Society

In Medias Res

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What I’ve got so far:

  1. Everything’s on the table. The likelihood that your preexisting ideology or priorities are an entirely adequate match to what this situation truly requires of us is close to nil. “In a time of drastic change it is the learners who inherit the future. The learned usually find themselves equipped to live in a world that no longer exists.” ”• Eric Hoffer
  2. That said, your life experience will give you insights. Privilege your experience over your ideology and nominal priorities.
  3. All disasters are local. Concentrate on your meaningfully immediate environment, which in this case will be the local market for medical resources. For most of the US, that will be our MSA. For those outside an MSA (metropolitan or micropolitan) that will be their county; and for some it will be the group of counties that feed into the one hospital in the region.
  4. Deprioritize pandemic news from outside your local area. There are people in the massive NY/NJ/MA outbreak that I worry about, but what happens there will only modestly resemble what happens in the KC MSA, not least because of the difference in population density, which can approach 20x.
  5. Mitigate or avoid your own risk (including the risk you pose to others) by both following the hygiene advice we’ve all heard and minimizing your physical interaction with anyone outside your immediate household. Internalize Râ‚€ = b × k × d, where Râ‚€ is the reproduction number of the virus, b is the probability of infection given contact with an infectious person, k is the contact rate, and d is the infectious duration. While the nominal Râ‚€ of COVID-19 is ~3, your personal Râ‚€ can be driven to < 1 by your own behavior.
  6. The general form of the challenge confronting us is abrupt wide variation in formerly relatively constant phenomena. In Talebian terms, we have migrated from “mediocristan” to “extremistan.” The multiplicative nature of a novel viral pandemic, especially by comparison to the relatively predictable seasonality of influenza viruses, has a thick-tailed (power law) probability structure and complex payoffs (notoriously ranging from large numbers of nearly asymptomatic cases to abruptly life-threatening “cytokine storm” reactions). For detail, see The Fourth Quadrant: A Map of the Limits of Statistics.
  7. So we find ourselves at serious risk of running out of ventilators, ICU beds, and even hospital beds generally, to say nothing of supplies (but see “all disasters are local,” above), raising the prospect of significant second-order mortality among those unable to obtain adequate care for entirely unrelated illnesses and injuries.
  8. In this connection, many prior customs, techniques, tools, and materials are being revealed as highly dysfunctional and, if all goes sufficiently well, will be swept into the dustbin of history. The bad news for me is that my earlier fears about easily-bottlenecked processes have been realized. But we may look forward to significant adaptation, including deregulation of medical services.
  9. Similarly, a large number of purported fixes and remedies will fail. Folk remedies, in particular, seem likely to be disastrous, and this blog’s audience needs no persuasion that attempts at central planning will fail thanks to the Hayekian local knowledge problem. In that connection, and to quote something I wrote a few years back: “John Gilmore famously said that ‘the Net interprets censorship as damage and routes around it.’ The future adaptation of representative democracies will depend on our capability, as individuals, to interpret endemic institutional dysfunctionality as damage and route around it.”
  10. The relatively vulnerable are closer to the center of the network: affluent, living in high-density major cities, well-traveled, extroverted, socially active, with large numbers of regular contacts (even if mostly in a “bubble” as per Murray’s notorious quiz). But some are the alienated and defiant who reject risk avoidance or even risk mitigation tactics (or attempt folk remedies instead), ordinarily associated with …
  11. The relatively invulnerable, who are at or near the edge of the network: impoverished, living in rural or low-density metro areas, untraveled, introverted, socially isolated, rarely in face-to-face contact with others. Many of these people have mental health issues and associated substance abuse problems. But the relatively invulnerable are also the intelligent and conscientious who promptly adopt appropriate risk management strategies.
  12. The post-pandemic preferences of the relatively invulnerable will have massive economic and cultural effects. I expect a reasonably quick partial recovery from the economic shutdown, but full recovery may take several years. Many of the “third places” which have done well over the last few decades will not regain their patronage, and as of early April 2020, we can only guess which ones. Fond hopes of some of my co-religionists aside for a sudden revival, I believe church attendance and involvement will be well down in the aftermath, and will not significantly grow until the next “Awakening,” which per Strauss and Howe should occur at mid-century. Until then, believers will be culturally marginalized and congregations will be smaller—but comprised of relatively fervent, active members.
  13. Geopolitical risks are heightened, especially US-China tensions, and if Xenakis’ “58-year hypothesis” holds, this very year will see an echo of the Cuban Missile Crisis.
  14. The most important output of this process—and it is a process, with inputs, providers, outputs, recipients, etc—will be a collective lessons-learned database, comprised of both tacit and explicit knowledge, and somehow transmitted to future generations.

