A Pandemic of Ignorance

The main failure in this COVID-19 pandemic has been about knowledge. The United States government was unprepared for dealing with a pandemic, specifically in being unprepared for quickly gathering the data, analyzing it, basing official policies on it, and communicating it to the public. We were blindsided and slow to respond.

We not only have lacked necessary info but, more importantly, lacked leadership in relationship to what we needed to know. Government positions and corporate practices for the most part have not been dependably based on good data nor did those making the decisions emphasize the importance of getting good data. Instead, we’ve too often been handed partisan politics, campaign rhetoric, and slogans.

Unlike in some other countries, US government and major businesses have failed to do mass infection testing, temperature scanning, contact tracing, and app tracking. All of this would’ve offered useful data for controlling the spread of infections and making informed decisions about which actions to take. Compare companies that kept running in the US to some in other countries.

In the US, meatpacking plants that have close working environments weren’t even requiring employees to wear masks and that is insane, as quickly became apparent. A German company, on the other, managed to keep infections down using not only masks but data collection to quickly determine the infected so as to isolate them. The same pattern was seen in how many Asian countries were much more systematic in their control measures. Why did those other places seek out knowledge early on and acted on it while the US decision-makers embraced willful ignorance in hoping everything would be fine?

Even when US leaders had info, they would sometimes keep it a secret, instead of sharing it in a way that could’ve helped. For example, health officials were apparently afraid of their being a run on medical masks and so, instead of being honest with the public, they intentionally lied to us by stating masks offered no protection. This led many to not take the protective gear seriously, including in extended care facilities that weren’t using protective gear.

This lack of transparency and accountability has continued. Governor Reynolds of Iowa has continually repeated that she is basing all her decisions on careful and regular analysis of detailed metrics, but she has never shared any of the supposed data and instead just makes declarations. Or consider how the Trump administration has silenced the CDC by disallowing their official report to go public. Are these officials worried what the public would do or demand if they had full knowledge?

Even now, decisions are being made about reopening businesses, schools, etc without any clear basis on data, at least not data that is being shared with the public. Almost no one in media or government is talking about how the second wave in fall will likely be far worse than anything we’ve seen so far. Many officials are acting like the pandemic is coming to an end and that now it’s time for everything to go back to normal, even as the reality is that waves of infections could continue for years.

Obviously, we still lack the knowledge we need. It’s true we know that COVID-19 isn’t as deadly as first thought, although it still is far more deadly than the common flu. All these months after the pandemic began spreading globally, there is no mass infection testing in the US nor are places of business implementing the basic tools like temperature scans used elsewhere from the beginning.

So, we aren’t sure how many Americans have been infected. On top of that, despite some hoping herd immunity will save us, our knowledge about immunity to this novel coronavirus is next to nothing. There might be some short term immunity, but even then it might not last long enough to prevent the same people getting infected again with the second wave. And no one knows if we will have a vaccine soon or ever.

Why is the US economy being reopened when even the most basic message of mask-wearing hasn’t been consistently and effectively communicated to much of the population? Instead, most of the major leaders are refusing to wear masks while speaking in public and so are modeling to Americans that they shouldn’t wear masks. Are we still at the level of not even agreeing on masks?

What lesson have we Americans learned from our mistakes during this pandemic? Have we learned any lessons? Would our leadership respond differently if the same situation happens again? When this pandemic began, we were in a state of collective ignorance and we were caught without even the capacity to ameliorate our ignorance. So, we acted blindly. In the same state of collective ignorance, we’d be forced to respond in the same way again or something similar.

The worst part is that this demonstrates the culture of ignorance that dominates in the US, as part of a broader failure of democracy. Much of the American leadership is brazen in pushing ignorance and much of the American public is apathetic in accepting it. There has been little political will to pursue data-driven policy and to put respect for knowledge front and center. Sadly, in the understandable mistrust by the public, those officials and experts worthy of trust are equally dismissed as the rest.

Our response in American society has been based primarily on ideology. The related problem in the US is that, in our reactionary hyper-individualism, a large part of the American population is dismissive to the very concept of public health, as if no individual should ever sacrifice the slightest freedom to save the lives of others. No healthy society can function that way.

