Interesting Times

No doubt you’ve heard of the ancient Chinese curse “may you live in interesting times.” It’s a legend, of course, and no such statement exists in Chinese; the closest aphorism is something about it being better for dogs in routine times than for humans in changing times. The saying remains popular despite its lack of provenance (it appears in 1930s England) because it rings true. All change is hard; great change is phenomenally difficult.

Seems like we do live in interesting times. Of late, we’ve had protest and riot coming on the heels of plague and economic collapse, following populism and climate change and financial disaster, which was preceded by accelerating technological advance and geopolitical change. Phew!

Some Christian sects constantly survey the news for signs of the impending End Times, and these days they have plenty of ammunition. Actually, they always have. There is a constant historical theme of how important and decisive today’s events are. What first-person histories we have contain comments by people great and small about how amazing it was to live through, well, any period of history. And from the standpoint of the individuals involved, it was all true: it was incredible (to them) to live through the era they did. Judgment Day remains scheduled for mañana.

This notion rises to its zenith in Presentism, a philosophical mistake that emphasizes things now at the expense of things past. It shows up when people treat current events as unprecedented, current fads as enduring or inevitable, and evaluate history using current standards. Presentism requires a unique combination of lack of historical knowledge and collective egotism. We’re witnessing an amazing peak of Presentism today.

I’ve seen claims we’re on the verge of a fascist takeover of the United States. Some cite secret conspiracies about vaccines, chips, or tracking apps. Several have quoted my favorite bomb-thrower, Thomas Paine, to the extent that “these are the times that try men’s souls” and call for action! Presidential abuse of power, crime, protest, anti-semitism, racial violence (especially by the police), and technological change are peaking. Except that they aren’t. Some are increasing, others stagnant or decreasing. Plus ça change . . .

Looks like a right reasonable chap, what?

Thomas Paine may be the ideal (if ironic) icon for our times. Paine was a failed English businessman who, at the suggestion of Benjamin Franklin, avoided debtor’s prison by emigrating to the colonies. His signature writing style was a clever mix of diatribe and well-turned phrases, making him easily the most followed writer during the American Revolution. His fellow revolutionaries (and historians since) credit his tracts, especially “Common Sense” with being the fuel that ignited the larger movement.

As it turns out, Thomas was a one-note wonder. His bombast was always stuck on “high” and he inevitably destroyed friendships with shrill accusations. He moved to Paris during the French Revolution, cheering it on as it went from LibertĂ©, EgalitĂ©, et FraternitĂ© to guillotine, garrote, and grotesquery. He was saved from execution only by the happy coincidence of a jailor’s misplaced mark on his cell door, and the impending turn of the tide against Robespierre, the architect of his imprisonment. He remained an ardent fan of the cause.

Paine ended up safely back in the States, but turned his ire on the one icon above reproach: George Washington. Paine accused Washington of hypocrisy, treachery, and vainglory, doing no damage to Washington’s legacy but cementing Paine’s reputation as a bitter polemicist. He died separated from his former friends, practically unmourned. When an English admirer later disinterred his remains for more honorable reburial in England, the remains were lost.

Thomas Paine was a wicked good writer, and many of his ideas about freedom and equality were as stirring as they were ahead of his time. Yet he couldn’t brook disagreement, viewed compromise as surrender, and saw excess as pure zeal. If atheists named patron saints, he’d be the patron saint of Twitter, if not social media writ large. Somehow, he was right about the revolution, but wrong about so much more.

Truth, Belief, Action (III)

In the first two posts, we considered truth versus narrative and the power of beliefs to propel either good or bad behavior. Now is the time for Action!

Peaceful protest is good, even when it’s wrong. What do I mean by wrong? Remember, there is objective truth, and sometimes people get worked up about something that isn’t right or true. Even in that case, protest is good. Peaceful protest is putting one’s belief into action, and that is the right thing to do. I respect people who go out, get together, and make their voices heard. Not with a #hastag, not with a social media frame, with their time, blood, sweat, and tears. If you really believe in something, put away your phone and join in. If you’re a bandwagon fan, re-tweet. #virtuesignalling. That is to say, joining an online campaign is a lukewarm action: it is ok for supporting mass-transit, unacceptably lame for fighting violence or racism. Serious issues demand serious responses. Twitter is lame.

How should we protest? I suggest all protests must be peaceful, proportionate, and purposeful. This is not an original idea: you’ll notice I have borrowed conceptually from from St. Augustine’s Just War theory here. Peaceful is non-negotiable: our right under the First Amendment of the US Constitution is protected ONLY when done “peaceably.” ((The exception often voiced about armed resistance is exactly that: an exception, in that it is no longer protest, it is revolt. This is why I often chide my friends about making broad generalizations today about totalitarianism or comparisons to Nazi Germany. If you make these, and really believe it, you are morally required to take up arms (unless, of course, you’re a pacifist). Failure to act in the face of enormity is morally suspect, so be careful with sweeping generalizations. Sorry for the long aside. Back to the principles of protest.))

Peaceful, yes, but also proportionate and purposeful. Proportionate relates to the size and type: one doesn’t set oneself on fire because of an unjust parking ticket. Thousands don’t paralyze a city over determining trash collection days. Purposeful refers to the target of the protest being the correct one: if your beef is with the police, it is improper to protest at the fire department. ((Two asides in one post? Mea culpa!! I believe that Colin Kaepernick’s kneeling protest fails in this regard. It is peaceful and proportionate, but the National Anthem is neither the root nor cause of local police violence, so his effort is misdirected. I understand that he feels his views garner more coverage by protesting a national symbol in a mass communications event, but what that also does is invite unnecessary controversy. More importantly, when you decide to re-target your protest to gain maximum publicity, you start down the proverbial slippery slope: why not peacefully jam 911 lines to make your point?))

Violent protest, like violence in general, is evil. It is not understandable, or justified, or necessary, all terms I have heard used to describe what is happening in the States recently. What we need is not violent protest, but protest against violence. I contend that America’s basic issue is not racism, but violence: we have a violence problem.

It’s not an original thought. Back in the 60’s, an activist then-named H. Rap Brown rejected Dr. King’s non-violent approach, and espoused black violence with the slogan “violence is as American as cherry pie.” I think he was right for all the wrong reasons.

It wasn’t racism when a veritable rainbow coalition of police officers murdered George Floyd. It wasn’t racism when a line of white riot cops knocked down and rendered unconscious an old white pacifist. It wasn’t racism when a slew of federal agencies cleared peaceful protestors out of a public park with pepper spray. It wasn’t racism when someone decided to try to execute two black cops in New York City. It wasn’t racism when people of color and pasty white suburban dudes looted stores together. It’s violence.

Think about it. Other cultures remark on America’s tendency to violence and it does stand out. We relish American football when it is at its most violent. When we play what the rest of the world calls football, they criticize us as unskilled and “too physical.” Our heroes are most often men of action who stand up and fight, often viciously. Take that tendency to violence and a constitutional right to bear arms and what do you get? More gun violence than anywhere else, including other nations that are heavily armed. More armed robberies and violent assaults. More road rage. People fighting over sales in stores. People screaming at diners in restaurants. Violence.

Solutions?

