OH! And by the way: this is why we depend on reliable governmental institutions and honest officials dedicated to common welfare, civic responsibility, social infrastructure and the greater good.
Yes, but... CDC, our go-to agency, was already in the throes of reorganization... or perhaps dismantling, depending on your outlook... when things got real with COVID-19. And, NIH, and by extension, CDC was prohibited from studying anything about shooting violence for so long, they'd lost the ability to rapidly do an assessment on these events until only recently.
Add to this our missteps with communication (note what Jha just told a group of docs about needing to step up to combat misinformation and disinformation with their patients as authoritative trusted soucr.
As a college student history major in the 1970’s I took a class in the History of Disease which focused mostly on social history. There were many interesting things ( how Polio led to the growth of overnight camps in some areas….who knew?) but the most fascinating thing was how people quickly “forgot” about the influenza epidemic in the earlier part of the century. How very little it was discussed after. I thought Downton Abbey did a good job of portraying this. Your home was turned into a hospital??….barely mentioned after. I have always expected COVID to be similar.
We don't forget what we consider urgent. Urgency could be defined as keeping some past event in the forefront of our minds, a constant presentment to that part of our executive function that prioritizes actions. We humans, as all biological organisms are, are not evolved to remain in a constant state of emergency. We cannot sustain it. Flight or fight are short term responses to danger. We can flee a forest fire or a predator but not an ever-encroaching fire, or an ever-pursuing predator, at some point we turn and fight the one or surrender to the other. Recruitment of our inner resources perhaps require perception that the danger is immediate rather than slowly developing, is well defined, rather than fuzzily abstract, is amenable to solution rather than so great as to be beyond our capability to remediate. Humans have a certain stoic fatalism that kicks in. The urgency fades, with it the presentment of memory to the executive function. Everything reverts to some default setting. We all get numbed. To school shootings, climate change...etc.
“Humans have a certain stoic fatalism that kicks in” is an excellent addition to Dr. Jetelina’s typically smart and thought-provoking post. I would be curious to learn whether this kind of fatalism has been studied. I certainly see it anecdotally. For example, when a friend and I (we are both up in years) noted a widely shared local concern that could be and needed to be addressed by a local representative, I suggested she might want to write her and let her know (as I had done). She responded that she’s done that many times in the past and never hears back, so she has given up expecting anything from her representatives. I am sure this is a common experience, and easily seen as applicable to gun control, given our utter failure to make any progress on this after so much slaughter.
I think part of the equation is a scaling problem. In this case an example is from college classrooms where in small seminars, students are more attentive and feel more ownership of the info imparted, whereas in larger auditorium size venues (like at UC Berkeley decades ago) the students were more likely to be inattentive. Translate that to city life, where if there is some problem, say homelessness, people don't take ownership of fixing it as readily as if the identical problem was happening in some population 700 small town. Scaling problems pop up again and again where large scale venues induce passivity and even resignation. At least that's my theory.
Michael: I think that theory of yours has a lot of merit. Amusingly, in the anecdote I mention, while the scale was not small town level, in our discussion, it transpired my friend knows her assembly person quite well. She was persuaded on that basis to try writing to her on the issue. But overall, yes, I see what you are describing all around me, and also, in a place as big as NYC, where I am, there are so many things that need addressing, one can be flattened just by that!
Thank you - helpful information. Cognitive limitations has been well studied by the decision science community (start with Simon). In organizational settings "decision support tools" (see Peter Keen) are built and used regularly to overcome what Simon refers to as "bounded rationality". This "limitation" isn't just after the COVID "adventure", but was clear at the start. Personal experience, I was sprinting on soccer field by myself on a cold Spring day, when a government official told me I was a risk factor. In NJ they closed outside parks and threatened to arrest people that went there. IF I never hear "we are going to follow the data and the science" again I will die happy. There is a plenty of blame to those who exploited the situation, there is also blame on those who were responsible for guiding us through the challenge by not admitting or recognizing what they didn't know.
In meteorology, we've delved into decision science. How do we get people to respond appropriately to threats. This is is a rather significant issue because of the number of deaths from various weather events, most of which would be avoidable if people were to take action when faced with National Weather Service warnings.
All too often, we've heard, "The tornado came out of nowhere..." when in fact, a severe weather event had been foreseen and information published to local resources 24 hours (or more) before, and the NWS and local media had been talking about the event for nearly as long. Instead of moving to safety when a warning is issued, too many people grab a cellphone, rush outside, and look for the storm, to take photos. Or ignore it completely, because they feel it can't happen to them.
