On cooperation and cons: Our theft from young people.

On cooperation and cons: Our theft from young people.

As a society, we’ve made enormous sacrifices during the Covid-19 pandemic. We’re wearing masks; we’re staying home; children are missing school.

We’re all cooperating to protect the people who are most at risk.

The risk profile for Covid-19 is opposite the risk from climate change. Covid-19 is more dangerous for the old. Climate change is more dangerous for the young, and for generations not yet born.

There’s another way to phrase this – Covid-19 is more dangerous for the wealthy, and climate change is more dangerous for those who currently have little or nothing. This is true both temporally and geographically.

(Wealth obviously protect individuals from Covid-19. Despite all his buffoonish posturing, when Donald Trump was infected, he received higher quality, more expensive medical care than almost anyone else. But on a population level, increased wealth is correlated with increased risk. Wealthy people are privileged to live longer, and in our capitalist society, people often accumulate wealth as they age.)

People with low risk from Covid-19 are making enormous sacrifices to protect others from it. But those with low risk from climate change are, in general, making no efforts to stop it.

Which conveys a clear message:

Younger people, you must solve this problem on your own. Despite your willingness to make sacrifices to protect us, we will not make sacrifices to protect you.

#

If we knew in March 2020 what we know now, we wouldn’t have closed schools. If you’re interested in some of the reasoning behind this, you should read this February 24, 2021 New York Times editorial from Nicholas Kristof.

Or, if you’re more scientifically inclined, you could read this February 23, 2021 review article in The BMJ:Closing schools is not evidence based and harms children.

We are hurting kids under the guise of protecting older people. But we’re not even succeeding. Schools have such low rates of Covid-19 transmission that we’re hurting kids without accomplishing anything.

People from “my” political party have orchestrated this harm, which makes it feel all the worse.

The New York Times recently printed an editorial from someone at the right-wing American Enterprise Institute chiding us for our totally un-scientific school closures. Members of the Republican party are positioning themselves as the defenders of public education.

The Republican party has been trying to undermine public schools ever since the Supreme Court decided that maybe Black kids deserve an equal chance to learn. And we’re letting them posture as the defenders of education?

#

During the vaccine roll-out, the New York Times set the stage for a big reveal – younger people were never in huge amounts of danger from Covid-19.

I don’t want to sound cavalier about this – Covid-19 is dangerous to people of all ages. It’s very similar to influenza.

Many people have a misconception that influenza is relatively harmless – sniffles & a runny nose – unless you’re elderly.

That’s not true.

Although the majority of cases of seasonal influenza are mild, it’s a deadly disease. Young healthy people die of influenza every year.

Most influenza deaths are recorded as “pneumonia” during post-mortem reports. To compare the dangers of Covid-19 to influenza, we’d want to measure how many more pneumonia deaths we’ve seen recently.

In a typical year, there are about 130,000 pneumonia deaths in the United States – these might be caused by influenza, coronaviruses, rhinoviruses, etc.

Many if not most of these deaths are caused by influenza – the column of numbers reporting verified influenza deaths is so low because we don’t always test for it, and when we do we typically use a low-quality antigen test.

Last year, though, was much worse – between January 1, 2020 and February 24, 2021, there were 670,000 pneumonia deaths in the United States. During those 14 months, five-fold more people died from this set of symptoms than we’d expect during a normal year.

We’ve also had about five times as many infections. Usually, about 30 million people contract seasonal influenza each year. The CDC estimates that perhaps 100 million people contracted Covid-19 during the ten months from February 2020 to December 2020.

That’s why the CDC’s rough estimates for the “infection fatality ratio” of Covid-19 are about the same as for influenza.

Last year, more people died from Covid-19 than would be expected from a typical year’s burden of seasonal influenza, but that’s because there were many more infections.

Seasonal influenza and Covid-19 are both deadly diseases. And it’s worth comparing them because the pandemic might be declared “over” once Covid-19 deaths fall to influenza-like levels.

That’s what most public health experts said when they were interviewed by Alexis Madrigal for an article in The Atlantic – that a reasonable goal is for Covid-19 “to mirror the typical mortality of influenza in the U.S. over a typical year.

Which seems like a bit of a cop out. You’re going to call it “over” while people are still dying?

But we have to. Covid-19 will probably be with us forever. Like the coronavirus OC43, which we picked up from cows and which probably killed over a million people during the 1890 pandemic, Covid-19 will continue to make humans sick indefinitely.

Elderly people – especially those who weren’t exposed to Covid-19 as children – will always be particularly susceptible.

#

Early on during the pandemic – when we already had a good sense that younger people weren’t in much personal danger but also knew that we could only slow the spread of Covid-19 if younger people made sacrifices – we concocted a narrative that healthy young people were at high risk, too.

In March 2020, the New York Times printed an editorial from Fiona Lowenstein, a 26 year old who became tragically ill, saying “Millennials: if you can’t stay at home for others, do it for yourselves.

In May 2020, the New York Times printed an editorial from Mara Gay, a 33 year old who became tragically ill, saying “I want Americans to understand that this virus is making otherwise young, healthy people very, very sick. I want them to know, this is no flu.

During a “mild” flu season, about 1,000 people aged 25-34 die of pneumonia.

This year, healthy young people have gotten very sick and even died of Covid-19 – which is tragic, but not unusual. Every year, healthy young people get very sick and die from influenza. This past year, with about five-fold more infections of an equivalently deadly disease, we’ve seen about five-fold more of these tragic young people’s deaths.

Now that a vaccine is available, though, the narrative has shifted.

In the February 28, 2021 New York Times Magazine, Kwame Anthony Appiah’s “Ethicist” column says that “Health care workers who are in their 20s and don’t have certain medical conditions aren’t at high risk if they contract Covid-19. Perhaps we could save more lives if we left them [to be vaccinated] until later.

Now that we have a limited supply of vaccines, older, wealthier people benefit if young people are less afraid of Covid-19.

#

By delaying Covid-19 infection, young people increased their personal risk. Early during the pandemic, the virus was not particularly dangerous for young people. By now, though, there have now been millions of transmission events – millions of opportunities for mutant variants to arise.

