Just got back from getting a haircut and a run to the grocery store (which had an atmosphere very similar to the one down here when a hurricane is imminent), during which time I think I heard enough crazy rumors to start my own conspiracy blog. The worst, by far, were variations that this is all just people freaking out over the flu, or a liberal conspiracy, or some kind of con. So, I’m sharing this Political Wire blog post, because I think it’s important.
Coronavirus Is Unlike Anything in Our Lifetime
Charles Ornstein: “As a longtime health care reporter, the unfolding coronavirus pandemic represents everything I’ve read about — from the early days of epidemiology to the staggering toll of the 1918 Spanish Flu pandemic — but had not covered in my lifetime.”
“And still, I have been caught off guard by the pushback from top elected officials and even some friends and acquaintances who keep comparing it to the flu.”
“Not one public health expert I trust — not one — has said this flu comparison is valid or that we’re overdoing it. Every single one, from former FDA Commissioner Scott Gottlieb to Harvard professor Ashish Jha, has said we’re not doing enough, that this is far more serious than it is being taken.”
I’m not an epidemiologist, but I listen to the experts. If you’re younger than 60, this virus probably wouldn’t do much to you. Congratulations. Good for you. (CORRECTION: Actually young adults still have a roughly 20% chance of ending up in the hospital. Your chance of survival is just better.) But you’d still be a carrier, a link in the chain threatening people who have a serious chance of being harmed by it: those over 60, or with chronic conditions like diabetes, asthma, heart conditions, etc.
Just about everyone knows and cares about someone in these categories. (Maybe you’re in one yourself.) It’s fine to risk your own safety, but don’t be one of those selfish chest thumping jerks who make a big deal about how brave they are while putting others at risk.
Maybe in three to six months we’ll all look back with hindsight knowing that this wasn’t as severe as the experts currently think it is. Maybe. But before accepting assurances from anyone who claims to know that right now, ask what evidence or information they have that the health professionals are missing.
SelfAwarePatterns 
It’s thinking beyond ourselves that’s required. Well said, Mike.
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Thanks Michael.
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I admit to being uncertain about this, because here in the UK the government’s scientific advisers are taking a different approach to the WHO and are talking about the inevitability of spread and the benefits of allowing herd immunity to provide long term protection of the population against recurrent waves of coronavirus. I am hoping that a clear consensus emerges very soon.
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I heard about the UK’s approach (although I also saw something this morning that Johnson appeared to be changing course, banning mass gatherings). The issue is how well vulnerable people could be protected while everyone else was getting it. There’s a lot of talk here too that the real goal is to smooth out the infection rate so the healthcare system doesn’t become overwhelmed. But there are epidemiologists urging people not to be fatalistic about it, pointing out that contagions have successfully been arrested before.
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Well, the UK is now changing course in line with other European countries, and our scientific advisers are starting to admit they made the wrong call.
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While it’s certainly possible for scientists to decide that they were all wrong, there’s another possibility here as well Steve. What good does it do any person to present a candle of reason when the world is gripped in a storm of hysteria? It’s a lesson that I should probably try to learn myself!
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It’s all a work in progress into uncharted territory. We just started working from home today. Yesterday was an intense and chaotic rush to establish protocols and mechanisms, and we’ve already had to modify it this morning. There’s an enormous amount of uncertainty. We all have to be willing to adjust as the information comes in. Glad to hear the UK is doing that.
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Duck and cover!
I read an article about how, if you can muster the will power to not touch your face, you can muster the will power to do all the other things that take will power (like quit smoking). It was really more an article about how hard it is to stop touching your face. 😮
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Yeah, I wasn’t sure if I wanted to post this. I almost didn’t.
Not touching your face is brutally hard. I have allergies, which makes it even harder. But someone pointed out that you don’t have to have full abstention. Even if we can just reduce the number of times we do it, it reduces our exposure.
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Yeah, even just being aware of it helps modify your behavior.
We look back at Y2K and Ebola as being no big deal, but that’s in large part to people taking them very seriously and doing what needed to be done. We might be overreacting a little, but I think the situation calls for an abundance of caution. This sort of thing gets out of hand very quickly, and our civilization is a lot more fragile than many appreciate.
