It seems that this is sort of inevitable; human history has been punctuated by pandemics, going back to the Plague of Athens in the 5th Century BCE. At one time epidemic disease was so common as to be nearly unremarkable - who even remembers the Third Cholera Pandemic which tore through the globe killing millions? - but that through advances in public health and medicine we've gone over a century without a genuinely frightening pandemic.
Is COVID-19 that frightening pandemic?
It's dangerous, that we do know. But how dangerous? There's still some big questions. The PRC, where it seems to have originated by animal-to-human transmission much as many other historical pandemics have (note that this is in no way some sort of accusation of biowarfare or aspersion of blame; southeast China is simply one of the world's largest concentrations of domestic animals - largely chickens and pigs from which many (and almost all influenza) viruses are incubated - and humans who come in contact with those animals, and trade routes), has 1) a sketchy record of lying about its internal affairs, and 2) tremendous motivation to lie about the course of this disease. I have a hard time believing that it's genuinely eradicated inside the PRC. Russia has a hell of a long land border with China, and, yet, we know nothing about the presence or virulence of this infection there.
The real problem here is that the data we're working off is so poor. On one hand the London study suggests that nothing short of extreme public closures - workplaces, public spaces...almost any and all public gathering places - will reduce the degree of infection to a manageable level.
On the other, our information level is so low. As noted, the PRC is not a reliable witness, much of the other polities infected are having the same issues with the level of testing that US is having, and we have some datasets that suggests that this disease may not be as deadly as we fear.
If it isn't, and we lock down much of the global economy for a year or more..?
I think we need to prepare for, and treat this, like it is a potential disaster.
But I'm willing to be convinced otherwise.
In other words, is the cure worse than the disease?
ReplyDeleteOr is there a third way, and this is an opportunity to radically overhaul our "business as normal"? To move away from heavy-polluting energy and industries; to introduce a universal basic income; to commit to universal health care; change our supply chains through local production (3D printing/milling/etc of on-line-IP-protected designs) and so on.
On a different note, if you're looking for a literary equivalent, Albert Camus' The Plague may be more appropriate than GGM.
The idea of a pivot away from heavy-industrial capitalism has been a persistent ideal on the Left for some time, along with corollaries like the UBI and national health.
DeleteWhile I agree that all of those are good ideas (although I'm not sure that local 3D printing is an unalloyed good; you're gonna get a lot of weapons mixed in with that...) there's no constituency for them that has any sort of political throw-weight. Look at the tsuris over the COVID relief bill; the center-left proposes a bunch of sensible measures targeted at general welfare and the Right proposes a bunch of payouts for cruise lines and a half-a-trillion-dollar slush fund allocated by a former foreclosure king.
So I'm just not seeing it...
Frankly, I do suspect it's an incomplete bioweapon that escaped the lab because of asymptomatic infections throughout the usual 14 day quarantine after an accident.
ReplyDeleteThat's no knowledge, but a hunch. It fits what we know about the virus and the Chinese actions.
I am sure that this was not an intentional release, though. And it's hard to blame the PRC for a suspected bioweapons program because their nuclear arsenal isn't nearly big enough to wipe out mankind. At least two other countries did worse.
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I find it remarkable that no country appears to be willing to accept a few per cent dead among its elderly and sickly. All governments did react similarly once the known cases exceeded a couple thousand cases. They were willing to let the economy do a nearly full stop, not knowing when and whether they could restart it back to normal.
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This plague will leave a huge imprint on the world
- incompetent governments get exposed
- governments get to choose surviving and failing businesses, reshaping national economies
- home office will be more widespread and teleconferences will be more widespread (both good for carbon emissions)
- distance learning gets a giant boost. MOOCs can revolutionise university education, but the rigid accreditation processes and habits borne in path dependencies have kept our universities really old-fashioned. There's no reason why a student in Hamburg shouldn't be able to learn his class on a specific topic not from the very best professors (who hardly ever happen to be in his university), class for class.
- we will be more determined to wipe out flu and corona viruses with global vaccinations campaigns, probably even against the harmless ones and against those that are so far only in domesticated animals
- architecture will change (anti-disease door handles made of brass have long been available , but now they will be installed en masse I suppose)
https://theconversation.com/copper-is-great-at-killing-superbugs-so-why-dont-hospitals-use-it-73103
- the plague suppresses the anti climate change movement that had a pretty good 2019 (this may hurt us really bad in the long run despite the short-term emissions reductions)
- the plague also suppresses anti-regime movements (examples Iran and HK), so be prepared for wild revolutions and uprisings in the 1...3 years after it's over
- "small government" rhetoric takes a hit
- people in particularly polluted regions see clear skies and smell fresh air. They may be determined to have more of it afterwards
I think the argument against a bioagent is just that; the PRC would have likely known 1) what it was that escaped and 2) that it HAD escaped. Instead of publicly stamping on the Wuhan responders they'd have quickly and quietly rushed to lock down the place and slow the infection transmission.
