Today’s entry is a Tale of Two Cities and then a Tale of Two Videos and then a Tale of Two Covid-19 statistics and then a Tale of Two Followups. But before I get in-two all that, I want to talk about me me me.
It could have been the warm Spring weather yesterday that allowed me to open all the windows and doors. It could have been the hour time shift that allowed me to see the faces of all my neighbors in the sunset light, applauding, as we do every evening at 8pm local time, the healthcare workers. It could have been yesterday’s Covid Diary entry about Spain reaching peak Covid-19 mortality. Whatever it was, I felt a huge sense of relief yesterday, a playfulness that’s been missing for a few days. Also I was able to continue revisions of my novel Dear Mustafa and submit my short story Ceiling Fan for consideration in a short story anthology. My writer’s block vaporized.
Even in isolation, I’m excited again about the prospect of exploring Barcelona. My friend Nicole mentioned during yesterday’s WhatsApp chat that the 23rd of April Diada de Sant Jordi celebration, which informally marks the beginning of Spring, has been postponed to June. That reminded me of all the festivals I (and everyone else) must be missing while in isolation. If you hang around Barcelona for a couple of months, you figure out there are festivals almost every week. You’ll be out buying toilet paper and discover the entire grocery store staff in costume. Or you’ll be wandering through Gracia only to find a parade of horse-drawn carriages slinking through the barrio. I still don’t know what half these festivals celebrate, but they’re always a good excuse to let down your hair and chat up your fellow barcelonés.
The Spanish isolation isn’t over, but there is a light at the end of the tunnel as Covid-19 peaked over the weekend. If you’re stuck in a Covid-19 tunnel, dear reader, the light will appear soon. But you won’t get dessert until you eat your vegetables. And you won’t understand how great the ending of Beethoven’s Ninth Symphony is until you listen to the entire piece. And, you know, all those other metaphors about how the payoff isn’t worth it unless you struggle through the process.
Now that I’ve got me out of the way, I want to tell a Tale of Two Cities. They could have been Barcelona and Madrid, but the story is half over in Spain. Instead they are San Francisco and New York, cities in a country where the story is just getting under way.
New York, as always, knows how to get all the attention. Its Covid-19 deaths have rocketed past 9/11 deaths. Yesterday I posted a horrifying map of New York City Covid-19 infection rates by neighborhood. As New York always does, it is rising to the occasion. There is a bit of good news. My friend Adam lives in the Broadway district, the ground zero, as it were, of Covid-19 in the US. He reports that, while Covid-19 cases are still doubling, they now are doubling every six days instead of every three days.
On the other hand and on the other coast, California statistics in general, and San Francisco bay area statistics in particular, look good after locking down. As in Barcelona, which has roughly the same population as the San Francisco bay area, new bay area Covid-19 cases and mortality peaked over this past weekend. The news isn’t quite as good around Los Angeles, but the flare ups in Southern California are nothing like New York (or New Orleans).
Brad reported that San Francisco is offering drive up (or walk-up) Covid-19 testing. Currently appointments are required because there are limited tests. As more testing becomes available, the city expects to offer free testing any time.
San Francisco Mayor Breed ordered a state of emergency in the city by the bay on 26 February, well before the first case. At the time, a state of emergency seemed like an overreaction to me, but it turns out to have been prescient. Something you might expect, say, a president to have done.
San Francisco’s care is inclusive, with help for Trans people and the homeless. Not that other cities aren’t including minority and disadvantaged residents in their responses, but it’s encouraging to see what appears to be a Covid-19 success story that treats everyone with respect. Something you might expect, say, a president to do.
Governor Newsom, Mayor Breed, and the other bay area mayors are to be commended for their early Covid-19 response. Governor Cuomo and Mayor de Blasio are to be commended for their valiant response in the face of an epidemic crisis. The local leaders have stepped in after the federal government failed.
So, you might be wondering how come cities like San Francisco and New York (or Barcelona and Madrid) have such different Covid-19 outcomes. It’s partly taking the right steps and partly luck. That brings us to the Tale of Two videos portion of today’s entry.