Some of the most successful methods, besides masks, have been contact tracing and tracking apps. But many Americans would call that authoritarianism. It’s understandable that we should be cautious about what we allow in a society that aspires to democracy (aspires, if rarely succeeds). The problem is when paranoia destroys the culture of trust that is essential to a democracy. By promoting mistrust, the sad result is that authoritarianism becomes inevitable. Truth becomes whatever is declared by those with the most power and influence, by those who control the media and other platforms.

That is exactly what President Donald Trump has taken advantage of, in his own brand of authoritarianism. He loves to play on people’s fears, to scapegoat and attack all sources of authority other than himself so as to muddy the water. In his authoritarian worldview, US workers should be forced to go back to work with nothing in place to protect their lives because to an authoritarian workers are expendable and replaceable. This was his position from the beginning and no new data was ever going to change this position.

Yet most Americans are opposed to fully reopening the economy. That is largely because the top US leadership has utterly failed in the most basic test of human decency, even ignoring all of the deception and demagoguery. Americans don’t trust Trump or many other figures of authority, including the capitalist class asking for Americans to sacrifice their lives for the profit of others, and they aren’t sure who to trust. If some basic protections were put into place as is done in certain other countries, we could begin to rebuild some public trust.

The American public health crisis first and foremost is a public trust crisis. And it is a crisis that has been a long time coming. If not remedied, it could become an existential crisis. And the only remedy would be democratic reform through an informed public. That means the public will have to demand knowledge or, failing that, will have to educate themselves. A functioning democracy with transparency and accountability is the best preparation for any crisis, but that would require nurturing a culture of knowledge and learning, a shared respect for intellect and expertise.

16 thoughts on “A Pandemic of Ignorance

  1. We can never ‘know’ a sufficient amount about the virus and its effects to be certain about anything. Causes of death on death certificates are not consistent (and, can we trust the reports from China and other totalitarian countries?); people who would have died of ANY additional insult to their diseased/vulnerable physical systems are sometimes counted as COVID ‘victims’ (and those who succumbed to COVID directly may have died ‘officially’ of other diagnoses); tests to determine the presence of COVID antibody in any given person (with or without symptoms) are “unreliable”; the COVID virus found in any given person (with or w/o symptoms) may be a mutant strain which is more, or less, virulent than the strain that the lab workers use as a reference; etc. Public officials, both scientists and politicians, have a shaky basis for assuming or determining anything regarding how to advise the public to behave.

    • We have an obvious culture of ignorance in America, as demonstrated by large swaths of our leadership. President Trump is simply the most obvious example. Some of our lack of knowledge is simply unavoidable, but that is compounded by the direct attack on knowledge and expertise that creates confusion and conflict.

      Yet, even though information has been imperfect, we have had a fair amount of knowledge that was ignored, suppressed, or not acted upon. We see that with the CDC report being silenced. That CDC report had specific evidence-based recommendations for how to reopen society at the very moment governors are making the decision about reopening. This is a top-down enforcement of ignorance.

      It’s not only that. Some of the failure was inevitable, although obviously much of it wasn’t as demonstrated by the well-informed responses in other countries. The question is will we learn from our mistakes and do better next time. Testing, as you point out, is imperfect. But even imperfect knowledge is better than no knowledge at all. Data gathering through mass testing combined with app tracking and contact tracing immensely reduced infections and deaths where it was implemented.

      I stand by my position that this was a failure of knowledge, a crisis of public trust. But it also relates to another failure of knowledge that I didn’t mention. The main comorbidity for COVID-19 infections is that of metabolic diseases. And the main cause of metabolic diseases is the dietary recommendations (high in carbs, seed oils, etc) pushed by the US government for the past several generations.

      Those dietary recommendations were based on bad science or rather political power that trumped scientific debate. And the US authority on diet was adopted by countries all over the world. It’s possible that, if not for the crisis in nutritional science, there wouldn’t now be such a wide-scale crisis in metabolic diseases that made the global population vulnerable to infections. COVID-19 might never have become such a serious pandemic.

