HIV and ID Observations

Pufferfish, from United States Exploring Expedition (1838-1842)

The future ain’t what it used to be, said one very wise man.

He might have also said, It’s difficult to make predictions, especially about the future, but alas we’ll have to credit that profundity to someone else.

Still, both these statements embody the insurmountable difficulty of making accurate predictions — a problem starkly evident during pandemic times. How many times have we watched people give conflicting views of when, or how, this thing is going to play out, even in the short term? 

Two recent examples come to mind. Dr. Mike Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, repeatedly warns of an additional surge this spring as more contagious variants take hold. This headline calls him “Dr Doom.”

On the flip side, Dr. Marty Makary from Johns Hopkins wrote in mid-February that we’ll likely be mostly done with COVID-19 in April — which, if I’m doing the math, starts 11 days from now. They can’t both be right.

Our ability to make accurate predictions is highly flawed, dependent on innumerable forces we can only begin to understand. 

We base these predictions on our background, our education, our knowledge base, plus an unconscious force that sends them in various directions — optimistic or pessimistic, confident or timid, contrary or mainstream.

The bold ones get the most attention, especially if backed by impressive credentials. If Larry Summers says we’re heading into ruinous economic territory with the stimulus package, who am I to question him? Or Janet Yellen, who predicts the exact opposite?

Enter Zeynep Tufekci — sociologist, computer programmer, and Associate Professor at University of North Carolina. You might expect an epidemiologist, or infectious diseases specialist, or virologist to have the best record in laying out the most likely way forward as COVID-19 continues its march around the globe, now 15 months in. But again and again I have found hers to be among the most logical voices, mostly in pieces published in The Atlantic and The New York Times.

And importantly, I’m far from the only one to hold this view.

Is it her diverse educational and vocational background? The fact that she’s a true “citizen of the world,” having lived in multiple places? That she works really, really hard to get things right? That’s she’s also wicked smart, to coin the Bostonian phrase to describe the smartest person in the room?

Probably all of the above. 

Zeynep kindly joined me recently on this Open Forum Infectious Diseases podcast to discuss how she ended up in her interesting current position, and her approach to COVID-19 — how we missed the mark for well over a month on the seriousness of the problem, our missteps on masks, the continued penchant for “beach scolding,” how we undersell the vaccines, and the general timidity of the biomedical community in questioning authority.

And yes, she finishes by speculating how this might end. 

Highly recommended.

Transcript here. Also available on Spotify, Apple Podcasts, etc.