Warning fatigue has been hypothesized as an issue. NWS took action to reduce the number of warnings for large areas, instituting "Storm Based Warnings" in the early 2000s, and reducing the area warned by nearly 80%, thus making warnings more specific. There may have been a brief improvement in response, but not one we could actually measure. New tools and large programs have ensued, trying to increase warning times, specificity and locality, but it seems the only people who are paying any attention are those already deeply involved in decision support processes and who understand the risk. The public is able to watch the devastation (think of the storms in the last week!) but in 10 days, when another round of storms pushes through the central US, they'll have forgotten, because it didn't happen to them, so they're immune, or, it was too far away and can't happen in my city/town, or, they've literally forgotten it could happen to someone.
I've been working on this problem with NWS for close to 26 years (external participant), and just realized this is a similar phenomenon, thanks to this discussion.
Great commentary Gerry! Decision Science is a great field! I sometimes feel that more and better data to share with the public isn't a solution. It may be part of the problem. People may feel swamped with data and develop a species of resistance to it. If we look at a computational model of consciousness, then we might say in terms of decisions people rely on data, memory, and powerful algorithms in concert. Many of the latter are involved with pre-conscious Bayesian probability calculations. There is a local weatherman who while using the various forecasting models, extols the GOLU model- "go out, look up" approach. That's not as simplistic advice as it sounds. It really our own internal ensemble process. We all use it, but when it comes to strictly meteorologicsl forecasting were well sdvised to rely on the experts
I just got done with a little exercise doing operational weather forecasting for a flying exercise for 2 weeks. Almost every day, I warned, in the briefing, that the models were not in good agreement beyond about 24 hours (Sort of disturbing: We usually can get 7-10 days of reasonable data out of several of them) and that I'd be consulting the Weather Rock for real time updates. Said Rock allowed me to get 'em flying several days when the forecasts did not verify (weather was better than models, and even humans, thought).
In the forecasting world, you have to possess an innate knowledge of the way weather develops in an area. To that end, a new forecaster should probably work with an experienced one for some period of time... 6-12 months... to grasp how things work on the local starship.
NOAA and NWS are employing a number of social scientists now to try to improve the decision support landscape around severe weather events... severe thunderstorms, rain and flooding, tornadoes, hurricanes, and of late, increased emphasis on winter storms. That said, I need to see if they've an epidemiologist involved in severe weather, or if we'll simply continue to call that "climatology"?
In the work we did on Storm Based Warnings, we attempted to refine the area where a severe storm (thunderstorm or tornado) was likely to have significant impact. This involved a human in the loop, drawing a polygon defining where the storm was expected to proceed in the next 15-45 minutes. The polygon approach reduced the warned area by some 80%, when compared to the older way, where we warned entire counties even when only a small portion was likely to be affected. Part of this related to how warnings were disseminated. Storm Based Warnings were the first to be disseminated as web-based products with a probability associated with them. Newer research is using both high-frequency, high-resolution ensemble weather models and algorithmic parsing to define a threat track that can be shown with time hacks for arrival. The models mentioned are a part of a 10 year program, now well into its 14th year, to create a numerical modeling system that could produce time-critical weather warnings based on model result, rather than waiting for an observation-based warning, either directly observed or remotely sensed (radar). This effort has seen some significant advances in modeling, but we're reaching the conclusion that, providing perhaps an hour to the warning timeframe might lead the public to take less head of the need to take cover and remain safe. Based on several studies, we're now targeting the output of this program, as well as the algorithmic threat tracker, to emergency managers who are more likely to understand the need for timely action. NWS continues to depend on private sector partners, as well as tools such as web pages and NOAA Weather (All Hazards) Radio to disseminate warnings. This includes the media and services that send warning data to cellphones and mobile devices.
The Bayesian decision process is more complicated than most appreciate, in my estimate. For that matter, most of us intuitively do utilize a Bayesian approach to a number of daily decisions, but subconsciously. And, some people can make stellar decisions based on sparse or incomplete data while others cannot make a viable decision even with complete data. So much of their decision process is, as you note, based on memories: I don't need to evacuate because I rode out a Cat 3 hurricane as a kid and it wasn't that bad... That the parameters, if not the specific metrics of a hurricane have changed (larger wind fields, more likelihood of significant storm surge) while the deterministic parameters of classification have not is often lost on the public. As an experienced tropical cyclone researcher, I couldn't believe the models' precipitation estimates for Hurricane Harvey in 2017 (nor the wind field fetch size of Katrina in 2005) based on my own experience. I've reset my "normals", much as I had to do routinely during the pandemic as more data became available.