Let’s start with the problem du jour: not police racism, but police violence. Demilitarize the police. They have added ever-more elaborate weapons and riot control gear at the same time the crime rate has plummeted. Go back to community policing, which puts cops on the streets not looking to pad statistics but in a non-adversarial role. Camden, New Jersey, did this with solid results. In what moral order is a choke hold still a police policy option? Pass rules requiring officers to intervene immediately in the case of active violations by fellow officers. Require training for recruits coming from a military background on the differences between the two cultures. Don’t bust up police unions, but perhaps make them liable for on-duty crimes committed by their members, thus turning the blue wall of silence into a self-policing community. And for God’s sake, stop the “defund police” nonsense. People who were screaming about the President’s defunding of WHO during a pandemic are calling for defunding the police during riots? Can we be intellectually consistent for a few moments here?

Protestors? Peaceful, Proportionate, Purposeful. Immediately turn in anyone fomenting violence (which has sometimes happened recently, but nowhere near enough). And no more quick bail/dropped charges: violate the order and go into lock up and face full prosecution (remember, this would only apply to those inciting or committing violence). It would be nice if the slogans protestors used bore some relation to the truth, since the slogans tend to become part of a narrative, and I think I showed how dangerous false narratives can be.

Government? Spend more effort on stopping violence and less on the motives of the violent. I don’t care whether Officer Chauvin was a racist or not: he needs to be tried (and convicted) of murder. I don’t care whether the people throwing Molotov cocktails or looting stores are animal liberationists, boogaloo boys, or anarchists: charge and convict them for their actions. In general, government at all levels should seek de-escalation during protests. This isn’t even 1968, let alone Shay’s Rebellion. Leave the Insurrection Act for when it is needed. It is not needed today.

Citizens? Be active. Protest if it really means something to you. I disagreed with the gun-toters protesting CoVid19 restrictions a few weeks past, but they were peaceful, proportionate, and purposeful: have at it! Police your fellow protestors. Just make sure you’ve done your homework (find the truth, not the narrative) and you always approach your effort from love. What about the “we’re really facing evil this time, it’s different” claim? Check your narrative bias. The civil rights movement faced an entrenched system of racism backed by dogs, guns, and fire hoses. It won by facing all this hate and violence with love, cementing support from Americans who couldn’t stand to be on the other side any longer. Think it’s worse today? Where’s that data? Is it worse today than in 1852? I’ll give the last word* to Harriet Beecher Stowe, who ended Uncle Tom’s Cabin thusly:

There is one thing that every individual can do,—they can see to it that they feel right. An atmosphere of sympathetic influence encircles every human being; and the man or woman who feels strongly, healthily and justly, on the great interests of humanity, is a constant benefactor to the human race. See, then to your sympathies in this matter! Are they in harmony with the sympathies of Christ? Or are they swayed and perverted by the sophistries of worldly policy?

* This quote was brought to my attention by Dale M. Coulter in a recent First Things essay. Lincoln allegedly said to Stowe “so you are the little woman who wrote the book that started this great war.”

PS. If you think I am overstating the danger of narrative, consider this: Uncle Tom, the protagonist of Ms. Stowe’s masterpiece, is a hero. He is a model of quiet dignity and refusal to respond with violence to violence. In the book, his example even elicits grudging admiration from his slave masters. In the world of the 19th century, his example won over countless people who previously were on the fence about slavery. During the civil rights movement, those espousing violence started a narrative that such a peaceful response to evil was a cop-out, and turned the character’s name into an epithet, which is what it is to this day.

Truth, Belief, Action (II)

In part I we focused on truth versus narrative. Now, let’s turn to belief.

Beliefs can be profound or casual. Let’s focus on deeply-held beliefs here. The casual ones will come up again in Part III, about Action. Suffice it to say you can always tell the difference. To borrow a sports analogy, if someone says they are a fan of a team, but they don’t watch the team, attend games, or know the players, they aren’t much of a fan: they have a casual belief in the team. They’re known as bandwagon fans; nobody likes bandwagon fans.

Our beliefs (in general) come from our experiences. You can be given a belief system (say from your parents), but if your experiences don’t confirm that system, you will reject it. Belief can become a powerful force, shaping how we view future experiences, and thus creating a vicious cycle: we see only what we want to see. A police officer who arrests criminals all day starts to see criminals everywhere, not fellow citizens. A young black man constantly told he will be mistreated by the police might act rashly when confronted by officers, providing the excuse for that mistreatment. You can find evidence of this daily. A President who sees any criticism as a personal attack becomes unable or unwilling to admit a mistake, however trivial.

Yet belief can also be the force for a virtuous cycle: ignoring the harmful, rejecting the hateful, and focusing always on the good, which then elicits a positive outcome . . . in the fullness of time. It was the Reverend Dr. Martin Luther King Jr’s nonviolence which eventually won the day; it was he who said “I believe that unarmed truth and unconditional love will have the final word in reality.” This emphasis on non-violence and love works because it is in accord with the truth. Violence may make progress in the short run, and hatred or rage may feel good for a sort period of time, but in the end, they are futile.

Nobody’s right, if everybody’s wrong

Some people believe that the American system is inherently racist. Some people believe that American police forces are racist. These beliefs stem from a experiences that, while real, are not true. Data deny them. I have lived in three countries, studied and visited many more. Every one which with I am familiar has a problem with racism. I endured lectures from my European friends about the racism of Americans only until their sisters were dating black US GIs. Sweden was a progressive racial utopia until it admitted dissimilar refugees. The Soviet Union? Read about the experience of African communists there. Asia? Perhaps the most brutally racist area of all, although many times its racism hides behind a polite smile. Mexico? Check out the furor over last year’s indigenous star of the movie Roma.

I am not arguing American racism is an illusion; rather, it is inherent in the human condition. We have a natural experiment in history to help understand this. The Republic of South Africa was the one country in modern times to believe in and enact a policy of state-sanctioned racism: apartheid. From this, we know what an inherently racist system looks like. A black RSA President was impossible to fathom under apartheid. Black athletes, black cultural stars, black academics, black professionals, black leaders: unlikely. All things modern America has enjoyed. Understanding the role racism plays–as a universal problem–is key to the way forward.

Likewise, those who see any criticism, any protest, any resistance to the current administration or the American system as unjustified, un-American, or treasonous are also wrong. They clutch at unfair criticism–which there is plenty–and reject all criticism. The MAGA crowd, the press, and the President have something in common: they believe it is all about Trump. It’s not. And we can’t get to the root of the problem until we get past that misapprehension.

Like Dr. King, I am not arguing for passive acceptance, or standing by idly and waiting for change. I am arguing that in order to make change, you must first accept truth, remove the blinders of your narrative, and love one another, unconditionally. Any other approach will end with more fear, more hatred, and more recriminations and revenge. That sets the stage for Action, my final post in this series, tomorrow.

Truth, Belief, Action (I)

There is so much emotion out there right now: pain, hate, fear & loathing. As a friend recently reminded me, catharsis has its use. If there is a time for all things (Ecclesiastes 3:1-8), then there is a time for rage, too. But then, too, “let us stop talking falsely now, the hour’s getting late.” (Jimi Hendrix, All Along the Watchtower)

When the dust settles and the smoke clears, we must put down our signs, our bricks and bottles, our tear gas and shields, and reason once again. In the end, there are truth, belief, and action; the first of these is truth.

Truth matters. There is only one truth, not your truth or my truth. We each have experiences which can be (in fact, always are) different. But there is objective truth. The truth is that a man was apprehended, then needlessly and intentionally murdered. Another truth is that thousands of people of all races and nations are so upset by this fact that they are peacefully protesting. A third truth is that a not insignificant number of people joining the protests are then fomenting violence, ending in destruction of property, looting, and violence to both police and innocent bystanders.

