Innovating to Solve the Pandemic

First published December 13, 2021.

“Seems that the amount of analysis published about the COVID19 pandemic is inversely proportional to the degree in which most of it can be trusted. So why spend 7 precious minutes reading what a self-professed medical ignoramus purports to contribute to this excess? It’s worth your while, only if you are willing to take my word that the latest Omicron-ic developments are a fascinating case study in the way our thoughts can easily flow down the same old paths, to the exclusion of potentially interesting novel possibilities”

These two paragraphs appeared in the New York Times on December 7th, 2021:

“The Omicron variant spreads quickly, but the resulting infection may be less severe than other forms of the coronavirus. Researchers in South Africa said that their Covid-19 wards were almost unrecognizable from previous phases of the pandemic, with few patients on oxygen machines.

A report from doctors at a major hospital complex in Pretoria, South Africa’s administrative capital, said that coronavirus patients with the variant were less sick than those they had treated before. Most of their infected patients were admitted for other reasons and had no Covid symptoms. The findings are preliminary, however, and have not been peer-reviewed.”

Similar references appear in the media daily this week. The jury, then, is still out, and will apparently deliver its verdict on the dangers of Omicron only within 2-3 weeks. But, for the sake of our thought experiment, let’s imagine that what seems to be is, indeed, the case:

1. The Omicron variant is way more transmissible than Delta or other variants;
2. The resulting infection from Omicron is less severe.

Regardless of one’s opinions on the pandemic and its remedies, it is a good opportunity, as a case study, to explore some common assumptions and thought processes one tends to follow more or less automatically, and how they can be challenged.

1) Assumption: The more transmissible a virus, the more dangerous it is for us.

1) Challenging the assumption: Can we decouple the parameters? What if the lethality of the virus would be independent of its contagiousness? What if “the more transmissible the virus” would lead to “the closer we are to solve the COVID problem”? As we will mention in more detail below, the opposite of this assumption is probably mostly the case: more transmissible viruses tend to be less harmful.

 2) Assumption: The virus is the problem. It is only the problem.

2) Challenging the assumption: Maybe the virus is also the solution. How can we use the virus itself to fight the virus? Fight fire with fire.

3) Assumption: Emergence of new variants is always bad news.

3) Challenging the assumption: On the contrary, very probably, the most common path for a pandemic to recede is by mutating to a relatively harmless series of versions through evolution of new variants. Luckily, modern medicine and especially modern hygiene and public health measures, can dramatically lower the cost in lives while this evolution-into-mildness occurs. Meanwhile, it would be beneficial for everyone’s mental health if the global public were not automatically thrusted into catastrophic mode every time a new Greek alphabet letter enters our lexicon.

4) Assumption: Dealing with the virus is a war, and therefore a zero-sum game. Either we kill it, or it kills us.

4) Challenging the assumption: Difficult enough to challenge this assumption (or reflexive position) when confronted with a human rival or enemy, so I can imagine how strange this may initially sound in the context of a virus, but – what if we searched for a win-win solution? A virus thrives and replicates only while its host is alive, so an interest in keeping infected humans alive may be common ground. A live virus, if not too damaging, is the best form of vaccination, in fact, this is exactly what vaccinations used to be about before new advances created alternative technologies – so can this be another interest we share with our “enemy”? A reasonable offer for a truce, from the human perspective, would therefore be: we help you replicate, you refrain from damaging us beyond an agreed-upon level. How could we set this kind of truce in motion, practically speaking? Or, in more scientific-sounding language: can we help less virulent strains evolve to create herd immunity?

5) Assumption: When the number of infections rises, hospitals are “overwhelmed”.

5) Challenging the assumption: Humanity has had 20 months to figure out solutions and has spent trillions of dollars on COVID-related expenses, including more than 50 billion dollars on the major vaccines alone. Can a fraction of these sums of time and money be used to upgrade public health, develop treatment in the community, redirect light cases away from hospitals and design a more robust hospital system that isn’t so easily “overwhelmed”? A good place to start could be improving the ability to distinguish, and help the public distinguish, between cases that require a visit to the hospital and those that don’t.

