A Tyranny of Averages
The overuse of averages in statistical analysis and decision-making where an average is relatively meaningless due to the shape of data distribution.
There’s a story being spun around the world today. It is epic, riveting, and draws a global audience. Each country is a chapter in this saga. Every doctor, nurse, and healthcare worker are heroes in scenes of dire circumstances, where saving lives and making positive differences in the outcome of suffering patients has become extraordinarily routine. And then there’s an apocryphal documentary that’s evolving daily, too — one that is brimming with bias and saddled with sophistry: This is the story of the story being told.
Social media is a swift brain trust of both exceptional and ordinary people. Anyone who understands where triumph and brilliance blossoms knows that the queer combination of people thinking outside the box is often the catalyst for positive game-changing developments. So we all tolerate, to a degree, the swaggering and swaying of various viewpoints. But we are also quick to suffocate alternative views if there’s a hint of inanity —and if the notions do not comport with our tempered (or ill-tempered) perspective, then it’s cancellation time. Yet this is where our narratives are spun these days. And it does require us to examine what’s happening in a more holistic manner. Because narratives are power.
Too often, people dismiss those who propose opposing views, preferring to have corroboration of their own agenda in an echo chamber of peers. That’s truly unfortunate for the obvious reasons: To attain balance, it is, as they say too often, baked into the American psyche to engage in discourse and debate issues toward a centrist solution. Our system of government is structured to find the fulcrum between our political polar opposites—a bicameral congress, an executive branch checked and balanced with a judiciary. We lean this way and that, depending on the election year one examines; but, mostly, our republic navigates center-left to center-right, sometimes careening, depending on who was last in office. This is why Bernie Sanders doesn’t stand a chance to win as president (at least now, in 2020) — because both sides (and the center) are against him. A nationalized power narrative was waged against Sanders in the last several months (and in the last presidential election). People listen to stories — and we all the more engage in those stories now, in this bold age where everyone is an expert because they have Google at their fingertips.
Beyond the body politic, we turn to the elephant in the room: It is stunning to witness the depth and breadth of commentary over the COVID-19 pandemic — some of it is fencepost didactic, while some of it just hovers over superficiality. But none of it is integrated or assimilated. Reactions range from number-crunching statistics by folks who know their stuff — to misinterpretations of that data — to complete abuse of mathematics to reach ridiculous coronapocalyptic or what-me-worry conclusions. These end points are really simply conjectures that are either forged by the fire of certain data sets or fueled by scandously spun stories from irresponsible reporters.
For every anecdotal story that serves one’s agenda, another can be found to counter it. This is the realm of social media, which drips with a toxic mixture of rational and irrational advice and brims with a bitter brew of breathtaking fear, tinfoil conspiracies, and semi-reliable reporting — all commingled to confuse, rather than defuse panic-prone people. What should someone think when we get information from the President of the United States that he is hopeful about stories brought to his attention regarding the administering of hydroxychloroquine and azithromycin to symptomatic patients?
Reactionaries claim, “Trump has blood on his hands!” and then point to the corroborating story of a man who died from taking chloroquine after the president spoke of the medication as a possible solution. Of course, beyond the headline, the story has details: the man self-medicated (with his wife, who is in critical condition), using a distinctively different version of the chemical chloroquine phosphate that’s used to clean fish tanks. So instead of headlines like, Man poisons himself and wife in effort to kill coronavirus, we get histrionic, anti-Trump, misleading click-bait. This isn’t news, it’s views. Is it any wonder that the president is routinely his own cheerleader-in-chief?
Information pre-existed Trump’s excited pronouncement about chloroquine being a possible game-changer: Sales of the “Aquarium Fish Only” chloroquine phosphate on eBay went from $9.99 in late February to $500 per 25 gram bottle by March 2 — well ahead of the Trump tweets. People conflated the two chemicals with ambiguous headlines from the likes of the New York Post: Fish tank additive could treat coronavirus, studies say and their web headline follow-up, Sales of fish tank additive skyrocket after studies say it could treat coronavirus. Is there logic in the thinking that something good enough to clean a fish tank is good enough for someone’s lungs? People truly need to follow directions and get their doctor to prescribe the chemicals they consume, versus self-medicating with toxic aquarium products. Why does that even have to be stated? This is what happens when people get desperate — they panic-shop, they ingest fish-cleaning products, they lose their sense of common sense.
