Monday, March 30, 2020

The Classic Trio: Emotion, Logic, Action


There’s a classic trio in literature. An advisor offers the emotional reaction. Another advisor offers the logical, rational reaction. And the main character takes action based on the input from those two sides.

You see it really clearly in the original Star Trek series and movies. Captain Kirk is the main character, the man of action. Bones, the doctor, offers the emotional side—but he’s also a scientist, so he’s not purely emotional. Spock, the Vulcan, offers the logical, rational side—pretty much devoid of emotion.

Star Trek cover art, found here


The purpose of literature is to show us patterns for our lives—so that we learn by experience vicariously, without having to go through everything the hard way personally.

We may each have tendencies that are more emotional, or more rational, or maybe a very confusing mix. But we are each the main character—the “man of action”—in our own story.

So, what we need to do is take in some input from the emotional, human side, while also taking a heavy dose of logic and rationality, and then find the right balance to make the wisest decision we can on how to move forward.

Maybe we can apply this to the current Covid-19 pandemic. How should we be dealing with questions about personal behavior, and about sharing scarce resources and business shutdowns?

Emotions are plentiful. Social media is full of that input. So are many regular media outlets. The input from that side is: We should worry! We should be fearful! We should take extreme protective measures! Lives are at stake! Even one life lost is too many! We’d better go out right now and stock up on anything we think we might run out of or be unable to get in the future! What about my job? How will I pay my bills? What will I do if I run out of food? Why isn’t everyone else taking this seriously? How can I deal with this all alone? Or cooped up with my crazy kids?

I think we’ll never have a shortage of emotion surrounding a worldwide pandemic. The word itself is enough to instill apocalyptic images.

That’s why we need plenty of logical rationality to temper that. But the rational side requires data.

A week ago, one of our movie choices was an old Star Trek movie, the one where they save the humpback whales from extinction. There’s a point when Kirk needs a recommendation from Spock, but Spock is reticent, because he doesn’t have enough data. But timing is urgent. Kirk tells him to just guess. He has to order him to guess, because otherwise Spock won’t do that. The story turns out all right—because it’s fiction.

But, here we are, without enough data, being forced to guess.

Here’s what we need to know:

·       How virulent is the virus? That is, how likely to cause severe illness or death to any given person who contracts it.
·       How contagious is the virus? How is it spread, and how easily? And how likely is a person to get it from various levels of contact?
We’re acquiring data. We know a lot more now than we did a month or two ago. But there are some sub-questions that it would be very handy to know:

·       Who in the population has antibodies and is now safe from the virus? These people could be used to help develop a vaccine. They could also feel free to go to work without fear of contracting the illness or spreading it.
·       Who in the population has the virus and could spread it, whether they show symptoms or not? These people need to self-quarantine, completely avoid contact with anyone else who does not yet have the virus. If symptoms appear and they need medical help beyond what they can handle at home, then they get help from hospitals equipped to safeguard medical personnel while treating the patient.
If we knew the answers to these “who” questions, we could wipe out the disease. Literally.

What we need is enough testing to provide data on those two questions. Then the decision-makers, the Captain Kirks of their communities, states, or nations, can advise accordingly. Everybody who is immune, you’re free to go about your lives. Just be careful not to track germs to someone not immune.

Everybody who tests positive, you’re in quarantine. Expect to be there for at least two weeks—enough time to have come down with the virus if you’re going to. If you do come down with symptoms, then your quarantine continues until you’re over symptoms and no longer “shedding,”—that’s the word I’ve learned for when you can spread the virus to others before, during, or after exhibiting symptoms. The practice has been to get at least two consecutive days of virus-free tests following the end of symptoms. Then you’re free to roam about the world with the other immune people.

Everybody who tests negative, you’re dependent on how well the others do their quarantining duty. If you’re concerned because you’re at high risk, then you might want to wait things out by sheltering at home as much as you can. If you’re not at high risk, then weigh the risks.

But what we haven’t had is population-wide testing. At least not here.

Scientists in NY have developed test for
Covid-19 immunity, photo credit:
Jacob King/Press Association via AP Images,
found here
Dr. Richard Epstein talks (also here) about how nationwide testing could happen, and that, if used correctly—quarantining anyone who accurately tests positive—you could wipe out the virus within weeks, without the need of a vaccine or even a cure. You would deprive the virus of new hosts, which means it would be eradicated. Assuming the rest of the world does this protocol as well. Which is a big “if.” But he thinks such testing ability is on the horizon. 


In the meantime we have cities and countries and economies being shut down. These bold steps are understandable, but they’re based on insufficient data—because we don’t know who has the virus.

There’s nevertheless some data worth looking at.

My son, Political Sphere, put together a spreadsheet concerning cases per million population and deaths per million population. Without full testing, we won’t know exactly how many cases there are, so we won’t know death rate, or virulence. But we can learn some other things.

New York City has the most cases/million population recorded worldwide, with 3,663 (a number going up daily, but this is yesterday’s snapshot). New York State as a whole is next, with 2,751. PS gathered data for the top 69, but here are the top 20. Note that some of these are countries (shaded green), and some are jurisdictions within a country (shaded blue).


