Rationality and COVID-19

The world is pretty crazy right now. COVID-19 has caused the closure of countless businesses and slowed down in-person business for most others (though there is a glimmer of hope as small business and schools are looking at reopening in some respect). Many, many people are without a job or facing some kind of cutback. This isn’t just a US tragedy either; the economic impacts are being felt around the world.

So the question is, why? Why has the world essentially ground to a halt? People get sick all the time, right?

Recently I heard the comment that “the coronavirus is just like the flu” and that I should “compare the numbers” to see how the world is overreacting. This wasn’t the first time I’d heard this idea, though it caught me off guard hearing it from someone I know. I, of course, did not have any numbers readily available off the top of my head. I’m not even sure I ever looked at “the numbers” to know if COVID-19 is worse than the flu. I clearly hadn’t used hard facts to come to a decision so it seemed worth examining why I was confident that it is. I have to admit, it is possible that huge swathes of the world’s population (including myself) have this whole coronavirus thing wrong.

None of us have the time or energy to know everything about everything; sometimes we just need to trust a reputable source. While there are certainly things each of us has some depth in knowledge about, we simply can’t be experts in every subject. A sensible way of dealing with this fact is delegating some of our thinking to experts. Not all experts are created equal and people pick their favorite experts for numerous reasons. Part of the reason for our country’s increasing polarization could be related to this. People belonging to the same political party seem to depend on the same experts. This can lead to a pretty astounding correlation between political party affiliation and views on many seemingly unrelated issues. One such issue is whether or not COVID-19 is a serious health issue. Besides political affiliation, another approach to picking experts is based on their agreement with other things we think are true. This isn’t necessarily bad if those conserved beliefs are founded on something solid but clearly this isn’t always the case. No matter how we select which experts we trust, they can still be wrong. So, with that in mind, let’s take a step back and take a look at the actual data rather than obsessing about who to believe.

Looking at the Data

First, what does it mean to compare the numbers? How do we determine if one set of numbers is “worse” than another? It seems like we need to establish some metrics. One view of one set of statistics clearly shows that the flu indeed infected substantially more people in the US during the 2018-2019 season than COVID-19 has in 2020 (~35,500,000+ vs ~6,287,000). The same sets of data (though obviously different columns) also show that the number of deaths (both the total number and especially as a percentage of cases) shows that the mortality rate is substantially higher for COVID-19 (~34,000 vs ~188,000). Which is worse? Clearly, dying isn’t the worst thing that can happen to a person. It does, however, seem like a decent indicator, especially as a percentage of cases, for how “bad” an illness is. After all, for all those deaths, there were likely many people close to death that didn’t die. Maybe worldwide numbers offer a different view. According to Johns Hopkins COVID-19 Map, the world is at ~27,479,000 cases and ~896,000 deaths. The World Health Organization estimates that approximately 1,000,000,000 people contract the flu each year and between 290,000 and 650,000 deaths related to the flu. Once again, it depends on which statistic we look at to determine which is worse.

What factors might lead to these numbers? For the flu, we have a few advantages. We have vaccines for the flu, there are several antivirals available to treat the flu (including reducing its severity and duration), and it appears that the flu isn’t as lethal. From what we can tell, COVID-19 is significantly more contagious with an estimated R0 of 5.7 (though the value has been stated as low as 2.2 and as high as 8+). The seasonal flu has an R0 of 1.53. Being more lethal (possibly 10x as lethal) and being more contagious, why aren’t the numbers worse? Here we see our efforts with social distancing and lock-downs, more attention to hand washing, actually paying off. There’s actually pretty solid math behind why social distancing works (not that staying away from potentially sick people needs that careful of an examination). All that said, COVID-19 is a novel virus, meaning humans and modern medicine simply don’t have much experience with it. There’s a possibility that the virus might have some lasting or latent side-effects or complications in a percentage of the population that we just don’t know about yet. Only time will tell.

Interpreting the Data

It looks like, based on everything we know so far, that COVID-19 is more contagious, more lethal, less understood, and we have less ways to prevent or fight it. This seems pretty uncontroversial given the data we have. Given all that, why aren’t there significantly more cases? This seems to be the one metric that makes people question if we’re overreacting to COVID-19. The Simplest answer is that the worldwide response and partial global shutdown probably helped. This is where the real sticking point lies: not everyone buys that our efforts are effective or necessary at all. What if all the data listed above — or really any data from public sources — is fabricated/doctored/or otherwise fake? Maybe it is part of some kind of conspiracy to shut down <insert country here>. I can’t deny that this is also possible, but comparing the two possibilities seems pretty straightforward:

Option 1: COVID-19 is real and our efforts to reduce its impact have so far worked:

• Viruses exist
• The world has seen pandemics (and other epidemics) before
• Our efforts to fight COVID-19 seem to line up with known effective methods to staving off viruses
• Nearly every nation on the planet has participated in these same countermeasures (meaning the scope of concern isn’t just one country)
• There’s a strong correlation between when countries start seeing COVID-19, the rate of infection, and the apparent affect of countermeasures on those rates (flattening the curve)

Option 2: COVID-19 isn’t so serious and we don’t need to do so much to prevent it:

• Requires that numerous, independent agencies and governments, along with the majority of the scientific and medical community collaborate to deceive most of the world.
  • There is no evidence this is the case
  • There is no precedent for such a global coordination of deception
  • Would require the cooperation, silence, or ignorance of hundreds of thousands, if not millions, of people around the world
• Dismisses first-hand accounts regarding the severity of COVID-19
• It isn’t clear what the motivations would be behind over-blowing the risks of COVID-19
  • Since most people, regions, governments, and industries are affected, who is gaining?
  • Accurately predicting what kind of worldwide effects would occur from exaggerating COVID-19 would be very difficult

Conclusion

It seems pretty clear that, even without embracing a full-on conspiracy about why COVID-19’s dangerous would be exaggerated, believing that it just isn’t as bad as the world’s medical professionals think is difficult to justify. Clearly it isn’t ruled out in principle, but there’s just no evidence for it. I’m left with the view that the world hasn’t gone entirely crazy and that COVID-19 is worth worrying about. This is not a justification for paranoia; it is all about reducing the chances of spreading the virus. For instance, I realize that wearing masks (at least DIY/cloth masks) isn’t as effective as we’d like, it is still helpful and worth doing. Social distance is saving lives, so at least cut down on time spent near other people. Wash your hands often and avoid touching your face. These are all simple, easy to understand, and generally low cost ways each of us can do our part.

One final note: I realize I may have gotten a lot wrong here. I did my best to be thorough, but please comment or reach out if you find mistakes or things I should correct.