Facemasks in Brussels: A Textbook Example of Bad Regulation

If you abstract from the very real impact these dystopian restictions have on our lives, there is a certain academic pleasure to be had in analysing just how bad the policymaking around COVID has been.

My favourite example of this is without a doubt the decision by the Brussels region to make facemasks mandatory in outdoor public places, with a hefty fine for non-compliance. I’m sure Brussels isn’t alone in this measure, but as I limit my exposure to the news and as travel is not allowed, I can’t comment on how this might be administered in other places.

But the Brussels face mask law manages to break every one of my principles of good policymaking. Here goes:

A good law should be

  1. Effective in achieving its stated aim (if enforced). We know, from multiple sources, that there is no scientific evidence supporting the use of face masks in the community setting. Randomised control trials on influenza-like illnesses have shown, for decades, that they either do nothing, or do next to nothing, to slow infections. Where they have been proven effective is in hospital settings, when used by trained professionals, in conjuction with other hygiene measures.
  2. Proportionate to the aim. Formally, proportionality means it should be the least burdensome way of achieving a stated goal. But as stated above, there is no evidence that the measure can achieve its stated aim, it cannot be said that the measure is proportionate to this aim. Indeed, much of the ‘wisdom’ behind the face mask rule seems to repose on the fact that, while it has no measurable benefits, it is also not really that onerous a requirement to impose (I question this – see below).
  3.  Transparent and clear in its application. The rule as written makes exceptions for anyone who is a jogger or is in the act of drinking or eating. There are less clear, but de facto just as real, exceptions for smokers. But what is a jogger? If I am kitted out for a jog, but decide to only walk, am I in breach of the law? What if I stop for a short breather? Should I put on my mask? What if I am walking very briskly or even running, but not wearing the requisite sporty outfit? Does the face mask rule come with a description of what is the appropriate sort of attire which permits one to be outside without strapping a piece of cloth to one’s face? What if one has an unlit cigarette dangling from one’s lips, which one leaves there for several kilometres? What if one’s juice bottle is nearly empty and one holds it, nursing the last few drops as one strolls from Berchem-St Agathe to Fort Jaco?
  4. Fair. Good laws do not have a disproportionate impact on the poorest citizens. But this one clearly does: If you have the good fortune to live in a large house with a garden, you can enjoy time outside with the sun on your face. But if you live in a little apartment, you will be denied this pleasure for months at a time.
  5.  Enforceable in a consistent manner. There is no way to enforce such a measure, even if clear criteria for its application could be assured. Simply put, there are too many people in the city and too few police to enforce this rule. Consistent enforceability is really important. Without it enforcement becomes a sort of lottery. This is very toxic for both the community and the enforcers themselves. Having unenforcable rules languishing on the books creates an environment in which the citizenry grows wary of police contact, generally unsure whether or not they might get called out for a breach of some half-forgotten law. On the opposite side, there is the risk that enforcement becomes arbitrary, giving to the enforcer the discretion to punish at will. To be clear, this is not something a well regulated state should tolerate: Police enjoy a monopoly on physical force with very clear strings attached; they must exercise that power with a minimum of personal discretion. Anything else opens the door to discrimination and abuse of power.
  6. Free of unintended consequences. The list of unintended consequences from forcing an entire population to cover its face in public is very long indeed. First is the loss of public discourse and social interaction, leading to psychological distress and isolation. Then there are the costs for hearing impaired people who rely on lip reading to participate in public life. Then there is the risk of criminal activity from criminals being allowed to walk about freely in disguise. Then there are the (albeit evidence-free) claims of adverse health effects from mask usage. Then there is the financial cost, the environmental burden, and the list goes on.
  7. Measureable in its impacts. For any law, it should be possible to perform a review, to assess using objective benchmarks whether or not the above criteria were indeed met. But for the facemask rule, there are no such criteria. How can we know if, in the absence of the measure, things would have been worse? This is why measures should be piloted first, tested to see if they work. It happens that tests were done in the Netherlands, and on the basis of them, the Dutch took the decsion not to implement outdoor facemask rules. Could the Brussels authorities not have learned from the example of their Dutch neighbours, and refrained from muzzling the entire population?

Nineties-stalgia: why the Golden Decade is due for a comeback

From Dust cover til Red Dawn

Those of us old enough to remember life in the 1980s will no doubt recall the very real fear of thermonuclear annihilation. We tried to make light of it at the time, with movies like Rocky IV or off-the-cuff black humour – how it was better to be close to ground zero than to suffer the slow, cancerous demise occasioned by a nuclear winter. Still, it haunted us at night. As children, we awoke in cold war sweats, to stare out our bedroom windows and watch imaginary mushroom clouds dominating the night sky.

