Like many of you, I’ve been consuming Covid 19 news and podcasts voraciously and non-stop for weeks. I’ve even taken to watching…watching…actual news. Like, on the TV. Mostly Anderson Cooper, none of the pundits, and obviously not the ridiculous Trump rallies, er, nightly State(s) of the Union or whatever. I’ve listened to updates from medical experts, economic advisers, political experts, authors, actual interviews with victims and healthcare providers, psychologists, frontline workers, business owners, you name it. This is all part of the new normal. All while navigating the fraught SBA loan process and waiting to see if we will still be in business when all is said and done.
When I read the comments on NextDoor, basically the definition of hell, what I see is a bunch of people who don’t know much but whose fears fall squarely along partisan lines. They can’t read stats critically. They can’t read articles past the headline. They don’t know why some of the stats don’t mean what it sounds like they mean. They lack basic comprehension and critical thinking skills, but what they lack in these things, they make up for in self-righteous lambasting of the opposing view. Oh, the humanity!
The problem is, nothing we are doing is really a plan. Nothing we are doing so far (nationally, some states are better) is necessarily going to make it safe to re-open the country. That’s because we don’t have the information we need. We sometimes think we have some information, and then it changes, and we realize we don’t really know what we think we know.
- Number of cases. What we know is the number of people who have tested positive. What we don’t know is the potentially large number of people who were positive who were never tested. As a result, we can’t know how many people have had it, how many have it now, or how many have recovered. We don’t have enough testing to know who these asymptomatic carriers are who have the ability to infect others or how many of them there are, or how long they can infect others. People can’t get tested if they don’t have symptoms, and they usually won’t even ask for a test unless they are very sick. We’ve been told they can spread the illness for 3-4 days before any symptoms happen. So the biggest gaps here are:
- People who couldn’t get a test in their state due to lack of availability.
- Asymptomatic people.
- People who chose not to get a test [1]
- their symptoms were mild
- they don’t know they were exposed
- they were uninsured
- they don’t live near a testing facility
- they need to work and don’t want to be told they can’t
- they just didn’t think they needed a test or didn’t want to get one
- Number of hospitalizations. What we can know is the number of people who were actually admitted to the hospital with Covid 19. This doesn’t include people who can’t be moved, like those in nursing homes, and it doesn’t include people who aren’t insured who won’t go to the hospital. It doesn’t include people who just stay sick at home, possibly dying there. But this is at least directionally helpful information since we know it doesn’t include all cases. It is one indication of how many cases are severe.
- Number of deaths. This is mainly going to be the number of people who were known to have Covid 19 who died while still hospitalized or under a doctor’s care. If they died in isolation at home, they may not have been reported. If they died early and had other health issues, their deaths may have been miscategorized as something else. There’s been a lot of controversy around the death numbers in NYC being revised upward recently, and the reason for that consternation is that there are different reasons to want to know it. Do we need this data to understand the spread and impact of the disease or to gauge when it’s safe to reopen the country? We don’t have good data around Covid 19 deaths that had a co-morbidity factor. We don’t know how many people died (or recovered) after being tested who did so in a place other than the hospital. And, since we don’t know who all has it, we can’t know the correct death toll for those who are outside of a hospital. At best, this is a directional number.
The only factor that we seem to be evaluating in terms of getting the country back to “normal” is the hospitalization case load and death toll, but without knowing the total spread, we can’t know if there will be a spike in cases if we start eating in restaurants or going to the movies again. My first post on this topic recommended we do random tests in the population to better understand asymptomatic spread. On March 26, I made several reasonable suggestions to get ahead of the novel coronavirus. Many of these were adopted in some form or other or in some parts of the country. Two that are vital have not been widely addressed, and they are at the heart of what we need to do to get back to anything resembling normal:
- Testing. The biggest gaps here are 1) many states still don’t have adequate testing available (Utah is ahead on this one, but AZ is just terrible; this is because Utah has companies that can provide testing, and AZ doesn’t have any of these types of businesses), and 2) nobody is testing the asymptomatic population at random to better understand the real spread of the illness. In Utah you have to have at least one mild symptom. In AZ, you have to have at least 3 severe symptoms for a prolonged period, and be willing to sleep with the test giver.[2]
- Contact Tracing. You have to be able to link cases to find out who has contracted the illness even before they start exhibiting signs, similar to what they’ve done in places like Singapore and South Korea. All citizens in those countries download a free contact tracing app that will track the other cell phones that are in proximity to theirs. In the US, contact tracing is a manual process. A person who tests positive has to provide names and places for contact tracing, which is the process used to notify people who were exposed to an STD. Then someone makes personal phone calls to those contacted to notify them they should watch for symptoms and get tested if they have symptoms or stay quarantined for two weeks. One obvious gap is who knows what people you were near before you were symptomatic? This isn’t an STD where only people you’ve had sex with are at risk. You don’t know who was on the subway near you or whom you passed in the grocery store! The apps that were created in Singapore track your “contacts” based on the proximity of others’ phones to yours using the bluetooth technology that already exists in the phone. It does require people to opt in, even in Singapore. In the podcasts where I’ve heard this discussed, even the interviewers are squeamish about the idea of using a phone app to track contacts, but without it, our solution is impractical and deeply flawed. I get that Zuckerberg has pretty much ruined any trust we ever had in big tech, but if it means movies and Costco samples, I am willing to download the app now, while reserving the right to litigate him back to the Stone Age at a later date.
