Covid Chronicles XXXI: Much of what we thought was true was not…

 

 Covid, Science, Psychology, psychoanalysis, failed shelter in place orders

Stephen Macedo and Frances Lee have written a book, “In Covid’s Wake”(Princeton) that was reviewed this week in the New Yorker by Daniel Immerwahr.  The book uses epidemiological data to evaluate some of the measures that we took to manage the COVID crisis.  Immerwahr uses this to muse about our willingness to accept the word of experts – and the perils of doing that.  He also points out that, in the long run, science will out.  Indeed, the results of the study that Macedo and Lee publish are scientific results, but he cautions that when science does not have enough time to fully test hypotheses, we can come to erroneous conclusions…

OK, so, the erroneous conclusions.  First and most importantly, the data clarifies that the stay at home orders did not lead to lower rates of death.  The first of the two primary sources of these data are from Europe – where there were no greater levels of death among the Swedes, who opened back up soon after the imposition of the stay at home orders, while the rest of Europe remained on lock down.  The second is the US, where red states (like Florida) that moved away from the lockdown did not differ from blue states (like California) where the lockdown was closely enforced in mortality rates (indeed, there were higher, though not statistically higher, rates of mortality – pre-inoculation – in blue states versus red states). 

Secondly, masks did not work outside of the laboratory.  Fitted N95 masks that were new worked in the lab, but the longer we wore the masks, the more the pores got filled with moisture and we ended up breathing around the fibers, allowing whatever germs we might expel in our breath to get out.

The good news is that the inoculations did, in fact work.  After those were introduced, death rates in blue states, where the shots had a higher usage rate, had lower death rates than in the red states.

Let me take a beat here.  The implications of these data are, of course, huge.  We engaged in a multinational one to two year moratorium on most of our trade and much of our social interaction based on bad and limited data.  There were early indications from the Chinese that sealed apartment buildings slowed the spread of the infection in some areas.  We extrapolated this to the planet, and shut everything down.

This speaks both to the state of our research capabilities in the midst of an unfolding threatening and novel situation (more on that in a moment), but also on our need to do something, anything, in the face of the tremendous anxiety that we were all feeling. 

When I bought my first house, I included a clause in the contract that included “parental approval” necessary.  There was a time limit on this approval clause – 48 hours.  During that time, I did, indeed, ask my parents to look at the house we were thinking about buying.  Mostly this was an effort to show it off.  The 48 hours also gave us time to scope out the neighborhood and make sure that we hadn’t overlooked anything egregious.  We had, to that point, only seen the house at night, and wanted to evaluate our decision, literally, in the light of day, but we also wanted to get our bid in before others did.

Well, on the Tuesday after my parents had seen the house, long after the 48 hours had elapsed, my father called to say that the cracks he had seen in the walls clearly indicated that the house, which was situated on the crest of a hill, was in the process of breaking in half and half of it would slide down one side of the hill while half of it would slide down the other.

 Needless to say, this assessment was unnerving.  We went ahead with the purchase of the house, had it inspected, and were reassured that it was structurally sound – though my sense that it was falling apart never completely left me.  When my father came to spend time at the holidays, he inspected the cracks that he had remembered and his comment was that “anxiety makes cracks grow larger.”  Never were truer words spoken.

Our anxiety about our mortality led us to take measures that imperiled us in ways from which we are still discovering.  What is the impact on those who were 5 and 6 and learning how to read being out of school for more than a year?  How is this different from the impact on Junior High Schoolers who missed critical and often painful social developmental periods?  How did the Seniors (in High School and College) who didn’t get to say good bye to their peers and participate in ceremonies that marked their transition fare in a world where those endings could not be acknowledged in traditional ways?

Of course, the article points to the economic impact of the decision to shelter in place, which was huge.  In my department, I chronicled here and here the Great Resignation and how it impacted us at the time – but the impact of those resignations is still lingering in a department where we are missing a whole tier of faculty that should be assuming much needed leadership roles at this point.

I decided to chronicle the real time reaction to the pandemic, though, in part to describe the state of affairs as it was happening.  When I was angry at administrators for forcing us back into the classroom – and angry at Catholics who were praying for this administrators who would feel so badly when the faculty and students died (and not praying for those same faculty and students), I think that was justified anger – outrage, even – though it now appears to have been wasted as we were, in fact, not increasing our risk by going back to the classroom – and to the dormitories and the cafeteria.

The issue that will haunt us now, though, is that people will use this new science to point out that the old science let us down and that, in turn, will be used to suggest that we don’t need science.  People will not see the irony in the need for science to understand the ways that science has failed us being used in this way in this argument.

That said, this should give us pause.  Especially those of us who are practitioners of science – or, as we call it in my program – local scientists.  Applying general principles to a particular case – and doing that under time pressure – which I do during many individual hours each and every day that I work as a clinician – will necessary lead to mistakes.  I will misdiagnose – in small and big ways – both in determining a course of treatment and in offering an interpretation at this particular moment that is poorly timed, insensitive, or just plain wrong. 

As a social scientist, I can predict trends.  As a practitioner, I am proposing ways of understanding that need to be plausible, need to be tested over time, and many of which will not bear up over time.  But many of them will and do.  And I can demonstrate that, for a general group, there will be a generally positive impact.  But that doesn’t mean that this or that particular outcome will be good. 

We just learned this lesson on a massive scale.  Ouch.  Will we more continuously monitor the next time something like this head’s in our direction?  Will we engage in real time studies – will we have the stomach for treating ourselves as guinea pigs when our lives are at stake? 

On the micro level, will we continue to question what authorities tell us – what our individual treaters maintain is the best treatment?  Peter Jamison, of the Washington Post, wrote that “Doubt is a cardinal virtue in the sciences, which advance through skeptics willingness to question the experts, but it can be disastrous in public health, which depends on people’s willingness to trust those same experts.”

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