Friday, September 04, 2020

Follow The Science

Teddy Roosevelt’s 1910 speech has been frequently quoted
"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."
I think of this with regards to all the complaints on a variety of topics about “following the science.” Folks are throwing that phrase around pretty blithely lately, both seriously and as a sneer.  I like Glenn Reynolds and his site is one of the ones I go to first every day, but his credentials, formal and informal, do not include anything about making judgements about scientific matters that affect others. He is complaining about the experts, always in quotes, and how they have failed us recently, and he is not the only one.  It has become a popular sport this year.  I'm calling it out. It's a cheap way to make points. People who have to read scientific research and try to get some sense out of it that they can pass it on safely to other people tend much more to “On the one hand, on the other hand.”  People trying to score political points tend to make broader statements.

So, should you take 81mg of salicylic acid, a baby aspirin, every day? Aspirin’s been around for a long time, a lot of people take it, we know its effects in significant detail, so it should be trivially easy to figure that out, right? Years ago folks started taking a regular aspirin 325mg figuring that the blood thinning would have a good effect if they were likely to have blood clots or blockages.  Lots of doctors signed on to the reasoning.  Then the word went out that the 81mg were just as good with less risk, so everyone went to that. Unless you had some sort of a scary incident that made you look higher risk, at which point they put you back up to 325mg, even though there was no real data supporting it and even if your event didn’t have much to do with a need for thinning the blood.
A couple of years ago a large study came out suggesting that 162mg was better, followed by an even larger study that said none of it does any good unless you are on your way to the ER, and even small amounts increase risk of “events.” Got all that? That is how science works. There was one study about statins that was full of holes, but we went for years wondering if we should go off them, because they have side effects of their own, like increasing diabetes risk, which could be a net negative, right? Doctors disagree about whether surgeries are needed, what medicines are the best fit and even whether they are needed at all case-to-case.  I suspect that mental health research, with political and cultural eyes over everyone’s shoulders are among the most difficult to make sense out of, but maybe I just say that because that is my task and it’s really irritating. Science is hard. That there are knuckleheads on the other side of your political divide who are even worse than you at figuring that out doesn't get you off the hook.  Not here.

We don’t do research about the things we already know.  No one is researching what the next planet out after Uranus is.  No one is applying for grant money to figure out what angle billiard balls go when they hit each other, or whether dogs can be taught to shake hands, or whether vitamins are good for you, or if investing in public sanitation reduces disease, or whether seat belts reduce auto deaths. We research things because we don’t know them, and even as the results are coming in they can look different every month.  The researcher Svante Paabo of the Max Planck Institute was preparing his speech for a conference in May 2010 to make the solid declaration that the research was finally confirming what had long been suspected, that even if Neandertals might have interbred with modern humans in Europe 40,000 years ago, they provided no genetic material that has come down to us.  That’s what the preliminary results showed after the full sequencing in 2009.  But he had to change the speech while it was in draft, as it became clear that 1-4% of non sub-Saharan human ancestry actually is Neandertal.

I don’t think that early on in the CoVid crisis we should have been told “Wear masks….no, no, I mean don’t wear masks…wait, did I say don’t?  I meant you absolutely have to wear masks.” But the worry at the time was that nervous people in South Dakota who never got out much anyway were going to hoard 50-100 N95 masks at a clip when we were worried about a shortage for city nurses who had people coughing in their faces. Also, masks are a mixed bag in terms of value.  The good medical ones do a lot, the others vary in terms of their quality and how accurately people use them.

 And even then it’s variable.  They don’t protect you much walking around, and the protecting others is mostly cumulative percentage increases.  Except of course, if the guy next to you sneezes without a mask, or starts coughing behind you in line.  Or that table of jolly folks at the restaurant are singing along and laughing, and talking loudly and making lots of trips to the small restrooms. Which happens in New Hampshire and everywhere else. At those moments, masks matter a lot, and you suddenly get it. When you are out in the parking lot getting in your car to go home, not so much. And we know that drunks are going to understand the distinctions perfectly. So if you are making brave pronouncements about masks and rules, I remind you that you are not in the arena.