DeletePlus, frankly, it's a shitty bioweapon.
The problem with "accepting a few percent dead among its elderly and sickly" is that 1) the Italian data suggest that while the incidence of cytokine storms is heavily loaded on the elderly and people who have pre-existing vulnerabilities, it's not exclusively the old and sick. Young adults - largely men - are getting hit as well.
Plus it's the Russian roulette aspect of it; if you DON'T make a large, visible effort to reduce mortality you convince the public that they're going to die. That's politically disastrous.
As for the imprint:
1) The Trump example shows that partisan affiliation will overcome everything else. Until we're looking at Black Death numbers (and we won't...) the 43% aren't going to give a shit.
2) Agreed, and that's a genuine problem here, where cronyism is rampant.
3) Yes; "business travel" is one of the most useless habits of capitalist economies, and hopefully this will drive home how useless.
4) My experience with teaching is that it's damn deadly difficult to get students to engage with the materials when they're sitting there in front of you. "Distance learning" is often an invitation for the students to play videogames while the lecture plays in a window. Ideally? That's great, and it works for the good students. For the rest? Not so much.
5) That presumes that governments will fund such vaccine development, given that vaccines are not a profitable line for most pharmaceutical companies. I'd like to think that, but at the moment it presumes facts not in evidence.
6) I'm guessing that any changes in structural design will be small, and marginal, in the same way that energy-efficient design has been local and dependent on the whims of the developer and the designer. Again, seems like a good idea, but I'm not sure that the public at large is connecting the dots enough to pressure the architects to make this happen.
7) Yes, unfortunately.
8) Or, conversely, the virulence drives new desperation into those rebellions.
9) See #1, above. It's a cult. Cults aren't amenable to evidence.
10) That'd be nice, too. But my guess is that they'll trade the clean air for a steady job, as they have before this.
I wish I was more hopeful.
And I just want to reemphasize how "accepting a few percent dead" is political suicide.
DeleteAll political and economic policies are trade-offs of risk versus reward. We accept that tens of thousands of people will die in motor vehicle accidents because motor vehicles are central to most of our economic and social lives.
But.
There has to be a public sense of effort. So we require air bags and brake inspections and driver training and DUI laws. We don't say out loud "Well, gee...some of y'all just gonna have to die so I can drive to work..."
It's being at the hands of a plague, the "arrow that flieth in darkness" that's so terrifying. And the idea that the government is in the hands of a real-estate grifter and that grifter will merrily let a few percent die so he can turn a buck on his hotels? That's...not good optics.
It's instructive to compare the GOP Senate bill and Trump's toddler impatience with having to lock down his golf clubs with the Johnson government's response - which has been bad, very bad, compared to, say, the ROK's or Taiwan's. The UK is taking the "this is WW2" approach and stepping to to keep people in their homes and eating. Not particularly generously - these are Tories, after all - but compared to the GOP talking heads like the idiot Texas Lieutenant Governor actually saying Dulce et decorum est pro plutocratria mori out loud?
Regardless of the morally questionable part...that seems to be a sort of "playing Russian roulette with one empty chamber" sort of thing for a political party in a democratic republic to do. You have to at least pretend you're trying to prevent that percentage of deaths, or those people and their families and friends will turn on you like cornered rats...
"To Sanmartin’s surprise, Rettaglia slammed shut the door. “Of course, they have nukes,” he whispered fiercely, “but the admiral doesn’t believe it. Shut up and don’t joke about it. Just don’t bunch up outside populated areas or they may tip their hand. Now get out of my sight. Next time you’re down, we’ll crack a bottle.” He slapped Sanmartin on the shoulder. “Menzies is waiting in the car for you. Next week, I’ll drop by and let you lose some money at chess.”
ReplyDelete"The key to live biological operations is controlled dispersal. Uncontrolled dispersal creates infection foci that the slightest mutation can turn into a pandemic. Harjalo had done some reading in the last few hours.
Psittacosis strains are uniformly marked by extreme contagion; apart from the odium attaching to live biological operations from the Wizard Wars, the difficulty of controlling dispersal normally rendered use of PS strains unacceptable, but war is rarely normal.
