know.

    None of this is conducive to a favorable light:heat or signal:noise ration.

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    1. * The singular of data is anecdote.
      * Human nature is invariant.
      * You cannot out wait a respiratory disease.
      * Doctors can't save everyone. Trying to does far more harm than good. Triage exists for a remarkably good reason.
      * Fear and despair cause deaths. So does bankruptcy, homelessness, and starvation.
      * As a civilization, the USA could lose 10 million mostly elderly people and keep functioning. We cannot keep functioning if we are all under house arrest.

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    2. Indeed, you cannot outwait a virus. Viruses are relentless. As far as anyone can tell, they never go away. Nothing but the acquisition of resistance will serve to reduce the threat of a virus...and that usually requires that you contract it.

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    3. >The singular of data is data point. Trying to include anecdotes into the discussion is proof one doesn't grasp the basic terms of the discussion.
      >Human nature is irrelevant to the discussion, beyond its ordinary application. It's a saw that cuts both ways.
      >No one here has suggested you try to outwait anything.
      >Doctors don't save anyone, over a long enough time scale.
      But deliberate stupidity can kill millions, and malign intent even more, and quite rapidly.
      >Fear and despair are emotions. Emotions never killed anyone.
      Acting on them does.
      Bankruptcy and homelessness are similarly not causative, merely contributory. Starvation, alone among the six items you listed, causes death.
      List the total umber of people who have starved to death in the U.S. since Feb. 1st because of the current situation.
      I'm betting that number is 0. If it's even as high as 1, it would be earth-shattering news.
      Kung Flu has a current tally in the neighborhood of >58,000.
      Tell the class which one is worse, and why.
      >There's always someone willing to load the boxcars. Your volunteer application is noted.
      No one's suggesting we stay under indefinite house arrest.
      Straw Man Fallacy achievement unlocked.
      >If anyone has any scientific evidence that contracting this virus confers immunity going forward, let them present it.
      FTR, substituting unfounded assumptions for data and evidence come from smoking hopeium, and are largely responsible what's gotten us to where we are now.
      How did "Don't worry about this virus; live your lives!" work out in NYFC?
      So, beyond gainsaying and non-sequitir reasoning, given that doing nothing didn't work out so well, and than it's a given that the country also can't wait indefinitely at home hoping for divine intervention, does anyone have any rational courses of action that avoids the extremes, and offers some quantifiable opportunity for productivity without worsening the pandemic?
      We don't need 49 more New Yorks.

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    4. The problem, Aesop, and my reason for writing this entire piece is this:

      List the total umber of people who have starved to death in the U.S. since Feb. 1st because of the current situation.
      I'm betting that number is 0. If it's even as high as 1, it would be earth-shattering news.


      You don't know that. Nobody knows because nobody is measuring anything except deaths, "with" COVID-19, not even necessarily "from" it. TANSTAAFL. Everything costs something, and every single life saved, if there even have been any, came at the cost of something, somewhere.

      I say, "even if there have been any" because the whole purpose of locking everyone up was to slow the rate of growth and not overwhelm the system. I don't recall anyone saying we'd stop the virus from killing, just that we'd save the medical system. Does the 30,000 layoffs from the Mayo Clinics yesterday sound like saving the system? Sounds to me like it was hurt badly but in a very different way than expected. TANSTAALWUC.

      I'm an engineer. I spent 40 years working in manufacturing, which means I've worked on continuous improvement teams. If you don't measure it, you don't fix it. Period. To quote Lord Kelvin, “When you can measure what you are speaking about, and express it in numbers, you know something about it, when you cannot express it in numbers, your knowledge is of a meager and unsatisfactory kind; it may be the beginning of knowledge, but you have scarcely, in your thoughts advanced to the stage of science.”

      You know as well as anyone that people die everyday, around 8000. Every death is a tragedy. 58,000 deaths, around 640/day is bad, but our response seems way, way out of proportion to the need.

      Do I need to say I don't want to see anybody killed by it? What I'm saying is what this whole column was about. There's a continent-sized pile of stuff going on and nobody is measuring anything except deaths.

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    5. Repeated for emphasis:
      Cutting off all patients kills healthcare.
      Overwhelming it with critical patients does too.
      End result identical in each case: no health care for anyone.
      Thus a reasonable and rational public policy would be to try to fly at some point between those two goalposts, without clanging into either one.


