Political Irony

Like many people, I’m curious what the future will look like after we spend a few years fighting the novel coronavirus into some kind of submission. Andy Slavitt, who was the Medicare, Medicaid, and ACA head for president Obama, talked to three scientists and came away with the conclusion “There is a Light at the End of the Tunnel“. Originally posted as a series of tweets, here it is all gathered together into a single story:

I spent the last 24 hours with three scientists, all of whom have seen vaccine data, two of whom are former regulators, all of whom have opinions. My core question was: What is the world going to look like in three years? (But I asked other things as well.)

I’ll start with a slew of good news.

The vaccine data from Oxford (being run in Brazil) looks strong. No real safety issues so far. Gives people the antibodies. People are getting it post-Covid-19 and some will get it in a challenge trial.

What “works” means, and for how long, and for whom is less clear. But probably more like a flu vaccine (40%?) versus MMR (97%). There will be multiple vaccines after the first expected in the Fall. Each likely progressively better.

The monoclonal antibody therapy is also very exciting. Maybe even more so than a vaccine. If you get infected, it’s another way to confer immunity and prevent the infection from advancing.

Therapy trials are easier and quicker than vaccine trials. There’s frustration that some vaccine trials are moving too slowly and developers are not sharing data other than in press releases. That’s something people can advocate for.

Everyone — and I can’t emphasize this enough — was a huge proponent of masks. Efforts to invalidate masks were considered absurd.

The reason I mention these things is that the principal thing I learned is that the future will be defined by all of these things in combination: vaccines, therapies, masks, and other human interventions.

Mutations yes, but there wasn’t much concern that vaccines could keep up. Also, viruses become less deadly over time and there is cross-immunity and other potential.

T-cells are more important and less understood than antibodies.

What is the FDA’s hurdle for approving an Emergency Use Authorization? Safety and a 50% or greater chance of improvement.

In six months or so, so far science is doing as well as our leaders are doing poorly.

The future is always murky but given what I heard I asked: So, optimistic about reducing lethality but not eradication? Basically that’s what it sounded like. Yes, there will be a new normal.

What’s in this new normal? Will I be able to hug my mother? The answers landed on “I hope so.” But no promises.

Will people wear masks in the future? Hope that we are more like Asia where this becomes a norm, particularly when people are sick.

Crowds, arenas? Take it slowly. Masks and immunity and digital apps will help. But people will be taking risks. Antibody therapies could make catching the coronavirus less deadly and therefore a more acceptable risk.

What will the time before a vaccine look like? Crappy. Horrible response in the U.S. Way too many unnecessary deaths. Fall will be awful.

Chance that the early vaccines turn out to be unsafe or don’t pan out? Possible but low.

Will people be able to trust what they hear from the FDA or Trump administration? It’s an issue. Will you? Likely. Will look at the data. Would you take a vaccine? Depends on the data. Expect there to be data before approval? Yes. Will you speak out no matter what? Yes.

This felt like a realistic glimpse into the future: continuously better. Not one dramatic moment. No “life before vaccine” or “life after vaccine.” But gradual changes.

The major takeaway. There absolutely is a light at the end of the tunnel even if it’s hard to see sometimes. Even if our leaders have made this harder. Even if it’s very dispiriting.

The hard things will pass if we’re patient (which is hard) and pass more quickly if we make tougher decisions. I know the marathon is harder to run when you don’t know what mile you’re at. But if you count on and help others, I view it better as a relay race.

Another day, another killer ad from the Lincoln Project. This one goes after the GOP senators who were too chickenshit to say no to Donald Trump, and instead repeatedly kissed his rear and enabled the destruction of our country.

The NY Times got an early copy of the book by Mary Trump, Donald Trump’s only niece, titled “Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man”. They just published an article about it.

The book answers a question that I’ve wondered about Donald Trump: how did he get into the prestigious Wharton Business School? He cheated, including hiring someone else to take the SAT test for him, and having his older sister do his homework. The book says our president practices “cheating as a way of life.”

According to Mary Trump, “By the time this book is published, hundreds of thousands of American lives will have been sacrificed on the altar of Donald’s hubris and wilful ignorance. If he is afforded a second term, it would be the end of American democracy.”

UPDATE: A similar, but longer article in CNN. And another in WaPo. And OMG the Lincoln Project has come out with a devastating new ad about this:

I could sure use some good news. And lucky for us, there is some!

The news today is completely dominated by the COVID-19 pandemic, Black Lives Matter, and the upcoming election. But there are other important stories, and in one of them — global warming and climate change — we have very good news. You might have missed it because it isn’t some big event that is newsworthy, it is a gradual thing, but nonetheless significant.

An article in Forbes magazine surveys the current impressive rise in renewable energy. While we are completely distracted by other things, the cost of technologies like solar and wind have become not just practical, but the least expensive ways to generate energy. It is cheaper to build renewable capacity, and cheaper to operate them. It is no longer cost effective to burn fossil fuels to generate electricity.

How much cheaper is solar? Enough that Singapore is building a huge solar array in Western Australia, and sending the power home over a 3,800-kilometer submarine cable. That project alone, which will be the largest solar farm in the world, will generate one-fifth of their energy needs. And an even bigger project in Australia is in the works, which combines solar and wind power. “The idea is to change Australia’s place within the global energy map and to transition from exporting mainly coal and natural gas to being a leader in clean energy.”

And literally, the sky’s the limit. If we could fill the Sahara Desert with windmills and solar panels, we could meet the energy needs of the entire world. This clean, non-polluting electricity would put the brakes on global warming as it replaces coal, natural gas, and even nuclear power.

In the United States, solar is already the most important source of energy, ahead of gas or wind, despite the tariffs imposed by its ignorant president on imported solar panels.

