3 January 2021 – Sunday – #128

The weather was a meteorological metaphor this week, strong winds blowing incessantly the final days of the 2020 to clear the Covid-19 taint from the air, then a cool sprinkle on New Year’s Day to cleanse celebratory hangovers, and finally a blushing New Year’s Day sunset to set the stage for 2021.

After sunset, I met Cristián in Barceloneta. We took a late New Year’s Day stroll along the Mediterranean.

Mediterranean Sea, late on New Year’s Day 2021.

The night before, on New Year’s Eve, Brad and I hosted Will and U.b. for a quiet dinner at Casa Solar. Four people for a celebration seemed reasonably safe, well within the current limit of six people for a social gathering.

Others had trouble with the idea of limiting their party to six, not to mention limiting their travel. 40-km (25 miles) up the coast from our dinner, there was a New Year’s rave in Llinars del Vallès. Reportedly 400 people from as far away as France, Belgium, and Holland attended.

Llinars del Vallès New Year’s Eve rave report.

The rave was organized on social media. No Covid-19 protocols were followed and it took two days for the police shut it down. With cases in Catalonia rising again, this rave seems like an avoidably irresponsible way to start 2021.

Catalonia Covid-19 cases per 100,000 for most recent 14 days. Source: Catalan News.

Of course, Catalonia wasn’t alone. In France, police broke up a two day New Year’s rave in Britanny that included 2,500 people.

New Year’s Day is a time for looking back and looking forward. New Year’s Day 2021 brought many retrospective pieces on Covid-19. My favorites were in The New Yorker (fans of the New Yorker’s old in-depth articles will dig this reporting), The Atlantic (everything Ed Yong writes is worth reading), and Politco (Trump’s dismantling of CDC, replacing scientists with political hacks).

What rang true in each of these articles is the importance of leadership, institutions, and preparation. I’ve harped about the importance of leadership in combating Covid-19, but public health and scientific institutions are other key elements of pandemic response. Good leadership without expertise and experience is like sword fighting with a wet bucatini.

These three articles provide example after example of Trump disassembling institutions with the expertise and experience required to respond to Covid-19, usually in the name of efficiency or better management. One of my hypotheses is that less developed countries are responding better to Covid-19 because, in order to deal with endemic disease and previous viral outbreaks, they maintain strong public health institutions.

Trump’s response sidelined government resources and relied on big pharma and the US healthcare system to manage Covid-19. While big pharma has delivered the vaccine, there is no coordinated system in place for its administration. The US for-profit healthcare isn’t designed for overwhelming numbers of sick people or for prevention. There is, for example, no test and trace in the US healthcare DNA. Trump dismantled non-profit parts of the US healthcare system like the CDC leaving for-profit parts lacking the requisite experience or expertise for the systematic shock of a pandemic.

Getting back to the Retrospection Department, the worst Covid-19 predictions came from none other than Trump.

Trump’s numerous 2020 Covid-19 predictions. Source: Politico, “The Worst Predictions of 2020.”

The bad news is that all of Trump’s Covid-19 predictions were wrong. It didn’t just “go away.” Instead, the US reached 20 million cases on New Year’s Day. The good news is that Trump keeps repeating another prediction: he’ll stay in the White House.

I hate looking forward right now. Sure, the Covid-19 vaccines are effective, but Covid-19 news was bad last week and is likely to get much worse for a couple of long winter months.

First, cases are rising in North American and Europe with colder weather (Covid-19 is more stable in colder weather) and holiday gatherings (more transmission opportunities). In the US, hospital bed maps are replacing weather maps.

Percent of US hospital beds occupied by Covid-19 patients. Source: National Public Radio.

Second, the new UK Covid-19 strain is really bad, portending future Covid-19 bad news. As this Twitter thread discusses, the reproduction rate R in this strain may be nearly double previous strains.

The UK B117 strain is spreading everywhere despite efforts two weeks ago to close down transportation lanes to the UK.

The news on the new South African Covid-19 strain doesn’t look good either, but there’s a dearth of information so far. What is clear with available information is that significant mutations in the South African strain may require a rework of Covid-19 vaccines.

Sir John Bell on the emerging South African Covid-19 strain.

South African researchers also are trying to determine if the new Covid-19 strain there is causing reinfections. “What doctors don’t know, [a Tygerberg Hospital spokeswoman] said, is whether these repeat positives are due to true reinfections, or to some people carrying the virus for a longer time.”

