Covid-19 6/​4: The Eye of the Storm

Link post

Still stand­ing by this: Covid-19: My Cur­rent Model

Pre­vi­ous up­date posts: Covid-19 5/​29: Dumb Reopen­ing, Covid 5/​14: Limbo Under

Re­mem­ber last week when I opened with this?

I re­mem­ber when peo­ple on Twit­ter had con­stant re­minders that to­day was, in­deed, only Wed­nes­day, or what­ever day it hap­pened to be. Time moved that slowly.

Time has sped up again.

Well, yeah. Not so much any­more.

In March and April I found my­self con­stantly check­ing Twit­ter and the fi­nan­cial mar­kets for news, fran­ti­cally hunt­ing for ways to get a han­dle on what was hap­pen­ing in the world, wor­ried ev­ery­thing would fall apart. Would our sup­ply chains hold? Would we be able to main­tain civil or­der? Would mil­lions die? How can I keep my fam­ily and friends safe?

My be­loved New York City was no longer a place one could live a rea­son­able life. So we fled. Even af­ter that, great worry.

Then things started to calm down. Most of May, I in­creas­ingly man­aged to re­lax. We learned how to grill prop­erly. I played a bunch of As­sas­sin’s Creed Odyssey. I stopped check­ing Twit­ter or the stock mar­ket.

My biggest wor­ries were deal­ing with get­ting the Emer­gents Alpha ready and Magic: The Gather­ing melt­ing down un­der the weight of the com­pan­ion me­chanic in par­tic­u­lar and its new de­sign philos­o­phy in gen­eral.

End of the Beginning

Then, on May 25, 2020, in Min­neapo­lis, four po­lice­men mur­dered Ge­orge Floyd.

The re­sult­ing cy­cle of protests against po­lice bru­tal­ity caus­ing more po­lice bru­tal­ity, which in turn am­plifies the protests, has been on­go­ing each day since then. Huge crowds flood the streets. The crowds come dis­pro­por­tionately from com­mu­ni­ties with more Covid-19 cases than av­er­age. The crowds of­ten yell. The po­lice use tear gas on them, which causes cough­ing. The po­lice ar­rest them and lock them in tight quar­ters, which is go­ing to spread the virus even if the out­door ac­tivi­ties don’t, hope­fully in small enough num­bers this isn’t a huge deal.

To the ex­tent other things are also hap­pen­ing, that only makes the in­fec­tion situ­a­tion worse.

It would be very sur­pris­ing if all this did not lead di­rectly to a surge of new Covid-19 in­fec­tions.

It would also be very sur­pris­ing if all this did not lead in­di­rectly to a much big­ger surge of new Covid-19 in­fec­tions.

Effec­tively, the lock down is over.

Nuance is hard in the best of cir­cum­stances. The com­mu­nity I know who got most ahead of the game on Covid-19, the Ra­tion­al­ist com­mu­nity, is still so bad at nu­ance that one of its de facto com­mu­nity lead­ers felt he could not go any­where or do any­thing dur­ing the epi­demic. Be­cause if he did, oth­ers would not be able to prop­erly parse his ac­tions as re­spon­si­ble, or be able to choose re­spon­si­ble ac­tions them­selves, and all quaran­tine would col­lapse for ev­ery­one..

Th­ese are not the best of cir­cum­stances.

Peo­ple have seen, and will con­tinue to see, the pho­tos and videos of gi­gan­tic crowds in the streets. They will see the ap­proval of those crowds, by the ex­act same peo­ple who told them they should face a de­pres­sion and 30% un­em­ploy­ment to fight Covid-19. The same peo­ple who told them they should not see fam­ily and friends and live their lives.

Even those who sup­port the protests are go­ing to have a very, very hard time tak­ing ex­treme re­stric­tions se­ri­ously go­ing for­ward. Life beck­ons.

For those who don’t sup­port the protests, for­get about it.

