covid-19

New Expertise Required

Rob Wiblin’s 80,000 Hours team has a goal of identifying the skill bottlenecks keeping us from solving the world’s most pressing problems. Yesterday he sent out an important question to the universe via Twitter.

“When a situation is super complicated and the analysis very rushed, is that a time to listen to experts more, or actually a time to listen to them less? Might be more accurate to say, do we need a different kind of expertise?”

Wiblin is of course referring to the only thing that matters at the moment; the Covid-19 epidemic. And his question is towering over all of us right now.

There’s no denying it. We’re not great at pandemic response or preparation in America. And though it’s certainly cathartic to energize political debates as to why, politics won’t make us better. And we need to be.

This is where Wiblin’s point becomes so important. We have mountains of medical experts, public health officials, legislators, and economists working the problem. I’ve been stuck in my house watching them between conference calls and design sessions for work. And something is startlingly clear.

I don’t think we have all the right kinds of experts.

This isn’t a criticism of the people working the issue. It’s a reckoning that modern technology and medicine hasn’t intersected the way other industries have. And so we aren’t very effective at ingesting data at scale, identifying patterns and creating feedback loops. These are the blocking and tackling functions of modern technology enabled capabilities. And we don’t really do much of it in pandemic response. Not relative to how much we do of it in other less important domains. We’re better at suggesting the next porn video than we are telling you how many ICU beds Chicago will need this month.

That feels like a problem to solve.

As tempting as it is to just say we need SiliconValley to weigh in here and fix it, I’m not sure we want that either though. Along that path we’re just as likely to get an opt in mobile app that allows us to turn our medical information over to a corporate enterprise that no one will trust as we are a more robust capability.

Apple and Google did that yesterday by the way. It’s a start. But it’s not exactly what we need. We need more.

Long before the terms machine learning, artificial intelligence and big data were broadly used as advertising buzzwords, I was in Iraq leading an all source intelligence team with much more archaic tools. While we were there, we piloted a new technology from a group no one had heard of. It was a new “intel” software. In actuality it was a pretty basic data aggregation and distribution suite.

At the time, we didn’t have any systemic content management system for our intelligence reports. We had no enterprise search function. We weren’t using anything at all that resembled the metadata or tagging that common applications like WordPress or even Facebook and Twitter use today. Shockingly, there was no curated single source of truth for the data.

The intelligence analyst next to you could be chasing the same target you were and you wouldn’t know it until the evening in person intel brief.

As crazy as it sounds to us now, at the time, we were actually pretty successful at our core job. Like the experts fighting the pandemic, the processes we’d built up over what was already a “long” war had been optimized. We had deep subject matter experts in areas in which we operated. We knew what we were doing. We just didn’t know what we weren’t doing. And how much better we could get by doing it. So when I briefed the brass on the technology suite we piloted and suggested we were in the technological stone age and needed something like it, I was brushed off.

I still remember the look on the senior intel officers face when I told him the Family Tree application on Ancestry.com was the best intel tool in the world. And that how they digitized, stored, tagged and used metadata of old documents to enable it was as close to what the needed future looked like to us as we were going to get.

He actually giggled at me.

So did the exec for the company that built the software suite we piloted when I approached them for a job after I got out of the service a year later. They wanted software engineers, data scientists and UX designers. Not Naval Officers. They were building technology. Not capability.

The point of that war story is Wiblin’s point. At the beginning of the intersection of technology and counter-terrorism, he could have asked the same question he did yesterday. We had the old experts on both sides of the people and technology divide. After technology created capability and then application created organizations and processes, we built new experts.

Today’s counter terrorism experts are steely eyed data and computer warriors. And they’re enormously effective. That company that dropped off that laptop on my desk in Iraq was Palantir. They’re going to clear a billion dollars in revenue this year and are deeply imbedded in a robust cybersecurity, counterterrorism, technology industrial complex.

They never did show any interest in me. So I went to another tech firm and built out a technology based work from home capability for fintech enabled financial experts. We were bad at that at first too. Until we learned how to use technology and data and processes to drive outcomes. And now we aren’t. And now it seems to matter a bunch.

Which brings us back to our current predicament. The intersection of technology, data and medical care should have intersected decades ago. It didn’t; not at the scale it could have and for reasons that could fill a few books. That intersection in the beginning would not have created magical capability any more than dropping a laptop with a software suite on my desk in Ramadi did. But it would have started something that, over time, would have gotten better.

Perhaps that intersection can happen at scale now. And the norms of medical care we valued in the past may wear away in the face of the clear and present danger of pandemic. And then we’ll get better. Just like we’ve gotten better at digitally enabled counter terrorism. Just like we’ve gotten better at baseball scouting. Just like we’ve gotten better at targeted advertising. Just like we’ve gotten better at electric cars.

