Willful Blindness

 Margaret Heffernan explains the term and the CDC provides a great example of it!

Heffernan lectures to MBA classes and runs a few businesses and such, so she's not someone I'd typically follow, but this is a great talk, and only 14 minutes, but the gist of it is in the slightly abridged transcript below:

In Libby, Montana, there's a rather unusual woman named Gayla Benefield [pictured above]. She always felt a little bit of an outsider, although she's been there almost all her life —a woman of Russian extraction. She told me that when she went to school, she was the only girl who ever chose to do mechanical drawing. Later in life, she got a job going house to house reading utility meters, gas meters, electricity meters. And she was doing the work in the middle of the day. And one thing particularly caught her notice, which was, in the middle of the day, she met a lot of men who were at home — middle-aged, late middle-aged — and a lot of them seemed to be on oxygen tanks. Struck her as strange. 

Then, a few years later, her father died at the age of 59, five days before he was due to receive his pension. "He'd been a miner," she thought, "he must just have been worn out by the work." But then, a few years later [in 1998], her mother died, and that seemed stranger still, because her mother came from a long line of people who just seemed to live forever. In fact, Gayla's uncle is still alive to this day and learning how to waltz. It didn't make sense that Gayla's mother should die so young. It was an anomaly and she kept puzzling over those anomalies and as she did, other ones came to mind. She remembered, for example, when her mother had broken a leg and went in the hospital and she had a lot of X-rays. Two of them were leg X-rays, which made sense, but six of them were chest X-rays, which didn't. She puzzled and puzzled over every piece of her life and her parent's life, trying to understand what she was seeing. She thought about her town. 

The town had a vermiculite mine in it. Vermiculite was used for soil conditioners, to make plants grow faster and better. Vermiculite was used to insulate lofts; huge amounts of it, put under the roof to keep houses warm during the long Montana winters. Vermiculite was in the playground, it was in the football ground, it was in the skating rink. What she didn't learn until she started working this problem, is vermiculite is a very toxic form of asbestos. When she figured out the puzzle, she started telling everyone she could. What it happened, what had been done to her parents, and to the people that she saw on oxygen tanks, at home, in the afternoons. But she was really amazed, she thought: "When everybody knows, they will want to do something." But actually, nobody wanted to know. 

In fact, she became so annoying as she kept insisting on telling the story to her neighbours, to her friends, to other people in the community, that eventually, a bunch of them got together and made a bumper sticker which they proudly displayed on their cars, which said: "Yes, I'm from Libby, Montana, and no, I don't have asbestosis." But Gayla didn't stop. She kept doing research. The advent of the Internet definitely helped her. She talked to anybody she could. She argued and argued and finally she struck lucky when a researcher came through town studying the history of mines in the area. And she told him her story, and at first, of course, like everyone, he didn't believe her, but he went back to Seattle and he did his own research, and he realised that she was right. So, now, she had an ally. 

Nevertheless, people still didn't want to know. They said things like: "Well, if it were really dangerous, someone would have told us." "If that's really why everyone was dying, the doctors would have told us." Some of the guys used to very heavy jobs, said: "I don't want to be a victim, I can't possibly be a victim, and anyway, every industry has its accidents." But still, Gayla went on, and finally succeeded in getting a federal agency to come to town and to screen the inhabitants of the town, 15,000 people. And what they discovered was that the town had a mortality rate 80 times higher than anywhere in the United States. That was in 2002, and even at that moment, no one raised their hand to say: "Gayla, look in the playground where your grandchildren are playing. It's lined with vermiculite." 

This wasn't ignorance. It was willful blindness. Willful blindness is a legal concept which means if there's information that you could know and you should know but you somehow manage not to know, the law deems that you are willfully blind, you have chosen not to know. There's a lot of willful blindness around these days. You can see willful blindness in banks, when thousands of people sold mortgages to people who couldn't afford them. You could see them in banks when interest rates were manipulated and everyone around knew what was going on, but everyone studiously ignored it. You can see willful blindness in the Catholic Church, where decades of child abuse went ignored. You could see willful blindness in the run-up to the Iraq war. Willful blindness exists on epic scales like those, and it also exists on very small scales, in people's families, in people's homes and communities, and particularly, in organizations and institutions. Companies that had been studied for willful blindness, can be asked questions like: "Are there issues at work that people are afraid to raise?" And when academics have done studies like these --of corporations in the United States-- what they find is 85% of people say yes. 85% of people know there's a problem, but they won't say anything. And when I duplicated the research in Europe, asking all the same questions, I found exactly the same number, 85%. That's a lot of silence. It's a lot of blindness. . . . 