There is no go­ing back. Either peo­ple’s pri­vate choices, af­ter the re­sult­ing ad­just­ments in per­cep­tion of risk, based on their lo­cal de­sire to keep them­selves and their com­mu­ni­ties safe, will still be enough to con­tain this virus. Or, we will en­tirely fail to con­tain this virus un­til herd im­mu­nity pro­vides enough help to turn the tide.

I can­not think of a more just cause then stop­ping state-sanc­tioned mur­der. That does not make these im­pli­ca­tions go away.

That is where we are go­ing to be. We are prob­a­bly go­ing to see a mas­sive dumb re­open­ing, much faster and more com­plete than pre­vi­ously pre­dicted or planned. That is the world we now live in.

I don’t know if I even think that these effects are bad.

This could all work out for the best.

It could work out be­cause we con­tain the virus any­way. I don’t ex­pect it, but it’s definitely plau­si­ble.

It could also work out be­cause we were never go­ing to suc­cess­fully con­tain in most places with­out stronger herd im­mu­nity – re­gard­less of whether we could have done so given bet­ter policy – and this gets us there faster and by in­fect­ing a rel­a­tively young sub­set of the pop­u­la­tion. Also definitely plau­si­ble.

Or it could work out be­cause out­door events don’t mat­ter, and this leads to lots more things hap­pen­ing out­doors but not in­doors, so we move to a bet­ter world no mat­ter the out­come. This, too, seems plau­si­ble to me.

Our, it could work out be­cause enough peo­ple ad­just their be­hav­iors to stay home more, be­cause they pre­dict a sec­ond wave, and this can­cels out or more than can­cels out the di­rect effects above. You never know.

How long be­fore we know the re­sults?

It has been over a week since things were set in mo­tion. The first few days were rel­a­tively small. Events didn’t start hav­ing their full im­pact un­til at least the last few days. They may not have reached any­thing like their peak yet. And if the virus is now spread­ing in a par­tic­u­lar sub-pop­u­la­tion, we may see ex­po­nen­tial growth within that par­tic­u­lar sub-pop­u­la­tion, over the course of sev­eral cy­cles of in­fec­tion. So the effect might be small at first, then only look large weeks later.

Se­condary effects, from oth­ers ad­just­ing be­hav­iors, will also be grad­ual and de­layed.

On top of any lag of the ac­tual in­fec­tions, the time from in­fec­tion to pos­i­tive test has always been an open ques­tion. My guess is it is cur­rently an av­er­age of seven days.

In the mean­time, what was hap­pen­ing be­fore all this?

The Numbers

Pos­i­tive test re­sults by re­gion:

Date WEST MIDWEST SOUTH NE ex-NY NY
Mar 19-Mar 25 4283 4103 5045 4955 19925
Mar 26-Apr 1 14962 18641 22823 31631 54920
Apr 2-8 17170 25899 32296 46365 54894
Apr 9-15 17393 30403 39118 63548 64342
Apr 16-22 17149 32804 32926 61955 52481
Apr 23-29 22958 39570 33974 65682 44484
Apr 30-May 6 22269 49256 37503 53803 26957
May 7-May 13 23612 43429 36280 43952 18102
May 14-May 20 22594 44054 40556 37567 14316
May 21-May 27 23595 41635 42679 32762 11393
May 28-June 3 30094 32216 46848 24926 8947

Deaths by re­gion:

Date WEST MIDWEST SOUTH NE ex-NY NY
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

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 3,022,470 5.1% 417,929 2.2%

New York had been win­ning its war. On June 2 there was a scary jump in pos­i­tive test rates. That was es­pe­cially scary as it could have rep­re­sented Me­mo­rial Day. But the trend was back on course again on June 3, so things were prob­a­bly fine at least un­til the protests.

New York con­tinues to re­open. On a per­sonal level, they are al­low­ing out­door din­ing here in a few days, and full restau­rants a week later. For all prac­ti­cal pur­poses the limit­ing fac­tors on my be­hav­ior will be my own risk con­sid­er­a­tions, not offi­cial re­stric­tions. I was train­ing my­self to stop sweat­ing the small stuff, and pre­pare to go out more and more into the world. Now it’s much less clear that’s go­ing to hap­pen.

