Note: to newcomers to this blog — this is largely not a political blog. I am a complex systems scientist, and while I do write about politics from time to time, I have strong feelings against politicizing the pandemic. We are going to go through this together, whether we want to or not.
As we move into the beginning of July, numbers of detected COVID cases across areas previously less impacted by COVID-19 are accelerating rapidly. At the same time, official deaths from COVID continue to decline, though what may happen in the near term is far from clear.
There are many who believe that the pandemic is “just getting started.” I think this is false on a number of levels, and I’ve written about exactly why this is false in a number of posts. The pandemic did NOT start because powers-that-be became aware of it. The pandemic is actually following a natural, relatively uncontrolled trajectory in all but a few countries. There are some factors that seem to make a difference, and now there are enough participatory countries with demonstrable results — notably some level of social distancing and mask wearing slows the number of symptomatic cases considerably.
This is HIGHLY desirable, as what is happening “under the radar” is asymptomatic/extremely low symptomatic cases, that provide larger population immunity, and in the long term, absent a vaccine, be necessary to end the pandemic. It is not highly desirable in the least!! to take this as some reason to have “chicken-pox parties” or other such icks.
I’ve been reading about COVID-19 now for the past five months, and there are a few things, after reading about 100 medical papers, and tons of other media, that I think are true.
- The disease was initially called as being highly infectious, and easy to contract –and it is. We know this because we’ve inadvertently run dozens of experiments in places like cruise ships, aircraft carriers, prisons and meatpacking facilities. Once you crowd people together in moist environments, and they have to yell, everyone gets it quickly. That means believing it hasn’t already shown up in your neck of the woods is wrong.
- The asymptomatic version of the disease spreads relatively silently, and has little mortality threat if you are not immunocompromised. We know this because when rigorous population diagnosis is undertaken, as in Lombardy, Italy, or even New York City, population antibody rates range anywhere from 15%-70%.
- How you contract the disease is dose-dependent. What that means is if someone coughs in your face that has it, that is far worse than potentially contracting it from contact with surfaces or other low dose modalities.
- The disease seems to not spread outside easily. If it did, the recent Black Lives Matter (BLM) protests, as well as people on the various beaches in the southern US, would be leading to wave after wave of deaths. That has simply not happened, and while certain outdoor exposure, such as BLM, seems to be accompanied by some level of mask wearing, a cursory glance at photos indicate a large number of people NOT wearing masks.
All these points of information actually help individuals how to understand how NOT to get the disease. And it’s actually pretty simple. If you’re immunosuppressed, then you have to stay inside away from people. If you’re not immunosuppressed, then it’s also simple. Stay out of bars. Don’t sing with other people. Don’t go to a mega-church. You will likely pick up COVID-19 in its asymptomatic form once it comes to visit your community. But it is highly unlikely you will contract the large-symptomatic/bad dose version of the disease that can kill you.
It’s worth it to take a minute to review exactly why singing and bars are so bad. Much has been made of singing — people in a choir aspirate droplets, as well as infectious aerosols, and the rhythmic breathing of people singing together is an important vector for people sucking in a large dose of coronavirus into their lungs at the same time.
Bars are a little different. Here, of course, we also have large numbers of people, grouped closely together, talking and drinking (think lots of fluids.) There is an interesting acoustic phenomenon that happens in bars, and everyone that has ever been in a bar has experienced it. It’s part of what’s called the Cocktail Party Effect, and it’s one of the fun phenomena that anyone who’s ever taken an acoustics class is familiar with. You can reference the Wikipedia link for more of the auditory details, but the short version that happens in a bar is this — people start off speaking softly. Over time, as the volume increases, people also increase their personal volume. This feedback loop continues until some auditory pain threshold is hit, and everyone stops talking all at once, and the room is silent. This cycle repeats itself throughout the course of the evening.
Considering that the “uncomfortable” threshold for human hearing is around 110 Db, and industrial noise (like running your power router or circular saw) is always around 100 Db, that means by the time you get to the sudden silent drop-off, people are really hollering. Especially if they’ve had a couple of beers. It’s not hard to see how this would turn anyone who had COVID-19 symptoms into a super-spreader. You’re literally screaming in the face of your friends.
There’s a cautionary tale for those of us running classrooms in the fall (as I will be doing.) Some kind of acoustic buffering might well take the edge off any student infected with COVID-19.
