Comments on COVID-19

I am, like you, restless and having trouble coping with the tragedy going on. It’s especially hard to think through the logical details of issues that only two weeks ago seemed urgently important. So instead, like you, I find myself with an internal dialogue of how the publicized statistics are consistently biased or wrong. At the risk of simply supporting your own internal thoughts, here are a few of mine:

  1. We still aren’t testing people, even in New York, which is the most tested population in the current mostly highly infected country according to the crap data we have.
  2. What that means to me is that we can ballpark how many actual cases we have if we know what the condition is for actually getting tested. In New York, it’s something close to “needs hospitalization.” Considering that only about the worst 10% of cases in countries that do widespread testing actually need hospitalization, that means we can multiply our confirmed case count by 10 to get an estimated total case count.
  3. That means that, instead of 60K cases in New York state, which is what this webpage says this morning, we can assume it’s actually more like 600K.
  4. Similarly as a nation, we should multiply the confirmed case count of 143K by ten to get an estimated 1.43 million cases in the US.
  5. Is that an overestimate? Perhaps. It’s possible that enough testing is happening in those car wash type setups, where people are at least capable of driving a car, to make it pessimistic.
  6. On the other hand, we’ve seen plenty of examples in the NYC area of people calling their doctor with intensely bad symptoms who are told not to overburden the hospital system and to take care of themselves at home.
  7. Also, it’s worth pointing out that multiplying by 10 assumes that more than half, and perhaps up to 75% of all actual cases are entirely asymptomatic. This is something we’ve been seeing in places that have done randomized or comprehensive testing.
  8. All the above are ballpark reckoning, but honestly I trust my numbers more than any official ones.
  9. Especially because we’ve been hearing stories told in Spain and Italy that their death counts are not including horrible fucking things that have been happening in nursing homes. That means those terrible numbers are heavily underestimating actual deaths.
  10. Also, we should not trust China’s death count numbers, which some say are underestimating actual death counts by a factor around 15.
  11. And if we don’t trust their death counts, we should also not count their confirmed case count, which has been tiny recently.
  12. Why this matters a lot to us right now is that China closed Wuhan on January 23rd, which means they are/were under quarantine stricter than ours for more than two months, and we’d REALLY like to know what the actual situation is right now, but we don’t.
  13. Long story short, being a skeptical data scientist means not trusting the data whatsoever. The best we can do is use the data and our real world knowledge to ballpark what might actually be happening. We will never know the true numbers.
  14. One exception might be the Netherlands, which I’m keeping my eyes on. I don’t think they lie as much as most other countries.
  15. I could be wrong about that too.
  16. I hope tomorrow’s post will be more optimistic.
  17. One last comments: Sunday reported deaths are lower than other days because of the way reporting happens.  Doctors and others are taking a well-deserved rest. So don’t get excited about flattening curves based on Sunday data:

daily deaths sunday effect

Categories: Uncategorized

A better proxy than confirmed cases for the US is hospital beds

If you’re anything like me, you’re driving yourself a bit nuts looking for information on the COVID-19 situation in the U.S. as well as internationally.

And, if you’re like me, you will have been tearing your hair out frustrated by the bad quality of data. For terrible political and cultural and of course capitalistic reasons, we are not getting tested at reasonable rates as charts like this demonstrate:

 

That means, as cool as websites like this or this are for up-to-date data on country and state level confirmed positive test results and deaths, we are not actually seeing enough to know how bad things really are. Note to the people who run those sites: please add columns for “number of tests administered” so we have some idea of how incomplete the data really is.

All of the above is nothing new, I’m sure you’ve already complained at length to your friends about this very topic.

The only things I really want to say is that, considering that we don’t know who is infected, we should use as a proxy of our problem not the “confirmed case” count but rather the “hospital beds used above normal” count.

It’s not perfect metric either, primarily because the virus takes days to spread and days to get people quite sick, and indeed once the hospital beds really start filling up, it’s already a much bigger problem. But I’d still argue that we should try to use this proxy, for the following reasons:

  1. Hospitals definitely keep track of their bed counts, you can be sure of that. So the data is available.
  2. It doesn’t depend on the availability of testing, which as we’ve discussed above, is very problematic. Our death count is most assuredly way too low because there have likely been plenty of people dying of coronavirus who just never got tested.
  3. In other words, counting beds is relatively free of political manipulation.

