Monday, March 23, 2020

On the Psychology of Toilet Paper (SARS-CoV-2/COVID19): the Case for Disjunctive Reasoning

In the wake of the spread of Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) which, if it travels though our species, may cause Coronavirus disease 2019 (COVID-19), a new [global trend] has been spotted: people, en masse, are buying toilet paper. For example, in England, three people have been arrested after dozens of stolen toilet rolls were discovered in a van. In Helsingfors, the capital of Finland, people are leaving supermarket shelves empty as they stockpile hand sanitizer, soap, and toilet paper. Why? And how do we resolve it? According to the principles of disjunctive reasoning, it’s about applying what you know about logic, probabilities, and scientific method, as well as taking many sources into consideration. 8 sidor.

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In the wake of the spread of Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) which, if it travels through our species, may cause Coronavirus disease 2019 (COVID-19), a new [global trend] has been spotted: people, en masse, are buying toilet paper.

For example, in England, three people have been arrested after dozens of stolen toilet rolls were discovered in a van.

In Helsingfors, the capital of Finland, people are leaving supermarket shelves empty as they stockpile hand sanitizer, soap, and toilet paper.

Why?

The human lineage goes back more than six million years and for most of that time, our ancestors lived, first in the trees and then, as hunters and gatherers. To 'dodge bullets' (avoid risky situations), life was guided by emotional reactions (spiced with some cognition); emotions evolved to pay more attention to negative rather than positive information; when a lion attacked, there wasn't much time to explore options. Fight-flight behavior kicked in. We are still born with these PRIMEs which are expressed through various biases, for example, negativity bias (Baumeister et al, 2001).

One great example is climate change. Most people have no idea what the climate is about. The same goes for change. Add them together and you have a very hard-to-understand concept. This lack of common knowledge has consequences. Certain stakeholders take the chance to influence people to act swiftly in a certain direction, for example, by claiming that if we don’t rapidly decrease the amount of one of the trace-gasses in the atmosphere, the world will perish.

The World Resource Institute went further. They claimed food preferences are associated with what they refer to as the 'Carbon footprint' (Playbook for Guiding Diners Toward Plant-Rich Dishes in Food Service). Following these kinds of messages may be explained by negativity bias.

In reality, food preferences have little to do with 'carbon footprint' or with climate for that matter (White and Hall, 2017).

And the climate does not equal the 'carbon footprint'. Instead, it's a multi-factorial concept that varies over [a long period of] time. ~540 million years ago, during something called the Cambrian explosion, when visible life emerged, the amount of Carbon dioxide in the atmosphere was 15 times higher compared to current levels.

The former chair of the 'Jasons', Dr. William “Will” Happer, professor of physics at Princeton University, suggests that we are jumping to conclusions. (Happer's detailed response to Karoly on climate change).

Dr. Happer refers to Svante Arrhenius’ (1859-1927) discovery that CO2 should be measured using a logarithmic scale.
“Arrhenius did not know all of the basic physics associated with thermal radiation, since most of his work predated Planck’s discovery of quantum mechanics. But at least he sensed that his estimates needed to be revised downward. And he correctly conjectured that the response to more CO2 would be logarithmic, with every doubling of CO2 giving the same increment of temperature”.

But besides CO2, the climate is explained by a number of factors, such as methane, nitrous oxide, and solar activities - the Solar minimum (11-year cycle) and the Grand solar minimum (Experts cool on prediction of a new 'mini Ice Age' for next 30 years).

The most famous Grand Solar minimum is the Maunder Minimum (1645-1715), which saw the Thames freeze. 2020 is the year when Solar minimum and Grand Solar minimum coincide again.

The above is a demonstration of what happens when disjunctive reasoning is applied. It basically means taking as many options (or factors) as possible into consideration (Stanovich, 2009) and to choose reasoning over argumentation (Mercier and Sperber, 2011; Pinker, 2011):

“The most important psychological contributor to the decline of violence over the long term may instead be reason: the cognitive faculties, honed by the exchange of ideas through language, that allow us to understand the world and negotiate social arrangements”.
One explanation for the lack of disjunctive reasoning is the lack of knowledge about probability, scientific method, and Bayesian Rationality - the ability to reason about uncertainty (Oaksford and Chater, 2009).

