I’ve been thinking a bit deeper on the frequent comparison of flu deaths with highway traffic deaths, total US deaths in the Vietnam War, or any variety of raw number comparisons. I’m working to get at something that feels to be an underlying mis-match in such comparisons.
Part of the challenge is that self-proclaimed epidemiology experts are popping up like Spring daffodils, busy asserting themselves as consummate experts in statistics and government policy while asserting themselves as enforcement authorities. And the Internet has been an amplifier for the echo chambers created by rabble. In short, finding the signal in the noise has become much harder. I can’t recall a time when there has been this much manufacturing and shoveling of confirmation bias around the world. Alas, it’s one supply chain that has grown significantly more robust.
At the heart of the raw number comparisons is a category mistake. Stopping at an equivalence of mortality across all categories for cause of death gives rise the category mistake. Not all causes of death should be considered equal when searching for a course of action that will affect millions – in the case of COVID-19, billions – of people. There are many differentiating factors that could be considered in the case of viral pandemics and traffic deaths. The principle one, in my view, is agency.
I can choose a robust and enjoyable lifestyle that significantly lowers my risk to death due to highway accidents (to use that number for my analysis.) In fact, I have done exactly that. A four mile commute to the office, all on local streets where the highest speed limit is 45 MPH…for exactly 3 blocks. To those that declare “But, many people can’t do this.” my reply is “Maybe.” There will certainly be outliers for a variety of reasons. But in many of these cases, the individuals are nonetheless making choices. Perhaps they don’t want to move or they don’t want to change jobs or they don’t want to up-skill or… There are likely a confluence of many choices in the mix that make it appear they are stuck or trapped. Frequently, even in the outlier cases, when circumstances press hard enough, they “find” opportunities and make changes, perhaps even subsidized by local and federal governments. But that’s a topic I’ll leave for much more qualified bloggers to tackle.
I can make other choices in the form of the car I drive or the route I drive to my destination. I can chose the time of day I drive for errands or the frequency with which I need to run them. I can chose whether to use my smart phone while driving or engage in some other distraction while driving. Or I can choose not to drive at all and take the bus, train, bike, walk, or a combination of any of those.
With a viral infection – as we are learning now – there is virtually no personal agency. The only way to avoid the adverse consequences is to severely curtail our lifestyle. Now. There’s no easing into it. No evening classes at the college annex to up-skill our ability to dodge the virus. No Ecopass that lets us leave the breathing up to someone else. Not much of any choice for replacing a stalled lifestyle with a different one because they’re all stalled.
Which gets me to the thinking behind “Mass transit kills.” It does so because its an efficient vector for transmitting biological infections. The early studies show how quickly COVID-19 spread due to air travel followed by trains, taxis, and buses in crowed urban settings. A fatal car accident, however, is a local event. First responders and surrounding communities are not at risk of death due to the now static car accident. A viral or bacterial outbreak is dynamic and spreads just by virtue of people moving around. Globally, how long would humans have to drive cars before the death toll matched that of the number of deaths that have been attributed to plagues and pandemics throughout history? And historically, plagues and pandemics moved at the speed of rats, mosquitoes, and ox carts. Today, they can move just shy the speed of sound.
Having read close to a couple dozen COVID-19 related research papers (surprisingly, none of them authored by CNN/MSNBC/FOX/CBS/ABC/NBC/BBC et. al.), the chances that we’re approaching a pandemic that won’t offer much of a lead time are increasing. The growth of human population has greatly increased the adjacent possible for animal virus’ to make the jump to humans. The probability of an asymptomatic contagious period combined with lethal morbidity increases as the adjacent possible horizon expands. If such a viral combination were to occur, mass transit will be that virus’ best friend.
My thinking is probably incomplete on this matter, so I welcome your comments.