There are also problems with this proxy, both of which make it underestimate the problem. First, because people who have elective surgery are rescheduling for a later date. Second, because our social distancing has probably made other illnesses less common, leading to less hospital stays for other reasons.

Even so, I’d love an intrepid journalist to try to collect this statistic from many national hospital chains, and compare it to last year’s bed count, as well as yesterday’s and last week’s, to see how things compare.

Categories: Uncategorized

Wash your hands *and* your phone

I don’t know about you but I’ve spent quite a bit of time on the phone talking to friends and family about the COVID-19 virus and bemoaning how difficult it is to get people to do simple stuff like washing their hands and not touching their face.

And, again, I’m on the phone talking about this, while copiously touching my face and my dirty phone.

And it occurred to me that washing our hands won’t be all that helpful if our phones are dirty, which they of course will be because we cannot stop using our phones even for a minute, especially when we want to check in on our loved ones and also Twitter.

Here’s the standard problem I see:

Go on subway, touch things, read phone, get to destination, touch things, put down phone, go to the bathroom, wash hands carefully, pick up phone again.

See how that works? The only germs we’re not getting on our phone is actual bathroom germs, and that’s only if you don’t bring your phone with you to the bathroom, which let’s face it people do in general.

So, how do we address this? It’s going to be tricky! We will need to clean our phones, and moreover to clean our phones without once again getting phone germs on our hands. I’m dizzy with the procedure we will have to follow assuming we have wipes that actually clean our phones and our hands.

Categories: Uncategorized

10 Silver Linings of Having an Asshole Father

I wanted to share my words from my dad’s memorial this past weekend, which took place at UMass Boston. You can read his official obituary here.

 

10 silver linings of having an asshole father

 

  1. When I met Larry Summers at the hedge fund he was known as a pushy, physically imposing and intellectually arrogant bully. He was all those things. He was also a pussycat compared to my dad. My dad taught me never to be intimidated by anyone.
  2. My father never displayed nor expected conformity. Since he never followed inconvenient constraints of etiquette or behavior, my father role modeled for me that most norms or even laws can be interpreted as rules of thumb to be considered and held up to inspection rather than thoughtlessly followed. That’s been useful to me, especially as a female intellectual.
  3. My father was incredibly wrong about a bunch of things, and wrong headed to top it off. He consistently argued that men are smarter than women, even as my mom consistently helped him write his research papers, he seemed to truly believe some eugenic beliefs, and he was very into evolutionary biological explanations for why he and men like him should be entitled to unquestioned power. But to his credit, he was always willing to argue these points. He taught me the value of intellectual debate and fighting for my ideas and values.
  4. For the same reasons as above, he often embodied selfishness, self interest, and lazy thinking. He didn’t even believe science when it was inconvenient to his worldview, as in the case of climate change. At those moments, it made it easy for me to see and pick apart the errors of his logic. He turned me into an intellectual critic, which has made me a ton of money over the years. So thanks dad.
  5. My dad claimed, out loud and often, to be the smartest person in the world. He even sometimes seemed to believe it. And the truth is he was really smart, but he was also weirdly emphatic about exaggerating such things to the point of incredibility. I want to thank my dad for helping me understand our current president at a deep level.
  6. In terms of parenting my children, my father taught me the value of consistent kindness by displaying the wreckage of sporadic cruelty. I’m a better mother for my childhood, during which I learned what not to do. It’s a backhanded compliment but it’s real.
  7. Just as his brutality was never subtle, his generosity was never fake. Many of the people in this room can personally attest to my father’s impressive generosity with his home, his hospitality, his jokes, and most especially his alcohol. I thank him for teaching me to welcome people into my home with openness and love.
  8. Along those lines, my father taught me to love ideas for their own sake. His favorite activity was reading, and reading out loud to whomever happened to be walking through the room. To this day I cannot stand Robert Heinlein or Oscar Wilde poetry but I do love ideas and I think he’s partly why.
  9. When I was a little kid, my dad expected me to sing folk songs with him. One day he yelled at me to sing the harmony instead. I thought it was just something I was supposed to know how to do when I was 8. So I did it. I don’t think I’d be able to enjoy music as much as I do without that.
  10. My father taught me to say what I mean and mean what I say. For example, he was such an asshole he wouldn’t even mind being called an asshole. Actually I’m not sure about that but I guess the apple hasn’t fallen too far from the tree.
Categories: Uncategorized

Star Island

Dude! No seriously, dude.

