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Straight into it this week!
What did I get wrong about COVID-19?
When I started this email list, all the way back in the beginning of 2020, I didn’t know what I wanted to write about.
I didn’t have to wait long.
When COVID-19 began to disrupt the world around me…
…when all the toilet paper was suddenly gone, and my friends were all staying inside to “flatten the curve,” and I wasn’t really sure if I’d have a job for much longer…
…I knew that I could use Better Questions to help me better understand the world outside my front door.
The resulting series on risk, uncertainty, and making decisions in confusing times was called “All Woods Must Fail.”
In that series I talked about priors, the past experiences we use to predict how likely or unlikely something is.
From Bad Priors:
“Every single moment of your life, you are amassing a database of information about the world.
You estimate statistical likelihoods based on what you’ve experienced.
When I asked you to guess you considered how many Toms you know, or have heard of.
Then you did a rough calculation in your head – even if you were unaware of it.
That information you brought to the table – your beliefs about how many Toms there are – is a prior.
Your priors are all the information about the world that you bring to any decision making process…
What you believe before you see any specific evidence.
You consult that information before you make a prediction.
And of course, all decisions are just predictions about how things will turn out.
Your priors influence what you predict AND how you interpret evidence afterwards.”
It’s difficult for us to update our priors when presented with new information.
When something contradicts our view of the world – especially if that view of the world is based on real, yet necessarily limited, personal experience – we tend to ignore it or explain it away rather than incorporate it into future predictions.
It isn’t that people don’t want to revise their priors. Lived experiences feel more real to us than disembodied facts and figures. It’s hard to know who to trust in this world, but we can always trust ourselves…or, so we think.
Once an idea gets rooted in our brains it’s very hard to get it out. Doing so requires discipline and practice – a dedication to trying to live as rationally (and as compassionately) as possible.
None of us are perfect, but we can all be better.
I’d like to share some of my personal beliefs about COVID, the pandemic, and the world in general that have been challenged in recent months.
I will provide a brief summary of each issue and where I now believe I was wrong. I’ll link to the articles that changed my thinking, but largely I’ll let you come to your own conclusions.
One last warning: I’m not a scientist or a doctor. I’ve been wrong before, and I’ll be wrong again. My opinions are just that – please balance them with your own sources of information before drawing any conclusions.
“We need to be washing our hands, disinfecting surfaces and potentially even cleaning our groceries.”
Don’t get me wrong – washing your hands is awesome. After all, there’s a reason that we practically wiped out the flu in 2020 – social distancing and better hygiene really do combat disease.
The problem is that, despite initial statements from nearly everyone, COVID-19 is not primarily spread via contact with people or surfaces.
“If the importance of aerosol transmission had been accepted early, we would have been told from the beginning that it was much safer outdoors, where these small particles disperse more easily, as long as you avoid close, prolonged contact with others. We would have tried to make sure indoor spaces were well ventilated, with air filtered as necessary. Instead of blanket rules on gatherings, we would have targeted conditions that can produce superspreading events: people in poorly ventilated indoor spaces, especially if engaged over time in activities that increase aerosol production, like shouting and singing. We would have started using masks more quickly, and we would have paid more attention to their fit, too. And we would have been less obsessed with cleaning surfaces.”
The focus on surface-transmission led to the ubiquitous “hygiene theater” of 2020 – people in HazMat suits disinfecting every possible surface. No harm, no foul – a little bit of playacting never hurt anyone.
But it also led to a disastrous lack of focus on airborne transmission. “Stand 6 feet away,” as universal a recommendation as you could find, turned out to be based on almost nothing at all.
The story of how all this came about is fascinating, frustrating, and heart-breaking, all at the same time. I highly recommend you read this in-depth piece on some of the scientists who struggled to get public health authorities to revise their priors (as we all know, a far more difficult task than it may seem).
“COVID-19 almost certainly spread from bats to humans. The idea that it was created in a Chinese lab is a racist fever-dream used by Donald Trump to stir up his base.”
This may be the single biggest U-turn I’ve experienced in my adult life.
I was 100% convinced that COVID-19 was naturally-occurring. I believed it came from bats and likely spread to humans from a wet-market in China, either from someone eating a diseased animal or by a diseased animal infecting some intermediate host that was then eaten.
While this still seems to be the most common take, the evidence – in my completely non-scientific opinion – now seems to point to COVID-19 being created in a lab.
Sound like a conspiracy theory? Believe me, I get it. The single best article on this topic is here, for anyone who wants a very deep but very readable summary of the science involved. If you read anything from this email, it should be this.