The Fox News website fuzzed the difference too, leading with the headline, Drug cleared by Trump, FDA for coronavirus testing also found in fish tanks. To be fair, the Fox News piece does discuss the distinction between the chemicals. It also notes the skyrocketing costs of the fish stuff. But for those who only read headlines and move along, it’s misleading at the very least. Fortunately, eBay has policed those selling the aquarium additive from their site.
Conflation of information also contributed to the poisoning of two Nigerians last week, shining a light on just how small of a world we live in thanks to omnimedia. Who isn’t tired of the intellectually-insulting home remedy memes that traffic their way around the internet and social media: Drink bleach to cure coronavirus, bathe in chlorine, ingest colloidal silver, gargle with hot lemon water and vinegar, peel an onion to absorb the virus at your bedside, dry yourself with high heat hair dryers, eat lots of garlic. For the record, none of that works — with the exception of the garlic‚ that does ward off vampires (and possibly vampire bats), but not viruses per se. What also doesn’t work well is heeding advice from felonious televangelist, Jim Bakker, who is being sued by the state of Missouri for peddling his Silver Sol Liquid as a cure for coronavirus. Indeed, misinformation can be potentially lethal.
Conversely, there are happy endings to the narrative of other anecdotal stories: Witness the story of Rio Giardinieri, a man who was resigned to die from coronavirus, and whose close friend provided him information about hydroxychloroquine. Rio told his doctor, who agreed to prescribe it — and he’s now in a hopeful recovery trajectory.
Then there’s the encouraging report of an unblinded clinical trial of 24 patients from the world’s top expert in communicable diseases, Dr. Didier Raoult, Professor of Medicine at Universite d’Aix-Marseille, where he leads the IHU Méditerrannée-Infection. His disclosure confidently boasts of using simple medications to clear coronavirus from patients, including chloroquine’s potential efficacy in the treatment of patients with COVID-19. The branded drug, Plaquenil (hydroxychloroquine), is the synthetic form of quinine. Comorbidity factors must be further examined, as chloroquine was ruled out by a recent European clinical trial due to potentially adverse effects from interactions with medications used to treat chronic health issues in patients. But the so-called Marseille Study, which at this writing is not yet published, was accepted by the European Union Clinical Trials Register on the 5th of March. In that trial, clinicians also combined therapy with azithromycin. The preliminary buzz in the medical community is cautious but optimistic.
Impressive articles have been written which illuminate data and re-purpose charts from the CDC, World Health Organization (WHO), Johns Hopkins, and all places in-between. But the walkaway from all the reports and graphs feels more like an Olympic event: Which country will blunt the curve the most? It’s a competition to see which nation performs socio-economic suppression the best. Then there’s the regional heat, with California looking good. Who needs sports when the international rush to crush the curve is so entertaining?
Few reports pay attention to significant variables that make analyzing data internationally a nearly fruitless exercise of comparing apples to oranges. Few are connecting the dots because they are not applying significant variables to their analyses. Imagine hanging in the middle of a spider’s web, but not seeing any of the radials or threads that create the structure. What we’re missing in the narratives surrounding coronavirus is the plotline — plot is structure. Structure derives from connecting story devices. We’ve got a good hook; we’ve got plenty of exposition, some discovery even; but we don’t have a cohesive story because it’s not crafted together in a coherent manner.
In the past month, there must be thousands of shared posts on social media looking at various data sets, statistics, and charts. But few, if any, pull them all together to create a tapestry of what’s happening. There’s the study about how rising temperatures may very well quell coronavirus by Summertime. There’s the surfaces study on how long coronavirus survives on plastic, paper, and glass. So, based on the headline, we start freaking out about packages arriving from China. Good news: Like people with skin allergies, coronavirus is not so fond of cardboard. Bottom line: When the myriad of studies pile up but aren’t compiled into a matrix or comprehensive overview, people hang on for dear life and slide into one hysterical reaction after another.
The world — and certainly our nation — needs a Department of Synthesis. And from that department, the director holds press conferences and provides us the narrative that we want to hear: The truthful story that has a captivating beginning, middle, and end. Something happens, challenges are overcome, heroes are made, people change for the better, and there’s resoultion that leads into the sunset of hopefulness. By the way, staffed at the Department of Synthesis would be a team of clever, entertaining writers — because we are, after all, creating the definitive national narrative for whatever is the issue du jour. Some governments have this already, in a much cruder form called propaganda. China is great at this — and effective in pushing out a one-for-all storyline, complete with empowering music videos.
