A friend recently flew Dallas to Boston on American Airlines (AA2579). He was accompanied by his 15-year-old son.
Has American adopted my dream scheme and blocked off the middle seats except for families traveling together? Not exactly! In fact, my friend and his son were both parked in middle seats, but not in the same row. Each was seated next to two strangers. Everyone was supposed to be wearing a mask on the flight, but a guy sitting next to my friend was not wearing a mask and was, in fact, coughing. The family now has direct seat-adjacency exposure to four unrelated people (would have been 0 under my plan!).
The Boeing 737-800 was almost 100-percent full. There were no special boarding or unboarding procedures for plague-minimization. It was the usual Fall of Saigon attempt to get everyone into seats and bags into overheads. I asked if people had to raise hands to get sequenced for using the bathroom and the answer was “no”.
What about the luxurious cuisine and wine list for which American Airlines is justly renowned? “They handed everyone a bag with a bottle of water and a snack at boarding.” The flight attendants came through the aisles only towards the end to pick up trash.
The wife is a medical doctor. She decided to place both father and son into home quarantine on their return!
Readers: How much would you have been happy to pay for this experience?
Vaguely related, my most recent flight on American Airlines, Miami to DCA back in February:
Disclosure: As a former Delta Airlines (proud union) employee, American is the frenemy!
Massachusetts created a pioneering program to track COVID-19 cases. Its challenges are multiplying as the state reopens
The marginal position of the Brazilian immigrants in Massachusetts represented a potential hole in the monitoring system that the C.T.C. was trying to build. Welch had come up with a characteristically P.I.H. solution, which was to fill that hole not with a protocol but with a person, Comin, whose life experience meant he might be trusted by the people he interviewed. Comin had arrived in the United States at the age of nineteen, a punk-rock enthusiast who came to Massachusetts because his aunt lived there; after his tourist visa expired, he was grateful for the older immigrants who had explained the rules of a new country to him—how, for example, when you stopped at a stop sign, you really had to stop, in order to avoid being arrested. To Comin, teaching people how to isolate at home during a pandemic, when they might not be here legally or have health insurance, was something like explaining the full and complete stop.
Throughout the spring, the Massachusetts contact-tracing program got faster. It took between three and four days for the C.T.C. to learn of a positive test, but after investigators had that information they were able to reach seventy per cent of cases, and contact tracers were then able to speak to seventy-four per cent of those cases’ contacts. This still meant that nearly half of potential contacts never spoke with anyone working for the tracing program.
But, until June, Massachusetts remained under lockdown—a temporary and highly artificial situation in which each case had, on average, about two contacts. That changed with the George Floyd protests, when crowds returned to the state’s public spaces. … Wroe, the C.T.C.’s director of implementation and design, had her eye on the protests but said that they were simply too difficult to trace. When contagious people told investigators that they had travelled on a bus, or visited a nursing home, the C.T.C.’s protocol was to alert the local Board of Health and move on. Wroe also believed that Massachusettsans did not want a program that would find ways to track their public movements. She said, “I don’t think there’s much epidemiological advantage in chasing people down in public places, versus the very real risk of losing trust.”
The core of the problem is that we don’t have enough welfare for low-skill immigrants:
The social safety net for immigrants in Boston can seem so porous that it might as well be all holes. Baez has been trying to make it airtight. “What people really want is to feel secure,” he told me when I called him one evening in May, just after his shift had ended. He began to talk through the cases he’d worked that day. All of the adults in a household had tested positive for the coronavirus, and they wanted to know how they could safely share one and a half bathrooms without infecting the children, or re-infecting one another. Another call came from a pregnant woman—who, Baez said, was “the most nervous person I spoke with today.” She and her husband, who both work at McDonald’s, had tested positive and had to stay home for two weeks. She was worried about eviction, and money for the baby, if they lost their jobs. A call came from a woman who worked as a nursing assistant at an assisted-living facility, who had just tested positive, along with many of her colleagues. “Everyone on my floor got it,” she told Baez. She was isolating at home and needed a nebulizer for her asthma, but didn’t have a hundred dollars to pay for it, so she had to figure out a way to purchase the device and then find a volunteer to pick it up at the pharmacy and drop it off on her doorstep. Baez said that this work reminded him of the challenges he has had trying to respond to emergencies overseas: “If there was equity, period, there wouldn’t be a need for us to fill these gaps.”
