Trust in Medical Scientists Has Grown in U.S.

C. Funk, B. Kennedy, & C. Johnson
Pew Research Center
Originally published 21 May 20

Americans’ confidence in medical scientists has grown since the coronavirus outbreak first began to upend life in the United States, as have perceptions that medical doctors hold very high ethical standards. And in their own estimation, most U.S. adults think the outbreak raises the importance of scientific developments.

Scientists have played a prominent role in advising government leaders and informing the public about the course of the pandemic, with doctors such as Anthony Fauci and Deborah Birx, among others, appearing at press conferences alongside President Donald Trump and other government officials.

But there are growing partisan divisions over the risk the novel coronavirus poses to public health, as well as public confidence in the scientific and medical community and the role such experts are playing in public policy.

Still, most Americans believe social distancing measures are helping at least some to slow the spread of the coronavirus disease, known as COVID-19. People see a mix of reasons behind new cases of infection, including limited testing, people not following social distancing measures and the nature of the disease itself.

These are among the key findings from a new national survey by Pew Research Center, conducted April 29 to May 5 among 10,957 U.S. adults, and a new analysis of a national survey conducted April 20 to 26 among 10,139 U.S. adults, both using the Center’s American Trends Panel.

Public confidence in medical scientists to act in the best interests of the public has gone up from 35% with a great deal of confidence before the outbreak to 43% in the Center’s April survey. Similarly, there is a modest uptick in public confidence in scientists, from 35% in 2019 to 39% today. (A random half of survey respondents rated their confidence in one of the two groups.)

The info is here.

'A coronavirus depression could be the great leveller'

Kyrill Hartog
The Guardian
Originally published 30 April 2020

Here is an excerpt:

So could the pandemic of our era, already considered the greatest global crisis since the second world war, turn out to be a great societal leveller?

Scheidel’s short answer is that the longer the pandemic wreaks havoc on the global economy, the greater the potential for radical equalising change. “It depends on how severe the crisis is going to be, how long it’s going to last and how much it’s ultimately going to interrupt supply chains.”

The pandemic has already exposed the limits of the market and highlighted the importance of effective state intervention and strong public healthcare provision. In the future this may well create a tolerance for higher and more progressive taxation. Governments have had to intervene to prop up businesses and jobs in ways that only months ago would have seemed unimaginable. The viability of a universal basic income — a dream for egalitarians worldwide — is once again part of the mainstream debate in many countries.

The response at EU level also shows a willingness for strong public intervention and an end to the fiscal restraint approach of the last decade — at least, temporarily.

As people start to believe in government intervention again, the post-corona political landscape may well provide fertile soil for reversing a situation where, since 1980, the richest 1% in the UK have tripled their share of household income and the wealth of the European top 1% grew twice as fast as the bottom 50%.

But Scheidel cautions that, while disasters are not uncommon, tectonic shifts are historical anomalies. In other words, it may take a disaster to usher in more equality, but not every disaster does.

The info is here.

Rebuilding the Economy Around Good Jobs

Zeynep Ton
Harvard Business Review
Originally posted 22 May 20

One thing we can predict: Customers who are struggling economically will be looking more than ever for good value. This will give the companies that start building a good jobs system a competitive advantage over those that don’t. After the financial crisis of 2008, Mercadona — Spain’s largest grocery chain and a model good jobs company — reduced prices for its hard-pressed customers by 10% while remaining profitable and gaining significant market share. Hard work and input from empowered front lines had a lot to do with it.

The pandemic is likely to accelerate the ongoing shakeup of U.S. retailing. The United States has 24.5 square feet of retail space per person versus 16.4 square feet in Canada and 4.5 square feet in Europe. This is almost certainly too much and the mediocre — the ones that don’t make their customers want to keep coming back — will not survive.

The pandemic is likely to speed up the adoption of new technologies. Although typically seen as a way to reduce headcount, adopting, scaling, and leveraging new technologies require a capable and motivated (even if smaller) workforce.

There is an alternative: A good jobs system that has already proven successful. Long before the pandemic, there were successful companies — including Costco and QuikTrip — that knew their frontline workers were essential personnel and treated and paid them as such. Even in very competitive, low-cost retail sectors, these companies adopted a good jobs system and used it to win.

There’s a strong financial case for good jobs. Offering good jobs lowers costs by reducing employee turnover, operational mistakes, and wasted time. It improves service, which increases sales both in the short term and — through customer loyalty — in the long term.

The info is here.

Four concepts to assess your personal risk as the U.S. reopens

Leana Wen
The Washington Post
Originally posted 21 May 20

Here is an excerpt:

So what does that mean in terms of choices each of us makes — what’s safe to do and what’s not?