There are other things that are becoming more clear as time goes on with COVID-19. First off, of course, is that the U.S. has done a pretty awful job of managing the virus. At the same time, it’s still poorly accepted that the U.S. is a truly continental ecosystem. All parts are connected to other parts — but we have demarcated parts! The US is not monolithic, like a nation-state in Europe might be. It is difficult, if not functionally impossible, to stop the spread of the virus. It will effectively go everywhere. While I may express admiration for Jacinda Ardern and New Zealand, we are not New Zealand – a functional island. We cannot truly protect our population from exposure, though I would argue we CAN effectively protect our population from high exposure – or at least do a much better job.
There is a great piece with maps in the New York Times that attempts to show how the virus spread throughout the U.S. The title is frustrating, because the virus isn’t looking to win or lose. The virus is simply spreading, and this kind of headline just reinforces limbic paralysis in our population. As of this posting, deaths from the virus is headed back down, albeit more slowly than in European countries, and it’s worth pulling this apart as we move forward.
First off, the virus arrived via air travel, and spread through the U.S. through the air travel network. It did this BEFORE the vast majority of Americans, or decision makers were aware, or took it seriously. The air travel network, prior to the start of memetic awareness of the pandemic, was the original super-spreader system. This is very clear when you look at the New York Times maps.
Once the virus, carried by air through our own high-tech super-spreader system, touched down, its efficacy in spread was directly related to the level of connection of a city’s mass transit system — in particular, its subways. There’s no surprise that NYC got hit as hard as it did. It has the most class/race/age-heterogeneous mass transit system in the U.S. The lines go everywhere, and everyone rides the subway.
But mass transit basically sucks in most of the rest of the U.S. And the other fascinating thing about the results of the disease, with the incumbent “second wave” hysteria, is that the disease highlighted the social divides across America. Many people will read this and grasp onto this — “a-ha! poor people get it worse because they are more exposed!” That is far from clear at this point. If the working poor got COVID worse, it would show up with a spike of service worker deaths. While there has been a ton of reporting on the potential risk to service workers (and service workers deserve protection!) the reality is I’ve yet to see a piece that shows increased mortality to service workers because of their jobs. Even people working in the meat packing plants, where there have been well-documented outbreaks, have not died at increased rates — feel free to provide a cite that proves me wrong in the comments.
Now things get tricky. What COVID-19 actually shows is the lack of linkage between classes in the U.S. because of a lack of direct sociability. The middle/upper/airplane-traveling classes simply don’t mix sociably, or more prosaically, drink together. People in the South just don’t mix with people from the West. The coasts may swap people, but the virus has to take the long road from the coasts to the center, or the south of the country. This is actually an amazing indicator of our empathy problem. Or rather, our lack-of-empathy problem.
In my home state of Washington, this has really held out in striking relief. The latest hotspot in Washington is the Yakima Valley. Heavily Hispanic, and one of the poorest parts of the state, Yakima is not on the middle-class, airplane super-spreader route. The Valley is the heartland of much of the state’s fruit orchards, whose fruit is primarily picked by migrant labor. As that labor has returned to the Valley, cases have spiked — though not deaths. Passed over by white folks in aircraft, it would not surprise me at all if the genetic vector for COVID in the Yakima Valley originates from Mexico. And while it is possible that it came up from California, from the Central Valley, I would also not be surprised if air travel from Mexico also helped bring up potential cases, as we gave the pandemic to Mexico. Now it is bouncing back, on a lower class strata, to the U.S. again.
What this means is that in the short term, causally reasoning through class strata and obvious social divides can tell us much about where or whether we can expect a “green fields” COVID pandemic to pop up, or whether we should expect an outbreak to be relatively easily contained because the virus has already burned through. Unfortunately, in the United States, we cannot have this conversation, because, at the same time, we are struggling with simplistic models of racial/ethnic separation. We live in a political environment where the obvious two sides — Left and Right — of the political debate are convinced they are in a cage match for pure survival. It breaks my heart.
But it does more than break my heart. Dichotomous thinking profoundly impedes the ability of a nation like ours, with many clearly delineated, but not accepted lines of demarcation to use knowledge for optimal solutions. We cannot respond in anything like an optimal, agile manner if our hands are wrapped around our perceived political adversaries’ throats.
Where this clearly matters is in two manners. First, as I’ve made the case above, social class delineation profoundly affects our ability to understand the wave of COVID-19 as it passes through the social network of the U.S. — because this disease is highly social.
