Covid-19 6/4: The Eye of the Storm

post by Zvi · 2020-06-04T20:50:01.199Z · LW · GW · 7 comments

Contents

  End of the Beginning
  The Numbers
  Analysis
None
7 comments

Still standing by this: Covid-19: My Current Model

Previous update posts: Covid-19 5/29: Dumb Reopening, Covid 5/14: Limbo Under

Remember last week when I opened with this?

I remember when people on Twitter had constant reminders that today was, indeed, only Wednesday, or whatever day it happened to be. Time moved that slowly.

Time has sped up again.

Well, yeah. Not so much anymore.

In March and April I found myself constantly checking Twitter and the financial markets for news, frantically hunting for ways to get a handle on what was happening in the world, worried everything would fall apart. Would our supply chains hold? Would we be able to maintain civil order? Would millions die? How can I keep my family and friends safe?

My beloved New York City was no longer a place one could live a reasonable life. So we fled. Even after that, great worry.

Then things started to calm down. Most of May, I increasingly managed to relax. We learned how to grill properly. I played a bunch of Assassin’s Creed Odyssey. I stopped checking Twitter or the stock market.

My biggest worries were dealing with getting the Emergents Alpha ready and Magic: The Gathering melting down under the weight of the companion mechanic in particular and its new design philosophy in general.

End of the Beginning

Then, on May 25, 2020, in Minneapolis, four policemen murdered George Floyd.

The resulting cycle of protests against police brutality causing more police brutality, which in turn amplifies the protests, has been ongoing each day since then. Huge crowds flood the streets. The crowds come disproportionately from communities with more Covid-19 cases than average. The crowds often yell. The police use tear gas on them, which causes coughing. The police arrest them and lock them in tight quarters, which is going to spread the virus even if the outdoor activities don’t, hopefully in small enough numbers this isn’t a huge deal.

To the extent other things are also happening, that only makes the infection situation worse.

It would be very surprising if all this did not lead directly to a surge of new Covid-19 infections.

It would also be very surprising if all this did not lead indirectly to a much bigger surge of new Covid-19 infections.

Effectively, the lock down is over.

Nuance is hard in the best of circumstances. The community I know who got most ahead of the game on Covid-19, the Rationalist community, is still so bad at nuance that one of its de facto community leaders felt he could not go anywhere or do anything during the epidemic. Because if he did, others would not be able to properly parse his actions as responsible, or be able to choose responsible actions themselves, and all quarantine would collapse for everyone..

These are not the best of circumstances.

People have seen, and will continue to see, the photos and videos of gigantic crowds in the streets. They will see the approval of those crowds, by the exact same people who told them they should face a depression and 30% unemployment to fight Covid-19. The same people who told them they should not see family and friends and live their lives.

Even those who support the protests are going to have a very, very hard time taking extreme restrictions seriously going forward. Life beckons.

For those who don’t support the protests, forget about it.

There is no going back. Either people’s private choices, after the resulting adjustments in perception of risk, based on their local desire to keep themselves and their communities safe, will still be enough to contain this virus. Or, we will entirely fail to contain this virus until herd immunity provides enough help to turn the tide.

I cannot think of a more just cause then stopping state-sanctioned murder. That does not make these implications go away.

That is where we are going to be. We are probably going to see a massive dumb reopening, much faster and more complete than previously predicted or planned. That is the world we now live in.

I don’t know if I even think that these effects are bad.

This could all work out for the best.

It could work out because we contain the virus anyway. I don’t expect it, but it’s definitely plausible.

It could also work out because we were never going to successfully contain in most places without stronger herd immunity – regardless of whether we could have done so given better policy – and this gets us there faster and by infecting a relatively young subset of the population. Also definitely plausible.

Or it could work out because outdoor events don’t matter, and this leads to lots more things happening outdoors but not indoors, so we move to a better world no matter the outcome. This, too, seems plausible to me.

Our, it could work out because enough people adjust their behaviors to stay home more, because they predict a second wave, and this cancels out or more than cancels out the direct effects above. You never know.

How long before we know the results?

It has been over a week since things were set in motion. The first few days were relatively small. Events didn’t start having their full impact until at least the last few days. They may not have reached anything like their peak yet. And if the virus is now spreading in a particular sub-population, we may see exponential growth within that particular sub-population, over the course of several cycles of infection. So the effect might be small at first, then only look large weeks later.

Secondary effects, from others adjusting behaviors, will also be gradual and delayed.

On top of any lag of the actual infections, the time from infection to positive test has always been an open question. My guess is it is currently an average of seven days.

In the meantime, what was happening before all this?

