Well, OK then

Let’s take this idea seriously:

Operation Moonshot ignored screening experts. No wonder it’s failing
Polly Toynbee

Government policy must be designed by experts. We must be a technocracy.

So, that’s pretty much all left wing economics in the bin then. as pretty much no one who grasps the subject signs up to those wilder shores of idiocy.

Do note that economists, as a profession, do actually lean left – leftier than the general population. It’s just that they propose policies which work, however they might appear to lean right when doing so.

For example, we want to improve the living standards of the poor. Lefty answer, abolish capitalism and those icky markets. Economists’ answer – more capitalism please and definitely, definitely more markets.

26 thoughts on “Well, OK then”

  1. Maybe you ought to read Simon Wrong-Lewis, or Paul Krugman. This is definitely NOT the kind of stuff they emit when writing for money

  2. On the original moonshot experts thought that they’d fill the capsule with pure oxygen. After the inevitable fire killed some astronauts, the experts gained more expertise and used air.

  3. Perhaps there is an example of an economy managed by expert economists? Or indeed of those experts ever making falsifiable predictions that turn out to be correct?

  4. ‘Government policy must be designed by experts. We must be a technocracy.’

    So she is against democracy.

    The root problem is ‘government policy.’ You’ve staggered into fascism if you have government policy. The answer is limited government. Government that can’t do much doesn’t need ‘experts.’

  5. ‘There was frequent pressure for prostate screening with PSA tests: men’s groups said it was unfair women had so much spent on breast cancer. But it would have led to needless surgery, with risk of incontinence and impotence for many men who would have died of something else long before prostate cancer developed.’

    Testing for breast cancer has led to mass mastectomies.

    PSA is a blood test. They just get an extra vile when testing your blood. NO ONE has ever been harmed by a PSA test.

  6. Fair point, but she’s not wrong about what a shitshow this Liverpool screening is. And I’m not quite sure why she was on a committee about health screening, but for once, a journalism with a bit of experience.

    Also, moonshots were a giant waste of money that the American public rarely supported. I’m not even sure they worked as propaganda. American movies probably did more to convince Asia they wanted to be like the yanks.

  7. @GC

    That’s splitting the wrong hair. Very little of the harm caused by screening programmes is in the initial test itself. Even an effective screening programme inevitably causes harm – from the psychological harm/stress of being unnecessarily told you’re initial test has come out as elevated risk (so yes in this sense a person can be harmed directly by the PSA test or at least its result), to people getting unnecessary physical examination / surgery / drugs as a consequence (which is where most of the harm lies, and is an indirect consequence of the initial test). The programme can still be effective if these harms are outweighed by the benefits. Since the ratio of harms and benefits depends on demographic factors, screening programmes are often targeted eg by age, and there’s often a marginal group in which the net benefit is doubtful / controversial.

  8. 0.6% false positive rate?

    So, to confirm, she believes the programme should be stopped because, after months of the entire country being locked up with devasting and varied effects, a few people might unnecessarily be asked to self-isolate for a couple of weeks.

    A cynic might suggest she eas playing politics with peoples’ lives here.

  9. @bom4

    Wasn’t Polly a health/social affairs journo back in the nineties? And at least hereditarily a member of the “great and the good”, so the kind of person who turns up on committees.

    I actually thought her article had a glaring weakness. She makes comparison to other screening programmes that were about cancers, strokes, etc, but doesn’t (unless I missed it) make the distinction that those diseases aren’t infectious. This radically changes the way the cost-benefit ratio of Covid screening works. Detecting asymptomatic or early-stage cases of Covid would be utterly pointless if it weren’t infectious. But if you can prevent transmission, you have a tool that can potentially ease pressure on healthcare capacity and trim away at the R number in a more efficient and less harmful way than a localised lockdown. That, at least, is the case in favour of mass testing.

    You can disagree with that case. You can argue that the characteristics of the test are insufficient to meet those objectives. But you should at least acknowledge what the case is and argue why it’s wrong. The comparisons to tests for cancer are largely irrelevant. If you only find half the asymptomatic people you hoped for because the rapid test isn’t good enough to find 100% then that doesn’t sound great but if finding those half of people is good enough to bring down transmission substantially then the programme may still achieve its objectives. Similarly you can argue it’s costly that one in two of the people told to self-isolate have been told to do so incorrectly, but if the alternative is not to do testing and those asymptomatic people the screening would have caught go on to infect others, some of whom become symptonatic and need to isolate (or the people they go on to infect and so on) then you may still end up with the same number, or more, of people isolating. Working out what the marginal costs/benefits of abandoning/implementing mass testing would be depends very much on the dynamics of transmission, and this is not addressed anywhere in the article.

