joshuazelinsky | Entries tagged with covid-19

In a small room, sit four men and a woman. An observer would note plates of caviar and other delicacies in front of all but one of them. The last man appears far younger than the others. He instead has a panini from a local sandwich shop. An observer would also note that the others give him far more deference, and it makes sense, for as a near immortal and the true head of the Bavarian Illuminati, he doesn't need to pretend to send signals of wealth or power in his tastes.

When they finish eating, the young-looking man makes a gesture, and one of the other men stands up. He presses a small electronic remote by her side and a holographic projection with bullet points and figures opens up. After all, having powerful holographic technology doesn't stop you from using Powerpoint.

He begins his presentation. "Stage four in project C-19 is close to completion. As we've discussed previously, the next stage requires multiple public celebrity deaths to convince the holdouts to take our injection. Our next intended target is Meatloaf."

The woman raises her hand. The speaker and the woman both looks over at the young man, who nods to let her ask a question.

"Sorry, maybe this is just because I'm new here and have only been the Rosicrucian representative for a few days. But wouldn't it make more sense to target a celebrity that's younger? An unvaccinated individual in the prime of his life would be far more shocking."

The speaker shakes his head. "No, we will do this the way we always do it. We'll make the event just barely indistinguishable from random happenstance."

The woman looks perplexed but doesn't say anything.

The speaker continues. "As per our major policies, we will fake his death and..." he trails off as the woman's hand goes up again.

"Yes?"

"Sorry, fake his death? Why bother faking his death. Is there a moral compunction here? We've released a virus which has killed over five million people worldwide. We went back in time and wiped Atlantis from our timeline, making it so that a hundred million people never even existed. We activated the Anti-Genesis Device, turning Mars from a fertile planet into a barren wasteland. Why don't we just kill him?"

"I'm not sure you understand. We're the Secret Masters of the world. This is how we do things. Now, as I was saying. We'll fake his death. And then when people try to figure out if he's vaccinated or not, we'll have his representatives refuse to confirm or deny it, so it leaks out slowly, rather than in any clear fashion. And we're going to try and put in some numerical symbolism too. So we're going to have his death faked 116 days after his birthday. After all, 116 flipped over is 911 and we all know we were responsible for that. "

This time, the woman does not even wait to put her hand up.

"While we're at it, we can retroactively declare that we're doing this when he's 74 years old, and born in 1947. After all, 47 is 74 backwards, and 47 is also the number of the famous Agent 47, which got made into a movie twice despite all odds, and 47 doubled is 94, which backwards is a perfect square, and 94 is the year we arranged for that whole Nancy Kerrigan and Tonya Harding thing."

"Oh that's very good. That sounds like a really good one. We'll definitely use that. It is good to see you are already seeing how to think like a member of the upper echelons of this conspiracy. Now, our next item of business— we need to discuss which young celebrities are going to have drug overdoses next year which look exactly like what one would expect given people with their history of drug abuse. And of course, we'll kill them off at age 27... "

There's been some speculation that in the US the difference in Covid deaths between "red" and "blue" areas will be enough to change some election results. It is true that red areas are seeing much higher death rates. This appears to be happening when one looks at data at both a state and county level. This is very likely due to lower vaccination rates among some Republicans and self-identified conservatives, and yet the majority of every major demographic political group, Republicans, Democrats, self-identified liberals, self-identified conservatives, and self-identified centrists, are vaccinated. At the same time, vaccination rates are lower among Republicans than among other groups, and a vocal minority of anti-vax Republicans are making it seem like a more common Republican position than it is.

However, it seems unlikely that the differences in vaccination rate, and thus death rate is enough to alter many elections. It could alter a close election, and that's especially likely in a Presidential election. Georgia was decided by a margin of a little under 12,000 votes, and has had around 30,000 Covid deaths. (There's some reason to think that Covid death totals are being undercounted, and that this undercount is especially strong in red leaning states and red counties of red states. But actually determining how much of an undercount this is seems very difficult). But despite that, it seems unlikely that Covid will by itself be enough to change a Presidential election.

