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Saturday, May 29, 2021

Kahneman et al's "noise" metaphor

"A flaw in human judgment."

It's a metaphor.
 
A figure of speech here denoting the unhelpful, wasteful imprecision wrought by excessive (and mostly remediable) variability in judgment and decision-making.
 
"Noise" in the aural definition context is that random conglomeration of sound waves that masks useful and desired "signals."

Inter- or intra-personal cognitive "noise" masks truths, impairing accurate judgments.

They commence with the venerable "accuracy / precision target" analogy, wherein "accuracy" simply means clustering tightly to the center bull's eye (Team A).


 
Team B is quite precise—and quite precisely "off" ("mis-calibrated," "biased"). Team C is simply randomly imprecise, and Team D is both imprecise and apparently biased.
This was a staple analogy for me during my university time in the early 2,000's as a "Critical Thinking / Argument Analysis" Adjunct. "You can be quite precise, and quite precisely wrong."
The focus of this book is "imprecision," not "bias," the latter of which is independent of variability per se. "Bias" has gotten way more ink than "noise." The authors, in addition to providing an extensive survey of the problem, posit a detailed method of analysis and mitigation.

An excerpt:
Matters of taste and competitive settings all pose interesting problems of judgment. But our focus is on judgments in which variability is undesirable. System noise is a problem of systems, which are organizations, not markets. When traders make different assessments of the value of a stock, some of them will make money, and others will not. Disagreements make markets. But if one of those traders is randomly chosen to make that assessment on behalf of her firm, and if we find out that her colleagues in the same firm would produce very different assessments, then the firm faces system noise, and that is a problem.

An elegant illustration of the issue arose when we presented our findings to the senior managers of an asset management firm, prompting them to run their own exploratory noise audit. They asked forty-two experienced investors in the firm to estimate the fair value of a stock (the price at which the investors would be indifferent to buying or selling). The investors based their analysis on a one-page description of the business; the data included simplified profit and loss, balance sheet, and cash flow statements for the past three years and projections for the next two. Median noise, measured in the same way as in the insurance company, was 41%. Such large differences among investors in the same firm, using the same valuation methods, cannot be good news.

Wherever the person making a judgment is randomly selected from a pool of equally qualified individuals, as is the case in this asset management firm, in the criminal justice system, and in the insurance company discussed earlier, noise is a problem. System noise plagues many organizations: an assignment process that is effectively random often decides which doctor sees you in a hospital, which judge hears your case in a courtroom, which patent examiner reviews your application, which customer service representative hears your complaint, and so on. Unwanted variability in these judgments can cause serious problems, including a loss of money and rampant unfairness.

A frequent misconception about unwanted variability in judgments is that it doesn’t matter, because random errors supposedly cancel one another out. Certainly, positive and negative errors in a judgment about the same case will tend to cancel one another out, and we will discuss in detail how this property can be used to reduce noise. But noisy systems do not make multiple judgments of the same case. They make noisy judgments of different cases. If one insurance policy is overpriced and another is underpriced, pricing may on average look right, but the insurance company has made two costly errors. If two felons who both should be sentenced to five years in prison receive sentences of three years and seven years, justice has not, on average, been done. In noisy systems, errors do not cancel out. They add up…


Kahneman, Daniel; Sibony, Olivier; Sunstein, Cass R.. Noise (pp. 30-32). Little, Brown and Company. Kindle Edition
From the Conclusion:
Noise is the unwanted variability of judgments, and there is too much of it. Our central goals here have been to explain why that is so and to see what might be done about it. We have covered a great deal of material in this book, and by way of conclusion, we offer here a brisk review of the main points, as well as a broader perspective.

Judgments As we use the term, judgment should not be confused with “thinking.” It is a much narrower concept: judgment is a form of measurement in which the instrument is a human mind. Like other measurements, a judgment assigns a score to an object. The score need not be a number. “Mary Johnson’s tumor is probably benign” is a judgment, as are statements like “The national economy is very unstable,” “Fred Williams would be the best person to hire as our new manager,” and “The premium to insure this risk should be $12,000.” Judgments informally integrate diverse pieces of information into an overall assessment. They are not computations, and they do not follow exact rules. A teacher uses judgment to grade an essay, but not to score a multiple-choice test.

Many people earn a living by making professional judgments, and everyone is affected by such judgments in important ways. Professional judges, as we call them here, include football coaches and cardiologists, lawyers and engineers, Hollywood executives and insurance underwriters, and many more. Professional judgments have been the focus of this book, both because they have been extensively studied and because their quality has such a large impact on all of us. We believe that what we have learned applies to judgments that people make in other parts of their lives, too…
(pp. 336-337).
I enjoyed it. Highly recommended.

