COVID: What We Think We Know, What It Means For What We Can/Should Do

Watching the mass of people cram into bars, onto beaches, and into parks sans masks is driving me crazy.  Watching North American governments fail to make use of the ten or so weeks semi-quarantine is agonizing.  Seems like so much wasted effort and sacrifice.  The New York Times has little obituaries to some of the nearly 100,000 Americans who have died due to COVID.  So, maybe it makes sense to take a step back and figure out what we know and what that knowledge implies.*  Oh, and I lay some blame at the end.


What We Mostly Know:

• The virus is more dangerous than the flu, and that is not even accounting for how badly it can hurt people who survive.  The death rates may not appear to be that much, but we are learning more and more about effects.  This thing is nasty as it is not just an upper respitory disease.  It causes blood clots and more.  When this thing started, I thought: I am in my mid-50s, I am reasonably healthy, I never smoked, I could get through this ok.  But as a nurse/neighbor reminded me, this thing has a way of revealing conditions one does not know about.  So, the idea of getting it is scarier now.
• Crucially, COVID-19 can be transmitted asymptomatically.  So, I have no idea why folks are using temperature testing as if it means anything. 
• It is mostly spread by inhaling aerosol droplets.  While we worry about touching something that someone else has touched, it is largely spread by people breathing out the disease and others breathing it in.  This is far more likely to happen in enclosed spaces and over time.  So, we can worry less about a grocery store visit and far more about classes, concerts, churches, and planes.  

What We Should Be Doing:

• The obvious stuff: social distancing and masks.  The best ways to stop the spread is to not gather in large groups indoors and to limit how much we breathe on each other.  Being outdoors is fine, as long as one is not on top of each other.  This weekend's pictures are so disturbing because people seem to think it is ok to be crowded again.  Yes, it is ok to be outdoors, but not when it is crowded.  This should not be that hard to figure out and respect.
• We should be willing to allow ourselves to be traced in the short to medium term.  That is, yes, government will need to know where we are.  It seems un-American and un-Canadian, and the polls certainly show lots of hostility.  But if we want to move forward, we have to be able to squash outbreaks, and we can't do that if the disease is passed asymptomatically unless we trace.  We have the tools.  Other countries have managed to do this.  Perhaps folks can't trust the Trump Administration do get this kind of info, but, damn it, Canada, we should be able to do this.  Part if this here is caught up in the tangles of federalism, but the feds should provide a single, useable app that provides info to a non-security organization/non-corporate entity.  
• Testing should be widely available so that we can do things like:
• Send kids to overnight summer camp--test the kids and the counselors, enforce mask wearing the first two weeks of the session and then after the results are clear and the infected are removed, have at it for the rest of the summer.  It means that the counselors can't spend their time off away from camp.  This would be a younger version of the bubbles the NBA is thinking of developing.  The camps are already away from people--with testing and tracing, this could work and give parents and kids both some relief.
• Start opening up smaller offices/factories/stores where you don't have large numbers gather. 

Which Brings Me to Who to Blame:

• Our governments have varied in their reactions, but the failure to get testing to be widely available is a huge failure.  Not just in the US but in Canada as well.  This stuff may be quite hard, but it is really difficult to see how much progress has been made in testing.  Some places have testing on demand, such as Los Angeles.  But this should be more widespread.  Mask wearing should be mandatory in public. 
• Some leaders.  Those that don't model good behavior--mask wearing--are setting lousy examples.  We are starting to see governors in the US push more on this.  But it is so little, so late.
• Our community leaders.  Well, some of them. Those that insist that large indoor services go on share much responsibility.  They have to work harder to find ways to share community and do their functions without meeting indoors in large groups.  Churches have been major vectors in the spread of the disease.
• China.  The early denial and the later conspiracy theorizing have made this thing worse than it could have been.
• The US.  Its failure to lead shows how essential American leadership has been over the past few decades.  I could go on and on about Trump, but suffice to say that the US under Trump has done incredible damage to international cooperation in many fields, and this pandemic is making that felt so much.  
• Russia.  We don't need the disinformation, Vlad.  Fuck off.
• Ourselves.  While the protesters against the shutdowns are minorities in every state/province, those large numbers of people gathering in parks and not wearing masks are not small.  These folks need to take more care, and I have no idea how to persuade these folks when the pictures out of Italy and out of NYC failed to do.  

There are ways out of this--we can learn from the past (the Spanish Flu really is quite useful here), we can learn from other countries both what to do and what not to do (don't be Sweden).  So many people have been so patient and diligent for two or three months.  If we can just develop some new habits--not just hand-washing but mask-wearing--we can limit the spread.  Otherwise, the hospitals will be driven to the point of collapse, the rate of deaths will not fall, and the economy will not rebound.  Even if governments allow stores to open up, most will have a hard time staying open since most people will be sensible and stay home if their neighbors aren't distancing and aren't wearing masks.

Right now, we have a very reasonable fear that the others out there are endangering us.  To get to the time where there are vaccines and reliable treatments, we must do better.  This weekend suggests we will not.  Damn it.



*  No, I am not an expert, and, yes, there is some uncertainty.  New science will beat old science.