It has been said that there are three kinds of lies: lies, damned lies, and statistics. It has also been said that Trump lies like other people breathe. This habit unfortunately makes it difficult for him to be effective against Covid. The little strand of RNA doesn’t care about “alternate truths”. Years from now, Vivian and Evan, you will wonder why we faired so poorly against this bug. Why other countries did so much better. This New Yorker cover from March sums it up.

When you are faced with a tidal wave of shit heading towards the fan, it is hard to find the individual turds for proverbial forest. But here’s a story of a very small turd on its journey towards the air circulation device dangling from the ceiling: a damned lie about statistics! Stick with me for a few minutes while we skim through basic immunology and some arithmetic.

If you survive an infection, it is because your body’s immune system produced a type of protein called an antibody that helped you fight the infection. In the case of Covid, the antibodies stick to the coronavirus at the very same spikes that the virus uses to enter your cells, thus preventing the virus from entering your cells. Your immune system retains a memory of how to produce these antibodies. If you have a future infection, the production of antibodies ramps up quickly, helping fend off the infection. It takes time to recognize a foreign body and make an effective antibody. Someone who has a fresh infection of Covid may not yet have her own antibodies. If she could get some of your antibodies, she may be temporarily protected against the virus. If you donate your blood for helping others, the antibodies and the liquid part, called Covid-19 convalescent plasma (CCP), is separated from the rest of your blood and injected into a Covid patient in need.

Here’s a quote from Dr. Stephen M. Hahn, the commissioner of the FDA from Sunday. Not from a guy whose cousin knows a janitor at the FDA. The Head of the FDA.

“Many of you know I was a cancer doctor before I became FDA commissioner. And a 35 percent improvement in survival is a pretty substantial clinical benefit. What that means is — and if the data continue to pan out — 100 people who are sick with covid-19, 35 would have been saved because of the admission of plasma.”

This 35% number was repeated by the President. Yes – it would be criminal to not use CCP with these numbers. You would understand why the FDA issued an Emergency Use Authorization (EUA) for Covid convalescent plasma. EUAs are precisely designed for something as miraculous as this. The FDA is effectively saying: go ahead and start saving lives while the scientists keep checking on the safety and benefits. It’s too important to wait!

Last week the heads on two other government organizations, the National Institute of Health, and the National Institute of Allergy and Infectious Diseases (Doctors Collins and Fauci respectively) told the FDA not to issue the EUA. They said that the data to support plasma was too weak. How on earth could they say that about convalescent plasma when it is saving 35 people out of every 100 sick people?

Unfortunately there hasn’t been enough time or plasma to run a nice randomized clinical trial to test the safety and benefit of CCP anywhere in the world. If we had, we would be able say something like this: take 200 people who have Covid. Split them randomly into two groups of 100 each. The first group receives CCP treatment and second doesn’t. X people die in the first group by the time the study ends, and Y people in the second group. If X is heaps less than Y, and X doesn’t have other dangerous side effects, X gets FDA approval to become a drug (my brother, Alu, will tell you it’s a bit more complicated and requires three phases of trials with tens of thousands of test subjects, a small army of scientists and statisticians, and several thousand pages of documentation).

So where did Hahn and Trump’s 35% come from? From this study that hasn’t yet been peer reviewed https://www.medrxiv.org/content/10.1101/2020.08.12.20169359v1.full.pdf. I’ve highlighted the relevant part:

Because there are no randomized clinical tests to fall back on, we must rely on various weaker results. Mayo and other medical organizations around the world have been collecting data on CCP for a while. This data from the Mayo study says that people that received more concentrated plasma (plasma with more antibodies) did better than those who got plasma with lower amounts of antibodies. One week after receiving the high dose plasma, 8.9% had died, while one week after receiving the weaker plasma, 13.7% had died. So if I had two experiments with a 100 sick Covid cases in each, about 9 people die in the first group in 7 days and about 14 people die in the second group in the same time. Now let’s do some simple arithmetic: The first group did 13.7% – 8.9% = 4.8% better than the second. That is an improvement of (4.8/13.7)x100 = 35.04% between the first and second types of plasma treatment. Not, as Hahn stated: What that means is — and if the data continue to pan out — 100 people who are sick with covid-19, 35 would have been saved because of the admission of plasma.

