The Norm Chronicles (17 page)

Big risks – those that might endanger hundreds, or thousands, or millions – are prone to cultural cognition, partly because the evidence is bound to be uncertain to some extent, as there’s no way of getting more data by re-running experiments on the whole planet with and without an industrial revolution.

And partly because the crunch may be years away, affecting our children more than us – and people will have different views about how
much the future matters. So climate change, like every other risk, is affected by the probability/consequence distinction, where some will care more and others less about the potential costs to future generations. In fact, we can express our feelings about the future in a simple number, what’s known as the ‘discount rate’. If something that will happen in 50 years’ time is just as important to us now as something that happens now, then our discount rate is 0 per cent. We don’t discount the future.

But this doesn’t describe most of us. If you’re offered £5 now or next month, most people think the £5 in the future is worth less – because it’s in the future. They discount it. When deciding on health policies, the UK National Institute of Health and Clinical Excellence (NICE) uses a default discount rate of 3.5 per cent, which means a year of life in 20 years’ time is worth only around half of a year of life now. Hospitals deciding whether to use their limited cash to treat an older person or a younger one could say that the young person has a bigger future, and this counts for more. But if that future is heavily discounted, this works in favour of older people because doctors are now required to put a higher value on their current year. Not having much of a future simply by virtue of being old is then less of a disadvantage in the scrap for resources. With a 0 per cent discount rate – which implies future years are as valuable as current years (and the future is not discounted) – all the NHS money would be spent on younger people, who have more years left in which to benefit.

When economists look at climate change, they usually use a lower discount rate, such as 0.5 per cent – to reflect people’s concerns for the long-term future. Similarly, when deciding where to dump nuclear waste, if we had a high discount rate, we might just shove it in a bucket in a cave where it would probably be OK during our lifetime. But which discount rate is the right one can’t be settled by science or statistics.

The UK National Risk Register
⁷
gets around this by only being concerned with horrible things that might happen over the next five years. People sit around mulling on possible causes of death and disaster and cheerily try and assess how bad they might be and how likely they are, and put them into a table like
Figure 14
(overleaf). The scale of harm goes from 1 to 5 on the vertical axis. This is a human judgement, not a
statistical fact, and so is the likelihood that many of these events will come to pass. In fact, the best that can be said in defence of these numbers is that they are better than nothing for governments that have no choice but to set priorities and make policies. They are intended to be fair working assumptions, not predictions.

Figure 14:
UK National Risk Register

These big hazards are hard to quantify with anything like the accuracy of the risk of heart disease, but they are risks that alarm governments. And again, it’s clear that how serious you think they are may depend on your cultural outlook. Are you horrified by the threat of industrial action – militants bringing the country to its knees – or do you see no risk there at all, just ordinary people defending their living, a threat to no one if they’re treated fairly? This is a repeated and important point in this book and in studies of risk generally: that some arguments about risk are not really about risk.

The UK National Risk Register only puts these threats into broad categories. To say, as it does, that the risk of an ‘explosive volcanic eruption’ is between 1 in 200 and 1 in 20 means anything between a 0.5 per cent and a 5 per cent chance over the next five years. But there isn’t much to base more precise figures on: the volcano in question in Iceland has gone off only twice in the last thousand years, so if we say that very roughly it goes off on average every 500 years, that’s a 1 per cent chance it will go off in the next five years. Mind you, it ranks highly on ‘impact’: the last eruption, in 1783, killed 20 per cent of the population of Iceland, wiped out their agriculture, sent clouds of sulphur dioxide across Europe, which fell as sulphuric acid and caused years of bad harvests, and so contributed to the French Revolution in 1789. One to watch out for.

When one of these crises occurs, or comes close, somebody has to be wheeled out to tell the public about it. There are manuals to teach you how to do this,
⁸
full of commandments such as: listen to people’s concerns, build on trust, express empathy, act fast, repeat messages, tell people what to do, acknowledge uncertainty, don’t just reassure, commit to learning.

Not much of this advice seems to have been followed when there was an outbreak of severe food poisoning in northern Germany in early May 2011, including cases of lethal hemolytic-uremic syndrome (HUS).
⁹
A local laboratory tested some organic Spanish produce, found E. coli, and on 26 May announced they had found the source. Result: a widespread boycott of Spanish vegetables despite film of the Spanish Minister of Agriculture desperately munching on organic cucumbers to show how safe they were. The problem was that, although the laboratory genuinely identified some E. coli, it was not the type that was causing the casualties, of whom 50 died. It was only once the Spanish industry had been well and truly messed up that the source was finally tracked down, in late June, to a shipment of Egyptian fenugreek seeds. And who remembers that?

An even more chilling case-study in how
not
to communicate risk was the earthquake in L’Aquila, Italy, in 2009. After a series of small shocks and a local amateur with home-made equipment had predicted a major earthquake, there was a crucial meeting of experts on 31 March
2009, intended by the Civil Protection Agency to reassure the public. The meeting concluded that ‘there is no reason to say that a sequence of small magnitude events can be considered a sure precursor of a strong event’, but at a press conference afterwards an official, Bernardo De Bernardinis, apparently translated this into the reassuring statements that there was ‘no danger’ and that the scientific community assured him it was a ‘favourable situation’. Go home, have a glass of wine, he reportedly said.