Disjunctive reasoning is not about intelligence per se, but rather, thinking rationally (Stanovich et al, 2008):
“to think rationally means adopting appropriate goals, taking the appropriate action given one's goals and beliefs, and holding beliefs that are commensurate with available evidence”.
This thinking style suggests that intelligent people can fall victim to irrational thinking - dysrationalia, meaning as the inability to think and behave rationally despite adequate intelligence (Stanovich, 1993).

In December of 2019, the world encountered a new challenge -Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which may cause Coronavirus disease 2019 (COVID-19).
“The disease was first identified in 2019 in Wuhan, the capital of Hubei province in central China, and has since spread globally, resulting in the 2019–20 coronavirus pandemic” (Wikipedia).
Like climate, few people have in-depth knowledge about viruses and SARS-CoV-2 and COVID19 in particular. So how does one go about to optimize the decision-making process in a situation like this?

According to the principles of disjunctive reasoning, it’s about applying what you know about logic, probabilities, and scientific method, as well as taking many sources into consideration. Here are some examples:

On March 2,  Low Serum Cholesterol Level Among Patients with COVID-19 Infection in Wenzhou, China Lancet (preprint).
“Background: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel coronavirus COVID-19. Meanwhile, as the infection progressed, a large number of cases were also diagnosed in Wenzhou, China. The objective of the study is to describe the clinical laboratory features, especially lipid profile of the patients with COVID-19 infection in Wenzhou.Methods: All cases were in a designated hospital in Wenzhou, and confirmed by positive virial nucleic acid detection through PCR assay. All clinical laboratory data were from the first test results after their admission. The unpaired t test was used for data analysis.

Findings: The absolute value of white blood cells, neutrophils and lymphocytes were lower than healthy controls ( P <0.05), more significantly, the patients had sharply decreased total cholesterol (TC), HDL-cholesterol and LDL-cholesterol levels ( P <0.001), 3.70±0.09mmol/L, 1.18±0.03 mmol/L and 1.82±0.08 mmol/L respectively, and increased monocyte/HDL-cholesterol ratio (0.37±0.02 vs 0.28±0.01 in healthy control). Among the patients, the primary infection cases showed the lower HDL-cholesterol levels (1.10±0.04 mmol/L) and higher monocyte/HDL-cholesterol ratio

(0.43±0.03) than the secondary infection cases by person-to-person transmission ( P <0.05). Compared with the female patients, the male patients had higher levels of monocytes [(0.46±0.02) ×10 9 /L], M/HDL-C ratio (0.44±0.02), and lactate dehydrogenase (LDH, 257.6±12.32 U/l).

Interpretation: Low serum cholesterol level in the patients with COVID-19 in Wenzhou, China. Altered serum cholesterol provide important information, and is meaningful to understand the disease. Funding Statement: This work is funded by Natural Science Foundation of Zhejiang Province (LQ18H020005).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was authorized by the Ethics Commission of Wenzhou Central Hospital. Keywords: coronavirus, COVID-19, lipid, cholesterol”
On March 3, How are people being infected with COVID-19? Livescience
“The new coronavirus spreads mostly through person-to-person contact within about a 6-foot (1.8 meters) radius, according to the Centers for Disease Control and Prevention (CDC). People with COVID-19, which is the disease caused by the coronavirus, spread viral particles through coughing and sneezing. The particles can land in the mouths or noses of those nearby.

It might also be possible to catch SARS-CoV-2 by touching a surface where the virus has recently landed and then touching one's mouth, nose or eyes, but CDC officials believe this method of transmission is less common. Some coronaviruses can live on surfaces for days, but not much is known about the new coronavirus' ability to survive on surfaces. Fortunately, ethanol, hydrogen-peroxide or bleach-based cleaners are effective at killing those coronaviruses that do survive on surfaces” (Pappas, 2020).
On March 11, Amesh Adalja, MD, an infectious disease specialist at the Johns Hopkins University Center for Health Security, gave similar testimony about COVID19 on neuroscientist Dr. Sam Harris podcast (#191 - EARLY THOUGHTS ON A PANDEMIC).

On March 16. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science:
“Estimation of the prevalence and contagiousness of undocumented novel coronavirus (SARS-CoV2) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV2, including the fraction of undocumented infections and their contagiousness. We estimate 86% of all infections were undocumented (95% CI: [82%–90%]) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections ([46%–62%]), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging”.
On March 17, Amesh Adalja visited Rubin Report (16 minutes): DOCTOR: What You Need To Know About Coronavirus Now | Dr. Amesh Adalja | CORONAVIRUS | In both appearances, Dr. Adalja emphasized the importance of keeping a 2-meter distance between each other.