I just spent a week on Star Island. Actually, I got back exactly a week ago but it’s taken me this long to recover from the lost sleep.

In case you haven’t heard of it, Star Island is tiny island off the coast of New Hampshire that has been operated by the Star Island Corporation for more than 100 years, which in turn is organized by a bunch of Unitarian-Universalist and United Church of Christ members.

They organize the island into week-long camps and programs and have a bunch of folks come over and cult out. And when I say “cult out,” I want you to imagine burning man except for New England WASP-y families of four with lots of knitting and choral singing experience.

Here is the webpage for the week I just went to. It was co-organized by my good friend and yarn whisperer and art historian professor Elizabeth Hutchinson.

Through Elizabeth, I was lucky enough to be invited to a particularly long-lived and intense week as the “Theme Speaker.” What this means is I got to spend 1.25 hours every day for six days talking about my shame book, And dude, yes, that’s a lot of time to talk. So actually I broke it up Occupy style with progressive stack commenting (thanks to Elizabeth for taking stack!).

Here comes the crazy thing about this whole story. Believe it or not, these kind UU folks were not only willing to have me, they were totally into the topic! The audience never diminished, and I think it might have actually gotten bigger by the end of the week! It was truly amazing and I’m incredibly grateful for their attention and patience, because now I’m feeling much more confident about how my book is going to function as a narrative.

Here was the outline:

  • Day 1: What is shame?
  • Day 2: When does shame work?
  • Day 3: Fat shaming and wellness culture
  • Day 4: Poverty shaming and meritocracy
  • Day 5: Social media, incels, and anti-vaxxers
  • Day 6: AI and automated shame

I got tons of great questions during each talk and, because I was often to be found sitting on the porch knitting in a rocking chair, there were plenty of moments for people to talk to me in between talks and make thoughtful and useful comments. A truly intense and wonderful week, and it couldn’t have come at a better time.

Thank you, Star Island folks! Thank you for welcoming me and my son, for having a ton of music to enjoy, and a talent show that my son participated in eagerly, the armada boat race made up of duct tape, and the slip-and-slide hilarity (I’m talking about you, Cece).

Dude, though, back to the cult thing. The last day, after the last dinner at which every person was thanked for their help with the amazing week including the cooks, wait staff, and bell hops, we all danced around the island holding hands and singing about promises to return next year. By the end of it  I was a little worried that my son, who is 10 years old and had a blast the entire week, had been irretrievably indoctrinated. By the next day I was no longer worried, because he absolutely had and we will be returning next year. We will, we will, we will.

Categories: Uncategorized

New Bloomberg Opinion column: China’s AI shows us the future of health insurance

 

Hey! I’ve been kind of hibernating but this week I got so riled up about some incredibly terrible facial recognition stuff going on in China that I wrote a Bloomberg piece:

 

China Knows How to Take Away Your Health Insurance

 

For my other Bloomberg Opinion pieces, click here.

Categories: Uncategorized

Shame Versus the Free Market

One of the ways I want to understand the power and dynamics of shame as a social mechanism is by comparing and contrasting how shame works with the other forces that play similar roles but that we are much more aware of. Today I’ll start thinking about that with respect to market forces, and more generally the viewpoint of the individual as an economic free agent (hat tip to Josh Snodgrass for this prompt).

Shame is often inconsistent with rational free agency.