SOME OTHER THOUGHTS ON "JUDGMENT NOISE"

With respect to wildly divergent, increasingly acrimonious social media "judgment noise," I have a "theory" involving the technical stats term "Kurtosis"—distributional "fat tails" where the lower and upper extremes of a distributional curve contain excessive proportions of the data under study e.g.,


My observation is that the "democratization" of online discourse materially resulting from the effective elimination of "barriers to entry" to opinion dissemination, irrespective of truth-value, has resulted in a frenzied "click-bait" communications cacophony culture wherein the only way to attract attention is to be more outlandish than the prior person. A "populist" exacerbation of the old media "If-It-Bleeds-It-Leads" ethos.

In fact, I would flip the allusive bell curve image on its head, where the bulk of noise is in the tails:

'eh? to wit-
Random screengrab today. 

NEXT UP
Summary
Given our long-standing interest in self-awareness, it is surprising how little science has traditionally had to say about it. What features of our brains enable us to think about ourselves? What are our strengths and weaknesses in this respect and how do they influence how we decide, learn, and interact? Can we train self-awareness, and how does this improve our performance? In the past three decades, however, research addressing such questions has been picking up speed. In Know Thyself, cognitive neuroscientist Stephen Fleming synthesizes this multifaceted research into an admirably coherent narrative and outlines how the resulting knowledge may be applied to solve societal problems.
Bears on "judgment," no? (And, so-called "Deliberation Science.") We'll see. Just got it. Deep into the Sally Weintrobe book at the moment.
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Tuesday, May 25, 2021

Tuesday, May 18, 2021

New book releases

 
I've been eagerly awaiting the Kahneman et al book for months. John Green's book dropped into my lap via a CBS Morning news segment with the author this morning. They were both released this morning.
 
Reading away. Both are killer reads thus far. Stay tuned. 

UPDATE

The John Green book jumped the queue. Marvelous writing. But only ever-so-tangentially and infrequently about the "Anthropocene."
I can’t remember when I first came across the word Anthropocene, but it must have been around 2002. The Anthropocene is a proposed term for the current geologic age, in which humans have profoundly reshaped the planet and its biodiversity. Nothing is more human than aggrandizing humans, but we are a hugely powerful force on Earth in the twenty-first century... This book started out as a podcast, where I tried to chart some of the contradictions of human life as I experience it—how we can be so compassionate and so cruel, so persistent and so quick to despair. Above all, I wanted to understand the contradiction of human power: We are at once far too powerful and not nearly powerful enough. We are powerful enough to radically reshape Earth’s climate and biodiversity, but not powerful enough to choose how we reshape them. We are so powerful that we have escaped our planet’s atmosphere. But we are not powerful enough to save those we love from suffering. I also wanted to write about some of the places where my small life runs into the large forces of the Anthropocene. In early 2020, after two years of writing the podcast, an exceptionally large force appeared in the form of a novel coronavirus. I began then to write about the only thing I could write about. Amid the crisis—and writing to you from April of 2021, I am still amid it—I find much to fear and lament. But I also see humans working together to share and distribute what we collectively learn, and I see people working together to care for the sick and vulnerable. Even separated, we are bound up in each other. As Sarah told me, there are no observers; only participants. Green, John. The Anthropocene Reviewed (pp. 4-7). Penguin Publishing Group. Kindle Edition. “I smell the wound and it smells like me,” Terry Tempest Williams writes in Erosion. I live in a wounded world, and I know I am the wound: Earth destroying Earth with Earth. What does it mean to live in a world where you have the power to end species by the thousands, but you can also be brought to your knees, or to your end, by a single strand of RNA? I have tried here to map some of the places where my little life brushes up against the big forces shaping contemporary human experience, but the only conclusion I can draw is a simple one: We are so small, and so frail, so gloriously and terrifyingly temporary. When I think of how I have enjoyed the Anthropocene so far, I think of Robert Frost, who wrote, “Like a piece of ice on a hot stove, the poem must ride on its own melting.” So it is with poems, and so it is with us. Like ice on a hot stove, we must ride on a melting Earth, all the while knowing who is melting it. A species that has only ever found its way to more must now find its way to less... (p. 273)
Bit of a clickbait book title? Quite worthy nonetheless. Elegant writing, candid, thoughtful revelations.

"NOISE?"

Just finished it. Fabulous. It will deserve its own post.

ON DECK
apropos of the "anthropocene."
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Sunday, May 16, 2021

Meanwhile, back at the Covid-19 pandemic

U.S. update.
 
Screengrab from the Sunday NY Times.
 