Each of these processes of building out expertise started with a burning need. We approached it with modern technology. And we built processes and organizations that turned that technology into capability. And then we built experts in that capability.

Wiblin’s right. We need that new kind of expert now.

Be wary of people to tell you that you can’t challenge a doctor on things not specific to medical care. But also be wary of the Silicon Valley tech guru who simply “has an app” to solve that problem too.We need both right now. And we’ll need the expertise that comes from that intersection.

That’s where the goodness begins.

Here’s to hoping this gets the train started. My guess is, you’d get some pretty smart people to climb on if it looked a little different than it does now.

COVID-19 and The Case for State Capacity

As the emails go out from the school district where I live that schools are closing, I can’t help but wonder if there is, or ever will be, a stronger case for state capacity as a base necessity for the protection of liberty than what we have going on right now.

While the classic view of American liberty wonders into the room from over the prairies on horseback with a Second Amendment guaranteed arsenal and a support the troops ball cap, the last few days has to make Americans ask ourselves if we’re really thanking the right things for our freedoms. Moreover, whether we’re fearing the wrong things as potential culprits to infringe upon our way of life.

It’s undeniable. My liberty has NEVER been infringed upon the way it has, in a literal sense, during this outbreak. I cannot go where I want. I cannot buy what I need. I cannot work the way I want. And my children don’t have access to education.

I am not free.

Amazingly, I actually don’t feel coerced by the government at all. Many of these measures feel appropriate given the risk. If they didn’t, in the face of an uncertain pathogen, I might have self imposed them anyway. The scary culprit against my liberty is not government overreach or censorship or cancel culture that won’t let me speak my mind.

It’s something else. It’s a disease. And the extent that my liberty is to be infringed upon depends heavily on one thing; my government’s ability to respond effectively to an event for which only government has the resources to respond.

At present, I’m sitting in my house with my three sons, whose Little League games have all been canceled, who have no school on Monday and who cannot go to a place that holds more than 250 people. How long this lasts is the dependent variable. That variable depends mostly on my government’s capacity to respond effectively.

What’s the diagnostic plan to enable the appropriate direction of resources to the right areas?

What’s the plan to increase capacity for what is a relatively low capacity healthcare infrastructure?

These are things only the Federal Government can do. And not because we’ve surrendered our rights to something we ought to be able to do ourselves. These are focused, highly specialize, high cost, high collaboration activities. A small government plan that lets state and local authorities work the problem, with reactive support from the Federal Government is a great strategy for many things. For a viral pandemic, it’s not.

Without decisive, proactive measures, we’re all forced to move on to a fall back plan of rolling cancelations and extreme limitations of travel and social distancing that would be less sweeping and less enduring if we had more diagnostic data to confirm certain areas weren’t at risk and confidence that our healthcare system could mobilize effectively in advance of the demand of full outbreak.

These intervention activities require proactive increased investment in state capacity. The stated policy of reducing resources of federal institutions is counter to this. On a platform of increasing liberty through “draining the swamp”, the result is the opposite of the promise of more freedom. It results in everyone I know not being able to do anything; a wholesale loss of liberty.

Expanding on this idea, carefully, we can find analogs.

Nothing reduces liberty like a hurricane flattening your town with no plan to build it back. Few things reduce liberty at the source like insufficient public education. Having to depend on an employer for healthcare makes us more dependent on our current employer, less mobile and less likely to start our own business and follow the American dream.

Less liberty.

We’ve had the luxury of a debate where some could reasonably believe that draining the swamp without rebuilding something in it’s place would be a good strategy. It’s possible this shock, like the Great Depression did for the requirements of a social safety net as a foundation for an industrial economy, will drive home an important point.

There are things only our government can really help with. The conservative Reagan mantra that government IS the problem is a great bumper sticker. But it’s a deeply harmful ideology if applied too broadly. Focusing resources and insisting on excellence for certain things should be possible with $4 trillion of American budget. And insisting on leaders we can trust to be the stewards of those resources, in service to our freedom, is a zero defect requirement.

I applaud the efforts the administration has rapidly put in place in the last 48 hours. But we should take note that the current administration rode into the White House on the fervor of a 40 year myth that liberty depended on a small, ineffective government.

A few press conferences of a different tone won’t do much to change the opinion of the people who’ve heard that message their whole lives and are now deeply concerned for the future.

Thoughts on COVID-19

I’ve been a part of enough things in my life that eventually became news stories to see a pattern. Whatever is reported is either an exaggeration, a partial truth or an outright misrepresentation of what actually took place.

Rarely is a dispassionate account of the truth rendered.

As a result, I’m skeptical of many things I read. I understand the forces that are at work in the media. The money, the ratings and the ultimate goal of eyeballs and clicks get in the way of the effective distribution of important information. It’s not a conspiracy. It’s a misalignment of incentives. The result is that we should remain healthy skeptics when consuming information.

