As Australia prepares to gradually relax the non-pharmaceutical interventions (NPIs) that have led to our success in containing COVID-19 — from locking down the border and mandatory quarantining of returning citizens, to social-distancing and the shuttering of pubs and restaurants — it is crucial that we have the correct narrative about what is behind us, and what lies ahead.
Narratives — stories, really — are important because they help us make sense of complicated fact patterns. And as we continue to battle COVID-19, there is another battle taking place: for the narrative describing our response to the pandemic.
In light of our success various commentators that were “lockdown sceptics” from the start — like Adam Creighton, Henry Ergas and Janet Albrechsten — have suggested we could go “too far” or even reinterpreted the success of NPIs in Australia as evidence that we may never have needed lockdowns at all, in the case of Creighton.
Some have said that epidemiological models are “wrong” and should not be relied on. Their preferred narrative is that we, as a nation, panicked and caused additional economic harm for no reason.
These claims are clearly false given what we have seen overseas, everywhere from Italy and Spain to the UK and US. Looking at the relatively “good” observed outcomes in Australia, 7054 cases and 99 deaths to date, and concluding that NPIs were unnecessary is a rookie error.
It’s akin to looking at a community with lots of police on the beat and a low crime rate and concluding that if all police were removed the crime rate would stay low.
Australia’s relatively good COVID-19 outcomes are precisely because of our interventions. And countries with bad outcomes are due to their interventions coming too late.
As leading epidemiologist Jodie McVernon told The Australian’s Paul Kelly: “I think in Australia we really don’t appreciate what we have been spared. We have not lived in a situation where we’ve used ice rinks as makeshift morgues or seen refrigerated trucks outside hospitals. These things are happening in other high-income countries.”
Whether we adopt the “McVernon narrative” or the “Murdoch narrative” remains to be seen. But that choice will affect how we respond to the remainder of this crisis, and to the next one. And that choice of narrative depends on how we understand the path of the pandemic in Australia to date.
One good way to do so is by reference to epidemiological models that predict various health outcomes like infections, hospitalisations, and deaths depending on what containment measures are put in place.
These models estimate the probabilities of different outcomes and report statistics like the “expected” (or average) outcome, but also what might happen with a 5% or 10% probability. This is because of the inherent uncertainty about key features of the virus such as the proportion of infections severe enough to require hospitalisation, and how containment measures reduce the replication rate of the virus.
So if we see better-than-expected health outcomes, we should not view that as inconsistent with a good model. Similarly, we should also remember that models often tell us that things might have been a lot worse than how they turned out.
That is particularly important in the case of a deadly virus that can grow exponentially, like the one we currently face.
Avoiding relatively low-probability but catastrophic events is the right policy response, even if, by their very nature, we don’t often see those horrible events occur.
We need to remember that low-probability events actually happen. The famous US election forecaster Nate Silver gave Donald Trump a 30% chance of being elected president in 2016, compared to Hillary Clinton’s 70%. We all know what happened. But just because Trump is president, it doesn’t mean that Silver’s model was wrong.
Similarly, a professional golfer has a 19% chance of missing a five-foot putt. So you would bet that, faced with such a putt, they will make it. But if they miss that doesn’t mean your model is wrong. The key is to remember your assessment of the probabilities before you know the outcome.
One long-recognised reason that we are bad at doing this is what social psychologists call “hindsight bias” — a concept first demonstrated by Baruch Fischhoff when he was a PhD student of the celebrated psychologists Daniel Kahneman and Amos Tversky, who pioneered the study of heuristics and biases.
A key flaw in most people’s reasoning is that we perceive events that occurred in the past as being more predictable than they actually were. Often it is relatively easy to construct a narrative that rationalises events after the fact, but which we couldn’t articulate before the fact.
In The Undoing Project, Michael Lewis recounts Tversky telling an audience in 1972:
All too often, we find ourselves unable to predict what will happen; yet after the fact we explain what did happen with a great deal of confidence. This ‘ability’ to explain that which we cannot predict … represents an important, though subtle, flaw in our reasoning. It leads us to believe that there is a less uncertain world than there actually is.
And it is this belief in a more deterministic world that is so dangerous, as it can lead us to not take appropriate precautions against dangerous future events. Other recent viruses like SARS and MERS killed fewer people than many models predicted, perhaps leading to a sense of complacency. No lesser figure than Bill Gates warned about a deadly global pandemic in 2015, but few of his precautionary measures were put in place.