      On multiple levels over a long period of time, politics has dominated over science during a time when public funding of science has been on the decline. It’s not any one single thing. That is why I speak of a culture of ignorance. That isn’t to say there aren’t scientists and public officials trying to do good work, but they are being hampered by a system that doesn’t fully support their efforts.

      • I grok your further statements. After I retired in 2002, I left much grieving behind me on issues related to what you offer here. My university studies started with physics and math, but ended fully in the realm of public health. I ended up managing acute and other hospitals and medical services (I am not a physician). Several times I was in charge of public hospitals (one at a time) which were usually part of a larger organization which included the local department of public health. During my 40 years in the “business” of sick care (not that marketing phrase, “healthcare”) I despaired at the neglect in funding real public health programs and entities in favor of the diagnostic, and curative–that is, after the public health system had failed many people who could have had their diseases and injuries prevented. There’s more revenue in diagnosing and treating sick and injured people than in working to prevent disease and injury. Thus,we have a super “industry” of “healthcare” which is noting of the sort. Public health measures include inoculation, case finding (under the heading of epidemiology, a term which we are now more familiar with), disease prevention (restaurant inspections, proper water and sewerage treatment, wash your hands, etc), health education in the earliest grades and continuing throughout adulthood, visiting nurses (God bless them), and much more. These are not sexy and don’t get the funding they should because there’s no short term profit or measurable benefit. And, they are purely tax-supported functions, for the most part. Taxes means politics, and the politicians have many other priorities than to spend money on stuff that cannot offer a clear, short-term benefit. I can’t speak to the large, national entities like NIH and CDC. But, I imagine they are like universities which have arcane rules and reward systems which are not always related to the mission, and are subject to political pressure.

        • That is definitely part of the large point being made. It’s a systemic problem.

          Part of the culture of ignorance is simply a side effect of bureaucracy. But there is a deeper element also involved. In well functioning social democracies, the bureaucracies also are more well functioning. Cultures of trust, by way of democratic transparency and accountability, are supportive of healthy cultures of knowledge and learning, authority and expertise. It’s not only about the differences between countries in pandemic response but as seen in so many other measures: education, employment rates, economic mobility, etc.

          That said, there were aspects of the US response to the pandemic that worked reasonably well. For all the criticisms at the slow response, local governments did eventually put in serious measures that controlled the spread of infections and kept hospitals from being overwhelmed. That is no minor success, but it would’ve been an event greater success if it had happened more quickly and more coordinated. We should learn both from our mistakes and our successes.

      • More than anything, the metabolic diseases have been on my mind. I’ve been thinking about it a lot these past couple of years. And the comorbidities was one of the first pieces of info that came out about COVID-19. Another had to do with the role of immune system and inflammation in the cytokine storms caused by the virus.

        But it was strange that no officials were talking about the diet and lifestyle factors that either help or worsen metabolic diseases and inflammation. For many people, a change of diet alone can reverse metabolic disorder in a short period of time. If that had been made a priority of public health, the past few months could’ve been used to decrease the very diseases that are the main comorbidities.

        Why are we passively waiting for herd immunity or a vaccine? We’ve long had the information about how to lower vulnerability to infections and strengthen the immune system. I’ve been in the process of writing a post about this, but here is one article looking into this:

        https://www.dailymail.co.uk/health/article-8308883/Is-inflammation-link-dementia-cancer-coronavirus.html

          • I forget which posts you may have commented on in the past. But I had a number of posts where I discussed Ancel Keys, largely inspired by my reading the books by Gary Taubes and Nina Teicholz. The history of Keys’ influence is disheartening. About a half century ago, Ancel Keys targeted the sugar researcher John Yudkin. Keys was brilliant with rhetoric and media, a talent not unlike that of Trump. He was able to destroy Yudkin’s credibility, even though Yudkin was right. That was only the beginning.

            Keys and his allies went onto end the careers and otherwise silence many other opponents. After the consensus convention in the 1990s, even well respected researchers who disagreed with Keys lost funding, couldn’t get published, and were no longer invited to speak. It was a political coup in nutrition studies. I’m not sure what to call it. Such actions of power-mongering are not the same as the culture of ignorance but it is related. Keys was a scientist and it’s not that he embraced ignorance. What he didn’t embrace, though, was open scientific debate as a democratic process — without which knowledge becomes impotent or distorted.