The first thing to note is that shame is not rational at the individual level. That is, when we are acting under the power of shame, we often act in direct conflict with our immediate “economic best interest.” Here are some examples:

  • If we’re shamed into being a good daughter or son in some way, we’re probably spending more time than we’d theoretically like helping out or spending time with our family.
  • If we’re shamed into being a “good mom,” that might translate into baking cookies for a bake sale that we know is ridiculous.
  • If we’re feeling spurned from normal society for being weird, it’s often an enormous amount of effort to either pretend to be normal or to accept the role of the social outcast.
  • Even if we’re the target of punching up shame, where we’re the the CEO of a chemical company that’s polluting the river, the point of the shame is to get us to stop it not because it’s in our interest to stop it – it clearly is in our interest to continue to do it – but because it’s against a larger public interest.

Indeed, shame often works really well to get individuals to act against their self interest in relatively small ways so that the group as a whole works more smoothly and is better off, at least ideally. The idea is, if the norms are reasonable and achievable, then people are shamed into following them for the sake of society.

When norms are unreasonable or unachievable, things can go wrong, and the free market ideology we have been indoctrinated with can make things worse.

So, when young men are informed that, in order to achieve social success they have to demonstrate sexual prowess, this is a huge burden on lots of shy, awkward, inexperienced youths. They feel an enormous amount of pressure to conform to this concept of “success,” and an enormous amount of shame when they continue to fail in this way.

My theory is that, in part because of our weirdly religious belief in free markets, coupled with the explicitly market-flavored nature of dating apps and other technological intermediations on the sex and dating fronts, we end up with bizarre pseudo-scientific theories of attractions and attractiveness that purport to “explain” everything about sex and dating but are fundamentally efforts to blunt the power of shame.

I’m thinking in general of the “PUA” culture, where women are scored from 1 to 10 and men learn strategies to land them in bed that have nothing to do with human connections. The flip side of that bizarre artificial market structure is that, at the extreme end, we have incels undergoing drastic plastic surgeries in order to look like sexually successful men which they refer to as “Chads.”

Of course we’ve seen women go under the knife for decades, and it’s become somewhat normalized, even though it’s of course due to the same thing: pressure to conform to some norm, and shame that one’s body isn’t a perfect 10.

Shame and Scoring Systems

Speaking of being a perfect 10, I think the easiest way to access how shame works vis-à-vis free markets is to think about how easily scores and scoring systems evoke in people a deep sense of shame.

Whether it’s an SAT score, a GPA, the ranking of the college you went to or your kid got into, your weight, your BMI, your IQ, or your Twitter followers, people have gotten used to – and to a large extent embraced – the concept of being measured by externally defined, maintained, and verified scoring systems. They have profound effects on society, at least to the extent they people care about them.

And, for me at least, that’s the weirdest part. People really do care about rankings and scores, far beyond what I’d consider reasonable.

I think I see the unreasonableness in such systems in large part because I often understand the flaws in the systems, and I’ve worked out the exceptional people who are measured as unexceptional, or the unexceptional people who look amazing to a scoring system. It’s not so easy to think through this kind of thing, and when you do, you lose admiration for the system itself, which on the one hand helps you distance yourself from your score and any associated shame you might have for a “bad score,” and on the other hand allows you to see just how much blind faith and undue grief we as a society project onto such systems.

Push and Pull

Stepping back, I think I’m ready to say that there’s been a massive and largely undescribed conflict between the two systems of powers represented by the informal social mechanism of shame and more formal market mechanisms. They are not consistent with each other, and as individuals and groups, we’re being pushed one way by shame and another way altogether by market incentives.

On the other hand, the proliferation of “markets,” whether represented by dating apps or college rankings, have given us new ways of determining our intrinsic worth, which is what shame is all about. And to the extent that we have embraced these systems, which I think is far reaching, we’ve got a whole new set of things to be ashamed of. You could almost say that we’ve come to replace some of our old-fashioned notion of self-worth as family members, as citizens, and definitely as consumers by the scores that we’ve achieved. In that sense we’ve externalized and even privatized the dominant shaming mechanisms.

How could we possibly keep up with all of these ways of evaluating ourselves and being evaluated?

How Technology Comes Into Shame

Next time I’ll talk further about the reason I’m writing this book now. It has to do with the way technology is intermediating shame mechanisms: how it works, how it’s been changing us, and how I believe it’s going wrong.

Categories: Uncategorized