Critical thinking is not just formulas to be taught but knowledge and experience to be acquired and tested and re-examined, along with habits and skills that can be demonstrated and practiced. But there is no separating the “process” from the “substance”. It may be a privilege to live in a society that does not always need official statements to be interrogated as such.But if the past few years have shown anything, that privilege is not something to be taken for granted.

Date:   2/18/2021 3:20:17 AM ( 3 y ago)

From: insight magizine

Critical Thinking isn't Just a Process
Authoritarian muscle memory and the twists and turns of lying

zeynep
Feb 13





After my last post expanding on some of the ways to best evaluate information and ways of knowing, people asked for more such discussions.

So let’s talk more about metaepistemology.

One of the things I noticed throughout the past year has been that a lot of my friends who had grown up in authoritarian or poor countries had a much easier time adjusting to our new pandemic reality. My childhood was intermittently full of shortages of various things. We developed a corresponding reflex for stocking up on things when they were available, anticipating what might be gone soon. That was quite useful for the pandemic. So was trying to read between the lines of official statements—what was said and what was not, who was sitting with whom on the TV, and evaluating what the rumor networks brought in. It turns out those are really useful skills when authorities are lying at all levels.

I commented on this:

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When Trump got sick with COVID last October, there was a lot of speculation about how sick he was. We knew he was taken to the hospital, but that may have been out of an abundance of caution. He was, after all, the president, and there was indeed footage of him walking to the helicopter. When his medical team held a press conference, one detail stood out: he had been given dexamethasone—a steroid that has been shown to greatly reduce mortality, but only when the patient was severely ill. In the early stages of the disease, the result was the opposite: it increased risk and negative outcomes.

The reason for this flip is that the disease has two phases: the early phase is dominated by the “virus pathology,” and in the latter phase, it’s the immune system response that’s doing the damage.

There is a growing movement to approach COVID-19 as a two-phase disease: in the early phase, virus pathology dominates; and in the later phase, immunopathology drives disease. In thinking about COVID-19 this way, perhaps it is not surprising that dexamethasone offered no benefit to patients in the RECOVERY trial whose disease had not progressed to a stage necessitating respiratory support; indeed, the immunosuppressive effects of glucocorticoids at this stage of disease might hamper antiviral responses. It is in the later, hyperinflammatory phase of COVID-19 that the immunomodulatory effects of glucocorticoids are beneficial, perhaps by breaking the inflammatory feedforward loop, at least in some patients.

Dexamethasone is a synthetic glucocorticoid that’s used to suppress the immune system—a very useful drug if it’s the immune system response that’s driving the disease, but obviously terrible if it’s in the early phase, where we want the immune system to work hard in suppressing the virus replication. Hence, the guidelines recommend against using it for patients who do not require supplemental oxygen—something that happens around low 90s percentage oxygen saturation.

So what had actually happened to Trump? One obvious hypothesis was that he was given dexa because he was sicker than his doctors were saying, and it was an appropriate medical response.

 

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