Note the “ignorant president” — pretty strong for a business journal like Forbes. And the same article was also published in Medium, where the author changed “ignorant” to “idiot”.

Enough about the future, what’s happening with renewable energy right now?

Renewable energy is already the cheapest and most logical way to produce energy without the need for subsidies. By introducing hydroelectric and geothermal energy into the equation, in addition to solar and wind energy, Costa Rica has already managed to go for 300 days in a row without burning fossil fuels to generate electricity. Portugal has managed four days with only renewable energy, the UK, a thousand hours without burning coal.

All the studies agree that not only that we must stop building and operating fossil fuel power plants, but that we have already built too many and that the fuel needed to supply them will now remain under the ground. The need to make this transition is becoming more urgent every day. Germany has already announced the closure of all its 84 coal-powered plants and India has canceled plans to build any more due to the plummeting cost of solar energy: with every day that passes, action in this regard is more important and more strategic. Only countries that act in time and update their generation policies can hope to win a place on the new global energy map.

New ways to store electrical power, such as lithium-air batteries, will mean that electricity will be available when the sun isn’t shining or the wind isn’t blowing. In addition, it can make electric cars with a 1000 mile range practical.

Solar power is easily decentralized; for example, solar panels are already a popular addition to homes and small businesses. Large businesses can install solar panels over their parking lots, which also provides shade. The side benefit is that this reduces the need for a huge power grid.

Newsweek published an article Friday titled “How Trump could Lose the Election — And Still Remain President“. It is an opinion piece, but was written by two fairly high-powered people (a former US senator, and the person who founded CNBC and MSNBC, the former CEO of TiVo, and is an editor-at-large for Newsweek, among other things).

They give a fairly detailed roadmap of what and how this could happen, and even give evidence that Donald Trump and Bill Barr have already taken steps that would facilitate this plot. It is fairly complex, so if you are curious you should read the article.

They also talk about the few ways this plot can be foiled:

• Make sure the election results overwhelmingly favor Joe Biden, especially in Arizona, Wisconsin, Michigan, and Pennsylvania. So even if everyone believes that Biden is definitely going to win, we cannot afford to become even a little complacent. We cannot make the same mistake twice.
• “We must ‘out’ this scenario—and do so loudly and consistently. We have an imperative to build a ‘people’s firewall’ that reaches deeply across the country and reflects public revulsion at the potential for Trump to undermine our entire democratic system of governance.”
• The military intervenes to stop Trump. Let us fervently hope that it doesn’t come to that.

And by the way, Happy Independence Day. Let’s not just hope we can keep our democracy, but actually fight to hold onto it.

Why do some people refuse to wear masks?

A few people actually cannot wear a mask, for various reasons. I read a post from a person who said they could not wear a mask, and they would get nasty looks and shaming the few times that they dared to venture out.

If you cannot wear a mask, I would suggest trying a face shield. There are face shields that attach to glasses, or to a hat, and other variations. One of those should work since they don’t even touch your face. And there is evidence that face shields might be more effective than masks.

I see other comments from people who basically say “there aren’t very many cases where I live, so I don’t need to wear a mask”. Unfortunately, these people are making a huge mistake. They are thinking linearly, while contagious diseases have exponential growth. The absolute number of cases doesn’t really matter. What matters is the growth R0 (R-naught), how many people (on average) get infected from an infected person. If R0 is greater than one, the number of cases will increase exponentially, if less than one then the disease will eventually die out.

A closely related number is the doubling time, which is how long does it take for the number of infected people to double. At one point in a province of China, the doubling time of COVID-19 was 1.4 days. And New York state had a doubling time of around 2 days for over a week.

Unfortunately, humans are notoriously bad at understanding exponential growth. There is a famous story about the person who invented chess for their king. The king loves the game so much that he asks the inventor what they want as a gift. The inventor replies that the king should put one grain of wheat on the first square of the chessboard, then two grains on the second square, and continue doubling until the last square. The king finds this a modest request so he agrees. However, the king doesn’t understand exponential growth, because the wheat required is 2,000 times the entire world production of wheat. Just starting with a single tiny grain.

Back to COVID-19, even if you have a small number of cases or deaths, if you do not reduce R0 (the number of people you infect) below 1, eventually everyone will get the disease. Wearing a mask (or a face shield) absolutely reduces the number of people you infect. Social distancing does too. Self quarantine does even better. So the choice is yours. Wear a mask now or endure another shutdown later. Or worse.

The result of the US not taking simple precautions is obvious. The US has 4% of the world population, but over a quarter (25%) of all the deaths and over a quarter of the cases in the world. We have more active cases than the next half a dozen countries put together (Brazil, Russia, India, UK, Spain, and Peru). We spend more on health care than any other country, but we can’t seem to stop one disease, even though other countries (including Australia, Canada, China, Japan, Italy, New Zealand, South Korea, Morocco, Thailand, Rwanda, Uruguay, and others) are doing it. We are currently failing.

And things are getting worse. On July 1, new reported cases of COVID-19 was 52,788, the largest single day total ever. Dr. Anthony Fauci already testified to Congress that we are heading toward 100,000 new cases a day if we don’t do something to stop it.

The seven day averages (which are better indicators than the daily numbers) are just as bad. The seven-day average of new confirmed cases is the highest it has ever been, topping 50,000 cases for the first time. And a whopping 45 states have seven-day averages of new infections higher than the previous week. At this rate, we will almost certainly have to close down the country again.

So what did Donald Trump do? He went on Fox News and said:

I think we’re gonna be very good with the coronavirus. I think that at some point that’s going to sort of just disappear, I hope.

Notice that he is now couching his words with “I think”, “I hope”, and “sort of”. Well, I think he knows he is lying. I hope he cares that people will die because of his words. But I sort of doubt it.