Herd Immunity

Day 39 – April 24, 2020

Yesterday, I talked about the dinosaur apocalypse… how they were all wiped out. But, to reiterate, the only ones that were fully wiped out were the ones on the ground. As hard as it is to believe, and I know some will take exception to this… but… birds… are not descendants of dinosaurs. They are dinosaurs… the ones that survived that cataclysmic event 65… sorry, 66 million years go.

That cataclysmic event was so… umm, cataclysmic… that it wiped out 75% of all species on earth. That was fortunate for those who survived, because it gave them the evolutionary advantage to thrive, among them… mammals.

It’s a long line of evolution between those mammals and the first hominoids… but it does beg an interesting question; has the human race ever been close to extinction? Terrestrial dinosaurs were around for close to 200 million years. Humans have only been around… well, depends how you look at it. With broad brush strokes, the human animal… maybe 300,000 years… but we only began to exhibit what you might call “modern behaviour” around 100,000 years ago.

What would’ve happened if a pandemic-capable virus had shown up? Not much, because there was next to no overlap of communities distanced by geography. It makes one wonder, how often have there been these sorts of viruses over the centuries? Probably lots. But it was localized, there was no treatment, there was no social distancing… all that happened was a big wave of very sick people dying, and eventually through herd immunity and/or lots of death, the virus made its way through everyone it could, and then disappeared from existence.

But the human race actually did come close to extinction, and it wasn’t that long ago, geologically speaking. Well, this is one theory. It’s interesting, as usual, to research things on the Internet because you can always tell where the conformation bias lies. You can tell what people want to believe, and how they conform their evidence to support their side.

Around 75.000 years ago, there was a massive volcanic eruption — one of the biggest ever. The Toba Supereruption (Lake Toba, Sumatra, Indonesia) erupted and ejected some 2,800 cubic kilometres of magma. That is a staggeringly huge cube of hot, melted rock… and it left behind something the same size as the crater that took out the dinosaurs… an enormous 100 x 30 km caldera complex. Once again, it messed with the environment very significantly… the six billion tons of sulphur dioxide that were ejected into the atmosphere caused a global cooling of up to 15 degrees all around the planet for at least a few years, and it was many decades before things returned to normal. This lowered the tree line and snow line by about 10,000 feet… and for humans who were used to a dry, temperate climate, years of perpetual snow did not sit well.

There is a genetic bottleneck at the time when looking back at humans, meaning it seems we can all trace our DNA back to a small group (like a few thousand humans) who made it through that. The rest were wiped out. And to some extent, if that’s what happened, you have to assume we’ve all evolved from a pretty tough group of humans. This was survival of the fittest imposed in the harshest of ways.

This is one theory, and it’s very interesting. There is another group of scientists who claim that’s hogwash, and that the evidence doesn’t necessarily imply any of that.

Whatever the case, all of that I learned yesterday while digging into dinosaurs… you know how the internet can be… one moment you’re reading about what you were researching, like dinosaurs and their extinction… and 40 minutes later you’re reading about mentally ill monarchs throughout human history.

That’s a good little segue onto a topic I really don’t want to touch here. I had a whole thing written out, and indeed, I could write a book on my thoughts with respect to American politics of the day, but this is a scientific and statistical endeavour, ostensibly aimed at keeping track where we are with respect to this pandemic. On that note, it’s not irrelevant to point out, as I have earlier, the shortcomings I see when it comes to leadership pulling in different directions, etc etc. But I just deleted many paragraphs that delve into far more detail, and will leave it at that.

