Decoding the Flood of COVID Data

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S1: I’m pregnant right now in my third trimester. And when I first got pregnant, I wanted to understand all the information that was coming my way, how much caffeine was okay. Is Deline really dangerous? Should I get that invasive test? I want a data, not judgment or old wives tales, which is how I got to know Emily Austen’s work. Oster is an economist at Brown University and she made her name with two books Expecting Better and crib sheet. They basically teach lay people who are expecting kids or have them how to think like economists to examine the underlying data and then make the best, most informed decisions for their own families. And lately, Oster has been applying that same talent for interpreting data to cope at 19. The pandemic, in a weird way, is not entirely unlike having a newborn. It’s scary, confusing, and there is so much information to sort through.

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S2: I think it’s fair to draw a parallel. I think an important difference is that when you are experiencing the chaos and fear of new parenting, there are often people around who can be like, hey, I’ve done this before and it’s going to be OK. And let me help you.

S1: And like I got through it, but with Cauvin, Emily points out that doesn’t exist. We’re all stumbling around and we don’t know how long that’s going to last.

S2: I think part of what is so hard here for many of us is the realization of like, I don’t see the other side. You know, I don’t know what it is going to be like to have gotten through this. Whereas when you’re a new parent and then you see the person with a four year old, you’re like, OK, it’s going to get there. Like the kid is going to walk and put on their own code and poop in the body like I’m getting there and you’re here. We don’t know where we’re at, where we’re getting. And I think that’s the piece that is probably much scarier about this than the new parenting experience.

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S1: So Emily’s been writing a lot. She’s got a parenting newsletter and a new Web site that breaks down what we do and don’t know about Copan 19. She’s trying to give people as much data driven information as she can. Do you see similarities in the kinds of questions or even the way your audience is approaching you right now?

S2: It’s interesting because I get people reaching out about very basic parenting, things that have nothing to do with the pandemic and then sort of simultaneously about questions about the pandemic. So I’ll get these emails that are both like, I don’t know which way my baby should sleep and they won’t sleep on their back. Also, if I really can’t figure out what to do about my parents visiting and the stakes feel higher, the stakes already feel high. And the same kind of fear, like if I don’t make the right choice about how to protect my family, something really, really bad could happen. And so it’s layering this kind of fear on top of all of these questions about how to make the right choices.

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S3: We’re all dealing with those questions and it’s hard to know what to do. Information is coming at us really quickly and it’s changing all the time. It can feel paralyzing. So today on the show, we get an expert’s view on how to deal with that flood of data for parents, for policymakers, for anyone just trying to be smart, responsible and safe. I’m Lizzie O’Leary and you’re listening to What Next, TBD, a show about technology, power and how the future will be determined. Stay with us.

S1: Emily Oster has made her name as a kind of translator. She takes huge swaths of data and often overwhelming information and turns it into simple, useful advice for her readers. But over the last few months, as she’s tried to translate the data coming out or uncovered, the process has been more difficult. What’s the difference between the kind of data you were looking at when you were writing your books or even when you’re thinking about non Kovik parenting advice and the kind of data you are asked to consider right now?

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S2: I mean, there are many differences, but I think the biggest is just that the that the data that we’re seeing now is not vetted and it’s very hard to get. So when I’m looking at data about pregnancy and parenting, it’s not all perfect, but I can see what it is. So it’s easy to see, you know, okay, here is the evidence on breastfeeding. I can see why some of it is better than others. It’s very complete. I understand what the researchers did. I understand how many people were in these different groups. There are parts of the covered space where it’s just impossible to find out basic numbers. So I was trying to figure out how many kids have this complication. People have been talking about this inflammatory thing. Just the question, how many cases of those are just that basic question, which in this space of pregnancy and parenting, a question like that, I would just look up the answer and then I would know the answer here. You can even get the answer to that. And so it makes it harder to answer all of the kinds of questions people have, because just the basic on the ground facts are not really complete yet.

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S1: Give me a couple of examples about what people ask you most frequently, or are they worried about, you know, transmission? Do they want to send their kids to daycare? What are the biggies?

S2: I think the biggies are about interacting with other people and and things that you appreciate in your everyday life that you can’t have anymore that involve interacting with other people. So questions like daycare. What about my parents? Those are the things that we miss most. And the things that most impact our our lives.

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S1: There’s an example I think of from my own life. I’m in a virtual baby group with a whole bunch of other people who are expecting kids in July, and none of us can get a clear answer on what is appropriate to let grandparents do.

