Academia: What we did wrong with Covid-19

[nonntt]

Exhibit 4 & the last, a twofer.

"Facing covid-19 reality: A national lockdown is no cure" by Michael T. Osterholm and Mark Olshaker, published in the Washington Post on 21 March 2020.
https://www.washingtonpost.com/opinions/2020/03/21/facing-covid-19-reality-national-lockdown-is-no-cure/

Michael T. Osterholm is regents professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"Perspectives on the Pandemic | Professor Knut Wittkowski," on YouTube, 3 April 2020
https://www.youtube.com/watch?v=lGC5sGdz4kg

Perspectives on the Pandemic Episode 2:  In this explosive second edition of Perspectives on the Pandemic, Professor Knut Wittkowski, for twenty years head of The Rockefeller University's Department of Biostatistics, Epidemiology, and Research Design, says that social distancing and lockdown is the absolutely worst way to deal with an airborne respiratory virus.

All of these people are experts in prominent positions. And at a critical moment, all of them used their pulpits to cast doubt on the one option we have right now to fight a global pandemic. And the academic reaction is to extend collegial courtesy and respect.

When all this is over, even the people who have acted most prudently and heroically will find things they should have done better. Academia should not avoid the same moment of introspection.

[Anon1787]

It is ultimately a political judgment--not a medical one--to decide that a lockdown is worth the cost, and the cost--undeniably high--will go higher the longer the lockdown lasts or if we see significant flare ups a few months after a lockdown ends that precipitate calls for yet another lockdown. The problems that Singapore (one of the countries held out as a model) is now experiencing hold out the dim prospect of such a lockdown yo-yo. Sweden is the most notable example of a country trying a different approach, and if they stick with it (more or less), it will be a good case study.

Different approaches will have different costs and benefits, so I do not see an overwhelming need for outrage directed at those who question conventional wisdom that there is only a "black-or-white option here."

[Stockmann]

Sweden is the most notable example of a country trying a different approach, and if they stick with it (more or less), it will be a good case study.

Sweden already has 88 deaths per million population. Compare this to 22 in neighboring Norway, 62 in the US, 33 in Germany, 4 in South Korea, 2 in PR China, 0.8 in Japan and 0.3 in Taiwan. So Sweden by this measure is two orders of magnitude worse than Japan and over two hundred times worse than Taiwan. The Swedish experiment failed. Social distancing, quarantines, etc are neither new nor based on any terribly complex theory - we're talking about tried-and-tested methods backed by basic germ theory. Whether the Swedes did it out of hubris or incompetence, because they believed that epidemics are things that happen to other people, or because they believed themselves to be in some form of "splendid isolation" surrounded by Nordic countries, or whatever, are questions perhaps sociologists and behavioral psychologists can answer. But that the Swedish experiment failed is just arithmetic.

[pigou]

But that the Swedish experiment failed is just arithmetic.

But the policy objective of the Swedish experiment isn't to minimize the number of deaths -- it's to limit the economic cost of the policy response.

They're accepting that they'll have more deaths per capita, so that can't be the measure of success or failure. In 5 years, someone can compare GDP per capita in Sweden to neighboring countries and we'll see what happened.

If their GDP grows faster, we can calculate some kind of economic gains per additional death. That's fairly straight-forward and one can compare it to other potential interventions that would save lives (e.g. shutting down coal plants). If they recover slower than neighboring countries AND had more deaths, then they'll definitely have failed.

[dismalist]

Alas, just gotta know what the value of a human life year is to figure out if it's worth it.

This is knowable from various sources, the best probably being individuals' response to a question like "How much are you willing to pay for reducing your chance of death by 1/100?" We get to about $10 million in the US. It'd be a tad lower in northwest Europe. But as it's the old that mostly get nailed, gotta reduce that number to the share of years left, so a relatively small number.

Of course, this is all strictly utilitarian. Distributional concerns can certainly be countenanced.

On a practical level, the Swedes do not seem to have to worry about their health care system being swamped by a mass of early deaths, which is what is driving concerns in most other countries.

[Stockmann]

On a practical level, the Swedes do not seem to have to worry about their health care system being swamped by a mass of early deaths, which is what is driving concerns in most other countries.

It's much too early to tell. Even if the system doesn't get absolutely swamped, it will be facing extraordinary costs. There's the sheer cost of keeping covid-19 patients isolated from everyone else - if it's not done, or the measures taken fail, then the hospitals themselves become infection hotspots, with all sorts of knock-on costs. If they do get swamped, there are all sorts of costs like hypoxic newborns because doctors are making split-second decisions on whether an emergency c-section is really necessary and "Your water broke? Come back tomorrow or the day after."
Regarding other costs, if enough people practice social distancing, etc, then that brings about some of the costs of lockdown, but probably for a much longer period - basically until there's enough herd immunity to contain outbreaks. The jury is still out on whether catching it confers future immunity, and if the answer is no then there won't be herd immunity until there's a widely-used, effective vaccine or until all the more susceptible people die. Also, if you have a much higher rate of infection, aside from deaths that also means a lot of work lost to sick days.
Another cost is high-risk folks, or people who live with them, who work deciding to, in the absence of a lockdown, quit or retire rather than continue showing up for work. Since in Sweden you can live on government handouts essentially indefinitely, that's a viable alternative, but one very costly to the state.
I do wonder how Sweden's rulers are taking it individually - have they gone all Prince Prospero (from Masque of the Red Death), let's wait for others to die, or is it a pathological denial of reality, Brazilian style?
It seems from international experience the most bang for the buck was basically shutting down the borders very early on and quarantining anyone coming in, come hell or high water. It's been extremely successful in Vietnam.

