2024-Week 14

This week will be a very short set of thoughts because I had been preparing to travel yesterday and finished settling in today at my home for the next three months.

CDC

Dr. Mandy Cohen, the director of the CDC, made two interesting posts on Twitter.

Where she states “Protecting health is a team sport,” the linked article in NEJM is paywalled. So much for real time data sharing.

Further, two sets of COVID data appear not to have been updated this week on https://healthdata.gov/, which is where I pull much of the data I visualize on this site. I pointed this out earlier this week in a Tweet where I linked this screenshot.

I started pulling the data to do the updates on the metropolitan section here and saw that nothing was changing in about the first 40-50 metropolitan areas. I’ve concluded that while SOME of the data has been updated at CDC, the COVID admission data has not been, which is already a lagging indicator of activity by two weeks.

I and others have been doing our best to provide data, but it’s hard when what should be a quality source of frequently updated raw data keeps shutting down the tap to just a trickle.

Psychology and H5N1

Currently there are about two dozen dairy cattle herds that have been infected in eight states. The number is likely much higher than that since testing is voluntary. It is also safe to assume that beef cattle are getting infected as well. As this spreads in farm animals, the risk of a human pandemic climb.

Systematic Densitization

One type of cognitive behavioral therapy is systematic desensitization therapy. It’s often used to treat phobias, anxiety disorder, and PTSD. The idea behind it is to reduce stress, anxiety, and fear of a stimulus by using relaxation techniques, working through fear on paper, and using VR or the actual stimulus to reduce that fear in a safe setting.

Some have argued that as a society we have become desensitized to violence through real events and the media, including fiction.

Now that we have experienced a pandemic for over four years, it seems reasonable to think that we are getting desensitized to the waves of disease and death. Many people are acting as if the pandemic is over, and many are even saying that it is, when the evidence shows that it clearly is not.

That poses a significant problem if H5N1 becomes a human pandemic. At the start of COVID, the majority of the population took it seriously. Now, it’s very uncommon to see anyone wearing any type of mask, much less a respirator. That kind of lackadaisical approach is not going to go well should another pandemic begin soon.

Temporal Discounting

That kind of systemic desensitization also plays into what is known as temporal discounting. It is simply the nature of humans to do something for a reward in the present as opposed to taking a bigger reward in the future because we are impatient as a species. As an example, we see this in corporate settings at times, when executive decisions are made that could hurt the company in the long term but will placate investors in the short term.

In the infectious disease setting, this means that people are more likely to take risks when they think that the costs to them are too far off into the future to be considered. This is exactly what is happening with a number of people related to COVID. They argue that deaths have gone down but are completely ignoring the long-term impacts of an infection, that may not show up for many years. The public does not seem to understand the occult damage of a COVID infection.

Even seasonal influenza does this kind of damage at a lower level, but people only look at the acute illness. The risk of an acute myocardial infarction goes up after having influenza.

Pluralistic Ignorance

This is a particularly interesting concept in psychology. It is part of the reason why people don’t step up to help someone who needs first aid. There is an assumption that there must be someone there who is more qualified in a crowd, so nobody responds. It also leads to think that larger proportions of the population share a majority opinion than actually do.

The problem is enhanced on two fronts. First, there are all of the physicians who are making false claims about the pandemic. People tend to gravitate towards those who speak what they want to hear, even if it isn’t the truth. There are many examples of this throughout the pandemic. Twitter has made this worse by allowing some of those who are spreading lies and misinformation to post again, and those posts tend to go viral in their circles.

Worse though is the lack of action by the CDC. One good example of this is when they changed the colors on the Community Risk Map for the US, That action led many who don’t dig into the data or just trust it blindly to think that the risk had dropped considerably. The lack of clear messaging that this is a respiratory virus that is airborne and that people should be wearing respirators in shared indoor spaces also leads people to assume that maybe things aren’t that bad.

It goes back to the idea of “Someone must know more about this than me.” When people stop wearing respiratory protection, those who may have been on the fence figure that maybe things have gotten better and I’ve just been overreacting. It has become somewhat of a positive feedback loop. If H5N1 comes into play, that is going to be a very hard trajectory to change.