The Coronavirus New Normal Has Only Started To Arrive

South Carolina and Georgia have started relaxing coronavirus restrictions despite the fact that grounds for optimism about combatting the disease spread are looking thin. For instance:

It’s not clear if getting coronavirus confers much immunity, and if so, for how long. We’ve been hammering on this concern for a while, and it is increasingly becoming official. From the Wall Street Journal:

So far, most medical researchers who have studied coronaviruses related to the pathogen that causes Covid-19—including SARS, MERS and the common cold—are confident that people who do recover gain some immunity to SARS-CoV-2, based on preliminary studies and case reports of the new virus. They don’t know yet whether that protection will last a few months, a few years or a lifetime….

SARS-CoV-2 has a mutation rate of less than 25 mutations per year, compared with influenza’s mutation rate of almost 50 mutations per year, according to an analysis by computational biologists of the Nextstrain consortium, based at the Fred Hutchinson Cancer Research Center in Seattle and the University of Basel in Switzerland. That gives researchers hope that any natural immunity or vaccine would offer more lasting protection, said Pamela Bjorkman, a virologist at the California Institute of Technology who studies viruses that cause AIDS, influenza and Zika…

In fact, little is known reliably about the risk of re-infection by the coronaviruses that cause SARS, which first emerged in 2002, or MERS, which was first detected in 2012, several infectious-disease experts said.

The WHO went out of its way to warn that having coronavirus antibodies (as in having been infected) does not necessarily confer immunity. From CNBC:

The World Health Organization issued a warning Friday about coronavirus testing, saying there’s no evidence serological tests can show whether a person has immunity or is no longer at risk of becoming reinfected.

“These antibody tests will be able to measure that level of serology presence, that level of antibodies, but that does not mean that somebody with antibodies” is immune, said Dr. Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit.

Despite that, quite a few infectious diseases specialists have been stating in the press that getting coronavirus ought to confer immunity. Nevertheless, there are still significant questions:

– Do asymptomatic/mild symptom cases generate enough of a response to confer immunity?

– What about reports of people who recovered getting the disease again? The tendency among experts was to dismiss cases of second infections China as the results of bad testing. However, it’s harder to waive off South Korea finding that 2% the patients deemed to be recovered got sick again. Some believe it’s just more botched tests, while others think it must be relapses. Virologists are strongly of the view that it’s unlikely that those who got the disease and recovered then were infected afresh.

Mutation may be occurring more rapidly complicating vaccine development. If getting an infection confers only short-term immunity, say six months to three years, it’s better than nothing but not hugely so. And on top of that, despite researchers being cheered by coronavirus appearing to mutate much less rapidly that other viruses, already has enough variants to slow coming up with a vaccine. From the South China Morning Post:

A new study by one of China’s top scientists has found the ability of the new coronavirus to mutate has been vastly underestimated and different strains may account for different impacts of the disease in various parts of the world.

Professor Li Lanjuan and her colleagues from Zhejiang University found within a small pool of patients many mutations not previously reported. These mutations included changes so rare that scientists had never considered they might occur.

They also confirmed for the first time with laboratory evidence that certain mutations could create strains deadlier than others.

“Sars-CoV-2 has acquired mutations capable of substantially changing its pathogenicity,” Li and her collaborators wrote in a non-peer reviewed paper released on preprint service on Sunday…

The deadliest mutations in the Zhejiang patients had also been found in most patients across Europe, while the milder strains were the predominant varieties found in parts of the United States, such as Washington state, according to their paper.

A separate study had found that New York strains had been imported from Europe. The death rate in New York was similar to that in many European countries, if not worse…

The most aggressive strains could generate 270 times as much viral load as the weakest type. These strains also killed the cells the fastest.

It was an unexpected result from fewer than a dozen patients, “indicating that the true diversity of the viral strains is still largely underappreciated,” Li wrote in the paper.

Needless to say, this creates additional unknowns. Does contracting a milder version of coronavirus confer much immunity to the deadlier versions? And what happens when that nasty version in New York starts making its way across the US?

Even under a best case scenario, a vaccine is 12 to 18 months away. That’s how long it takes. And don’t put your hope in the BCG vaccine as a quick save. Yes, having had the BCG vaccine appears to offer some protection against coronavirus. However, for reasons over my pay grade, which I believe are among other things due to BCG being a live vaccine, getting it now would be a bad idea (as in it would increase vulnerability near term).

Some promising treatments are getting thumbs down. Doctors in Italy had reported when they threw everything against the wall in treating Covid-19 patients, hydroxychloroquine in combination with azithromycin was beneficial when not much else helped. Trump made hydroxychloroquine controversial by hyping it long before research firmed up whether it held up to scrutiny.

The NIH is now warning against the drug combination. From the Financial Times:

Experts convened by NIH said coronavirus patients should not use a combination of hydroxychloroquine and azithromycin due to possible “toxicities”, meaning the risk of serious side effects, including poisoning…

The NIH report said there was “insufficient clinical data” to determine whether hydroxychloroquine or chloroquine, another version of the antimalarial medicine, were appropriate treatments for Covid-19 patients…

The report was done by a panel of 50 government and outside experts, and included members of the team that reports to Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases who serves as the top scientist on the White House coronavirus task force…

There are no big studies that have proven that hydroxychloroquine works against Covid-19. And a series of smaller ones have shown mixed results. Scientists have warned that it can have significant side effects including disrupting the heart’s electrical system and psychological problems….

On Tuesday, a study of patients at hospitals run by the Veterans Health Administration taking the combination of hydroxychloroquine and azithromycin showed there were more deaths among those taking the drug than those who did not. There were also more deaths in the group taking just hydroxychloroquine…

The study involving 368 patients was the largest report to date. But it was not a formal trial and the paper has not been peer-reviewed, a process designed to meet scientific standards.

Disappointingly, one of the clinical trials underway is for hydroxychloroquine only, when it wasn’t used in the field that way. The VA has a negative preliminary finding on hydroxychloroquine plus azithromycin, but the drugs weren’t administered using a clinical trial protocol (such as consistency with size and timing of doses, and one suspects, being double blind, placebo controlled). Nevertheless, the higher death rate gives cause for pause.1

CDC warns that disease may be worse in the fall. We’ve also highlighted this concern, but now it’s official. From the Washington Post:

“There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,” CDC Director Robert Redfield said in an interview with The Washington Post. “And when I’ve said this to others, they kind of put their head back, they don’t understand what I mean.”

“We’re going to have the flu epidemic and the coronavirus epidemic at the same time,” he said.

Needless to say, the CDC chief seems to be declaring victory over the current outbreak awfully early. US cases are still rising, even if they have started falling in some large cities. And that is with those cities having moderate to severe restrictions in place. We may find that this peak might look more like a plateau, particularly if some parts of the country see infections rise and have to tighten up again.

Note this scenario isn’t allowing for a Spanish Flu-like outcome, that the second wave is also more lethal in and of itself.

On top of that, more reports indicate coronavirus death counts are understated, which isn’t surprising. If someone dies at home or in a nursing home, what is the incentive to do the forensic work to ascertain whether it was coronavirus or not? Consider this update from the Financial Times:

The coronavirus pandemic has already caused as many as 41,000 deaths in the UK, according to a Financial Times analysis of the latest data from the Office for National Statistics.

The estimate is more than double the official figure of 17,337 released by ministers on Tuesday, which is updated daily and only counts those who have died in hospitals after testing positive for the virus.

The FT extrapolation, based on figures from the ONS that were also published on Tuesday, includes deaths that occurred outside hospitals updated to reflect recent mortality trends.

Contrast this less than cheery news on the medical front with rising agitation in the US to get back to normal to save the economy (oh, and keep parents who can work at home from going nuts minding their offspring).

This demand ignore the fact that most workplaces have employees within close proximity to each other (that is the point, after all) which promotes contagion. And it should come as no surprise that a lot of workers have figured that out and are not keen with the risks they are or soon will be expected to take.

Remember that the Smithfield factory in Sioux Falls, South Dakota that provides nearly 5% of the US pork is closed due to a coronavirus outbreak. The Intercept reported that other Smithfield operations are disease hotspots and management has resisted taking action:

Now, the Wisconsin plant, which employs more than 1,000 workers, has more than two dozen confirmed cases and closed down on Wednesday for cleaning and sanitation. Workers at the plant, who spoke to The Intercept under condition of anonymity for fear of reprisal, say much more should have been done.

One plant worker with asthma said that when he asked for a mask last month, an official at the company declined his request because if he was provided one, Smithfield would “have to do it for everyone else.”

He said that one of his co-workers had brought his own mask and was reprimanded to Smithfield’s human resources department, which told him that wearing his own mask would result in suspension.

After days of back and forth between the plant managers and workers, the Cudahy plant allowed its workforce to bring its own masks. Some appeared at work with homemade cloth masks, but most continued to work without basic safety equipment, such as N95 masks.

“Eventually they tried to do some social distancing in the cafeteria, but actually, they’re working elbow to elbow on the line, so there’s no social distancing there,” said the sister of another plant worker. There are currently no Plexiglas dividers between workers, though UFCW Local 1473, which represents workers at the plant, has called for such safeguards to be installed.

In the “not making this up” category, Smithfield is blaming the outbreaks, including a new report of infections in a North Carolina plant, on the dirty immigrants which it is generally happy to exploit. From Buzzfeed:

“Living circumstances in certain cultures are different than they are with your traditional American family,” she explained. The spokesperson and a second corporate representative pointed to an April 13 Fox News interview in which the governor of South Dakota, Kristi Noem, said that “99%” of the spread of infections “wasn’t happening inside the facility” but inside workers’ homes, “because a lot of these folks who work at this plant live in the same community, the same buildings, sometimes in the same apartments.”

Needless to say, the rest of the article provides information that undercuts this claim.

Mike Elk in his PayDay Report is keeping tabs on employee strikes; he notes that his tally in the map below is likely to be low:

In particular, some Amazon workers have had it. In France, the government has ordered Amazon to limit operations to essential items to protect warehouse staffers. The giant retailer in a show of pique, has shuttered all six warehouses until it can get before a judge.

The press reports considerable anxiety among Amazon workers and protests have started. So far, the company asserts they don’t add up to much but organizers plan more actions.

Business Insider prepared an odd list of workers most exposed to coronavirus risk. The reason it is peculiar is that it mixes types of jobs with job characteristics. Nevertheless, it’s not hard to see that a lot of positions at establishments that will presumably reopen soon due if nothing else due to political pressure will be of workers at risk:

Medical professionals…

First responders…

Service workers…Barbers, fast food workers, physical therapists, athletic trainers, and manicurists all work in close physical proximity to their customers and colleagues.

Retail salespersons, concierges, restaurant servers, and cashiers all work directly with the public, putting them into potential exposure with those infected with the coronavirus.

Jobs without a lot of flexibility….

Airline personnel…

Actors, dancers, and other performers

Americans haven’t seen much in the way of shortages beyond PPE, ventilators, and hospital beds, and for consumers, toilet paper. Most consumer shortages are the result of stockpiling, but that situation may not last.

The press warned early of the risk of shortages of some critical drugs supplied from China, as well as other key items made solely or almost solely in China like ascorbic acid. I don’t recall seeing red alerts on these fronts but I would not assume that danger has passed.

The US is seeing more lasting shortfalls, which could become shortages, on the food front. From Bloomberg:

At a Publix store in St. Petersburg, Florida, handmade signs limit customers to two packages of beef, pork and Italian sausage. In Toronto, shoppers at a west end Loblaws can’t buy more than two dozen eggs and two gallons of milk.

Spoiled for choice before the pandemic, North American shoppers are finding they can’t get everything they want as grocery stores ration in-demand items to safeguard supplies.

