Thoughtful Pieces on the Lessons of COVID-19
Janan Ganesh, in the Financial Times, forcefully argues that the Covid19 has “no grand lessons for the world”. The significance of the pandemic is being stretched as implying the triumph of a “system” over another, but on the basis of poor evidence. Covid19 has taken the world by surprise and it is difficult to claim that systems characterized by more civic trust, or with stronger government, or with more liberal governments, performed better than their opposites.
The closest thing to a pattern in this tempest of data is the scarcely believable success of east and south-east Asia. But that region encompasses communist China, the multi-party democracy of South Korea and various polities in between. What systemic lesson is the rest of the world to take from this zone of competence?
There is no disgrace in the quest for such certainty. The “narrative fallacy” is a technical term for a very human foible. It refers to our need to see shape and order in scattered events: to explain and not just record them. The alternative, which is to accept the role of randomness in life, is often too much to ask. And so an on-form sports team is assumed to have a sublime new tactic at work. Energy stocks are said to rise “on the back of” an oil-price rise, as though coincidence is unthinkable.
This urge to attribute cause and effect is all the stronger in a mortal crisis. Confronted with mass suffering, it is soothing to believe that we will emerge wiser about how best to arrange our societies. A tragedy without a corresponding agenda for reform is all the harder to bear.
Unless the data coheres into some shape, however, that is what we have. The evidence does not even throw up many hard-and-fast rules about the right policies for a virus (Taiwan, whose total death toll is seven, has had no national lockdown). Far less does it elevate one model of social organisation over others. In the geopolitical propaganda war, China will claim that its system is the one that worked this year. The liberal west will argue the same, and both will have half a point, without a clinching case.
Beyond the tautological — good government is preferable to bad government — the world has amazingly little insight to show for its year of anguish. Its challenge is to resist forcing a narrative on to facts that do not support one.
I found the piece refreshing.
Miles Kimball, instead, points out that “perfectionism made the pandemic worse”. Kimball writes that “some of the caution about evidence, accuracy, efficacy and side-effects would make sense if we were facing a lesser disease. But when people are dying all around, getting the job done is what counts, even if you get the job done by imperfect means. The way the reproduction ratio works, combining a set of several very imperfects means that pushed the reproduction ratio below the critical value of 1 could crush the spread of the coronavirus.”
In other words, “every little bit would have helped reduce the reproduction ratio of the coronavirus, but only things that were big bits were allowed”.
Consider particularly his last two points:
– Because the vaccine protocol used two doses, the vaccine-rollout plan while vaccine doses are scarce is to vaccinate half as many people with two doses rather than twice as many people with one dose, which the vaccine trials suggest has a high enough level of efficacy that vaccinating twice as many people with one dose would lower the vaccines reproduction ratio much more.
– Finally, in something that shocks me, the article at the top, “Highly Touted Monoclonal Antibody Therapies Sit Unused in Hospitals” by Sarah Toy, Joseph Walker and Melanie Evans suggests that there is a reluctance to use monoclonal antibodies because there is not yet evidence that goes far beyond what was needed to get government approval. Monoclonal antibodies work by the same principles as vaccines; the big differences are (a) vaccines get your body to make antibodies, monoclonal antibody treatment directly injects antibodies, (b) the monoclonal antibodies are chosen to be especially high-quality antibodies, while your body might or might not make a lot of high-quality antibodies after you are vaccinated, and (c) you have to vaccinate everyone, but the monoclonal antibody treatment can be given to people after they start to show some symptoms and so can be prioritized better. You can bet that I would ask for monoclonal antibody treatment if I got Covid-19.
I shall add that this attitude goes very well with the unrealistic expectation that we can and should aim for “zero risk”. This would imply that either we can reach for big enough guns enough to achieve that goal, or it is better to wait. This strikes me as unrealistic.