Thursday Reads: Ghost Cities In the Time of Coronavirus

Congress Street near Boston City Hall, typically teaming with tourists and vehicle traffic at 2pm on a Sunday is empty due to the coronvirus, March 16, 2020 (Jim Michaud, MediaNews Group/Boston Herald)

Good Afternoon!!

We truly are living in a whole new world now, and we may never return to the old one.

Gideon Litchfield at MIT Technology Review, March 17, 2020: We’re not going back to normal.

To stop coronavirus we will need to radically change almost everything we do: how we work, exercise, socialize, shop, manage our health, educate our kids, take care of family members.

We all want things to go back to normal quickly. But what most of us have probably not yet realized—yet will soon—is that things won’t go back to normal after a few weeks, or even a few months. Some things never will.

Seattle traffic merging onto interstate, 3PM, Thurs. March 15, Amanda Snyder, Seattle Times

It’s now widely agreed (even by Britain, finally) that every country needs to “flatten the curve”: impose social distancing to slow the spread of the virus so that the number of people sick at once doesn’t cause the health-care system to collapse, as it is threatening to do in Italy right now. That means the pandemic needs to last, at a low level, until either enough people have had Covid-19 to leave most immune (assuming immunity lasts for years, which we don’t know) or there’s a vaccine.

How long would that take, and how draconian do social restrictions need to be? Yesterday President Donald Trump, announcing new guidelines such as a 10-person limit on gatherings, said that “with several weeks of focused action, we can turn the corner and turn it quickly.” In China, six weeks of lockdown are beginning to ease now that new cases have fallen to a trickle.

But it won’t end there. As long as someone in the world has the virus, breakouts can and will keep recurring without stringent controls to contain them. In a report yesterday (pdf), researchers at Imperial College London proposed a way of doing this: impose more extreme social distancing measures every time admissions to intensive care units (ICUs) start to spike, and relax them each time admissions fall. Here’s how that looks in a graph.

The orange line is ICU admissions. Each time they rise above a threshold—say, 100 per week—the country would close all schools and most universities and adopt social distancing. When they drop below 50, those measures would be lifted, but people with symptoms or whose family members have symptoms would still be confined at home.

A woman in New York walks through a lightly trafficked Times Square on March 16.Seth Wenig AP

What counts as “social distancing”? The researchers define it as “All households reduce contact outside household, school or workplace by 75%.” That doesn’t mean you get to go out with your friends once a week instead of four times. It means everyone does everything they can to minimize social contact, and overall, the number of contacts falls by 75%.

Under this model, the researchers conclude, social distancing and school closures would need to be in force some two-thirds of the time—roughly two months on and one month off—until a vaccine is available, which will take at least 18 months (if it works at all). They note that the results are “qualitatively similar for the US.”

I strongly recommend reading the rest at the link above. Like many other publications, Technology Review has made their coronavirus coverage free to everyone.

Another excellent source of information about the coronavirus can be found at Tulane University School of Health and Tropical Medicine, which is publishing a daily newsletter with lists of articles and up-to-date numbers of Covid-19 cases around the world.

We’ve all seen photos of young people partying down in Florida for spring break. They’ve been led to believe that they aren’t vulnerable to Covid-19, but that’s not true.

The New York Times: Younger Adults Make Up Big Portion of Coronavirus Hospitalizations in U.S.

American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 of the first recorded cases in the United States.

The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients had the greatest likelihood of dying and of being hospitalized. But of the 508 patients known to have been hospitalized, 38 percent were notably younger — between 20 and 54. And nearly half of the 121 patients who were admitted to intensive care units were adults under 65, the C.D.C. reported.

Wuhan, China, Feb 4, 2020, pop 11 million

“I think everyone should be paying attention to this,” said Stephen S. Morse, a professor of epidemiology at Columbia University’s Mailman School of Public Health. “It’s not just going to be the elderly. There will be people age 20 and up. They do have to be careful, even if they think that they’re young and healthy.”

