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.

27 December 2020 – Sunday – #127

There are a couple of odd Christmas traditions in Catalonia, el Caganer y el Caga Tió. Ruben taught these to Brad and me when we arrived last year. The polite way of explaining el Caganer is that he’s a pastor symbolizing fertility, but fertility in the sense of fertilization. As in, how to say this tastefully, taking a dump.

At Casa Solar, we had un Caga Tió. Tió in this case is not an uncle (that’s tío in Spanish), but a log (in Catalan), and, in the case of Caga Tió, a log that Catalan children feed and then hit until it poops Christmas presents.

Caga Tió at Casa Solar.

Not sure why the scatalogical fixation in Catalonia, but word is that the log got a face upgrade to make it easier to feed (and to compete with Santa Claus in retail). The Catalan traditions make as much sense, of course, as a man in a reindeer powered sled who slides down chimneys to deliver presents.

Although Brad and I didn’t feed or hit our Caga Tió, I, for one, believe it’s entirely responsible for the Pfizer’s Covid-19 vaccine that showed up in Spain for Christmas.

In the tradition of celebrating Christmas as an extended marketing event, the Spanish government has outdone itself with its Covid-19 Christmas wrapping paper. Spain and other countries moved quickly to deploy the Pfizer vaccine after EMA gave it full approval (not a EUA) last Monday. Not to be outdone by EMA and in the holiday spirit, the Vatican also gave the new Covid-19 vaccines its blessing, even if some of the underlying technology uses fetal tissue.

The first vaccination is like the immaculate conception. Every country has its iconic first vaccination Tweet. It’s the contemporary Madonna and child. Here is the Spanish first vaccination from Prime Minister Sánchez this morning.

Given the way Covid-19 numbers have risen since restrictions were relaxed at the beginning of December, the Spanish government can use good Covid-19 P.R. In the days before Christmas, Spanish regions started clamping down again. In Catalonia, restaurant hours have been cut back to two hours in the morning and two hours in the afternoon. Para llevar is allowed any time, so many restaurants continue serving in the evening from their front door. Travel is limited again, curfew at 10p (except Christmas Eve and New Yearś Eve at 1:30a), and social gatherings cannot exceed six.

Caga Tió gave us another Christmas present. US vaccine surveys show that Covid-19 vaccination attitudes are changing as actual vaccine arrives. “In polls by Gallup, the Kaiser Family Foundation and the Pew Research Center, the portion of people saying they are now likely or certain to take the vaccine has grown from about 50% this summer to more than 60%, and in one poll 73% — a figure that approaches what some public health experts say would be sufficient for herd immunity.”

Word of caution: Lots of debate about what percentage of the population needs vaccinations to achieve Covid-19 herd immunity. Second word of caution: I’m still encountering lots of vaccine misinformation on my social feeds.

One last Christmas present, an amazing jamón serrano from Jim, all 15 lbs of it. Our small Christmas Eve orphans’ dinner started by learning how to carve el jamon. We needed vocabulary lessons for parts of the ham and carving equipment. If you’re in the mood to give a late Christmas present, we still could use carving lessons. The best maestro cortador charges €4,000 to slice a jamón. It’s an art that takes practice.

Jamón serrano at Casa Solar.

Our Christmas Eve feast included roast chicken and artichokes. Alexa, who’s returning to Germany soon, cooked up excellent German sauerkraut and mashed potatoes. For dessert, Cristián made a delish German-style vegan berry tart and Amy brought creamy tiramisu. Brad survived his first Christmas intact.

Most of the Covid-19 news before Christmas sensationalized new virus strains from the UK (reportedly more transmission in children, stronger binding) and South Africa (reportedly more virulent, higher viral load). Bottom line is that more study is needed of both new strains to characterize their virulence and transmission.

The UK strain got more press as countries stopped travel to the UK to contain the spread. That didn’t work very well. In addition to cancelled holiday flights, around 3,000 lorries transporting Christmas goods were stuck when their continental passage was denied. In spite of the UK transportation bans, the new strain has been detected around the world. For the UK, the whole debacle seemed to be a preview of life after next week’s Brexit.

The new strains brought up questions about Covid-19 vaccines. Specifically, will the current vaccines work as the virus mutates? The answer is that Covid-19 vaccines are based on so many proteins that a handful changing shouldn’t change effectiveness significantly.

The question is, is this virus going to change the surface proteins in a way that can obviate either the vaccines or prior immunity, and there’s no indication that it’s doing  that right now, but over time it will evolve in ways where it can probably obviate prior infection or vaccines to some degree, so we’ll probably need to adapt our vaccines over time.