A thousand tracers, in the middle of a pandemic, gets you somewhere, but maybe only partway. In the evenings, when Baez walks around his parents’ neighborhood, he often passes Boston Medical Center, which runs a large opioid-addiction program, and where he can see clusters of addicts on the street corners. They’ve still been getting their methadone, but their presence reminds Baez of all the vectors for transmission that might still be beyond his compass, and the gaps in care he can’t cover. Baez told me, “Obviously, we can’t promise the world.”
So… the official story back in March was that we would lock down to “flatten the curve” (same number of infections, spread out a bit). This morphed by April into a “shutdown until contact tracing is ready” plan (nytimes). By May this was no longer sufficient. We needed a long shutdown, to hire more contact tracers, and to turn the state into “Maskachusetts” (i.e., don masks at least a month after the infection had peaked).
Now it seems that, because (1) we don’t ladle out enough welfare to low-skill immigrants (who are, after all, our greatest source of economic prosperity and per-capita GDP growth!), and (2) we have the occasional mass gathering, the magic of Asian-style contact tracing will be forever out of reach.
From our neighborhood, the ponies of Maskachusetts:
Related:
“Boston Mayor Declares Racism A Public Health Crisis” (NPR): Yes, we shut down for 4 months and have more than 2X the Covid-19 death rate of never-shut Sweden, but the real public health crisis is not coronavirus…
We also find that the severity of the disease is politically patterned: even when controlling for density, counties with a high proportion of Trump voters in the 2016 general election have lower cases and deaths.
In other words, even the coronavirus cannot bear the sight of a Trump/Pence sign on a front lawn!
So… if you want to find a place in the U.S. where children are likely to be able to go back to school in September, a thinly populated state that voted for Trump in 2016 is the safest choice.
Among the above, my bet is on South Dakota as the least likely to be perturbed by the plague. Based on my source on the ground there, the state had a minimal shutdown, actually tried to reopen schools before the year ran out (unionized teachers thwarted these efforts, though), and has committed to reopening schools and universities in the fall (example).
Readers: What are your bets for which states will offer residents the closest experience to a normal life? (not a “new normal”, which is code for “bad”!)
The Swedes who refused to lock down were the previous favorite targets of “scientists” and the media armed with forecasts of doom (see https://philip.greenspun.com/blog/2020/05/24/did-doom-visit-the-swedes-yesterday-as-planned/ for example). Now that the Swedes are enjoying, unmasked, their summer and an abundance of UV light, the doomsayers need a new target. How about Brazil? They don’t have an effective lockdown and it is winter there. We all know the critical importance of national leadership whenever a virus is circulating and Brazil’s leader is an infidel with respect to the Church of Shutdown (“‘Death is everyone’s destiny’: Bolsonaro’s words of comfort”).
On August 4, Brazilians will be dying at the rate of 5,248 per day and the rate of death will be accelerating. They will need 57,639 ICU beds and will have just 4,060 to go around.
Who wants to predict the actual numbers for Brazil? Keep in mind that the population is 210 million, so the number of deaths will be dramatic compared to what the typical European nation experiences.
I will go first. My perspective is a “scientific” one. In other words, I will look at one or two data points and then extrapolate wildly. From the chart below, it looks like the non-virtuous Brazilians have, by dint of doing nothing, already “flattened the curve” to a large extent. So my first scientific observation (i.e., guess) is that the death rate on August 4, 2020 will be roughly the same as it is today. On the other hand, the virus has already killed a lot of the easiest-to-kill Brazilians. Therefore, the number should be a little lower. On the third hand, General Winter is fighting alongside the coronavirus in parts of Brazil. If the latter two factors cancel out, the number of deaths tagged to Covid-19 in Brazil on August 4 should be 1,274 (the number from yesterday’s WHO report).
Readers: What’s the result of your own scientific analysis? Care to use the comments for a prediction regarding August 4, 2020?
Now that things are open in most states (not here in Massachusetts, though! We liked Months 1, 2, and 3 of Shutdown so much we’re going into Month 4.), people have a reason to get in the car and drive. I wonder if convertibles will become more popular as a way of reducing coronaplague. If you have to drive with a non-family member, just put the top down first.