The problems start when we stop worrying about truth and start considering the term in vogue today: narrative. We used to call this a meta-story, or spin, or even propaganda. Narrative places truth at the service of a larger idea. This idea then colors how we understand the truth, sometimes directly undermining it. Which is dangerous.

How does it work?

If you’re a progressive, your narrative includes the ideas that the American system is fundamentally racist, that blind justice is not justice at all, that the system is rigged against minorities. The murder of George Floyd typifies an epidemic of police violence against African-Americans, the arrests at protests the willful authoritarianism of the American police state. Looting is the act of clandestine cells of Boogaloo boys or the understandable outrage boiling over after centuries of mistreatment and marginalization.

If you sport a MAGA hat, the suspect was a defrauder. You scan his autopsy for the tell-tale signs of alcohol or drugs and presume he resisted arrest. The protests are either the beginning of a race war or a carefully-staged provocation funded and organized by George Soros to undermine the President’s re-election. AntiFa is the cause of violence; looting is what bad people always do, given the opportunity.

Exaggerations? Hardly! I would provide links to these views, but then I don’t want to encourage their spread. But they are legion. You may have visited a site espousing them.

How do such narratives undermine the truth? Mr. Floyd was only a suspect–not a criminal–there is no evidence he ever resisted anything except to beg to be allowed to breathe. If you want to check the data on police violence, the Washington Post and The Guardian have the best data sets: but you won’t find evidence to support an epidemic against minorities. Believe it or not, the numbers haven’t increased for years. As to the protests, most were peaceful, and while no one doubts outside instigators were behind some of the violence, there is no evidence of a vast, coordinated conspiracy. As it happens, there was violence at protests long before the Boogaloo movement or AntiFa existed. It happens when masses of emotional people get together.

The Boston Massacre: without AntiFa or the Boogaloo boys, yet violence ensued!

What both sides get wrong is their reliance on narrative in place of truth. See how the man, George Floyd, gets lost in the narrative? He becomes a symbol, a prop, a cudgel used to bash a competing narrative.

What was the simple truth? A man was accused of committing a misdemeanor crime. He was murdered, without resistance, by the police after being apprehended. All four policemen involved were fired twenty-eight hours after his death. None of the officers involved cooperated in the investigation (i.e., they all pled the Fifth Amendment), thus prolonging it. The policeman directly responsible for his murder was charged within four days. The other officers were charged five days later, and the initial charges upgraded to murder in the second degree. According to the Minnesota Attorney General, Keith Ellison, the decision to charge and the timing of those charges were unrelated to the protests. Don’t believe him? Google him and try to stick him in your narrative.

When people replace truth with narrative, bad things happen. People start to believe in narrative the way that honest people believe in truth. And that can have terrible consequences. Which leads to Part II on Belief.

Everything you know is wrong VII: Coronavirus edition

Watching the medical system, governments, and the public come to terms with the coronavirus has been fascinating. It calls to mind the old joke about why they call it “the practice of medicine”: because they haven’t perfected it yet! While viruses are old hat, each behaves differently, so what worked last pandemic may not work this time. The treatment must match the disease, which only becomes clear over time. Meanwhile, it spreads, and sickens, and kills.

Governments face many dilemmas: respond quickly and risk being considered panicky, wait and be charged with neglect. Mandate behavior and you’re a totalitarian, suggest and you’re weak. Act early and the public will weary of your measures, bide your time and the media will roll out a list of casualties.

The public (and the media) bears some responsibility, too. We want clarity when clarity is not possible. Our demands for scientific certainty are answered by Professor Heisenberg, who determined there are areas with fundamental limits about what we can know for sure. Anybody who has faced a serious diagnosis from a doctor across the table knows the routine: they only suggest courses of treatment, not rules. The public writ large got to experience–all at the same time–what only an unlucky few do everyday.

In that spirit, what’s been wrong about coronavirus? Even though it’s still early, a few obvious “truths” have met their demise:

  • Masks, especially homemade or surgical ones, do no good against this virus. Early mask adoption is one of the few consistent characteristics of countries which have experienced a less severe outbreak. Some blame governments for spreading the “useless mask” error, but the CDC message was more nuanced: N95 masks work, but IF the virus spreads mostly via aerosol particles, it will pass through other masks. Researchers now believe that transmission is primarily via droplets (not aerosol), so governments began to recommend or mandate masks. However, aerosol transmission is a possibility, so the government can’t say “wear a mask and you’ll be ok” because that is not always the case. So the utility of masks was really a function of understanding the disease. Sadly, some still believe masks are not helpful at all.
  • Lockdowns are a solution, not just a measure to buy time and “flatten the curve.” A lockdown does work. If everybody on the planet locked themselves in their houses for fourteen days (the apparent incubation period), the virus would be at least temporarily arrested. But most people can’t do that. Governments sold lockdowns as a means to slow the spread of the disease, avoid overrun hospitals (i.e., flatten the curve ) and buy time for therapies and vaccines. But no country can extend a lockdown for months, let alone a year (when a vaccine might be ready). Which leads to a related falsehood:
  • Reopening the economy puts money ahead of lives. This is a particularly nasty charge, that if a nation reopens it does so heedless of the possible deaths which would ensue. More importantly, it is wrong. There is death on both sides of the ledger: Covid19 deaths versus heart attacks missed, cancer undiagnosed, deaths of despair accelerated and so on. Some suggest that the immediacy of coronavirus death trumps the counter argument, but that is also wrong. The World Food Program, the UN organization responsible for fighting world hunger, has noted that the breakdown in the global economy will place another 130 million people (total 265 million) worldwide in danger of starving by the end of this year.
  • Massive testing is a prerequisite for successful reopening of any national economy. The media especially likes this one. Here is a simple fact: no country has attempted to do massive testing, and the countries deemed by the media as “successful” haven’t even tried to do massive testing. I am not quibbling about the word “massive” here. Some suggest the US, which currently does over 350k tests a day (and is the world’s leader in that statistic), needs to do three million tests a day, indicating a massive shortfall. South Korea, the paragon for testing, has never done more than 14k tests a day. The key? Early, targeted testing. As each new case developed, Korea traced and tested everybody exposed (not everybody who wants a test), requiring fewer overall tests and giving better, immediate feedback. This is a model which can be implemented at any time in the pandemic timeline, but works best earlier. Oh (pun intended), and South Korea never did a lockdown.
  • Herd immunity is a long term solution. Herd immunity is the concept that once enough people have been exposed and are now immune, the virus will die out for lack of new people to infect. It is only a solution in the same way that waiting for the summer to dry things out was a solution to Hurricane Katrina for New Orleans. No country is trying to achieve herd immunity: some erroneously suggest that Sweden is doing so, but instead they are simply avoiding closing the economy while protecting the most vulnerable populations (voluntarily locking down the vulnerable, not everybody). The success of their approach won’t be known until the pandemic ends, we add up the death and economic tolls, and compare results.

Perhaps the most interesting “wrong” thing I uncovered about coronavirus is how it spreads. Because it spread so quickly, epidemiologists initially assumed it was primarily an aerosol particle transmission, like the flu or measles. Most highly contagious diseases are airborne. However, as more data came in, it was apparent that while some airborne spread was happening, cases of direct contact with droplets were more the norm, and that the average infected patient infected no one at all!

