Working with third-year medical students involves much struggling with SQL, R, and data, but also chatting about the topics of the day. This year it is coronavirus, of course. Of the nine M3s that I work with most commonly, at least one believes that he has already had COVID-19 and recovered. Absent significant testing capability for infection or antibodies, however, these bright young people are as much in the dark as anyone else.
Leaving aside the true alarmists, estimates of likely U.S. deaths from COVID-19 seem to range from 50,000 to 500,000 in a “life goes on” scenario. The prospect of this many deaths has motivated us to shut down society and mobilize for what people say is a “war” (let’s hope it isn’t like any of the wars that the U.S. has fought and lost since 1960, e.g., Vietnam War, War on Cancer, War on Poverty, Iraq War, Afghanistan War, etc.).
This is as it should be, right? Let’s take a mid-range estimate. The prospect of 275,000 people dying is terrible and should motivate us to bold action. Yet roughly 36,500 Americans die every year in motor vehicle-related accidents (NHTSA data from 2018, the latest available).
This led to a discussion regarding human psychology. We are pretty confident that there will be more than 275,000 car-related deaths over the next 8 years in the U.S. Maybe this should motivate us to bold action, but it actually does motivate us to do almost nothing.
In the 24th year of the smartphone, we don’t bother with a car-to-smartphone communication system, for example, that would reduce pedestrian fatalities (since the car would know where all of the pedestrians were; I wrote about this in 2016; ordinary Bluetooth range seems to be roughly 100 meters outdoors). Considering the nation as a whole, we don’t invest much in separated (e.g., with a curb) bike lanes like they do in Denmark and Holland. We don’t cut the speed limit on the Interstate back to 55 or lower. We don’t say that cars have to have electronic governors so that it simply is impossible to speed (“I’m sorry, Dave, I feel you pressing the accelerator, but I can’t go faster than 35 mph on this stretch of road”). We don’t re-engineer the road network to eliminate traffic lights in favor of (a) traffic circles, and (b) overpasses. We don’t put in a car-to-traffic light communication system so that the car knows when the light is red and will hit the brakes before we inadvertently drive through an intersection (imagine a traffic light that broadcasts in Bluetooth “I am the light at Massachusetts Avenue and Vassar St. and am currently green for Vassar St.”). We don’t ask America’s nerds to stop working on clever Internet ad technology and try to come up with innovative ideas for reducing the carnage on our roads. We’re willing to invest $trillions to reduce the death toll from coronaplague, but hardly a dime to build centerline dividers on more of our two-lane roads so as to eliminate head-on collisions.
As with most discussions about psychology, we came to no conclusion!
Readers: What is the answer? Why do we accept that hundreds of thousands of Americans will die in the next 10-20 years because of our failure to invest in engineering and infrastructure today, but we can’t accept that up to hundreds of thousands of Americans will die in the next year because we didn’t do a sufficiently thorough shutdown?
- Sweden’s Vision Zero, kicked off in 1997, which worked to reduce fatalities until it stopped working in 2013.
18 thoughts on “Why do we care about COVID-19 deaths more than driving-related deaths?”
Matthew Yglesias on Twitter:
Because Covid-19 is *new*. Deaths from the pandemic will be in addition to car fatalities. If deaths from accidents suddenly spiked by 100% to 1000% after the introduction of some new variable (a new kind of vehicle or cultural practice), we’d address it with the same urgency. And it’s not like we don’t address it now–my hometown is adding traffic circles and overpasses and concrete barriers between opposing lanes of traffic–but these things are expensive and take time. But Covid-19 is also *urgent*. That mid-range estimate is if we do everything we can to mitigate the disaster. If we throw up our hands and do nothing, the deaths in this country will be in the tens of millions.
Avoiding car accidents with a bit of technology and some overpasses is “expensive”? How could the cost be significant compare with shutting down the U.S.? There are only 300,000 traffic lights in the U.S. The $2 trillion stimulus recently passed would give us $6.6 million per light to put in a Bluetooth transmitter.
$6.6 million per light for Bluetooth is right at the lower end of what Lockheed Martin could do it for. Stockholders have to eat, too!
Ever notice how drivers of non European descent just aren’t that good? Oh right you’ve been taught to be afraid of noticing such things. Give it a try. I have a buddy, when in traffic plays guess the ethnicity of the idiot driver ahead, he gets 90% correct. Technology can’t cover for low speed humans.
That is often true of drivers of non northern European birth as well. We actually received real driving education.
The fat (white american) lady, who never thinks twice about parking her shopping cart next to another parked shopping cart, and blocks the whole isle, and will also make a traffic jam in the parking lot, because she’s waiting a minute for the spot close to the door, is someone I don’t cherish sharing the road with.
