Covid 6/​25: The Dam Breaks

Link post

Last week: Covid-19 6/​18: The Virus Goes South

Off-topic re­minder that this is hap­pen­ing: New York Times, Please Do Not Threaten The Safety of Scott Alexan­der By Re­veal­ing His True Name

The United States has failed to con­tain Covid-19. The fight is over in large sec­tions of the coun­try. We have lost.

There is no state ca­pac­ity left to fight this. No will. Faced with this dis­ease, large sec­tions of the coun­try have cho­sen herd im­mu­nity.

We can only hope it kicks in at a rel­a­tively low thresh­old, that our treat­ments have im­proved, and that im­mu­nity is long last­ing.

Hospi­tals are already be­ing over­whelmed through­out the South. Things there rapidly get­ting worse day by day. Even here in New York, where hope for con­tain­ment is strongest, there are trou­bling signs. My dec­la­ra­tion of lo­cal vic­tory might prove pre­ma­ture, at least when it comes to the city it­self.

Let’s run the num­bers. They’re pretty alarm­ing.

Note that start­ing next week I plan to trun­cate the num­bers for space rea­sons, un­less I get feed­back that I shouldn’t do that.

Pos­i­tive Tests by Region

Mar 19-Mar 25 5744 6293 7933 8354 28429
Mar 26-Apr 1 15684 20337 24224 34391 52901
Apr 2-8 19455 31148 39618 56772 65604
Apr 9-15 16291 29267 35570 61921 64463
Apr 16-22 20065 34130 33932 64669 43437
Apr 23-29 20263 42343 33773 62189 42475
Apr 30-May 6 23216 49205 37880 51693 24287
May 7-May 13 22419 43256 37591 40209 16683
May 14-May 20 22725 42762 40343 39273 13709
May 21-May 27 23979 39418 42977 26434 10595
May 28-June 3 32200 31504 50039 24250 9120
June 4-June 10 35487 24674 55731 16622 6071
June 11-June 17 41976 22510 75787 12905 4986
June 18-June 24 66292 26792 107221 10922 4524

Infections by Region 6-25

Mar 19-Mar 25 138 104 144 116 278
Mar 26-Apr 1 380 615 572 606 1656
Apr 2-8 707 1454 1309 2115 4327
Apr 9-15 890 2195 1596 3577 5318
Apr 16-22 1033 2343 1727 5147 3716
Apr 23-29 1128 2588 1685 4722 2713
Apr 30-May 6 1012 2413 1747 4908 2582
May 7-May 13 1082 2288 1597 3911 1416
Apr 23-29 1090 2060 1442 3578 963
Apr 30-May 6 775 1723 1290 2341 667
May 28-June 3 875 1666 1387 2121 436
June 4-June 10 743 1297 1230 1611 325
June 11-June 17 778 1040 1207 1270 225
June 18-June 24 831 859 1204 908 153

Deaths by Region 6-25

Pos­i­tive Test per­centages:

Date USA tests Pos­i­tive % NY tests Pos­i­tive %
Mar 19-Mar 25 347577 16.2% 88,882 32.0%
Mar 26-Apr 1 728474 20.2% 117,401 45.1%
Apr 2-8 1,064,225 19.8% 144,273 45.5%
Apr 9-15 1,026,741 20.4% 160,859 40.1%
Apr 16-22 1,235,393 16.1% 143,970 30.2%
Apr 23-29 1,552,560 13.0% 202,499 21.0%
Apr 30-May 6 1,759,548 10.6% 183,446 13.2%
May 7-May 13 2,153,748 7.5% 202,980 8.2%
May 14-May 20 2,643,333 6.0% 246,929 5.6%
May 21-May 27 2,584,265 5.7% 305,708 3.5%
May 28-June 3 3,022,469 5.1% 417,929 2.2%
June 4-June 10 3,252,870 4.6% 438,695 1.4%
June 11-June 17 3,470,057 4.6% 442,951 1.1%
June 18-June 24 4,118,048 5.9% 500,174 1.0%

Things are even scarier than these num­bers im­ply. The scariest part is that this jump is largely con­cen­trated in the last few days.

Here’s the daily trend in pos­i­tive test rates over the last two weeks, Ex-NY:

Date Ex-NY Pos­i­tive %
6/​11/​2020 5.5%
6/​12/​2020 4.4%
6/​13/​2020 5.6%
6/​14/​2020 4.8%
6/​15/​2020 4.6%
6/​16/​2020 5.7%
6/​17/​2020 5.4%
6/​18/​2020 6.6%
6/​19/​2020 6.2%
6/​20/​2020 6.1%
6/​21/​2020 5.9%
6/​22/​2020 6.6%
6/​23/​2020 7.1%
6/​24/​2020 8.4%

May 16 was the last time prior to this that we had a pos­i­tive rate (ex­clud­ing New York) of 7.1% or higher. We have to go back to May 9 to see one above 8%.

