Mixed

Reports of new world sightings are mixed.

For the first time in well over a year, a poster called Annie Laurie, at the group blog Balloon Juice, will take a three-day vacation from her daily COVID update.  Thorough and wide-ranging (every day!), the early-morning post is the basis for the day's understanding of the pandemic for thousands of us, including me.  Her notice, in bold up top of her post on Thursday:

Barring an unexpected spate of new discoveries, I’ll probably skip these updates over the holiday weekend (Saturday, Sunday & Monday nights). We can all use the break, IMO!

We sure can.  And the fact that AL feel we can live without updates for a few days suggests that things are winding down.

Next up is a tweet from Dhruv Khullar, a physician and researcher: 

Can't help but marvel at the incredible efficacy of the vaccines.

This time last year, our hospital was filled with Covid. Every patient I cared for had it. We converted pediatric floors to ICUs and psych units to Covid wards.

Today, I don't have a single patient with Covid.

Sounds great!  But wait...

Today, some rich countries are vaccinating children as young as 12 years old, who are at extremely low risk of developing severe COVID-19, while poorer countries don’t even have enough shots for health care workers. Nearly 85% of the COVID-19 vaccine doses administered to date have gone to people in high-income and upper middle–income countries. The countries with the lowest gross domestic product per capita only have 0.3%.

Here's what that actually looks like:

Here at "The New World" we've talked about COVAX and vaccine inequality a lot, all in the service of understanding global herd immunity, which looked, for a while, like it would be the new world, only to fade into fantasy.  The virus is still winning all over the world, and we really have to be careful about declaring victory* when vaccine hesitancy, variants and especially vaccine inequality will be lengthening the pandemic as we celebrate.

Enjoy your break, Annie - we're still a long way from home.

* - To be fair, Annie Laurie and Dr. Khullar are not celebrating the end of anything, but instead are describing a point in a long and continuing history. 

More Math

In a podcast aimed at medical clinicians, Dr.Amesh Adalja of Johns Hopkins, tells us that the COVID data modeling for the next year includes a surge in the winter, with a death rate in January of about half of what we saw this year.

January, 2021, was the most deadly month in the US at that point, with nearly 80,000 deaths.  So the prediction for next January is that around 40,000 Americans will die.

This alarming prediction encouraged me to do some more math.  If we take the total number of Americans who have died from COVID (604,000) and divide by 16, which is the number of months since the first of those deaths (early February, 2020), we get an monthly average for American COVID deaths:  37,687.  

So Dr. Adalja is suggesting - and he did so as if this were no big deal - that next January's death toll from COVID will far surpass the average monthly American death toll throughout the pandemic.

So this is what "endemic" means?  Looking less and less like the new world.

Thanks Again, Kevin

Kevin Drum has seen the new world, and reports back.

Over The Weight Limit

Endemic

BMJ, which is, as far as I can tell, a former medical journal turned medical research, advocacy and education organization, puts it this way:

The SARS-CoV-2 coronavirus will not be eradicated but will become endemic, continuing to circulate in pockets of the global population for years to come and causing outbreaks in regions where it had been eliminated, scientists working in the field believe.

That's the bad news.  The sort-of-good news:

But the impact of the virus on the world in terms of deaths, illness, and the need for social isolation will lessen, they say, as more of the population acquires some immunity to it through exposure to the virus or from vaccination.

BMJ is passing on the result of a study in Nature, in which they asked "more than 100 immunologists, infectious-disease researchers and virologists working on the coronavirus whether it could be eradicated."  The answer was, effectively, "No."

"Endemic future" is a chilling phrase that we will be hearing and reading about more frequently as the political drama of vaccine resistance plays out, and the chance of herd immunity disappears over the horizon.  "Endemic" refers to a disease which is always present, in at least a certain portion of the population.  Chicken pox, malaria, the flu in all its variety, and the common cold are all endemic.  Even the bubonic plague is endemic. Smallpox is not endemic, because people got vaccinated and herd immunity worked.  

So that's where we are.  Where is the new world?  Somewhere out there, maybe.

Back to Normal? I Hope Not

Sometimes, when you click on the headline at cnn.com, the headline of the article you are sent to is different from the headline you clicked on.  For instance, this morning, on the main page:

    "Can the US go back to normal now?"

And the actual article's headline:

    "Wait, does this mean the pandemic is over for vaccinated people?" *

Two very different things, no?  Even if the pandemic were over for vaccinated people - which is absurd, as only 35% of us are fully vaccinated, and we are still living in a world featuring death, sickness, despair, confusion and tribal divisions - that would not in any way mean that the US could go back to "normal."

You'd think an organization as huge and wealthy as CNN could hire a few people to check this kind of thing.  Apparently not.

This headline choice also, of course, betrays CNN's assumptions that the post-COVID world will be exactly the same as the pre-COVID world - "normal."

I've been thinking a lot about this - how popular culture, or at least the media that reports popular culture to people like me, seems to be straining toward a vision of how it used to be.  Obviously, this eliminates the possibility of learning anything about ourselves, our lives, or our world while we were suddenly cast out of our comfort zones and into a holding pattern.  Do we really just want to slide back in to "normal" and not have to think about how and why anything works again?  

I don't.

 * - The article is about the CDC's new guidance regarding mask-wearing for fully vaccinated people.

Baby Bust Generation?

We have talked a great deal, here at the New World, about possible baby busts and baby booms resulting from this endless pandemic.  Both could happen, in different parts of the world.