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Somehow overlooked this reply earlier.
On Y2K, interestingly enough, we recently got burned by one of the fixes, that left the two digit year in place, but if it was less than 20, assumed 20xx, but 20 or higher, 19xx. Guess what happened on January 1, 2020. 😀
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Ouch! 😮
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I jumped the gun and commented just before Mike had a formal post out on the subject.
https://selfawarepatterns.com/2020/03/09/ai-an-exercise-in-analytical-philosophy/comment-page-1/#comment-56364
Neither Mike’s post nor the one he linked to here provide me with much reason to believe that this disease will be worse than the cure that’s now being instituted (or shutting down major portions of the economy). I haven’t looked at this issue otherwise, except just now at an article from Mike’s home state. To me it doesn’t seem too worrisome either. https://www.wwno.org/post/how-dangerous-covid-19-we-asked-epidemiologist
And what if we some day face a disease that provides no visible symptoms for months, is easily transmitted, and ends up being extremely debilitating to all types of people? Something more like HIV through hand contact? It seems to me that that could be utterly devastating! So it may be that the coming response (and recession) might end up being good practice for a pathogen which might lie ahead.
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You didn’t jump the gun Eric. I didn’t even know I was going to post this until I got home and saw Taegan Goddard’s post.
On the cure being worse than the disease, it’s a judgment call. We don’t shut down for the flu, but its mortality rate is less than 0.1%. Even by South Korea’s numbers (mentioned in the article you linked), COVID-19 is nine times deadlier. The international rate is more like 3.4%, which makes it 34 times deadlier than the flu. And most health experts see SK’s numbers reflecting what they did to manage it, a lot of the same steps you’re now seeing as overkill. SK’s example can be a source of comfort, but only if we heed the full lesson.
Sure, it could always be worse. But I don’t know that we want to avoid action until we have The Stand.
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By jumping the gun I meant that your readers need you to always post whenever something of this magnitude hits. We’re naturally going to be curious about your thoughts every time. And we know it goes the other way as well.
Yes right now it’s a judgement call on cure costs versus disease costs. Plenty of unknowns. Personally I’m just not hearing much that sounds all that scary on the disease front (not that other scenarios wouldn’t be far worse!), and plenty that seems scary on the economic front.
Fortunately I’m not in economic peril myself. I suppose that we’ll refi our home at a sweet rate in a few months and hang out here for the coming recession rather than downsize as we’d planned. My father is giddy right now because he took out all his stock money beforehand and now gets to think about when to buy low. Furthermore he’s hoping this will take out Trump. When we see them for Easter I’m sure they’ll not permit us to wear masks around them, and my mother will demand a kiss. I suspect that even in infected metro areas the statistics say that old people haves tremendously greater chance of dying from a car crash than COVID-19. But rather than “news”, that would be more like providing “credible information”. If it doesn’t sell, then it just ain’t news!
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Your call Eric. I hope you’ll respect the concerns of anyone around you. Accepting risk for yourself is one thing. Putting others in jeopardy is something else. In other words, don’t be Rudy Gobert touching everyone’s mic.
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Thanks for this, Mike.
The goal is to look back from the future and say, “Yeah, maybe we overreacted” as opposed to looking back and saying “if only we had reacted a little sooner, not so many people would have suffered and died”.
Things get a little more concrete when you know the places where people have been infected. For context, my current occupation is driving for Lyft and Uber [I’m managing my mid-life crisis]. When I heard about the first local infection, it was fairly far away from my normal routes. I’m sure I have driven close by, but I kinda don’t think I’ve had a customer there. I expected something was coming but I didn’t change what I was doing. It wasn’t until someone who worked in downtown Seattle tested positive that things “got real”. That simple fact suggested that there are lots of people all around me now who will be carrying the virus whether they know it or not. Unsurprisingly, demand for rides went down sharply.
Fortunately for me, I have the luxury of not depending on the income I was making [my wife has an actual career], and so I’ve just stopped driving. Others are not so fortunate.
