Coronavirus

Yesterday our vast network of spies sent us an interesting analytical report from JP Morgan. Sadly, we cannot link it since it came by email. Strictly in the interests of the public health, however, we share this interesting fair use excerpt relating to the prospects for relief from the novel coronavirus as the northern hemisphere warms up:

Update: tracking COVID-19 outbreaks and geographical vulnerability bands (March 12, 2020)
This is controversial and many scientists are still uncertain about it, but there has been some research on COVID-19 outbreaks as a function of latitude, temperature and humidity. A paper just released from the Institute of Human Virology at the University of Maryland [(link to pdf)] which makes the following observations:
• The most severe community outbreaks have occurred in regions along a narrow east-west distribution roughly along the 30-50 N” corridor at consistently similar weather patterns (5-11°C and 47-79% humidity). Cities at greatest risk below are on the border of the yellow zone and the green zone
• Average temperatures (5-11°C) and relative humidity (47-79%) in affected cities are similar to each other, and also similar to laboratory conditions conducive to coronavirus survival (4°C and 20-80% relative humidity). None of the infection concentrations have occurred (yet) in places with minimum temperatures below 0°C either.
• Outbreaks have been lower (so far) in places with large populations and substantial travel connections with China, such as Bangkok

Which cities are most at risk? The table below show cities with community spreading and those deemed at risk by the authors of the study using their (in my view highly simplified) approach, simply due to the latitude and average temperatures/humidity of each. The authors note that the cities below will experience rising temperatures and humidity in the weeks ahead, and if temperature and humidity do affect the transmission of the COVID-19 virus, the passage of time could help. As the “ideal temperature/humidity” zone for the survival of the virus moves further north over time, the authors believe it would overlap with population centers with much lower density.

However, let’s be cautious here. The authors cite the decline in Wuhan infections as possibly being related to warming weather when there are many other factors involved: the rising effectiveness/severity of the quarantine, increased knowledge of the virus and social distancing by citizens, and “herd immunity” once a large percentage of the population has already been exposed to the virus. This paper makes an important contribution to virus severity tracking and suggests that weather may play a role, but the results are far from conclusive this early in the outbreak (for example, the only cities circled on the map are ones with >6 deaths as of March 5; there are a lot more cities that would have circles today, and I do not have an updated map overlaying these circles on latitudes/temperature zones). To me, the primary value of the paper is to highlight cities with potentially high risk, and secondarily, that we wait and see if weather may mitigate it. I would NOT recommend any reduction of density reduction and social distancing simply out of the view that weather will solve the problem. [Bold emphasis added.]

The same report, which is regularly updated, had an earlier bit that suggested the mechanism.

Update: Could the onset of spring and summer slow virus transmission rates? (March 4, 2020)
There have been press articles and government statements on the possibility that COVID-19 infection rates could fall as the winter comes to an end. There are three main theories as to why the flu season in temperate regions peaks in winter months:
• More clustering of infected and uninfected people indoors due to colder temperatures
• Colder, drier air is more conducive to airborne travel of viruses; colder air allows viruses to survive for longer periods and to travel longer physical distances
• Lower levels of winter sunlight may play a role given the ability of UV light to sterilize surfaces and kill both viruses and bacteria
Some details:
• Scientists have found that influenza peaks in periods of low humidity, low temperatures, low solar radiation and low precipitation. In other words: in cold, dry winter months
• In lab studies using animals, scientists also found that high temperatures and high humidity slowed the spread of influenza sharply, and at very high humidity levels, the virus stopped spreading completely
• During the SARS epidemic in 2003, infection rates declined from March to May as temperatures rose. However, there were other factors changing at the same time (changes in hospitalization rates, greater provision of gear to medical personnel, higher quarantine rates and the natural erosion of epidemic severity over time) so results were not conclusive with respect to weather in isolation. Even when combining all these factors, researchers were only able to explain two thirds of the change in SARS infection rates
• Why might infection rates be impacted by temperature?
o Low winter humidity might impair the function of mucus, which traps and expels foreign bodies like viruses or bacteria. Cold, dry air can render mucus drier and less efficient at trapping a virus
o In addition, influenza “virions” (an infective virus outside a host cell) appear to be much less stable in conditions of higher humidity, when respiratory droplets fall to the ground more quickly
• It’s not just the heat, it could be the sun as well. Direct and scattered radiation from the sun can break down viruses that have been transmitted to surfaces (“fomites”), but is much less abundant in winter. UV light is so effective at killing bacteria and viruses that it’s used in hospitals to sterilize rooms and equipment
o One study found that in Brazil, there’s a correlation between increased influenza hospital admissions and solar UV-blocking by smoke during the burning season
o The US military reported that UV radiation sterilization virtually prevented the spread of influenza among patients in a veterans hospital, during the same time that an epidemic of influenza ravaged similar patients in nearby non-irradiated rooms
• However, COVID-19 is not the same as influenza and SARS, and its reaction to changes in temperatures, humidity and sunlight is still unclear. SARS did not completely subside until late May 2003, which suggests that temperature factors, if they did mitigate the disease, took time to work
• If weather DOES play a role in COVID-19, then infection rates could FALL in the Northern Hemisphere as temperatures rise, but RISE in parts the Southern Hemisphere in June/July/August when temperatures fall there (i.e., what happens with the flu each year)

Read the underlying paper here.