When comparing data from China to South Korea or Italy, we must accept certain conditions of those nations: the prism of communism (distortions, denials, disinformation, no information) from China, island sensibilities from South Korea, and the second oldest population in the world from Italy. Factor in the decades-old Silk Road flight routes direct from Wuhan to Tuscany, the heart of the fashion, design, and textile industries, and it’s more revealing why the death rate in Italy is strikingly different from South Korea’s morbidity rate. Further lay data sets about comorbidity factors in Italy with underlying health issues in an aged population where it’s culturally tuned to have middle-aged men living with their mothers — respectfully mingling with their seniors, where smoking habits that have not been broken contribute to lung disease, and where porous European Union (EU) borders allowed for a flow of potentially infected but asymptomatic individuals for weeks, unwittingly spreading the virus throughout the population, undetected. Stay-at-home orders may have been the worst advice — for Italy — and the best advice for China and South Korea.
These variables matter because the course of action taken has a direct impact on the success or failure of a lowering or rising death rate, the control of which is the world’s ultimate objective. Every country, one might say, is cooking the data, as evidenced by the manner in which they account for the number of infection cases and the related death rate. Yet this is the standard utilized by empirical studies. Those charts and graphs we all see—what do they truly mean when so much of the data is inconsistently derived and so many of the variables are missing?
Indeed, this is a dynamic crisis that is proving defiant of simple comparative analysis — especially when the data sets are inconsistent worldwide. Even the sophisticated Imperial model fails to factor in significant variables—but to its credit, it was timely and sounded a blaring alarm in the United States and now the United Kingdom. It’s also dynamic: The early established doomsday scenarios the Imperial model envisaged are now more tempered because of new data from the feet-on-the-street realities. But a newer study from the University of Oxford is out, which challenges the Imperial model from the get-go:
“I am surprised that there has been such unqualified acceptance of the Imperial model,” Sunetra Gupta, the professor of theoretical epidemiology at Oxford, told the Financial Times. The Imperial model predicted that as many as 250,000 Englanders could succumb to the coronavirus if the government merely used suppression techniques to combat it. In the UK, as of this writing, 422 people have died from COIVD-19, while 135 have recovered. Mind your head: don’t be disappointed that the death rate in the UK is much lower than projected. That’s a triumph in-the-making, if the citizens there continue to lay low and the escalation of infection doesn’t convert to an accelerated death rate. In hindsight yet to be seen, it could also be an indication of how far off the modeling was (and admittedly is, since the Imperial College reports are rightly updated to reflect realities). As time will tell, if the curve is minimized after the inflection, it will be attributed to both preliminarily off-modeling and a proactive populace.
Incidentally, Dr. Amy Acton, the Director of the Ohio Department of Health, used the Imperial model to get her estimated 100,000 infected, which is as of this writing, shy by 99,436 of hitting that mark; Ohio has reported 564 infections and 8 deaths. It may also come to pass that Ohio has more than 100,000 infected cases already — with the lionshare resolved without awareness or reporting. Without random sampling, who knows?
In sum, the missing variables of culture, age, geography, policy, existing health conditions, and sociological attitudes haven’t been effectively overlaid onto the data points. We are not South Korea (an ethnically homogeneous island); we are not China (an air-polluted state); we are not Italy (second-oldest population on Earth). Wuhanites, in fact, have been immuno-compromised for years because of significantly poor air quality. As recent as 2019, while the world was riveted to riots in Hong Kong, the citizens of Wuhan were protesting for a breath of fresh air as the threat of another massive incineration facility was threatening their already noxious air. Perhaps the suppressed immune systems of locals in Wuhan contributed to their morbidity — and may serve to explain data discrepancies in other countries of the world.
The U.S. closed out China travel early on, swelled out the restrictions to include Italy, then all of Europe. We stand out quite differently now from other countries in this regard. For that matter, on a state-level, it’s clear that New York is not West Virginia. Density or dispersion? As this crisis ebbs, people may very well ponder their desires to live in purple-martin nests in massive megalopolises. We clearly have some distinctive comorbidity factors, too, compared to other countries (overall lifestyle, air quality, healthcare system, patient advocacy, etc).