As the medical field gathers more data, they have found some patients produce and expel far more virus than others, and that the viral load any patient produces varies over time. Some asymptomatic patients produce almost none. There are now data from several natural experiments: the infection aboard closed cruise ships, the isolated Italian town of Vo’, several quarantined nursing homes in the States, the choir incident in the state of Washington. There is also the established story of the unusual spread of infection, high initially in China. Then to Europe and the US coasts, but in different ways, and at different rates.

The more that epidemiologists study it, they are identifying superspreader events as a key to transmission. What are superspreader events? Indoor meetings of closely-gathered people doing things like singing, talking loudly, and interacting. Introduce a high-viral load infected person to these events, and a mass spread occurs. For example, at the two-hour choir practice in Washington, fifty-three of sixty-one choir members got sick!

The story of how the virus spreads is not so much “wrong” but simply how we learn what the truth about the virus is. And what it means. Perhaps outdoor baseball with fans in the bright sun is ok, but indoor basketball is a no-go. An evening with friends at a quiet bar, maybe; a mosh pit at the concert and afterparty karaoke, hmmmm, no. Yes to church services with communion in hand, social distancing, music but no singing; nope to loud choirs, sing alongs, common cup, hand-holding & hugs. Dining al fresco at spaced tables under the stars: si! Eating at a crowded, loud food court in the Mall: no.

And this may all change, too, as we learn more. It’s not a conspiracy, nor is it evidence of lying or incompetence. It’s called science, which proceeds by trial-and-error. Don’t forget the error part. It’s especially important.

Part Two: The WABAC machine

If you never watched the original cartoon Rocky & Bullwinkle, you missed something good, so go find it on YouTube or Cartoon Network. If you did watch (like me), you’ll remember the original Sherman and the talking dog, Mr. Peabody, who had various historical adventures using the WABAC (Way-back, get it?) time machine.

Mr. Peabody and his sidekick, Sherman.

As I was writing the last blog post on media bias, I had a WABAC moment: what was the media coverage like during the last pandemic: the 2009 H1N1 or Swine flu outbreak. To remind, this virus was a new strain of the infamous Spanish Flu bug which terrorized the world in 1919-1921. This time, it lasted about twenty months. Note this: confirmed cases worldwide were 1.6 million, deaths 18,000; estimated cases were 700 million to 1.4 billion with 284,000 deaths. Yes, ten years later, we still can’t narrow down the data within an order of magnitude. That might give some pause, even today, when making instant judgments about the coronavirus. But I digress.

H1N1 hit within the first hundred days of the Obama Administration, right next door in Mexico, oh, and simultaneously with that pesky little Great Recession. So I began searching the paper of record, the New York Times, to see how it covered the administration’s response and unfolding crisis.

Was I in for a surprise!

You will want to read the hyperlinks on this one. What I found was telling, in the “I can’t believe I’m reading this” way. My comments below are italicized.

Early on (in April) The Times published an opinion piece by a doctor entitled “Sound the alarm? The Swine Flu bind” noting “History teaches that the influenza virus mutates to cause worldwide spread about twice a century, on average. But scientists have yet to figure out what causes the mutations, when they will occur and what makes certain viruses more lethal than others.” and that public officials faced a damned-if-they-do and damned-if-they-don’t decision. Oh for that sane, balanced perspective today!

On May 1st, the Times noted how seriously the Obama administration was taking the threat. The Times reported the President was deliberate in trying not to cause a panic:”It was no coincidence, his aides said, that he played golf the day his administration declared a national emergency.” Oddly enough, no reporter asked about the recently eliminated NSC staff position covering infectious disease. Yes, believe it or not, it happened first way back then, but no one seemed to care. Golf as a crafty signal: yes, that’s it!

White House spokesman Robert Gibb was asked about the fact that there was no Health and Human Services Secretary and only five Presidential nominees (out of twenty positions, none confirmed) in the department, he said “‘Our response is in no way hindered or hampered.’ When pressed to say whether White House officials would prefer to have a full team in place, he said, ‘We’d rather not have a swine flu.'” There was no follow-up on how the Department could possibly be effective without any appointees, nor any opinion from the Times.

Asked about Mexico’s more drastic actions responding to the outbreak, CDC acting director Richard Besser said “You don’t know if this is a virus that will fizzle in a couple of weeks or one that will become more or less virulent or severe in the diseases it causes.” Perhaps President Trump should have suggested the coronavirus may “fizzle.” That appears to be the scientifically appropriate term, or at least no one in the media objected when the CDC head used it.

Another Times story the day after the US declared a public health emergency noted that “only two laboratories, in Atlanta and Winnipeg, Canada, can confirm a case” and that Besser “praised decisions to close individual schools in New York and Texas but did not call for more widespread closings.” Only two labs, but no follow up about why, or when would more come on line? And no questions about the lack of a national policy? Enquiring minds apparently didn’t want to know!

In October, HHS Secretary Sebelius was asked to account for the fact that only 23 million of the 120 million promised doses of vaccine were available, she responded, “If we could wave a magic wand or have the tools in our government shop to fix this, I think there would be a different expectation.” Noticeably absent from the questions was any mention of the Defense Production Act of 1950, which was ready and available for use. Maybe it grew into a magic wand later?

Regarding that shortage, the Times created a helpful video explaining that it was due to “old technology” and “an inefficient process.” The video says the federal government “responsibly” contracted with all five vaccine producers, but “in a weird confluence” all five had problems. “Some people will die” due to the vaccine shortage, the video intones, and the federal government has confirmed that. That’s it. Nobody at fault? People will die. Move along now.

When the President’s daughters got the coveted, in short-supply vaccine shots, the Times did cover it by saying, “The vaccinations could raise questions about whether the Obama girls were given special treatment” but quickly noting “The White House may be trying to set a good example amid concerns about the vaccine’s safety. Sharing the news that the president has allowed his daughters to receive the shots could ease the fears of ordinary Americans who are wondering whether to get vaccinated.” This was simply embarrassing. President Obama’s daughters were in a high-risk group and deserved the vaccine; couldn’t the Times have left the defense to the White House Spokesman?

Finally, an otherwise irrelevant opinion piece by Gail Collins, which has this jewel: “The swine flu scare has made it clear why Barack Obama picked Joe Biden for vice president. As the White House’s unfiltered talking head, Biden is the perfect warning bell to show the White House when things are veering out of control. A kind of mental canary in the governmental mine shaft.” It also provides the following Biden story: “‘If you’re out in the middle of a field and someone sneezes, that’s one thing. If you’re in a closed aircraft or a closed container or closed car or closed classroom, it’s a different thing,’ Biden babbled happily on the Today show. He also assured Matt Lauer that he had warned his family away from subways and that he ‘wouldn’t go anywhere in confined places now,’ but unfortunately Lauer did not inquire whether the Oval Office counts as free range.” This has nothing to do with my point, but I bet you a stiff drink that this quote will show up in an ad during the campaign, whenever the former Vice President attacks the President about coronavirus.

I could go on, but you get the point. Look at any of these articles (less the last one) from the paper of record and compare how the coverage was different. Assertions left unquestioned. Off-hand comments unexamined. Difficulties and challenges highlighted; failures explained away. Note I am NOT comparing how the Obama and Trump administrations performed; just how the media covered them in remarkable similar circumstances. The Obama administration response is on the books: probably a “B+” for messaging (smooth, reassuring, consistent), a “C+” for actual work (slow to enact national guidance, failure in vaccine mass production). Most importantly, the swine flu that year didn’t turn out to be the big one; extending the analogy, swine flu was a quiz, not the final.