OK, one paragraph. I worry greatly for the great country of the United States of America. Every single day, thanks to the actions or words of just one man, the chasm that separates two groups (big broad brushstrokes here: Republicans and Democrats) — gets a little bigger. It started on day 1, lying about the inauguration crowd size. “Who really cares” is really what should have been the answer, but he chose to lie about it, then double down on his lies, then make others lie for him… it was bewildering, to be honest. What the hell is going on? There was incontrovertible evidence… pictures and witnesses and everyone who was there… but no. It ended up with “alternative facts” trying to be jammed down our throats. All of this on day 1 of his presidency. And since that day, whenever he says or does something that is completely unpresidential, both sides rise to the challenge. And while the argument rages on about who’s right and who’s wrong, the country slides a little bit more downhill. This is not to bash on Republicans and Democrats… there was a time when both those parties worked in harmony for the greater good of the country, especially in times of crisis. I really wonder how repairable this is now. Long after Trump is gone, the degree of bipartisanship needed to successfully guide a country — may not be achieved for many, many years. And I’m not interested in the bullshit arguments of what a great job he’s presently doing. He’s not. I don’t use vague handwaving and gut feel to come to my conclusions, I use hard facts. As you may recall, this entire project of charts and graphs and light commentary started with a simple exercise of trying to track Canada’s response to this crisis as measured by comparing the U.S. and how they were doing. And comparing them to Italy, who was ahead of them. The short answer now is: Awful. Brutal. Look at the numbers, look at the graphs. This isn’t fake news, this isn’t opinion. These are their numbers. These are confused people. These are hospitals that can’t keep up. These are states and leaders with mixed messages. These are deaths. These are the preventable disastrous blue line and its associated numbers, towering over the green, red and black ones below it. This is failed leadership, from the very top.

Sorry for the long paragraph… but I did say, just one paragraph. But, some numbers… Canada, today, flat or better growth all across the country. U.S…. more deaths today than the number of new cases in Canada. Also U.S., more deaths today than the entire number of known cases seen in B.C., active or resolved, since the beginning of this pandemic. And finally, U.S., more new cases today than all of what Canada has seen, combined, since day one. By the end of the weekend, the U.S. will have seen its one millionth case. Canada will be below 50,000. That same proportion maps to deaths. And some quick math for you… no, the population of the U.S. is not 20 times that of Canada. Not even 10. As President Trump likes to sign at the end of many of his Tweets: Sad.

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By |2020-10-08T01:24:50-07:00April 24th, 2020|Categories: COVID-19 Daily Report, The First 100 Days, Politics, Science of COVID-19, Travel Stories, Philosophy, Art & Literature|Tags: , , , , , , , , , , , , , , , , , , , , |0 Comments
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Day 36 – April 21, 2020

The answer to the question…. “Where are you finding all this time to research and write?” — is every simple. All the time I spent driving, parking, walking… from meeting to meeting to lunch to meeting to meeting to whatever… well, when all of that travel can be measured in centimetres and the time it takes in seconds… here we are. These scribbles are the result of free time that never used to exist. Also, the length of many of these meetings now can quickly be trimmed… well, jeez darn it, looks like the WiFi is crapping out, gonna have to let you go, my people will call your people, yeah ok, bye.

I don’t do a lot of that… I’m too polite. That’s never really an option when it’s in person, but when you’re behind a screen and keyboard… it’s tempting. In any event, you can always check your brain out of a meeting, and that often happens when I’ve lost interest… which sometimes happens right off the bat. I listen to a lot of ideas and proposals, but certainly one way to get me to hang up my brain is to throw lots of buzzwords at me.

“Hey Horatio, thanks so much for taking the time to talk to me. I know you’re busy so I’ll get right to it. What our app intends to do is to disrupt the market, to shift the blockchain paradigm by leveraging existing synergies in the deep learning space and employing best practices to scale-up the mission-critical algorithms that’ll fuel the next generation of mobile.”

Dude, you’re a paragraph in, and you’ve already lost me.

And this is the same filter I’m using while trying to wade through the colossal amount of information with which we’re being bombarded these days. More than three buzzwords in one breath equals nonsense.