And indeed, in February 2021 the New York Times reports that “it is likely that the [new Covid-19 virus] variant is linked to an increased risk of hospitalization and death.”

#

Currently, we’re rationing the limited supply of Covid-19 vaccines based on age.

This is hypocritical, and potentially misguided.

When people develop such severe complications from Covid-19 that they require ventilation in order to have a chance of surviving, a younger person is more likely to benefit from the treatment. This holds both in terms of absolute number of lives saved, and is even more dramatic if you consider the years of life saved.

With a limited supply of ventilators, you can accomplish most by reserving them for the young – and we said that would be horrible.

In a March 2020 article for the New York Times, Sheri Fink wrote that the health department’s civil rights office would ensure “that states did not allow medical providers to discriminate on the basis of … age … when deciding who would receive lifesaving medical care.

In April 2020, Joel Zivot wrote for Medpage that “Rationing ventilators by age is wrong.

Although we declared that it would be unethical to ration healthcare (ventilators) by age, we’re now rationing healthcare (vaccines) by age. The difference is that a different group of people – older, on average wealthier – benefits.

#

Rationing vaccines by age doesn’t even save the most lives.

Based on the CDC data, if both a 50-year-old and a 70-year-old are infected with Covid-19, the 70-year-old is about ten times more likely to die. That’s scary!

The major benefit of the vaccine is that it reduces the chance of severe illness if you are exposed to Covid-19. But we also know other ways to reduce the odds of exposure – a person can stay home, wear a mask near others, minimize the number of unique individuals they come into contact with.

If the 70-year-old has retired, they should be able to reduce the number of unique individuals they see each week to ten or fewer. But a 50-year-old grocery store clerk might see a thousand or more unique individuals each week, and have to spend time in fairly close proximity to each.

If the 50-year-old is at least ten-fold more likely to be exposed to Covid-19, then you’ll save more lives by giving the vaccine to them instead of to the 70-year-old.

Not only did we declare that rationing healthcare by age was wrong when it benefited younger people, but now we’re doing it even though it doesn’t save the most lives.

The unfairness is even more dramatic if we consider the risk of hospitalization. According to the CDC chart above, if both a 20-year-old and a 70-year-old are infected with Covid-19, the 70-year-old is about five times as likely to be hospitalized. But Medicare will pay the hospital bill. If a 20-year-old is hospitalized, they might face ruinous medical debt.

It’s quite likely that the obligations of most 20-year-olds – going to school, going to work, taking care of family – make them at least five times as likely to be exposed to Covid-19. We could stop lives from being ruined by medical debt if we vaccinated 20-year-olds first.

A friend of mine works in a take-out & delivery pizza restaurant in Chicago. For other people to be able to stay home and order food, he had to go in to work. His risk of exposure to Covid-19 was much higher than other people’s. As a healthy athlete in his late twenties, he wasn’t at high risk, but he was unlucky – when he got sick, he was so ill that he spent weeks in the hospital. He’s still recovering from his ruptured lung. He has no idea how to pay the $200,000 medical bill.

Because we’re rationing care by age, we’re not protecting people like him. Even though his risk – interacting with customers all day – made it possible for others to stay safe.

#

The Covid-19 pandemic has been awful, but I was pleased that people took fewer plane flights. Our carbon emissions briefly dropped.

Now that older people have received vaccines, though, they’ll resume flying.

For a February 17, 2021 article in the New York Times, Debra Kamin writes that “When the coronavirus hit, Jim and Cheryl Drayer, 69 and 72, canceled all their planned travel and hunkered down in their home in Dallas, Texas. But earlier this month, the Drayers both received the second dose of their Covid-19 vaccinations. And in March, armed with their new antibodies, they are heading to Maui for a long overdue vacation.

Americans over 65, who have had priority access to inoculations, are now newly emboldened to travel – often while their children and grandchildren continue to wait for a vaccine.

Newly protected against Covid-19, they’ll increase their contributions to climate change.

#

Climate change has the opposite risk profile from Covid-19. Covid-19 is most dangerous for the old; climate change is most dangerous for the young, and for generations not yet born.

In some sense, it’s trivializing to even compare these. The risk from climate change is so much more severe.

If we make our planet inhospitable – if our crops fail due to storms or heat waves – the carrying capacity of Earth could easily fall by half.

We will see billions, not millions, of deaths.

Someone who is elderly today is unlikely to survive long enough to experience the worst effects of climate change – although it’s true that in severe weather events like Chicago’s fluke summer heat waves or Texas’s fluke winter storms, elderly people who live alone are exceptionally vulnerable.

Still, younger adults will have to endure worse calamities. They’ll live through more years of severe weather, crop failures, dangerous heat, lingering smog. And, since society will be forced to spend more money each year to maintain humanity’s precarious place on this planet – rebuilding after fires or floods – younger adults will face an increasingly inhospitable world with less wealth at their disposal.

Today’s children will encounter even worse. They’ll experience every disaster that today’s young adults will survive to see, and then some.

Generations not yet born may inherit a nightmare.

#

When people who currently have wealth were in danger, we created a narrative that everyone needed to make sacrifices. The largest sacrifices came from those who benefited least.

We’re still keeping children out of school – for almost no benefit in terms of Covid-19 transmission – in order to protect older, wealthier people.

#

Climate change is and has been caused primarily by those with the most wealth. If you can buy more meat, if you can take more plane flights, if you can purchase a bigger home, then you’re able to cause more climate change.

To stop climate change, we need wealthy people to make sacrifices. Buy less, fly less, eat plants.

But why would they?

Currently wealthy people aren’t in danger.

And – worse – currently wealthy people often became wealthy by treating the world as a competitive place. Now we’re asking them to cooperate? To make sacrifices for the sake of others?

Meat tastes good. Flying to Maui is fun. Doesn’t a person who worked hard deserve an enormous home?

#

A curious thought about the Gamestop stock trading phenomenon: Many small investors – often younger people – were convinced through emotional arguments to buy a few shares of stock and hold them with “diamond hands.”

Don’t sell, even if the price dips!

There was a strange cooperative / competitive system going on. The cooperative portion would have been illegal had it not been done in public – people were colluding to make the shares hard to get, which forced the hedge fund to pay more in order to cover their short sales.