First Outlandish Idea: the Calls are Coming from Inside Your Phone
Let me expand on the idea of a contact tracing phone app and how it might work (in conjunction with testing). To enter restaurants, movie theaters, and stores, you require that patrons scan a QR code they have on the app at the entrance. Their code must be “green,” meaning that they have not tested positive and they have not been in proximity with anyone who has tested positive. If someone is tested positive, the app immediately changes the QR code of those they were in contact with anytime up to 4 days in advance of their symptoms to a “yellow” status, meaning that they need to be tested and cleared before their code is green again and they can go to public places. A red QR code means you are currently infected and must be fully quarantined. It’s a solution that still requires a lot more testing availability than the US has managed, leaving it up to individual states to try to figure out their own testing. That doesn’t work as well in some states that don’t have those types of companies, which is why we should be using the Defense Act to ensure all states have an adequate number of tests. Leaving it all up to governors is destined to result in a mish-mosh of halfway solutions. So that’s one of my two “outlandish” ideas: use phone apps and testing to reopen stores, movie theaters, etc. to anyone who is “cleared” with a clean QR code.
Second Outlandish Idea: Pandemic Duty
Which brings us to my next outlandish idea, and this one is truly going to sound dystopian. If you didn’t like the “big brother” aspect of the last one, this next one is going to sound like Logan’s Run or Shirley Jackson’s short story The Lottery. Social distancing for a prolonged period was designed to “flatten the curve” so that we didn’t overrun the capacity of hospitals and medical staff. The problem in many states, including the one I live in (Arizona) is that we are not utilizing the full capacity of the health care system yet (aside from our absolutely inadequate testing here). We have only been filling about a third of our hospital beds in our state. If the curve is too flat, it takes longer for the illness to peak and run its course. The disease is still out there because it has such a long incubation and infection period, but we are just slowing down how long it will take to develop herd immunity and for the disease to evolve to something less deadly.[3] Social distancing is meant to contain and reduce the spread, but the disease still spreads, just more slowly. Well, what if we used the jury duty selection process and used our hospitals to full capacity rather than waiting for nature to take its course? As with jury duty, you can allow exemptions based on specific co-morbidity factors and risks (even for the uninsured, you could run a panel of co-morbidity tests to “qualify” someone for pandemic duty). Then, if we can ascertain that recovery makes one immune (or enough immune to be safe to return to work), those who complete their duty return to work and are available for any job duty that is needed.
Don’t get me wrong, I know why we aren’t doing this one. Some people we think are healthy have died. We don’t have a good handle on why that is. Nobody wants to sign up to get sick (or for jury duty, for that matter, which is how I got this idea–I got a jury duty notice in March for April duty). And no politician wants to have to explain to a family why the government killed their loved one for the public good. This one would be about as popular as the draft. and I can just imagine the interviews with grieving families that would hit the media. The only practical way to do this one is if compulsion were off the table and if it was so easy to get out of pandemic duty that it was really voluntary. Maybe you could compensate people for agreeing to it, but you’d have to pay much better than jury duty does.
On the upside, we would know a heckuva lot more if we had taken this approach. How many people would get it and have really light symptoms? How many would be completely asymptomatic? For those who did get sicker, we would have them under observation with medical staff on hand and be able to evaluate what the disease did and what their other issues were. As they say, the best defense is a good offense. And let’s be honest, shutting down the economy, which would basically happen anyway, is totally compulsory and hurting a lot of people (as well as socially enforced). Regardless, this is at minimum a great plot for a movie if we are ever allowed to go to the movies again.
Discuss.
