My Monday post this week is late. Instead of trying to cobble something together, I will share this video from T1J’s YouTube channel published last week. It gave me a lot to think about.
“Now these stories are very complex and nuanced, and American schools generally do a bad job of teaching Black history. But the point I’m making is, it’s not true that Martin Luther King Jr. did some peaceful protests and gave some speeches and then single-handedly changed everyone’s minds. The progress we’ve seen is due to the combined efforts of Black leaders and activists throughout history, some of whom disagreed on the best path forward, but all of whom contributed towards shaping the world and making the world a little better for people of color. Another thing people fail to realize is that Martin Luther King Jr. was very unpopular during his time. So, whether or not something is palatable to the white masses is not a good measure of whether it is the right thing to do.”
I apologize for the late post this week. I had a few ideas kicking around in my head, but given the updates, I felt this ramble-post was a better attempt to capture some of the zeitgeist, rather than my usual attempt to feign some sort of authority on whatever it is I’m trying to accomplish on this site. Maybe I’ll rant another time about the scummy people who are profiteering through the COVID-19 scare.
Most of the information circulating concerns how an individual can help protect themselves from contracting the virus. Obviously this information is spread around not to protect any one individual, but because it’s the government’s attempt to flatten the curve and ease the economic and public health downsides to the current behaviours of people, from clogging up emergency rooms with sniffles to wholesale runs on items in the grocery store.
I’m not entirely sure what I should write about this week. It’s pretty hard to form a coherent thought when the majority of my bandwidth is occupied with keeping up with the shifting narrative around what’s going on. Thanks to technology, information (or misinformation) spreads quickly, and we are seeing multiple updates per day as a result. At my place of employment, they took the unprecedented step of shutting down face-to-face curriculum delivery. Unlike the faculty strike from Fall 2017, the College is working to keep the educational process running. While it may be that in the School of Engineering it can be impossible to replicate lab or shop time, the majority of faculty are working hard to translate their delivery to an online format.
So far, our employer has done a good job, in my opinion, with taking prudent steps to a.) keep people meaningfully occupied in their work so that no one has to lose their salary, and b.) do its part to stop the spread of the virus. I’m not saying that things couldn’t be better, but given the circumstances they’ve done a good job.
I’ve been thinking about the purpose of social isolation as a pandemic response. As I said above, the point is less about protecting oneself and is instead about protecting hospitals from being overwhelmed. If we’ve learned anything from countries around the world that are going through the worst right now, it’s that it becomes impossible to protect our vulnerable when there is a shortage of hospital beds. Hospitals are having to triage patients to focus on saving those who can be saved, who have the highest chances of recovering.
It is because of this that I’ve been thinking about the concept of a “brother’s keeper.” It’s not necessarily enough that governments or citizens remain mindful about the well-being of our vulnerable populations. Oftentimes while we are focusing on immediate dangers before us, we tend to not anticipate higher-order consequences of our policies or decisions.
Closing schools is great in theory – children are rabid spreaders of contagions, whether they are actually symptomatic or not, which means they infect their parents (some of whom are front line medical workers). But when we close schools, you have second order consequences that parents struggle with childcare, or children living in poverty lose access to food that is supplied at school.
When you close borders, you stop carriers of the virus from entry. But it also means that our international students (who are in some cases being vacated from post-secondary residences as school’s work to limit social contact among students) have no where to go. Airports are limiting international travel and the cost of purchasing tickets are skyrocketing. By them being in a foreign country, these students are vulnerable and caught in difficult positions on how to keep themselves safe.
By shutting down public spaces, you are helping to keep people from accidentally infecting each other. But when you close down businesses such as restaurants, you cut off people from the economic means they need to support themselves. Sure, the government is offering assistance to persons and businesses alike, but that will provide little comfort to people who can neither travel for groceries, nor pay for the supplies they need.
And let’s not forget what panic purchasing is doing to our supply chain – leaving store shelves cleared out of supplies, which means folks like the elderly are left without.
The hardest part I’m finding in all of this is the feeling of being powerless. You can’t control other people, and so you are forced to anticipate their moves to ensure you won’t be left without. But it’s this kind of thinking that leads to more drastic measures being taken. The virus also makes you feel powerless because you feel like an invisible stalker is coming for you – you don’t know who will be the final vector that leads to you. And you aren’t totally sure if our ritualistic hand-washing and hand-sanitizing is actually keeping us safe, or merely providing comfort. You can’t predict the future, and you can’t be sure you’re doing everything you can; you always feel like there is more you could be doing.