What the research shows is that some people are blind out of fear, they're afraid of retaliation, and some people are blind because they think: "Well, seeing anything is just futile, nothing's ever going to change. If we make a protest, if we protest against the Iraq war, nothing changes, so why bother? Better not to see this stuff at all." And the recurrent theme that I encounter all the time is people say: "Well you know, the people who do see, they're whistleblowers, and we all know what happens to them." So there's this profound mythology around whistleblowers which says, first of all, they're all crazy. But what I've found going around the world and talking to whistleblowers is, actually, they're very loyal and quite often, very conservative people. They're hugely dedicated to the institutions that they work for and the reason that they speak up, the reason they insist on seeing, is because they care so much about the institution and want to keep it healthy. And the other thing that people often say about whistleblowers is: "Well, there's no point because you see what happens to them, they're crushed, they're destroyed. Nobody would want to go through something like that." And yet, when I talk to whistleblowers, the recurrent tone that I hear, is pride. . . . 

We all enjoy so many freedoms today, hard-won freedoms: the freedom to write and publish without fear of censorship, a freedom that wasn't here the last time I came to Hungary. A freedom to vote, which women in particular had to fight so hard for. The freedom for people of different ethnicities, and cultures, and sexual orientation, to live the way that they want. But freedom doesn't exist, if you don't use it. And what whistleblowers do, and what people like Gayla Benefield do, is they use the freedom that they have. And what they're very prepared to do is recognise that "yes, this is going to be an argument, and yes, I'm going to have a lot of rouse with my neighbours and my colleagues and my friends. But I'm going to become very good at this conflict. I'm going to take on the naysayers because they'll make my argument better and stronger. I can collaborate with my opponents to become better at what I do." These are people of immense persistence, incredible patience, and an absolute determination not to be blind and not to be silent. 

When I went to Libby, Montana, I visited the asbestosis clinic that Gayla Benefield brought into being. A place where, at first, some of the people, who wanted help and needed medical attention, went in the back door, because they didn't want to acknowledge that she'd been right. I sat in a diner and I watched as trucks drove up and down the highway carting away the earth out of gardens, and replacing it with fresh uncontaminated soil. I took my 12-year-old daughter with me because I really wanted her to meet Gayla. And she said, "Why? What's the big deal?" I said: "She's not a movie star, and she's not a celebrity, and she's not an expert, and Gayla's the first person who'd say she's not a saint. The really important thing about Gayla is she's ordinary." She's like you, and she's like me. She had freedom, and she was ready to use it.

Heffernan doesn't mention the lawsuit Gayla helped win for workers in her town to the tune of $36.5 million. 

I don't know how people can be so willfully blind to the most recent studies, and the many studies that have come out since 2020, that show that Covid has long term effects on children, particularly their brain development. People just keep hoping the data are wrong or that the children in their lives will beat the odds and not be in the 19.4% of people with severe brain damage after a mild case, or the 53.5% of people with severe brain damage with Long Covid. They might not believe it's true until they know someone, personally, who's profoundly disabled by Covid. But now that we've stopped testing, we run the danger that many cases will be mislabelled, and then we'll feel even safer from a very real and present danger. 

Dr. Eric Feigl-Ding is using his freedom to call out the CDC today for their complicity in perpetuating transmission of Covid by doing shoddy data analysis to conclude that it's cool to go to work and school when you're sick as long as you feel better today than yesterday. This is American, but we tend to follow their lead, so it'll be coming here too. In a nutshell, the economy can't manage with so many off work sick and there are concerns with so many kids missing so much school because they're sick, so, instead of preventing illness, the Center for Disease Control and Prevention is just changing the rules to make it so you have to work while still sick (and contagious)!! Clever monkeys!

I am devastated—I saw with my eyes what’s coming from CDC tomorrow. My sources told me on what their rationale is based. And based on what I know (epidemiologist for 20 years)—it is complete bullshit crafted on thin flimsy data. I can’t believe CDC has such incompetent leaders. What the CDC is doing is relaxing the guidelines of isolation to effectively ‘you can go out and have fun as long as you’re improving since yesterday’. Yes it’s ridiculous. Others have written on it. And it is totally public health abdication. What are the hell are folks at the CDC thinking??? 