[1] I know someone who has several symptoms but she is uninsured. I read that Banner Health is administering tests to those who are uninsured and gave her the information. She went and explained her symptoms, and at first they said they wouldn’t give her the test without a doctor recommendation (which she doesn’t have because she is uninsured). Then they said they wouldn’t give her the test unless she was sick enough to be hospitalized (which she would never agree to because she is uninsured). So they just said to stay home for two weeks. She is not included in AZ’s Covid 19 numbers because she hasn’t been tested. Our state likes to tout how few cases we’ve had, but we literally don’t know how many have had it!
[2] OK, so that’s probably not true because the test giver doesn’t want to get infected.
[3] A virus that kills its hosts is a less successful virus than one (like the common cold or the flu) that just makes us sick, then we get well but we can be infected again. That’s the goal of any self-respecting virus, not killing its hosts and ending up dead with them.
Wheat & Tares 
Anderson Cooper. 🤣
No media briefings from the POTUS. Nice. Try to refrain from your political biases please.
Your idea of Pandemic Duty is not as outlandish as you think. There are enough whackjobs and conspiracy theorists out there who believe that COVID-19 is a hoax (or at least an exaggerated threat supposedly being used to trample their civil liberties), and would gladly participate in such a program just to try and prove themselves right. There will be enough volunteers, no need to summon unwilling participants. And by infecting the very people who deny the pandemic, we are doing a valuable public service. It’s win-win!
A twist on outlandish idea 2: what if we allow people to opt-in and you give them some sort of reward or incentive like a pass to go wherever they like, like actual freedom? I think lots of 40 and younger would take this risk.
Being an AZ resident myself, I’ve been wondering if our soon-to-skyrocket temperatures will do anything to Covid-19 transmission rates. I’ve wondered if healthcare workers in NYC are being tested for antibodies. Seems like you could figure out pretty quickly if they were getting reinfected.
Also I’m no fan of censorship, but can’t the media show some self restraint with some of their headlines?
Yes, the sad lack of testing means the policymakers are shooting blind. I stated four weeks ago when the lockdowns started that it would be a lot easier to put them in place than to reverse them. My view was based on bureaucratic conservatism: no bureaucrat wants to take an action that might generate blame (“You lifted the lockdown, then my mother got Covid and died!”). So they’ll keep the lockdowns in place until long after they should be relaxed based on balancing costs and benefits.
But the lack of data also contributes to the difficulty of reversing the lockdowns. How can you state and employ data-based metrics for progress in fighting the spread of Covid and then relaxing lockdowns when the data is so spotty? Their lips are moving but they don’t really have a workable plan. It’s not clear they understand they don’t have a workable plan. There is no plan.
Here’s what they ought to be doing: Any business that can present a plan to local authorities that they can operate with adequate social distancing and disinfection procedures in place can reopen. A gym can close (yellow tape) half the equipment and have a person full-time circulating with spray and wipes. A restaurant can reopen if they close half the tables and have better ventilation. A furniture store can reopen if they limit the number of customers entering to 5 per 1000 square feet. And so forth. This pragmatic approach is what we need, not blanket measures that close everything while waiting for … what? A vaccine ? Cases to go to zero? These things simply will not happen for years. NO ONE HAS A WORKABLE PLAN to move things forward. Policymakers are still in panic mode and are getting pretty much zero help from the top. The daily Trump briefings are a clown show whenever he is speaking (most of the time). It’s just very depressing.
Jess, appreciate your defense of our great president. The truth will emerge in due time, and Comet Ping Pong will prove to have a basement, at long last. Q
Prior to the advent of vaccines, people did sometimes get inoculated by exposing themselves or their children to a disease. One well known example of this was a small pox epidemic in Massachusetts when Abigail Adams purposely exposed her children to small pox, along with many others in the community. That sounds a lot like pandemic duty.
https://en.wikipedia.org/wiki/1775%E2%80%931782_North_American_smallpox_epidemic
The practice was dangerous and contraversial, but would be much more contraversial today when we presumably can expect a vaccine to be available in a year or two.
“but without knowing the total spread, we can’t know if there will be a spike in cases if we start eating in restaurants or going to the movies again. ”
I see this kind of statement often, and I have to say, I think this is just wrong. I mean, eventually it will be true if we don’t improve testing, but right at the moment there really isn’t any question that there would be a spike in cases. Or a better way to say it is that the chances that a spike wouldn’t happen if we opened stuff up right now are extremely small.
I’m not sure how much effort I should go into to be convincing on this point. Perhaps I should just say trust the CDC; I don’t think they would recommend closing things if they didn’t know it was important.
But you can look at the numbers and have a pretty good idea of what is going on with some numerical analysis tools. It’s pretty clear to me that deaths and infections grew exponentially up until the social distancing began. Infections slowed down after that and I expect deaths are slowing down now as a lagging indicator. There was no indication of slow down before then and so to say that there’s any kind of herd immunity is to assume a pretty big coincidence.
