View Response to COVID-19 Wearing Six Thinking Hats
The amount of information, misinformation, and disinformation about COVID-19 is overwhelming and frightening. But it's not surprising. The current pandemic is a complex wicked problem
where everyone sees the COVID-19 problem
differently, depending on their beliefs, needs, and interests.
Edward de Bono created Six Thinking Hats
to help develop a blueprint free from biases of information, optimism, pessimism, and emotions to see the big picture and enable pathways for innovative solutions to emerge. The "thinking hat" is symbolic of thinking but without falling in love with one's idea, as hats can be replaced. Bono proposed attributing a colour to each of the six hats encompassing a range of human thoughts and emotions.
Let's address the pandemic using Six hats.
In this case I use this order: Red, White, Black, Red, Yellow, White, Green, Blue.
In the current pandemic the gullible public (Editor: ~unskeptical, inexperienced), the majority in most countries too numbed to think clearly, accepted mostly the Red hats thrust on them. Rakish cowboys wearing hats of a single colour hijacked issues and shot down people wearing other hats and pushed the Red hat of emotions - fear, panic, and anxiety. Cowed into submission people happily fell prey to politicians, social and market forces, career scientists, and pseudoscience advocates. Yes, it's okay for you to express what your heart feels and let emotions spew out under the Red hat. For 30 seconds max. But then, take the Red hat off.
De Bono reminded us that Information arrives sequentially in time. Decisions are based on what we know at that moment (Known knowns)
. We also may be aware of Known unknowns and try to cover them with risk assumptions. We have no White hat information about Unknown unknows, Unknowables, or Unimaginables. These conceivably may reveal themselves later and we call that hindsight
As of November 2021, the latest data available confirm that initial estimates of the lethality of the virus were highly exaggerated. Most people who died in the West were around 80 years old with co-morbidites. Only 6% of the reported Covid-19 deaths were solely due to the virus. Subsequent research attribute much lower lethality to the virus.
Stanford University researchers provided data on age-wise survival rates. From these figures it is evident that risk of dying from Covid-19 for children and young people is negligible. This is important for framing policy since a recent paper in Toxicology Reports titled, "Why are we vaccinating children against Covid-19," concludes that deaths from Covid-19 in children are negligible, but post-vaccination deaths in children are not.
Let's put on the Black hat to challenge the White hat data. Particular concerns have been raised in the papers about the spike protein of the vaccine, which have been found in different organs, and the uncertain long-term effects. These concerns are serious as data for England and Wales from 01 May 2021 until 17 September show excess deaths ranging from 16% to 47% above expected levels in 15-19-year old males, coinciding with the roll out of the vaccine in this age group.
Parents were quick - perhaps too quick - to switch to the Red hat evoking fear and panic that their children would fall prey to the virus. Red hat thinking promoted exploitation and greed, and pushed for mass vaccination of children. Be on the alert for extreme cries such as "It's Fake News!", It's all a conspiracy!", "QAnon says that...", etc. Offer to discuss these Red hats under the less emotional White and Black hats.
Yellow hat thinking is influenced by perceptions. For those who use the White hat, those who use data extensively to assess risks and benefits, low mortality is a cause for optimism. For those who succumb to propaganda without looking at the data, blind faith in the vaccine brings optimism.
"Expert" narratives fuelled this faith in vaccines as the saviour of humankind. Waiting for the vaccine justified prolonged lockdowns and associated misery. The inflated estimates of lethality of the virus were not corrected in people's mind, leading to a sort of "medical stampede" during the second wave in India when a majority of people who had Rt-PCR positive results, but who had mild to no symptoms, rushed to hospitals overwhelming the system and depriving more serious patients of beds and oxygen. If the White hat been used judiciously from the beginning this "stampede" could have been avoided saving many lives.
After the vaccine roll out in many countries, we now have more data which should guide policy. Studies from Israel among others have established that recovery from natural infections gives 13 times more robust immunity compared to vaccines. Solid White hat data.
Be aware that research papers can be blend of hats. An example is one paper in the European Journal of Epidemiology. The study published online on 30 September 2021, titled, "Increases in Covid-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States," concludes that vaccines should be offered with humility and respect without stigmatizing (excessive use of the Red hat), as mass vaccination does not seem to check transmission. A bit of Black hat there.
Creative Green hat thinking has played a huge part. Scientists collaborated around the world in trial & error experiments to advance initially vaccine development using mRNA technology. Modern vaccines often stretch out past a decade of development. Last month after years of failed experiments and mixed results, a malaria vaccine has finally earned the endorsement of the World Health Organization. The previous fastest-ever vaccine developed, for mumps back in 1967, took four years. In March 2020, historical wisdom was that, even with all the stops pulled, a vaccine would take at least a year and a half to develop. BioNTech and Moderna shattered that conventional timeline.
Serendipitous opportunities emerge
while wearing the Green hat. Novel learnings from COVID-19 have paved the way for mRNA vaccine development for other diseases such as Influenza.
However, success should always be tempered. Just because a technology has been developed it should not be used indiscriminately. Unintended consequences must be carefully monitored as new White hat data continually arrives.
I like to summarize discussions wearing a Blue hat to provide the big picture, next steps, and even a debrief using Six Thinking Hats. Did we balance all the hats equitably? Did we practice Parallel Thinking and switch hats when appropriate? How well did we distribute a lot of White hats (data) and Yellow hats (optimism based on data), and some Black hat too (regarding the efficacy/harm of vaccines, based on White hat-driven data)? And of course, how well did we manage Red hat thinking for those still in panic mode and being exploited?
Inspiration for this topic: "Global response to COVID-19 pandemic has been amateurish; complex issues need many thinking hats
", by Dr. Amitav Banerjee, Professor & Head, Community Medicine and Clinical Epidemiologist at Dr DY Patil Medical College, Pune.