America Has an Autoimmune Disease

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An autoimmune disease is an illness that occurs when the body tissues are attacked by its own immune system.  The US today has this condition big-time.  Historically, the condition has arisen and reached toxic levels in other countries; as an example, France, during the run-up to the Second World War and even during the campaign of 1940.

General Edward Spears, who was Churchill’s military liaison with France, was told by Georges Mandel, the combative interior minister, about the mayor of a district in Paris which had been bombed who went about the lobbies, screaming:  I will interpellate the Government on this outrage as soon as the chamber meets!  Mandel expressed his contempt for this kind of behavior, saying sarcastically “Paris is bombed by the German?  Let’s shake our fists at or own government.”  Spears notes that “The other way, that of silently going off to collect a gun and have a shot at the enemy, was a solution that occurred only to a few…How Hitler must have laughed, I told myself.”

A few months earlier, an interviewer asked Paul Reynaud, who had just become Prime Minister of France, about his long-standing and bitter rivalry with Edouard Daladier.

Nevertheless, ”the interviewer  said, “Daladier is certainly a man who loves his country.”

“Yes,” Reynaud replied, “I believe he desires the victory of France, but he desires my defeat even more.”

This may have been a bit unfair to Daladier, who was far from the worst of the leading French politicians of the day. But it gives an accurate impression of the state of things in the late Third Republic.  And it may actually understate the state of things in America today, where for many politicians and journalists, the well-being of America and of Americans doesn’t seem to enter into the equation at all compared with the search for political advantage.

The obsession with political power, and with the denunciation of opponents, is not today limited to politicians, journalists, and ‘activists’…it has spread to a large proportion of the population.  Millions of Americans, it seems, are in a state of visceral rage against not only Trump, but against any and all of his supporters.  There is no activity, of any sort, that is safe from volcanic overflowings of political rage…not even knitting, as strange as that may seem.

It often seems impossible to find any point of entry for an attempt to get Progs to reconsider their beliefs, in however small a way.  I’m reminded of something written by Arthur Koestler, himself a former Communist, on the subject of intellectually closed systems:

A closed system has three peculiarities. Firstly, it claims to represent a truth of universal validity, capable of explaining all phenomena, and to have a cure for all that ails man. In the second place, it is a system which cannot be refuted by evidence, because all potentially damaging data are automatically processed and reinterpreted to make them fit the expected pattern. The processing is done by sophisticated methods of casuistry, centered on axioms of great emotive power, and indifferent to the rules of common logic; it is a kind of Wonderland croquet, played with mobile hoops. In the third place, it is a system which invalidates criticism by shifting the argument to the subjective motivation of the critic, and deducing his motivation from the axioms of the system itself. The orthodox Freudian school in its early stages approximated a closed system; if you argued that for such and such reasons you doubted the existence of the so-called castration complex, the Freudian’s prompt answer was that your argument betrayed an unconscious resistance indicating that you yourself have a castration complex; you were caught in a vicious circle. Similarly, if you argued with a Stalinist that to make a pact with Hitler was not a nice thing to do he would explain that your bourgeois class-consciousness made you unable to understand the dialectics of history…In short, the closed system excludes the possibility of objective argument by two related proceedings: (a) facts are deprived of their value as evidence by scholastic processing; (b) objections are invalidated by shifting the argument to the personal motive behind the objection. This procedure is legitimate according to the closed system’s rules of the game which, however absurd they seem to the outsider, have a great coherence and inner consistency.

The atmosphere inside the closed system is highly charged; it is an emotional hothouse…The trained, “closed-minded” theologian, psychoanalyst, or Marxist can at any time make mincemeat of his “open-minded” adversary and thus prove the superiority of his system to the world and to himself.

In attempting to debate with “progressives,” one often encounters this kind of closed-system thinking:  there is absolutely no way you are going to change their minds, whatever the evidence or logic.  (I don’t think this is true of  all  “progressives”otherwise the situation in America today would be even more grim than it actually isbut it’s true of a lot of them.)