Have to wonder whether our increasingly widespread vax deployment is beginning to bear fruit. Places such as India and Brazil continue to suffer drastically. One hopes that restriction relaxations in the U.S. will not come back to bite us. 

UPDATE: Blistering COVID-19 post today over at Naked Capitalism. Read all the comments too.
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Tuesday, May 11, 2021

Is there a "science" of science communication?

 This
led me to this.
Introduction: Why Science Communication? Dan Kahan, Dietram A. Scheufele, and Kathleen Hall Jamieson #SciComm

Part One  
•  The Science of Communicating Science


1. The Need for a Science of Science Communication: Communicating Science’s Values and Norms Kathleen Hall Jamieson
2. Overview of the Science of Science Communication Heather Akin and Dietram A. Scheufele
3. On the Sources of Ordinary Science Knowledge and Extraordinary Science Ignorance Dan Kahan
4. How Changing Media Structures Are Affecting Science News Coverage Mike S. Schäfer
5. What the Public Thinks and Knows About Science—and Why It Matters William K. Hallman
6. Science Controversies: Can the Science of Science Communication Provide Management Guidance or Only Analysis? Bruce V. Lewenstein
7. A Recap: The Science of Communicating Science Joseph Hilgard and Nan Li

Part Two 
•  Identifying and Overcoming Challenges to Science Featured in Attacks on Science


8. Science as “Broken” Versus Science as “Self-Correcting”: How Retractions and Peer-Review Problems Are Exploited to Attack Science Joseph Hilgard and Kathleen Hall Jamieson
9. Publication Bias in Science: What Is It, Why Is It Problematic, and How Can It Be Addressed? Andrew W. Brown, Tapan S. Mehta, and David B. Allison
10. Statistical Biases in Science Communication: What We Know About Them and How They Can Be Addressed John P. A. Ioannidis
11. Is There a Hype Problem in Science? If So, How Is It Addressed? Peter Weingart
12. Is There a Retraction Problem? And, If So, What Can We Do About It? Adam Marcus and Ivan Oransky
13. A Recap: Identifying and Overcoming Challenges to Science Featured in Attacks on Science Joseph Hilgard

Part Three  
•  Science Comunication in Action: Failures and Successes


14. A Comparative Study of Communication About Food Safety Before, During, and After the “Mad Cow” Crisis Matteo Ferrari
15. Cross-National Comparative Communication and Deliberation About the Risks of Nanotechnologies Nick Pidgeon, Barbara Herr Harthorn, Terre Satterfield, and Christina Demski
16. Communications About Biotechnologies and GMOs Across Europe Heinz Bonfadelli
17. A Tale of Two Vaccines—and Their Science Communication Environments Dan Kahan and Asheley R. Landrum
18. A Recap: Science Communication in Action Heather Akin

Part Four  
•  The Roles of Elite Intermediaries in Communicating Science


19. Science Communication at Scientific Institutions Tiffany Lohwater and Martin Storksdieck
20. The Role of Scholarly Presses and Journals Barbara Kline Pope and Elizabeth Marincola
21. The Role of Governmental Organizations in Communicating About Regulating Science Jeffery Morris
22. Science Communication and Museums’ Changing Roles Victoria Cain and Karen A. Rader
23. The Role of Funding Organizations: Foundations Elizabeth Good Christopherson
24. Promoting Popular Understanding of Science and Health Through Social Networks Brian Southwell
25. Designing Public Deliberation at the Intersection of Science and Public Policy John Gastil
26. Translating Science into Policy and Legislation: Evidence-Informed Policymaking Jason Gallo
27. A Recap—The Role of Intermediaries in Communicating Science: A Synthesis Asheley R. Landrum

Part Five 
•  The Role, Power, and Peril of Media for the Communication of Science


28. The (Changing) Nature of Scientist–Media Interactions: A Cross-National Analysis Sara K. Yeo and Dominique Brossard
29. New Models of Knowledge-Based Journalism Matthew C. Nisbet and Declan Fahy
30. Citizens Making Sense of Science Issues: Supply and Demand Factors for Science News and Information in the Digital Age Michael A. Xenos
31.  The Changing Popular Images of Science David A. Kirby
32. What Do We Know About the Entertainment Industry’s Portrayal of Science? How Does It Affect Public Attitudes Toward Science? James Shanahan
33. How Narrative Functions in Entertainment to Communicate Science Martin Kaplan and Michael Dahlstrom
34. Assumptions About Science in Satirical News and Late-Night Comedy Lauren Feldman
35. A Recap: The Role, Power, and Peril of Media for the Communication of Science Nan Li and Robert B. Lull