Your Editor self-identifies as an Iowan, and — like most Iowans — is a fool for Iowa propaganda. To wit: “Iowa biotech firm says it has produced enough coronavirus tests for 700,000 patients.”

Coralville-based Integrated DNA Technologies began producing test kits after the Food and Drug Administration amended rules last week to allow private labs to create products that detect the virus.

On Friday, the company told the Des Moines Register it had delivered materials that enabled testing of 700,000 individuals for the coronavirus that causes COVID-19. A company spokeswoman said it is ready to send additional materials for more testing.

Note that the reported constraint, per The Des Moines Register, was FDA “rules.” With the greatest respect and delicacy, we suggest that the FDA is only occasionally a “forest-for-the-trees” regulator.

For the many people wondering whether aggressive action to curb the spread of the novel coronavirus is worth the cost or the hassle or the loss of intimacy, this graphic captures the big public health issue:

If the infection spreads quickly in a jurisdiction, the rush of cases will exceed the capacity of hospitals and other health care providers. Not only will those patients not get the care that they need, but other patients who need care for acute conditions may suffer or die because they are crowded out.

If we flatten the curve, not only do we reduce the risk of crowding out, but we buy time to build capacity — say, by installing more ventilators — and get to a vaccine.

So flatten the curve. An infection delayed can be a life saved.

Austin has not yet had a documented case of Covid-19, and the city fathers are trying hard to keep it that way, or at least trying hard to appear doing so. Not that we are cynical about this — we are not, actually — but neither are we unmindful of the political stress around this crisis at all levels of government.

The city of Austin has imposed potentially crippling limitations on events that gather more than 2500 people, which are a big part of the city’s brand, as it were. Events expecting more than that number must get separate approval from health officials, presumably conditioned on prevailing Covid-19 risk under all the circumstances and plans to mitigate it. University of Texas sporting events are continuing as usual, supposedly because people do not travel from far away to attend them.

Except, you know, from all over Texas, including Houston and San Antonio where there are documented cases, and never mind the fans of the visiting teams.

That might be where one would sound cynical, if one were so disposed.

Regardless, all of this makes us wonder whether the politicians in charge of Milwaukee and Charlotte are so happy to be hosting the Democratic and Republican conventions in July and August. If the novel coronavirus remains “a thing” this summer, and we expect that it will, will they do the right thing?

By now everybody knows that the city of Austin effectively ordered the cancellation of SXSW on account of Covid-19 concerns. This was the right thing to do, even though, in our case at least, it is a ginormous bummer. SXSW is our favorite week of the Austin year, a long-planned staycation for me and Mrs. Blueberrytown, and this year we were honored to be selected as a “mentor” and were thereby graced with a platinum badge in compensation.

Imagine you just lost your free boondoggle to Hawaii or London or whatever you people enjoy. It is a lot like that for us.

Why was cancelling SXSW the right thing to do? Well, because people fly in from all over the world, including especially the virus-ridden Left Coast. There hasn’t been a known case in Austin yet, and the longer we defer that day the better. The more we learn about this bad boy before we catch it, the likelier we are to get through it without permanent damage, benefit from drug therapies, and avoid spreading it to people we love. Or, for that matter, people we could easily do without, but still want to avoid the guilt of infecting.

We have had a few thoughts since last Saturday, when — from our suite in the Palazzo in Las Vegas, shortly before the craps roll of a lifetime — we penned our original Covid-19 speculations, none of which have been proven wrong, but few of which have turned true. These are more like “musings,” in no particular order.

We’ve been practicing social distancing. Remembering not to shake hands takes practice, so don’t wait until your city is scouting for pauper graveyards to start doing it.

Notwithstanding our first preference for Japanese-style bowing, without, of course, the silly hierarchy — we are Americans, goddamn it! — in our nerdy circles the Vulcan greeting, accompanied by “live long and prosper,” seems to combine hep n’ cool irony with an actually relevant message, the sort of best wishes that are suddenly top of mind.

The good news in all of this is that it is killing off the “business hug,” which we deplore. And, no, we do not deplore business hugging because of a Pence-like obsession with #metoo issues, but because hugging for us is about sharing intimacy and connecting closely with a loved one. Business hugging is artificial at best, degrading if you think about it. If a few people have to die to kill off business hugging, the price will be worth it.