Suppose that you’re stuck in traffic on America’s roads built for 150 million and now serving 330 million. If everyone is in a convertible with the top down then everyone is breathing on everyone else (not okay unless at a BLM protest, right?). Maybe that problem could be solved by rolling up all of the windows? Now it is like being a grocery store cashier: you’re protected by a clear barrier.
What about exploiting a height advantage? To avoid any virus exhaled by someone stopped next to you at a light, try to have a taller vehicle. If he/she/ze/they bring a Miata, you bring a Mini convertible. If he/she/ze/they bring a Mini convertible, you bring an SUV with the top cut off. If he/she/ze/they bring an SUV with the top cut off, you bring an SUV that has been jacked up before the top was cut off.
My Facebook feed is now packed with panic regarding coronavirus infections that are occurring post-reopening in various states. This is exactly what “science” told us would happen under our March 2020 dogma (example). And it is exactly what Angela Merkel told us to expect. But somehow people are treating it as new information.
One thing that is odd is that people are refusing to consider adapting. People who live in tiny San Francisco dwellings say that they are proud to wear masks all the time and make sure that their only connection to the rest of humanity is Internet. They express pride in not being “selfish” by going out and/or going unmasked. Example:
I feel very lucky in San Francisco and the bay area. SF protocols have been very strict and remain so and there has been only 44 deaths out of 800,000. We’re starting outdoor dining this weekend but not much more. And masks are required if you are within 30 feet of anyone outside (not just 6). Goal is to set culture of mask wearing before things open more. I have seen too many Americans online complaining about mask wearing as if it’s an imposition. I totally agree about too much entitlement as you note and very selfish. I hope we keep this mask requirement for quite a while!
Why does she stay, though? She could have a bigger house in Wyoming, the same Internet, zero income tax, and be as isolated as she wants to be (though does not have to be, since Wyoming is mostly reopened, including for school).
At least until the fearful are confident that coronavirus has burned its way through the U.S. population and/or there is an approved vaccine, why wouldn’t people without a job that requires physical presence seek to move to places where life (and driving) can be conducted outdoors?
Readers: What convertibles do we need? Personally, I want a five-seat convertible, but there is nothing on the market except for one Jeep. Given the height issue discussed above, it would also be awesome to have a topless SUV or at least minivan. At the risk of being tarred with the label of “Tesla fan-boy/girl/zirl/they”, I have to say that electric drive would be more valuable in a convertible than in a regular car. When going slowly downwind there is no exhaust to be blown back into the seating area. It should be easier to keep the cabin quiet if there are no explosions in cylinders.
I met with a cardiologist friend last night. He says that he is working roughly 60 percent as much as he was pre-coronapanic. “Where we would do five procedures per day, we can now do only two,” he said. “That leaves enough time for deep cleaning between patients. Also, they’re reserving 20 percent of the rooms in the hospital for Covid patients, just in case.”
He and his colleagues have already had multiple patients die while waiting for heart valve procedures that were considered “elective”. (see “StayHomeSaveLives or #StayHomeTradeLives?” and the link to the NEJM article) He gets paid in full despite the reduction in work and billing, and is at a vulnerable age for Covid-19 (70s), but is nonetheless anti-shutdown: “It was only a few years ago when parents were supposed to make sacrifices for their children. Now it is the other way around.”
Today is #ShutDownSTEM day. Plenty of righteous posts on Facebook from friends who are professors of various flavors of nerdism. They’ve been sitting on their butts for three months now, taking baby steps in the direction of online teaching (nowhere near as competently as faculty at Western Governor’s University, which has been online since the mid-1990s). Today they will sit on their butts even more firmly? It has been a struggle for me to refrain from asking “How could you possibly do less than you’ve been doing since mid-March?”
(Not all professionals are idle. A friend Facebook messaged me today about some divorce litigators who are fully engaged on an issue of life insurance. The defendant father wants to have the beneficiaries of his life insurance be a trust for the children (tweens). The plaintiff mother wants to ensure that the life insurance cash is paid to her, to compensate her for any reduction in profits from alimony and child support. The parties are divorced, but the litigation lives on (legal fees on both sides paid for by the father’s earnings that would have been the children’s inheritance).)
