I Don't Know And You Don't Either

In the midst of this pandemic there are many things we don't know, a great number of which are simply unanswerable as the coronavirus marches through the world.  Yet many people, both experts and others, act like there is much more certainty about the coronavirus and COVID-19 than actually exists, and therefore the correct courses of action blindingly obvious.  We see too many people, who should know better, trying to use geometric logic to prove who stole the strawberries when we don't know if there were twenty or a million strawberries and or even if blueberries were somehow involved.

As individuals and through various layers of government we need to make decisions nonetheless.  I would be happier if we just acknowledged what we don't know and made our best judgments.  Those judgments inevitably will contain an element of the values we bring to our decisions (1).  So be it.  We may be right, we may be wrong but we must make decisions and live with the consequences.

As is often the case, Winston Churchill provides us with good advice:

It is not given to human beings, happily for them, for otherwise life would be intolerable, to foresee or to predict to any large extent the unfolding course of events. In one phase men seem to have been right, in another they seem to have been wrong. Then again, a few years later, when the perspective of time has lengthened, all stands in a different setting. There is a new proportion. There is another scale of values. History with its flickering lamp stumbles along the trail of the past, trying to reconstruct its scenes, to revive its echoes, and kindle with pale gleams the passion of former days. What is the worth of all this? The only guide to a man is his conscience; the only shield to his memory is the rectitude and sincerity of his actions.(2)

Among the unknowables while the pandemic, or at least this phase, is ongoing:

Will the Swedish approach work?  For those opposing lockdowns, Sweden has become a beacon of hope.  Yet the data at this point is ambiguous as to whether the strategy is succeeding.  We don't know now and won't know until this is over.

How effective are social distancing and lockdown strategies?  While I think they are to some degree  because there is a plausible underlying mechanism to explain effectiveness, there is some contradictory data out there (3).  It is possible there are some inherent population density or cultural factors at work or something about the specific structure and actions of this virus that might make distancing less effective. 

Will any or some of the therapeutic treatments being discussed prove effective?  With both clinical trials and on the front lines where ER and ICU doctors are using anything available to try to save patients the evidence so far is unclear whether any of the many therapeutics proposed for treatment are truly effective.  Unfortunately, the Hydroxychlorquine War has diverted public attention from the other promising therapies, though I guess it makes Trump haters, Trump lovers and Trump himself happy since it makes the discussion about Trump, which is all any of them care about.

Will there be second, third or fourth wave?  Will this stick around for years like other coronaviruses?  We simply do not know, yet the success or failure of decisions we must make now depend on the answers to those questions.

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(1)  On this point, I disagree with Governor Cuomo when he announced yesterday the regional re-opening plan and stated as a general principle:

Any plan to reopen society MUST be driven by data and experts, not opinion and politics.

We won't have the data we would like.  Available data and expert advice is helpful but the final decisions will, and should, depend on the judgment and values of politicians who, among other things, will gauge public opinion.  The truth is Governor Cuomo actually knows this but it sounds better to pretend otherwise.

(2)  From Churchill's eulogy for Neville Chamberlain, November 1940.  A rhetorical masterpiece and demonstration of Churchill's characteristic magnaminity towards a man who had treated him, both politically and personally, very shabbily.

(3)  Though some of the specific lockdown requirements make no sense to me and we need to find a way to start lifting them as soon as possible.