COVID-19 and the Protagaros Paradox

One of my friends forwarded me this message. It’s a really interesting argument. Read through this post and share your views on how things could pan out globally in the face of the coronavirus pandemic. The text below is as received. I have no clue about the author, though I would love to acknowledge him/her if I knew.

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Paradox

Over 2000 years ago, in Greece, there was a lawyer named Protagoras. A young student, Euthalos, requested to apprentice under him, but was unable to pay the fees. The student struck a deal saying, “I will pay your fee the day I win my first case in the court”. Teacher agreed. When the training was complete and a few years had elapsed without the student paying up, the teacher decided to sue the student in the court of law.

The teacher thought to himself: ‘If I win the case, as per the law, the student will have to pay me, as the case is about non-payment of dues. And if lose the case, the student will still have to pay me, because he would have won his first case. Either way I will get paid’.

The student’s view was, ‘If I win the case, I won’t have to pay the teacher, as the case is about my non-payment of fees. And if I lose the case, I don’t have to pay him since I wouldn’t have won my first case yet. Either way I will not pay the teacher.’

This is known as Protagoras Paradox, which ever way you look both have equally convincing arguments, one can go either way in supporting the teacher or the student and would not be wrong.

Those of us in medical practice often come across such situations, either in making a diagnostic or therapeutic decision. One physician can recommend a course of treatment based on scientific evidence and another can recommend a diametrically opposite course again based on medical evidence. Right or wrong, but some merit would exist on both sides. Often the physician himself is having an internal struggle to make a decision about the most appropriate course of action, Protagoras & Euthalos are arguing in his mind, to do this or to do that. The horns of dilemma are tearing him apart.

But what prompted this essay was a tweet by Donald Trump, ‘hope the cure is not worse than the disease’. L & G, I hate to say, but I find some merit in this tweet. In our global attempt to flatten the COVID curve, I hope we do not flatten the global economy curve. The question is what’s the best way forward. One group recommends ‘total lockdown’ to break the transmission chain, based on evidence from China, they managed to control the spread of the virus by ruthless lock down and 3 months later they are showing that disease is controlled in Wuhan. On the other hand, the other school of thought is graded isolation & protection of elderly and very young and those with co-morbidities, let it spread amongst the young and healthy, after all the disease ultimately will be controlled when we achieve ‘herd immunity’. The medical community is divided in these two groups. To enforce complete lockdown or Graded isolation?

To complicate the issue the epidemiologists have joined the bandwagon with cacophony of statistical analysis. From Rosy to Dooms day predictions. If we don’t do a complete lockdown then a million people will die in 1 year. No say some more like 90 million will die in 1 year. Whose data analysis is correct. Some suggest do nothing, nature will take over in a few months and all will be well, they quote historical data to justify their recommendations. On whose inputs should we base our disaster management strategy.

Then come the economists with their doomsday predictions. If this continues till May our medical resources will be overwhelmed, Agriculture will suffer, food shortages will occur, production will come to a standstill. There will be an economic crisis of the proportions that world has not seen ever. So, break this lockdown nonsense and let’s get back to work as usual.

What will our political masters do? My guess is they will listen to medical experts, epidemiologists & economists. Then they will decide what course of action will ensure their survival, what will get them people’s votes and they will run with that. At present ‘Lockdown” finds favour with them. Boris in UK had to abandon the recommendations of the medical community about graded response, because the people’s perception became that our Government is not doing enough to protect us citizens. That means revolt against him. So, screw it, lets go with total lockdown if that’s what the people want. Gradually people will get tired of lockdown and demand- let life go on. Then with equally convincing arguments the governments will say the time has now come to lift the blockade, we have controlled the contagion, we have won.

Incidentally, the Protagoras Paradox has not be resolved till date. Students in Law school still hold mock trial and give arguments on both sides. With out any resolution of the dispute.

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Tapping into the power of new scicomm formats to control the spread of coronavirus

I must admit that I just stopped short of writing the title as “Using science communication to flatten the curve.” But then, I figured that a lot of people might not relate to jargon like “flattening the curve.” Let me explain.

As the world struggles to cope with the coronavirus pandemic, simple and appropriate science communication can be a very powerful in helping governments, local authorities, businesses, institutions, and the common public in controlling the spread and minimizing the damage caused by this pandemic. Check out this GIF below showcased on the SpinOff website. In one simple graph, the reader can get an overview of how flattening the curve is a very effective and important strategy to help the entire world manage the coronavirus pandemic. The graph has now been translated into several languages for wider dissemination across geographies.

