Friday, March 27, 2020

We're number one

Today the U.S. overtook China as the country with the most confirmed corona virus cases in the world.  Italy is still the world leader in deaths, but that will almost certainly change before too long because we have six times as many people and we have not yet battened down the hatches.  I can just see president Trump getting on TV and crowing about the fact that once again the U.S. is leading the world.  Never mind that it is leading the world into an unprecedented catastrophe.

The U.S. has had it so good for so long that it is easy to fall into the trap of believing that we really are chosen by God or something like that, that we are somehow cosmically entitled to be the richest, most powerful nation on earth, and so all we have to do is carry on as usual and everything will turn out all right.  Unfortunately, everything is not going to be all right this time.

It has now been over three months since the Covid-19 epidemic began, and the U.S. still doesn't have widespread testing in place.  Lockdowns are still sporadic and widely ignored.  Hospitals are already starting to be overwhelmed.  The President is talking about getting everything back to normal by Easter.

It ain't gonna happen.  We have only to look at Italy to see what our future looks like.  Italy has been on lockdown since March 9 -- more than two weeks ago -- and their numbers, both confirmed cases and deaths, are still going up every day.  Wuhan was on lockdown for two months before the situation began to improve.

So even in a best case scenario, where we lock down the entire country tomorrow, we're looking at the beginning of June before we have a realistic prospect of getting back to normal.  But of course that is not going to happen.  It's not going to happen because Donald Trump and his Republican enablers have their heads buried in the sand.  They still believe that American exceptionalism knows no bounds, that we are the chosen of God and are therefore exempt from the laws of physics and biology and economics.

I have bad news for them, and for you: we are not exempt.  But because we are proceeding on the assumption that we are, a lot of people are going to go bankrupt, and a lot of people are going to die.

Texas Lieutenant Governor Dan Patrick has (in)famously suggested that all these deaths are perfectly fine.  Here's the quote:
No one reached out to me and said, ‘As a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that all America loves for your children and grandchildren?’ ... If that is the exchange, I’m all in.  That doesn’t make me noble or brave or anything like that. I just think there are lots of grandparents out there in this country, like me, I have six grandchildren, that what we all care about and what we love more than anything are those children. And I want to live smart and see through this, but I don’t want the whole country to be sacrificed…I’ve talked to hundreds of people, Tucker, and just in the last week, making calls all the time, and everyone says pretty much the same thing. That we can’t lose our whole country, we’re having an economic collapse. I’m also a small businessman, I understand it. And I talk with business people all the time, Tucker. My heart is lifted tonight by what I heard the president say because we can do more than one thing at a time, we can do two things. So my message is let’s get back to work, let’s get back to living. Let’s be smart about it and those of us who are 70-plus, we’ll take care of ourselves. But don’t sacrifice the country, don’t do that, don’t ruin this great America.
I have to admire the man's skill at taking what would normally be an unspeakable suggestion, that we intentionally condemn hundreds of thousands, possibly millions of people to die slow and painful deaths suffocating on their own bodily fluids, in order to preserve the lifestyles of the rich and famous, and making it sound not-entirely-unreasonable, even noble (notwithstanding his humblebraggy insistence to the contrary).  But this is the way of demagoguery.  It never sounds overtly unreasonable.  You have to actually think in order to see it for what it is, and apparently there are vast numbers of Americans who are no longer capable of this.

(At the risk of stating the obvious, it's not just people who step up to the plate and volunteer who are going to die.  The virus does not discriminate on the basis of patriotism.)

Funny how no Republican ever suggested that the victims of 9-11 should be written off in the name of preserving freedom and economic prosperity.  The conservative devotion to the sanctity of human life has some very peculiar Ts&Cs.

I can't help but wonder just how deep this conservative capacity for denying obvious truths runs, but we're about to find out.  You think things are bad now?  You ain't seen nuthin' yet.  In the next few days, the death toll from the virus in the U.S. is going to exceed that of 9/11 (2977).  A few weeks after that it will exceed the direct U.S. military casualties of the Iraq war (4,491).  Very likely, unless we radically change direction in the next week or two (and I don't see that happening) we will very likely exceed the total number of civilian casualties in the Iraq war (hundreds of thousands, but no one ever actually counted them all).  A final tally in the millions is not out of the question.

