Because most philosophies that frown on reproduction don't survive.

Wednesday, May 13, 2020

Understanding the COVID-19 Outbreak: Part 1

For reasons of length, this post has had to be broken into multiple parts.

The coronavirus outbreak and the way that it's been dealt with by our country is such a big topic that even though I've been following the story a great deal and trying to understand it, writing comprehensively on the topic seems daunting. And yet, it's trying to fit the entire topic together in some sort of context that seems most needed. Thus, this post will attempt to tackle first how I came to think about the topic the way I do, and then my understanding where we are, how we got here, and where we may be going.

How I Got This Way

I heard about the coronavirus fairly early (mid-January) because the company I work for has offices in China and in Taiwan, and so we had colleagues who were affected by the Chinese lockdown and travel restrictions back in January. I also knew from seeing the dramatic slowdown in sales to our Chinese customers (and from my Chinese colleagues who were working from home despite being over five hundred miles from Wuhan) that China was making a massive effort to contain the virus and that that was likely to have significant economic effects.

And yet, I was blind to the possibility that we would actually end up with a significant outbreak in the US. Looking back, there wasn't any rational basis for this blindness. Rather, there was a sort of habitual interpretive filter that we often apply instead of reason because it's quicker and easier. Various other outbreaks had occurred without becoming widespread in the US (SARS, MERS, Zika, Ebola, etc.) and so I made the assumption that somehow or other -- through luck or the efforts of epidemiologists or travel screening or the blessings of first world life we take for granted -- we wouldn't get more than a smattering of cases in the US.

It was in early March, as it began to become clear this was not the case, that I started to play catch up on reading about the virus. In my reading I was fortunate, in that the first people I looked to were people I knew to be scientifically and statistically literate. I quickly realized that Razib Kahn of the Gene Expression blog was taking the virus very seriously. Razib is someone I've been reading off and on for nearly fifteen years, almost since this blog began. His scientific work is in genetics, he's got a strong understanding of data analysis, and he's also very historically literate. Nor is he easily led by convention. (The NY Times at one point invited him to be a recurring contributor and then pulled the invitation because they decided he was too un-PC.) Another person whose thinking about the virus guided my early impressions was Josiah Neeley who ages ago was the libertarian voice on Vox Nova and wrote the Blackadder blog. Now you can hear him under his own name at the Urbane Cowboys podcast (which is one I try to listen to every week even though I don't like podcasts as a format.) If you want to hear my two main influences come together, Razib was a guest on the Urban Cowboys podcast in this episode back in March focusing on the coronavirus. Through them I found a number of people on twitter who seemed to be addressing the topic realistically and linking to good scientific content.

This was my background when I wrote my first post touching on an aspect of the coronavirus outbreak and the measures proposed to slow it's spread back on March 14th, which not-coincidentally was the day after my last day in the office at my employer, as those of us not working the manufacturing plant had all been told to work from home until further notice. (That I have a job I'm able to do from home and remain gainfully employed is a good fortune for which I am duly grateful, though the economic effects of the pandemic will still be hitting the company hard and thus we're dealing with pay cuts, etc. in order to keep the company solvent.)

But as I was learning about the situation, the situation and the response to it by various countries was changing rapidly. What are we to make of these developments?

Coronavirus: Origin Story

I have no intention of trying to dig into the question of how the virus got loose in the first place, as this is one of the things it will probably take us longest to have clear information about.  What does seem pretty clear, however, is that China first went through a phase of trying to pretend the outbreak did not exist.  While they're an oppressive autocracy, their instincts here were probably not that different from the instincts that have made more democratic governments deny the seriousness of the situation at first.  They didn't want to scare people, admit possible incompetence, and suffer the economic disruption of a major disease outbreak, and so at first they hoped it would go away.  It didn't.  So China then went into a second phase of trying to actively suppress the disease.  To that end, they shut down travel between the city of Wuhan (where the outbreak had originated) and other parts of China.  They put people both inside and outside Hubei province under lockdown.  And then within Wuhan itself (which is by population about the size of New York City, but is only the 9th most populous city in China) they began to enforce strict quarantines of all sick people and even of people who had been exposed to sick people.  China being a repressive and secretive society, it's hard to know for sure what did and didn't happen, but there are rhumors that spread from China at the time about sick people being welded into their apartments and left to die.