While the panic that swept through supermarkets in the first weeks of the coronavirus lockdowns has eased, people are still filling fridges and pantries with stay-at-home staples from flour and yeast to pasta sauce and meat.

The strong demand comes at a time of supply disruptions as food makers adapt to dramatic shifts in buying patterns and some processing plants close as workers fall ill. As a result, stores are restricting purchases to prevent items from vanishing from shelves. For shoppers, that can be unnerving.

“Unnerving” may seem overwrought, or alternatively, proof that Americans are pampered. My mother remembers real rationing from World War II.

But I recall during 9/11, when I was pretty sure I was less rattled than most Manhattanites (it was a full three days before I had to have a drink), I was conscious of the fact that going to a grocery store was comforting. Everything on the shelves, in order, the store as tidy as it ever was (good but not great) was a proof of normalcy, that despite the deaths and the acrid smoke smell from the burning site and the upset, most things were still operating as usual.

A CO2 shortage may be a more immediate risk. From the Guardian:

An emerging shortage of carbon dioxide gas (CO2) caused by the coronavirus pandemic may affect food supply chains and drinking water, a Washington state emergency planning document has revealed.

The document, a Covid-19 situation report produced by the State Emergency Operations Center (SEOC), contains a warning from the state’s office of drinking water (ODW) about difficulties in obtaining CO2, which is essential for the process of water treatment.

The document says that the ODW is “still responding to [that day’s] notification of a national shortage of CO2”.

It continues: “Several [water plants] had received initial notification from their vendors that their supply would be restricted to 33% of normal.”…

The main reason for national shortages, according to the CEO of the Compressed Gas Association (CGA), Rich Gottwald, is a ramping down of ethanol production….

This led to plant closures, including among the 50 specialized plants that collect CO2 for the food and beverage market.

If the US were rational, water treatment plants would get priority over soda plants. But rationality hs not been much on display here.

And we have yet to see the impact of businesses failing. One thing that has kept the lockdowns feeling less dislocating than they are is people are stuck at home, the most familiar setting they have. And when they go out, while the dearth of activity is odd, it’s not unheard of. You’d see streets that empty, say very early on a Sunday or a major holiday.

When restrictions are loosened and local retail areas start having empty storefronts where long-established vendors once operated, consumers will get daily reminders of the damage.

I keep thinking of the sentence from a failed first draft that many years later spurred Margarite Yourcenar to again take up what became her classic, Memoirs of Hadrian: “I begin to discern the profile of my death.” Coronavirus marks the end of an era, just as the start of World War I did. We can only hope the outcome isn’t as bloody.


1 Could the fact that the Italian virus was more deadly account for the difference? If that version of the coronavirus is more deadly, it would be worth the risk of the side effects, while it might not with the less lethal strain.

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  1. voteforno6

    I recently re-read John Barry’s The Great Influenza, and it’s actually quite remarkable how much the current situation echoes what happened during that time. Even though medical practices have improved significantly since then, there does still seem to be that sense of desperation now to fight this virus, that there was back then. One other interesting thing from that book was that the people who were infected during the milder first wave of the Spanish Flu seemed to have at least a limited immunity during the much deadlier second wave. That doesn’t mean that the same will happen with COVID19, but it’s possible.

    1. Steve

      When John Barry was the featured speaker on MPR Live from the Westminster some years back he was asked what was something he learned from writing The Great Influenza that he didn’t know before. His response was immediate, – how our government lies constantly, often with no reason. History seems to be repeating itself especially with the pressure from the Trump Administration and businesses to reopen the economy ASAP. It seems like the parade in Philadelphia all over again.

    2. Jason Boxman

      Having just read that book, I kept waiting for the part where medical science conquered the virus. Never happened.

      Given what Yves mentioned about the economic affects, I was puzzled that Barry’s book doesn’t cover economics at all, anywhere. And Stoller’s book, of which some parts of a chapter overlap with the end of the Great War, doesn’t really mention the pandemic at all, on the flip side. (It’s nonetheless a fascinating read, and worth getting!)

      Is there any work that does cover the economic affects of the pandemic? With the overlap of the Great War’s end, perhaps it gets all rolled into one. But given the deaths I can’t believe the affects aren’t concomitant.

      1. juno mas

        Medical science (and scientific communication) was very different then than now. Knowledge of virus was minimal in the early twentieth century. Many prominent doctors thought the pandemic was caused by bacterium. Clinical treatment for the flu was essentially palliative.

        While scientists surmised there was a pathogen smaller in size than bacteria (evidenced through filtration techniques), it wasn’t until the invention of the electron microscope (~1931) the virus could be viewed and their structure confirmed. Scientists today, with knowledge of DNA, have a very different and expanded view of virus. In fact, coupled with global communication (Internet) scientific knowledge and collaboration on Covid-19 is progressing rapidly. The 1918 flu pandemic was a world flying blind, comparatively.

        Unfortunately, some folks are itching to replay the Philadelphia parade. (Which my mother attended.)

      2. jonboinAR

        I don’t think the economy was nearly as fragile then what with in our 21st c. economy everything depending on 10 other things working correctly.

    3. YankeeFrank

      Yep, it certainly mirrors the Spanish Flu era. Even down to the ticker tape parade DeBlasio wants to throw for healthcare workers. They held one in Philly after the first wave and let’s just say it didn’t go well for the attendees… or for the (tens? hundreds? of) thousands of others infected by them.

      We’re being led to the slaughter by morons.

    4. Bsoder

      Looking at all the data, I don’t believe the science supports John Barry’s conclusion. Just the opposite for the majority of people, those that had limited immunity, in the Sept-Dec second wave were more like to die not less. As everyone’s dna is different, as the virus mutates, as we understand how to positively treat those that are sick, we are going to get different outcomes. By no means is Covid-19 well understood. We come to the data as scientists and but as doctors with dying patients, many various things are tried, but this is not going well. Take everything you read and hear with a degree of Skepticism, not in a cynical way, but in way that admits Covid-19 is ‘Hard Problem’ to solve. A ‘Hard Problem’, is an actually category of problems defined in math as ‘derangement’. Right now the single best the can do is test everyone in the country, at least once, “essentials”, everyday.

  2. PlutoniumKun

    I think its only very slowly seeping into peoples consciousness that this will not be over by the summer. One downside of educating everyone about the merits of ‘flattening the curve’ is that so many people – including, I would say, experts who should know better – have internalised that once we see the back end of the curve, we can go back to normal, or something like it. But the truth is that there isn’t one ‘curve’, there could be multiple curves, geographically and temporally. We could well see worse outbreaks later in the year. We’ve already seen Singapore, an early ‘success’, struggle to deal with a second wave. We could also see flattened curves refuse to go down like they should… in other words, plateaus that extend over time as R0 refuses to fall below 1 as people lower their caution when things look like getting better. Here in Ireland I noticed that once the government started making positive noises about winning, there was almost immediately a noticable increase in road traffic as people seemed to see it as a sign they could get back to work or shopping.

    As for shortages, I suspect that rather than an immediate crisis with supplies, as many of use expected, we may see unexpected issues over the coming months as supply chains buckle in unexpected ways. I haven’t been to a supermarket in a month – I do all my shopping now in local shops and my local co-op, but I’ve been noticing odd ‘gaps’ in inventory, such as coffee and teas and other products. I’m told that local cafes which are trying to open for take-out are struggling to get things like speciality flour.

    One other anecdote – a family member works for a company that supplies design services for data centres. He said they are overwhelmed with requests by certain well known companies to push schemes forward as quickly as possible. Between online shopping and bored people on Tik Tok and Netflix, it seems there is an insatiable appetite for data.

      1. Susan the other

        I was surprised last nite to see the local-state news channels asking for blood donors from recovered covid-19 patients. They are now using the most available resource – fresh antibodies – to treat the seriously ill. Or buy them time while the illness is most destructive. There are only about 3000 cases total so far, since March till now. But that could be close to 3000 doses of serum. It almost sounds more rational than all the other approaches.

      2. Anthony G Stegman

        Is there an effective treatment for seasonal flu? None that I am aware of. Why expect one for COVID-19 and its variants?

        1. Edward

          There is a flu vaccine, and eventually may be one for Covid-19. Even if a cure is not found, something less then a cure might reduce the severity of the disease, so a lockdown isn’t required.

    1. Adam1

      I can be a data and info junky, so I’ve been following the daily new cases data for a couple weeks now. If you view any of the states with a fairly high case count and a couple weeks at the plateau what you’ll start to notice is a pattern of waves. The pattern isn’t a simple repeating fluctuation, but I’m thinking that’s because of the 2-14 day incubation period. With that said I am convinced that what is being observed are the weekends where people are shopping and visiting family (or still going to church) and that’s with the lock-down in effect. If they lift the lock-down even some it’s likely to get back out of control in my opinion.

      1. Romancing The Loan

        Fascinating theory and deserves closer attention. Is there a data source that shows this already or did you have to put it together yourself?

        1. Adam1

          My most frequent activity is reviewing the charts from the Water Cooler. In the controls you can select to view the New Cases by Day as the default is set to Total Confirmed Cases. I have once or twice downloaded the full US daily data set directly from John Hopkins but it’s massive (county level or even lower – haven’t looked that closely) and then aggregated up to the NYS level. You can see the ebbs and flows and while they could be just random my gut says they are not. However, nailing down the pattern hasn’t been easy. If there is a weekend effect that is complicated by the (up to) 14-day incubation period as you could have been infect not in the most recent weekend, but in the prior weekend. Also, there are some delays in the data. I’ve noticed when trying to compare local county numbers with the state health department ( and then the John Hopkins data that each step can add a day, but not always. And then there are likely instances where data is really getting delayed (and it’s probably frequently happening at the county level) – like Mass showing 0 new cases on 4/20, but reporting 1,705 on 4/19 and 3,122 on 4/21. That one is easy to identify and fix data wise, but how many of those types of issues are going on at a lower level that isn’t as easy to spot and then aggregate those misses up. Ugh. At the very least there are definite waves in the past couple weeks as regions plateau. Something has to be driving that pattern. My hunch is that it’s weekend gatherings/interactions. Hopefully that we’re now past the Easter / Passover holiday period further gatherings will be curtailed, but again, I’m thinking this virus is too contagious to start easing anytime soon.

          1. Biologist

            Hi, that’s very interesting, and I agree with you that it’s too early to start easing restrictions.

            One alternative (more mundane) explanation for the waves you see–but this depends on their period–might be that they reflect fluctuations in how well the cases are reported. For instance, it seems plausible that in weekends staff shortages are even more pronounced than during the week, and less priority is given to reporting new cases. Just a thought.

            1. Adam Hill

              I’d love for it to just be a data reporting issue; there is definitely some of that anyhow.

      2. PlutoniumKun

        Thats interesting – but could it also be the impact of the weekend on reporting deaths? Sweden has a particularly noticeable wave pattern which I believe is down to recording weekend deaths on a Monday.

        1. Ale

          The weekend impact on data collection is confirmed also here in Italy where figures on Monday and Tuesday have been steadily lower than in other days of the week, and also some virologists state that Monday/Tuesday figures are not to be considered unless they are confirmed in the following (normal) days.

        2. vlade

          CZ has abuot 1/3rd fewer tests on the weekends than on a weekday. No difference to death reportings, but we just crossed 200, so it’s not like there’s much to write about there…

    2. Redlife2017

      One anecdote from me – local non-big corporation groceries have less of a hard time keep shelves stocked as they seem to get basic goods like eggs, flour and pasta from wholesalers. My local French grocery has sourced lots of flour, including gluten free! The local bakery is the same. Also a local restaurant has started including goods that they can order from their wholesalers (I will not run out off serrano ham, tuna steak, pork belly or heirloom tomatoes!). So I can easily get eggs and flour from at least 4 different places in a 15 minute walk.