The findings served to underscore an appeal issued Wednesday at a White House briefing by Dr. Deborah Birx, a physician and State Department official who is a leader of the administration’s coronavirus task force. Citing similar reports of young adults in Italy and in France being hospitalized and needing intensive care, Dr. Birx implored the millennial generation to stop socializing in groups and to take care to protect themselves and others.

“You have the potential then to spread it to someone who does have a condition that none of us knew about, and cause them to have a disastrous outcome,” Dr. Birx said, addressing young people.

In the C.D.C. report, 20 percent of the hospitalized patients and 12 percent of the intensive care patients were between the ages of 20 and 44, basically spanning the millennial generation.

See also this piece at The New York Times: A Deadly Coronavirus Mix in Florida: An Aging Population and Lots of Young Visitors.

Young people–at least the ones in Florida right now–don’t seem to be taking this seriously.

And Florida’s Gov. Ron DeSantis isn’t helping. NBC News: Florida governor refuses to shut down beaches amid spread of coronavirus.

Florida Gov. Ron DeSantis refused to issue an order to close the state’s beaches, despite fears regarding the spread of the coronavirus.

He instead signed an order that would limit parties on beaches to 10 people per group and force any businesses authorized to sell liquor to reduce occupancy by half, DeSantis told reporters Tuesday. The governor said that local governments can make their own decisions but that his order would follow the latest guidance issued by the Centers for Disease Control and Prevention.

“What we’re going to be doing for the statewide floor for beaches, we’re going to be applying the CDC guidance of no group on a beach more than 10 and you have to have distance apart if you’re going to be out there,” DeSantis said. “So that applies statewide.”

DeSantis is a Republican, of course.

Why is Covid-19 so contagious and difficult to treat?

The problem is that the coronavirus was transmitted to humans from animals and therefore we have no natural immunity to the disease. David Quammen is a science writer wrote a book, Spillover, about  these animal-to-human infections–known as zoonotic diseases–was in 2012. From the NYT review by Dwight Garner:

In his powerful and discomfiting new book, “Spillover: Animal Infections and the Next Human Pandemic,” the science writer David Quammen cites a dismal word we’ll be getting used to in the coming decades, whether we like it or not: zoonosis.

Rome, Italy, March 5, 2020

A zoonosis is an animal infection that, through a simple twist of fate, becomes transmissible to humans. Maybe that twist is a needle prick, or contact with an exotic animal or hiking downwind of the wrong farm.

“It’s a mildly technical term,” he admits, but probably not for long. “It’s a word of the future, destined for heavy use in the 21st In his powerful and discomfiting new book, “Spillover: Animal Infections and the Next Human Pandemic,” the science writer David Quammen cites a dismal word we’ll be getting used to in the coming decades, whether we like it or not: zoonosis….

Ebola and bubonic plague are zoonoses. So are, he writes, in a list that peals off the tongue like a distraught Allen Ginsberg poem or an outstanding list of death metal band names, “monkeypox, bovine tuberculosis, Lyme disease, West Nile fever, Marburg virus disease, rabies, hantavirus pulmonary syndrome, anthrax, Lassa fever, Rift Valley fever, ocular larva migrans, scrub typhus, Bolivian hemorrhagic fever, Kyasanur forest disease, and a strange new affliction called Nipah encephalitis, which has killed pigs and pig farmers in Malaysia.”

A couple in Barcelona, Spain, embrace in Catalunya Square on March 15.David RamosGetty I mages

AIDS, he adds, that destroyer of 30 million people, is of zoonotic origin.

In “Spillover” Mr. Quammen investigates many of these diseases, some more than others. He describes the baffled horror of initial outbreaks and then tracks calmly backward. He talks to virologists, doctors, field biologists and survivors about how the animal-to-human infection came to pass. He hopscotches the globe like a journalistic Jason Bourne. Often there aren’t doctors left to be interviewed. The medical personnel who first came into contact with sick patients are frequently dead.

Here’s an article by Quammen in from the January 28, 2020 New York Times: We Made the Coronavirus Epidemic. It may have started with a bat in a cave, but human activity set it loose.

