The New Normal (May 10)

Some states are starting to reopen, and many residents are eager to get back to the old normal. It shows up in the data: half the states now rate an F on the social distancing scorecard, and only 5 beat a D+. In a month or two, we’ll find out if relaxing was a mistake.

On a personal level, here’s an informative guide to avoiding infection in a reopened world. There’s a lot to be said for not catching Covid-19. It may lose you some work time due to sickness or quarantine. You may die from it, or survive with reduced lung capacity and/or blood clot damage. Or, maybe you infect someone you care about.

On a larger scale, what happens next is hard to see. There are plenty of better experts out there, but here are some guesses on what the new normal will be like.

  • Covid-19 is here for the long haul. It escaped containment and is almost everywhere. Even if some regions stamp it out, someone without symptoms can bring it back in. The disease may reach “herd immunity” eventually, but that will take a few years.
  • Covid-19 may be permanent. Immunity to the 4 species of Coronavirus that cause common colds only lasts a year or two, so they keep circulating. Odds are good that Covid-19 becomes #5. If so, it gradually will become less lethal in the really long haul (decades to centuries). Until then, it will need a vaccine. Maybe an annual one, similar to influenza.
  • Developing a vaccine won’t be quick or easy. Trials have already started, but it takes time to ensure a new treatment is both safe and effective. Previous vaccines developed for Coronavirus diseases in pigs, chickens and dogs had problems. The stakes are higher for humans. After that, ramping production into the 100 millions will also be challenging. 18 months seems the best guess, give or take a few.
  • More testing is needed. Most tests done so far check for viral RNA in the deep part of your nose: it tells if you currently are infected. Simpler saliva tests are in the works. What’s also needed is antibody testing, to see who was previously infected. That includes folks who didn’t show any symptoms. Knowing the overall infection rate helps for planning, and helps catch outbreaks before they become deadly.
  • Still need some social distancing. Large group events of any kind will be risky until there’s a vaccine. People may need to wear masks routinely. The current social distancing measures pushed the R value below 1, but it needs to stay there for a long time. Hopefully there’s a sweet spot so life can go on without killing health workers or grandma.
  • Still need contact-tracing and quarantines. As long as the virus is still circulating, there’s always the risk it grows out of control. State and local health departments have dealt with a few dozen infectious diseases over the past century, and this will be one more that needs attention.
  • The economy will be weird for years. Money is just an arbitrary concept, so in theory we should be able to cancel a few months and get everyone squared up. In practice, nobody has any idea how to actually do that. This new recession isn’t like previous ones. There’s a lot to unravel.
  • The economy will never be the same.  Priorities will change. It’s hard to guess what 2022 will be like, but it won’t be 2019.
  • More Covids are coming. This is the third Coronavirus outbreak since 2003. It’s unlikely to be the last. The next one may spread faster or slower. It may be more lethal, or less.
  • Other pandemics are coming. Influenza sometimes gets deadly. There are always wildcard viruses like Ebola and Zika. Maybe something brand new. Humans are overpopulated and crowded. Nature tends to fix that with diseases.
  • It would help to be more ready. CDC and FEMA kinda dropped the ball, as did many others. We need better prep on all levels: personal, business, county, state, national, global. Fortunately, I think Covid-19 was bad enough to be a wake-up call for most people.

Dennis Kolva
Programming Director

Covid-19 in New York #2 (May 1)

A couple weeks ago I reported on the impact of Covid-19 on a few mostly-rural counties in upstate NY. Here’s a quick update.

Tompkins County (home of Ithaca, Cornell and TurtleSoft) is still doing well. 132 confirmed cases so far (1oo recovered, 32 active). Still 0 local deaths. The social distancing score has dropped from B+ to C+. However, most people wear masks outdoors now, and masks are required inside stores. That isn’t visible in cell phone location data, but probably makes a big difference.

