The Only Thing that Matters about Incidence is Consequence

I’m going to get more pointed with this Covid-19 blog, but my purpose is still primarily to discuss the way we talk about the virus, not draw social policy conclusions — though the data in this blog could definitely lead to some.

Here’s a ridiculous hypothetical example I’ve created to illustrate the point I’m going to make: “The Medical and Cultural Crisis of Amazon-Induced Paper Cuts!” Imagine that headline for a second. Or maybe these related ones:

“Since March 1, 2020 the incidence of paper cuts has gone up 3,000%”

“Customer reliance on Amazon to deliver household necessities during the pandemic has led to an exponential rise in Cardboard Injury Syndrome, as ill-equipped citizens tear into boxes without the proper tools.”

“Government calls for ban on box-based shipping practices!”

Imagine the fearful word choices centered around the C.I.S. (Cardboard Injury Syndrome) story: “rise” “exponential” “explosion” “ban”

Maybe you can’t, because the intelligent reaction to such ridiculous headlines would be a rousing “SO WHAT.”

In other words, the incidence of something is by itself meaningless. It is the severity of its consequence that makes it worthy of fear, concern, restriction, or analysis. Obviously coronavirus is inherently more consequential than paper cuts. Our very first reactions as a global or US culture imbued the phenomenon of coronavirus with a sense of consequence greater than other flus or illnesses. Today I’m not going to discuss the appropriateness of that initial sense of deadly consequence. But I’m going to look at a curious fact: at least on an emotional, sound-bite level we haven’t updated our sense of consequence over the past five months.

The graphics at the top of this blog come directly from King County, Washington’s Covid-19 dashboard today: two very basic graphics easily accessed by the general population (i.e. anyone who takes the time to visit the site). On the left the number of cases, which is back up to levels detected in the spring, and on the right the number of deaths per day.

A couple of immediate observations: We see far more discussion, especially in headlines, of the left graphic. If we make the assumption that we KNOW Covid-19 has a fixed mortality percentage, then the left graphic alone says all we need to know about the progression of the virus through our community. But everyone knows and admits that we are still very much in the middle of a long learning curve. The actual consequence (as measured here in one particular way, hard number of deaths per day) is ever-changing. The two graphs have significance considered separately, but they have a third, completely new significance when considered together. The right-side graph informs the left. If cases are at a high point similar to Spring numbers, but deaths now are at a late February rate (not a March or April rate) then the mortality rate of Covid-19 has starkly fallen. The disease appears to be far less deadly than it was in the Spring. Has the disease itself mutated somehow? Has something about the statistical process changed? These are really interesting questions. To my eye–as a random member of society who is fairly invested in the pandemic issue but also doesn’t tend to scour every online source–these questions aren’t being asked very much. Wouldn’t a change in the virus’ mortality rate be of chief interest, both in terms of how the disease works, and in terms of public policy governing social behavior.

If I had to trust one set of statistics, I would trust today’s over April’s. Why? Because we’ve been at this longer now and are less overwhelmed by the newness of our reactions and procedures to handle the virus. And also because today’s statistics seem to be at odds with King County and Washington state mandates, which makes me trust their validity more.

So why isn’t every headline and every virus-related conversation “Cases are Up, but Mortality is Down — We’re Beating Covid” or something to that effect?

The answer is different depending whose behavior you analyze.

With the media, I am always tempted to conclude it is because Bad News sells or grabs attention better. And a three-part statement, however important, simply takes more space and destroys the elegant simplicity of “Cases Soar!”

With the man or woman on the street, it’s a mix of things. We’re not scientists. We’re afraid. We’ve already sacrificed a ton of things to the Covid-19 danger narrative, so we’re highly invested in a certain version of reality. Constant re-analysis takes time and energy, and is exhausting. We think we are doing the right thing. And so on…no conspiracy theories needed to explain our actions and reactions.

With our leadership the phenomenon is most concerning. I hope it’s merely a variant on the man / woman on the street hypotheses. Our leaders are just people in the end, subject to the same fears, indecisions, and confirmation biases as the rest of us. Because if it is not that, then we are left with more chilling realities: ignorance, incompetence, conspiracy theories. I don’t (yet) find the conspiracy theories very helpful, but I sympathize with why some people turn to them. When you’re presented with what seems to be vast or intentional illogic, it’s a tempting route.

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