Self-serving, bias-conforming, buzzword-infested “reports” that magically wind up at the conclusion that perfectly aligns with the author’s intended audience, political beliefs, click-bait potential… whatever. If you want to believe that this virus was caused by reptilian aliens who’ve arrived on earth, and who’ve activated it with their nefarious 5G signals so as to expose Bill Gates’s agenda of GMO’ing vaccines because he’s just a pawn for big pharma who already have the vaccine because they’re in cahoots with the aforementioned aliens… yeah, I guess there’s not much I can say that’ll change your mind. That’s an extreme example of the crap that’s out there… but since it’s on a well-designed website with a very trustworthy-looking font… well, it might be true, right? Yeah… no… why don’t you just take that paradigm and shift it, if you know what I mean.

But once in a while, credible reports — from credible sources — arrive at similar conclusions, having started at very different points. And those are always interesting because they, unless they’re referencing each other, might offer some unbiased, independent… dare I say it… truth.

There’s this famous Stanford report that’s buzzing around these days… claiming that recently, while Santa Clara county had only 1,094 confirmed cases, antibody tests suggest that the number was somewhere between 48,000 and 81,000. The range of that number is wide enough that it makes one wonder about the inherent problems of the test sample. I have no idea, but that’s a pretty big error range. Nevertheless, let’s go with it and just pick the average… 48+81 = 129….. 129k ÷ 2 = 64,500…. and 64,500 ÷ 1,094 = 59x. If we apply a 59x factor here in B.C., that’s 59 x 1,724 cases… which is around 100,000… which is 2% of our population of 5,000,000.

Independently, the WHO have announced that they’ve found that 2% to 3% of the population they’ve tested has antibodies.

And independent of that, a study in the Netherlands of 7,000 blood donors found that 3% had antibodies.

Which brings up the discussion of one of the buzzwords-of-the-day: herd immunity.

Herd immunity is where enough people of a population are immune; immune enough that the infection will not spread within that group. The more infectious a disease, the higher that percentage has to be. For example, mumps is very contagious… Rø of 10 to 12, meaning every infected person will infect, on average, 10 to 12 others. Left unchecked, this would lead to 95% of the population getting infected. The other 5% inherit the benefit of the herd immunity that provides, because eventually there’s no one to catch it from. That herd-immunity threshold can only be reached via vaccination because allowing everyone to catch it is not an option. It’s a horrible disease, and these days, completely preventable.

For COVID-19, the Rø number is much lower… around 3, which implies a herd immunity percentage of around 70%. Which unfortunately, is well above the natural 2% to 3% that may be occurring.

Germany claims the “cases in the wild” number to be higher than that… a little over 10%. Better, but still far from what’s needed… which is a vaccine, which would launch that number into the high 90s and that would be the end of this pandemic.

Until that happens, the best thing to do is not catch this and/or give it to someone else.

BUT — and this is a big but, in two parts… IF you are already one of those 3% and IF having antibodies grants you immunity, then your individual life going forward does look a little different. For one thing, you can stop worrying about catching it.

There is no general agreement yet on how much immunity these antibodies confer, but some… for sure. What concentration you need in your blood, how long it lasts… all of that remains to be seen. I’m not sure who gets those antibody tests and when, but they’ll be arriving here in B.C….. soon. Sign me up.

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By |2020-10-08T01:24:52-07:00April 21st, 2020|Categories: COVID-19 Daily Report, The First 100 Days, Science of COVID-19, Space & Astronomy, Philosophy, Art & Literature|Tags: , , , , , , , , , , , , , |6 Comments
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Day 22 – April 7, 2020

When Her Royal Majesty, Queen Elizabeth II, took to the airways recently to address her nation, it was only the 5th time in her 68-year reign that she had done so (other than to say Merry Christmas). And when I say her nation, I’m not just talking about the U.K., and I don’t just mean the British Commonwealth, whatever is left of it, though it’s somewhat eyebrow-raising to realize that she has been Canada’s reigning monarch for 47% of this country’s existence… but no, her nation is the world. When you reference “The Queen”, nobody asks you which queen you mean. We’re not talking about the queen of Sweden or the queen of Spain or the queen of Bhutan. Or Beyoncé. There is only one Queen.

The rarity of this sort of event underlines its importance. In time of war, in time of national mourning… when everyone needs a serious dose of encouragement.

