If you’re among those affected by the COVID-19 pandemic, read Michael Lewis’s (no relation) The Premonition: A Pandemic Story. If you aren’t, you’re probably living in New Zealand and might not find it as interesting.
I know I can’t provide a summary that does the book justice. Heck, I’m not sure I can even explain what it’s about. What I know is that after having read the book I know more and understand less about the pandemic – not because Lewis does a poor job of things, but because he does such a good job of it.
And anyway, as one of his reviewers commented (I’m paraphrasing), “If Michael Lewis published an 806-page book on the history of the toaster, I’d read it.”
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Members of the KJR community know I generally hold up scientific inquiry as the gold standard for understanding how something works. But scientific inquiry has its limitations. Lewis provides an example in the CDC’s early response to the emerging pandemic.
The CDC, to its credit, bases its recommendations on science. But that limits its ability to carry out its mission: In the early stages of a pandemic, leaders have to make policy before there’s enough science to provide reliable guidance, just as military leaders sometimes have to plan for combat without good intelligence to guide them.
Lewis quotes Charity Dean, one of the book’s protagonists, who suggested the CDC is, as a result, mis-named: It should be called the Centers for Disease Observation and Reporting. By the time it had enough science to provide useful policy guidance the disease was already spreading according to the mathematics of compound interest.
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Science is the gold standard for understanding how things work. That doesn’t make scientists the gold standard among human beings for objectivity and insight. The reason we do (or at least should) trust science is because it’s a self-correcting process designed to compensate for the all-too-human scientists who practice it.
Example (and thanks to “Robert B” for bringing it to our attention in the Comments last week): According to peer-reviewed research by John P A Ioannidis, the fatality rate among those infected by the virus is 0.23%. This is quite a lot lower than the reported U.S. fatality rate, which is 611,000 fatalities out of 34,600,000 cases – 1.8%.
So far as I can tell, the discrepancy arises from two causes. The first: Ioannidis based his 0.23% statistic on a worldwide “study of studies” methodology. His denominator is the presence of the virus in study subjects’ bloodstreams.
That’s in contrast to the 1.8% mortality rate. Its denominator is the number of (presumably) symptomatic cases reported in the U.S.
Neither mortality rate is wrong. Both are important pieces of information. Policy makers, and this includes private-sector Chief Risk Officers (CROs), need to understand these subtleties to do their jobs well. They need to factor in the levels of contagion and morbidity alongside rates of fatality.
They also need to recognize when any decision is better than no decision.
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Each of us is our own CRO. We … every one of us … sets “policy” for ourselves in the form of decisions like when to wear masks, when to practice social distancing, and whether to be vaccinated. With less expertise than CROs can build into their organizations we’re more reliant on who we choose as our sources.
And that’s a tough call. Even if you ignore the political and media bloviators completely (recommended), the line separating the need for knowledgeable scientists to debunk quacks and propagandists from the temptation to vilify colleagues with whom they disagree is neither sharp nor bright. The case of Professor Ioannidis is, in this respect, instructive (see “The Ioannidis Affair: A Tale of Major Scientific Overreaction,” Shannon Bownlee and Jeanne Lenzer, Scientific American, 11/30/2020).
Whatever else you do, check your own source selection carefully. In the case of COVID-19, confirmation bias can be lethal.
Bob’s last word: Had we as a society treated the creation of the coronavirus vaccines as we did the Salk and Sabin polio vaccines, we would by now have achieved the herd immunity that would let us put this pandemic behind us.
As business leaders, as pointed out in last week’s column, we all have some ability to nudge society in the right direction.
Bob’s sales pitch: I’m on a roll with CIO.com. New this week: “11 dark secrets of application modernization.” Check it out.
the us govt counted anything that could be related to covid a covid death. they also used a lot of dirty data to fudge other claims. I would believe that 0.23% by Ioannidis before the govts wild claims.
