I’m reposting a Mindf*ck Monday newsletter from April 27, 2020 (i.e. when COVID-19 was beginning to fuck us up big time) because I believe it’s important. It’s an effort to cut through a lot of the confusion and bullshit out there with regards to the coronavirus pandemic. Things have gotten contentious around the world with a lot of blaming, arguing, and finger-pointing going on. So, I’d like to use this as an opportunity to dispel anyone’s sense of certainty about, well, anything.
Let’s dive right in.
No One Has Any Idea What the Fuck Is Happening or What We Should Do About It
Right now, we have two large, complex systems. The first is a virus sweeping through the global population and our combined efforts to mitigate it. The second is a declining global economy. Both systems are incredibly difficult to measure and understand, much less predict. Both are so large and unruly that we struggle to even comprehend them in their entirety. And so far, pretty much everything we’ve thought about either has been utterly wrong.
Let’s start with the first system: the spread of the virus. Despite months of research and testing, we still know very, very little. For example, we know that the virus is highly contagious, but we still have no clue how contagious. Studies pin its R0 number (how many people each sick person goes on to infect) as high as 6.6 and as low as 1.4. For reference, that’s like saying the virus will infect anywhere from 20% of the population to 80%, a range so broad that you might as well pick a number out of a hat.
What about how many people have been infected? A series of studies came out in the past week showing that infections have likely been vastly undercounted and that there are thousands (perhaps millions) of people out there who have been infected but had no symptoms. This would be big news, because it would suggest that the virus is far less deadly than we thought. A recent Stanford study argued that the real mortality rate could be from 0.12% to 0.2%, making coronavirus hardly more deadly than the seasonal flu (which has a mortality rate of 0.1%). The problem is that these studies relied on inaccurate tests, did not test people randomly, and had other major methodological errors.
Okay, but what about deaths? A recent New York Times investigation found that there are potentially 20 to 30% more people dying from COVID-19-related deaths than are being reported (note: this study has also been widely challenged.) So, while there may be far more people being infected than we’re counting, there’s also likely far more people dying than we’re counting.
This means… well, I don’t know what the fuck this means. And neither does anybody else. Pretty much every projection model, including the ones government officials have relied upon, have been wildly incorrect so far. Lockdowns work! But, then again, they might not. Hydroxychloroquine was supposed to be a successful treatment. Then it turned out it wasn’t. Remdesivir was supposed to be a successful treatment. Then it turned out it wasn’t. Ventilators were supposed to save lives. Then it turned out they probably don’t. The hospitals are going to be overloaded! Until they weren’t. Smokers were all going to die! Wait, no, smokers might be the ones who live.
A few weeks ago, the US government’s estimate of 240,000 deaths seemed so absurd that they revised it down to 60,000. Now that number seems completely absurd and will likely need to be revised much higher again. The cherry on top of the shit sundae, of course, is the US president talking about beaming ultraviolet rays through our bodies as though we live in an episode of Star Trek… and then following that up by suggesting that maybe we inject ourselves with disinfectants.
If there’s one thing we know for certain about this pandemic, it’s that we know almost nothing for certain about this pandemic.
And that’s only the first system we’re wrestling with. The second is our economic system. Within a span of a couple of weeks, the travel, hospitality, entertainment, restaurant, and brick and mortar retail industries have practically been annihilated. Just in the United States, 26 million people have lost their jobs in a little more than a month—an unemployment rate that rivals The Great Depression (note: this number is also likely being undercounted). The consensus is that we are certainly entering into a recession with whisperings of the D-word… no, not that D-word… the Depression D-word. The International Monetary Fund has said that we are potentially entering a global depression that will rival the 1930s in its depth and scope.
It’s for this reason that working class people have begun protesting and rioting in the western world, demanding economic relief. Leaders and pundits have come out arguing that lockdowns are a “cure worse than the virus itself.” Others argue that because the virus disproportionately affects the elderly, we should only tell old people to stay home and let the rest of the population build immunity as quickly as possible.