On March 18, Correcting under-reported COVID-19 case numbers, BMJ (preprint):
The COVID-19 virus has spread worldwide in a matter of a few months. Healthcare systems struggle to monitor and report current cases. Limited capabilities in testing result in difficult to guide policies and mitigate lack of preparation. Since severe cases, which more likely lead to fatal outcomes, are detected at a higher percentage than mild cases, the reported death rates are likely inflated in most countries. Such under-estimation can be attributed to the under-sampling of infection cases and results in systematic death rate estimation biases. The method proposed here utilizes a benchmark country (South Korea) and its reported death rates in combination with population demographics to correct the reported COVID-19 case numbers. By applying a correction, we predict that the number of cases is highly under-reported in most countries. In the case of China, it is estimated that more than 700.000 cases of COVID-19 actually occurred instead of the confirmed 80,932 cases as of 3/13/2020 ( Lachmann).
On March 19, professor Christakis at Yale, visited the Rubin Report: What You Need To Know To Not Get Infected | Dr. Nicholas Christakis | CORONAVIRUS
The virus takes advantage of the fact that we are social animals, that we assemble in groups, that we have friends, that we touch each other and hug each other, and it uses those connections - that we assemble ourselves into those networks  - as a highway to travel through our species. Our challenge is to interupt that ...
On March 19, What’s the Evidence on Face Masks? What You Heard Was Probably Wrong. Medium:
“Can face masks offer protection against SARS?
According to research on the SARS epidemic, face masks were the most consistently effective intervention for reducing the contraction and spread of SARS. In a Cochrane Review on the subject, 6 out of 7 studies showed that face masks (surgical and N95) offered significant protection against SARS. Hand washing was also very effective, supported by 4 out of 7 studies in a multivariate analysis” (Adrien Burch).
On March 22, cardiologist Aseem Mahotra reported his findings from Italian victims. It wasn't only about age, but also about metabolic diseases (Corona Virus and The Elephant in the Room Sky News). Stay away from processed and ultra-processed alternatives. Eat real food.

On March 22, Coronavirus: ‘strange pneumonia’ seen in Lombardy in November, leading Italian doctor says. Liu Zhen, South China Morning Post.

On March 23, Johns Hopkins webpage that summaries global stats about the spread of the virus had 339 259 confirmed cases globally (81000 in China) (at 5 pm.)

On March 27, DW News reported that Germany is testing 500 000 people per week, and attributing that to the low death rate (see Johns Hopkins webpage).

On March 30, Perspectives on the Pandemic | Dr. John Ioannidis. Interview. Youtube (62 minutes). There are two (2) cuts from the interview: How COVID-19 Overwhelmed Italy (06:17 minutes), The Truth about COVID-19’s Death Rate (2:35 minutes).

On March 31, Lustig, R. (2020). Real Food is your best defense against dying from coronavirus, blog Robert Lustig.com.

The conclusion so far seems to be that the virus thrives when we gather together. If we stay apart, it cannot 'travel through our species'. Face masks seem to have some protection. Also, we don't know everything about how many people are infected. If the figures from Johns Hopkins are true, the risk of dying is much higher than by traditional flu. If the stats reported by Lachmann are accurate, the risk seems to diminish. Adding to that, lifestyle seems to matter (alter the explanation). People who eat a lot of processed and ultra-processed alternatives to real food seem to fare worse than people who eat real food. Focus on the consumption of micronutrients, e.g. 13 vitamins (e.g. A, several B:s, C, some D, E, K2-Mk4 and Mk7), 15-16 minerals (Heme-Iron, Magnesium, Zinc and so forth), Choline, and Docosahexaenoic, Arachidonic fatty acids.

There are, so far, three (3) viable strategies to meet the challenge of SARS-CoV-2 that may lead to Coronavirus disease 2019 (COVID-19):
  1. Social distancing
  2. Testing
  3. Eating nutrient-dense [real] food.Check this post about the prospect for sustainable food: "Perception versus facts”: What is the future for sustainable food? The case of the prospective mind
The post was originally posted on the University of Helsingfors blog for my research project (2018-2021).

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