The short version? Covid19 is much more contagious, perhaps more than five times as deadly.

in comparing that coverage to today’s, one could assert today’s media was only responding to the incompetence of the Trump administration, but that assertion fails because Obama’s team was new and unproven, understaffed, and made similar mistakes (e.g., reorganizing out the NSC staff position, failing to respond quickly with respect to vaccine production, making bold/rosy projections).

You might say the media treats the Trump administration differently because it acts differently. There is no doubt the President sees the media as an antagonist, if not an enemy. But this is not a personal relationship, it’s an institutional relationship. I don’t claim the media is a neutral observer; they do. If you’re going to make that claim, you forfeit the right to say “we have to be confrontational because he was first.”

Read those articles again. Read any article today. Tell me this is the rightful, impartial role for the media.

We all know how important it is (from the Times coverage) that the US has the most deaths from coronavirus. Bonus quiz, before you look at this graphic: who had the most deaths (worldwide) from the H1N1 pandemic, despite having only the fifth highest number of cases?

Other countries with more cases but less deaths? Germany & Italy

Of course, the Times went back and did an in-depth review of the Obama administration’s performance based on the discrepancy between how the US did and other nations. Well, I am sure they will eventually.

Part One: All the news that fits your bias

The New York Times masthead proudly proclaims “All the news that’s fit to print.” Some call it the newspaper of record, the official version of what’s happening, and to some extent that’s true. Some call it the home of “fake news.” I dislike the later term, only because it seems to have become shorthand for “news I don’t like.” Several friends have asked me my views about media bias. The Onion captures it well:

I like my bias like my whiskey: straight up, with a satire chaser!

As I’ve said many times, everyone has bias. Bias is simply the accumulated opinion of your experiences. It’s what makes you, you. Media personalities like to claim they are unbiased, but of course they aren’t. A day does not pass that I could not find three examples of biased coverage in the news sections of the major media sources.

What does media bias look like? Much of it is subtle, shaded by determining what is news and what is deemed not news. One example:

Two marches happened in Washington DC in January: the Women’s March (January 18th) and the Annual March for Life (January 24th). Both gathered “tens of thousands” but local traffic reports confirmed the second was somewhat larger. The Times had one news report on the March for Life, one on the Women’s March. Under normal circumstances, neither of these events may be news. In this case, the President spoke at the March for Life, the first to do so (and a major change). One march had a precedent-shattering speech, which several Times opinion writers commented on; absolutely nothing of news importance happened at the other march. This even but unequal coverage represents an improvement: almost every year since 1974, generally, the only coverage the March for Life gets is arguments over the crowd size.

Earth-shattering? Hardly. I chose this example because it’s one I have been following for decades with consistent results. The media usually covers larger marches, but somehow neglects this one even when the total surpassed half a million marchers. In this case, the media determines that the views of one side aren’t newsworthy–or as newsworthy–as the other side: bias. A worse type of bias is only telling one side of a story. Try these on:

  • On Saturday, March 14th, ABC’s Weekend News led with a story of chaos at US airports, as Americans fled back to the States on the eve of the President’s just announced travel ban from Europe. I was deeply interested, as I had a pending flight stateside. They repeated the story, with the same videos and images, on Sunday, Monday, and Tuesday. Now it’s not unusual for networks to rerun stories from the weekend, as their viewership on those days is different and much lower. And the chaos was certainly newsworthy on Saturday. Except, it wasn’t newsworthy on Tuesday, or Monday, or even Sunday. Because the ICE and CBP personnel at the airports adjusted and eliminated the lines . . . before Sunday morning! In this case, the Times led its Sunday edition thusly “After a night of chaos at some of the nation’s busiest airports on Saturday, officials scrambled on Sunday, with some apparent success, to reduce lines . . .” ABC went days and days and never reported that things were fixed. How come?
  • No doubt you heard about the April 15th coronavirus outbreak at the meat packing plant in Sioux Falls, South Dakota. When the national media caught the scent, they descended on the story with a vengeance: The Times cited it as the #1 coronavirus hot spot in the nation, and lamented the poor immigrants (some war refugees) who were about to lose their lives or jobs. Other media called out Smithfield Foods for endangering its workers, and ridiculed South Dakota Governor Kristi Noem for resisting stay at home orders for her state. This much of the story was well covered. There was palpable glee by some that the rubes were finally getting their just desserts. What happened? Over eight hundred employees were infected, most asymptomatic. Two died. The county reported under two thousand cases and eleven deaths linked to the plant. Sioux Falls hospitals weren’t stressed. The President declared the industry vital and the employees are cautiously getting back to work with new policies. You can only find local news coverage of this part of the story.

Another bias is how much attention the media pays to a subject and why. As in:

Are you embarrassed by the President’s hawking of various treatments or cures for the coronavirus? #Metoo. Even with all the disclaimers he makes, he shouldn’t be highlighting anything that hasn’t come out of a reliable, properly conducted and peer-reviewed study. Get this! Have you heard about the positive effects of Remdesivir? The problems with Hydroxychloroquine? Clinical use of HIV/AIDs drugs? #Metoo! And all these results were initially covered extensively in national media despite being preliminary: not final, not peer-reviewed. Even the President’s ludacris observation about UV light and disinfectant: how many of you saw that press conference live (I did)? How many of you saw the clip during the entire week when the media continuously covered it? Now riddle me this: if the point is it’s dangerous for the President to say such things (because people might do something stupid), who has given more people the opportunity to do something stupid? In this case, the need to ridicule the President (however deserved) outweighed the life-and-death calculation the media claimed as the reason for the coverage.

And of course there is sensationalism:

As the US and nearly every other country on the planet begins to reopen, we’re starting to see stories like this: why we are heading into trouble reopening. This was a Times opinion piece, but it got picked up by various news sites and networks. Look at the key chart:

The point is clear: the decline in CoVid19 cases is illusory, driven by a decline in several major metropolitan areas. Now look at this chart:

During the same time period (March-May) the US went from almost no tests to over eight million tests total. And what happens, the more you test? The number of confirmed cases goes . . . up. The original opinion made no reference to it, but that’s ok, an opinion piece is trying to convince you. It’s like a lawyer’s summary, not a judge’s ruling. But then several news media outlets reprinted the chart, and made no mention of the testing issue. I did see one article where an expert commented that ‘tests had greatly increased, but that wasn’t the reason for the increase in confirmed cases.’ Now I’m willing to follow experts, but I would an explanation based on some multivariate analysis, a little less “because I said so.”

Sensationalism bias is sometimes called “if it bleeds it leads,” meaning bad news gets the headline. Some might see several of these examples as simple sensationalism. But when was the last time eleven deaths over the course of a week in South Dakota elicited front page NYT and major television network coverage? Heck, a tornado killing twice that in an hour would merit 30 seconds or a weather section article.

I have little problem with bias or partisanship in editorial or opinion pieces, (except when they then get cited by the straight news side). Television networks have news and entertainment departments, and people who get them confused have nobody but themselves to blame (if you get news from Rachel Maddow or Sean Hannity, good luck!). No, of course I don’t think Fox News is unbiased, either. Fox was explicitly created to provide a different bias.