Part Six  
•  Challenges in Communicating Science in a Polarized Environment


36. Countering False Beliefs: An Analysis of the Evidence and Recommendations of Best Practices for the Retraction and Correction of Scientific Misinformation Man-pui Sally Chan, Christopher Jones, and Dolores Albarracín
37. Using Frames to Make Scientific Communication More Effective James N. Druckman and Arthur Lupia
38. Philosophical Impediments to Citizens’ Use of Science Jonathan Baron
39. Overcoming Confirmation and Blind Spot Biases When Communicating Science Kate Kenski
40. Understanding and Overcoming Selective Exposure and Judgment When Communicating About Science Natalie Jomini Stroud
41. Overcoming Innumeracy and the Use of Heuristics When Communicating Science Ellen Peters
42. Overcoming Biases in Processing of Time Series Data About Climate Bruce W. Hardy and Kathleen Hall Jamieson
43. Understanding and Overcoming Fear of the Unnatural in Discussion of GMOs Robert B. Lull and Dietram A. Scheufele
44. Protecting or Polluting the Science Communication Environment?: The Case of Childhood Vaccines Dan Kahan
45. Overcoming False Causal Attribution: Debunking the MMR–Autism Association Nan Li, Natalie Jomini Stroud and Kathleen Hall Jamieson
46. Overcoming the Challenges of Communicating Uncertainties Across National Contexts Michael Siegrist and Christina Hartmann
47. A Recap: Heuristics, Biases, Values, and Other Challenges to Communicating Science Heather Akin and Asheley R. Landrum

ConclusionOn the Horizon: The Changing Science Communication Environment Dietram A. Scheufele, Kathleen Hall Jamieson, and Dan Kahan

Index
Yikes. Three editors, 59 contributing authors, 508 pages. And, $127.49 Kindle edition (ugh).

Ironically, those communicating about science often rely on intuition rather than scientific inquiry not only to ascertain what effective messaging looks like but also to determine how to engage different audiences about emerging technologies and get science’s voice heard. For decades, one plausible explanation for this state of affairs was the relative absence of empirical work in science communication. This is no longer a problem. As the essays in this volume confirm, researchers in fields as diverse as political science, decision science, communication, and sociology have examined how science can best be communicated in different social settings and in the process have evaluated different approaches to cultivating societal engagement about emerging technologies. A central task of the work in this handbook is distilling what they know about the science of science communication and unpacking how they know it.

By the science of science communication, we mean an empirical approach to defining and understanding audiences, designing messages, mapping communication landscapes, and—most important—evaluating the effectiveness of communication efforts. The science of science communication, as a result, relies on evidence that is transparent and replicable, theory driven, and generalizable. In short, evidence is derived by the scientific method, drawing on theories and methods from disciplines including economics, sociology, psychology, education, and communications science. What makes science communication distinctive is the fact that science’s way of knowing places constraints on communication that are not present in the same way in other forms of communication—for instance, communication about politics…

The audience we envision for this book includes scholars and students interested in understanding the pitfalls and promise of a scientific approach to science communication as well as, but not primarily, those on the front lines tasked with communicating complex and sometimes controversial science to policymakers and the public on consequential topics ranging from nanotechnology and nuclear power to the need for vaccination.

The Science of Science Communication
In 2012, the National Academies of Sciences, Engineering, and Medicine took a leadership role in connecting a community of social scientists who were conducting empirical research on different aspects of science communication. Two Sackler Colloquia and two special issues of the Proceedings of the National Academy of Sciences devoted to the “Science of Science Communication” were the result (Fischhoff and Scheufele 2013, 2014). Their intent was both to heighten awareness among bench scientists about empirically based approaches to better communicating science and to promote the exchange of ideas among social scientists working on problems related to science communication in various (sub)disciplines.

Built on the foundations laid by those Sackler Colloquia, this volume is predicated on three major assumption. First, science is not monolithic. Second, the aspects of science or its applications that are being communicated or debated are a function of the nature of the science itself, the types of applications made possible by science or their societal implications, and the social dynamics surrounding emerging science. Finally, communication is an inevitable part of the process of characterizing scientific findings, engagement among scientists about them, and the process of sharing them with policymakers and diverse publics…

(2017-05-08T23:58:59). The Oxford Handbook of the Science of Science Communication (Oxford Library of Psychology). Oxford University Press. Kindle Edition.
FROM THE PRESIDENT OF THE AMERICAN ACADEMIES
Since its inception, the American Academy of Arts and Sciences’ Public Face of Science Initiative has sought to understand and strengthen the relationship between science and society. The COVID-19 pandemic has stressed the critical role science plays in ensuring the well-being—indeed, the very survival—of both individuals and society as a whole. As we face this crisis, we can take some encouragement from the findings of the Public Face of Science Initiative, which show that confidence in scientific leaders has remained relatively stable over the last thirty years. It is worth noting, however, that this confidence varies based on age, race, educational attainment, region, political ideology, and other characteristics.
 