What about Senate and House elections? This seems a bit more plausible, but the House is so gerrymandered that this doesn't seem to be that likely. And even aside from Gerrymandering, the Democrats are just really unpopular right now, and the generic congressional ballot looks bad for them.
Governor elections seem to tell a similar story. Virginia's off-year gubernatorial election was decided by about 60,000 votes, but that was after there was already an uptick in "red" voters dying, so that already bakes some of that in. Even if it didn't, Virginia has had around 16,000 Covid deaths, not enough to change an election result.

However, there are two unappreciated sets of elections where Covid deaths may have a major influence. Local elections have much lower turnout than state-wide or federal elections. And primaries have very low turnout also. More importantly, the data suggests that the most likely to be unvaccinated Republicans are one who are more conservative. Thus, this may mean that there will be fewer right-wing voters coming out to vote in primaries. Here, then the numbers do look a lot more plausible. Let's look again at the Virginia governor election, but this time at the primaries. The Republican governor was decided at a convention with a form of ranked choice ballot . But that's less important than the fact the total numbers are tiny. The final difference in the last round of elimination was 1182, which is tiny. If there's only a small number of conservative voters dying, that still can look drastically different. And that's before we get to how since there were six candidates in this election, it is potentially sensitive to the order of elimination in the various rounds. And the final round candidate who Youngkin beat, Pete Snyder, was noticeably to his right.

Other elections also look pretty close. The Republican senate primary in Alabama was decided by around 12,000 votes. Right now, about 16,000 people have died officially from Covid in Alabama. It would need to be an extreme ratio to have an influence on the election of that sort (especially because many of the initial deaths in Alabama have been among poor African-American communities, as well as in the major cities, and those people are not going to be right-wing anti-vax conservatives generally). But if that election were slightly closer, it starts looking pretty plausible.

Many other primary elections state and local offices have similarly low turnout. Obviously, this isn't universally the case, but it does seem to be common. If this pattern is enough, it may not change much in the way of general elections directly, but it may result in more moderate Republicans winning primaries. That may moderate the Republican party as a whole, but it might also help the Republican party itself, as more moderate candidates may be more likely to win general elections.

In the last few years, there's been a lot of discussion of "virtue signaling." This is the idea that someone is doing something not because it is actually a good thing to do but because it signals to one's community that one is virtuous, that one is a loyal member of the tribe, and certainly not allied at all with that hated Other Group. The idea first arose in the context of sociology of religion, as an explanation of essentially ostentatious displays of piety. The idea is now most popularly used by some on the American right-wing as essentially an accusation directed against political opponents.

One of the basic problems with such accusations is that they frequently conflate not understanding or not sharing a motivation with deciding that it must be signaling. For example, people who have solar power on their homes or buy electric cars are often accused of virtue signaling; almost invariably this is done by people who at a fundamental level, don't care about climate change or don't believe in it. In this situation, the accusers are confusing people having a genuinely different set of motivations with instead having a cynical motivation.

To be sure, some virtue signaling certainly does exist. The decisions by some large corporations in the last month to issue statements in support of Black Lives Matter, or engage in name changes which no one asked for, can be in part understood as virtue signaling by the corporations. Similar remarks apply to cities: painting a giant slogan on the road is substantially easier than making any sort of systemic changes to how policing occurs. And this really does seem to be virtue signaling: it takes little effort to issue a statement or paint a road. The easiest signals are the cheapest ones. The hardest signals of genuine feeling to fake are those which require a lot of resources.

One recent area where the accusation of virtue signaling has been most prominent has been wearing masks. People have claimed that wearing masks is about signaling virtue, not any actual desire to protect anyone else. At this point, the evidence suggests that wearing a mask helps protect both the wearer and people around them. That it also may protect the wearer does not seem to have filtered down to the general population. Thus, the virtue signaling claim has focused on the idea that people are wearing masks not to protect others, but to signal that one is one of the sort of good, responsible people who wears a mask.

And there's probably at least a little truth to this claim. I took a walk this afternoon in the local park, wearing a mask, and I definitely felt some degree of pride about it. "Look at me! I'm responsible! I'm wearing a mask! You should too!" I'd like to think that's not the only reason I wear a mask, but that's tough to say. It is very easy for a person to convince themselves that they have noble intentions.