            The saddest part is that Keys was able to have such wide influence, not only in the US but all across the world. The post-war scientific authority of the US held sway in the global scientific community. US scientific policy, including in nutrition studies, set the tone for what governments did elsewhere. So, it wasn’t only that scientific debate was shut down in the US but in every English-speaking country and beyond. Only places like China maintained their own separate scientific community, but their research was isolated by a language barrier.

    • Here is another example. The White House knew about the COVID-19 outbreak in November. Based on this knowledge, the US government warned Israel and NATO. But the official position of the White House was denial they knew anything at all. Instead, the Trump administration downplayed the threat and continues to do so, not based on any facts but as part of his political positioning in seeking reelection.

      This caused months of delay during which preparations could’ve been made and systems of coordinated actions could’ve been established between federal and state governments. Valuable time was lost. It was worse than that, though. In the attack on knowledge and expertise, the Trump administration had been seeking to undermine the very public institutions and that had begun prior to the pandemic. The culture of ignorance wasn’t a new situation and preceded Trump’s election.

      This didn’t only harm Americans. The White House not only kept the American public in the dark early on but also most other countries. Not even most of our allies were informed of the developing outbreak. This knowledge could’ve helped many governments in preparation for when COVID-19 reached their country. So, the American culture of ignorance affected people far beyond US borders. On top of that, the US refused to cooperate and coordinate with the UN and other countries in fighting the spread. Instead, Trump has almost on a daily basis stood before Americans and stated misinformation.

      We can’t know for certain how differently this crisis would’ve been if we didn’t have a culture of ignorance. But it’s probably safe to say that it wouldn’t have been nearly as bad in the infection and mortality rates. We can see that simply by comparing with countries that embraced a more evidence-based approach and so quickly got the situation under control. Through data-gathering, South Korea was able to accomplish this without any need for a total lockdown. There was nothing stopping the US government and corporations from doing similar data collection. Knowledge really does matter.

    • Here is something that explains why the knowledge we did have should’ve made us better prepared. The authors argue that we had enough information about these kinds of viruses to have understood how to prevent them turning into a pandemic. Reacting to them after they’ve already spread is not wise.

      “Following the emergence of SARS-CoV-2 (1, 2) in China, causing COVID-19, the remaining question is whether we could have been ready for it after learning from the SARS epidemic in 2003. It is not possible to predict the emergence of an infectious disease because it is an accidental process, i.e., the occurrence of a very low probability event resulting from the stochastic conjunction of independent low probability events (3). Even if the SARS-CoV-2 outbreak was unpredictable, we should have been able to prevent it because some features are consistent with previous coronaviruses outbreaks.”

      https://www.frontiersin.org/articles/10.3389/fmed.2020.00223/full

      • I don’t feel argumentative; I merely observe that accurate, timely, reliable, trusted, and reported (by all nations) data/information is necessary for political and public health leaders to effectively deploy whatever preparations have been made for such an outbreak and its progress. I agree we, and all nations, could have and should have been better prepared.

        • Don’t mind me. I mean no harm. Like you, I don’t feel argumentative. I realize I can come off that way, not just to you but many others. I have a natural talent for sounding critical, even when that isn’t (consciously?) my intention. What you say here in this comment fits what I was trying to communicate, but I often fail to communicate well, despite my wordiness.

          Yes, data/info is necessary. The question is how much is necessary for an effective response. For what we already knew, we could’ve responded better. And if there had been the political will, we could’ve used mass testing, temperature scans, app tracking, and contact tracing to have quickly gathered more data/info that would’ve allowed a more optimal response, rather than thrashing around in the dark as we did.

          Still, all of that is judging from the outside. As I see it, some countries responded quite successfully. The US not so much. It boils down to us learning from those who did better than us, but learning from other countries is not something Americans are prone to doing. If another pandemic hit, I’m not confident we’d follow the best examples of this pandemic. As with most other Americans, my trust of our leadership is not strong.

          That might be the worst part. Everything comes down to trust. Without it, we are absolutely fucked in any crisis, no matter about all the rest.

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