29 November 2020 – Sunday – #123

Happy Thanksgiving! I made my first annual Paella Pavo-rita and my first Spanish language pun at the same time. It’s a Paella Valenciana, with turkey substituting for chicken.

Paella Pavo-rita.

Brad found a cranberry adjacent accompaniment and Amy lived up to her commitment to bring pumpkin ice cream with the tasty improvisation she brought. That was the guest list for this year’s small Covid-19 restriction compliant gathering.

In Spain, Thanksgiving is known as El jueves, or just another Thursday. However there are signs of American influence on this particular Thursday. For instance, Amy mentioned that the butcher at Mercat de l’Abaceria had turkey, whole and in pieces. He showed her a list of all his American customers who’d ordered a bird. Other traditional ingredients like allspice and raw cranberries are more problematic.

On the day after Thanksgiving, there also is an American-influenced Black Friday (in English). As the next photo shows, however, it’s a bit more understated here than in the states.

Black Friday sign at Carmina shoe store on Avinguda Diagonal.

The joke is that the only reason Spanish retailers have adopted Black Friday is so they can jack up their prices most of November in advance of a big one-day sale.

Barcelona is all decked out for Christmas. Here, in fact, are tastefully decked out decks above the tasteful Chanel store on Passeig de Gracia.

Christmas decorations above the Chanel store on Passeig de Gracia.

Why is it that I want to see the rent agreement that makes this perfect display possible?

A few steps down Passeig de Gracia, the Philipp Plein store has adopted a holiday skull theme, a theme which I take as an homage to Covid-19. After all, with November’s vaccine news, this may be our last chance to celebrate the holidays and look fashionable with a mask.

Skulls abound at Philipp Plein on Passeig de Gracia.

In a similar vein, the Centre d’Optometria on Carrer del Rosselló turned a motorcycle helmet into a cross between a Philipp Plein inspired skull and Damien Hirst’s For the Love of God.

Motorcycle helmet at Centre d’Optometria.

I’m not sure what the metaphor is here. Glasses protect you from Covid-19? The end is near / so buy them here?

There were two significant differences I noticed this year between Black Friday here and Black Friday in the states. The first is crazy lines. There were lines outside the stores here, mostly on the order of 5 to 10 people and mostly so shops stayed in compliance with Covid-19 occupancy restrictions.

In Los Angeles, on the other hand, helicopter views of shoppers reminded me of what life was like before Covid-19.

The other difference? Covid-19 numbers in Barcelona are under control again while most of the US needs a lockdown stat. Here’s what things look like as Catalonia starts relaxing the latest round of Covid-19 restrictions.

Covid-19 reproduction rate R (yellow) and Outbreak Risk (blue) in Catalonia as of 27 November 2020. Source: Catalan News.

The reproduction rate R has been well below 1.0 for weeks. As expected, hospitalizations are falling off. We still have a 10p curfew and a limit of six for social gatherings, but the holidays will be relatively safe in Barcelona.

On the other hand, here’s how the US is doing versus other countries in distress.

Covid-19 cases in 10 most affected countries as of 27 November 2020. Source Johns Hopkins

Like Spain, the European countries in the chart above—UK, Germany, and Italy—saw Covid-19 numbers increase in October and imposed Covid-19 restrictions around the beginning of November. The chart shows how Covid-19 infections in all three of those European countries peaked and now are dropping. While Trump has been in the White House or on the golf course sulking about his loss, the US has applied few new restrictions and Covid-19 cases are climbing inexorably (the recent bump down probably is a holiday reporting anomaly).

It is frightful to watch America’s healthcare systems collapse. Twitter is full of threads from healthcare workers documenting the collapse in most states. Typical story lines are either no ICU beds or no hospital beds left to admit ICU patients. One example:

The price of Americans insisting that they know what’s best for their health care? The advent of Governor Palin’s dreaded “death panels.” Healthcare workers now make the decisions about who lives and who dies from Covid-19. Forget about routine medical procedures.

Three things kept Americans’s minds off Covid-19 last week, Thanksgiving, Black Friday, and the news that enough states certified election results for President-elect Biden that he will win the Electoral College next month. The slow motion transfer of power has started officially, but it will take months before Biden can implement new Covid-19 policies. Trump and his legal strike force made election fraud noise all week in court and with Republican legislators. His fruitless protests primarily appear to provide fodder for fundraising because they aren’t changing the outcome of the election.

Parenthetically, last week’s assassination of Mohsen Fakhrizadeh looks like a hit job by Israel to draw the US into a conflict with Iran before Trump leaves office. Trump needs to line up US$1 billion to refinance his debt in the next four years. My little conspiracy theory is that Netanyahoo’s meeting with Saudi Arabia two weeks ago was, in part, to get Saudi buy in on the assassination and to agree on what to pay Trump if he starts an Iranian war. Trump’s strange DoD personnel changes after the election appear to insert loyalists in the chain of command who would follow Trump’s order to start such a war. Obviously war with Iran would be yet another huge distraction from Trump’s disastrous Covid-19 response.