Apart from the question if should accept the fact that part of population will die and continue living or seat in our homes like cowards for two years letting the country burn, your assessment doesn’t seem to be correct. In Seattle area a lot of traffic circles and bicycle lanes were added in the last ten years, and this process continues.
SK: I said “almost nothing”, not “absolutely nothing”! I’ve was in Seattle last year and rented a bike from the bike share system. I didn’t have a separated-from-the-road-by-a-curb lane like I would have had in Denmark 10 or 20 years ago. My Uber drivers were not alerted by their vehicles to red lights. They were free to speed. I saw advertisements from local politicians. The ads promised voters that they would save on rent (due to centralized economic planning and government-set prices), not that traffic deaths would be prevented via investment in infrastructure. See https://philip.greenspun.com/blog/2019/11/05/immigrant-who-drove-up-prices-for-housing-now-runs-for-office-on-a-rent-control-platform/
Compared to the “shut down society and the economy and spend $2 trillion without looking” response to COVID-19 (134 deaths in the state so far, says nytimes), has Washington State responded as aggressively to its roughly 550 driving-related deaths per year?
philg: > “The ads promised voters that they would save on rent… not that traffic deaths would be prevented…”
My lifelong experience has been that, when death occurs, it happens to other people and not me. Rent, on the other hand, has afflicted me regularly. So I don’t hold these two things in the same mental space. In order to put both on the same plane, perhaps the ads should talk about car insurance rates, which are partly determined by my address.
A friend is a VC who invested in auto-related startups, and spent time dealing with automakers. According to him, auto company executives regard software an alien magic to outsource to subcontractors, and do not invest in it themselves. This is why my Honda’s lane-departure-alert starts complaining when the lane-keeping-assist steers over the white lines. The two features were implemented by separate subcontractors, and don’t know how to talk to each other.
Expecting the auto companies to achieve the level of software integration described in your 2016 post on avoiding pedestrians via their smartphones is inconceivable with their current management. The one auto company that does “get” software is Tesla, and it is conceivable they could implement such a scheme. It’s also why Tesla is worth more than Ford or GM, despite their vastly smaller sales.
And now Americans are demanding that Donald Trump order Ford and GM to make ventilators on which our lives will depend! (If we are going to have car companies make medical equipment, can I ask for a ventilator made by Toyota?)
Software is only one concern with inexperienced medical equipment manufacturers. Bio-compatibility is a another huge concern. To quote the twitter thread: “…Basically it means you want materials that a) don’t fall apart, and b) don’t poison/kill when you use them in something that’s gonna interact with the gooey meat stuff. “
Because overreacting to the multiplicative and non-ergodic processes of novel virus propagation is a good long-term survival strategy for the entire species. It may be that pandemic panic is innate for this reason.
Traffic fatalities are well-behaved (ergodic) and don’t grow exponentially with traffic density or any other variable. Traffic fatalities will not kill 2% the world’s population in the next year. I am willing to guarantee this. But coronavirus….
Here is an illuminating exercise:
How good of an estimate today can you make of traffic-related deaths in the US in the next year? This estimate is quite uncertain given that miles driven will likely plummet and depend on the duration of various shutdowns. You can still probably guesstimate the total miles driven will be some fraction of the previous year and be within 0.25X to 4X. You won’t be wrong by 100X.
Now predict today the number of coronavirus deaths in the next year in the US. Your estimate could very easily be off by 100X or more.
I was gonna say the same thing without using the word “ergodic”.
I’m not sure what happened to Phillip Greenspun. I think too much fox news has melted his brain. Maybe he’s trying to get another law named after himself. “Any person spends too much time watching Fox news (or other tea party/modern conservative bullshit) will end up as an ad hoc, bug ridden, slow version of half of themselves.”
Hooded: why can’t we extrapolate from Lombardy to get a reasonable estimate? Out of 10 million people, COVID-19 has killed 5,000 to date. Assume that becomes 10,000 by the end of the year. That’s 1 in 1,000 people. Applying that to the U.S. we get 330,000. Horrific, of course, but about the same as the driving deaths expected for next 10 years (which didn’t seriously concern the nation). I don’t think this can be off by 100X. 33 million is too much. 3300 is, sadly, likely to be exceeded (1,301 as of right now). Maybe we can do 4X better than Italy due to advances in knowledge and drug therapies that are available. That brings us down to 82,500 deaths, not too different from what the Imperial College folks are predicting per capita for the UK. We’re not as competent as other countries when it comes to health care, so estimate 150,000 COVID-caused deaths through February 2021? Let’s come back to this post on March 1, 2021 and see if the mortality was, in fact, within 0.25X to 4X of 150,000.
