Facts in Figures: Fiction Besotted Mind in a Factful world

 

Facts in Figures

Fiction-Besotted Mind in a Factful World

 

These days figures are everywhere. They flaunt themselves in dailies. They hog news headlines on TV. They dance on the world wide web, popping up all the time from the corners of your screen. They smudge WhatsApp messages freely. Your ward-boy in the hospital throws them at you, defiant in his new-gained knowledge. ‘Sir, we are much better in UP. We had only ten cases in Kanpur, yesterday. Delhi had more than two thousand five hundred.’

 

You are submerged in a deluge of data: day-in, day-out. Data’s outreach is astounding; total cases, twenty-four hours' surge, seven-day growth rate, doubling rate, mortality rate, tests done daily, sensitivity and specificity of various tests, the infectivity rate, the positivity rate. There are curves that run amok; the ascending and the descending curves, the plateauing and the flattening curves. And the changing recommendations for quarantine, for testing, for admissions, for discharge: one issued by Ministry of health, other by ICMR, some by WHO and more by the state government. I have only covered about ten percent of the essential data being divulged daily for the benefit of suffering mankind. Multiply this by fifty for major Indian cities and states, and the worst affected countries. You will then glimpse the volley of bullets being fired at the bewildered citizen.

 

The dance of data started in March. The story apparently began the previous winter, when a teeny-weeny collection of paltry nucleic acids in a flimsy bag of proteins—the SARS COV-2 virus—breathed its way into human body. Figures in our lives grew more exponentially than the virus, till they became ubiquitous.

 

We Indians are not known for our love of data. Rather, we are contemptuous of truth that is supported by data. We believe in an analogue world, where the boundary between truth and untruth is not marked by the unsavoury, inelegant figures. Veracity of a statement depends on the respectability of the person offering it and not on these dry-as-dust data propping it. Claim can be interpreted with equal ease at the two opposite ends of correctness. Analogue world is a world of colourful emotions where no truth is sacred. Everything is relative in this wonderful world. Our varied experience and expectations in life, influence the credibility of the expressed views. Digital world of facts is in contrast, despairingly staggered in discreet lumps of lifeless numbers. How can numbers decide the truthfulness of an opinion? They do not broach the lengthy life-sustaining yarn that begins with, ‘in my experience,’ and ends with, ‘I can feel the truth of it in my bones.’ It is these stories that generate faith. Facts cannot equal faith. 

 

Data do not offer a viewpoint on their own. They stand mute, like orphan words extracted from a dictionary. Words have to be placed in order, as per accepted rules of a language, to weave them into sentence and then a sense emerges. Similarly, data has to be analysed to arrive at an opinion. As same words can be arranged differently to imply different meaning, same data can also be employed to reach different conclusion. This was amply evident throughout the unfolding epidemic in last few months.

 

Incessant rain of data in these months and bureaucrats and politicians prattling figures in news briefings, prompted some people to foresee a bright role for science in public policy decisions, henceforth. A cynic that I am, I harbour uncomfortable doubts about this sanguine prophecy. A little analysis of the bureaucratese and the governmentese, thrown at public in these months, would disabuse one of belief in the sincerity of policy makers.

 

Daily new cases were few in the initial days. These numbers were projected as proof of government’s successful strategy, conveniently disregarding the universal knowledge that an epidemic always starts insidiously. When cases began to rise rapidly, measure of success changed to mortality rate. No one talked about the increase in number of infections now. This despite the fact that mortality was low across the globe. Age-specific mortality was given short shrift. This in India is allegedly higher even than Italy. Role of India’s humungous proportion of people below thirty years (56%, one of the largest in world)—in reducing overall mortality—was glossed over in every discussion. When the disease exploded in society, a new yardstick of success, recovery rate, was ferreted out. Recovery rate is inversely proportional to mortality rate. If later is low, recovery rate is bound to rise as days pass and more people are rid of infection. As newer, clever facts were unearthed from the mine of data and were used to trump-up a favourable opinion of the situation, many heaved a sigh of relief. This new-fangled love of data can never trounce the penchant of our species for a skilfully knit yarn. 

 

Scientific methods were thus exploited to defeat science. Science is pursuit of truth employing verifiable and repeatable tests that stand scrutiny, including the assertion being vouchsafed. Manipulating these methods to propagate a belief that one desires is chicanery.

 

Collection of data and its analysis is a rigorous process. Statistics, the science involved, is barely a couple of centuries old. It is anathema to our mind which has learned to arrive at truth through the experience impinging directly on our senses. This process of anecdotal learning through subjective observations, has evolved over two hundred thousand years. Our abhorrence of figures, our fear of statistics, have roots in the way our brain is wired. A pandemic cannot rid us of our nature that has evolved over hundreds of millennia. 