The current crisis has underscored the importance of a society in which everyone has equal opportunity to learn from, engage with, and participate in science. However, revenue losses and budget cuts are having an enormous, and still-evolving, impact on the professional writers, educators, museum curators, outreach organizers, and researchers who are dedicated to building the connections between science and society. While the goals and suggested actions identified throughout this report are more important than ever, they are even further from being realized due to diminished resources and field-wide layoffs. For those with the power and capacity to support the institutions and organizations that provide access to science, now is the time to act. The priorities and goals in this report highlight important means for local science engagement efforts, science journalists, and the scientific community more generally to communicate and engage more effectively… 
I got on this recurrent riff in part in response to a Science Magazine article touting the so-called "Science of Deliberation." There's also, recall, the putative "Science of Success." And, hmmm... how about "Neuroaesthetics" science? more mundanely, "Data Science." A "Science of Compassion?"
 

Oh, and by the way. "I am not a scientist."

 
In a "democracy," citizens are properly among the core decision makers. Hence, science literacy, particularly in the policymaking context, is rather important, ja?

There's no shortage of exigent realities in need of adroit, rational evaluation and decision-making. For starters, beyond pandemic prevention and mitigation, climate change adversity will not disappear.
 
More from Oxford:
Identifying and Overcoming Challenges Featured in Attacks on Science
The overall credibility of science and scientists is higher than that of many communities (Scheufele 2013), with only military leaders eliciting greater public confidence than the scientific community in 2014 (General Social Survey 2012). Nevertheless, popular understanding of how scientists generate knowledge is freighted with misleading simplifications. The gap between how people think science works and how it actually does can itself generate confusion that undermines public confidence.

Climate science communication furnishes a case in point. The popular conception of the “scientific method” envisions scientists “proving” or “disproving” asserted “facts” through conclusive experiments. The contribution that climate science makes to policymaking, however, consists less of experimentally corroborating basic climate mechanisms, most of which are well-known, than it does of establishing how they interact with one another. To generate such understanding, climate scientists use dynamic models, which are iteratively refined and adjusted to take account of new data. Discrepancies between model forecasts and subsequently observed data are expected—indeed, they are the source of progressive improvements in understanding. By design, dynamic modeling enlarges knowledge through its failed predictions as much as through its successful ones (Silver 2012).

Not only did science communicators fail to make this element of climate science clear to the public, but over the past decade, many of them adopted communication “strategies” that elided it. To promote the urgency of action, they depicted the projections of the Intergovernmental Panel on Climate Change (IPCC) reports—particularly those of the Fourth Assessment—as extrapolations from settled and incontrovertible scientific findings. But because this framing was selected to accommodate the popular understanding that science warrants confidence based on experimentally “proven” facts, it made climate science more vulnerable to attack by those intent on undermining public confidence in it when, as was anticipated by scientists themselves, actual data diverged from the climate-science model forecasts…
[Oxford Handbook, Kindle loc 502]
'eh?
 
Interesting: One of the editors and contributing writers in this Oxford Handbook is Dan Kahan. I ran into his name in another book I'm reading.
Yale law professor Dan Kahan surveyed Americans about their political views and their beliefs about climate change. As you would expect, those two things were highly correlated. Liberal Democrats were much more likely than conservative Republicans to agree with the statement “There is solid evidence of recent global warming due mostly to human activity such as burning fossil fuels.”

So far, not surprising. The twist is that Kahan also measured his respondents’ “science intelligence” with a collection of different questions: Some were puzzles designed to test reasoning ability, such as “If it takes 5 machines 5 minutes to make 5 widgets, how long would it take 100 machines to make 100 widgets?” Other questions were tests of basic scientific knowledge, such as “Lasers work by focusing sound waves—true or false?” and “Which gas makes up most of the earth’s atmosphere: Hydrogen, nitrogen, carbon dioxide, or oxygen?”

If knowledge and intelligence protect you from motivated reasoning, then we would expect to find that the more people know about science, the more they agree with each other about scientific questions. Kahan found the opposite. At the lowest levels of scientific intelligence, there’s no polarization at all—roughly 33 percent of both liberals and conservatives believe in human-caused global warming. But as scientific intelligence increases, liberal and conservative opinions diverge. By the time you get to the highest percentile of scientific intelligence, liberal belief in human-caused global warming has risen to nearly 100 percent, while conservative belief in it has fallen to 20 percent.