Now the issue is why masks and another shutdown when auto accident death rate is much higher than the covid death rate. clearly it is politicians making fake claims for some perceived benefit to them in the next election.
real data shows that 1.9 million extra people over and above the covid amount of deaths were caused by the shutdown. while the shutdown may have saved some covid deaths it caused just as many plus 1.9million more people to die by having the shutdown.
and dont pay no never mind to millions about to be evicted now that the moratorium is over, nor all the small businesses that are gone forever, nor the families in turmoil from abuse and suicides, plus the millions of kids who lost a year of schooling.
it is really time to get big brother out of our lives and let us decide what risks we choose to take and let us get on with our lives and businesses. 6EMY
PS
No decision is far better than a truly bad one especially one that was made for political reasons without any true scientific basis.
No matter, there will be more and worse plagues coming unless the country repents of its sins and turns to worshiping the one true God, and follows the guidelines that He gave us so that we could live better and in harmony.
Can you provide any citations for your assertions? You keep using these numbers. I could comment that “I believe that COVID has a 86% lethality rate, due to dirty numbers and denialists trying to hide the danger”, and that statement would have just as much evidence as yours.
billy
I tell the truth. Believe it or don’t. You should always do your own research to find out the sitrep before you make up your mind.
I stand by my statements as being true and accurate.
The rest is up to you.
Perhaps we were too successful eradicating the old diseases. The politicians grew complacent and cut public health budgets. There is also the terrible trend of believing that all viewpoints and perspectives are valid without considering confirmation bias and other delusions. There is also the embracing of a strain of anti-intellectualism that celebrates ignorance. We endured a lockdown to save lives and we still killed a good proportion of our elderly due to infected staff moving from nursing home to nursing home. I really don’t know what to make of things. It is like people have thrown out the rules that allow a society to fully function.
To elaborate on your point, John: In various places in the Federal government are dedicated professionals who are paid to assess the various risks we’re likely to face in the immediate future, and to provide contingency plans for addressing them. We refer to these folks with the regrettable term “bureaucrat,” which we should reserve for those who apply rules so slavishly that basic good sense goes out the window.
During the previous administration, there were those who referred to these folks with the even less flattering term “deep state.”
As it’s been explained to me, with changes of administration, political appointees are swapped out at the top of the various federal agencies. The smart ones recognize that their time in office will be limited. They institute policy changes but don’t swing a wrecking ball at their agency’s functioning, any more than a new CEO would shred the organization they take over before understanding what is working and what isn’t.
In this case the risk of future pandemics was well-understood by the experts. The problem was that those responsible for policy weren’t willing to invest what was needed in risk management, instead engaging in risk denial.
Sadly, the risk of pandemics is far from the only risk the previous administration’s policy makers chose to ignore. It will be interesting to watch how the current one approaches the subject.
Bob
we should assess the risk for ourselves
the crats can make suggestions but we should get to decide what we do
and if those govt weenies were more believable then they would get better results. fibbing flip flopping Fauci proved that their assessments are not worth all the money we are paying them.
Yes, you should assess the risk for yourself, just as we let drunk drivers assess the risks for themselves.
Oh, wait. We don’t do that, because it would be … what’s the word? … oh, yes, Stupid!
@John Moore
Or maybe the Revelation of Jesus to Saint John is true and accurate and we are starting the end times. SarsCov2 is just the warm up virus causing a mild Covid19 which will be less deadly than many other things when we hit steady state.
You should worry about the other plagues and disasters that are coming because of the evil in the USA and the world.
Again, an excellent piece! I liked the military example of having to take action with incomplete info
I visited a friend last week. They had this on a wall:
“I know you believe you understand what you think I said, but I am not sure you realize that what you heard is not what I meant.”
No attribution, but it certainly seemed to sum up the way many attempts at communication seem to go in 2021.
Hi Bob.
