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.