Wednesday, April 01, 2020

The curious age discrimination of coronavirus

The generational effect of the corona-virus is cunning and baffling. By often being so mild in the young and healthy it turns people into heedless carriers. By often being so lethal in the old and sick, it makes carriers into potential executioners of friends and neighbours.

The virus is very dangerous for people who have certain underlying illnesses, which is probably the main reason it is so serious for the elderly. It is almost as if it does not kill people by itself, just worsens other disorders. This is unlike flu, where children are as much at risk as old people. By contrast, in this case, young people in good health, even very young children, generally get such a mild coronavirus infection that they rarely have to seek treatment. An analysis of Chinese cases found that just 0.1 per cent of children under the age of nine who caught the virus needed to go to hospital and only 5 per cent of those needed critical care; just 0.002 per cent died, compared with 9.3 per cent of those over 80.

It is surely this pattern that is making the disease so difficult to stop. People are passing on Covid-19 before they feel unwell, perhaps without ever feeling sick. According to a study of 468 cases in China, where the source of infection could be traced, the average time between one person getting ill and the person he or she gives it to getting sick (the ‘serial interval’) is about four days, with 59 of the infectees getting sick even before the infector felt ill — a so-called negative interval. (This could have been, for example, a young person with no early symptoms giving it to an older person.)

That serial interval is half as long as Sars, and signals how contagious Covid-19 is. In the absence of social distancing, the average person gives the disease to about three people, twice as many as flu. In short, the evil genius of this virus is that it is creating an epidemic of rapid transmission without making most of its victims sick enough to stop getting out and about. That is why its lethality for a few is not such a problem for the germ itself: normally, a virus transmitted by coughing would have to evolve towards not killing people in order to keep going.

The relative invulnerability of the young probably explains the indifference of some people to the government’s increasingly desperate advice that people should keep a distance from each other. On Sunday evening, a television reporter interviewed fit young men using exercise bars in a London park in close proximity to others and -frequently swapping equipment: an ideal recipe for spreading the virus. They were not bothered. ‘I thought, you know what,’ said one, ‘this is even better because I’ve got the fresh air.’ It had not dawned on him that he might pass on the virus while feeling fine.
Many younger people feel invincible anyway, but the horrible truth is that the data from the epidemic has made them more confident rather than less, apparently forgetting their risk as carriers, rather than victims, of the virus.

Typhoid Mary was a cook who moved from one rich employer to another in New York and Long Island, infecting seven households with typhoid between 1900 and 1907 before doctors traced her as the common cause of the infections. The key point is that she was in good health herself throughout. When confronted, she indignantly refused to submit stool samples for analysis, until eventually imprisoned for this refusal.

After three years she was released while promising not to work as a cook. -Unhappy with the low wages of a laundress, she changed her name, resumed cooking and resumed causing typhoid. After a 1915 outbreak in a hospital for women in which 25 people fell ill and two died, Mary Mallon/Brown was again arrested and kept in quarantine for the rest of her life, refusing to have her gall bladder removed. When she died in 1938, an autopsy revealed a thriving colony of typhoid bacteria in her gall bladder. For some genetic reason they had not caused any symptoms in her.

I am not suggesting that people are being as deliberately irresponsible as Typhoid Mary, and of course people are infectious with the coronavirus for only a week or two, not a lifetime. But there is a disturbing echo here, in the crowds that turned up at parks, markets and shops last weekend, of her unwillingness to believe she could have been part of the problem.

There may be another reason too. This was articulated by the broadcaster -Timandra Harkness on Twitter: ‘Is it tactless to -suggest that people who have spent the past 20 years being told not to do anything fun because it’s bad for them may now be less receptive to urgent Public Health advice?’ Don’t drink! Don’t eat sugar! Don’t leave your home! The indifferent may not be very public-spirited, but they are not irrational. Most people’s chances of dying if they get the disease probably are very low. The case fatality rate overall is likely to be well below 1 per cent. It seems much higher right now because most of those being tested are the people who have fallen ill enough to go to hospital. We all now know people who have caught the virus and are showing the symptoms — including that unusual feature of a loss of smell and taste — but have not been tested. And if you are under 70, then you are almost certain not to die unless you have a serious other condition.

Indeed, perhaps that is true if you are over 70 too. The elderly are increasingly plagued with ‘co-morbidities’ — the name for those who have several different things wrong with them, all being treated with separate drugs — and this is perhaps why they are succumbing to the virus. It may have nothing to do with age itself.

Thus, if we really could isolate those with underlying conditions from the rest of the society then everybody else could get the economy back to normal, push on through the epidemic to gain herd immunity. Schools could reopen, businesses get going again and the health service might cope. Once enough people were immune, they could care for those who are more vulnerable. But can that be done? How does a care home operate if some of the staff are spending time out in the rest of the world? Delivering post or shopping to a person with heart problems is itself a risk. Besides, the death of several doctors in Italy implies that the virus can still kill healthy people sometimes — though these individuals probably received much larger doses of the virus than most people would.