The Psittacosis37 strain Raul had let loose when he triggered the transponders was distinguished from other PS strains by its low lethality and delayed onset of symptoms. Infection settled in the respiratory system and was spread by coughing or spittle. The illness was characterized by high fever, disorientation, and muscle ache, with complete convalescence requiring several months. Strain-specific immunization was ninety-eight percent successful."
"He had them now. He could feel it. Out of the corner of his eye he saw Scheepers cowering, Strijdom flushed with rage so that he could not speak. In that instant, Pienaar knew that God had answered his prayers truly, by cleaving Strijdom’s lying tongue to the roof of his mouth so that truth might this once be spoken. It was then that Pienaar’s old, grim humor began to reassert itself.
Psittacosis.
Parrot fever. The very thing for a roost of jackdaws.
Pienaar flashed his broken, yellowed teeth. “God is my witness, and I am His servant. I have buried my father and my brothers. I will fight no more in this unhallowed cause. Look out there, all of you! Can you not see the fever come to take our young men? Can any of you doubt that we would not have suffered such terrible defeats if the Lord had hallowed our cause? For our sinful pride and ambition, will we cast aside everything our people have built? You prattle of guerrilla war. I know it. We are beaten before we have even begun. Let be. If it is our lot to be ruled by Imperials and by men like Beyers who have the bravery to speak out with words which none of us wish to hear, then let His will be done. For this delusion, let us spend no more Afrikaner blood. For now, we ourselves must make a harsh peace and reknit the sundered fabric of the Volk in this fair land.”
Malan, who was master-at-arms, recovered his courage. Hearkening to Strijdom’s ample gestures, he fired one shot into Pienaar and let the pistol drop from his hands with a shiver.
Pienaar fell to his knees. He tried to say something, but no words came out. Malan made a sudden chopping motion with his left hand. One of his gunmen stepped behind Pienaar. He shot him once in the back of the head.
“So will perish all traitors!” Strijdom stuttered exultantly, abruptly recovering his speech.
Meagher was outside watching. The mud in his mouth tasted rancid. It tasted of blood."
From, for those who are wondering, "A Small Colonial War", by Robert Frezza, which in my biased opinion should be standard reading at the U.S. Army War College and most other military universities. Not just because it's a terrific yarn, but because it does a terrific job of pointing out the difficulty for imperial powers to suppress local rebellions in ways that don't leave both the imperial power and the locals with more problems than they started with. As well as the difficulty inherent in trying to run an imperium on the cheap.
DeleteWhat's kind of funny ("what a huge mistake" sort of funny, not ha-ha funny) is how two of the base assumptions for the Frezza "Colonial War" series turned out to be colossally wrong. The first was that Japan was going to be the Great Power successor to the then-current Great Powers extant when the book was written in the late Eighties/early Nineties. I vividly recall the freakout paranoia here in the U.S. about how the Damn Nips were buying up Amurikan Real Estate and, lookout!, we were gonna all be eatin' sukiyaki and sippin' sake' before we knew it!
Yeah, well.
The other was that a nuclear exchange between the US and USSR was the Great Cataclysm. That, too, fit with the whole Day After/WarGames terror of the period. Frezza uses it as a plot key, and that hasn't worn well, obviously...
Like any fictional work, it has it's flaws, but overall a hell of a fun read. Worth the cost if you can find a secondhand copy...
Less of a fun read, but perhaps more immediately relevant, is the summary of a Naval War College pandemic response exercise: https://digital-commons.usnwc.edu/cgi/viewcontent.cgi?article=1001&context=civmilresponse-program-sims-uo-2019
DeleteOne finding that caught my eye: "11. A highly unusual mission and/or unprecedented response conditions will meet with significant resistance, even among experienced professionals. This can directly inhibit effective planning and adaptation."
Maybe a silver lining to this crisis is that future such aggressive pathogens won't be "unprecedented" so there will be less "significant resistance" to "effective planning" and prompt responses (complementing Stormcrow's point below about learning everything we can from this experience).
What's kind frustrating is that we've been overdue for a pandemic pathogen for some time; given air travel and international trade the fact that we haven't had a serious pandemic disease since 1919 is pretty amazing. We "should" have known it was inevitable, and we actually had all sorts of plans in place developed after the H1N1 and Ebola scares.
DeleteThe Trumpkins 86ed them because...well, Obama.
The GOP shows little or no sign of learning from this, but, given that they are, effectively, a cult at this point, well...hardly surprising.
Sigh.
ReplyDeleteThe "bioweapon" story again.
