Saturn?

We're back!  Been visiting with nuclear family - two sons, one daughter-in-law, one grandbaby - for about two weeks.  Wonderful.  Now, back to real life.

'Real life,' as it pertains to the new world, contains more concern about the imbalance in vaccination supply.  If no one's safe until everyone's safe, then the new world doesn't begin until there is herd immunity all over the world.

It seems like just yesterday that we were bemoaning the fact that it would be until 2022 until this happened, and we upgraded our analogy-journey from Columbus's new world to the asteroids to Jupiter.

Now we hear that an outfit called the Economist Intelligence Unit ("the world leader in global business intelligence," according to them) is predicting that "...most poor countries will not achieve mass Covid-19 immunisation until at least 2024 and some may never get there," leaving us with "...a starkly divided world over the next few years in which a handful of developed countries are fully vaccinated while others race to catch up."

Countries such as the UK, US, Israel and those in the EU will probably achieve “widespread vaccination coverage” – meaning priority and vulnerable groups, and almost all of the rest of the population – by late 2021. They will be followed by a slew of other developed countries by the middle of 2022 and then most middle-income countries by the end of that year.

But 84 countries that make up the world’s poorest will not receive enough doses to sufficiently immunise their populations for at least a further year, a global faultline that will run through the first half of this decade, said Agathe Demarais, the unit’s global forecasting director and author of the report.

“It’s going to define the global economy, the global political landscape, travel, pretty much everything,” she said.

The reasons for this disparity are pretty much what you might have guessed:  "...existing supply deals, production capacity, vaccine deliveries so far, infrastructure to administer doses and vaccine hesitancy rates."  Another new phrase for all of us to ingest:  "vaccine hesitance rates."  And remember COVAX?  The Economist Intelligence Unit is "skeptical" of its projections:  “There’s a lot of political hope that the targets will be hit … but we can see there are already delays for production and delivery in richer countries, so we can expect some delay in poor countries.

We won't have reached the new world until herd immunity is global, of course, but the other half of the equation is economic:  we won't have reached the new world until the economy is normalized, whatever that will look like.  But it won't happen until COVID is under control everywhere there are consumers, in other words, everywhere.  

And the International Chamber of Commerce, in a report titled "The Economic Case for Global Immunizations," tells us that the sophisticated modeling used in their research makes it clear that "...no economy can recover fully from the COVID-19 pandemic until vaccines are equally accessible in all countries."

 Which will be sometime in 2024.  Looks like we're going to Saturn.

'Universal' is the Hard Part

Yes, we're going to need a reliable, quick and easy, universal method of proving that we've been vaccinated.  We've been through this.  It seems like the hardest part will be the "universal" part.

If nothing else, this pandemic will teach us how inescapably global our world has become, so to speak.  A virus that doesn't recognize any border of any kind forces us to find solutions that are, well, universal.  Global.  No one is safe until everyone is safe.

"For some period of time, most all of us are going to have to demonstrate either negative Covid-19 testing or an up-to-date vaccination status to go about the normal routines of our lives, " said Dr. Brad Perkins, the chief medical officer at the Commons Project Foundation, a nonprofit in Geneva that is a member of the vaccine credential initiative.

The "vaccine credential initiative."  Sounds great.  But there's no realistic plan, at this point, to make it universal.  Every country vaccinates according to its own schedule and system, and in the United States, there are fifty separate schedules and systems, most of which do not communicate with each other, no less.

The VCI would require hundreds of complex systems running at different speeds, in different languages, to all get themselves standardized and available at a moment's notice.  As long as people want to get on planes, go to concerts and conferences and meetings and sporting events and work and school, eat at restaurants, drink at bars, use public transit of any kind - as long as they want to go somewhere and do something where they are less than six feet from strangers for more than five minutes - it's highly likely that they'd like those strangers to prove that they've been vaccinated.  I know I would.  It's not clear that any part of economy can return to normal until we can do that.  

By the way, the "credential" in VCI will be digital, so you've got to have a smartphone.  Don't have one?  Can't afford one?  Can't get online?  Some other reason?  Too bad.  So - not universal.

And the VCI is not the only initiative planning to get us all credentialed.  Remember the IATA travel pass?   There's also CommonPass, IBM's Digital Health Pass, and Clear's Health Pass.  Etcetera.  Remember when there were nearly every phone had a different charger jack?  Chargers everywhere, but your phone's still dead.  