Former FDA chief Dr. Scott Gottlieb, CNBC, “‘I think this is already in the U.S.,’ Dr. Scott Gottlieb says of new U.K. Covid strain” 21 December 2020.

If you want to get into the weeds, here’s a good Twitter thread about “antigenic drift,” the dance between the mutating virus and vaccines.

To me, the bigger question is whether Covid-19 IFR will change as the virus mutates.

Marc Bevand, comparison of Covid-19 and flu IFR by age based on several studies. Source: https://github.com/mbevand/covid19-age-stratified-ifr

The only way we know how IFRs change is to measure each new dominant strain. The risk of letting the virus essentially run wild is that more infections lead to more mutations and to more uncertainty about vaccine effectiveness and IFRs.

If you’re a software nerd who wants a software explanation of how Covid-19 vaccines work, Brad passed me this article on reverse engineering the BioNTech mRNA code. Even if you’re not a software nerd, the technology is impressive.

Since it’s the end of 2020 (thank goddess!), I’m going to post a year end review of Covid-19 mortality.

Cumulative Covid-19 deaths per million by country. Source: Australian Broadcasting Company.

This chart is based on confirmed cases. The actual Covid-19 deaths for countries at the top of the chart are much higher according to excess death statistics. At the end of the year, it looks like the US did end up copying Sweden as so many anti-lockdown pundits recommended. Too bad.

One local Covid-19 note: there sure is a lot of road construction going on around Barcelona. Not far from Casa Solar, Avinguda Diagonal is completely closed at the intersection of Passeig Sant Joan. This is like closing Broadway at 42nd Street in New York City, or Market Street at Van Ness in San Francisco, or the 405 in Los Angeles.

Road construction on Av. Diagonal

Brad mentioned that during the pandemic, while there is so little traffic, San Francisco has prioritized all approved and funded infrastructure projects that slow traffic. I suspect Barcelona is doing the same thing.

Covid-19 bits.

I arrived in Barcelona on the first of January, so this coming week I’ll celebrate my first anniversary living here. This article, 72hrs in Barcelona, describes the city I expected to enjoy in 2020. It’s a quaint read now. Covid-19 has changed life here and everywhere. I feel lucky to have met so many great people in spite of the Covid-19 restrictions. Going forward, Barcelona seems like it will be a little less touristy than it used to be. I can’t wait to enjoy more live events and to travel around Spain and Europe more.

It’s not only the winter holiday season, it’s also still 2020. That, and I’m living in the land of scatalogical Christmas symbols. So what more perfect way to end this Christmas blog post than a touching Covid-19 fecal transmission story.

Covid-19 fecal airborne transmission.

I write this to create a long form record of life during the Covid-19 pandemic. If you like it, please pass it on to friends and family. For more frequent Covid-19 updates, please follow me on Twitter.

Until we reach herd immunity, please wash your hands, keep your distance, and wear a mask.

Happy New Year from Barcelona!

20 December 2020 – Sunday – #126

Happy Winter! ¡Feliz Invierno!

Pork for sale in Gracia.

As the northern hemisphere transitions from Fall to Winter, transitional stress is upon us. Stress is normal during the holidays, but this year I’m feeling stress that’s different from normal.

The stress of not whether, but when new restrictions will be announced as Covid-19 numbers rise again. The stress of risky gatherings during a normally social holiday season. The stress of living with a deadly virus not knowing how many months until vaccinations. The stress of an unending political transitions.

What did I do in the midst of all my stress? I had the most social week I’ve had since March.

It started when Brad and I had an impromptu latke night to celebrate Hanukkah.

2020 latkes!

We improvised with Greek yogurt for sour cream and apple compote for apple sauce. Delish.

Two other dinners at Casa Solar this week. My friends Ana and Alexa are returning to their homelands, Ana to Mexico after nearly a dozen years here and Alexa to Germany after five years. Happy for their new adventures, but sad to see friends leave. How could I not celebrate and share a dinner with each of them? It reminds me of myself a year ago, staying at Ebet’s place on the Upper West Side and celebrating with friends as I prepared to move to Barcelona.

Wednesday I took a trip up to Canet de Mar to see friends. It’s been months and it was great to catch up, but there’s the stress of the hour train ride as Catalonia’s Covid-19 numbers rise again. Most of the high school boys who boarded near the end of my journey wore masks, but not the class cutups. Stress.

Here is a graph of my stress. The Covid-19 reproduction rate R and Outbreak risk here look as bad as they looked in October when Europe’s second Covid-19 wave started in earnest.

Catalonia Covid-19 reproduction rate R (yellow) and Outbreak risk (blue), 18 December 2020.

