Responses to “On testing.”

Responses to “On testing.”

My spouse posted my previous essay on social media, and I’d like to address some of people’s comments.  There were some excellent points! 

My apologies if I failed to address everything that people said, but I tried my best.

Scroll to find my responses to:

  1. A shutdown could have prevented the Covid-19 epidemic.
  2. We know that the current shutdown is either delaying or preventing deaths due to Covid-19. 
  3. Ending this epidemic with a vaccine would be ideal. 
  4. Ending the shutdown while requesting that at-risk people continue to self-isolate would save lives.
  5. Why is it urgent to end the shutdown soon?
  6. Why might more people die of Covid-19 just because we are slowing the spread of the virus?
  7. How is the shutdown causing harm?
  8. What about the rate at which people get sick?  Isn’t the shutdown worthwhile, despite the risks described above, if it keeps our hospitals from being overwhelmed?
  9. Don’t the antibody tests have a lot of false positives?
  10. What about the political ramifications of ending the shutdown?

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1: “A shutdown could have prevented the Covid-19 epidemic.”

If we’d acted early enough, we could have isolated all cases of Covid-19 and prevented this whole debacle.

But we didn’t.

Covid-19 is highly infectious, and we made no effort toward containment or quarantine until the virus was already widespread.  We took action in March, but we already had community transmission of Covid-19 by January.  Given where we are now, current models predict that the epidemic will continue until the level of immunity reaches somewhere near 70%.

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2: “We know that the current shutdown is either delaying or preventing deaths due to Covid-19.”

To date, the data suggests that the virus has only reached saturation inside a few closed environments, such as prisons.  In Italy, both the timecourse of mortality and the results of antibody studies suggest that infections were still rising at the time of their lockdown. 

Among the passengers of the Diamond Princess cruise ship, deaths peaked 21 days after infections peaked – if the virus had already reached saturation in Italy, we’d expect to see deaths peak sooner than 21 days after the lockdown began.  They did not.

So, again, this much is clear: worldwide, there was a significant new cause of death.  When we look at mortality data, we see the curves suddenly rise in many locations.  Some researchers, such as John Ioannidis, have speculated that Covid-19 causes death primarily in people with low life expectancy, in which case we would expect to see these mortality curves drop to lower-than-average levels after the epidemic ends.  But even then, it’s unprecedented to see a number of deaths that would usually occur over the course of a year all within a matter of weeks.

Covid-19 is killing people, and the shutdown is either delaying or preventing people’s death from Covid-19.

For the shutdown to actually prevent death, one of the following needs to happen:

1.) We create a vaccine, allowing our population to reach 70% immunity without as many people contracting the illness.

2.) We take action to change which segment of the population is exposed to the virus, allowing us to reach 70% immunity without as many at-risk people being exposed.

See #3 and #4, below.

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3: “Ending this epidemic with a vaccine would be ideal.”

Vaccination is great science.  Both my spouse and I love teaching about vaccines, in part because teaching the history of vaccine use is a good component of anti-racist science class.

Developing vaccines often takes a long time.  I’ve read predictions of a year or two; my father, an infectious disease doctor, epidemiologist, research physician who runs vaccine trials, and co-developer of Merck’s HPV vaccine, guesses that it will take about five years.

And then, for the vaccine to end this epidemic, enough people will need to choose to be vaccinated that we reach approximately 70% immunity.

The reason it’s worthwhile to compare Covid-19 to seasonal influenza is that a vaccine will only end the epidemic if enough people choose to get it.  Many people’s personal risk from Covid-19 is lower than their risk from seasonal influenza.  Will those people choose to be vaccinated?

Obviously, I would be thrilled if the answer were “yes.”  I’d love to live in a nation where people’s sense of altruism and civic duty compelled them to get vaccinated.  My family is up-to-date on all of ours.

But many privileged families in the United States have elected to be freeloaders, declining the (well tested, quite safe) measles vaccine with the expectation that other people’s immunity will keep them safe.  And, despite the well-documented dangers of influenza, only 40% of our population gets each year’s influenza vaccine.

Yes, the influenza vaccine tends to be less effective than many others – some years it gives as little as ten percent protection, other years about sixty percent protection.  By way of comparison, the HPV vaccine has over 90% efficacy.

A vaccine with low efficacy will still offer better protection when more people get it.  If a higher percentage of our population were vaccinated against influenza, then influenza transmission would drop, and so each person’s immunity, whether high or low, would be less likely to be challenged.

Also, the efficacy of influenza vaccines is measured in terms of the likelihood that vaccination prevents infection.  The influenza vaccine is not great at keeping people from getting sick.  But vaccination also tends to reduce the severity of your illness, even if you do catch influenza.  Because you got sick, it seems as though the vaccine “failed,” but your case might have been far more severe if you hadn’t been vaccinated.

The influenza vaccine saves lives.  In Italy, where fewer people choose to get vaccinated against influenza (about 15% compared to our 40% of the population), the death rate from influenza is higher.  Although it’s worth noting that this comparison is complicated by the fact that our health care system is so bad, with poor people especially having limited access to health care.  In the United States, people between the ages of 18 and 49 comprise a higher proportion of influenza deaths than anywhere in Europe.  Either our obesity epidemic or limited access to health care is probably to blame; possibly a combination of both.