But as the 80s drew to a close, the fear ended too. David Hasselhoff stood on the Berlin Wall wearing piano keys. And as every non-German marvelled at the fact that Knight Rider could kinda sing, the conflict and angst that defined two generations crumbled into legend. The mighty Soviet Union was reduced to an alcoholic Russian joke, in the person of Boris Yeltsin.

Mr Gorbachev, tear down this wall!

Thus were born the 1990s. A decade when any remaining questions the world had asked about Western dominance seemed to be answered. The slow progression of liberal values looked inevitable. Sure the Third World was still a mess, but give us a bit of time and we’d sort that out too. Bob Geldof was, after all, recording a second version of Band Aid, and after U2’s musical death in a custom-graffittied Trabant, Bono was soon to reveal himself at Emmaus.

Image result for dawsons creek
Only a decade with the confidence of the 1990s could have given us something as deliciously bad as Dawson’s Creek.

And so slipped by the Golden Decade. Our thoughts turned to home affairs perhaps, with only a distracting glance in Dan Rather’s direction, to see if the glove fitted on OJ’s hand, or if the cigar fitted into Monika Lewinsky’s … version of events. The news had become a light distraction, a welcome interruption from the humdrum of our civilisation’s happy ending.

As you undermine our security, we undermine yours

And with a whiff of not-too-genuine concern about the Y2K bug, we set about partying like it’s 1999. But the Golden Decade had a little more to give. Which is why we failed to brace for impact when, 20 months later, it all came crashing down in a heap of dust and debris, and a new shadow swept over the West – the spectre of Islamic terrorism. Like the current crisis, the reality of terrorist threats was nothing near as deadly as our overreaction to it – in this sense the terrorists succeeded in every goal they had. With a couple of box cutters, they got us to submit to any and all kinds of security checks, extraordinary rendition or the waging of reckless, endless war on petty despots and the civilians they oppressed. The enduring impact of 9/11 was not the bullets of Kalishnikov-wielding theocrats, but the subtle abandonment of our liberal values; the precedent that when our fear is great enough, we will throw away everything we pretended to hold dear.

Rohan, my lord, is ready to fall

After this traumatic early childhood, the Millenium’s awakening into teenagerdom was little better. There was no single drama that defined the crappiness of the 2010s, rather we were caught in an emotional pinser movement by three slow-moving threats: Immigration, Climate Angst and the inequality which followed the Great Recession. What belief we might once have had in our own civilisation was just about thoroughly beaten down, and as any casual glimpse at the Netflix catalogue will reveal, by mid-decade we could hardly imagine any kind of fiction that didn’t sport the adjective ‘dystopian’. We valued our democracies as little as we valued our data, all to be given away for trinkets in the clouds. We were ready for something like Donald Trump’s tweets. Oh and we got them. We got Rachel Maddow in ‘literal’ [sic.] hysterics over imagined Russian collusion. We got slick, Youtube-ready comedians dispensing sanatised, corporatist Identity Politics by the sound bite. And we kept giving away our privacy to enjoy more of the show.

This background helps us make sense of the madness that is 2020 – how a seemingly mighty tree can topple with only a slight gust of wind, once its core has been allowed to rot away for twenty years. How three hundred years of enlightment principles could be uprooted in a single storm.

Rediscovering the lost decade

And it’s also why, looking back on them now, the 1990s seem so damn appealing. It’s why Nineties-stalgia is the way to go. I defy anyone to tune in to the first few seasons of Friends and not find themselves longing for a time when music sucked but we still had public payphones. Your job might have been a joke, you might have been broke, but if you were young in the 1990s, Western Civilisation was there for you.

Even better than Friends is Dawson’s Creek. Not actually ‘better’. The scripting is at times painfully bad, the accoustic underscores are suburban coffee-shop cringeworthy and the teenagers are, even by the standards of the Golden Decade, implausibly articulate and self-confident. But it is the most perfect encapsulation of the optimism that came to those who grew up in the long Indian summer of a victorious empire.

One that did not yet see its downfall coming.

What is life?

Life is that time you played

What started out as hide-and-seek

Then someone added Nerf guns

Secret bases, boys-vee-girls

And finally a rope swing and a dare

Water so cold it warmed the after-swimming air.