Un­less some­thing highly un­ex­pected has already hap­pened to pre­vent it, things are about to get very bad, very quickly.

Talk To Your Area Man About Lagged Ex­po­nen­tial Growth

Peo­ple are bad at ex­po­nen­tial growth. We now have had the op­por­tu­nity to run a nat­u­ral ex­per­i­ment. Hav­ing been bit­ten not only in­ter­na­tion­ally but also do­mes­ti­cally, will peo­ple act any differ­ently the next time around? The an­swer is no. They will not.

Twit­ter is full of peo­ple try­ing to help who feel the need to re­peat­edly and force­fully say that this re­sult is not due solely to a rise in test­ing. Who feel the need to keep in­sist­ing that things are get­ting worse, that the epi­demic is not es­sen­tially over.

It seems that only when the ICUs are full, which is hap­pen­ing about now through­out sev­eral south­ern states, do nor­mal peo­ple take no­tice that some­thing might be wrong. Only when the death rate it­self rises do peo­ple think that there might be dan­ger.

Others think that so long as the situ­a­tion is get­ting worse suffi­ciently slowly, things will turn out fine. That is not how this works. That is not how any of this works. When Cuomo put up the slide that said goal of R0 less than 1.1, the mind bog­gled. If your R0 is 1.05, ev­ery­one gets in­fected. This isn’t a hard thing to rea­son out. And yet.

Area Man Con­fesses To Heinous Crime

He also held a rally in Tulsa.

At that rally, he said that more tests meant more pos­i­tives, which looked bad. So I told my peo­ple, “slow the test­ing down.”

I will re­peat that. The Pres­i­dent of the United States or­dered coro­n­avirus test­ing slowed down.

The defense was that he was kid­ding.

He wasn’t kid­ding.

When asked to deny the state­ment, he sidestepped it. When asked about whether he had been kid­ding, he re­sponded, and I quote: “I never kid.”

I do not point this out to ask why it has yet to be­come an ar­ti­cle of im­peach­ment. I point it out for its log­i­cal im­pli­ca­tions. We need to un­der­stand what is ac­tu­ally hap­pen­ing.

To what ex­tent are our num­bers ma­nipu­lated or fraud­u­lent? In pre­dict­ing the path of the pan­demic, to what ex­tent will our gov­ern­ment ac­tively in­terfere with our at­tempts to save peo­ple’s lives and their liveli­hoods? We know that the fed­eral gov­ern­ment has at many points ac­tively in­terfered with our abil­ity to test for Covid-19, and has waged a war of ban­ditry and piracy to seize med­i­cal sup­plies.

I have seen nu­mer­ous re­ports that Florida, along with other states, is ma­nipu­lat­ing data in or­der to jus­tify re­open­ing.

This all helps us an­swer the next ques­tion, which is:

What Went Wrong?

There has been a dra­matic wors­en­ing of the trend lines over this past week. Even here in New York, what looked like clear steady im­prove­ment now risks fal­ling apart. What made things go so wrong so quickly?

My cur­rent model says that it is a com­bi­na­tion of fac­tors.

The cen­tral thing that I be­lieve is go­ing on is lock­down fa­tigue com­bined with a rel­a­tive-to-oth­ers sense of re­spon­si­bil­ity, and no state ca­pac­ity to do any­thing else.

It has been sev­eral months. A lock­down can be a fun change of pace for a week. It can be not so bad for a few months. But af­ter a while it takes its toll. One goes stir crazy. You miss your friends. You lose your job and your sav­ings start to run out. You can’t take it any­more.

Com­bine that with peo­ple ad­just­ing to the be­hav­iors and norms they no­tice around them. When most peo­ple judge who is be­ing re­spon­si­ble, they are grad­ing on a curve. If oth­ers are do­ing un­safe things, and you’re do­ing un­safe things but things that are less un­safe than oth­ers are, or that seem to you more jus­tified, then that’s not be­ing ir­re­spon­si­ble. That’s do­ing what is nec­es­sary. That’s liv­ing one’s life.

The dam broke on that. The sec­ondary effect of the protests was some­thing be­tween the straw that broke the camel’s back and the un­leash­ing of a tidal wave. Peo­ple saw oth­ers break­ing the rules to protest. Many did so mostly to blow off steam af­ter such a long lock­down. The rhetoric shifted to things like ‘de­fund the po­lice’ and other un­pop­u­lar far-left agenda items.