      But if I go to a Sainsbury’s local that is literally next to these same businesses, eggs are irregular, flour is totally out of stock and pasta is often non-existent. Rice is also irregular.

      What I’m trying to get an insight into is whether this sort of thing can continue or if the supply chains aren’t as supple as what they currently seem like (at least with the non-chain businesses).

      1. PlutoniumKun

        Yes, I think its ironic that small producers and suppliers may be better off than the big commercial suppliers, who work on much tighter time and cost margins. A city centre deli I go to occasionally which is very expensive but has an amazing array of high quality vegetables seem to have an entirely normal range as of last week, while the chain supermarket next door has very conspicuous gaps in its fruit and vegetable selection.

    3. Dennis Brown

      Plutoniumkun, with the greatest of respect I have to a question some of your comments. You state, ” The truth is that there isn’t one ‘curve’, there could be multiple curves, geographically and temporally.”

      Your own choice of words in that sentence implies that your statement is a projection, not necessarily a known”truth”.

      This, because no one anywhere really knows what is going to transpire with this disease in future . I realize the mainstream media is filled with dire projections about future, mutating, waves of this virus. But it is also a fact that several highly respected epidemelogists around the world—such as Dr. Johan Giesecke in Sweden–have hypothesized that the current global quarantine approach is doing little more than delaying the progress of the existing curve of the epidemic. The Swedes, despite being so reviled in the media, have adopted the strategy of allowing this “curve” to pass through the population.In so doing they believe the majority will suffer few or no ill effects. They are concentrating on protecting the elderly and the vulnerable instead of a mass quarantine strategy.
      You may disagree with experts like Dr. Giesecke—I don’t know what your credentials in epidemiology are–and that’s fair enough. But I think it is unwise that we rush to judgement–or make irrevocable changes to the world — before we have all the necessary evidence to even know the true mortality rate of this virus.
      I am not questioning your post because I think your overall concerns are unfounded , or I because I think this is all just some sort of a hoax.Of course we should take every possible precautionary step to prevent loss of life. But some of the ways in which some people are reacting at the moment, as well as the dire ‘solutions’ they are purporting( i.e. mass digital survelliance, immunity passports, police state tactics, dubious vaccination schemes etc seem very problematic, if not down right frightening, to me.
      Finally, you state without numbers or context that Singapore is “now struggling” with a second wave, to justify your claims. But according to W.H.O statistics as of April 21, Singapore has had a total of only 11 Covid-19 deaths.

      Let us be vigilant about this disease. Let us continue to be guided by reliable statistics and not emotionally charged reports in the media. Let us keep our mind open and our eyes wide open. And hope that we come through all this in a civilized, peaceful, and co-operative way.

      1. ChrisPacific

        Deaths are a lagging indicator. Singapore has had an almost 7-fold increase in total cases in not much over two weeks. I don’t think the reasons why Singapore’s death rate is so low compared to other countries are well understood, but I’d be astonished if the total number of deaths didn’t rise significantly – it could easily be over 100 in two weeks.

        The mathematics of viral spread are actually pretty simple. The number of cases today are a multiple R times the number of cases X days ago, where X is the average time between infection and detection/diagnosis. That leads to an exponential distribution and means that the number of cases in X, 2X, 3X… days will be R, R squared, R cubed etc. times the current case number. This is why you will hear people talk about the ‘doubling time’ for case numbers. The value of R is different for different locations, or for the same location if there is a meaningful change in active or baseline responses. New Zealand, for example, was sitting around R=4 or 5 before the 4 week lockdown was announced, and now appears to be around R=0.5. If you look at the global numbers over time they actually track extraordinarily closely to this model, but only if you allow for different R values by geography and by time (for example, New Zealand before and after the lockdown policy). The number of changes to R are low compared to the overall data points, correspond closely to policy decisions and move in the direction you’d expect (so for example, implementing social distancing or shelter at home policies lowers R for that location).

        So given that the viral spread model is (a) very simple and (b) a good description of what we are observing in practice in pretty much all cases, I would say PK is on pretty solid ground with his multiple curve assertions. Given everything we’ve seen so far, an increase in traffic or social distancing restrictions (for example) without an effective testing/contact tracing mechanism to replace it will cause an increase in the transmission rate. Because of the delay in the public perception of that fact and response to it (due to the incubation period and the slow-then-fast nature of exponential growth) that will lead to another period of rapid exponential growth until cases rise to a point where the government and/or public is alarmed enough to reinstate lockdown or social distancing measures, and for a week or two after that (again due to the incubation period). We have seen exactly this dynamic play out over and over again around the world, including multiple cycles of it in the same location in some cases.

        1. ChrisPacific

          On reflection my definition for X was incorrect – it’s actually more like the lag between initial infection and the point where the individual becomes contagious.

        2. Tom Bradford

          New Zealand might be something of a test tube, for as well as its hard internal lockdown it has also closed its borders, with anyone arriving in the country – mostly returning citizens if they can get a flight – going into compulsory supervised 14-day quarantine. Hence there is no possibility of ‘waves’ of new infections being introduced from ‘outside’.

          New Zealand also has – something I’ve not heard of anywhere else – been able to identify ‘clusters’ of infections arising from a single source. The largest, >80, is from a wedding party. Another is via a school. A third apparently centers on a stag-party! (Having to explain to the wife how you became infected would be interesting.) The claim is that every one of the known cases in New Zealand is either traceable to one of the clusters or developed by a returnee in quarantine.

          There are 16 such clusters, and while everyone developing CV in the community can be linked to one of them there must be people still in the community who were infected while the cluster was developing but who are either asymptomatic or who developed only a mild case and did not report it. However they will still have been contagious and infecting others.

          So New Zealand might be the ‘gold standard’ for determining:

          1. If reports of relapse are true, as every apparently recovered case is known and supervised, and

          2. If the virus can lurk unnoticed in the community through two or three incubation cycles before breaking out again in individuals with no direct links to any identified carrier.

          1. Yves Smith Post author

            Your bit about asymptomatic cases appears to be misleading. Further down in comments:

            April 22, 2020 at 2:54 pm
            For what it is worth, New Zealand is currently searching madly for asymptomatic cases by both testing “around” (socially and geographically) known clusters, and by doing random-samplings in a variety of cities around the country.

            So far they have found none. Zero.

            1. ChrisPacific

              Careful about drawing conclusions too early on that. Yes, there are regular tests and none of them have turned up any positives so far, but they’ve only been going for a matter of days. Generally N = around 300 for the tests, and with the overall low rate of positive tests in the country presently (less than 1% positive, even among those self-selecting for symptoms or contacts of known cases) it would be quite easy for a single test or even several to show no positive results, even if there were enough asymptomatic cases out there to form a significant fraction of active cases.

              If they keep doing them for a couple of weeks and still show no positive results then I think it starts to become safe to conclude that it’s not happening.

    4. jonboinAR

      Been telling everyone I know since the beginning of this that, until the Corona virus is conquered completely, the moment we quit the social distancing measures we’re using now the thing is liable to come roaring back. We’ll see, I guess.

      1. Dennis Brown

        Hi Jonboinar,

        You may be right that ” the moment we quit social distancing measures we’re using now the thing is liable to come roaring back.” But then again you might not be . I myself do not know. I’m not an epidemiologist, are you ?
        I also agree with you that we will have to see. But in so doing I am loathe to simply submit to the media narrative of the dominant elites. Especially when there is significant debate among the leading experts in the field of epidemiology.

        Let us try to focus on data and scientific evidence before utterly transforming our world. (No I am not some Trump supporting, Alex Jones style nut case. And no I do not advocate we do nothing in face of this disease.)

        Recall that the whole rationale behind social distancing and flattening the curve was to avoid the melt down of the medical infrastructure in all countries around the world, not necessarily to eradicate the virus.
        Most epidemiologists agree that viruses come and go according to the degree in which the population develops immunity. That can be either through “mother nature’s vaccine” aka herd immunity, or vaccines in some cases. But not all cases. Still no vaccine for the HIV virus for example. Or the common cold, which is part of the corona virus family. We have the flu shot–which I always get–but we have no absolute certainty that they are that effective . But as I say I’m no expert.

        I do however find it interesting that countries with relatively superior heath-care systems in place are generally coping better than those who do not.Which is only to say that preventative medicine may actually better than a “silver bullet ” Big Pharma cure. Which may turn out to be chimerical, if not outright draconian. Let’s keep our minds open. All the best!

        1. Yves Smith Post author

          Why are you copping the attitude of having science on your side when you don’t? There is no valid reason whatsoever to expect infections not to pick up substantially if restrictions are lifted in full. Look at Singapore and Taiwan.

          And what about “people only get at best short lived immunity from coronaviruses” don’t you understand? Since when do you know better than the WHO?

          The only thing that is likely to moderate infections somewhat is the coming of warmer weather, which makes upper respiratory passages less vulnerable and a lot of people still practicing social distancing and other protective measures. I for one will not go to restaurants. would go to my gym only at off hours (when I can stay 6+ feet away from people) wearing a mask and still being Miss Alcohol Spray bottle) and only do other shopping when stores were underpopulated.

          And your comment about health care systems is false too. Italy is considered to have a good health care system but was short on hospital beds as a result of austerity. Ditto the UK with the NHS. India which no one would hold out as having a good health care system (in terms of access) has low infections.

          This is disinformation and it has to stop.

          1. gepay

            I find the WHO not a reliable source. ditto the CDC. Can nobody remember the swine flui boondoggle that made much money for the pharma manufacturers and left countries with tons of unused vaccines (the vaccilne for the swine flu was tested even less than the poor safety testing of most vaccines. Sheryl Atkinson of CBS news heard that the in the middle of the flu season that the CDC told everybody to stop testing for swine fliu. She looked into it and found it was true – the reason – there very few cases of people with flu symptoms who tested positive for swine flu. In fact many cases didnt’ test positive for any fliu – it was some other unknown (as not being tested for) pathogen like a corona virus. . But the CDC made estimates anyway that were just guesses that supported their and WHO’s position that the swine flu that year was a serious pandemic. I am old enough to remember the Swine Flu scare in the 70s that was also a dud with more people getting damaged by the vaccine than the swine flu – that vaccine wasn’t even cursorily tested .
            The corona virus has had somewhat dire results in Italy. Like Wiuhan it took place in an area with poor air quality. This filled the hospital ICUs in Italy every flu season with serious respiratory problems. Now the health care professionals in Italy are good but the EU mandated austerity has caused cuts to the health care system. Adequate precautions were not taken initially causing many doctors and nurses to be not able to work as they tested positive. Many health personnel from neighboring countries that worked in the Lombard area hospitals were not able to come back into Italy. Many of the patients were prematurely put on ventilaror with what is now being recognized as doing harm iitsefl Many patients were treated with antivirals that have known serious side effects. But still this is not the black plague. In Italy almost all the deaths were older people with pre -existing conditions some with 3 and many with 2.
            As for America – I think people in the US are not as healthy as most industrialized nations. I get scared when I go to Walmart – not of bodily harm but how most of the customers work. I can remember when I was a kid in the 50s – there was nowhere near the overweight and obesity there is today.
            there were people who worked on a vaccine for SARS – it didn’t work well – when they gave mice who had been vaccinated they developed cytokine storms and some of them died. Then SARS went away so nobody continued, I imagine with the rush and the hype that the vaccine for SARS COV 2 will not be tested adequately for safety and there won’t be time for any long term safety tests. Meanhwile I sure you have noticed that Wall ST and major corporations with everyone distracted by COVId-19 are getting trillions from the Treasury and the FED,
            Soon you won’t have to be a suspected terroiist to be taken off the streets and confined ithout access to a lawyer.. I even heard a spokesman from WHO saying that it might be necessary to test confined families and even take children away and put them in isolation if they test positive. But this corona virus isn’t quite deadly enough to get the full medical martial law that this is pandemic is conditioning people to accept.