We will have other pandemics in the coming decades, and we may yet face a second wave of this pandemic in Australia. Epidemiologists worry about things like an avian flu with a 60% fatality rate. And rightly so. Australia’s story so far is one of catastrophe avoided, not overreaction.
Richard Holden and Bruce Preston are professors of economics at UNSW Business School and the University of Melbourne, respectively.
Kahneman’s “Thinking, Fast and Slow” and Michael Lewis’s “The Undoing Project” are two of the most interesting books I have ever read. Nassim Nicholas Taleb’s “The Black Swan: the impact of the Highly Improbable” is also very interesting but it’s wordy and less easy to read. And I did struggle with Nate Silver’s “The Signal and the Noise: the Art and Science of Prediction” because it is heavily loaded with sporting examples that I did not understand.
I wish I could be confident that some people in the federal parliament, from all parties, were considering the valuable insights that these titles all offer.
and one of the most salient passages in Kahneman’s book is (pg 177):
success = talent + luck
great success = a little more talent + a lot of luck
All those “self made” people who think they got their by their own endeavors, take note.
Sometimes you just need a lot of luck : Donald Trump = lots of luck + No talent
Not to mention the luck of the Dems having chosen the single candidate shown by every poll who would struggle to win against the most reprehensible candidate ever to stand.
Purely because “it was her turn“.
Not sure what to make of this. The author’s in their piece in The Converstation made the claim that there could have been 250,000 deaths on the fairly heroic assumptions that the death rate from COV-19 is actually 1% and everyone in Australia got infected.
In 2018 (the most recent data I could find), 3102 people died from “Influenza and pneumonia”. Irrespective of whether flu is more or less contagious, or more or less deadly, I gaurantee if there was a lock down and social distancing, some at least of those people would not have died. (Although just as with COVID-19, co-morbidities play a huge role, and maybe most of those people listed as dying of flu would have died of the co-morbidity withing the next 12 months anyway, just like with COVID-19). Where were all people in 2018 or earlier saying we should look after the vulnerable and close the joint down ?
A good any of those who die of flu and I nearly did last year, took it too cheaply. I have some chronic illnesses that could make me covid 19 endangered, but I am rarely ill. Even if someone is very ill with the flu, we can treat it. The ER Doctor said had I waited a few more hours, the results might have been disastrous. I was in the ICU for 4 days, but after about 12 hours of antibiotics for pneumonia, and Tamiflu I did not feel very sick, just bloody tired. As to the death rate, based on a quick scan of deaths as a percentage of cases world wide it is about 6%. That would make a death toll of 1 500 000 is everyone caught it.
More precisely, the authors suggested in their Conversation piece that the deaths would be 225,000 at a 1% death rate if close to 90% were infected. Why are they ‘heroic’ assumptions, or more accurately, why are they more ‘heroic’ than any other predictions or models based on several unknowns? What about the precautionary principle and asymmetric risk? Aren’t you falling into ‘hindsight bias’?
Even if the modelling were shown in retrospect to be hugely pessimistic, and if with hindsight we see later that the total number of deaths, without restraining measures being adopted, would have been in the region of 50,000, that is still vastly higher than your 3102 influenza deaths in a whole year, and a figure that would almost certainly see the health system struggle or fail to cope. So there’s part of the answer to your final rhetorical question. The other part is the availability of effective vaccine (50-60% effective) and treatment for flu, and the very much lower rate of transmission. I won’t go into the implied ‘moral question’ of whether we should deal with all transmissible diseases with the same degree of ‘lock-down’, nor will I make any heroic assumptions about how many would have died of comorbidities within 12 months ‘anyway’.
” I won’t go into the implied ‘moral question’ of whether we should deal with all transmissible diseases with the same degree of ‘lock-down’, ”
… but that’s actually what I was pointing out. The authors in their Conversation piece laid out the cost benefit of lock down vs the potential scary numbers of deaths for COVID-19.
I pointed out that 3102 people died of a transmissible disease in 2018 in the “do nothing” case (i.e. no lock down/social distancing/whatever during flu season). So the conclusion can only be that society as a whole placed no value on saving some or all of those 3102 lives by instituting the society wide measures as we see today.
It is indeed a moral question I haven’t seen addressed anywhere.
Richard, I really wish you guys would apply more rigorous logic to your arguments. I agree with the ‘gist’, but you rely falsely on the assumption that correlation equals causation. Perhaps this is blindspot for economists as it seems to be for political scientists?