In China, patient advocacy is resisting arrest when the police come to take you away “for care.” In the U.S., patient advocacy certainly contributes to compelling doctors to try off-label solutions, versus standard of care. I know this from personal experience with a family member. It makes all the difference in the world. Where would Rio Giardinieri be without having the support of friends to feed him information — beyond what healthcare providers knew or were doing for him? These story-by-story cases make a difference when looking at the full picture of what’s happening. When we do not examine the full narrative of a crisis and the motivations of its storytellers, we end up with panic-purchasing and online hysteria.
I watched the coronavirus story evolve from China, via their social media (WeChat and Weibo) and reconnaissance from our business clients (who are based in Italy, China, and Hong Kong). I was receiving anecdotal information on a daily basis about life in China and Hong Kong as the narrative of this virus matured and mutated across the globe. Of course, the information flow is monitored, so the insights are tempered. But plenty disturbing info leaked out anonymously via social media. I experienced the sigh of relief via email when factories in China went back to work and were at 80% capacity several weeks ago. I saw this as our future, if we did the basic hunker-down and distancing that has been prescribed by the CDC and the whole of our government (as they did in China with a more totalitarian approach). It’s now all about patience — something Americans have in short supply. It’s also about keeping an open mind — thinking beyond the talking points — because that’s where the answers are.
We seek easy answers to complex problems — because our brains love symmetry and linear narratives. Governments know this very well — and with the tool of social media, they exploit storylines to support various agendas — because we will gladly consume them to provide ourselves with the satisfaction that we know what’s going on.
China has mastered narrative power and they play it out like a chess game to influence international politics. Did China create the virus — or did the U.S. create the virus? Or did both? Intentionally or inadvertently? Did Trump use the term “China Virus” because he’s a racist? Or did he counter-punch because China played our media? How about Spanish Flu? Or German Measles? It’s shaky grounds at best, unless you come from the side of the argument that accepts years of stories about how xenophobic the president is. And in the same breath, it’s a silly argument if you’re a minority and have benefitted from his policies.
What about that virus, though!? Should the Chinese stop eating bats, based upon the 2007 study that found evolutionary relationships between bats and coronaviruses? (Honestly, I’m married into the best Chinese family — none of them eat bats, even the ones from small villages — the family, not the bats. They were more disturbed by me when I sampled spicy tarantula from a street vendor in Wuhan). Many of the crazy questions are fueled by our visible enemies — the countries who are also our trading partners. I know — weird. It’s the way of the world. What if COVID-19 isn’t zoonotic? A bioweapon to destroy the America First agenda? Sounds so… conspiratorial. But it’s also in the realm of possibilities. Do we trust the World Health Organization? Without question, the W.H.O. is comprised of a curious cocktail of characters.
Also a way of the world — panic-purchasing. Few episodes in the saga of the coronavirus pandemic are as richly human as the tales of people lunging for the last roll of toilet paper. We have friends and family in England, Germany, Singapore, and Macao who claim the toilet paper thing is international. Talk about going viral. Please, go easy on the sanitizer and paper products. Creating a demand for this stuff only forces at-risk groups to visit more stores and hunt for their necessities, exposing themselves to possible infection, because too many people panicked from hyperbolic journalism, thus created a hoarding phenomenon. Be Sheryl Crow — introduce a one sheet per potty visit policy.
The first scent of a run on goods came at a visit to Costco last month, where I discovered empty boxes in all areas of the refrigeration sections, including the faux-butter product, Country Crock. Even during a real end of world story, that just shouldn’t happen. I’m not a consumer of Country Crock, so I wasn’t bothered by its unavailability. But I was disturbed because it glared out at me as emblematic of things to come. Nothing good will come from buying up all the Country Crock.
Just as the world is in wild search for toilet paper, the phenomenon has extended to hospitals and jurisdictions in desperate search for personal protective equipment (PPE) and ventilators. Before the crisis-level of COVID-19 hit America, several months earlier, U.S. firms and non-profit organizations provided med-materiel to China to help combat its fight against the deadly virus. Our government assisted in clearing the way for donated FedEx shipments to ensure humanitarian aid would not be hindered. Our country’s beneficence is now a political hot potato, given our internal demands for the same supplies and equipment. The four star charity, Direct Relief, provided a statement on the shipment of PPE provisions to China back in February:
“Direct Relief maintains an emergency stockpile and, whenever possible, prepositions emergency caches of essentials that are likely to be needed immediately and can help avert or reduce the health effects of an emergency situation. While responding to the COVID-19 outbreak in China, and seeing the rapid-onset shortages of PPE, treatment capacity, and unprecedented quarantines, Direct Relief reserved stocks and immediately began preparing for the expected arrival of the virus in the U.S., which has since occurred.