Some in the southern and sun belt states dismissed the idea that they were going to have a problem.  It was all just those dumbasses in New York, we don’t need this level of shutdown.  Some places, I guess you could say that was true.  But Atlanta, Houston, Phoenix and lots of other sunbelt places did have problems.  Nowhere near as bad, partly because the medical care was better, as people learned in the hard school hospitals of Detroit and Newark what worked best. Other people paid that cost for you. It might be nice if you at least said thank you.

OTOH, it has been ugly to hear people in this northern state actually gloating over deaths in those states, though, purely out of defensiveness and spite. They don't think that's what they are doing, but taking a breath and looking at simple content of sentences reveals that truth.

Lots of Americans broke the quarantine and distancing rules, egged on by people who said “Americans will never put up with that and will rebel.”  Yeah, gee, thanks.  So the others have to stay locked down even longer because you made excuses for the scofflaws.  How is that different, except in scale, from making excuses for looters? So wise, so cynical, so...anosagnosic and ultimately selfish.

For openers, stop with the blanket statements about how well “the experts,” and the politicians, the men in the arena did or didn’t do.  We had a lot of people talking, so you can prove whatever point you want with a little googling. That's good to keep in mind when you read things that prove your POV. Some did better than others, and for many the book is still out.  I made few predictions myself, whether from humility or timidity, but I did say that if we didn’t have that many deaths that some people would say “See, we never needed to worry.” 


james said...

"No one is researching what the next planet out after Uranus is. " Actually, that would be sociological research, wouldn't it? Back between 1979 and 1999 the next planet out was Pluto, except that Pluto isn't supposed to be a planet anymore.

Medical science is extra hard. There are so many variables, and doing experiments on people is frowned on.

Assistant Village Idiot said...

Yes the elliptical orbit of Neptune does confuse that issue, doesn't it? I should have picked Saturn instead,

GraniteDad said...

Well said.

DirtyJobsGuy said...

The proprietor at the Coyote Blog had an interesting though. He classified people’s attitude to “SCIENCE” as if they were “Catholic” or “Protestant”. He meant that his Catholic’s looked to an established authority for guidance where Protestants had to decide themselves. Thus most NPR listeners rely on a whatever the progressive consensus is at the moment. So when the Dutch government decides that mandatory mask wearing provided little benefit except on crowded subways (also the Danes and Swedes) they were expelled from the consensus that Europeans as a group got COVID right. Dissenting viewpoints were not allowed. Ditto for recent studies (rather many) showing lockdowns had little impact, largely because they missed large parts of the population and were too late. Hearing our trust fund governor in CT make numerous references that “we are not Georgia (or Florida, Texas and other non-Northeast states) and what a great job he did while failing to shut down the commuter rail from NYC resulting in us being #3 in COVID deaths and cases is laughable. Failing to be honest enough to learn from your mistakes is the great crime.

Assistant Village Idiot said...

The science of blogspot ate my brilliant comment. I'll come back tomorrow.

Tom Bridgeland said...

I thought it was going to be a lot worse than it turned out to be, thank God! The insane-appearing actions of the Chinese really spooked me.

By the way, get your flu shots this year, please.

David Foster said...

Rarely, when dealing with practical matters, does Science remove the need for judgment. When Biden says 'listen to the scientists', I ask: Which scientists? Those virologists and immunologists who are focused on Covid-19 are going to have a different view from Public Health researchers who are concerned with a whole range of medical conditions, some of which may be impacted negatively by things which *improve* the C19 situation. Then there are Social Scientists, who may offer data on things like suicides and 'deaths of despair'...not to mention Economists.

I would think anyone with experience in running large/complex organizations and/or projects would understand about conflicting recommendations from different experts, but evidently not Biden.

Many (most?) politicians don't have any sense of how science actually works, and scientists are to them indistinguishable from magicians or shamans.

PenGun said...

Masks. They are useful for two reasons.

They prevent spread by containing an infected person's viral output. About 80% is a number some people agree on, for viral particles contained in the mask, that will not go on to infect others.

As well its been shown, originally by the Chinese, that the actual viral load, the amount of virus ingested, has a great deal to do with how severe the infection will be. Wearing a mask reduces that viral load.