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This pandemic has knocked us all for a loop. Most of us are scared, frustrated, angry, frightened, or some combination of the above. Also, many of us are certain of the correct thing to do next, and a few of us are certain it’s a conspiracy.
“What the human being is best at doing is interpreting all new information so that their prior conclusions remain intact.” -Warren Buffett
I’m an OB/Gyn here in Redding. I love my work. I am not a social scientist, or an economist, or a politician. I’m just a doctor. I’ve lived here since 2006 and I love our town. I post on Facebook mostly about my kids when they let me, and traveling with my wife.
During the shelter in place we all seem to have more time on our hands because thankfully we have not had a surge of COVID-19 patients needing to be hospitalized. I have followed with interest the various recommendations from the CDC, NIH, Federal and State Governments. The data initially was sparse, it’s getting better, but we certainly do not have a perfect picture of just how disruptive this virus is going to be locally and nationally in the near and not so near future.
Last week Dr. Dan Erickson and his business partner were interviewed about their urgent care practice down at the other end of our valley in Bakersfield. They spoke well, presented some personal data and then commented on how they felt the shelter in place should be lifted now, suggested doctors were being encouraged to inflate COVID diagnoses, and opined that the shelter in place order was hurting our immune systems.
I wouldn’t normally comment on such a topic but I reflected on what they said and how they said it and decided to put my two cents in. From my Facebook post:
“This physician may have some valid points about the data he has collected. But this is exactly the sort of reporting that I think makes so many of us confused. This physician leads with presenting personal data and then shifts to expounding on social issues and conspiracy. He’s credible as a physician but why should we be interested in his political beliefs? If he is truly interested in the data, then he should publish it and discuss the ramifications it may have on policy. There are many accelerated web-based platforms for peer review of data. His coupling of data he does not provide, with pronouncements about Dr. Fauci and conspiracy, should give us pause. To ask for more transparency from the CDC is one thing, but to suggest the CDC is conspiring against us is quite another.”
The subsequent back and forth of differing viewpoints on Facebook was interesting. I appreciated that for the most part folks who either agreed or disagreed with his viewpoint were able to have a reasoned dialog.
Subsequently, Dr. Erickson’s claims that the temporary shelter in place was hurting our immune systems, was a hot topic in social media. I took issue with that as there really isn’t any evidence to support that claim. Dr. Jennifer Kasten, MD, MSc(Oxon), MSc(London): a pathologist with degrees in infectious disease epidemiology, mathematical modeling of epidemics, and fieldwork in epidemic control, stated in response to Dr. Erickson’s claim, “The world is absolutely teeming with microbes. You’re coated in them, your house is coated in them, they enter your body with every breath you take and everything you eat. Your immune system is getting a perfectly adequate workout. You’re just restricting your exposure to a handful of things (respiratory pathogens) for a very short period of time”.
The subsequent social media discussion started to become much more divided.
Then finally, his own medical specialty board felt that his actions were unacceptable and decided to “emphatically condemn the recent opinions released by Dr. Daniel Erickson and Dr. Artin Massihi”.
It is very uncommon for a medical specialty board to do this in such a public manner. It happens only in the most egregious of circumstances. Interestingly, most people either felt that either the board’s condemnation refuted his claims or actually bolstered its veracity.
“The eye sees only what the mind is prepared to comprehend.” – Robertson Davies
This phenomenon is referred to as confirmation bias. Most of us are guilty of it. We crave cognitive consistency. There is so much information out there. It is so much easier to have a shortcut. Once you have made up your mind about a certain topic, you look for ways to confirm it, even if there is significant data to the contrary. I’ve certainly been guilty of it as a doctor. I was trained by professors who I hold in high esteem. As the medical field advances, newer studies can refute long-standing practices or therapies. I don’t want to believe them because that is not what I was taught by my mentors. I would argue that I need to be open to new, cognitively dissonant ideas, if I want to be the best physician that I can be. But it is difficult.
Trying to find an unbiased source of information about the COVID-19 pandemic feels immensely difficult. Some people now claim it’s impossible with mainstream and social media. I believe the data and testing is coming that can help guide us. It’s taking longer than any of us like. I want to go to our small businesses again. They are suffering mightily. As we start to reopen our town I would advocate for a reasoned approach that does not increase the risk of unnecessarily overburdening our hospitals. Together, with an open mind, and an appreciation of confirmation bias, I think we can do great things safely.