    5. rd

      I have projects with field work coming up and I have made it very clear to everybody involved that this is going to be around for at least 18 months. So we have been staging PPE and sanitizing equipment ahead of time so the work can move forward and am working on how to plan the work with small discrete teams with as little interaction as possbile. We will probably stage arrival times at the sites spread apart so that people don’t congregate. I am informing all my tieams to plan on the rest of 2020 and all of 2021 to be done udner strict protocols to avoid infection. Infection would not be good for the employees, their families, or the projects, so not becomeing infected is a win-win for everybody. I am baffled why so many employers don’t get this.

    1. Mikel

      I’m stunned as well.
      It only makes sense if you believe the government should not even be in the water treatment business. Then I remember the type of ideologies bred here and I see how this could happen.

      The USA is going to tell the fictional idocracy world : Hold my beer…

      1. rd

        Public water supply systems are one of the greatest achievements of modern civilization. That and modern sewage collection, conveyance, and treatment systems have done more to save lives and extend lifespans than anything else, other than maybe washing hands with soap in clean water.

        You combine all of those things and you can account for about two decades of increased lifespan. all the fancy drugs and medical procedures are just a fraction of the benefit.

        1. juno mas

          A safe public water supply and massive effluent treatment is what makes the modern city possible. Suburban housing would be even more dispersed without the miles of collection pipes and pumping stations that feed treatment plants.

    2. cnchal

      Consider who the public is bidding against. The purveyors of poison in a plastic bottle, Coca Cola, the real life Brawndo backed by Buffet.

  3. Edward

    For some reason animal transmission doesn’t get discussed much. Is this something to worry about?

    1. Steve H.

      Not for cat people…

      . .

      True this. Dogs inna park smelling each other everwhar. A study on cats found about a hundred, sitting in a large circle around 2 am, practicing proper social distancing.

      1. Jack Parsons

        All of them industriously cleaning themselves and carefully ignoring the other cats while surreptitiously eying them.

  4. Jesper

    I am curious about what might be decided to be the best way to minimise the risk that people who interact a lot with people come to work while sick and thereby risk spreading a disease. I see two possible outcomes (there are probably more but for now these two and/or a combination of these two):

    1. Sickpay being paid -> Someone with mild symptoms can stay at home without losing pay
    2. Every worker is tested for disease before every single shift starts -> If the test shows infection then the worker is sent home

    One of the options seems to care more for the person (worker/peon) the other is more about control. Which option is less costly? Which option is likely to be preferred by The Powers That Be?

    1. ambrit

      There is also a third option, which I suspect will become more and more utilized as time and the coronavirus goes on. To wit, the other workers at a business get together and force symptomatic workers to go home under threat of physical violence if they do not comply. It can happen off business grounds and thus be ‘spun’ as a civil disturbance item, rather than a work action. During the Great Plague in England around the 1600’s AD mark, one reads of villages “closing their borders” to outsiders.
      I say this because it is becoming clear that the Public entities are bungling the response to this pandemic. The brighter among the workforce see this and eventually, for sheer self protection, will work out “organic” amelioration strategies. Consider this a form of “Wildcat Strike.”
      Knowing how groups act in times of stress, I do not imagine much assistance to the targeted individuals will emerge. Group safety will be the paramount concern.

        1. Shonde

          It need not be chaos if it is handled like the case of someone I know who went on a west coast cruise just as this virus was taking off and some cruise ships were already infected.

          He went back to work the first work day after he came back. One of his co-workers told management that his presence made him uncomfortable and the person who stupidly put himself and his family at risk was asked to take family leave and go home for 14 days.

          1. ambrit

            The problem there is that many lower paid jobs do not have “family leave,” or leave of any sort. If you do not show up to work, you go hungry. A classic case of a perverse incentive. Said perverse incentives are usually based upon a business model that directly uses the immiseration of labour as a primary profit mechanism.
            So, the “chaos” if we will, proceeds from the abdication of responsibility for the health of the workforce by management. The workforce then has to act in it’s pwn best interests. This being a case of labour acting in lieu of management is why I characterize this action as a ‘wildcat strike.’ It has many of the characteristics of a strike.

    2. False Solace

      It is clear that much of the spread comes from asymptomatic and presymptomatic infected people, so many of these methods won’t work. Testing is inhibited by numerous shortages throughout the supply chain that are nowhere near resolution. China has been doing temperature checks at the door for a while now. Based on personal experience I can tell you people can easily run a temperature of 100F+ and have no idea. However, there’s too much we don’t know about this disease and the R0 is too high to mess around.

      To digress slightly, it looks like the ruling class is going hard in on forcing states to reopen. Instead of monetary aid, McConnell wants states to declare bankruptcy (to break whatever remains of pensions) and no additional funding for food stamps (while they act like Nancy Pelosi is uniquely callous). The bloodthirsty ruthlessness of the ruling class is truly a sight to behold. While I don’t believe the rich are uniquely evil they have more capacity to exert their will — evidence of a repugnant moral flaw in our species.

      1. 1 Kings

        Yes, not all the ‘rich’ are evil, but those two political a holes and the lobbyists that fed them are.

  5. remmer

    Rationality does seem to be in short supply here in the USA. Here is what a right-wing relative emailed to me a few days ago: “Basically doctors have known since 2010 SARS to treat this kind of virus (RNA) with hydroxychloroquine and antibiotics. The treatment also works for seasonal flu. No vaccine needed. Absolutely incredible that the country is shut down for a very treatable virus. SOB Fauci needs to loose his job.” This relative also wants the economy to reopen.

    Is this kind of thinking common on the political right in Europe?

    1. Edward

      Big Business probably wants the economy restarted, and they are activating their minions on the far right to agitate for this.

      1. Amfortas the hippie

        after the second invasion of iraq…i said to myself(being primed to skepticism by 9-11):”now why would they do that?”
        didn’t take long to find Oil,lol.
        so i ended up at Latoc…a peak oil forum of some repute….like a distributed think tank.
        we talked about Doom a lot, to say the least.
        the worst case scenario(aside from things like gamma ray bursts and large asteroid impacts) was a pandemic that got out of hand.
        I never liked pandemic…or zombie…movies…but i had to actively avoid them after that.
        and reading Rolling Stone’s Timeline a minute ago, it’s looking a lot like the unmitigated Doom we gamed out all those years ago.

        the most worrisome thing to me this morning is the apparent astroturf protests popping up all over.
        let’s make certain to politicise this even more!lol
        make it a culture war issue, and put jenny mccarthy and alex jones out front.

        my bunch is feeling the strain:agitating to get off-farm…to go shopping…to eat out…lots of magical thinking and hopium…
        just adds to my mental load.
        meanwhile…grasshoppers are back.
        and still no sprayer that would enable me to spray the pastures.
        they’re in the first instar, at the moment, in a few relatively isolated patches…mostly where i planted turnips and mustard as a trap crop.
        so I….MR Organic…got out the dursban and laid waste to those patches in the hopes of at the very least lessening their numbers early(allegorically similar to the pandemic)
        another grasshopper plague…like the last 3 years…would not be ideal, to say the least.
        film at 11.

        1. elissa3

          There is a product, I believe safe around humans, that you can put in sheltered containers around your garden/crops. If I remember correctly, the grasshoppers eat it and then eat each other. I seem to remember it’s called “nolo” and could be ordered from a company called Arbico.

          1. Amfortas the hippie

            “Nolobait”= Nosema Locustae, which is a gut bug for grasshoppers, on bran flakes. they eat it, get constipated , and die…and their buddies eat their corpses(a commonality among grasshoppers)>
            it works…but it’s expensive to do on a large scale…it doesn’t keep well…and must be applied at the earliest sign of infestation….which means close, prolonged surveillance.
            it’s also undone by dew…let alone rain,lol.
            there’s also a bait that’s essentially sweet feed(like for horses) and sevin dust(carbaryl).
            I found it much cheaper to mix my own…with proper protective gear). that had some noticeable effect, too…for the last 3 years.
            (I hate using such stuff…but at least carbaryl, to my knowledge, breaks down readily)
            the problem, again, is that they hatch out all over our valley…and move.
            i can spray some horrible crap and kill them here…only to have a billion+ here the next day from next door.
            My trap crops(mustard and turnips) seem to be effective….i’ve seen them in only a couple of places without them.
            so i can limit my spraying to those spots.
            I hope.
            they have been so bad, these last 3 years, that i dream about them(!)…hundreds per square yard…eating everything except grass,lol.
            I’ve ordered a sprayer for the pastures and neighbor’s places, and a quart of beauvaria bassiana. supposed to be here day after tomorrow.
            that’s the organic version of a nuke…but i intend to wait until the dew has dried, and the hoppers are up on top of things attempting to dry off. then i can limit the carnage to the tops of plants.
            at that hour, the good bugs are generally absent/elsewhere.
            We’ll see,lol….I feel terrible being in this situation.
            But we need the derned gardens and fruit trees.
            this year especially.

            1. BlakeFelix

              If you don’t want to use poison can you harvest the bugs? Grasshoppers are kosher. Maybe fried and dried? Grasshoppers beat up my garden but I haven’t gotten up the nerve to try eating them yet

              1. Oregoncharles

                A delicacy in SE Asia – fried. Most things taste good fried, if they’re edible at all.

      2. The Rev Kev

        What clued me in was watching the American Experience documentary on the 1918 flu pandemic. After that I did a fair bit of research and read a coupla books on this episode of history which, until SARS came along, had been neglected by history. When Coronavirus started to rear its ugly head in January, I had an idea what to expect but was surprised how events spun so quickly out of control. It was not so long ago that we saw the story of how northern Italy were locking themselves down and we were saying saywhat? –

    2. Arizona Slim

      Loose his job?

      And what happens when his job gets loose? Will it run snarling and snapping all over the place? Threatening to attack anyone who tries to capture it?

  6. rick shapiro

    ” flu epidemic and the coronavirus epidemic at the same time” If social distancing is again required in the fall, I wouldn’t worry much about a flu epidemic also gaining traction. A high mutation rate, however, will require regular immunizations, when developed, for the foreseeable future.

    1. Phacops

      Mechanism of genetic drift and shift are quite different between influenza and coronavirus. Besides drift due to minor mutations, influenza has a segmented genome and can recombine when two different strains infect a reservoir animal and the segments resort in a novel combination.

      I suspect that surveilance will be quite different and require even more cooperation than now done for influenza. Generally, influenza surveilance is a stepwise activity that culminates about this time of year to agree upon which strains to incorporate into a multivalent influenza vaccine. With different strains of SARS-CoV 2 circulating similar procedures are probably necessary.

      Not a good time to shortchange the WHO or our public health professionals.

      1. Amfortas the hippie

        when the boys were little, but big enough to start asking questions every october about why we all get a flu shot, and their buddies do not, I’d tell the story of the Flu Detectives who go out into rural China to try to apprehend what strains of flu would be around a year later.
        it’s a hell of a story…or can be…and an example of the best of Us.
        this will be the same, I reckon.
        I just hope that the deaths likely to be directly caused by all the “let us go back to work!” protesters will finally put the whole antivaxxer craziness behind us.
        I doubt it, but still.
        we have quite a few of those folks around here…mostly poorer white folks, distrustful of gubmint for the People, but flagwaving for gubmint blowing up brown people, and selectively happy for gubmint of the People.
        even my mom…Team Blue…refuses to get a flu shot…even after getting all the rest of us sick, and almost dying, herself.

        1. Shonde

          How many people this fall will not get a seasonal flu shot simply because of fear of being around a medical person?