“The organization has been working with public agencies and nonprofit safety-net partners and initiated deliveries of PPE to protect health workers as the first cases were discovered. Direct Relief is continuing that effort, keenly aware that its stocks were limited and resupply is challenged by the global spike and production backlog.”
Now China is reciprocating the favor with 22 flights scheduled to bring tonnage of PPE to the United States — an initiative launched by a public-private partnership put together by Trump’s senior adviser and son-in-law, Jared Kushner. Major health care distributors like McKesson Corporation, Cardinal Health, Owens & Minor, Medline and Henry Schein are participating in the project. It’s the ol’ give and take.
There are typically at least two sides to a story. We’ve all seen reports about price-gouging-profiteers selling masks and other personal protective equipment at over-market prices — conversely, have you seen the Chinese Good Samaritan who delivered face masks to police in Anhui Province? Let’s also not miss out on the irony that the hub city for manufacturing surgical grade medical masks is in Wuhan — and they supply 48% of such PPE to the United States! Narratives — they are powerful things, especially in the wrong hands. So we must be careful what we profess as truth — and we must recognize shades of truth, so we can be a little more reasonable to one another.
We have a thirst for answers. The internet promises us answers to everything! Just search and find. So we delve in to find it, imagine it, create it, shape it. Physiologically, there is a link between hunger and hysteria—starvation leads to depression, hypochondriasis, and other anxiety disorders. When the brain feels deprived of thoughtful connections, it, too, suffers. We experience insomnia, which drives the brain to cannibalize its own synapses. We grow agitated—we tweet, we lash out with invectives, we berate friends and friends of friends; we become unhinged. That’s the online world of social media, when we seek answers and other truth-mongers get in our way with their idiotic thoughts! But—aha! Those people aren’t mindless. They’re seeking answers, too. You are in the way!
We teeter between under- and overreaction because of uncertainty, incited by manic media, political distrust, and biased intuition. Top it off with the cherry of rapidly shifting focus, more bombastic headlines, more sensationalized information, more malignant misinformation, and our instincts dare to crave even more response from our government. As Anthony Newly would say, “Stop the world, I want to get off!” In all the whirlwind and breathlessness of wanting answers, we demand more from our leaders because more is the only thing that makes sense — which, not so coincidentally, feeds and justifies the very existence of a government that wants to grow into an ever-looming Leviathan.
In fact, in the world of the media, every one of our administration’s responses is seemngly wrong because in each instance it is either too much or not enough. The decision—any decision—is either too soon or too late — never just right. Add to that the obvious divisiveness of the country and we get charges of xenophobia on one side to the travel restrictions for China, while on the other side, hails to the chief for Trump’s brilliant move to close-off travel from a country hot with infection. Try to fix the economic pitfalls congressionally and it’s either too much or not enough money being spent. Get parts of America back to work by hinting at a regional relaxation of restraints—which should be better positioned as a hopeful light at the end of the proverbial tunnel—and half the country believes the president is a killer. Where does all this lead? To another episode of Beat the Press, where Trump punches back to every provocative pundit posing as a journalist. (Note that the link to the faux-show, Beat the Press, is a video excerpt put together by CGTN, which is partially-funded by the Chinese central government). They love showcasing our division. Wonder why….
It is stunning that media prefer to be mass hysteria merchants who constantly entertain with rhetoric that widens into an existential vacuum. You can’t win in a game that has no apparent rules. But, nonetheless, the press is keeping score. Meanwhile, across the Pacific pond, China, in one fell swoop, quarantined hundreds of millions of people and shut down any discussion about it. Now they taunt American efforts with social media trolling that mocks our open society. Because we’re all free to think as we will, we fall for stories about the coronavirus being bio-engineered by the U.S. Army and CIA. China, incidentally, loves that we debate this issue.
But we should all be grateful that the coronavirus outbreak happened in China: no other country on the face of the Earth could so systematically and effectively quarantine individual cities with populations in the tens of millions. China is like a hitman—you know he’s there if you need him to do the thing you don’t have the guts to do. Even though the virus originated in China, the world owes China a depth of gratitude for containing it as well as they did, despite possible denials early on. China, in our evolving story, is both the villain and the hero, the architect and the demolisher.