The fact that, so far, Australia has not suffered badly from the Covid pandemic might have little to do with government policies. A retrospective look at the data for Europe, Scandinavia and the UK, including excess deaths data, shows not much difference in outcomes with different government policies vis lax versus strict lockdown, except perhaps Germany.
And while we both pity and laugh at the disaster unfolding in the USA, it really isn’t doing that much worse than Canada, and appears to be tracking perhaps a little better than Europe. This is based on per capita deaths.
I think we are not really going to have a good understanding on the ’causes’ of the differences any time soon. I’ve seen researchers postulating that the different national results can best be explained by the degree to which the country/city has frequent international travellers, the density of the population, the reliance on crowded mass transport systems like trains, and the time taken to close the borders. Other than the borders issues, there is not much here governments could do in a month.
Commentators may be correct in saying that Australia’s State and Territory governments were too strict in closing down. And I agree this is all in hindsight. But every time I put on a seatbelt in a car, when the journey is finished I could reflect (though I don’t) that my effort to wear the seatbelt was an over-reaction as there was no crash. That is the way I view it.
What I’m waiting for is the more rational commentators, if there are any, put the case that if governments had provisioned hospital capacity better (as Germany did) through public funding, we would not have had to ‘flatten the curve’ as much. In such a situation a strict lockdown might not have been necessary, or as long, and the impact on people and the market economy would have been less.
“Commentators may be correct in saying that Australia’s State and Territory governments were too strict in closing down”
And where is their supporting data? They have as little as anyone else, so I’d rather follow the precautionary principle. I’m a risk modeller myself and am only too well aware of the many variables and assumptions that underly every model.
In this instance, we are still waiting for all the data to come in and the value of each variable to be given its appropriate value.
I’m with you on the precautionary principle .But those gate keeper commentators jostling for position,, are just busting to get out and spread their narratives, as fast as they can make them up .
Bluey, I think you may have misunderstood me. I meant that they maybe correct in the sense that the burden of putting on a seatbelt is wasted effort looking back after a crashless drive. This is, of-course, only true if you ignore the lost chance or probability value of the seatbelt.
” if governments had provisioned hospital capacity better (as Germany did) through public funding, we would not have had to ‘flatten the curve’ as much. ”
That I agree with. We had not planned adequately for this pandemic which was predicted to happen at any time, and yet we did bugger all. This lack of planning is the price we are now paying in the response we needed to take. Naturally, our govt will never admit to this.
Gawd I wish we could put a bullet through Rupert. Albrechtsen and her science free cronies are just running Fox News lite.
A bullet wouldn’t work, going by their modus operandi …more like it would need a wooden stake through the heart ..or an appropriate vaccine ( those viruses can be tricky zombie buggers )
You could have mentioned Taleb, an exponent of mathematical probability, randomness and uncertainty and an expert in p*ssing off economic and academic experts. He very well explains in The Black Swan (a highly improbably but highly damaging event) the dangers of the human reflex embracing the narrative fallacy that you mention here. All retrospective history is infected with the over-confidence caused by the narrative fallacy.
But it is Taleb’s ideas set out in Antifragility that we should be attentively heeding; ie:
* All systems ought adopt a precautionary stance (ie build in resilience and redundancy derided by economists as ‘inefficient’).
* Stop making decisions on the basis of predictions. Instead make decisions on the basis of current evidence that indicates what caused more good and what causes more harm. When the evidence changes, change the decision. Use prediction only as yardstick to measure the effectiveness of the decision, not as its fundamental basis.
By the way, Taleb does not characterise the COVID-19 pandemic as a ‘Black Swan’. He says, and he is right, that such a pandemic was entirely predictable; ie given what we knew about the probabilities, every government is guilty of failing to adopt precautions to immediately deal with it when it arose.
The problem is that Capitalism has sought for centuries to convince us that we are entitled to demand certainty about future events. That is a the dangerous lie that underpins the our readiness to be unprepared and then shocked and amazed and it is that idiotic assumption of certainty that fuels the right-wing nutters at News Corpse.
Yep BA. Kahnemann and Taleb have been my main teachers over the last 20 years, thinking far in advance of their contemporaries.
Antifragility, though poorly written, is full of ideas that are brilliant in their simplicity and elegance, and he is right.
Yes, this was no black Swan event, and building resiliency into your economy and society is what a smart populace would demand. Unfortunately we have many more economists than Talebs in this world.