In summary, for this plan to help us save lives, we will need to develop an effective vaccine, and then people will have to get it. 

I am quite confident that we can eventually develop a vaccine against Covid-19.  The virus includes a proofreading enzyme, so it should mutate more slowly than most RNA viruses.  We don’t know how long it will take, but we can do it.

I am unfortunately pessimistic that people will choose to get the vaccine.  And, unfortunately, when a low-risk person chooses to forgo vaccination, they’re not just putting themselves in harm’s way, they are endangering others.  Most vaccines elicit a weaker immune response in elderly or immunocompromised recipients – exactly the group most at risk from Covid-19 – which is why we spend so much time harping about herd immunity.

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4: “Ending the shutdown while requesting that at-risk people continue to self-isolate would save lives.

This plan has major downsides, too.  Because we didn’t take action soon enough, every plan we have now is bad.

Low-risk people can still die of Covid-19.  Even if they don’t die, Covid-19 can cause permanent health effects.  Covid-19 reduces your ability to get oxygen to your body and brain.  Even a “mild” case can leave your breathing labored for weeks – you’re not getting enough oxygen.  Your muscles will ache.  Your thoughts will be sluggish.

With a more severe case, people can be looking at heart damage.  Renal failure.  It would be cruel to look at all these long-term consequences and blithely call them “recovery.”

If our health care system were better, we’d treat people sooner.  The earlier you intervene, helping to boost people’s oxygen levels, the better outcome you’ll have.  There’s a great editorial from medical doctor Richard Levitan recommending that people monitor their health with a pulse oximeter during this epidemic.

If you notice your oxygen levels declining, get help right away.  Early intervention can prevent organ damage.  And you’ll be helping everyone else, too – the sooner you intervene, the less medical care you will need.

Because medical debt can derail lives, many people in this country delay treatment as long as possible, hoping that their problems will go away naturally.  That’s why people are often so sick when they show up at the ER.  I imagine that this is yet another reason – alongside air pollution, food deserts, sleep loss, and persistent stress exacerbated by racism – that poor communities have had such a high proportion of people with severe cases of Covid-19.

And I imagine – although we don’t yet have enough data to know – that financial insecurity caused by the shutdown is making this worse.  It’s a rotten situation: you have a segment of population that has to continue working during the shutdown, which means they now have the highest likelihood to be exposed to the virus, and they’re now under more financial strain, which might increase the chance that they’ll delay treatment.

We know that early treatment saves lives, and not everyone is sufficiently privileged to access that.

All this sounds awful.  And it is.  But, if we took action to shift exposure away from high risk groups, the likelihood that any individual suffers severe consequences is lower.

And there is another caveat with this plan – some people may be at high risk of complications for Covid-19 and not even realize it.  In the United States, a lot of people either have type 2 diabetes or are pre-diabetic and don’t yet realize.  These people have elevated risk.  Both smoking and air pollution elevate risk, but people don’t always know which airborn pollutants they’ve been exposed to.  (Which, again, is why it’s particularly awful that our administration is weakening air quality standards during this epidemic.)

Even if we recommended continued self-isolation for only those people who know themselves to have high risk from Covid-19, though, we would be saving lives.  The more we can protect people in this group from being exposed to the virus – not just now, but ever – the more lives we will save.

We won’t be able to do this perfectly.  It’ll be a logistical nightmare trying to do it at all.  People at high risk from Covid-19 needs goods and services just like everybody else.  We might have to give daily Covid-19 PCR tests to anyone visiting their homes, like doctors, dentists, and even delivery workers. 

At that point, the false negative rate from Covid-19 PCR tests becomes a much bigger problem – currently, these false negatives reduce the quality of our data (but who cares?) and delay treatment (which can be deadly).  A false negative that causes inadvertent exposure could cost lives.

Stores will need to set aside morning hours for at-risk shoppers, and undertake rigorous cleaning at night.  We know that infectious viral particles can persist for days on a variety of surfaces.

Some people will be unable to work, either because they or a close relative has high risk of Covid-19.  Some children will be unable to go to school.  We will need a plan to help these people.

We will have to work very hard to keep people safe even after the shutdown ends for some. 

But, again, if everyone does the same thing, then the demographics of people infected with Covid-19 will reflect our population demographics.  We can save lives by skewing the demographics of the subset of our population that is exposed to Covid-19 to include more low-risk individuals, which will require that we stratify our recommendations by risk (at least as well as we can assess it).

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5: “Why is it urgent to end the shutdown soon?

1.) By delaying Covid-19 deaths, we run to risk of causing more total people to die of Covid-19.

2.) The shutdown itself is causing harm.

See #6 and #7, below.

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6: “Why might more people die of Covid-19 just because we are slowing the spread of the virus?

[EDIT: I wrote a more careful explanation of the takeaways of the Harvard study. That’s here if you would like to take a look!]

This is due to the interplay between duration of immunity and duration of the epidemic.  At one point in time, seasonal influenza was a novel zoogenic disease.  Human behavior allowed the influenza virus to become a perpetual burden on our species.  No one wants for humans to still be dying of Covid-19 in ten or twenty years.  (Luckily, because the virus that causes Covid-19 seems to mutate more slowly than influenza, it should be easier to design a single vaccine that protects people.)