It's great that the need is recognized and sophisticated tech corporations are working on it.  But don't we need it right now, or at least in the next month or two?*  And don't we need it to be universal?  

Seems like we've got a long way to go.  Maybe by the time we go flashing past Ceres?

 * - Actually, if we don't get more organized about vaccinating a lot of people quickly, it probably won't matter for a long time.

Jupiter

Already I'm wrong. It's not the asteroids.

The World Health Organization now says it will be 2022 before we can say we've reached the new world.  Or at least that's what the WHO's Chief Scientist (a really cool title if there ever was one, straight out of a comic book) said.  

"We are not going to achieve any levels of population immunity or herd immunity in 2021," said Chief Scientist Soumya Swaminathan on Monday.  Why?  No surprise:  less developed countries will take longer to get access to enough vaccines; one in four people worldwide won't get the vaccine until 2022, and most of them will be in less-developed countries.  Also large portions of the population will refuse/are refusing the vaccine, at least at first.  And variants caused by genetic mutations may become more resistant to the vaccine.  As we know, the virus hasn't learned about national (or even state!) borders yet, and probably never will.  No one has herd immunity until everyone has herd immunity.

So:  2022.

We're going to Jupiter, not the asteroids.  We can wave to the asteroids on the way by.  Two years to Jupiter, if you don't want to slow down.  If you want to slow down - maybe do a few lazy orbits, take some pictures from different angles, or actually land - well, more like six years.  

So here we are, halfway to Jupiter, heading further out.  If everything goes just right.  

To the Asteroids

As you know, I have been comparing the pandemic experience to Columbus' first voyage across the Atlantic in 1492.  To the crew, it must have been frightening, intense, and mystical.  They were going where no one that anyone knew had ever gone.  Some believed in sea monsters, some in the end of the earth.  Most, in some sense, believed in fabulously rich spice islands, and that's why they went. 

I think that this analogy is reaching the end of its useful life, although it will be interesting to do a final analysis of the two journeys someday.  The problem is, that no sea voyage, that anyone survived,  ever sailed out of sight of land for a complete year, with no end in sight.  It was a different world.

We're a year into our pandemic - the anniversary is today, or next week, or yesterday, or whatever day you believe was the beginning last year.  Or March 11, when WHO formally declared a pandemic.  But we were already out of sight of land by then.

How long to go?  At least six months, maybe a year, depending on how well vaccinations are organized, and how many refuse the jab.  

It would take about seven months for a space mission to reach Mars.  Seven months isn't even in our rear-view window any more.  More like the asteroid belt - maybe around 18 months.

So we're going to the asteroids.  Imagine that. 

Asthma in the New World

I don't know much about asthma, so I was surprised to learn that quite a few children need to visit the ER often enough that, when the number of these visits decreases, it's very noticeable.  Those visits decreased a lot recently:

Just one week after Massachusetts closed schools and day cares in March, Boston Children's Hospital saw a drastic change in asthma-related visits to the emergency room:  They were down 80% from the prior two months.

ER visits continued at about the same low rate as long as the shutdown continued.  Other pediatric ER visits didn't follow the pattern, it was just the case with asthma.  And "most cases that made it to the ER weren't any worse than usual."

OK, fine.  Elements of the pandemic environment and the shutdown and quarantine life have led to innumerable impacts on nearly all areas of our lives.  Here at "The New World," we're not interested in those changes that will dial themselves back to normal once everything else is back to normal, but only those impacts which will create some interesting changes in the new world.

It turns out that the folks from Boston Children's have found some factors that might have been responsible for reducing pediatric asthma ER visits to nearly zero.  Most of them were factors which won't last:  masks/distancing/handwashing (which are reducing a whole host of common respiratory ailments), a lot less contact with outdoor allergens, and the elimination of school sports, which trigger a lot of "exercise-induced asthma."

But there are two effects which may last in the new world.  Not knowing much about asthma, I certainly didn't know that, according to the CDC, "only 54% of children who take asthma medications use them as prescribed, which can lead to more frequent and severe, asthma attacks."  54%, indeed.

The Boston Children's researchers report a great improvement in proper use of prescribed medications during the few months that they studied, the first few months of the pandemic.  They speculate that the high profile of distressing health news, and the fear of encountering COVID in the hospital, may have focused these patients (and, perhaps more important, their parents) on better medication cooperation.

Still, this is certainly an effect that will fade when our attention returns back to life in general, and hospitals are no longer COVID hotspots, right?  Right, except for one more thing I didn't know about asthma: "...medications are able to maintain better control of symptoms over time."  