Here are four concepts from other harm-reduction strategies that can help to guide our decisions:

Relative risk. Driving is an activity that carries risk, which can be reduced by following the speed limit and wearing a seat belt. For covid-19, we can think of risk through three key variables: proximity, activity and time.

The highest-risk scenario is if you are in close proximity with someone who is infected, in an indoor space, for an extended period of time. That’s why when one person in the household becomes ill, others are likely to get infected, too.

Also, certain activities, such as singing, expel more droplets; in one case, a single infected person in choir practice spread covid-19 to 52 people, two of whom died.

The same goes for gatherings where people hug one another — funerals and birthdays can be such “superspreader” events. Conversely, there are no documented cases of someone acquiring covid-19 by passing a stranger while walking outdoors.

You can decrease your risk by modifying one of these three variables. If you want to see friends, avoid crowded bars, and instead host in your backyard or a park, where everyone can keep their distance.

Use your own utensils and, to be even safer, bring your own food and drinks.

Skip the hugs, kisses and handshakes. If you go to the beach, find areas where you can stay at least six feet away from others who are not in your household. Takeout food is the safest. If you really want a meal out, eating outdoors with tables farther apart will be safer than dining in a crowded indoor restaurant.

Businesses should also heed this principle as they are reopening, by keeping up telecommuting and staggered shifts, reducing capacity in conference rooms, and closing communal dining areas. Museums can limit not only the number of people allowed in at once, but also the amount of time people are allowed to spend in each exhibit.

Pooled risk. If you engage in high-risk activity and are around others who do the same, you increase everyone’s risk. Think of the analogy with safe-sex practices: Those with multiple partners have higher risk than people in monogamous relationships. As applied to covid-19, this means those who have very low exposure are probably safe to associate with one another.

This principle is particularly relevant for separated families that want to see one another. I receive many questions from grandparents who miss their grandchildren and want to know when they can see them again. If two families have both been sheltering at home with virtually no outside interaction, there should be no concern with them being with one another. Families can come together for day care arrangements this way if all continue to abide by strict social distancing guidelines in other aspects of their lives. (The equation changes when any one individual resumes higher-risk activities — returning to work outside the home, for example.)

The info is here.

How Could the CDC Make That Mistake?

Alexis C. Madrigal & Robinson Meyer
The Atlantic
Originally posted 21 May 20

The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.

Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.

The widespread use of the practice means that it remains difficult to know exactly how much the country’s ability to test people who are actively sick with COVID-19 has improved.

The info is here.

Suicides of two health care workers hint at the Covid-19 mental health crisis to come

Wendy Dean
statnews.com
Originally posted 30 April 2020

Here is an excerpt:

Denial, minimizing, and compartmentalizing are essential strategies for coping with a crisis. They are the psychological tools we reach for over and over to get through harrowing situations. Health care workers learn this through experience and by watching others. We learn how not to pass out in the trauma bay. We learn to flip into “rational mode” when a patient is hemorrhaging or in cardiac arrest, attending to the details of survival — their vital signs, lab results, imaging studies. We learn that if we grieve for the 17-year-old gunshot victim while we are doing chest compressions we will buckle and he will die. So we shut down feeling and just keep doing.

What few health care workers learn how to do is manage the abstractness of emotional recovery, when there is nothing to act on, no numbers to attend, no easily measurable markers of improvement. It is also hard to learn to resolve emotional experiences by watching others, because this kind of intense processing is a private undertaking. We rarely get to watch how someone else swims in the surf of traumatic experience.

Those on the frontlines of the Covid-19 pandemic, especially those in the hardest-hit areas, have seen conditions they never imagined possible in the country with the most expensive health care system in the world. Watching patients die alone is traumatic. Having to choose your own safety over offering comfort to the dying because your hospital or health care system doesn’t have enough personal protective equipment to go around inflicts moral injury. When facing the reality of constrained resources and unthinkable choices, working to exhaustion, and caring for patients at great personal risk, the only way to get through each shift is to do what is immediately at hand.

The info is here.

Proximate Cause Explained: An Essay in Experimental Jurisprudence

Knobe, Joshua and Shapiro, Scott J.
University of Chicago Law Review,
Forthcoming.
https://ssrn.com/abstract=3544982

Abstract

Among the oldest debates in American jurisprudence concerns the concept of “proximate cause.” According to so-called formalists, the legal concept of “proximate cause” is the same as the ordinary concept of “cause.” The legal question of whether a cause is proximate for the purposes of establishing tort liability, therefore, is an objective matter about the external world determinable by familiar descriptive inquiry. By contrast, legal realists think that issues of proximate causation are disguised normative questions about responsibility. As the realists William Prosser and Robert Keeton put it, “Proximate cause is better called ‘responsible cause’.”