But today’s Progressivism is not a coherent intellectual system with definable axioms like Marxism or a Christian theology; it seems much more a cluster of emotional reactions.

Certain Progs have gone so far out on the limb that there seems no hope they could ever come back; this certainly is true of most commentators on CNN and MSNBC…they will just become angrier and more extreme, and it will all be broadcast to millions as long as their owners (AT&T and Comcast, respectively) keep the money flowing.  But what about ordinary people, those whose lives do not center (or at least previously have not centered) around politics?…Is there any sign that some may be willing to reconsider some of their beliefs, specifically in the midst of the Cornavirus crisis?  I have seen comments by people saying they have friends who have recently been willing to reconsider their support for open borders, or for offshoring most American manufacturing to China, in the light of current events.  I haven’t seen much of this, personally.  What I see is more people who are so completely aligned with their ‘side’, that they view events largely through the light of how they can be interpreted to support that side.  These are often people who were not particularly interested in politics or political philosophy  prior to recent years.

This isn’t one of my more coherent posts, but I’d like to discuss: Can the American autoimmune disease be cured?  Why did it develop and get so bad?  What, as individuals, can we do to help with the cure or at least the mitigation?

Dueling Doctors

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In the blue corner, we have the joint statement on multiple patients on ventilators by the Society of Critical Care Medicine (SCCM), American Association for Respiratory Care (AARC), American Society of Anesthesiologists (ASA), Anesthesia Patient Safety Foundation (APSF), American Association of Critical”Care Nurses (AACN), and American College of Chest Physicians (CHEST) which recommends letting people die when spare ventilator reserves run out. And in the red corner, we have the VESper by Prisma Health fresh off of its recent victory to get regulatory approval under emergency use rules to allow ventilators to be used by up to four patients.

It is triage with its ugly logic of letting patients die vs hope and technical advancement to save everyone, live in the United States at Covid-19 virus hot spots across the nation. This may affect you personally so it is important that you know whether or not the hospital you might depend on to save your life has picked one side or the other in a thoughtful way.

Everybody could ask the question but it would be better if our press did ask and broadcast the answers. At the time of writing, they’ve had two days to do so. Are you informed on the issue? Are your neighbors? Is your hospital?

This lack of discussion is the death of journalism. This time ignorance can have deadly consequences for us all.

China Virus

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Seriously, I do wonder if there isn’t a strong antipathy against all things Official-Mainland-Chinese/ Chinese Communist Party and all its works building among Americans, in the wake of the almost-universal infection by the Wuhan Corona-virus epidemic. I mean the damn plague started there, despite what all the official CCP agencies and bodies, and their sympathizers and hired media can and will insist. Bungling containment, concealing practically everything about the epidemic (the third devastating epidemic originating in China, by the way, the swine flu and the H1N1 virus being the first two) and then having the unmitigated gall to blame it on the United states that takes the absolute cake, as far as I am concerned. It reminds me of the books I absorbed, growing up; most by English and American authors of the mildly popular sort (some fiction, some non) and dating anywhere in the first half of the 20th century whose detestation of Germany and Germans hung in the atmosphere of those books like a particularly dank fog. It was an almost visceral dislike, for all that we generally had been inclined favorably towards Germany before the turn of the previous century. Martin Luther, Johan Sebastian Bach, the Brothers Grimm, Schumann, Beethoven, Goethe, scientific, technological and medical advances all flowed to the rest of Europe and to the Americas, making us all the richer for it but German ‘frightfulness’ in World War I, and the horrors inflicted by Nazi Germany burned through that enormous fund of respect and favorable opinion, leaving a very bad taste in the mouths of those old enough to have been exposed to them, either directly or at first and second remove. That bad taste may only now be fading with regard to Germany, but I wonder if it isn’t now about to be replaced with burning resentment of China, or at the very least, the Chinese Communist Party.

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How to Think About 2019-nCov

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In the wake of Ebola, NVD-68, and Zika, we should have all learned our lesson by now. We haven’t. This is 2020—Iowans took a week to count the votes of 5% of their population, and an elderly white Northeastern president is principally opposed by a gaggle of downright ancient white Northeasterners. There aren’t any quick fixes for emergent idiocies like those, but a few simple heuristics will go a long way toward avoiding panic over coronavirus.

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