Monday, March 8, 2021

The Covid Conundrum

Environmental & Science Education, STEM, Health, Medicine, Nature of Science, History of Science

Ed Hessler

The worldwide discrepancies in death rates of COVID-19 represent one of the great conundrums of this pandemic. It is, as Dr. Siddhartha Mukherjee writes in The Covid Conundrum (The New Yorker, March 1, 2021), "an epidemiological mystery". The worst off nations are the wealthiest and the poorer nations are "curiously low (South Africa, which accounts for most of sub-Saharan Africa's reported COVID-19 deaths, is an important exception.)"

In this essay, Mukerjee reports on a number of models that might explain what has been observed. "It was," Mukerjee notes, "an epidemiological whodunnit," one that includes variables such as differences in demographic structure (age distribution), undercounting, the role of government, how the elderly live ("house bound," "warehoused"), open or closed air ventilation. The story is complex and detailed so worth reading rather than trying to summarize.

Near the end of the essay Mukerjee refers readers to William of Ockham, a fourteenth-century theologian with wide ranging interests. We remember him because of an idea referred to frequently in science: "'Ockham's razor": the idea that, when seeking the cause of an event, we should favor the most parsimonious solutions--the simplest one." And Mukerjee includes a wonderful and short summary of the "special premium (Ockham's razor has) in the realm of science."

This finished Mukerjee takes a turn, to Agatha Christie and Hercule Poirot. In her classic mystery 'Murder on the Orient Express', Poirot happened to be on the train.  A passenger is killed but Poirot is stymied. It doesn't fit "the logic of the classic mystery tale: one murder, one murderer, one weapon" until he realizes that the murder was due to "a plurality of murderers." And this may be instructive in explaining the peculiar feature of the pandemic's distribution of deaths: "there is no one culprit but many." The global pattern observed--unequal distribution of death rates--may be one of many contributing factors." (my emphasis)

The pandemic "When it comes to a crisis that combines social and biological forces," Mukerjee suggests, "we'll do well to acknowledge the causal patchwork. What's needed, Muckerjee writes, isn't Ockham's razor but Ockham's quilt." I very much like the way he puts what is needed: humility in the face of an intricatel1y evolving body of evidence."

Mukerjee begins his story with Mukul Ganguly an eighty-three-year-old retired civil engineer who at the height of the pandemic in Kolkata, India, went to a wet market to buy fish. This was not a quick in an out but real shopping: looking, choosing, handling vegetables and fruits, and, of course, haggling. His family tried to prevent him from shopping but he could not be persuaded. Two days later Ganguly tested positive for COVID-19 which turned into a serious case, especially for someone his age. A cousin of Mukerjee's,  Ganguly's daughter-in-law who lives in New Jersey learned about his illness, called Mukerkee and a plan was worked up. Infected roughly on December 4, Ganguly was mostly back to normal by Christmas. While he hasn't been back to market since, this week (March 1)  the intrepid haggler, now fully recovered "plans to go the fish market." 

The Mukerjee essay, titled differently than the one in the print version and the one I used in the title--Why Does the Pandemic Seem to be Hitting Some Countries Harder than Others?--may be read here. It will give you an idea of how hard epidemiology is.

No comments:

Post a Comment