Treats meant to last the week eaten then and there.

Nothing ever tasted so sweet.

No one saw the June sun duck below the trees

behind the river line.

Well past supper time!

On legs sore from running you nonetheless peeled

Across the fields

To a half-meant ‘sorry momma’, and a half-cold spaghetti meal.

 

Life is the buzzing sound

From music played too loud

And the noise of the college crowd.

That lingers still in ears and on your clothes

All down September’s rain-painted side-walk home,

Reminds you of that second pint,

The little smile she bore you

Sideways, mid sentence to her friends,

That might – just might – some future night, blossom into much, much more.

 

Life is those endless minutes waiting, anticipating

The breaking of the swept and polished order of long-kept

Knick-knacks, unmoved since last They stormed the door;

That in two violent minutes of shedding little coats and mittens triggered

More noise than needles make in all the winter weeks of knitting new ones, one size bigger.

Then They finally appear, you find

Little faces so filled with Now and so in likeness of Their parent-child, standing, smiling just behind,

It calls to mind, every school lunch prepared, every memory shared

and all those times bygone.

This rich reward, this weekend chaos, is the reason why you struggle on.

 

Life is never ‘staying safe’,

Waiting, clutching to existence,

Until every living risk fades to nothing.

 

 

 

Bonne Année 2021 (12ieme lettre)

Mon cher fils,

Un petit mot pour te souhaiter une bonne année 2021. J’espère que tu as passé des bonnes fetes, et que le Père Noel a été généreux comme il faut.

Nous, c’est assez tranquille ici. Daphné a beaucoup apprécié le temps, surtout le fait qu’elle a pu rejoindre ses grand-parents. Elle a eu de la part de Père Noel un chateau fort de Duplo et aussi une poupée, qu’elle a appellée “Gala”.

Ta soeur Anna est resté a Dublin, elle bosse beaucoup pour l’université, mais elle a pu aussi voir ses copines et copains un petit peu. Je lui avais offert des bottes de “UGG” comme cadeau de Noel (ca sont des bottes a mon avis assez moches, mais apparemment très comfortable).

Et maintenant, on va avoir de la neige! J’espère que tu puisse aller dans le parc pour construire un bonhomme.

L’école recommence (et pour toi, et pour Daphné) après-demain – donc profitons des vacances encore quelques jours! Apres, j’espère qu’on puisse retourner, peu a peu, a la normale, après cette longue période de COVID, dont on a tous marre maintenant.

Je te donne tous les câlins possibles et je pense fort a toi, comme toujours.

Love,

Dad

My Review of Ken Follett’s “The Pillars of the Earth”

The Pillars of the Earth (Kingsbridge, #1)The Pillars of the Earth by Ken Follett
My rating: 3 of 5 stars

Imagine an apple that has been drawn two different ways. The first is a mere illustration, an outline in black and white, one which lacks detail. Simple, yes. Yet it perfectly expresses the essence of the fruit – like the logo of a certain computer company.

The second drawing attempts to render the apple as true to life as possible, with colour, texture and background: all the details the human eye supplies to the brain when confronted with the real thing. But imagine the artist lacks the high degree of skill to deliver on this photographic promise. Let’s say the colour is wrong, the hue of the light rings false, the texture is not sufficiently apple-y.

When we put these two pictures side by side, we ‘see’ a better apple in the illustration. By providing us only with an idea, it allows our imagination to fill in the other details. The second, on the other hand, jars in our brains. It bothers us, despite the effort that might have gone into its crafting. Less is sometimes more.

In ‘The Pillars of the Earth’, Ken Follett has tried for more. A lot more. His portrayal of medieval life in the south west of England is very detailed. We eat, sleep, travel and even copulate with the stonemasons, monks and earls who populate his pages. It is obvious to the reader that he has meticulously researched his subject. But that is precisely the problem – the reader is too aware of the research. At times it feels like we are reading his notes and not his fiction. It is too studied, and therefore rings false.

There are also a number of structural problems, again due to the high level of ambition. It’s damn nigh impossible to sustain over three generations and as many cathedrals the strong plot dynamics for which Follett is known. There are lulls and the conclusion to one of the central plot threads is both contrived and unsatisfying. Follett also seems unsure whether to write Aliena, one of the central characters, as a fierce female protagonist, or as a weeping damsel in distress. In the end, he tries a bit of both, and for me it simply doesn’t work. This I found particularly disappointing, given how well he rendered the characters in the other novel of his I read (“Night Over Water”).