Short sales: a hedge fund had borrowed many shares of the stock and sold them, hoping the price would fall and that new shares could be purchased more cheaply when it was time to return them. So the hedge fund had basically announced, “On such & such a date, I must have this stock, no matter the price!” If other people all cooperate and say, “On that day, don’t sell it for less than $420.00,” then the hedge fund has to pay $420.00 per share, even if the company that the stock represents is worthless.

But here’s the competitive portion – the company, Gamestop, is probably going out of business eventually. Driving to a strip mall to buy a video game cartridge instead of downloading it? The stock isn’t worth much money. So people wanted to cooperate to hurt the hedge fund, but people were also forced to compete because nobody wanted to be holding the stock at the end of the day.

Everyone would like to sell it for a bunch of money, but not everyone will get to sell it.

Even if more than a hundred percent of shares are short sold, not everyone will get to sell it – the hedge fund can satisfy all their contracts by buying a share, returning it to someone, buying the same share back from that person, returning it to someone else, and so on.

So if you know that everybody else has put in a “sell order” at $420.00, because they think it’s a funny number, you benefit by putting in a sell order at $419. That way you get almost as much money as anyone else, but you’re guaranteed to sell yours, whereas only a fraction of the people with $420 sell orders get to trade their (worthless) stock for money.

But then, if you know that other people are going to plug in a sell order at $419, you benefit from selling yours at $418. Because what if too many people sell their shares at $419?? You might still be left out!

So there was an incentive for savvy investors – wealthy people who might have thousands of dollars on the line – to convince other people to hold onto the stock no matter what … even while selling their own.

Billions of dollars changed hands. Some people “made” a lot of money. And it wouldn’t have happened without cooperation – lots of people colluding against the hedge fund.

But the particular people who benefited were determined by a con. By selling shares while promoting a narrative that “if we all hold with diamond hands, this is going to the moon!”

#

In some ways, our response to Covid-19 encourages me.

So many people – especially younger people – have shown themselves to be willing to cooperate.

A cloth mask traps your exhalations. Wearing a cloth mask makes your life worse, but it protects other people. Almost everybody in my home town wears a mask. Every young person at school wears a mask.

And yet.

Young people are willing to make sacrifices to protect older people. But therein lies the con.

We’re not making sacrifices to protect them.

Our carbon emissions are no different from pulling off this face mask and intentionally coughing in a young child’s face. We ought to feel ashamed.

.

.

.

header image from Socialist Appeal on flickr

On perspective and Zoom.

On perspective and Zoom.

In Unique, neuroscientist David Linden describes the cultural associations between smell and taste.

Most people from the United States will say that vanilla, strawberry, or mint odors smell sweet.

On the face of it, this doesn’t make sense. Sweet is a taste, not a smell. A substance cannot smell sweet any more than something can sound red.

There’s nothing intrinsically sweet about these odors – we’ve just learned to associate them with sweet taste.

As a counterexample, in Vietnam, where caramel and mint are used primarily in savory dishes, their odors are not typically described as sweet.

#

This association is sufficiently powerful that its effect can be measured in the lab.

For people whose past cultural experiences have led them to associate mint smells with sweet tastes, pairing the scent of mint with a sip of sucrose solution makes them believe that the drink is more sugary than it really is. When mint scent is paired with a sip of mildly acidic water, the drink seems less sour than it really is.

This experiment didn’t assess people’s perception of alcoholic drinks, but people in the United States probably make the same mistake about the bourbon in a mint julep.

photo by Grizdave at flickr

Our assumptions – particular to our own cultural experience of the world – can powerfully deceive us.

A mint julep mixed perfectly for someone from the United States would taste bitter to someone from Vietnam.

#

Viet Thanh Nguyen – author of The Sympathizer, which I’ve written about previously – strives to draw attention to our cultural blindness. The way our minds’ innate self-deceptions allow us to overlook or misinterpret the experiences of others.

My spouse and I have often felt grateful for Nguyen’s work. His essay about the sinking sensation he felt after teaching his child to read was particularly beautiful. (I linked to it in my own essay about teaching a child to read.)

Which is why we felt so dismayed by Nguyen’s most recent New York Times editorial.

#

Nguyen explains why he enjoys teaching over Zoom. He’s prompted with students’ names; he can see their reactions up close; student voices contribute to the lecture from the same up-front position of power as his own; typed remarks can overlap without distracting; lectures are recorded for students to review later.

All well and good. Nguyen is quite intelligent. If he thinks Zoom is good for lectures, I’m inclined to believe him.

But lectures aren’t the best way to learn.

For many subjects, project-based learning is a more effective way to educate students. Many of my spouse’s resources – designed primarily for teaching college-level biology and introductory Earth & space science with a social justice bent – are available on her website, here.

#

For the better part of a decade, I’ve hosted a poetry class in the county jail. We read poems and discuss how they make us feel. Our discussions touch upon contemporary scientific research, mythology, economics – all safe enough topics, for most folks – but also religion, addiction, trauma, violence, relationships, loss – which can be tough for anyone to talk about, let alone a room full of men who won’t get to see their families for months.

Because people cycle through the county jail, I never know who will be coming to class each week until I get there. For a few months, I might be with mostly the same group of men. Other weeks, I won’t have met any of the dozen or so people previously.

And there’s a huge difference between what we can accomplish – between what sorts of things feel safe to discuss – when the people in class haven’t met me before, and haven’t been in a class like that with each other. If we haven’t built the necessary emotional connection, we can do less. The class is worse for all of us.

Recently, the jail has allowed a small number of classes over Zoom. But Zoom doesn’t let you make the same emotional connection.

People sometimes complain about the supposed invasiveness of Zoom – the camera snatches up your personal surroundings, the pictures on your wall, the books on your shelves, your family in the background – but it’s by no means the intimacy of being there.

screenshot from a video by Rose Bythrow

#

My spouse says, “Over Zoom you can’t tell who’s hungry.”

It would be nice if she meant this metaphorically – that it’s hard to tell who’s eager to learn. But, no. Many students aren’t eating enough. They are hungry.

Worse, we read Nguyen’s paean to Zoom on a snow day.