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S2: Yeah, I actually get some outreach from grandparents, some of which is heartbreaking. People saying, like, I haven’t been able to see my grandkid because my daughter says it’s not OK. And someone wrote to me to say, I feel like it might be better to be dead than to be, like, separated from my. I think I would take that risk knowing that that’s the risk. The idea of the idea of continuing like this and not getting to see my grandkids is so devastating for me that I want to take the risk. And the question is like, how do you think about the choice when that’s what they’re saying? But then again, you don’t want to be the person who put your parents in that risk situation. I think that’s why such a hard balance and something I think many of us haven’t really grappled with.

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S4: Well, let’s talk about that a little, because every day there’s a new scary thing and it’s really hard to know what is something to worry about. And what’s maybe meaningless are going to be debunked in five days. How do you pass out what’s worth digging into versus what’s something to dismiss?

S2: One piece is just trying to figure out what are the numbers look like? So Koven has a lot of different manifestations in terms of symptoms and you see a lot of different weird things people are saying. What about Kovik toes? What about the loss of sense of smell? What about. And so some of that is I think there’s a question of sort of looking at is this plausible? Like, is it possible that this is what’s going on? I think that’s kind of one piece I’d like to look for. But then the other thing is just trying to follow something over time and try to understand. Are we seeing more of this when we look back? But it’s hard because you see, you know, a lot of these things engender a tremendous amount of fear. And you’ll have an example of something that just is terrifying. But it’s it’s one example, one person, one incident, and then it’ll sort of disappear. And no one will ever come back and say, oh, by the way, that turned out to just be kind of a random thing that wasn’t related to this at all. So you’re sort of left with this idea that, like, everything is terrifying.

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S1: Well, let’s take one of those things, so Kovik toes is this example, these toes that look like they have frostbite or chilblains. And they’ve showed up in certainly anecdotal reports and some medical data. Woody, what do you do with that? Like, what’s your analytical approach?

S2: The first thing is to sort of think about this question of is this plausible? But in the case of vatos, the answer is like. This is an inflammatory thing. Then we try to think about is this attention? And there’s a piece of that attention which is actually more important, a lot of these cases than you might expect when you start telling people, you know, hey, if your toe looks weird, that might be a sign of coalbed. Then a lot of people like, oh, what’s on my toe? And a lot of people’s toes. Look where my my husband’s toes look really weird. I don’t think they look weird for this reason. But, you know, there’s like there’s a sort of availability bias, particularly when you’re looking at these more mild symptoms. So, you know, we try to kind of look at whether it’s plausible, think about is it really the case that we’ve seen more of this? You know, what’s the base rate in the population? It’s not something we talk about a lot. Maybe people have these all the time. So those are the kind of pieces of of that that we talked about in that case.

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S1: There are the weird symptoms like comatose, which can range from puzzling to scary. And then there’s the terrifying stuff like reports. Rare but alarming for parents of a serious inflammatory syndrome in kids that is similar to Kawasaki disease. And that might be linked to cope at 19. Asked Emily what she’s telling readers about that.

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S2: They’re really sort of two pieces that I’m trying to help people pass through. One is the question of, you know, are a lot of kids getting cold? It is cold. It really super dangerous for kids. And that is a question which is totally separate from this particular complication. The answer is all of the data that we have suggests that majority of kids have mild or asymptomatic or moderate cases of this. And so I think it’s really important to separate these two things. We think it’s easy when you hear reports like this to then move to like, well, this means that every kid who gets this is incredibly seriously ill. And that’s that’s just really not true. Then the second piece is, you know, is this syndrome really linked to coalbed or is this like an availability bias where, you know, kids are coming in with something we know happens to some kids anyway and we’re attributing it took hold it. And so there again, I think, you know, there’s actually increasingly some pieces of data that suggest that at least some of these cases are covered, linked. And there are a lot of reasons to think that could be true. The Lancet just published something yesterday from one hospital in Italy showing that, you know, they saw many more cases means that a lot of cases, but they saw more cases that looked like this in the covered period than they would expect based on their earlier data. That kind of piece of data is very is very valuable. At the same time, like some of the information that’s coming out of New York is probably way scarier than it should be, because we’re seeing numbers that sound like, you know, every day 50 more people are showing up with this. But that is very unlikely to be true because we’re now messaging to people. If your kid has a high fever, come into the E.R., they might have this complication. But actually, kids have a high fever a lot who do not have this. I think on top of that, it’s probably pretty important for people to understand that this syndrome is, for the most part, very treatable. So no Kawasaki as liking this sort of typical time, something like, you know, fighters like maybe 5000 cases a year in kids in the U.S. and the vast majority of those kids recover without any long term consequences. So even though this is super scary, it is largely treatable.

