Month: June 2020

People sometimes joke (well, maybe they’re not joking) that this is “the darkest timeline”, between COVID-19, the idiots in the White House, the idiots in 10 Downing Street, etc. But it’s easy to imagine the development of COVID-19 taking even darker turns. I think about this sometimes, and wanted to write down some of my thoughts.

This is going to be a pretty dark post, so if this isn’t your thing, then you should skip it.

I have two what-ifs for you, one building on the other, and some thoughts on how they might go:

1) What if we never develop a vaccine?

This is possible. We’ve never developed a vaccine for the common cold, which can be caused by coronaviruses. We don’t yet know whether COVID-19 can be vaccinated against, and we probably won’t know for a year, if not several years.

What does it mean if we can’t develop a vaccine? Well, it means that almost everyone in the world will eventually contract the virus, which at a 1% fatality rate means that about 70 million people will die worldwide, 3.5 million in the United States, and many more will have serious health problems, probably for the rest of their lives. (I don’t know what percentage of infected survive but develop such problems.) I don’t think humans have the will to be able to go into the long-term total lockdown that would be necessary to prevent this.

It also seems likely that immunity to the virus provided by recovering from it won’t last forever – maybe it would last for 2-5 years. So if there’s no vaccine, then everyone who contracts it and recovers would contract it again a few years later. People who got seriously ill the first time around might not survive the second time, raising the fatality rate. And maybe people who came through fairly easily the first time would have a harder time the next time. Or the next. We might each of us end up living in fear of the day that the virus eventually hits us hard.

Moreover, we know that older people are more susceptible to the virus than younger ones, so as we age we may be aware that the next time we catch it could be the last time. People who before were expecting to live to age 70 or 80 might start thinking they’ll live 10 or 15 fewer years – and most of them might be right.

What might such a world look like? Well, we might just decide that since there’s nothing we can do, we’ll just go back to living the way we did before. Maybe we’d ramp up medical services to ameliorate the impact on individuals, but maybe not. (Many nations probably wouldn’t be able to. Some nations might not have the political will to do so.)

Alternately we might continue the lockdown for years, or forever, altering the way the economy works to accommodate. Office buildings would largely be a thing of the past, as would restaurants as we know them and many other social gatherings. Lots of things would move online further. We’d probably see a gradual reshaping of our cities and suburbs along lines it’s difficult to predict – more single-family homes? Fewer? No mass transit? As some have already predicted, people who work in jobs where they can telecommute would no longer be motivated to live near work, and housing prices in places like the Bay Area might plummet as people leave. On the other hand, jobs where people need to interact with other people might become less desirable – but no less critical. Maybe they’d start to pay better as a result.

Some people have already clamored for Internet to be classified as an essential service, regulated or free. That might be a necessity in such a world, but of course the need for medical care hasn’t prevented the U.S. from developing a for-profit health care system where people get raked over the financial coals for essential care. So Internet service might be no different. And even if it is, providing quality Internet service across as large a nation as the U.S. would take time, as many rural areas still have poor service.

If this were to continue into the future, one can imagine significant investments in robotic technology and other automation to serve people who are mostly living in their homes. Automated production, packaging, and delivery, overseen by a bare minimum of people. Restructuring of infrastructure around this sort of life, where cities have automated distribution centers and roads get narrower and mainly used by robots. At an extreme there’s the cheesy science-fictional idea where humanity becomes slaves to our machines, letting our physical bodies atrophy as we’re all living alone in our own homes without the interest in going anywhere. (Much like the “Seerons” in this comic book.)

But I digress. Maybe.

2) What if the virus mutates?

From what I’ve read, COVID-19 is not mutating very quickly. The reason we need to get a flu shot every year is because influenza mutates rapidly, so there are new strained every year. Fortunately we do a pretty good job creating influenza vaccines, though it’s not perfect. COVID-19 doesn’t seem to have this characteristic, and the strains we’re aware of seem to be closely related.