I agree about science’s self-correcting process but unfortunately that can take decades to be fully realised and may sometimes never be corrected – as long as those who “have the stage” are dogmatic in their views and refuse to entertain other ideas contrary to their own or “the scientific community”. Others in the scientific community may tow the line for fear of having their grants/research funding stopped. Around 70 years ago the scientific community believed the universe was constant and the medical community encouraged smoking to name two out of many examples. Sometimes the “quacks and propagandists” are correct… if they are able to provide scientific evidence to backup what they are saying. One just needs to be diligent and open-minded enough to seek out and evaluate the facts, whereever that may lead.
I do not agree with your polio vaccine comment though. Salk took a number of years, about 5, to get the vaccine right in the 1950s (and event then it was on decades of research from the 1930s). Only then did clinical trials commence and only after about 2 years, it was deemed safe and effective total of at least 7 years. In 1962 Sabian brought the oral vaccine to market, almost 10 years later (https://www.history.com/this-day-in-history/salk-announces-polio-vaccine). It cannot therefore be compared to the Covid vaccines which has taken 9 months and granted EUA and with more and more evidence coming out on its failures (waning efficacy, adverse events, etc.). People counter the 9 month statement with mRNA being around for 10 years but nothing with that tech has ever been approved for human trials. But yet, here we are with governments literally forcing people to be injected with these experimental drugs or coercing them with various rewards.
There is always the argument of a pandemic so “tough times calls for tough measures” and all that. However, is all the adverse events, not just from the vaccine but lockdown, damaged economies, destroyed livelihoods, increased depression, anxiety, suicide, etc. all worth it? For a relatively low IFR? From the CDC, around 50% of the underlying conditions of people who have died is hypertension (https://www.cdc.gov/pcd/issues/2021/21_0123.htm). There is not yet readily available data for top causes of death worldwide (heart disease in 2019 from WHO, https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death) but I can confidently bet it is not going to be covid and still be heart disease. Why is no one boycotting all the fast food outlets, sugarry drink manufacturers, etc., no governments clamping down on unhealthy diets, forcing people to go outside and get some exercise? Instead of dialing up fear and anxiety to 11 amongst the population….?
Makes one wonder, maybe all those “quacks” talking about government power-grabs, overreach and control are not that far off. But that would be a conversation for another day. Cheers.
Robert,
I’m afraid that you are conveniently ignoring some gaping holes in your arguments. Your last paragraph fails to note that heart disease, while certainly a concern worth a change in behavior for many, is not contagious. COVID most certainly is. And it’s variants have shown a demonstrable evolutionary tendency toward becoming even more so. Add to that a huge variation in symptoms when infected that leaves many who are unaware they are actively shedding virus (at much higher rates in the case of the Delta variant) out and about with the rest of the population.
Your paragraph on the Salk vaccine completely ignores relative risk as well as vaccine advances in the past 70 years. The technology is vastly improved. (Surprise, surprise.) No, it is not perfect, but nothing is. Still, flu vaccines vary year to year, and those annual versions do not get the same ten years of testing as they must be tailored to the expected flu virus variants of a given season. Yet there is a huge volume of data demonstrating that people get those vaccines with no side effects and that those who do suffer any generally they pale in comparison to what would happen if they had contracted a flu. Despite the COVID vaccines still being under an EUA we already have a huge volume of evidence regarding side effects from, and safety of, the those vaccines. There are virtually no side effects noted after the first 42 days from vaccination, and most noted in those first 42 days pass with no long term harm done. Of course there are outliers, but their rate vs the possibility of serious illness from getting the virus is miniscule. And don’t forget there is now actual science that helps identify those at risk.
If you work in IT, you must be familiar with doing a risk/benefit analysis. The risks from contracting COVID, with the likelihood of doing so getting higher by the minute with Delta around, far outweigh any identified from the vaccines. Granted, there are no studies showing longer term effects from the vaccines because the earliest clinical trials were less than a year ago, but by the same token, there is no evidence to support expecting any severe ones down the road. The risks of being hurt in an auto accident may continue to be mitigated, but remain higher than the risk of the COVID vaccine introducing a serious side effect down the road.
