Authorities and Amateurs

Link post

Peo­ple are writ­ing a lot about the coro­n­avirus, and I’ve seen a lot of push­back on how pieces of­ten haven’t been writ­ten by peo­ple with epi­demiol­ogy or pub­lic health cre­den­tials. For ex­am­ple, Flat­ten the Curve of Arm­chair Epi­demiol­ogy, Listen To Ac­tual Ex­perts On Coron­avirus, and com­ments like this one. The ar­gu­ment that we should be listen­ing to ex­perts and not ran­dom peo­ple would make a lot of sense if the “arm­chair” folks didn’t keep be­ing right.

Let’s look at the ar­ti­cles they’re crit­i­ciz­ing for hav­ing non-ex­pert au­thors:

With two weeks of per­spec­tive, how­ever, these ar­ti­cles were ex­actly right. They clearly laid out the case for de­ci­sive ac­tion, and if we had fol­lowed their pre­scrip­tions more closely we would be in much bet­ter shape right now.

This goes be­yond a few ar­ti­cles, how­ever. All the as­pects of this crisis that have in­volved plan­ning more than a cou­ple weeks out have been very poorly han­dled:

  • Peo­ple weren’t told to stock up on food so that they’d be able to re­duce trips out­doors, and so that they’d have food in case they were quaran­tined for 2+ weeks. Stores weren’t told to pre­pare for a rush. A gov­ern­ment that was on top of things could have started ad­vo­cat­ing this in early Fe­bru­ary in an “if you can af­ford to” way. This would have spread peo­ple’s buy­ing over a longer pe­riod and avoided the empty shelves we see now. In­stead, once restau­rants were clos­ing and peo­ple re­al­ized that they could be quaran­tined at any time, ev­ery­one si­mul­ta­neously tried to buy weeks worth of in­gre­di­ents and we had wide­spread short­ages of ba­sic goods start­ing in mid March.

  • Hospi­tals weren’t told (or al­lowed?) to ra­tion per­sonal pro­tec­tive equip­ment such as masks un­til they had short­ages. The CDC didn’t pub­lish guidelines for san­i­ti­za­tion and reuse, and start tel­ling peo­ple to con­serve. In weeks of han­dling ini­tial cases, hos­pi­tals burned through amounts that would have lasted months with care­ful ra­tioning.

  • The fed­eral gov­ern­ment, state gov­ern­ments, or even hos­pi­tals could have placed emer­gency ven­tila­tor pro­duc­tion or­ders in Fe­bru­ary, but didn’t. Be­cause we don’t al­low price goug­ing, ven­tila­tor com­pa­nies can’t ramp up pro­duc­tion spec­u­la­tively figur­ing that if there is re­ally an epi­demic then they’ll make their money back. By mid March it was ob­vi­ous that we were far short of where we needed to be and the com­pa­nies started ramp­ing up but we lost about a month of pro­duc­tion in­crease.

  • Masks were sit­ting on shelves across the coun­try, and the gov­ern­ment could have req­ui­si­tioned them for emer­gency med­i­cal use, or even just gone and bought them. In­stead the Sur­geon Gen­eral tweeted a re­quest that peo­ple not buy them.

  • Test­ing has been com­pletely messed up, though it’s hard to tell how much was bad luck vs rea­son­able ra­tioning of scarce tests. But we should have been quaran­tin­ing peo­ple who seemed to have it based on symp­toms, in­stead of say­ing “well, since we can’t test you we have to as­sume you don’t have it, so you’re wel­come to con­tinue liv­ing your life”.

  • We could have planned and built out COVID-spe­cific fa­cil­ities to re­duce the risk of oth­ers get­ting sick and make more effi­cient use of ven­tila­tors and per­sonal pro­tec­tive equip­ment. We’re just start­ing to do this now, much too late.

  • The pas­sen­gers of the Grand Princess were offered test­ing but told that if they tested pos­i­tive they would be re­quired to un­dergo quaran­tine. Of 858 pas­sen­gers, 568 de­clined test­ing and were re­leased with­out even ad­vice to self-iso­late.

  • The CDC is still (3/​24) not recom­mend­ing the gen­eral pub­lic avoid con­tact with oth­ers un­less you’re sick, they’re sick, or you know covid-19 is spread­ing in your com­mu­nity. They’re only recom­mend­ing peo­ple stay home if they’re sick.

And I un­der­stand: this is mov­ing very quickly, and au­thor­i­ties aren’t used to need­ing to re­spond so rapidly. But there was a meme go­ing around:

Neil Di­a­mond: touch­ing hands
CDC: no don’t touch hands
Neil Di­a­mond: reach­ing out
CDC: please avoid that
Neil Di­a­mond: TOUCHING YOU-
CDC: ev­ery­one is Bos­ton is doomed
@ac­tion­cook­book (2/​27)

This joke and its many copy­cats fea­ture the CDC we wish we had. A CDC that would have been push­ing so­cial dis­tanc­ing a month ago, when it would have helped so much more.

Google Trends: “so­cial dis­tanc­ing”

If we had listened to the warn­ings and pre­pared bet­ter we would have the ex­perts we need, with the in­fluence to get poli­cies changed, and we wouldn’t need the ad­vice of the arm­chair epi­demiol­o­gists. But that’s not the world we’ve found our­selves in, and the am­a­teurs have been do­ing crit­i­cal work filling in for them in push­ing policy.

A policy of “listen to ran­dom ex­perts” is bet­ter than a policy of “listen to ran­dom am­a­teurs”. But re­ject­ing the ar­gu­ments of am­a­teurs who were mak­ing clear ar­gu­ments, solely on the grounds of their non-ex­pert sta­tus, was harm­ful here.