Covid-19: The Necessity of Evolving Wisdom

April 29th, 2020

I have previously confessed to spending a little too much time acquiring information from diverse sources. However, after one exposition on a well-known mainstream news channel I realised that I actually knew less after the programme than I did at the start.

Stories about Covid-19 from all over the world have a multiplicity of platforms, channels, networks and even newspapers on which to propagate – and there is neither transmission inhibitor nor vaccine! Once we are on line we are exposed.

One of the main themes, at least here in the UK, is stories which purport to compare the inadequate performance of the government of Country A (the host country) with the amazing performance of the government of Country B (any other country – or even several of them). In such a case, a number reported (I hesitate to call them metrics) is worse in Country A than it is in Country B.

We have all become familiar with the international league tables of deaths and recovery rates, the test rates for various categories of citizens, virus reproduction rates and the assorted speculations over antigen tests, antibody tests, post-infection immunity, viral load and the efficacy, or not, of experimental treatments and prophylactics including face masks, social distancing, self-isolation and the militaristically toned ‘lockdown’.

But:

We are seeking certainty where none exists, nor can it (yet) exist.

Why:

Not enough is yet known, by anyone, about the virus itself to provide certainty of almost anything

And:

We are making comparisons where none is meaningful, nor can they (yet) be meaningful!

Because:

Comparisons made are often not appropriately underpinned by a comprehension and appreciation of differences:

Countries vary in their approach to recording primary cause of death:

The basis of recording and reporting of illness and death varies from country to country; are people dying purely OF Covid-19 or of some pre-existing morbidity but while infected WITH Covid-19;

          The timing of recording and reporting varies from country to country;

The impact of infected patients pre-existing conditions on the course of the virus is not fully understood;

Testing regimes vary substantially;

The effectiveness of therapeutic techniques is not fully understood:

PPE, ventilators, CPAP devices, intensity of care, existing drugs (or their absence), the physical conditions of the hospital itself

The skills, experience, insight of clinicians is variable;

Differences in a wide variety of life circumstances are not factored in to gross comparisons:

Population Density, Domestic Circumstances, Living Conditions, Working Conditions, Population Age Profile, Diet and Nutrition, Alcohol and Tobacco Consumption, Co-morbidities, Occupations.

I could go on.

The welter of stories is amplified to a tsunami by the apparent desperate need among news providers to “keep the public informed” during the current pandemic. The curious might wonder about the real purposes of the various stories, in the meanwhile we should work on these assumptions:

Scientists, everywhere, are doing their very best to provide their governments with the best information and advice they can give;

In a rapidly evolving situation it is inevitable, indeed it is to be expected, that some of that advice will change over time;

Different scientists in different countries drawing on different data will arrive at different advice and recommendations;

It is inevitable, indeed it is to be expected, that governments will be differently advised;

Governments, everywhere, are doing their very best to provide their countries with the best decisions, guidance, information, social and economic outcomes that can be achieved in the light of the evidence they have received;

Given different advice it should be no surprise that governments do different things;

In a rapidly evolving situation it is inevitable, indeed it is to be expected, that some of the decisions, guidance, information, social and economic outcomes will change over time.

A useful working assumption is that every scientist and politician is authentically and persistently making the best recommendations and decisions they can in the light of the information available at the time. If when the information changes, they make a different decision, that does not mark a failure of the previous position but their evolving knowledge which we experience as wisdom.