  7. Ignacio

    Good article. I was wondering if the amazon model could indeed be more susceptible to the epidemic than less centralized suppliers. Are Amazon warehouses more prone to be closed for safety reasons? Can Amazon devise a strategy to reduce those risks?

    Amongst all this I think that CDC warning about next autumn is very well pointed. This is not to say that in summer the disease won’t go on spreading, on the contrary, but because we can expect milder symptomatology and accompanying relaxation of social distancing the restart of the epidemic in autumn could be epic. Also, given that infection/contagion is more difficult in summer there could be a selection towards the most infectious varieties during the summer. Only after herd immunity is achieved for some time is when one can expect less infectious and virulent variants start to prevail.

    Regarding mutation rates one thing is to consider the error rate of the viral polymerase (OK, lower for CoVs than for other RNA virus) and a different thing is to consider the overall population variability of the virus which not only depends on the replication error rate but on selection through interactions with the host. Being SARS CoV 2 such a recent zoonotic jump it should be expected to diversify very fast as the virus adapts to humans. This means that there are relatively high risks due to the possibility of new variants with different infectivity and or virulence properties spreading in the population.

    1. panurge

      The revenge of brick and mortar …

      It would be ironic if at the end of the pandemic small shops would show more resilience than big biz.The former saved by their short reach and the latter hamstrung by an overstretched supply-chain.

    2. tiebie66

      “This means that there are relatively high risks due to the possibility of new variants with different infectivity and or virulence properties spreading in the population.”

      Could this not already explain the reinfection phenomena seen in China and South Korea?

  8. gallam

    The growing realisation amongst the medical community that there is a significant re-infection risk, and that there may be no immunity at all, has been seriously under-reported.

    An easily transmissable disease that kills 1-5% of its victims each go around without any immunity developing in the poulation could be an extinction level event in a species that cannot respond (eg. cows or Tasmanian Devils). I’m not saying that the corona virus is this disease in humans, but it appears to be ticking boxes with alarming frequency.

    1. Amfortas the hippie

      Re:”extinction level event”
      I’ve worried over that, too…BUT, the asymptomatic features would seem to contradict this.
      More of a Culling…a herd reduction.
      like thinning one’s carrots.
      this is, of course, disturbing in it’s own way…

      I find that i’m using the phrase “nature bats last” a lot more than i used to,lol.

      1. gallam

        “I’ve worried over that, too…BUT, the asymptomatic features would seem to contradict this.”

        I’m not too sure about that – it would require that an asymptomatic experience previously predicts a subsequent asymptomatic experience. We have to pray that is the case at this point, because if it is not we are in real trouble.

    2. phil m

      Does it kill 1-5%? That’s one of the difficult metrics to get a handle on. If some of these latest stories ( Santa Clara study which is controversial and the latest LA County Study) are anywhere near correct it would seem that the death rate is substantially less.. my a significant #.

      1. periol

        I’ve heard these tests could very well be picking up false positives from previous exposure to other SARS-type illnesses, hence the high number of asymptomatic positives.

        There’s an audio interview with a German doctor named Christian Drosten where he says the asymptomatic cases are a myth in Germany, and the ones being picked up by test probably still have remnants of dealing with a recent cold or other human coronavirus that is being detected. I have no idea if he’s worth listening to, but his explanation for the asymptomatic cases sounds reasonable to me here:

        He specifically speaks about this in minute 47-48 of the interview:

        “Probably a small fraction, I think. Pre symptomatic and asymptomatic is widely confused. Asymptomatic… Well I mean in the Munich cohort for instance that was in the end no asymptomatic transmission because if you’re really went back and spoke to the people, they would remember some 2 or 3 days of some sort throat but they didn’t take it seriously.

        And now all of this talk about let’s say silent zero conversions, I don’t know, we are not seeing this and especially now I mean this is not the time to detect silence zero prevalence, right? The epidemic hasn’t even begun. At the same time we’re just moving out of the common cold season so there is all the those cases that have residual IgM from their recent human coronavirus infections and this will cause cross reactivity with ELISA tests actually the IgM positive cases so the predictive value will of course increase as we move into may June July but now I don’t know, all of these ELISA studies that are now starting if they show something like 3-4% over the the known PCR based background in the population this is probably contributed by false reactivity and only later on can ELISA test really identify something like a I don’t know a population background. But then, also these cases this doesn’t mean they are asymptomatic it just means they haven’t been diagnosed when they were infected.”

      2. marku52

        Regular flu kills about .12%. The 10,000 deaths in NYC are about .12% of the population. If the IFR for corona was actually .12%, that would imply that every person in NYC has been infected already.

        That doesn’t pass the smell test. Hence death rate is higher than the flu. The excess graph graphs that rocket up out of normal for time of year imply it as well.

        1. rd

          From everythign I have seen, I suspect the weaker variants are 0.5% and the stronger variants are 1%-2%. It seems like everywhere they look, there are a lot of asymptomatic cases, so the under-reporting of cases means it is likely the 4%-5% morbidity stats are actually 1% by the time the untested, asymptomatic cases get factored in. similarly, its probably only 10% of cases that end up in hospital. But that means there are still a lot more people to infect and herd immunity is a long way off.

          1. Yves Smith Post author

            See the comment above from periol about Germany. A prominent MD there argues that asymptomatic cases are a myth, the tests are picking up other coronavirus infections.

            And further down:

            April 22, 2020 at 2:54 pm
            For what it is worth, New Zealand is currently searching madly for asymptomatic cases by both testing “around” (socially and geographically) known clusters, and by doing random-samplings in a variety of cities around the country.

            So far they have found none. Zero.

    3. Knifecatcher

      It seems within the realm of possibility that we’ll see a wave of people who survive the virus once then succumb to a second infection months or years later. Most of the fatal cases still seem to have a co-morbidity such as an existing lung issue, and since in many cases lung function is impaired for survivors they will likely be weakened and more vulnerable to the second infection.

    4. False Solace

      The virus likes to nom on a lot of different tissue types, including neurons, the GI lining, and testicular cells. It wouldn’t be unusual for a virus to find a reservoir in neural tissue or spinal fluid. If that’s true it would account for “asymptomatic” carriers, periodic flare ups, and recurring positive tests. I hope this is all just “the fog of war”, but a lot of signs seem to be pointing to people who aren’t clearing the infection the way one would hope.

  9. lyman alpha blob

    Thanks for the info on the possible multiple strains. I’d been wondering if it might be the case that there were two or more separate and distinct diseases here. We’ve seen reports of hundreds of people crammed together in a homeless shelter or a ship who all tested positive but were asymptomatic, and then other reports of people who came down with a mild cough and were dead in a few days.

    I am certainly not epidemiologist, but it didn’t make sense that such disparate effects could be the result of the exact same virus.

  10. Eustache de Saint Pierre

    Just a tiny bright spark born from a seed planted by NC.

    A sculptor friend who is out of work due to C-19 has been using his 3D printer & some other large piece of equipment which is above my understanding that he has since bought, has been manufacturing visors firstly for NHS workers, now care workers & due to the Thailand babies link I found here, when he gets on top of the rest is going to start on baby visors, which apparently will be most welcome by maternity staff.

  11. ChrisFromGeorgia

    I am still seeing way too much denial out there. Unfortunately being from GA, we are probably leading the nation in this regard, embarking on an experiment starting this weekend on what happens when you allow certain parts of the economy to open too soon.

    But the main area of denial seems to be with things like mass transit and airlines. I have yet to see anything in the press that would suggest somebody somewhere is looking at making changes to things like those TSA lines that snake for hundreds of yards in Atlanta during busier times, or what to do about transit workers facing higher risk. Subsidizing airlines to pay idle workers to sustain a workforce for a level of travel that isn’t coming back makes no sense, either.

    It is truly a shame that thinkers like Taleb get ignored by policy makers.

  12. David B Harrison

    A short time ago it was determined that the reason that the Spanish flu killed healthy people was that it put their immune systems into overdrive(known as a cytokine storm).An article written by Gabrielle Glaser for STAT “He ran marathons and was fit.So why did Covid-19 almost kill him?”April 21,2020 describes a cytokine storm as a result of Covid-19.Not good.

    1. rd

      My underrstanding is that some of this may be due to initial viral load. If the initial infection is from a large dose of virus, your body gets slammed very quickly. One of the goals of face masks, spatial distancing, hand washing wtc. is to reduce viral load in the intial infection which may reduce severity of the disease.

      A lot of young soldiers probably died in 1918-19 because they were crammed together on troop ships and in the trenches, so when somebody was sick everybody around them was bathed in virus and the high viral load increased the intital infection. The ame thing with things like the parade in Philadelphia, where people stoodshoulder to shoulder for hours.

    2. Yves Smith Post author

      Fit does not = healthy in terms of disease resistance. Marathoners (if he was training) are pushing their bodies very hard and are creating oxidative stress all the time.

      The healthiest and most productive way to exercise is interval sprints, short burst of maximum activity (30 seconds to 2 mins) followed by a rest period of 5-6X the work period. 20 mins of that is very hard and much better for you than 20 mins of jogging. If you weight train hard, that has similar benefits.

      Marathoners stress their hearts. Coronavirus in many cases attacks the heart as well as the lungs. See for instance:

  13. John Wright

    It seems ironic that in the midst of Covid-19 the USA ends up with a CO2 shortage.

    While the USA economy continues to create vast quantities of CO2, little is captured.

    If the touted “carbon capture” solution to climate change had occurred, the USA might have had vast reservoirs to tap.

  14. Lins

    I came across this comment and humbly ask for feedback:

    “80% of the cruise ship population do not develop asymptomatic infections. 20% test positive, of these 60% are asymptomatic and 1-2% develop serious illness and only from there does it matter how old or debilitated the individual is. The obvious scientific explanation is that SARS-COV-2 attacks only one variety (polymorphic) of ACE-II receptor, which has a 10% distribution. Thus 80 out of 100 people lack the necessary susceptibility factor and are totally immune. 18 of 100 have a heterozygous form – one of two alleles is susceptible. These people develop positive tests and perhaps mild symptoms. Only 2% of the population is heterozygous, they have two copies of the susceptibility gene. These are the only people who are at risk and their disease is modified by age, health status, and general immuncompetence. There’s been a great deal of research on the ACE receptors because of their role in high blood pressure. All we need to do is look for the ACE-II receptor variant with a 10% distribution in the US population. After that, a simple genetic test will let anyone know if they can contract COVID-19 disease. “

    1. Monty

      Thanks, that is an interesting theory. I have heard a lot about those ACE2 receptors lately, but I didn’t know they came in different flavors, I just heard there are different amounts. This could be an area to watch.

      Thinking about their maths….
      If the crew and passengers on the cruise ship were representative, and they all had equal opportunity to get infected, you could predict the virus would sicken about 8% and kill 0.4% of a total population where it presented itself.

      In the U.S. that would mean 28 million sick and 1.3million dead. 3x WWII = Nasty….But the ship must skew older as there are no kids, and it’s impossible to say whether everyone had a chance to get infected. So who knows… it’s anyone’s guess.

      1. lyman alpha blob

        I don’t believe your assumption is correct. It says 1-2% of those positive cases develop serious illness, which equates to about 1.3 million seriously ill, not dead, and that’s if you take the high end of 2%. That word ‘serious’ is doing a lot of work – what constitutes serious? Is it a few days of bad fever at home, a short hospital stay, ventilator treatment? If it’s the latter, then yes that’s pretty serious seeing as the survival rate after being on a ventilator for this isn’t good. But otherwise, maybe not so much. And, we’ve seen some reports that putting patients on a ventilator may exacerbate the problem in some cases. Also, we don’t know the source of that comment.

        As you said, who knows, it’s anyone’s guess. I do believe we should err on the side of caution until we figure out how this little bugger operates, considering what the worst case scenario could be.

        But we also need to keep a level head. We certainly don’t need people panicking.

