Potential exit paths from the COVID-19 pandemic

How we got ourselves into this pandemic was quite straightforward: too little, too late, too much incompetence, and a shocking lack of preparation.

How we will get ourselves out of it is not so obvious. Here are the avenues I see:

We do nothing.

If so, the pandemic grows exponentially, infects most humans on the planet in short order, the healthcare system is so overloaded it might as well not exist, but the pandemic burns itself out quickly as well.

  • Duration: short (say 6 months)
  • Healthcare system: overwhelmed by some factors
  • Deaths: millions upon millions
  • Economy: recovers
A medication is found relatively quickly.

I think of it like Robutussin extra-extra strength. This (hypothetical) medication gets symptoms of the infection down to non-lethal levels, say like the common cold. Of course, I have heard nothing to indicate that such a medication could exist, but if one were found then:

  • Duration: medium
  • Healthcare system: functioning
  • Deaths: few
  • Economy: largely not impacted
Lockdowns, until an effective vaccine is found/developed.

If so, everybody says it’s at least 12 months out, if it can be found. Then it needs to be mass-produced and delivered. So:

  • Duration: 12-18 months
  • Healthcare system: stressed
  • Deaths: a few percent of population
  • Economy: in shambles by the time the vaccine exists
Lockdowns, but no effective vaccine is found/developed.

That’s of course possible. In which case, we will either stay on indefinite lockdown or, because we do need to eat and need a functioning economy, the lockdowns will stop and the situation reverts to “We do nothing” after some time.

  • Duration: 18-24 months
  • Healthcare system: stressed, then overwhelmed by some factors
  • Deaths: millions upon millions, but not immediately
  • Economy: in shambles

And finally, perhaps there is a way to throw information technology at the problem:

Dynamic quarantine. See separate post with details.

The idea is to track the likely infection status, and infectiousness, of everybody on the planet, plus their movements with respect to other people and things that help transmission, and continuously update their likely status based on the infectiousness of the people and things they encountered. If this were done with enough information, and enough spatial and temporal resolution, we could with high confidence quarantine only those people who are likely infectious, and let the rest live their lives – in particular their work and consumption behavior – relatively unchanged.

  • Duration: long term
  • Healthcare system: functioning
  • Deaths: a function of a parameter in the algorithm
  • Economy: impacted, but to a degree determined by a parameter in the algorithm.

To make this kind of thing work, there would literally be thousands of problems to solve, and there is no guarantee whatsoever those problems could be solved, but it is an intriguing thought.

Summary: I wish we had the option of “and then a miracle occurs”.

These are the times historians write about

When the Berlin Wall fell, I didn’t quite make the connection. In hindsight, it was the first major event happening in my lifetime that would get a big chapter in the history books, but I didn’t quite realize it at the time. History was the stuffy thing they quizzed you in school about, not something that happened in the world where you and I barbecued in the sunshine.

There have been several history-book-level events since: the disintegration of the Soviet Union; the emergence of the internet; the 9/11 attacks; the financial crisis in 2008; but not all that many.

Now, the global Coronavirus pandemic is another one. And I fear the chapter on it in future history books will be longer, containing more death and human misery, but also more disruptive impact than any of the others that happened in my lifetime.

The governor of California mused today that schools in the state – closed since yesterday – would probably not reopen for this school year. That sounds likely to me. More so, I don’t think they will open on time for the next school year either, and we’ll be hunkered down and “sheltering in place” for many months to come. I can see only two ways to get out of this mode:

  • We have a vaccine – which everybody tells us is at least a year away; or:
  • We have herd immunity – which would take years if the limiting factor is critical care beds, and it is.
  • (Of course there is also “damn the torpedoes and who cares if millions die” but I hope that won’t be what happens in most places.)

So: what will the world look like if most stores, and restaurants, and hotels, and movie theaters, and conferences, and what have you, have been closed for a year or more? If you haven’t been able to visit your friends across town, or your family across the country for a year or more? If kids grow up without play dates, or without ever hanging out at the mall or the soccer game? If you haven’t been able to meet new people, or fall in love, for a year or more? Or: what if all of this gets somehow replicated on-line and life mostly moves into cyberspace as countless sci-fi novels have it? Whichever it is: as small as the virus is, its impact is as big.

And then there is economics. If China has record-low pollution right now (because there has been far less demand for coal-based electrical power), so low that it supposedly has saved the lives of 77,000 people already, and the canals in Venice have cleared for the first time in living memory so you can see the fish in them, this tells you more about what the GDP numbers will look like than any bespectacled talkshow guest ever will. As my friend Sari says, that’s great for the planet. Not so great if you have a 401k retirement plan or want to keep a job. The economic impact, and the ripple effect from there, will likely take up far more pages in the history books than even the pandemic itself. It’s such a big disruption.

We are in unchartered territory. Something like this has never happened in human history. The historians are going to have rows of unfilled PhD positions, so much is there to write about. For the rest of us: hang on tight, and throw out all preconceived notions of what your life should be like, because whatever you thought it was going to be 3 months ago is not going to happen. There is a chance it will be much better – the 77,000 certainly will think so! – but that’s not guaranteed even for those who don’t die of the virus. I shudder thinking about when real shortages start to happen, and they will.

We are looking at hard work and much hardship. But perhaps a better chance to save the planet than even 3 months ago was conceivable. The future is more uncertain than it has ever been in my lifetime. Fear permeates everything, and much pain is certain. But maybe, maybe, much good will come out of it, too. I tell myself: let’s try to focus on that.

Onwards.

Silicon Valley is closing up shop

As of midnight tonight, the residents of all counties in the 8-million people San Francisco Bay Area, including all of Silicon Valley, have been ordered to stay at home. What a little virus can do.