The latest scary new virus that has captured the world’s horrified attention, caused a lockdown of 56 million people in China, disrupted travel plans around the globe and sparked a run on medical masks from Wuhan, Hubei Province, to Bryan, Texas, is known provisionally as “nCoV-2019.” It’s a clunky moniker for a lurid threat.

The name, picked by the team of Chinese scientists who isolated and identified the virus, is short for “novel coronavirus of 2019.” It reflects the fact that the virus was first recognized to have infected humans late last year — in a seafood and live-animal market in Wuhan — and that it belongs to the coronavirus family, a notorious group. The SARS epidemic of 2002-3, which infected 8,098 people worldwide, killing 774 of them, was caused by a coronavirus, and so was the MERS outbreak that began on the Arabian Peninsula in 2012 and still lingers (2,494 people infected and 858 deaths as of November).

Police officers patrol the empty Trocadero plaza next to the Eiffel Tower in Paris on March 17, 2020, Francois Mori AP

Despite the new virus’s name, though, and as the people who christened it well know, nCoV-2019 isn’t as novel as you might think.

Something very much like it was found several years ago in a cave in Yunnan, a province roughly a thousand miles southwest of Wuhan, by a team of perspicacious researchers, who noted its existence with concern. The fast spread of nCoV-2019 — more than 4,500 confirmed cases, including at least 106 deaths, as of Tuesday morning, and the figures will have risen by the time you read this — is startling but not unforeseeable. That the virus emerged from a nonhuman animal, probably a bat, and possibly after passing through another creature, may seem spooky, yet it is utterly unsurprising to scientists who study these things.

Read the rest at the NYT.

Three interviews with David Quammen to check out:

Orion Magazine, March 17, 2020: Why David Quammen Is Not Surprised.

Bozeman Daily Chronicle, February 28, 2020: Quammen: Coronavirus epidemic not a one-time threat.

An audio interview with Quammen at Scientific American, March 18, 2020: David Quammen: How Animal Infections Spill Over to Humans.

One more article about zoonotic diseases from Scientific American, March 18, 2020: Destroyed Habitat Creates the Perfect Conditions for Coronavirus to Emerge.

Those are my recommended reads (and one listen) for today. What stories have you been following?

Tuesday Reads: Trump Seemingly Wakes Up To Reality

Good Morning!!

Yesterday Trump finally appeared to be waking up to reality. He walked out to the afternoon coronavirus briefing looking like he did when he came out of his secret meeting with Putin in Helsinki–shoulders slumped, feet dragging, appearing beaten and humiliated. Watch:

Suddenly Trump seemed to be taking the global pandemic seriously. What changed his attitude overnight? It’s not completely clear, but there are a few possibilities. One is a new report that was sent to the White House over the weekend. Axios: Dire new report forces U.S. and U.K. to change course on coronavirus strategy.

A startling new report from Imperial College London warns that 2.2 million Americans and 510,000 Britons could die from coronavirus if extreme action isn’t taken to change the course of the outbreak.

Why it matters: The report’s dire warnings prompted a quick course correction from both the American and British governments on their strategies, but its strict recommendations and long timeline — 18 months — to stem the tide could have far-reaching implications for both populations and economies.

What they found: The report states the effectiveness of “mitigation,” which includes isolating only the sick and those linked to them while advocating social distancing for at-risk groups, is limited. It instead recommends “suppression,” a much more wide-ranging tactic to curb coronavirus’ spread.

The researchers say that suppression “will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members.” It also recommends school closures.
The report notes that this strategy could have to be in place until a vaccine is developed, which could take 18 months — saying it is “the only viable strategy at the current time.”
Worth noting: While China and South Korea have managed to suppress the outbreak using similarly draconian strategies, the report admits that it’s not yet clear if suppression’s successes can last in the long-term.

Buzzfeed News: The UK Only Realised “In The Last Few Days” That Its Coronavirus Strategy Would “Likely Result In Hundreds of Thousands of Deaths.”

