Hospitalist Perspectives: Logic as Bias

As I shared before, I really have gotten out of the business of predicting things.  Well, I thought I had.  But now I find myself being surprised by some things, which means I must have had some internal predictions that I wasn’t aware of.

I find myself surprised that all of the major sports have been playing, and we haven’t had any further COVID disasters since early in the baseball season.  Somehow, hundreds of people are getting together, spending lots of time in close contact, and are not causing a wave of COVID infections.  Maybe we could take a lesson from these organizations – if you put in place proper safety protocols, along with regular testing, timely results, and minimized outside contact, you can keep COVID at bay.  Unfortunately, while we could learn that lesson, it appears that we haven’t.

In the US, after peaking in mid-July at ~67,000 new cases/day, and trending down to ~35,000 cases/day in mid-September, now that schools have opened up, the numbers are climbing again.  We’re up to 43,000 new cases/day, and it appears that despite many schools using remote learning, we lack the will or ability to prevent further spread.  Colleges are having significant outbreaks, and to compound the problem, are sending students home (which potentially spreads the virus into their home community).  Elementary, middle, and high schools don’t have the capacity to do regular testing of students and faculty, and apply subsequent contact tracing.  And the real trouble hasn’t started yet.  What happens when kids get the sniffles and a sore throat (it is cold season now, after all)?  Are they staying home for two weeks?

Now to be fair, we don’t know where all of this growth in the numbers is coming from.  It may not all be school-related.  The beginning of autumn, flu season, cold season, more time indoors, lower humidity (we’ve already started using the heat here north of Boston), and other factors could be contributing.  But, it seems as if our efforts to reopen without having the ability to do it safely is reinvigorating this pandemic, and prolonging its effects.

So, since I (clearly) haven’t been able to get out of the prediction game, what am I to do when presented with a dearth of data?  I guess we do what we always do.  Make the best decisions we can with the best information we have available at the time, then hope for the best.  So, I’ll keep using appropriate PPE when I work, wearing my mask in public, continue social distancing, moderating my kids’ school/activities, and hope for a safe (!), prompt (!!), and effective (!!!) vaccine.