That said, the opening is strong enough; the protagonists likeable enough and the villains loathsome enough to keep the reader hooked.

It’s just a pity he didn’t stick to mere illustration.

The Great Barrington Declaration

I am reprinting this on my blog:

As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical, and mental health impacts of the prevailing COVID-19 policies and recommend an approach we call Focused Protection. 

Coming from both the left and right, and around the world, we have devoted our careers to protecting people. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice. 

Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.

Fortunately, our understanding of the virus is growing. We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza. 

As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. We know that all populations will eventually reach herd immunity – i.e.  the point at which the rate of new infections is stable – and that this can be assisted by (but is not dependent upon) a vaccine. Our goal should therefore be to minimize mortality and social harm until we reach herd immunity. 

The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection. 

Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals. 

Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.

Great Barrington, Massachusetts, 4th October 2020

To sign the declaration, follow this link (will be live later today):
www.GBdeclaration.org

Bonne vacances d’ete (11ieme lettre a toi)

Cher Daniel,

Bonjour mon cher fils! J’espere que tu profites bien des vacances (il a quand meme fait beau ce dernier temps, bien que un peu frais pour la saison).

Moi je dois encore travailler, mais ta soeur Daphne est deja parti en vacances avec ses grand-parents (J’etais un jour a la plage au Pays-Bas, magnifique!). Anna va venir a Bruxelles aujourd’hui et ensuite elle partira en France pour marcher dans les montagnes – tres, tres joli la-bas (il parait qu’il y a meme des loups!)

Je ne sais pas si tu pars en vacances, mais si c’est le cas, et bien j’espere de tout coeur que tu t’amuse bien. Peut-etre aller a la plage et manger une glace? Peut-etre faires des stages avec tes copains? Tu es devenu tres grand maintenant, donc, je suppose qu’il y a beaucoup d’activites possible pour toi (malgre le corona).

Et puis, pour Septembre, esperant qu’ils ne vont pas fermer les ecoles de nouveau. Ces mesures corona sont tres nuisibles pour nos enfants, qui ont bien le droit a une education libre des peurs et des craintes des vieux…

Je te donne un gros calin virtuel,

– Dad

Take me back

Take me back somehow

To when I dreamed I’d have

A better now than now.

 

Return me in place and mind

To those fledgling times when we were lax and preened,

So small we lodged ourselves between the cracks

Of that and this unchanged machine

In which we now have risen to be full-fledged cogs.

 

Take me back

To when my back impressed upon the chain-linked wire

Dangled legs all splayed, tired out

From too much tennis played,

And spent this one forgetless hour

Before a shower and off to watch a movie.

 

Return me even to those since-forgotten fears,

To the stoney months and years

Of want and doubt and grit and scree,

From which Nostalgia – liar that she is –

Pans out her precious golddust memories.

 

Take me back

And if you say it can’t be done

For pity’s sake,

Give my back the strength to carry on.

My review of George du Maurier’s Trilby

TrilbyTrilby by George du Maurier
My rating: 3 of 5 stars

It happened the other day, while I was reading George du Maurier’s Trilby, that a young man asked me whether I read mainly fiction or non-fiction – his preference clearly being for the latter. I answered the former, and had to supress within me a slight sense of shame. Does the fiction reader not, after all, sunbathe in supercillious fantasy while lazing on the beach; whereas the non-fiction reader applies his mind to the ‘hard facts’?

Maybe it is engrained in us to think so. But the distinction is shallow and meaningless when you dig a little deeper. For one thing, if 2020 has anything to teach us, it is that the ‘hard facts’, even those that are as hard as rock, are so numerous and tiny that they give way to the cudgel of dogma and zealotry, like grains of sand on that very same beach. One eye-catching event, propelled by the right algorithms, can trump an entire discipline of rigorous empiricism.

Non-fiction can easily fall into the trap of pretending the ‘castle of truth’ which the author has built up is structurally sound. Fiction, as written from the perspective of the narrator, or better still, the third persons who inhabit the narration, harbours no such pretense of architectural stability. The reader knows that the truth on which a novel is based is a shifty one; changing with the tide and giving way to the footprints left by the author’s own biases, those of his characters and those of the reader.

In this respect, a book like ‘Trilby’ helps us gain perspective on the ‘truthiness’ of our own age. It places fantastical events in a historical and subjective context, and in doing so removes us from the fantastical context of our own time, allowing us to regard these as no less subjective and ephemeral.

