In upcoming weeks we will look into science concepts behind the approaches to fight COVID-19.  The purpose of this series is to better understand some of the current practices, to consider how the increase in the positivity rate of new cases can significantly complicate efforts, and to think about how to proceed.  Thank you for subscribing, and if you enjoy reading this, please forward the newsletter to your friends. ~ KevinQuote: "The most beautiful experience we can have is the mysterious. It is the fundamental emotion that stands at the cradle of true art and true science."  ~ Albert Einstein

Does anyone remember Mr. Wizard’s World?  It was a science show that I enjoyed in the 1980s  and in recent years I still think about that TV program.  I have wondered how Mr. Wizard would explain some of the important concepts behind understanding COVID-19 and our human response.  While I am not a scientist in the areas most often discussed as ways to combat COVID-19 (though cognitive and social behavior is way underappreciated right now), numerous tools and approaches cross disciplines.  My effort here will be to illustrate these concepts to enhance the discussion of ways to deal with COVID-19.  This week we will focus on testing.Testing: In recent months countries, including the US, have employed group testing. By this, I am not saying that individuals are tested together in a group. Rather the tests are run by grouping individual samples.  Grouping individual samples help expedite the testing process. This is especially the case with determining which individuals are negative for carrying COVID-19 antibodies. I believe this approach can best be illustrated in a way that Mr. Wizard might have approached it.

Imagine having nine billiard balls and a scale.  The scale would be like the one Justice holds in the statues we see around courtrooms.  The billiard balls all look similar except someone tells us one detail, that one of the balls is heavier than the other eight.  How would you go about determining which ball is slightly heavier and finding it most efficiently?  As you may tell this question is as much about efficiency as it is about accuracy.  You could organize each of the billiard balls and weigh them one at a time against each other.  But outside of the few times you are lucky and find the heavy ball right away, over time it would be very inefficient.  However, just like with the samples for COVID testing, you could group the billiard balls. 

For example, you can place three on one side of the scale and another three on the other side of the scale.  If you find that one side is heavier you immediately narrowed down your pool of prospective billiard balls from 9 to 3.  You could even determine this if the results from the scale were even because it would point to the group of three billiard balls that were not yet weighed.  Now you will simply have three balls that you can weigh to determine at random you can pick one ball for each side and be able to logically determine which billiard ball the heavy one is.  This approach allows one to process the nine balls in just two steps.instead of needing many more steps to test them individually.  Given the high demand for COVID 19 testing and the social need for it, this is an effective way to get test results.  There is an excellent article from Nature that explains this in more detail.  It explains how this approach was applied in other pandemics to useful effect. Another challenge with testing is the desire to fix individual pieces of the process (this is not arguing against the efficacy of doing so).  Two cognitive blind spots are at play and some could argue that those spots are in tension with each other.  One is the assumption that incremental progress is effective. Others claim whole change is effective.  Both have clear downsides but, in this issue, when looking at testing it is important to consider the possibility that fixes create problems.  For example, the serious problem of testing capacity may resemble the congestion we see in a city’s transportation flow.  This can be addressed sometimes by fixing some specific points.  However, that act of relieving congestion will reveal other sources of congestion that were less noticed before.

Wholesale changes while we are building the plane we are flying in are completely unrealistic. It is also important to see the downsides to tweaks and unexpected effects.  We should at least entertain the possibility that these effects will occur and how to respond to them in the present, while other problems are fixed. There is a big vulnerability to these approaches.  Returning to the illustration with the billiard balls, imagine instead that you were told that the group of nine billiard balls has two or three balls that are a little heavier and it is your job to identify them.  Grouping them is still better than checking them individually, but it does take longer than in situations where fewer billiard balls are heavy.  Of course, my analogy carries over if you have more positive cases of COVID-19 in your pooled sample. It then takes more time to isolate and determine all of the positive cases.  This is bound to happen in any pooled sample. But if it occurs frequently, it causes delays in getting results, like we are hearing about now.  This relates to one of the core arguments of my newsletters this year, related to the compounding side effects of responding to a virus that grows exponentially.  Most systems can be vulnerable to this problem of compounding numbers of COVID cases.  Many systems that would face considerable strain have benefited from robust mitigation practices.  Another lesson from this experience is that having success for a while does not cause you to succeed in the future.  We will talk about all of this in more detail in the coming weeks.News:

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I am enjoying the chance to share these newsletters with you in the form of the new podcasts and appreciate your continued feedback. You can reply to this email or leave your comments below.  I sincerely enjoy chatting and learning what folks think. Thank you ~ Kevin

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