Razib Khan One-stop-shopping for all of my content

May 20, 2020

Late spring in the age of coronavirus

Filed under: COVID-19,Health — Razib Khan @ 10:33 pm

I haven’t posted on COVID-19 in a while. What’s there to say? The last month or so has been a great muddle. We soldier on, without purpose or direction. At least here in the United States of America. In regards to the pandemic, we’re in, all I can say is that I feel a sense of listless ennui. But perhaps I should say something, just for historical purposes of tracking where we’re at for this weblog?

On March 23th, T. A. Frank mentioned me in Vanity Faire as being a COVID-hawk. You can search this weblog and note I was relatively sanguine at the end of January, but we began to stockpile in early February. By the middle of February, I was alarmed. On February 19th news broke that Covid-19 was spreading Iran, and to be frank I flipped out.

Between February 20th and March 10th, there was a slow and gradual shift in thinking. But the real switch was flipped between March 10th and March 15th, as broad swaths of the culture moved into a high state of alarmism. It was curious seeing scientists who I followed who were fixated on Richard Dawkins in February joining the alarm about Covid-19. When they’d give a thought many (though not as many privately!) were reassuring.

They shouldn’t have been.

Some considerations and observations:

The COVID-doves: early in the pandemic there were critics who were accusing me of alarmism. This was March, so who knew? I asked for some numbers. One individual said that at most there would be 20,000 deaths. We are around 100,000 now. Over time the initial wave of skeptics faded away because the numbers were too high.

But, the second round of skeptics emerged. The interesting thing here though is that the second wave of skeptics was more focused on the opportunity costs of the lock-down. The key problem I have with this wave of COVID-doves is that I wish they would just admit that 250,000 miserable deaths may be the price we have to pay. Perhaps. We just need to put the numbers on the table and remember that the deaths seem quite unpleasant and protracted.

I am on friendly terms with many COVID-doves. I disagree with them, but I have friends and many who are liberals too, and I disagree with them. In fact, in an ideal world, I would be convinced by their arguments, and become a COVID-dove. I am not convinced by their arguments. Yet.

There is a broader class of COVID-skeptic which is, to be frank, unhinged, conspiratorial, and a promoter of misinformation. This is a serious problem.

The COVID-hysterics: another class of individuals are those who are hysterical about the impact of COVID. They want a two-year-long lockdown. They believe that the governor of Georgia has blood on his hands. They believe that COVID could kill anyone! Any skepticism or cost-vs.-benefit thinking is anathema to the COVID-hysteric.

The data is clear now that COVID-19 is particularly dangerous for older people. But the number of media profiles of young women who die of COVID-19 is quite high. There is, to my mind, a clear attempt by the media to make it seem like everyone is at risk. In fact, for people in their 20s and younger the seasonal flu seems to be more risk. The spate of stories about Kawasaki disease and children is, in my opinion, part of the issue. To convince COVID-skeptics those who wish people to take this pandemic seriously need to not exaggerate, or they’ll lose all credibility.

The IFR: I now believe that the infection fatality rate in the United States is around 0.75%. This is, as the above comment should make clear, not unconditional. For the young, it is quite low. For the aged, it is much higher. But when estimating how many Americans may die of COVID-19, this is the number that I think is reasonable. Perhaps higher. Perhaps lower. But this it the ballpark. If 50% of Americans become infected, that’s 1.2 million or so deaths. The IFR, like the R, is not a fixed parameter. Perhaps the virus will change. Perhaps our therapeutics will get better. But we go to war with the parameters we have, not the ones we want.

The uncertainty: There is still a great deal of uncertainty as we proceed forward. We know some things (e.g., no, children are not at high risk of death), but not enough. I have stopped paying attention to whether the weather impacts COVID-19. I think it does, but more in the range of 25-50% changes in the R, not an order of magnitude. There are lots of small things that are having impacts that we don’t know. And there are likely stochastic factors as well. We look through the mirror darkly.

Perhaps COVID-19 will fade away. Burn itself out. But that’s hope. A guess. We have no idea. We’re still not clear why the outbreak in New York City was so much worse on the West coast of the USA. Why Southeast Asia has been left relatively unscathed.