Flatten the curve

In simple terms, the healthcare system in any country of the world has a certain capacity, and if the spread of the coronavirus is not controlled, it might lead to unmanageable stress on the healthcare infrastructure and result in much higher number of casualties. Patients affected by the virus need isolation and utmost care, with some acute cases even needing ventilators to survive. Now, imagine what happens if our hospitals get a sudden influx of patients 10X their handling capacity? Many lives are bound to be lost, and healthcare staff will have to take the difficult call of deciding who gets the ICU bed or the ventilator! Do we want to be in such a situation?

Now, Dr Siouxsie Wiles, Head of the Bioluminescent Superbugs Lab at the University of Auckland, has gone a step ahead to explain what experts are now exhorting – we must aim to stop the spread rather than just aim to flatten the curve. This new GIF by Toby Morris on stopping the spread presents a brilliant illustration of the importance and benefits of moving quickly to stop the spread of the coronavirus.

Stop the spread!

The full article by Dr Siouxsie Wiles on what can be done to stop the spread can be read here on the SpinOff website. Governments, businesses, and various authorities need to act quickly to stop the spread.

The impact of newer, easy to consume formats

Now, allow me to elaborate on the original point I wish to make about the importance of science communication, more so of new formats in science communication, in stemming the spread of this global pandemic.

We need to understand that the public at large will always relate to something that can be consumed and understood easily and quickly as compared to complex research papers suited for a scientific audience. Just think of what has more potential to go viral on WhatsApp, TikTok, or Facebook groups worldwide? It’s always something that’s not too technical and what most people can relate to quickly.

There are several rumors doing the rounds on social media, ranging from coronavirus being an act of biological welfare to China orchestrating the entire pandemic to regain control of high-value technology companies from American and European investors at throw-away prices (phew!). And what’s common with all such rumor mills? Easy-to-consume formats that even the common man can understand and add thus to the virality of the unauthenticated information.

An unprecedented crisis requires concerted global effort

Hence, if global authorities are looking to educate the public and encourage quick and effective action, verified scientific information needs to be disseminated in easily understandable formats such as infographics, GIFs, and videos. I’d like to refer to one of my earlier posts on how The coronavirus has sparked a mini revolution of sorts in the need for Science Communication. But this is probably not enough. We need more such powerful infographics, GIFs, and videos to ensure quick action and compliance to minimize the damage caused by this devastating virus. Such formats of science communication can be a very powerful tool in driving home the point very quickly and effectively and enable quick decision-making.

Now is the time when the scientific community should embrace newer formats of communication, especially for issues that relate to direct action by the common public. The coronavirus pandemic is a crisis of unprecedented proportions and needs a concerted global effort to limit the unimaginable damage it can cause. It’s time that we take drastic steps to not just flatten the curve but also stop the spread globally. Act now!

Three reliable sources to get all the information you need on the novel coronavirus

With the World Health Organization declaring the coronavirus outbreak a pandemic, the actual impact on economies, travel, businesses, education, and almost every sphere of life has begun to sink in globally. In such a situation, it is very important to seek reliable sources of information and avoid rumor mongering and sharing half-baked information.

Thankfully, there are a few sources that are doing a stellar job at this. In this post, I’d like to point out three important and trusted sources that might suffice the needs of most researchers, doctors, government authorities, and the general public.

The World Health Organization

Special section on the Coronavirus disease (COVID-19) outbreak

The World Health Organization is an obvious source for some of the most reliable and definitive information from across the globe. WHO now has a special section on the Coronavirus disease (COVID-19) outbreak. The page has a host of sources that provide information on the current situation worldwide, online training resources, videos, travel advice, and the latest updates from across the globe.

Interactive infographic by John Hopkins CSSE

Second, I’d like to point out to the Coronavirus COVID-19 Global Cases dashboard hosted by Johns Hopkins CSSE. At one glance, this dashboard gives a holistic picture of how the pandemic is spreading its wings globally. The mobile version of this dashboard is available here.

Global aggregator for research and news feed

Novel Coronavirus Outbreak Special Edition feed by Atypon.

