02 April 2020

Coronavirus / COVID-19: Chicken Little, The Disease Itself, and The Cure?

The Skepticism

One of the problems with overstating things and fear mongering is that no one trusts you when the trust is needed. We're all taught at a young age The Boy Who Cried Wolf, which teaches us that people won't believe someone if they constantly state that a threat is upon us when it isn't, and Chicken Little, which teaches that we should be suspicious when someone tells us the sky is falling because they may just have been hit on the head with an acorn. Herein lies the problem surrounding the coronavirus.

(1)  Every couple years or so, the press and elements of the medical establishment yell that [Disease of the Year] is going to kill us all!  I know that every couple years I've seen frantic meetings followed by directives to do X or Y because [Disease of the Year] was on the way. And nothing happened. Typically, the disease had a significant impact on another continent, but didn't get across either ocean to America before it was controlled or died out.

(2)  And the specifics of this year's [Disease of the Year] have been chicken little'd too. The promised death rate of 2%-4.5% turns out to be .66%. They act as though the rate of spread through the community is incredible like the measles (between 12-18 persons per infected) when it's actually more along the lines of 2 people catching it from any given infected.

(3)  And beyond that there's been been the fact that the politically inclined of either stripe among us have been using this as a political tool rather than treating it as a real situation. Early attempts to deal with this were scoffed at by one side while that side was obsessed with something else. Then things flipped and the second side went after the first side for not acting quickly enough to deal with the issue. The latest thing on FB has been a series of pictures showing someone playing golf as the crisis ramped up which were almost immediately countered showing pictures of another someone playing golf as another such threat loomed (but never quite hit). When those involved and interested in national politics are signaling to us that this is nothing more than another tool to gain an advantage over the other side it does not indicate that a situation is serious.

So, if those of you truly convinced this is the end are wondering why the rest of us have been slow to come around, there it is. We've been for years told this time it's for real!, had the current reality exaggerated over and over again, and watched the political among us on all sides signal that it's not enough of a threat to worry about. The people pushing the threat of this disease have squandered large portions of their credibility and the basis for the skepticism is rational.

However, that doesn't mean the disease isn't really here. It just means you are going to have to prove that what you are doing and asking us to do is rational and will not have far worse consequences down the line. For instance, when portions of your State in the East have outbreaks and the West has almost nothing, does it make sense to shut businesses (thereby destroying many unrecoverable small businesses) in the West? Why? You could be right. Please explain with specificity as to expectations in the West and not platitudes, speculations, and fear. Or, some governors are engaging in clear constitutional violations denying the practice of religion in any practical manner in an entire State. Oh, it's necessary? Really? Please explain with specificity why then you are having press conferences with clearly more than ten people in the room when those could be done by a video on YouTube (or if you want to be trendy Zoom). Freedom of the Press? You mean the right that's the the third right in the constitution while religion is the first? And please explain with specificity why going to mosque, church, or synagogue once a week is so much worse then the large crowds that are gathering at Lowes, Wal-Mart, grocery stores, etc. every day, all day long. You are clearly interjecting government very intrusively into religion. Unless you can explain why it's worse than all the things above, why should we trust or believe you? Even then, it might not be constitutional, but at least it would be rational and not based upon an anti-religious bias.

The History

Look folks, I'm not saying you shouldn't act as though this is serious. However, it would be a lot easier if people were just honest and straight forward about this. Yes, it came out of China. Much like other overseas diseases, it looked like fairly minimal restrictions on travel would stop it from spreading to the USA in any significant way. Then it hit Europe (thank you to those countries stupid enough to be part of One Belt One Road) and that meant it was going to get here. Our federal government did not react quickly to a threat it thought was contained and politicians on all sides at one point or another said or did something stupid which we've all seen posted many, many times on Facebook (it's almost painful to open my feed).

The disease started to come to people's attention. Mostly, it was the media banging out whatever story they thought might scare you enough to keep your attention and get views or clicks. Facebook and other social media started to fill with jokes because of the unfortunately named "coronavirus."

Then, the Italians lost control of the virus for reasons no one can understand because it couldn't have anything to do with One Belt One Road. As this was going on, our medical establishment starts to freak out, our press jumps on the bandwagon, and the disease is just about declared to be the Black Death. People, including me, started to express skepticism and ask why we should think this is going to turn out worse than the flu. Generally, skeptics get shouted down rather than anyone making rational arguments and comparing it to the flu gets one shown scorn.

The governors step in at various stages, depending on the State and its actual situation. This is how it should be in a large multi-state emergency because while the federal government might be able to throw a lot of resources at one or two locations it takes too long to react and when the problem becomes too widespread it cannot act everywhere and may consider your State unimportant enough to prioritize it well below others. The governors prove, in general, to be unprepared and flail about issuing general "shelter in place" orders for their entire States that don't seem particularly well thought out or directed toward the solution of anything and will cause millions of dollars in economic damage (instead of quarantining effected areas). But at least they're doing something. Meanwhile, the federal government is concentrating on a macroeconomic save of the economy through legislation and the various bits of pork that legislators can attach to it.

And here we stand.

The Disease Itself

Coronavirus COVID-19 is perhaps closest related in history and genetics to Coronavirus SARS. However, for our purposes an analysis might also want to compare it also with the Spanish Flu. I know it's not influenza (before anyone yells at me) but in some effects it may be closer to Spanish Flu than SARS.

