The Grand Strategy Is . . . Trench Warfare
The strategic vision of ‘flattening the curve’ has led most of the world’s governments to destroy their economies, take away their people’s employment, and immiserate society with the ‘suspension’ of those rights once proclaimed to be inherent in humanity itself and therefore inalienable. And what is the essence of this strategy? To hold the line while we wait for . . . what? The answer to that has changed regularly over the past five months: the resources to track the infected; testing capacity to identify every carrier of the disease; enough ICU beds; the changeover of manufacturing capacity to produce enough ventilators; and on and on.
The most usual expression of the purpose in holding the line is that we prevent the ‘healthcare system’ from being overwhelmed. But what does that mean, either in theory or in practice? In theory the healthcare system is the abstraction for classifying all of those resources, all of the goods and services available for fighting disease and ill health. If the demand for those resources outstrips their supply we suppose that the healthcare system is then overwhelmed. We further presume that any such gross imbalance of supply and demand is of itself an unmitigated disaster in the real world and not just insolvency in the abstract balance sheet of healthcare supply and demand. In other words, we presume that this imbalance is not just a catastrophe within the narrative. But in fact there would be no real world catastrophe were it not occasioned by ‘expert’ responses as the accepted narrative unfolds and by the ‘best practices’ of playing an assigned part in that narrative, rather than adapting in response to observable data which is clearly outside the a priori narrative.
In the 160 years since Darwin real science has come to understand — or should have — that biological change is driven by speciation in adapting to changes of state and circumstance. The converse (in fact the polar opposite) of speciation is classification. The inductive process of generalizing data from the past into abstract categories is, at best, a distraction from the fundamental mechanism of survival, which is the derivative process of adapting the internal functions of an organism to changing external circumstances.
The CoViD-19 disease is an observed set of symptomatic manifestations of MRGPRX2-mediated mast cell responses. How any particular manifestation exhibits; what particular MRGPRX2-mediated kinetics are triggered; which specific mast cell properties are activated in what manner by which exciters or inhibited by which blockers are all variant in different cell sites; in different human hosts; and in different conditions of excitation or inhibition.
Yet despite variance in the progression and the manifestation of symptoms, we have formulated an etiology which exactly describes those identifying characteristics by which we define this disease. Those characteristics are kinetic and transactional: we observe the state of particular data transformed by the instance execution of a particular function, yielding new observable matter as its product, which is in turn transformed by further downstream processes to yield still further observable outcomes. That is, in fact, exactly what a valid etiology is and does — and it is also the very diagnostic process which our ‘healthcare system’ has become systemically incapable of.
It is not necessary to have medical expertise in order to understand that this definition of the CoViD-19 disease is correct, or at least can be validated as correctly stated and appropriately described. The logic of the proposed etiology itself — its validatable transactional nature in proceeding from measurable material in an observable state through the provable instance execution of a particular transformative function, yielding downstream of the execution of that function new measurable material in a newly observable state — ties the abstract etiology in a particular and intimate way to the instance data which validates it, or not, on each occasion.
That procedure might sound exactly like what we are taught is the process of formulating and testing a scientific hypotheses. Well, yes, except that in ‘healthcare’ and and the social ‘sciences’ the hypotheses have become 1) entirely the product of statistical inference rather than the etiological description of a series of observable transformative processes; and 2) formulated from ontologies which abstract and classify both materials and the functions which transform them, based on goodness-of-fit to some previously-inferred pattern. This has progressed so far as to have become the sole functional basis of ‘artificial intelligence’ and ‘deep learning’ in ‘data science’.
What we are seeing in this pandemic is not simply a loss of confidence in the experts, or even just the failure of putative experts to achieve a correctness and success which would justify the general public’s reliance on their abilities. This failure is actually the outcome of at least three generations spent mis-defining expertise; debasing proper etiological diagnostic procedure; hopelessly muddling etiology with ontology; and ultimately imagining that a scientific hypothesis is proved, or disproved, by A/B testing. The media is filled with opinion pieces crowing that the coronavirus has exposed the limits of Donald Trump’s snake-oil salesmanship and smugly proclaiming that spin won’t alter the path of a disease. That is true, of course, but it is more devastating for being true of the healthcare establishment than for being what everyone always knew about salesmen.
This is not a new argument: Socrates challenged Gorgias on just this issue in the 5th century BC. Socrates argued that the best saddle was made by the craftsman with the greatest skill and the deepest experience of the step-by-step process for transforming raw material into a saddle. Gorgias argued that the best saddle was the saddle with the most persuasive narrative: that is, the one you could most readily sell and profit from. Double-blind randomized trials are nothing other than the A/B testing of AdTech: change the formulation and see statistically how the target group responds, as compared to the control group.