It's such a simple explanation. And introducing it has the same effect as introducing the "conspiracy" explanation for an unexplained event: common sense and reason both fly out the window.
I don't suppose S O knows about how common viral zoonoses become, when you start forking over ecosystems your immune system has no experience with.
But you don't have to take my word for it. 6 years ago, Ron Barrett and George Armelagos wrote a survey book on that topic and much more besides: "An Unnatural History of Emerging Infections". If you prefer a more popular science approach, work your way through David Quammen's "Spillover".
Here's a rhetorical question: did anyone hear of Ebola, prior to humans setting up mining and logging operations in the Congo Basin rain forest? No? I didn't think so.
There's lots more viruses where this one came from.
And we don't even have names for most of them.
So we'd better learn everything we can about incident response to a novel pathogen from this experience, because, trust me, next time could be a lot worse than this is liable to be. Even if this one costs us a couple of hundred thousand dead Americans.
The other thing a pathogen "needs" to be a useful bioweapon is that it has to affect the targeted population without blowing back on the user.
DeleteThe problem with trying to use a coronavirus is the same problem that the world's epidemologists are having now; given that most strains have a tiny mortality rate the pharmaceutical industry has no catalog of vaccines the way it does for standard zoonotic influenzas. It's just hasn't been worth developing vaccines for coronaviruses that way it has been for the great killers like smallpox (or influenza).
Had the PRC been genuinely trying to develop this AS a bioweapon they'd have had to develop a vaccine first (or, at least, have been far along on the process) or it would have done just what it did - tear through the PRC's military as it seems to now be doing around the world.
I'm not saying that it's IMPOSSIBLE. Just improbable. Occam's Razor suggests that this developed just as it's supposed to - from human-animal contact in SE China, the way crap-tons of epidemic diseases have throughout history...
About the question FDChief raised about the CFR ...
ReplyDeleteYesterday, CNN published a story about this: Coronavirus death rate is lower than previously reported, study says, but it's still deadlier than seasonal flu.
The thrust of the CNN story was that the generally accepted value of about 2% for COVID-19's CFR ("Case Fatality Rate") may be too high.
That CNN story mentioned but did not cite a paper published in Lancet Infectious Diseases. So I dug it up myself. It's here: Estimates of the severity of coronavirus disease 2019: a model-based analysis.
All the gods love them, they published the whole paper on the Internet. No paywall.
The money quotes are in the "Findings" section, at the top.
"However, after further adjusting for demography and under-ascertainment, we obtained a best estimate of the case fatality ratio in China of 1·38% (1·23–1·53), ..."
They're taking "CASE" fatality to mean deaths versus numbers of people actually diagnosed with this stuff.
"Our estimated overall infection fatality ratio for China was 0·66% (0·39–1·33), with an increasing profile with age."
They're taking "INFECTION" fatality to mean deaths versus numbers of people who actually contracted COVID-19, whether they were formally diagnosed with it or not.
The way I'm reading this, to the extent my layman's brain can process it, the reason they're putting forward for the discrepancy is the numbers of people who had cases so mild they either didn't come to the attention of health care workers as potential COVID-19 cases, or didn't seek care themselves because they didn't feel sick enough.
The flip side is, that if this is true, it's not really good news.
Because the immediate corollary is that the US, and every other country who isn't aggressively and systematically testing everyone who has so much as a sneeze or a runny nose, is sitting on whole boatload of "low severity" cases that are going completely under their radar.
The SARS virus that circulated briefly in 2003, before guttering out in June of that year, didn't make you dangerous to be around until you were so sick you were probably in a hospital ICU already.
This one isn't playing so nice. It's creating an ungodly large number of people who are contagious as hell, but who aren't (yet) sick enough to take fright and seek medical care.
So we're seeing gothic horror stories like this one: A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead. This catastrophe got rolling on March 10, almost 2 weeks before Jay Inslee locked the state down on March 23.
Normal social activity in an environment full of low-intensity cases, is like tap-dancing on top of a minefield.
If the first three months of this pandemic should teach us anything, it's that the very first thing we have to do when dealing with a potential high-velocity infector which is capable of generating both acute and mild sets of symptoms, is set up a pervasive testing and contact tracing system, on a very large scale, operating as far ahead of the wavefront of cases as they can.
Of course, in order to do that, you need a political regime at the national level that isn't primarily a freak show.
Which leaves the US out in the cold, both during this epidemic and into the foreseeable future.
Just to clarify, I don't believe for a second this was any sort of bioweapon.
ReplyDeleteDamnned if it isn't showing up the fecklessness of our settler societies..
People did not have to die.