China also effectively used their pervasive surveillance apparatus to monitor their citizens. Thermal scans for people walking about with fevers during the day led to arrests in the dead of night (or so their fragile social media posts indicated). Some of the tales of infected people running from some Orwellian medical-police force have been debunked — some have not. While the West may shudder at this thought, the Chinese are proud of it—it saved lives! The point is that the surveillance systems worked—and just as we surrendered some of our freedoms after 911 with the ironically named Patriot Act, coming soon to a united state near you— a similar system deployed on street corners of every metropolis, in the name of public safety, welfare, and health. Think this is science fantasy? There’s a system already in use in Austin—that’s in Texas, one of the united states — the blue part of a red state. “We don’t like the word ‘surveillance,’” says Lisa Falzone, CEO of Athena Security, the company behind the technology.
But there is hope with our national rhetoric. On March 23, 2020, Dr. Deborah Birx, Response Coordinator for the White House Coronavirus Task Force — you know, the lady of stature and maternal fashion scarf icon of America — touched upon this phenomenon of how the data sets work, during a marathon White House presser of the Coronavirus Task Force that lasted an astounding 1 hour and 50 minutes. Dr. Birx is an impressive presence for some: she does not cotton to wild assumptions that desperately try to connect the dots; neither will she have false analogies in her presentations — and, most importantly, she doesn’t bend to those who use them. She correctly avoids comparisons of COVID-19 with influenza or deaths on the freeway. Beyond her bureaucratic bravado, her discourse is far more riveting than any of the doctors on the task force, including recent facepalming immunologist, Dr. Tony Fauci, who clearly has difficulty with parsing our president and staying politically neutral. The man is a contradictory curmudgeon. Meanwhile, Dr. Birx said, unscripted, on live television:
”I will never speculate on data. The mortality rate is driven, almost exclusively, as we have talked about, by people with pre-existing conditions and older. The estimate in Wuhan originally — it was over 3%. When they look outside of Wuhan it was about .7%. [point 7, emphasized] It depends very much — in South Korea, it was about .7 — .8%. But that’s like a tyranny of averages. That’s probably missing 50–60% of the data because no one was testing asymptomatics…. We’re making case fatality rates when we’re missing a significant part of the data. If anything, it will go lower. But that should not be reassuring because the death rates escalate with age and pre-existing conditions. I want to be clear: although it may be very low if you’re under 40, or very low if you’re under 50, or very low if you’re under 70, there is an inflection curve: The average age of the persons dying in Italy is in the mid 80s. There is really a significant issue in our older generation that we feel strongly about protecting.”
Trump chimed in: “What you do know are all the people who are very sick.” A simple statement that has layers of dimensionality embedded in it, wittingly or not. It is the very essence of why people are confounded by all the charts and stats they see in their social media feeds, where Uncle Joe is suddenly an expert virologist or Aunt Suzy is the most qualified statistician. Who knew?!
Dr. Birx went on to elaborate: “The question about the antibody test was so critical because that will give us really a much better baseline to really understand.”
In theory, that’s exactly spot-on: if any test should be given across the span of America, it’s the serological test. That — or random testing — are the most efficient ways to determine where we are in this fight and would give us far more than the snapshots we’ve been getting with partial data sets. It would give us a panoramic view! But, don’t get your hopes up too high: that test is considered accurate only 50% of the time.
Many believe that the coronavirus has already swept through the country: Anecdotally, I’ve read countless reports, including having direct family experiences, with classic coronavirus symptoms expressed over the past two months here in California, and in Massachusetts and New York, where we traveled prior to the specter of the officially rising curve of corona. Thousands of people traveled between Wuhan, Hubei, Shanghai, and Beijing in December of 2019 and January 2020, before any official government reaction, restriction, or policy. It takes one passenger 16 hours to get from Wuhan to Los Angeles. Is it possible there’s a level of herd immunity already present in the population of California? Time will tell. These are bicoastal stories — but, again, they are merely evolving narratives. So who ya gonna believe? China and the media?
