Fascinating new piece today in the New Yorker: Seattle’s Leaders Let Scientists Take the Lead. New York’s Did Not
https://www.newyorker.com/magazine/2020/...ks-did-not
Quote:The initial coronavirus outbreaks on the East and West Coasts emerged at roughly the same time. But the danger was communicated very differently.
One of the E.I.S.’s core principles is that a pandemic is a communications emergency as much as a medical crisis. Members of the public entering the hospital, Riedo told his staff, must be asked if they had travelled out of the country; if someone had respiratory trouble, staff needed to collect as much information as possible about the patient’s recent interactions with other people, including where they had taken place. You never know, Riedo explained, which chance encounter will shape a catastrophe. There are so many terrifying possibilities in a pandemic; information brings relief.
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Epidemiology is a science of possibilities and persuasion, not of certainties or hard proof. “Being approximately right most of the time is better than being precisely right occasionally,” the Scottish epidemiologist John Cowden wrote, in 2010. “You can only be sure when to act in retrospect.” Epidemiologists must persuade people to upend their lives—to forgo travel and socializing, to submit themselves to blood draws and immunization shots—even when there’s scant evidence that they’re directly at risk.
Epidemiologists also must learn how to maintain their persuasiveness even as their advice shifts. The recommendations that public-health professionals make at the beginning of an emergency—there’s no need to wear masks; children can’t become seriously ill—often change as hypotheses are disproved, new experiments occur, and a virus mutates.
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The lead spokesperson should be a scientist. Dr. Richard Besser, a former acting C.D.C. director and an E.I.S. alumnus, explained to me, “If you have a politician on the stage, there’s a very real risk that half the nation is going to do the opposite of what they say.”
During the H1N1 outbreak of 2009—which caused some twelve thousand American deaths, infections in every state, and seven hundred school closings—Besser and his successor at the C.D.C., Dr. Tom Frieden, gave more than a hundred press briefings. President Barack Obama spoke publicly about the outbreak only a few times, and generally limited himself to telling people to heed scientific experts and promising not to let politics distort the government’s response.
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By the time Seattle’s schools were formally closed, on March 11th, students and teachers were already abandoning their classrooms. The messaging had worked: parents were voluntarily keeping their kids home. Cell-phone tracking data showed that, in the preceding week, the number of people going to work had dropped by a quarter. Within days, even before Washington’s governor, Jay Inslee, issued official work-from-home orders, almost half of Seattle’s workers were voluntarily staying away from their offices. When bars and restaurants were officially closed, on March 15th, many of them were already empty. Constantine himself had been working from home for a week. He was giving interviews all day, and always underscored to reporters that he was speaking from his bedroom, and that the noises in the background were coming from his children, who were home from school. After he heard that the county’s basketball courts were still being heavily used, he ordered them closed.
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Today, Washington State has less than two per cent of coronavirus cases in the U.S. At EvergreenHealth, hospital administrators have stopped daily crisis meetings, because the rate of incoming patients has slowed. They have empty beds and extra ventilators. The administrators remain worried, but are cautiously optimistic. “It feels like we might have stopped the tsunami before it hit,” Riedo told me. “I don’t want to tempt fate, but it seems like it’s working. Which is what makes it so much harder when I look at places like New York.”
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Today, New York City has the same social-distancing policies and business-closure rules as Seattle. But because New York’s recommendations came later than Seattle’s—and because communication was less consistent—it took longer to influence how people behaved. According to data collected by Google from cell phones, nearly a quarter of Seattleites were avoiding their workplaces by March 6th. In New York City, another week passed until an equivalent percentage did the same. Tom Frieden, the former C.D.C. director, has estimated that, if New York had started implementing stay-at-home orders ten days earlier than it did, it might have reduced COVID-19 deaths by fifty to eighty per cent. Another former New York City health commissioner told me that “de Blasio was just horrible,” adding, “Maybe it was unintentional, maybe it was his arrogance. But, if you tell people to stay home and then you go to the gym, you can’t really be surprised when people keep going outside.”
More than fifteen thousand people in New York are believed to have died from COVID-19. Last week in Washington State, the estimate was fewer than seven hundred people. New Yorkers now hear constant ambulance sirens, which remind them of the invisible viral threat; residents are currently staying home at even higher rates than in Seattle. And de Blasio and Cuomo—even as they continue to squabble over, say, who gets to reopen schools—have become more forceful in their warnings. Rasmussen said, “It seems silly, but all these rules and SOHCOs and telling people again and again to wash their hands—they make a brobdingnagian difference. That’s why we study it and teach it.” She continued, “It’s really easy, with the best of intentions, to say the wrong thing or send the wrong message. And then more people die.” ♦
https://www.newyorker.com/magazine/2020/...ks-did-not