12 July 2020 – Sunday – #103

A taste of social life in Barcelona after the Covid-19 lockdown.

Yesterday Ana prepared a BBQ feast at Casa Solar. The night before, on Friday, we went shopping for hamburger meat, chicken wings, avocados, watermelon, and other summer treats. Ana knows the Gracia markets like that back of her hand. She showed me her favorite butchers, produce stands, and Mexican supply stores. These are things that are hard to learn during confinement.

Another thing that’s hard to learn during a lockdown is local restaurants. There are many and the locals are a perfect shortcut to finding the best. After shopping, Ana took me to Entrepanes Díaz for a late meal. I say “late,” but it was only 9pm. As the sun was setting, the place was starting to fill up, nearly everyone sitting outside.

Sorry my food porn is mid-stride, but you get the idea.

Tapas and vermut at Entrepanes Díaz, 10 July 2020.

The mashed potato and beef tail dish at the top left is a Spanish version of shepherd’s pie spiced with a picante sauce. The ubiquitous roasted peppers and pan tomate should be familiar to Spanish diners. The little oval shells are what remains of tallarinas, a sort of micro-shellfish, in a green olive oil sauce. The crunchy micro-shrimp from down the coast are eaten whole. Not in the photo is a fish similar to a sardine, but smaller. Later came the perfect chocolate dessert a la mode. Since you asked, all this (with two drinks each) came out to a little over US$40 a head.

The hardest part about the BBQ itself was the guest list. I’m trying to limit social events at Casa Solar to ten. Covid-19 is a numbers game and the best way to avoid a scandalous news story about hosting a superspreading event is to limit headcount. Infections are going to happen. Spain has 73 active outbreaks right now and recorded 241 new Covid-19 cases on Thursday.

We’re not out of the woods. Normally, I’d do an email blast to friends and anyone could come to the BBQ. Coordinating with Ana, we were adding one guest at a time until we got to eight confirmed and a few “maybe’s.” We ended up at eleven. So far, it hasn’t turned into a scandalous superspreader event, or even a scandalous event, for that matter.

Then comes the awkwardness of greetings. I’m all in on the elbow bump, but some guests go for the traditional kiss on each cheek. I’m learning to extend my elbow quickly and grin before a guest gets close. Usually the elbow bump suffices for the traditional peck. Once people are inside, masks come off. There’s good cross-ventilation at Casa Solar and the terrace seems safe with a gentle breeze carrying away any possible viral load in a whirl of hot charcoal smoke.

Although I’ve witnessed parties at neighbors’ terraces across the street, I wasn’t quite sure about Spanish BBQ protocol. It turns out these events extend the entire afternoon. I learned from guests more than I’ll ever remember about BBQ timing of various Latin cultures, except that for Argentinians it seems that the drinking and cooking is the main event and, after a few hours, the eating is practically an afterthought. An afternoon of partying was fine by me after the last few months’ lack of social life.

The festivities didn’t stop after the BBQ. I walked with Laura, Jacob, and Joan Miguel to an outdoor concert, my first live concert since March.

Cruïlla XXS outside Teatre Nacional de Catalunya, 11 July 2020.

Like all performing arts organizations, Cruïlla is figuring out how to navigate a post-lockdown environment. The ensemble played a medley of pop hits meant to draw a large audience. No wind players to spread virus onstage. A few of the string players wore masks. As you can see in the photo, the audience was well distanced. There were 400 tickets available. My unofficial count was about 200 sold. I’m not a huge fan of pop music concerts, but it still was transformative to sit outside and enjoy a live concert after so many months without live performances. The only reminder of Covid-19 was wearing a mask. Catalonia requires masks now in public spaces. No one here is protesting.

Other arts organizations are coming to life, too. There are a number of museums I hope to visit soon. MACBA, Barcelona’s contemporary art museum, is trying live performance to draw an inside crowd.

