Chances are...about 99 out of 100: Pandemic Primer, Part 3 - Prognostications

I'll bet: that you've already engaged  in making a prognosis at least once today by the time you've read this. Whether you decided to wear certain apparel, based on the meteorological prognosticator you overheard on the television last night or the sage of our age, Alexa, informing you this morning as you awoke. You may have even 'hedged your bets' (an important concept in making prognostic statements), guarding against a bad outcome by, "just in case, take an umbrella". 

Overheard, not underappreciated: This very morning, by the time I wrote this, in hopes of you reading it, while working out and listening even casually to the morning world news, I heard the following statements containing prognostic implications: "Biden warns that states with low vaccination rates may see COVID cases rise again...We believe based on our analysis and previous foreign policy experience in the Middle East that 'quiet intense diplomacy' will provide the best outcome...what are the chances that your citizens will listen to you in your attempts to persuade them to...?" Yep, all in a morning's work (out). These, as examples among hundreds, if not thousands, you hear every day. Examples in daily life of predictions, many of which are of little importance, of little impact, relatively benign, ranging to those suddenly life changing statements we may overhear from an 'expert' on the news or our personal physician in our annual physical (or this time of year, could include our tax preparer): "do you want the good news or the bad news first?". 

Guaranteed: that we all prognosticate, all the time, based on our own probability tables (OK, probably not as sophisticated as the actuaries for insurance companies or even casinos use in betting 'against' us), which are in turn based on vast experiential data (depending on your age) and hopefully when it comes to health or wealth decisions, empirically generated data (e.g., approximating that which an actuary, medical specialist has on hand). Essentially it comes to statements like, "Based on condition X, what are the chances of outcome Y or Z?" Many iterations, derivations on this basic prognostic question. Early in the pandemic we heard such statements as "wear a mask and keep your distance and you will minimize your chances of getting the virus..."; and then "...based on a positive test the chances are ____that..."; and then "...we're not entirely sure of the long term outcomes of various patients who have had this virus; some appear completely recovered whereas others...our vaccine is 95% effective in at least preventing serious illness with minimal side effects...Oh yeah, well ours is 96% with..." (best bang for your buck?); and finally, "...we're learning a lot from this pandemic that will enhance outcomes in the future..."

Prognosis, Personalized: In addition to the prognoses that are made formally on our behalf, we all have predictions and aspirations that we hope would occur, conditions that would allow for various outcomes: " ...if I won the lottery my life would be...If I could only go to a different school everything would be...when this pandemic's finally over, the first thing I'm gonna do is..." I mention these to simply raise your awareness of the almost continuous prognostic process, which is based on our previous experiences, current observations, and futuristic expectations, hopes, and aspirations. These predated the pandemic -- in fact, for 19th century physicians, the main aim of practicing medicine was to give a medical diagnosis and achieve a favorable prognosis of the patient's chances. Only several decades later did the focus of Western medicine shift to curing disease.

More or less, give or take, close to home: The ability to state various 'levels' of prognosis with decreasing degrees of equivocation has, of course, also evolved over the past century or so. When applied to large statistical populations, prognostic estimates can be quite accurate: "45% of patients with severe septic shock will die within 28 days...____ % of patients with COVID-19 will fully recover within _____ days..." We now have a range of adjectives descriptors that practitioners in various settings utilize, ranging from "excellent, favorable, good, to fair, poor, critical, grave, and even deferred" (the latter dependent on more findings in order to make a stronger statement or judgement). There are different schools of thought as to when and how to deliver various levels of prognosis, which essentially becomes part of one's 'bedside manner'. But how would you feel if, in a discussion with either a health or wealth pro, they said, "I think you're going to be OK but just in case, you might want to take an umbrella...?"

Next up (after another interlude): Part 3 - mistranslation, obfuscation, politicization...