Rank
Country/State
Cases/mil pop
1
New York City
3,663
2
New York State
2,751
3
Switzerland
1,642
4
Spain
1,567
5
Italy
1,533
6
New Jersey
1,252
7
Austria
929
8
Belgium
793
9
Louisiana
711
10
Germany
694
11
Massachusetts
613
12
France
569
13
Washington
566
14
Netherlands
564
15
District of Columbia
485
16
Michigan
471
17
Connecticut
427
18
Iran
426
19
USA
379
20
Colorado
358


It looks like New York is in terrible shape. Worse than Italy, which we’re all fearful of becoming. But let’s add another piece of data: deaths per million population:


Rank
Country/State
Cases/mil pop
Deaths/mil pop
1
Italy
1,533
166
2
Spain
1,567
128
3
New York City
3,663
80
4
New York State
2,751
43
5
Netherlands
564
37
6
France
569
35
7
Switzerland
1,642
31
8
Belgium
793
31
9
Iran
426
30
10
Louisiana
711
29
11
Washington
566
25
12
Vermont
338
19
13
New Jersey
1,252
16
14
United Kingdom
256
15
15
Michigan
471
11
16
Connecticut
427
9
17
Colorado
358
8
18
Austria
929
8
19
Georgia
230
7
20
USA
379
7


Italy and Spain move to the top, above New York. In fact Italy doubles NYC’s rate. Dropping out of the top 20 entirely are Germany, Massachusetts, and District of Columbia. New to the top 20 are Vermont, United Kingdom, and the state of Georgia.

Some of this data will change as cases move past active to recovered or deaths. So PS plans to update the data weekly. But for now we can at least ask some questions about what we’re seeing:

·       Do the areas with higher death rates have more vulnerable populations?
·       Do the areas with higher death rates have overwhelmed resources making them  unable to treat some patients?
·       Can we learn from areas with lower death rates what practices are working best?
Italy has an older population, which means probably more vulnerable. As overwhelmed as NYC is, their hospitals are still only at 80% full, with the hospital ship USS Comfort arriving. Greater resources. Those details can make a difference.

In areas with more cases per million population, the harder hit areas, we have other questions:

·       Do areas with higher prevalence have certain characteristics? Population density, use of public transit, colder climate?
·       Did areas with higher prevalence wait longer to take precautions?
I’ve been wondering about that last question. President Trump cut off travel from China at the end of January. His usual detractors accused him of xenophobia. And there were areas that insisted he was overreacting. New York City went ahead with Lunar New Year celebrations, encouraging big crowds, more than a week after that travel restriction.




These two tweets were posted on a friend's
Facebook page, with speculation about
NYC's serious virus breakout.

Time has been passing kind of slowly this month. But here in Texas, where we had no known cases, things were going on through February and early March fairly normally. The first big cancellation was SXSW in Austin, a combination technology and music festival, cancelled March 6th, a week ahead of the ten-day event. 

Meanwhile the annual 20-day Houston Rodeo kept going. These are different events in that SXSW had major companies, from elsewhere, that withdrew, so there wasn’t much choice about it. The Houston Rodeo is made up of a whole lot of smaller vendors and contestants, some of whom make much of their annual income during that month. So it would take a lot to convince all those people to shut down. But the rodeo did shut down, 11 days early, as of March 11th.

At the time the Greater Houston Area, with more than 4 million people, had only a handful of cases, all related to a particular travel group to Egypt, all of whom were immediately quarantined. The number of cases has been growing now, but not as fast as many other places. It may be that the social (physical) distancing, followed up with the more recent stay-at-home directive, were done early enough—based on how many cases there were—to prevent spreading.

Maybe New York already had too many unknown cases before they began discouraging social gathering.

Church that had a Covid-19 breakout among choir members
image found here
There’s a church choir in Washington State, in a county that had no known cases when they went ahead with a rehearsal on March 10th, although there had been other cases in Washington State, about an hour north in Seattle. Schools and businesses were still open, and large gatherings were still permitted.


They used hand sanitizer on the way in and refrained from hugging and shaking hands. They thought they were being prudent without being reactionary. But within days they learned it was the wrong decision. Sixty people attended—half of the total choir. Now, three weeks later, 45 have tested positive for Covid-19 or are exhibiting symptoms (without yet being tested); two have died and at least three have been hospitalized.

Here in Houston I participated in a church choir just a week and a half before that. As far as I know, we’re all still fine. But at that point I think we hadn’t had any local cases yet. I feel blessed to have gotten in all the socializing I did, safely, before we had to take precautions. But in the interactions we had that last week before being shut down, we were also trying to be prudent without being reactionary.

It’s not usually a matter of stupidity; it’s a matter of not knowing enough. Until we know who actually carries the virus, we’re stuck making deductions based on insufficient data.

I’ve been following this interactive map. It has raw numbers, but not per population info. 

Interactive map of Covid-19 worldwide
screenshot from here

The Houston Chronicle has provided this map more relevant to just Texas, also raw numbers without population info. 

Interactive map of Covid-19 in Texas,
screenshot from here

The more data the better. I have to make decisions for myself, balancing the emotional and the rational. I naturally lean more toward Spock than either Bones or Kirk. But when there isn’t enough data, more emotion creeps in than I’d prefer. I don’t like to just guess. I am, however, pretty comfortable staying home; that has always been true. But there’s a lot of anxiety surrounding things as mundane as grocery shopping. I could do well with some going back to normal.

May God bless the researchers and innovators. We could use more testing—quick and easy and cheap for absolutely everyone. We could use more equipment—ventilators, protective equipment. We could use medicines that work to treat this. And we could use more data to help with wise decision-making.

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