  10. @Hallowed Be

    To be fair, the fire risk of 100% oxygen was understood, and there were strict limitations on the amount of flammable material in the command module – which the astronauts ignored and nobody dared overrule them.
    It wasn’t a cost saving or weight saving economy: the problem of using air is that the nitrogen content is (was?) very hard to monitor, and too high a nitrogen content results in death without the warning signs of oxygen starvation (which as pilots, they would spot). I believe this continues to kill unwise workers in apple storage plants today.

    So it’s dangerous either way. They chose one way, and had a fatal accident. Equally, they might have gone the other way and killed the first crew with nitrogen excess. Who can tell. 20/20 hindsight.

    If there were faults, they were:
    1. The extra risk of the plugs-out test on the pad wasn’t fully appreciated (100% oxygen at 18 psi instead of 100% at 3psi in space) – and the astronauts needed to be overruled with their velco.
    2. The Mk1 CM was a death trap.
    After the fire, everyone went around saying “How can people die in a rehearsal!”
    Eventually, soneone asked “How can people die in a rehearsal?”
    So they looked. They didn’t find a way, they found hundreds. That’s a lesson I remember and have applied and taught. Ask the question BEFORE the disaster. Sounds a bit Dilbert!

    Oh, and the capsule stank that day from a leak, and then comms didn’t work. But none of the managerial types said “Stop”. As ever, “GO-itis” was enforced by those in charge. “Reality will comply with the schedule!”

    Today we see Princess Nut Nuts telling reality that cars will run on unicorn farts and shops will restock themselves. Sigh.

  11. MBE,

    I’m not saying she’s an expert, but at least she’s met a few people, maybe a bit has stuck.

    “Similarly you can argue it’s costly that one in two of the people told to self-isolate have been told to do so incorrectly, but if the alternative is not to do testing and those asymptomatic people the screening would have caught go on to infect others, some of whom become symptonatic”

    And that’s a whole big problem of cost and effectiveness. If people know the test is 50% wrong, how are they going to behave, especially if they feel OK.

  12. It’s like the logic puzzles that have become popular during lockdown. MyBurningEars is smart and has the right answer; Polly is too thick to get it.

  13. @TtC

    Not convinced by your reasoning about why it was an all O2 atmospheric though. If you use an N2/O2 mix then isn’t having too much N2 synonymous with having too little O2? (And the O2 level was relatively easy to measure but needed kit to do so, you didn’t need to measure N2 directly.) My understanding was that there was a weight issue with using the N2/O2 mix, not so much of the gas itself but the fact it would have required a more sophisticated system for storage, piping, measuring and mixing. If you stick to O2 you can just measure the pressure and that’s that. In the end, once they learned some lessons from the fire, I believe they took off with an N2/O2 mix already aboard, vented it, then used a O2 alone once in space.

    Also I think you’re maybe being harsh on the astronauts by primarily blaming there for the flammable materials. My understanding (potentially incorrect) is that there was a lot of flammable material simply designed in, and moreover, even before the time of the fire, the design for the block of modules actually going to the moon had specified that a lot of the flammable materials from the first block needed to be stripped out. Not helpful for the astronauts testing out the first block, unfortunately (particularly if testing something that didn’t even require live human beings to be there at all).

    @BoM4

    Her understanding of screening is very good, based on that article. For non-infectious diseases. The article is basically a rehash of the annual(ish) polemic about prostate screening. For infectious diseases, the whole point of the thing changes. The ethics, the costs and benefits, everything. It’s no longer about finding your cancer at an early stage to optimise your own treatment, it’s about preventing you transmitting a disease you didn’t know you had and maybe never would – the thing you get out of it is that it may stop you inadvertently harming people you care about. Or more worryingly, you hoped you’d get out of it a potentially false reassurance from a negative test.

    You’ve just made, off-hand, a more telling point – if the proportion of positives that are false positives is so high, does that affect how often people will comply with isolation advice? Seems plausible, though if people are volunteering for a test they intend to ignore the results of, that would be a bit daft of them. Some compliance statistics for the rapid tests versus the traditional tests would be interesting, though the article doesn’t address that at all.

  14. You are flat wrong, MBE.

    There is a problem with urology. How urologists handle patients with elevated PSA. They haven’t figured out how to “first, do no harm.”

    Which has double ought zero to do with the test.

    “Urology isn’t very good, so let’s not test for something that might send them patients.”

    Mr Spock says, “Highly illogical.”

  15. @GC

    Well aside from the fact that an unnecessary scary test result can cause psychological harm before the urologists get involved, albeit relatively minor… if you’re prepared to accept that a certain group of patients on balance may receive more harm than benefit from being forwarded to the urologist, aren’t you prepared to accept that a poorly targeted screening programme that sends such a group of patients on to the urologists is, indirectly, producing more harm than benefit? If you’re not prepared to accept that you need to look at the wider system/consequences, then how do you propose to measure the harm/benefit of the screening programme “in isolation”?

