World Pandemic from 30,000 Feet

Looking at the world wide incidence of covid-19, I see the influence of networks--it's as if the virus is a tracking molecule, like taking barium before a CT scan. 

You start with Wuhan, which is networked both to Europe and the US. (I'm guessing it might have particular ties to Italy?) The US is more closely networked with Europe than China, so a majority of our virus imports seem to have come from there. Meanwhile nations such as Russia, India, and Brazil are less closely connected to China and, perhaps more significantly, are less networked internally than countries such as UK and US.

Within the US the  NYTimes map shows a correlation, in my mind at least, between the timing and volume of cases and the networking of the state and county.  Currently the Northeast states are on the down slope, while the Southeast states are on the upswing. 

Tom Friedman in NYTimes

Last week Friedman had a doom and gloom op-ed in the Times, rather surprising given his past optimism.  He argues three trends have made the world more fragile:

Over the past 20 years, we’ve been steadily removing man-made and natural buffers, redundancies, regulations and norms that provide resilience and protection when big systems — be they ecological, geopolitical or financial — get stressed. We’ve been recklessly removing these buffers out of an obsession with short-term efficiency and growth, or without thinking at all.

At the same time, we’ve been behaving in extreme ways — pushing against, and breaching, common-sense political, financial and planetary boundaries.

And, all the while, we’ve taken the world technologically from connected to interconnected to interdependent — by removing more friction and installing more grease in global markets, telecommunications systems, the internet and travel. In doing so, we’ve made globalization faster, deeper, cheaper and tighter than ever before. Who knew that there were regular direct flights from Wuhan, China, to America?

Today he returns with an even more gloomy one, at least by title:

"I am not at all certain we will be able to conduct a free and fair election in November or have a peaceful transition of presidential power in January. We are edging toward a cultural civil war, only this time we are not lucky: Abraham Lincoln is not the president.

He goes on to segue into praise of local leaders, since he's given up on national leadership/Republicans.

The "doom and gloom" phrase dates back to the 1950's, when Ike attacked Democrats for spreading doom and gloom.  It's a hint that I think Friedman is unreasonable in his fears.   For example, the current pandemic will, I think, kill many fewer people than the 1918-20 one.  Why? Mostly because of our advanced science and communications.  The world is fighting it together, not as together as it could be, but much more so than in 1918.

Another example: the current riots are much less serious than in 1964-68--they don't reflect a racial division nearly as serious as then, mostly because conditions have improved greatly since then. 

US Pandemic from 30,000 Feet

It seems to me the general pattern of the pandemic spread was:

• the first to become ill and those who spread the disease were the well-off.  By definition if you were traveling between China and Europe, or between Europe and the US, or China and the US, you had money and an upper-middle class or upper class lifestyle.  And those you gave the virus to likely shared those characteristics.
• but second to become ill were the parents and grandparents of the travellers, those in nursing homes and assisted living homes.  My assumption is that most people in such homes are from backgrounds with above-average incomes, even though Medicaid may cover care.
• the final tier of victims were the vulnerable, those in meat packing plants, those in congested areas living in crowded homes, immigrants and the poor.

This is just speculation; I hope I live to see some good social research on the subject. 

Our Pictures in the Head Are Wrong

Until today I had an image in my mind: people come down with some symptoms, they start to get worse, they go to the hospital to the ICU.  Sometimes they go on ventilators and likely die; sometimes they are able to recover and leave the hospital.  That to me was the normal course of events for people with covid-19.  It's wrong.

I started looking at data today.  One set of data was the rate of death, which turns out to be about .6 of  1 percent.  Then I tracked down CDC data on the rate of ICU admissions.  That turns out to be much smaller.

I should have realized: sometimes people die in the hospital as I was thinking, but sometimes they die in their nursing or assisted living home.  And sometimes they die in their home home. So dying in the hospital is not the majority experience. 

As is often the case,things are more complicated than the images you have in your head.

Revising the US Food System

In the wake of the pandemic I'm seeing calls for the US to change the way we produce and distribute food.  Some of the proposals are intended to make it more resilient to disasters, some just hope for environmental friendlier ag.  See this piece and this 

I've doubts.  The way our food system currently works was never planned, but evolved. The forces at work were economic,governmental, social--the market system meant rewards for greater productivity and lower costs; the government ensures uniform food regulations for the country, government programs have eased the dislocations caused by the growth of more productive agriculture, the society as a whole values education, science and technology and the new, people place less of a priority on the taste and provenance of food and more of a priority on fast, cheap food which they don't have to prepare themselves.

