Though little else appears to be getting done, the global coronavirus pandemic is at least reminding us of the nature of risk and risk assessment, and how little the latter has to do with the former in absolute terms.
Here, Victoria is getting yelled at by the rest of Australia for a new flare-up involving a few hundred cases, and the country has locked down against us. Meanwhile in the UK, with the thing still raging — 500 new cases a day, 44,800 deaths so far — lockdowns are easing, people are being given vouchers to dine out, and the gyms are reopening next month.
The UK is not the US, where virus denialism has become a right-wing cause; it remains a relatively rational society. The push to reopen is clearly coming from the capital, but the absence of a unified pushback suggests that it is largely being consented to — that the risk assessment of the publics of the two countries is at variance.
That should remind us that there is no “obvious” way to deal with this virus. Anything that looks “obvious” is simply the assumptions of a given culture, clearing their throat and making themselves heard. We are looking for certainties out of the need for certainties, and then attaching them to a situation which offers none.
After all, the UK’s policy is being moved forward against the emerging evidence that the coronavirus is not simply a young v old, healthy v afflicted, die v live sort of matter.
The growing evidence of chronic health damage — including neurological damage — to those afflicted, including those without visible symptoms, is now surely becoming too insistent to ignore. But we are ignoring it because it is too difficult to think about.
It throws current strategies into disarray and reveals them as having, at some level, a relapse into superstition. At some point, rational-purposive activity becomes its opposite: an act of appeasement to the gods of reason, and the residual notion that humans are radically separate from nature. If “doing” becomes a fetish, then it precludes clear-eyed inquiry, the attempt at “knowing”. And the first act of knowing is to admit what you don’t.
The most urgent task now is surely to get some greater understanding of the manifold effects of this virus. A lung condition has become a blood disease with whole-system effects, including — it is hardly surprising — post-viral fatigue, aka chronic fatigue, which may last for months or years.
If this is the case, then it must surely radically alter how we deal with this. But we don’t want to think about that because it is simply too momentous. It would demand a conscious restructuring of some deep aspects of social life at a time when we are barely able to restructure the superficial aspects of capitalism that we run the place with.
Some commentators are shying away from it because they don’t want to sound like Chicken Littles after the fact should it all be tamped down. Understandable, but cowardly. The best outcomes take care of themselves, by definition. The worst are what require our exacting attention.
This sort of tendency is everywhere. In The Age/SMH, Stephen Duckett and Will Mackey have what could be said to be the assertive progressivist position: don’t suppress the virus, eradicate it. But their strategy for eradication is simply super-suppression: a lockdown two weeks past zero recorded cases.
Quite aside from the question as to whether that is socially and politically possible, what is the evidence that it could be maintained without a regime of near-total isolation from the world? After all, the current flare-up in Victoria appears to have arisen from exactly the procedures — arrivals quarantine — that they propose as a major line of defence to achieve eradication.
I am not suggesting eradication is not possible. But without a strategy that would include its failure, the proposition becomes magical thinking to reassure us that we can resume our lives — and to hold off the growing sense that we won’t be able to.
In that respect, we need to decisively and assertively prioritise medical research resources to acquire a basic understanding of what we face. We also need plans for more radical social resource re-allocation — for example, via new build and repurposing, a more than doubling of aged- and disability-care facilities, so that high-risk patients have real social distancing and separation.
We may need to consider a more radical move yet: closed communities within our open society, in which staff (paid a premium) live with high-risk groups in facilities which essentially act as walled villages. We need to think about changing the mass character of the school, and break up large schools into smaller, self-contained units. Ditto big office buildings, and on and on.
We’re going to need to do this with the next virus, the one that has a 5% death rate, not a 0.5% one, so we may as well use the advantage of this mild scourge to practice now. If governments won’t do this, groups of experts have to get together to create such plans, ready to go, and make them publicly known.
