Quickie Post — Why Guessing about Asymptomatic Coronavirus Cases is so Hard

Blue Helicopter Jesus — on the edge of the Frank Church/River of No Return Wilderness, after arranging a successful heli-vac

This is a geek post, and if you’re familiar with my work, you might love it. If you’re not, well, good luck. You’ve been warned.

Why do we have such a hard time knowing at this time what the real rate of COVID-19 deaths are, as well as what the real infection rate is? NOTE — it looks from preliminary evidence to be 10x the flu, and if you get the disease with complicating factors, a terrible way to die — that we DO know. So don’t take this post as some odd minimization. It’s not. DO the right things!

The problem is that at the current time, we are attempting to understand this using people in hierarchical social structures (in this case, academic and industry virologists) whose main tool in the arsenal is algorithmic rule processing, which turns into our well-known empirical science. What that means is that they’re going to do some tabulation, a little data analysis, maybe plot things on an axis and make some guesses. That’s what folks have pretty much done. Work is improving — I liked this piece, and you can check this out. Make no mistake — while I talk about some of the science with questions, I HONOR our uber-geeks who are pouring themselves into this crisis. That’s one of the vectors to get to answers.

The truth is that this kind of thing works GREAT with what I call “closed systems” — where you can isolate a given population, subject them to a clinical trial of some sort, where you control the inputs, the population is also homogeneous, and there’s a start-and-end date that makes sense.

None of those things are present in the current problem. What we have here is an Open Systems problem — a society is infected from an unlikely source — a virus that has jumped from bats (we think) to humans (I actually think the evidence for this is reasonable) and is now exploding. We can’t draw any meaningful system boundaries YET on this, because we don’t really understand the system. We can guess on vagaries (animal -> human transmission, consumption of the virus through purchase at a wet market, etc.) but we just don’t know. And when I talk about system boundaries, I’m not just talking about the obvious ones — Wuhan city limits, Hubei province boundaries, etc. I’m talking about all the potential inputs and feedback loops present.

For example, we also don’t know a ton of other stuff about the impact to human health of people regarding their environment to resiliency against this virus. China’s air is absolutely execrable in most of the big cities. I have been in Beijing where the pollution fog is as thick as the dense fog that sometimes settles in on the Palouse — except ours is water vapor. And there are other open system factors that no one knows about. Chinese people smoke cigarettes. And they also have adopted about half of our own awful, sugar-based diet. I maintain, as a lone voice in the wilderness, that many of our problems are inflammatory-diet-related as far as overall health, psycho-social shift, etc. Especially in an epidemic. Here are a couple of pix — the daytime one is not so great showing the air — visibility was low, but trust me that the nighttime one is just air pollution, and you can see this through the lights. People had on masks and such.

On the Bei-Da Campus
Next to the Olympic Stadium. Yep, that’s Pirate Minnie.

What that means is we have a respiratory-handicapped, immune-compromised population who have watched this sweep through their population. And we have statistics associated with the virus, functioning under a combination of these exacerbating factors, along with age-related mortality. These things, at this time, are impossible to uncouple. Scientists may come up with a vaccine in a few months. But they will take years to untangle this mess.

What this means is virologists are observing a new phenomena with few guiding principles (up there in the Knowledge Structure stack) and a poor ability to guess at how exactly the virus messes you up. It is true that one can see the dynamics of transmission, and we can do things like count patients and symptoms, and make guesses based on intuition that vary on the guesser’s and their field’s past practice. Interestingly enough, it’s the virologists’ past experience with epidemics that really drives insights. Experience assembles tons of multi-dimensional data into complex narratives, and gives insights that are simply impossible to extract from a standardized data set. The brain’s demands for coherence from an expert lens can often drive insights that would be normally unavailable.

But it’s a tricky business (confirmation bias and all!), and as amenable to hunches as anything. It’s not that I don’t trust the virologists — actually, I do. But the public, and especially the media, like certainty. And we just aren’t going to have that for a while. As I said in the previous piece, you should act like this is the Big One. And hope that it isn’t.

Most important to understanding this whole deal are the people who got the virus and didn’t get sick at all, or only got moderately sick. But those people can’t meaningfully AT THIS POINT be included in any of the analysis. (This piece is an early attempt.) Later, down the pike, we might be able to do this with certain populations. Wuhan, China, has a population of 8.5M people, and Hubei province, where Wuhan is, is up around 58M! The different cordons that were drawn around these areas will, with intensive research, show the permeability of these boundaries and how it all works, as well as who actually likely got infected. Rapid contagion and fatality can go hand in hand. But there are also reasons why viruses like Ebola burn out quickly, and don’t go on to devastate countries.