The worst part of living in Barcelona right now is reading Covid-19 news from the US. Sure, Spain has its problems. We’ll know by the end of this month whether Spanish public health authorities can control the inevitable Covid-19 outbreaks. There were rumors at the BBQ of more lockdowns this fall.

The US, on the other hand, seems stuck in a summer rash of uncontrolled Covid-19 outbreaks. Remember the wishful thinking that Covid-19 was seasonal, like the flu? It seems that air conditioning may be the way that not only southerners beat the hot weather, but also Covid-19 does as well.

One issue for the US is partisanship. Dr. Fauci calls out partisanship explicitly as a deterrent to the US Covid-19 response. The Covid-19 response probably seems to Fauci like a replay of Reagan’s response to HIV / AIDS.

Masks are one example of unnecessary partisanship. Trump and his supporters decided masks should be a partisan rather than a public health issue. Then Trump wore one.

The question is why Trump waited to wear a mask in public until 157,000 Americans died. The thing that got Trump to wear a mask wasn’t the death toll or the public health recommendations. He finally wore a mask a few days after Goldman Sachs predicted mask usage would give a trillion dollar uplift to the US GDP. Masks were partisan until they were economic.

Another issue with the US response to Covid-19 is the incompetence of the Trump administration. Besides the obvious problem of lobbying states to re-open early rather than follow CDC re-opening guidelines, Trump still is promoting hydroxychloroquine while missing obvious treatment opportunities like blood plasma.

[Dr. Michael] Joyner, of the Mayo Clinic, said there are probably 10 million to 20 million people in the U.S. carrying coronavirus antibodies — and the number keeps climbing. If just 2% of them were to donate a standard 800 milliliters of plasma on three separate occasions, their plasma alone could generate millions of IG shots for high-risk Americans.

Los Angeles Times, “A plasma shot could prevent coronavirus. But feds and makers won’t act, scientists say,” 10 July 2020.

The US is also woefully behind in Covid-19 testing even as Trump orders less testing. A South Korean case study for tracking down Covid-19 exposures after a weekend Covid-19 flare up shows why.

The 58k Covid-19 tests South Korea encouraged in order to track down all possible exposures during one bar event represents 1/10th of the current daily Covid-19 testing capacity of the US. In other words, the US could track down exposures for 10 bar incidents in the entire country each day and run out of testing capacity.

Why increase testing capacity to enable testing and tracking? Even though it takes a lot of tests to “see” a small outbreak, it’s a lot harder to slow things down after an outbreak is easy to see.

If you don’t trust me that the US Covid-19 response is a complete failure, look at the numbers. Three million infected and 157,000 dead. These numbers are far worse than EU, even though the US had more time to prepare for Covid-19 and more resources to apply.

Here’s a chilling failure analysis written as though the NTSC were analyzing a wreckage of a doomed flight.

The United States still possesses the strongest economy in the world, its military is by far the most powerful, its culture is diverse, and, confronted with the vicissitudes of history, the country has proved resilient. But a veteran of the intelligence world emphasized that the coronavirus era has revealed a sobering reality. “Our system has a single point of failure: an irrational president.” At least in an airplane cockpit, the first officer can grab the controls from a captain who is steering the aircraft toward doom.

The Atlantic, “The 3 Weeks That Changed Everything,” 29 June 2020.

The US failure affects me even though I’m in relatively safe Spain. When I moved to Barcelona, I expected lots of visits from friends and family. My Barcelona friends told me that, unlike other cities I’ve lived in, when friends say they will come to Barcelona, they show up. Brad and I even set up a nice guest room. Unfortunately, the US Covid-19 response is so disastrous that a US passport has become nearly worthless.

Medium, “American Passports Are Worthless Now,” 9 July 2020.

It’s also nearly impossible for me to travel to the US. If my mother were to become seriously ill, assuming I could find a flight, I then would have to quarantine for 14 days before I could see her. If she were sick enough for me to fly, I’m not sure whether I could make it in time. It bothers me that this situation is preventable. My situation is minor compared to others.

A few of the odd medical and science tidbits this week.

