Tag: covid

Being better than Superman

MIKE2 Comments

Maxim four from Richard Zeckhauser is: “When trying to understand a complex real-world situation, think of an everyday analogue”.

Alex Tabarrok has been using this strategy to communicate about vaccines.

“To me the vaccines are like a superpower. Superman is immune to bullets and I tell people: ‘Wouldn’t you like to be immune to bullets? The virus has killed many more people this year than bullets have, and the vaccine makes you immune to the virus, it’s better than being immune to bullets!'” – Alex Tabarrok, July 2021

In Dan Levy’s book about Richard Zeckhauser he includes a section from Gary Orren who used the everyday analogy strategy to describe the AmeriCorps service program. AmeriCorps, Orren told legislators, is like a Swiss Army knife, it does many things well though it’s never the perfect tool. A few weeks after addressing the governmental staff Orren returned to their offices. “Oh yeah, I remember you. Swiss Army knife.”

This strategy helped, Orren explained, because it focused his thinking and the audience’s understanding. A lot of times our thinking is FAST and analogies shift complex concepts into simpler situations.

Simplification isn’t the end though. Extremes, like questioning the Ohio vaccine lotto, are not the final answers but a first foothold. If we can understand an issue’s basic components first, it can be easier to build up to the rubber-meets-the-road challenges of IRL.

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My year of AmeriCorps was health based, and I remember many vision screenings .

Hurdling past covid

MIKE1 Comment

One way to think about “adoption” is as series of hurdles. If something is “adopted” it has succeeded by crossing the set of hurdles. There are few food bacteria “adoptions” because of hurdle technology: hot, cold, salt, and acid all make the process harder for food bacteria to survive.

Another metaphor for this approach is Swiss cheese: one layer has multiple holes but if the layers are independent, then stacking one on top of another removes the holes.

Part of the problem with studying, treating, and living with Covid is that it’s hard to figure out what works. There are models, but we’re still kinda guessing. As of August 2021, more than one-fifth of all FDA approved drugs were tried as off label treatment for Covid. Ironically, there’s not enough Covid to study it.

“What should give us reason to be hopeful is that there’s this cumulative effect that if you give the right drug at the right time along the way…there are these 15-30% reductions at each step so if you are someone that gets a monoclonal antibody early on, if you get fluvoxamine, you get remdesivir on admission, you get dexamethasone once you are on oxygen. We should model out where this puts you at.” – David Fajgenbaum, Wharton Moneyball, August 2021

Ah not so fast, Eric Bradlow follows up. How independent are these? Is this like a piece of Swiss cheese? “It’s shocking,” says Fajgenbaum, “they all seem to hit it from a different angle.” That angle appears to be time. Vaccines are like sunscreen, David explains, and that’s the pre-infection prevention. Then it’s one drug to stimulate the body’s immune response, then it’s another to slow that response way down.

Abraham Lincoln is attributed as saying, give me an hour to chop down a tree and I will spend the first fifty minutes sharpening an axe. Rather than trees and axes we can ask: Is our situation a hurdle condition? With Mr. Lincoln and the suggestion of Charlie Munger to invert, always invert (!), we can come up with a simple situational:

For deceleration, we want to create a series of independent hurdles an agent must cross. In the case of covid this might mean that a place mandates masks, vaccines, and social distancing — or maybe just be outside.

For acceleration, we want to create fewer hurdles for an agent. If not possible, we want homogenous hurdles. Smartphones did this for ride sharing: the who (payments), where (location), and when (on-demand) were all integrated into an app. Another way to consolidate hurdles is find the JTBD.

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Even 17 months into it still feels early to say these are the treatments. While they may not be this approach still feels okay.

Apples to apples in Iceland

MIKE

The basic base rate question is: what should I expect in situations like this? Most often we have looked at base rates through the lens of projects. We have an optimistic tendency to think, “yeah but…”. Sometimes it is! Sometimes it’s not.

but it might work for us

The general advice for using base rates has been to start with them, rather than our impressions, and then adapt from there.

Another way to think about base rates is as sampling. It’s important to get the “situations like this” part right, right? This is tricky, and this came up during the summer of 2021 as more and more covid vaccinated people became infected with the covid virus. At one point 67% of Iceland’s cases were among the vaccinated.

“When you look at Iceland and graph out (cases) by who is vaccinated, who is not, and where the cases are, you can see that there are more cases in the vaccinated group than the unvaccinated group.” – Dr. Kat, NPR Planet Money, August 2021

That sounds like the vaccine doesn’t work, or doesn’t work as well, or never-worked?! Maybe, but maybe our conclusions are muddied by an initial assumption that’s wrong.

Rather than jump right to Iceland, let’s pull a Zeckhauser and simplify everything. Imagine in Indiana there is a group of 100 people, half are vaccinated and half are not. In the vaccinated group there are five infections and in the unvaccinated group there are five infections. Putting aside “long-infection”, hospitalization, and death, it-looks-like, in-this-case, that the vaccine is meh.

Okay, now in Nevada there is another group of 100 people. This time there are 90 which are vaccinated and 10 are not. In the vaccinated group there are five infections and in the unvaccinated group there are five infections. Putting aside the same other-factors, in this case the vaccine is doing a lot of work! This was the case in Iceland too. Six of every thousand vaccinated people caught covid while fifteen of every thousand unvaccinated people caught covid. And all of the other-factors were much worse for the unvaccinated group. Vaccination reduced someone’s risk by more than half.

