Thursday, September 3, 2020

Covid19, Causality, "Real Numbers"

The linked is from Vox, and biased left, however if you read it with glasses not so tinted, it does provide some useful info on cognitive issues like "motivated reasoning".

The CDC recently updated some of their stats to show that only 6% of the deaths listed as being "caused" by Covid19, was Covid19 the ONLY potential causal mechanism present. Determining "cause of death" is more art than science. 

Trump and others have jumped to the conclusion that those were the only deaths caused by Covid19, and most of the media left wing government complex says that is COMPLETELY WRONG ... the commonly reported big number is "right"! (or maybe even low!) 

My guess is that the likely answer is something less than that -- say "40-60K" ... this post is the reasoning that leads to that number. 

Reading the linked article will give you at least a bit more information that the right answer is almost certainly "in between" ... however since the folks writing that article are not immune from all the cognitive  problems described they fall into them and assume that all of the folks reporting the big numbers are correct! Hey, our tribe MUST be right!  We ALL ... readers, statisticians, media people, docs, scientists, Vox article writers, etc have A LOT of biases! What is a Moose to do? 

What I ATTEMPT to do (imperfectly) is to assume that if something completely agrees with my biases, it is nearly certainly "mostly false". The world is nearly never black and white, and it takes EFFORT to get to something approaching truth -- and none of us really "likes" effort, although we will make it if we are motivated by something  -- like if the information challenges our deeply held beliefs, indicates we may be "wrong", "stupid", or such. 

One of the ways we can learn is by paying attention to history, even RECENT history like H1N1 in 2009, when Obama stopped testing as the numbers got too high! There is fairly good evidence that H1N1 was more serious problem than Covid19 -- it killed the young. 

Last year, I had a seizure 4 days after I drove my motorcycle from Rochester to our place in IA. Had I seized on the bike, crashed and died, they would not have done an autopsy. Looking at the chart, they would have likely selected "unintentional injury". Autopsies are not commonly done on people over "60" unless the cause of death is "suspicious" -- or, they are looking for something (like Covid). 

If you go look at the CDC instructions for filling out cause of death, the most interesting relative to this discussion may be the following. 

The elderly decedent should have a clear and distinct etiological sequence for cause of death, if possible. Terms such as senescence, infirmity, old age, and advanced age have little value for public health or medical research. Age is recorded elsewhere on the certificate. When a number of conditions resulted in death, the physician should choose the single sequence that, in his or her opinion, best describes the process leading to death, and place any other pertinent conditions in Part II. If after careful consideration the physician cannot determine a sequence that ends in death, then the medical examiner or coroner should be consulted about conducting an investigation or providing assistance in completing the cause of death

Clearly, this guidance is going to lead to "motivated reasoning"  (discussed in link). At least in Minnesota, the docs got a 6 page memo to help motivate them toward Covid19. At one time it was possible to follow links and actually read the memo, which I did. As someone who worked in a bureaucracy for 34 years (IBM) the memo was CLEAR ... "when in ANY doubt, it's Covid!" So, given the chart above and all of our well known proclivities to "take the easy way", "follow the crowd", and others covered in the link above, it seems extremely and conservatively reasonable to assume that the "reported deaths" can at LEAST be cut in half. My guess is that the likely answer is something significantly less than that -- say "40-60K". 

While we are on "motivated reasoning", one of the common ideas proffered for Covid mortality is: " Covid MUST be CAUSING more death since there are "excess deaths" "!  This is discussed in this post. The simple answer is "correlation is NOT CAUSATION"! Drowning deaths correlate with ice cream sales, but that does not make ice cream a cause of drowning! 

Elderly people are vulnerable to lots of things ... their routine being disrupted, being scared, being cut off from their loved ones, having procedures delayed (even for just "weeks"), etc, etc. We are regularly told -- and to some degree I believe,  that "life events" are a significant causal factor in death -- older people die after "something traumatic" -- death of a loved one, a move, a change in health status, etc. 

The way we have responded to Covid was going to "cause" (be a factor) in more death among vulnerable populations like the elderly, mentally ill, etc. There was GOING to be a "bump" in deaths given isolation, delayed procedures, scare factor, etc. This is why the past response to things like Covid as been "first do no/minimal harm" -- amputation will always "cure" an infection in a limb, but reasonable docs don't go there first. So why did we respond so differently to Corona? If you follow the link, that topic is discussed more deeply, but I think the simple answer (as it is for EVERYTHING in 2020) is TRUMP! 

In my view, the greatest tragedy of this is that it appears that not many people are learning from this event -- they have retreated to their tribal bunkers and other than firing some Social Media pot shots at their perceived "enemies" on the "other side", they are dug in like WWI trench warriors. Ideology kills at least learning -- and typically, people as well! 

Naturally, I think I'm the exceptional "reasonable person" -- don't we all? 

Can we all agree that these are not "reasonable times"? Mass and social media compete for "clicks". The sensational gets "reported",  the reasonable does not. Our "tribes" increasingly attempt to filter what we even see ... and to the extent we become more tribal, or unwilling to even look at the news at all, we become comfortable in our tribal ignorance. 

Masks may or not be effective relative to Covid19, but they certainly ARE effective in increasing government control of the population and in dividing the population politically! 

Yes, I know this is the age of "Identity" -- which often makes the purity of the Pilgrims seem liberal by comparison. We are where we are -- we need to realize that neither the current upper or lower bound is reported is likely to be correct, and neither are any of our assessments -- but if we THINK, we can likely get closer to reality than the extremes. 

Humility and thought would seem far more beneficial than  retreat to opposite incorrect conclusions.

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