Thinking Aloud: ‘Midinformation’ and the Covid Pandemic

I crossed that lens when I read an article about filing cabinets in The Atlantic [1]

“The coronavirus pandemic is a powerful example of this tension between information and knowledge. In the early days, it became clear that much less was clear about what was going on. …Our information systems were not only rife with misinformation—false or misleading information—but I “midInformation” (note d), or Informational ambiguity is based on scant or conflicting evidence, in many cases about emerging scientific knowledge.” [emphasis added]

Think back to the early days of COVID, a new virus that led to rapidly increasing cases and deaths. Remember to look “all hands on deck” for increased anxiety and cause and treatment. For various reasons, and you can impose whatever intention you want, it is irrelevant; Our social hair was on fire. And our great cultural tool, science, stopped what it was doing and focused its considerable collective attention on the growing epidemic.

Fomites and the rise of the disinfection theater

In those early days we suggest leaving the packages out for at least a day before bringing them in and cleaning them with sanitizer while wearing gloves. I wrote about the underlying science, which was based on the work of physicists and others on laboratory models. Unfortunately, while their calculations of how long COVID can survive on surfaces were accurate, the underlying model they used, like all models, was flawed. In the following months, it became clear that Covid was spread as a respiratory virus; Disseminated contact through fomites was rare. That early work about the age of COVID on cardboard is a perfect example of midInformation. It is also a perfect example of how science works.

The Western scientific enterprise is built on the assumption that the power of a hypothesis lies in its explanatory potential. It can never be fully “proven” but can be disproved. The hypothesis that fomites could transmit COVID was replaced by the hypothesis that it was spread primarily as a respiratory virus, which could further explain the infections. The Fomite hypothesis was not false or MIsinformation; It was midInformation.

Big Glove didn’t pay for fomite research, nor did Big Glove (remember switching distilleries to produce hand sanitizer?). It was a reasonable faith attempt to use our available knowledge to combat a terrifying invisible entity.

The six foot rule

Once it became clear that COVID was transmitted through the air, science focused on our breath. We applied everything we knew about aerosols to how we could assemble safely. As I wrote, the CDC decision to change its recommendation from six to three feet between individuals in schools was based on a scientific study, not a flip-flop. It was moving from earlier milesdAfter information and better, new information. This is how our scientific enterprise works.

Preprint and policy

“Laws are like sausages; better unmade than seen.” – Otto von Bismarck

The result of our initial fear of the pandemic and the resulting efforts to prevent and treat Covid was that we, the public, were caught up in the sausage-making of “settled” science. Science has its own rhythm. It initially begins with individual studies shared among collaborating scientists and, when important, finds their first real mention at a national conference in the form of a slide presentation. Otherwise, it will take several months as scientists find a journal willing to publish their work and go through the six-month publication process. Once a consensus is reached, that scientific information will find its way into yearbooks summarizing the field’s annual work, and only much later will this science find its way into textbooks. The very real fear of epidemics short-circuited the rhythm of science production with increasing use and reliance on prints.

Preprints were intended to rapidly disseminate scientific findings to those interested in the field. They are a new digital form of collaboration, reaching people faster than a speech at a national conference. They are early in the sausage-making process and need to be read and parsed not with a jaundiced eye but with knowledge. Once again, due to our social urgency and repeated “abundance of caution,” we jumped from a chunk of the mile.dother information; Policymakers did just that.

Should we forgive policymakers for making their best possible decisions?dInformation? Many of my colleagues, writing and tweeting, have strongly condemned the actions of policymakers. The Great Barrington Declaration, the price of masks, vaccinations in children, and school closures. Of course, they don’t actually make decisions that will result in adverse financial or health outcomes; They will not be responsible for their words. I doubt they are hypocrites, but they are spared the burden of guilt over the lives and money lost by their actions. Actions speak louder than words.

Recognizing my roledEpidemic information should soften some of the anger and lower the presumed high ground of various blamers and shamers of our public health response. We can obviously do better. We need to change our systems to make them more agile and transparent. Perpetuating the intent, serving no useful purpose as part of some cabal out to do no harm or tear at our social fabric. Physicians make life and death decisions every day in uncertainty. We are often right, sometimes wrong. To improve our ability to make good choices under uncertainty, we focus on enhancing our judgment and experience. The same goes for improving our public health system’s response.

[1] The logic of the filing cabinet is everywhere, the Atlantic

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