Jess: To explain my choices to ignore Trump’s daily briefings, I am simply exhausted by the Trump outrage. I have no more gas in the tank. He provides no expertise I can’t get better elsewhere, and his main objective is to campaign and to boast that his ratings are higher than the Bachelor finale. I don’t need to contribute to his ratings. To paraphrase Napoleon, leaders exist to explain reality and give hope. He’s so bad at both of those things that I can’t summon any more disdain. He’s just irrelevant. The only reason to watch his briefings is to see which way he’s blowing, not to find out any actual information about the virus or the economy. I like Anderson Cooper’s show because he invites interesting experts, but I don’t like Chris Hayes because watching someone rant about the failures of the administration is a waste of time, and the failures of the administration are inevitable with someone at the helm who doesn’t know what he’s doing surrounding himself by underqualified loyalists and family members. To be clear, I haven’t hated everything Trump has done in response, although he’s made a ton of mistakes (stakes are high, and anyone would), but hearing him talk about it is like eating glass. It erodes confidence rather than boosting it.
Rockwell: I didn’t intend to cast doubt on the idea that there will be a spike if we open things back up; I should have been more clear that we don’t know how big a spike rather than implying there could be no spike. In AZ, we have capacity to handle more cases up to a point. I’m not advocating against social distancing, but we currently have no plan to get out of it, and while I follow and agree with the CDC guidelines, we did this to flatten the curve, but if you watched the four models and the impacts of social distancing, the more you flatten the curve, the more you prolong the window. There’s a sweet spot there somewhere. Flattening the curve significantly below capacity levels for the health system has an adverse effect on the length of time social distancing is required because you can’t reach herd immunity as fast (theoretically). Right now, in AZ we are way under our health care capacity. In NYC, they are way over it. The news focuses on NYC and other hot spot cities because their news is more exciting, their stories more harrowing. Local Covid news here is a snooze. There’s a lot of people sitting at home with our thumbs up our butts. That’s about it. Back to the studio. Utah seems to be doing a much better job at getting data than my state.
Maybe a hybrid solution is that states engage in lockdown at a certain % of capacity (with an assumption that cases spike within 2 weeks of relaxing of social distancing.) The other factor is that there’s how we used to be (no social distancing, indifferent hand washing at best, pressure to work even if you are sick, pressure to shake hands and/or hug, crowded restaurants and movie theaters, Costco samples with crowds around them, etc.) and how we are now (stores often empty, no restaurants except delivery or pickup, no samples, people wearing masks, no working while sick even if it’s just allergies, no movies, no events, no funerals, church or parties, no handshaking). We will never go back to the pre-Covid norms. People are going to still try to stay 6 feet apart, wash hands, not shake hands, not work while sick (in higher numbers). So we probably won’t spike to the early Covid levels even if retail stores were opened or restaurants with outdoor seating were allowed to have some dine in options.
I have it on good authority that God has revealed to Pres. Nelson the he will stop this pandemic if Utah votes for the Democrats this Fall.
CM, that has to be for laughs but I can’t imagine how there are still people who haven’t had enough of the lying and preening and neglect and bungling. How could anyone still need someone to tell them or bribe them into choosing the … well … right?
That’s a good clarification, Angela. Thanks.
I still think most people are likely still underestimating the contagiousness of the disease. It’s true the disease may not spread as quickly due to public awareness. But the science behind the recommendation “six feet apart” is not actually very strong, and people are notoriously bad at washing hands. They think gloves make them safe but they don’t change them often enough, etc etc etc. The fact is that no country has yet been able to keep this under control without draconian measures and testing.
I would like to open the country up, too, of course. So it all goes back to your first point: testing. We’ve botched the testing, it’s a total cluster, and until we have a good way to test a LOT of people every day in every state there will be a huge cost to public health to opening stuff up.
According to my (admittedly amateur) calculations, the pre-lockdown rate of spread was increasing exponentially over 25% per day. That was based on deaths, which is a lagging indicator but more resistant to bias from limited testing. At that rate, cases were increasing 5 times per week, 220 times per month. But it takes a week or two to even know someone is infected, during which time the number of cases can increase by five times.
This is why the testing and contact tracing is so crucial. If there is any delay in testing, any difficulty that slows things down, it’s a huge problem. Every day is critical. Once we have a robust testing system, we can begin to open things up and monitor closely to see the infection rate and keep it from increasing too quickly.
(as is often the case, I messed up the math a bit, but people shouldn’t be trusting Random Guy like me on the internet anyway. But folks can check the total deaths due to covid in the month preceding the lockdown for comparison).