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S1: At the same time that Emily is researching and writing to help other parents navigate this outbreak just to make decisions for her own family. And in doing so, has to take on this kind of dual role, data driven expert and parent who just really love for her kids to have a normal summer if it is safe.

S5: I would really like my kids to be able to get out and see some other kids. I mean, I’m doing a bunch of work with the state, with the people who are going to decide about camp. And I will sometimes be on a call, which is about something else, like about power modeling the epidemic and hospitalizations that I’ll be like, hey, what do you think we’ll know? About half of people are like, OK, I’m like, this is a call about hospitalization. I’m trying to have a job and I’m trying to trying to parent. And it’s it’s increasingly hard to separate them.

S1: What are you thinking about when you make decisions about what your kids can and can’t do right now?

S5: I’m spending a lot of time trying to understand that there is not a correct answer, and I’m, you know, a person who is is used to to kind of looking at the data and coming up with, you know, here is exactly the calculus I can do. And now I can sort of subject that to my to my own risk tolerance. And here there is so much unknown that it’s hard to even do that.

S1: And I think just recognizing that, as has been important for me, there’s also the question of how we as a society talk about the virus and the decisions that politicians or educators have to make and then convey to the public. Let’s talk about messaging a little bit, because sort of a common thread in so much of the public conversation about this virus is is about how we communicate about it. And I wonder how you think about the messaging that comes from government. You know, we are hearing just stay home. You have written that that is unhelpful. Tell me why.

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S2: I think that there’s some nuance missing from the from the messaging, and so I what I wrote is I think when we tell people just stay home and we don’t give them any guidance about the relative risks of the non-state home activities, you run the risk that people just feel like, I just can’t I can’t stay home anymore. I have to go to the grocery store. I have to take a walk. I have to get out. And that because you haven’t told them within the range of going out here as a sort of safer and less safe activities. People will go all the way to extreme and say, well, if you’re telling me I can’t take a walk with my friend six feet distant, I might as well, you know, have everybody that I know over for a barbecue or go to a crowded beach. You know, that’s the sort of extreme example. But I think that by not acknowledging that some people are not going to stay home and by not including in our messaging, you know, like here’s sort of the second best. Here’s how you lower the probability of spread. If you need to go out by missing that and our messaging, we miss an opportunity to lower the risk of of infection and we may actually make things make things worse.

S1: She also worries that new policies from public officials might sometimes contribute to the sense of information overload.

S2: First, the messaging is stay home, stay home, stay home. And then, you know, I live in Rhode Island. They opened outdoor dining. Starting next week. And so now the messaging is like everyone should go do take advantage of the outdoor dining because we need to restart our economy. That’s a confusing message. You know, 15 minutes ago, you told me, don’t leave my house. Now you’re telling me get out to a restaurant. And you know, it’s well-meant. You know, I actually think really, really highly of the states of the states response here. And I think they they’ve tried to be nuanced about that.

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S6: But the fact is that hears people hear that in a sort of like, well, you hear something is one thing that you’re telling me this other thing, like, how do I understand these things together?

S3: If you were, you know, magic wand in charge, what’s a better way to frame all this stuff?

S6: We need to have some messaging about about prevention, and then we need to explain to people why that matters. I think giving people that control. I think that’s really important. I think in some ways for me, that resonates with some of what I did in pregnancy. And parenting is sort of trying to return the control to people and tell you like, OK, this is how you can make this experience better and safer and happier for you by understanding what is what is going on. Some of the same messaging can work here.

S3: Emily Oster, thank you. Thank you. Emily Oster is an economics professor at Brown University. She’s the co-founder of the website Covered Explained. You can read her work there or at Slocomb, which is reprinting some of the pieces from our site. That’s our show for today. What Next? TBD is produced by Ethan Brooks and hosted by me, Lizzie O’Leary, and is part of a larger What Next family. TBD is also part of Future Tense, a partnership of Slate, Arizona State University and New America. Mary will be back on Monday. Thanks for listening. Talk to you next week.