Recently I posted on Facebook what I thought was a fairly innocuous article, originally published in Forbes, with a headline The Most Important Coronavirus Statistic: 42% Of U.S. Deaths Are From 0.6% Of The Population.
I commented neutrally:
‘This statistic seems accurate and should get lots more attention. Any medical numbers experts out there? What are the implications for policy?
The article’s headline made a simple statistical point: 42% of US coronavirus deaths are from 0.6% of the population — people living in nursing homes and care homes. The article made some fairly straightforward suggestions to protect this vulnerable population.
I didn’t expect much of a response; most postings on Facebook are far more controversial and polarized.
To my surprise, people posted deeply emotional comments — mostly angry and bitter. I recognized several who had made a significant number of anti-Trump posts.
But almost all of them borrowed Trump’s tactics to make their point: finger-pointing, name-calling, and ridicule.
Post anything about the coronavirus and you may feel like you’re holding up a Rorschach card. People read their own beliefs, fears, and fantasies into the title. To me, the article demonstrated a need for an important type of analytical thinking — the kind we do every day in a variety of economic and personal sectors. To many readers, the article appeared to be a subversive Republican plot. That’s scary.
Anyone involved in planning and strategy pays attention to patterns.
Imagine any of these scenarios (rounding up to 1% for ease of examples):
42% of your sales come from 1% of your customers.
42% of your past due accounts come from 1% of your customers.
42% of your revenue comes from 1% of your marketing actions
…you have 100 people on your sales team and 1 of them brings in 42% of your sales dollars.
… you have 100 teachers in your high school. Those who take Mrs. Anderson’s math class account for 42% of students accepted to college. Those who take Mr. Green’s English class account for 42% of the dropouts.
…one household accounts for 42% of the balance of unpaid dues of your homeowners’ association.
In any of these cases, what would you do?
Most likely you’d look at the 1% and the 42%. You’d realize that you won’t move the needle much until you face the challenge head-on. You have finite resources. Where do you focus?
For example, if 42% of sales come from 1% of your customers, you face a decision. You change your marketing to get more customers. You work with those customers to get them to buy even more. Maybe you focus more resources on that segment.
The one thing you don’t do is nothing.
You can’t interpret your data accurately by ignoring this reality and you can’t make wise decisions.
That’s all. The article itself doesn’t suggest a radical change in our actions to Covid19. But it does suggest that the risk to the general population — outside these homes — may somewhat lower than anticipated.
Perhaps we need to write to our legislators, asking them to pay more attention to nursing homes and care homes. These facilities have very strong lobbying groups that fight any attempt at regulation.
The article also reinforces what other experts are teaching us about how the disease is transmitted. Large families crowded into close quarters are at risk. We are now seeing evidence that household size can be a stronger predictor of getting Covid19 than other demographic factors; some studies even show that you’re more likely to contract the disease from family than from strangers, possibly because you see them more often.
The hot spots affect everyone. Singapore kept numbers down initially with lockdown, masks, distancing, and contact tracing. But new outbreaks occurred because they ignored “huge dormitories” housing migrant workers.
Coronavirus spread through the Texas Panhandle through the meatpacking firms. Conditions in a plant — close working conditions, cold temperatures — contribute to easy transmission.
These are undisputed facts. The way to argue against facts is to present conflicting but equally credible data. Trump rarely does this — and neither did the people who commented on my post.
People respond out of fear, not rationality.
Here are some (but not all) of the comments:
(1) “Wear a mask even if there’s no one else on the street.”
The Forbes article makes no reference to masking, except once in a brief reference to PPE equipment for health care workers. Masking has a place but will have much less impact if the “hot spots” are ignored.
Introducing an irrelevant topic to make a point: doesn’t Trump do this all the time?
Anyway, all the guidelines say we don’t need masks if we’re outdoors and safely distancing. This article focuses on crowded indoor conditions.
(2) “Deaths are the wrong metric.”
It would be wrong to use them as the only metric. But deaths from one source can point to a hot spot, which can affect the ability of the entire country to deal with the pandemic.
(3) “ Republicans are harping on the fact so many of the deaths from COVID-19 have occurred in nursing homes because they view the elderly as expendable.”
Finger-pointing! A classic Trumpster tactic, this time turned on to Republicans.
Fact: The vast majority of the elderly are not in nursing homes. As I’ve written elsewhere, simply being elderly doesn’t seem to be a risk for susceptibility or severity.
Perhaps the placement of the article in Forbes, a business publication, suggests a Republican perspective. However, an even larger article making the identical point was featured in the New York Times, which is hardly a bastion of Republicanism.
(4) “Are the other 58% not important?”
When you focus on 42% of revenue from 1% of your customers, you don't ignore the other 58%. You plan around them. You actually take better care of them because you understand what’s going on.
But if you ignore the 1% to 40% ratio, you may end up being unable to serve anyone. You certainly won’t allocate resources wisely.
(5) “The statistics are outdated. More cases are reported among young people.”
Blatant falsehood. No fact-checking. Who else does this? Yes — the orange-haired T-man.
Fact: The New York Times updated the numbers, with its own research, July 7. Nursing homes still accounted for 42% of deaths nationwide. Got another source? Bring it on!
Data analysis leads to freedom.
Once we understand how the disease is transmitted, we’re much closer to solutions that move us out of quarantine faster. Another New York Times article explains:
Since most transmission happens only in a small number of similar situations, it may be possible to come up with smart strategies to stop them from happening. It may be possible to avoid crippling, across-the-board lockdowns by targeting the superspreading events.
“By curbing the activities in quite a small proportion of our life, we could actually reduce most of the risk,” said Dr. Kucharski [an epidemiologist at the London School of Hygiene and Tropical Medicine].
Why are people responding so emotionally?
We have a vacuum of leadership at the top, combined with a dizzying array of news articles from a large number of sources. Many of the articles contain inaccuracies and it’s difficult to know what needs fact-checking.
For example, Scientific American published an article on the need to address the virus’s airborne transmission.
Another publication, LiveScience, quotes equally distinguished experts who disagree not so much with the facts, but with the implications. A British epidemiologist says, “Aerosol transmission can occur but it is probably a relatively minor route, and it won’t make much difference to the course of the pandemic.”
Who’s got time to read all these articles, let alone analyze the fine print? We’re more likely to grab snippets of data and cling to facts that support our beliefs.
Ideally, we’d have a qualified pandemic leader who could balance the theories of science with the cost-benefit reality of applying those theories. We’d have leadership who’d acknowledge that, unlike other countries, the US has a safety net with the strength of a cobweb.
That would take a lot of pressure off and leave us free to be open to ideas that initially seem counterintuitive, if not threatening.