So that first death was 2 weeks ago. Since then, many of the people at that nursing home have died. One week ago we learned of a case at a nearby nursing home, one at which I have definitely picked up and dropped off customers in the past, although not in the last several months. That man died 3 days later. I don’t know if there are more positive cases there, but I would have to guess.
My mother is in her eighties in Ohio. She’s pretty healthy and lives at home, but she has two sisters in different care facilities who she visits regularly.
So I’m worried. Not for me, but for all those people who can’t afford to have their income go away for a month or two. And all those people in those nursing homes are mothers and fathers and sisters and brothers.
*
[Again, fortunately for me, I have a serious stack of books I’m half way through. I read very slowly. Heidegger anyone?]
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Thanks James. From what I’ve read, things are particularly bad out your way. Glad you’re able to reduce your exposure. Keep safe.
We only have a few dozen confirmed cases in my state (Louisiana) right now (although testing is so stingy that’s guaranteed to be low), but we also have a lot of people self quarantined for having visited level 3 countries, or interacted with confirmed cases. My university shut down all events as well as classes until after Spring Break and will conduct the rest of the semester online, which as someone who works in central IT, is making life interesting.
I know enough people who are either old enough or sick enough to be very concerned. And the economic consequences seem guaranteed to be ugly.
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I agree entirely. It’s also important to think about asymmetric risk. Here’s an analogy: suppose you live in a neighborhood with significant gun violence. 90% of the time when you hear a loud bang, it’s a car backfiring. 9% of the time, it’s targeted assassination of rival gang members (you’re not a member of any gang.) 1% of the time, it’s gunfire that hits random citizens. In that case, the rational response is to run like hell every time you hear a bang. Sure, *most* of the time, you’ll look like an embarrassed scaredy cat. But you’ll be a *living* scaredy cat. The harm of doing some unnecessary running just doesn’t compare to the harm of death.
Ditto for some unnecessary hand washing. Most epidemics get overblown in US Media (SARS, Ebola…) This one is the opposite, and even if it weren’t, eventually there will be a(nother) pandemic. Since it’s very hard to tell at an early stage which diseases will be worst, caution is the better part of valor and wisdom.
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Jared Diamond, in The World Until Yesterday, recounted how traditional native people often avoid asymmetric risk situations, such as refusing to setup their tent under a tree because it might choose that night to fall. He recounts how, in a hurry, he once boarded a boat that was manned by young men prone to horsing around. The carelessness of the crew led to an accident and the crew and passengers had to be rescued at sea. Later, talking with one of his native friends, the friend noted that he had thought about taking that boat, but once he saw how the men were behaving, chose the inconvenience of waiting for the next available boat. Diamond realized that he had chosen to accept a risk he could have avoided.
Some years ago I became religious about regularly and thoroughly washing my hands. With that plus the annual flu shot, I rarely get sick anymore. (Other than allergies.) It’s a good permanent habit to develop.
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Another way to be religious on hygiene is to use those packs of plastic flossers (I recommend the micro mint Plackers). Instead of requiring two hands (one in your mouth) to work string through all those gaps, these things do the job far better with a single hand. It now irritates me to eat anything without flossing as well. I only brush in the morning, though thoroughly with a quality electric toothbrush, as well as manually for the soft parts. But with 15 years of this, beyond wear my teeth never seem to have any issues.
Not setting up your tent under a tree because it might fall while you sleep, sounds to me like choosing the wrong side of a given asymmetry! 🙂
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Thanks for adding more unnecessary plastic to the environment.
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And given the impending coronavirus apocalypse Wyrd, let me thank you for reminding me to fortify my stock of plastic disposables!
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Ha. You never disappoint me, Eric.
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On the tree, I omitted a key detail (sorry). The tree was dead, although it looked solid enough to Diamond. But his New Guinea native companions steadfastly refused to camp under it. Diamond initially thought it was ridiculous. But as he spent time in the forest, he noticed that it was common to hear trees falling somewhere in the distance. And the natives had stories of people who had been killed by them.
It cost them nothing to change their camp site, except frustrating Diamond’s desire for the picturesque scenery under that tree, but it avoided a remote but real risk of death. It’s a common attitude in traditional societies.