But for now — with the knowledge structures we have — we just can’t know. And the best thing we can do is follow the precautionary principle (especially with the potential for hospital overload) and DO YOUR PART . But also realize that outcomes as far as pandemic deaths will likely be less than the straight multiplicative estimates we are seeing. That means your odds of surviving this pandemic, especially if you are in one of the low-impact groups, are extremely high. And the best course of action is to calm down, and think about how you might help others. That’s the empathy thing. We are all in this together.

5 thoughts on “Quickie Post — Why Guessing about Asymptomatic Coronavirus Cases is so Hard

  1. Yeap it was a good one – now can you write that for a wider audience and put it on Medium?

    Ryan

    On Mon, Mar 16, 2020 at 9:41 AM It’s About Empathy – Connection Ties Us Together wrote:

    > Chuck Pezeshki posted: ” Blue Helicopter Jesus — on the edge of the Frank > Church/River of No Return Wilderness, after arranging a successful heli-vac > This is a geek post, and if you’re familiar with my work, you might love > it. If you’re not, well, good luck. You’ve been wa” >

    Like

  2. In that case, we are lone voices together. As you know, I also ascribe to the correlation of sugar, immune suppression, and inflammation as being central to chronic diseases in the modern world. They are contributing factors to a wide variety of diseases.

    Obviously, the immune system is quite necessary; but if it is underactive or overactive or some combination of the two, you’re going to have problems. Sugar both suppresses the immune system and causes inflammation, which is an immune response.

    Did you see the study on ketosis and the flu, I think done on mice. The mice fed a keto diet had a high rate of survival of that particular strain of flu, whereas those fed a high-carb diet all died. Here is the interesting part — simply giving mice exogenous ketones did not help.

    It wasn’t the ketones themselves that offered protection against the flu. It was a sub-process in the production of ketones that was necessary. It had to do with the body producing a unique mucosal layer to the lungs that was highly effective.

    Guess what is one of the areas of the body the coronavirus attacks? Yep, the lungs. It’s why respirators are needed. But ketosis helps to keep viruses from getting into the lungs. So, why isn’t there a public policy recommendation for the whole population to do a very low-carb diet?

    Some estimates put the possible final death count for the US population between a few hundred thousand to a bit over a couple million. It’s not at the level of the Spanish flu, but that is still a serious death count, not to mention those who will survive only to remain physically harmed.

    Yet our public health response has been mostly bumbling. And, in some cases, it looks like corruption for reasons of private profit. It puts one in a conspiratorial mindset, in an era when culture of trust is low. Americans, in particular, have little trust in their government and the Trump administration certainly isn’t inspiring confidence.

    https://naughtthought.wordpress.com/2020/03/16/flattened-herds/

    “Contagion does address big pharma and hucksterism but it pales in comparison to what Gilead is currently suspected of doing – blocking Chinese attempts to release a vaccine at cost. This is also suspected to be part of the slow testing rates in places like the USA – the rejection of the WHO tests so that local pharma can make big money producing their own. […]

    “It seems obvious that one has to understand the constructive aspects of biology as they are twisted but at times positively magnified by governmental structure. It’s the ways in which liberal democracy cows to the markets that is the real villainy – Trump attempting to buy exclusive rights to a vaccine or propping up markets but refusing to give sick pay or cover treatment or make testing readily available.”

    Liked by 1 person

    1. About coronavirus and the economy, below is a decent breakdown of potential implications and consequences. The economy has been in a weakened state for a long time, but has been artificially propped up and pumped up. Many people have been predicting that we just need a trigger to set it all tumbling. That would reverberate out into politics and into the larger society. This could be an socioeconomic event at a level few Americans have ever seen.

      The coronavirus is just the beginning of our troubles. Yet the crisis is also an opportunity. It’s certainly a wake-up call, showing the fractures at the foundation of our society. If we don’t learn important lessons from this, imagine if we are ever hit by a serious pandemic that kills off a large part of the population. Hopefully, we will learn, although Americans seem resistant to learning lessons of this kind. Our talent tends to be in reacting at the last moment.

      What I’m hoping for in the short term is for there simply to be widespread public debate. There hasn’t been any serious public debate about public health in my lifetime. The timing is perfect with the presidential campaigns going on. Sanders is almost guaranteed to lose but he still can use his voice to force these issues to the surface. Basic public awareness of the situation would be a good start.

      https://popularresistance.org/were-in-a-recession/

      Liked by 1 person

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