At one of Utah’s press briefing I recall Angela Dunn, the state epidemiologist, saying that testing asymptotic individuals was not very accurate. I believe they end up with more false negatives and then people still spread the virus because they think they are all clear.
My prayers go out to the doctors and scientists studying this virus. There is still so much we don’t know.
I haven’t been in physical contact with the outside world in 41 days – except a trip to the ER for sciatica (which has contributed to my confinement). I’m going a bit batty. But I find myself having to repeatedly talk with family members about the science and logic behind much of what we are doing. There are so many that don’t want this to be a reality and will seek out pseudoscience, crackpots, religious zealots, ignoramuses – any straw to grasp at. No stretch of logic is too great.
And then there are the family members that see God’s plan in every increase or decrease in death rates Appearenty God either wants to kills us or just use this to prove that the church is true.
On the plus side, my wife has been a mild Trump supporter and did not want to hear any negativity about him. However, after a week of his press conferences on the virus, she sees that the emperor has no clothes. It gives us something to bond over during a time when she could very easily be pretty tired of having me around 24/7.
In Australia we are told the cold is also a covid virus, so no vaccine or heard immunity. That people have caught it a second time and it is worse the second time.
We are in lockdown, we are being encouraged to stay at home. We can not go to another state. No non Australians allowed in. Australians coming home are taken to a hotel where they are required to stay for 2 weeks.
Our governments are starting to talk about reducing the restrictions in a couple of weeks. We have squashed the curve.
I live in Queensland which has a population of 5 million, has 1007 cases, 19 in hospital, 11 in icu, and 5 deaths. We have had 2500 tests in the last 24 hours.
Compare to
Utah 3 million, 2680 cases 24 deaths
Az 7.3 million 4234 cases 150 deaths
Idaho 1.8 million 1609 cases 41 deaths
Californis 39.5 million 28900 cases 973 deaths.
Our leaders have made mistakes
Some countries in Europe have had terrible results, while others like Germany have done well.
America is not doing well.
This is a situation where the decisions of leaders have consequences measured in lives.
https://www.abc.net.au/news/2020-04-15/donald-trump-cutting-funding-to-who-explained/12149550
alice, never underestimate the stupidity of the American voters especially in Utah.
This is mainly address to Geoff in Australia- there is no single CFR (case fatality rate). It varies by region due to age demographics, co morbities, even gender. The countries doing “terrible” or “well” are likely greatly influenced by the demographics. I read obesity (and Often associated diabetes) aside from age, is the number one factor in the severity or fatality of covid19. Italy , with its population which is the oldest in Europe, was always destined to be higher than many places.and America, with our less than stellar obesity demographics and health in general, frankly,, was not going to fare the same as say, a Scandinavian country. However, mix in other preventive measures ,social distancing, etc. ,that governments implemented at different times and you get different outcomes too. Regarding the math with the modeling and predictions and even the CFR and Infection rate , “numbers aren’t facts- they’re the result of subjective choices” of data collection -who is deciding what to include or count and how they count it. All we can do is try to make sure we aren’t at the point of diminishing returns as far as the suffering of at risk populations (immigrants, minorities, those already living below poverty line and children living in dangerous home situations ) . I think we are on the razors edge here. The best “study in a lab” scenario we have is the Diamond Cruise scenario. It’s not perfect, it’s population was heavily skewed older so not representative of diverse population but there is no “land “ case that’s a better. I’m copying directly from researchgate.com here
“Adjusting for delay from confirmation-to-death, we estimated case and infection fatality ratios (CFR, IFR) for COVID-19 on the Diamond Princess ship as 1.2% (0.38-2.7%) and 2.3% (0.75%-5.3%). Comparing deaths onboard with expected deaths based on naive CFR estimates using China data, we estimate IFR and CFR in China to be 0.5% (95% CI: 0.2-1.2%) and 1.1% (95% CI: 0.3-2.4%) respectively.“
I know I’ll sound callous but I’m not sure subjecting the country to unemployment numbers that are soaring past those the Great Depression and erasing at least 10 years of economic gains in weeks is worth those numbers . Everyone can down vote and hate me now I’m good with it :).
You lost me at Anderson Cooper 😂
He’s your filter huh? Did you actually write that with a straight face ?
“What we know is the number of people who have tested positive. What we don’t know is the potentially large number of people who were positive who were never tested.”
Before we can truly determine Covid cases are decreasing we need to track the number of tests being done. If we are now testing fewer than we were 3 weeks we are identifying fewer cases.
Additionally, some states have seen a spike in people dying at home. These people didn’t necessarily get a Covid19 test prior to dying so they may very well be victims of Covid.