Streets near my spouse’s high school school were well-salted and plowed, but we live in a sprawling, semi-rural area – the school district serves families from a mix of socioeconomic backgrounds. There are hills and valleys – not everyone can get a satellite signal at home. And the for-profit cable companies certainly haven’t connected those families to the modern world with wires.

Still, the pandemic has made “e-learning days” seem like a reliable alternative. If it snows, kids learn from home.

“What’s Zoom supposed to do,” my spouse asked, “for my students with no heat?”

This isn’t (only) a concern for fluke events like the avarice-fueled power outages and heat losses in Texas. My spouse grew up in Albany, New York. Every winter was cold. The infrastructure to heat homes there was secure – for children whose families had money.

My spouse’s family didn’t. Her father failed to pay the electric bill. The power was shut off. And then the district called a snow day.

If my spouse and her sibling had gone to school, it wouldn’t have been so bad. Warm classrooms, a hot meal.

Instead they were stuck at home, shivering. Wanting so badly to go to a neighbor’s house. But then the neighbors would know.

In the United States, where poverty is often stigmatized as a moral failing, people hide the ache of want.

Which is why Zoom is so horrible. Zoom makes it easy. When you only have to disguise a small corner of your life, you can convey the illusion that things are okay.

Even when they’re not.

.

.

.

header image from Zoom corporation’s “About” page

On complexity and seemingly good ideas.

On complexity and seemingly good ideas.

Elizabeth Kolbert’s lovely essay in the New York Review of Books, “Chemical Warfare’s Home Front,” describes Fritz Haber’s contribution to the use of toxic gas in war.

Haber orchestrated the use of chlorine to suffocate all animal life – including soldiers – downwind of his nation’s troops. And his plan succeeded. After unleashing 300,000 pounds of chlorine gas, huge numbers of people died. Soldiers– some of whom suffocated, some whose lungs burned, some who committed suicide when enveloped by the gas – as well as horses, cows, chickens, wildlife.

Chemical warfare is horrible, but Haber’s battlefield “experiment” was considered a success. Military researchers then concocted more dangerous chemical agents, like DNA-crosslinking mustard gas and muscle-clenching Sarin nerve gas.

#

Fritz Haber’s other ideas were seemingly more beneficial for humanity. Haber was awarded the Nobel Prize in chemistry for making synthetic fertilizer.

Synthetic fertilizer let us grow more crops.

We could feed billions more people!

The global population soared.

If we hadn’t invented synthetic fertilizer, the global population would still be under four billion people.

Climate change would still be a huge problem – the most outrageous polluters haven’t been the most populous nations. Climate change was caused primarily by the United States and other wealthy nations, whereas overpopulation will first devastate equatorial nations.

A seemingly good idea – more fertilizer! – has greatly exacerbated the scale of suffering.

#

Kolbert discusses the invention of chlorofluorocarbons, which seemed like great coolants. With CFCs, Frigidaire could build cheaper refrigerators! Regular families could keep their ice cream cold without spending as much on electricity.

Unfortunately, CFCs also dissolve our ozone layer. More dangerous ultraviolet radiation began to reach us from the sun, causing horrible skin cancers.

CFCs seemed like a good idea — they do work great as coolants — but they caused awful problems as part of a bigger system.

Kolbert quotes the chemist F. Sherwood Rowland, who said, in reference to his studies of CFCs, “The work is going very well, but it looks like the end of the world.”

#

Anthropologist Joseph Tainter argued civilizations collapse when overwhelmed by complexity.

Like the children’s nursery rhyme about the old lady who swallowed a fly — then a spider to catch the fly, then a cat to catch the spider — our complicated solutions can create new, perhaps worse, problems.

This is the theme of Jenny Kleeman’s Sex Robots and Vegan Meat. Kleeman investigates several industries that purport to solve our world’s problems – You can eat meat without killing animals! You can make a baby without a mother’s body! – without addressing the fundamental causes of these problems.

Describing her travels, Kleeman writes:

I head back to my hotel as the reassuring cloak of darkness falls on Las Vegas. I’m exhausted. Music is thumping out of huge speakers mounted on the building’s exterior: throbbing, pounding beats that are supposed to entice gamblers into the hotel’s casino. I wipe my key card and flop down on the giant bed.

On the bedside table, there’s a metal dish full of individually wrapped pairs of earplugs: wax ones, foam ones, silicone ones – a profusion of solutions supplied by the management to the noise pollution problem caused by the management.

They could just switch the music off, of course, but they have provided a little piece of technology instead so they don’t have to.

My head is full of Eva, [a prototype interactive sex doll] who has the body of a real woman, but can be beaten without feeling a thing. Rather than dealing with the cause of a problem, we invent something to try to cancel it out.

Perhaps we should eat different foods. Perhaps our attitudes about sex or the importance of a sociable community are making our lives worse. Perhaps if we addressed these issues directly, we wouldn’t need sex robots or vegan meat.

Clean meat is one of many possible futures of food, so long as we continue to eat meat. We will always have the power to not want it anymore, or to want it much less.

That is where the real power lies: in harnessing our desires, rather than in mastering technology. Until we do, we will be even further removed from where our food comes from, and will feel even less responsible for it.

We will be perpetuating the kind of thinking that caused the meat mess in the first place.

#

In April 2020, I described two major drawbacks to our efforts to “slow the spread” of Covid-19 instead of providing targeted protection for the people at high risk of severe illness.

1.) Immunity to most coronaviruses lapses within a matter of months. Keeping the virus in circulation longer increases the total number of infections and makes it more difficult to shield people at high risk from eventual exposure.

2.) Each infection encompasses some number of viral replications and thus genetic drift. If a population of 20 people transfers a virus between themselves one by one, rather than all catching it from the same initial carrier, the virus has 20-fold more generations to mutate and better evade our immune systems.

#

Admittedly, my April 2020 prediction about the timeline for vaccine development was quite wrong – I thought this might take three to five years. I’m thankful that I was wrong. I’m obviously grateful for the fantastic work done by vaccine developers so far.

For these vaccines to effectively staunch viral transmission, we’ll need to vaccinate large numbers of people – immunity from prior infections won’t necessarily help much because immunity to this particular virus lapses so quickly, and because people’s prior infections were staggered in time. (Indeed, we’ll probably need to vaccinate large numbers of people repeatedly, because some of our data suggests that vaccine-derived immunity to this also lapses on a timescale of months.)