No meetups. No restaurants. No venture capital pitches. No trade shows. No business meetings. No shopping at the mall. No going to work.

Who can, will work on-line. So far, the interwebs are still up – although I experienced the first choppiness in the video feed during this very announcement today.

This shelter-in-place order is for 3 weeks. Which is laughably impossibly short, because just the incubation period for the virus might be that long! We’ll be holed up with cabin fever for much, much longer.

And when we finally re-emerge, the world will be drastically different, I think. How – I don’t know; visibility is very bad. But very different for sure.

Hang in there. See you in cyberspace, which is a corona-free zone :-)

Pandemonium at Trader Joe's, with an extra dose of insane carelessness

I had to venture out today for a new dental crown, and on the way back, I decided to stop at Trader Joe’s to pick up some eggs. Traffic on highway 101 was extremely light, although it was Friday afternoon – many people must be working from home. So I was quite surprised when Trader Joe’s parking lot was packed.

Walking into the store, a scene that I had never seen: checkout lines that disappeared into the back of the store; all registers open; most staffed by two employees for extra speed. And then: bare shelves, with lots of empty shipping boxes in the aisles – customers must have been picking up things from shelves faster than employees could restock and remove their boxes.

I had done my bulk “prepper” shopping the weekend before, when everything was normal and I only got an occasional glance from people. And today apparently everbody decided it was time to do the same thing. Must have been Trump’s emergency declaration today.

While waiting in the long time, I had time to observe, and ponder. First, what did people pile up in their carts? Almost all of the carts I could see had typical weekend grocery stuff in it. A bag of chips. A can of corn. Some veggies. One guy had filled his cart mostly with already cut-up fresh fruit. Hardly anybody had enough stuff in their cart to last for longer than a week, unless they subsist on a chocolate snack diet. And you are panic-shopping for what, today? So you have to venture out shopping again in just a few days?

What about high-energy, long-shelf-life bulk food instead? Like 25 or 50 pound bags of rice, or a few dozen cans of everything from veggies to processed meat? Admittedly Trader Joe’s is not the store where to get those things … so why even go panic shop there? Few of the people I saw seemed to have thought through why they are panic shopping today and what problem they are trying to solve.

But it gets worse. Here I’m standing in line, and for the lack of anything better to do, I count/estimate the number of people in the store. A few hundred, I thought (let’s call it 250 for my argument here). Standing all here, in relatively close proximity, all breathing the same air. And there are exactly three people (me, and an Asian couple, unsurprisingly) who wear a mask.

To compare, Santa Clara County (about 1.8 million people) today reports on its website 79 Coronavirus cases, of which 36 are hospitalized. Accounting for the disaster that is testing in the US, other countries have about 10% of known cases hospitalized, so that would lead to about 360 known cases if testing had been done properly. However, given the rapid growth of the disease (currently about 30% a day in the county), many more people will be contagious prior to the onset of symptoms, and of course there are those who have few or no symptoms at all. So I will pull a number out of my hat, and claim that there might be 5x as many cases as there are proven (well, would be proven) positive test at this time. That leads to 1800 infected, and likely contagious, people in the county today.

So, back of an envelope, 1 out of 1000 people in Santa Clara County today has the virus and can infect me. The grocery store, when I was in it, had about 250 people in it, with new people pouring in as soon as others left. I’d think that certainly more than a thousand people moved through that store today. Which means at least one infected person moved through the store, stood in line like everybody else, breathed and exhaled, and left their infectious droplets in the air around them.

And nobody, nobody – other than the three of us who were wearing face masks – seemed the least concerned about it. On the same day that the county banned all meetings above 100 people! (for good reason, given the above calculation!)

The employees, at least, had hand sanitizer at their checkouts and used it frequently. But each one of those thousand-plus customers walked by a checker within a few feet, and paused to pay and get their purchases packed, and looked at the checker and spoke to them in a direct line of sight – and exhaled droplets. There were some Corona infections in that store today.

And this, ladies and gentlemen, is why epidemics spread. Needlessly. Because people don’t think.

Incredibly impressed by China's COVID-19 response

This diagram clearly shows what must be the best-case response to a highly infectious disease IMHO. Once the Chinese authorities got into gear, the new cases just fell off the cliff and have remained very low ever since. In a few months, we will look at the equivalent of this diagram in the US and other countries, and compare.

I’m afraid we’ll do much worse. The rise here may be slower (lower population density) but the sharp turnaround on 2/4 is hard to imagine here, we are not decisive and publicly-minded enough. (I so hope I’ll be wrong.)

Diagram from Wikipedia.

Existential Threats

The World Economic Forum, not an organization easy to rock the establishment, summarizes a speech by pundit Yuval Harari at this year’s meeting with the title “Read Yuval Harari’s blistering warning to Davos in full”. Choice quotes:

Three problems pose existential challenges to our species …:

  • nuclear war,
  • ecological collapse and
  • technological disruption.

Technology risks dividing the world into wealthy elites and exploited “data colonies”.

Those who fail in the struggle against irrelevance would constitute a new “useless class” – people who are useless not from the viewpoint of their friends and family, but useless from the viewpoint of the economic and political system.

… some corporations and governments will be able to systematically hack all the people. We humans should get used to the idea that we are no longer mysterious souls – we are now hackable animals.

We are facing philosophical bankruptcy. The twin revolutions of infotech and biotech are now giving politicians the means to create heaven or hell, but the philosophers are having trouble conceptualizing what the new heaven and the new hell will look like.

The global order is now like a house that everybody inhabits and nobody repairs. It can hold on for a few more years, but if we continue like this, it will collapse.

Agree or disagree, go read the whole thing.

Link to article