Late in the press conference, when asked if talk about re-opening the government quickly undermines the vigilance we’re presently engaged in with social distancing and teleworking (or not working at all), Dr. Birx easily responded:
“Actually, it should reinforce it. If people know that we’re considering and trying to understand the impact of the good work that they have done, I think it reinforces them to do good work….
It says to them: we’re looking very carefully at the impact that the work that you did, the selflessness that you brought to this, the ability to stay home with your fabulous children, your ability to social distance, the ability to give up on going to restaurants and just having take-out, all of those sacrifices, the ability of your protecting your elder generation — the Greatest Generation — and making sure they’re safe in nursing homes but not seeing them. All of us have made sacrifices. I haven’t seen my grandchildren in 3 weeks. I know other people are like that — that they have really made those personal sacrifices. What we’re asking every American to do is to make those personal sacrifices for the next week and now, so that we can evaluate the impact of that sacrifice. So I think if anything, it strengthens the willpower to say, ‘Yes, I can do this.’”
Bless the soul of anyone who speaks spontaneously with parallel construction.
We are all in response mode, nation-to-nation. As this pandemic settles out, we will learn much — and it will be critical to examine how we got to where we are and where we were. Did China hide information? Oh, come on. Of course they did. The answer is in the question: China! Were they upfront as the W.H.O. claims? Uh, really? These are debates for all of us to have — and social media will be there, 24/7, with all of its bizarre connections, inconsistencies, and likewise, semi-valuable information. Our best foot forward will be to move as a united force: challenge, believe, engage, and listen. By listening, we will come to a better understanding of the nuances of how these crises work — the geo-political implications, the personal consequences — all factors that should be viewed, reviewed, tested, and analyzed thoroughly. This epic story is still being written. As we each play our part in defeating the scourge, let’s not ruin the ending.
In a world where media is truncated to tantatilizing tweets, snappy sound bites, and pithy posts, it’s every citizens responsibility to check their sources and challenge the data — all of it, not just the points that prove your agenda. Honestly, some of the doctors on television must be demigods to have to patiently explain and expound upon the voluminous number of presumptions and postulations that are fomented by an often out-of-control media (and their own colleagues). That Fauci’s inconsistencies have to be spun is an immense problem. Beyond the sensational gotcha headlines, perhaps it’s time we all start treating one another and ourselves as humans, too. We all make mistakes — even Dr. Fauci. If only he had less hubris to admit his contrarian presentations. To mask or not to mask — that is the question!
Maybe, just maybe, the enemy is invisible — it’s our narrow-mindedness for opposing views. What would happen if we started waking up from being woke — and realized that the invisible enemy is intolerance? And further, open our minds to nuance and subtlety. The world, for goodness sake, is not black and white. This failure to see dimensionality is where all the hysteria originates in the way people process the problems of the day. Essayist and noted New York Intellectual, Lionel Trilling, wrote of the conservative movement in the Fifties that it does not express itself in ideas, but rather in “irritable mental gestures which seek to resemble ideas.” Sound familiar? And seventy years later, here we are, all pitched up and partisan, with some leaders idolizing science . Many of our scientists have relied and resorted to more postulation and punditry — while the world yearns for more inquiry, challenge, and probity. Perhaps our scientists should embrace deployment of the ol’ scientific method — with less shunning to sabotage for a political agenda.
One story that should sound very familiar to us at this time is Easter—the story of the ultimate sacrifice, followed by Resurrection. Let’s embrace the message behind the story of Easter: That sacrifice is followed by redemption and rewarded with eternal hope. For the secular side, it’s Spring! Perhaps we can blossom together as a nation with a renewed covenant—reaffirm our social contract to not only get along, but support one another. Yeah, that’s not gonna happen.
While it’s possible, it’s probably improbable that our global tale will not have a denouement from netizens sharing sensational headlines. Those actions are factored in to the exposition portion of our story, to build drama and suspense. I may be wrong, but I’m pretty confident that the resolution to this crisis doesn’t come from people clicking on articles, comparing graphs, and sharing fear in a mass hysteria outbreak that rivals St. Vitus’ dance. The falling action of this tragic story comes from the scientists, researchers, and front line medical professionals who discover medications with efficacy and a well-tuned vaccine. Vaccinations and time — those are the two factors that will soften us to moving on with life. One day soon, we will all be able to see one another smile. Just like how the Spanish Flu pandemic of 1918 became the opening act for the Roaring Twenties, we have a lot of decade left in us.