  16. @MBE
    Wasn’t my intention to primarily blame the astronauts, not all all.
    The primary reason was the capsule was a death trap because the schedule was supreme and reality must comply. Just too many corners had been cut and no one would act on the warnings, of which there were many. The Velcro issue was just one factor, but demonstrated no one’s hands were entirely clean; the astronauts had been lording it over the engineers because they could.

    And I think the mixed atmosphere was used throughout, except for some hour-long sessions prior to any EVA: they had to switch to pure oxygen before using a spacesuit to let the nitrogen be flushed from their blood. Must admit, I’m puzzled by the low-oxygen symptoms bit, but as you linked, these poor people suffocated without sufficient warning to remove themselves.

    To loop back to the original post, the technical input was OK but those in charge would not listen. A common story in any public enquiry, those in charge know best and anyone disagreeing with them is at best a troublemaker, at worst a mutiny. Isn’t it odd how often a “Technocratic” governement appears to not understand technology at all. Seems PPE know nothing about PPE (ahem, sorry).

  17. Tim the Coder- great response. A lot there i wasn’t aware of, but they went with a different solution so still reasonable to say the other option was safer. Easy for a layman to suggest afterwards,of course, but yeah moonshots difficult lemon difficult.

  18. @TtC

    I believe NASA switched to N2/O2 mix in near-atmospheric ratio for the Shuttle onwards but Apollo only ever had systems for oxygen only, though it could launch with some nitrogen already in the cabin. From wiki, what happened on later crewed missions was:

    The cabin atmosphere at launch was adjusted to 60% oxygen and 40% nitrogen at sea-level pressure: 14.7 psi (101 kPa). During ascent the cabin rapidly vented down to 5 psi (34 kPa), releasing approximately 2/3 of the gas originally present at launch. The vent then closed and the environmental control system maintained a nominal cabin pressure of 5 psi (34 kPa) as the spacecraft continued into vacuum. The cabin was then very slowly purged (vented to space and simultaneously replaced with 100% oxygen), so the nitrogen concentration fell asymptotically to zero over the next day. Although the new cabin launch atmosphere was significantly safer than 100% oxygen, it still contained almost three times the amount of oxygen present in ordinary sea level air (20.9% oxygen). This was necessary to ensure a sufficient partial pressure of oxygen when the astronauts removed their helmets after reaching orbit. (60% of five psi is three psi, compared to 60% of 14.7 psi (101 kPa) which is 8.8 psi (61 kPa) at launch, and 20.9% of 14.7 psi (101 kPa) which is 3.07 psi (21.2 kPa) in sea-level air.)

    The environment within the astronauts’ pressure suits was not changed. Because of the rapid drop in cabin (and suit) pressures during ascent, decompression sickness was likely unless the nitrogen had been purged from the astronauts’ tissues before launch. They would still breathe pure oxygen, starting several hours before launch, until they removed their helmets on orbit. Avoiding the “bends” was considered worth the residual risk of an oxygen-accelerated fire within a suit.

    But sadly the source reference doesn’t confirm all the technical details, just that “NASA and North American substituted a nitrogen-and-oxygen atmosphere at ground level, replacing the nitrogen gradually with pure oxygen after launch”: https://www.hq.nasa.gov/office/pao/History/SP-4205/ch9-4.html

    You may be interested that the ISS is currently testing a new gas monitoring system that does real-time detection of N2 levels, as well as a host of other things including minor contaminants (eg from all the science experiments they run) that currently have to be monitored by taking air samples down to Earth periodically(!) https://www.nasa.gov/feature/nasas-spacecraft-atmosphere-monitor-goes-to-work-aboard-the-international-space-station

    Not sure how the Shuttle monitored its N2/O2 mix but in UK industries where there’s a risk of high nitrogen levels (like the apple store example or anywhere there’s a risk of leakage from liquid nitrogen tanks) I believe it’s more common just to have an O2 depletion sensor rather than measure the N2 levels directly.

  19. BiND- there’s something about the story which the author makes very trite. Yes inflationary expectation is in itself inflationary. But it’s still not the underlying cause. I suppose that the real was a relatively painless way to jump off the spiral,- rather than tell government workers they’re not getting pay rises, but if your president then goes and prints more reals it doesn’t help in the slightest.

  20. That is, of course, what then happened, a few years later the printing started again.

    But it is a nice story about *how important* expectations are concerning inflation. One of the reasons why Snippa’s wrong about MMT as well…..

  21. “Perhaps there is an example of an economy managed by expert economists?”

    Hong Kong, in the early days post WW2? Admittedly only one person, but certainly did pretty well at growing Hong Kong into an economic powerhouse.

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