Unfortunately, we live in a country where large numbers of people distrust the medical establishment. Even if we had sufficient doses of the vaccines available today, I don’t know what percentage of our population would choose to get them.

#

Masks definitely reduce viral transmission. It was obviously a good idea for everyone to wear masks anywhere that high risk and lower risk people share the same space.

Cooperation definitely makes for a better place to live. In places that enacted mask orders, it’s obviously a good idea to follow them.

It’s worth remembering, though, that any fix – even something as simple as this piece of cloth covering my nose and mouth – can have unintentional consequences. New virus variants – which our current vaccines may be less effective against – are a predictable result of our effort to “slow the spread” with masks.

And yet.

I volunteer with Pages to Prisoners, an organization that sends free books to people who are incarcerated. We’ve included a sheet of information about Covid-19 with each package recently, helping to explain that Covid-19 is not a hoax, that it’s a dangerous respiratory disease, that masks and social distancing can help people reduce their risk.

I’m currently revising this information sheet – it was put together months ago, when we understood less about this virus – and I’m still recommend that everyone wear masks.

Not just because prisons are places where many low risk and high risk people are confined together — although, they are. Outrageous sentencing practices have led to a large number of elderly people being stuck in prison.

But also, anecdotal evidence suggests that people are more likely to develop severe illness from Covid-19 when they are exposed to a large number of viral particles at once.

Viruses reproduce exponentially – you can get sick if you inhale even one capsid. But you’re more likely to get seriously ill if you inhale a whole bunch of viral particles. If you’re initially exposed to a small number of particles, your body will have more time to fight off the infection before it makes you feel sick.

Research studies from military bases have shown that Covid-19 will continue to spread even when everyone wears masks and tries to stay six feet away from each other. But we haven’t tested – an experiment like this would be totally unethical – whether we’re more likely to see asymptomatic or mild cases when people’s initial exposure is to a small number of viral particles.

It’s quite likely, though.

So, although I think our efforts to “slow the spread” weren’t the best plan last year, I’ll still be recommending masks.

On magic.

On magic.

There’s broad scientific consensus that school closures hurt children, probably making a significant contribution to future increases in premature death.

There’s also broad scientific consensus that school closures – particularly elementary school closures – aren’t helpful in slowing the spread of Covid-19. Children aren’t major vectors for this virus. Adults just have to remember not to congregate in the teachers’ lounge.

Worldwide, a vanishingly small percentage of viral transmissions have occurred inside schools.

And … our district just closed in-person school for all children.

In-person indoor dining at restaurants is still allowed. Bars are still open.

Older people are sending a clear message to kids: “Your lives matter less than ours.”

#

For at-risk children, school closures are devastating. A disruption in social-emotional learning; lifelong education gaps; skipped meals.

But for my (privileged!) family, the closure will be pretty nice. I was recently feeling nostalgic about the weeks in August when my eldest and I spent each morning together.

Our youngest attends pre-K at a private school. Her school, like most private schools around the country, (sensibly) re-opened on time and is following its regular academic calendar.

My eldest and I will do two weeks of home schooling before winter break. And it’ll be fun. I like spending time with my kids, and my eldest loves school so much that she often uses up most of her energy during the day – teachers tell us what a calm, lovely, hard-working kid she is. And then she comes home and yells, all her resilience dissipated.

Which is normal! Totally normal. But it’s a little crummy, as a parent, to know you’ve got a great kid but that you don’t get to see her at her best.

Right now she’s sad about not going to school – on Monday, she came home crying, “There was an announcement that we all have to switch to online only!” – but I’m lucky that I can be here with her. Writing stories together, doing math puzzles, cooking lunch.

Maybe we’ll practice magic tricks. She loves magic.

#

Last month, I was getting ready to drive the kids to school. T. (4 years old) and I were in the bathroom. I’d just handed T. her toothbrush.

N. (6 years old) walked over holding a gallon-sized plastic bag.

“Father, do you want to see a magic trick?” she asked.

“Okay, but I have to brush my teeth while you’re doing it.”

“Okay,” she said, and opened the bag. She took out a multi-colored lump of clay. It was vaguely spherical. Globs of red, white, and blue poked up from random patches across the surface, as though three colors of clay had been haphazardly moshed together.

“So you think this is just this,” she said, but then …”

She took out a little wooden knife and began sawing at the lump. “This is just this?”, I wondered. It’s an interesting phrase.

Her sawing had little effect. The knife appeared useless. I’m pretty sure this wooden knife is part of the play food set she received as a hand-me-down when she was 9 months old. “Safe for babies” is generally correlated with “Useless for cutting.”

She was having trouble breaking the surface of her lump.

I spat out my toothpaste.

She kept sawing. She set down the knife and stared at the clay intently. A worthy adversary.

I stood there, watching.

She grabbed the knife again and resumed sawing. More vigorously, this time. She started stabbing, whacking. This was enough to make a tiny furrow. She tossed aside the knife and pulled with her fingertips, managing to pry two lobes of the strange lump away from each other.

“Okay,” she said, “it’s hard to see, but there’s some green in there.”

T. and I crouched down and peered closely. Indeed, there was a small bit of round green clay at the center of the lump.

“Wow!” exclaimed T. “I thought it was just a red, and, uh, blue, and white ball! But then, on the inside, there’s some green!”

“I know!” said N., happy that at least one member of her audience understood the significance of her trick. “And look, I might even get it back together!”

#

N. started performing magic when she was four. T. was asleep for her afternoon nap.

“Okay,” she said, “you sit there, and I’ll put on a magic show. Watch, I’ll make, um … this cup! See this cup? I’ll make it disappear.”

“Okay,” I said, curious. We’d just read a book that explained how to make a penny disappear from a glass cup – the trick is to start with the cup sitting on top of the penny, so that the coin looks like it’s inside the cup but actually isn’t.

I had no idea how she planned to make the cup itself disappear.

“Okay, so, um, now you’re ready, and …” she looked at the cup in her hands. Suddenly, she whisked it behind her back. And stood there, looking at me somberly, with her hands behind her back.

