Really, however, it is doubtful if this could be called a victory. All that could be said was that the disease seemed to be leaving as unaccountably as it had come. Our strategy had not changed, but whereas yesterday it had obviously failed, today it seemed triumphant.
We humans are vulnerable to a variety of cognitive illusions, not the least of which is the illusion of control. The idea that an event is completely out of our control is extremely difficult for us to accept, apparently; and so our brain tricks us into thinking that we are the ones pushing the buttons. This can take many benign and amusing forms. For example, many of us repeatedly push the call elevator button or the crosswalk signal while waiting, with the idea that we can somehow speed it up. Or we leave the pit of an avocado in some guacamole, thinking we can prevent it from going bad.
This behavior often leads to superstitions, especially in situations when chance plays a major role. For example, baseball is notorious for the great many superstitions which abound, as players recruit supernatural intervention to reduce the role of chance. Fundamentally, these superstitions all make the mistake of confusing correlation for causation. So if a batter eats sixteen carrots and then hits a home run, he may conclude that the home run was due to the carrots.
And this process can take place on a societal scale. The classic example is, perhaps, the rain dance—an attempt to control weather patterns through ritual. Indeed, the idea that humans can influence the natural order through carefully prescripted and repeated gestures is arguably one of the psychological roots of religion.
The reason that I am bringing all of this up is that I believe we can observe this process quite clearly in our response to the coronavirus. All of us badly want to feel as though we can control the spread of the virus, and this has led to some sensible and, I suspect, some far less sensible solutions. I have observed several people in my neighborhood who put little bags on their dogs’ feet. Only slightly less ridiculous are the shoe disinfectant mats being sold online. Even the practice of wiping down our groceries with bleach strikes me as more ritualistic than sensible.
Indeed, considering that we can get the virus just from breathing in particles, then all this trouble to disinfect surfaces does seem rather suspect to me. I cannot help thinking that, by the time you touch an infected surface, you will have breathed in the virus ten times before. (And by the time you get it from your dog’s paws, you will have gotten it one hundred times before.)
Just as in superstition, irrational virus precautions can take place on a societal as well as an individual scale. The most notorious example of this I have seen was the bleaching of a Spanish beach, in the coastal town of Zahara de los Atunes. While undoubtedly causing significant environmental damage, the benefits to coronavirus control seem doubtful in the extreme. As another doubtful measure, I would offer Governor Cuomo’s decision to disinfect New York City’s subway system every night. Again, if the virus can be breathed in, then the threat from contaminated surfaces may be entirely redundant.
More generally, I think it is fair to say that we do not completely understand the pattern of coronavirus spread. A few days after announcing the nightly subway cleaning—a massive and expensive effort, which displaces the homeless and may impede some people’s commutes—Cuomo announced the results of a study on 600 people who were diagnosed with the virus in a hospital. He was surprised to find that only 4% had used public transportation. The large majority were not working. This result is puzzling. If mere exposure to the virus was enough, then one would expect the essential workers—especially those on public transport—to constitute a far larger portion of cases, since they come into contact with far more people.
Perhaps we have overestimated the importance of mere exposure, then, and underestimated the importance of “viral dose.” (Please keep in mind that I am in no way an expert, and this is pure speculation on my part!) This means that a long amount of time spent with one infected person could matter more than a passing proximity with several. If this is the case, then forcing people to stay in their homes, even if they have symptoms (which was the policy here in Spain), may be somewhat counterproductive, since it would increase the viral dosage of any co-residents.
This would also mean that prohibitions on outdoor exercise were not sensible. Indeed, over two weeks after finally letting children go outside in Spain, no noticeable uptick has been observed (despite complaints that people were not maintaining the correct distance). Other evidence points in this direction as well. This Chinese study could only find one single case of an outdoor transmission, and instead found that the vast majority of outbreaks took place inside the home.
