Parable

September 25, 2020

There’s that old parable where, suddenly, people can’t bend their arms. There’s plenty of food to eat, but people are starving… because they can’t reach their mouths.

The parable goes on to explain how, actually, it’s only the self-serving narcissists that are starving. The good people have figured out that all they need to do is feed each other, and everyone will be ok.

To some extent, we’ve been told that masks are sort of like that; you wear one, more than anything, to help others; to avoid you infecting them with your sneezes and coughs… and, as long as everyone is doing that to help others, we all benefit.

For a lot of my life, I thought catching a cold or flu was like getting pregnant; you’re either pregnant or you’re not. Similarly, either you have a cold… or you don’t. Certainly, you can be 7 weeks pregnant vs. 7 months, and it’s a very different experience… just like you can have a mild cold or a really bad cold.

The subtle difference in my mind was this: Once you have a cold, how bad it is depends on that particular cold virus. Some hit you really hard, while some give you little sniffles. Some years it’s really bad, some years… not so much.

What I didn’t understand was the whole concept of viral load. It’s not necessarily the severity of the strain of the virus… it’s also how much of it you got. The actual level of dosage, the actual number of little virus balls you inhaled… like, how badly you were infected… has a huge influence on how it affects you.

This is becoming very evident with the analysis of C19 patients; those exposed with high viral loads have a much more difficult journey. In fact, viral load at the time of diagnosis seems to be, on its own, an independent predictor of mortality.

All of this goes back to masks, and a recent article that pointed out something that should be pretty obvious, but perhaps hasn’t been made abundantly clear: If you wear a mask, you’re not only protecting others, but you’re protecting yourself. Your chances of receiving a lethal infectious dose are dramatically reduced if you’re wearing a mask.

Further to that – a very promising conclusion that follows from that is that by wearing a mask, you may well be creating immunity in yourself. As we know, a vaccine simply stimulates an immunity response… well, guess what… you may already have done that, in small doses. We also know that 80% of cases are asymptomatic, and that may in large part be due to the low viral loads that caused them in the first place. Perhaps the small amount you got from a distant sneeze. Or, perhaps, the small amount you got from someone nearby… but your mask took the hit, and all you got was 1% of the potential viral blast in your face.

And one final (also promising) conjecture… it seems that even tiny viral loads in your body may stimulate strong immune responses. By the time the vaccines roll out, you may already be immune… and only because you’ve been wearing a mask, self-vaccinating yourself in small doses.

I’m not sure any of this will change the minds of the ardent anti-maskers, for whom this whole issue is entangled with political (and other) agendas… but if you know any somewhat-reasonable anti-maskers who think it’s not worth it for medical reasons, feel free to pass this along. Or maybe to that “me me me” narcissist who doesn’t feel the need to benefit others, at the expense of their personal comfort. Well, guess what… it may benefit you greatly.

And for the rest of you reasonable people, just keep doing what you’re doing… and wear your mask with the knowledge that your little contribution to the greater good may actually be doing a lot more good than you think.

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Day 69 – May 24, 2020

No updated numbers for B.C. today, so, as usual… I’ll make an intelligent guess and fix it tomorrow.

So let’s talk about yesterday’s numbers, and let’s begin with the old “5 blind guys and an elephant” parable. The premise of it is straightforward… these 5 guys have never encountered an elephant, and each reach different conclusions about the different parts of the elephant that they touch. The guy who grabs a leg describes it like a tree trunk. The guy who grabs the tail describes it as a rope. The guy who grabs an ear describes it as flat and floppy. The other two guys… one grabs a tusk, the other grabs the trunk. Their interpretation and discussion with each other is outside the scope of this post; we’ll leave Freudian experts to discuss their conclusions.

The moral of the story actually changes, depending on what lesson you’re trying to teach. Maybe that vastly differing opinions are all justified when talking about the same subject, like someone else’s opinion is just as valid. Maybe that sometimes, we’re fighting about the same thing. Maybe that we need to question our method of questioning. In some versions, the guys aren’t blind; just in the dark. But once they’ve “seen the light”, they all agree.