Before she even opened her mouth, the picture spoke thousand words. The setting was like a glorious painting, liberally sprinkled with meaning. The bed of roses, because life is beautiful, but sometimes a little thorny. The single lamp, off in the distance — the proverbial light at the end of the tunnel. The blank slate; the future unwritten. The empty office holders — signifying the paralyzing of business — which one day again will hold pens, paper clips and postage stamps (no doubt with her ubiquitous silhouette).

Then there was the Queen herself, looking radiant and royal and confident in green — the colour of nature and Spring and renewal. Her trademark pearls. I looked up what turquoise might represent, because that was the stone at the centre of that incredible brooch: Healing, love and protection. Perfect.

And, of course, there is what she said. The final sentence of her address was this: “We should take comfort that while we may have more still to endure, better days will return: we will be with our friends again; we will be with our families again; we will meet again."

It’s hard not to read that in her voice. Strong, powerful words, spoken with an accent that exudes class and elegance to a level we can only hope to achieve. Those familiar with the history of World War II (and/or the music of Pink Floyd) will recognize the reference to Vera Lynn at the end of it; the war-time song that kept them all together during those darkest of times: “We will meet again”.

Indeed, it’s been a brutally difficult few years for our friends across the pond. Long before this pandemic hit, they were wrestling with Brexit… an enormously complex problem that has no Plan B. It simply can’t be allowed to fail because nobody is sure what that would look like, but they all agree it’s ugly. Very. And in the midst of trying to push it over the finish line, oh, let’s throw in a global pandemic and see how that affects things. The answer is… not well.

There’s a lot to learn from the U.K.’s COVID-19 experience, because their attitude was initially quite different, and its effects are worth exploring.

Their initial assumption that this was just a bad flu that would course its way through the population eventually (and hopefully quickly) establishing herd immunity. It was thought that this would only harshly affect elderly people, and that people whose age was below a certain threshold might get affected, but they’ll get over it, and there’s really no reason to panic because as long as we isolate those at risk (elderly, immunocompromised, asthmatic, diabetic, etc), this shouldn’t overwhelm the medical system.

By the time that attitude was course-corrected and social distancing imposed, things were already launched in a worrying trajectory. This was far more virulent and serious than initially thought. The lockdowns are now in place and how it plays out remains to be seen, but those critical few days of “not a big deal” and people going about their business… have made a big difference. Prime Minister Boris Johnson, the fearless leader (and the man tasked with delivering Brexit) was proudly going about shaking hands with people, including those in hospital… only a few weeks before his own positive test. Today he finds himself in the ICU of a London hospital, battling for his life.

Closer to home, where we are all taking social/physical distancing seriously (right?), especially this long weekend with its good weather and where even though there are holidays coming up that are usually big family gatherings, we will do all that remotely (right?) — as Dr. Henry and Mr. Dix keep hammering home, we are in the midst of this. And we are succeeding. They don’t want to come right out and tell you that, but I will. Barring a significant very-out-of-left-field sort of thing, we are looking very good here in B.C. But what sort of thing might that be? Glad you asked, because it’s exactly what they’re telling us… if you go out these coming days and pretend things are ok, and you hang out with family and/or you visit the family cottage, then guess what… things can go from great to gruesome in a hurry.

Our dynamic duo always talk about the coming weeks, but we all know we’ve been cooped up for longer than 14 days, so what’s the deal? The deal is this… if you think things are so good right now that we can just get back to normal, what will happen is a sharp increase in cases starting… well, starting shortly after the long weekend and extending to 14 days past that. And if that happens, if just a few people let up, it can make a big difference. The actions of the coming weeks will make all the difference.

Listen to The Queen. Hang in there. After much to endure, there’s a finish line. We will meet again.