But secondly, it impairs our ability to create advice that would protect people’s health through building their personal immunity. The idea that one could take certain prophylactic measures and improve your risk portfolio with the disease is anathema. Instead, what we see is a shrugging of any responsibility turned into a vector of blame onto the other side of the political spectrum. Instead of taking a Vitamin D pill and getting some sunshine, or even understanding the effect of melanin on Vitamin D uptake, obvious paths are turned into racialized or politicized commentary.
And it’s on both sides, folks. We must constructively problem-solve through opening small businesses or we are going to be left without a small-business strata in our society. There is no small business that can stay closed for a year and not go bankrupt. If we are not mindful and proactive, small business will not survive the head-on assault of both COVID and Amazon.
At the same time, mass wearing of masks and maintaining social distancing is not a Lefty plot to infect you with another killer virus. Ask yourself how long you actually wear a mask in an interaction. When I go to Walmart or Safeway, I never spend more than 20 minutes in the store. 20 minutes wearing a mask isn’t going to kill me.
There are also critical, under-the-radar holes in our safety net that will prolong this thing. One is the safety net we provide for nurses. I learned just last night from a friend that nurses’ sick leave and vacation time are conjoined. If you don’t take off time when sick, you get that as a vacation day. And this time is also constrained as too low — 4 weeks for a whole year. What kind of incentive does this create to show up when mildly sick for work? I’m at a loss that this kind of thing can, or will be fixed by the end of this version of the pandemic. But can we at least learn a little bit?
And it goes on and on. I have yet to see any convincing paper that COVID spread is really touch-based. It’s not that you can’t get it from surface contact. But that’s just not the way this thing rolls. And the notion that you’re supposed to wipe and disinfect every surface between every use simply is not possible — nor necessary. I have a friend who runs a small personalized bakery in Portland. You go to his cafe’, create a personalized dessert, and he bakes it for you right on the spot. Between every cake (now limited because of seating because of social distancing restrictions) employees must change gloves. The cake goes into an oven that kills everything. The short version — there’s no way to make money when you add a pair of latex gloves into every order.
What is needed is an elevated understanding of two things. First off is the immunity stack — that people have varying susceptibilities to getting this thing. For the record, this is a colloquial version of the immunity stack:
- Antibodies created from interaction with the disease.
- T-Cells that combat the disease.
- Super-immune response (“goop-ers”) – people that produce enough mucus/bodily fluids that the virus can’t get started.
- Shared immunity from other coronaviruses — my veterinarian friends laugh at the idea they’ll get COVID. “How much calf diarrhea do you need to be exposed to get immunity from every coronavirus on the planet?”
Any seasonality of the virus is at LEAST due to the fact that our immune systems are stronger in the summer than in the winter, due to enhanced Vitamin D uptake. And I’ve advocated eating more saturated fat to help with mucus production.
Second is dispelling the popular myth that we can avoid exposure, and that we are on the front end of the pandemic. There is only one way to truly avoid exposure until the pandemic is past. You have to lock yourself in your room and not come out. It is INCREDIBLY infectious.
And we are FAR from being on the front end of this thing. Even if you don’t accept my argument that super-spreaders and situations are the way that people primarily get COVID, through high dosing, we have passed the only peak we know — the death toll (which is plenty suspect as well) — in most of the country for a while now. There may be some states, like Texas and Florida, that are truly behind the curve, though after reading this piece about COVID in the deep Amazon, I even doubt that. But if there’s been an outbreak in your state, it has likely gone everywhere. Science is still being done to evaluate it, but as this study from Penn State shows, because of a complex of factors, it’s been out there. And if you’re reading this, you’re not dead yet. The belief that we can avoid this thing entirely is literally destroying us a nation. It would be one thing if it were true. But it’s not.
There are still important unknowns. We know that you can achieve some degree of immunity. We don’t know how long that will last, and won’t know for a while. We can confront our nation’s fundamental problem with metabolic syndrome, and the immunosuppression that is concomitant impairs our individual ability to deal with the virus. This paper is a bit old — things are far worse now — but it’s pretty clear that obesity is a problem we all share, and the problem is not overeating — it is metabolic destabilization through poor diet.
We are, sooner or later, going to have to get back to living. I recommend thinking through the patterns I’ve discussed here, and finding ways forward. We all share the common need for our country to survive.