At the beginning of this month, Catalonia allowed bars and restaurants to reopen and relaxed retail capacity restrictions. People want normal life, especially during the holidays. The numbers rose again. It looks like new restrictions will be coming soon.

This week’s final social event was yesterday when I met Cristián for coffee at SandwiChez. We sat outside, which felt relatively safe, if a bit brisk. Even though the tables inside were well spaced, it felt like a Covid-torium with a large room of maskless people and no fresh air ventilation. I spent as little time as possible inside ordering.

After my final social event of the week, I walked along Rambla de Catalunya looking for Christmas decorations.

Holiday shoppers on Gran VIa and Passeig de Gracia in Barcelona, 19 December 2020.

Masked shoppers were out in force. I felt a little uneasy waiting in line for the cashier with my hands full of ornaments, but at least there was a breeze as shoppers entered and exited the store.

Everyone seems to be sneaking in as much shopping and social life as they can before the next restrictions come. It’s like everyone knows a vaccine is coming and they’re playing a game to see how much they can get away with while waiting for shots. The stress of restrictions is bumping heads with the relief of a vaccine, so people are questioning more and more what restrictions are fair and necessary.

For instance, here’s a report from Madrid about the Rafael concert last night.

Matthew Bennett on the Raphael concert last night.

During 2020, while most US states let Covid-19 run wild, most European countries put in place restrictions as outbreaks occurred. The difference couldn’t be clearer (this chart is through the first week of December).

Covid-19 cases per million, US versus EU as of 11 December 2020. (Source: @euromaestro)

There’s no question most US states won’t impose any serious Covid-19 restrictions this winter. The question is whether any European countries can impose restrictions again with Covid-19 vaccines around the corner.

Beyond unnecessary deaths, there are significant costs to allowing Covid-19 spread. One is that high infection rates slow down economies. When people are sick and dying, they can’t work. Another is that the virus has more opportunities to mutate.

And guess what? This week UK detected a new strain of Covid-19 that’s 70% more transmissible.

In response, Prime Minister Boris Johnson raised Covid-19 restrictions and, in an attempt to contain the new strain to the UK, will keep anyone from traveling out of areas where the new strain is detected. Likewise, Scottish First Minister Nicola Sturgeon raised Covid-19 restrictions in response and asked Scots to remain at home for Christmas.

Officials say there is nothing about the new strain that indicates so far that it has different mortality characteristics or a different response to vaccines. My guess is that it’s too early to know that for sure. I don’t have to guess about more strains appearing as the number of cases skyrockets worldwide.

Will government requests to stay home work? Last week, I posted German Chancellor Merkel’s heartfelt appeal to stay home during the holidays. Spain has issued stay home requests. So has the US CDC.

US air travel numbers indicate that at least US travel isn’t creeping up to last year’s levels.

US Air Travelers per Day, 1 November through 18 December. Source: TSA

It would be better to see 2020 numbers declining rather than tracking at about half of last year’s numbers. If Thanksgiving is any indication, these travel statistics indicate many US families will be sharing their final Christmas together.

Vaccines are coming, but it’s months until their effect reduces the need for Covid-19 restrictions. The UK, Canada, and the US have started administering Covid-19 vaccinations. Spain expects to distribute Covid-19 vaccine as soon as the EMA approves use of the Pfizer / BioNTech vaccine, probably the last week of December or first week of January 2021.

The US vaccine rollout shows the main reason we shouldn’t let down our guard: the logistics of providing hundreds of millions of injects are hard. I was worried that the lack of communication from Trump about his Covid-19 vaccination plan meant there wasn’t a solid plan. More and more, that seems to be the case.

Rachael Maddow on US Covid-19 vaccine debacle.

On Friday, General Gustave Perna said that a Pentagon computer model used to plan distribution was the source of the distribution problem. One report said that the model was still using simulation data until last week when actual data was loaded. Although it appears doses of Pfizer’s vaccine still are sitting in warehouses awaiting instructions from Trump where to send them, Perna says 20 million doses will be delivered to states by the first week of January.

Paint me skeptical.

For one thing, Trump is still focused on winning the election. On Monday, the Electoral College gave President-elect Biden 306 votes to Trump’s 232, and Republican senators finally acknowledged Biden’s win. However, Friday evening, Trump was planning a coup with his voter fraud legal strike team lawyers Rudy Giuliani and Sydney Powell as well as with disgraced General Michael Flynn. Flynn wants Trump to declare martial law in states that voted against Trump and have the military re-run those elections. It’s an understatement that Trump is ignoring Covid-19 vaccine delivery problems. The US will be lucky if Trump’s coup plan goes as well as his Covid-19 vaccination plan.