To finish off this week’s post, I’m bringing you two dystopian remixes of the promotional video for this weekend’s opening of Walt Disney World in Florida. The first is the Walt Disney World opening as an A24 trailer

The second is the Walt Disney World opening to the Ligeti Requiem.

Which do you like better?

As an encore, here is a Twitter thread of videos from the re-opening of Walt Disney World.

Seems to confirm the Harvard study that high-income people care more about their safety than pumping cash into the economy.

I’ve started tweeting about Covid-19 daily. I’ll continue blogging weekly for now until I see what kind of progress I make with other writing projects and my Spanish language skills. Please sign up for email notifications if you want to know when I post here.

Thanks for following along!

5 July 2020 – Sunday – #102

Sweden tried something different with its Covid-19 response. It didn’t go well.

I don’t mean to make fun of Sweden. Sweden’s Covid-19 response favored its economy. A lot of smart people still make the claim that more people will die as a result of the Covid-19 economic downturn than die from Covid-19 itself and, so their reasoning goes, it is better to lose a few more souls to Covid-19 now than to risk an economic downturn that takes even more lives later. At the beginning of a pandemic, it’s not always clear how to make that particular cost-benefit trade-off and, to its credit, Sweden was clear about the trade off it chose.

Sweden had two other options known to work, to test, trace, and quarantine, and to lockdown. The former was known to work without major economic disruption, but only when testing and tracing capacity enabled the quarantine of most possible cases. South Korea, Taiwan, and Vietnam were early examples of successful test, trace, and quarantine implementations. In this mode, a country’s economy can operate until a treatment or vaccine comes along. Presumably Sweden, like most European countries, lacked the testing and tracing capacity to elect this option.

Sweden could have locked down like the rest of Europe. Lockdowns were known to reduce infection levels, but also known to wreak havoc on economies. China and Italy were early examples of successful lockdowns. Lockdowns reduce infection levels so that countries then can restart their economies while implementing test, trace, and quarantine. Besides reducing infection levels, lockdowns also limit severe Covid-19 cases that can overwhelm a country’s healthcare system.

Instead of test, trace, and quarantine or a lockdown, Sweden opted for herd immunity. Its public health goal was to keep the economy open and allow a Covid-19 “slow burn” until 60% of Sweden’s population was infected. At that point, enough Swedes would have immunity from Covid-19 that, while there might continue to be new infections, there could be no further disruptive outbreaks.

Unfortunately, the Swedish herd immunity experiment demonstrated that Sweden wasn’t able to save its economy by imposing significantly fewer Covid-19 restrictions than a lockdown. There are many reasons that might be true but, at the very least, we know from Sweden that minimal Covid-19 restrictions meant to keep an economy functioning do not lead necessarily to a better outcome than lockdowns, in terms of either lives or money.

Sweden per-capita Covid-19 mortality versus Scandinavian countries and Germany, 30 June 2020.

Sweden’s economy dropped about the same as its Scandinavian neighbors, but its Covid-19 mortality rate was significantly worse. There is no herd immunity. The measured infection rate of the general population in Stockholm last month was 7%, nowhere near the 60% infection rate (give or take, depending on your assumptions) needed for herd immunity.

It’s probably worse than that, though. There are many reasons the Swedish policy could have failed. It could be simply that the Sweden’s economy is so intertwined with its neighbors and the world that no matter what Covid-19 policy it enacted, its economy would decline.

However, a study from Harvard indicates that fear of Covid-19 infection caused most of the economic decline in the US. Based on reams of credit card and other economic data, the study found the culprits in the Covid-19 recession were high-income people who, fearful of Covid-19, stopped spending.

“The fundamental reason that people seem to be spending less is not because of state-imposed restrictions. It’s because high-income folks are able to work remotely, are choosing to self-isolate and are being cautious given health concerns. And unless you fundamentally address that concern, I think there’s limited capacity to restart the economy.”