Relax. That was a joke. Goddamn.

The world’s economy is stopping like a car door slamming, do not believe otherwise. Why? Because nobody wants to kill their grandmother, or Willie Nelson. There are, however, a lot of questions to which we do not know the answers.

Are we heading in to a recession, with multiple quarters of economic decline, or does this thing look like a “V”? Our guess is that it all depends on March and April. If the global infected population doubles every few days, we’re in it for the long haul. If it takes weeks to double, then people are going to adjust, and cautiously get back on planes and such. If you are really courageous, start buying plane and cruise tickets for later in the year. They may be the best investment you make this month.

The CEOs we know are spending a ridiculous amount of time planning around this farookin’ disease. Right now, securing supply chains, protecting their employees, and avoiding exposure in the inevitable blood-sucking “you shoulda done” lawsuits are their biggest concerns. And, of course, nobody is spending any time thinking about innovation or growth, unless they run a biotech company pointed at viruses.

Companies that need current cash flow to service their debt could be in a lot of trouble. Leverage is not your friend in such times. Cash has gone from trash to beautiful, glorious, invigorating stuff you want to rub all over your body. Well, only if it is in crisp, uncirculated bundles. But you get our point.

With the ongoing collapse of the stock market, we are rapidly getting less unequal! Bernie problem solved! Add to that the mother of all oil price wars and the return of ZIRP and working people who do not lose their jobs will be, as our beloved father was wont to say, “fartin’ in silk.”

We were on a brewery and distillery crawl in Austin yesterday — something of a last hurrah, we suppose — and we learned that people do not appreciate frequent reporting on the status of this website. Not everybody reacts to stress the same way. So if you love watching infection counters, as we admit we do, keep it to yourself.

The news is that global cases are up roughly 4000 in the last 24 hours, from roughly 106,000 to roughly 110,000. That sounds bad, and for the individuals involved, it is. We find it comforting. An increase of around 4% in a day implies a doubling every 18 days. If that rate persists, Covid-19 seems manageable, suggesting that we would not hit a million cases around the globe until around the end of April. That buys a lot of time to prepare.

Sadly, the reported infection rate is probably going to accelerate. Our guess is that the reported rates of infection accelerate for the next few weeks as testing for the disease proliferates. That will look bad, but it might actually not reflect a rising transmission rate.

This is worth your time, especially if it leads you to adjust your helmet over inconveniences.

It feels like the right time to do our best to be a better citizen. Hunt down your local blood bank and give blood, because apparently there is a shortage looming.

Follow the example of Ted Cruz, if presented with the opportunity. “Opportunity” being, of course, a euphemism.

The press coverage is extremely tedious, with no end of argument about whether President Trump is, or is not, incompetent. How about hoping that he is, or that the remnant of his team is? So far, the evidence is mixed, but the United States has one of the lowest per capita rates of known infection in the traveling world. Let’s hope it stays that way, even if it is Trump’s fault.

Speaking of Trump, what controversial Covid-19-oriented executive order will he issue next? Given the soaring infection rates in the cradle of Western Civilization, we speculate Trump will soon ban travel from Europe. Do not go there unless you are prepared to stay for a while.

Is Time going to make the novel coronavirus its “Person” of the Year? Sitting here in early March, that seems like a lock.

Somebody needs to invent an inexpensive little wristband that vibrates if you raise your hand to scratch your face.

View Post

Iran’s leadership is reportedly getting hammered by Covid-19, the disease caused by the novel coronavirus. In certain circles, one does not need look hard for consequent schadenfreude, and, in spite of our generous nature, we admit to temptation in that direction.

But then we worry about karmac blowback.

We in the United States are in the middle of a presidential campaign. What are the odds that one or more of the current septuagenarian candidates, including perhaps the sitting POTUS, will be exposed and perhaps even threatened, just as Iran’s leadership? Given the travel, exhaustion, and relentless exposure to people from all over the country, there is a non-zero chance that the virus will infect one or more of them soon.

That day will sorely test our civil society.

As recently as last summer, 45% of Americans (according to one credible survey) “doubted” the safety of vaccines. This did not necessarily translate in to opposition to requirements for children to be vaccinated before going to school, for example, but it remains the case that most states have broad exemptions from mandatory vaccination.

The politics of this defy easy explanation. If the Great Karnak were asked to provide the question to the answer “California, New York, West Virginia, and Mississippi,” there is no chance he would have said “states with the fewest exemptions to mandatory vaccinations.”

Yesterday’s election results, coming as they did on the brink of the now virtually inevitable Covid-19 pandemic, offer early evidence that the tide may be turning. Last year, Maine’s legislature eliminated most exemptions from vaccination requirements by a one-vote margin, effectively turning it from dark blue to yellow on the map above. The anti-vaxxers being nothing if not committed tried to overturn the new strict law by referendum. They were destroyed.

