The Experts

It seems to me that not all people called experts actually are.  In fact, there are whole fields in which none of the experts are experts. But let’s try to define terms.

You might say that an expert is someone who knows more about a subject than some random dude off the street.  That could mean that the man in street typically had false ideas [worse than a coin toss] about the subject, while the expert admits that he knows nothing, but let’s aim higher.  We’ll define expertise as something that not everyone has, that gives you at least some predictive value (possibly a lot), and sometimes the ability to control outcomes.  Such real expertise can be proven experimentally.  Generally, that kind of expertise can be acquired (the wisdom of the Occident), but it may be that not every one is talented enough to be very good at it.

Then again, by a different but occasionally useful definition, an ‘expert’ is someone that society considers an expert, whether he actually has any predictive power or not.  We denote that social position by quotes.

Sometime no-one has any any predictive ability: some stuff, nobody understands.  There’s a good chance that we will still have some some socially-approved ‘experts’ on that subject.

You can have a situation in which expertise exists in some field exists  – there is a knowledge set that can confer predictive value, and at least some people have that knowledge – while the people generally considered experts by society (‘experts’)  are useless, or worse than useless.  You can even have situations in which virtually everyone – except for the ‘experts’ – has expertise on a subject.  You can have negative time trends: things go from a situation in which virtually everyone knows certain facts to  one in which the overwhelming majority of people – including the ‘experts’ know things that just aren’t so.

There are plenty of examples.  At the high point of Freudian psychoanalysis in the US,  I figure that a puppy had a significantly positive effect on your mental health, while the typical psychiatrist of the time did not.  We (the US) listened to psychologists telling us how to deal with combat fatigue: the Nazis and Soviets didn’t, and had far less trouble with it than we did.

Fidel Castro, a jerk,  was better at preventive epidemiology (with AIDS) than the people running the CDC.

In the 1840s, highly educated doctors knew that diseases were not spread by contagion, but old ladies in the Faeroe Islands (along with many other people) knew that some were.

In 2003, the ‘experts’ ( politicians, journalists, pundits, spies) knew that Saddam had a nuclear program, but the small number of people that actually knew anything about nuclear weapons development and something about Iraq (at the World Almanac level, say) knew that wasn’t so.

The educationists know that heredity isn’t a factor in student achievement, and they dominate policy – but they’re wrong.  Some behavioral geneticists and psychometricians know better.

In many universities, people were and are taught that really are no cognitive or behavioral differences between the sexes – in part because of ‘experts’ like John Money. .  Anyone with children tends to learn better.

Along these lines, I’ve read Tetlock’s book, Expert Political Judgment. A funny, funny, book. I will have more to say on that later.

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The Advent of Cholera

Most of this is stolen from William MacNeill’s Plagues and Peoples.

Cholera seems to have existed in the Ganges delta for a long time, but it only spread to the rest of the world fairly recently.  An unusually severe epidemic broke out in 1817: it spread by ship to Sri Lanka, Indonesia, Southeast Asia, China, and Japan between 1820 and 1822.  A British expeditionary force brought it southern Arabia in 1821, and from there is filtered down the east coast of Africa.    It moved up into the Persian Gulf, reaching Iraq and Iran, then Syria, Anatolia, and the Caspian.

In 1826 a new epidemic moved even further, spread through Europe and North America.

It had been some time since the last outbreaks of bubonic plague, and most of the techniques for limiting its spread had lapsed. Some places still remembered: Marseilles, for example, had experienced a late outbreak of plague in 1721 and annually commemorated it.

Two main factors interfered with an effective policy response to cholera (not counting ever-present human stupidity and obstinacy): bad science and 19th century liberalism.

Scientists at the time had convinced themselves that the germ theory of disease was just wrong.  Yellow fever’s decimation of the French force in Haiti made it important, and when yellow fever hit Barcelona in 1822, French scientists were all over it. They concluded that there was no possibility of contact between yellow fever victims in Barcelona, and ruled out contagion.  Mosquito transmission didn’t occur to them.

Worse yet, they generalized their error: they concluded that contagion was never the answer, and accepted miasmas as the cause, a theory which is too stupid to be interesting. Sheesh, they taught the kids in medical school that measles wasn’t catching –  while ordinary people knew perfectly well that it was. You know, esoteric, non-intuitive truths have a certain appeal – once initiated, you’re no longer one of the rubes.  Of course, the simplest and most common way of producing an esoteric truth is to just make it up.