      We're not doing magic in the hospital, so there are ways of managing exposure while still going about one's business.
      We already have the vivid example of America's largest city trying the "Nothing to see here" approach, so there's no further argument to be made for apeing that plan 49 more times, unless one passed the 19th century iron-ring screening for cretinism.
      The current approach has succeeded wildly beyond expectations at flattening the projected curve.

      So something less than that, and more than NYFC's HUTA response would seem to be in order.

      By all accounts, that's exactly what's in the cards in 49 other states. Some will do it better than others, and a couple will probably go full retard, and fire this thing up again. One hopes not, but the odds are against going 49-0 on getting the re-opening right.

      Now, if you or anyone can come up with a way to measure anything, when the COVID-19 tests used in-hospital are loaded with false negatives, and the antibody tests (which aren't COVID-19 specific) used for half-@$$#! "surveys" are loaded with false positives, I've yet to hear of it. The only certainty is that it's something at which the CDC has proven itself utterly incapable.

      Dead people, despite some shenanigans, are still relatively fool-proof. So it's what there is.

      90% of the problems with this outbreak, at both ends, have been placed there by the government "here to help".
      The other 10% are because of The 10% Gilligans In Society Factor, licking toilet seats, going to Mardi Gras, and certain this was all just a hoax.

      If I wanted to create a dumbass magnet to capture all the stupidity possible in society, I think I'd unleash a pandemic, and just sit back and watch.

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  3. Here in the more rural parts of Kommiecticut, there has been a recent spike in cardiac arrest calls. The theory is people are not/will not seek medical attention until it is too late. I realize my analysis is strictly anecdotal, but as someone listening to fire frequencies in three counties all day long, it is unusual.

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  4. Dr. Nicole Saphier, a radiologist, is out of her depth and expertise promoting bad statistical science.

    Conventional unemployment equates to (long term) economic impoverishment, where the unemployed lose the drive/will to survive. The newly unemployed typically are the least-employable rather than the broad cross section of our current situation.

    Pandemic unemployment equates something temporary - a pause that will right itself.

    Ms smart ass Dr. Nicole Saphier, "a radiologist" perhaps hasn't grasped the differential between the contrived original study and the completely different situation we temporarily find ourselves in.

    Very much a false analogy she's made.

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  5. From WMBriggs: https://wmbriggs.com/post/30583/?doing_wp_cron=1588168800.2147419452667236328125

    * Taiwan, 6 dead, 24 million people, 0.025 per 100,000, no lockdown.
    US, 55 thousand dead, 331 million people, 16.7 per 100,000, martial-law lite lockdown, highly variable across the country.
    All of UK, 22 thousand dead, 67 million people, 32.8 per 100,000, draconian lockdown, more or less enforced.

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    1. Let me try to punctuate that better than Blogger does: WMBriggs

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    2. Briggs is the man. I asked him if all we needed as a model was the Diamond Princess and he agreed.

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    3. Taiwan has 6 dead out of 429 cases, and the entire country is locked down from outsiders.
      "By January's end, the country suspended all flights from China and began integrating its health insurance database with information from immigration and customs to begin tracking potential cases of COVID-19."
      Also, they're an island 100 miles from anywhere else.
      That horse left the barn for the U.S. months ago, so pointing out that we could whip this thing if only we'd pulled up the drawbridge before we knew about it isn't helping much.

      And 58,000 dead people later, the utility of the MV Death Princess as a model for anything, except how not to handle a pandemic virus onboard a cruise ship, pretty much is as permanently out-to-sea as that doomed ship is. It's now a prison hulk for the crew, forbidden to dock anywhere, and no one allowed onto nor off of it, UFN.

      A lot like Taiwan.

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  6. We haven't slowed death by abortion one bit.

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  7. paraphrasing Thomas Sowell: There are no solutions, only trade-offs.

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  8. The word...and people's mistaken concept....of "free" has possibily contributed more to the destructive policies of socialism/communism remaining a viable political choice than any other word or idea in history. By promising ignorant low IQ people something, anything and so stoked everything for "free" corrupt power mongers perpetually gain and maintain power an use that power for nefarious and selfish purposes. The reality is that there is no "free" anything anywhere in the tangible world. Everything in reality exists at the cost of something to some other entity. We need to replace the word "free" with the phrase " the cost has been shifted to someone or something else". This may, at least for a small portion of Homo Stupiducus, change perceptions.

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    1. You're absolutely correct about that Dan, but IRL, you're wasting your time, and annoying the pig.

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