If you still believe the lab theory was all about Trump and racism, you’d expect the Biden administration to quickly disavow the claim…but that hasn’t happened.
This is the most glaring recent example of my personal politics clouding my judgement.
Whether you buy the scientific arguments for a lab origin or not, it is certainly possible; there are multiple historical instances of man-made viruses escaping labs we can point to. Despite this, I would have argued that Trump’s claims were pure fantasy.
Why? Because Donald Trump said it, so it must be bullshit.
Trump simply lied so often, and distorted reality so brazenly, that I not only ignored everything he said but actively took the opposite stance whenever possible.
That’s still letting Donald Trump dictate my political opinions, which isn’t something I’m comfortable with.
“We need to wear masks outside. The kids should mask up on the playground.”
The CDC has repeatedly claimed that “less than 10 percent” of all COVID-19 transmissions occur outside.
10% ain’t nothing, right? So, I wore a mask on my walks around the block. We always made sure our kids wore masks to the playground or to play outside with neighborhood kids. We wore masks when my Mom dropped birthday presents off on the front porch.
The “wear-a-mask-outside” belief heavily influenced how I saw 2020’s surge in political activism.
If the protestors were right-wing, they were reckless, didn’t care about anyone other than themselves, and were anti-science. They were putting everyone at risk over nothing!
If the protestors were supporting Black Lives Matter, they were taking a personal risk, but only because participation in such a major civil rights moment was an ethical obligation. I wasn’t happy about it, but I was on their side.
As it turns out, nearly all of this intellectual-hand-wringing was based on false pretenses. As this article explains, the “less than 10%” number used by the CDC should have been “less than .1%.”
“Saying that less than 10 percent of Covid transmission occurs outdoors is akin to saying that sharks attack fewer than 20,000 swimmers a year. (The actual worldwide number is around 150.) It’s both true and deceiving.”
Outdoor transmission of COVID-19 is practically non-existent. None of the protests resulted in a significant spike in cases; ditto for people going to the beach. Knowing that might have encouraged me to get outside more, to let the kids play more freely, to be a little more willing to get together with family, friends, and neighbors.
“We still need to wear masks after we’re vaccinated – after all, you can still get the virus, the vaccination just stops you from being hospitalized. I don’t want to spread it to anyone else.”
The messaging around post-vaccination life from the CDC has been cautious since the beginning – appropriate, perhaps, since the effect of the then-new vaccines was still unproven.
But from what I can tell right now, while you can still contract and spread the coronavirus after you’re vaccinated, it’s incredibly rare.
From the New York Times:
“…The [CDC] effectively acknowledged it had fallen behind the scientific evidence: Even though that evidence has not changed in months, the C.D.C. overhauled its guidelines. It said fully vaccinated people could stop wearing masks in most settings, including crowded indoor gatherings.”
“Although no rigorous study has yet analyzed whether vaccinated people can spread the virus, it would be surprising if they did. ‘If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!’ Dr. Paul Sax of Harvard has written in The New England Journal of Medicine. (And, no, exclamation points are not common in medical journals.)
On Twitter, Dr. Monica Gandhi of the University of California, San Francisco, argued: ‘Please be assured that YOU ARE SAFE after vaccine from what matters — disease and spreading.'”
Despite this information, I find myself reluctant to give up masking altogether, even though I’ve been fully vaccinated for over a month.
Masking took on additional layers of meaning during the pandemic. For me, personally, it wasn’t just a way of decreasing the chance of getting COVID-19, although it was certainly that.
It was also a way of signaling to the people around me that I gave a shit. That I was willing to listen to what authorities were saying, that I was aware of the dangers of COVID-19 and was willing to experience some personal discomfort in order to ensure that the people around me were as safe as possible.
When I saw other people masking, it meant I could relax a little bit – and that feeling of communal responsibility was incredibly important to me.
We had so little control for so long. The little steps we could take – washing our hands, wearing masks, standing apart, avoiding our loved ones – could be painful, but they were also a way of asserting ourselves against the chaos of the wider world.
If we all do our part, we can make a difference.
It’s hard to let go of that, now.
I may be protected from this particular virus, but I’m still vulnerable – still unable to predict what will happen next, still dependent on the people around me to do the right thing, still watching, still waiting…
And still updating my priors.
Cool Stuff To Read:
How to Not Let Work Explode Your Life. This article tied so many disparate things I’d been thinking into a nice, tidy bow…a fantastic read for anyone trying to make their way through our increasingly-anxiety-producing world.0