Covid-19 6/11: Bracing For a Second Wave

Last time: Covid-19 6/4: The Eye of the Storm

There has been a lot of news in the past week. Very little of it is actually about Covid-19.

That is not because Covid-19 went away. People are still dying. People are still being infected. In many places things are getting worse rather than better.

Despite this, our focus has turned elsewhere.

It seems like left-wing people now expect a second wave and blame it on the actions of right-wing people. While right-wing people expect a second wave and blame it on the actions of left-wing people.

Both give out a shrug emoji when it is suggested a second wave might be something worth preventing, or something we have the state or civilizational capacity to prevent.

I don't think these conclusions came from good thinking. That does not make them wrong. I continue to mostly agree with the perspective that for all practical purposes we have done all that we can to prevent Covid-19 here in the United States. It seemed mostly right before the protests, and it seems clearly correct now. If our current behaviors cause a second wave, trying to stop it would be a cure worse than the disease. We lack both the will and the ability.

It has now been seventeen days since the murder of George Floyd. It does not seem like good measurements are being taken, but from what I can tell there has since then been a steady rise in the number of protesters, with peaks on the weekends, including in countries outside the United States. Meanwhile, official re-openings continue in many places, and increasing numbers disregard precautions regardless of official recommendations, as they see others disregarding them, and as they grow stir crazy.

The question is, are we going to 'get away with' our current and implied future package of behaviors? Or will things get worse before they get better?

Let's see the data.

Infections by region: Date WEST MIDWEST SOUTH NE ex-NY NY Mar 19-Mar 25 5744 6293 7933 8354 28429 Mar 26-Apr 1 15684 20337 24224 34391 52901 Apr 2-8 19455 31148 39618 56772 65604 Apr 9-15 16291 29267 35570 61921 64463 Apr 16-22 20065 34130 33932 64669 43437 Apr 23-29 20263 42343 33773 62189 42475 Apr 30-May 6 23216 49205 37880 51693 24287 May 7-May 13 22419 43256 37591 40209 16683 May 14-May 20 22725 42762 40343 39273 13709 May 21-May 27 23979 39418 42977 26434 10595 May 28-June 3 32200 31504 50039 24250 9120 June 4-June 10 35487 24674 55731 16622 6071 Deaths by region: Date WEST MIDWEST SOUTH NE ex-NY NY Mar 19-Mar 25 138 104 144 116 278 Mar 26-Apr 1 380 615 572 606 1656 Apr 2-8 707 1454 1309 2115 4327 Apr 9-15 890 2195 1596 3577 5318 Apr 16-22 1033 2343 1727 5147 3716 Apr 23-29 1128 2588 1685 4722 2713 Apr 30-May 6 1012 2413 1747 4908 2582 May 7-May 13 1082 2288 1597 3911 1416 Apr 23-29 1090 2060 1442 3578 963 Apr 30-May 6 775 1723 1290 2341 667 May 28-June 3 875 1666 1387 2121 436 June 4-June 10 743 1297 1230 1611 325

Including a graph of the charted data on deaths to see if people find it useful, if they do I can provide more in future updates slash add others to this one.

Positive test percentages nationwide and in New York state: Date USA tests Positive % NY tests Positive % Mar 19-Mar 25 347577 16.2% 88,882 32.0% Mar 26-Apr 1 728474 20.2% 117,401 45.1% Apr 2-8 1,064,225 19.8% 144,273 45.5% Apr 9-15 1,026,741 20.4% 160,859 40.1% Apr 16-22 1,235,393 16.1% 143,970 30.2% Apr 23-29 1,552,560 13.0% 202,499 21.0% Apr 30-May 6 1,759,548 10.6% 183,446 13.2% May 7-May 13 2,153,748 7.5% 202,980 8.2% May 14-May 20 2,643,333 6.0% 246,929 5.6% May 21-May 27 2,584,265 5.7% 305,708 3.5% May 28-June 3 3,022,469 5.1% 417,929 2.2% June 4-June 10 3,252,870 4.6% 438,695 1.4% Aggregated as a country, we see clear improvement. Less people died. We did more tests but found less positives. It's not as rapid as one might like, either in improvements in testing or positive rates, but it is improvement.

Looking at regions, we see good progress in the Northeast and Midwest. Things seem well under control.

We have reason to be very worried about the West and South. Arizona is seeing the most rapid increase in the West, so this is potentially very much a north versus south phenomenon.

What can we conclude from what we see?

We Got Away With Memorial Day

There was a big story at the time about how people were disregarding social distancing on Memorial Day weekend. It has now been long enough to conclude that this did not have a big impact. This is a data point in favor of outdoor activity not being very dangerous.