At the time of its publication, ‘Trilby’ was a sensation – the ‘Da Vinci Code’ of its day. Upon reading it, it’s easy to see why. Borrowing with self-effacing openness from Thackery, Dickens and Dumas, this festival of vanity, a tale set in Two Cities, chronicles the adventures of three very British ‘musketeers of the brush’ (artists) and their acquaintance with the Anglo-Irish Parisian washerwoman of the title. The narrative is light and fun, rich in the tradition of turn-of-the-Century satirists like Wilde or Saki. The plot is compelling, though perhaps somewhat too linear for modern tastes.

Mostly though, I read it as an antidote to the irrationality and illiberalism of the dominant ‘Liberal’ world view. If we must inhabit sand castles in order to have a coherent frame of reference, let’s at least decorate them with the colourful seashells of funny, well-written Victorian prose.

View all my reviews

Open Letter to Dr Trish Greenhalgh on her BMJ article concerning face masks

Dear Trish,
I’m writing to you to express my concern about the medical consensus that has slowly formulated around the use of face masks in public settings as a measure to mitigate against the spread of COVID-19. I read your bmj article on the subject and was frankly alarmed at the arguments you used to back this position.
Having looked at the issue in some detail, it seems reasonably clear that there is at best, as you put it, ‘sparse and controversial’ evidence that face masks stop the spread of SARS-Cov-2 in the community setting.The fact that you nevertheless argue in favour of such measures, on the basis that you see them as essentially costless – “we have little to lose” – is deeply worrying.
Mandatory rules around the use of masks in public are far from costless. In the first instance, they have important and detrimental consequences on the hearing impaired, who rely on lip reading to understand and contextualise verbal meaning. More generally, facial expression is an intrinsic part of human interactions; physical barriers impede not only droplets of saliva, but also the visual appreciation of body language which is a large part of the context in which speech is delivered.
Second, there is the economic and environmental cost of mass production, dissemination and disposal of face masks. A single mask is of low cost, but multiplied by millions, it represents a not-insubstantial addition to our impact on the planet, and a related economic burden, particularly on the most vulnerable in our society.
Finally, and perhaps most importantly, the very act of mandating an accoutrement of this kind entails a system of state intervention and imposition on public life. The symbol value is strong; it is a mark of control, just as certain religions mandate the use of clothing to demarcate adherence to doctrine; just as military and law enforcement mandates the wearing of uniforms to instil discipline and diminish any instinct towards individualism which might threaten the goals of the collective.
Indeed, the very requirement to conform is a small – but persistent and deep – incision into our liberties. It lessens our individuality all the more to have the most expressive and personal part of our anatomy covered from view in public, and it allows the state and the medical establishment to dictate our behaviours, not – I repeat – on the basis of any substantiated scientific knowledge, but rather on the whim of a cadre of experts, who merely deem it possible that this measure could have a beneficial effect.
Apropos the beneficial effect: Your article was written in early April, when less was known about the shape and scale of the COVID threat. Though even at that stage the contours of the epidemic were crystallizing as less than apocalyptic, there was still some concern that COVID could carry with it an infection fatality rate of as high as 1-2%, with an infected population of 70 to 80% of the general population.
It is now amply clear to anyone who takes an honest look at the data that this worst case scenario is not only implausible, but in fact nearly impossible. In Belgium, where I live, almost all lockdown measures have been relaxed since early June – schools reopened, shops, bar and restaurants are full – all with no effect on new ICU admissions. Hospitals are almost completely empty.
Indeed, as some experts wisely predicted even at the time, populations would reach full exposure (Belgium, France, Northern Italy, most of the UK, New York) as the disease followed a classic gamma trajectory, with heavy left skewness; whereafter the rate of new infection would cease to be a major public health concern. The infection fatality rate will never exceed 0.01%, and is even lower when measured in quality adjusted life years.
As the evidence gathers, in fact, it becomes increasingly obvious that the lockdowns put in place had only marginal or no effect on the spread of the disease, and that to the extent they did anything, it has been only to slow the virus’ inevitable progression across the population.
In this context, your core argument for insisting on the use of face masks: “covid-19 is a serious illness that currently has no known treatment or vaccine and is spreading in an immune naive population. Deaths are rising steeply, and health systems are under strain.” appears much less compelling than it perhaps did in April.
Given the above, I would ask you to reconsider your position as expressed in the article, and work with your co-authors to publish a corrigium, in which you argue against the mandatory use of face masks in the community setting.
The stakes are, in fact, quite high.
Kind regards,
Graham Stull