“Insanity is doing the same thing over and over and expecting different results.” This quotation attributed to Einstein, was said by him (if he really said it) in the context of quantum mechanics, where doing the same experiment repeatedly does give different results. But in the macro world the same experiment properly performed does give the same result, hence the assumption of insanity to someone who expects a different outcome to a well executed measurement.
The last issue of the New England Journal of Medicine contains a brief article by an epidemiologist that contains, as it penultimate paragraph, the following:
In all mechanistic models, epidemics can die away in two ways: either the disease runs out of fuel because there are no longer enough susceptible people to infect, or something changes to slow or halt transmission — for example, the number of contacts is reduced by dramatic physical distancing interventions. Since this latter mechanism slows the spread of disease without changing the number of people at risk, Covid-19 models agree that almost all populations are at risk of disease resurgence when societies reopen. Recent serosurveys indicate that even where this pandemic has been most severe, we remain far from starving it of susceptible hosts and must continue to control spread with contact-reduction measures.
The author says Covid-19 models agree that almost all populations are at risk of disease resurgence when societies reopen. Then she says we remain far from starving it of susceptible hosts and must continue to control spread with contact-reduction measures. I interpret her to be advocating a strategy she admits has failed.
Her recommendation is way beyond her area of competence. It’s not only out of her ballpark, it’s from another planet. The role of an epidemiologist is to define the properties of a public health issue and then to suggest ways that its harmful effects might be mitigated. If such advice seems to be the incarnation of the old cliché – the cure is worse than the disease – then it should be modified or rejected.
The current mess we’re in, where the world order seems at risk of disintegration, is the result of relying entirely on the wisdom of a small group of epidemiologists whose knowledge of economics, politics, and societal cohesion is no better than the average postman, room clerk, or psychiatrist.
What was lacking from the start of this crisis, and which is still out of sight, was a risk-benefit calculus of all possible responses to a new highly contagious disease. What we got instead was global panic and the disorder that inevitably follows a disjointed response.
We are still acting as if closing down most of useful activity is going to end the plague and leave prosperity and plentitude as its sequel. This delight in disorder response appears so far advanced that nothing can reel it back. What we should have done is to admit that we faced a disease that would kill a lot of people before it went away. We could have warned the vulnerable population to shelter as much as possible, realizing that such a response would be difficult in multigenerational families. We are still using the war image to depict the pandemic; but we act as if war were without casualties or deaths.
If you think that ruining the social and economic lives of a large percentage of the world’s inhabitants, disrupting its ecology, and causing turmoil yet to be fully realized is worth the effort against the virus that so far has had little result – then we should continue down the descending trail plotted by our tunnel-visioned epidemiologists.
But if you believe that Sweden got things right by staying open, you’ll find much to criticize about the approach of the US and most of the rest of the world. Sweden has had a higher mortality rate than the other Scandinavian countries, but less than the rest of Europe. It’s economy is in much better shape than elsewhere. It kept its schools open. Its number of new cases has fallen sharply. There’s a price for everything. Sweden elected to pay it up front. We’ll be arguing for a long time about which country made the best decision. The invoice for the choice the US made has yet to be tallied. It’s almost certain to far higher than Sweden’s – both in human suffering and materiel. Einstein would know how to classify our approach.