However, we could be wrong about how fast it’s mutating. Alternately, it might start to mutate faster. Either way, it might become more virulent, or more fatal, and mutations might also mean the temporary immunity gained from contracting one strain wouldn’t provide any immunity from another strain.

This isn’t necessarily game over for the human race. If the virus doesn’t become more fatal then it would just be a rougher form of the scenario above. If it does become more fatal, though, well… it probably means mass deaths, close to an extinction-level event. Our only hope as a species then is that it kills so many people that it kills off its ability to spread, and a few pockets of uninfected humans manage to survive long enough to restart the species, without being infected by the remnants of the virus left elsewhere. This is sort of how Europe survived the Black Death – exactly how things play out depends on how fatal the virus becomes.

A cheery picture, yes?

And so:

How likely is all this? Heck if I know. Probably not very likely. I choose to be optimistic that we will develop a vaccine, and that at worst we’ll all be getting an extra shot every year or two to stave off the virus. While it could take longer than the 18 month minimum, supposedly we were close to developing a vaccine for the 2012-13 MERS outbreak before it was determined to be much less virulent than feared and research funding petered out. If so, then hopefully we’ll be able to develop one for COVID-19.

Everyone keep your fingers crossed.

As I write this (and I say this mainly for posterity, not for anyone who reads this in the next few days), we’re about 5 months into the COVID-19 pandemic in the United States, and over 3 months into the shelter-in-place measures which have closed down much of the economy.

Just under 110,000 Americans have died from the virus, with about 2 million having tested positive. However, testing in the U.S. has been woefully inadequate, due in large part to the inaction of the Racist Impeached President Trump administration – since usually government action and coordination is key in driving nationwide efforts to deal with an emergency – so its likely far more people have been infected. A case fatality rate of 1% means that about 11 million people – around 3% – of the population has been infected. Adjust accordingly if you believe the fatality rate is actually higher (which would be bad) or lower (which would be good, but still pretty bad even at 0.5%).

In other words, the pandemic is a long, long way from being over.

Despite this, the nation is starting to “open up”. It differs by state – some states never really entered full ‘lockdown’ – but even California is allowing outdoor dining at restaurants, retail is reopening, and I think we’re on the cusp of hair and nail and similar stores reopening. (I honestly haven’t been following the details that closely as there are some businesses I just don’t plan to visit any time soon.)

We’ve also had the Black Lives Matter protests – as well as some other, smaller (and in some cases far stupider) gatherings – over the last few weeks, where mask wearing has been haphazard and physical distancing difficult or impossible.

COVID-19 has a gestation time of about 2 weeks, which means right about now we’d expect to be seeing additional cases, but it’s difficult to be sure due to the poor testing. The number of new cases reported nationally has been going down very slowly, but it’s going up in some states such as California and Texas. It’s hard to know whether this is due to more cases, or more testing. This is one reason that I look to the death rate rather than the reported case rate. We’ll probably know a lot more by the end of July, unfortunately in the form of a spike in deaths (or not).

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The question I keep coming back to is: How many people will get the virus before we develop immunity?

Some people have advocated letting the virus run its course through the population for us to develop herd immunity. But if it takes at least 70% of the country catching the virus to develop herd immunity, that means 230 million people. And that means between 1 million and 4 million deaths – maybe more, if the medical infrastructure gets overwhelmed. Sweden elected not to enact significant social changes and it hasn’t been going well for them. The other issue with this approach is that we don’t yet know whether people who catch and then recover from the virus end up with durable immunity, and many people who survive have significant health problems. So it’s a painful and risky approach.

(When I’ve occasionally butted heads with someone who thinks herd immunity is the way to go, I’ve noted that they should be prepared to say goodbye to between 1 and 5 of every hundred people they know. This goes over about as well as you’d expect.)

Most experts think we’ll need to develop a vaccine. Putting aside the question of whether we can develop a vaccine (which we don’t yet know one way or the other), experts agree that it will take at least 18 months to develop a vaccine which we know works and is safe (i.e., that won’t kill or injure the people who get it) and it could take 3-to-4 years.

