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Archive for the ‘Corona’ Category

Prognostication

A few predictions:

First, I’m done talking about number of infections. Is is partly because we have no idea. The official tally says 1.3 million, but that’s an underestimate by a factor of 3 to 10x. That number starts to mean something once it hits around 100 million and the virus starts to run into problems finding new hosts. So, we’re not there yet, plenty of kindling to burn still. More interesting is total deaths.

We’re at 78,000 as of the end of the first week in May. Deaths have been steady at 13-15K a week for the last three weeks, and I see that continuing, as NY’s numbers fade but other states get worse. I think we’ll cross 100K dead by before Memorial Day. We should go into June around 110,000.

Into the realm of speculation. I see the environmental factors and the “opening of the economy” counter-balancing each other, so I think we’ll keep this death rate up through June. Put us around 150K by the 4th of July.

I bet we start to see a drop in death rates thereafter as we develop more effective treatment regiments, be they in the form of prophylaxis or treatments of those already infected. I think we’ll see a drop to half the death rate for the months of July, August, and September. In that case, we’d get into October between 200 and 250K. I think that we’ll see the first small scale roll outs of a vaccine by then. That said, with schools in session in most of the country in September, we’ll have a burst of cases in October, where we’ll bump the death rate back up, but at a lower fatality rate as our treatments improve. I see us adding 50K deaths a month through December, so that will put us around 400k total by the end of 2020. Beyond that will depend on what we’ve learned about antibodies and herd immunity and vaccines. I see that 400K as neither optimistic or pessimistic. The absolute worst case, in my mind, is around a million dead by 15 months from now. I hope that’s not possible.

All of these numbers are way worse than I would have predicted two months ago. We’ve done a horrible job.

As for other things, in no particular order…I think that…

…Trump embraces absentee and mail-in ballots for at-risk populations, as defined by voters over the age of 60. They are reliable Trump voters.

…many members of the cabinet already have access to the trial vaccine and that they will not get sick. I could be proved wrong in a matter of days on this one.

…the CDC becomes an unreliable source of death tallies and a massive misinformation campaign attempts to slow roll past numbers. They’ll claim you can’t trust the numbers, and will say that the true numbers are far less, but will have no evidence or alternative tallies. The media will continue to maintain accurate numbers, though some states will keep their tallies under strict control. Statisticians will note the excess deaths, however.

…unemployment will steady at around 15% and will remain their for the rest of the year. Consumer confidence will be in the toilet, no one will buy anything, attendance at sporting events will be either not allowed or very poor, and we’ll all be a bunch of ridiculous germophobes in a few months.

…the conspiracy theories will get worse and worse, and those who believe in them will be disproportionately infected and killed.

…it will be a bad hurricane season and Florida and/or Louisiana and/or Texas will be impacted. It will cause a spike in cases and deaths locally.

…the coronavirus will mutate in a way that makes it more contagious and less lethal (again).

…we’ll be out from under this cloud of infection by the start of the school year 2021.

…we’ll be getting SARS-CoV-2 vaccines alongside our flu shots until someone makes a discovery that eliminates the need for either in 10-20 years. The surge of research and development (in an effort to prevent the economy from once again losing 10s of trillions of dollars) will grow long term results. Unless the MAGAs start killing scientists. Which isn’t outside the realm of possibility.

…the Third World will catch up with the United States in the coming months, with major outbreaks in tropical South and Central America (starting in Brazil, whose president is even stupider than ours), Africa, and South Asia. Numbers will be difficult to measure.

…the economy, starvation, and the like will overtake the virus as the principle problem in the world. Some will blame those who overreacted to the virus (as many many die), but in reality, other scenarios were just as bad, with more dead people.

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The Fatality Conundrum

Occasionally, you’ll hear some virus apologist say something like “of course our numbers are higher than other countries’ – we’re testing more!” Also comforting, you’ll hear statisticians saying that the fatality rate is likely must lower than is reported. Sure, the New York Times has plenty of anecdotal evidence of fatality undercounting, but given the vast quantities of deaths and the attention that everyone is paying to it, this is probably a small factor at this point.

And then you have this:

What this is showing is that the observed fatality rate is RISING. It was ambiguous a week or so ago, but now it’s clear. This is very concerning, because this rate is a very simple calculation: deaths/confirmed infections. This is especially problematic because the CDC notes that the death rates lag confirmed infections by 1-2 weeks. 10 days ago, there were only 86,000 cases, and now there are 337,000 cases. In the same way that there is a latency or lag between getting sick and dying, there is a latency between showing up in the “positive” column and showing up in the “fatality” column. Holding other factors equal, we’d expect 3x the deaths a week from now, as we have 3x the cases now than we had a week ago.