[Hegemony]

Clearly many Swedes are still out and about.  The ones I know personally, which is 8 or 9, are horrified and self-isolating as much as they can.

[polly_mer]

Your example doesn't show what you think it does, nonntt.  Instead, it shows exactly the same fallacy for which you criticize the Internet randos: picking one easy soundbite and spouting off instead of trying to learn enough about a complex situation to make an informed decision.

Your points have minimal credibility for those who know a fair amount about higher education and have spent more than three weeks thinking about the problem.

You've latched on to what happens in your tiny part of academia or resonates with you from some mass media soundbites instead of actually knowing something from peer-reviewed research or at least extensive discussion for decades with relevant parties from a large cross-section of academia.

You don't actually know enough about either problem, but you've written an opinion piece and expect to be taken seriously by those who know.

And you expect your 'rebuttal' without even one specific observation criticized to be taken seriously...why exactly?

This one doesn't have to be taken seriously by those who need examples to be convinced.

That's in contrast to the people who need to take personal action to get off the death march, get a new job before the institution goes under, or other instances where individuals have to take individual action to save themselves from a predictable hardship.

This is merely an academic discussion that doesn't have nearly the personal, real-world implications to individuals for choosing to believe something comforting instead of taking action.  What individuals believe on the topic of what academia did or didn't do to ensure only real experts are in the media has little to do with what will happen to those individuals in real life.

The stakes are low so my providing voluminous examples is a waste of time, unlike yesterday's posts related to why discussing something that is roughly priority 1007th in importance to individual faculty members was ridiculous when the top 10-20 were so much more pressing to individuals who expect to teach in the fall.

[nonntt]

The Chronicle has recognized that academia has a problem: "This Harvard Epidemiologist Is Very Popular on Twitter. But Does He Know What He's Talking About?"

https://www.chronicle.com/article/This-Harvard-Epidemiologist-Is/248557

"Everyone is very frustrated with him and regretting that we didn't band together to discredit him," said one epidemiologist. Another called him a "guy with zero background" in infectious-disease research who is "spouting a bunch of half-truths."

[dismalist]

The Chronicle has recognized that academia has a problem: "This Harvard Epidemiologist Is Very Popular on Twitter. But Does He Know What He's Talking About?"

https://www.chronicle.com/article/This-Harvard-Epidemiologist-Is/248557

"Everyone is very frustrated with him and regretting that we didn't band together to discredit him," said one epidemiologist. Another called him a "guy with zero background" in infectious-disease research who is "spouting a bunch of half-truths."

The medium is the message. :-)

[Caracal]

The Chronicle has recognized that academia has a problem: "This Harvard Epidemiologist Is Very Popular on Twitter. But Does He Know What He's Talking About?"

https://www.chronicle.com/article/This-Harvard-Epidemiologist-Is/248557

"Everyone is very frustrated with him and regretting that we didn't band together to discredit him," said one epidemiologist. Another called him a "guy with zero background" in infectious-disease research who is "spouting a bunch of half-truths."

It isn't exactly a new problem. There's a figure in my broad sub field who wrote a big book a few years ago that got a lot of popular attention. In the press he has managed to represent the book as ground breaking scholarship, that goes against established views. The problem is that the most "revolutionary" conclusions have been accepted by almost everyone in the field for twenty-five years. Almost all of this scholarship is ignored, even in the footnotes. Even worse, he gets all kinds of things wrong. It is the kind of book that you read and some parts seem interesting, but when it covers a subject you know well the omissions and inaccuracies are really bad. When you discuss it with other people you realize that this is true of all of it.

It is hard to deal with this sort of problem, because academics who complain about someone's popular success like this tend to just look jealous. There's some truth to it. Of course people in the field resent the guy who wrote the book or this epidemiologist. If you think your work is important and has value, you try to do it well and carefully and then somebody comes along who weaponizes their lack of nuance and carefulness, that is pretty maddening.

It isn't really a new story though. Academics have been complaining about this for a very long time.

[writingprof]

It is ultimately a political judgment--not a medical one--to decide that a lockdown is worth the cost, and the cost--undeniably high--will go higher the longer the lockdown lasts or if we see significant flare ups a few months after a lockdown ends that precipitate calls for yet another lockdown.

