An epidemiologist’s fantasy would be to isolate everyone at least 6 feet away from all other human beings for 14 days. Such a policy would stop the COVID-19 pandemic in its tracks. Of course, it would also exact untold costs on our economy and emotional health. Sigh. Well, we can dream, anyway.
Businesses, schools, churches, and governments at all levels have been struggling to balance the tradeoffs between different public health policies for the last year. Human beings thrive on social interactions, but so do epidemics. How do we throttle these interactions to slow the spread of an epidemic, while not overly stifling society’s necessary organizations?
If we had let the virus run through the human population unchecked, then we would have overwhelmed hospital capacities and the death toll would have been higher. But we quickly learned that if we lock down our society too much or for too long then the damage to our economy and institutions will outweigh the benefits of social distancing. Where is the “Goldilocks zone” which balances all of these factors? Unfortunately there is not an easy solution.
Part of the problem has been the “moving target” aspect of it. A year ago, when the most severe lockdowns began in earnest, our knowledge of SARS-CoV2’s biology was pretty sketchy. Over the last 12 months we have answered a lot of questions about its transmissibility, the broad spectrum of symptoms it can cause, the most effective treatments, and how long immunity lasts after a natural infection. Our public policies have scrambled and mostly failed to keep up with this flood of knowledge.
But other things have changed too, like supply lines for PPE, the know-how to make your own mask, and the technology to hold meetings virtually. We have also witnessed an explosion of disinformation, including conspiracy theories about the origin of the virus and the nefarious intent of the people promoting various policies, and of the vaccine producers. All of these things affect the degree to which people benefit from and tolerate social distancing.
So the challenge of public policy makers in the COVID-19 pandemic is first to understand the science, and then to apply that science to decisions, while weighing the benefits of each policy against the harm it would cause, and while trying to convince the public that you are not actually trying to harm them, and to constantly revisit and revise policy in light of the fact that all of these calculations are changing over time.
Sometimes it feels like we’re in a harmonic oscillator, and the whole experience is giving people whiplash.
- Don’t worry about COVID-19; it’s not nearly as bad as influenza … actually, let’s close all schools, churches, and restaurants for the next few weeks to try to stop the worst public health disaster in a century.
- Don’t wear masks … actually, do wear masks … no, wear two masks!
- Don’t go to the doctor and don’t have surgery … actually, do go to the doctor and please have that surgery now because our hospitals and clinics are all going bankrupt without your business.
- Don’t have youth activities … actually, do have them … no, wait … … ok, it’s safe again.
- Don’t get together for holidays … but since we know you are going to anyway, at least try to be responsible about it.
What is a harmonic oscillator?
A simple example is a vibrating guitar string. Plucking a string with your finger moves it away from its resting position, and the elasticity of the string tends to pull it back to its initial position. But the elastic forces keep accelerating the string as it moves, so that by the time it reaches the resting position it overshoots and keeps moving beyond. Those same elastic forces will cause the string to stop moving and return again and again to the center position, overshooting each time. Thus, the guitar string will vibrate, or oscillate, at a frequency defined by its elasticity, length, tension, and other factors.
Harmonic oscillators can be found everywhere: in musical instruments, weather phenomena, in astrophysics, machines of all kinds, and of course in biology. If you watch very closely you might see a dampening harmonic oscillator in the pupil’s response to light. Hormone cycles, tendon stretch reflexes, the motor functions of the cerebellum, and the flapping wings of honeybees are more examples of biological harmonic oscillators.
Public policy through mid-2020 had some features of harmonic oscillation. The strictest lockdown in the spring seemed to be successful at holding the daily case counts steady in my home state, so we eased up a bit on social distancing through the early summer. When the case counts started climbing in the summer months, and then again in the fall, some restrictions were put back into place, like the directive on masking in public places. The pandemic stats were a moving target, at least partly due to effective policy, and the policy had to move to match the changing trends.
Medical doctors routinely face dynamic situations where we must make decisions despite having incomplete knowledge. This kind of uncertainty drives some people crazy, but for medical doctors it becomes old hat.
Sometimes the only way forward is to try something and see what happens. For instance, if I see a patient with frequent migraine headaches, then I will usually recommend a medication to reduce that frequency. There are a handful of medicines that we use for this, and the first one that we try might not work, or have intolerable side effects. It helps the patient if I tell them up front that we will be using a trial-and-error method to find the right drug and dose to help their condition. “I can’t promise that the first medicine we try will work,” I might say. “But we’ll keep trying. And we’ll keep ‘playing Goldilocks’ until we find the one that is just right for you.”
Some things are best learned — or only learned — experimentally. Which bowl of porridge is just right? I dunno. Let’s sample a bit from each one. Which is the right migraine medicine for this patient? Let’s start one and see what happens. How do we best approach public policy in a time of pandemic with a viral illness that has never been seen before? We start with our best guess and adjust things as we learn more.
We can also use an empirical approach when it comes to matters of faith.
“Jesus answered them, and said, My doctrine is not mine, but his that sent me. If any man will do his will, he shall know of the doctrine, whether it be of God, or whether I speak of myself” (John 7:16-17).
In other words, a testimony of the truth of Jesus’ teachings will come through experiential learning as you strive to live your life the way he taught us to.
Here is another example:
“Bring ye all the tithes into the storehouse, that there may be meat in mine house, and prove me now herewith, saith the Lord of hosts, if I will not open you the windows of heaven, and pour you out a blessing, that there shall not be room enough to receive it” (Malachi 3:10).
If you want to know the truth of the principle of tithing, then make your offering to the Lord and see if the blessings flow into your life. (It really works!)
Your efforts to learn about spiritual things may be off-target at first. You will surely over-correct and oscillate around the point, but over time you will narrow in on the right way. It may take some experimentation, and you may at times burn your metaphorical tongue on porridge that is too hot, or lay down on the spiritual equivalent of a bed that is too firm or too soft, but if you keep trying you will eventually find the truth that the Lord will guide you to.
And it is definitely worth the effort to do so.
Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist. Cover art includes “Goldilocks and the Three Bears” from Mother’s Nursery Tales by Katharine Pyle (1918, public domain), altered by Marisa Sanderson, and moodswingerscale.svg (public domain)