“It’s like driving at night. You never see further than your headlights, but you can make the whole trip that way.”
In much of life, we can only see what’s directly in front is us. This not only applies to Covid-19, but to everything else. And it’s apparently also a facet of human nature. Most people live for the moment or the near future and fail to plan for retirement or create contingency plans in case of job loss, disability, or natural disasters.
Or epidemic planning.
After SARS and MERS, funding dried up on coronavirus research, a vaccine for many possible coronaviruses was possible but never pursued, Bill Gates warned of future pandemics happening, and we of course put the 1918 Spanish Flu memories long behind us. A possible SARS vaccine was never tested, as even that money dried up.
That said, sometimes you can’t be prepared for every contingency. One can invest for retirement or buy disability insurance, but you can’t know if or when a disability will strike or when a layoff is coming, or whether you will face forced early retirement. You can only plan for all contingencies as best you can. But you can learn from history and from others’ experiences, if you choose to pursue that.
Before a crisis hits, this is all academic, philosophical, and theoretical.
Reality is upon us. Covid-19 is raging and at present is only barely starting to be contained on a global scale. Results have been uneven. In the US, it’s not just lack of planning, but actual dismantling of the apparatuses that were in place plus ignoring briefings back in January plus denial and refusal to take steps until things blew up together led to the current US situation. Other countries have taken drastic steps, both good and bad, but most have not been able to get ahead of the virus (so far), with some exceptions — New Zealand is doing extremely well. Some countries have been lucky that few carriers came their way in advance, making quick isolation effective, while others were not so lucky. Some have taken stronger measures than others, and some want to use vast testing to reopen quickly.
On the other hand, virus deniers and apologists want to infect everyone, with various rationalizations, or are claiming that specific measures that are popularly used but imperfect are all that’s needed (armchair epidemiology). Or, often, both. They are starting with the conclusion that they don’t want to change how they live, and therefore are working hard to convince the rest of us to fall for their predetermined conclusions with whatever argument sticks.
In last few days, I have been thinking about this “what if?” scenario, which on its face has nothing to do with the virus but is about the scale and magnitude of the entire world’s population. Upon rereading it with 2020 glasses, note that they are not socially distanced. Worth a read before continuing.
If we wanted to test hundreds of millions of people a day, how would we reach them? We should not ask them to appear in one place, as that is impractical and would risk causing Covid-19 to spread. An unknown number of people would be infected. In the recent Wisconsin election, conservatives forced in-person voting to proceed, leading to a spike. (They forced this through because they believed it would give them an electoral advantage — never waste a crisis to get what you wanted all along.)
Will contact tracing be enough? Multiplication comes into play. If a few people have it and they only contact a few before the tracing begins, then it can work. If millions have it, then tracing all of them becomes exponentially more difficult. If a few have it but go to locations where many go, then it’s very difficult. Big box stores could lead to an entire city being infected from only one individual in the perfectly wrong place at the wrong time (bear in mind that many live in multi-person households, and 6 degrees of separation and all). The R0 of this virus makes multiplication exponential. Now, if we can reduce the R0 to less than one, it might be sufficient.
However, the fact that Covid-19 can spread while people are asymptomatic may be its greatest offensive weapon.
A drug treatment could be used if a current drug could be repurposed (as new drug development takes years). We might even consider giving to everyone as a blind blanket treatment, but this becomes an ethical dilemma — a serious side effect that happens to one in a thousand will lead to millions of incidences of harm. And we would need to quickly manufacture billions upon billions of pills in short order. Perhaps we train a million Covid-19 -sniffing dogs and they go from house to house certifying people disease free, and those people are allowed to go back to normal, bearing in mind its accuracy rate. It’s logistically tough but doable. Maybe a vaccine comes along and is proven safe, but that may take too long.
We must not put all our eggs into one basket, and we may need many baskets working together to achieve victory, a balancing act to be sure, but not undoable. Someone once said, whether you believe you can or believe you cannot, you are correct.
The next issue is that at what point of no more virus will it be enough to reopen everything? One screwup and the cycle starts again. This is not academic — the second wave is already a grand experiment in many countries and US states, even against popular opinion. One option is contact bubbles (but compliance is not guaranteed). That said, if the number of cases is low, then contact tracing will work, as small pockets can be quickly tracked and frozen dead in their tracks.
So, none of this is going to be easy, but we can’t use that as an excuse to not figure out how to make it happen. One argument of deniers and the “herd immunity” crowd is to appeal to defeatism — it can’t be done so don’t try. It can be done, but how are we going to do it needs to be figured out. Uncertainty makes correct decision making difficult, and not having an expected end in sight is demoralizing. However, we cannot allow these facets of human nature to guide our virus response, as the virus does not care about our cognitive biases. We cannot argue with it, reason with it, gaslight it, or persuade it to surrender with a convincing speech. It only knows how to replicate when it comes into contact with a suitable host.
Humans have one advantage the virus cannot replicate, our imagination and ability to conceive of and test new ideas, and we must us this to our advantage.
The real issue in defeating Covid-19 may in fact be scale — scale of testing, scale of production (masks, food, testing, drugs, vaccines), scale of ideas, scale of funding, scale of researchers in this field, scale of exponential growth. So, the answer may be in deciphering scale and preparing for future scaling (ability to produce tests, PPE, vaccines, education, compliance, number of trained Covid-19-sniffing dogs, etc.).
In the end, we need to envision every possible way out of this and figure out which one(s) are most feasible, and then get going on them. But the nonsense crowd will try to gum up discourse with their easy answers, defeatism, half measures, and any other tactic they can summon which will hinder effective planning and execution. We must also bear this in mind, because they are dangerous and willing to throw all of humanity under the bus.
And once we have defeated Covid-19, we must assume another pandemic will come in the future, and be ready for it. This needs money and cooperation, and the need to avoid complacency and false gods. We did defeat smallpox. We have all but defeated HIV. And we have come a long way from the days of the bubonic plague and Spanish flu of just 102 years ago. But we have a long way to go if we want to get through this pandemic and be prepared to prevent or quickly defeat the next one.
Expect many of the comments below to be about easy-answer measures or defeatism. Let’s try to look at the real issues at hand and figure out realistic solutions instead of going in circles with people whose goal is sealioning and wearing us down with their nonsense, gumming up productive discourse instead of addressing the real problems and successfully defeating Covid-19.
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