        1. Monty

          3711 total population. 710 test positive, but only 300 sick enough to need medical attention and so far 14 died.

          1% of 3711 is 37.
          14 divided by 37 is 0.4%.
          0.4% of ~350m population of US = 1.3m

          Did I do the math wrong?

          1. lyman alpha blob

            I don’t think the math is wrong. I took the percentages from the cruise ship figures and expanded that to the entire US population. I used ~330m as the US pop, took 20% of that as positive for the virus, and then 2% of that as being seriously ill and came up with approximately 1.3m myself.

            The difference is you are assuming all those 1.3m are dead but the comment said that percentage were seriously ill, not necessarily dead. I’m assuming some of the seriously ill recover, but the initial comment is unclear as to what constitutes a serious illness in this case, so it’s unclear what percentage of the seriously ill eventually recover.

            1. Monty

              I just used the latest figures from the Diamond Princess. Perhaps that’s where the confuzzlement is creeping in. I thought that was probably the cruise ship which the original post was referring to.

              3711 on board
              710 positive test
              410 a or pre symptomatic
              300 needed medical intervention
              14 dead

              So we know for a fact that ~0.4% of total population died so far. If you apply that to the US population. 330m*0.4=1.3m dead.

              1. rd

                Cruise ship passengers tend to be older and wealthier than the average person. So the stats probably reflect a population with a median age of around 60 or so.

                Aircraft carriers like the Theodore Roosevelt are at the opposite end where the median age is likely less than 30 years old.

                Comparison of the Theodore Roosevelt and the Diamond Princess outcomes will be very interesting. Two tin can incubation devices with similar sized but very different populations. The Navy even has women now, so they can even put gender into the statistics.

                BTW – I find the whole discussion about the cruise ship industry and disease fascinating:

                It is not clear to me that people are aware that “quarantine” comes from the Italian phrase ” quaranta giorni” or 40 days which is how long a ship suspected of disease had to wait before docking in Venice starting in the 14th century. Cruise ships are now whining when they are infected and have to wait 14 days or more offshore unaware that historically it would have been more than a month..

    2. Basil Pesto

      I can’t speak to the science, but my understanding is that gene tests are quite expensive, which raises its own set of follow-up questions.

    3. Lins

      The source is a comment thread from a popular, however devolved (IMHO), site that I have read for years right along with NC. Unfortunately, my finance background does little to help translate. I posted because I recall a few weeks back some very engaging comments by NC users that appeared to be “fluent” in this language and was hoping to get a reaction from that crowd, no slight to my friends below btw!!! FWIW, I agree that cost could be the reason a genetic testing route is a non-starter.

      I keep returning to the idea that there must be a genetic explanation…why does a healthy 25 yr old end up in ICU near death, while others present with mild to no symptoms? I suppose its just desperation on my part, searching for sanity or a baseline in this bleak landscape.

      My county (OH) just announced testing availability to the general public, but one must present with at least 2 symptoms to be tested, which I think is illogical. Yes, I get that confirmation will induce the infected to isolate (hopefully) and reduce spread, but I think this is misguided at best and at worst misses the real threat: asymptomatic spreaders. At this point, there is far more utility in testing those with no symptoms. Either way we’re relying on the confirmed positives to self-isolate. All things equal, I feel far more confident knowing that healthy people who test positive will isolate (hopefully) vs not being tested, believing they are not infected, then going out and about to spread away when we reopen.

      1. CuriosityConcern

        Could be a mix of different COVID19 variants and viral load and pre existing conditions and host genome.

    4. John Wright

      Is the math a bit off?

      Trying to recall my statistics class of 40+ years ago.

      10% = 0.1 = distribution of ACE-II receptor in the population

      Probability of not inheriting it from either parent = 0.9 x 0.9 = 0.81 = 81% lack any copy of the factor

      Probability of inheriting the factor from both parents = 0.1 x 0.1 = 0.01 = 1% have two copies

      residue = probability of inheriting only one copy = 1 – 0.81 – 0.01 = 0.18 = 18% inherited one copy from a parent

      This has the percentage of the population that is heterozygous (two copies?) at 0.01 = 1%, not 2%

      This puts the percentage of the population with vulnerability of severe consequences at half the stated 2% value if the theory is correct.

      If the hypothesis is correct, this has 99% of the population subject to no or mild consequences of the Covid-19 illness.

  15. anon in so cal

    California expects its cases to start to peak in May. The state released a set of guidelines concerning how to prioritize care and an associated scoring system, given potentially limited resources.

    ““Patients who are more likely to survive with intensive care are prioritized over patients who are less likely to survive with intensive care,” the guidelines state. “Patients who do not have serious comorbid illness are given priority over those who have illnesses that limit their life expectancy.”

    The scoring system would assess potential organ failure risk and the presence of life-limiting conditions to determine prognoses for hospital survival and longer-term survival. For example, major life-limiting chronic diseases, such as moderate Alzheimer’s disease or moderately severe chronic lung disease, would add two points to someone’s score. Chronic diseases likely to cause death within a year’s time, such as severe Alzheimer’s disease or severe chronic lung disease, could add four points.

    Total scores would range from one to eight, with priority for ventilators given to those with lower scores. If there are not enough resources to treat all patients with the same score, the guidelines suggest hospitals group patients by age — ages 12-40, 41-60, 61-75 and older than 75 — and treat younger people first.

    “The ethical justification for incorporating the life-cycle principle is that it is a valuable goal to give individuals equal opportunity to pass through the stages of life — childhood, young adulthood, middle age, and old age,” the document states. “The justification for this principle does not rely on considerations of one’s intrinsic worth or social utility. Rather, younger individuals receive priority because they have had the least opportunity to live through life’s stages.”

    In addition, the document states that people whose work is “vital to the public health response, including all those whose work directly supports the provision of acute care to others, should be given heightened priority” to settle a “tie” between patients who can’t all be treated. Hospitals could eventually turn to a random lottery should such a tie still exist.

    Anticipating a peak in infections to begin in May, California officials have sought 50,000 more beds and 10,000 more ventilators beyond the state’s regular supply.”

    1. JEHR

      Yes, a scoring system seems to be a good method of choosing who should receive what treatment but it has overtones of selections we would rather not think of; i.e., choosing who is fit for work and who is not. Not a route we should have to go through if everyone did the physical distancing that would not overwhelm the healthcare system and thus let each person receive the health care they require without making others subject to “scoring” decisions.

      1. ambrit

        It really is a thorny conundrum. It brings to mind items such as the morning “races” between concentration camp inmates. The winners lived a day longer. The losers, to the showers.
        Overt social triage has not been seen in the West since those dark days.
        What bothers me is that these triage decisions today are being ultimately overseen by a self selected cadre of sociopaths.

        1. anon in so cal

          > “What bothers me is that these triage decisions today are being ultimately overseen by a self selected cadre of sociopaths.”

          Yes, exactly.

          Amitai Etzioni weighs in on this (although he has a black eye, imho, for apparently recently advocating bombing Beirut):

          “U.S. ethicists used to hold that one should save the lives of those who can do the greatest good. However, in recent years, the consensus has shifted from maximizing lives saved—to maximizing life years. Thus “Saving one child may outweigh the ‘good’ of saving two elderly adults, according to the cold arithmetic of life expectancy.”

          “The role of age in healthcare rationing has been debated for a long time. A leading figure in this debate has been Daniel Callahan, a renowned ethicist and a cofounder of the prestigious Hastings Center, which specializes in bioethics. He often co-authors with Sherwin Nuland, a physician. They called for a ceasefire in America’s “war against death,” arguing that those who surrender gracefully to death “may die earlier than [is now common], but they will die better deaths.” They urge the medical profession—and ultimately, the American people—to undergo a cultural shift they believe is necessary to prevent the otherwise inevitable financial failure of our healthcare system. This shift will replace a “medical culture of cure” with a “culture of care.” They held that “rationing and limit-setting will be necessary” to bring about this change. They advocated an age-based prioritization, giving the highest priority to children and “the lowest to those over 80….

          In a 2009 interview, Callahan advocated that those who “have lived a reasonably full life of, say, 70 to 80 years,” should get “high quality long-term care, home care, rehabilitation and income support, but not extraordinary and expensive medical procedures.”

          Wondering if these positions may have roots in the earlier, much-criticized, Skinner / Fisher Dartmouth Atlas Study which attributed regional variations in hospital Medicare expenditures to physician over-use of resources. The DAS’ emphasis was on the efficiency and effectiveness of the national healthcare system and the study was apparently admired by Obama.

          1. ambrit

            Yes to the Skinner Fisher paradox.
            When a society measures almost everything with a scale based on money and it’s possession, the allocation of resources becomes ‘skewed.’ Skewed towards the wealthy cohort of the population.
            What the above ignores is a hidden assumption in the theorizing on resource allocation. That assumption being that throwing more money at a problem will inevitably result in a solution to the problem being addressed. This takes no cognizance of the idea, nay, the reality of, limits.
            There is always a point of diminishing returns. Where to set that point, politically speaking, is a perennial political battle.
            Interesting times.

  16. Kevin C. Smith

    Rapid development of an inactivated vaccine for SARS-CoV-2
    bioRxiv preprint doi:
    it was noted that Spike-domain IgG was protective in a macaque model against infection with SARS-CoV-2, and that the vaccine under study did a good job of eliciting this variant of IgG.
    I suppose a good antibody test for immunity in the general population would be one which looked specifically for Spike-domain-specific IgG, because THIS seems to be “the good stuff”.

  17. lb

    Travel restrictions are a less-visible part of the new normal, I believe. International restrictions (borders being basically closed or long quarantine times upon entry making short trips not occur) are already in place, but most Americans don’t feel them. It seems likely that domestic travel restrictions in the form of required (and perhaps aggressively enforced) quarantine upon entry to a state will become more prevalent. As some states open before others, this seems like a natural defensive choice by the coalitions of more careful states (WA/OR/CA, IL+midwest states, NY+northeast). In the most recent NextStrain situation report, one summary conclusion was:

    The decisions made by each state profoundly impacts the fate of the others. Safely easing restrictions in any state will require coordinated containment, with all states acting to protect each other.

    While I am doubtful that “all states” will act to protect eachother, I do expect some localized form of this, and that people will get used to some interstate travel being dissuaded if not impossible.

  18. Kevin C. Smith

    It should be borne in mind that while there will be all sorts of random genetic mutations in the SARS-CoV-2 genome, only a small subset of those mutations will result in a change to the immunogenicity of the organism, and it only a subset of those mutations which could interfere with the effectiveness of a vaccine.

    1. Yves Smith Post author

      The big differences in virulence across the existing strains would suggest differences in immunogenicity. Generating a 270x greater viral load could be enough of a difference in degree to amount to a difference in kind.

  19. Jeremy Grimm

    The US response to the Corona pandemic has been chaotic, ill-considered, and appears most driven by the same colossal forces of Greed that worked so well building the conditions which promise disaster in response to almost any disturbance.

    After Corona we will have fewer medical doctors, nurses, orderlies, first-responders, and hospital housekeepers. We will have fewer hospital beds and hospital charges will increase to make up for the loses from the times of Corona. There will be further consolidations of hospitals, doctor’s practices, and medical service providers. I also suspect some actions will be taken to chasten the Nurses Unions — new laws passed, new measures to undermine and co-opt the Union and its leadership. Insurance companies will add new disclaimers for pandemic coverage and new levels of coverage to Obamacare — tin, and clay.

    We will have fewer small and medium size businesses, and the jobs they once provided supporting our ‘service’ economy will be gone forever. I do not know what will happen for any ventures started to produce items in the US — but I suspect they will be allowed to die or close after merging into the existing Big Money Cartels, and their productive capital will be shipped somewhere far far away although probably not China, at least for a while. Unemployment will remain at high levels … but the unemployment numbers will steadily improve as people without work are slotted into new measurement categories. Wages will remain stagnant or decline and real incomes will increase their rate of decline.