Speaking for myself, I participated in a Zoom meeting regarding some health records data analysis today, but all of the coding was in SQL so I am not sure if that qualifies as “STEM”! Later today it will be time to fly the helicopter, which can be considered a “STEM” activity by American journalists when a member of an officially recognized victim group is at the controls. One of the participants in the call is a third-year medical student. He won’t be able to do a clinical rotation until about a month from now (i.e., he will miss at least three months of clinical training).
From a neighbor’s front yard, “Science is Real” (but also not so important that you’d want to do it every day?):
From a recent visit to the doctor’s office in Concord, Massachusetts to get some blood drawn in advance of a regular checkup:
(any of 50+ gender IDs is okay, but we will depict, recognize, and give priority to only two?)
One of the finest achievements of American cinema, Team America: World Police, features a group of heroes who have one yardstick for determining success or failure: the number of terrorists killed. The movie opens with the team declaring victory over a small group of jihadis in Paris. They’re satisfied with their results, but the citizens of Paris are unhappy about all of the city’s monuments being destroyed.
Now that our cities are in ruins, I’m wonder if the same logic has been applied in 2020 regarding coronaplague. Americans now care about one thing only: the number of people killed by Covid-19. It doesn’t matter how old or sick these people were before coronavirus got them. Every life that can be saved from Covid-19 is worth an unlimited amount of (a) deaths due to withheld non-Covid health care, (b) family and life destruction due to unemployment, poverty, and kids kicked out of school and imprisoned in small apartments with a miscellaneous collection of adults (“Fewer than half (46%) of U.S. kids younger than 18 years of age are living in a home with two married heterosexual parents in their first marriage.”), (c) dollars borrowed that the children being denied educations, playgrounds, and friends will have to pay back, etc.
Isn’t it the same in Europe, you might ask? No! They took a more balanced approach. Yes, coronaplague was bad, but as soon as they figured out that schools weren’t primary drivers of plague, they reopened their schools (except in Sweden, where the schools never closed). Maybe the Europeans will suffer a handful of additional Covid-19-tagged deaths are a result, but they are looking at more than a single number to measure how their nations are doing. How about India? A brief lockdown followed by a swift reopening. Brazil? “sorry for all the dead, but that’s everyone’s destiny.” (even Trump can’t say stuff like this!)
Readers: Was Team America prescient regarding our national tunnel vision? We have a slightly lower death rate nationwide compared to Sweden (where I live in Massachusetts, though, the death rate is more than 2X never-shut Sweden’s, as we enter Month 4 of shutdown).
Emergency health measures implemented in six major countries have “significantly and substantially slowed” the spread of the novel coronavirus, according to research from a UC Berkeley team published today in the journal Nature. The findings come as leaders worldwide struggle to balance the enormous and highly visible economic costs of emergency health measures against their public health benefits, which are difficult to see.
“The last several months have been extraordinarily difficult, but through our individual sacrifices, people everywhere have each contributed to one of humanity’s greatest collective achievements,” Hsiang said. “I don’t think any human endeavor has ever saved so many lives in such a short period of time. There have been huge personal costs to staying home and canceling events, but the data show that each day made a profound difference. By using science and cooperating, we changed the course of history.”
Armed with a few lines of Excel or R code, epidemiologists had been making prophecies about what would happen 1-8 weeks into the future. Citizens would then be able to see what actually happened:
(It is not surprising that these “scientific” results proved to be false, even beyond the usual “Why Most Published Research Findings Are False” factors. As no country had ever tried an American-style “shutdown” (in which citizens still meet at grocery, liquor, and marijuana stores and still party every night on Tinder), only a scientist with a letter from God would have had a prayer (so to speak) of predicting the effects of such a shutdown. The self-proclaimed “scientists” also had no data regarding how easy it was for coronavirus to spread, what percent of the population was naturally immune, etc.)
What’s the solution? Scientists can take up the genre of alternative history science fiction.
Traditional novel: What if the Germans had won World War II? Maybe the U.S. would be governed by an authoritarian puppet president, controlled by a foreign dictator. State governors would issue stay-at-home orders that eliminated Americans First Amendment rights to assemble. Young children would be locked into small apartments, denied schooling, friends, and playgrounds. Some brave folks would #Resist by going into the streets to battle with the city governments that they themselves had elected and would soon vote to re-elect.