First of all, someone in CDC did a very basic short term state-level analysis of a certain unnamed states (you can guess which) that did the shitty policy early and look at the rough short term correlations. But covid had already peaked / peaking in the big state by the time the crap policy was enacted!!! Why is this junk? Well if they base recommendations on a peak that is passing / has passed, then there would be little signal. In epidemiology, the “signal to noise” ratio matters to detect a signal over background noises in the data. Also if it based on mainly one major (mega) state— then any signal's hard to see. Plus, third no signal seen if ALMOST NOBODY IN LAY PUBLIC HEARD THE POLICY in first place! 

Now let’s talk about junk state level ECOLOGIC CORRELATIONS— When I first started my doctoral epidemiology program, I was warned by faculty mentors of a golden rule in epidemiology — never trust short term ecological studies. I was taught to almost never do state level epidemiology correlations because of their notorious unreliability in short term data for both reasons of ECOLOGIC FALLACY, CONFOUNDING bias, and junk NOISE NOISE NOISE! What “Ecological fallacy”? Well it’s when you label a higher unit of analysis with the same label pretending people inside the group do the same thing — eg correlation analysis of “violent crime by state, versus condom / BC pill use frequency by state” — if you did such an analysis you would spuriously conclude that birth control use leads to violent crime, or crime leads to pill use” — it is not only CONFOUNDED, but you also don’t know that PILL USERS are the actual ones who committed the crime!!! Or in our case that just cuz a policy was quietly enacted in a mega state that anyone heard about it or actually did the thing the policy told them to. This is the ecologic fallacy of state level data—you don’t know who’s actually doing the thing.

Now about the other CONFOUNDING bias problem — as we all know US states are highly highly different from one another—a myriad of social cultural political and demographic difference between states. Whenever you do correlation analysis of them (especially in short term data), the correlation with “other factors” besides the X factor of interest can completely bias the results. Classic example is a study of people’s “condom use and household appliances” — very strong association - but does it mean using condoms will lead to spontaneous more toasters and TVs? Or buying TV sets will lead to more condom use? Of course not. Such a factor is confounded by other variables like wealth and education, etc. But that’s why STATE LEVEL analysis is very tricky - especially in short term data. I can try to statistically adjust for them, but in short term data it’s very unstable to do so in data. I’ve tried in my early career 20 years ago - got scolded by a trust faculty mentor (who is now a Dean of a major SPH) who told me never try to publish or base policies on state level analysis— short term CONFOUNDING AND ECOLOGIC FALLACIES renders them shoddy and unstable 99% of the time. Yet, this is what the new CDC guidelines are supposedly based on!!! Wtf. They fail Epidemiology 101!!! 

According to sources, the data analysis is mainly based on change in COVID levels after a certain state announced & enacted a similar controversial isolation relaxation policy — on Jan 9th 2024!!! It’s a brand new policy after the Nov-Dec 2023 wave had already peaked! The peak is visible in the Biobot Analytics and CDC’s very own NWSS data. Thus using state data (see other major flaws above) for analyzing a policy enacted after the national wave has already peaked and hoping to find a signal above the noise of the immediate post-holiday season is ludicrous—especially with such short term data!!! Not finding any signal would be the expected default — which is what this kind of shoddy analysis is pre-destined to do! Again, what the holy hell CDC. 

Also, even worse—the enactment of this rule to relax isolation guidelines without any period of public comment is potentially illegal / inappropriate under California law. The WHN will soon be filing a formal complaint that under CA legal framework - “Underground Regulations” - such a health guideline cannot be enacted without a period of public comment. We at the WHN will be posting a formal complaint to CA very shortly. Stay tuned. But hey, CDC will jump at the chance to use shoddy data based on shoddy enacted state level policy. If you want to complain to the @CDCgov - then feel free to call the CDC tomorrow at 1-800-232-4636 and tell them how you really feel about their new supposed “health” guidelines. . . . Think about this— what if the CDC says - 📌‘NO NEED FOR CONDOMS ANYMORE IF YOUR HERPES OR SYPHILIS SYMPTOMS ARE IMPROVING SINCE YESTERDAY!!!’📌—because that is exactly the analogous policy the CDC is now enacting with their new ‘to hell with it’ respiratory guidelines!