Can these forces be changed, even if you have a popular cause that supports government action? Tastes can change, norms can change, but I'm not sure how well any social movement can manage such change.

What Will the Recovery Look Like?

I've no insight, but since when does that stop a true blogger?

Personally I think it will be slow-fast-slow. 

• the first slow will because the majority of people won't be risk-takers, they'll let others be the trailblazers.
• the fast will be as people realize that it is relatively safe--isolated incidents but nothing drastic enough to cause major political subdivisions to revert back to a lock-down.
• the second slow will be because of the drag on economic activity from the measures taken to minimize risk plus dealing with the economic damages of the pandemic--the closed restaurants, the half-empty nursing homes, etc.

We'll see.

The Usefulness and Reuse of Masks

Early on in the pandemic, I think I was informed that masks would insulate the wearer from the world, particularly the viral particles floating around in the air from those already infected.  So it made sense that masks were one-time use--you go out wearing a mask, you meet someone infected and his virus particles get hung up in your mask. You then go home, and the mask represents a threat to anyone who contacts it.  Fine.

But now I'm getting the impression the main function of the mask is to protect the world from you, the wearer.  It captures your germs, your viral particles.  Is that true?  If it is, then the mask can be used more than once.  If you're infected, and the mask captures your virus, there's no new contamination in the home and no real downside to reusing it.

Suppose We Didn't Have Work From Home

There have been a lot of comparisons between the current pandemic and those in the past, particularly in terms of case numbers and deaths.

One thing which isn't accounted for in such comparisons is the existence of the Internet and the enabling of work from home. My point is that in 2020 we had the option of closing offices and working from home, of closing schools and going to remote learning, of moving to tele-medicine.

I don't know how much difference it makes; I don't know the extent to which shelter-in-place was implemented in past pandemics.  But I'm sure it makes a significant difference, which social scientists will be trying to figure out over the next years.

Superspreader Individuals or Situations

Megan McArdle offered this thought in a thread commenting on an elaborate analysis of probabilities (too elaborate for me to even try to follow):

Over the long term, I think this stuff matters less; if you remain open, in any moderate population center, a superspreader will find you. But early in the epidemic, a random walk will make some places look smart and others look dumb, purely by chance.

— Megan McArdle (@asymmetricinfo) May 4, 2020

I can venture to comment on this, however.  The assumption here seems to be that "superspreading" is a function of an individual (think Typhoid Mary perhaps, but not necessarily asymtomatic).  That's certainly been my understanding from the past. 

But in the context of this new pandemic, I ran across an interesting report by someone who tried to assemble worldwide reports of mass contagion and then to analyze common features. I may have mentioned this before.  The features were crowds plus intimate contact and/or a lot of vocal activity--cheers, shouts, etc. 

One would think we could rely on people to avoid such situations, although when you look at the rallies protesting against lock-downs you have to wonder.  But in principle avoiding such situations is easier than identifying potential superspreaders.  It's likely unknowable currently to determine the proportion of total infections occurring from superspreader individuals, versus crowd contagion, versus individual contact.

What's Most Dangerous Today?

An interesting essay which tried to identify superspreader events and tease out commoalities among them. https://quillette.com/2020/04/23/covid-19-superspreader-events-in-28-countries-critical-patterns-and-lessons/

From his summary:

"When do COVID-19 SSEs happen? Based on the list I’ve assembled, the short answer is: Wherever and whenever people are up in each other’s faces, laughing, shouting, cheering, sobbing, singing, greeting, and praying."

I take this to mean that sporting events in the ways we're used to will be slow to resume. On the other hand, ordinary work should be quicker to resume. 

How about education--the theory being people can't go back to work if the schools are not open?  That's more difficult.

What the Pandemic Reveals

So far it seems that the elderly and impaired in residential/nursing homes and workers in meatpacking plants are especially susceptible to the novel coronavirus and at least the former are more likely to die. 

The unseen portion of our population is the category which is now proving vulnerable in Singapore, migrant workers, those living in group quarters.

There may also be vulnerability among the Haredim, the ultra Orthodox Jews.

All of these groups are outside the what I'd call the "core" population of our society, they're marginal-they aren't who we think of when talking about American workers.

Unfortunately for meat eaters, the packinghouse workers are essential.