Some media do better at times: look at the NYT lead on the airport chaos story: solid work! PBS NewsHour generally only displays the “what we cover” bias, so kudos to them, too. All that said, if you don’t think the media is biased, if you’re not taking all your media reporting with a big bag of salt, you’re too gullible! The key is to access multiple media sources and to know and account for their biases . . . not to believe they’re unbiased.

Coming next, an extra-special bonus: something I stumbled across while researching media bias! Stay tuned!

A Coronavirus quiz (part II)

As promised, here are the answers to the quiz, with some commentary included.

Country A was the among the earliest to announce a travel ban on China, pending the arrival of tourists for the busy Chinese New Year celebration, and later enacted a total ban on immigration. It has only managed to ramp up to 50,000 tests a day. Its case fatality rate (hereafter CFR) hovers near one percent, and it is starting to relax restrictions on outdoor activities. New Zealand, where no one called the travel ban racist, as the Kiwis normally welcome tens of thousands of Chinese visitors for the New Year, which they were very wise to avoid. They still don’t do many tests but are among the leaders in per capita testing at 2.5%.

Nation B was among the first to ramp up viral test production, but has never completed more than 25,000 daily viral tests. It eschewed a national lockdown, and businesses and public spaces remain open. Instead, it deployed strict quarantines of areas where it detected an outbreak in progress. It also deployed a series of apps for contact tracing, and made failing to carry cell phones with these apps a crime punishable by several thousand dollar fines. South Korea, who is selling viral tests internationally despite the low daily testing level. That and the lack of a lockdown demonstrate it’s not just one thing, it’s the combination of policies which matter.

State C initially acted like the virus was “under control.” Eventually its leadership decided they had a problem on their hands and ramped up testing from nothing to hundreds of thousands daily. Its largest city is also its pandemic epicenter, and the national government is continuing to argue with state and local officials about responsibility for stringent quarantine measures. It hasn’t flattened the curve, yet, but is considering how to relax restrictions in light of the May holiday season. Call yourself Tovarisch if you ignored the false leads and guessed Russia. President Putin is staying out of the limelight and leaving the Mayor of Moscow to be the public face of the crisis. The May holidays? May (labor) Day and Victory Day!

Country D is still open for business, although without large gatherings. It has experienced several surges in cases and deaths, but its medical system has not been overwhelmed. It believes its relaxed rules and emphasis on social distancing are far more sustainable for the months-to-years before a vaccine is developed, and that it’s CFR–now higher–will eventually be the same as its neighbors who have shut their economies down. Sweden insists it is not sacrificing its vulnerable citizens and continues with its unique approach, despite withering foreign criticism and a vocal domestic minority. We won’t know who is right until all the data is in.

Nation E was the first to warn against Chinese claims on the coronavirus. It enacted strict border controls, then tightened them further! Its fines for violating quarantine or contact tracing rules continue to rise (above $10,000 US). It investigates and enforces fraudulent news coverage (such as a claimed toilet paper shortage) to the tune of US $100,000 fines. It emphasized ramping up mask production, then decreed controls on sales to ensure everyone has and wears them. It has practically eradicated the disease. The other China, Taiwan, tried to warn the WHO, but was rebuffed because, well what do they know? Turns out a lot, based on SARS and the proof in the data. Can you imagine the US with fines for “fake news?” No, me neither.

State F started out slowly, hoping to achieve herd immunity by simply protecting vulnerable populations and relying on its universal health service. As cases and deaths mounted, it engaged in a full reverse, enacting a lockdown and ramping up testing. It seems to have weathered the worst, but still has the second highest number of daily deaths. If I had said “National Health Service” it would have been obvious– the United Kingdom.

Country G was one of the world leaders in responding to the coronavirus. It enacted early and effective social distancing, restricted immigration, provided free health services, mass testing, and contact tracing. Its government is unusually effective and efficient, yet it suddenly finds itself with a spike in new cases and the most in its region. Singapore is blaming infected returning citizens for the new outbreak, but the new cases are centered in workers’ dormitories where low-skilled foreign workers are assigned to barracks-like accommodations.

Nation H is trying a little bit of everything. It has apparently past the peak in new cases and deaths, but the spread is uneven: urban areas were hard hit, while other regions not so much (yet). Some areas are reopening, while others still fear having overrun medical facilities. Testing is on the rise, but the public’s willingness to maintain strict lockdown conditions is waning. Many decry the lack of a single national policy in the place where the debate rages between “Make America Work Again” and You’ll “Make America Sick Again.”

State I enacted the first and most extensive lockdown in the Western world. Its higher CFR appears to be due to a perfect storm of older victims, inadequate emergency facilities, and the bad luck of being one of the first places hit hardest. Still, it has turned the corner on cases and deaths and is preparing to loosen restrictions. Italy tried to do everything right, and still got hammered for things no one thought were important (e.g., regional intensive care beds?).

Country J has the most cases and deaths in its region. Its leader has encouraged protests against state lockdowns, and engages in a running public debate with the press and medical officials. That leader still says it’s no worse “than the flu” and refuses to wear a facemask. J is for Brazil’s Jair Bolsonaro, the man most likely to out-trump President Trump. He is firing his health minister, leading protest rallies, and suggesting he needs to bring back martial law.

Nation K was initially hard hit, but enforced a tight regional lockdown and now has no deaths, officially. It fears a recurrence due to foreign visitors, which it is tightly controlling, and questions the account that the virus originated in China. C’mon, it’s a gimmee, the only nation questioning where the virus began is the People’s Republic of China, although they are clever enough to trumpet it in domestic news, but only whisper it in translation.

State L’s leaders insist they are fully prepared in terms of tests, ventilators, and hospital beds due to a national health system. However, their case count and deaths continue to rise, and hospital workers have been especially hard hit. The largest city is the pandemic epicenter, but their leader has only reluctantly given up his well-attended political rallies. This is how we coronavirus in the home of Corona beer–Mexico.

Country M is a world leader in testing per capita and total tests. It is in the top five for total numbers of cases, but has the best CFR among them. It attributes its success to younger initial victims, more testing, and well-resourced hospitals. The national lockdown is strongly supported, but more than a thousand protestors gathered in the capital city last week against it. The Germans demonstrated the same ruthless efficiency they always do, along with a little luck this time.

Nation N has an older, more densely situated population, making it very vulnerable. But it is also known for high technology and cultural compliance, so its early low infection and death rates seemed to indicate success at limiting movement and using contact tracing. But it wasn’t testing very much, and now its daily deaths are increasing, causing its leaders to fear they missed an opportunity to avoid a tragedy. I’ll publicly withdraw my earlier criticism that Japan was suppressing their data to avoid postponing the Olympics; it seems they were just lucky in fewer Chinese visitors, fewer international visitors, and a population lacking the complications which lead to deaths. But the virus never sleeps, and Japan’s luck has run out.

State O was late to the game but acted boldly, enacting a nationwide shutdown, which immediately backfired as millions of poor migrants began walking hundreds of miles to return home from the cities where they worked. The government fears that official data hides the magnitude of the crisis, and is preparing to blame a religious minority if a catastrophe ensues. It’s never a good time to be poor and Muslim in India, but the sight of millions of people walking the roadways home was one for the ages!

“You don’t have to go home, but you can’t stay here.”

How did you do? Any perfect or near-perfect scores? Take credit! Any particularly difficult clues? Any quibbles? Sound off!