Note that this doesn't mean we've gotten away with things in general.

Protests Haven't Shown A First-Order Impact Thus Far

Predictions of a fast spike in cases, either in general or in the places with the biggest protests, have not come to pass. There's no sign of trouble in Minneapolis, or New York City, or Washington, D.C, or in Berkeley, California where a friend predicted a local spike in cases.

That doesn't mean that protests are not spreading the virus. They obviously must be spreading the virus more than if those people had stayed home slash gone about their normal activities. I believe in the physical world far too much to believe otherwise.

Despite that, it has now been over two weeks since things started. Testing should only be delayed from infection on the order of one week. What can we rule out or in? What are the possibilities?

The effect could be small, and/or the effect's larger impacts could be delayed, and/or measurement of the effect could be delayed or distorted.

The effect could be small if being outside is a big enough deal, combined with enough mask wearing and mask wearing being a big deal. I'm guessing this is a lot of it.

The effect could also be small if sufficiently few of the protesters have been infected. One can imagine a world in which people who are low-level feeling lousy, or who suspect they have been exposed in some way, largely avoid protests. I'm guessing this isn't important, but it's possible.

The effect could also be small if enough of the protesters are immune. In some areas of New York City, there are minority areas where 50% or more of people are testing positive for antibodies. Is it possible that the protesters already have a lot of herd immunity? I'm guessing this is a non-trivial effect, but not the main effect.

The effect's larger impact could be delayed if it only comes when protesters infected at protests in turn infect other protesters, or even one cycle beyond that. If that was true, we wouldn't be seeing anything like the full effects at this time. That can't explain there not being a noticeable effect at all, but this dynamic should be a big deal. When the flare-ups from protests happen it may mostly be after several cycles of previous spread.

The effect's measurement could be delayed or distorted if the people involved are generally healthy, generally suspicious of health care and government and its potential hazards and costs, or both. This seems like it fits the situation quite well. The only question is magnitude.

That leaves a lot of potential explanations. We can't rule out the protests having a sizable impact. What we can rule out is them causing a huge explosion on the spot, the same way most other photo opportunity social distance violations haven't caused an explosion. That's because the explosion expectation doesn't take into account the scope of the actual violation, instead thinking of this as a failure to sacrifice to the gods. We have been wicked so of course the virus will strike us down as punishment.

Except, of course, that it won't. That's not how this works. That's not how any of this works.

Protests should still have a large secondary impact. Again, it was plausible that this would happen right away and be huge. People would see giant crowds, see them welcomed by the media, and say screw it. That too didn't happen enough to see a giant spike, so we can again rule out the worst parts of the distribution. And again, I still think we'll see a big impact here, especially in our ability to react to bad news, which seems like it's at zero. It just won't be as big as we might have feared a week or two ago.

Different States, Different Stories, Different Futures

The scare story of 'cases increasing in some states' are entirely unsurprising. Unless we are doing exceptionally well, there are always going to be some places doing relatively poorly. Right now it's two entire regions, though, even after adjusting for test counts. So the story does seem to be fair.

There will be lots of attempts to blame this, that or the other thing for increased cases, especially relaxations of restrictions that appear to be failures to make the proper sacrifices to the Gods. Red states are especially vulnerable to this type of story among blue state narratives.

An alternative explanation is the reverse weather effect. The states where we're seeing problems are, to put it bluntly, too damn hot. Instead of June being a reason to go outdoors, June becomes a reason to stay inside with the air conditioner on. That would be entirely compatible with outdoor activities being mostly safe, and seems like the story that best fits recent facts.

Where do we go from here? How long before we know?

If we see continued increases in the West and South for another week, I'll be very surprised if it then reverses itself any time soon.

If we see continued declines in the Northeast and Midwest another week, I'll conclude that outdoor activities are even safer than I thought, and that protests don't seem to be having that big a direct impact nor that big a secondary impact. We'll probably be safe until at least September, in the sense that conditions will continue to improve regardless of official relaxations of restrictions. People aren't going to do enough especially risky additional things.

Even if there is a feedback-loop spike from the protests, if it doesn't show up relatively soon, there's no reason to expect it to escape out into the broader community, so any such spike shouldn't be able to sustain itself.

Here in New York, it feels like it's time to make our way out into the world. Time to start seeing friends again, time to dine at restaurants, go places, do things. Responsibly, but at all. We're down 98.3% from peak infections in this state. What risk is left is largely concentrated in areas I wouldn't have any reason to go anyway. We know a lot more about risk factors. Our health care system is in good shape again and will stay that way. At some point one has to start adjusting one's behavior to the new facts. I've been waiting for the protests to see if things are still all right. By early next week New York positive rates should be under 1%, and I hope to enter that next phase.