“I don’t have it,” she said.

#

Magic – convincing an audience to believe in an illusion.

This is just this.

I don’t have the cup – it’s gone.

Much of our Covid-19 response has been magic-based. We repeat illusory beliefs – schools are dangerous, reinfections are rare, death at any age is a tragedy – and maybe our audience is swayed.

But that doesn’t change the underlying reality.

The cup still exists – it was behind her back.

#

Everyone will die. Mortality is inescapable.

Our species is blessed with prodigious longevity, probably because so many grandmothers among our ancestors worked hard to help their grandchildren survive.

(The long lives of men are probably an accidental evolutionary byproduct, like male nipples or female orgasms. Elderly men, with their propensity to commandeer resources and start conflicts, probably reduced the fitness of their families and tribes.)

After we reach our seventies, though – when our ancestors’ grandchildren had probably passed their most risky developmental years – our bodies fail. We undergo immunosenescence – our immune systems become worse at suppressing cancer and infections.

We will die. Expensive interventions can stave off death for longer – we can now vaccinate 90-year-olds against Covid-19 – but we will still die.

Dying at the end of a long, full life shouldn’t feel sad, though. Everybody dies. Stories end. That’s the natural arc of the world.

What’s sad is when people die young.

Children will face the risk of dying younger due to unnecessary school closures.

Children will face the risk of dying younger due to unmitigated climate change.

Children will face the risk of dying younger due to antibiotic resistant bacteria.

These are urgent threats facing our world. And we’re not addressing them.

The cup is still there.

#

For my daughter, of course, I played along. I smiled, and laughed. She stood there beaming, holding the cup behind her back.

“Magic!” I said.

N. nodded proudly, then asked, “Do you want me to bring it back?”

It’ll take the same measure of magic to bring back schools.

On predictions and a scientific response to calamity.

On predictions and a scientific response to calamity.

We’re fast approaching flu season, which is especially harrowing this year.

We, as a people, have struggled to respond to this calamity. We have a lot of scientific data about Covid-19 now, but science is never value-neutral. The way we design experiments reflects our biases; the way we report our findings, even more so.

For example, many people know the history of Edward Jenner inventing the world’s first vaccine. Fewer are aware of the long history of inoculation in Africa (essentially, low-tech vaccination) that preceded Jenner’s work.

So it’s worthwhile taking a moment to consider the current data on Covid-19.

Data alone can’t tell us what to do – the course of action we choose will reflect our values as a society. But the data may surprise a lot of people – which is strange considering how much we all feel that we know about Covid-19.

Indeed, we may realize that our response so far goes against our professed values.

Spoiler: I think we shouldn’t close in-person school.

#

Since April, I’ve written several essays about Covid-19. In these, I’ve made a number of predictions. It’s worthwhile to consider how accurate these predictions have been.

This, after all, is what science is. We use data to make an informed prediction, and then we collect more data to evaluate how good our prediction was.

Without the second step – a reckoning with our success or failure – we’re just slinging bullshit.

#

I predicted that our PCR tests were missing most Covid-19 infections, that people’s immunity was likely to be short-lived (lasting for months, not years), and that Covid-19 was less dangerous than seasonal influenza for young people.

These predictions have turned out to be correct.

In my essays, I’ve tried to unpack the implications of each of these. From the vantage of the present, with much more data at our disposal, I still stand by what I’ve written.

But gloating’s no fun. So I’d rather start with what I got wrong.

#

My initial predictions about Covid-19 were terrible.

I didn’t articulate my beliefs at the time, but they can be inferred from my actions. In December, January, and February, I made absolutely no changes to my usual life. I didn’t recommend that travelers be quarantined. I didn’t care enough to even follow the news, aside from a cursory glance at the headlines.

While volunteering with the high school running team, I was jogging with a young man who was finishing up his EMT training.

“That new coronavirus is really scary,” he said. “There’s no immunity, and there’s no cure for it.”

I shrugged. I didn’t know anything about the new coronavirus. I talked with him about the 1918 influenza epidemic instead.

#

I didn’t make any change in my life until mid-March. And even then, what did I do?

I called my brother and talked to him about the pizza restaurant – he needed a plan in case there was no in-person dining for a few months.

#

My next set of predictions were off, but in the other direction – I estimated that Covid-19 was about four-fold more dangerous than seasonal influenza. The current best estimate from the CDC is that Covid-19 is about twice as dangerous, with an infection fatality ratio of 0.25%.

But seasonal influenza typically infects a tenth of our population, or less.

We’re unlikely to see a significant disruption in the transmission of Covid-19 (this is the concept of “herd immunity”) until about 50% of our population has immunity from it, whether from vaccination or recovery. Or possibly higher – in some densely populated areas, Covid-19 has spread until 70% (in NYC) or even 90% (in prisons) of people have contracted the disease.

Population density is hugely important for the dynamics of Covid-19’s spread, so it’s difficult to predict a nation-wide threshold for herd immunity. For a ballpark estimate, we could calculate what we’d see with a herd immunity threshold of about 40% in rural areas and 60% in urban areas.

Plugging in some numbers, 330 million people, 80% urban population, 0.25% IFR, 60% herd immunity threshold in urban areas, we’d anticipate 450,000 deaths.

That’s about half of what I predicted. And you know what? That’s awful.

Each of those 450,000 is a person. Someone with friends and family. And “slow the spread” doesn’t help them, it just stretches our grieving to encompass a whole year of tragedy instead of a horrific month of tragedy.

If we don’t have a safe, effective vaccine soon enough, the only way to save some of those 450,000 people is to shift the demographics of exposure.

#

Based on the initial data, I concluded that the age demographics for Covid-19 risk were skewed more heavily toward elderly people than influenza risk.

I may have been wrong.

It’s difficult to directly compare the dangers of influenza to the dangers of Covid-19. Both are deadly diseases. Both result in hospitalizations and death. Both are more dangerous for elderly or immunocompromised people, but both also kill young, healthy people.

Typically, we use an antigen test for influenza and a PCR-based test for Covid-19. The PCR test is significantly more sensitive, so it’s easier to determine whether Covid-19 is involved a person’s death. If there are any viral particles in a sample, PCR will detect them. Whereas antigen tests have a much higher “false negative” rate.

