24 May 2020 – Sunday – #70

It turns out the car horns I heard while I was writing yesterday’s diary entry were from a protest by the Spanish right-wing party Vox. It’s still a mystery how people in Spain find out about these events. Once in a while I’ll get a message that we’re banging pots and pans to protest some or other cause, but most of the time I hear something unusual and have no idea its significance.

I don’t pretend to know anything about Spanish politics except from what I’ve seen in the even-handed documentary Dos Cataluñas. I figured I better at least know something about the local independence movement before I got trapped in a vermut-fueled cocktail party conversation. El País reports 6,000 vehicles participated in yesterday’s Vox protests in both Madrid and Sevilla, but only 500 in Barcelona. Because of the correlation between right-wing politicians and homophobes, this seems like another good reason to be in Barcelona.

As a quick compare-and-contrast of Spanish and US right-wing politics, in Madrid the protest organizers asked protesters to comply with Covid-19 safety measures.

The far-right leader called on protestors to respect all of the necessary health precautions, but with the streets of Madrid at a standstill due to the demonstration, many people were seen leaving their cars and failing to keep two meters apart. Municipal police officers in the area instructed protestors to put on face masks, something that this week became obligatory in Spain when social-distancing is not possible.

El País, “Protestors take to Spanish streets in vehicles, at anti-government marches organized by far-right Vox,” 23 May 2020.

In the US, on the other hand, conservatives have turned refusal to wear face masks into a defiant rallying cry against government public health experts, so much that the Republican North Dakota Governor Doug Burgum held back tears while asking his constituents to wear masks.

The messaging problem US conservatives face in reopening states is that masks signify that things aren’t normal.

It hasn’t just been White House leaders stroking divisions surrounding the facial coverings. Missouri Gov. Mike Parson earlier this month defended his decision to go mask-free when visiting a thrift store for veterans in Joplin, Missouri. He said he didn’t believe it was the “government’s place” to determine whether residents should wear a face mask in public and it was up to the individual.

Business Insider, “North Dakota’s GOP governor grew emotional discussing the partisan divide over face masks, asking residents to ‘dial up your empathy’,” 23 May 2020.

Trump’s unfortunate choice to politicize face masks is good for his bouffant and his campaign positioning, but bad for public health. If he had brains, he would be giving away campaign face masks so that people could go back to work with a smaller chance of a repeat Covid-19 outbreak. That’s a sensible way to restart the economy, but once Trump digs himself in on any position, he prefers to doubling down, as they say, to a reality check. Being wrong is a sign of weakness.

Masks are a perfect example of why it’s a bad idea to adhere religiously to any position on Covid-19. Oh so many months ago at the beginning of the Covid-19 pandemic, masks were considered protective gear. The World Health Organization, the CDC, and other health experts implored the public not to buy masks so that front-line healthcare workers could obtain them.

Except that it turns out that, as Covid-19 transmission became better understood and Covid-19 aerosols became better measured and new models were built, new information now says people should worry less about surface transmission of Covid-19 and more about extended time with others in closed quarters. The new advice is that everyone should use masks, not for personal protection, but (in the absence of adequate testing) to reduce the amount Covid-19 available for others to breath.

Which brings me to my real topic today. As the US surpasses 100,000 Covid-19 deaths in the next couple days, most of which were unnecessary, it’s important to consider the things we still don’t know about Covid-19. My social media feed is full of people who know what to do about Covid-19. They’ve dug themselves into various Covid-19 public health positions the way Trump has dug himself in to the benefits of not wearing masks and of taking hydroxychloroquine. Lockdowns are good, or not. Masks or good, or not. Everyone should do what Sweden is doing, or not. Covid-19 kills old people, or not.

The reason to stay flexible on your Covid-19 worldview is that Covid-19 will continue to surprise us. Some examples.

Covid-19 mortality is higher as age increases, especially over 60 years old. Anti-lockdown advocates want to cloister older people so that everyone else can go back to work. Never mind that cloistering older people in poor and immigrant neighborhoods is nearly impossible, this anti-lockdown argument goes that if we lose a few older people, the overall population is better off in a better economy.

However, in developing countries, Covid-19 kills more younger people than in developed countries. A lot more younger people.

In Brazil, 15 percent of deaths have been people under 50 — a rate more than 10 times greater than in Italy or Spain. In Mexico, the trend is even more stark: Nearly one-fourth of the dead have been between 25 and 49. In India, officials reported this month that nearly half of the dead were younger than 60. In Rio de Janeiro state, more than two-thirds of hospitalizations are for people younger than 49.

Washington Post, “In the developing world, the coronavirus is killing far more young people,” 22 May 2020.

This is a new piece of Covid-19 information. If you’ve poured all your social media heart and sould into your anti-lockdown identity, now you’re faced with either cherry-picking data that say it’s still mostly older people who die or changing your online identity. If you’re a politician who’s advocated anti-lockdown, you have a lot more to unwind.

Ditto Sweden, which I wrote about yesterday. More specifically, though, the model Sweden used to pursue its failed “lockdown lite.”

Philippe Lemoine on problems with the ICL Covid-19 model Sweden used.

Philippe Lemoine argues that researchers have failed to understand why the ICL model predictions were wrong in Sweden. He writes that it is easier to attribute the failed prediction to, say, incorrect social distancing assumptions, without checking if that’s, in fact, the reason the model failed.

Which is to say that our ability to predict what happens next with Covid-19 is limited. Pushing down the classic infection curve works, but predicting when we get to herd immunity doesn’t seem to work at all. Sweden proved that. Parenthetically, I’m concerned about the mask models used to predict masks will slow the spread of Covid-19, but the risks of trying the mask experiment are low, whereas the risk of Sweden’s herd immunity experiment were quite high.

And then there’s Japan. Japan is ready to reopen, but nobody understands exactly how they did it. They didn’t have mass lockdowns. They didn’t have extensive testing. No silver bullet in reducing their Covid-19 caseload to the lowest of any G7 country.

Japanese Covid-19 cases by day.

If you’re fluent in Japanese, here’s 43 possible ways Japan beat Covid-19, including the suggestion that Japanese speakers expel fewer Covid-19-laden droplets than speakers of other languages expel.

Covid-19 will continue to surprise us. And to reveal who we are. Think about what you really know about Covid-19 before you get up in arms. Think about who you are.

Some things we know. We know that social distance and hand washing work. We are pretty sure masks work if over 80% of us wear them. We know hydroxychloroquine doesn’t work. We know a lot about the pathogenesis of Covid-19, how it attacks the body and the kind of damage it can do. We have a lot more to learn about how to treat Covid-19.

We also know that leadership is a key component to a successful Covid-19 response. Poor countries and provinces with good leadership have minimized Covid-19 mortality without expensive public health investments.

Because it’s Memorial Day weekend, before I sign off today I want to note that the USS Comfort left New York City’s Upper West Side. It’s a strange symbol to me of the US response to Covid-19. The ship treated 182 patients during its month stay in New York City. Military medical personnel are reportedly staying in New York to help with the city’s Covid-19 response. All the intentions were good, but it seemed like the Comfort delivered more promise than help.

Last, but not least, Brad found this a capella Covid-19 re-work of Imogene Heap’s Hide and Seek. It’s called Quarantine and it’s by Tim Blais.

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