This reminds me of the story of the tinfoil house and pink dragons. A person covers their house in tinfoil, and when asked about it they say it keeps the pink dragons away. When asked if it works, the person shrugs and says “I don’t know, but I haven’t been attacked yet.” Of course, asking “if it works” is the wrong question here because there are no pink dragons. But as Taleb tells us in his book about Black Swans, there are always those highly unprobable events with massive downsides that we don’t see coming. Public policy and budgets are created to deal with clear and present dangers, and those policies and budgets are eroded when it’s felt that the money is not being allocated optimally. Therefore, you run into problems where you are never sure if the resources you spend to prevent something actually works – it’s really hard to prove causality in something that never happens.
Instead, we often are left to scramble to try and get ahead of trouble when we are already flat-footed, which means that our vision narrows as we focus on the fires in front of us that needs to be put out. Fighting fires is great (even heroic at times), but often the measures we take to deal with crisis have unanticipated second-order consequences that become difficult to deal with.
I’m not sure how to deal with this, but it makes me wonder about being my brother’s keeper, and what I can do to protect them.
From time to time, I catch myself thinking some pretty stupid stuff for entirely dumb reasons. A piece of information finds a way to bypass any critical thinking faculties I proudly think I possess and worms its way into my belief web. Almost like a virus, which is a great segue.
A perfect example of this happened last week in relation to the COVID-19 news, and I thought it important to share here, both as an exercise in humility to remind myself that I should not think myself above falling for false information, and as my contribution to correcting misinformation floating around the web.
Through a friend’s Stories on Instagram, I saw the following screencap from Twitter:
My immediate thought was to nod my head in approval and take some smug satisfaction that of course I’m smart enough to already know this is true.
Thankfully, some small part at the back of my brain immediately raised a red flag and called for a timeout to review the facts. I’m so glad that unconscious part was there.
It said to me “Hang on… is hand-sanitizer ‘anti-bacterial’?”
I mean, yes, technically it is. But is it “anti-bacterial” in the same way that it is getting implied in this tweet? The way the information is framed, it treats the hand-sanitizer’s anti-bacterial properties as being exclusively what it was designed for, like antibiotics. For example, you can’t take antibiotics for the cold or flu, because those are not bacterial infections but viral infections.
According to the author on the topic of alcohol-based hand sanitizers (ABHS),
There are some special cases where ABHS are not effective against some kinds of non-enveloped viruses (e.g. norovirus), but for the purposes of what is happening around the world, ABHS are effective. It is also the case that the main precaution to protect yourself is to thoroughly wash your hands with soap and water, and follow other safety precautions as prescribed.
The tweet, while right about the need for us to wash our hands and not overly rely on hand-sanitizers, is factually wrong generally. Thanks to a mix of accurate information (bacteria =/= virus) and inaccurate information(“hand sanitizer is not anti-bacterial”), and a packaging that appeals to my “I’m smarter than you” personality, I nearly fell for its memetic misinformation.
There are a number of lessons I’ve taken from this experience:
My network is not immune to false beliefs, so I must still guard against accepting information based on in-group status.
Misinformation that closely resembles true facts will tap into my confirmation bias.
I’m more likely to agree with statements that are coded with smarmy or condescending tonality because it carries greater transmission weight in online discourse.
Appeals to authority (science) resonate with me – because this was coming from a scientist who is tired of misinformation (I, too, am tired of misinformation), I’m more likely to agree with something that sounds like something I believe.
Just because someone says they are a scientist, doesn’t make the status true, nor does it mean what they are saying is automatically right.
Even if the person is factually a scientist, if they are speaking outside of their primary domain, being a scientist does not confer special epistemological status.
In the aftermath, the tweet was pulled and the person tried to correct the misinformation, but the incident highlights that the norms of Twitter (and social media more broadly) are entirely antithetical to nuance and contextual understanding.
It’s interesting how much information spread (memetics) resembles pathogen spreading. If the harmful thing attacking us is sufficiently designed to sidestep our defenses, whether that’s our body’s immune system or our critical thinking faculties, the invading thing can easily integrate within, establish itself within our web, and prepare to spread.
The one thing that really bums me out about this event is the inadvertent harm that comes to scientific authority. We as a society are caught in a period of intense distrust of the establishment that is coinciding with the largest explosion of information our species has ever seen. The result of this is not that good information is scarce, but rather the signal-to-noise ratio is so imbalanced that good information is getting swept away in the tide. If people grow distrustful of the sources of information that will help protect us, then forget worrying about gatekeepers that keep knowledge hidden; there will be no one left to listen.
In the ethics of conducting research with human participants, there is the concept of “informed consent.” At its foundation, informed consent is the process of communicating a sufficient amount of information about a research project to a prospective participant so that the prospect is able to decide whether they want to consent to being a participant in a study. There is a lot of nuance that can go into selecting what gets communicated because you have a lot of necessary information that needs be shared but you don’t want to share so much information that the participant is overwhelmed by the volume of information.