Pre-COVID-19 times

The quarantine: The major lacunae in the Western response has been quarantine-containment. The lockdown has, on the whole, not taken COVID-19 positive people, and put them in some sort of quarantine. It doesn’t look like it will happen.

That means COVID-19 is endemic. For now.

Where are we? It looks like as we move into fall the number of American deaths will be in the low 100,000s. This is a victory, after a fashion. My family is still self-quarantining. We have no date when we’re not going to keep doing this, at least for the foreseeable future. My children have grandparents that they want to see. What are we supposed to do? But the day will come when we go back out into the world…

April 28, 2020

Not too many young are dying from COVID-19

Filed under: COVID-19,Health,Health & Medicine — Razib Khan @ 12:44 am

When does COVID-19 get more dangerous than the flu? The CDC has some deaths listed for COVID-19. It also has deaths recorded for influenza. These are not perfect records, but, they give us a general comparative sense.

The total count in their data for the column I’ve plotting is about half of or so of the current death total for the USA. With that said, COVID-19 seems to be a really marginal disease in terms of mortality for those 24 years and under. For those 85 years or old COVID-19 is killing order of magnitude more than the flu.

Of course, there is morbidity as well as mortality. COVID-19 seems to have a longer course of progression for the symptomatic, and, there is the worry that it may cause lifetime problems in many people who survive from the severe cases (and even possibly the asymptomatic).

But, the number of people who are under the age of 40 who are dying doesn’t seem that high. And yet when I see headlines and profiles in the media, a huge number of feature focuses seem to be about younger people who die of COVID-19. Why? Obviously, because the deaths of the younger are surprising. But, I also think that part of it is the same rationale for the HIV-AIDS campaign: by pretending as if everyone is vulnerable, you obtain mass social mobilization.

I happen to know lots of people will not look at the raw data to understand what’s happening. But enough will to get annoyed.

50% of the deaths in Europe are in care homes. My family is self-quarantining no because we feel at risk, we’re not. But because there are older people in our family from whom we don’t want to be exiled. Does the media think if we admit and highlight the enormous danger that older people in particular face, we’ll conclude that they’re disposable?

April 27, 2020

COVID-19 in India, one week before the easing…

Filed under: Health — Razib Khan @ 12:51 am

Huge regional differences. The two southernmost states, Kerala and Tamil Nadu have more people who have recovered than are active. This is a good sign.

April 20, 2020

Razib Khan corona-casting in the time of coronavirus

Filed under: coronavirus,Health — Razib Khan @ 8:40 pm

I recently talked about coronavirus with our old friend Kushal Mehra. I decided this is probably a time where I can post all the different coronavirus related podcasts I’ve done. I started on February 17th, on my podcast with Spencer Wells. You can see all the podcasts in rough order of date recorded…

It’s not live yet, but I’m going to have an episode on Two for Tea soon (it was recorded before the two below, so I put it here).

April 16, 2020

COVID-19 status update, mid-April

Filed under: Health — Razib Khan @ 2:05 am

Spencer and I recorded another coronavirus episode of The Insight. It should be live in a day or so. Therefore, I thought it was good to take stock and make some comments (my Twitter autodeletes).

– A few weeks ago I had been optimistic and suggested that the USA would have 40,000 deaths. That seems unlikely. I will remain optimistic and suggest 85,000 deaths by August 31st.

– I think most of the country will “open up” between May 15th and June 15th.

– Heterogeneity in trajectory persists. Some of this is through clear policy (e.g., Taiwan). But some of it is through demographics (USA is 40% obese, Japan is 3% obese). And, some of it is probably genetics.

– Many commentators make the correct observation that “no evidence of X” is not good evidence. E.g., “we have no evidence of human-to-human transmission…”

– The term “conspiracy theory” is totally debased. Just like the word racist or squish.

– High levels of uncertainty on everything. For example, many preprints which find confusing associations between weather and COVID-19 somehow transform in the media to titles of the form “COVID-19 won’t disappear in the summer!”

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