Awesome expertise on display in your remarks. I live in the northern Willamette Valley and forecasting for NWS is difficult to say the least. What with continental and oceanic airmasses colliding, the Cascade Range doing its adabiatic thing with downward Westerly flow, the Gorge acting as a conduit for high winds, microclimates galore, the urban heat island in the pdx/Vancouver area... We've had major winter storm warnings for storms that never occurred and on the flip side, off shore clipper lows that stalled out and brought heavy rain/snow for days! This winter one forecast had us getting a dusting, but instead we got eight inches of snow over ice!
Just recently, here in Colorado Springs, we were forecast for a dusting overnight. We got 5.25 inches (measured), but it was all gone, some early sublimation, and later, melting, by nightfall.
I've threatened to trademark the term, "Winter weather forcasting is HARD."
Ken, so agree with your statement, “there is also blame on those who were responsible for guiding us through the challenge by not admitting or recognizing what they didn't know.” Or, indeed, things they refused to learn, despite full court press from knowledgeable people trying to educate them. A salient example of the latter was Linsey Marr’s often lonely quest to educate the CDC et all about aerosol transmission, including indoor v outdoor transmission. On that one, to add one to your salient example of a genius move on the issue of closing the parks, early in the pandemic, my county in the Hudson Valley closed the rail trail, one of few places to walk in the area without dodging cars, to anyone 70 or older. As is my wont in such cases, I contacted the office of the genius in chief and noted, among other things, that those of us who are 70+ are taxpayers and very reliable voters and equally entitled to use the county parks. But the list goes on ad infinitum, doesn’t it? Indeed, our presence here at Dr. Jetelina’s Substack is precisely because public health communication from the governmental entities that are supposed to be doing it has been and remains subpar, to put it mildly.
As an aside on the overall issue of Dr. Jetelina’s platinum standard for public health communications, here is a video of a WHO official who is also doing a top-notch job explaining what is known and what is being watched on the new XBB.1.16 variant: https://twitter.com/mrigankshail/status/1643029761713643521 More of this, please, and also wish our media would push this kind of thing out instead of obsessing on what DJT had for lunch.
I have an urgent question relating to an earlier post of yours, "Do we need a spring COVID-19 booster?" I posted it in the comments, but I think it got lost in the crowd. After I asked it, a couple other people echoed the question. I hope you will answer it, because it seems to me that the info in the graph you posted is quite scary. Here is a link to the graph itself : https://i.imgur.com/PYUdJ2J.png
And here is my question about it: In the big 4-part figure showing waning protection over time from the booster for various groups, why is it that around month 7 all groups drop below zero? Zero is the amount of protection you'd have if you'd never gotten the booster, right? So does the fact that around 7 months out all groups drop below zero (sometimes a LOT below, like they're at -50%) mean that at that point the boosted people are *worse off* than if they'd never gotten boosted? I'm not a vax skeptic at all -- just perplexed and worried by these graphs. Am I misunderstanding them somehow? If not, wtf?
Antigen production is only one aspect of immune response. That fades—reinfection is the norm with coronaviruses, even (I think) if there is no consequential evolution. Add that and it’s worse.
But B cells, T cells, etc seem to be keeping up protection against severe disease though that slipped a bit, too.
Doug and Hypervaxed, totally get it that antigen production, which protects against infection ,is just one aspect of protection, fades in a few months, meanwhile B&T cells remember the virus and you have continuing protection against severe illness, which is the really important thing. If the 4 graphs just showed protection against infection going down to zero in a few months, then that's just what I would have expected. But all 4 graphs, each for a different group, dip down below zero around month 7 and with every month from then on they drop further below zero. Not just a little below zero, but as low as 40-50%. My understanding is that when protection reaches zero, it's as though you had not had a booster (when it comes to getting infected -- in other ways you're still benefitting). But when your protection drops way below zero, that would seem to mean that people are MORE likely to become infected than if they had not had a booster. That does not make sense to me. Does it to you? And Hypervaxed, you and I actually discussed this graph in the comments on the post containing the graph, both of us vexed and puzzled. Why are you now sounding like it's a bit inappropriate to ask this ("if your aim is to make decisions for your circumstances . . ."). No, my circumstances are not unusual and anyhow the 4 graphs pretty much cover all circumstances -- more vulnerable, less vulnerable, etc. I would certainly not be asking Dr J for advice here about my particular circumstance. I am asking about these results because they do not make sense to me and they are relevant to my circumstances and to those of anyone else who got the booster.
Agree with Doug, antibodies aren't the only line of defense.
It's also worth remembering that these are aggregate statistics. If your aim is to make decisions for your own circumstances, you can discuss that with your doctor.