So even if we continue to impose physical distancing and masks and other measures, how many people are going to end up catching the virus anyway in that time? If 11 million people have been infected so far, that probably means 33 million by the end of the year, and double that before a vaccine is developed, assuming it’s developed in the 18-month window and is rolled out more-or-less instantaneously. 66 million a lot less than 230 million, but still a lot of deaths.

But now the country is starting to re-open, which means more people may be infected, at a faster rate. Humans are social animals, and our economy and social structures are based around getting together in groups. And it’s just very, very hard for humans as a group to make significant sacrifices over a long period of time to combat an emergency. Historically – for example, during war – this behavior is reinforced through strong leadership at many levels, but especially driven from a unifying force at the top. The United States obviously doesn’t have that – we have the opposite of that – and the mid-level leaders such as the governors don’t have the social capital to maintain this level of sacrifice indefinitely.

I don’t think it’s necessarily impossible to find a way to start re-opening and country safely, but I don’t think the people motivating the re-opening are interested in “safely”, they’re just interested in “re-opening”. So I believe things are going to continue to open up, and then the virus will spread faster, people will get sick and die, medical facilities will be overwhelmed, and things will get worse.

I could be wrong. There are a lot of things we don’t know (for example, maybe face masks are a magic bullet – if we can convince people to use them). But based on what we know so far, I think it’s going to be a long summer, possibly leading into a painful autumn.

We’re much closer to the beginning of this than the end.

I was thinking that it was past time to provide a personal update about living during the pandemic, but something more important has obviously come up, the protests in the wake of the death of George Floyd.

Make no mistake, I support these protests. Like many, I worry that it will hasten the second wave of the COVID-19 outbreak, but I can’t in good conscience judge the protestors’ actions in this regard. Institutional racism has been holding down the country for centuries – literally centuries – and Racist Impeached President Trump has emboldened the plainer variety of racists for many years. The lives and well-being of millions of people are at stake, regardless of the pandemic.

The protests have been mixed with a dose of rioting as well, but it seems clear to me that the rioters were a combination of right-ring agitators trying to cast the protestors in a bad light, and opportunistic looters. In the last week peaceful protests have continued to grow – spreading across the world – while the rioting and looting has declined.

It’s been delightful seeing our Coward-in-Chief flailing around, talking tough while hiding behind ever-growing fencing between the White House and the rest of Washington, DC. And a smattering of his racist party showing their true colors, such as Boy Blunder Senator Tom Cotton’s New York Times op-ed calling for Trump to send in the troops against American citizens, which led to the Times editorial page editor resigning. (Honestly, what good is the Times these days? They seem like little more than apologists for the Trumpists.)

Far less delightful has been protests against police brutality being met with waves of police brutality. The latest news are people calling to “defund the police”. I don’t know what the answer is here, but the status quo clearly isn’t it.

I live in the suburbs and though a couple of neighboring cities have had some surprisingly-large protests, mine hasn’t. There were some curfews in nearby cities and a neighboring county, and there was at least one ugly incident in nearby San Jose. Across the country, though, science fiction & mystery bookstore Uncle Hugo’s & Uncle Edgar’s was burned to the ground in the Minneapolis riots, while fellow Twin Cities store Dreamhaven (which I’ve actually patronized) was vandalized. Moreover, the offices of one of my favorite Magic podcasts, Good Luck High Five, was damaged in a fire and I don’t think they’ve yet been able to access it to find out what state it’s in.

If this sounds like a “but” to my original statement of support, it’s not. It’s an accounting of some of the things that I’ve noted during the protests. There are many others, such as the arrests of the officers involved in the Floyd killing, and I hope we’ll see more people called to account for the attacks on the protesters.

But I do hope this leads to change. Fast change, slow change, durable and systemic change. I realize that I’m at the high end of the privilege scale in this country, but I recognize that this change needs to happen. I believe that we – individually and as a nation – are better off when we all are able to thrive.

And in order to get there, we need to understand, and act on the understanding, that black lives matter.