The UK only realised “in the last few days” that attempts to “mitigate” the impact of the coronavirus pandemic would not work, and that it needed to shift to a strategy to “suppress” the outbreak, according to a report by a team of experts who have been advising the government.

The report, published by the Imperial College COVID-19 Response Team on Monday night, found that the strategy previously being pursued by the government — dubbed “mitigation” and involving home isolation of suspect cases and their family members but not including restrictions on wider society — would “likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over”.

The mitigation strategy “focuses on slowing but not necessarily stopping epidemic spread — reducing peak healthcare demand while protecting those most at risk of severe disease from infection”, the report said, reflecting the UK strategy that was outlined last week by Boris Johnson and the chief scientific adviser Patrick Vallance.

But the approach was found to be unworkable. “Our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over,” perhaps by as much as eight times, the report said.

In this scenario, the Imperial College team predicted as many as 250,000 deaths in Britain.

“In the UK, this conclusion has only been reached in the last few days,” the report explained, due to new data on likely intensive care unit demand based on the experience of Italy and Britain so far.

“We were expecting herd immunity to build. We now realise it’s not possible to cope with that,” professor Azra Ghani, chair of infectious diseases epidemiology at Imperial, told journalists at a briefing on Monday night.

Read more at Buzzfeed. Also see this detailed analysis at BBC News: Coronavirus: UK changes course amid death toll fears.

The New York Times on the new White House message, based on the report: White House Takes New Line After Dire Report on Death Toll.

Sweeping new federal recommendations announced on Monday for Americans to sharply limit their activities appeared to draw on a dire scientific report warning that, without action by the government and individuals to slow the spread of coronavirus and suppress new cases, 2.2 million people in the United States could die.

To curb the epidemic, there would need to be drastic restrictions on work, school and social gatherings for periods of time until a vaccine was available, which could take 18 months, according to the report, compiled by British researchers. They cautioned that such steps carried enormous costs that could also affect people’s health, but concluded they were “the only viable strategy at the current time.”

That is because different steps, intended to drive down transmission by isolating patients, quarantining those in contact with them and keeping the most vulnerable apart from others for three months, could only cut the predicted death toll by half, the new report said.

The White House guidelines urged Americans to avoid gatherings of more than 10 people. That is a more restrictive stance than recommendations released on Sunday by the U.S. Centers for Disease Control and Prevention, which said that gatherings should be limited to 50.

The White House also recommended that Americans work from home, avoid unnecessary shopping trips and refrain from eating in restaurants. Some states and cities have already imposed stricter measures, including lockdowns and business closings. Asked at a news conference with President Trump about what had led to the change in thinking by a White House task force, Dr. Deborah Birx, one of the task force leaders, said new information had come from a model developed in Britain.

“What had the biggest impact in the model is social distancing, small groups, not going in public in large groups,” Dr. Birx said. “The most important thing was if one person in the household became infected, the whole household self-quarantined for 14 days. Because that stops 100 percent of the transmission outside of the household.”

Read more at the NYT.

Trump previously had been listening to advice from his son-in-law Jared Kushner–who know absolutely nothing about science or pandemic diseases. Now he is supposedly “pissed” at Kushner for misleading him. Gabriel Sherman at Vanity Fair:

With the markets in free fall despite emergency action by the Fed over the weekend, Trump is waking up to the reality that’s been clear to everyone: Coronavirus poses a once-in-a-hundred-years threat to the country. “In the last 48 hours he has understood the magnitude of what’s going on,” a former West Wing official told me. As Trump processes the stakes facing the country—and his presidency—he’s also lashing out at advisers, whom he blames for the White House’s inept and flat-footed response. Sources say a principal target of his anger is Jared Kushner. “I have never heard so many people inside the White House openly discuss how pissed Trump is at Jared,” the former West Wing official said.