Do we forget or are we pressured to let go and get back to working and spending? As I was rewatching “The Looming Tower,” I realized there have been 3 transformative, global crises over the past 22 year: 9/11, the Great Recession, and the COVID-19 pandemic. All 3 were followed by a subtle or not-so-subtle push to resume our consumerist behavior (“get down to Disney World in Florida,” “end the lockdowns”).
At a state agency level, the interval between major events (hurricanes, influenza pandemics) is typically just a little longer than staffers' tenure in particular jobs. People get promoted or move to another agency or another state. So the people who could apply what was learned in each episode are no longer in positions to do so.
Depends on the event and the agency involved. Since I span several fields (especially since I've officially "retired") I see responses from a number of state Emergency Management departments, especially for weather phenomena. At the EM level, most people are attuned to natural disasters. At the Health Dept. most are attuned to infectious disease and outbreak. That said, leadership in those departments, and above, are often skeptical of what's happened in the past. This was manifested in the political response to SARS-CoV-2. On the other hand, the creation of an influenza task force, by Pres. George W. Bush, was because he had read about the 1918 Pandemic and was concerned that the Country was ill-prepared, in part because we'd not seen something similar and had lost our corporate knowledge of how to cope with such an event. The Obama Administration maintained the team, although a number dispersed, as well as the plan. The Trump Administration folded it into the National Security Advisor's portfolio, but the plan itself was parted out to other areas of the administration for any required action, which diluted its effect and led to the US having, essentially, no plan.
The current pandemic is creating an environment where there's interest from the EU, WHO, US, and a number of other countries, in documenting what happened and creating a plan, ahead of time, that can be immediately referenced. This sort of planning will likely be crucial for the next outbreak, especially if it's as transmissible (or more so) and virulent as SARS-CoV-2.
It seems there are two issues at play here, although I'm sure they affect each other: memory of experience and memory of physical reality.
Anyone who's given birth will tell you they cannot remember the pain. They remember that they were IN pain, and maybe that it was the worst pain they'd ever felt; and they probably remember the story of the birth. But they cannot capture/remember/feel the true depth of the pain. As the saying goes, if they did, no one would ever have more than one kid.
But that applies to other things about being a parent, too, which are more experiential--being up all night with a newborn, constantly changing stinky diapers, answering toddlers' endless questions, dealing with tantrums, etc... Again, if people really felt the way they did in those moments, they'd be much less likely to have more kids.
Covid is different in that we are trying NOT to have another experience like it, but I assume the biological/psychological mechanisms around memory are the same.
Nah, we just don’t care. Must protect our Beautiful Minds from reality so we can keep droning along serving immediate selfish needs. Our system massively encourages such delusional sociopathy.
If we were literally incapable of remembering—of being rational—we couldn’t even have this discussion, of course.
We don’t care—whether out of delusion or sociopathy or both, and it’s utterly obvious. Covid, emergent diseases, carbon, plutonium. Just barreling on ahead.
I just got around to reading this one, and it confirmed my own observations that the horrible atrocities of yesterday are simply out of awareness two days from now. Who talks about the Valdez or even the BP Gulf spill, and I've never seen whether either company paid its fine. Guns stay in the news some because of their repeated occurrences, so that it seems like one long mass murder...yet the inactivity of government suggests despair. Your analysis makes great sense. As always.
I am grateful to people like you, Dr Osterholm, Dr Topol, Dr Hotez, Laurie Garrett, Ed Yong, Angela Rasmussen and on and on, who help us not only remember, but learn more.
Most catastrophes involve the government (correctly!) asking people to give things up for their fellow human beings, and it's almost impossible to do that equitably. Both Covid and active shooter situations involve this, to a certain extent. With Covid people were asked early on to forego high quality masks; stay home but not "hoard" supples; asked to "wait their turn" for vaccines even as "vaccine passports" were already being floated (next time, let's not do those two messages simultaneously). With active shooter situations, people are called on to fight back and help other people get out "if possible", as if it's not *always* safer to get the heck out. In severe droughts, people are asked to conserve water - in some cases even *drinking* water. In heat waves, people may be asked to turn off their air conditioners.
It's not that being asked to ration is bad; it's absolutely the government's role to ask people to conserve resources in catastrophes - or better yet enforce rationing. The latter is seldom possible in the context of late stage global capitalism that we're in. Instead we just get a signal from the government (or workplace, or utility company, or grocery store) that a given resource is scarce, and you just end up with an ugly every-man-for-himself situation.
People who dodge serious catastrophes don't become versions of themselves they care to remember.
OH! And by the way: this is why we depend on reliable governmental institutions and honest officials dedicated to common welfare, civic responsibility, social infrastructure and the greater good.