It’s also worth mentioning that getting a vaccination (or wearing a well fitted mask for that matter) is every bit as much about protecting those around you as yourself. Children, spouses, parents, grandparents, friends, coworkers, or even those around you when you shop can all be affected by your decisions. They may also be the ones who suffer the most serious consequences if you get it wrong. I like to think I would ignore the risks and run into the street to knock a child out of the path of a speeding car. Getting a shot to help protect those around me is far less risky, but just as potentially life saving.
Hi Derek,
Yes, covid is contagious but with the relatively low IFR, the vast majority of infected people recover. Tuberculosis is much more infectious but we don’t see governments shutting down entire cities where people happen to contract it – those at risk are isolated. That was the crux of my argument, the government’s reactions across the world are not measured (see the Great Barrignton Declaration for a more sane response that should have occurred – https://gbdeclaration.org/).
The fallout of the lockdowns and long term physical and psychological effects on society far outweigh the risk of the virus in my opinion. My risk/benefit analysis comes to a very different conclusion than yours. As for virtually no effects of the current vaccine, 11,900 dead Americans may disagree with you, along with 500k others who have had adverse effects to the vaccines according to VAERS (https://www.openvaers.com/covid-data) – which according to a Harvard study is under reported. 1,8 million people across Europe as per the EudraVigilance database may also want to have a quiet word with you over their adverse reactions (https://www.adrreports.eu/en/) – ranging from heart attacks, miscarriages, bells palsy, anaphalaxis, blindness and, oh yes, death. How about about 350k in the UK’s adverse reporting system (https://coronavirus-yellowcard.mhra.gov.uk/) – I could go on but you get the picture. Saying the benefits of the vaccine outweigh the risks is all good and well. Until it happens to you. Again, for a virus with a relatively low IFR.
And finally, pretending that taking the vaccine is about protecting others and is a selfless duty one should do is kind of self-righteous and misguided in my view. It is a selfish act, one to protect yourself from dying, not those around you. And don’t pretend otherwise because you can still get infected and still spread the virus if vaccinated. Just look at all the breakthrough cases happening across the world. Why else is the CDC recommending you to still wear a mask even if fully vaccinated? And don’t say “Oh, but the chances are reduced blah blah…” – the fact that it can happen is what matters.
So, go ahead and get the vaccine if you want. And if you don’t want to then that also should be ok. It is, after all, your choice. You may differ in your opinions from me but that is also ok… you have your reasoning, your experience and I have mine – that is the whole point of having a free society where people can engage and debate ideas – not the dogmatic, “you must do what I believe or think or else…” mentality that pervades current social interactions. Or the pronouncements coming from on high out of the Minstry of Truth, sorry, the Government, which declares that it alone is the single source of truth and no other views should be believed or entertained (see New Zealand PM for that one). That is not a society I want to live in and if Aldus Huxley’s “A Brave New World” or George Orwell’s “1984” is in our future then may God help us all.
I think it comes down to this:
Is it within the government’s constitutional powers to forbid behavior that endangers others? Clearly it is, or else DUI would not be illegal.
Is it within the government’s constitutional powers to compel? In conditional situations, absolutely, otherwise driving on public motorways without a license and insurance would not be illegal, the “conditional” part being “on public motorways”. You can drive on your own property without a license and insurance to your heart’s content.
How about compelling us to do something, period – in other words, mandates? As we require people to register with the Selective Service System, and have in the past drafted some registrants into the armed forces, it’s clear that mandated actions are legal as well. We can argue about the merits of specific cases, and should. Arguing that the government lacks the legal status to do this is demonstrably wrong.
One other point: Invoking Orwell’s Ministry of Truth is ad hominem argument. As Daniel Patrick Moynhanan famously said, you’re allowed your own opinions, but not your own facts. A major role of government is amassing and analyzing data (read Michael Lewis’s “The Fifth Risk” if you don’t understand this point).
So you can believe the skies are going to remain sunny and winds will be pleasantly breezy all you want. But that doesn’t make your belief worth paying attention to when NOAA says a hurricane is headed in my direction, and it certainly doesn’t make NOAA an Orwellian Ministry of Truth.