Brad shared two videos yesterday which I’m commending to everyone. If you’re stuck inside with kids or with “adult” family members or with roommates who act like kids, both these videos might be an opportunity for a group learning moment. You’ll look like a genius for presenting them. The first video is fun math (no, really, it’s fun). The second is practical protection.
In the first video, mathematician Grant Sanderson (not an epidemiologist) shows us simple models of how different factors influence the course of an epidemic. As I’ve mentioned, Covid-19 is a math problem. Here are a bunch of solutions!
Here are some of the takeaways Sanderson finds in his exploration:
- Infection growth rate is very sensitive to number of daily interactions, probability of infection, and duration of illness
- Testing and quarantine is highly effective at reducing total infections
- Changes in how many people slip through testing cause disproportionately large changes to the people infected
- Social distancing slows spread of the virus, but even small imperfections in distancing prolong an epidemic
- R0 for Covid-19 is about 2, which is about the same as the Spanish Flu and is higher than the 1.3 for common flu
- Stopping travel doesn’t reduce total infections much after an infection is established
Now that you’ve earned a PhD in mathematics, you can move on to the second video packed with practical advice on Covid-19. I see a lot of social media discussions about how to talk about Covid-19 with roommates or family who share the same living space. Here’s a useful, if somewhat long (1 hour), Covid-19 video by a New York City ICU physician. It covers infection, symptoms, treatment, and protection. I’ve also put this on the Resource page. Here are the basic takeaways:
- clean your hands
- be aware of where your hands are and keep them off your face
- wear a general purpose mask – you don’t need an N95 mask
- keep distance from others and avoid sustained contact in close quarters with people who might be infected.
- if you feel short of breath, go to the hospital
Now let’s move on to the Tale of Two Statistics segment. Statistics are important, but there are confusing statistics out there as the pandemic evolves.
First, here’s a comparison of infection by age for Iceland and the Netherlands.
Why does Covid-19 appear to infect older people in the Netherlands and younger people in Iceland? It turns out that Iceland tests its entire population while Netherlands only tests those demonstrating symptoms. Younger people are just as prone to infection as older people, but less likely to show symptoms.
The second statistic today is the re-infection statistic, the reports floating around that some people infected with Covid-19 show positive RNA test results after they have recovered. What’s going on with these reports? I speculated that it might be faulty Chinese tests, and maybe it is. A real world virologist says it’s more likely that tests are picking up random virus-like material that remains after the infection.
Last but not least in this entry of Twos, the Tale of Two Followups.
One followup is that the German government agrees my friend Shane’s Covid-19 exposure bracelet idea. Instead of bracelets though, which I think are very tasteful, Germany will issue Covid-19 infection certificates to people with a positive Covid-19 antibody test. People may present a certificate to return to work. This seems ripe for a counterfeit market to me, but probably a reasonable trade-off to get Germany’s economy going again. Parenthetically, Shane reported overnight that his husband’s family back in the US has seven members with Covid-19 infections, three of whom in the ICU. Send your love vibes!
The second follow up is on ventilators. I noted yesterday that Dyson is introducing a simplified ventilator that will come to market in April. It turns out a cross-disciplinary MIT team has built a prototype ventilator in a week that can be built for US$100. Still a ways to manufacture and scale, but impressive effort.
One of the reasons any of this ventilator innovations is necessary is the monopoly power of a company with the unfortunate name Covidien. It appears that Covidien, which is now owned by Medtronic, bought its rival Newport in 2012 in order to block Newport from introducing less profitable ventilators to the US market. Covidien’s stranglehold on the US ventilator market has left the US in short supply during the Covid-19 pandemic. The unexpected life and death power of a monopoly.
One final Spanish note. The Orquesta Sinfónica de Castilla y León based in Valladolid performed Ode to Joy from Beethoven’s Ninth Symphony in isolation last week. It made me cry.