But there are many problems with these arguments. The first is that we don’t even know if herd immunity can exist. We do not know how long immunity lasts for COVID-19. People who contract many of the other coronaviruses only remain immune for a short period of time. Sadly, there have already been a number of reported cases of people contracting COVID-19 twice. If people only remain immune for a few weeks or months, then herd immunity will be impossible.
Second, while the virus is far more dangerous to the elderly, it’s no cakewalk for some of the young as well. There are reports of long-lasting damage to lungs, hearts and potentially even brain stems of those who have been hospitalized. Doctors are seeing strange numbers of infected young patients dying of strokes. On a new subreddit for people who have tested positive to share their experiences, there are horror stories of 25-year-olds on ventilators and people with persisting symptoms over a month later.
Third, re-opening the economy is not a magic bullet. As I wrote a couple of weeks ago, nobody is going back out to a crowded public area any time soon, even if they are open. Would you go to a concert next week? I sure as fuck wouldn’t. What about next month? Next year? Lockdown or not, tens of millions of people are going to stay home no matter what, guaranteeing that consumer spending remains in the toilet and tens of millions remain unemployed.
Fourth, we don’t even know that the economy was healthy in the first place. Some of the greatest investors in the world such as Ray Dalio have been arguing for years that we were due for a once-in-a-century collapse. For years, many pointed to negative interest rates and high levels of debt as a ticking time bomb waiting to go off. A pandemic may actually not be the cause of our economic woes, but merely the proverbial straw that broke the camel’s back.
Then again, this could all be wrong. Epidemiological projections have been famously wrong for the past month, but economic projections have been consistently wrong for… well, pretty much as long as there’s been economists.
We still don’t know what COVID-19 does to the body or its long-term repercussions. We don’t know if building herd immunity is even possible, much less worth the cost. We don’t know how many people would die if we opened the economy up sooner rather than later, and we don’t know how stimulating opening up the economy would be anyway.
We just don’t know a damn thing. Nobody does. So, stop acting like you do.
An Impossible Philosophical Conundrum
Probably the most difficult book I’ve ever read cover to cover was Reasons and Persons by the Oxford philosopher Derek Parfit. It’s a book that’s widely considered the most important philosophical work of the last 50 years.
The book is divided into four parts. Each part presents its own logical conundrum that leads the reader to unexpected and uncomfortable places. For example, the first part argues that it is impossible to act in self-interest. Similarly, the third part argues that the notion of an identity or “self” is irrational and incoherent to begin with. The logical arguments are meticulous and airtight. You come away from each section with your head spinning.
In the fourth and final part of the book, Parfit explains through a number of clever thought experiments that our basic ethical intuitions are often incoherent.
He imagines a number of scenarios where you are forced to consider questions like: would it be ethical to let one person die to guarantee a million people do not live in excruciating poverty? What about letting one person die to guarantee a million people go from feeling okay in life to feeling exquisitely happy and healthy? What about a thousand people? What about ten people? What if the person who dies is old and already sick? What if they are a violent criminal? What if they are an innocent child? What if they are picked at random?
Basically: what is the trade-off between quality of life and life itself? At what point does a life cease to be worth living? And at what point is the marginal increase in happiness of millions worth the profound misery of a few?
There is no correct answer to these questions, yet we all have deeply-held intuitions about what feels right and wrong about them. Parfit, of course, does his Parfit thing and shows how all of our instincts around these questions are self-contradictory and irrational. But regardless, we all have thresholds where we feel comfortable making certain trade-offs between well-being and life itself. Yet, we rarely think about that threshold because the question is incredibly uncomfortable and upsetting to think about.
But, if you do think about it, this ethical conundrum is at the heart of the most contentious political and economic policy questions. Do you go to war, sacrificing the lives of thousands of young people to promote and improve the lives of hundreds of millions? Do you institute policies that will ruin the lives of a few to improve the lives of the many? Does it matter who the few are? Does it matter who the many are?