I read that to mean that the longer you take your medications properly, the better your asthma becomes, overall.  Instead of asthma being something that makes life difficult and requires constant ER visits, it becomes a less-salient difficulty, when you take your medication regularly, and the ER can become a not-so-fond memory.

The other factor that researchers suggest has an impact on ER visits, and that I think might have an impact on the new world, is telemedicine.  Once you get over the novelty, and learn how to do it, telemedicine is way easier than actual doctor visits, and much cheaper and more efficient than ER visits.  And - as an added bonus - it tends to improve medication adherence, at least in adolescents.  Win-win.  

So - maybe some hope for children who suffer from asthma in the new world?  Healthier kids emerging from the pandemic, with the understanding that it is medication adherence that has made life better?  Kids who are used to telemedicine and therefore more likely to maintain a positive relationship with healthcare providers?  Kids who grow up and pass these habits and attitudes on to their children?  Wouldn't that be a breath of fresh air.

Isolated Chapter

At some point in the endless life of this blog, I linked to an article which suggested that 2020 would be a chapter break in the history books of the new world.  We were wrong about that.

2020, which will end on January 20, 2021, will have its own chapter.  With, we hope, some blank pages either side to, you know, help prevent the spread of the infection.

Boutique Options and the Crowded, Noisy Kitchen Table

Here at "The New World," we've covered the speculation regarding what wealth inequality will look like in the new world.  Recently, an NPR program called "Innovation Hub" looked at impact that the pandemic will have on education inequality.  The format is an interview with two university academics from prestigious education programs, and the news is, apparently, not good.

It will probably come as a surprise to no one that, during the wide-ranging discussion of the future of education, there was agreement that economic inequality in educational quality and opportunity will continue and grow.

School closures during the pandemic, as we know, drove districts to develop systems for online learning, for kids from preschool to graduate school, literally overnight.  In addition to radically overhauling the curriculum on the fly, remote education required that students assemble a rather sophisticated collection of resources - again, overnight.  A reliable internet connection and a computer or tablet were essential, as were a place to work, a relatively quiet, distraction-free environment, and (for most students) some level of adult supervision.  In that regard, our experts agree, the overall approach has been "Everyone's on their own, do the best you can."  We all know how that turns out.

Here's how the text summary accompanying the program sums it up:

...many students were unable to consistently participate and became disengaged because of access issues, including shaky internet connections and lack of suitable devices... Overcrowded housing situations, parents working outside the home and homelessness have made remote learning particularly challenging.

Others had much less difficulty participating in their own education:

...parents with more resources have been able to supplement or even replace their student' public shool education with the help of tutors, learning pods, online activities, and other enrichment opportunities.

Apparently, many families with more resources sprang into action and brought those resources to the task of continuing their children's education and enrichment.  Parents were "shopping around" for educational services to supplement or replace public education.  They organized "a la carte" menus containing online instructional content and enrichment activities, and actually hired teachers to provide the instruction, paying in some cases in the six figures - often enticing these teachers away from their roles in public schools.  Some of these ad hoc consortiums even called themselves charter schools, and have received public funding.  "Boutique options" were there for those who could afford them.

So, in the new world, many middle and upper class children will resume their pre-COVID education as if little had interfered with their progress for this long year.  Poorer students, with fewer resources, will have missed much or most instruction during that year; they will have lost a year and will be even further behind the wealthier kids in their cohort.  

The solution?  Our experts suggest "extra summer school classes and addition tutoring."  And the additional public funding that these programs require.  Anyone who's spent any time in an actual public school understands that these solutions will be too little, too late.

Not good enough.  Welcome to the new world. 

Thanks, Kevin

I am no more immune to "Top Ten" lists at year's end than the next guy.  But I don't go looking for them.  This one came to me.

I read Kevin Drum daily, and have for about fifteen years.  He's a voice of calm, usually, and an important component of the daily mix of media.  His "Top Ten" lists are interesting and, occasionally, tongue-in-cheek.  OK so far.

But Kevin thinks I've been wasting my time the last ten months.  In a list of predictions for 2021:

Things will mostly return to normal when the country opens back up. A few little things will get a boost, but humans are fundamentally social animals and will remain so. We will very quickly return to nearly all of our old habits.

Thanks, Kevin.  Well, at least this blog has kept me off the streets.  Oh, wait - no - that was the virus.

Oh, well.