The North­east in gen­eral con­tinues to do well, but not as well as New York.

The rest of the coun­try is still a more mixed bag. The Mid­west is en­courag­ing and a wel­come sur­prise, enough to make over­all num­bers move in the right di­rec­tion. But the jump in cases out West is trou­bling. It is spear­headed by Cal­ifor­nia, with most Western states see­ing a marked jump. The South also con­tinues to creep up­wards, es­pe­cially Texas, South Carolina and Virginia. It’s worth not­ing that Florida and Ge­or­gia saw de­clines, so un­less they’re fudg­ing the data this isn’t about speed of le­gal re­open­ing.

The death counts aren’t chang­ing much, as one would ex­pect given their lag. They are listed as a valuable san­ity check, but the three week or more de­lay is fatal to them usu­ally pro­vid­ing the key new in­for­ma­tion in a given week. By com­par­ing the two charts, we can see ex­actly how de­layed. If any­thing, it’s a big mys­tery that the deaths move way too much in lock­step with cases, rather than on a de­lay. Is this that case di­ag­no­sis is more de­layed than seems rea­son­able, or is un­der bad cir­cum­stances? Or is it some­thing else?

Analysis

Thus, this week’s up­date was mostly spec­u­la­tion about the fu­ture.

Please keep the com­ments sec­tion con­fined to Covid-19 con­sid­er­a­tions.

Watch­ing the pos­i­tive test counts over the next few weeks will be cru­cial to figur­ing out our new path, as we also de­ter­mine the path of our na­tion in other ways.

New York is see­ing ma­jor protests, and had a very clear im­prov­ing trend line, with very good plen­tiful on-de­mand test­ing. I think it’s a very good place to look to see the delta from re­cent events, as it’s one place where we know the prior score.

If New York con­tinues to make similar progress for two weeks, then the protests are not very dan­ger­ous as a pri­mary effect. Even one full week of the same trend line would be enough to be pretty con­fi­dent this effect is not large.

If New York quickly stops mak­ing progress, or even re­verses, we have to as­sume that the pri­mary im­pacts are very dan­ger­ous.

Nei­ther of these tells us much about sec­ondary ad­just­ments. Those will be grad­ual. Peo­ple are crea­tures of habit. Many of them are also scared of go­ing out­side given the un­rest. In the short run, this likely works the other way. We won’t know what the real im­pact of the un­rest is upon the curve, un­til there is less un­rest. And that long term trend is what mat­ters.

If we do have a sec­ond wave, es­ti­mat­ing the im­pact of par­tial herd im­mu­nity will de­ter­mine the path for­ward. If I am right that New York’s ad­van­tage over other ar­eas is mostly its larger herd im­mu­nity, and I’m also right that it is mak­ing up for oth­er­wise rel­a­tively un­safe cir­cum­stances rather than Cuomo hav­ing de­liv­ered the goods on that front, then that’s very good news. We should see similar ac­tions re­sult in shrink­ing R0 over time.

How­ever, note that this will be a de­layed effect. First, in places with very lit­tle im­mu­nity, we will in­stead have the op­po­site effect. As the new nor­mal sets in, peo­ple’s choices in the new nor­mal de­ter­mine their risk level, and the more risky are in­fected more. As this takes effect, things look like they are get­ting worse, even as the ground­work is laid – by mak­ing those risky peo­ple im­mune – for things to get bet­ter later. Or so we hope. We can even view ‘New York City gets very in­fected’ as a ge­o­graphic ex­am­ple of the ex­act same thing. For a while it made the na­tion’s epi­demic seem much worse than it was. But that con­cen­tra­tion of risk made our long term prospects much bet­ter.

Ul­ti­mately, I con­tinue to be an op­ti­mist of sorts on this, but with lit­tle con­fi­dence.

As dis­cussed above, it’s doubt­ful the United States has much state ca­pac­ity left to take mean­ingful ac­tion against Covid-19. It’s up to the in­di­vi­d­u­als now, even more than it seemed to be a week ago.

The die has been cast. The only ques­tion is what num­ber it lands on.