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Speaking as someone who has done a bit of deep wood camping, absolutely. Walk around any forest, and you’ll see plenty of fallen trees. And the thing about being in a tent is very limited visibility. You go from “What’s that noise?” to a tree crashing through the thin fabric walls pretty quickly. Tents have zero crush protection.
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Have to admit that the last time I went camping, we camped under a tree, actually a copse of trees, and didn’t really check their health. The biggest thing I remember from it: tree roots digging into my side and back all night!
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It depends on a lot of factors. How firm the soil is, what kind of tree (how deep it roots). Even if the tree doesn’t fall on you, dead branches are more common. Wind sometimes knocks them down. Even large pine cones can surprise you. 🙂
Besides, one of the great pleasures of camping is waking up and walking outside at, say, 3 AM when your eyes are seriously dark-adapted and the campfire is long dead. On a clear night the stars take your breath away and suck you up into them. You can see the Milky Way with your own eyes.
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Well that makes more sense Mike. I’m all about pragmatism.
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Started wondering today if conventional wisdom from epidemiologists might be wrong. Let me explain and you can tell me where I might be wrong.
Imagine three scenarios:
1- Business as usual for everybody. Large numbers of people get sick quickly and vulnerable people overwhelm hospitals. Some are turned away and many of them die.
2- Conventional wisdom. Shut down almost everything. Smaller numbers of people get infected but they get infected over a longer period of time so vulnerable people do not overwhelm hospitals. Some of the vulnerable people die, possibly fewer than scenario #1. This is the flattening the curve scenario they keep talking about.
3- Business as usual for everybody not vulnerable but strict quarantine for vulnerable. Vulnerable do not get sick in large numbers so do not overwhelm hospitals. Many of the non-vulnerable get sick but don’t die.
The problem with scenario #2 is you can’t shut down everything for everybody for the extended amount of time required for the flattened curve to stretch out. Eventually even the vulnerable will need to come out of quarantine and when they do they will get infected. I heard an epidemiologist talking last night about the disease is likely to reemerge in China as people come out of quarantine. Actually since many vulnerable will die with or without medical care, scenario #2 may just be causing people to die over a longer period of time than scenario #1.
In a scenario #3, few vulnerable people will die because they are isolated. Non-vulnerable people will get sick, become immune, and hence unable to transmit the disease. Once enough people are immune the infection won’t be able to spread nor will the population become easily reinfected so the vulnerable people can come out of quarantine with greatly reduced odds of catching the infection because there will be few in the population who can transmit it.
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Steve Morris didn’t get into that kind of detail James, though he did imply that this is what UK scientists were thinking. But then earlier today Steve mentioned that they were backing away from that position. Did these scientists decide that they (and you) were wrong? Or did they decide that it would be bad for their careers to challenge the status quo? When the sirens of moral need call, it seems to me that only historians are allowed to be objective, and sometimes not even then.
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I’m certainly not adamant that I’m right but it seems to me that having most of those not vulnerable to serious complications get sick would be more or less the same as getting everyone vaccinated. A key difference is people do get sick and some who think themselves not susceptible to complications might be, but I would bet eventually most of these people are going to get sick anyway. It might happened three or four months from now with scenario #2 rather than the next few weeks with scenario #3. Ultimately keeping a medium level of infection for a longer time might be worse than a high level of infection (for non-vulnerable to complications) for a shorter period of time.
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The issue, as I understand it, is there isn’t a sharp line between the vulnerable and everyone else. The way the disease works still isn’t well understood. There are plenty stories of people in their 20s and 30s ending up in the ICU. The doctor in China that got in trouble for initially trying to get the word out, and who subsequently died from the virus, was in his 30s. People over 60 and with medical conditions have heightened vulnerability, but people in their 50s are more vulnerable than those in their 40s, who are more vulnerable than those in their 30s, etc.
From what I read this morning, it’s not even well established yet that having recovered from the virus necessarily grants immunity, although I think just about everyone expects that to be the case. (And we’re utterly screwed if it isn’t.)
There are a lot of epidemiologists urging everyone not to be fatalistic about this. They point out that contagions have been blunted and/or suprressed before. No one knows for sure whether it will work. But if we simply let it run rampant, there will be a lot more deaths. Even if we isolate a group we decide to designate as “the vulnerable”, letting it otherwise run rampant could still result in a lot of people dying and overrun health services.