With luck a better choice may present itself: test and trace, as seems to have worked in South Korea. Once we have enough test kits, including a serological test to find those who have had it and are immune, then we can test enough people to identify and trace the contacts of every carrier, and we can surely turn the tide. But by then the health service might have been overwhelmed.



Poll: 15 Percent of Bernie Supporters Will Vote for Trump Over Biden

A new ABC News/Washington Post opinion poll has some very bad news for former Vice President Joe Biden. If he secures the Democratic presidential nomination -- which he will, of course -- a full 15 percent of Bernie Sanders supporters plan to cast their vote for President Donald Trump's reelection. That's extremely troubling for Biden, because in 2016, only 12% of Bernie's supporters broke for Trump after their guy's historic intraparty fight with Hillary Clinton.

But, USA Today reports, there's some good news in there. You see, the 15% of Bernie-istas who plan to vote for Trump in that scenario represent "just 6% of Democrats and voters who lean Democratic." Meanwhile, "Trump won 8% of Democrats in 2016."

Huh? Wait a minute. How about Democrat or Democrat-leaning voters who supported other candidates in the primaries... or who may not have supported any of them? Isn't it likely that these Democrat runaways will add some percentage points to the stat cited above?

You'd think so. And matters may get even worse for Biden considering the fact that Trump's approval rating is on the rise. That too will convince at least some traditional Democrat voters to go with Trump this time around.

Oh yes, this could get much, much worse for Biden than USA Today anticipates.



The Coronavirus Killed the Progressive Left

Covid-19 and the Democratic presidential primaries, the two biggest stories of the year so far, reflect a common theme: the death of the progressive left. Looking back, historians may well see late 2019 and very early 2020 as a kind of high-water mark for American progressivism.

It wasn’t so long ago that Bernie Sanders and Elizabeth Warren were commanding most of the attention in the presidential campaign, especially among intellectuals. Right before Super Tuesday, Sanders was a clear favorite in the prediction markets. Yet the actual voting showed the strength of Joe Biden, a (relative) centrist; Warren attracted very little support, and Sanders failed to reach the same vote totals he achieved four years ago.

And a big comeback for the left four years from now seems unlikely. Democratic Party success is likely to come from other directions. Covid-19 could well be a front-page story for the next year or two, possibly more. Over the span of less than a week, virtually every major institution in American life has been subject to radical changes to their daily operations, and it is not clear when things will return to normal. Covid-19 may well make a bigger impression on the national consciousness than 9/11 or the financial crisis of 2008.

How will Covid-19 reshape public opinion? I am not suggesting that what follows is rational, much less correct, but here are some guesses:

-- The notion of very open international borders will seem strange and indeed intolerable, as most of the world’s wealthy nations have been looking for ways to keep foreigners out. The new restrictions on movement will not be repealed so quickly or so thoroughly, and for a while the U.S. may restrict movement across domestic states and cities. President Donald Trump will appear to have been ahead of his time, and immigration will no longer be a viable mobilizing issue for the left.

-- The egalitarianism of the progressive left also will seem like a faint memory. Elites are most likely to support wealth redistribution when they feel comfortable themselves, and indeed well-off coastal elites in California and the Northeast are a backbone of the progressive movement. But when these people feel threatened in their lives or occupations, or when the futures of their children suddenly seem less secure, redistribution will not be such a compelling ideal.

I am not saying you have to welcome this change, only that it is likely.

-- A massive dose of fiscal policy has been another progressive priority. Now that even Republicans are embracing stimulus, as a political issue it will cease to be effective for the left.

-- The case for mass transit also will seem weaker, because subways and buses will be associated with the fear of Covid-19 transmission. In a similar fashion, the forces of NIMBY will become stronger, relative to those of YIMBY, because people secure in their isolated suburban homes will feel less stressed than those in densely packed urban apartment buildings.

-- There is likely to be much more government intervention in some parts of the health-care sector, but it will focus on scarce hospital beds and ventilators, and enforce nasty triage, rather than being a benevolent move toward universal coverage. If anything, it will drive home the message that supply constraints are binding and America can’t have everything — hardly the traditional progressive message.

-- The climate change movement is likely to be another victim. How much have you heard about Greta Thunberg lately? Concern over the climate will seem like another luxury from safer and more normal times. In addition, the course of anti-Covid-19 efforts may not prove propitious for the climate change movement. If the fight against Covid-19 suddenly improves (perhaps a vaccine working very quickly?), Americans may come to expect the same in the fight against climate change.

Alternatively, if Covid-19 risk persists, it will distract and seem like the bigger problem. And the various national responses to date also do not suggest that international cooperation is going to be very successful on a wide variety of issues, climate change included.

Again, this is all conjecture. But as Covid-19 continues to spread, it is likely that the list of things it will change — in politics and the world of ideas, much less daily life — is only going to grow.



For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCHPOLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

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