In the Harvard model, we can see that there are many scenarios in which a single, finite shutdown leads to more deaths from Covid-19 than if we’d done nothing. Note the scenarios for which the colored cumulative incidence curves (shown on the right) exceed the black line representing how many critical cases we’d have if we had done nothing.

Furthermore, their model does not account for people’s immunity potentially waning over time.  Currently, we do not know how long people’s immunity to Covid-19 will last.  We won’t know whether people’s immunity will last at least a year until a year from now.  There’s no way to test this preemptively.

We’ve seen that immunity to other coronaviruses fades within a year.  If immunity to Covid-19 is similar, we really don’t want to prolong the epidemic past a year.

If we could all go into stasis and simply not move for about a month, there’d be no new cases of Covid-19, and this virus would be gone forever.  But people still need to eat during the shutdown.  Many people are still working.  So the virus is still spreading, and we have simply slowed the rate of transmission.

This seems good, because we’re slowing the rate at which people enter the hospital, but it’s actually bad if we’re increasing the number of people who will eventually enter the hospital.

Based on our research with other coronaviruses, we expect that re-infection will cause a person to experience symptoms less severe than their first case of Covid-19.  But a re-infected person can still spread the disease to others.  And we don’t know what will happen if a person’s risk factors – such as age, smoking status, diabetes status, etc. – have increased in the time since their last infection.

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7: “How is the shutdown causing harm?

If you turn on Fox News, I imagine you’d hear people talking about the damage we’re doing to our economy.  They might discuss stock market numbers.

Who gives a shit?  In my opinion, you’d have to be pretty callous to think that maintaining the Nasdaq bubble is more important than saving lives.

At the same time, I think you’d have to be pretty callous to not feel extremely concerned by the United Nations’ policy brief, “The impact of Covid-19 on children.”

In this report, they estimate that the shutdown we’ve had so far will cause hundreds of thousands of children to die, many from malnutrition and the other health impacts of poverty.  The longer the shutdown continues, the more children will die.

That’s a worldwide number, and most of those children live outside the United States.  But I’d like to think that their lives matter, too.

The report also discusses the lifelong harm that will be inflicted on children from five months (or more!) of school closure.  Drop-outs, teen pregnancy, drug abuse, recruitment of child soldiers, and the myriad health consequences of low educational attainment.

I live in a wealthy college town, but even here there is a significant population of students who don’t have internet access.  Students with special needs aren’t getting the services they deserve.  Food insecurity is worse.

You’re lucky that privacy protections prevent me from sharing a story about what can happen to poor kids when all the dentists’ offices are closed.  I felt ashamed that this was the best my country had to offer.

As the shutdown continues, domestic violence is rising.  We can assume that child abuse is rising, also, but we won’t know until later, when we finally have a chance to save children from it.  In the past, levels of child abuse have been correlated with the amount of time that children spend in the presence of their abusers (usually close family), and reporting tends to happen during tense in-person conversations at school.

We know that online sex work has increased during the shutdown.  There is an increased supply of sex workers who are experiencing increasing financial insecurity.  We don’t yet have data on this, but I’d be shocked if the shutdown hasn’t led many to feel pressured into riskier acts for lower amounts of money, including meeting clients in isolated (and therefore unsafe) spaces.

The shutdown has probably made our drug epidemic worse (and this was already killing about 70,000 people per year in the U.S.).  When people are in recovery, one of the best strategies to stay sober is to spend a lot of time working, out of the house, and meeting with a supportive group in communal space.  Luckily, many of the people I know who are in recovery have been categorized as essential workers.

But any slip can kill someone recovering from addiction.  One of my friends froze to death last year.

A neighbor recently sent me a cartoon suggesting that the biggest harm caused by the shutdown is boredom.  (I’m going to include it, below, but don’t worry: I won’t spend too much time rattling sabers with a straw man.) And, for privileged families like mine, it is.  We’re safe, we’re healthy, we get to eat.  My kids are still learning – we live in a house full of computers and books.

But many of the 75 million children in the United States don’t live in homes like mine, with the privilege we have.  Many of our 50 million primary and secondary school students are not still learning academically during the shutdown.

Whether the shutdown is preventing or merely delaying the deaths of people at risk of serious complications from Covid-19, we have to remember that the benefit comes at a cost.  What we’ve done already will negatively impact children for the rest of their lives.  And the longer this goes on, the more we’re hurting them.

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8: “What about the rate at which people get sick?  Isn’t the shutdown worthwhile, despite the risks described above, if it keeps our hospitals from being overwhelmed?

In writing this, I struggled with how best to organize the various responses.  I hope it doesn’t seem too ingenuous to address this near the end, because slowing the rate of infection so that our hospitals don’t get overwhelmed is the BEST motivation for the shutdown.  More than the hope that a delay will yield a new vaccine, or new therapies to treat severe cases, or even new diagnostics to catch people before they develop severe symptoms, we don’t want to overwhelm our hospitals.

If our physicians have to triage care, more people will die.

And I care a lot about what this epidemic will be like for our physicians.  My father is a 67-year-old infectious disease doctor who just finished another week of clinical service treating Covid-19 patients at the low-income hospital in Indianapolis.  My brother-in-law is an ER surgeon in Minneapolis.  These cities have not yet had anything like the influx of severe cases in New York City – for demographic and environmental reasons, it’s possible they never will.  But they might. 

