Ioannidis on COVID-19

"A Conversation with John Ioannidis"

Social justice matters more than social distance

"Suddenly, Public Health Officials Say Social Justice Matters More Than Social Distance"

Doublethink

From George Orwell's 1984:

The Ministry of Truth—Minitrue, in Newspeak—was startlingly different from any other object in sight. It was an enormous pyramidal structure of glittering white concrete, soaring up, terrace after terrace, 300 metres into the air. From where Winston stood it was just possible to read, picked out on its white face in elegant lettering, the three slogans of the Party:

WAR IS PEACE
FREEDOM IS SLAVERY
IGNORANCE IS STRENGTH

The course of coronavirus

It doesn't look like the numbers or percentages are entirely accurate. However it's still useful as a generic schema for how the coronavirus seems to be playing out.

Confirmation bias

Coram Deo asks a good question here:

I don't know if either Hawk or steve (or another active T-blogger) would be willing to take up the question, but both here and elsewhere I'm seeing what I perceive as rampant confirmation bias swirling amidst the current coronavirus pandemic and I'm wondering if it's possible to implement guards or filters in our critical thinking to avoid this to some extent.

This assumes of course that folks wish to avoid or mitigate this feature, indeed many seem to rush to pick out this or that expert, model, or theory which bolsters their preconceived notions.

Thanks, CD. That's a good point and a good question! What you've said is important to keep in mind. If I can offer my random thoughts:

The mist

1. Just in passing, I'm sure everyone has already heard California has declared a state of emergency and is on mandatory lockdown. The governor mentioned the possibility of martial law, but later issued "clarifying remarks". I guess California is taking Italy's strategy.

2. It's interesting how life imitates art in our coronavirus pandemic. I'm sure examples could be multiplied.

A recent one is the film Five Feet Apart. I've only seen the trailer. The main characters appear to have cystic fibrosis, but that's where the analogy breaks down, because cystic fibrosis isn't infectious. Rather it's a genetic disease. But the social distancing fits.

3. Of course, movies like Contagion and Outbreak are obvious. There's likewise some overlap with the apocalyptic genre in general.

4. I suppose the pandemic has some parallels with Stephen King's The Stand. Thankfully COVID-19 isn't Captain Trips.

5. Perhaps one of the more apt parallels is Stephen King's The Mist.

Basically the film is about a group of strangers stuck together in a supermarket while an impending mist gradually surrounds them and traps them inside.

Man-eating monsters lurk outside in the mist. So people can't venture outside without taking their life into their own hands. Without risking death.

However, as scary as the mist and its monsters are, there are monsters lurking inside with them too: their fellow human beings. Which monsters are worse? Both are bad, but one is in the open, while the other is hidden. The difference between a massive fire-breathing dragon and a slithering snake in the grass.

We can sympathize with their confusions and frustrations at the beginning. No one seems to know or understand what's happening. They're thrust into their predicament after a storm hits the town.

Some immediately take on a "survival at any and all costs" mentality. Others are more selfless at first, but that changes too.

As the story progresses, we begin to sense increasing mistrust and distrust. We begin to see the heightened fear in their eyes.

We feel the growing panic. The fevered paranoia. It breaks out in yelling and screaming and fighting. People take sides. Form factions.

So, in the end, one by one, individuals are picked off. Either by the monsters outside or by the "monsters" inside, as people realize there's no escape. Death - or a worse fate - awaits them all.

6. In short, it's instructive to witness how some people are responding to this pandemic.

It's like they're stuck inside a locked gas chamber with the gas diffusing across the room and inching toward them by degrees. There's nowhere to run, but some people will still claw and scratch one another to savor a few more moments in the corner farthest away from the steadily approaching poison.

It's also somewhat reminiscent of Camus' The Plague as well as Sartre's No Exit.

By contrast, Christians need not fear death. We know this life isn't all there is. Death isn't the end - or worse. There is an exit. There is a door. His name is Jesus: "I am the door. If anyone enters by me, he will be saved..." (John 10:9).

Unconcerned about constitutional rights

I recently saw a political conservative (as well as Reformed Christian) state the following on Twitter:

Given the current health crisis, no one is currently concerned about constitutional rights.

1. I don't understand how any full-blooded American could ever say something like this. The Constitution and Bill of Rights were forged in the wake of war. In the midst of a fledgling nation threatened to be torn apart from internal strife. Surrounded by opportunistic enemies (e.g. British, French, Spanish). Facing outbreak after outbreak of disease which afflicted Americans in general as well as American soldiers defending the nation. Perhaps the most fearsome of the diseases at the time was smallpox. Smallpox is scarier than coronavirus. It had a higher transmission rate (R0) and fatality rate (CFR). (Thankfully we eradicated smallpox a few decades ago.) Yet, despite all these real and present crises as well as crises waiting to happen, including public health crises, our Founding Fathers were keenly "concerned about constitutional rights".

2. In fairness, the statement could be saying "constitutional rights" aren't even on the table right now. Not that we should be unconcerned about constitutional rights. If so, that's likewise something I don't understand. Why shouldn't constitutional rights be on the table during a public health crisis? If not during a crisis, then when? Only during "normal" times? Perhaps he's alluding to something like Lincoln suspending habeas corpus during the Civil War. If so, it's arguable whether Lincoln should've done that.

Coronavirus public policy

I have no public health expertise (e.g. MPH), I'm just thinking out loud here:

1. As far as public policies go, I think it's a bad idea to have a one-size fits all policy. I think it's better to tailor a policy to certain locales. Some locales might have low risk of coronavirus transmission while others are hot zones of coronavirus. As Steve has pointed out in the past, we should treat like cases alike, but unalike cases unalike.

2. What's more, there'd be less harm to our economy overall if many or most places can keep things "business as usual". For instance, not that I'm necessarily advocating this, but I'm at least using this as an illustration: if only impacted areas in a city shut down, but other areas remain open, then the city could still be productive and our economy less hurt overall vs. the entire city on lockdown.

3. I guess there's a tradeoff between how much we should take preemptive measures vs. how much we should take reactive measures. Perhaps there's no need to take preemptive measures if there's zero evidence of anyone sick with the coronavirus in the area. Perhaps places with no evidence of coronavirus can get ready so if there is eventual evidence of coronavirus in their community, then they can react with speed and purpose.

4. People argue there could be asymptomatic coronavirus carriers walking around in our communities. However, should we take preemptive actions like closing down stores and restaurants for this possibility? Isn't that sort of like worrying there could be a serial killer in one's community, therefore shut down everything, and let's start a man hunt?

Granted, it's an imperfect parallel. For one thing, there (hopefully) aren't many serial killers as a percentage of the population, whereas I've seen high percentages of how many could be asymptomatic carriers. Still, I presume that would more likely cluster rather than be diffused across the entire nation. More likely be nearer to where the outbreaks and hot zones are rather than across the entire country or even regions of the country. At least at this point.

Of course, if the virus has spread across the entire country, then that may call for different strategies. My concern is people are already fearing this without hard evidence of this. My concern is we're getting ahead of ourselves. My concern is that people are acting like there's an asymptomatic carrier hiding behind every tree or bush when that's not entirely clear to me.

5. At most, if we want to take preemptive measures, then why not far less dramatic or drastic preemptive measures? For instance, point-of-care testing at clinics alongside wider surveillance of affected regions. Stuff like that. And otherwise more or less business as usual.