Instead of using data from these tests, I looked at the total set of pneumonia deaths. Many different viruses can cause pneumonia symptoms, but the biggest culprits are influenza and, in 2020, Covid-19.

So I used these data to ask a simple question – in 2020, are the people dying of pneumonia disproportionately more elderly than in other years?

I expected that they would be. That is, after all, the prediction from my claims about Covid-19 demographic risks.

I was wrong.

In a normal year (I used the data from 2013, 2014, and 2015, three years with “mild” seasonal influenza), 130,000 people die of flu-like symptoms.

In 2020 (at the time I checked), 330,000 people have died of flu-like symptoms. Almost three times as many people as in a “normal” year.

For people under the age of 18, we’ve seen the same number of deaths (or fewer) in 2020 as in other years. The introduction of Covid-19 appears to have caused no increased risk for these people.

But for people of all other ages, there have been almost three times as many people dying of these symptoms in 2020 compared to other years.

In most years, one thousand people aged 25-34 die of these symptoms; in 2020, three thousand have died. In most years, two thousand people aged 35-44 die of these symptoms; in 2020, six thousand have died. This same ratio holds for all ages above eighteen.

Younger people are at much less risk of harm from Covid-19 than older people are. But, aside from children under the age of eighteen, they don’t seem to be exceptionally protected.

Of course, my predictions about the age skew of risk might be less incorrect than I’m claiming here. If people’s dramatically altered behavior in 2020 has changed the demographics of exposure as compared to other years – which is what we should be doing to save the most lives – then we could see numbers like this even if Covid-19 had the risk skew that I initially predicted.

#

I predicted that four or more years would pass before we’d be able to vaccinate significant numbers of people against Covid-19.

I sure hope that I was wrong!

We now know that it should be relatively easy to confer immunity to Covid-19. Infection with other coronaviruses, including those that cause common colds, induce the production of protective antibodies. This may partly explain the low risk for children – because they get exposed to common-cold-causing coronaviruses so often, they may have high levels of protective antibodies all the time.

Several pharmaceutical companies have reported great results for their vaccine trials. Protection rates over 90%.

So the problem facing us now is manufacturing and distributing enough doses. But, honestly, that’s the sort of engineering problem that can easily be addressed by throwing money at it. Totally unlike the problem with HIV vaccines, which is that the basic science isn’t there – we just don’t know how to make a vaccine against HIV. No amount of money thrown at that problem would guarantee wide distribution of an effective vaccine.

We will still have to overcome the (unfortunately significant) hurdle of convincing people to be vaccinated.

For any individual, the risk of Covid-19 is about twice the risk of seasonal influenza. But huge numbers of people choose not to get a flu vaccine each year. In the past, the United States has had a vaccination rate of about 50%. Here’s hoping that this year will be different.

Covid-19 spreads so fast – and so silently, with many cases of infected people who feel fine but are still able to spread the virus – that it will almost certainly be a permanent resident of the world we live in. We’re unlikely to eradicate Covid-19.

Which means that elderly people will always be at risk of dying from Covid-19.

The only way to protect people whose bodies have gone through “age-related immunosenence” – the inevitable weakening of an immune system after a person passes the evolutionarily-determined natural human lifespan of about 75 years – will be to vaccinate everybody else.

Depending on how long vaccine-conferred immunity lasts, we may need to vaccinate people annually. I worry, though, that it will become increasingly difficult to persuade people to get a Covid-19 vaccine once the yearly death toll drops to influenza-like levels – 50,000 to 100,000 deaths per year in the United States.

#

I wrote, repeatedly, that immunity to Covid-19 is likely to be short-lived. Immunity to other coronaviruses fades within a few months.

(Note: you may have seen articles in the New York Times suggesting that we’ll have long-lasting protection. They’re addressing a different question — after recovery, or vaccination, are you likely to become severely ill with Covid-19? And the answer is “probably not,” although it’s possible. When I discuss immunity here, I mean “after recovery, or vaccination, are you likely to be able to spread the virus after re-infection?” And the answer is almost certainly “yes, within months.”)

And I wrote about the interplay between short-lived immunity and the transmission dynamics of an extremely virulent, air-born virus.

This is what the Harvard public health team got so wrong. When we slow transmission enough that a virus is still circulating after people’s immunity wanes, they can get sick again.

For this person, the consequences aren’t so dire – an individual is likely to get less sick with each subsequent infection by a virus. But the implications for those who have not yet been exposed are horrible. The virus circulates forever, and people with naive immune systems are always in danger.

It’s the same dynamics as when European voyagers traveled to the Americas. Because the European people’s ancestors lived in unsanitary conditions surrounded by farm animals, they’d cultivated a whole host of zoogenic pathogens (like influenza and this new coronavirus). The Europeans got sick from these viruses often – they’d cough and sneeze, have a runny nose, some inflammation, a headache.

In the Americas, there were fewer endemic diseases. Year by year, people wouldn’t spend much time sick. Which sounds great, honestly – I would love to go a whole year without headaches.

But then the disgusting Europeans reached the Americas. The Europeans coughed and sneezed. The Americans died.

And then the Europeans set about murdering anyone who recovered. Today, descendants of the few survivors are made to feel like second-class citizens in their ancestral homelands.

#

In a world with endemic diseases, people who have never been exposed will always be at risk.

That’s why predictions made in venues such as the August New York Times editorial claiming that a six- to eight-week lockdown would stop Covid-19 were so clearly false. They wrote:

Six to eight weeks. That’s how long some of the nation’s leading public health experts say it would take to finally get the United States’ coronavirus epidemic under control.

For proof, look at Germany. Or Thailand. Or France.

Obviously, this didn’t work – in the presence of an endemic pathogen, the lockdowns preserved a large pool of people with naive immune systems, and they allowed enough time to pass that people who’d been sick lost their initial immunity. After a few months of seeming calm, case numbers rose again. For proof, look at Germany. Or France.

Case numbers are currently low in Thailand, but a new outbreak could be seeded at any time.

And the same thing is currently happening in NYC. Seven months after the initial outbreak, immunity has waned; case numbers are rising; people with mild second infections might be spreading the virus to friends or neighbors who weren’t infected previously.