We continue to stumble along—without leadership at the top to help states get adequate PPE and testing.
A pandemic is precisely where the federal govt can play a role—to help pull together necessary resources.
Not, states have to “get their own,” federal govt has its “own supply.”
The federal govt exists to help, aid Americans in times of crisis.
The current POTUS is ill-suited for a leadership role.
“Leadership is a choice, not a position.”
Stephen Covey
“The supreme quality for leadership is unquestionably integrity. Without it, no real success is possible, no matter whether it is on a section gang, a football field, in an army, or in an office.”
Dwight D Eisenhower
Geoff – Aus
I always love your viewpoint.
You may want to verify the reasons there is not a vaccination for the common cold yet. From my understanding, it’s that there are about 200 different viruses (including strains of viruses) that cause the symptoms we collectively call the common cold. These include rhinovirus (most common), adenovirus, respiratory syncytial virus, parainfluenza, and coronavirus. It’s difficult to create a vaccine effective against all of those. Researchers continue the quest, with various approaches. In one that I read about, they were examining the various rhinovirus strains, hoping to find identical segments that a vaccination could target.
I’m holding out hope that there will be a COVID-19 vaccination. The world’s health and economic future looks rocky without one. I’ve heard credible voices indicate that we will likely develop a vaccine in one to two years.
Everyone knows that Corona affects the old much more than the young. But do you know the actual data? 94% of US deaths consist of folks 55 and over. 80% of US deaths are folks 65 and over. Maybe we should consider targeting these folks for distancing? Less than 1% of US deaths are folks 44 and younger but my kids can’t go to school? We need to be more focused and targeted in our approach.
Tangent: Synagis, the treatment to protect at risk infants from RSV, was developed by respected Mormon history and current issues author, Gregory Prince, DDS, PhD in Pathology.
Joshua, how do you know who to target without mass testing? Maybe that’s exactly what you’re advocating. Your kids may not be outwardkly sick, but they can still carry the virus and share it. People in their middle ages may not die as frequently, but they do end up in the hospital. If they are asymptomatic and are permitted to just socialize like before, many of them will end up in hospitals and the healthcare system is overwhelmed; people with other illnesses–heart attack, kidney failure, diabetes–can’t get treatment in emergent situations because ERs and ICUs are full of COVID-19 patients. So, it isn’t just the deaths that you need to be concerned with, although those are still a concern because death rates are all over the map globally. Right now, in the U.S., death as an outcome in closed cases–those serious cases that are actively monitored and treated–is 38 percent.
I think you’re correct.–we need to be much, much more focused and targeted, but not just on who we isolate. We need to know who is carrying the virus and who they have spent time with recently, i.e., testing and contact tracing.
Good “outlandish” ideas. The coronavirus pandemic appears to be inevitably changing the whole landscape of politics and human culture as we know it, the latter shaping the former. Simply to be able to combat the virus on the scale that we need, we have to undertake drastic changes. There is no going back to the way we had things before (only a very memorable few months ago). Just to develop, test, produce, and distribute a vaccine will require the effort of dozens of countries and millions and millions of human workers, not to mention hundreds of billions of dollars, and possibly trillions.
My political prediction is that coronavirus will severely dampen the political philosophies of libertarianism and Trumpian conservatism. Governments will grow larger and larger. They have to. The government is the only apparatus large enough with enough money (it can deficit spend!) to be able to tackle the challenges that lie ahead. There is no free market solution to the coronavirus pandemic. People around the world will look to governments to solve the problems that arise because of coronavirus and will continue to do so even when governments fall short. Conservatives are already deeply divided about the coronavirus and how to handle it. Denialist currents in conservative and libertarian circles can last only so long. This virus spreads fast, and once governments let up on restrictions, the virus will continue to spread fast and it will not take long before everyone on the planet knows someone who will die from it. As that happens, attitudes will drastically change and the idealistic, utopian visions of freedom from government that have been mobilizing conservatives and libertarians for the past few years will quickly die. More and more people will see governments and effective science-trusting leadership as the only way to have freedom from the virus. Trump has no idea what to do. Denying science won’t help him. Pointing fingers at China and the WHO will buy him only a little bit longer. He will continue to fumble. He will continue to be ineffective in the face of this vicious beast. And it won’t take long before a margin of his supporters (just a few percentage points is all it will take as Trump as always been holding on by a shoestring) abandon him. The economic crisis is fresh, but people are beginning to crack under it. It will be a long painful solution to economic woes caused by the virus. Trump will be devoured in the midst, as will conservative and libertarian philosophies. A part of me reacts with relief and glee that these delusional philosophies will meet their demise, but I am deeply pained at how it has had to happen.