Peo­ple no­ticed. Then oth­ers no­ticed them notic­ing, and ad­justed ex­pec­ta­tions. Then oth­ers no­ticed them in turn, and so on. With the per­cep­tion that a large por­tion of peo­ple was do­ing what­ever it wanted, when a lot of other peo­ple ran the pro­gram ‘be about as re­spon­si­ble as other peo­ple’ that quickly spiraled in many places to very lit­tle in the way of pre­cau­tions.

That is then com­bined with the prob­lem of air con­di­tion­ing, es­pe­cially cen­tral air, and it be­ing too hot to want to be out­doors through­out the South.

Mask wear­ing helps where it is pre­sent, but has turned into a poli­ti­cal is­sue. And it turns out that in many places, most peo­ple will do an an­noy­ing thing for only a brief pe­riod be­fore they stop do­ing it. What I saw in Westch­ester was an ex­cep­tion.

Then state ca­pac­ity comes in.

We don’t have any abil­ity to reim­pose re­stric­tions at least un­til af­ter the death rates sky­rocket. It’s un­clear we’d be able to do any­thing even then.

We can’t con­tact trace, even in places like New York City where we hired the peo­ple to do it and have a man­age­able case load. A track­ing app is dead in the wa­ter. Our blue cognoscenti has de­cided that anonymity for protesters over­rides any mo­ti­va­tions to trace. Our red cognoscenti was never on board with the idea.

In Texas it’s like New York in March, ICU ca­pac­ity is be­ing maxed out and we can’t even get proper PPE to the hos­pi­tal work­ers let alone take ex­tra mea­sures.

The good news is we’re start­ing to fi­nally see a con­sen­sus that masks are the only way for­ward with­out com­plete dis­aster. The mask mes­sage is in­creas­ing in in­ten­sity and more peo­ple are get­ting on board, in­clud­ing red voices.

The bad news is we’re start­ing to fi­nally see a con­sen­sus that masks are the only way for­ward with­out com­plete dis­aster. We’ve agreed that we don’t have the abil­ity to do much else that is use­ful.

My real an­swer to what went wrong is that our civ­i­liza­tion is profoundly in­ad­e­quate. We have lost our abil­ity to do things. If you haven’t read the Mo­ral Mazes se­quence, it may help ex­plain how we got to this point. So will un­der­stand­ing simu­lacra lev­els. That post was origi­nally in­tended to be called ‘Si­mu­lacra Levels and Covid-19’ and to con­nect it to the claims of Covid-19: My Cur­rent Model, but that turned out to be too am­bi­tious for one post. My work is not yet done to con­nect it back to our gen­eral situ­a­tion, but es­sen­tially we have lost not only the abil­ity to fo­cus on the ob­ject level, but where de­ci­sions are made we have lost the abil­ity to ac­knowl­edge the ob­ject level even is a thing. Our top peo­ple don’t be­lieve in a phys­i­cal world the way our grand­par­ents did, and deny that any­one ever be­lieved in one in that way. I’m work­ing on ex­plain­ing this fur­ther, and hope to get the next post out in a few weeks. Can’t rush this.

Base­ball! Base­ball! Base­ball! Base­ball! Base­ball! Base­ball! Base­ball! Base­ball! Base­ball! (with apolo­gies to Bill Sim­mons)

For many months I have yearned for the re­turn of Ma­jor League Base­ball. Noth­ing would be bet­ter suited to pass­ing the sum­mer days while main­tain­ing so­cial dis­tance. The game car­ries min­i­mal risk rel­a­tive to many other ac­tivi­ties. A few can en­ter­tain so many for so long. Yet things kept be­ing post­poned, as the own­ers and play­ers were locked in a bat­tle over money.

That bat­tle seems to have ended with the play­ers get­ting most of what they wanted, through a willful (in my read­ing) mis­in­ter­pre­ta­tion of an agree­ment the par­ties reached in March. The own­ers of course also did not cover them­selves in glory on this one. But in the end, they did agree to play ball. Whether or not cir­cum­stances let it hap­pen is un­clear. I re­ally, re­ally hope we find a way, even if things get bad again. Base­ball will be a huge help in get­ting us all through this.

Foot­ball will be even more im­por­tant, and that much trick­ier. Foot­ball is dan­ger­ous un­der the best of cir­cum­stances. I’m not con­vinced in­tro­duc­ing Covid-19 is that big an in­crease in dan­ger in per­centage of risk terms for the ac­tivity, but that is not how peo­ple will think about it. We can only hope the huge psy­chic cost of not hav­ing it is prop­erly re­spected.

