Coronavirus Diary (22): “I Don’t Know What I Can Do to Save People Anymore…”

A viral video worth watching:

There are two ways of interpreting this video.

One is to see this as a single panicky anecdote by a single ER nurse. Since mere anecdotes don’t add up to data, this woman’s effusions, though no doubt sincere, don’t amount to very much in the way of hard-nosed evidence. To genuinely evaluate this woman’s merely anecdotal claims, we’ll have to wait a few years for a double-blind peer-reviewed study that tells us what really happened. Until then, Olympian skepticism is in order, along with a dispassionate retreat to the ivory tower.

The other approach is to treat the nurse’s testimony as prima facie plausible, given its coherence with everything else we know about this pandemic, and infer that a conservative formula for calculating the magnitude of the problem we face is to multiply her anecdote by x, where x is a positive integer of unknown value intended to measure harm, and brace for impact.

There is, I guess, a third possible response: calculate the value for x, and then point out that as large as it may be, it is after all smaller than x squared.

Feel free to describe your interpretation in the combox. I’m guessing that at this point, you know mine.

11 thoughts on “Coronavirus Diary (22): “I Don’t Know What I Can Do to Save People Anymore…”

    • P.S. Because I could later edit the post at my blog, I will document the (data-driven) prediction here by copying it from my blog post as I published it today (03/29/20):

      Assuming that lockdowns, quarantines, and social distancing continue for at least two more weeks, and assuming that there isn’t a second wave of COVID-19 because of early relaxation or re-infection:

      The total number of COVID-19 cases in the U.S. won’t exceed 250,000.

      The total number of U.S. deaths attributed to COVID-19 won’t exceed 10,000.

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      • As I’ve said on my Facebook page, I find the entire discussion of expected aggregate infections and expected aggregate deaths to be a pointless academic exercise of interest only to ideologues concerned to make this or that polemical point.*

        I lack the statistical and epidemiological expertise to evaluate the rival claims here, but I also regard the entire discussion as utterly beside the point.

        First of all, your qualifications come with a proviso whose probability is completely unknowable:

        Assuming that lockdowns, quarantines, and social distancing continue for at least two more weeks, and assuming that there isn’t a second wave of COVID-19 because of early relaxation or re-infection:

        That’s a lot of assumptions to make.

        Is it really legitimate to make assumptions about adherence to lockdown protocols and the like? Some places are locked down, some are not. Some people are engaged in social distancing, some are flouting the need for it. So adherence differs even if we look at things synchronically. But adherence will differ yet more if we look at them diachronically. Peoples’ resolve will either intensify or slip. Do we know which one they’ll do? I don’t–but neither do you.

        You offer no calculations or estimates re the probability of universal or near-universal or high levels of adherence. So, academic or polemical exercises aside, can we really so blithely “assume” that we’ll get it? If not, can we so blithely assume that there won’t be a second wave? Unless we somehow rule it out, we have to consider the possibility that adherence will be spotty, and that a second wave could indeed materialize. Your calculations remind me of the old joke about economists needing to dig a hole, and producing equations that assume the existence of a shovel (along with soft ground).

        Second, the relevant practical issue is not, “How many infections and how many deaths will we see?” The practical issue is: all things considered, what is the likelihood that our medical case load will overwhelm our capacity to handle it? If so, how can we quickly generate extra capacity to handle it in a way that doesn’t wreck the life-prospects of non-COVID patients?

        The two predictions you make don’t address either of the preceding issues at all:

        The total number of COVID-19 cases in the U.S. won’t exceed 250,000.

        The total number of U.S. deaths attributed to COVID-19 won’t exceed 10,000.

        It’s not even clear to me what time-frame you have in mind. Total number of cases won’t exceed 250,000 over what time frame? Deaths attributed to COVID-19 won’t exceed 10,000 by when? Deaths attributed how? If a renal patient without COVID suffers premature mortality on March 30, 2021 due to complications incurred by lack of availability of medical services on March 30, 2020, is that a death attributable to COVID? I’d say so. Would you? But if it is, it changes the calculations.

        In the absence of answers to the questions I’ve just posed, I guess I’d pose a question back to you. Why is it of such great interest to you that the total number of cases won’t exceed 250,000, and total number of deaths won’t exceed 10,000? Apart from your evident belief that your calculations somehow serve to own the libs, what practical difference do they make to anything?

        Suppose that the total cases were 25,000 and deaths were 1,000. Or suppose that the total cases were 2.5 million, and deaths were 100,000. If any of those figures would wreak absolute havoc on the health care system and those who staff it, the basic practical issue we face is: how do we avert that outcome, or at least mitigate it? It is not, “How do we score polemical points against leftists by making confident assumptions about unknowable events?”

        The bulk of my blogging here has focused on micro-level realities: not regions or states, but particular hospitals. If there weren’t a lockdown, I would actually be at specific hospitals in New York, New Jersey, and Pennsylvania, blogging about the situation there. Bear in mind that COVID-19 patients can’t even be transported from one town to the next. If I go to Hunterdon Medical Center (in Flemington, NJ) in acute respiratory distress, I will be treated there, and if there are no beds or vents there, I will die there. No one will put me on an ambulance, much less airlift me, to Robert Wood Johnson Hospital in New Brunswick, just down the highway. Likewise huge numbers of hospitals in every “hot spot” in the land. Whether this yields x or x-squared infections, or y or y -squared deaths doesn’t much matter.