Based on the case fatality rate measured elsewhere, I’d estimate that only 10% of the population in Minneapolis has already been infected with Covid-19, so the epidemic may have a long way yet to go.

If we ended the shutdown today for everyone, with no recommendation that at-risk groups continue to isolate and no new measures to protect them, we would see a spike in severe cases.

If we ended the shutdown for low-risk groups, and did a better job of monitoring people’s health to catch Covid-19 at early, more-easily-treatable stages (through either PCR testing or oxygen levels), we can avoid overwhelming hospitals.

And the shutdown itself is contributing toward chaos at hospitals.  Despite being on the front lines of this epidemic, ER doctors in Minneapolis have received a 30% pay cut.  I imagine my brother-in-law is not the only physician who could no longer afford day care for his children after the pay cut.  (Because so many people are delaying care out of fear of Covid-19, hospitals are running out of money.)  Precisely when we should be doing everything in our power to make physicians’ lives easier, we’re making things more stressful.

We could end the shutdown without even needing to evoke the horrible trolley-problem-esque calculations of triage.  Arguments could be made that even if it led to triage it might be worthwhile to end the shutdown – the increase in mortality would be the percentage of triaged cases that could have survived if they’d been treated, and we as a nation might decide that this number was acceptable to prevent the harms described above – but with a careful plan, we need not come to that.

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9: “Don’t the antibody tests have a lot of false positives?

False positives are a big problem when a signal is small.  I happen to like a lot of John Ioannidis’s work – I think his paper “Why Most Published Research Findings Are False” is an important contribution to the literature – but I agree that the Santa Clara study isn’t particularly convincing. 

When I read the Santa Clara paper, I nodded and thought “That sounds about right,” but I knew my reaction was most likely confirmation bias at work.

Which is why, in the essay, I mostly discussed antibody studies that found high percentages of the population had been infected with Covid-19, like the study in Germany and the study in the Italian town of Robbio.  In these studies, the signal was sufficiently high that false positives aren’t as worrisome. 

In Santa Clara, when they reported a 2% infection rate, the real number might’ve been as low as zero.  When researchers in Germany reported a 15% infection rate, the real number might’ve been anywhere in the range of 13% to 17% – or perhaps double that, if the particular chips they used had a false negative rate similar to the chips manufactured by Premier Biotech in Minneapolis.

I’m aware that German response to Covid-19 has been far superior to our bungled effort in the United States, but an antibody tests is just a basic ELISA.  We’ve been doing these for years.

Luckily for us, we should soon have data from good antibody studies here in the United States.  And I think it’s perfectly reasonable to want to see the results of those.  I’m not a sociopath – I haven’t gone out and joined the gun-toting protesters.

But we’ll have this data in a matter of weeks, so that’s the time frame we should be talking about here.  Not months.  Not years.  And I’ll be shocked if these antibody studies don’t show widespread past infection and recovery from Covid-19.

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10: “What about the political ramifications of ending the shutdown?

I am, by nature, an extremely cautious person.  And I have a really dire fear.

I’m inclined to believe that ending the shutdown is the right thing to do.  I’ve tried to explain why.  I’ve tried to explain what I think would be the best way to do it.

But also, I’m a scientist.  You’re not allowed to be a scientist unless you’re willing to be proven wrong.

So, yes.  I might be wrong.  New data might indicate that writing this essay was a horrible mistake.

Still, please bear with me for a moment.  If ending the shutdown soon turns out to be the correct thing to do, and if only horrible right-wing fanatics have been saying that we should end the shutdown soon, won’t that help our current president get re-elected?

There is a very high probability that his re-election would cause even more deaths than Covid-19.

Failing to address climate change could kill billions.  Immigration controls against migrants fleeing war zones could kill millions.  Weakened EPA protections could kill hundreds of thousands.  Reduced access to health care could kill tens of thousands.

And, yes, there are horrible developments that neither major political party in the United States has talked about, like the risk that our antibiotics stop working, but I think it’s difficult to argue that one political party isn’t more dangerous than the other, here.

I feel pretty confident about all the scientific data I’ve discussed above.  Not as confident as I’d like, which would require more data, but pretty confident.

I feel extremely confident that we need to avoid a situation in which the far right takes ownership of an idea that turns out to have been correct.  And it’ll be dumb luck, just a bad coincidence.  The only “data” they’re looking at are stock market numbers, or many the revenue at Trump-owned hotels.

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EDIT: I also wrote a more careful explanation of the takeaways of the Harvard study. That’s here if you would like to take a look!

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Header image by Goran Paunovic.

On testing.

On testing.

UPDATE: Wow, this got a lot of readers! Honestly, though, I wrote a response to common questions and comments about this essay and it is probably a better read.

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My spouse recently sent me a link to the article “Concerns with that Stanford study of coronavirus prevalence” by Andrew Gelman, a statistician at Columbia University.  From reading this article, I got the impression that Gelman is a good mathematician.  And he raises some legitimate concerns. 

But I’ve noticed that many of the people criticizing the work coming out of the Ioannidis group – such as the study of how many people in Santa Clara county might have antibodies to Covid-19 – don’t seem to understand the biology underlying the numbers.