What do we take from all this? There are no silver bullets. Some countries went all in on testing, but no major country has gotten above 4% of per capita testing (Iceland has 13%). Some invoked electronic monitoring and contact tracing measures that no advanced Western nation would stomach, due to civil liberties concerns. Some added physical restraint to the mix (Google “China violently quarantines its citizens” for the shocking videos). Some had more masks on hand and insisted everyone wear them; those without enough masks took to dissuading citizens from hoarding them in place of medical users (bad move, if understandable).

Remember when ventilators were the main topic of American discussion (who has them, why won’t the federal government release them, how do we use the DPA to build thousands more)? Well, even New York City didn’t use half what it asked for, and the data from one study suggests they weren’t the lifesavers we were lead to believe (under normal circumstances, half of all ventilator patients die; with CoVid19, 88% of such patients died).

Because this is the first true pandemic in one-hundred years, we’re witnessing a real-time experiment with hundreds of variables and approaches. Some lessons are obvious; in other cases data points out a discrepancy that is not yet explicable. What has proved important?

  • Early social distancing/mask wearing/limited quarantine of the sick. Anything to slow the spread of infection, enabling time for all other measures. Note the word limited: full scale stay at home orders can only last so long; enact them too early, and you will have people breaking out before the curve has flattened.
  • Open exchange of data. Whether it is on cases, symptoms, therapies, clinical approaches, or vaccines, everyone does better when the data is correct, openly-shared, and correctly reported. And being honest about what’s being counted: there are several ways to make data errors which don’t involve nefarious intent. Leaders should not hawk cures or treatments; anybody notice the number of news accounts leaking preliminary study results? Yeah, same thing.
  • Expanding local/regional intensive care facilities. The type of health system (universal/national or not) and the quality of its doctors were less important than numbers of intensive care beds. We may not use all of them, but one way to avoid avoidable deaths is to ensure one has enough treatment facilities for the worst cases. Hardly a cognitive breakthrough, but one worth repeating that the benefits far outweigh the costs.
  • Protecting nursing homes. Even countries with exemplary care standards have experienced extreme death rates at nursing homes. The combination of vulnerable populations kept close together with staffs rotating between homes has proven deadly. Everywhere.
  • Geography and the interplay with demography. Have more old people? Bad. Have more obese people? Bad. Have more international travel connections? Bad. Greece is like Italy, but hasn’t suffered the same. Mexico is much like the US, but hasn’t suffered the same. The differences don’t point to policies as much as other factors (perhaps climate?) yet to be explained.
  • Recent experience with severe contagion: Taiwan (MERS, 2012) and South Korea (H1N1, 2009) are among the best, despite not doing mass testing or total lockdowns. In fact, low-level testing works fine if started early enough. And people being inclined to wear facemasks. And the country being a more compact one. Oh, and being suspicious of the People’s Republic of China plays a role, too.

Hope you enjoyed this testing exercise as much as I did creating it!

A Coronavirus quiz (part I)

I spend (too much) time sniping at social media friends who post or share thoughts such as ‘why doesn’t the President just do something’ or ‘why can’t we be like country X?’ I generally respond with hard questions like “what specifically do you want him to do?” or “what do you think that country X is doing that we can/should emulate?”

To test your knowledge (and to kill some time) of who-is-doing-what in the world of coronavirus policy, here is a sampling of national approaches. Your task is to guess which country I’m describing in each case. I’ll describe them in some detail, but I can’t give all the data in every case, or else it would be too easy. And no, the answers aren’t at the bottom of the post; I wouldn’t want to put any of my friends in the near occasion of the sin of cheating! Part II will contain the answers, and some commentary. If you’re really bored or bold, put your answers (questions? comments!) in the comments section.

Here goes (the use of terms country/state/nation and the letter are NOT clues):

Country A was the among the earliest to announce a travel ban on China, pending the arrival of tourists for the busy Chinese New Year celebration, and later enacted a total ban on immigration. It has only managed to ramp up to 50,000 tests a day, yet its case fatality rate (hereafter CFR) hovers near one percent, and it is starting to relax restrictions on outdoor activities. Country A?

Nation B was among the first to ramp up viral test production, but has never completed more than 25,000 daily viral tests. It eschewed a national lockdown, and businesses and public spaces remain open. Instead, it deployed strict quarantines of areas where it detected an outbreak in progress. It also deployed a series of apps for contact tracing, and made failing to carry cell phones with these apps a crime punishable by several thousand dollar fines. Nation B?

State C initially acted like the virus was “under control.” Eventually its leadership decided they had a problem on their hands and ramped up testing from nothing to hundreds of thousands daily. Its largest city is also its pandemic epicenter, and the national government is continuing to argue with state and local officials about responsibility for stringent quarantine measures. It hasn’t flattened the curve, yet, but is considering how to relax restrictions in light of the May holiday season. State C?

Country D is still open for business, although without large gatherings. It has experienced several surges in cases and deaths, but its medical system has not been overwhelmed. It believes its relaxed rules and emphasis on social distancing is far more sustainable for the months-to-years before a vaccine is developed, and that its CFR–now higher–will eventually be the same as its neighbors who have shut their economies down. Country D?

Nation E was the first to warn against Chinese claims on the coronavirus. It enacted strict border controls, then tightened them. Its fines for violating quarantine or contact tracing rules continue to rise (above $10,000 US). It investigates and enforces fraudulent news coverage (such as a claimed toilet paper shortage) to the tune of US $100,000 fines. It emphasized ramping up mask production, then decreed controls on sales to ensure everyone has and wears them. It has practically eradicated the disease. Nation E?

State F started out slowly, hoping to achieve herd immunity by simply protecting vulnerable populations and relying on its universal health service. As cases and deaths mounted, it engaged in a full reverse, enacting a lockdown and ramping up testing. It seems to have weathered the worst, but still has the second highest number of daily deaths. State F?

Country G was one of the world leaders in responding to the coronavirus. It enacted early and effective social distancing, restricted immigration, provided free health services, mass testing, and contact tracing. Its government is unusually effective and efficient, yet it suddenly finds itself with a spike in new cases and the most in its region. Country G?

Nation H is trying a little bit of everything. It has apparently past the peak in new cases and deaths, but the spread is uneven: urban areas were hard hit, while other regions not so much (yet). Some areas are reopening, while others still fear having overrun medical facilities. Testing is on the rise, but the public’s willingness to maintain strict lockdown conditions is waning. Nation H?

State I enacted the first and most extensive lockdown in the Western world. Its higher CFR appears to be due to a perfect storm of older victims, inadequate emergency facilities, and the bad luck to being one of the first places hit hardest. Still, it has turned the corner on cases and deaths and is preparing to loosen restrictions. State I?

Country J has the most cases and deaths in its region. Its leader has encouraged public protests against state lockdowns, and engages in a running public debate with the press and medical officials. That leader still says coronavirus is no worse “than the flu” and refuses to wear a facemask. County J?

Nation K was initially hard hit, but enforced a tight regional lockdown and now has no deaths, officially. It fears a recurrence due to foreign visitors, which it is tightly controlling, and questions the account that the virus originated in China. Nation K?

State L’s leaders insist they are fully prepared in terms of tests, ventilators, and hospital beds due to a national health system. However, their case count and deaths continue to rise, and hospital workers have been especially hard hit. The largest city is the pandemic epicenter, but their leader has only recently and reluctantly given up his well-attended political rallies. State L?