Yes, but... CDC, our go-to agency, was already in the throes of reorganization... or perhaps dismantling, depending on your outlook... when things got real with COVID-19. And, NIH, and by extension, CDC was prohibited from studying anything about shooting violence for so long, they'd lost the ability to rapidly do an assessment on these events until only recently.
Add to this our missteps with communication (note what Jha just told a group of docs about needing to step up to combat misinformation and disinformation with their patients as authoritative trusted soucr.
Absolutely. All catastrophes involve the R word:
Rationing.
As a college student history major in the 1970’s I took a class in the History of Disease which focused mostly on social history. There were many interesting things ( how Polio led to the growth of overnight camps in some areas….who knew?) but the most fascinating thing was how people quickly “forgot” about the influenza epidemic in the earlier part of the century. How very little it was discussed after. I thought Downton Abbey did a good job of portraying this. Your home was turned into a hospital??….barely mentioned after. I have always expected COVID to be similar.
We don't forget what we consider urgent. Urgency could be defined as keeping some past event in the forefront of our minds, a constant presentment to that part of our executive function that prioritizes actions. We humans, as all biological organisms are, are not evolved to remain in a constant state of emergency. We cannot sustain it. Flight or fight are short term responses to danger. We can flee a forest fire or a predator but not an ever-encroaching fire, or an ever-pursuing predator, at some point we turn and fight the one or surrender to the other. Recruitment of our inner resources perhaps require perception that the danger is immediate rather than slowly developing, is well defined, rather than fuzzily abstract, is amenable to solution rather than so great as to be beyond our capability to remediate. Humans have a certain stoic fatalism that kicks in. The urgency fades, with it the presentment of memory to the executive function. Everything reverts to some default setting. We all get numbed. To school shootings, climate change...etc.
“Humans have a certain stoic fatalism that kicks in” is an excellent addition to Dr. Jetelina’s typically smart and thought-provoking post. I would be curious to learn whether this kind of fatalism has been studied. I certainly see it anecdotally. For example, when a friend and I (we are both up in years) noted a widely shared local concern that could be and needed to be addressed by a local representative, I suggested she might want to write her and let her know (as I had done). She responded that she’s done that many times in the past and never hears back, so she has given up expecting anything from her representatives. I am sure this is a common experience, and easily seen as applicable to gun control, given our utter failure to make any progress on this after so much slaughter.
Hi Susan!
I think part of the equation is a scaling problem. In this case an example is from college classrooms where in small seminars, students are more attentive and feel more ownership of the info imparted, whereas in larger auditorium size venues (like at UC Berkeley decades ago) the students were more likely to be inattentive. Translate that to city life, where if there is some problem, say homelessness, people don't take ownership of fixing it as readily as if the identical problem was happening in some population 700 small town. Scaling problems pop up again and again where large scale venues induce passivity and even resignation. At least that's my theory.
Michael: I think that theory of yours has a lot of merit. Amusingly, in the anecdote I mention, while the scale was not small town level, in our discussion, it transpired my friend knows her assembly person quite well. She was persuaded on that basis to try writing to her on the issue. But overall, yes, I see what you are describing all around me, and also, in a place as big as NYC, where I am, there are so many things that need addressing, one can be flattened just by that!
Thank you - helpful information. Cognitive limitations has been well studied by the decision science community (start with Simon). In organizational settings "decision support tools" (see Peter Keen) are built and used regularly to overcome what Simon refers to as "bounded rationality". This "limitation" isn't just after the COVID "adventure", but was clear at the start. Personal experience, I was sprinting on soccer field by myself on a cold Spring day, when a government official told me I was a risk factor. In NJ they closed outside parks and threatened to arrest people that went there. IF I never hear "we are going to follow the data and the science" again I will die happy. There is a plenty of blame to those who exploited the situation, there is also blame on those who were responsible for guiding us through the challenge by not admitting or recognizing what they didn't know.
The Cambridge Elements series has a nice series of small books on Decision Science for any interested in this fascinating field.
In meteorology, we've delved into decision science. How do we get people to respond appropriately to threats. This is is a rather significant issue because of the number of deaths from various weather events, most of which would be avoidable if people were to take action when faced with National Weather Service warnings.
All too often, we've heard, "The tornado came out of nowhere..." when in fact, a severe weather event had been foreseen and information published to local resources 24 hours (or more) before, and the NWS and local media had been talking about the event for nearly as long. Instead of moving to safety when a warning is issued, too many people grab a cellphone, rush outside, and look for the storm, to take photos. Or ignore it completely, because they feel it can't happen to them.
