Charting COVID Cases

One thing that has been frustrating me with the pandemic is that the way that data are being presented to the public is often confusing and incomplete. This seems like exaclty the time to develop better science communication and graphics designs skills but results seem to vary by county/state/etc…

Our testing capacity has been…questionable at best for a lot of the pandemic. This hasn’t helped. It’s hard to compare statistics from today to three months ago knowing that our ability to capture the whole picture of what’s happening through increased testing, awareness, conflation of different types of tests, etc has varied wildly through time.

One thing I do think would help (especially for those of us who are not statistical wizards or inclined to dig through the data ourselves) is to stop using cumulative case count charts as a main source of information for the general public and replace them with % positive test charts. Reasons for this:

  1. Cumulative cases are always going to go up. The most we can hope for is a flat line, but outside of showing how well we’re “flattening the curve” this isn’t an incredibly useful way to see at a glance if conditions are getting worse in your area or not, especially when formatting makes it difficult to really interpret the slope of the line.
  2. Cumulative cases does not take into account testing capacity. If you test more people in an area with active infections, you’re going to find more positive cases. This makes the cumulative case line spike up, even though the actual infection rate might have stayed the same.
  3. Graphing the % positive tests is a (somewhat crude) way to take testing capacity into account by merely showing how likely it is that a COVID test on a given day comes back positive. This isn’t quite as useful when the only people getting tested are people who are almost certainly sick (as happened early on when people were being screened for symptoms before testing), but as testing capacity increases, allowing a wider range of people to get tested (and ideally, as we do broader surveys of a community to seek out infections before they result in bigger local outbreaks), this becomes more representative of the community at large.

I like the way testing results are being reported in the UW Virology Twitter account (here) – you see the number of tests, number of positives, a percentage positive is reported, and you can get cumulative total positives all in one page.

Ultimately, though, however the data are presented, there will be issues. The important thing is to realize what is actually being conveyed and what information is missing from the picture. Personally I think that any time a graph of coronavirus cases is being presented in the news it should be accompanied by a graph of testing totals at minimum, if only to make local ability to handle new cases more transparent. We should be able to see if our area is ramping up testing or is still overwhelmed, because a greater ability to detect new cases means we have more reliable information to help navigate our personal choices to reduce risk. If my area is unable to test, how do I know that there isn’t a growing outbreak in my area making it unsafe to work, run errands, or walk around the park?

We can still do all the personal preventative measures, like wearing masks in public, avoiding large gatherings, and distancing as much as possible in indoor spaces, but as more places are starting to open up, it seems vital to have complete and easy to understand information available to everyone.

The Virus and the Uncertainty Monster

So, it’s been a while. A long while.

I’m not sure why this blogging thing turned into such a difficult habit to adopt. Maybe I’m just bad at developing habits. Maybe it’s just hard to overcome the desire for perfectionism and producing something of value. I need to accept that the world is messy and not every single thing needs to be worthy of award and acclaim to have some value in discussion. Better to try to contribute to a conversation, than to not.

So, in the midst of a pandemic, let’s start again. I think my goals here are twofold. First, to share some of the extraordinary things we’re learning about the world, because it’s incredible, and inspiring, and I think science doesn’t always do a good job of reaching out beyond the immediate science community, and as an individual with interest and education in earth science and biology, I think my particular slice of interests doesn’t always get represented, especially in combination. Secondly, as a scientist-in-training, and a storyteller-in-training (and probably perpetually in training for both), I’m interested not only in the facts, but in how we engage with them: what narratives we build about the world, why we struggle with big issues, what biases we bring into our studies. By ignoring the very human storytelling, meaning-making impulse, be its products good or bad, I worry that we lose the ability to identify the ways we can make science/education/the world more accessible and understand how we got to where we are today.

And yes, it is messy and there are no perfect answers and I know nothing, really, but without digging in and starting conversations, I’m not sure how we can hope to grow.

And so, this pandemic! I’ve had this project in the back of my head for a long while about Frankenstein and climate change, exploring how/why we’ve employed analogy to Frankenstein to science, and the monster narratives around research and big scary issues like climate change that are full of uncertainty. But a lot of that material is applicable here, too, I think. I wanted, as a person who has spent some time in the land of viruses and vaccines, to do a sort of informational post about the situation, but honestly, there are enough voices and fact sheets on this already. Maybe I’ll do something more personal at some point, but not today.