So let’s see where we are after several weeks. Discussions about whether we as a nation experience a recession or depression are bootless until we have more data: Perhaps a better serological test or random testing will ensue over the coming weeks that will better inform our decisions on when to return to normalcy.
In the meantime, let’s keep protecting the vulnerable: those over 60—yes, young ones, protect me! Protect anyone with underlying health issues that are especially respiratory-linked — let’s certainly continue practicing social distancing, with an eye on helping the elderly from afar.
As a closet anti-social creature, I’m rather enjoying this time (though we’re as busy as ever with development work happening in China). Family time: Binge-watching Star Trek: Picard, Curb Your Enthusiasm, The Prisoner; dusting off board games (Pandemic, of course, and bards dispense profanity have proven great games to play with only three people); trying out new recipes; praying the curve down; waving at neighbors but not getting so close that they ask to borrow some butter—these are good times! Cherish the memories being made. This is the event of the century that defines this generation. As it is currently being written, we have the power of choosing an apropos title: Is it Fiascorona? Or something more monumental like The Great Suppression?
The Greatest Generation rose to the occasion when called to fight the Nazis. This generation boo-hoos about not being able to walk at their graduation and missing out on Spring Break. Okay—an unfair comparison; I have hope they will do great deeds during this time. Because it’s important to make this story great, from beginning to end. And let’s not count on there being a sequel. An audience doesn’t ask for more from a truly terrific film: Citizen Kane is good enough. We don’t need Citizen Kane: Rosebud’s Revenge.
Finally, let’s follow a new Golden Rule: Never take averages across groups who are very different. Because it is skewy and screwy — and it compels people to jump to conclusions that are often virtually baseless and at best mere conjectures. Then let’s determine a course of action based upon not only partial and emergent statistics, but common sense, better top-and-down data, and a united front in the fight to destroy the “invisible enemy,” which, speaking of entertaining narratives, also happens to be the title of one of my favorite episodes of The Outer Limits.
“Without contraries is no progression.”
— William Blake, from The Marriage of Heaven and Hell
Addendum: Since posting this piece, Dr. Birx has noted that there is no off-the-shelf approach in how to best handle this crisis. She spoke about the granularity of solutions —that each country, each region, each state, each community must adopt policies, then adapt and modify based upon emerging realities. These are her most recent statements, made after this article was first posted:
“When I talk to you about how we are, we’ve done some things that are very horizontal across the country, but we’re collecting data now in a county-by-county, granular way.
“So it’s like any epidemic; it’s not equal everywhere. There are places that are very spared and there’s places where there’s more. We have a very vast country with a lot of capacity and a lot of infrastructure.
“And so, looking very specifically about where the virus has been, where is it going, who’s got freed up resources from where it has been — because it didn’t hit all — it hit Washington State earlier than it hit New York — and looking at all of those pieces to really ensure how we can innovatively move equipment around based on the need.
“And so, I know that it has become a place where people are looking at numbers rather than what is needed. Because if you do these projections, when you got to those projections that said — like in Germany and others, that implied that 60 percent or 50 percent of the population would get infected — the — I want to be very clear, the only way that happens is if this virus remains continuously moving through populations in this cycle, in the fall cycle, and another cycle. So that’s through three cycles with nothing being done.
“And so we’re dealing with Cycle A right now, not the one that could come in the fall of 2020 — although we’re getting prepared for it by the innovations that are being worked on — and not the 2021. We’re really dealing with the here and now, while we’re planning for the future. And I think the numbers that have been put out there are actually very frightening to people.
“But I can tell you, if you go back and look at Wuhan and Hubei and all of these provinces, when they talk about 60,000 people being infected, even if you said, “Oh, right. Well, there is asymptomatics and all of that” — so you get to 600,000 people out of 80 million. That is nowhere close to the numbers that you see people putting out there. I think it has frightened the American people.
“Finally, the situation about ventilators, we were reassured in a meeting with our colleagues in New York that there are still ICU beds remaining, and there are still, significant, over a thousand or two thousand ventilators that have not been utilized yet.
“Please, for the reassurance for the people around the world, to wake up this morning and look at people talking about creating DNR situations, do-not-resuscitate situations for patients, there is no situation in the United States right now that warrants that kind of discussion.”
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“Those who have a ‘why’ to live, can bear with almost any ‘how’.”
― Viktor E. Frankl, Man’s Search for Meaning