All of which is why I initially thought that universal mask orders were a bad idea.

We’ve known for over a hundred years that masks would slow the spread of a virus. The only question was whether slowing the spread of Covid-19 would cause more people to die of Covid-19.

And it would – if a vaccine was years away.

But we may have vaccines within a year. Which means that I may have been wrong. Again, the dynamics of Covid-19 transmission are still poorly understood – I’ll try to explain some of this below.

In any case, I’ve always complied with our mask orders. I wear a mask – in stores, at school pickup, any time I pass within six feet of people while jogging.

To address global problems like Covid-19 and climate change, we need global consensus. One renegade polluting wantonly, or spewing viral particles into the air, could endanger the whole world. This is precisely the sort of circumstance where personal freedom is less important than community consensus.

#

The transmission dynamics of Covid-19 are extremely sensitive to environment. Whether you’re indoors or outdoors. How fast the air is moving. The population density. How close people are standing. Whether they’re wearing masks. Whether they’re shouting or speaking quietly.

Because there are so many variable, we don’t have good data. My father attended a lecture and a colleague (whom he admires) said, “Covid-19 is three-fold more infectious than seasonal influenza.” Which is bullshit – the transmission dynamics are different, so the relative infectivity depends on our behaviors. You can’t make a claim like this.

It’s difficult to measure precisely how well masks are slowing the spread of this virus.

But here’s a good estimate: according to Hsiang et al., the number of cases of Covid-19, left unchecked, might have increased exponentially at a rate of about 34% per day in the United States.

That’s fast. If about 1% of the population was infected, it could spread to everyone within a week or two. In NYC, Covid-19 appear to spread to over 70% of the population within about a month.

(To estimate the number of infections in New York City, I’m looking at the number of people who died and dividing by 0.004 – this is much higher than the infection fatality rate eventually reported by the CDC, but early in the epidemic, we were treating people with hydroxychloraquine, an unhelpful poison, and rushing to put people on ventilators. We now know that ventilation is so dangerous that it should only be used as a last resort, and that a much more effective therapy is to ask people to lie on their stomachs – “proning” makes it easier to get enough oxygen even when the virus has weakened a person’s lungs.)

Masks dramatically slow the rate of transmission.

A study conducted at a military college – where full-time mask-wearing and social distancing were strictly enforced – showed that the number of cases increased from 1% to 3% of the population over the course of two weeks.

So, some math! Solve by taking ten to the power of (log 3)/14, which gives an exponential growth rate of 8% per day. Five-fold slower than without masks.

But 8% per day is still fast.

Even though we might be able to vaccinate large numbers of people by the end of next year, that’s not soon enough. Most of us will have been sick with this – at least once – before then.

I don’t mean to sound like a broken record, but the biggest benefit of wearing masks isn’t that we slow the rate of spread for everyone — exponential growth of 8% is still fast — but that we’re better able to protect the people who need to be protected. Covid-19 is deadly, and we really don’t want high-risk people to be infected with it.

I’ve tried to walk you through the reasoning here — the actual science behind mask policies — but also, in case it wasn’t absolutely clear: please comply with your local mask policy.

You should wear a mask around people who aren’t in your (small) network of close contacts.

#

I’m writing this essay the day after New York City announced the end of in-person classes for school children.

This policy is terrible.

A major problem with our response to Covid-19 is that there’s a time lag between our actions and the consequences. Human brains are bad at understanding laggy data. It’s not our fault. Our ancestors lived in a world where they’d throw a spear at an antelope, see the antelope die, and then eat it. Immediate cause and effect makes intuitive sense.

Delayed cause and effect is tricky.

If somebody hosts a party, there might be an increase in the number of people who get sick in the community over the next three weeks. Which causes an increase in the number of hospitalizations about two weeks after that. Which causes people to die about three weeks after that.

There’s a two-month gap between the party and the death. The connection is difficult for our brains to grasp.

As a direct consequence, we’ve got ass-hats and hypocrites attending parties for, say, their newly appointed Supreme Court justice.

But the problem with school closures is worse. There’s a thirty year gap between the school closure and the death. The connection is even more difficult to spot.

Even if you have relatively limited experience reading scientific research papers, I think you could make your way through this excellent article from Chistakis et al.

The authors link two sets of existing data: the correlation between school closures and low educational achievement, and the correlation between low educational achievement and premature death.

The public debate has pitted “school closures” against “lives saved,” or the education of children against the health of the community. Presenting the tradeoffs in this way obscures the very real health consequences of interrupted education.

These consequences are especially dire for young children.

The authors calculate that elementary school closures in the United States might have (already!) caused 5.5 million years of life lost.

Hsiang et al. found that school closures probably gave us no benefit in terms of reducing the number of Covid-19 cases, because children under 18 aren’t significant vectors for transmission (elementary-aged children even less so), but even if school closures had reduced the number of Covid-19 cases, closing schools would have caused more total years of life to be lost than saved.

The problem – from a political standpoint – is that Covid-19 kills older people, who vote, whereas school closures kill young people, who are intentionally disenfranchised.

And, personally, as someone with far-left political views, it’s sickening for me to see “my” political party adopt policies that are so destructive to children and disadvantaged people.

#

So, here’s what the scientific data can tell us so far:

  • We will eventually have effective vaccines for Covid-19. Probably within a year.
  • Covid-19 spreads even with social distancing and masks, but the spread is slower.
  • You have no way of knowing the risk status of people in a stranger’s bubble. (Please, follow your local mask orders!)
  • Schools – especially elementary schools – don’t contribute much to the spread of Covid-19.
  • School closures shorten children’s lives (and that’s not even accounting for their quality of life over the coming decades).
  • An individual case of Covid-19 is about twice as dangerous as a case of seasonal influenza (which is scary!).
  • Underlying immunity (from prior disease and vaccination) to Covid-19 is much lower than for seasonal influenza, so there will be many more cases.
  • Most people’s immunity to Covid-19 probably lasts several months, after which a person can be re-infected and spread the virus again.

#

So, those are some data. But data don’t tell us what to do. Only our values can do that.

Personally, I value the lives of children.

I wouldn’t close schools.