        Until we get COVID-19 securely under control, and avert the catastrophe that befell Italy and Spain, the predictions you’re making are of academic interest in the classic sense–the equivalent of predicting how many COVID-19 viruses can dance on the head of a pin. Feel free to win that battle. The rest of us have a different one on our hands.

        *The Facebook link didn’t come out, but here is the link for my page:

        https://www.facebook.com/irfan.khawaja.3701

        The relevant post is March 27, 2020 around 7:30 am. It’s on a public setting.

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        • So much for those estimates, LV, whether in or out of the “ballpark.”

          USA 348,042 +11,369 10,309 +693 19,208 318,525 8,830 1,051 31 1,799,447 5,436

          At this rate, the 10,309 mortality figure is not long for this world.

          As I said in my comment, you went wrong because you made far, far too many assumptions in order to pursue a will o’ the wisp of secondary importance. Let’s assume a simple linear model. Let’s assume adherence to social distancing guidelines. Let’s wish away the possibility of a second wave. In other words, let’s put our amateur epidemiological skills on display to pursue a polemical end based on a statistical house of cards that will require endless revision and modification in order to make a point that doesn’t matter to anyone or anything.

          I feel no great sense of triumph in pointing out that 348,042 cases > than 250,000 and that 10,039 deaths two weeks after your prediction of 10,000 deaths is a refutation of your claims, full stop. I’m just stating facts. Hand up the shovel. It’s over. You were wrong.

          Your errors wouldn’t be so offensive if all that they involved was epidemiological amateurism and bad calculations. That would just make them a useless waste of time and energy that might have been put to better use at a time when the time and energy of intelligent people was at a premium. Now, of course, it’s basically a lost fucking cause. Now, we’ll just peak wherever we peak, travel down the other side of the curve, and some fond day in the distant future, revert to the mean.

          No, what’s offensive is someone who insists on wasting all that fucking time and breath on such a pointless endeavor, but still insists on doubling down on this:

          A few weeks ago, when COVID-19 was just beginning to look like a serious problem in the U.S., I saw a gloating op-ed by a left-winger on the Sunday “left vs. right” op-ed page of my local paper. The thrust of the lefty’s op-ed was that COVID-19 would push the U.S. into recession or depression, and that Trump wouldn’t be able to brag about the strength of the economy during his presidency.

          Sick, sick, sick. But there’s a lot of that kind of sickness going around on the left. In yesterday’s NYT, for example, there was a piece by Robert Sharma under the headline “This Is How the Coronavirus Will Destroy the Economy“. Sharma’s piece makes some sense (as I will come to), but it is telling that the leftists at the Times chose to showcase it.

          What is it with leftists and doom-saying? Well, doom-saying serves the purpose of justifying more and bigger government. And doom saying comes naturally to leftists, because they are neurotics. (See the section on Psychology at my “Leftism” page.)

          COVID-19 was just “beginning to look like a serious problem.” Right. You mean it isn’t one? You saw gloating by a left-winger. I like that, coming from a guy who wants to treat New York as the national leper colony: “Avoid New York (and New Yorkers) Like the Plague.” Incidentally, it’s not just leftists who think that COVID-19 will push the U.S. into depression; so do libertarian economists like Michael Munger. That Trump won’t be able to brag about the strength of the economy is obvious, because that strength is already gone. But hey–if only Obama had had the sense to create a Space Force, I guess, none of this would ever have happened.

          I’m not a leftist, so I can only read your fulminations with a detached sense of wonder. “The psychology of leftism” is your abiding fixation. The leftists are “sick, sick, sick.” Please. I would leave those topics alone if I were you. The more you try to draw attention to them, the more the reader wonders about you. As Chesterton famously put it, when a man thinks any stick will do, he picks up a boomerang. A piece of free advice: it’s time to put the stick down. There’s enough danger out there that you shouldn’t want to add to it.

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    • I certainly hope this is right, LV. However, your being right is consistent with what this nurse is going through happening at many hot-spots around the country. There is an immediate problem, and not a small one, to get these folks equipment to save lives and not get infected themselves (in NY, NJ, LA, MI at least).

      Liked by 1 person

  1. Highly relevant articles in today’s New York Times:

    I’m just hurriedly writing this between (online) classes I’m teaching; will respond to LV at the end of the workday, but basically, I agree with Michael’s comment above. More later.

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  2. A putatively intelligent Facebook friend of mine is promoting this video, in all seriousness, as a skeptical corrective to what he thinks of mainstream reporting on front-line realities during this crisis (not that the video of the nurse above is “mainstream”; it was just uploaded to social media). Call it yet another desperate, inept attempt to minimize and deny reality for ideological reasons–libertarian Lysenkoism in the case I have in mind.

    This is the video the unnamed “man” above was responding to. But I mean, who ya gonna believe–an ER physician, or some fucking moron trying to create a conspiracy theory out of a Chinese restaurant sign?

    What’s relevant here is not that random people would promote stupid conspiracy theories at a time like this, but that educated, ideologically zealous people would, and would gain traction among like-minded people. Hard to say how many people are doing this, but clear that many are. The implicit message seems to be: if only we had adopted their pet ideology, the pandemic would never have happened, and no one would have an obligation to do anything about it. If only we could inhabit the imaginary universe in which such fantasies were true. Too bad we don’t.

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