Pandemics are confusing. We’re being accosted by something too small to see that we don’t even know is present until it’s far too late, that has effects that we don’t even quite understand. The rapid pace and openness of research right now is boosting our ability to respond, but also making it hard to keep up with information and revealing how little we know and how quickly what we do know can be overturned by a new experiment, and in general, our society isn’t fluent enough in that process to be comfortable with that uncertainty. More could be said here, but I feel like it has already been nicely summed up in other places (like here, for instance).

I keep returning to this idea of an “uncertainty monster,” which I was previously interested in through the context of climate change, but also puts useful language on the current situation. I think it’s a no-brainer that one of the worst parts of the pandemic, at least for those of us who are fortunately healthy and housed, is the uncertainty, not knowing what’s going on and what will happen in the future. But what’s really interesting is looking at how we talk about the pandemic, and which patterns of response we fall into. And I hope that by identifying these patterns we are better equipped to manage the flood of information and misinformation through awareness of the strategies used to communicate it.

To summarize (badly) the uncertainty monster (citations below if the link doesn’t work):

  • We like to be able to categorize and explain our world.
  • Things that don’t fit neatly into our cultural boxes (“monsters”) produce fascination and/or fear
  • Big issues (like climate change, new technologies with major ethical considerations, pandemics, etc) produce an “uncertainty monster” – we’re stuck in a grey space where we know enough to know there’s a problem but not enough to fix it, and have to navigate informational shortcomings, weigh our values, balance policy and research priorities, etc.
  • There are a few general strategies for transforming the unknown into something we can live with:
    • Monster exorcists try to get rid of the monster. They see the way we categorize our world, as inflexible, and thus anything that interferes with the status quo must be removed by any means. On the one hand, an exorcist might say that if we just do enough research and throw enough money at the problem, we’ll be able to fill all the gaps in our knowledge, and make the virus go away for good. On the more unfortunate side, monster exorcists might say things like “it’s time to go back to normal,” pointing to individual studies as adequate information to make a plan, ignoring the much greater complexities in play. Other monster exorcists who take issue with vaccines (categorical monsters in their own right, but that’s a side topic and please get your vaccines, dear readers) might co-opt the pandemic to further their anti-vaccination stance, using one monster to battle another. How do we make this nightmare, and everything it might imply about our weaknesses, go away?
    • Monster adaptors seek to adapt the monsters to better fit into our existing understanding of the world. On the good end of the spectrum, these include researchers and science communicators who try to put the pandemic into perspective. Another adaptation strategy is to try to transfer as much of our usual way of life to this new, distant and online format, proceeding to the greatest extent possible as normal to keep chaos from infiltrating every aspect of life. On the bad side, reframing it as “just the flu” and conspiracy theorists who concoct stories, say, about viral origins. Can we reframe the narrative to make lemonade from these viral lemons?
    • Monster embracers are eager and excited about the monster. And okay, I doubt anybody is happy about a pandemic, which is where this metaphor, originally applied to new technologies, breaks down a bit. But there’s plenty of people who are using their time at home to be more productive than they usually would be, or are finding value in the new mode of life that they hope to keep once “normal” returns. And there are a few who veer off course and rationalize the virus as due punishment for human action (i.e. the “nature is better off without us, nature defends itself” approach), accepting it as if not fantastic, justified. Monster embracing does not question why the monster is, but accepts it as it is.
    • Monster assimilators adapt the monster and our conceptions of the world. This balanced approach is best encapsulated by conversations that acknowledge both the current risk posed by the pandemic and the need for future resiliency. Monster assimilators may seek to understand the virus to minimize its impacts (through social distancing strategies, vaccines, medications, etc), but also believe there is no real return to the status quo. They may imagine ways to make society more responsive to crisis, and hope to use the current break from ordinary life as an opportunity to find solutions to the larger problems that play into the pandemic.

I think it’s also interesting that these categories can all be effective or harmful depending on the context and application. So, what monster strategies do you tend to fall back on? What narratives are you consuming, and what’s their underlying focus? How do these strategies differ in the face of different problems (linking to the uncertainty monster & climate change below).

  • Smits, M. “Taming Monsters: The Cultural Domestication of New Technology.” Technology in Society 28, no. 4 (November 1, 2006): 489–504. https://doi.org/10.1016/j.techsoc.2006.09.008.
  • Curry, J. A., and P. J. Webster. “Climate Science and the Uncertainty Monster.” Bulletin of the American Meteorological Society 92, no. 12 (August 8, 2011): 1667–82. https://doi.org/10.1175/2011BAMS3139.1.
  • J, van der Sluijs. “Uncertainty as a Monster in the Science-Policy Interface: Four Coping Strategies.” Water science and technology : a journal of the International Association on Water Pollution Research, 2005. https://pubmed.ncbi.nlm.nih.gov/16304939/.