One of two things is happening:
1) Despite the fact that we are running more tests, we’d actually detecting a lower percentage of the infected population over time. So, three weeks ago, maybe we detected only 10,000 sick, when there were really 15,000. Now, we detected 338,000 sick…but…there are really more like 700,000 infected – and probably many more to account for the lag. That is what it would take to pull the fatality rate down to the 1.4% estimated in the study above. Not only must more people be sick, but more people have to be getting sick compared to the number we’re catching in the infection statistics – if not, the fatality rate would not be increasing.
2) It’s a lot deadlier than we think. Or, at least, now that portions of our health care system are overwhelmed, it’s a lot deadlier than the estimated fatality rate. The rate is rising because more people are having a chance to die from it, as earlier on, they were just on the road to death, not yet having arrived at their destination.

As with all things here, it’s probably a combination of the two – let’s hope that it’s mostly #1, though.

This is the problem with these statistics. Both solutions are possible, depending on which data are missing and by how much. We’ll start to gain some clarity when the antibody test comes online, as this will allow for us to start to understand what percentage of the population contracted the virus without ever getting a test to confirm it. Until then, that fatality rate is ugly, ugly stuff.

Some predictions:
We hit a million cases by Tax Day.
We hit 5,000 deaths in one day between now and then as well. Max so far is 1,400 or so, from yesterday.

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[From March 14th]

Let’s say we slow the spread and only a couple million people get sick between now and June. Then it fades to a few dozen isolated pockets for the summer (assuming it’s seasonal, which remains to be seen). In this scenario, it’ll come roaring back in September/October, simultaneously re-emerging from everywhere.

1) Does it seem prudent to, say, have 140 million people cram next to each other on November 3rd so that we can all touch a few surfaces one after the other?
2) Do you suppose that anyone in power currently finds this scenario to be sufficiently concerning to legislate universal absentee ballots?

Contrary to popular belief, this fiasco is of benefit to the incumbent. Rules be damned, it really, truly, is a terrible idea to hold an election during a pandemic.

Of course, we’ll all realize this during the primaries. Let’s see if we can do anything about it. Like protest from our socially distant homes.

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[From March 8th]

Let’s call them alternative explanations since “conspiracy theory” is inherently pejorative. There are a few floating around surrounding Covid-19. In fact, you’ll often see the same people that say “no big deal” also claim that the disease is a Chinese Superbug or somehow released by Bill Gates or whatever. The thing about alternative explanations is that they are never internally consistent. The ability to hold contradictory evidence in one’s hand and simultaneously arrive at mutually exclusive conclusions is a hallmark of nutjobs…I mean, free-thinkers…across the globe. I’m going to make my version of one, and talk through it. Disclaimer: no doubt someone else has already created this one.

(to moderators, it ends up looking ridiculous)

In 1979 China introduced a One-Child Policy in order to stem population growth. As China’s per capita incomes have increased over time, life expectancies have increased. This has caused a demographic disaster. There are too many old people in China, and not enough young people to keep them alive while they are not enhancing the state. The old people are not dying quickly enough.

What if we could make a virus that would culle out the old and weak while leaving the young and virile virtually unscathed? We’d solve our demographic problems at the same time that we kept our populations in check. Money would be released to the younger generation, spending would increase, businesses would boom heralding another 20 years of 8% growth, medical expenditures would drop. It’s a perfect crime, a final solution.

So, in a secret lab, start with SARS. Using CRISPR, splice in the protein spike from Ebola to make it more contagious. Do some unintelligible mumbo-jumbo to make it target epithelial cells of old people (more plaque, less something, more something, lipase, cisplatin, who knows what). Problem solved.
Plausible, right?

So, who is the agent supporting this outcome? China
What is their goal? to cull the aged without resorting to unpopular state sponsored suicide
How did they do it? release a bio-engineered superbug into an area deeply integrated into the Chinese economy, yet distant from the politburo.

First off, I’m not sure if you’ve noticed, but we can’t make a vaccine for the flu that’s effective from year to you. Do you really think we’re capable of targeting a specific demographic with a super cold? I see this as all or nothing: we can wipe out half the planet, we can make someone have itchy eyes, we can’t do diddly in between.

Further, this premise has a problem. China has shuddered their entire economy for 2 months to try to stop it…right when it was accomplishing the goals that they had supposedly engineered it for. The whole motive falls apart when they implode their entire society to stop it from doing what they wanted it to do in the first place.

Another problem? Everybody in power basically everywhere in the entire world is old! The Illuminati? Old! The ruling classes? Old! Barons of industry (barring a few aging techies)? Old! Biting off our noses to spite our faces, much?