 

Brain evolved to confer survival and reproductive advantage to the body that housed them. For more than two hundred thousand years our ancestors lived in small groups. Every member knew the other intimately. Very little knowledge was required for gathering food and hunting. Most of this could be gained from one’s personal experience and that of other group members’, through word of mouth. Large settlements of people began only with the advent of agriculture, about seven to ten millennia back. This led to growth of large nation-states, governed by a monarch. For affective governance ruler had to know their subjects: their numbers, their professions, their incomes. This required collection of data. This was the beginning of statistics. But statistics grew rapidly only with advent of the theory of probability in sixteenth century. This occurred when man recognised the importance of chance in human affairs.

 

Probabilistic reasoning is counterintuitive. A brain that evolved to navigate the world through intuitive decisions, cannot adapt to the time-consuming, demanding ritual of information-based statistical methods. Even in situations involving chance, it reflexively falls back on its old circuits which have served it well for ages. But in novel unprecedented situations created by modern world, where uncertainty rules the roost, brain goofs up massively. These conditions are varied: a whimsical stock-market that creates billions of dollars in minutes and wipes them out in seconds; thousands of remedies for an illness offering only minor incremental advantages over others; the bizarre science of matter, Quantum Mechanics, most precise in all its predictions but which tells us that things are not what they appear and feel; evaluation of public policy decisions which affect lives and livelihoods of millions. 

 

But brain is a terrific decision-making machine. It is not stumped easily. It has learnt ingenious tricks to solve problems beyond its capacity. I will cite only two of the most used tricks: substitution of hard question by an easier one and the ease of recall.

 

We form impression about a stranger just by looking at their face, without even knowing their name. We like or dislike a new colleague at work merely by speaking with them for a few minutes. When faced with decisions on hard questions on which we do not have much information, brain automatically substitutes the hard question with an easier, related question on which more information is available. ‘Is this lady standing next to me in metro a good housewife?’ a difficult question, is answered by substituting it with ‘how pleasant are her looks?’ ‘Will this new colleague be a good partner at work?’ is replaced by ‘how confidence-inspiring is his voice?’ 

 

Most people believe that Corona is the foremost cause of death in our country today. This in a country where about ten million people die every year, i.e., about two lakh seventy thousand daily. Close to two thousand people die from diarrhoea every day, nearly twelve hundred from tuberculosis and five hundred in traffic accidents. Corona infection has killed about fifty thousand Indians in four and a half months or about three hundred seventy daily. Tuberculosis kills approximately seventy-five thousand in the same period. Mind judges the frequency of an event by the ease with which it can recall instances of the event. With headlines screaming CORONA in every media, mind deems this the biggest source of mortality. Tuberculosis, diarrhoea never make it to first-page or prime-time news. And cannot be recalled when figuring causes of mortality in country. Terrorist violence in Kashmir is a big news. Most people would think terrorism the biggest cause of accidental death in Kashmir. In 2019, 366 people were killed in violence while 447 died in accidents on highways.

 

I quote these figures not to convert the immitigable agony of a death into hollow, insentient statistics. Each and every death brings to naught, a lifetime of relationships, care, love, affection and millions of throbbing, alive moments. But it is important to know the extent of the menace of a disease to plan effective public health policy. Statistics helps us to overcome the limitations of our marvellous mind.

 

I have practiced medicine for more than three decades now. The most noticeable change in practice of medicine in these years is Evidence Based Medicine (EBM). Individual experience of a doctor is limited. It is insufficient to arrive at a decision regarding accuracy of a diagnostic test or efficacy of a treatment through this sparse exposure. Studies concerning health issues are done in a large number of subjects. They lend themselves to statistical analysis. These not only reveal startling differences from the old anecdotal ways, but often expose the frankly harmful practices of past. But many doctors continue to have scant regards for EBM. They are unwilling to let go of the charm of the old ways of medicine. They consider the lure of personal experience and opinion of venerated old professionals worth their weight in gold. Medicine based on their own experience feels like an art they have honed by tough labour. While, practice chiselled by the sharp edge of hard figures seems to reduce this art to a mechanical skill. EBM brings to each doctor, experience of thousands of others: analysed, supported by data and in the form of pithy recommendations. It is a gross negligence not to train our minds to follow these in favour of reassuring, although fictitious and often spurious, old practices, passed on to us as hearsay.

 

Methods of statistics have helped in improving the lot of mankind, be it in any field of public policy management. Tendency to be sceptic about truths these methods uncover, is woven in the fabric of our mind. One of the modern science’s spectacular success is understanding the mechanisms that engender these biased decisions. These mechanisms are an insuperable component of mind’s intricate problem-solving apparatus. Later have served our species unfailingly for ages. They slog ceaselessly, enabling us to steer successfully through the multifarious conundrums of daily living. It is now within reach of our mind to understand its minor failings too. Inherent disbelief and horror of statistics is one of these. Our mind errs, but fortunately it errs predictably. We cannot rid our mind of these biases, but we can teach ourselves to be wary of them. 

 

A world view based on facts is as beautiful as one woven by our mind, drunk on its love for stories. We must embrace it, to make a little more sense of the chaos surrounding us, as we cleave a path through the thick clouds of uncertainty that befog our future.