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First, some background: in case you haven’t noticed, most of the United States is operating under a half-assed lockdown.  In theory, there are stay-at-home orders, but many people, such as grocery store clerks, janitors, health care workers, construction workers, restaurant chefs, delivery drivers, etc., are still going to work as normal.  However, schools have been closed, and most people are trying to stand at least six feet away from strangers.

We’re doing this out of fear that Covid-19 is an extremely dangerous new viral disease.  Our initial data suggested that as many as 10% of people infected with Covid-19 would die.

That’s terrifying!  We would be looking at tens of millions of deaths in the United States alone!  A virus like this will spread until a majority of people have immunity to it – a ballpark estimate is that 70% of the population needs immunity before the epidemic stops.  And our early data suggested that one in ten would die.

My family was scared.  We washed our hands compulsively.  We changed into clean clothes as soon as we came into the house.  The kids didn’t leave our home for a week.  My spouse went to the grocery store and bought hundreds of dollars of canned beans and cleaning supplies.

And, to make matters worse, our president was on the news saying that Covid-19 was no big deal.  His nonchalance made me freak out more.  Our ass-hat-in-chief has been wrong about basically everything, in my opinion.  His environmental policies are basically designed to make more people die.  If he claimed we had nothing to worry about, then Covid-19 was probably more deadly than I expected.

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Five weeks have passed, and we now have much more data.  It seems that Covid-19 is much less dangerous than we initially feared.  For someone my age (37), Covid-19 is less dangerous than seasonal influenza.

Last year, seasonal influenza killed several thousand people between the ages of 18 and 49 in the United States – most likely 2,500 people, but perhaps as many as 5,800.  People in this age demographic account for about 10% of total flu deaths in the United States, year after year.

Seasonal influenza also killed several hundred children last year – perhaps over a thousand.

There’s a vaccine against influenza, but most people don’t bother. 

That’s shocking. 

Seasonal influenza is more dangerous than Covid-19 for people between the ages of 18 and 49, but only 35% of them chose to be vaccinated in the most recently reported year (2018).  And because the vaccination rate is so low, our society doesn’t have herd immunity.  By choosing not to get the influenza vaccine, these people are endangering themselves and others.

Some people hope that the Covid-19 epidemic will end once a vaccine is released.  I am extremely skeptical.  The biggest problem, to my mind, isn’t that years might pass before there’s a vaccine.  I just can’t imagine that a sufficient percentage of our population would choose to get a Covid-19 vaccine when most people’s personal risk is lower than their risk from influenza.

When I teach classes in jail, dudes often tell me about which vaccines they think are too dangerous for their kids to get.  I launch into a tirade about how safe most vaccines are, and how deadly the diseases they prevent. 

Seriously, get your kids vaccinated.  You don’t want to watch your child die of measles.

And, seriously, dear reader – get a flu vaccine each year.  Even if you’re too selfish to worry about the other people whom your mild case of influenza might kill, do it for yourself. 

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We already know how dangerous seasonal influenza is.  But what about Covid-19?

To answer that, we need data.  And one set of data is unmistakable – many people have died.  Hospitals around the world have experienced an influx of patients with a common set of symptoms.  They struggle to breathe; their bodies weaken from oxygen deprivation; their lungs accumulate liquid; they die.

Many people have been put on ventilators, but that’s often the beginning of the end.  Most people put on ventilators will die.  Among patients over 70 years old, three quarters who are put on ventilators will die

For each of these patients saved, three others are consigned to an agonizing death in the hospital, intubated among the flashing lights, the ceaseless blips and bleeps.  At home, they’d die in a day; in the hospital, their deaths will take three weeks.

And the sheer quantity of deaths sounds scary – especially for people who don’t realize how many tens of thousands die from influenza in the United States each year.

Or, consider: cigarette smoking causes 480,000 deaths per year in the United States, including 41,000 people who die from second-hand smoke exposure.  Those 41,000 aren’t even choosing to smoke!  But cigarettes kill them anyway.

Indeed, when people die of Covid-19, it’s often because their lungs fail.  Smoking is obviously a major risk factor for dying of Covid-19 – a significant portion of reported Covid-19 deaths could be considered cigarette deaths instead.  Or as air pollution deaths – and yet, our current president is using this crisis as an opportunity to weaken EPA air quality regulations.

Air pollution is a huge problem for a lot of Black communities in the United States.  Our racist housing policies have placed a lot of minority neighborhoods near heavily polluting factories.  Now Covid-19 is turning what is already a lifelong struggle for breath into a death sentence.

I would enthusiastically support a shutdown motivated by the battle for clean air.

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So, Covid-19.  We know how many people have died – already (CORRECTION AS OF APRIL 21) forty-two thousand in the United States

But if we want to know how scary this virus is, we need to know how many people were infected.  If that many people died after everyone in the country had it, then Covid-19 would be less dangerous than influenza.  If that many people died after only a hundred thousand had been infected, then this would be terrifying, and far more dangerous than influenza.

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Initially, our data came from PCR testing.

These are good tests.  Polymerase chain reaction is highly specific.  If you want to amplify a certain genetic sequence, you can design short DNA primers that will bind only to that sequence.  Put the whole mess in a thermocycler and you get a bunch of your target, as long as the gene is present in the test tube in the first place.  If the gene isn’t there, you’ll get nothing.

