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COVID: Arguing About the Invisible

Stephen Maurer, Adj. Em. Prof. of Public Policy | May 7, 2020

Democracies are only as good as voters’ ability to see and judge for themselves. That’s why we’re at our best when citizens experience the issues firsthand. Like the economy. Political strategists have made a fortune telling clients “It’s the Economy, Stupid.” And they’re right. After all, most voters are bound to know someone who’s out of work, or worried about their job, or have just been fired themselves. The experience is personal. They might not know what to do about it, but at least they know when things get bad enough that something has to be done.

But what happens when the problem’s invisible?

Disease isn’t like other issues. To be effective, it’s not enough for politicians to make the right decisions. In many cases, they have to make them weeks in advance at a time when hardly anyone is sick yet. The result, as Albert Camus wrote in The Plague (1947), is that every epidemic begins as an abstraction. In order to feel deeply, we first have to see the corpses. Worse, imagination finds itself pitted against the evidence of our eyes, which obstinately insist that nothing is wrong. Yes, culture matters. Novels and history books can change our judgments. But it’s always an uphill fight.

Nobel economist Daniel Kahneman (2013) has argued that this peculiar hesitancy is hardwired in each of us. That’s because the brain circuits that recognize patterns are physically different from the ones we use to construct logical arguments. No wonder, then, that we feel anxious when they disagree. Worse, neither type is demonstrably “better” than the other. Academics know in their bones that abstract reasoning is always simplified. You keep some facts and discard others, and hope that the latter turn out to be less important. For planetary orbits, the procedure works beautifully. For epidemiology, not so much.

American politics has seen many pathological debates like this, but the most recent example is surely global warming. No matter how much advocates like to say that storms and humidity “prove” climate change, that rhetoric only works for the converted. But an intelligent skeptic constantly hears friends and relations yammer on about ice cores and computer models and papers in Nature that they have plainly never read. Meanwhile her own life hasn’t visibly changed and anyhow, the detailed logic really doesn’t interest her. Because even if the math is right, “common sense” tells her there’s been a mistake somewhere.

So now we have COVID. Given the precedents, the early politics went pretty well. The reason, as social psychologist Paul Slovic long ago observed, is that people take risks more seriously when the possible downside is catastrophic. That described COVID nicely back in March when the modelers said sixty percent of the country could get sick. Even with a modest one percent fatality rate, that would have meant 250,000 dead in California, and four times that if the emergency exploded fast enough to overwhelm hospitals. Then too, the opposition to lockdowns was just getting organized. So when the government announced strong measures it was mostly pushing against a vacuum.

The difference now, of course, is that social distancing worked much, much better than we had any right to expect. So instead of a million dead, California is looking at perhaps 1,300 cases per day. Assume one percent mortality, and you end with roughly 5,000 fatalities per year compared to the State’s 7,000 annual flu deaths. Even if no politician will admit it, selling the risk as “catastrophic” will be a lot tougher going forward.

Meanwhile, the anti-lockdown crowd has gotten its act together. Predicably, their rhetoric mostly dwells on the sameness of everyday life. Conversely, they hardly ever address abstract arguments that the epidemic could just as easily get worse again. That’s smart. Slovic and his colleagues have shown that just mentioning the other side’s arguments, even in criticism, has a way of validating them. So the Anti-Vaxxers never explain why the 1918 Epidemic can’t return. The Libertarians yell that there’s nothing to discuss, the real issue was settled by the Constitution. And the Trumpians insist that it’s all a hoax even if, embarrassingly, their leader often acts as if it’s real.

The test going forward will be to see whether the country can loosen social distancing without unravelling it entirely. That middle ground will probably be sustainable if the epidemic ends quickly. Beyond that, though, the all-or-nothing arguments between believers and non-believers should warn us that we’re headed for political dysfunction.

The debate won’t be easy to manage. Because Camus was right: Disease is and always will be an abstraction. That said, politicians and journalists can at least target their message to those specific parts of the brain that most need convincing. That means giving the public patterns that we can judge for ourselves. And then explaining them simply, and honestly, and with as little theory as possible. The good news is that we already know this strategy can work. How else could the austerely geometric “Flatten the Curve” have become the Crisis’s best-known slogan?

So here’s my suggestion. Graph the total number of cases for every local community – national patterns blend too much together – and publish it with great fanfare once a week. Then tell the public that loosening can continue on two conditions. First, that new hospitalizations must never exceed the number of COVID patients who are discharged each week, because an upward trend that continues long enough will collapse the system. And second, that social distancing will be tightened immediately if the curve’s slope ever starts to increase again.

That’s it. No deep theory, no moving parts, no heckling slogans like “I believe in Science.” Just a simple geometry to track goals that either are, or soon will be within each State’s reach. Accompanied by the clear understanding that loosening is wonderful – but only so long as it works.

Comments to “COVID: Arguing About the Invisible

  1. Hey Stephen,

    Great piece and thank you for sharing. I couldn’t agree with you and Camus more regarding, “Disease is and always will be an abstraction.”

    How exactly do you anticipate to tighten social distancing if the curve’s slope were to start increasing?

    Keep up the great work,
    Matthew

    • Well yes, that’s the hard part! The best I can do is adopt a rule that authorities should always “do something,” because if the new steps also fail they will have to try something else the week after. And if the new steps do work, the following week the authorities could try relaxing something else. So with a month or two of trial-and-error, maybe you get down to a set of rules that does the job.

      This really isn’t the best way to do policy, I’d like to be more scientific, but my excuse is that epidemiology models are what the physicists like to call “semi-empirical,” we just don’t understand what’s going on well except in the middle part where infections explode. And people always try to write down substantive rules, when sometimes it’s easier and more effective to just write down a procedure that will generate the right answer over time.

      So you raise an important point. It would be great to have some rigorous algorithm for deciding when the trend should terrify us and when it’s not that bad, and how big the interventions need to be if it’s only somewhat bad. I worry that this particular research task is beyond us, but if everybody thought that way we’d never make progress!

      cheers,

      smm

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