I watch these protesters with great interest. Many of them are far right figures, and strong Trump-supporters. They think that vulgar libertarian and gun-toting philosophies are the answer. These are folks I used to mock. Now I just feel sorry for them and sympathize with them. It is difficult to see the economy on hold and on the precipice of a depression. I want to reopen things too. And of course, things will be reopened, gradually, and in due time. What that will mean, however, the spread of the coronavirus, the eventual overwhelming of the healthcare system, more shutdowns, and more panic and an embrace by the previously reluctant, but now desperate and grief-stricken of strong government philosophies.
I make this prediction on the basis of what has happened in the past. Governments have always strengthened and grown in the face of military, economic, and social crises. Abraham Lincoln and the Civil War, Teddy Roosevelt and the plight of factory workers, FDR and the Great Depression and WWII. To the chagrin of libertarians, the few figures about whom most Americans can agree are heroes are the ones who grew the size the government. Even the Founding Fathers, in the wake of post-Revolutionary War social crises, imposed a stronger government on the US with the creation of the Constitution of 1789, which replaced the much weaker Articles of Confederation.
Viral evolution: you bring up a popular idea that maybe viruses should evolve toward being benign, because killing their own host is bad for them. This is interesting but an oversimplification and not at all predictable. They can just as well evolve to be worse. Viruses’ goal is to spread, which involves coopting host cells to reproduce and infect new hosts. If a virus evolves to be gentler to its host, that may help with having a long time during which to transmit, but may hurt its transmission efficiency (in order to be gentle, it probably has to kill fewer cells > fewer new copies of itself. Or less irritation of respiratory organs > less aerosols and droplets produced). These goals are locked in a trade-off that can go a lot of ways. Another evolutionary pressure on the virus is to keep evolving to dodge our immune systems. In flu and existing, milder seasonal corona viruses, they regularly evolve such that last season’s antibodies are no longer a match, which doesn’t much affect how deadly or virulent the disease is, but does make it extremely hard to vaccinate or eradicate.
What I was trying to covey above is how effective or otherwise strategy has been.
QLD. 1 death/ million people
NSW 1 death/ 288460 3 times worse than qld (neighbouring state)
AZ 1 death/ 48666 20 times worse
UT 1 death/142857 6 times
ID 1 death/43902 25 times one in 1000 infected.
These calculations are done in my head so aproximate.
These figures are very low but the experts say without the shutdown the figures could skyrocket.
Reports here are that your president is advocating people “liberate their state” by defying the shutdown
https://www.abc.net.au/news/2020-04-18/usa-protests-for-coronavirus-reopening-after-donald-trump-tweet/12160930
That could be very interesting. The report shows a big protest in Idaho. Idaho is the worst on the list above. The protesters were not social distancing. This may be OK where there are known to be no carriers. But in Idaho about 1 in a thousand of the population is positive, and how many unknown carriers. How many were at the protest? Were any positive?
But if you liberate large areas where there are carriers you could have a disaster.
We have country towns where there have been no cases, and we have a travel ban. Some of these towns are asking to have the restrictions lifted;except on travel. This seems reasonable.
If America (or parts of it) is liberated from restrictions, the world will be watching to see how it goes. If it doesn’t go well the president will have to find someone else to blame WHO already used. This is a test for science too, if no problem.
Another aspect of this is how much you are willing to sacrifice for the common good. My impression is that the further right politically you are the less likely you are? Or perhaps you are just less likely to believe the science?
Trump is taking a big risk. It appears the US is reducing the number of new cases, but this could change things for the worse. Consequences? Election?
Interesting times. When ideology has consequences, that can be counted.
I commented on the blog about the fast a week ago when there were 15000 deaths in America recorded. There are now 37158, is the fast working? How many membrrs who fasted will follow Trump to liberate from scientific advice? If you were the Lord and someone fasts to stop the pandemic but takes action not to; do you overrule their actions because of their fast?
After this blog was posted there has been a couple of stories posted on Faux… I mean, Fox News, about testing asymptomatic people. At least one was antibody testing and one was unclear to me. Both were fairly localized studies. The antibody study was conducted by Stanford and showed that the number of people in Santa Clara who have been infected has been under counted by 50-85 times (not percent). I haven’t seen this reported in other news outlets yet, so I’m waiting to see if there is criticism of the study.
This could mean mortality rate could be much, much lower than a lot of people have thought. And with further testing in other communities we can get a handle on how wide it has spread.
