Tuesday, May 12, 2020

At Least a Million? (Covid predictions.)

CN: Sort of frank Covid death toll talk. Not trying to be your doom-scroll itch-scratch of the day; I just think we have hard truths to face in this country.  

I've predicted that, when all is said and done, we'll be near a million US deaths from Covid-19 a couple of times, and people think I've lost the plot. They think a quarter mil is on the high end. And to be honest, they're probably right. I don't have a very high opinion of mainstream US culture or its ability to handle this crisis. 

But frankly, I also don't have a model or a forecast I'm using. I don't believe this thing is far more dangerous than the CDC claims or some conspiracy theory or think it is secretly airborne or anything. I just watch our CURRENT fundamentally horrible reaction, and I think we are a perfect storm of incompetence and cultural vulnerability. When cases jack up, deaths jack up (there's no stopping that statistical reality yet), and cases are about to jack WAY, WAY up.

There are 330 million people in the United States. Even Covid's low, beat-the-curve, not-overwhelming-the-ICU's (and the low end of the current guestimate) numbers mean that the cold mathematics are that only about 1/5 of the country falling ill would come out to about a million dead.

1- We haven't even begun to see case spikes from all the reopenings. And by the time anyone says, "Holy shit, reclose it! RECLOSE IT!!!" they will be dealing with two weeks of exponential growth before their curves flatten. Those kind of numbers will grow with dizzying speed.

2- We have the numbers we do BECAUSE of the social distancing and the Shelter in Place that we've managed. And those numbers are.......(wait for it).......the worst in the industrialized world. 4.4% of the population and about 30% of the deaths. That's us on our BEST behavior. And we're about to relax. And conservatives have taken to actively "misbehaving."

3- The federal government's response to insufficient PPE has been criminally derelict. Most places STILL don't have the PPE, beds, ventilators to handle a spike in cases (like the one we're likely to see from reopening), which means you'll see the outcomes of an overwhelmed healthcare system––when that mortality rate jumps.

4a- We have a significant number of people who refuse to take even basic precautions because "fuck the libs" (and fuck academia and science and the media), and no one's going to tell them what to do. When they get it, they will spread it a lot. Not because the info wasn't out there, but because the right-wing leadership found it politically expedient (in the light of facts having such a liberal bias) to undermine any institution that would propagate good data.

4b- It is super hard to watch HALF of a society NOT make a sacrifice you're making for the good of.....them. (Like we can do that shit for our kids, and maybe close family.) Not that there won't be some people who keep social distancing for various reasons, but you're going to see a lot of people (especially if they're in places that aren't doing it at all) wondering what the point is if no one else is doing it.

5- Our governing administration has said openly and on the record that testing just makes the numbers look worse so let's not do that. This is absolute anathema to every medical institution's insistence that one of the highest priorities needs to be testing so we know who has it, who they've been exposed to, and who needs to go into quarantine. Donald Trump has done everything from dismiss the numbers to peddle untested cures. They are completely, absolutely, grotesquely inept. Literally doing nothing would have been better because then at least the states would have the PPE they had to smuggle in from other countries.

6- Even on my friends list, where you would think the people who follow medical and science advice are pretty well represented, and the vast majority would care about public health risks and have the compassion not to expose vulnerable folks….   EVEN THESE FOLKS are getting Isolation Fatigue. They're starting to post pictures of small social gatherings and "just a couple of friends" and trips with their BFFs. And if they're maintaining cell integrity (and trust implicitly that their friends aren't having another "just a couple of friends" with another group), they can make that work, but done casually, it's just the sort of thing that basically make most social distancing and shelter-in-place rules statistically meaningless.

7a- The most scientifically and medically minded states are still opening back up. We are handling CV-19 the absolute WORST IN THE INDUSTRIAL WORLD, and we're opening back up like we've pretty well got this thing licked. And whether you think they've done enough or not (I happen to think Gavin Newsom has done pretty dang well), reopening can't NOT raise exposure rates, thus cases, and thus––statistically––deaths.

7b- The states that flung their doors open (not soft openings) represent a pretty large contingent whose basic outlook is, "let them die (just a bunch of old fogies anyway*). “ The leader of the Republican party and most of its leadership have said that the economy is more important than the death toll, and have basically doubled down on it already.

[*It’s not.]

8- A shocking number of people, irrespective of "side of the aisle," think they know better than the experts. Not "fuck the libs" no-protection types, but people who think that the exposure rate is probably low enough that they can have dinner parties, or who think that it's not really worse than the flu so it doesn't really matter if they get it, or that masks are useless or whatever. Or my personal fave: that they probably had it last spring when "...remember that bad cough," and really don't need to worry because they're immune. They just....know better. And no epidemiological expert is going to convince them otherwise. And every American exceptionalism cultural narrative plays STRAIGHT into disdain for expertise.

1-8: So I don't really think we're going to get a first and second wave. I think we're going to get just one long mushy wave with lots of hotspots, resurgences, and a highly HIGHLY politicized reaction. While I think it's easy to imagine that in two weeks, all the open states will see the error of their ways and close back up, you also have to realize that these are the same people who have basically called Covid deaths the price of doing business, so it's going to take more than a few days of numbers going up, "that's not a moon" trepidation for them to hear the branch crack under their feet.

And it doesn't end in the fall, no matter how badly politicians want it to.

9- Our healthcare system is about the worst equipped in the industrialized world to handle distribution of a vaccine. I don't have the slightest trouble imagining that it won’t be AFFORDABLE to many people for months or even years.

10- We know for a fact that there will be people and forces actively discouraging using the vaccine that will leave wide gaps in herd immunity––probably for years.

11- An administration that has lowballed, underestimated, and mismanaged everything since they got rid of the pandemic response team..... The same administration that has padded numbers, has openly admitted to not testing to keep numbers low, and is run by a guy so out of touch with numbers that make him look bad that he INSISTS he won the popular vote and his inauguration was bigger.... THOSE GUYS....are predicting 3000 deaths every. single. day. Do you think there's any chance in the world, if that's what they're OPENLY ADMITTING TO RIGHT NOW, that it's going to actually be that low?

12- I don't really put it past our current administration not to descend even further into the depths of depravity to try and get the economy going. I wouldn't put it past them to coerce or even force people back to work. I wouldn't put it past them to mount a propaganda blitz that everything is awesome (when you're part of a team). I wouldn't put it past them to engage in TRULY massive cover-ups. Basically, they're doing all that stuff already, so all we have to do is imagine that *more* of it is happening than we know about, and that they will up their game as they grow more desperate....not exactly a stretch of the ol' imagination.

13- When other countries want and try to send in medical teams to help us, we will refuse because that's the way we treat countries we look down upon.

We have a political party that has, three months in and with clear evidence available of how bad this is, turned doing nothing into a loyalty test for their deepening cult mentality. I think there's very little chance the US is going to suddenly step up and magically govern its way well through a crisis (not until maybe next year--vote!). And I just think we are still thinking we can turn the ship the instant we see an iceberg. But exponential growth is a cruel master; by the time the party who is currently governing might actually admit they were wrong about anything, those numbers will be SOARING out of control. There are ways to get this under control (and other countries have), but we seem to have everything going against us.

Hope I'm way off on this one. Bunch of gut feelings. Not a lick of evidence.

Surely a huge overestimate. Yes.


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