Sources told me Trump is regretting that Kushner swooped into the coronavirus response last week. Kushner, according to sources, encouraged Trump to treat the emergency as a P.R. problem when Fauci and others were calling for aggressive action. “This was Jared saying the world needs me to solve another problem,” a former White House official said. One source briefed on the internal conversations told me that Kushner advised Trump not to call a national emergency during his Oval Office address on March 11 because “it would tank the markets.” The markets cratered anyway, and Trump announced the national emergency on Friday. “They had to clean that up on Friday,” another former West Wing official said. Trump was also said to be angry that Kushner oversold Google’s coronavirus testing website when in fact the tech giant had a fledgling effort. Trump got slammed in the press for promoting the phantom Google product. “Jared told Trump that Google was doing an entire website that would be up in 72 hours and had 1,100 people working on it 24/7. That’s just a lie,” the source briefed on the internal conversations told me.

Politico has an analysis of the possible economic consequences of the pandemic: How ugly could it get? Trump faces echoes of 1929 in coronavirus crisis.

The early signals from the coronavirus crisis point to a scale of damage unseen in the modern U.S. economy: the potential for millions of jobs lost in a single month, a historic and sudden plunge in economic activity across the nation and a pace of sharp market swings not seen since the Great Depression.

As the coronavirus outbreak ravages a paralyzed nation, Wall Street suffered another brutal bloodbath on Monday with the Dow Jones Industrial Average diving around 13 percent in its worst percentage loss since 1987’s “Black Monday” crash. A reading on business conditions in the New York area plunged a record 34.4 points to -21.5 in March, suggesting a recession is underway that could be sharp and deep as revenue quickly bleeds out of major industries from airlines to hotels, restaurants, bars and sports leagues.

The Standard & Poor’s 500-stock index, the broadest gauge of U.S. companies, fell 12 percent. It has shed $6 trillion in value since peaking in February, slamming retirement accounts for millions of Americans in ways that could have psychological ripples for many months to come. The last time the S&P had three days of similar wild swings was 1929, on the eve of the Great Depression.

The S&P is now only around 300 points away from wiping out all its gains since Donald Trump won the White House in November 2016. President Trump himself, one of the grandest boasters of the strength and resilience of markets and the American economy, appeared to capitulate on Monday with a more somber tone reflecting the immense magnitude of the challenge facing the nation.

Read the rest at the link.

Meanwhile, there are three Democratic primaries today. The Washington Post: Democratic primaries live updates: Voters in three states head to polls to weigh in on Biden-Sanders contest; Ohio postpones voting amid coronavirus outbreak.

Voters in three states — Arizona, Florida and Illinois — are headed to the polls Tuesday amid the coronavirus pandemic to weigh in on the Democratic presidential contest between former vice president Joe Biden and Sen. Bernie Sanders (I-Vt.), while Ohio’s governor has declared a “health emergency” to postpone scheduled voting there.

Ohio Gov. Mike DeWine (R) announced late Monday that the polls would not open in his state despite a state judge’s ruling that the election must go on.

A total of 441 delegates to the Democratic National Convention are at stake in Arizona, Florida and Illinois. Biden is looking to build on his momentum of recent weeks and extend an advantage over Sanders in a nominating contest transformed by the coronavirus outbreak and full of uncertainty.

More stories to check out:

Raw Story: Coronavirus death toll passes 7,000 as WHO urges world to ‘test, test, test.’

The Washington Post: On Fox News, suddenly a very different tune about the coronavirus.

The Washington Post: How U.S. coronavirus testing stalled: Flawed tests, red tape and resistance to using the millions of tests produced by the WHO.

The New York Times: Inside the Coronavirus Response: A Case Study in the White House Under Trump.

Vanity Fair: Why the Fed’s Rate Cut Tanked the Market.

NPR: Poll: Americans Don’t Trust What They’re Hearing From Trump On Coronavirus.

The New York Times: Mayor Resisted Drastic Steps on Virus. Then Aides Said They’d Quit.

The Daily Beast: Sanders Not Planning to Quit Race After Tuesday’s Votes, Aides Say.

CNN: Toilet paper makers: ‘What we are dealing with here is uncharted.’

What stories are you following today?