In the case of COVID-19, it appears to many that there is a clear trade-off between economic stability for billions, and the lives of, let’s say, a few million. (I would argue that this trade-off is an illusion, but we’ll get to that.) People have opposing intuitions about these questions and cannot really be argued out of them. One camp is willing to sacrifice life for greater life. The other is willing to sacrifice life for greater life. You say tomato, I say… tomato.
Unfortunately, our information networks and media industry are set up to capitalize on these sorts of “us vs them” categories and exploit them. Therefore, people on one side of the ethical quandary find themselves repeatedly bombarded with certain studies, facts, and data that seem to justify their view. And people on the other side are exposed to the studies, facts, and data that seem to justify theirs.
But this is a false either/or argument to begin with. There are substantial public health risks. There are substantial economic risks. One triggered the other but that does not mean that they can be interchanged. An economic depression is not like returning an ill-fitted pair of pants to the store. You can’t walk in and say, “Hold up, I want my 26 million jobs back.” That ship has sailed. The economy is fucked. Public health is fucked. We do not know the extent or depth of the fuckage of either. Nor do we know to what extent they interact with (or should I say, “fuck with”) one another.
We are mostly blind here. And even if we could see the trade-offs clearly, we still wouldn’t agree on what is ethical and appropriate. We would simply muddle on, each individually making the best of a terrible situation, each blindly believing they are right and just in their intuitions.
So, let go of the fight. Focus on yourself. Focus on your loved ones. And assume the worst. Assume nothing—not the virus, nor the economic downturn—is going to get resolved any time soon. That way, you will be prepared—mentally, emotionally, financially, and physically—for all possible scenarios. And if things turn out okay sooner than you thought, all the better.
Whatever the Response Is, It Won’t Be Evenly Distributed
But despite all of the uncertainty and ethical headaches, here are a few things that do seem to be clear and true:
- This is definitely worse than the flu. This is important to return to, since it was just a month ago that many people (including many readers of this newsletter) were claiming that we were all getting worked up over nothing. This was dangerously false. Despite the wide-ranging estimates and the flawed sets of data, even the most optimistic numbers put COVID-19 as significantly more dangerous than the flu. It is far more contagious, gives people worse symptoms for much longer, and is significantly more lethal. There is a reason why COVID-19 has killed as many people in six weeks as the flu usually does in 6-8 months. And we’re still at the very beginning of this thing.
- This will last a long time. Until there are reliable therapies and/or a vaccine, our lives will continue to be disrupted, we will continue to socially distance, we will continue to stay home. We don’t know how long it will take to develop these therapies and vaccines (or if a vaccine is even possible), but right now the most optimistic guesses are some time in 2021. Until then, I would not expect the global economy to get much better. But hey, what the fuck do I know?
- Place matters. As far as we can tell, population density and indoor lifestyles are some of the largest predictors of the spread. New studies suggest that almost all infections occur indoors. Similarly, some cultures seem to be better suited for social distancing than others. Some cities have more resources, so staying at home is easier for people. Some places have more elderly and vulnerable people than others. Curves in some places started earlier than others.
Given the three points above, I think it’s reasonable to expect that not all policy responses should or will look the same. Each local population manages their situation based on the unique factors of the area they live in. Policies that make sense in New York City probably don’t make sense in Saskatoon and vice versa. We shouldn’t expect people in Texas to behave the same way as people in Taiwan, nor should we shame them for not doing so. We shouldn’t expect that government policies that work fine in Singapore will work well in New Jersey, nor should we be upset that they won’t.
We should reserve judgment about these things. Especially online when we’re all coming from different places globally, politically, culturally, etc. It’s easy for me, in New York City, to get pissed off when I see masses of people enjoying the beach in Florida. But it’s also different. Culturally, geographically, demographically, it is different. And it’s in these moments, when I find myself getting sucked into my emotions, or climbing up onto my high horse of social media judgments, that I remind myself: I don’t know a damn thing.
And neither do you.