No Thanks: I don’t watch any broadcast TV and get most of my news from the New York Times…
While I love this point, I do think it’ more reasonable to think about mitigation COVID-19 than driving deaths because as we get more driverless cars the fatalities will go down by itself!
And of course we should be thinking about reducing deaths due to flu! Hopefully some of the social measures that people learn to do because of COVID (take your flu shot, don’t go to work if you are sick, have a good hygiene, wear masks during the flu outbreaks) will help there as well!
The official mainstream “wars” on this or that have thus been “wars” on the unsuspecting public: to keep them misinformed and misguided. The ‘war on the coronavirus’ is no different.
Take the ‘war on cancer.’ If the public were to scrutinize what the medical industry and its government pawns are telling them about the ‘war on cancer’ instead of blindly believing what they’re saying, they’d find that the cancer industry and the cancer charities have been dismissing, ignoring, and obfuscating the true causes of cancer while mostly putting the blame for cancer on the individual, denying or dismissing the serious harms from orthodox cancer treatments and chemical toxicants, and resorting to deceptive cancer statistics to “educate” (think: mislead) the public that their way of treatment is actually successful (read this well referenced scholarly article’s afterword on the war on cancer: do a search engine query for “A Mammogram Letter The British Medical Journal Censored” by Rolf Hefti, a published author of the Orthomolecular Medicine News organization, and scroll down to the afterword that addresses the fraudulent ‘war on cancer’).
The “war” on anything is almost always one big fraud, whether it is actual military war, the war on drugs, the war on poverty, or the war on cancer, because huge corporate interests are the leading motive for these “wars” instead of their officially advocated missions.
The orthodox cancer establishment has been saying a cure for cancer “is just around the corner” and “we’re winning the war on cancer” for decades. It’s all hype and lies (read Dr. Guy Faguet’s ‘War on cancer,” Dr. Sam Epstein’s work, or Clifton Leaf’s book, or Siefried’s work on this bogus ‘war’).
Since the war on cancer began orthodox medicine hasn’t progressed in their basic highly profitable therapies: it still uses primarily and almost exclusively highly toxic, deadly things like radiation, chemo, surgery, and drugs that have killed millions of people instead of the disease.
As long as the official “war on cancer” is a HUGE BUSINESS based on expensive TREATMENTS (INTERVENTIONS) of a disease instead of its PREVENTION, logically, they will never find a cure for cancer. The upcoming moonshot-war on cancer inventions, too, will include industry-profitable gene therapies of cancer treatment that are right in line with the erroneous working model of mechanistic reductionism of allopathic medicine.
The lucrative game of the medical business is to endlessly “look for” a cure but not “find” a cure. Practically all resources in the phony ‘war on cancer’ are poured into treating cancer but almost none in the prevention of the disease. It’s proof positive that big money and a total lack of ethics rule the official medical establishment.
It’s just like with any bogus official “war” (‘war on drugs’, ‘war on terrorism’, etc) — it’s not about winning these wars but to primarily prolong them because behind any of these fraudulent “war” rackets of the criminal establishment is a Big Business, such as the massive cancer industry. The very profitable TREATMENT focus of conventional medicine, instead of a PREVENTION focus which these official medical quacks (or rather crooks) can hardly make any money off, is a major reason why today 1 of 2 men and 1 in 3 women can expect a cancer diagnosis at some point in their lifetimes” yet that rate was multiple times lower 5 decades ago when the phony ‘war on cancer’ began (1 in about 16). That fact alone proves we are NOT winning the war on cancer.
At the same time, this same orthodox cancer cartel has been suppressing and squashing a number of very effective and beneficial alternative cancer approaches. You probably guessed why: effective, safe, inexpensive cancer therapies are cutting into the astronomical profits of the medical mafia’s lucrative treatments. That longstanding decadent activity is part of the fraud of the war on cancer.
What the medical establishment “informs” the public about is about as truthful as what the political establishment keeps telling them. Not to forget, the corporate media (the mainstream fake news media) is a willing tool to spread these distortions, lies, and the scam of the war on cancer.
Does anyone really think it’s a coincidence that double Nobel laureate Linus Pauling called the ‘war on cancer’ a fraud? If anyone looks closer they’ll come to the same conclusion. But…politics and self-serving interests of the conventional medical cartel, and their allied corporate media, keep the real truth far away from the public at large. Or people’s own denial or indifference of the real truth.
Potentially because we only react when we can imagine catastrophe. Car accidents can’t spread and kill us all, but corona “could”.
Invisible is more scary.
The “novel” part mentioned above is also an input – i’d say that accounts for most.
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