    Although Corona was most lethal to the old, late teens and young adults are the true victims of this pandemic. Schools and Colleges will become more standardized-test heavy, more online, more ‘credential’ vending, and staffing will be cut accordingly. There will be few if any entry level jobs and they will pay at or slightly below the cost of living in a room in a shared apartment, eating a lot of pasta, and little else. The price for beans will continue to increase. Unless something changes — which would be most unexpected based on past government response to Corona — many young adults and young families will have a large chunk of back rent due. I believe the uncounted numbers of homeless will be increased, along with the number of hungry, the mentally ill, and the criminal both violent and non-violent [and the number of crimes and the harshness of their punishments will be increased]. As the jail and prison cells made available by Corona fill up the US may need to start several new wars just to find places to spend the excess populations of young people. Our unhappy country will grow still more unhappy. Unrest will be most harshly dealt with but there will be more jobs in ‘law’ enforcement ….

    The Corona pandemic is just one of many pandemics we should be ready for and expect in the future — but I believe the US will be even less ready to respond to the next pandemic or new disease which will spread in the future. As a link yesterday elaborated — the changing climate combined with the rapid spread of new and old disease vectors and old diseases from more tropical climates will only increase the chance for a new possibly more deadly pandemic.

    I wish I could be more optimistic. I see nothing to encourage me a rainbow might follow this storm.

    1. Edward

      The federal response is worse then no response; they have used the crisis as an excuse for giant corporate giveaways and removing EPA restrictions. We would be better off without this “help” and just have the efforts of governors.

      1. Edward

        Especially obnoxious has been the refusal of Trump to cooperate with international efforts or his attempts to make conditions worse in countries like Iran or Venezuela.

    2. Aloha

      Although I do agree with you on how this scenario might go, we have to remember that the human spirit is strong and so many people with creative and innovative ideas will take the lead in their communities and that on local levels things may change for the better. Clearly more and more people are becoming aware of just how much our government officials don’t care about anything but profit at our expense and it will motivate the younger generations to rise and demand a better life. Just one small example of “pain” that is coming for many teenagers and a vast majority of the population will be paying their monthly phone plans let alone Netflix, Disney, apps, etc.
      I am on the sidelines cheering strikers all over the world!!! And and as another person made a comment on here about what they can do to help this Friday and on May 1st, I too will be turning off the internet for the day.

      1. Jeremy Grimm

        I wish I could share your optimism. Yes the human spirit is strong. I very much believe that Humankind will survive the coming collapse. I like to believe I have and can identify and help champion “creative and innovative ideas” [those attributes are becoming more and more like Lambert’s “smart” attribute] … but my experience with government and Corporate governance at every level where I have had access, admittedly not much access, has proven to me how little regard government and Corporate governance has for “creative and innovative ideas”. Remember “creative and innovative ideas” are “disruptive” [another word falling into what I regard as Lambert’s category of rhetorical cautions]. The last thing all levels of government or Corporate governance want, the very last thing they want is anything that changes the ways things are or in any way challenges the power, authority, or decisions of those “chosen” [think a Biblical sense of the word sans anti-Semitism] few who govern.

        I will follow your example and eschew Internet for May 1 [I trust others will capture the details of whatever events there are for me to regard on May 2]. I am a little skint lately but I hope you will join me in attempting to identify where a little green support might help the most worthy causes that appear on May 1. A little green helps augment sideline-cheers —- although I grow ever more skeptical of causes and their leaders as time progresses. I may save my dry powder for the wildcats and sabocats that will follow if things continue as they have.

  20. K teh

    The virus is like a predator, culling the weakest in the herd. The MMT sickcare .economy is geared toward preserving the aged in the last years of life, creating a positive feedback loop, at the expense of young people. The ecologists have been warning about this for decades.

    Between what you are witnessing – the replacement of the lower rungs on the economic ladder and replenishment of the credit system, the university certification/student loan scam, and all the welfare programs for real estate investors, young people are getting screwed out of buying a home and raising their own children.

    The bias in favor of the sickcare system and against young people is itself a sickness. There are millions of empty homes all over the country, rotting away, while young people are told that their only option is to comply.

    And once again Bernie has proved the futility of participation.

    On the bright side, homeschoolers are increasingly employing experiential schools for adaptation and social skilling.

    1. montanamaven

      What about both honoring the wisdom of age and taking care of the young and the working middle ages 35 to 65? Why not considerably raise the old age pension aka social security. That would allow the oldsters to comfortably hand over the reins to younger workers. Also like the Brits did after WWII as a reward for shared sacrifice, the US institutes a national healthcare system. A reward for this “war”. Seems like these are the right kind of incentives and does not demand “culling” when people still have a lot to offer.

      1. flora

        Children are dying of covid-19, too.
        Anger at preditory systems and businesses is fully justified. I think targeted bailouts are good, but no strings bailouts to predatory businesses are a bad idea; predatory businesses like HCA , speaking of health care.

        This business is screwing everyone they can, not just the seniors. (Is original commentor trying to divide the all people working together against predatory medical pricing?)

        1. montanamaven

          I totally agree with you on the anger at these predators (I pretty much agree with all your posts, by the way). The tales of the selfless are in sharp contrast to the predators. I just listened to a story on “Tyson Food” in Waterloo Iowa. They are just now going to institute testing for their workers. I think the “sick out” helped that along. The PTB did not treat their workers with any kind of respect or decency. I continue to be shocked which I suppose is a good thing. But how to get ourselves heard? Nobody even remember Obama’s Simpson/Bowles Commission or as we called it “the Cat Food Commission.” That was Obama. And Biden… Bernie had a platform, but he folded again just when we need somebody who can get some attention. I know. I am howling into the wind.

          1. flora

            Thanks. I agree about the selfless vs the predators.

            The last para of this J.W.Mason’s blog post, under the heading “The opportunity to be lazy” hits the nail on the head, imo:

            “The opportunity to be lazy. This fascinating review of a book on the plague in 17th century Florence quotes a wealthy Florentine who opposed the city’s policy of delivering food to those under quarantine, because ” it would give [the poor] the opportunity to be lazy and lose the desire to work, having for forty days been provided abundantly for all their needs.” It’s striking how widespread similar worries are today among our own elite. It seems like one of the deepest lessons of the crisis is that a system organized around the threat of withholding people’s subsistence will deeply resist measures to guarantee it, even when particular circumstances make that necessary for the survival of the system itself. ” (my emphasis)


            Both parties elite estabs seem happy upholding a system organized around threatening to withhold the people’s subsistance, imo. Explains a lot about the D.C. kabuki. Why is it so damned hard to get unemployment insurance during this pandemic, but so easy for the bigs to get billions in a near instant? Why is affordable healthcare a ‘never ever’ but bailing out insurance cos is necessary? Why are states told they’re own their own to find PPEs, then the feds hijack the shipments?

            1. flora

              adding a trivial example: Why can I go to the hardware store and buy a packet of nails, but in the same hardware store I can not buy a packet of garden seeds for sweetcorn, lettuce , and radishes?

    2. Jeremy Grimm

      Your comment is annoying. A virus is only somewhat like a predator. But neither a virus nor a predator “culls” the “weak” from the herd. I believe the “weak” — “strong” dichotomy attributed to Darwinism is an artifact of Social Darwinism. A virus infects, disables, and sometimes kills the susceptible. Virus particles mutate. The susceptible today may not be susceptible tomorrow — and now another selection of the population could be susceptible. Those susceptible to the virus who recover could be infected again by that same virus and/or suffer longer term effects from the virus — like the lung damage and whatever damage the Corona virus does to other organs. Viruses mutate relatively rapidly compared to predators. A novel virus has no long standing relationship with its host and can potentially kill all or almost all members of its host. You would have no herd to worry about after that.

      As an old guy I don’t agree that sickcare and the economy are geared toward preserving me and certainly not at the expense of young people. I think you need to find some new “ecologists” to listen. I feel like the sickcare and the economy are geared toward making sure I will be unable to leave anything for my children, and worse leave them a broken world careening toward a horrific collapse. I do not believe I am alone or exceptional in helping my grown children pay their medical and dental expenses, rent deposits, and sometimes rent too. On top of that I have to make sure I can pay my own medical and dental expenses and other costs. And thank FDR for Social Security and Medicare or I would be very hard pressed just to take care of myself — as long as I can remain healthy. And thank FDR that I receive a small but steady income that enables me to help keep my children afloat while they’re unemployed and keep them safe in their apartments and out of the service workplaces — the only kind of work they found.

      I did not say much about the mortgage payments coming due for the working middle aged people montananmaven outlined. Post Corona a lot of those people will also be unemployed, evicted, and more than a few divorces will follow. There is misery aplenty for old and young alike. The difference is that at least the older generations had a some — I won’t say good — some all right years. There will more millions of empty homes to rot away and a large number [I don’t know how much small and medium business there were before Corona] of empty storefronts, office buildings, shops, and factory floors.

      We will all share in paying the monopoly rents the growing Big Money Cartels will extract from all. We will all suffer the loss of what few public services our State and Local governments provide and all pay the higher taxes State and Local governments have to collect.

      1. Yves Smith Post author

        To your point about who is susceptible, one of the winter flus maybe 6 years back was serious and killed more people in their 20s and 30s than old people. That flu resembled the 1957 flu pandemic, so anyone old enough to have gotten that had pretty good immunity, while younger people were fully exposed. Our WordPress jockey at the time, in her late 30s, nearly died of it and her MD attributed her survival to having gotten a flu shot, which he claimed improved her immune response.

    3. JTMcPhee

      Got to hand it to young people who want to “cull the herd.” I see where a number of you are herding up to hold what when I was growing up was called “chickenpox parties:” getting your kids together, unprotected and up close and personal, with friends’ kids known to be infected, so as to catch the disease and power through to Golden Immunity.

      Worked for varicella, why not for Covid-19? After all, it’s just another flu. The cool part is when us herd members get old, the “chicken pox” herpes zoster varicella that we are now supposedly “immune to,” has hidden in our nerve cells and can reactivate, causing a painful and dangerous condition called “shingles.” Nobody knows how this coronavirus will work its way through our systems and whether it will recur. A little is known, however, about how CV can kill or disable:

      Right wing people under 20 years old. Go for it, I say.

      What’s the most common last words from a redneck? “Hooold muh beeer, and watch thee-is!”

      Let us recall the five basic laws and four main kinds of human stupidity:

      1. rd

        In 1918-19 it was often the young that were culled. There was double culling of that generation at that time – WW I warfare and the flu. There is a strong tendency for economies to do better when a significant percentage of the population is in their peak years of productivity, basically late 30s through early 50s. The lack of able-bodied and experienced men in the prime of their life in the 1930s could have been a contriobuting factor to the depth and duration of that depression throughout the Western countries that fought in WW I and was subjected to the flu.

  21. Carolinian

    Since SC is mentioned above just a brief spin through this morning’s NYT corona stats

    SC Deaths per 100k-3; total deaths 135 (out of a population of around 6 million)
    GA Deaths per 100k-8; total deaths 810
    TN Deaths per 100k-2; total deaths 167
    NY state Deaths per 100k-79; total deaths 14,828

    In my state projections now state that we are on the back side of the hump for wave one and that new cases per day are diminishing. The governor has said he will begin reducing restrictions including beaches and non essential retail but the 5 customer per 1000 sq ft rule will remain. Schools remain closed. This is treated as controversial while the last of the above stats receives less mention. Clearly there is a huge US health emergency and it’s pretty clear where it is. If SC now sees a resurgence then those tighter restrictions can be reintroduced but if that doesn’t happen one wonders whether the msm will choose to take any notice.