The disease started in China, much like SARS, as a bat virus that transferred to humans probably through an unknown secondary animal. This is an issue in areas of China where various and sundry wild animals are caught and sold in markets for consumption. Due to the normal Chinese reaction of hide, deny, delay, and downplay the disease got out of control. The figures out of China are not reliable, but it's clear they had a massive outbreak that was well spread before serious reaction took place.

Compared to SARS, COVID-19 is less contagious and less deadly. It's capacity to be spread is more like Spanish flu as is its fatality rate (slightly higher in initial estimates for both). The problem is that quite often - in fact most often - people don't realize they have it. That is the major problem. Originally the claim was that for 80% of the population it is at best a minor nuisance if they notice it at all. Another 15% would be bad enough to need oxygen, and 5% would be so bad they would need a respirator. Predicted death percentages were all the way up to 4.5% and settled down to normally seen numbers of 2% - 3%. At this point, it appears that even that is much higher than reality which is now being stated to be at .66%. This doesn't appear to mean that there aren't many people dying, but that there are at lot more people out there who've had it without much in the way of symptoms. The fact that it spreads widely without serious symptoms means that no matter what people tell you, unless we have the national guard patrolling the streets in MOPP4 and shooting anyone who leaves their house, it's going to spread.

It appears that there is a good chance that COVID-19 will die down or out over the warmer months much like SARS and Spanish flu. There are no guarantees of course, but articles I've read over at SSRN seem to indicate it has a harder time spreading when the temperature hits a certain level and the humidity is higher. Trying to pin any numbers down is impossible because they're all writing in medicojibberish and statistiobfuscation (as well as being broad and throwing out tons of sheet anchors), but it seems that somewhere below the North 30th parallel, or in certain "thermal bands" roughly correspondent, the virus did not spread as well during the various outbreaks. This is consistent with flu which has been shown to have a problem persisting the higher the temperature is and in higher humidity period. More importantly, it is consistent with Coronavirus SARS which died out by June of 2003: "high temperature at high relative humidity has a synergistic effect on inactivation of SARS CoV viability while lower temperatures and low humidity support prolonged survival of virus on contaminated surfaces." Page 3 of this paper.

Let's be clear here, we're talking about the viability of the virus outside the human body. A combination of higher warmth and humidity make the period in which a virus is viable outside the body of an infected shorter. If you run up and start snogging your infected girlfriend in 95 degrees F it doesn't matter if the virus would only survive for thirty minutes outside her body because it'll transfer to you in 30 seconds or less. Anyway, the place where Coronavirus SARS was described as surviving longer term in the Summer months? Air conditioned buildings - specifically hospitals.
In countries such as Singapore and Hong Kong where there is a intensive use of air-conditioning, transmission largely occurred in well-air-conditioned environments such as hospitals or hotels
. . . 
It may also explain why Singapore, which is also in tropical area, had most of its SARS outbreaks in hospitals (air-conditioned environment). Interestingly, during the outbreak of SARS in Guangzhou, clinicians kept the windows of patient rooms open and well ventilated and these may well have reduced virus survival and this reduced nosocomial transmission.  Id. [side note: nosocomial means "in hospital"]
Hospitals that aren't taking heat and humidity cautions (adding them) are asking for the spread of these viruses and potentially Coronavirus COVID-19 as well. The rest of us should spend as much time as we can without air conditioning and with our windows open and I specifically mean in 75+ degree F heat. It might not work, but it's probably got a better chance than all this social distancing does.

The Cure?

Best bet? Warmth and humidity. I'd bet this is what a lot of our governors are banking on too. Of course they'll never say it out loud because they'd immediately get jumped all over by the doomsayers and fearmongers. Plus, if warmer weather doesn't prove to be an absolute 100% cure they'd get blamed for that too. 

Still, it's the most logical reason consistent with the actions they've taken. The "flatten the curve" strategy is meant to buy time. There is nothing about it that promises lives will be saved; we could just be delaying the deaths of the same number of people and spreading them over several months. The very first thing we would be buying time for is a break in the disease because of the onset of warmer months. 

If that fails then we're holding on for the medical industry to tool up and absolute medical capability to become more elastic so it can grow to service the need. There's a lot of noise in that direction, but the purpose there isn't so much to save lives. It's to make things easier on the medical industry and medical professionals. As a side effect, some lives should be saved when medical capacity improves, although that may just be wishful thinking on my part because those that die tend to have secondary medical issues and I've not seen anything outside of aspirationally vague statements indicating the level of mortality will be any different. In fact, the major argument I keep seeing thrown out for "flatten the curve" is that if we have as many respirators as the medical industry desires the doctors won't have to triage and deny terminal patients respirators in order to supply them to those with a chance to live.

If you've been paying attention, you've probably noticed the slow push to increase the time of the lock downs. This appears to have come from some report's guess that an eighteen month period would be needed before an inoculation can be developed (if things go perfectly). I don't think our governors want to go there at all. The damage they've already done to their States' economies has been massive and if they keep this up much longer it's going to get far worse. Nobody wants to be the governor who caused generational poverty through the destruction of all locally owned businesses and the subsequent loss of jobs. That's not to mention, how does the government continue to function when the tax base crashes? They don't want it and I'm certain that in their heart of hearts each governor is counting on that warm weather die off.

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