There is every chance they may turn out to be of little use in the coming years. In the coming decades, there is no chance of that at all.
How sure are you about that 0.5% death rate? There are plenty of reports and trackers that put it at somewhere between 5% and 10%, depending on location, and about 7% globally: https://www.worldometers.info/coronavirus/
Or check the “case fatality rate” button on this one: https://ourworldindata.org/coronavirus That helpfully shows Australia as about the lowest, but still 1.1%, having declined from a 1.4% peak in late May. Lower than New Zealand…
Yes, it seems to be significantly lower in Australia, where we haven’t reached the point where hospitals can’t cope, but that is not the global experience.
This seems to be the way to quickly nail the corona virus in Australia. Works especially well where low numbers. Developed by mathematicians in Rwanda!
You don’t need to test every one just everyone. You can test an aged care facility and staff with one kit. Then, if it comes back positive you run further tests to narrow it down. And you can use a three-dimensional algorithm to further limit the number of tests needed. You do not have to keep halving the test population, you can do it faster and with less kits. Say you have 128 to test you can have mixes of samples i.e. person A’s sample is put in a number of test batches and same for everyone else in a pattern and if all the test batches that test positive have A as a contributor then he or she is it.
https://www.bbc.co.uk/sounds/play/w3cszh0k
The government just needs to organise to do widespread testing. This is what I said at the beginning. Everyone could be run through an electoral type process including non-citizens.
We had the closed communities at one stage-TB sanitoria.
If we are to go down that route, then it would be imperative that we avoid stigmatization and the danger of institutional abuse.
How sure are you about that 0.5% death rate? There are plenty of reports and trackers that put it at somewhere between 5% and 10%, depending on location, and about 7% globally.
One nice plot of “case fatality rate” that I found helpfully shows Australia as about the lowest, but still 1.1%, having declined from a 1.4% peak in late May. Lower than New Zealand…
We haven’t reached the point where hospitals can’t cope, but that is not the global experience.
(Re-posted with URLs elided, in case that was what the algorithms didn’t like. Easy to google and find them.)
Case fatality rate is different to the real rate and is an artefact of the reach of testing. The mortality rate of under 1% is fairly well attested in places where sufficient testing has been done and where hospitals haven’t been overwhelmed.
There are clearly many factors involved. Australia seems to be testing at about the same rate as the USA, currently just under 1.9 per 1000 people on a seven day average, but our case fatality rate is 1.1% and theirs is 4.2%. The UK doesn’t seem to be doing much less testing (1.48 per 1000) and yet their case fatality rate is 15.5%.
Case fatality rate obviously only tells about fatality, too. It says nothing about how many linger in illness or incapacity: it’s only measured once death or wellness occur to an identified sufferer.
With those sorts of numbers, even among countries with decent health care systems that aren’t “overwhelmed”, you’d have to say that this isn’t something to be keen on catching, even in the interests of “protecting the herd”. So let’s not catch it. Isolate, drive R0 down, make it die.
Bit more poking at the statistics: Denmark seems to have been doing some of the heaviest testing, twice the rate of Australia and about four times that of Germany, and yet their case fatality rate is slightly higher than Germany’s: 4.7% vs 4.6%. So it’s not just the case that the more you test the lower the rate becomes, (as you find more cases).
The relevant testing rate in understanding the true amount of cases is percentage of positives. In the US it’s very high – I read today Florida was around 25% of tests are positive. In Australia it’s well under 1%. The rule of thumb is if you’re getting a positive rate well under 5% you’re probably catching most of the cases in the community.
In other words, if your positive rate is 5% or above, you’re not catching the true amount of cases in the community, therefore your case fatality rate is skewed upwards.
As left a d right continue to blur the Aust Liberal party has cometo realise the universal appeal of carefully doled out rationality and benevolence.no doubt furtheralgorithms are being generated.
Meanwhile theirfundamental is the interest of business.
Beware of false fuzziness….