The same funnel-shaped pattern shows up when you ask people for their opinions on other ideologically charged scientific issues: Should the government fund stem cell research? How did the universe begin? Did humans evolve from lower animal species? On all these questions, the people with the highest levels of scientific intelligence were also the most politically polarized in their opinions…


Galef, Julia. The Scout Mindset (pp. 45-46). Penguin Publishing Group. Kindle Edition.
UPDATE
 
Finished The Scout Mindset. Enjoyable read. Not a ton of new ground for me, but worthy nonetheless. Useful "Scout" metaphor.  
 
On deck, pre-ordered (5-18 release):

Amazon blurb:
From the Nobel Prize-winning author of Thinking, Fast and Slow and the coauthor of Nudge, a revolutionary exploration of why people make bad judgments and how to make better ones--"full of novel insights, rigorous evidence, engaging writing, and practical applications” (Adam Grant).

Imagine that two doctors in the same city give different diagnoses to identical patients—or that two judges in the same courthouse give markedly different sentences to people who have committed the same crime. Suppose that different interviewers at the same firm make different decisions about indistinguishable job applicants—or that when a company is handling customer complaints, the resolution depends on who happens to answer the phone. Now imagine that the same doctor, the same judge, the same interviewer, or the same customer service agent makes different decisions depending on whether it is morning or afternoon, or Monday rather than Wednesday. These are examples of noise: variability in judgments that should be identical.
 
In Noise, Daniel Kahneman, Olivier Sibony, and Cass Sunstein show the detrimental effects of noise in many fields, including medicine, law, economic forecasting, forensic science, bail, child protection, strategy, performance reviews, and personnel selection. Wherever there is judgment, there is noise. Yet, most of the time, individuals and organizations alike are unaware of it. They neglect noise. With a few simple remedies, people can reduce both noise and bias, and so make far better decisions.
 
Packed with original ideas, and offering the same kinds of research-based insights that made Thinking, Fast and Slow and Nudge groundbreaking New York Times bestsellers, Noise explains how and why humans are so susceptible to noise in judgment—and what we can do about it.
All part of a "deliberation science" piece. Whether the topics are judicial, legislative, scientific, or public/social policy deliberations, we need our best honest, objective reasoning efforts, particularly given this time of rampant mis- and disinformation (i.e., shoddy advocacy borne of ignorance and intent respectively).
 
More to come...
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Sunday, May 9, 2021

On Mother's Day

 
Thinking about my late Mother today.
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Tuesday, May 4, 2021

The Covid-19 Premonition

Michael Lewis
 

INTRODUCTION
The Missing Americans


This book began with an unholy mix of obligation and opportunism. During the first half of the Trump administration I’d written a book, The Fifth Risk, that framed the federal government as a manager of a portfolio of existential risks: natural disasters, nuclear weapons, financial panics, hostile foreigners, energy security, food security, and on and on and on. The federal government wasn’t just this faceless gray mass of two million people. Nor was it some well-coordinated deep state seeking to subvert the will of the people. It was a collection of experts, among them some real heroes, whom we neglected and abused at our peril. Yet we’d been neglecting and abusing them for more than a generation. That behavior climaxed with the Trump administration. My book asked: What happens when the people in charge of managing these risks, along with the experts who understand them, have no interest in them?

I had no clue what was going to happen next. I assumed something was bound to happen. But it didn’t—not really. For the better part of three years, the Trump administration got lucky. That luck ran out in late 2019, as a freshly mutated virus in China made its way toward the United States. This was just the sort of management test I’d imagined when writing The Fifth Risk. How could I not write about it? But as I got into it, and found these wonderful characters to tell the story through, it became clear that Trump’s approach to government management was only a part of the story, and maybe not even the bigger part. As one of my characters put it, “Trump was a comorbidity.”

Back in October 2019—nearly three years into the Trump administration, and before anyone involved was aware of the novel coronavirus—a collection of very smart people had gathered to rank all the countries in the world, in order of their readiness for a pandemic. A group called the Nuclear Threat Initiative partnered with Johns Hopkins and The Economist Intelligence Unit to create what amounted to a preseason college football ranking for one hundred ninety-five countries. The Global Health Security Index, it was called. It was a massive undertaking involving millions of dollars and hundreds of researchers. They created stats and polled the experts. They ranked the United States first. Number 1. (The United Kingdom was Number 2.)…

Critics quibbled with the rankings. The complaints weren’t all that different from the complaints you hear before every college football season. For years the University of Texas football team, with its vast resources and sway with voters, always seemed ranked more highly at the start of the season than at the end. The United States was the Longhorns of pandemic preparedness. It was rich. It had special access to talent. It enjoyed special relationships with the experts whose votes determined the rankings.