On the other hand, 19th century liberals (somewhat like modern libertarians, but way less crazy) knew that trade and individual freedom were always good things, by definition, so they also opposed quarantines –  worse than wrong, old-fashioned ! And more common in southern, Catholic, Europe: enough said! So,  between wrong science and classical liberalism, medical reformers spent many years trying to eliminate the reactionary quarantine rules that still existed in Mediterranean ports.

The intellectual tide turned: first heros like John Snow, and Peter Panum, later titans like Pasteur and Koch. Contagionism made a comeback.  I am not an expert on that history, but I think that the classical liberals didn’t argue that it would have been better for people to die than survive due to state-imposed public-health methods.

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The Coming Plague

Laurie Garret has an article out in the Washington Post.  She say that there’s no point in trying to block the spread of Ebola by travel bans.

The problem is, she’s full of crap.  Look, there are two possible scenarios.  In both of them, r, the number of new cases generated by each case, is greater than 1 in parts of West Africa – which is why you get exponential growth, why you have an epidemic.  If r < 1.0, the series converges – a case generates a few extra cases before dying out.

Everything we know so far suggests that even though it is greater than 1.0,  r in West Africa is not all that big (maybe around 2), mostly because of unfortunate local burial customs and incompetent medical personnel.

It seems highly likely that r in US conditions is well under 1.0 which means you can’t get an epidemic. However,  r is probably not zero.  It doesn’t mean that you can’t get a few cases per imported case, from immediate contact and hospital mistakes.  As an example, suppose that on average each case imported to the US generated a total of two other cases before dying out (counting secondary, tertiary, etc infections).  Then, on average, the number of US citizens infected would be twice the number of infected visitors.

Now suppose that a travel ban blocked 80% of sick people trying to fly here from Liberia.  We’d have 80% fewer cases in US citizens: and that would be a good thing. Really it would.  Does Laurie Garret understand this?  Obviously not. She is a senior fellow for global health at the Council on Foreign Relations, but she is incompetent.  Totally useless, like virtually everyone else in public life.

We hear people from the CDC saying that any travel restrictions would backfire, but that’s nonsense too.  One might wonder why they say such goofy things: I would guess that a major reason is that they were taught in school that quarantines are useless (and worse yet, old-fashioned), just as many biologists were taught that parasites are really harmless – have to be, because evolution!

In the other scenario, r > 1.0 in US conditions as well, or at least is greater than 1.0 in some subsets of the US population.  This is very unlikely- even more unlikely considering we can adjust our behavior to make transmission less likely.  But suppose it so, for the sake of argument.  Then you would want – need – to stop all travelers from the risky regions, because even one infected guy would pose a huge risk.  Some say that blocking that spread would be impossible. They’re wrong: it is possible*, although it wouldn’t happen, because we’re too crazy.  In fact, in that scenario, we’d be justified in shooting down every plane that _might_ carry an infected passenger.  This scenario is the one that fits Garrett’s remarks, but if she really believed it, she would be frantically buying canned goods and finding a cave in the Rockies to hide her family in.

*the Atlantic is pretty wide.

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Draft of paper about Amish

Mike Weight and I have a draft of a manuscript about responses to personality tests by Amish and non-Amish young men from the same county in Indiana. We have mentioned this material before on the blog. The paper is getting ready to ship out: we are hoping to take advantage of our readers and solicit comments and criticisms and outrage and whatever. Drs. Charlton and Thompson may be especially knowledgeable about this approach along with many of our anonymous cowards.

Our approach is to use published data from a personality test from 1970 to construct an index of “Amishness” that we call the AQ that is analogous to the well-known IQ of cognitive testing. With that, the whole standard machinery of quantitative genetics is immediately available. Whether or not the genetic model is correct or near correct there is a clear and explicit baseline that alternate models should be able to match. For example the difference in mean AQ between young Amish men and their non-Amish neighbors is about 2.8 standard deviations. In the IQ world this would correspond to a group different of 42 points. In the stature world this would correspond to a height difference of about 8 inches.

Please have a shot at our draft if you are interested at this link.

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The Road Not Taken

A lot of people are bothered by the idea of biological determinism – the idea that given the genetic hand they’ve been dealt, and the environment they experienced, their path in life was essentially inevitable.  When you consider the fates of identical twins raised apart, particularly examples like the Jim twins, you can feel boxed in.  In a philosophical sense, that is:  you are probably thinking too hard if the the fact that your non-existent clone might have gone down much the same life path as you engenders weltschmerz.

