I’ve come to the conclusion we are not thinking rationally about the COVID 19 pandemic. The problems are in large part driven by its novelty which leaves us vulnerable to our cognitive biases. First we have tunnel vision (AKA Cognitive Tunneling combined with Zero Risk Bias) and basically have focused on COVID 19 to the exclusion of all other considerations. This means we are looking at the results of the virus to consider every death from COVID 19 as a loss but ignore every other death, and infection from COVID 19 as a loss but ignore all other health and non-health problems. And loss aversion means we can’t take our focus off COVID, we only see the risks associated with COVID 19 infections and fatalities and are blind to all other risks. Essentially the enormous uncertainty and newness so terrified us that we pulled the covers over our head and refused to get out of bed. That’s OK for a day or two, but if we all do that how long can we keep it up?
So my suggestion is to lose the exclusive focus on COVID since it leads to a terrible local optimization problem where we are only optimizing for COVID and nothing else. Clearly COVID is a serious disease, but it isn’t the only serious disease we face. Instead, we should recognize the loss from COVID without action and count every decrement from that as gain – because we can think much more rationally about gains and in large part that’s how we think about all other disease and causes of death.
So what does that mean? Let’s take that initial estimate of 2 million deaths in the US over the next two years (approximately) and use as our benchmark the 2.8 million non-COVID deaths (just to put an anchor out there, the case fatality rate for a year of life in the US is 0.86%) plus the 1 million COVID deaths per year and then strive to drive the number down from 3.8 million per year. And this is realistically the situation we confront. Since COVID would be the leading cause of death in this framing, clearly efforts should be significantly but not exclusively focused there as it would be only somewhat ahead of heart disease at over 647,000 and cancer at 599,000 deaths per year. This framing allows us to take a holistic system approach to the problem and we need our metrics to reflect that. The constant drumbeat from the media showing the daily death count from COVID alone doesn’t help us, it hurts us.
You may ask how is our current framing is hurting us. Keep in mind that the general rule of thumb (Pareto Principle) is that the first 80 percent of a solution is cheap and easy and the remaining 20 percent is increasingly expensive and difficult. In our zeal to drive one risk to 0, we are paying the full expense of getting to a complete solution for one problem (COVID) while starving all others of resources and attention – and in terms of fatalities those problems cause more deaths. If we don’t look at the full picture, we will be worse off and won’t make the right trade offs. Adult life is tradeoffs. We need to pull the covers down and get back to living.
Death statistics can be found at: https://www.cdc.gov/nchs/fastats/deaths.htm