Let’s go with something like that… the guys aren’t blind, just initially blindfolded… but were convinced by their first impressions, especially because they went around telling everyone, and in doing so, convincing themselves that their version was “the most correct”. Indeed, even after the blindfolds were lifted, and they could see the big picture, they still clung to their beliefs… perhaps since they were already so invested. And, to add a bit more to it… once they could see, they realized that they were actually in an elephant park… with lots of different elephants. And, all of the elephants had been given names… of places, like in that series “Money Heist” (side note: watch Money Heist, and watch it in Spanish, with subtitles… incredibly good.. it’s on Netflix).

So these elephants… there’s one off in the distance… her name is New Zealand. She’s tiny, but looks very healthy. There’s one called Canada, who is really big and, for the most part, looks ok — parts of him looks much healthier than other parts, but he’ll be fine. There’s an elephant called United States… poor thing is really beaten up and needs to rest, but some trainer has a rope around him and is literally trying to drag him onto his feet.

But the elephant these guys had all initially touched and reached wildly different conclusions about… his name is Sweden.

Let’s pause here and be perfectly pragmatic. Without any opinion yet, here are some numbers, and a bit of comparison… of two places in the world where lots of people insist things are going really well: Sweden, and British Columbia. Starting points can be arbitrary, but for what it’s worth, both places had the same number of known cases (7) on Feb 27th. Sweden accelerated upwards far quicker than BC, and here’s where things are at, as of yesterday:

Population: BC 5.1M, Sweden 10.2M (2x)

Testing rates: BC 21.6 people out of 1,000, Sweden 20.8 (~same)

Known cases: BC: 2,517, Sweden 33,459 (13.4x)

Deaths: BC 157, Sweden 3,998 (25.5x)

Active cases: BC 303, Sweden 24,490 (81x)

Resolved cases recovery: BC 92.9% recovered, Sweden 55.4% recovered

Resolved cases deaths: BC 7.1% died, Sweden 44.6% died

Last 3 days: BC +40 positive tests, Sweden +1,665 positive tests (41.6x)

Last 3 days: BC 7 deaths, Sweden 161 deaths (23x)

I was chastised for stating somewhere that Sweden is letting their old people die. OK, I will clarify… they’re not letting their old people die; they’re letting everyone die. And by that, I simply mean they’re letting the virus run its natural course through the population, taking down whoever is unfortunate enough to contract the serious symptoms that might show up. The demographic profile of who’s actually dying is similar in both places, it’s just that for every elderly BC resident that passes away, 25 pass away in Sweden. That is the cost they’re willing to bear to keep the economy going, and there are undoubtedly people who’ll look at all of that, the same elephant I’m looking at, and come to a completely different conclusion as to what’s success and what isn’t. At some point, this is purely about opinion. The numbers speak for themselves, and you’re free to interpret them however you wish.

Yes… the measuring sticks of success are different, for different people. I don’t like to dwell in the purely pragmatic world, because it leaves out many things I consider very important and are part of my core values. Purely pragmatically, if you’re worried about economics, letting old people die makes sense. Same for sick or disabled people. The moment that the carrying-cost of someone’s existence outweighs the benefit, economically, to society, we’re throwing money away. Care homes? Wheelchair ramps? Braille on signs? Feeding into old-age pension plans? Think of all the money we could save.

A little over 80 years ago, around 1,000km south-west of Stockholm, there emerged a madman with that sort of agenda. Off he went, trying to rid his society of who and what he deemed undesirable, in the name of his version of the greater good. I wonder if perhaps the deep personal attachment I have to that particular historical event skews my objectivity, but on the “lives vs. economy” scale, I am very heavily tilted towards the “lives” side. Notwithstanding that without lives, you don’t have an economy anyway.

The few family members who managed to survive The Holocaust came out of it with very little, except each other, and that’s what I keep thinking about when this discussion comes up. Lives and family first, economy second. Elephants never forget… and when it comes to this, neither do I.

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Day 68 – May 23, 2020

Imagine a good old-fashioned campfire. The kind where you roast old-fashioned marshmallows and sing Kumbaya. Much like the kind many of you will be enjoying around here soon… as long as you’re a B.C. resident. Works for me… a policy I very much agree with, especially if we’re all being told to not leave the province. Here’s a great advantage to living in Beautiful B.C. — we have world-class everything at our disposal.

