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Mestema: In a future reality I shall destroy you!
Paul: I reject your reality and substitute my own!
The Dungeonmaster (1984)
We write a lot about how governments and businesses desperately want Official Numbers to be treated as synonymous with the real-world feature they are used to describe. You might say it’s kind of our thing here at Epsilon Theory. We even have a word we use for it: cartoons.
We have written about COVID-19 cartoons being promoted by the Chinese Communist Party.
And pension obligation cartoons.
And top-line revenue cartoons.
And labor statistic cartoons.
And daily stock price attribution cartoons.
And risk-model cartoons.
And user / subscriber count cartoons.
The air of legitimacy offered by facts and figures makes them impossibly seductive for leaders in need of a friendly way to frame what is going on in the world. The problem, of course, is that numbers are not always a true reflection of the thing they are being said they are or what they represent. That may be because of how they are measured. It may be because of simplifying assumptions, abstractions and priors in their calculation. It may be because they are based on a model. It may be because they are biased or otherwise influenced in ways that confound the relationship. It may be because they represent only a dimension of the thing and not the thing itself. It may be because of mistakes. It may be because of outright fraud.
It isn’t hard to understand why sensitivity to cartoons around COVID-19 is high. Some of those reasons are good, and some are bad. All the same, it should not be surprising that the article below both topped our Zeitgeist of the most linguistically influential articles AND was by far the most shared article about COVID-19 over the last two days. It certainly helps when the President retweets it, and even more when the self-appointed truth arbiters at Twitter decide to censor it.
New CDC report shows 94% of COVID-19 deaths in US had underlying medical conditions [Various Fox Affiliates]
I have my own views on whether the popularity of this article was driven more by serious, well-informed questions about medical coding methodologies or pre-existing political conditions. That’s my diplomatic way of saying that I suspect the number of people capable of having a reasoned discussion on the implications of reported comorbidities falls somewhat short of the number of shares this article got on Facebook.
Still, confirmation biased click-bait or not, the Common Knowledge implied by this article sitting at the top of the Zeitgeist is that COVID data is cartoonified. So what’s the verdict? Should citizens be worried that strident representations about what COVID case and mortality data mean might be cartoonified?
YES.
I mean, of course they should. And considering that we have multiple official statements from the White House indicating an explicit preference for the reported data to look a certain way, I think most of that evidence points to cartoonification in the direction of underreporting of most statistics. Beyond that, however, there are significant methodological differences between and among states, agencies and individual institutions. There are fog of war issues in hospitals and clinics. There are testing abnormalities. There are high-risk financial incentives for reporting non-COVID pneumonia treatments as COVID-related, and low-risk political incentives for minimizing the number of cases, hospitalizations and deaths under various local and regional political leaders’ watches.
Major media outlets, likewise, have so thoroughly erased whatever line existed between their editorial and news practices that the number of stories they can concoct by simply cherry-picking start and end dates, taking advantage of reporting irregularities, discussing ratios or rates of changes is limitless. If you want to create a COVID-19 Cartoon that will suit your political sensibilities, you will have no difficulty doing so. If you are not on cartoon-watch each and every time you see anyone quoting COVID statistics of any kind, you are nuts.
But y’all. Seriously?
The existence of cartoons does not give us a put option on thinking.
The point of being aware of numbers that are prone to manipulation is not to permit us to turn off our brains and pretend that there is no underlying real world feature being measured. The point of being aware of cartoons is not to permit us to write off entire issues as being clouded by the complication of measurements or the attempts by political powers to manipulate their relationship to features of the real world. When you find Wittgenstein’s Ruler, you don’t throw your hands up and say, “Oh well!” The fact that the world of Narrative is powerful and messy and fraught with emotional pulls and unknown intentions doesn’t give us carte blanche to reject reality and substitute our own.
The impulse should be the complete opposite.
When we see cartoons, it is a warning that our focus must be on seeking out facts and measurements that are less vulnerable to abstraction. Things like models for excess deaths that predate COVID-19 that can shed light on the aggregate marginal effect of the pandemic on deaths in America. Things like actual nationwide ICU and hospital utilization rates. Things like the actual, demonstrable activities of medical professionals at hundreds of medical facilities. Things like historical data on comorbidities and conditions contributing to death for comparable diseases.
