Confused About How to Stay Safe in a Pandemic? Emily Oster is Here to Help

SARAH BALDWIN: Hey there. This is Sarah, the host of Trending Globally.

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SARAH BALDWIN: All right. Enjoy the show. From the Watson Institute at Brown University, this is Trending Globally. I'm Sarah Baldwin. Over the past five months we've learned a lot about coronavirus and COVID 19. But sometimes, it feels like we're just as confused about this disease as we were back in February.

What's safe to do? What activities should I be avoiding? When will things go back to normal? For some questions, we still just lack information. But a lot of the confusion has come from the fact that there's almost too much information.

People don't know where to look to find the answers they can trust. And that is where Watson economist, Emily Oster, comes in. Emily's two most recent books, Expecting Better and Crib Sheet, took an economist's view towards practical questions about pregnancy and parenting.

They became best sellers, and required reading for nervous young parents. Now Emily has trained her focus on the novel coronavirus. With her collaborator, Galit Alter, Emily has created an online resource called COVID Explained. It's one of the most accessible, clear, and helpful web sites out there for understanding the risks of coronavirus, and how to move safely through our new reality.

On this episode, we talk about the project, and look at some of the most popular questions it seeks to answer. We also look at why health recommendations can be so hard to navigate, and how average people can learn to start thinking a little more like economists.

EMILY OSTER: I think the biggest thing I've been telling people is try not to whiplash. Another way to say that in more economic ways that is to be a little more Bayesian-- thinking about how your evidence can combine with what you already thought, or what you already knew-- I think that's pretty important.

SARAH BALDWIN: We'll get to Bayesian thinking a little later, as well as whether you should wash your groceries. I start, though, by asking Emily how this project began, and how it relates to her previous work on parenting and pregnancy. Here's Emily.

EMILY OSTER: So, I think all of my stuff is kind of related. So when the pandemic started, I had started this newsletter-- Parent Data-- to try to talk to people, actually, about my books. This was before there was any COVID. And of course then, as, kind of, COVID became a thing, I started writing about it, particularly for parents and pregnant women, trying to help people understand risks to kids, risk to grandparents, and questions in that space.

And then at some point-- actually a friend of mine reached out and said, I feel like people are really struggling to understand a lot of basic facts about the pandemic. And know not just parents, but everyone. Just even questions like, how do I get this?

If I go to the grocery store, and someone has been there before me, and they touch the salad box, and they-- and then I touch the salad box-- do I just die immediately? And there was sort of some feeling like that. Some people think that. And then some people think, well, this is an imaginary thing that no one could ever get.

And so kind of trying to find a way to give people information that actually tells them, this is-- let me help you understand how the virus works. And that kind of understanding is then the key to thinking about questions like, how can I avoid this? And so I got together with Galit and with a bunch of people in her lab, and now with a bunch of undergrads and post grads and different people. And the site really aims to speak, partially, to parents and-- who are struggling with these things-- but also to just everybody, and try to say, here's where you can get some just facts about what's going on with the virus.

SARAH BALDWIN: It's such a great site. It's so straight forward, and clean, and black and white, and almost image free and distraction free. I can't imagine that that wasn't deliberate. Because it just screams clarity.

EMILY OSTER: Yeah. I think we really wanted to go for very sort of basic-- this is where to get some facts, as opposed to this is where to get beautiful images. Some people have said, why are there not more beautiful images? And we do have-- we have tried to put together some infographics that we have on Instagram and so on that sort of break it down a little bit.

But I do think there's a sort of deliberate attempt here to really say, sometimes what you want to know is just, what are the facts about treatment? What happens if I get COVID? What will happen to me? And what are the treatments that are out there? And let me just read about that. And I think that's the place that we're trying to be.

SARAH BALDWIN: Yeah. No. And you do it really well, because you've got this different levels of dives, really-- like shallow dives about current news. And then you have these deeper explainers which are also super uncomplicated and really straightforward. And then a fantastic glossary. And I thought of a word earlier that I would suggest or ask you to add. And now I can't remember what it was. But I'll get back to you on that.

EMILY OSTER: Let me know if you remember.

SARAH BALDWIN: And I you cover everything from the meaning of immunity, to the importance of testing, take out, air travel, baldness, protesting in the era of COVID 19. But I wonder, how would you say your site is different from, say, a news article or a CDC web page?

EMILY OSTER: I think the thing that we have that I think is-- I don't know if unique is probably too strong-- but is kind of special, is the fact that we have these long form explainers. And I think that that lets us put some of these newer things in context. So I think-- if I think about, how is this different from the way the media is covering a lot of this stuff-- when the media covers a story, covers a new piece of data-- there's often this moment where it's like, this is the new-- the Moderna vaccine.