Globally, the data also seems to indicate that we do not fully understand the relevant variables. The virus seems to be striking some countries hard while leaving others mostly untouched, in a pattern that is not easily explained either with governmental action or weather. The case of Spain and Portugal seems especially baffling, as Spain’s small neighbor has so far suffered five times fewer fatalities per habitant as Spain. And this, in spite of never having imposed mandatory stay-at-home orders or closing all non-essential businesses. Though Portugal is given credit for acting early, the two countries entered into a state of alarm at about the same time, closing schools and restaurants the same week. Yet the contrast is striking.
If we are going to effectively combat this virus, then I think this means doing our best to resist the illusion of control. This is because the cognitive illusion blinds us to the real effectiveness of our strategies. If we embark on a maximal strategy—doing everything we can think of to stop the virus—and the virus indeed abates, we may conclude that it takes a maximal strategy to beat the virus. But in that case, we may end up like the carrot-eating batter, drawing false conclusions from a mere correlation. And since so many individual measures are rolled into a maximal strategy, we remain in the dark as to which specific measures are the most helpful, which are basically useless, and which are counterproductive.
This information is vital if we are to achieve anything resembling a functional economy. Our goal should be to uncover which measures have the lowest cost-benefit ratio—inexpensive and minimally inconvenient strategies which effectively curb the virus. If indeed masks work, then widespread mask usage would be such a strategy, since they do not significantly disrupt normal life and cost mere pennies to produce. If it is not too late, increased security measures for senior care homes would be another such strategy, since age is a major risk factor.
Perhaps the easiest way to determine such measures would be surveys. Governor Cuomo has already demonstrated the knowledge that can be gained by surveying incoming hospital patients. Indeed, we probably should have been doing so from the beginning, allowing a more detailed picture to emerge of which activities tend to increase risk. Widespread serological testing for antibody prevalence can also be easily supplemented with detailed surveys. With any luck, certain patterns will emerge from this data, which will point us in the right direction.
Another way to find out more about how and where the virus spreads would be to turn our testing capacity away from patient diagnosis and towards investigative studies. This would mean testing representative samples from relevant populations, to ascertain the prevalence of the virus in different areas and professions. Such testing may reveal useful patterns in the virus’s spread. Contact tracing—once we have the ability to do so—can be similarly used as an investigative tool.
But as it stands now, I often get the impression that officials (here in Spain at least) are like a blindfolded boxer, swinging left and right hopping to connect with the target. The result is rather incoherent. For example, when people were finally allowed outside to walk and run, the officials decided to impose time constraints for these activities. I am not sure what they hoped to gain from this. But the result has been that everyone rushes out the door as soon as the clock strikes, and the streets are consequently packed.
Adding to this, officials decided not to open the parks, so there is less space for walking. To compensate, they tried converting several roads in the city into pedestrian zones. But I cannot help wondering: how is a pedestrian zone any safer than a park? Last weekend we were treated to the absurd spectacle of joggers squeezed into a narrow, tapped-off zone, jogging in one big circle around Madrid’s Retiro park, which remained closed.
Such policy mistakes are harmless enough, I suppose. But I think we need to be very wary of what this blind swinging can lead to. Traumatic events can provoke a panicked response that can do more damage than the threat we are trying to avoid. America’s last traumatic event—the September 11th attacks—provoked some very sensible changes, like increased airport security, but also set off a series of interventionist wars that cost far more lives than the original attacks themselves. Such wars seem rather absurd to many of us now; but at the time, when the threat of terrorism seemed to overshadow every other consideration, we were willing to react with a maximal strategy.
Does this crisis present us with a similar danger? I think it may. And if so, we need to do our best to avoid the coronavirus equivalent of an Iraq War, and focus on finding strategies equivalent to bomb screenings and reinforced cockpit doors—easy, cheap interventions that can save lives, rather than a giant quagmire that only adds another problem on top of the one we already have. If we are the blindfolded boxer, we need to focus on removing the blindfold, rather than swinging as hard as we can.