Harvard Professor Raj Chetty, NPR, “Why Reopening Isn’t Enough To Save The Economy,” 23 June 2020.

In other words, regardless of Covid-19 policies, economic demand won’t return until high-income people feel safe or until someone invents new ways for them to spend their money during Covid-19 outbreaks.

The US Federal Reserve echos that finding more generally, saying the severity of the US economic downturn is tied to the resolution of Covid-19 outbreaks.

The Fed has repeatedly said the U.S. economic outlook remains highly uncertain and reiterated that a full economic recovery hinges on the battle to control the spread of the novel coronavirus, which has killed more than 127,000 people in the United States.

Reuters, “Fed revisits idea of pledging to keep interest rates low,” 1 July 2020.

At the time Sweden chose its Covid-19 policy, it couldn’t have known about the Harvard study, couldn’t have known that economic demand would drop off a cliff as long as Covid-19 was hanging around. Unfortunately, assuming rich Swede’s behave similarly to rich Americans, Sweden’s herd immunity policy choice exacerbated the very economic downturn it was trying to mitigate.

The Swedish Covid-19 experiment is an example of Covid-19 denialism, a way of sweeping Covid-19 under the rug as if something else was the problem, a rationalization to avoid change in the face of Covid-19. For politicians, Covid-19 denialism is an easy way out of asking for personal sacrifice when the payoff for such sacrifice is watching the economy tank while in social isolation. It’s also an easy sell before an outbreak, when an incipient exponential Covid-19 outbreak seems like something that only happens in other places.

Sweden is not alone in its Covid-19 denialism. It has good company in Brazil, Russia, and the US. Brazilian President Bolsonaro insisted hydroxychloroquine would mitigate the Covid-19 outbreaks as he kept Brazil’s economy open. Russian President Putin minimized Covid-19 by classifying deaths as pneumonia, but no one has seen an outbreak of pneumonia cause the depth of economic turmoil Russia now faces. Then there is the US.

Covid-19 per-capita mortality, US, Brazil, Germany, and Russia, 2 July 2020.

The world expected an exceptional Covid-19 response from the US. The US delivered, but not the way the world expected. The US had the CDC, the biotech industry, the money. It had advanced warning about the severity of Covid-19 and time to prepare. What could go wrong?

The US blundered through a Covid-19 plan both vague and poorly executed which, just as it was showing results, Trump cut short to appease his pro-business friends. Now the states that relaxed Covid-19 restriction early are facing a renewed surge in Covid-19 cases and deaths. The US is left with no Covid-19 plan, a sputtering economic recovery, and lots of happy talk from Trump.

“I think we’re going to be very good with the coronavirus. I think that at some point that’s going to sort of just disappear, I hope.”

Trump on Fox Business, 2 July 2020, as reported in “Virus will ‘sort of just disappear’: Trump has happy talk, but no plan.”

The cost of Covid-19 denialism is high in terms of lives and money for Sweden, Brazil, Russia, and the US. Denying that Covid-19 takes precedence over the economy misses the point that economic demand won’t grow until fear of Covid-19 diminishes so that high-income people boost demand. Losing a few more souls to Covid-19 now will not bring back the economy and save more people later on. Covid-19 has baked in that future loss of life already.

Last week the EU provided Brazil, Russia, and the US with a mirror to reflect on their respective Covid-19 responses. The mirror is in the form of travel regulations, the Covid-19 criteria a country must meet before it can send travelers to EU countries that have beat back the first wave of Covid-19. Residence of these three countries cannot travel to Europe, even rich ones who arrive on private jets.

This is, of course, a blow to US airlines that want to re-start intercontinental routes. Beyond that, it signals that if a country’s leadership won’t comply with its own public health recommendations, eventually either they comply or they isolate their countries from the world, further hampering their own economic recoveries. Sweeping Covid-19 under the rug starts a death spiral, as it were, in the world economy.

Perhaps more disheartening this week than Trump’s racist Independence Day jeremiad was reading Trump’s new Covid-19 campaign messaging, that the US must “learn to live with it.” This is a picture of what Trump wants the US to live with.