Trump needs a miracle cure for Covid. It’s at least a bit ironic because he has spent the last seven months convincing his people that the disease doesn’t exist or isn’t very harmful. He needs a cure to this non-existent harmless disease before election day. He wishes he could be like Putin and start injecting people with a half baked vaccine that Jared made in the basement. So he has been pressuring the FDA for anything. Issue an EUA for plasma so I can hail it as “a major therapeutic breakthrough on the China Virus” and declare the pandemic over (again). When Collins and Fauci told the FDA that the data supporting plasma was too weak, Trump forced the FDA to act alone. Here’s a link to FDA’s website and a screen grab of the press release. Does this read like a scientific press release headline? How often do they normally mention anything about an “administration” :-)? https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment

The scientific discussion about convalescent plasma will continue among researchers till enough data is available. CCP has been used on more than 70,000 patients in the US in the last few months. My friend was instrumental in building the first free plasma bank in Hyderabad to help Covid patients there. Scientists from Wuhan to the middle east are trying to figure out how and when to use plasma to fight Covid. At least one potential vaccine is taking this route. But this isn’t about how good plasma is. This isn’t even about Trump lying about how good plasma is (we’ve become somewhat immune to Trump lying). Our scientists and doctors from the best government scientific institutions are having to lie. Hahn tweeted today to half apologize.

Those that want to re-elect Trump heard him and a top doctor say that 35% fewer people will die now with convalescent plasma treatment. They also saw Trump’s tweet that the deep state is keeping therapeutics from the people. They don’t care about the details. Trump is more important than a few morals or what’s good for the country or scientific honesty.

And that is the story of a tiny turd caught in a shit storm that is heading for the fan, my dear children.

Skittles likes to sleep on Vivian’s 7th grade math textbook. While we were traveling, Vivian and Evan skipped school for the 2019-20 school year and did a sort of abridged homeschool instead. Jo says the kids have become quite feral especially the lad. Back before we left for our year of wandering, we had planned that during the 2020-21 year the kids would try and catch up on some formal schooling – teachers, classrooms, curriculum and stuff like that.

Remember back in May when it looked like we were figuring out how to slow the spread of Covid? And then we managed to snatch defeat from the jaws of victory. Having messed up how we reopened our economy, now we are getting ready to do the same thing to our schools. Same people. Same leadership. Same shit.

Jo and I know we are lucky. We don’t have a desperate need for our kids to be at in-person school. We are mostly at home so we can keep track of the kids if needed. Families where all the adults are working don’t have that option. Our kids, while not prone to listening, can self manage themselves most of the time. And while physical human contact is undeniably important, they can learn almost everything that is in their curriculum through online classes. Kids with severe special needs or students in higher grades with lab components can’t do that. And kids a few years younger than ours who learn by doing and imitating and meeting and touching and playing and licking will also miss out.

There is a possibility that schools and teachers will innovate in the face of this unprecedented stimulus called Covid. But they will need our support to experiment and the funds to do so. Either way, it will be an interesting school year up ahead.

Imagine a VR based zoom call. Slip on your headset and turn your head to look around the classroom. By using the camera on your computer, and technologies like Artificial Intelligence and image recognition/analysis/generation, the software builds a 3D image of each participant in real time. If Johnny says “Teacher!”, the teacher can tell where the sound is coming from and zeroes in on Johnny almost like in real life. “Raise your hand if you have a question, Johnny. And please stop picking your nose in class”.

Evan started fifth grade earlier this week. Unlike his fellow students, online live class and google meet and google classroom are all new to him. After a couple of hours he settled in and by the end of the first day he said he liked it better than in-person school “because it goes a lot faster”. Which I am translating to “because I’m more engaged”. Kudos to his teachers. But the rest of the school year may not go so smoothly. And for many others, for many reasons, it may not be going smoothly at all. Evan’s in-person school is supposed to start on September 8th. Unless it get’s pushed back further.

A couple of days ago, a friend who is a school principal dropped by for a socially distanced chat. Some of her parents want school to only be online. Others want their kids in school yesterday. There are teachers who hate the idea of being online and physically separated from their students. And others who balk at the idea of coming back to school. The administration is flip-flopping on major issues on a regular basis. The students are anxious. The principal has to navigate this minefield, and she said that everyone was unhappy with her. I told her that in a perfect negotiation, no party leaves happy because everyone thinks someone else got a better deal. So she was doing her job as well could be done! Jokes aside, her job is one that I don’t envy. But being able to look under the hood of a couple of schools where I am on the board is fascinating. Expectations are running high, anxiety is through the roof, and the demand to be flexible is daunting. No one can tell how this experiment will turn out. Meanwhile, I’ve taken the advice of an educator friend to heart. “Be prepared to lose this school year”. In the big scheme of things, that is okay. Skittles, you can keep napping on the math textbook. They have put up an old fashioned blackboard at the beach at Sand Island in Kenya on the Indian ocean where we spent a few blissful days a little more than a year ago. Not much internet there, so education will have to be delivered in person. Even then Jo would pick up and move in a heartbeat.