I wonder if there will ever come a point where Donald Trump's supporters will realize that much of the pain to come could have been avoided if the pandemic had been taken seriously early on rather than being dismissed as a Democratic hoax.  We spent a trillion dollars attacking Iraq because we thought they might have WMDs.  Now that we are actually under attack by the operational equivalent of a biological weapon, Donald Trump is still dithering about what to do about it, indeed, whether anything needs to be done at all.

Remember this in the coming weeks and months.  Things are about to get worse than you have ever imagined they could.  People you care about will probably die.  You could die.  This is not all Donald Trump's fault; he didn't start the pandemic.  But he actively fanned its flames long after it was apparent that it was burning badly out of control, and long after people sounded the alarm.

I'm writing this not because I think it can have much of an impact on what is to come, but in the hope that once this blows over and the conservatives cry, "But we couldn't have known" (which I am sure they will) I will be able to point to this post and say: no.  We were warned.  We were warned about the pandemic, and we were warned about Trump long before the pandemic started.  It's too late to avoid catastrophe this time.  But maybe, just maybe, next time we will listen.

4 comments:

Don Geddis said...

FWIW, there's apparently an ongoing debate in the medical community about just how deadly covid-19 actually is. What is the Infection Fatality Ratio (IFR)? Initial cases were very high, but most estimates I've seen put this at around 1% (+/- 0.5%), making it about 10x more deadly than the seasonal flu. But there are a group of researchers that are arguing this is an overestimate, and the best guess for C19 IFR is instead only 0.2%, "merely" twice as deadly as the flu.

The actual real-world IFR for C19 will make a huge difference in how this plays out over the next few weeks and months.

(Also, there's a huge age factor. The death rate for the over 50 population is around an order of magnitude worse than for the under 50 population.)

Ron said...

I started out as a covid skeptic. I wrote this back in February:

https://news.ycombinator.com/item?id=22287373

What changed my mind was watching what is happening in Italy. Yes, the seasonal flu kills many more people than is generally realized. But it does not overwhelm emergency rooms. Covid does.

Also, the mortality rate by itself is not what matters. What matters is the product of mortality and transmissablity. The mortality rate of ebola is vastly higher than either the flu or covid, but it is ultimately less dangerous because its transmissability is lower. The nasty thing about covid is not its mortality rate per se (though I would not want to roll those dice myself) but the fact that you can easily catch it from someone who has no symptoms.

Publius said...

Delete your your blog. This isn’t the time. This can’t be the new normal, where American tragedy is applauded for the sake of political opportunism

@Ron:
> I can just see president Trump getting on TV and crowing about the fact that once again the U.S. is leading the world.

You've now achieved infamy as being as despicable as Hillary Clinton.

>It has now been over three months since the Covid-19 epidemic began, and the U.S. still doesn't have widespread testing in place.

You don't do widespread testing. Nasal swab tests are only done are those presenting with symptoms consistent with COVID-19. You don't use that test on asymptomatic people because it has a 50% false positive rate.

If you are symptomatic, the test is irrelevant to your treatment. If the test comes back positive, or if it comes back negative, you get the same treatment. Testing is important from a public health standpoint to understand the scope and spread of the disease, but it's not essential for treatment.

The antibody test will be available soon and it will allow studies to be conducted to determine the number of those infected in the population. About 1 in 5 people have no symptoms at all.

>Lockdowns are still sporadic and widely ignored.

The US has implemented the most comprehensive social isolation measures in its history.

>Hospitals are already starting to be overwhelmed.

Not yet.

>The President is talking about getting everything back to normal by Easter.

By which time, we will have had 3 weeks of extreme social isolation.

But he's not talking about it going back to normal, he's talking about sending most people back to work. It may be on a regional basis.
I expect the schools won't go back (stay online), movie theaters may open but few will attend, and the airlines will be operating a reduced schedule with few people flying. Professional sports stay on hiatus until fall.

But barbershops and gyms would open. Manufacturing plants would resume operation.

Given out federal system, it's really the call of the governors.