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By |2020-10-08T01:26:05-07:00April 7th, 2020|Categories: COVID-19 Daily Report, The First 100 Days, Politics, Business & Economics, Science of COVID-19, Life in Vancouver, Philosophy, Art & Literature|Tags: , , , , , , , , , , , |24 Comments
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Day 12 – March 28, 2020

There’s that feeling you get when you sit down in a rollercoaster… first of all, what the hell am I doing, do I really need to be doing this… but once the thing starts moving, there’s no way out, so the impending dread as you start going up that first big hill… click-click-click as the chain underneath pulls the train slowly… wow, this thing is going a lot higher than I thought… click-click-click… this was such a stupid idea… click-click-click… ugh, this is a lot steeper than it looked… click- ohh.. no more clicks. We all know that means…

… and as the train gains momentum and sends you flying down that first huge drop, two things will come to mind… one, this part of it will thankfully be over soon and two, now you have a clear idea just how steep it was. Which serves to illustrate where we are today with respect to the numbers coming our way in the next little bit… there is a finish line to them, a week to ten days… and we once we hit that bottom, we will know exactly how steep things were.

Given where we are today and as per what I wrote yesterday, I don’t think we need to close our eyes and scream and hope for the best. It’s looking better than that. At least, on paper and at least, for now.

In B.C., although we had the largest one-day increase in cases yet, it’s perfectly in-line with our linear growth. Dr. Henry, for now, would like to see that number consistent at 12% which is roughly where it’s been. The average of the last 10 days is actually 11.1%. Today’s number was 11.6%. Yesterday was 9.2%. Nice solid straight yellow line, right in the sweet spot. And might I add, I am tracking total cases as they accumulate, not factoring in recoveries and deaths. The outcomes of these cases is a whole separate topic. But on that note, while we saw an increase of 92 new cases, we also saw 121 cases moved to the “recovered” column. As far as these numbers are concerned, today in B.C., there are less active cases than yesterday.

Canada’s number is bigger, but also consistent and also, slowly, hopefully, for now… going down day by day. Yes, of course the number of cases is increasing, but that rate of increase is itself decreasing. See that column… 4 out 5 days of green numbers. The rate of growth is slowing. For now. Are we still following the U.S. trajectory? Visually, and numerically, we’re not. Not so long ago, and you can still see it on the chart, Canada’s data was almost exactly perfectly 8 days behind the U.S: Feb 29, Mar 1, Mar 2… the U.S. had 68, 75 and 100 cases. 8 days later, Mar 8,9,10 — Canada had 66, 77, 94 cases. Perfect lockstep. And if you eyeball those numbers as you slowly go down the two columns, you see them in lockstep… and then they slowly start drifting apart.

The hope is that we wouldn’t follow them down the hellhole-course they’re presently on, and, for now, we’re not. We’re at 5,655 nationwide cases. 8 days ago, the U.S. was at 24,218. Had we “kept up”, today’s number would be 4x what it actually is. We’re now more than 11 days behind them.

So what does it all mean…

I’d like to address some of the comments that question the usefulness of these numbers in general, how the testing is inadequate, this isn’t reality, this is a useless exercise because the numbers are all bullshit. That the real case numbers are anywhere from 10x to 50x and it’s anyone’s guess. And therefore, blahblahbblah.

So, first of all, the way to solve big problems is to break them in half. Solve each half independently, and once you do, the big problem is solved. And if one or both of those halves is too complicated to solve, break it in half again and solve that. Keep breaking it in half until you have manageable pieces to solve.

The enormity of our present situation requires breaking it into hundreds of pieces, but here are some of the big ones, each of which needs to be broken down into many smaller pieces:
– the actual number of cases out there, factoring in recoveries
– the actual number of cases that require hospitalization
– why are some demographics hit so differently than others
– the testing infrastructure, and the strategy and adequacy of it
– the ability of our medical infrastructure to handle the cases
– the actual number of people dying from this
– the economic implications of allowing this to go on too long
– the herd immunity thing
– the treatment options, effectiveness of therapies, and timelines
– when and where is the vaccine

Without tackling all of that, notwithstanding each of those topics is its own book, and that’s only a small snippet of topics that need addressing, where we’re at right now is trying to solve chunks of a problem with incomplete information. One thing we have to our great advantage is learning from what others have or haven’t done ahead of us. Like one big change that was implemented today here is that the number of patients on ventilators doubled. Because suddenly a lot more people got a lot more sick? No. Because we learned from data elsewhere that putting people on ventilators sooner has a huge impact on positive outcomes. We didn’t know that two days ago, and now we do, and now we use it to our advantage.