If it does, though, there’s a way out of it.  Find a situation with at least two alternate  courses of action that are sure to lead to wildly different outcomes, and make your choice based on a truly random event, such as nuclear decay.  Even if your clone did exactly the same thing, there’s no way of predicting what path he would take*. If you’re feeling wimpy, you can restrict your paths to ones that don’t have a high likelihood of immediate crucifixion.

On the other hand, if you are truly determined, you can pick paths that are chaotic as well, so that infinitesimal difference in your initial actions will eventually lead to big differences in your trajectory.  In that case, though, all bets are off.

I’m thinking that there’s probably already an app for this.

 

*unless the Everett-Berra theory is correct.

 

 

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Disaster in the South Pacific

The 1918 influenza pandemic hit every country on Earth – well, almost every country. It missed American Samoa entirely, which is interesting.  It’s even more interesting when you notice that it hit the neighboring islands of West Samoa harder than anywhere else.

Worldwide,  the Spanish Flu killed 3-5% of the population – lower in most developed countries, which had better supportive therapy.  Medicos had no useful vaccines or  antiviral agents: in fact they mistakenly thought it was caused by a bacterium. Doctors were useless, but nurses were not.

In the South Pacific, the flu was spread by the SS Talune, which regularly visited Tonga, Fiji, American Samoa, and West Samoa.  Crewmen had picked up the flu in New Zealand and spread it to those ports, excepting American Samoa.

The islands of Western Samoa were administered by New Zealand, which had recently seized them from Germany. The administrator (Colonel Robert Logan) had little administrative experience (former sheep farmer) – he felt that he needed approval from Wellington for any action and he received no instructions.  Medical officers also waited for instructions – none came. In addition, plantation interests were important, and they opposed any quarantine, which was also the case in Fiji. So, no quarantine. Thing went very badly: so many were sick (~90% of the population)  that few were left to care for them. Since food was mostly in gardens, rather in cupboards,  people starved while weak.  Europeans were less vulnerable, and those that could helped, but there were relatively few in Western Samoa.  20-25% of the population died, concentrated among young adults, the highest death rate in the world.

American Samoa was physically quite close to Western Samoa, less than 100km. There were close cultural ties: people intermarried and often sailed back and forth.  But the governmental structure was different.  There were no copra plantations in American Samoa, so you didn’t have any powerful business interests lobbying for suicide.  The US Navy ran the colony.  John Martin Poyer, an officer that had retired from active duty due to illness, was brought back to active duty in 1915 to serve as Governor of American Samoa.

Both American Samoa and West Samoa had advance warning of the flu’s danger: they both had wireless sets and occasional mail.

Washington didn’t micro-manage American Samoa, not being all that interested.  A policy of benign neglect was interpreted by Poyer as an opportunity to act on his best judgment, in the finest traditions of the US Navy.  He imposed quarantine. That was harder that it sounds, because of the frequent family visits between West Samoa and American Samoa – but Poyer also had  the support of the local  chiefs, who understood how serious imported epidemics could be.  The people of American Samoa self-blockaded, on top of official quarantine: they sent out canoes to stop any and all visitors.  They never had a single case.

Of course there was a disaster.  Some people will think that it occurred in West Samoa. Others will think that the real disaster was in American Samoa.

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Nurses vs doctors

Medicine, the things that doctors do, was an ineffective pseudoscience until fairly recently. Until 1800 or so, they were wrong about almost everything. Bleeding, cupping, purging, the four humors – useless.   In the 1800s, some began to realize that they were wrong, and became medical nihilists that improved outcomes by doing less.  Some patients themselves came to this realization, as when Civil War casualties hid from the surgeons and had better outcomes.  Sometime in the early 20th century, MDs reached break-even, and became an increasingly positive influence on human health.  As Lewis Thomas said, medicine is the youngest science.

Nursing, on the other hand, has always been useful.  Just making sure that a patient is warm and nourished when too sick to take care of himself has helped many survive. In fact, some of the truly crushing epidemics have been greatly exacerbated when there were too few healthy people to take care of the sick.

Nursing must be old, but it can’t have existed forever.  Whenever it came into existence, it must have changed the selective forces acting on the human immune system. Before nursing, being sufficiently incapacitated would have been uniformly fatal – afterwards, immune responses that involved a period of incapacitation (with eventual recovery) could have been selectively favored.

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