By Dr. Anthony Policastro

I play a lot of online Scrabble. I often play against people I don’t know. They have a Scrabble user name. They also frequently have a photo.

Neither one of those things has any effect as to how well they play Scrabble. However, when I look at a name or a photo, I sometimes tell myself how good I think they are based upon that.

The formal term for this is implicit bias. It is defined as an unconscious association, belief, or attitude toward any social group. When the attitude is conscious it falls more into the realm of stereotyping or prejudice.

It is not also a negative thing. For example some of the Scrabble players have names or photos that are intimidating enough to make me think that they are better players. That is a positive implicit bias.

Implicit bias can be related to race. It can be related to gender. It can be related to religion. It can be related to weight. It can be related to another personal characteristic. It drives us subconsciously to develop a warm feeling or cold feeling about an individual that we encounter.

There are psychological reasons why this happens. One of those is that our brain tends to seek out patterns. Doing this for human interactions is a term called social cognition. When we meet someone new we tend to see what box they fit into in our mind.

A second reason is that our brains like to take shortcuts. We have much information thrown at us on an ongoing basis. Therefore we have to sort through it quickly. Implicit bias allows us to move some of the information quickly into a familiar box.

A third reason has to do with experiences. Some of those experiences might be direct. Some of them might be what we have seen or heard from others. Those might be other individuals. Those might be the media.

There are real consequences to implicit bias. For example society has long suggested that boys are better at math than girls. This is not true. However, as girls go through school the subconscious bias to that is reinforced. The result is that by age 9 years girls in general think that they cannot be as good as boys at math.

Names can create implicit bias. A study was done on this. Four reports judged to be equal in terms of their components were give to teachers to grade. The names at the top of the four papers were David, Michael, Elmo and Henry. One hundred teachers graded the reports. David and Michael consistently received higher marks than Elmo and Henry. The names were switched so that David and Michael now had their names at the top of Elmo and Henry’s reports and vice versa. One hundred different teachers graded the reports. Again David and Michael had higher score than Elmo and Henry.

Racial profiling may not be a conscious thing. However, it clearly occurs. The individuals who deny that they are doing so may be perfectly correct in saying there is no conscious decision to do so. However, even if it is subconscious, it is still racial profiling.

The approach to dealing with this has several aspects. People need to be seen as distinct individuals from others of their type. We need to understand that we have these biases and desire to change them. The old adage of walk a mile in my shoes applies very well here.

I may continue to make inferences about the names and photos of Scrabble players. Invariably I am wrong when I do so. Darn that implicit bias.


For the last week, the number of new cases has ranged between 32,000 and 50,000. That is only slightly higher than it had been the week before and still below the July peak.

Coronavac is the COVID vaccine that is most like traditional vaccines. It is currently in Phase III trials. In the Phase II trials all the candidates were between 18 and 59 years of age. About 97 percent of the 743 of them developed antibodies to the COVID virus.

The Phase III trials included a group of 421 healthy individuals between the ages of 60 and 88. About 98 percent of them developed antibodies. As expected this vaccine has a high seroconversion rate. It remains my favorite among those being developed. The numbers of individuals are still small but the results are promising.

There have been anecdotal reports of people who had significant respiratory illness before the epidemic began in the February-March time frame. This suggested that perhaps COVID infections began earlier than we thought. A recent study looked at that suggestion.

It involved a health system centered in Los Angeles and Seattle. They had 3 hospitals, 180 clinics and over 2,500,000 annual patient visits. They compared the 10 weeks beginning December 22, 2019 until the end of February 2020 with the same periods for the preceding five years.

They looked at how many visits there were with a chief complaint of “cough” according to the medical records. They only looked at cough and not other COVID type symptoms.

Every year for the previous five years there had been increased visits for cough in the winter. However, this year all 10 weeks showed significantly higher office visits for cough. Six of the 10 weeks showed significantly higher ED visits. Seven of the 10 weeks showed significantly higher hospitalizations.

The actual number of excess visits was not that high. There were 168 excess clinic visits. There were 56 excess ED visits. There were 18 excess respiratory failure hospitalizations. They also noted that there were increased positive flu tests over this period compared to other years as well. So clearly some of the increase was due to the flu.

Their conclusion was: “It is possible that some of this excess represents early COVID-19 disease before clinical recognition and testing.”