US confirmed Covid-19 cases, 4 July 2020.

Trump’s denialism enables his supporters to make irrational claims. Individual freedom is more important than forcing citizens to wear masks. Business must stay open to support the economy. Look! The mortality rate of Covid-19 isn’t rising as cases rise, so it’s not as deadly now!

Simpson’s paradox and Covid-19 in the US.

The US now finds itself where it was in March. For the sake of Trump’s re-election, the US must “learn to live with it.”

Andy Slavitt on Covid-19, 3 July 2020.

Yesterday, my friends Will and U.b. took me to their vineyard near Sant Marti for a lavender harvest. It was my first big trip to the countryside outside Barcelona since I arrived six months ago. The valley where cava is produced reminded me of California wine country. I felt at home.

Lavender harvest near Sant Marti Sarroca, 4 July 2020.

The crowd was a blend of Spaniards, Brits, and Americans. A lot of our conversation during the course of the day was about Covid-19, of course. We’re learning to live with Covid-19 here, but our version of “learning to live with it” is different from the White House version. We’re intent on keeping the case numbers low, not watching them skyrocket.

There was excitement and trepidation about the prospect of travel. Will and U.b. are driving and taking ferries to Greece. Others were traveling to Normandy to see the D-Day memorial. I asked about good day trips around Catalonia. Even as I read reports of a Covid-19 outbreak and lockdown in the Catalan city of Segriá, I felt safe among new friends here. There was no mention of individual rights or a need to prioritize the economy.

After almuerzo, I realized my arms were sunburned, so I mostly stayed in the shade while others cleaned up or continued harvesting. Near the end of the day U.b. was kind enough to cut a bundle of lavender for me with large flowers, something to take home as a memento. As I smelled the lavender this morning, I came to understand that yesterday we harvested more than lavender. We harvested the fruits our our Covid-19 lockdown.

28 June 2020 – Sunday – #101

Mobile World Congress is a huge event every February in Barcelona. Mobile technology companies from around the world meet in Barcelona to show their latest wares. Faster chips! Sharper cameras! 5G! Barcelona’s best hotels and restaurants are sold out a year in advance. Deals are done over vermut and paella.

One of the many reasons for moving to Barcelona was that my friends Donna and Steve attend MWC every year. Since they live in Arizona, that meant I was more likely to see them in Barcelona than in the US. I was disappointed last fall when they shelved their 2020 trip to Barcelona, but I figured I would be crazy during this year’s MWC anyway, getting my residence card and finding a place to live.

Of course, the whole event was called off. Not because Donna and Steve weren’t coming, but because MWC was scheduled to start 25 February, just as all hell Covid-19 was breaking loose in Wuhan. As I expected, I was busy getting my residence card and searching for an apartment the week MWC organizers called off the conference. I barely noticed the news except that suddenly I could get a table at any restaurant without a reservation.

I wasn’t thinking about any of this last week when I read that University of Barcelona researchers measured Covid-19 in Barcelona’s sewage in March 2019. I had to read that twice. March 2019, not March 2020. Sewage is a leading indicator of Covid-19 outbreaks, so it makes sense that Barcelona researchers were checking how early Covid-19 was here. It’s just that March 2019 is an unexpected result. Covid-19 in sewage is a leading indicator of an outbreak by about five days, not by a year.

My first thought was that the researchers needed to check their results. March 2019 is preposterous for Covid-19 in Barcelona. I wasn’t alone in this sentiment.

Prof. Gertjan Medema of the KWR Water Research Institute in the Netherlands, whose team began using a coronavirus test on waste water in February, suggested the Barcelona group needs to repeat the tests to confirm it is really the SARS-CoV-2 virus.

Reuters, “Coronavirus traces found in March 2019 sewage sample, Spanish study shows,” 26 June 2020.

