Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49009, USA.
Asian J Psychiatr. 2020 Jun;51:102165. doi: 10.1016/j.ajp.2020.102165. Epub 2020 May 13.
The coronavirus SARS-CoV-2 (COVID-19) pandemic offers many medical, economic, societal, and cultural challenges. The response by individual states in the United States of America varies, but with the common initial impetus for all being to "flatten the curve," which was intended to delay infections and spread the burden and impact on hospitals and medical systems. Starting with that intention, the responses by states has included many major steps not taken in prior pandemics. Those steps have significantly adversely affected hospitals rather than support them, and the overall impact has been to "flatten the economy" rather than just to "flatten the curve." Many state governors have stated that their decisions are "science-led" and "data driven" but the reality is that there is not relevant experimental data. The progression of decisions during the early pandemic decisions is traced, and the basis of decisions based in science or herd mentality is discussed. Experiences are not experiments, and experiences are not founded in the scientific process. Medical and government leaders must be vigilant to recognize the limitations of available data in responding to unique circumstances.
冠状病毒 SARS-CoV-2(COVID-19)大流行带来了许多医学、经济、社会和文化方面的挑战。美国各州的应对措施各不相同,但最初的共同目标都是“减缓曲线上升”,旨在延迟感染并减轻医院和医疗系统的负担和影响。从这个意图出发,各州的反应包括了许多在以往大流行中从未采取过的重大步骤。这些措施对医院造成了严重的负面影响,而不是对其提供支持,其整体影响是“使经济放缓”,而不是仅仅“减缓曲线上升”。许多州的州长表示,他们的决策是“以科学为导向”和“数据驱动”的,但事实是,没有相关的实验数据。本文追溯了大流行早期决策的进展过程,并讨论了基于科学或群体思维的决策基础。经验不是实验,经验也不是建立在科学过程的基础上。医疗和政府领导人必须保持警惕,认识到在应对特殊情况时可用数据的局限性。