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I was hearing this morning that they were thinking the people who they had thought got the disease twice either had testing errors or hadn’t cleared of the disease. If getting it doesn’t create immunity, it would seem getting a vaccine to work would be a problem too.
Yeah, the category of the susceptible to complications is hard to pin down. Still I think we know the older and the ones with other conditions are going to be the majority of them and in scenario #3 they would be isolated. In various triage situations these might not even get care anyway. I’m in the older group myself without any major diseases that might complicate a recovery.
Still letting a medium infection rate run for a longer period of time might end up with a worse overall result. although it would be less noticeable because many of the deaths would be happening after the lock downs are lifted and the virus is off the front page.
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I think the key thing is that there remains enormous uncertainty with all this. The infection rates have been going down in China and South Korea. Will they simply re-surge as the restrictions are loosened? Will the warmer summer temperatures inhibit it? How fast can they spin up a vaccine? We’re all operating through a fog right now, and lives hang in the balance.
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The epidemiologist I heard last night thought there will be more waves of infections in China (and I would assume South Korea too). That makes sense to me because, if you manage to reduce the rate of infection by extreme measures, you end up with a lot of people without immunity. So as soon as the extreme measures are lifted, the new group without immunity becomes infected unless you’ve eliminated the virus completely (which seems unlikely). So the cycle begins again until sufficient immunity is acquired in the entire population that there is little transmission. The early deployment of a vaccine could break the cycle.
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It seems like a lot depends on how people interact once the restrictions are lifted. If they keep doing the same thing they were before, then the new waves do seem inevitable. The virus will just start from the latest infected. But it seems like people will be more cautious for a while. The question then becomes whether a vaccine can be brought out before everyone gets sloppy again.
That said, apparently a third of the country is still not taking this seriously, particularly conservatives and young people. Their attitude may kill a lot of people.
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James, have you seen this Ed Yong article? He discusses why keeping vulnerable populations isolated is easier said than done.: https://www.theatlantic.com/health/archive/2020/03/coronavirus-pandemic-herd-immunity-uk-boris-johnson/608065/
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It will be impossible to keep vulnerable populations isolated during the time it takes for the curve to flatten. Even Trump is talking about July or August, which means the real timeline is probably closer to the end of the year. There is certainly the economic impact but people themselves are not going to take a shutdown for more than a few weeks. Probably even the governments aren’t going to be able to insist on it once the economic consequences settle in.
I see the experts are questioning the U.K. government’s explanation of concern about “behavioral fatigue” but to me the government’s plan makes sense.
What would have made more sense, of course, would have been a crash program to produce a vaccine that started last year, but that ship has sailed.
Of course, there have been so many bad decisions made already and so many people infected that there is probably no good options at this point.
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I think we have to make allowances for how uncharted this situation is. Anyone who claims to know how the public will respond over time is guessing adamantly. My own guess is that if it becomes prolonged, people will figure out a way to do business under the situation. For example, a lot of restaurants are beefing up their take out and delivery operations. Demand for them might be low right now, but eventually people will be sick of eating their own food.
We’re probably about to see the information economy progress more in a few months than it has in the last decade. Not that it won’t suck for a lot of people.
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We’ve had to adopt new social distancing measures this week by moving our mail box away from the front door. In so doing, we’ve pushed the postman and couriers away from our front door, lessening the chance of them potentially transmitting the virus to us: https://myhomefarm.co.uk/enforcing-social-distancing
It’s a small measure, but with a potentially big impact.
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Good move. Also nice place from what I can see in the pictures!
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Thank you for sharing your story. There is a comforting passage that I appreciate so much. Isaiah 33:24, God promises that soon “No resident will say: ‘I am sick.’”
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Thanks for commenting. I hope that turns out to be the case, but I definitely think it’s our responsibility to collectively make it so.
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I agree. As much as I don’t like staying in ALL the time (and this is coming from an introvert😂) and am tired of wearing a mask every time I do go out for essentials, I don’t want this COVID-19 to continue forever. We all have to do our part. Stay home, save lives!
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