Then the game was played. The preseason rankings no longer mattered. Neither, really, did the excuses and blame-casting and rationalizations. As the legendary football coach Bill Parcells once said, “You are what your record says you are.” At last count the United States, with a bit more than 4 percent of the world’s population, had a bit more than 20 percent of its COVID-19 deaths. In February 2021, The Lancet published a long critique of the U.S. pandemic performance. By then 450,000 Americans had died. The Lancet pointed out that if the COVID death rate in the United States had simply tracked the average of the other six G7 nations, 180,000 of those people would still be alive. “Missing Americans,” they called them. But why stop there? Before the pandemic, a panel of public-health experts had judged the United States to be more prepared for a pandemic than other G7 nations. In a war with a virus, we were not expected merely to fare as well as other rich countries. We were expected to win…


Lewis, Michael. The Premonition: A Pandemic Story (pp. xii-xv). W. W. Norton & Company. Kindle Edition.

I have long eagerly devoured everything Michael Lewis has written and published, all the way back to his Wall Street time. Hie latest book has just been published. 
 

Thia was all that Donald Trump saw and heard. He thought he was gonna ride the Dow-S&P-NASDAQ limo to a second term as Acting President. Everything else was irrelevant.
 
Cited Michael's book The Fifth Risk here.

 
Stay tuned. Just downloaded The Premonition.

UPDATE
 
Finished the book in a day and a half. Great story, compellingly written. Michael Lewis rocks. NY Times book reviewer wrote "I would read an 800 page history of the stapler if he wrote it."

Me too.

The CDC does not come off well in this book (nor do a number of other entities), in part for reasons long pre-dating the derelictions of the absurd Donald Trump.
 
Bring on the screenplay. Erin Brockovich, make room for
 
PUBLIC HEALTH HEROINE CHARITY DEAN
 
Dr, Dean resigned her California public heath position to co-found The Public Health Company (PHC).
Even before she’d quit her job she’d had that odd thought, that the country didn’t have the institutions that it needed to survive. In particular, it did not have what it needed to battle a pathogen. The pandemic had given America’s enemies a clear view of the country’s weakness: its inability to respond to a COVID-like threat. On her calls with the Wolverines, she’d ask: “What does the country need?” She was really asking herself, as no one had the answer. Her conclusion had pained her some. Once she’d become a public-health officer, she’d imagined an entire career in public service. Now she did not believe that the American government, at this moment in its history, would ever do what needed doing. Disease prevention was a public good, but the public wasn’t going to provide anything like enough of it. From the point of view of American culture, the trouble with disease prevention was that there was no money in it. She needed to find a way to make it pay.

The problem was a crazy problem. It wasn’t going to have a non-crazy solution. Still, she’d sort of shocked herself. She’d never had the slightest interest in business. But if she wanted to save the country, she’d need to become an entrepreneur, and create a company—though in business, she quickly learned, she couldn’t talk like that. When she said she wanted to build a tool “to save the country,” people just smiled and thought she was goofy in the head. But when she said things like “I’m going to create a data-based tool for disease prevention that companies can use to secure their supply chains,” serious business types nodded. “Five smart people have replied with confusion when I said the company was to save the world and protect our country,” said Charity, after her first attempts to explain her vague idea. “Then when I said, ‘We’re going to do private government operations, like Blackwater,’ their eyes lit up and they said, ‘Oh wow, you could take over the world.’ ”
[Lewis, pp. 298-299]
THE UPSHOT
 
 
They've come out of the blocks hot. to wit,
The Future of U.S. Public Health

Abstract

COVID-19 demonstrated a single pathogen’s ability to wreak havoc at global scale. Though organisms with this capacity strike sparingly, their impact nevertheless remains palpable for years to follow. Anticipating such biological threats has been historically difficult. As evidenced by the recent pandemic, our responses are often reactive, rather than proactive, and the consequences unforgiving…

This white paper outlines our framework for the future of U.S. public health as it relates to communicable diseases and public-private partnerships...

Closing remarks

Failing to address the fragmented and antiquated structure of our underlying U.S. public health system will continue to come at the unnecessary expense of lost human lives, shuttered businesses, and worsened divisions in our economic and health outcome chasm.
 
