Philip Greenspun’s Weblog

Our schools and cubicle farm offices shut down more than two months ago. Our “non-essential” stores a little less. So I think it is fair to say that today is roughly the day that we in Massachusetts enter our third month of shutdown.

Charts of new cases and new deaths don’t suggest that whatever we did during the first two months of shutdown had much effect on the virus.

How are we doing compared to the Swedes? Our death rate thus far is up to 2.3X what they are suffering in “let the virus burn through the younger than 65 population” Sweden (see “Number of new COVID-19 cases worldwide is declining now?” for my tracking of the numbers).

How about compared to the states with no income tax? Our death rate is 20X that of Texas and Tennessee, 10X Florida’s, 7X Nevada’s, 75X what they have in Wyoming and Alaska.

With the virus failing to live up to its dramatic exponential promise, but also failing to go away, we’re grasping at straws such as a recent governor’s order to fine people $300 who don’t put masks (that are impossible to purchase) on 6-year-old children (who will probably not follow WHO guidance regarding proper use of the mask!).

The current IHME prophecy for Massachusetts is 9,629 deaths through early August on a slow decay:

How does this compare to a country with no lockdown? The IHME prophets predict 5,760 deaths for Sweden during the same time period:

Tough for me to discern a dramatic difference in these shapes (though of course there will be a higher death rate, adjusted for population, in Massachusetts, roughly 2.4X Sweden’s if IHME proves correct).

The slow/steady curve seems to be the virus’s plan for the entire world:

Maybe there is a downward trend visible in deaths, though? The flat graph for new cases is an artifact of increased testing?

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I had a physical checkup scheduled for March (the U.S. health care system had so much spare capacity prior to coronaplague that it took only 3 months to get on the schedule). As part of this, the doc ordered some bloodwork. Of course, everything has been pushed back until at least June. But I thought I would call the doc to see if he would add a coronaplague antibody test.

“Don’t do it yet,” he told me over the phone. “Everyone is waiting for the Mount Sinai test, which should be available in a couple of weeks.”

He said that even the best of the existing tests, such as the one from Roche, suffer from being triggered by previous infection to unrelated coronaviruses, e.g., due to a common cold a year previously. This is at variance with the Roche press release, so I am not 100 percent sure that he is correct, but since there is nowhere to go right now maybe waiting a couple of extra weeks doesn’t matter.

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One of the arguments advanced by citizens of our Boston suburb (Lincoln, Massachusetts) in favor of a $600/square foot renovation/reconstruction of the K-8 school (about $250,000/student, making it perhaps the most expensive school ever built in the United States) was that the 25-year-old windows in the classrooms and the exterior door from every classroom to the outside grass (single-story building) were leaky and prevented the building from reaching Net Zero nirvana. Without A/C in the classrooms, teachers had windows completely open for much of the year.

The construction project, contracted for at the very peak of the Boston real estate market, will commence in June 2020. (One argument by project proponents was that the vibrant local real estate economy would continue to expand forever, thus construction costs would rise at 5 percent forever, so we would be saving huge $$ by spending $110 million now.) The building shell will be sealed as tightly as possible and fresh air will be kept to the absolute minimum. Students will have to funnel in through one of a handful of exterior doors and funnel out through those same doors when school ends. Obstructing direct student egress from individual classrooms was sold as a defense against mass shooting. Apparently students are safer when trapped into their classrooms than they would be if they’d run 1/4 mile away.

I wonder if we have been and are building ourselves into a plague-friendly environment. Even with energy recovery ventilators, we still need to minimize fresh air in order to achieve Net Zero Nirvana. Green building advocates claim that somehow indoor air quality is actually higher in the latest green buildings, but perhaps they are comparing them to the failed Jimmy Carter-era energy crisis sealed office buildings (complete with plastic carpet emitting toxic fumes for decades!).

It is tough to believe that the new school, in which air gets in and out primarily via a handful of central pipes, will be as plague-resistant as the old school, in which every group of students had direct access to fresh air via a massive window bank and/or an open door.

As the U.S. population grows, thus packing a higher percentage of us into multi-family housing, and an ever-larger percentage of our buildings are designed for minimum energy consumption, will viruses end up being the primary beneficiaries?

Related:

• “LEED Building Standards Fail to Protect Human Health” (Yale): One of LEED’s major accomplishments — saving energy by making buildings more airtight — has had the paradoxical effect of more effectively trapping the gases emitted by the unprecedented number of chemicals used in today’s building materials and furnishings. … Programs such as LEED place relatively little emphasis on indoor air quality.

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I had searched in vain to find the Swedish equivalent of the IHME model that Americans love. Surely there had to be an academic in Sweden who wanted to be interviewed by hysterical journalists about the forthcoming doomsday. Yet I couldn’t find anything in English, at least. I thought that maybe Swedes simply didn’t care how many people would get sick, when peak deaths would occur, or how many of their fellow citizens would die. They seemed to be content to let the 15 epidemiologists on the governor’s team be their only soothsayers (example).

As usual, I was dead wrong! “Can we trust Covid modelling? More evidence from Sweden” (The Spectator) shows that Sweden had its PhDs willing to make a few assumptions and then stick them into a simple model. And the ones who came up with the most dramatic forecasts of doom got some media attention. Demand for critical care was going to be “16,000 patients per day” in early May:

Another team upped this to over 20,000:

The government team thought Sweden would have 1,700 patients in the ICU right now. The actual number is around 500.

The doomsayers thought that doom was inevitable even if the Swedes converted to the Church of Shutdown:

And obviously, there is an argument that these models scared us into changing our behaviour and ramping up capacity, and so helped us to avoid a disaster. But they were also clearly based on faulty assumptions that would always result in absurd predictions. We know this, because both models actually assumed that it was already too late, and estimated that ICU capacity would be exceeded by around 10 times even if Sweden switched to strong mitigation.

The need for ICU beds in Sweden will be ‘at least 10-fold greater [than capacity] if strategies approximating the most stringent in Europe are introduced by 10 April’, wrote Gardner et al.

Those strategies were never introduced in Sweden, and yet, additional ICU capacity is 30 percent and the number of patients in intensive care has been declining for two weeks. The newly constructed field hospital in Stockholm, with room for hundreds of patients, has still not received any patients. It will probably never have to open. Here’s a zoomed-in graph of eventual ICU: numbering in the hundreds, not the predicted thousands.

(i.e., the Swedes also built a temp hospital that was never needed!)

I’m kind of curious as to why Americans have placed such faith in the prophecies offered by epidemiologists given that epidemiology is primarily a retrospective activity and there is no historical data on how virus transmission is affected by a Western-style “porous lockdown”. It is as though people in the 1980s had decided that the “complexity” theorists of the Santa Fe Institute, who also could spin a few assumptions into an interesting tale, could be relied upon as reliable oracles. People don’t have the same faith in models of the future stock market. Nobody says “I’m going to hire three PhDs, download R, and become fabulously wealthy starting next week after my team’s model tells me the future prices of stocks.”

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At the end of March, I wrote “First friend with COVID-19: mild symptoms for 5 weeks”. He recently got an antibody test:

So… he’s positive for antibodies to coronavirus, but “sensitive information, such as the sex of your baby” remains private.

His reflections on the experience:

• “Maybe I should have taken off work when I had it.”
• “It was like having three flus in a row.”
• “I did some of my best work during that period.”

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