The importance of definitions

Back in the 1980’s, Bill James, the pioneer in sabermetrics (which is the study of statistics in baseball) wrote an article that distinguished between a players’ value with respect to the peak of his career compared to his value regarding his career as a whole.  Of course, most people at the time (or even now) would not have thought much about this, and perhaps telling James’ “you are making this complicated, why can’t we just have a discussion”?

Why?  Because clarification/definition on just about any discussion is very important.  If you are a baseball fan, you have no doubt been embroiled in debates regarding the greatest players of all time.  One such discussion might have been “who is the greatest left-hand pitcher in history”.  But let’s pare this down to simply being a debate between Warren Spahn and Sandy Koufax.  Most people probably would probably say Sandy Koufax, if only because his legend was bigger.  If you look at their career statistics, you will see that Spahns’ statistics tower over Koufax (and not just in longevity).  In other words, if you look at career value, it would be extremely hard to say that Koufax was better.  The point here is that unless one defines what is meant by “greatest”, it is really hard to answer the question.

This is true for just about any discussion.  Look at the situation with COVID-19.  The media and supposed experts are in the news every day (heck, every hour) and they have done a poor job, if at all of defining what they mean with a “COVID related death.”

If somebody is 91, and they have all kinds of illnesses, and they essentially die of old age, while having have high cholesterol, is it fair to say they “died of high cholesterol”?

Even if they are assessing these deaths in the same manner they are defining flu related deaths, a flu related death has never been clearly defined, and further, if we are given a definition, is it a fair definition?  Note: (By the way, allow me to make an important distinction.  When I say clearly defined, I mean talked about, or written about enough to make the general public aware.  If it is written on page 24 of some dusty document, that doesn’t’ count as being ‘clearly defined’ in this context.)

There are just short of 80,000 deaths in the U.S. as of this writing.  How did they count these? What if you have somebody with an assortment of maladies, in their late eighties, they test positive with COVID-19, and pass away?  Should that count as COVID-19 death? 

I believe there are two reasonable ways to go about this.  Assume a person has three ailments and they pass away.  We could either pick what we believe has the strongest impact towards dying (and count that as THE condition they died from).  So, in the case of a person having conditions A, B, and C, if they would have lived just two months without A (while having B and C), but two years for each of the other two scenarios, then it seems reasonable to say they died due to condition A and A only. 

Or we could try to assess how long they would have lived without having a particular condition.  If it is believed they would have lived a few days (without COVID-19) it seems absurd to say they died from COVID-19.  If they would have lived a year, it seems reasonable to say that that they died from COVID-19.  So, what is a reasonable cutoff (i.e., threshold)?  Whatever you deem it to be, define it.  Note that by this second way, you can die from more than one illness.

This is not just important because of curiosity.  This is important because it allows lawmakers to make reasonable decisions with regard to social distancing, etc., and further allows the citizens of this country to be enlightened to respond to those decisions appropriately.  For instance, if the flu kills 30,000 people a year by however you define it, and COVID ends up killing 40,000 this year (by the same definition), then these extreme measures are nonsensical.  But if it ends up by that same definition that 500,000 die (or would have died without intervention) then it would appear that most of these measures have been reasonable. 

Notice we go back to word ‘reasonable’.  That word, in many ways defines our decision making, doesn’t it?  It is at the crux of our court system, i.e. guilty beyond a reasonable doubt.

We all need to use reason.  Have the lawmakers used reason with these restrictions?  There are at least two problems in answering.  Record keeping/assessment is one of them.  That is tough nut to crack, and even our best methods are going to leave debate along with uncertainty.  But the other problem is something they could have and should have easily resolved: how precisely do they define a COVID related death?  Nobody seems to know, because nobody seems to be defining it.


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