This idea is known as the “base rate fallacy” but really it’s comparing apples to apples which will make the idea stick better anyway(another bit of Zeckhauser advice is to keep explanations simple). BRF is good for talking with economists and behavioral scientists but for implementing this idea it’s an apple-to-apples question a day that will keep the bad decisions at bay.

Will there be another “2020”?

MIKE5 Comments

Probably.

“The fact is we are a more interconnected world. The two main drivers of new pandemics are the two things that are being debated about the origin of this one: animal-human interface and dangerous laboratory work.” – @DrTomFrieden, Wharton Moneyball

But let’s consider the case for why there won’t be another 2020. Tyler Cowen writes as at least three different people: an economist on his blog Marginal Revolution, a contra-Tyler as Tyrone (also on the blog), and from a business perspective on Bloomberg. He aims to understand the same story from different sides.

Cowen’s colleague Caplan (Bryan) coined the ideological Turing test (ITT). Like the Turing test asks: can a person distinguish if an output is from a machine or a human. The ITT asks: can a person distinguish if an argument is from a person who believes X or not-X?

The legs of my argument point in the same direction as the March 2020 argument to ‘flatten the curve’. If everything I note moves 10% away from “2020” then the chances of another pandemic are greatly reduced. Only rather than lots of talk about flattening people will do it anyway.

Why there won’t be another 2020:

Technology. Teenagers are driving less and doing fewer drugs. There’s less movement across state lines. Look at screen times: they’re going up and time is a zero sum game.

Work has become remote, or at least can be. In the 1990s I first heard of “Blizzard Bags”. If there was an anticipated snow storm headed for Ohio, schools made up a day of work for the kids to take home. Now there are 40 million Google Chromebook in education.

I’m not sure the move digital all bad. Audiobooks for instance are a fine addition. YouTube teaches almost anything, maybe everything by the time you read this. “My internet friend” feels less and less weird each time I tell my wife. Some jobs are more productive online.

Salience. Experiencing a thing makes us overrate it (relatively). After a serious car crash I was a very conservative driver. Even now when it rains I slow way down, especially on the drag strips known as ‘Florida highways’.

Most people know someone who passed away due to Covid, who had their lives seriously stressed as a medical professional, or who (might) have long-Covid symptoms. It’s one thing to hear about an experience and another to live it and we all lived “2020”.

Experience. It’s crazy looking back. We did what?!?!? It reminds me of a grandfather-ism: good decisions come from experience and experience comes from bad decisions.

When someone starts they often copy someone. That’s fine. That’s how humans learn basic things. Then as that person figures things out they change their game (sports), pitch (sales), interactions (relationships).

That’s how the 2020 pandemic feels looking back. We had no idea what to do. Taking a page from a long-time Florida family member, we prepared as if a hurricane was coming through. Now though, we know more than we did. It’s hard to imagine personal, local, regional, and national reactions that are worse.

Medicine. March 2020 through March 2021 was not a good stretch for most, but look at the medical field and it’s pretty dang amazing. The virus was sequenced, the vaccine was created, tested, produced (!), and distributed (!!). Treatments improved. There are probably relevant discoveries we don’t even know yet.

Each of these areas: technology, salience, experience, and medicine offers the bare minimum case. Isn’t there even a good chance medical or technological advances leap forward? Even if they don’t, a small reduction in actions (more work from home, more masks, better medicine, more experience, etc.) will flatten the future curve.

Good organizations know there’s value to argue-well. James Mattis says to be “hard on the issues, not on the people”. Ben Horowitz said you want to be friendly but not so friendly you don’t ask the opposition difficult questions.

After writing this I believe this case more. How much more is hard to say. Maybe I’ve moved from from very likely to likely.

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Eric Jorgenson has been writing a lot of about leverage and I guess this post is about leverage. My main idea here is that if many people change in a small way then there will be a substantial change. Erik tweets about leverage as people, time, or money. On the blog we’ve addressed this idea too but under the name Large N small p.

Creativity, Conflict, and Choice

MIKE

One skill rising in importance is choosing when to use technology. Circa June 2021, it’s pretty clear that technology does two things really well: repeated calculations and reductions in space. Rory Sutherland credits the Covid pandemic with normalizing video calls, a service wrongly pitched as the poor man’s travel rather than the rich man’s call.

Covid has also highlighted scientific accomplishments. What used to take a graduate student (or twos) career, now takes minutes. Via the BBC:

“When I was a young scientist we did this manually and it was very laborious. To get the sequence of a Coronavirus it would have taken at least a full graduate student’s career and maybe more. Now we can do it in a few minutes.” – Marilyn J Roossinck

But just because we can use tehcnolgoy to reduce distance or make calculations doesn’t mean we should.

In the room or zoom we noted Jason Blum’s opinion that to support creative things it helps to be in the room. That’s true for movies-creative but also for technology-creative. Ben Horowitz said:

“One of the things that has become clear is that remote work is more efficient than in-person work. But, there’s kinda a couple of things it’s probably not as good at. One is creativity and the other is tough conflict resolution.”

Work from home is different.

When explaining the idea of jobs-to-be-done, JTBD, Bob Moesta asks his interviewer if they like steak or pizza. ‘Well I like both’ they respond. ‘Right!’ Moesta says. Sometimes the situation calls for pizza and sometimes it calls for steak. That’s the kind of mindset good technology use calls for. What about a situation makes it better for the room or using Zoom?