    1. Grumpy Engineer

      Yes. Death rates vary a LOT. It really depends on where you live:

      I think South Carolina is wise to look at partially relaxing their restrictions and closures. NYC (with 179 deaths per 100k of population) clearly needs strong restrictions to reduce virus transmission. But do we need that same level of lockdown in regions with a handful of deaths per 100k? Heck, I reside in the foothills of the Appalachian mountains, and there literally hasn’t been a COVID-19 death within a hundred miles of where I live. But the job losses easily measure in the tens of thousands. I would argue it wasn’t worth it in my region.

      I’m not sure what they’re going to do when it’s time to re-open schools, though. That’s going to be trickier. It’s hard to keep young children from sharing germs.

    2. rd

      I am suspicious of US statistics in pretty much every state. The deaths that are counted are generally ones with positive tests that died in hospitals or nursing homes. NYC showed that was a huge undercount when they started looking at excess at home deaths and NYC/NYS are fairly well organized for statistics. Many states have relatively poor statistics that are collected slowly and amalgamated at the local level, sometimes sent to the state, and occasionally sent to the federal government. I think China lies about its stats but the US often just doesn’t bother to organize them.

  22. David in Santa Cruz

    Thank you for this thoughtful review. The more we know, the more we know that we don’t know.

    I’m fortunate that I probably had COVID-19 over the Christmas-New Years holiday — caught at a lunch attended by Silicon Valley one-percenters and people close to them — at least one of whom was actively sick. A few days later I lost my senses of taste and smell, developed severe conjunctivitis, and suffered two weeks of up/down fevers and a persistent dry cough. I traveled by air between Silicon Valley and Seattle in late February-early March and didn’t get sick — possibly resistance due to antibodies, but I can’t get reliable testing, so who knows?

    Supply chains are only beginning to show the true effects of the shut-down. Let’s not kid ourselves. This pandemic is another coal-mine canary of over-population and globalization. It won’t be severe enough in the near-term to reverse that root cause of cascading crisis on an over-burdened planetary ecosystem.

    Not pretty.

  23. Mike

    The upshot of all of this, to me, is that every position of responsibility has been put on the market, for sale to whomever (or whatever) can afford to buy into its decision-making process. Not all scientists, researchers, or doctors are bought yet, but enough to have a public argument against any proposition that curtails business or hurts profits. Obviously, there are enough citizens poor enough, mentally and financially, to be bought or convinced to carry their submachine guns into battle over the shutdown (and for the police to allow it). While this reaction is understandable to a degree, it is fed by a gross lack of knowledge of both medicine and the political machinery existing now — a product of our not-so-estimable educational system nurtured by capitalism to ensure minimal critical thought.

    Workers and the poorest among them hope college will aid their children in leaving poverty behind, while they paradoxically hate the education that makes a tiny portion of those students aware of the criminality of this system. The lack of weight for counter arguments due to lack of money behind them shows our attitude toward education is financial, not intellectual. Endemic to most of society as we see it behave today, this is a corruption of the populace that allows corruption at its heights to go, not only unpunished, but smilingly tolerated if not praised.

    What will it take to clean out this nation (nay, the world) of this attitude that is not proto-fascist or Stalinist and smashes what liberties we supposedly received from that iconized piece of paper?

  24. Jeotsu

    For what it is worth, New Zealand is currently searching madly for asymptomatic cases by both testing “around” (socially and geographically) known clusters, and by doing random-samplings in a variety of cities around the country.

    So far they have found none. Zero.

    Is this due to viral strain difference with what we’ve been fighting here? So far we’ve had a very low fatality rate (0.1%), a low hospitalization rate, and all the deaths have been elderly — unlike NYC which is seeing many healthy under 50’s in ICU and morgue.

    I wonder if many of the “asymptomatic” are actually just pre-symptomatic, as the studies are being done in locations with runaway doubling times against a disease with a long pre-symptomatic period. Has this difference been distinguished?

    I’m also leery of antibody testing post-facto. Are we just seeing people “exposed” to the virus that never developed any (even super mild) disease? I’m thinking about Johnes disease (a big problem in farmed deer), where antibody tests are useless because of a large background “exposed but never really got the disease” background.

    1. Jeremy Grimm

      What exactly are the symptoms peculiar to a Corona infection? If someone who is infected never shows the signs or symptoms; if the signs and symptoms are characteristic [including loss of sense of smell] of several other colds, flus, or allergies — so that many people with the signs and symptoms do not have the infection — then what exactly are the signs and symptoms? I am also not aware whether there has been testing to confirm that people who have the Corona infection and show the signs and symptoms — do NOT also have coincident, colds, flus, or allergies piggy-backing on the Corona flu and which are the source or main source for the signs and symptoms manifested. I am also not aware whether it can be or has been confirmed that the signs and symptoms of some Corona flu infections are the ONLY signs and symptoms which a Corona flu might manifest.

      I was greatly heartened by the study linked to in today’s Links: “How SARS-CoV-2 (COVID-19) Gets into Respiratory Tissue …” Finally a study that actually takes a closer look at what is going on! I only peaked at a few pages of the introduction to this study but it appears to examine the cellular level effects of a Corona infection. This is ONE of the kinds of study which must be done and done soon for Corona and other viral diseases. Viruses are not going away any day soon. I believe we need to understand much much much more about how they work before we jump into searches for new vaccines or drugs willy-nilly.

      1. rtah100

        As an amuse-bouche: there is a story in the UK today that the child (12?) who caught coronavirus in the Alps from the super-spreader who brought it from Singapore to the UK went on to contact ~170 other people – and gave it to none of them! The child was found to have active concurrent influenza and common cold infections too! He was obvious scrupulous about washing his hands, to have passed none of that on.

        Then, as the main course, I’m disappointed at the stance that coronavirus needs a peculiar symptom. Medicine doesn’t work that way. Diseases have common signs and symptoms, hit a certain number of them and you can make a presumptive diagnosis that needs confirming with in vitro diagnostics / imaging / biopsy / surgery (e.g. peritonitic appendix) or, worst case, post mortem (e.g. Alzheimer’s). Context is everything. Tremors and hallucinations in the teetotal are very different to tremors and hallucinations in alcoholics drying out. We need to trace contacts of the sick, test them and isolate them. In the absence of magic bullet therapies or vaccines, that is all we have: detective work, suspicion, action and, for those that need closure, confirmation.

        1. ChrisPacific

          It would be quite interesting to understand whether anomalies like this are just luck or whether something else is going on. A similar example from New Zealand: back in March, two schools (one in Dunedin, one in Auckland) had to close after a student and teacher respectively tested positive for the virus. The Dunedin school tested 200+ contacts and was able to reopen after all came back negative. The Auckland school eventually became a cluster with upwards of 70 cases. Why the different outcomes? Nobody knows, yet.

    2. rd

      Its how vaccines work. You don’t get the disease and recover. Your body is exposed to critical components and creates antibodies to them that protect you in the future. Sometimes the protection is total, and otehr times you may get a weaker version of the disease that your body can fight off relatively easily. This is commonly seen with flu vacciens and is probably how the common cold works.

  25. nothing but the truth

    There are some articles which claim Covid has HIV like capacity to attack the immune system. This has troubling implications:

    1. For an unrelated virus to develop HIV like traits is almost impossible. These traits evolve over millions of years. ie, this is man made.

    2. HIV can lie dormant for years before manifesting. That means all those “unsymptomatic” cases could in reality be dormant cases. Scary beyond belief.

  26. Ep3

    “ This led to plant closures, including among the 50 specialized plants that collect CO2 for the food and beverage market.”
    Yes let’s close public water plants. We have nestle, which is slowly buying up all the fresh water in Michigan. Praise be the power of the free market.

  27. JoeC100

    Report today on our local situation from Brunswick, Maine: Shopping weekly at a natural food store that is very well organized and has adapted significantly to COVID – bulk commodities containers (rice, beans, etc.) have been removed and replaced by shelves with bagged commodities, etc. Staff has been eating masks and gloves for the past several weeks. Everyone shopping uses a cart which is taken by a staffer to checkout and bagging (by staff) and then bags back into the cart. Requested payment is by non-contact credit card (first time I ever used this feature). Store limits reduce “social distance” concerns. I have noticed very few product shortages – more or less “shopping as usual”, but through a different “pathway”. Then past two Saturdays all shoppers had masks and gloves, which was not the situation three weeks ago. This morning I needed to shop at our local large conventional grocery store during the 60+ only early morning hour. The process for entering, moving around the store and maintaining “social distance” with other shoppers was well organized, but no staffers were wearing masks – and I don’t recall if they were wearing gloves. There were a few obvious stocking shortages (paper towels for example – shelves in that area were mostly bare) and there were “one per customer” limits for a few products including paper towels and eggs! Many local area farms have set up retail stands/online ordering etc. and a high quality fish company that previously only supplied restaurants has transitioned to online ordering and pickup at their facility at the local former Naval Air Station. And my wife’s former (pre Lyme+) aerobics teachers is streaming two video sessions per week on her former session days to maintain contact and support her (mostly) girls. I mostly work with colleagues who have worked remotely for years, so I don’t have any sense of how this is impacting (presumably quite seriously) local people out of work. Pretty much only the few regulars at my daily early morning walk with our dog at a nearby former navy facility on the water with about a two mile perimeter walk – but I think there is more walking traffic than usual during the day, but not enough to close off access. The big local concern seems to be that the Navy is not wiling to shut down production at Bath Iron Works where the bunions have been pushing hard for shutdown. There has been very significant modifications in how ten workers travel to work to minimize exposure.

    1. Jeremy Grimm

      [Warning — this is a slight detour from the main thrust of JoeC100’s comment — a side-trip — I took an aerobics/stretching class at one place I lived [I only stopped going because I had to move]. Most guys think these classes are just for women. That is so WRONG. I took the class hoping to meet one of the women [confession — I once took “jazz dance” for the same reasons and enjoyed and benefited from the class immensely although I failed at my “mission”]. I never received more physical benefit from any exercise I have done than that I did in this aerobics class [and again I failed at my main mission]. This comment is for his wife.]

    2. Yves Smith Post author

      Hah, I know the stores you are referring to so I can visualize this.

      Do you think the care the locals are taking (gloves and masks) has to so with high average age in Maine, or with messaging by state/local officials in the news? I am really appalled down here in the South with how few people are wearing masks.

      1. JoeC100

        I thought you would know the stores! Regarding the Natural foods store (in Freeport, as to is less crowded than the Brunswick store) – I think it has been a combination of mask access, which for most has been mostly the past two weeks and the characteristics of patrons of this store. Yesterday at the big Brunswick grocery it probably was the age group as this was an early 60+ hour and it seemed like a much broader group of people. I also think people who had masks maybe three weeks ago were were reluctant to wear them as no one el,se was. But no one I run into in my early walk has worn a mask yet – but this is a small handful of people in a big (30+ acre) area. In my case, I had some N-95s, Tyvek body suits and even a full face clear N-100 cartridge mask as I unfortunately had to do some mold remediation this past fall – and I did not start using a mask until I saw other people doing so about three weeks ago.. .

  28. Keith

    A CO2 shortage may be a more immediate risk. From the Guardian:

    An emerging shortage of carbon dioxide gas (C.O2) caused by the coronavirus pandemic may affect food supply chains and drinking water, a Washington state emergency planning document has revealed.

    It appears for soda and beer, SO2 costs are increasing 25%. Wine would also be affected, as it is used during the aging process in barrels and tanks

    1. rd

      We need to rush to Mauna Loa Observatory to collect some of that rapidly rising CO2 in the atmosphere to save beer and soda.:)

      I find it humorous we are running into a CO2 shortage these days with the stress on climate change and greenhouse gases. need something to smile about.

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