Here's the important thing though: It doesn't matter why someone is wearing a mask. A person could literally put on a mask while thinking "I don't care if I'm protected by this. I don't care if anyone else is protected. I just care about everyone seeing how prosocial I am." That person's droplets will be just as blocked as the droplets from a person who puts on a mask with perfect sincerity. The laws of physics and biology don't pay attention to one's personal motivation.

This last idea is tough for humans to get. We have some basic intuitions that intention matters in a deep way. Ideas about magic in almost all societies and general beliefs strongly connect to this. In fact, one of the ways in the modern world we sometimes distinguish natural or supernatural claims is whether human intent impacts them. In other contexts intent also matters.

To some extent this idea is connected with the sometimes repeated slogan that people need to realize that "the map is not the territory" that is that our conception of something isn't the same as what exists in the external world. Curiously, although this is a tough lesson, it turns out to be actually not completely true in a limited, technical sense. There's a neat theorem that if you take a map of a region, crumple it up and drop it somewhere in the region, no matter what, at least one point on the map will be exactly marking itself. I've been surprised for a long time that no mystic has tried to read something deeper into that statement.

What is labeled as magical beliefs though aren't unique to magic. For example, most major religions believe that at least some of their ritualized behavior only works with intent. In Judaism, the idea of intent for religious rituals, called kavanah, is important. There is a large amount of disagreement in Judaism over which things require kavanah and which do not.

There's a wonderful little children's book, "Hershel and the Hanukkah Goblins," about the folk hero and trickster figure Hershel of Ostropol. In the story, Hershel confronts a series of goblins which play tricks with the Jews of the town. The only way to defeat the goblins is if the King of the Goblins lights a Menorah on the last day of the holiday. Spoiler alert: Hershel manages to trick the King into lighting a Menorah without realizing that the candles are for Chanukah, and the goblins' hold on the town is broken. Some readers may be aware that for a long-time I've argued that the story should have a different ending: The King should have explained that Jewish law is that lighting candles for Chanukah takes intent, and that all he has done is light a few candles in a row. Then he should have ripped off Hershel's head, and the book would have a good lesson about how one shouldn't interact with any supernatural being unless one understands the rules under which it operates.

But at another level my criticism of the story is a poor one. The story is a modern story, not a true folktale, and so if anything it is a positive sign of understanding how people think that intent does not end up mattering. All that matters are the abstract rules.

In that context, let us all realize that COVID-19 is just like the King of the Goblins. What intent anyone has does not matter. Wearing a mask is helpful whether or not one has proper intentions. So if wearing a mask is virtue signaling, then by all means, let us all signal our virtue.

There's been a fair bit of discussion about people running summer camps this summer. Right now, I've seen both Christians and Jews arguing that their summer camps for kids should run, and that with appropriate safeguards there won't be any serious risk of issue. There's a lot wrong with this argument, but one aspect which is possibly not getting enough attention is something that is an implied assumption people are making without even realizing it, which is that if one increases the scale, the number of probable infections will rise linearly and that the chance of an infection event rises roughly linearly. Neither of these are the case. My suspicion is that this sort of assumption is occuring not just in the camp discussions but in all the discussions about opening up. So let's discuss these ideas.

First, let's imagine a game. In the first game, you'll get to roll a regular six sided. If it turns up 1, then one loses the game, otherwise one wins. The chance of losing is 1/6. Now, play the same game, but roll 10 dice. The chance that at least one show up is much much higher. If a one represents an infected person, then as one increases the number of people, the chance that at least one infection is present goes up drastically. This is, by the way, part of the point of isolating in small groups, rather than just isolating with a larger number all of whom seem safe. (And yes, the chance that anyone is infected with COVID in life is less than 1/6 but the same basic pattern holds.)

