On modellers and the elderly

Tank Green/ January 23, 2022/ Thoughts

Professor Carl Heneghan is one of those people who have an amazing knack for cutting right through to the crux of a matter and explaining things simply, calmly, and clearly; and it is for these reasons, that I really, really recommend listening to this recent interview with him on why he spoke out against lockdown.

There are two things he said that I wanted to comment on further: the first is the atrocious abandonment of the elderly; and secondly, the failure of a numbers-only approach to understanding complex social phenomena.

It was clear early on to me that lockdowns were not helping those who needed to be helped, and hurting those who did not need to be hurt. Numbers on TV aside, I knew someone who worked in a care home and knew how catastrophic the disease was to the people she cared for. (Incidentally, I am a support worker to a highly at risk disabled person, and nothing done so far has made her any safer either.) So I intuited quite early on that our approach was all wrong and needed a rethink.

Another element which played into my thinking was the fact that I used to work in the healthcare industry, once as a care worker (an eon ago), and more recently for a company which sold and serviced hospital equipment for, primarily, care homes and local authorities. So that’s things like hospital beds, hoists, lifts, and so on.

My primary take home from this experience was that I never, ever want to end up in a care home because the treatment of the elderly is dire. This is less to do with the seriously underpaid and undervalued care workers, who usually (but not always), do an impeccable job given the circumstances and resources. Rather, I never want to end up in a care home because they are chronically mismanaged by greedy corporates who, rather like charities, pay their CEOs enormous sums at the expense of the elderly (and the people who actually do the hard work, the carers).

As an example, a common complaint of our engineers was that a care home would wait until after an elderly person had developed sores before purchasing a pressure relieving air mattress, by which point it was generally too late. As serious pressure sores can cause sepsis and subsequently death, this practise of waiting until it’s too late to purchase a pressure relieving mattress is verging on criminal.

Likewise the atrocious abandonment of the elderly throughout the pandemic: criminal. Prof Heneghan (and also the GBD authors) offered some excellent alternatives to the failures of policy in real time. At some point the question of why their approaches weren’t trialed when it became clear that total lockdowns weren’t working, will need to be fully answered.

The second element which I wanted to respond to is Prof Heneghan’s comment that people (i.e. the modellers) who do maths (but not people) utterly fail to understand context and the real world. As a qualitative researcher, this is one of my major bugbears. Whilst I have never wanted to be an academic, I did want to become a researcher and had hoped that a PhD in the history of racism would be useful to the Third Sector. However, much to my dismay, I discovered that nowadays, organisations are only interested in quantitative analysis.

Hundreds of failed applications later, I ended up working in a quantitative Geography research cluster supporting a disabled academic. Much of my job revolved around editing journal articles and PhD theses and, frankly, for a variety of reasons, what I read disturbed and alarmed me. I have written before about the utter lack of respect for privacy that these data analytic researchers engaged in, but what is relevant to Prof Heneghan’s comments is how poor and lightweight the analyses of these researchers was. It was abundantly clear to me that these researchers were highly capable from a technical point of view, but not a single one of them, Professors and ECRs alike, had any meaningful insight into the fields their numbers were weighing.

I don’t really know how to end this blog post, other than to say that there is something here to be thought through about the digital, and the ways in which our understanding of the world is being filtered and mediated through numbers. We are losing our ability to recognise humanity and in its place, we see numbers and statistics, not real people dying or real people doing hard jobs. Instead our reality is being mediated by statistics and maths which inherently are incapable of the richness and the depth which constitute what it means to be human. I do not mean this to denigrate quantitative research, but rather to insist that its outputs be tethered to the deep thought of qualitative researchers.