Much of this devastation is preventable but requires early detection, rapid response, and frictionless coordination. The public health system of the future gives private entities and local public health jurisdictions access to real-time information at their fingertips. A robust bio-surveillance and total infection control support system powered by science and technology results in rapid, tactical guidance and avoidance of deadly outbreaks. As pandemics increase in frequency and severity, the U.S. must stand ready with an infrastructure capable of protecting humanity against impending biological threats. We must break through existing structural forces and build a modernized system that has greater reliance on technology (including both genomics and dissemination of expertise via networked hub-and-spoke models) and empowered private sector leaders. As pandemics will certainly increase in frequency and severity, the U.S. stands at the precipice of a critical inflection point: continue with business as usual or use the COVID-19 pandemic as a turning point to reimagine our public health infrastructure.
They are Loaded for Bear, flush with significant VC funding.
When I was covering the healthcare startup space, I saw a lot of "Silicon Valley HBO" SMH stuff. PHC is immeasurably different. Totally substantive. As serious as a heart attack (read the white papers). I wish them well.
"Bears" watching.
 
The only thing I'd recommend goes to my recent study of Davarian Baldwin's "In the Shadow of the Ivory Tower." PHC lists its prospective business lines as encompassing "Business, Government, and Healthcare" sectors. What about "Academia?" See Dr.Baldwin's riffs on "Meds and Eds"—
Indeed, urban universities and their medical centers—the “meds and eds”—stand as one of the most central yet least examined social forces shaping today’s cities. In today’s knowledge economy, universities have become the new companies, and our major cities serve as their company towns. But unlike Amazon, Microsoft, and other info-tech industries, higher education claims responsibility for our public good. It’s time we investigated that promise, asking whether a school’s increased for-profit ambitions can undermine the interests of the public. In fact, the presumption that higher education is a public good has for too long distracted critics and urban residents from getting to the heart of the matter: what makes universities good for our cities? We need fewer assumptions and more analysis...

Baldwin, Davarian L. In the Shadow of the Ivory Tower (p. 6). PublicAffairs. Kindle Edition.
If your cardinal goals iinclude communicable disease prevention and mitigation, the urban environs comprise the fish in the barrels. Leverage academia.

MORE PHC WHITE PAPER STUFF

Summary
Although it is difficult to predict when the next ‘big one’ will happen, it will likely be similar to something we have seen before. The pandemics of the last century have all been caused by influenza. The COVID-19 pandemic was caused by a pathogen related to a seasonal coronavirus that causes colds and the SARS epidemic in 2003. Thus, the next pandemic will likely be caused by another airborne pathogen, probably in the influenza and coronavirus families, with a period of pre-symptomatic transmission able to disseminate quickly and widely due to global air travel and crowding.

However, a global pandemic is not the only biothreat the U.S. should prepare for. Epidemics that spread across parts of the country or across a single continent can still have grave repercussions for healthcare systems and economies. Dengue, Zika, and Ebola epidemics have increased in frequency in recent years despite being caused by pathogens that have been known for many decades, and they will likely return to U.S. shores once global travel resumes. Furthermore, pathogens (whether released intentionally or accidentally) present a less likely but far more catastrophic biosecurity risk that could cause large outbreaks in the U.S. due to extremely high case fatality or transmission rates.

While fortifying healthcare and technology infrastructure is needed for pandemic preparedness,
we also need to safeguard the parts of the system that have protected us over the last year: public health officers, epidemiologists, public health nurses, doctors, nurses, scientists, janitorial staff, and delivery services.

There are hundreds of pathogens that could cause outbreaks in the U.S. spread through any of the transmission routes described in this white paper. Improving infrastructure to better prevent, detect, and contain these smaller but more frequent threats will help us prepare for the next ‘big one.’ These improvements are further detailed in another white paper, ‘The Future of U.S. Public Health.’

UPDATE: COVID COMPLACENCY ADMONITION
 
 
Click the screengrab.

MAY 8TH NEWS

It's not over.
 
IRASCIBLE COMMENTARY

Grr.r.r.r...
 
ONE LAST UPDATE FOR THIS POST
 
PHC issued a new White Paper

Abstract
In the COVID era, public health jurisdictions around the world have used SARS-CoV-2 genomic data in their pandemic response at unprecedented scale. As of April 23, 2021, over 1.2 million viral genomes have been sequenced for public health purposes. These data have enabled policy decisions (e.g., Denmark increasing interventions despite falling cases in response to detecting the UK variant), cluster investigations (e.g., uncovering transmission clusters across healthcare facilities that share staff), diagnostic test and vaccine development (e.g., establish diagnostic assays to detect the UK variant), and more.
A good read. As is Michael Lewis's new book The Premonition, which got me down this path.

MAY 9TH AFTERWORD

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Saturday, May 1, 2021

MayDay

 
Musical diversion. My friend Bill Champlin.
 
BONUS TRACK
 
As my Vegas peeps would say, this cat is just WRONG!

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