When I review research ethics applications, I am privy to a lot of information about the project. In the course of reviewing the project, I have to make judgement calls about what should be included in the informed consent letters that participants read. It would be counter-productive if the participant had to read all the documentation I am required to read when reviewing an application, so we use certain best practices and principles to decide what information gets communicated as a standard, and what is left in the application.
There is, of course, some challenges that we must confront in this process. As I said, when reviewing a research project, you have to balance the needs of the project with the needs of a participant. All research, by virtue of exploring the unknown, carries with it an element of risk. When you involve humans in a research project, you are asking them to shoulder some of the risk in the name of progress. Our job as researchers and reviewers is to anticpate risk and mitigate it where possible. We are stewards of the well-being of the participants, and we use our experience and expertise to protect the particpants.
This means that one challenge is communicating risk to participants and helping them understand the implications of the risks of the research. In many instances, the participants are well aware of risks posed to their normal, every-day lived experiences and how the research intersects with it. The patient living with a medical condition is aware of their pain or suffering, and can appreciate risks associated with medical interventions. A person living in poverty is acutely aware of what it means to live in poverty, and understands that discussing their experiences can be psychologically and emotionally difficult. Our jobs (as reviewers and researchers) is to ensure that the participant is made aware of the risk, mitigate it as much as we can without compromising the integrity of the research program, and to contextualize the risk so that the participant can make choices for themselves without coercion.
The concept of informed consent is hugely important, arguably the most important component of research projects involving humans as participants. It is an acknowledgement that people are ends in themselves, not a means to furthering knowledge or the researcher’s private or professional goals. Indeed, without a respect for the autonomy of the participant, research projects are likely to not be moved into action even when research funds are available.
All of this is a preamble to discuss the anger I felt when I read a recent CBC report on how anti-vaxxer advocates are using the concept of informed consent as a dog-whistle to their adherents, and are using informed consent as a way of both furthering their awareness and raising money with well-meaning politicians and the public.
In fairness, I can see the chain of reasoning at play that tries to connect informed consent with concerns about vaccines. For instance, in the article there is a photo of supporters of a vaccine choice group with a banner that reads “If there is a risk there must be a choice.” This sentiment is entirely consistent with the principles of informed consent. The problem with this application is that the risk is not being communicated and understood properly within context, and instead fear, misinformation, and conspiracies that lead to paternalistic paranoia are short-cutting the conversation. Further, the incentive structures that are borne out of the economics of our medical system are doing little to address these fears. Because so little money is flowing from the government to the medical system, doctors are forced to maximize the number of patients they see in a day just to ensure enough money is coming into the practice to pay for space, equipment, staff, insurance, and supplies. Rather than seeking quality face-to-face time with a patient, doctors have to make a choice to limit patient time to just focus on a chief complaint and address questions as efficiently as they can.
I don’t think it’s all the doctor’s fault either. I think we as patients, or more specifically we as a society, have a terrible grasp of medical and scientific literacy. I don’t have a strong opinion about what the root cause of this is, but some combination of underfunded schooling, rapid technological innovation, growing income disparities, entertainment pacification, a lack of mental health support, increasingly complex life systems, and precarious economic living in the average household are all influencing the poor grasp people have about what makes the world around us work. Rather than being the case that we are hyper-specialized in our worldviews, I think it’s the case that “life” is too complex for the average person to invest time into understanding. Let’s be clear, it is not the case that the average person isn’t smart enough to grasp it (even if sometimes my frustration with people leads me to this conclusion). Instead, I think that people are pulled in so many directions that they don’t have the time or economic freedom to deal with things that don’t immediately pay off for them. People are so fixated on just making it day-to-day and trying not to fall behind that it becomes a luxury to have the leisure time to devote to these kinds of activities.
What this results in, then, is the perfect storm of ignorance and fear that congeals into a tribal call to rebel against the paternalism of a system that is ironically also too cash-strapped to allow the flexibility to educate people on the nature of risk. People don’t have the time and ability to educate themselves, and doctors don’t have the time to share their experiences and knowledge with their patients.
Within this gap, opportunistic charlatans and sophists thrive to capitalize on people’s fears to push their own agendas. This is why bad actors like the disgraced former doctor Andrew Wakefield and movement leader Del Bigtree are able to charge fees to profit from speaking at anti-vaccination events. I’m not saying a person who spreads a message should do it for free. What I am saying is that they are able to turn a personal profit by preying on people’s fears while doing little to investigate the thing they claim to worry about.
We must find a way to communicate two simultaneous truths:
There is an inherent risk in everything; bad stuff happens to good people, and you can do everything right and still lose. Nevertheless, the risks involved when it comes to vaccines are worth shouldering because of the net good that comes from it and the risks themselves are vanishingly small.