Warning fatigue has been hypothesized as an issue. NWS took action to reduce the number of warnings for large areas, instituting "Storm Based Warnings" in the early 2000s, and reducing the area warned by nearly 80%, thus making warnings more specific. There may have been a brief improvement in response, but not one we could actually measure. New tools and large programs have ensued, trying to increase warning times, specificity and locality, but it seems the only people who are paying any attention are those already deeply involved in decision support processes and who understand the risk. The public is able to watch the devastation (think of the storms in the last week!) but in 10 days, when another round of storms pushes through the central US, they'll have forgotten, because it didn't happen to them, so they're immune, or, it was too far away and can't happen in my city/town, or, they've literally forgotten it could happen to someone.
I've been working on this problem with NWS for close to 26 years (external participant), and just realized this is a similar phenomenon, thanks to this discussion.
Great commentary Gerry! Decision Science is a great field! I sometimes feel that more and better data to share with the public isn't a solution. It may be part of the problem. People may feel swamped with data and develop a species of resistance to it. If we look at a computational model of consciousness, then we might say in terms of decisions people rely on data, memory, and powerful algorithms in concert. Many of the latter are involved with pre-conscious Bayesian probability calculations. There is a local weatherman who while using the various forecasting models, extols the GOLU model- "go out, look up" approach. That's not as simplistic advice as it sounds. It really our own internal ensemble process. We all use it, but when it comes to strictly meteorologicsl forecasting were well sdvised to rely on the experts
I just got done with a little exercise doing operational weather forecasting for a flying exercise for 2 weeks. Almost every day, I warned, in the briefing, that the models were not in good agreement beyond about 24 hours (Sort of disturbing: We usually can get 7-10 days of reasonable data out of several of them) and that I'd be consulting the Weather Rock for real time updates. Said Rock allowed me to get 'em flying several days when the forecasts did not verify (weather was better than models, and even humans, thought).
In the forecasting world, you have to possess an innate knowledge of the way weather develops in an area. To that end, a new forecaster should probably work with an experienced one for some period of time... 6-12 months... to grasp how things work on the local starship.
NOAA and NWS are employing a number of social scientists now to try to improve the decision support landscape around severe weather events... severe thunderstorms, rain and flooding, tornadoes, hurricanes, and of late, increased emphasis on winter storms. That said, I need to see if they've an epidemiologist involved in severe weather, or if we'll simply continue to call that "climatology"?
In the work we did on Storm Based Warnings, we attempted to refine the area where a severe storm (thunderstorm or tornado) was likely to have significant impact. This involved a human in the loop, drawing a polygon defining where the storm was expected to proceed in the next 15-45 minutes. The polygon approach reduced the warned area by some 80%, when compared to the older way, where we warned entire counties even when only a small portion was likely to be affected. Part of this related to how warnings were disseminated. Storm Based Warnings were the first to be disseminated as web-based products with a probability associated with them. Newer research is using both high-frequency, high-resolution ensemble weather models and algorithmic parsing to define a threat track that can be shown with time hacks for arrival. The models mentioned are a part of a 10 year program, now well into its 14th year, to create a numerical modeling system that could produce time-critical weather warnings based on model result, rather than waiting for an observation-based warning, either directly observed or remotely sensed (radar). This effort has seen some significant advances in modeling, but we're reaching the conclusion that, providing perhaps an hour to the warning timeframe might lead the public to take less head of the need to take cover and remain safe. Based on several studies, we're now targeting the output of this program, as well as the algorithmic threat tracker, to emergency managers who are more likely to understand the need for timely action. NWS continues to depend on private sector partners, as well as tools such as web pages and NOAA Weather (All Hazards) Radio to disseminate warnings. This includes the media and services that send warning data to cellphones and mobile devices.
The Bayesian decision process is more complicated than most appreciate, in my estimate. For that matter, most of us intuitively do utilize a Bayesian approach to a number of daily decisions, but subconsciously. And, some people can make stellar decisions based on sparse or incomplete data while others cannot make a viable decision even with complete data. So much of their decision process is, as you note, based on memories: I don't need to evacuate because I rode out a Cat 3 hurricane as a kid and it wasn't that bad... That the parameters, if not the specific metrics of a hurricane have changed (larger wind fields, more likelihood of significant storm surge) while the deterministic parameters of classification have not is often lost on the public. As an experienced tropical cyclone researcher, I couldn't believe the models' precipitation estimates for Hurricane Harvey in 2017 (nor the wind field fetch size of Katrina in 2005) based on my own experience. I've reset my "normals", much as I had to do routinely during the pandemic as more data became available.