But imagine you’re sitting by that campfire, and you have an old-fashioned 1,000-page phone book that you want to burn entirely. There are right and wrong ways of doing that. For example, you can tear out one page at a time, scrunch it into a little ball, and throw it into the heart of the fire. What will happen? That little ball of paper will burn to a crisp 100% of the time. And if you do that for every page, you will have a 100% success rate if the intent was entirely burning that phone book.

But what if you throw the whole phone book in there? It’ll catch on fire, for sure… the entire brick of paper will be burning.

But eventually, when everything has gone out, what will be left? Chances are, that phone book will not have been entirely consumed. It’s a big thick block of paper, and oxygen probably couldn’t reach the very center of pages 470 to 530. There will probably be some fragments of paper that’ll still have some legible print on them.

Would it be fair to say that this particular fire was only 99.8% effective in burning this phone book? No… it’s not the fire’s fault. It would’ve done the job just fine if you’d given it the opportunity.

Similarly, we’re told hand washing is 99 point whatever percent effective in disinfecting your hands. Well, not quite — it’s actually 100.0% if you do it right. As it happens, COVID-19 is pretty fragile… and to make a long chemistry story short, the virus is wrapped in fat, and soap annihilates fat. Whatever armor the virus had while trying to hop from host to host — is gone. Common soap is as effective as alcohol in wiping out this virus — perhaps better — unless you have the necessary concentration, like what is found in hand sanitizers. If you wash your hands properly, ie. you get soap on every surface of your hands, the virus can’t survive. There is no tiny fraction of super-protected virus balls that make the percentage less than 100, just like there’s no magical page 567 of that phone book that, when crumpled alone, will survive burning.

And so… masks. Yes, masks. Dear, lovely, sainted masks. Let’s talk about masks one final time. Haha! Yeah, you’ll be hearing a lot more about masks, whether from me or numerous other people. One thing you might hear is that they’re not 100% effective, so why bother… and the simple answer is that if you need to burn the phone book quickly, getting all the edges and most of the pages is better than nothing. A lot better.

The arguments you hear against wearing masks are many, but they all have a common denominator. Me, me me… my rights, my freedoms, you’re free to wear a mask and I’m free to not wear one. Sometimes coupled with the “scientific” reasons to try to justify that… they cut off oxygen, they hurt your lungs, they’re bad for the immune system. Come on.

The truth is… me wearing a mask helps you more than it helps me. Conversely, you wearing a mask benefits me more than you. There’s that old parable… religious/inspirational/team-work — whatever the set-up is, I’ll go straight to the punchline… it’s the one were everyone’s arms are suddenly frozen, sticking straight out. Suddenly, people can’t feed themselves and are starving. But of course, those that learn to cooperate… feed each other, and humanity is saved, yadda yadda, It’s not a difficult lesson to understand… the kind you can wrap your head around; no need to memorize. Also works for me.

I was amused with a Facebook ad that popped-up on my feed; an ad for masks, but they’re all branded Trump and MAGA and “It’s my choice not to wear a mask” and “U.S.A” and all the rest of it. For those whose intellect is incapable of indulging in the delicious irony provided, great! Wear them as your protest…. “See this mask I’m wearing?! Well, I don’t have to be wearing it!! It’s my choice, and I’m showing you how much I’m against them and how you’re trampling my rights… by wearing it!!”. I love it — more power to you. Just wear the mask. Yeah… works for me.

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Day 25 – April 10, 2020

There’s an interesting experiment going on, on the other side of the planet. Our furniture-making, meatball-eating, hockey-dazzling friends in Sweden’s approach to managing this crisis is a lot different than what’s going on around here. We’ve seen a few examples around the world how not to do things. How a few days here and there can have a drastic effect. How not taking it seriously can have big implications. The Globe & Mail wrote about Sweden last week. CNN picked up on it yesterday. Sweden, not a culture that I would associate with recklessness, is taking a huge gamble. If I were a betting man (and I assure you, by any definition of that expression, I am), even I wouldn’t rolling the dice the way they’re doing it.

I will summarize the articles, add a few comments… and something they left out.