Now CNN passes on a CDC report suggesting that the US is in for a baby bust.  After years of birth rate declines as much as 2% annually, the US saw a decline in births in 2020 which was double that - a decrease of 300,000 births, year-over-year.  As we've seen before (see "baby bust" links above), people who have the ability to do so, put off having children during troubled or uncertain times.  We shouldn't be surprised that this is proving true on America, as well.  And this is just the start: 

...experts have noted that in terms of total births and fertility rates, the real impact of the pandemic will be seen in data from 2021, when all babies born will have been conceived after the health crisis began.

So what does this mean?  Demographers could probably write a book to answer that question, but right now the aspect seems hazy:

The decline in births caused by the pandemic, coming after years of decreasing birth rates, could add up to significant shifts in society, Levine says. "The fact that it's coming on the heels of a lengthy ongoing decline in births exacerbates its impacts. In reality, it's not the 300,000 fewer births once (as a result of Covid), it's the hundreds of thousands of fewer births every year that's likely to have substantial impacts on society," he says.

"Those include things like economic activity, the solvency of our retirement system and significant other social implications."

Think about the huge societal impacts we saw after the baby boom in the 1950s.

"This," Levine says, "has the potential to be the opposite of that."

The opposite of the baby boom - which took a decade or more to develop?  We'll see.  Meanwhile, we have general and vague analysis.  I'm waiting for the book.

Nervous CEOs

Remember David Solomon, CEO of Goldman-Sachs?  Not a fan of WFH.  Neither is Jamie Dimon, CEO of JP Morgan Chase & Co.  Now Cathy Merril, CEO of Washingonian Media, has weighed in.  

I am not a disinterested observer here; I believe that CEOs are getting nervous about the change in corporate culture that will occur if their employees work from home.  Specifically, they are nervous about a change that reduces their ability to abuse their employees' time, health, family bonds, and mental health in support of greater profits and bonuses for themselves.  When someone like Dimon writes that working from home “doesn’t work for young people... It doesn’t work for those who want to hustle."  "Hustle" is corporate-speak for "giving up everything in your life to enrich the stockholders."  It's hard to "hustle" at home, I guess, but it's certainly possible to work effectively. 

Merril goes a step further - well over the line, I think.  She notes that if an employee does not participate in the office culture...

...management has a strong incentive to change their status to “contractor.” Instead of receiving a set salary, contractors are paid only for the work they do, either hourly or by appropriate output metrics. That would also mean not having to pay for health care, a 401(k) match and our share of FICA and Medicare taxes

Read the whole thing.  Merril's tone and purpose is chilling.

There is a lot of talk about things that can be accomplished in person that can't be done remotely, mostly focused on the ephemeral value of breathing the same air as the person or people you're meeting with, and the serendipitous connections that can occur at the water cooler.  Nowhere (and I have read a lot of this) is there any deeper analysis of why being in the same physical space is so significantly more effective that we all have to go way our of our way to gather in that space.  If digital communication as a whole has done one thing, it is to provide us all with the means to have almost any kind of interaction with others that can possibly be imagined.

I found Merril's article in a link from Kevin Drum, and a comment in that post puts this whole thing to rest, I think:

It is possible to foster a collaborative environment online, but you have to work at it and use the proper tools.

Right.  Any questions?

How About We Don't Be Stupid?

 

                                                 Clay Jones via GoComics.com via Balloon Juice

The New New World (2)

The rules have been changed.

Just a couple of days ago, we were doing math to find out how long until herd immunity.  How naïve we were, back in those days.  Apparently, at least in the United States, herd immunity has become an unrealistic goal.

Due to vaccine hesitancy (or, probably more accurately, the polarizing effect of political tribalism), not enough Americans will choose to be vaccinated.  Vaccination rates are already falling off.  Also, new variants continue to brew, and they may (looking at you, India variant) be able to "evade antibodies in the immune system that can fight coronavirus based on experience from prior infection or a vaccine."  So - if a vaccine-resistant variant emerges, suddenly no one's vaccinated any more. 

So what does this mean?  Right now, seen through the mists of prediction and speculation, it seems that we'll have COVID-19 around pretty much forever.  We'll be vaccinated on a regular basis forever, and people will get sick and be hospitalized and die, although at a much lower rate than during the last year or so.

So the new world will include COVID-19, just like the old new world included smallpox.  There's something to think about.

More Math

Today I discovered the Global Commission for Post-Pandemic Policy.  Its mission is "to enable and impact informed learning, debate, and decision-making on the wide range of issues connected with the Covid-19 pandemic crisis in all its dimensions."  This, I think is an organization which is as interested as I am in figuring out when the pandemic will be over.

Right out of the gate, they have bad news for those of us whose view of the new world reaches to "summer" or "fall by the latest."  It's pretty basic math.

As of today, a billion COVID vaccination doses have been jabbed in arms worldwide.  During April, which just ended yesterday, 415,769,587 doses were produced by all pharmaceutical companies involved in the COVID vaccine process.

The world population is over seven billion, giver or take, meaning we'll need about fourteen billion jabs to get the job done.  One billion have already been given.  Estimates of effective herd immunity range widely, because we just don't know, but let's be conservative and suggest that we have to vaccinate 85% of the world's population.  That leaves us in need of roughly 11 billion doses.

If we can ramp up production from 415 million does a month (April's total) to half a billion, that's 22 more months of production to get to herd immunity.  That puts us at March 1, 2023.  The life span of a jab, from production to someone's arm, is apparently only a few days, so by mid-March, almost two years from now, we can - theoretically - be at global herd immunity.

Theoretically.  March 2023 is the perfect result, the ideal, the best-case scenario.  Every obstacle adds time - vaccine hesitancy, production or transport interruptions, resistant variants, premature openings, not to mention the enormous level of inequality of distribution already firmly entrenched in the system.

We - meaning everyone - need to be very careful for a very long time - nearly two years.  I really don't want it to take that long.  Too bad.