Just because we don’t know something is no reason to throw our hands in the air — “these numbers are all crap anyway” — but to tackle this particular aspect…

Knowing the actual number of cases out there would have a profound effect on many aspects… first of all, how many actual new cases are there each day… how many of them will the person never even know, how many will they get sick but not too sick, how many will need a hospital, how many will die. If we could snap our fingers and know all that, it’d be great. One school of thinking that might kick in is that if actually the number is not 10x or 50x but actually 500x, and many of us have had it and never even knew it, and now we’re immune and will be for several months and even if we’re not, who cares, clearly I can fight this thing off so let me get a little sick and impose my herd immunity and get back to work since the actual mortality rate is only 0.2% etc.

Don’t think everyone has their heads stuck in the sand thinking the published numbers are the extent of this. One day, in hindsight, we’ll know those numbers. It’s possible that one day, we will have instant, cheap and available tiny-traces antibody testing. You’ll be able to wander into Starbucks, and along with your chai latte, spit into some throw-away little thing that’ll turn red if you’ve had it, stay blue if you haven’t. But until we get to that point, to a great extent, all we’re doing is buying time. Flattening the curve to suppress the load on our medical infrastructure. Isolating ourselves so we don’t infect others, especially those who are much likelier to get lethally ill. Keeping this thing controlled and contained until we’re certain we can manage it. It’ll likely never go away, and the waves of it appearing in the future will hopefully wind up in the “no big deal” pile.

But for now, the published numbers, the important numbers… the ones that are putting load on our medical system… the 884 confirmed, the thousands of others likely presumed but not confirmed… don’t think they don’t know about it. Don’t think when they tell you to stay home for 14 days, pay attention to your symptoms but don’t come in — that they’re not tracking you. You, who may well have it who think you don’t count — trust me, you do. Not in my numbers, not in their published active-cases numbers, but you’re out there somewhere, included in all of the projections of what might happen and how they’re going to take care of you if you get really sick. Some of you think you have it, but don’t. Some of you have it and don’t know it. Neither of you got tested, so hey what the hell they don’t know what they’re doing this is bullshit… yeah, no. Not at all. They’re not going to waste a test to confirm a mild test. There’s an N% chance you have it, depending on your age and other risk factors. Take care of yourself with the provided guidelines, and you’ll most likely be ok. And if you’re not, critical care awaits you with open arms. As opposed to everyone who thinks they might have it coming in and overwhelming a system that, certainly at the moment, is not prepared to test 2 million people overnight. If you’ve had it, one day you’ll know.

The fact that our hospitals are not overrun… the fact that we’re prepared at present to handle anything but the absolutely worst-case scenario… the fact that were are notably flattening our curve, both provincially and nationally… and the fact that we’re doing that with incomplete information, tackling big, multi-faceted problems… don’t worry too much about absolute numbers and how you feel they don’t reflect reality. They’re serving us well.

Speaking of serving us well, please take a moment to step outside at 7pm tonight (and every night) to cheer the heroes of this nightmare — hope you never need their help, but the army of medical workers of this province and this country, and indeed, around the world… deserve to (loudly) hear our gratitude and appreciation.

None of us like this. They don’t. You don’t. I don’t. But let’s remember… as hellish as it may be, the rollercoaster ride eventually ends.

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By |2020-10-08T01:26:09-07:00March 28th, 2020|Categories: COVID-19 Daily Report, The First 100 Days, Science of COVID-19, Travel Stories, Philosophy, Art & Literature|Tags: , , , , , , , , , , , , , , , , , , |0 Comments
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