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Tuesday, July 28, 2020

The Only Way Out Of The Pandemic In One Piece

As time goes on and the endgame of the COVID-19 pandemic is now coming into focus, it is becoming increasingly apparent that not only do lockdowns not work very well and in fact do more harm than good, but that there is really only one realistic way out of this nightmare at this juncture.  And that way out will ultimately come about sooner or later, via a combination of three things:
  1. "Herd immunity", which simply means that a large enough percentage of the population has become at least relatively immune to the disease (either via natural infection and/or mass vaccination) so as to quash the epidemic and keep it from taking off again in the near future.  The former route is far more likely in the near term than the latter, and the herd immunity threshold (HIT) is most likely far lower than was originally believed, and many states and countries are likely already there by now.
  2. "Attenuation", which really is just a fancy way of saying that the virus becomes weaker over time, losing its "mojo".  There is some evidence that this process has already begun at least several weeks ago.  Especially if combined with herd immunity, the virus may eventually become the new common cold, if not phase out entirely.
  3. Better early treatment of patients with the disease.  This cannot be overstated, as we have learned a lot about how to treat such patients, and most importantly what NOT to do, through trial and error (sadly, mostly error).  Now if only the feds were use the Defense Production Act to force production of PPE for hospitals rather than focus on often counterproductive ventilators.
These three things are, of course, all a result of the widespread circulation of the virus, which of course came at a very heavy price in terms of human lives.  But once the proverbial horse is out of the barn, as it has already bolted long ago, such a thing is inevitable sooner or later.  Especially with the prospect of a safe and effective vaccine likely years away.

Sweden, as we know, understood this very well from the start.  It is really a shame how most other countries did not, and some still seem not to for whatever bizarre reason.  Instead, they mocked Sweden's moderate mitigation strategy and attempted to suppress the virus all the way to zero via lockdowns and mass quarantines, often belatedly.  Those that acted too late basically trashed their economies for nothing while inadvertently creating a Sweden-like herd immunity scenario anyway (albeit often with far more excess deaths), while those that acted early seemed to dodge a bullet, only to see a resurgence (or extra legs) of the virus later.  Basically, as the now-famous Swedish epidemiologist Anders Tegnell predicted, a year from now (if not earlier) we will see that practically all countries and states will end up the same way (within error bounds) regardless of what strategies they pursued, a few lucky (or unlucky) outliers notwithstanding.

In other words, the virus is in the wild and has been for a while now, so shutting down again will only delay the inevitable, and drag it out that much longer and more painfully.  So don't do it again!

That said, we should also note that the TSAP unequivocally does NOT support the practice of "corona parties" or any other deliberate or grossly negligent mass infection-inducing behavior.  This virus is, at best, extremely difficult to control.  Just because most people will inevitably be exposed to the virus at some point does NOT mean that anyone should willingly and unnecessarily tempt fate in any way.  And even though the virus is relatively harmless to most people, that clearly does NOT mean that it is for everyone, and there are of course documented cases of people dying or suffering irreversible damage from it at surprisingly young ages.  This is still a potentially dangerous and deadly virus, after all.  So seriously, live your life, "keep calm and carry on" as the old saying goes, but please do take precautions, avoid large crowds, and don't be stupid and reckless about it!  Young people, this means you too.

UPDATE:  Some pundits apparently still believe in a "Zero Covid" strategy in which no level of the virus is tolerated, assuming that it can actually be truly eliminated via suppression measures.  The problem with that quixotic, ivory-tower idea is twofold--first, even if possible, we missed our chance to do it many months ago, and secondly, any attempt to do so now will only drag it out and prolong the pain by further delaying herd immunity.  With plenty of collateral damage too.  And we would basically have to live like the unfortunate folks in Susan Cooper's Orwellian-style dystopian novel Mandrake for the foreseeable future, a truly disproportionate response to a disease whose deadliness is most likely in the range of seasonal flu to medium pandemic flu.  And with most likely zero lives saved as a result.  Fortunately, we will likely reach herd immunity and/or attenuation of the virus sooner than expected, if not already there, so it won't be long before this debate becomes academic.

And sorry, but moving the goalposts does NOT really furbish the "Zero Covid" strategy one bit, which is still just as ridiculous as a "Zero Flu" strategy.  After all, there was a reason we were able to (relatively) tame the flu over time without eradicating it, and that reason was via the three aforementioned factors:  herd immunity, attenuation, and improvements in treating patients.  We'd be wise to learn from history.

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