That's the thing. And everyone's like, yes. That's it. That's the thing. And I think there's a need to step back, especially as information is coming so quickly, to say, well, is this the only vaccine? What is special about this? Why-- what is the context for why this would be-- or might not be-- an exciting new finding?

And so when we write these shorter pieces, or when we update the explainers, we try to say, OK, you may be hearing this. This is kind of where it fits into the overall landscape. So we could say on the one hand, here's this new news about this vaccine. That's great.

Actually, there are 138 vaccines in development. And so just so you understand that this is one vaccine. There are 138 vaccines. By the way, this is how vaccines work. Something you might be interested to know is that this particular kind of vaccine works with a technology that has never been used to produce a commercial vaccine before.

That doesn't mean it won't work. But just so we so we sort of think about, where should I put this in my space of how likely is this to be the real thing? It's unusual.

SARAH BALDWIN: And how often-- what's your process? How often do you update? And where do you-- how do you decide what questions you want to answer?

EMILY OSTER: So we've been iterating around a lot. And we kind of constantly-- constantly changing our process is a little strong. But we've been trying to be to be adaptive. We update something on the site almost every day during the week. So whether it's a new piece of news or whether it's updating the explainer-- so that's a piece that we've been focusing on a lot lately, is making sure that when new news comes out, it's often something that really belongs inside one of the explainers.

And we're sort of thinking about, how can we make those really adaptive? So even this morning-- or yesterday-- there was some new news about steroid treatment-- for using steroids in treatment for hospitalized patients on ventilators. And so it was like, OK, we've got to get in and make sure that the treatment-- the discussion of treatment is updated with that kind of information.

So there's a team, of which I am sort of the head, but one of my grad students is kind of the site manager. There are some website guys. There's a ton of undergrads. So there have been some really amazing work from Brown undergrads on a lot of this stuff, which is just absolutely awesome.

And then there are a bunch of post docs. And we all kind of work together. The funnest thing for me is actually when new stuff comes out, we have a slack channel-- we have many slack channels. But we have a slack channel on kind of new news, where there's a bunch of kind of experts, and PhDs, and post docs, and doctors, and whatever.

And we just sort of chat about these different pieces of news that come out. And that's been really fun for me, because I feel like I'm learning a lot. In general, I feel like I'm learning a lot.

SARAH BALDWIN: Given how fast discoveries are being revealed to us, or how fast things change-- do you ever worry that something on your website is going to be proven wrong?

EMILY OSTER: Yeah. I mean, of course. And in fact, there are many things in this space where the advice has changed so the anti malarial that the president says he's taken-- there's been a lot of back and forth on that, including some studies published in the very best medical journals, which were then retracted for, basically, made up data.

So there's just there's a lot of flow in this space. What we've been trying to do on the website is just be very clear about what is-- what are we-- how good is this piece of evidence for this? So this morning, when I was writing about this new steroid study out of the UK, we were pretty careful to say, all that we know from this is a press release.

So there's a press release. There's not pre-print. It's not a peer-reviewed paper. That's-- a press release is not the same as a publication in the New England Journal of Medicine. And so, I think just being clear about, how good is the evidence on this, and where does it, again, sort of fit inside the context of other things.

We think, is it plausible. Does it seem even plausible that this drug could matter? And I think kind of putting all of that together is what we try to do. But I think that, not just for the website, but in general here, as this pace has just pushed and pushed and pushed and pushed and pushed-- we have to recognize that sometimes people are going to be-- some of the things we see are going to be wrong. We're just going to have to kind of adapt to that.

SARAH BALDWIN: And related to that, what advice would you give to people who are consuming news on a daily basis? Besides coming to your website to get the lowdown, how should we be consuming news-- with a grain of salt, or what perspective should we bring?

EMILY OSTER: I think the biggest thing I've been telling people is try not to whiplash. So I think that because information is coming so quickly, it can be very easy to react to just the last thing that you saw, and to sort of try-- when you're seeing a new piece of data-- just try to step back a little bit, and be like, OK, this is just one-- this is just one piece of evidence.

And it's-- just because it's the thing I see right now doesn't mean it's the most important thing. And I think when I see-- sometimes what's happening-- and even in the stock market, which, of course, is like populated, in principle, by smart people or something-- you sort of see a small piece of good news, and the stock market will be up 8%.

It can't actually be that that is 8% of good news. The next day it's back down by 7%. So somehow, we're kind of-- we're moving too quickly. We're adjusting too much. And so, another way to say that a more economic space, that is to be a little more Bayesian. Take a Bayesian approach.