But of course none of this is any use in novel circumstances. A ‘good’ response matches a pattern which has been seen before and which in those prior circumstances was judged a successful outcome. For Gorgias the best saddle is the saddle which best matches the customer’s previously formed image of the saddle he wants, the saddle he is most pleased to imagine himself with. There are two ways to get there: you can shape the customer’s desires with advertising (demand-side design) or you can test those desires and then build your product to what statistically appeals to the most potential customers (supply-side design). But design of either sort depends upon a fixed goal — that is, a pre-existing product or a previously measured product desire— to design toward.
Because the CoViD-19 coronavirus is novel, there is no demonstrated reason to imagine that there is a feasible vaccine. We have had a two and a quarter century run of success with vaccination, but that most emphatically does not guarantee that the novelty this time is not precisely the novelty that makes those centuries of success obsolete and irrelevant. After 160 years we have still not entirely internalized Darwin’s great insight (and to be fair, Darwin had to pull himself repeatedly out of slipping into Intelligent Design thinking). Speciation is the converse of classification, and the only proof of fitness is simply survival itself, however inelegant the process might appear, or however unappealing as a narrative.
To defeat the disease we need to understand the particular speciation which is novel with this virus. We then need to map the etiology by which every observable symptom proceeds from that novel starting point (with particularly urgent attention to the most fatal symptoms, of course). Only then will we understand precisely where in the process, and by what mechanisms, we can interrupt or disrupt the progression of disease. For two millennia, at least, that was understood as the fundamental process of medicine. The alternative is to turn away from the instance (and presumably previously unobserved) data which is before us and instead look to classify that data by its goodness-of-fit to abstractions of the past.
Whatever the origins of this virus, the crisis is man-made. Shutting down the economy and surrendering to fear in suspending the rights which keep us actually civilized and not merely herdable is truly ‘destroying the village in order to save it’. Nobody wanted the First World War. Nevertheless through the summer of 1914 the Old World Empires scrupulously followed their treaty obligations and the best practices of Great Power Diplomacy as understood since the Congress of Vienna a century earlier. The mobilization of each empire’s armies triggered treaty provisions forcing other empires to mobilize until war was not only inevitable but actually underway in contact battles. On the Western Front the two sides held to their grand strategies: the Germans to break through into France and the French and British to hold the line. The encounter of that irresistible force and that immovable object led to the Race to the Sea, as each side continued in its grand strategy until they ran out of ground and settled into trenches.
In the 40 years before the First World War the greatest percentage of human beings had been lifted out of poverty, compared to any period of human history until these most recent 40 years. Once the trenches were dug the economies which had made that prosperity possible were re-purposed to destroy all of that progress and two generations of gains. Today the grand strategic plan is to flatten the curve so that the healthcare system is not overwhelmed. The implicit assumption is that most people will get the disease. The strategic vision is to spread out that wave of infection into a long tail so that the healthcare system is at capacity, but not beyond, and does not collapse into insolvency.
Meanwhile, that healthcare system does not provide any known response to the progress of this disease; it merely provides a costly place to convalesce in isolation and with the hope of surviving the disease. Increasingly desperate measures, culminating in intubation, are available in healthcare facilities, to provide the illusion of doing something against the disease. The economy, re-purposed to Defense Production, is ordered to turn out ventilators so that with a greater supply the healthcare system can accommodate a greater demand for desperate measures and hopeless interventions. Testing kits are produced by the millions so that it can be determined that at a given moment in time a person had a measurable load of the virus. This does nothing for the symptoms which that person might exhibit — and may soon die of — whether or not there is official confirmation of the presence of the virus.
And those not part of this healthcare system sit at home, deprived of both their livelihoods and their allegedly inalienable rights. Their governments claim that they are protecting them — but how, and from what? Ordinary citizens cannot avoid the responsibility for protecting themselves from infection and for keeping their own germs away from others — if that is in fact what, after a reasonable consideration of the options, they want to make their goal. But even then most governments will not allow them to pursue that goal as seems best to them each as individuals. Open your shop, set your own rules for social distancing, and let a free market decide whether your way of doing it appeals to enough customers to sustain a business? Nope.
At what point are we fed up with the experts who re-purpose our economies to pour blood and treasure into the trenches? They think that we are stupid and will do as we are told indefinitely. Are we, or is it time to realize that we are each responsible for our own salvation? That is not what we will achieve by delegating our governance to those who expect us to believe that they are saving the village by destroying it.