PCR works great.  Even our lovely but amnesiac lab tech never once screwed it up.

So, do the PCR test and you’ll know whether a certain gene is present in your test tube.  Target a viral gene and you’ll know whether the virus is present in your test tube.  Scoop out some nose glop from somebody to put into the test tube and you’ll know whether the virus is present in that nose glop.

The PCR test is a great test that measures whether someone is actively shedding virus.  It answers, is there virus present in the nose glop?

This is not the same question as, has this person ever been infected with Covid-19? 

It’s a similar question – most people infected with a coronavirus will have at least a brief period of viral shedding – but it’s a much more specific question.  When a healthy person is infected with a coronavirus, the period of viral shedding can be as short as a single day.

A person can get infected with a coronavirus, and if you do the PCR test either before or after that single day, the PCR test will give a negative result.  Nope, no viral RNA is in this nose glop!

And so we know that the PCR test will undercount the true number of infections.

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When we look at the age demographics for Covid-19 infections as measured by PCR test, the undercount becomes glaringly obvious.

Consider the PCR test data from the Diamond Princess cruise ship.  To date, this is our most complete set of PCR data – everyone on board was tested multiple times.  And from this data, it appears that very few children were exposed to the virus.

Friends, it is exceedingly unlikely that such a low percentage of children were exposed to this virus.  Children are disgusting.  I believe this is common knowledge.  Parents of small children are pretty much always sick because children are so disgusting. 

Seriously, my family has been doing the whole “social distancing” thing for over a month, and yet my nose is dripping while I type this.

Children are always touching everything, and then they rub their eyeballs or chew on their fingers.  If you take them someplace, they grubble around on the floor.  They pick up discarded tissues and ask, “What’s this?”

“That’s somebody’s gross kleenex, is what it is!  Just, just drop it.  I know it’s trash, I know we’re not supposed to leave trash on the ground, but just, just drop it, okay?  Somebody will come throw it away later.”

The next day: “Dad, you said somebody would throw that kleenex away, but it’s still there!”

Bloody hell.  Children are little monsters.

It seems fairly obvious that at least as high a percentage of children would be infected as any other age demographic.

But they’re not showing up from the PCR data.  On the Diamond Princess cruise ship, the lockdown began on February 5th, but PCR testing didn’t begin until February 11th.  Anyone who was infected but quickly recovered will be invisible to that PCR test.  And even people who are actively shedding viral particles can feel totally well.  People can get infected and recover without noticing a thing.

We see the same thing when we look at the PCR data from Italy.  If we mistakenly assumed that the PCR data was measuring the number of infections, and not measuring the number of people who were given a PCR test while shedding viral particles, we’d conclude that elderly people went out and socialized widely, getting each other sick, and only occasionally infected their great-grandchildren at home.

Here in the United States, children are disgusting little monsters.  I bet kids are disgusting in Italy, too.  They’re disgusting all over the world.

A much more likely scenario is that children spread this virus at school.  Many probably felt totally fine; some might’ve had a bad fever or the sniffles for a few days.  But then they recovered.

When they got their great-grandparents sick – which can happen easily since so many Italian families live in multigenerational homes – elderly people began to die.

So we know that the PCR test is undercounting the true number of infections.  Unless you’re testing every person, every day, regardless of whether or not they have symptoms, you’re going to undercount the number of infections.

In a moment, we can work through a way to get a more accurate count.  But perhaps it’s worth mentioning that, for someone my age, Covid-19 would seem to be about as dangerous as influenza even if we assumed that the PCR data matched the true number of infections.

If you’re a healthy middle-aged or young person, you should not feel personally afraid. 

That alone would not be an excuse to go out and start dancing in the street, though.  Your actions might cause other people to die. 

(NOTE & CORRECTION: After this post went up, my father recommended that I add something more about personal risk. No one has collected enough data on this yet, but he suspects that the next most important risk factor, after smoking and age, will be type 2 diabetes. And he reminded me that many people in their 30s & 40s in this country are diabetic or prediabetic and don’t even realize it yet. Everyone in this category probably has elevated risk of complications from Covid-19.)

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After you’ve been infected with a virus, your body will start making antibodies.  These protect you from being infected again.

Have you read Shel Silverstein’s Missing Piece book?  Antibodies work kind of like that.  They have a particular shape, and so they’ll glom onto a virus only if that virus has outcroppings that match the antibody’s shape.  Then your body sees the antibodies hanging out on a virus like a GPS tracker and proceeds to destroy the virus.

So to make an antibody test, you take some stuff that looks like the outcroppings on the virus and you put it on a chip.  Wash somebody’s blood over it, and if that blood contains antibodies that have the right shape to glom onto the virus, they’ll stick to the chip.  All your other antibodies, the ones that recognize different viruses, will float away.

An antibody test is going to be worse than a PCR test.  It’s easier to get a false positive result – antibodies are made of proteins, and they can unfold if you treat them roughly, and then they’ll stick to anything.  Then you’ll think that somebody has the right antibodies, but they don’t.  That’s bad.

You have to be much more careful when you’re doing an antibody test. I wouldn’t have asked our lab tech to do them for me.