In the 22 years since Wakefield published his study and the 16 years since its retraction, there has not been any peer-reviewed credible evidence that supports many of the claims given by the anti-vaxx movement. The movement is predicated on fears people have of the probability of something bad happening to them or their loved ones. The motivation behind the fear is legitimate, but the object of the fear is a bogeyman that hides behind whatever shadows it can find as more and more light is cast on this area.
The anti-vaxx ideology knows it cannot address head-on the mounting scientific evidence that discredits its premise, and so it instead focuses on a different avenue of attack.
This bears repeating: the anti-vaxx ideology cannot debate or refute the scientific evidence about vaccination. We know vaccines work. We know how they work; we know why they work. We understand the probabilities of the risk; we know the type and magnitudes of the risks. These things are known to us. Anti-vaxx belief is a deliberate falsehood when it denies any of what we know.
Because of this, the anti-vaxx ideology is shifting to speak to those deep fears we have of the unknown, and instead of dealing with the facts of medicine, it is sinking its claws into the deep desire we have for freedom and autonomy. It shortcuts our rational experience and appeals to the fears evolution has given us to grapples with the unknown – the knee-jerk rejection of things we don’t understand.
Informed consent as a concept is the latest victim of anti-vaxx’s contagion. It’s seeping in and corrupting it from the inside, turning the very principle of self-directed autonomy against a person’s self-interest. It doesn’t cast doubt by calling the science into question. Instead, it casts doubt precisely because the average person doesn’t understand the science, and so that unknown becomes scary to us and we reject or avoid what brings us fear.
Anti-vaxx ideology is a memetic virus. In our society’s wealth, luxury, and tech-enabled friction-free lives, we have allowed this dangerous idea to gain strength. By ignoring it and ridiculing it until now, we have come to a point where it threatens to disrupt social homeostasis. Unless we do something to change the conditions we find ourselves in – unless we are willing to do the hard work – I fear that this ideology is going to replicate at a rate that we can’t stop. It will reach a critical mass, infect enough people, and threaten to undo all the hard work achieved in the past. We have already seen the evidence of this as once-eradicated diseases are popping up in our communities. The immunity and innoculations have weakened. Let’s hope those walls don’t break.
It is sometimes amazing how cyclical social and political problems can be. While I am not pessimistic in our ability to move forward in something that can be recognized as “progress,” I do have some cynical attitudes towards our collective habit to backslide. I realized some time ago that while we espouse enlightened positions, such as “never again,” people as a whole tend to by historically myopic and prone to letting fear get the best of them – or to quote Agent Kay “A person is smart. People are dumb, panicky dangerous animals and you know it.”
As of writing, I’m working my way through Ron Chernow’s biography of Alexander Hamilton. Around ten-hours into the audiobook, Chernow is discussing the political maneuvering between Hamilton and New York Governor George Clinton over trying to get the newly-drafted Constitution ratified in 10 States in order to bring it into force. The two sat on opposite sides of the federal government question, with Hamilton believing a strong central federal government was the key to sustaining the American experiment, while Clinton was distrustful of a central government superseding the power of the States. Hamilton had a poor opinion of Clinton, believing Clinton to be only concerned with consolidating his own wealth and power, and only pandering to the populace when elections rolled around.
Chernow gives a striking description of what Hamilton feared, and in a single line spells out a looming threat we are seeing anew in our own modern political discourse. Hamilton worried that “American democracy would be spoiled by demagogues who would mouth populace shibboleths to conceal their despotism.”
Chernow penned those words some fifteen years ago. Whether it’s 1788, 2004, or the dawning of the neo-20’s, the fears expressed in those words caution us that we must remain vigilant against those who seek to exploit our fears to manifest their vision in reality.
A few weeks back, my wife and I were preparing for a then-upcoming vacation. Our voting cards had recently come by mail and I was listing off the voting information (location, date, etc.) when she realized that election day was happening while we were out of the country. This was the first time I would be physically unable to vote on the day, so we started looking into what one does when this happens. I had heard in the past about early voting, though never needed it.
Turns out, the early voting days would start the day after we departed for our trip (of course).
In cases like this, you need to contact your local elections office to request a special voting kit that would allow you to send in your votes early. Thankfully the elections offices are open during the week until 9pm, so we were able to go in person to fill out the paperwork to pick up our kits and vote. It required us to write out our candidate of choice on a blank ballot, then seal those votes in an envelope, which was then sealed in a separate envelope to track that we had voted but not track who received our votes.
I’m glad these kinds of provisions are in place to allow us to exercise our civic duties. While we know our votes would not be missed if we had skipped this election, and even though we had to go out of our way to vote, my wife and I nevertheless feel it’s important that we do our part to show up and participate in the process.