Now, we're going to imagine a different game. In this game, there are a whole bunch of people. When we start one person has a red slip of paper, and everyone else has a blue slip of paper. We'll play the game in stages. At each stage, every person shakes hands with every other person, but if one of the people they shake hands with has a red slip of paper then they roll a fair 10 sided die, and on roll of 1, they give a red slip of paper to the other person. Having a red slip here represents being infected. For simplicity, we'll imagine that only two rounds happen, so first everyone shakes hands with everyone else, paper is given as necessary, and then a second round of handshakes occur.

Now, we can ask, how likely is anyone to have a piece of red paper at the end? Let's look at the simplest case, where we have two people playing, one with a blue slip and one with a red slip. The chance that the person with the blue slip is 19%. To see this, note that there's a 10% chance in either round that they'll get a red slip , but that double counts the possibility they get a red slip in both rounds, which has 1% chance (1/10 times 1/10 of happening). Now, let's imagine that we play this game with 3 people; a little figuring will convince you that the chance now that either of the two people with blue slips end up with a red slip has gone up: why? Because in the second round, there are more pathways for infection, if one of the two with blue was infected on the first round. By the time one gets to 20 people playing this game, most people with blue slips will end up with a red slip by the end. If one plays with 30 people, almost every blue slipped person will end up with a red slip.

Shaking hands here is of course a proxy not just for shaking hands but for many other forms of contact, including coughing and touching. In the case of teenagers at camps there is probably more other experimental behavior than some of the parents are comfortable thinking about even if they remember their own time at such camps. But the essential upshot is the same; if one has more pathways, the chance for infection goes up drastically. This really is not just about summer camps; similar remarks apply to any gathering of people or extended way for people to interact.

A lot of people have wondered why there's so much concern about COVID-19.  I've taught classes on both differential equations and graph theory before with some degree of disease modeling, so I have some relevant expertise, although certainly much less than a trained epidemiologist or someone whose research focuses on disease modeling. In that context, I want to discuss some of the reasons why this is generating more concern than the regular flu from a mathematical standpoint.  

The most common basic model of disease spread is the SIR model  , and it turns out that simple versions of this model work pretty well empirically for many diseases. The basic idea of the model is that one has three compartments representing three types of people, people who are susceptible to the disease but are uninfected, people who are infected, and people who have recovered. People move from the susceptible to the infected category based on the number of people infected, with some parameter representing how likely an infected person is to infect new people. People move from the infected to the recovered population at some fixed probability. Strictly speaking "recovered" for our purposes also includes people who died and thus aren't spreading the disease but that distinction doesn't matter much for this sort of model. The basic model assumes that once one is in the recovered category one is either dead or immune.  

When one uses this sort of model, and one looks at the disease presence over time the basic pattern one gets is a large hump followed by the number of infected then trailing downwards. For a graph of this sort of hump occurring in China with this virus, along with a lot of other good data, see here.

This is the basic model, and one can do a lot of things to play with the model. For example, one can imagine one has a vaccine for some people; this moves some people directly from the susceptible box into the recovered box. This drastically reduces the size of one's hump. Another thing one can do is have more than three boxes; one can imagine each region (say a city, school or nation) with its own set of boxes but then a chance for people infected in a region to infect people in a nearby region. One can also imagine diseases which have long periods of spread and infection, so the presence of births in the population become relevant. A good exercise is to think of some other thing you'd want to add to this sort of model. 

As these models get more complicated, much of the modeling becomes empirical, running many different small variants of a model with computer approximations rather than much emphasis on analytic techniques; there's not as much as we can satisfactorily prove about some of these models as we'd like from a mathematician's perspective.

In this context,  let's talk about three things which make from an SIR perspective  this virus to be potentially worse than influenza (aside from the higher mortality rate which while also concerning isn't something that the SIR perspective really models much):

First, not everyone who gets the virus becomes immune after they recover; we're seeing not just relapses but  evidence of reinfection. One essentially has some people who would move from infected to recovered but instead are moving back to susceptible.  If one plays around with SIR models one will see that having such movement can easily make epidemics much worse. We're not completely certain that such reinfection is occurring but it looks likely. One difficulty is trying to distinguish reinfection from relapse. There's some evidence for low-level infections in people who are otherwise considered to have recovered.  Trying to figure this out is going to be something doctors are thinking about very carefully. This is a general news article discussing some of the issues involved. 