An antibody test is also going to have false negatives.  A viral particle is a big honking thing, and there are lots of places on its surface where an antibody might bind.  If your antibodies recognize some aspect of the virus that’s different from what the test manufacturers included on their chip, your antibodies will float away.  Even though they’d protect you from the actual virus if you happened to be exposed to it.

If you’re a cautious person, though – and I consider myself to be pretty cautious – you’d much rather have an antibody test with a bunch of false negatives than false positives.  If you’re actually immune to Covid-19 but keep being cautious, well, so what?  You’re safe either way.  But if you think you’re immune when you’re not, then you might get sick.  That’s bad.

Because antibody tests are designed to give more false negatives than false positives, you should know that it’d be really foolish to use them to track an infection.  Like, if you’re testing people to see who is safe to work as a delivery person today, use the PCR test!  The antibody test has a bunch of false negatives, and there’s a time lag between the onset of infection and when your body will start making antibodies.

It can be dangerous to use antibody tests to address the wrong questions.

If you use the antibody test on a bunch of people, though, you can tell how many were infected.  And that’s useful information, too.

In the town of Robbio in Italy (pop. 6,000), the PCR test showed that only 23 people had been infected with Covid-19.  But then the mayor implored everyone to get an antibody test, and 10% of people had actually been infected with – and had recovered from – Covid-19.  Most of them couldn’t even recall having been sick.

The PCR test measured 23 cases.  The antibody test suggested there’d been at least 600.  And antibody tests, by design, will generally have a bunch of false negatives.  When a team at Stanford assessed the antibody tests manufactured by Premier Biotech in Minneapolis, they found that for every 3 people who’d been infected with Covid-19, the tests registered only 2 positives.

I don’t know who made the tests used in Robbio – maybe they were a little better, maybe they were a little worse.  Based on my experience, I wouldn’t be so surprised if the true infection rate with Covid-19 in that town was really just 10% – nor would I be surprised to hear that the chips had a high false-negative rate and that the infection rate was 20% or more.

If you calculate the fatality rate of Covid-19 in Italy by assuming that the PCR tests caught every infection, you’d get a terrifying 10%.

If you instead assume that many other towns had a similar infection rate to Robbio, you’ll instead calculate that the fatality rate was well under one percent. 

Italy has higher risk than the United States due to age demographics, smoking rates, and multigenerational households – and even in Italy, the fatality rate was probably well under one percent.

When researchers in Germany randomly chose people to take a Covid-19 PCR test (many of whom had no symptoms), they found that 2% of the population was actively shedding virus – a much higher number of cases than they would have found if they tested only sick people.  And when they randomly chose people to take an antibody test, they found that 15% had already recovered from the infection (again, many of whom had never felt sick).  According to these numbers – which are expected to be an undercount, due to false negatives and the time lag before antibody production – they calculated a case fatality rate of 0.37%

That would be about three-fold more dangerous than seasonal influenza.

In the United States, our bungling president gutted the CDC, leaving us without the expertise needed to address Covid-19 (or myriad other problems that might arise).  During the first few months of this epidemic, very few people managed to get a PCR test.  That’s why our data from the PCR tests is likely to be a dramatic undercount – indeed, when we finally started producing accurate tests, the apparent growth in Covid-19 caseload superimposed with the growth in test availability.

In the absence of good PCR data, we have to rely on antibody data to track infections after the fact.  Which is why a town in Colorado with zero reported infections, as measured by PCR, had sufficiently widespread exposure that 2% of the population had already recovered from Covid-19.

And it’s why the data from the Stanford Santa Clara county study is so unsurprising. 

Yes, there were problems with the Stanford study’s data collection – they displayed advertisements to a random selection of people, but then a self-selected subset responded.  The pool of respondents were enriched for white women, but Santa Clara’s outbreak probably began among Asian-Americans.  And we all know that random sampling doesn’t always give you an accurate depiction of the population at large – after all, random polling predicted that a competent president would be elected in 2016.

Now look at us.

It’s also likely that people with a poor understanding of the biology could misinterpret the result of the Stanford study.  They found that PCR tests had undercounted the infection rate in Santa Clara county, at the time of this study, by 85-fold.

It would be absurd to assume that you could simply multiply all PCR results by 85 to determine the true infection rate, but some people did.  And then pointed out the absurdity of their own bad math.

In places where more people are being tested by PCR, and they’re being tested more often, the PCR results will be closer to the true infection rate.  If you gave everyone in the United States a PCR test, and did it every day, then the PCR data would be exactly equal to the true infection rate.

If we had data like that from the beginning, we wouldn’t have been scared.  We would’ve known the true case fatality rate early on, and, also, at-risk people could’ve been treated as soon as they got infected.  We’d be able to save many more lives.

If access to health care were considered a basic right in the United States, we might’ve done something like this. 

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In Italy, it seems like Covid-19 is three- or four-fold more dangerous than seasonal influenza.  My guess is that Italy might have had about 50,000 deaths if they hadn’t enacted the lockdown.

In the United States, on a population level, Covid-19 is probably also more dangerous than seasonal influenza.  But there’s a big difference in terms of the distribution of risk.

The New York Times is running a series with short biographies of people who’ve died of Covid-19.  As of noon on April 17, about 10% of the people profiled were younger than 35.