The statistics would say, take what you know before and then every new piece of evidence should move you a little bit. But you shouldn't move you that much if you knew a lot about it before. And so I think thinking about how your evidence can combine with what you-- with what you already thought or what you already knew-- I think that's pretty important.

SARAH BALDWIN: Well, that was another question I had. Have you-- what's the coolest or most valuable thing you've learned? And what's the most surprising thing you learned?

EMILY OSTER: So I think just the basic virology for me has been the coolest-- the coolest stuff. So I just-- I didn't know that much about how viruses work. I mean, I had a sort of-- I went to college and I took some science, I guess. But it's been a long time since I reviewed-- since I reviewed this stuff.

And so, just sort of even thinking about the question of why would it be so important to wash your hands? And kind of remembering that, oh, it's because viruses need to get in your nose. And if you wash your hands, then they go away. And actually, one virus particle isn't enough.

You need many virus particles. And then, what is your body doing to fight them? And so just reviewing all those things has been kind of fun for me. I will say, I think the pieces that have been most surprising are-- is the stuff about vaccines. Because the kind of move in technology, in terms of how vaccines are working, is very big.

And so even though I actually did learn some things about vaccines in college, they're kind of way-- the new technologies for vaccines are so different than they were then. And so that's been just like wow. We really made a lot of progress on that.

SARAH BALDWIN: So it's like not relearning, it's learning. That's cool.

EMILY OSTER: It's learning-- basic learning-- which I got to do for my books, also. But this I get to do much faster.

SARAH BALDWIN: You have to do it faster.

EMILY OSTER: You have to do it faster.

SARAH BALDWIN: How did you and Galit get together in the first place? Did you know each other, because you're an economist and she's a physician?

EMILY OSTER: Yeah, so we were actually connected by a friend of mine, who sort of came up with this-- the idea for this website in the first place. So a friend of mine who knows Galit through a friend of hers, and so she had been talking to Galit about her work. And then she called me, and she said, I think that what's missing here is somebody to sort of take the kind of subject matter expertise that somebody like Galit has, but write it in a way that is closer to the way something like Expecting Better or Crib Sheet is written, where it's really a sort of trying to be translational.

And I think the gap that this friend identified-- which I think is an important one-- is that a lot of people who are doing the kind of front line work-- which is more what-- I mean, Galit works on serology and understanding the virus. It is not the same set of skills that make you necessarily very good at learning about the virus as make you very good at explaining it to people who don't know much about the virus.

And I feel like the thing that I have been working on, and cultivating, and trying to get better at over the past decade, is really, how do you translate scientific work to a lay population in a way that actually engages with the work, and isn't just, oh trust me. I'm an expert. And so, I think that's what we're trying to do here, is sort of be that translation for people.

SARAH BALDWIN: And we've talked about this before, but tell me again about your motivation for doing that. Because you are a social scientist. You don't have to talk to lay people. But you seem to have dedicated so much of yourself to making all kinds of data now-- also medical information, economical data, and other social science data-- digestible by the average intelligent person. And it feels a bit like a crusade.

EMILY OSTER: Yeah. I mean, I think crusade is probably a little strong. But I think for me, this is something that I am-- I think is very important, because-- I mean, obviously, I think it's very important. But I feel like sometimes in academia we can get a little bit into talking to ourselves.

And if we think what we're doing is valuable broadly, then we should be able to explain to people why that is. And we should be able to translate our work into things that people understand. And I think there can sometimes be this kind of like, well, I'm an expert. And I don't need to tell you about my stuff.

But if you actually want people to change what they're doing, then you need them to really understand why. I also think, like all people, I like to do the stuff that I feel that I'm good at. And this is a kind of thing that I think, whether it is something that I am inherently good at or something that I have trained to be good at, it is a way in which I think that I can contribute. As the economist would say, I think it is a comparative advantage. And so I like to do the things I have a comparative advantage in.

SARAH BALDWIN: I wonder, too, if there is a stealth public health motivation in the case of the COVID Explained. Are you doing this not just so people feel more informed, but also so people might act smarter, which would benefit everybody?

EMILY OSTER: Absolutely. No. I mean, I don't think it's that stealthy. My newsletter, every three weeks is like, why won't you open camps? I'm running this newsletter so people will open my kids' camp? And so Yeah. No. I mean, I have a strong-- I have a strong public health motivation, in part because I think that a lot of the things we're going to face around COVID over the next few months-- we're getting into a place where the trade offs are really extreme.