Two small election footnotes. One is the letter of ascertainment Emily Murphy of the GSA sent to the President-elect. In the letter, Ms. Murphy informs Biden that the GSA will provide resources for a presidential transition. It’s a small thing, but her salutation is “Dear Mr. Biden” rather than “Dear President-elect Biden.” While Ms. Murphy asserted at length in her letter that the delay in her ascertainment had nothing to do with White House political pressure, her salutation has the White House’s fingerprints all over it. It is not Ms. Murphy who is refusing to address Biden as President-elect.

The other is how this election affected my writing. My mind keeps working on my writing long after I step away from the keyboard. How do I know? Most mornings when I’m working on a piece, I wake up with a few ideas. It’s a little freaky. For instance, I’ve woken up and thought of a specific word change in the middle of a hundred thousand word novel. Lately, though, I’ve had a mental block. My strange mind games stopped for the past few anxious months. The block stopped Monday night, the night it was clear Biden had the electors needed to win, the night it was clear Ms. Murphy would have to ascertain the election. After months of waking up without new ideas, Tuesday morning, I woke up with two ideas for my novel.

I will credit Trump with keeping Covid-19 off many people’s minds. About 30% of American’s minds, to be more precise.

How worried Americans have been about Covid-19. Source: fivethirtyeight.com

Americans are more worried about the economy than about Covid-19. Unlike Europe where governments are prioritizing Covid-19 containment, Trump has prioritized the economy over Covid-19 containment. The results speak for themselves.

Food lines in the US. Source: USA Today.

Food banks are broken and about two percent of US households (roughly 10% of the population) face homelessness in a month if the eviction moratorium isn’t extended.

A big problem is that Trump continues to foster a culture of social media misinformation. Yesterday, a right wing pundit I follow posted on Facebook this NPR story:

Covid-19 social media post for NPR story:”Government Model Suggests U.S. COVID-19 Cases Could Be Approaching 100 Million.”

There are a few of problems with the poster’s comment, “If so, the fatality/hospitalization rate is much lower than we thought.” One is that IFR is more useful than CFR. I calculated IFR using the CDC’s assumption that there are eight Covid-19 cases for every one case confirmed. Using the excess deaths for the US rather than the confirmed Covid-19 deaths, I came up with an IFR just shy of 0.4%. That compares with an IFR of 0.1% for flu. In other words, Covid-19 is four times more deadly than the flu and much more contagious.

Another problem with the post is the implication that, with this new CDC model, the US must be doing great managing Covid-19. As the Johns Hopkins chart above shows, the US is among the worst in the world at containing Covid-19. It would be nice to think that the US has much better outcomes caring for Covid-19 patients than the rest of the world. Even if that were true, it’s hard to believe it would continue to be true as Covid-19 cases swamp US healthcare systems.

Yet another problem is that this post focuses on one data point that, in the scheme of things, isn’t that important. What’s important? Hospitals and ICUs are out of beds and low on healthcare workers. At this point, IFRs and CFRs are a distraction. You can rationalize as much as you want about how well the US is managing Covid-19, but scarcity of healthcare resources is the high order bit, as they say, for US healthcare right now.

In my mind, the biggest problem with the post is cherry-picking a data point and sharing a conclusion as though it’s a fact. As you can see from the post, it got a lot of engagement in a day. Trump has encouraged social media behavior that challenges experts. This post is an example of how smart people post with bad consequences.

Why do I care? There are vaccines on the way!

First, I think the vaccines are likely to get Covid-19 under control in the developed world by the end of next year. But there are a lot of caveats.

While we have lots of evidence that vaccines are safe, we don’t really know short- or long-term effects of newer techniques used for mRNA and viral vectors vaccines. For example, an HIV vaccine candidate that used an adenovirus as a vector ended up making people more susceptible to HIV for reasons that aren’t understood, but probably have to do with the vector rather than the payload.

There’s also a problem with viral vectors that the immune system probably will raise immunity to the vector. That may explain why different dosing of the Oxford/AstraZeneca vaccine had such different effectiveness outcomes (a smaller initial dose may have raised less adenovirus immunity allowing the second dose to work better).

The mRNA vaccines have known cold storage issues that make distribution to most of the world’s population problematic or impossible. If most of the world’s population can’t get vaccinated, Covid-19 becomes an ongoing health problem.

Unrelated to vaccines, it’s not clear yet that everyone is clearing Covid-19. Here’s a good thread on that topic.

Like many viruses, it appears that covid-19 is hanging out in some people resulting in long-term infections. There also are plenty of documented cases of reinfection. As the pandemic spins out of control in the US, giving the virus plenty of opportunities to mutate, viral persistence and reinfection are growing wild cards for Covid-19 vaccine performance.

Covid-19 bits.

After my Black Friday exploration in Barcelona, I have a shopping tip for my readers. If you’re having trouble finding just the right gift, scented candles always make a nice holiday present. This year, they double as a Covid-19 detector. In fact, scented candle reviews on Amazon have turned out to be a good proxy for the general state of Covid-19.

I’ll leave you today with this sentimental German Covid-19 PSA.

I write this for my sanity. If you like it, please pass on to friends and family. For more frequent updates, follow me on Twitter. Stay safe!

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