This picture shows two Shepard Tables, named after Roger Shepard, the Stanford psychologist who conjured up this illusion. The geometric parallelograms that make up the tops of the two tables are identical. Yes one looks skinny and long, the other short and stubby. My brain fills in information that doesn’t exist (three-dimensionality) and in this particular case it arrives at an incorrect conclusion that the two table tops are different. The reason my brain is tricked by this illusion is evolutionary – the shortcut my brain takes is what allows me to navigate my three dimensional world every moment of ever day without stumbling and crashing into things. When I first came across this illusion, I didn’t believe my eyes. So I created a google slide and manually shifted one parallelogram on to the other. They fit perfectly. But knowing this didn’t change a thing. The table tops still look different. Shepard said “any knowledge or understanding of the illusion we may gain at the intellectual level remains virtually powerless to diminish the magnitude of the illusion.” Wow. Makes me feel stupid.

It is easy to trick our brains. This is why marketers and Russian trolls have jobs. They make us buy crap we’ll never use or manipulate us to vote for The Rump. Psychologists create traps for our biases that, like the Shepard Tables, prove that we often act irrationally but predictably. If you are interested, explore the works of Ariely, Tversky (whose grandson played soccer with Evan last season), and Kahneman.

Don’t wear masks. Don’t reopen schools. Black Lives Matter. Defund the police. Vote by mail. We are constantly grappling with what’s the right thing to do. There is an overpowering tendency to collapse complex issues into blinding moral certainties. And whole groups of people into idiots or flakes. The other day someone asked me, “so, has it been shown that Trump supporters are dumb?”. Only anecdotally, I wanted to think.

It turns out that social psychologist Jonathan Haidt has answered a similar question: do conservatives and liberals have different morals? How can you and I each hold that face masks are a constitutional infringement and that face masks are useful in slowing the spread of Covid?

Haidt has suggested that each of us come equipped with five moral foundations: care/harm (for instance, almost universally people care about children and cute young animals and morally oppose harm to them), fairness/cheating (we like to be treated fairly and bristle at cheaters and free loaders), loyalty/betrayal (also referred to as “ingroup” – our tribal instinct to like our own people and our instinctive fear, dislike, or apathy for outsiders), authority/subversion (the moral power of hierarchical structures that permeate our families and societies like the patriarchy, teachers, priests), and lastly sanctity/degradation (the emotion of disgust for things like rotting meat or unusual sexual practices).

A moral foundation can be interpreted in different ways. The care/harm foundation gets me to send money to displaced Covid workers in a distant country and makes you like videos of kittens on Facebook. The fairness/cheating foundation means I like public education and you want lower property taxes. The loyalty/betrayal foundation triggers my support of Black Lives Matter and your support for Behind the Blue. Authority/subversion nudges me to listen to Fauci and you to Kushner. The sancity/degradation foundation explains why you are worked up about rioters defacing statues of confederate “heroes”. Haidt’s studies have shown that if you are conservative and I am a liberal, we value or prioritize the five moral foundations in different ways.

So now, in addition to interpreting the same moral foundations in different ways, it turns out that if you are conservative, you have more moral triggers than me. It explains why I don’t get worked up about kneeling during the national anthem while you do. It explains why Fox News and the OAN network and your preacher have a big effect on what you decide is right while I teach Vivian to question everyone including myself.

How do we examine morals of people separated from us in space and time? Should morals be relative? Is slavery wrong? Was it always wrong? Did the founding fathers (not mothers?) of America know that? Should they get a hall pass today because of the social mores of their times? How do you judge another culture? One view is that morality is local and relative. Another is that relativism is a slippery slope and that things are right or wrong, everywhere, every time. What will our descendants hold us morally responsible for? Incarceration of the largest number of people in the world in the land of the free? Fucking up the planet? Living in a world which includes Jeff Bezos and millions of wretchedly poor people?

So you aren’t stupid because you are conservative (though, I suspect that liberals mainly worry that the causality of that relationship works the other way around). And I’m not immoral because I am not patriotic. Additionally, we both think we are right and morally superior to the other. In the face of such clear moral differences, the only option left is to think of the other as stupid. You can dig deeper into all this in THE RIGHTEOUS MIND: Why Good People Are Divided by Politics and Religion by Jonathan Haidt.

Opinions are like assholes. Everyone’s got one. In today’s world, our opinions are rarely ours. Our moral certainties emerge from our tribal social-media fueled group-think resulting from the same types of evolutionary shortcuts that make us fall for illusions. We are predictably irrational.

This exercise is an attempt to bridge the gap between conservatives and liberals. It does not shed any light on the vacant idealess cult of The Rump. If you believe that face masks are an instrument of evil created by Bill Gates to topple Trump, you are sadly beyond help. Moral foundations aside, Trump is still an huge asshole and if you vote for him in November you are still a bag of shit, and that’s my opinion and I’m sticking to it 🙂