Whether these darker stories are true or the CCP was merely pursuing a conventional but strict set of isolation rules, the result was that although by the end of January there had been cases identified in many parts of China as well as in nearby countries and even in the US, the virus never spread widely in Chinese provinces other than Hubei. Pulling down data from the John Hopkins data portal, and charting the number of reported new cases each day, Hubei frequently reported over a thousand new cases a day in late January and early February, while the other provinces with the largest outbreaks were reporting just over a hundred.
Of course, that phrase "reported cases" is key. China is not a free society, and throughout the crisis the regime has acted to preserve its prestige. It may well be that China is lying to some extent about the number of cases and number of deaths. Even if they aren't intentionally lying, local officials may be hiding the truth from higher officials in order to make themselves look better. And of course, all countries' counts are suspect at this point because information is difficult to come by. There's no way to know at this point how accurate the Chinese data is, but it's not implausible that the kind of heavy-handed quarantining of sick or exposed people which China was engaging in could have kept the spread mostly in Hubei Province and eventually have eradicated the virus even there.

 Free societies such as South Korea and Taiwan have successfully crushed their COVID-19 outbreaks through serious but less inhumane methods. These Asian countries in particular had good reason to take an outbreak of a new coronavirus seriously. They had borne the brunt of the SARS outbreak -- a related coronavirus which was much more fatal but much less easily spread -- eighteen years ago, and so they had the experience of having identified, isolated, and eliminated a deadly new respiratory virus.

A recent Twitter thread described what South Korea's measures to contain the virus are like to this day:
1) Upon arrival, they take your temperature at the airport and ask if you’ve experienced any symptoms. If you have, they move you to a separate area and give you a coronavirus test. If you haven’t, they take you to another area and interview you. They also install ankle bracelets

2) You are required to install an app on your phone and enable location tracking all the time. You are required to self-report symptoms in the app twice a day. If you don’t have symptoms, you need to report that too. This goes on for a period of 14 days

During this time, you are not allowed to leave the quarantine dormitory or your home if you’ve chosen to self-isolate at home. You cannot take public transportation or taxi, and you cannot self-isolate in a hotel or Airbnb. If you don’t have a home, you must use the dorm.

If you break quarantine, you are fined $10,000 USD and face jail time. Also, they check your location on your phone frequently. My wife had her location checked 37 times in a 3 day span. And they’ve caught enterprising folks who leave their phone at home and go out.

During this self-isolation, you cannot have contact with anyone during this time. They give you special trash bags to throw away your trash in, and people in hazmat suits come and collect your trash upon request.

You are assigned to a case worker who is responsible for making sure you are following all the orders. They will call you and text you to make sure you are OK. They also will send you care packages that contains a lot of food, gloves and masks, sanitary pads for women, etc.

3) If there’s a new coronavirus case in your general area (same city or district), you get a Public Safety Alert on your phone that tell you about the person (age, male/female, city) and provides updates as they receive them.
You can read the whole thread here.

Needless to say, lockdowns and quarantines are not without economic cost. China has the advantage of having their initial outbreak behind them, and having taken such extreme measures that their outbreak was comparatively short. Nonetheless, their economy has taken a considerable hit, and it will continue to do so because a good deal of their economy is centered on making things to export to other countries. When those countries are in their turn going through lockdowns and the recessions related to them, they will be buying less stuff from China. And that's before we consider that people in many countries may feel just a little bit peeved with China before all is said and done.
The article this above chart comes from, which talks about what China looks like as it slowly reopens its economy, is worth reading.

Read Part 2 here.


Anonymous said...

Thank you for this. I'm checking back regularly! (Other people are waiting, too.) This is very needed.

Darwin said...


Thanks! Part 3 goes up tonight.