I remembered Professor Medema from my 3 May 2020 entry. He knows his shit, so if he thinks the U. of Barça study could have measured the wrong thing, that was good enough for my confirmation bias. March 2019 was far too early to see Covid-19 in Barcelona.

But then I remembered an article early on in the pandemic questioning whether the infamous Wuhan seafood market was, in fact, the source of Covid-19. Chinese researchers looking at 41 early Covid-19 patients found that 13 of them had no connection to the seafood market.

[Georgetown University infectious disease specialist Daniel] Lucey says if the new data are accurate, the first human infections must have occurred in November 2019—if not earlier—because there is an incubation time between infection and symptoms surfacing. If so, the virus possibly spread silently between people in Wuhan—and perhaps elsewhere—before the cluster of cases from the city’s now-infamous Huanan Seafood Wholesale Market was discovered in late December.

Science, “Wuhan seafood market may not be source of novel virus spreading globally,” 26 January 2020.

And then I wondered why Covid-19 would show up in Barcelona sewage in March 2019 only to disappear until January 2020. And then, while I was looking at the horrendous increase in Arizona’s Covid-19 cases this week, I remembered Donna and Steve and the cancelled 2020 MWC event. And then I asked myself, did any companies from Wuhan attend the 2019 MWC?

Well, it turns out, yes, at least one company called Wuhan GreenNet traveled to Barcelona at the end of February 2019. It’s not clear whether they sent staff from Wuhan or Beijing, but they did send someone. In case you want to know, the company “provides products relating to the fields of fixed networks, mobile networks and Internet of Things.” Wuhan GreenNet’s headquarters are “located in what is known as ‘China Optics Valley,’ Wuhan East Lake High-tech Development Zone Software Park.”

So, when Univeristy of Barcelona researchers confirm their findings, as I now expect they will, I hope at least one of them finds this diary entry and gives someone at Wuhan GreenNet a call. I sent a LinkedIn request to an employee there. Let’s see what happens.

[UPDATE: 12 July 2020. This article has more details on the wastewater findings.]

The other big news story in Spain is travel. Tourism officially opens up 1 July, but Spain’s R is already rising as Covid-19 restrictions are lifted.

Reproductive rate R = 1.48 for Spain, 28 June 2020.

The increase in Spain’s R is concerning, but neither unexpected nor alarming, as I wrote two entries back. With small case numbers, a few outbreaks can spike R even though all the outbreaks are under control.

Speaking of keeping outbreaks under control, there are useful tracing techniques emerging from the Covid-19 study in the Mission District of San Francisco. Researchers are now using Mission District data to connect viral mutations of SARS-Cov-2 to social interactions.

Viral relationships can reveal social relationships, making connections we otherwise wouldn’t make, which has implications for contact tracing.

Applying this technique, researchers were able to determine, for instance, that two workers at the same plant who came down with Covid-19 had different strains of the virus. That showed that the workers didn’t get infected working together and allowed the plant to remain open.

Anyway, even as tracing improves, Spain’s increasing R gets more problematic when people start flying to Spain from places with higher Covid-19 activity. While Spaniards are worried about the Brits bringing along Covid-19 for their vacations on la playa, the EU (and Canada) are worried about Americans bringing along their freedom from masks and soical distancing.

The immediate concern here at Casa Solar is how Brad returns. I think a motorcade and parade along Gran Via would be perfect, but Brad is more concerned about navigating customs wherever he enters the EU. In a world where Americans aren’t welcome until they get their Covid-19 act together, the number of intercontinental flights is shrinking and the way to Barcelona is through a larger hub, like Heathrow or Frankfurt. In theory, Brad’s residence visa qualifies him for essential travel. In practice, we’ll know more after the EU finalizes its regulations next week.

The global concern is whether American can get is Covid-19 act together. Dr. Gilman has assembled a list of 16 questions leaders need to answer in order to turn around the situation.

This week, I’m going to leave you with some tips on masks. I’m getting used to mine. I hope you get used to yours. Here’s how much just one layer helps protect others if your sick.