It shouldn’t be a surprise, but I’m struck once again about how our news programs are reporting on alternate Universes. CNN’s headlines are doom and gloom about how people are getting reinfected, although if you read the article it’s a lot more nuanced. What it really says it that people are testing positive a second time, but they don’t have evidence of live virus. It can take a lot of work to get meaningful information out of the news.
When I take in all the news sources together, I start to feel like I can pull out my crystal ball and make a few amateur predictions:
– Things are going to start opening up gradually come May.
– Pandemic duty, while it is an interesting idea to create a controlled spread, will not be necessary or useful, because this disease spreads so fast.
– In late May or June we will see if there is an explosion of cases. I think it is quite likely we will see outbreaks spread out from big urban centers to small and medium sized cities. Extreme contact tracing with cell phone technology could reduce this substantially, butn I’m not getting any indication that this will happen in the U.S.
– This seems crazy to me, so *this isn’t actually a prediction I’m making*, but New York cases could be practically over. It depends on how much they have been testing and what percentage of people are asymptomatic, but if a Stanford-like study had similar results in New York it’s possible their cases will slowly burn down to herd immunity levels and have minimal new cases by, say June or July maybe.
– Future outbreaks may proceed a little bit slower paced as the immune population increases.
– A lot of people will say we overreacted in our response, using the success of the response as evidence that it was unnecessary. This group will lean conservative.
– Trump will blame someone else for anything bad that happens
For the first time in a while, I am a little bit hopeful that this could all be over by winter next year. If there really are so many asymptomatic and unreported cases, we could have herd immunity a lot sooner than I thought.
Yes, my understanding is that achieving a certain level of immunity is possible and probable. I have seen people saying that immunity may not be possible, but that is not the sense I get listening to experts that I trust.
John W
I really appreciate your thoughts and think you will be proven correct on the erosion of far right ideologies among thinking people.
It may be tempered at least, by those who attribute cause and effect to the Devine. No matter which way things go they will be considered part of God’s plan:wrath:vengeance and a fulfillment of prophecy. This group will become further entrenched and we’ll be hearing a lot more from them.
I received an email from the Church yesterday with links to documents containing instructions for various aspects of church life: baptism, ordinations, funerals, etc. Repeatedly, members were instructed to comply with government directions. It will be interesting to see how well those admonitions are followed in our Utah neighborhoods.
Ahhh Rockwell please be very careful with the Santa Clara study. It’s got problems. Be very careful with all serology results coming out. They are very important datasets but will necessarily have high false positive rates at the population level at this stage of the pandemic. It’s like this: the test used in Santa Clara, like even the best tests, has a small error rate. It is known to have a 0.5 – 1.8% false positive rate, meaning that of every 100 non-immune people tested, 1-2 will be falsely reported to be immune. That’s a small error rate, but when you test large populations who have mostly not been exposed, there are so few true positives to be found that **most of the reported positives will actually be false.** To interpret correctly, one needs to analyze the results with Bayesian probabilities — calculate the probability of immunity conditioned on observing a positive test result, given the test error rates and the total sample sizes, etc. One advisable way to handle this challenge, early on when exposed numbers are a small percentage of total population, is to re-test all positives a second time. The Santa Clara study is *NOT* good evidence that we are dramatically closer to herd immunity than other models suggested. In Santa Clara study, only 1.5% of all the tests came back positive. You can see that can potentially be completely explained by the false positive rate. Also, friendly suggestion to quit Fox completely 🙂
Addendum: to connect all the dots, Santa Clara study is also NOT evidence that the mortality rate is way lower than previously estimated
Angela, I am right there with you on your analysis with only one small additional data point. It just seems clear as day. That is that flattening the curve not only keeps us from quickly overwhelming our healthcare capacity, but it also gives a bit more time for us to figure out what might work to help treat those with serious cases. Normally the medical profession is methodical (as in slow and sure) and would like years of various tests before making wide-scale recommendations for treatments. But we don’t have time for that now. But give the medical community 8 weeks vs 2 weeks to give a few things a quick analysis and they might find some things that can really help save lives.
Dave B – I agree that before long it would be great to have plans that allow the less risky parts of the economy open back up if they have documented plans on how they will minimize the spread.
I have a plan for getting most of the “volunteers” for Angela’s proposed jury duty. It is a strange concept called freedom. However, freedom combined with ignorance does not usually produce good results. The increase in testing is needed before we should just let everyone go back to business as usual. The aircraft carrier had a 10% infection rate, 1% hospitalized and 1 fatality out of 6000 people. Social distancing is impossible on a functioning war ship and I will be interested in any further data that the Navy releases.
There are plenty of businesses that should reopen as soon as the infection rates drop. That is now in many areas.
There have been several good “tests” done on confined populations like cruise ships and the USS Teddy Roosevelt.