[Editor’s note … I’m sorry, Rusty is trying to be nice here. I won’t.]
If you actually read the actual CDC report and you still think that it is at all damning to the seriousness of this pandemic that deaths from a novel coronavirus that definitionally manifests in cardiopulmonary distress are being coded alongside pneumonia (42%), respiratory failure (34%), ARDS (14%), other types of respiratory failure (9-14%), cardiac arrest and arrhythmia (13-36%), and renal failure/sepsis most frequently reported to be primarily related to direct viral damage rather than co-infection with bacteria (8-17%), then you are wrong [Ed. Note: You are a fool].
If you actually read the actual CDC report and you still think it is at all damning to the level of concern that “normal” Americans should have about COVID-19 that 22% of deaths were coded alongside a condition experienced by roughly half of the adult population (hypertension), or that 16% of deaths were coded alongside a condition experienced by about a third (diabetes and pre-diabetes), or that 11% to 15% of deaths were coded alongside one or more conditions experienced by as many as half of American adults above the age of 85 (i.e. dementia and Alzheimer’s), then perhaps it is worth considering whether how the Widening Gyre is influencing your humanity [Ed. Note: You are a sociopath].
If you think that the rate of comorbidities and conditions contributing to death associated with COVID-19 somehow makes its numbers less “real” than other diseases, like, say, the actual flu (which similarly often has a coded comorbidity in more than 90% of deaths, consisting of the same laundry list of cardiopulmonary and sepsis/infection-related conditions contributing to death) or the dozens of other viral infections that make you die in specific ways for which an ICD-10 code exists, then it may be worth spending more time trying to understand the feature of the world the data represents and less time letting people tell you what it means [Ed. Note: You are sociopathic fool].
The point of being aware of cartoons and other abstractions isn’t to reject someone else’s reality and substitute it with our own.
It is to reject someone else’s reality and substitute it with…reality.
Simple idea. People were living with these conditions and are now dead early because of the COVID-19 virus. Yes, we are all going to die but none of us want to go earlier! Wake up and smell the virus folks!
Very difficult to measure cartoons these days, Gentlemen.
In our county we recorded our 6th death (with) CoViD over the weekend. Three of these were over 85, obese and diabetic, one was a mid-50’s heart attack coded (dead) at the scene and the other two in their late 70’s with what would have been called “natural causes” in the halcyon days before The Novel Corona. Extremely unlikely any of them would be alive with or without CoViD.
Yes, in this small community it is simple to investigate every single one of the souls lost to (with?) CoViD. Hospitals are empty, healthcare workers cut to part time shifts.
Because we misbehaved in April, Mommy Guv’nuh put us in time-out all summer.
This has certainly correlated with great comparative ‘numbers’ of hospitalizations and deaths to the ‘careless’ states. If one were willing to ignore the closing of thousands of small businesses, tens of thousands of lost livelihoods and growing numbers of suicides, overdose and alcohol related deaths, you could say it was completely justified.
No sociopathy here.
You see, on our mission to defeat Death itself we are no longer allowed to question the costs to the living. If we are to save the most vulnerable and unhealthy, many whose lifestyle choices have destroyed their natural immune systems, it shall be at the expense of the young, healthy, and strong.
Nothing anti-social about that.
Shut.The.World.Down.
I turned 57 last week, Ben, and have been feeling your pain this summer as you struggle with your health. Your story has inspired Our Pack to get strong. Eat better, exercise, build immunity and prepare for what we expect to be a hard winter. We are gardening, canning and learning some of the old ways to store food in a climate of affection and joy, detached from the media narrative cartoons.
But in the background, those of us forced by our occupations to ‘keep up’ there is a growing anger at our public institutions.
Where are our so called “Leaders” or minstrels of the media telling us to get healthy, lose weight, eat right or in any way boosting our beleaguered immunity?
All we see is doom and gloom sponsored by Big Pharma, alcohol or fast food.
Hide Out (with a giant burger, fries and a milk-shake) and wait for The Shot!
Only The Shot can save us!
Yes, the man responsible for killing Netscape, Lotus 1,2,3, WordPerfect, et c and making the monopolized alternatives a subscription service requiring constant updates and a small monthly fee is now in charge of Global Health. Good Luck With That.
Herding us in The Exact Wrong Direction.