I know my read­ers don’t get this. I do. Sports are im­por­tant. Sports go sports. Ath­let­ics are num­ber one. Par­ti­ci­pants are heroes. Go team, yeah. For real. Let me put it this way, not as a de­mand but as a warn­ing and dec­la­ra­tion of fact:

No Foot­ball, No Peace.

What Hap­pens Now? What Should We Do as In­di­vi­d­u­als?

If you are in the area see­ing the ex­plo­sion in cases, ex­pect things to look like New York City looked in March and April.

We can hope that our im­proved knowl­edge will help us bet­ter pro­tect the most vuln­er­a­ble. That is good. It does not make the world around you any less dan­ger­ous when de­cid­ing what ac­tivi­ties to do.

This ac­tu­ally could make things worse. It was crim­i­nal that we let our el­derly down early in the pan­demic, es­pe­cially by let­ting the virus into nurs­ing homes. But those very deaths drove home the need for mea­sures that con­tained the virus. With the new lower death rates, by the time that statis­tic gets peo­ple’s at­ten­tion, we will be much farther along in the in­fec­tion rate. A younger per­son’s real risk will be sev­eral times higher rel­a­tive to av­er­age risk, and thus they will take even less of the pre­cau­tions they need to than they would have be­fore. Then that greater rate means the el­derly in turn can’t be pro­tected.

Florida fo­cused early on pro­tect­ing nurs­ing homes. That is the right strat­egy if and only if it still lets you con­tain in­fec­tions in gen­eral. Fail, and noth­ing you did will save you, un­less you can pro­tect them through full herd im­mu­nity. That’s a tall or­der.

Herd im­mu­nity is where the South and West are headed. A few Western states might still es­cape, but some­thing would have to change. Hawaii was down to one case in an en­tire week, but if you don’t han­dle things, they come back any­way, and now they’re back up to 91 and grow­ing fast. I think New Mex­ico, Colorado and parts of North­ern Cal­ifor­nia are the only ones who might be all right. In the South, Ken­tucky and Virginia might mud­dle through, which not co­in­ci­den­tally are the most north­ern mem­bers of the re­gion, while Florida and Texas are look­ing like the biggest dis­asters.

The Mid­west is start­ing to trend back in the wrong di­rec­tion, and sev­eral North­east­ern states looks vuln­er­a­ble as well. If there’s been the same level of cul­tural shift here as there was down South, but de­layed and/​or start­ing from a bet­ter point, we are at se­vere risk of tip­ping back above the crit­i­cal R0~1 level, and hav­ing things start to get worse again. Once that hap­pens, un­less some­thing changes, things might go slower, but it’s only a mat­ter of time.

You can look at my spread­sheet for fur­ther nu­mer­i­cal de­tails un­der the tab In­fec­tions by State.

If you are in the North­east, Mid­west or a rel­a­tively safe lo­cal re­gion, en­joy your rel­a­tive safety re­spon­si­bly while it lasts. Wear a mask. Re­mem­ber to keep things out­doors. Don’t sweat the small stuff. Get your­self psy­cholog­i­cally pre­pared for things to po­ten­tially get worse again, per­haps soon. Keep an eye on lo­cal num­bers.

If you are in most of the West or South, this is when the real crisis likely starts for you. Due to ex­haus­tion and ad­just­ment, chances sup­ply chains break down are rel­a­tively low, but not zero. Chances the med­i­cal sys­tem col­lapses are very high. Be pre­pared. If you need to see a doc­tor in the next three months, now is bad but next month is worse. Be ready to not go out­side for sev­eral months, or to stay within your own re­gion of space if you have one of those within your prop­erty, if it comes to that.

Re­sumed The Quaran­tine Wars Have

New York, New Jersey and Con­necti­cut are now tel­ling trav­el­ers who have been to any state with pos­i­tive test rates above 10% that they must quaran­tine for four­teen days. It would not sur­prise me if the rest of our re­gional al­li­ance fol­lowed. The rate over­all of pos­i­tive tests out­side New York was over 8% yes­ter­day, so it might not be long be­fore this is the ma­jor­ity of the coun­try.

Last time this was tried, we in New York were the ones be­ing told to quaran­tine and stay out. It definitely feels good to turn the ta­bles. The ques­tion of how this could be en­forced re­mains un­clear. It is also un­clear whether the rest of the coun­try will tol­er­ate it. What will the fed­eral gov­ern­ment do when a blue state says red cit­i­zens aren’t wel­come? So far, it seems to have been quietly ac­cepted. Th­ese days, it’s hard to pre­dict what will or won’t get a re­ac­tion. Per­haps the re­ac­tion will come when en­force­ment is at­tempted.

We live in in­ter­est­ing times.