The succeeding events have the air of a scripted tragedy. At 11 p.m. on 5 April 2009 there was a strong shock, and families had to decide whether to stay indoors or spend the night out in the town squares – the traditional response to tremors. Families who heeded the apparently ‘scientific’ reassurances remained indoors, and 309 people were subsequently killed in their beds when the devastating earthquake struck at 3.30 the next morning, flattening many modern blocks of flats.

Six top Italian scientists and De Bernardinis were accused of manslaughter and stood trial in Italy. The scientists were not accused of failing to predict the earthquake, contrary to the impression given in some news reports in the UK, as it is acknowledged that this is currently impossible. The trial instead focused on what was communicated to the public. Did they appear, or did someone appear on their behalf, to predict that there would
not
be an earthquake, despite their own knowledge of the uncertainties? If so, they had not read the manual.

A key question is what scientists and officials think that people want to hear. One common refrain – often from scientists – is that people crave certainty and that that is unreasonable. The prosecution’s claim in L’Aquila seems to have been, on the contrary, that the one thing they were sure they didn’t want was to have
un
certainty suppressed. The prosecution has been caricatured in some quarters as typical of a country that tortured Galileo, typical of a public demand for fortune-telling from necessarily uncertain scientists. The real issue is arguably almost the reverse.

One witness, Guido Fioravanti, described how he had called his mother at about 11 o’clock on the night of the earthquake, after the first tremor.

‘I remember the fear in her voice,’ he said. ‘On other occasions they would have fled but that night, with my father, they repeated to themselves what the risk commission had said. And they stayed.’ His father was killed in the earthquake.

Another witness said: ‘[the messages from the commission meeting] may have in some way deprived us of the fear of earthquakes. The science, on this occasion, was dramatically superficial, and it betrayed the culture of prudence and good sense that our parents taught us on the basis of experience and of the wisdom of the previous generations.’ Otherwise, he said, they’d have slept outside.
*
As it was, they stayed in.

All the accused were convicted by a lower court of multiple manslaughter and sentenced to terms of six years in prison but are expected, at the time of writing, to appeal. One of them pointed out that he had previously identified L’Aquila as the biggest earthquake risk in Italy. The quality of the buildings also had a lot to do with the death toll.

Who else might be culpable for issuing reassuring statements? The British TV weather forecaster Michael Fish jovially discounted the possibility of a hurricane in October 1987, and the subsequent storm killed 18 people. In 1990 the UK agriculture minister John Gummer was similarly reassuring about the safety of British beef when he force-fed his four-year-old daughter Cordelia a beefburger in front of the cameras. Over 100 people have subsequently died of variant CJD in the UK.

Of course, there’s a difficult balance to be struck between reassurance and precaution. For every unheeded warning about a sub-prime crisis or cod depletion, there’s an exaggerated claim about the potential dangers of saccharin or the Millennium Bug.

So although the Italian prosecution seems harsh, it’s a salutary warning that people’s emotions and intelligence should be treated with respect. People need full information and guidance for action, rather than just reassurance, and their concerns must be taken seriously.

11
GIVING BIRTH

‘U
HH!’ SHE SAID
.

Norm shuffled his notes …

‘Uhhhhhhghnnng!!’

… bit his lip.

‘When will this
thing
be out?!’

‘Erm, hold on,’ he said, shuffling even faster. ‘Right, yes, got it,’ he said. ‘“Among 2,242 women with spontaneous onset of labour, the median duration of labour for those delivered vaginally was 8.25 hours in para 0, er … 5.5 hours in para 1 and 4.75 hours in para 2+ mothers.” You’re a para 0.’
*

He smiled.

‘Oh God!’

Norm had spent days, days compiling data.

‘Another one …’

He had footnotes on all his sources.

‘Oh Goooodddddd!’

Everything written down alphabetically for ease of reference.

‘Phu, phu, phu,’ she breathed.

He had been able to tell her at critical moments how likely she was to die.

She grabbed his sleeve.

And had relative risk ratios
at his fingertips
for various anaesthetics.

‘Tell me one more … and I’ll … nggghhaaa …’

Ah, threat of violence … under ‘V’. Here it was. Page 12. With the risk factor assigned to the psychological profile he’d done on her: ‘Personal injury – low. Violent verbals – high (possibly of personal nature referencing anatomy)’, he had written.

‘You … dick! You stupid, stupid f… nnnnnngggghhh.’

Excellent, he thought, spot on with that one. But then he dropped his notes. This, of course, was about the time she moo-ed.

‘Mmmmmnnnnnoooooooo!’
*

Just as he was on the floor, scraping together the pages.

‘Animal noise, animal …,’ he mumbled, but the pages were all over the place. Although now he thought about it he didn’t recall anything about …

‘Nearly there,’ said the midwife. ‘You’re doing brilliant …’

Well, thought Norm, depends what metric she uses. Performance, P… P…. He should have used staples. Time-wise, his wife was about average, if truth be told. He was about to ask from under the instrument trolley what the midwife meant when a note caught his eye on a meta-analysis of randomised controlled trials of vitamin K injections for new-borns, he heard a gurgle, and the midwife tapped him on the back.

‘Norm… Norm… It’s a boy.’

And there he was.

‘A beautiful baby boy,’ she said.

And Mrs N with a huge sappy smile, the baby in her arms, the midwife grinning like a slice of melon.

But now, ‘beautiful’ … A tomato thrown at a wall, more like. Always tricky these aesthetic metrics.

Email from Prudence to Norm.

Attachments:
Health and Safety Executive: New and Expectant Mothers at Work: A Guide for Employers.