Awesome expertise on display in your remarks. I live in the northern Willamette Valley and forecasting for NWS is difficult to say the least. What with continental and oceanic airmasses colliding, the Cascade Range doing its adabiatic thing with downward Westerly flow, the Gorge acting as a conduit for high winds, microclimates galore, the urban heat island in the pdx/Vancouver area... We've had major winter storm warnings for storms that never occurred and on the flip side, off shore clipper lows that stalled out and brought heavy rain/snow for days! This winter one forecast had us getting a dusting, but instead we got eight inches of snow over ice!
Just recently, here in Colorado Springs, we were forecast for a dusting overnight. We got 5.25 inches (measured), but it was all gone, some early sublimation, and later, melting, by nightfall.
I've threatened to trademark the term, "Winter weather forcasting is HARD."
Ken, so agree with your statement, “there is also blame on those who were responsible for guiding us through the challenge by not admitting or recognizing what they didn't know.” Or, indeed, things they refused to learn, despite full court press from knowledgeable people trying to educate them. A salient example of the latter was Linsey Marr’s often lonely quest to educate the CDC et all about aerosol transmission, including indoor v outdoor transmission. On that one, to add one to your salient example of a genius move on the issue of closing the parks, early in the pandemic, my county in the Hudson Valley closed the rail trail, one of few places to walk in the area without dodging cars, to anyone 70 or older. As is my wont in such cases, I contacted the office of the genius in chief and noted, among other things, that those of us who are 70+ are taxpayers and very reliable voters and equally entitled to use the county parks. But the list goes on ad infinitum, doesn’t it? Indeed, our presence here at Dr. Jetelina’s Substack is precisely because public health communication from the governmental entities that are supposed to be doing it has been and remains subpar, to put it mildly.
As an aside on the overall issue of Dr. Jetelina’s platinum standard for public health communications, here is a video of a WHO official who is also doing a top-notch job explaining what is known and what is being watched on the new XBB.1.16 variant: https://twitter.com/mrigankshail/status/1643029761713643521 More of this, please, and also wish our media would push this kind of thing out instead of obsessing on what DJT had for lunch.
I have an urgent question relating to an earlier post of yours, "Do we need a spring COVID-19 booster?" I posted it in the comments, but I think it got lost in the crowd. After I asked it, a couple other people echoed the question. I hope you will answer it, because it seems to me that the info in the graph you posted is quite scary. Here is a link to the graph itself : https://i.imgur.com/PYUdJ2J.png
And here is my question about it: In the big 4-part figure showing waning protection over time from the booster for various groups, why is it that around month 7 all groups drop below zero? Zero is the amount of protection you'd have if you'd never gotten the booster, right? So does the fact that around 7 months out all groups drop below zero (sometimes a LOT below, like they're at -50%) mean that at that point the boosted people are *worse off* than if they'd never gotten boosted? I'm not a vax skeptic at all -- just perplexed and worried by these graphs. Am I misunderstanding them somehow? If not, wtf?
Antigen production is only one aspect of immune response. That fades—reinfection is the norm with coronaviruses, even (I think) if there is no consequential evolution. Add that and it’s worse.
But B cells, T cells, etc seem to be keeping up protection against severe disease though that slipped a bit, too.
Doug and Hypervaxed, totally get it that antigen production, which protects against infection ,is just one aspect of protection, fades in a few months, meanwhile B&T cells remember the virus and you have continuing protection against severe illness, which is the really important thing. If the 4 graphs just showed protection against infection going down to zero in a few months, then that's just what I would have expected. But all 4 graphs, each for a different group, dip down below zero around month 7 and with every month from then on they drop further below zero. Not just a little below zero, but as low as 40-50%. My understanding is that when protection reaches zero, it's as though you had not had a booster (when it comes to getting infected -- in other ways you're still benefitting). But when your protection drops way below zero, that would seem to mean that people are MORE likely to become infected than if they had not had a booster. That does not make sense to me. Does it to you? And Hypervaxed, you and I actually discussed this graph in the comments on the post containing the graph, both of us vexed and puzzled. Why are you now sounding like it's a bit inappropriate to ask this ("if your aim is to make decisions for your circumstances . . ."). No, my circumstances are not unusual and anyhow the 4 graphs pretty much cover all circumstances -- more vulnerable, less vulnerable, etc. I would certainly not be asking Dr J for advice here about my particular circumstance. I am asking about these results because they do not make sense to me and they are relevant to my circumstances and to those of anyone else who got the booster.
Agree with Doug, antibodies aren't the only line of defense.
It's also worth remembering that these are aggregate statistics. If your aim is to make decisions for your own circumstances, you can discuss that with your doctor.