I can see colleges and other institutions that are ripe for the suing agreeing to another lockdown, but I'd be shocked if the American people agree to it again. When it happened the first time, we knew nothing and had to make an instant, fear-based decision. Now, there's a semi-organized anti-lockdown political movement, a host of governors (and a president) who think lockdowns are silly, and an easily memorized set of anti-lockdown talking points. We're not going back inside unless we see corpses in the streets.

[Caracal]

It is ultimately a political judgment--not a medical one--to decide that a lockdown is worth the cost, and the cost--undeniably high--will go higher the longer the lockdown lasts or if we see significant flare ups a few months after a lockdown ends that precipitate calls for yet another lockdown.

I can see colleges and other institutions that are ripe for the suing agreeing to another lockdown, but I'd be shocked if the American people agree to it again. When it happened the first time, we knew nothing and had to make an instant, fear-based decision. Now, there's a semi-organized anti-lockdown political movement, a host of governors (and a president) who think lockdowns are silly, and an easily memorized set of anti-lockdown talking points. We're not going back inside unless we see corpses in the streets.

Actually, there is broad support for restrictions. A whole bunch of polls have found that Americans want a national stay at home order, another poll showed that two thirds of people were more worried about ending restrictions too soon than leaving them in place too long. Even among Republicans that number was over half. These anti lockout movements are mostly astro turfed by extremists and naturally egged on by the president because he's a sociopathic clown.

More broadly, you're missing the point. Nobody thinks massive country-wide lockdowns are good. They are a last ditch option to contain uncontrolled spread. But, the only way we are going to avoid it happening again is if people are willing to accept substantial restrictions. These might sometimes include local stay at home orders. If people aren't willing to accept that, we are going to end up here again one way or the other. You aren't going to just have everyone going about their day to day lives while lots of people are getting very sick and a substantial number are dying.

[Anselm]

The biggest mistake I have seen at my school and others is a combination of denial and dragging of the feet while we wait for another announcement about a change in policy.   

[nonntt]

It isn't exactly a new problem. There's a figure in my broad sub field who wrote a big book a few years ago that got a lot of popular attention. In the press he has managed to represent the book as ground breaking scholarship, that goes against established views. The problem is that the most "revolutionary" conclusions have been accepted by almost everyone in the field for twenty-five years. Almost all of this scholarship is ignored, even in the footnotes. Even worse, he gets all kinds of things wrong. It is the kind of book that you read and some parts seem interesting, but when it covers a subject you know well the omissions and inaccuracies are really bad. When you discuss it with other people you realize that this is true of all of it.

It is hard to deal with this sort of problem, because academics who complain about someone's popular success like this tend to just look jealous. There's some truth to it. Of course people in the field resent the guy who wrote the book or this epidemiologist. If you think your work is important and has value, you try to do it well and carefully and then somebody comes along who weaponizes their lack of nuance and carefulness, that is pretty maddening.

It isn't really a new story though. Academics have been complaining about this for a very long time.

Thank you, Caracal. This is what I was trying to suggest in the OP. These are long-standing issues in academia, and they're almost always ignored, because ignoring them is easier than raising a fuss about it. I can immediately think of books in my field as similarly bad and similarly famous as the example you mention. But who wants to spend the time to write a negative review of a bad book? Not me, I learned my lesson the hard way.

Here's another instructive and timely example. My Exhibit 1 above was from John Ioannidis. Now Ioannidis is in the news again as an author of the Santa Clara County study that everyone is talking about. If 4% of people in Santa Clara County have been infected, but only 69 have died, then COVID-19 is no worse than the flu, as the argument goes - and I've seen this argument made a lot already.

Only here's a response today from Andrew Gelman, professor of statistics at Columbia. Emphasis added.
https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/

I think the authors of the above-linked paper owe us all an apology. We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error.

I'm serious about the apology. Everyone makes mistakes. I don't think they authors need to apologize just because they screwed up. I think they need to apologize because these were avoidable screw-ups. They're the kind of screw-ups that happen if you want to leap out with an exciting finding and you don't look too carefully at what you might have done wrong.

Look. A couple weeks ago I was involved in a survey regarding coronavirus symptoms and some other things. We took the data and ran some regressions and got some cool results. We were excited. That's fine. But we didn't then write up a damn preprint and set the publicity machine into action. [...]

Also, remember that reputational inference goes both ways. [...] The study got attention and credibility in part because of the reputation of Stanford. Fair enough: Stanford's a great institution. Amazing things are done at Stanford. But Stanford has also paid a small price for publicizing this work, because people will remember that "the Stanford study" was hyped but it had issues. So there is a cost here. The next study out of Stanford will have a little less of that credibility bank to borrow from. If I were a Stanford professor, I'd be kind of annoyed. So I think the authors of the study owe an apology not just to us, but to Stanford. Not to single out Stanford, though. There's also Cornell, which is known as that place with the ESP professor and that goofy soup-bowl guy who faked his data. And I teach at Columbia; our most famous professor is . . . Dr. Oz.

Or in other words: Academia has a problem. Usually we can ignore the problem with few consequences, but eventually institutions risk their credibility. And this time, the consequences include additional people dying.