Sometimes I read something that's just so good, so perfect, so right, that nothing needs to be added to it. Nonetheless, I'll add this introduction to encourage you to read it. The author is anonymous, else I'd give credit. Link to the original article is below.
Cross-posted from marginalrevolution.com
We have another globe spanning epidemic that we tried to contain through behavior modification. It is called HIV.
HIV has the advantages for us that it spreads only through frank fluid exchange (largely sex and IV access), has immaculate antibody testing that has a very narrow window of false positives (and has had such immaculate testing for decades), and was heavily concentrated in identifiable populations (e.g. MSM, prostitutes, IVDU).
In order to stop the spread of HIV, we had one exceedingly simple social change: Not have sex outside of committed, long term monogamous relationship. We could work, recreate, travel and all the rest to our hearts' content as long as we limited our sexual adventures to one person. But if that was too onerous we could adopt serial monogamy with sufficient time between partners to use antibody testing. Failing that we could dramatically lessen the spread by consistently using condoms or other barriers.
At present HIV has killed 507,351 Americans to date according to Google.
Why on earth would we expect the sorts methods to control the spread of HIV would somehow be successful in the more trying circumstance of Covid?
If you cannot expect Americans to embrace even serial monogamy with regular testing, why exactly would we expect social distancing to work? If you cannot close down even the bathhouses to prevent pandemic spread, why would we expect people to give up bars, parties, and family gatherings?
And masks? Well about 33 million some Americans used condoms last year according to survey data. Even if we assume that all the elderly, children, married couples, folks on PrEP, and long term cohabiters both use no condoms and do not need to, we are still looking at around 50 million Americans courting some level of HIV risk by eschewing condoms. And lest we forget about 14% of condom users cannot even manage to prevent pregnancy because they are using them ineffectively. We expect the population to adopt effective mask quickly why?
Add onto this the fact that we have politicized this, used all the forms of coercion and hectoring that delegitimated HIV prevention decades ago, and prefer to spend our time calling out fault and blame … I am just not seeing how this works long haul.
I can certainly see buying time for a vaccine or better treatments.
But our failure to stop HIV transmission (particularly at a global level) bespeaks poor odds for Covid. Certainly the measures suggested thus far have every reason for us to believe they will eventually fail.
**and note I do recommend masks, social distancing, and the rest as the best way to reduce risk of catching Covid. I am less certain on lockdowns being effective and certainly haphazard lockdowns like virtually all I work with seem to be close to useless. But the long run is either a vaccine or herd immunity at this point.
Comment written by username "sure" can be found in the comments section here:
https://marginalrevolution.com/marginalrevolution/2020/08/the-hawaii-bastion-has-fallen.html