Do we forget or are we pressured to let go and get back to working and spending? As I was rewatching “The Looming Tower,” I realized there have been 3 transformative, global crises over the past 22 year: 9/11, the Great Recession, and the COVID-19 pandemic. All 3 were followed by a subtle or not-so-subtle push to resume our consumerist behavior (“get down to Disney World in Florida,” “end the lockdowns”).
At a state agency level, the interval between major events (hurricanes, influenza pandemics) is typically just a little longer than staffers' tenure in particular jobs. People get promoted or move to another agency or another state. So the people who could apply what was learned in each episode are no longer in positions to do so.
Depends on the event and the agency involved. Since I span several fields (especially since I've officially "retired") I see responses from a number of state Emergency Management departments, especially for weather phenomena. At the EM level, most people are attuned to natural disasters. At the Health Dept. most are attuned to infectious disease and outbreak. That said, leadership in those departments, and above, are often skeptical of what's happened in the past. This was manifested in the political response to SARS-CoV-2. On the other hand, the creation of an influenza task force, by Pres. George W. Bush, was because he had read about the 1918 Pandemic and was concerned that the Country was ill-prepared, in part because we'd not seen something similar and had lost our corporate knowledge of how to cope with such an event. The Obama Administration maintained the team, although a number dispersed, as well as the plan. The Trump Administration folded it into the National Security Advisor's portfolio, but the plan itself was parted out to other areas of the administration for any required action, which diluted its effect and led to the US having, essentially, no plan.
The current pandemic is creating an environment where there's interest from the EU, WHO, US, and a number of other countries, in documenting what happened and creating a plan, ahead of time, that can be immediately referenced. This sort of planning will likely be crucial for the next outbreak, especially if it's as transmissible (or more so) and virulent as SARS-CoV-2.
History repeats itself applies once again.
Excellent topic and well presented as usual!
It seems there are two issues at play here, although I'm sure they affect each other: memory of experience and memory of physical reality.
Anyone who's given birth will tell you they cannot remember the pain. They remember that they were IN pain, and maybe that it was the worst pain they'd ever felt; and they probably remember the story of the birth. But they cannot capture/remember/feel the true depth of the pain. As the saying goes, if they did, no one would ever have more than one kid.
But that applies to other things about being a parent, too, which are more experiential--being up all night with a newborn, constantly changing stinky diapers, answering toddlers' endless questions, dealing with tantrums, etc... Again, if people really felt the way they did in those moments, they'd be much less likely to have more kids.
Covid is different in that we are trying NOT to have another experience like it, but I assume the biological/psychological mechanisms around memory are the same.
Nah, we just don’t care. Must protect our Beautiful Minds from reality so we can keep droning along serving immediate selfish needs. Our system massively encourages such delusional sociopathy.
If we were literally incapable of remembering—of being rational—we couldn’t even have this discussion, of course.
We don’t care—whether out of delusion or sociopathy or both, and it’s utterly obvious. Covid, emergent diseases, carbon, plutonium. Just barreling on ahead.
I just got around to reading this one, and it confirmed my own observations that the horrible atrocities of yesterday are simply out of awareness two days from now. Who talks about the Valdez or even the BP Gulf spill, and I've never seen whether either company paid its fine. Guns stay in the news some because of their repeated occurrences, so that it seems like one long mass murder...yet the inactivity of government suggests despair. Your analysis makes great sense. As always.
I am grateful to people like you, Dr Osterholm, Dr Topol, Dr Hotez, Laurie Garrett, Ed Yong, Angela Rasmussen and on and on, who help us not only remember, but learn more.
Most catastrophes involve the government (correctly!) asking people to give things up for their fellow human beings, and it's almost impossible to do that equitably. Both Covid and active shooter situations involve this, to a certain extent. With Covid people were asked early on to forego high quality masks; stay home but not "hoard" supples; asked to "wait their turn" for vaccines even as "vaccine passports" were already being floated (next time, let's not do those two messages simultaneously). With active shooter situations, people are called on to fight back and help other people get out "if possible", as if it's not *always* safer to get the heck out. In severe droughts, people are asked to conserve water - in some cases even *drinking* water. In heat waves, people may be asked to turn off their air conditioners.
It's not that being asked to ration is bad; it's absolutely the government's role to ask people to conserve resources in catastrophes - or better yet enforce rationing. The latter is seldom possible in the context of late stage global capitalism that we're in. Instead we just get a signal from the government (or workplace, or utility company, or grocery store) that a given resource is scarce, and you just end up with an ugly every-man-for-himself situation.
People who dodge serious catastrophes don't become versions of themselves they care to remember.