Second, the contagion rate of this virus appears to be higher than that for influenza. While there's a lot of uncertainty about the reproduction rate, R_0, which roughly speaking, represents the number of average new infections from infected individual, those numbers range from about 2.2 to about 4.5 and they seem to be likely on the higher end. In contrasts, many estimates for influenza put this number for it at at most 2; for the 1918 flu the number was probably between 2 and 3. Increasing R_0 has for what should be obvious reasons, a pretty severe impact on the severity of epidemics. The exact translation of R_0 into the SIR has some subtleties, and estimates for R_0 do change for diseases. They frequently start off larger than they would be otherwise until procedures targeting a disease are in place. There's some substantial criticism of R_0 as a metric in general , but as a rough guide it is useful here.  There's also been some statement by the WHO (such as here) saying that at least by some metrics, COVID-19 is less efficient at transmission than the flu. I''m not sure what metrics they are using there, but if that's accurate that's a major reason to be less worried. 

Third, there are people who get infected and are contagious but are almost completely asymptomatic. That basically doesn't happen with flu almost at all, and that means that containment is much harder. (This is not double counting evidence with the R_0 point above because those estimates are generally for people who do exhibit symptoms.) We're still uncertain how often this happens. In the case of influenza, people can  be infectious before any substantial symptoms appear, but symptoms always show up. In the case of this virus, there appear to be some people, especially young people, who are not just infectious while being asymptomatic, but remain completely asymptomatic. Even a tiny percentage here can drastically interfere with containment efforts.  Remember how I mentioned how one variant of SIR models involves triplets of boxes each for a different location? Well, if you do that, you can model how effective travel restrictions and quarantines are, and they become substantially less helpful if there are completely asymptomatic people. It only takes one infected person to enter a new location.

Right now one of the biggest issues is simply how many unknowns there are. It could turn out that all three of these issues above aren't that severe. Or it could turn out that all three are substantially in play. We don't completely know at this point, and have a worrying amount of evidence that all three of these issues are cropping up. 

In this context, one might wonder why taking steps to delay infection matter. In these models, people get infected and eventually move over to recovered, so you might think that everyone gets infected. But that's not actually the case. Eventually, a disease becomes low enough levels that some people who are in the susceptible box category never get infected. If one can delay infection the number of people left in that  box at the end stages can get bigger. Another major issue is the maximum number of infected. Remember the hump I mentioned above? The size of that hump matters a lot from a treatment perspective because ill people aren't as economically productive and many of them will need to be in hospitals, taking up limited hospital bed space. Even if the total number of infected were to remain the same over the entire period, the stress on the hospital system will be lower, resulting in likely fewer deaths from the disease, or deaths from other medical issues as the entire system is subject to less of a resource crunch. There's also the issue that other treatments may be developed; the longer we delay things the higher the chances that more people will be saved by new treatments.      

In this context, what can you do? Washing hands and not shaking hands are steps which have been mentioned by many but I'll repeat them here; they can't be emphasized enough. But aside from that, buying extra non-perishable goods that are frequently used is the obvious place to start. One doesn't need at this point to run out and buy all the toilet paper (looking at you Australia), but having a few extra days of food, and yes toiletries, is not a bad step.  When you go to the store, buy a few extra food items. You don't need to buy them all now, but but buy a few, and then put them away, and (this bit is a important) don't count them as present when calculating whether you need to pick up more food in the future, until the disease is passed. The same goes for some other basic items, medicines and the like when possible and practical. 

Another thingy you can do is get the flu vaccine. While Trump's comments about the flu vaccine for COVID-19 were, not surprisingly, stupid and ignorant, there are two good reasons to get the flu vaccine if you have not before. First, for many diseases, multiple infections are a major cause of fatalities. With the 1918 flu, many who died died not directly from influenza but from bacterial infections which occurred with it  and this is a pretty standard pattern for deaths from influenza or similar illnesses. Second, the flu vaccine makes it less likely that one will need to be hospitalized for flu; that's even more important now than it usually is, because of the possible issues with limited hospital resources. If we can minimize stressing the system as a whole, we'll be in better shape.