I ran across that lens while reading an article about filing cabinets in The Atlantic [1]

“The coronavirus pandemic is just one powerful example of this tension between information and knowledge. In the early days, it became clear that very little was clear about what was going on. …Our information systems were filled not simply with misinformation—false or misleading information—but with what I call “mydinformation” (note d), or informational uncertainty based on scant or contradictory evidence, in many cases regarding emerging scientific knowledge.” [emphasis added]

Think back to the early days of COVID, a new virus that saw cases and deaths rise exponentially. Remember the added concern and “all hands on deck” search for cause and treatment. For various reasons, and you can impose whatever purpose you want, it is irrelevant; our society’s hair was on fire. And our great cultural vehicle, science, stopped whatever it was doing and turned its considerable collective attention to the growing pandemic.

Fomites Theater and the Rise of Disinfection

Consider in those early days the suggestions to leave packages outside for at least a day before bringing them in and to clean them using a disinfectant while wearing gloves. I wrote about basic science, which was based on the work of physicists and others in laboratory models. Unfortunately, while their calculations of how long COVID can survive on surfaces were accurate, the underlying model they used was, as with all models, flawed. In the following months, it became clearer that COVID was transmitted as a respiratory virus; widespread contact through fomites was rare. That early work on the longevity of COVID on cardboard is a perfect example of minedinformation. It is also an ideal example of how science works.

The Western scientific enterprise is built on the idea that the power of a hypothesis lies in its explanatory power. It can never be fully “proved,” but it can be disproved. The hypothesis that fomites could transmit COVID was replaced by the hypothesis that it spread primarily as a respiratory virus, which could explain most of the infections. Fomite’s hypothesis was not wrong eithersinformation; it was minedinformation.

Big Glove didn’t pay for fomite research, nor did Big Disinfectant (remember the distilleries that switched to making hand sanitizer?). It was a reasonable effort of faith to use our available knowledge to fight a terrifying invisible entity.

The rule of six feet

Once it became more apparent that COVID was transmitted through the air, science turned its attention to our breathing. We applied everything we knew about aerosols to determine how we could safely gather. As I’ve written, the CDC’s decision to change its recommendation from six to three feet of distance between individuals in school was based on a scientific study, not a flip. She was moving from mine beforedinformation for later and better new information. This is how our scientific enterprise works.

Preprints and policies

“Laws are like sausages; it is better not to see them being made.” – Otto von Bismarck

One of the results of our early panic in the pandemic and the resulting urgency to prevent and treat COVID was that we, the public, were exposed to the sausage production of “settled” science. Science has its own pace. It begins with individual studies first shared among collaborating scientists and, when relevant, finding their first real mention at a national conference as a slide presentation. Otherwise, it will take several months after scientists find a journal willing to publish their work and go through the six-month publication process. As a consensus is reached, that scientific information will find its way into yearbooks summarizing annual work in the field, and only much later will this science find its way into textbooks. The real fear of the pandemic cut short that scientific pace as the use and reliance on preprints increased.

Preprints were intended to rapidly disseminate scientific findings to those interested in the area. They are the new digital form of collaboration, reaching individuals faster than a speech at a national convention. They are at the beginning of the sausage production process and should be read and analyzed not so much with a jaundiced eye, but with a knowledgeable eye. Once again, due to our social urgency and often from “an abundance of caution”, we jumped from a piece of ratdinformation about another; so are the policy makers.

Should we forgive policy makers for their judgments made in the best possible waydinformation? Many of my colleagues, writing and tweeting, have strongly condemned the actions of policymakers. The Great Barrington Declaration, the value of masks, childhood vaccinations and school closures. Of course, they are not actually making decisions that will result in adverse financial or health consequences; they will not be held responsible for their words. I doubt they are dishonest, but they are shielded from the burden of guilt for the lives and money lost by their actions. Actions speak louder than words.

Knowing my roledinformation about the pandemic should assuage some of the anger and lower the perceived high level of various blamers and shamers of our public health response. Clearly we can do better. We need to change our systems to make them more flexible and transparent. Continuing to attribute intent, to do no harm, or as part of some cabal to tear apart our social fabric serves no useful purpose. Doctors make life and death decisions under uncertainty every day. We are often right, sometimes wrong. To improve our ability to choose well under uncertainty, we focus on increasing our judgment and experience. The same applies to improving the responsiveness of our public health system.

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

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