Science-informed novel: Look at this two-parameter mathematical model. It shows what would have happened if we hadn’t locked down like I was recommending.
The beauty of this new approach is that, as with the “What if the Germans had won?” novel, there is no way to prove the author wrong.
As a nation, we can’t admit our mistakes. We have never apologized to the Vietnamese for our role in the pointless and destructive Vietnam War. We have never apologized to the Russians for supporting the jihadis fighting them in Afghanistan (ultimately, of course, we fought a 19-year (so far) war against those same jihadis). So it seems safe to say that we are never going to apologize to Americans, especially to young Americans, for shutting their schools, jobs, and social life down in a futile attempt to modify the trajectory of coronavirus (against the advice of the former chief scientist of the European CDC and his colleagues in the Swedish government).
Coronavirus has already killed quite a few of the Americans who are easiest for a virus to kill: the old, the sick, those who live in ideal virus breeding grounds (New York City and Boston), etc. When the virus comes back in the fall, as Dr/Saint Fauci says it will, rather than admit that shutdown was a dumb idea, born of panic, how about the following strategy:
approve a saline injection as a “coronavirus vaccine” and say “like the flu vaccine, this Covid-19 shot isn’t 100 percent effective”
tell people “you should expect coronavirus to be a little worse than a bad flu season, perhaps killing 100,000 Americans, but also many of these will overlap with what would have been flu deaths”
Schools can stay open, social life can proceed more or less normally, businesses can run except those that depend on mass gatherings, and the American people and government never have to admit that they made mistakes in the past.
Update: Facebook friend’s comment on this post… “If a bandana is effective PPE for Covid, then a saline injection is surely an effective vaccine.”
Related:
1957-58 flu (killed as many as 116,000 Americans, equivalent to about 225,000 today given that the population has nearly doubled since then)
2017-2018 flu (killed an estimated 80,000 Americans)
“Chasing Seasonal Influenza — The Need for a Universal Influenza Vaccine” (NEJM, in which Dr. Fauci is an author): “Influenza A (H3N2) viruses predominated [in Australia], and the preliminary estimate of vaccine effectiveness against influenza A (H3N2) was only 10%.” (i.e., if we still love the flu vaccine when its effectiveness may be as low as 10 percent, why not a saline injection whose effectiveness is 0 percent?)
“Charlie Baker can’t admit he blew it” (Boston Herald, by 68-year-old Howie Carr): You have totally blown it with your hysterical overreaction to a crisis that was largely of your own creation. Just admit it — you panicked when you realized all those nursing-home deaths were going to be on you, and in a pathetic attempt to change the subject, you needlessly shut down the entire state. And now, like the buck-passing bureaucrat that you are, you have no idea how to climb out of this hole that you’ve dug for yourself and 6.7 million innocent citizens. … Let Maskachusetts be Massachusetts again. … Deaths among people under the age of 50: 104. Unemployed since the lockdown began: 1 million plus.
An incredibly intelligent friend of mine retired early from his career as a patent litigator and abandoned high-tax New York City for no-income-tax Nevada. He’s now walking distance from about 15 partly-open casinos and multiple shut-down convention facilities.
In a recent FaceTime, he was shockingly (to me) optimistic regarding the city’s future, predicting a bounce-back to normal within a few months.
I would expect Vegas to suffer one of the biggest shocks among U.S. cities. Casino customers are older than average (see this Harvard thesis) and therefore more likely to be concerned about catching coronavirus either on a flight to Vegas or within a casino. Given the essentially pointless nature of the typical convention, will companies still want to send people to these multi-thousand- (or 170,000 for CES) person gatherings? If people don’t show up for conventions, they can’t be lured into paying for hotels, restaurants, gambling, etc.
One countervailing factor is the meltdown of California. Since the economy of California has shrunk while the government hasn’t, tax rates in California will need to be raised. In the meantime, a lot more employers in California are allowing work-from-home. The tax-averse might decide to work from home from Nevada and pay an income tax rate of 0% as well as enjoy a larger house for less money. But I don’t see the influx of people coming to work from home outweighing the loss of business from people who don’t want to get on an international airline flight and sit directly next to someone in a middle seat, masked or not masked.
Readers: What do you think? Is Vegas going to suffer the kind of epic decline that it did in 2008-9?