Of course, it is impossible to know whether the anti-vaxxer referendum would have passed in the absence of the recent scare, but we strongly suspect that at least the margin of its defeat was so great because we have been reminded, rather harshly, of the social and economic consequences of unchecked infectious disease.

We are back, at least temporarily. Extraordinary times demand an extraordinary commitment from all of us, and this is mine.

Herewith, a few COVID-19 speculations.

It would be most helpful if you commented with reference to the numbered speculation. If I add speculations to this post, as the bourbon sinks in, I will insert them without renumbering.

Finally, it should be said, that no doubt others have thought of all of these before me. We stand on the shoulders of giants.

1. A large number of Americans, exceeding millions, will become infected.

2. The death rate in the United States will be substantially lower than in China, because we have much lower rates of respiratory illnesses and our medical intervention will, most of the time, be more aggressive.

3. Still, Americans value life and are afraid of dying, so social norms will change rapidly, and perhaps permanently, because of this event.

4. Shaking hands at large gatherings — sales meetings, conventions, and the like — will go out of style. I imagine we will try lots of things, but I hope we settle on a more equal version of Japanese bowing. (It will be interesting to see whether any of our presidential candidates stop shaking hands to make the point.)

5. Workers who do not perform in-person functions (construction workers, massage therapists, real estate brokers, and so forth) will be encouraged to work remotely for a period. Many of them will find they like working at home, and in the end many employers will agree. This will rapidly accelerate the decentralization of work. If you own a huge office building, consider selling it.

6. If you build houses, shrink the closets — people won’t have to dress up for work as much — and build home offices.

7. While you’re at it, offer “prepper” options, like a generator and a cellar with two exits and a built-in gun safe. These will become much more popular in the next few years.

8. The Japanese have already sent their school children home for a month. This might turn out to be a reasonable thing for Americans to do, but it would be much harder for us. What happens to the kids who need school lunches? Who supervises the kids at home if the parent(s) [both] [all] have in-person job requirements? What happens to high school football practice in Texas? We may yet find out.

9. The world will move away from China as a sole source for anything. The beneficiaries will be countries that make it easy for foreign investment. Latin America ought to be the ideal beneficiary, except that (by and large) the countries of the region make things very difficult for foreign investment. The American heartland will be a long-term economic beneficiary to a degree that will surprise even Trump and his acolytes.

10. We will expose huge gaps in our own competencies, gaps that we have long been worried about, in our quiet moments, but are reluctant to admit to ourselves. For example, a big reason why Chinese companies make so many medicines on which we depend is that China produces a staggering number of students with chemistry degrees. If you need to hire 200 chemists in a hurry, China is the place to do it. That won’t change until Americans raise their children to study useful things again (#SUTA). This event may do it. I predict that the number of Americans studying biology and chemistry will increase significantly.

11. Nevertheless, there will be big opportunities in making basic stuff right here in the USA. “Made in America” will become a far more potent marketing device. If I were a young person who knew something about manufacturing — and there are such people — I would figure out what products are now *only* made in China and start making some of them here. There is a window opening.

12. The cost of basic consumer products will go up significantly as a result. While this will hurt the standard of living of the poor, the culture-shapers will be all for it. I, for one, will be shocked.

13. Businesses will learn new habits, including that they can get by with much less travel. Obviously, this will be very tough on airlines and lodging companies. Interestingly, reduced business travel (along with a lot more telecommuting) will result in a non-trivial reduction in incremental CO2. Further speculation: When a climate activist oversteps and suggests that this is a “silver lining,” he or she will be mocked as a “Thanos wannabe” on Twitter.

14. There is a non-zero chance that COVID-19 will be a blessing in disguise. We will in short order learn a great deal about how to respond to situations such as these, and changing social norms will be high on the list of important adaptations. If we learn these new habits and techniques now, instead of in a worse crisis that involves a much more lethal disease, we will save a lot of lives in the future.

15. If the first effective vaccine for COVID-19 in fact comes out of Israel, virtually all the people who believe in boycotting and divesting from Israel will take the vaccine anyway. None of them will change their minds.

16. Our response to COVID-19 may challenge contemporary American ideas about autonomy and liberty. We may need to reinstate old school quarantines and sanctions for people who break those quarantines. Somebody is going to sue after a public health official locks them up. I doubt very much that in the middle of a pandemic the federal courts are going to side against the public health authorities, especially given the long, albeit old, precedent. (I have long thought that the American individual rights era, which roughly coincided with the [temporary?] elimination of infectious disease as a leading cause of death, was in practice *enabled by* the control of infectious disease through sanitation, vaccines, and antibiotics. We shall soon see if I am right.)

17. Your Editor is a speaker (mentor) at the upcoming SXSW conference in Austin. We hope to see you there, but we will bow, rather than shake your hand.

What else?