>We have only to look at Italy to see what our future looks like. Italy has been on lockdown since March 9 -- more than two weeks ago -- and their numbers, both confirmed cases and deaths, are still going up every day.

You were expecting them to go up every day, right? There is a lag between the intervention (lockdown) and the number of cases dropping due to the incubation period of the virus. Also, the fatalities in Itay may be over reported.

>Wuhan was on lockdown for two months before the situation began to improve.

Let's examine Wuhan, or Hubei province specifically. Hubei has recorded 67,801 cases with 3,177 resulting in death. Hubei has a population of 58.5 million. Therefore, the case rate was 0.12% and the total dead rate was 0.01%. The case dead rate was 4.7%. Everyone fixates on the last number, forgetting you first have to get the virus before you can die from it.


>So even in a best case scenario, where we lock down the entire country tomorrow, we're looking at the beginning of June before we have a realistic prospect of getting back to normal.

Are you assuming that the only strategy to counter the virus is lockdown?

But of course that is not going to happen. It's not going to happen because Donald Trump and his Republican enablers have their heads buried in the sand. They still believe that American exceptionalism knows no bounds, that we are the chosen of God and are therefore exempt from the laws of physics and biology and economics.

The above paragraph is fantasy. President Trump has taken significant, effective action against the virus.

Publius said...

Apocalypse Not

I can't help but wonder just how deep this conservative capacity for denying obvious truths runs, but we're about to find out. You think things are bad now? You ain't seen nuthin' yet. In the next few days, the death toll from the virus in the U.S. is going to exceed that of 9/11 (2977). A few weeks after that it will exceed the direct U.S. military casualties of the Iraq war (4,491). Very likely, unless we radically change direction in the next week or two (and I don't see that happening) we will very likely exceed the total number of civilian casualties in the Iraq war (hundreds of thousands, but no one ever actually counted them all).

When will it exceed the 24,000 deaths from the flu this year? There have been 39 million flu illnesses this year, with 400,000 hospitalizations. This isn't even the the worst flu season we've had -- 2017-18 was much worse, with an estimated 61,000 deaths (see chart).

When will it exceed the 36,560 deaths from motor vehicle accidents in 2018?

A final tally in the millions is not out of the question.

For that to happen, 500 new deaths would have to be added to the daily per day total (1750 today, 2250 tomorrow, 2750 the next day, etc.) for 60 straight days until it reaches 30,000 deaths/day. Or, the death rate needs to get to about 2,000 a day and stay at that level for three straight years.

I wonder if there will ever come a point where Donald Trump's supporters will realize that much of the pain to come could have been avoided if the pandemic had been taken seriously early on rather than being dismissed as a Democratic hoax.

President Trump didn't say the virus was a democratic hoax. He said the criticism of him by the democrats over his response to the virus outbreak as "this is their new hoax" -- you know, like the Russia collusion hoax and the impeachment hoax.

Biden called the China travel ban xenophobic.

When the federal government started organizing its response to the virus, the democrats concern was the lack of diversity on the task force.
Coronavirus task force another example of Trump administration's lack of diversity

You're also forgetting the states and cities. New York city as not prepared (you like to talk about warnings -- how about 9/11 as a warning).

We spent a trillion dollars attacking Iraq because we thought they might have WMDs.

We attacked Iraq (the second time) because our allies were starting to weaken on the economic sanctions, Iraq's threat to regional peace, and the criminal treatment of the Iraqi people.

>Now that we are actually under attack by the operational equivalent of a biological weapon, Donald Trump is still dithering about what to do about it, indeed, whether anything needs to be done at all.

Dithering? Have you not been paying attention the past two weeks on everything the President is doing?

Things are about to get worse than you have ever imagined they could. People you care about will probably die. You could die.

When all is said and done, the death rate from COVID-19 is going to be small integer multiple of influenza and we will have realized we spent trillions of dollars to try and avoid an apocalyptic threat that wasn't one.

>But he actively fanned its flames long after it was apparent that it was burning badly out of control, and long after people sounded the alarm.

He reacted in 1 week by banning flights from China. One week.

But maybe, just maybe, next time we will listen.

The Twilight Zone - The Old Man in the Cave