Third, Atypon has done a brilliant job at aggregating information from across the globe on the coronavirus. Atypon has launched the Novel Coronavirus Outbreak Special Edition feed that aggregates information from over 30,000 authoritative sources across the Internet. The real-time feed includes latest peer-reviewed research, preprints, and the latest news on the novel coronavirus outbreak.

I’m hoping this should help a lot of authorities and people get verified information on the global coronavirus pandemic. In case you know of any other verified sources that can be useful for specific audiences, do share details through the comments section.

The coronavirus has sparked a mini revolution of sorts in the need for Science Communication

Science communication is ripe for a paradigm change, and newer content formats might have a role to play. This probably hasn’t been more evident than now given the situation around the novel coronavirus (COVID-19).

As I type this sentence, there are a total of 119,134 confirmed coronavirus cases* worldwide. Mainland China has detected 80,958 cases, half of whom have already recovered. South Korea (7,755), Italy (10,149), and Iran (8,042) are the new epicentres with the maximum number of cases outside China. And how, you may ask, do I know about these exact figures at a glance? This is courtesy of the Coronavirus COVID-19 Global Cases dashboard hosted by Johns Hopkins CSSE.

*Coronavirus COVID-19 Global Cases Dashboard

This amazing interactive infographic gives a bird’s eye view of the global situation around the coronavirus epidemic (the World Health Organization just stopped short of terming it a pandemic). There are several other such dashboards, but this one caught my eye immediately because of its non-technical nature and the fact that a layman can immediately start relating to the situation.

How does Coronavirus spread? (PDF)

The above PDF handout on coronavirus I’d found is a very good example of how research converted into plain and easy-to-understand formats can be very helpful to the common man on the ground.

Then, this simple graphic by Sara Chodosh posted on Popular Science shows how measles, smallpox, rubella, mumps, and SARS are much more contagious than coronavirus (COVID-19)! Now that’s the power of an infographic! (It should be noted that this doesn’t imply that measles is more fatal; it’s just that the world has dealt with diseases that are far more contagious, and the real challenge with the coronavirus is finding the right treatment and cure.)

Graphic by Sara Chodosh, Popular Science

Necessity of Reliable Data Flow

What needs to be noted here is that dashboards such as the one hosted by John Hopkins are possible only if reliable data flows in unhindered. Authorities across the world have been providing access to local data on the epidemic on a regular basis. In addition, the world’s top scholarly publishers such as Elsevier, Springer Nature, Wiley, Taylor & Francis, and SAGE Publishing have all announced immediate open access publishing of data and findings on the novel coronavirus (COVID-19). Nature has gone ahead and launched Outbreak Science Rapid PREreview—an open-source platform for rapid review of preprints related to emerging outbreaks—with support from the London-based charity Wellcome. All these efforts will go a long way in the effective treatment of patients and in helping the entire world emerge out of this crisis.

On a related note, several leading preprint servers such as bioRxiv, medRxiv, and ChemRxiv too have seen a surge in the number of preprint submissions related to the novel coronavirus. But given that preprints are not peer-reviewed, some of the material lacks scientific rigour, and some has already been exposed as flawed, or plain wrong, and has been withdrawn, writes Kate Kelland from Reuters as she discusses the risks of swiftly spreading coronavirus research.

However, Kristen Sadler, former research director at the Nanyang Technological University, Singapore, is of the opinion that if right quality controls are in place, preprints have the potential to speed up the dissemination of research.

Furthermore, several language editing companies have gone ahead to offer free editing services to all manuscripts related to the novel coronavirus.

The free availability of reliable research data has helped various authorities and doctors battling the situation to present the public with easy-to-understand handouts for dispelling notions and preventing the outbreak from further deteriorating.

The Real-life Impact of Science Communication

Hundreds of thousands of people have been able to make swift decisions around their travel plans and decision-makers at all levels have been able to respond with urgency AND clarity. Conferences have been cancelled at the last minute, and the entire conference circuit has taken a beating. Imagine the disaster if reliable data wasn’t presented in easily consumable formats, and these huge conferences had continued on schedule.

What can be the real-life impact if science communication available in the right format is actioned on in the appropriate manner? Check out this Op-ed on Why Vietnam has been the world’s number one country in dealing with coronavirus. Which is why I feel that science communication is ripe for a paradigm change, and newer content formats will have a role to play. More power to science communication!

Note: This post was first published on the Impact Science blog.