Uncertainty, Arrogance, and Mourning in the time of Pandemic

As I write this I have been fielding messages from a friend and interlocutor who, a knowledgeable health industry professional, seems quite confident that had President Trump been successfully impeached—or, better, never elected—the COVID-19 pandemic would not have been such a trouble for us. 

And there may well be something, more than a little something, to this.  Catalogued charges of missed opportunities and willful neglect are well known.  At the same time, in some quarters anyway, Trump’s adversaries have not escaped criticism.

Of the first 100,000 or so deaths from COVID, about 40% are said to have occurred in nursing homes and assisted-living facilities for elderly people.  Joy Riley discussed the situation in a fine post on June 6.  But how accurate is the count?  We don’t know. The government can’t quite get the data, or its rules block collection of the data, or something. 

All the counts are imprecise.  The self-declared uncertainty in the IHME estimates appears rather narrower now than it did in April—it should, with more data—but it still gets wide after a while.  One doesn’t hear much about that uncertainty, unless you consult a site like five thirty-eight.  Lack of certainty does not mean that the modelers are purposefully misleading us, but, although they are making their best estimates to help guide public decision-making, it does guarantee that their projections will be “wrong.”  (The National Weather Service forecasts thunderstorms for Omaha next Monday night, June 22.  I think they are more likely to be accurate.)

How much of a greater outbreak will there be this fall?  We don’t know.  We can and should be concerned, and prudent, and considerate of our neighbors, but we don’t know.

Right now we’re overrun by people of all political persuasions, not just at one “end of the spectrum,” who are quite certain they are right and the other guys and gals are knee-walking stumblebums of the apocalypse.  Add in a dash of ulterior motive or hastiness and you get a lot of folks who, as President Reagan said, “know so many things that aren’t so.”  And then you get high-profile retractions

The pandemic is a poor topic for a bioethics blog because so much of bioethical discourse is about logical argument rather than decisions under uncertainty, or judgments unencumbered by data, and because there is a temptation to get on rather a high horse about matters.  Your correspondent confesses he is all too familiar with the latter.

When the humble (we hope), uncertain, doing-their-best public health forecasters speak, it would help if they would take care to sort value judgments from judgment calls, if they would stay in their lane and point out where their expertise ends and their opinions begin, and if they would resist expanding their remit to make every social concern, as great as those may be, a “public health” issue, and therefore a matter of science, with the attendant risk of false precision and, indeed, category error.  As readers of this blog have recently been reminded, what is “essential,” or more important than something else, is not subject to measurement and experimental verification.

And the rest of us should give those forecasters some grace.

Gerald Seib of the Wall Street Journal recently wrote that there is no goodwill in America anymore.  Sixty percent of people in each major political party think the opposing party is “a serious threat” to the nation.  Forty percent of each party think that the opposing party is “evil.”  About 15 percent (give or take a little) of each party think that violence would be “somewhat justified” if the other side wins the next presidential election.

I once heard a story—no doubt apocryphal, I can’t find it, but it serves my purpose—that Abraham Lincoln, at a friend’s funeral, listened to several people speak then rose to eulogize his dead friend—and just cried and sat down without uttering a word.

Maybe there’s a lesson there.

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