To summarize, their schools are open, their pubs are open and there’s no lockdown. Gatherings of more than 50 people are banned, but everything else is left up to the honour system. Trust that others will do the right thing. Recommendations, not orders. Their PM calls it a “common sense” approach. Their chief epidemiologist is saying that it’s working “reasonably well” so far, and that they’ve had “not very much” spread into elderly homes and “almost no” spread into hospitals. In other words, it is, at best, working ok, but it’s in the elderly homes and it’s in hospitals. So basically, it’s everywhere.

Not everyone has bought into the plan… a letter from 2,000 doctors and public-health experts went out, urging the government to get a reality check. But for now… many Swedes get it, and are isolating and maintaining social/physical distancing. But also, many are hosting big family Easter celebrations this weekend. How will it all play out? The articles suggest we’ll know “next month”. I think we’ll know a lot sooner.

A quick look at numbers shows a sharp increase yesterday… like, double the number of new cases from the previous day… a 12% increase, implying a TTD of 6 days… so if that rate remains constant, their 9,000 cases will be 18,000 next week and 36,000 the following week. I will say that the growth rates before that were lower, and as I said yesterday, one day doesn’t make a trend. But the whole thing makes me very uneasy.

Some other numbers that are troubling and not mentioned… once you become infected and are verified by a test, you become a statistic. Your statistic will get modified as time goes on… symptoms or no symptoms, hospitalization or not, ICU or not and so on. The final statistic you will have attached to you is in the “Resolved” category, and it can go one of two ways: Recovered or Deceased. To be clear, this doesn’t include anyone who may presently have it, symptoms or no symptoms… this is exclusively those who definitely had it, and now definitely don’t. At last tally, Sweden had 1,251 resolved cases.

Here are the numbers, for comparison… for all known resolved cases, these are the percentages of those who fully recovered:

South Korea: 97.2%
Canada: 91.3%
Italy: 61.8%
USA: 59.5%

And while we’re here… BC: 94.1% — and that number would be higher were it not for the type of clusters (like long-term care homes) that we’ve experienced here.

And Sweden…? 30.5%.

Out of 10 people in Sweden who’ve had this thing and it’s run it course, 7 have died. Which seriously brings to question how deeply they have their heads buried in the sand. That is a staggering number for a first-world country that claims to have things under control. I hope they come to their senses soon.

Closer to home…

There seems to be some confusion when it comes to physical distancing. Stay home or go out in the sun but don’t get together with others and jog, but away from other people and bike, but not where others do, so bike lanes are sort of not ok, so what’s the deal…

Here’s the deal. You can go out if you pretend the following… pretend that you’re carrying this virus… you’re very fortunate that you have no symptoms, but you’re very infectious… and, if you give this to someone else, the moment you do, a lightning bolt will shoot out of the sky and strike you dead, instantly. Just like that.

So… what do you need do to avoid that? A mask or mouth covering helps… a lot. It doesn’t help you as much as it helps others, but like that parable where everyone’s arms are frozen straight out and everyone fears they’ll starve to death because they can’t feed themselves… well, duh, just feed each other. Everyone wins when you do your part.

When you cough or sneeze, you eject particles into the air…. little droplets within which the virus is carried… and those droplets can hang around, suspended in the air. Not for hours, but for several seconds. While the virus itself is small enough to penetrate most fabrics, water droplets are comparatively much bigger… so wearing a mask is like coughing or sneezing into your elbow or a handkerchief.

Assuming no masks, if you’re walking single file outside with other people (Arbutus corridor, seawall, sidewalks…), maintain a distance of 4 to 5 meters. If the guy in front of you coughs or sneezes, it’s unlikely to reach you. If you’re jogging or slow biking, 10 meters. And normal biking, 20 meters. And if you’re heading towards each other — well, you’re in the wrong place. As much as I enjoy cycling, not there, not now. Someone else just breathing hard, let alone coughing/sneezing — within 20 meters of us approaching each other — I would be breathing his exhaust. I don’t want to do that.

The numbers across the country look good. Flat, or lower… let’s keep at it… and hope that the people who decided to ignore what Dr. Henry and Mr. Dix said about 100 times this week…. “This is not the time to…”, and jammed up the ferry line-ups this morning, and swarmed Victoria and the Gulf Islands — don’t wreck things for all of us.

 

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