For many, the appeal of President Trump has been his willingness to challenge what experts, the media or anyone, frankly, is saying. The uncomfortable truth for many of us is that so much of what circulates in our modern information stream is not entirely true or skewed by spin. And so if one decides to “call bullshit” on everything, one has a very good chance at being right quite often.

President Trump has made it a standing policy to call bullshit on everything that doesn’t come from him or that doesn’t align with administration policy. Based on the patterns I just described, he’s often right.

The risk has never been accuracy with this approach. The risk is a loss of confidence in the institutions we need to take action when something eventually isn’t bullshit.

The global COVID19 outbreak is not bullshit. It is real. And it is shutting the world down in front of our eyes. The claims that this is just the flu are not real. Even it it were, doubling a flu outbreak and increasing the mortality rate would still overwhelm our current care infrastructure. Pointing out that it’s just the old and sick that will die isn’t helpful either. We will not simply sit back and let everyone of us who isn’t completely young and healthy die. Along the way, we will shut down daily life and the modern global economy to avoid that end.

Does anyone honestly believe that China is prone to overreact to save some lives? The state that brought you a famine that starved millions to death and a Cultural Revolution that exterminated an entire class of intellectuals shut down the country to keep the virus from spreading. We should take notice. This is not a drill.

There is good news though. Because for once, we actually have some control over our fates.

In a world where we seem powerless against the march of never-ending wars, environmental catastrophe and the erosion of social cohesion, this pandemic gives us an opportunity. This virus needs us to live. We have domain over its host.

For once, we are in control. And we can be heroes.

There are things that spread viruses faster. We know what they are. We have already stopped doing many of them. There are things that impede progress of spread. We should do them. Limiting public gatherings, taking sick days, social distancing, self-quarantining and washing hands are all things that slow the spread of the virus.

Those are the things we can do as individuals. But there’s more. This is an opportunity to address some things.

It’s probably time to have legislation that ensures that the people who serve our food get paid sick leave. Think about that. The people handing you your food all feel like they have to work through being sick. Coronavirus or not, I’d rather that end. Trader Joe’s changed their policy on this immediately. Heroes.

It’s probably time to figure out how more roles can work remote. It’s probably time to figure out how employers handle parents that have to stay home to care for kids whose schools are closed. It’s probably time to identify a national response plan for any epidemic. What buildings get used for overflow. What labs can be used for emergency testing. What funding can be immediately released.

I thought this was all already in place. It’s not.

Today the New York Times reported that we had testing capacity in Seattle weeks ago. The lab there wasn’t allowed to test because of a standing CDC policy. Two dozen people in Washington state are dead. It’s easy to Monday morning quarterback and lay blame. But it’s also easy to stand up and say that for the next six months, all policies prohibiting testing are waved.

One great question this pandemic may bring us closer to answering is this:

How do we pandemic proof our globally integrated economy?

The real risk that we have is that we can’t save lives right now without tanking the economy. What would need to be true in order for that not to be the case?

The United States of America has been at war nearly my entire adult life. Aside from the days and weeks after 9/11, nothing the war has had to offer has impacted Americans the way the COVID-19 outbreak already has. Understanding the risk and what to do going forward should be a national policy issue second to nothing.

The goal is simple. Short Term: Take positive action to slow the spread of the virus to a rate that allows our medical response to keep pace with it. If we don’t, medical facilities will get overwhelmed, people won’t get treatment and our ability to respond to other everyday medical issues will be limited. Longer Term: Drive institutional change that makes us more resilient to future outbreaks.

I’ve worked in risk my entire professional life. The regrets I have from taking actions against things that didn’t materialized into catastrophe are zero. The regrets I have from not taking action when it could have mattered are substantial. Moreover, I have no idea what catastrophes were avoided by small actions early on in the problem. I’ll never know. And I don’t regret that either.

In the world of the material, beyond politics and media swirl, when we work to solve these sorts of existential issues, no one claims we’re overreacting. The word panic doesn’t even wander into the room. Instead, the tone is one of a requirement to be stewards of the resources we’ve been trusted with to carry out the responsibilities we have to those that count on us.

No one calls bullshit. Because it’s not bullshit.

We have a window here. But it’s going to close. If it does, the outcomes won’t be disaster movie extinction. It will be thousands of lives lost, the loss of effectiveness of our current medical care infrastructure and eventually the catastrophic shut down of the domestic and global economy.

That’s one potential outcome. The other is a coordinated and committed effort to doing what we can, while we can to avoid it. So, before you hit share on the witty, people all need to calm down meme, ask yourself this.

What’s the cost of being wrong about that?

The math on this one is clear. And we’re on the clock. This is our chance to be heroes.