Cartoons Indeed.
The cartoon idea ( and describing that idea with that word) has been in my life since childhood but for very different reasons. My father had been a navigator in the military and I grew up in boats. He called a dead reckoning position on a chart that was not able to checked within a span of 12 hours with a position fix either off a point of land, radio direction finder or from a celestial observation a cartoon (this was prior to the accessibility of modern electronic navigation). When I took up civil engineering as a profession the small company i worked for had two principles, one a registered land surveyor and the other a licensed professional engineer. There was a very strong emphasis on survey control and any engineering done on a plot of land in the absence of a closed property boundary was called a cartoon and use of a cartoon was restricted to preliminary planning discussions.
A word I would use to describe both my father and the two principles would be rigorous in terms of their thinking and need to be convinced to a very high degree that their thinking was tied into objective reality.
We’ve come along way baby.
Narrative becomes so much more powerful when so many abdicate their own thinking process to a prepackaged “best fit” message and totally bypass any referencing to objective reality. Add up decades of this and reality becomes so intensely subjective that it has morphed into the cartoon of which you speak.
Isolation and economic duress are not great choices. Accepting disease into your life and into the lives of those you come into contact with is a much worse choice. Objective reality.
Right? It seems simple, but “who is dead that wouldn’t have been dead but for X” is indeed the correct first question. The correct next question is “what do we do about it?” Those whose preferred answer for #2 affects their answer for #1 are probably under the influence of a cartoon.
This is a powerful illustration of one of the best ways that we accept cartoons - because of the lack of reference points or because we perceive the lack of reference points. As you’ll know well, the subsequent decisions we make from those uncheckable dead reckoning points become cartoons of cartoons. Thanks for this, tromares, and for the stories.
I don’t think there’s anything wrong with analyzing the costs of our decisions, even when it’s morbid, especially when they are decisions which come from the top down. That’s why we’ve been against universal shutdowns for months in favor of continued testing expansion, PPE provision and mask-wearing. But dismissing deaths because they happen to be disproportionately sick or old? I’m with Ben on that one. I appreciate your anecdotal example from your county, but it’s not what is observable in the national data.
I think the narrative that “we should be worried more about obesity / health” is a dangerous one, however. Certainly these conditions cause vastly more deaths, but those conditions are not the result of contagion nor aggravated by concentrated diagnoses in a short period nor reasonably influenced by policy over any but a long horizon. The response function at the margin to mask-wearing, PPE provision and testing is so vastly superior in terms of its cost/benefit against both liberty and treasure to anything we could do about the much larger, more intractable health problems that plague us. THAT’S why it warrants our focus.
Great Reply, Rusty.
My point is more to the effects of ALWAYS being concerned about health and strong immunity WHILE we protect the vulnerable during an outbreak of a communicable disease.
National Data in the CDC Report that inspired this piece very much supports the fact that this disease disproportionately affects the old and the already ill.
Italian Health Authorities report the same thing.
The One Size Fits All response is infuriating to the mathematically engaged.
Closing parks and playgrounds? Ridiculous.
I have always been baffled by the idea that cities would close wide open outdoor spaces like most parks. I still think there’s sufficient evidence that kids 10-18 are still perfectly capable spreaders, so there are reasonable concerns about other environments, but I’m with you on this one!
Ultimately you crash out. Shipwrecks and lawsuits for grading the neighboring property in the examples stated above. My favorite line (reported by a third party) heard before hitting the reef was “Here, hold the wheel a moment while I go below and make more margaritas”. All were saved.
Crashing out of this present scenario does not a pretty picture paint and we need better alternatives than what are currently on offer as so many of our companions on this long strange trip are in imminent peril of getting seriously weirded out.
As a former hospital based RN I was able to witness a disproportionate number of patients who continued life in a very poor state of health, with multiple comorbidities both self-induced and otherwise. It was astonishing how some of them could continue in such an extremely reduced health capacity for years, with multiple hospital admissions for related acute situations which healthier people would usually be able to readily shake off. The cartoon we would occasionally hear is “still walking by the 6foot hole and about to step on a banana peel”. Please forgive the crassness, but such is life. When it comes to medical coding (and billing…) it can be very tricky to accurately provide full understanding of the actual cause of death. Very much appreciate how your piece provides insight on how that coding data is eventually utilized