The Numbers

Positive test results by region:

Date	WEST	MIDWEST	SOUTH	NE ex-NY	NY
Mar 19-Mar 25	4283	4103	5045	4955	19925
Mar 26-Apr 1	14962	18641	22823	31631	54920
Apr 2-8	17170	25899	32296	46365	54894
Apr 9-15	17393	30403	39118	63548	64342
Apr 16-22	17149	32804	32926	61955	52481
Apr 23-29	22958	39570	33974	65682	44484
Apr 30-May 6	22269	49256	37503	53803	26957
May 7-May 13	23612	43429	36280	43952	18102
May 14-May 20	22594	44054	40556	37567	14316
May 21-May 27	23595	41635	42679	32762	11393
May 28-June 3	30094	32216	46848	24926	8947

Deaths by region:

Date	WEST	MIDWEST	SOUTH	NE ex-NY	NY
Mar 19-Mar 25	138	104	144	116	278
Mar 26-Apr 1	380	615	572	606	1656
Apr 2-8	707	1454	1309	2115	4327
Apr 9-15	890	2195	1596	3577	5318
Apr 16-22	1033	2343	1727	5147	3716
Apr 23-29	1128	2588	1685	4722	2713
Apr 30-May 6	1012	2413	1747	4908	2582
May 7-May 13	1082	2288	1597	3911	1416
Apr 23-29	1090	2060	1442	3578	963
Apr 30-May 6	775	1723	1290	2341	667
May 28-June 3	875	1666	1387	2121	436

Positive test percentages:

Date	USA tests	Positive %	NY tests	Positive %
Mar 19-Mar 25	347577	16.2%	88,882	32.0%
Mar 26-Apr 1	728474	20.2%	117,401	45.1%
Apr 2-8	1,064,225	19.8%	144,273	45.5%
Apr 9-15	1,026,741	20.4%	160,859	40.1%
Apr 16-22	1,235,393	16.1%	143,970	30.2%
Apr 23-29	1,552,560	13.0%	202,499	21.0%
Apr 30-May 6	1,759,548	10.6%	183,446	13.2%
May 7-May 13	2,153,748	7.5%	202,980	8.2%
May 14-May 20	2,643,333	6.0%	246,929	5.6%
May 21-May 27	2,584,265	5.7%	305,708	3.5%
May 28-June 3	3,022,470	5.1%	417,929	2.2%

New York had been winning its war. On June 2 there was a scary jump in positive test rates. That was especially scary as it could have represented Memorial Day. But the trend was back on course again on June 3, so things were probably fine at least until the protests.

New York continues to reopen. On a personal level, they are allowing outdoor dining here in a few days, and full restaurants a week later. For all practical purposes the limiting factors on my behavior will be my own risk considerations, not official restrictions. I was training myself to stop sweating the small stuff, and prepare to go out more and more into the world. Now it’s much less clear that’s going to happen.

The Northeast in general continues to do well, but not as well as New York.

The rest of the country is still a more mixed bag. The Midwest is encouraging and a welcome surprise, enough to make overall numbers move in the right direction. But the jump in cases out West is troubling. It is spearheaded by California, with most Western states seeing a marked jump. The South also continues to creep upwards, especially Texas, South Carolina and Virginia. It’s worth noting that Florida and Georgia saw declines, so unless they’re fudging the data this isn’t about speed of legal reopening.

The death counts aren’t changing much, as one would expect given their lag. They are listed as a valuable sanity check, but the three week or more delay is fatal to them usually providing the key new information in a given week. By comparing the two charts, we can see exactly how delayed. If anything, it’s a big mystery that the deaths move way too much in lockstep with cases, rather than on a delay. Is this that case diagnosis is more delayed than seems reasonable, or is under bad circumstances? Or is it something else?

Analysis

Thus, this week’s update was mostly speculation about the future.

Please keep the comments section confined to Covid-19 considerations.

Watching the positive test counts over the next few weeks will be crucial to figuring out our new path, as we also determine the path of our nation in other ways.

New York is seeing major protests, and had a very clear improving trend line, with very good plentiful on-demand testing. I think it’s a very good place to look to see the delta from recent events, as it’s one place where we know the prior score.

If New York continues to make similar progress for two weeks, then the protests are not very dangerous as a primary effect. Even one full week of the same trend line would be enough to be pretty confident this effect is not large.

If New York quickly stops making progress, or even reverses, we have to assume that the primary impacts are very dangerous.

Neither of these tells us much about secondary adjustments. Those will be gradual. People are creatures of habit. Many of them are also scared of going outside given the unrest. In the short run, this likely works the other way. We won’t know what the real impact of the unrest is upon the curve, until there is less unrest. And that long term trend is what matters.

If we do have a second wave, estimating the impact of partial herd immunity will determine the path forward. If I am right that New York’s advantage over other areas is mostly its larger herd immunity, and I’m also right that it is making up for otherwise relatively unsafe circumstances rather than Cuomo having delivered the goods on that front, then that’s very good news. We should see similar actions result in shrinking R0 over time.

However, note that this will be a delayed effect. First, in places with very little immunity, we will instead have the opposite effect. As the new normal sets in, people’s choices in the new normal determine their risk level, and the more risky are infected more. As this takes effect, things look like they are getting worse, even as the groundwork is laid – by making those risky people immune – for things to get better later. Or so we hope. We can even view ‘New York City gets very infected’ as a geographic example of the exact same thing. For a while it made the nation’s epidemic seem much worse than it was. But that concentration of risk made our long term prospects much better.

Ultimately, I continue to be an optimist of sorts on this, but with little confidence.

As discussed above, it’s doubtful the United States has much state capacity left to take meaningful action against Covid-19. It’s up to the individuals now, even more than it seemed to be a week ago.

The die has been cast. The only question is what number it lands on.

 

 

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