So we're going to need to think about, in something like schools-- we're going to need to think about there are clearly costs to opening schools. If we open schools, some people are going get the coronavirus. There's no question. Even in the best case scenario, where kids are not major spreaders of the virus-- which seems to be where we are-- still some people are going to get the coronavirus when we open schools.

On the other hand, if we don't open schools, then a lot of kids are going to lose a lot of learning. And those costs are where you're going to feel for their whole lives. And they're going to be felt disproportionately by poor students, students of color, underrepresented groups.

So we're going to face a lot of trade offs like that. The key to making progress on those, I think, is to figure out how can we open schools as safely as possible. And the key to doing that is understanding how the virus works. And understanding things like, why is it important for people to wear masks?

It's really important for people to wear masks. It just seems clear-- masks are a big deal. And if we had-- if people understood why, then maybe they would do more of that. And that would help with some of these trade offs.

SARAH BALDWIN: Well, speaking of schools and openings, you're on-- you're co-chair, actually, of Brown University's Healthy Fall Twenty-Twenty Task Force.

EMILY OSTER: That's right. Yes. There are a lot of task forces. That's mine.

SARAH BALDWIN: What is the thinking about the fall semester?

EMILY OSTER: So, I think the president said she's going to make an announcement in the next-- in the next few weeks. I think, like many universities, our hope is to return in some form for some kinds of in-person instruction in the fall semester, if we can do it safely. So I am personally hopeful that that will be feasible. It's not going to look exactly like the fall of Twenty-Nineteen.

But I think it is-- I think it's very important, actually, for the many reasons for the university to come back in some way. And so I'm hoping that we will. And I think that we will. We're working hard to make that possible.

SARAH BALDWIN: Wow. OK. Well, we'll be looking for that announcement from President Paxson.

EMILY OSTER: Yeah. Me too.

SARAH BALDWIN: I just-- I've been thinking about how much you do-- between teaching and research, and projects like newsletters, and answering emails, and all the number of-- and tweets, and all the people who are in touch with you looking for your expertise. And I just wondered how you do it. And if you have any time management secret that we don't know about, but would love to know about.

EMILY OSTER: No. I mean. My daughter would say I freak out a lot. So that's-- I recommend that. I don't have any real secrets. I basically, parent and work and don't-- and sleep and don't do much other of much other fun stuff, I guess. But I really like this kind of writing. And so doing sort of a lot of what I've been doing in the last few months is really this sort just writing and writing and writing-- and I find that really fun.

So I don't, maybe, get as tired of doing it as I would of other-- of other things. But I will say, I mean, I think, like a lot of people, I have found the pandemic hard, in terms of just like, I'm very tired. And I don't know how much of that would be true if I wasn't doing all this stuff and how much of it is just, it's hard to be in your house all the time. That's part of why I'm really eager to get us back to my office. So I don't have to Zoom you from my bedroom.

SARAH BALDWIN: I mean, hopefully, this project will go away someday.

EMILY OSTER: It's very funny. I've been having a lot of conversations with people about the project. And so, because we got a little bit of funding from the Arnold Foundation-- which was great-- and they hooked me up with a lot of different people who are trying to help amplify through things like this, and try to get people excited about the site. And people keep asking me, what's your long term goal for the site? My long term goal is to not have it.

SARAH BALDWIN: Obviously.

EMILY OSTER: The best case would be if we just didn't have the site anymore.

SARAH BALDWIN: Obviously. [INAUDIBLE].

EMILY OSTER: It's a funny-- it's a funny thing to think about, because all the other long term projects-- my books, people are like, what's the long term goal? The long term goal is to have these books be something people read [INAUDIBLE]. Now it's like, my long term goal is to never see this again.

SARAH BALDWIN: Take it down. Take down the site.

EMILY OSTER: Exactly. Take down COVID Explained. I know they weren't quite there yet.

SARAH BALDWIN: Well, I know you have 70 million other things to do. So I just want to thank you again for talking with us and bringing us up to speed on your latest great project. And I hope you'll come back to Trending Globally again.

EMILY OSTER: I hope so too. Thank you so much for doing this.

SARAH BALDWIN: Thanks, Emily. Stay safe. This episode of Trending Globally was produced by Dan Richards and Babette Thomas. Our theme music is by Henry Bloomfield. I'm Sarah Baldwin. You can subscribe to us on Apple Podcasts, Stitcher, Spotify, Google Play, or wherever you listen to podcasts.

If you like what you hear, leave us a rating and review on iTunes. It really helps others find the show. For more information about this and other shows, go to watson.brown.edu. Thanks for listening, and tune in in two weeks for another episode of Trending Globally.

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