If we imagine a variant, call it O, which is highly and competitively transmissible, while being (for the sake of our thought experiment) common-cold-harmless, we may consider the following chain of hypothetical events:

1. Our putative O variant is highly transmissible and relatively harmless;
2. Authorities everywhere encourage the spread of the O variant, by asking its bearers to avoid social distancing measures, such as wearing masks in public, for example;
3. A large percentage of the population is infected by O, and is treated for their light symptoms in a calm and efficient manner, without involving hospitals, except for the small percent of those with grave symptoms;
4. The O variant becomes dominant, edging out Delta and other, more noxious, variants;
5. The elusive “herd-immunity” goal is achieved at a relatively low cost in health and deaths, and an extremely low financial cost;
6. The COVID 19 pandemic follows in the spikesteps of the Spanish and other flus, thus ceasing to monopolize humanity’s agenda.

Or, if this optimal scenario fails to play out as planned, and the O variant falls short of overpowering its evolutionary competitors, what about designing variant O* that does succeed in this task? While yet another, even grander jury, is still out on the question whether COVID19 is the result of a gain-of-function experiment set accidentally loose from a lab, maybe the scientific community should devote time and energy to developing a loss-of-function experiment, creating an O*, even more transmissible than O, but much less damaging to humans?

This entire chain of hypothetical events might be totally senseless. There are, as is usually the case when confronting fixedness and well-established assumptions, strong arguments against this type of approach. A key argument can be that the risks involved in letting loose a virus whose mechanisms of action are not very clear are too great. What if we encourage the spread of O and then discover it is actually more dangerous than we thought? What if O* proves to be deadly? What if increasing the number of infected human hosts increases the number of new variants, among them versions that are both more transmissible and more harmful than O*?

These concerns are valid, of course, and I recommend that you go through the exercise of considering how they can be mitigated (they all can, to varying extents). One assumes that at least some of these concerns have also been voiced in one version or another along the 35 or so years since transporting mRNA into cells was first attempted, and more so as the vaccines based on this approach have been deployed. And those concerns may as well have been valid, and yet, here we are, 50+ billion dollars-worth of vaccines into this great experiment. But, meanwhile, these concerns also express another common fixedness: the belief that not-doing, or sticking to the same modus operandi (even when results, as in our case, are mixed) is somehow inherently less risky than doing. Locking up populations in response to the apparition of Omicron is just as much “an experiment” as not locking them up, or even encouraging those infected by Omicron to run around mask-less. Mechanisms unleashed by lockdowns and quarantines and their effects on wellbeing are just as obscure as those that underly viral action, and therefore not less risky. In spite of the risks inherent in acting in this relative dark, steps should be taken, based on what is known. Social distancing, quarantines and even vaccines are all legitimate tools in the toolbox. But selecting not to use them in certain scenarios is a no less legitimate course of action.

Regardless of your views on the pandemic, I invite you not to discard the call to observe your assumptions – COVID-related or others – and challenge them. SIT obviously has no position on COVID related issues, but we do have strong positions on mental fixednesses and how to overcome them. Those who are familiar with the method, and/or have followed some of my articles and posts, may have identified some tools and principles that play out in this post, notably:

• UDP Chains for Problem Solving
• Qualitative Change
• Attribute Dependency

If you are curious, or wish to refresh your memory about these tools, you may want to read “An Effective Tool for Problem Solving”, Part 1, here:

https://www.linkedin.com/pulse/effective-tool-problem-solving-amnon-levav/

and Part 2 here:

https://www.linkedin.com/pulse/effective-tool-problem-solving-part-2-amnon-levav/

Or simply set yourself, with courage and sincerity, the task of reviewing some of your positions while challenging their underlying assumptions. You may find yourself coming up with some exciting novel concepts.