CORONAPOCALYPSE

To control spread of coronavirus, use wisdom of the crowd

Ask people in slums what works—not running water for 20 seconds to handwash.

In Summary

• Large groups of diverse people are collectively smarter in problem-solving, decision-making, innovating and predicting, than a few individual experts. 

• Why does Kenya rely on experts who don't know what it's like to live in the slums, do manual labour and ride matatus daily? End the groupthink and open up. 

Governor Anyang’ Nyong’o at the Kisumu bus park during a forum to educate the public on how to protect themselves from Covid-19 on March 23.
Image: DANIEL OGENDO

Who Wants to Be a Millionaire?

This was one of the earliest US televised game shows that aired in the early 2000s. The contestant was asked several questions that had multiple-choice answers. As the show progressed and the contestant got the answers right, the questions became successively more difficult. If she answered all 15 questions correctly, she walked away with a prize of $1 million. [It could have been 'he']

If she did not know the answer to a particular question, she could be assisted in three ways. One, she could request that two of the four multiple-choice answers be removed. This left her with a 50-50 shot at the right response. Two, she could place a call to a friend or relative, a person whom before the show she had singled out as one of the smartest people she knew, and ask him or her for the answer. Three, she could poll the studio audience which would immediately cast its votes electronically. The crowd was always right 91 per cent of the time compared to the experts at 65 per cent.

This is called the wisdom of the crowds. It affirms that large groups of diverse people are collectively smarter in problem-solving, decision-making, innovating and predicting, than a few individual experts. The crowd’s wisdom is characterised by a diversity of opinion and each person’s opinion is independent of those around him or her.

The coronavirus pandemic has ceased being a faraway threat. It is getting closer and real in various parts of the nation. In response, last month President Uhuru Kenyatta formed a 21-member National Emergency Response Committee headed by Health CS Mutahi Kagwe, to coordinate the nation’s preparedness, prevention and response to Covid-19.

This committee is constituted of other Cabinet and Principal Secretaries of Defence, Transport, ICT, Interior and Foreign Affairs. Others include representation from the Council of Governors, uniformed forces, health and immigration professionals.

It is commendable how regularly this committee has been briefing the nation on the status of the disease spread, the prevention measures it is requiring Kenyans to take and the consequences of violating those measures. They have told us that their frame of reference is driven by science and evidence of what other nations have successfully implemented to flatten the infection curve.

Three key prevention measures have been lockdowns, washing hands frequently and self-quarantining. Experts have passionately defined and demonstrated these measures by telling us to wash our hands with soap under running water for 20 seconds, and to self-isolate in a room for 14 days. This has turned out to be a great science textbook theory.

Statistics show that a running tap uses six litres of water per minute. So, washing for the recommended 20 seconds, while singing the happy birthday song, will consume two litres per person. This is in a country where, according to a Unicef 2017 report, 23 per cent of the population has no access to a water system, 70 per cent has no access to basic sanitation at home, and only 14 per cent have handwashing facilities on-premises with soap and water.

Elsewhere, the 2020 Budget Policy Statement from Treasury noted that there are 10 million Kenyans who live in slums. This is 21.2 per cent of our population. In Nairobi county alone, 36 per cent of the 4.39 million people live in the city’s informal settlements. This equals 1.5 million people. In Mombasa 24 per cent live in the slums. The population density averages over 60,000 people per square kilometre. The majority of the people live in single rooms whose average size is about nine by 10 feet, constructed with iron sheets, with an average household size of five persons.

 

Begs the question, despite science and trends showing us that the recommended prevention measures are effective, how pragmatic are they in our context? Is it a wonder, then, that the government dictates being issued are largely not being complied with?

 

I submit, however, that this does not mean that our experts are wrong in making these recommendations. But I hazard a guess that none of them has lived in a slum, touted a matatu, hawked in CBD, been a mason, sold sukuma wiki or daily commuted on the Mombasa ferry. And herein lies the challenge.

The majority of us believe that valuable knowledge is concentrated in the hands of a few experts. We believe that the key to solving problems or making good decisions is finding that one right person or a few people, who will have the answer.

Medical staff carry a box at Jinyintan hospital, where the patients with pneumonia caused by the new strain of coronavirus are being treated, in Wuhan, Hubei province, China.
Image: REUTERS

But on the contrary, small homogenous decision-making groups are often victims of groupthink because the members are too much alike in worldview and mindset. Due to their small size in number, not only do they become more cohesive, but also more dependent on the group’s thoughts and ideas. This results in three things: One, an increase in their insulation from outside alternative opinions; two, a readiness to rationalise away possible counterarguments to their team’s position and three, a conviction that dissent is not useful.

In the context of the unprecedented Covid-19 disease, diversity and independence of opinion are critical because the best collective decisions are the product of disagreement and contest, not consensus or compromise.

Kagwe, I submit that you should consider prioritising mitigating the spread of coronavirus in our informal settlements and in the informal economy for the reasons I elucidated earlier, and others that have been underscored in different fora

In medical-speak, this is known as triage. Triage is the assignment of degrees of urgency to decide the order of treatment or intervention to a large number of patients or casualties.

Experts have told us that the reproductive ratio or R naught for Covid-19 is a minimum of three and could be higher in densely populated areas. R naught applies to a situation where everyone in the population is susceptible, and no control measures are taken. It gives us the number of new cases that one existing case can generate over time.

A simple illustration is where one infected person infects three other individuals, I,e A infects B, C, and D, and then B, C, and D infect three more people each. Now extrapolate this scenario to the 10 million slum dwellers and you can see that failure to triage in these informal areas will be akin to mopping the floor while the roof is still leaking, which will make Italy look like child’s play.

To do so, I suggest that you consider incorporating the wisdom of the crowd from these informal settlements and economic sectors to develop pro-poor coronavirus prevention strategies. This is because research shows that when you make it possible to aggregate wisdom in independent, diverse and decentralised ways, the resulting wisdom of the crowd can be uncannily accurate and effective. This aggregation often outperforms the most accurate individual expert judgement.

Mr CS, consider assembling a team of social and behavioural practitioners who will convene focus group discussions with the populations where it is impractical to implement the proposed prevention measures for reasons earlier elucidated.

These respondents have over the years devised, adapted and mastered strategies to live and work under extremely dire conditions, which the majority of your 21-member team cannot endure for a day. They, therefore, have first-hand knowledge and recommendations of what would work, and wouldn’t work in their contexts. Incorporating them also gets you a buy-in, which in turn increases compliance with the proposed measures.

These FGD (focus group discussion)  respondents will also not be intimidated by authoritative administrative hierarchies that would stifle their diverse and independent opinions, thus forcing them to conform to groupthink. When there is pressure to conform, people change their opinion because it is easier than to challenge the group, particularly in the presence of their seniors.

The findings from these FGDs will then be analysed and aggregated, and the responses that occur repeatedly will give your team an indication of what is likely to work. Then use this to inform the appropriate strategies that should be implemented.

Finally, my unsolicited advice to Kagwe; flattery is like chewing gum. It is meant to be enjoyed for a short while, not swallowed. Likewise, you have received accolades for your work, leadership and passion. Proposals to make you the next Mt Kenya kingpin are already being floated. Do not let the praise get into your head, nor the insults into your heart; neither should you allow your appetite for publicity and exaltation delay your pursuit of successfully navigating the nation out of this coronapocalypse.

An expert knows all the answers, if you ask the right questions – Levis Strauss