Besides distribution, another problem with the US vaccination effort is local administration. One example comes from Stanford University. There the hospital prioritized vaccinations for doctors who primarily work from home right now while failing to offer vaccines to residents working with patients daily. After protests, the university apologized and adjusted its vaccine allocations. This seems like the kind of problem that a well run vaccination effort would have anticipated.

The beginning of the vaccination process should be the easiest because the low-hanging fruit (healthcare workers and retirement homes) are easy to target. Trump can’t even seem to get that job done. President-elect Biden takes office in 31 days. The inauguration probably will mark the actual beginning of the US Covid-19 vaccine distribution program. It would be difficult for other countries’ governments do a worse job than the US, but it’s likely most programs at this scale will have hiccups.

Vaccines are many months away. We will be better off complying with ongoing Covid-19 restrictions.

Now for a quick trip in the time machine! Nine months ago, here’s what Goldman Sachs wrote to its clients about the emergence of Covid-19.

Goldman Sachs memo to clients, March 2020My commentary
50% of Americans will contract the virus (150m people) as it’s very communicable. This is on par with the common cold (Rhinovirus) of which there are about 200 strains and which the majority of Americans will get 2-4 per year.Overestimates spread. Covid-19 very different from Rhinovirus.
70% of Germany with contract it (58m people). This is the next most relevant economy to be effected.Spain is now around 10%, so Germany probably less.
Peak-virus is expected over the next eight weeks, declining thereafter.Implies reach of 50% of US and 70% of Germany in 10-12 weeks.
The virus appears to be concentrated in a band between 30-50 degrees north latitude, meaning that like the common cold and flu, it prefers cold weather. The coming summer in the northern hemisphere should help. That is to say the virus is likely seasonal.Ecuador is a counterexample to both latitude and cold weather.
Of those impacted, 80% will be early-stage, 15% mid-stage, and 5% critical-stage. Early-stage symptoms are like the common cold and mid-stage symptoms are like the flu; these are stay at home two weeks and rest. 5% will be critical and highly weighted towards the elderly.Early characterization of Covid-19 as old person’s disease.
Mortality rate on average up to 2% heavily weighted towards the elderly and immunocompromised; meaning up to 3m people (150m * .02). In the US about 3m/yr die mostly due to old age and disease, those two being highly correlated (as a percent very few from accidents). There will be significant overlap, so this does not mean 3m new deaths from the virus, it means elderly people dying sooner due to respiratory issues. This may however stress the healthcare system.The US probably will reach about a million Covid-19 deaths over a much longer period.
Goldman Sachs memo to clients, March 2020.

What’s striking in this early Goldman Sachs language is how it writes off old people. This appears to lay the foundation for the idea that it’s okay to achieve herd immunity by letting Covid-19 run wild. It suggests old people will just lose a few years and the whole thing will be over in a matter of two or three months.

Contemporaneously, Richard Epstein from the Hoover Institute published a paper called “Coronavirus Perspective.” Among other things, Epstein argued that adaptations would thwart the virus and the virus’ effect would be small as a result. Epstein is a lawyer, not an epidemiologist. Still, his paper found favor with Trump, probably because it discounted Covid-19’s virulence.

Based on his non-scientific analysis, Epstein explained in a New Yorker interview from late March 2020 how Covid-19 would evolve.

“So, in the United States, if you start looking at yesterday’s figures, it was about two per cent higher than the day before, which is already indicating that the speed-up is slowing down. We’re going to have to see what the next days do. But we’re talking ten thousand cases a day at the current maximum, and the flu was vastly larger in terms of its number and its extent. And my sense is, given the reactions that you’re going to have, this thing will peak earlier and start to decline earlier than the common models start to say, because they don’t seem to build in anything by way of adaptative responses.”

None of Epstein’s Covid-19 predictions were correct, but they also laid the foundation for doing nothing but let the virus run wild.

A month later, the Stanford epidemiologist John Ioannidis argued that lockdowns were the wrong approach, that it would be better to protect the elderly and let everyone else carry on. Ioannidis also authored the controversial Stanford study that claimed Covid-19 spread was much higher than thought and, by inference, Covid-19 IFR was much lower than thought. Ioannidis’ study was flawed, but it lent credibility to Trump’s claims that Covid-19 was going to go away.

A better US response would have been to increase testing so that policy could be designed based on better reporting. In retrospect, these three influential reports provided fodder for policies that resulted in hundreds of thousands of unnecessary deaths.

Covid-19 bits.

Last, I’d like to leave you with the Tracies who are tracing you.

Merry Christmas! I write this for my sanity, not for money. If you like it, send a link to your friends and family as a holiday gift! Follow me on Twitter for more frequent updates.