So, maybe it’s a rogue state new world order who wants to topple world governments and usher in their technocratic dystopia? WTF! Read that again! I have encountered nothing in my time on this celestial plane which would indicate to me that anyone is competent to pull off any substantial subterfuge, let alone architecting the clandestine development of a superbug that would kill everybody’s grandparents. Do you know what the masses don’t like? When they lose their video games (irrelevant for this example). Do you know what else? When you kill their grandma!

Anyway, you know what has made sense for the last 4,000 years of human history? People doing weird stuff with wild animals and getting sick and some of them dying because of microbes evolving via random Darwinian processes. No reason to dredge up theories that make no sense and fail under basic scrutiny!
I’m not much for conspiracy theor…I mean…alternative explanations.

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[From March 3rd]

A few days ago, I read something about how China, with their repressive worldview and shoddy single payer health care system, was particularly predisposed to these sorts of viruses, and that they were currently reaping what they had sown (curiously, the article mentioned that they also eat weird creatures and that their kids crap on the street through holes in their pants, but this was of secondary importance to the author).
Before we go gloating about how China’s government causes problems like this, perhaps we should wait a few weeks, no? Their draconian response relied on a sort of nationalistic vigor that only a nightmarish authoritarian regime could muster. Had this virus started in Mumbai and not Wuhan, 400 million people would be sick now, but the Chinese somehow seem to have shoved the genie back in the bottle, against all odds.

As for us, we’re not testing people (because insurance won’t cover it, or because we botched the first generation of test kits?), and we now have a handful of hot spots of community transmission. I hope the guy’s silly article turns out to be prophetic, but fear it is destined to be ironic.

Also, updates: my last post about survival of the least lethal seems to have been premature, as more deaths from the past few weeks are being attributed to the virus. Of course, they weren’t tested at the time and all the health care providers and family members have had an opportunity to share in the intervening weeks. Also, better data is saying that only 1% develop no symptoms. That is good, because it’s detectable, but bad because it means that there are few missing cases that could be used to water down the lethality statistics.

Anyway, enjoy the story about what to do in Seattle if you have the virus.

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To Be a Virus

[From March 1st, moving here since it really is a blog post]

Random viral thoughts for the day, inspired by https://www.nytimes.com/2020/03/01/health/coronavirus-washington-spread.html, which hinted that several hundred undetected cases are currently in Washington state.

Viruses have one singular goal: to reproduce their genetic material. It’s a goal shared with the kingdoms of the living, though we like to decorate our intentions with varying amounts of window dressing to de-emphasize that goal.

It is clear that even within this sub-species (to misapply a term) of coronavirus, there is genetic variability. It is how researchers were able to tie the two cases together in WA, and how they were able to interpolate the life and times of the virus over the last few weeks.

I see two possibilities: one is that the researcher’s conclusions are a bunch of hooey, and what really happened was that the first case got his son-in-law sick, and that guy used a restroom at McDonalds right before this high school kid grabbed the same door knob then picked his nose, and that’s that. The other is that low levels of non-serious manifestations of the virus have been masquerading as common colds, viral bronchitis, and the like for weeks now, without raising alarm bells.

Let’s assume it’s the latter. It is my assertion that natural selection is going to push this novel coronavirus to a less lethal state. When someone gets a virus and immediately gets very sick, they are isolated and entire towns are locked down. The virus has cut off its own viral vectors. This was what happened with SARS – people got too sick, the virus was cut off from the population too quickly, it couldn’t spread.

Meanwhile, if someone can carry around a mild virus for weeks with limited symptoms, that virus can jump from person to person, host to host, making trillions of copies of its milder form. It is successful. It is naturally selected, as those hundreds of people remained within the broader population plenty long to give it to a friend. The virus means no ill-will, it doesn’t have some primal urge to kill its host – it merely loves itself and wants to share.

It seems to me that over time, the milder versions of this virus will become more successful than the more severe versions. Moreover (and maybe this invalidates part of my point), people will develop immunity to these particular cultivars, and this immunity will lessen the impact of the more potent strains. Every so often, one of those strains is like the Spanish Flu, but more often than not, it’s just the regular old flu, and it sucks, but is fine.

Anyway, all this to say, our feverish response to the more deadly and severe form of this virus should serve to deselect those versions when compared to their milder brethren. Within a couple of years, we’ll have all gotten it, but maybe it won’t amount to much.

Or maybe 2% of the population will die, or maybe we’ll snuff it out by the summer and have a vaccine ready by autumn. What do I know.

I’d lean toward the less severe solution, for this reason, and also because the virus has recently devoured 5 trillion rich-guy dollars, and if there’s one thing rich guys hate, it’s when something gobbles up 5 trillion of their dollars.

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