Tioga County (former home of TurtleSoft) has gotten much worse. In the past week they went from 0 to 14 deaths: mostly in a single nursing home. 98 confirmed cases in a population half that of Tompkins. Social distancing rated a D. I went down there last weekend and nobody wore masks, despite state regulations. Going into the Mini-Mart to pick up a gas receipt felt like a trip back to February.

Steuben County (2 to the west) had it rough in the previous report, and it’s even worse there now. 231 confirmed cases, and 37 deaths in a population similar to Tompkins. Still D for social distancing.

New York State has started small-scale antibody testing (which shows past infection, even if no symptoms). Results are very preliminary, but they suggest that 20% to 25% of folks in New York City may have been infected already. In NYC suburbs it ran 10%, and only 2.5% around here. “Herd immunity” probably requires at least 60% infected, so everyone still has a ways to go.

The theme locally (and elsewhere) is that even rural areas have places that are crowded. Infections can run rampant there. Nursing homes are the most likely target, but prisons, meat processing plants and factories are also hot spots.

It’s a systemic problem, since employees that work in all those places are often poorly paid, often with no benefits. They probably live in more crowded housing that is prime for transmission. And of course, the high cost of healthcare in the US means they are less likely to call in sick, or get treated.

I have no idea how any of this will correlate with conditions in the rest of the US. Too many unknowns.

Dennis Kolva
Programming Director

Exponential Growth Part 3 (Apr 27)

In past posts I’ve talked about big exponential growth. The scary kind. Covid-19 was like that for most of the world in March. Multiplying by 2 or 3 every 4 or 5 days makes rapid changes.

Fortunately, thanks to social distancing, the pandemic settled down in April. People are still being infected, but in most places the number of new cases is close to constant. That means the Rt growth rate is about 1 (with some exceptions).

Here is a chart of small exponential growth rates.

Back when humans went to work, parties, restaurants and sports arenas, the Rt growth rate for Covid-19 was mostly between 2 and 3. Those would be almost vertical on this chart. The more horizontal curves come from a world that still has social distancing. Their shape depend on how much it reduces the infection rate. If the rate is more than 1, cases increase. If below 1, they gradually subside.

Small changes in the rate have a big impact. For example, if a region has hospitals currently at half-capacity, then an Rt of 1.05 overwhelms them in June. 1.04 hits crisis in July, 1.03 in August, 1.02 in October, and 1.01 postpones it til early 2021. 1.0 prevents it entirely.

One challenge is, there’s no way to know the current exact Rt number. The Rt Tracker website calculates a value for each state based on testing data and other factors, but their model is based on a lot of guesswork. The site include error bars above and below each estimate, to show how much uncertainty there is.

Even worse, there’s no way to know the impact each policy decision has on Rt. If everyone wears masks in public, the infection rate surely goes down: but how much is just a guess. Ditto for every other change in daily life. In a year or two there will be tons of data to help calculate impacts, but right now we’re on brand new terrain.

Even more worse, the system is complex and sensitive. The drastic changes in March dropped Rt all the way from 2.7-ish to 1.0. Small decisions like mask-wearing or opening restaurants could easily shift the Rt value up or down by several or many times .01. After a few months, that makes a big difference.

Governors, mayors and local health departments will make policy decisions. Individuals and business owners will make personal decisions. The net result will be some Rt number that won’t be known until infection data comes in, several weeks or a month later. That feedback delay can make the ride even bumpier.

If you’ve ever lost control of a vehicle on snow or ice, you probably experienced a feedback/delay loop. Skid to the right so you steer left, but there’s reaction time so you over-compensate. That leads to a few left/right cycles of increasing magnitude, until you’re backwards in a ditch.

Covid-19 will probably be similar over the next year or two. Odds are good there won’t be a whole giant pandemic again, but expect lots of little outbreaks. Local ones on the scale of factories or cities. Maybe some on the scale of states or countries or continents. The rules will need constant tweaking. Fasten your seat belts, folks.

Dennis Kolva
Programming Director