Recent work in cognitive science has afforded us new insights into the way people make causal judgments that were unavailable at the time of the original debate between formalists and realists. We now have access to the results of systematic experimental studies that examine the way people ordinarily think about causation and morality. This work opens up the possibility of a very different approach to understanding the role of causation in the law — one which combines the attractive features of both formalism and realism without accepting their implausible consequences.

In addition to providing a model for interpreting the case law of proximate cause, this paper also exemplifies a new way of doing legal theory — a method we call “experimental jurisprudence.” Experimental jurisprudence is the study of jurisprudential questions using empirical methods. Jurisprudential disputes about proximate cause are especially ripe for empirical analysis because the debate revolves around whether the legal concept of proximate cause is the same as the ordinary concept of causation. Interrogating the ordinary concept of causation, therefore, should shed light on this question.

The paper can be downloaded here.

Is identity illusory?

Andreas L. Mogensen
European Journal of Philosophy
First published 29 April 2020

Abstract

Certain of our traits are thought more central to who we are: they comprise our individual identity. What makes these traits privileged in this way? What accounts for their identity centrality? Although considerations of identity play a key role in many different areas of moral philosophy, I argue that we currently have no satisfactory account of the basis of identity centrality. Nor should we expect one. Rather, we should adopt an error theory: we should concede that there is nothing in reality corresponding to the perceived distinction between the central and peripheral traits of a person.

Here is an excerpt:

Considerations of identity play a key role in many different areas of contemporary moral philosophy. The following is not intended as an exhaustive survey. I will focus on just four key issues: the ethics of biomedical enhancement; blame and responsibility; constructivist theories in meta‐ethics; and the value of moral testimony.

The wide‐ranging moral importance of individual identity plausibly reflects its intimate connection to the ethics of authenticity (Taylor, 1991). To a first approximation, authenticity is achieved when the way a person lives is expressive of her most centrally defining traits. Inauthenticity occurs when she fails to give expression to these traits. The key anxiety attached to the ideal of authenticity is that the conditions of modern life conspire to mask the true self beneath the demands of social conformity and the enticements of mass culture (Riesman, Glazer, & Denney, 1961/2001; Rousseau, 1782/2011). In spite of this perceived incongruity, authenticity is considered one of the constitutive ideals of modernity (Guignon, 2004; Taylor, 1989, 1991).

Considerations of authenticity have played a key role in recent debates on human enhancement (Juth, 2011). The specific type of enhancement at issue here is cosmetic psychopharmacology: the use of psychiatric drugs to bring about changes in mood and personality, allowing already healthy individuals to lead happier and more successful lives by becoming less shy, more confident, etc. (Kramer, 1993). Many find cosmetic psychopharmacology disturbing. In an influential paper, Elliott (1998) suggests that what disturbs us is the apparent inauthenticity involved in this kind of personal transformation: the pursuit of a new, enhanced personality represents a flight from the real you. Defenders of enhancement charge that Elliott's concern rests on a mistaken conception of identity. DeGrazia (2000, 2005) argues that Elliott fails to appreciate the extent to which a person's identity is determined by her own reflexive attitudes. Because of the authoritative role assigned to a person's self‐conception, DeGrazia concludes that if a person wholeheartedly desires to change some aspect of herself, she cannot meaningfully be accused of inauthenticity.

The paper is here.

Discussing the ethics of hydroxychloroquine prescriptions for COVID-19 prevention

Sharon Yoo
KARE11.com
Originally published 19 May 20

President Donald Trump said on Monday that he's been taking hydroxychloroquine to protect himself against the coronavirus. It is a drug typically used to treat malaria and lupus.

The Federal Drug Administration issued warnings that the drug should only be used in clinical trials or for patients at a hospital under the Emergency Use Authorization.

"Yeah, a White House doctor, didn't recommend—I asked him what do you think—and he said well, if you'd like it and I said yeah, I'd like it, I'd like to take it," President Trump said, when a reporter asked him if a White House doctor recommended that he take hydroxychloroquine on Monday.

In a statement, the President's physician, Dr. Sean Conley said after discussions, they've concluded the potential benefit from treatment outweighed the relative risks. All this, despite the FDA warnings.

University of Minnesota bioethics professor Joel Wu said this is problematic.

"It's ethically problematic if the President is being treated for COVID specifically by hydroxychloroquine because our understanding based on the current evidence is not safe or effective in treating or preventing COVID," Wu said.

The info is here.