Country M is a world leader in testing per capita and total tests. It is in the top five for total numbers of cases, but has the best CFR among them. It attributes its success to younger initial victims, more testing, and well-resourced emergency rooms. The national lockdown is strongly supported, but more than a thousand protestors gathered in the capital last week. Country M?

Nation N has an older, more densely situated population, making it very vulnerable. But it is also known for high technology and cultural compliance, so its early low infection and death rates seemed to indicate success at limiting movement and using contact tracing. But it wasn’t testing very much, and now its daily deaths are increasing, causing its leaders to fear they missed an opportunity to avoid a tragedy. Nation N?

State O was late to the game but acted boldly, enacting a nationwide shutdown, which immediately backfired as millions of poor migrants began walking hundreds of miles to return home from the cities where they worked. The government fears that official data hides the magnitude of the crisis, and is preparing to blame a religious minority if a catastrophe ensues. State O?

There you have it: fifteen examples. Choose some or do them all (what else do you have to do?)! There are some tricky ones, and a few red herrings thrown in. Answers in the next post.

Testing, testing, one, two, three

Several friends have asked me about the importance of, and status of, coronavirus testing in the States. It is the single most important factor in returning to the status quo ante virus, so why is the US behind other countries? Let’s focus on virus testing today (tests to determine if one has the virus now), but what we’ll see also applies to antibody testing, certification of equipment (like ventilators) and even “proof of” processes (like testing protocols).

The President trumpets (sorry, couldn’t resist the pun) the fact that the US has completed more virus tests (3.7 million, all data as of 5/19) than anybody. Which is true. The numbers change daily, but the US has done twice as many as Germany amd six times more than South Korea. Still a little behind the EU, which is a better comparable. The President’s many critics point out that total numbers of tests are not the right way to compare nations: you should compare tests adjusted for population. They are correct: it is a better way to compare, and here the US lags in forty-second place, behind such notable nations as Russia and San Marino, with the Faeroe islands leading the pack.

Let’s take a analytic look at the data, which tell an interesting story.

All scientists and health officials agree testing (in all its types) is the long pole in the tent (a military phrase meaning the thing in a sequence of things that takes the most time, thus is critical to on-time mission completion). All agree it is essential to restoring society to normal working order. All governments are trying to get to this end state: sufficient testing to achieve normalcy. No one is sure how many tests or what percentage of the population must be tested to get there (that is a judgment call, not a scientific determination), but all agree it is large. And no one is anywhere near there yet.

Data does not include Germany, as this site does not recognize Germany’s data, but the German numbers are very close to Russia’s. If you want to play with the data yourself, go here.

So per capita testing is a valid way to describe how well a country is doing on the road to getting back to normal. But let’s go back to the total testing numbers to see how they influence how to assess the progress. Only the US, Russia, Germany, and Italy have exceeded 50,000 tests daily, and the numbers are not increasing rapidly in any country. The US has achieved around 150,000 tests daily. If testing is the long pole, and everyone needs to do a lot more testing, why haven’t those numbers spiked?

Some suspect a failure in governmental leadership, so let’s compare.

Look at Germany, considered (rightly) a world leader. They had a head start on the regional crisis (it started in Italy), a favorable set of initial cases (younger by half than that of Italy), universal health care, and a world-class pharmaceutical sector. The acclaimed technocratic German administration was alert and responsive, led by the capable and experienced Chancellor Angela Merkel. They recognized testing was a challenge, and engaged both government and commercial resources on the problem. And the end result is they have done 1.7 million total tests., about 70,000 a day, with a goal of 200,000 a day.

Look at South Korea, another obviously positive case. Again, an early start at social distancing, a culture accustomed to wearing masks and willing to abide government restrictions, universal health care, good high tech manufacturing, world’s best internet penetration and adoption, and recent experience with MERS (Middle Eastern Respiratory Syndrome, a coronavirus which hit in 2015 and left ample lessons). Which resulted in half a million total tests, stuck at 10,000 test a day.

Is Germany not as sophisticated as we imagined? Did Angela Merkel not emphasize the importance of testing? South Korea has done well in many areas, but if testing is the key, they have only tested about one percent of the population, with almost no growth in the testing rate per day. Who’s to blame in these countries?

The answer lies in a simple observation: testing is hard. It is not at all like surging to make tanks in World War II (which were cheap and functional–long unrelated anecdote at the end of this post*). If testing were easy to scale, some scientist or company or leader would have done it. If you look at the testing numbers, they roughly correspond to a nation’s pharmaceutical research and/or production capability, nothing more, nothing less. And they are increasing at a roughly the same rate, everywhere.

To paraphrase what my old Army Master Sergeant would have said, “You can crap out a a zillion M4 tanks, but you can’t crap out a zillion coronavirus tests.”

How hard can virus testing really be? Well, every year we have to prepare a new test for that season’s flu virus (not talking about the rapid diagnostic flu tests, those are a shortcut we accept). We know it will only be a variation of what has come before, we know roughly when the flu season will start, and we know many thousands of people will die without tests (and vaccines). And it takes the full year between flu seasons to get it done.

Testing itself is a complex, multi-step process: You need the different reagents, production capability for the test kits, distribution and training for end users, a system for administering the tests and collecting samples, logistics to consolidate tests and transfer them to labs, lab capacity to evaluate tests, and a system to provide results. Some parts can be streamlined: there are multiple sources for reagents and training may be simplified. The government can play a role in establishing mass testing sites and moving materials. The internet provides an easy means to transmit notifications. But building tests? Creating evaluation capability? Not easily scalable, or someone, somewhere would be doing it.

Virus testing is closer to “nuclear power” complex than to “WWII tank” difficult. No one ever said, “hey, let’s spit out a thousand or so nuclear power stations in order to move to clean energy now.” Setting aside the politics, nuclear plants are difficult to build, require costly engineering and rigorous testing, and we have no tolerance for failures of any kind (rightly so). No nation wants faulty tests, or insensitive (false negatives) ones, or nonspecific (false positives) ones. The infrastructure for making tests can’t just be inflated. They can be increased at the nargin, and we are seeing that in many countries right now. New test equipment or processes have to go back through the same rigorous protocols, so again there is no shortcut.

Some things just take time. We are right to be impatient, but wrong if we ascribe blame when there is no alternative. Perhaps the problem is we’ve become used to modern medicine’s ability to do the seemingly impossible. We’ve come to expect science and medicine to do miracles. Read that sentence twice; the non sequitur should be obvious. That is the root of the problem. When science and medicine fail, we look for someone or something to blame. It may be rational, but it may not be correct.

* Back in the US Army in Germany in the eighties, we would go out on maneuvers for weeks, tramping around the German countryside. At the end of an exercise (ENDEX), there would be a day or so pause to re-organize before heading back home to garrison. The officers would find the nearest gasthaus and go for dinner and bier with the locals. It served two purposes: first to thank the locals for indulging our tearing up their farm fields, and second to blow off steam with a schnitzel and a great beer. We’d inevitably meet up with some old German WWII vets, who always told us they fought against the Russians. (Thus began a local joke: we won WWII because when we landed, Normandy was empty, since all the Germans were on the Eastern Front). One night, there was only one German left at the stammtisch when the night ended, and after several rounds of bier and Jagermeister, he fessed up to fighting on the Western front! We had to ask: what was it like fighting the US Army? “Ja, ich hatte es gern” (I liked it) he slurred, “when you hit the American tanks, the top popped off like a champagne cork!” We all grew quiet at the weight of what he said, and what it meant. “Good thing you got that fixed!” he quickly added.