The final bit of bad Covid-19 news from last week is that the US vaccine rollout is slow. After Trump announced pre-election that the US would administer 100 million vaccine doses in 2020, and then scaled down his estimate post-election to 20 million doses in 2020, the actual number injected at year’s end was closer to 3 million. That number has increased to 4.3 million today. The US needs to deliver about 3 million doses per day (25-30 times more doses per day than it’s currently delivering) in order to achieve herd immunity this year.

It’s too early to tell about Europe vaccine rollouts since EMA Covid-19 vaccine approval came late in December and shipments started last week.

If the Covid-19 vaccine rollout is slow, one way to fix that might be to postpone the second dose so more people get first doses. UCSF’s Bob Wachter has suggested that, as has Professor Akiko Iwasaki in this Twitter thread.

The UK has adopted this approach. For now, though, it looks like Dr. Fauci wants to stick to the protocol that vaccine makers have tested (n.b., there are conflicting news reports on Fauci’s position).

One final end of year topic: Covid-19 disinformation. This is largely a US problem (European disinformation ROIs aren’t as good because the market is fragmented by language). Disinformation is a problem that extends well beyond 2020 and well beyond Covid-19.

The Guardian had a good year-end review of US disinformation, including Covid-19.

Mainstream media outlets still follow a traditional top-down broadcast model: an authoritative source produces the news and sends it out to consumers. The rightwing media ecosystem, which developed through talk radio, on the other hand, operates as a network of media personalities interacting with each other, “a community telling stories to their own community”, [Claire Wardle, the executive director of First Draft] said.

The Guardian, “Facts won’t fix this: experts on how to fight America’s disinformation crisis,” 1 January 2021.

Fox News is the bedrock of US conservative media. Evidence of its Covid-19 disinformation isn’t hard to find. From the 2020 Retrospection Department, here’s Tucker Carlson’s extensive 2020 Covid-19 disinformation.

The latest salvo in the conservative echo chamber is a faux debate about whether Covid-19 skeptics are being classified unfairly as Covid-19 deniers. The disinformation problem isn’t about skeptics versus deniers. It’s about owning the narrative and about the agenda of those who own it.

Stock markets are one place to look for disinformation correction. Will Covid-19 just go away? Is it something we shouldn’t worry about? What do funeral stocks tell us?

Zacks one year industry performance, Funeral Services vs Internet Commerce vs. SP500. As of 3 January 2021. Source: Zacks.

First of all, the market clearly prefers living consumers who buy stuff. While Covid-19 lockdown skeptics say that the economy won’t come back with lockdowns in place, the numbers show online commerce performing well above the market. More generally, industries that can conduct business online are doing fine.

With the long delays in funeral services due to high numbers of Covid-19 deaths, I would have thought the funeral industry would be booming, too. As I dug a little deeper, though, I found out that profit margins are sliding into the ground as consumers switch from formal memorial services with caskets to simpler cremation.

Rising demand for cremation over traditional funerals has hurt revenue per client in the funeral services space. Cremation costs significantly lower than traditional funeral, with the average cremation service cost being roughly $2,500. In fact, we note that the pandemic has fueled this trend, with families choosing cremations over the elaborate traditional funerals.

Nasdaq Latest News, “Rising Demand Keeps Funeral Industry Going: 4 Stocks to Watch,” 29 September 2020.

Part of the problem, of course, is that people can’t travel to funerals, so there’s less demand for elaborate services. Ironically, this suggests that the funeral industry, which is not inherently online in any sense, would benefit from lockdowns. Like many industries, if Covid-19 levels subsided and people felt comfortable meeting in person (with masks on, of course) in places like funeral homes, then profitability would increase even if fewer people went in the ground.

Covid-19 bits.

Happy New Year! Here’s a salute to you from our Casa Solar celebration.

Steven, Brad, Will, and U.b. celebrate New Years at Casa Solar.

I know you’ve been wondering why I used the awkward “wet bucatini” reference above. It has nothing to do with our New Year’s dinner. It’s because of the 2020 bucatini shortage. Yes, that’s right. Toilet paper was not the only critical shortage in 2020, at least in the US. Still not sure whether the bucatini shortage was due to Covid-19, but Covid-19 herd immunity might come before the bucatini shortage is resolved.

I write this for my sanity and to make a long-form record of living during the time of Covid-19. If you like it, please pass on to friends and family. For more frequent Covid-19 updates, follow me on Twitter.

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