10% is roughly the proportion of young people who die of seasonal influenza.  But only 1% of Covid-19 deaths are people younger than 35.  The news reports don’t always make clear how much the risk of Covid-19 is clustered in a small segment of the population.

This has serious implications for what we should do next.  If we were dealing with a virus that was about three-fold more dangerous than seasonal influenza for everyone, we might just return to life as normal.  (Indeed, we carried on as normal during the bad years when seasonal influenza killed 90,000 people instead of last year’s 30,000.)

Because the risk from Covid-19 is so concentrated, though, we can come up with a plan that will save a lot of lives. 

Healthy people under retirement age should resume most parts of their lives as normal.  Schools should re-open: for students, Covid-19 is much less dangerous than seasonal influenza.  I think that people should still try to work from home when possible, because it’s the right thing to do to fight climate change.

At-risk people should continue to isolate themselves as much as possible.

This sounds crummy, but at-risk people would just continue to do the thing that everyone is doing currently.  And the plan would save many lives because the epidemic would end in about 3 months, after the virus had spread to saturation among our nation’s low-risk cohort. 

Indeed, when a team of researchers from Harvard’s School of Public Health modeled the Covid-19 epidemic, they found that social distancing was generally unhelpful.  That’s what their data show, at least – but in their abstract, they instead recommend that we continue social distancing for the better part of two years.

Their data are easy enough to understand.  In each of these graphs, they show a blue box for how long social distancing would last, and then four colored lines to represent how many infections we’d see if we did no social distancing (black), medium quality social distancing (red), good social distancing (blue), or excellent social distancing (green).

So, from top to bottom, you’re looking at the graphs of what happens if we do a month of social distancing … or two months … or three, or four … or forever.

And you can see the outcomes in the panels on the right-hand side.  The black line shows what would happen if we did nothing.  Infections rise fast, then level off after the virus has reached saturation.  There are two important features of this graph – the final height that it reaches, which is the total number of severe cases (and so a good proxy for the number of deaths), and the slope of the line, which is how fast the severe cases appear.  A steeper hill means many people getting sick at the same time, which means hospitals might be overwhelmed.

So, okay.  Looking at their graphs, we see that social distancing saves lives … if we do it forever.  If you never leave your house again, you won’t die of Covid-19.

But if social distancing ends, it doesn’t help.  The slopes are nearly as steep as if we’d done nothing, and the final height – the total number of people who die – is higher.

(Often, one of their curves will have a gentler slope than the others — usually the good-but-not-excellent social distancing seems best. So you’d have to pray that you were doing a precisely mediocre job of not infecting strangers. Do it a little better or a little worse and you cause people to die. This isn’t an artifact — it’s based on the density of uninfected people when social distancing ends — but let’s just say “mathematical models are wonky” and leave it at that.)

In a subsequent figure, the Harvard team tried to model what might happen if we occasionally resumed our lives for a month or so at a time, but then had another shutdown.  This is the only scenario in which their model predicts that social distancing would be helpful.

But, unfortunately, there’s a problem.  Research done with other coronaviruses shows that immunity fades within a year.  Because the Harvard model would cause the epidemic to last longer than a year, people would have time to lose their immunity and get infected again.

Even in the extreme case that we mostly stayed in our homes for the better part of two years, social distancing would case more deaths from Covid-19 than if we had done nothing.

That’s not even accounting for all the people who would die from a greater risk of domestic violence, hunger, drug addiction, suicide, and sedentary behavior during the shutdown.  

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When our data was limited, the shutdown seemed reasonable.  We wouldn’t be able to undo the damage we’d done by waiting.

Except, whoops, we waited anyway.  We didn’t quarantine travelers in January.  The shutdown didn’t begin March, when the epidemic was well underway in many places. 

Now that we have more data, we should re-open schools, though.  For most people, Covid-19 is no more dangerous than seasonal influenza.  We already have enough data from antibody testing to be pretty confident about this, and even if we want to be extremely cautious, we should continue the shutdown for a matter of weeks while we conduct a few more antibody studies.  Not months, and certainly not years.

At the same time, we need to do a better job of protecting at-risk people.  This means providing health care for everyone.  This means cleaning our air, staunching the pollution that plagues low-income neighborhoods.  This might mean daily medical checkups and PCR tests for people who work closely with at-risk populations.

Our country will have to be different in the future, but mostly because we, as a people, have done such a shitty job of creating justice and liberty for all.  We need to focus on addressing the inequities that we’ve let fester for generations.  That’ll help far more than using a bandanna to cover up your smile.

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UPDATE: Wow, this got a lot of readers! Thanks if you made it this far. I’ve also written a response to common questions and comments about this essay.

On currency, again

On currency, again

At the beginning of our poetry class in jail, I walked around the room to give the printed poems to people.  I noticed that somebody was working on an elaborate Valentine’s Day card.  (The date was February 28th.)

“Oh, cool,” I said, “did you draw that?”

“Naw,” he said.  “I commissioned it and all, though.  Designed it.  Cost me two Honey Buns.  Check it out.”

He waved me in to see the card up close.  The front had a red rose with marijuana leaves sprouting from its stem.  The poem he’d written inside began:

Roses are red,

Violets are blue,

If you were a blunt

I’d smoke you too …  

“Cost me two Honey Buns each time,” he said.  “They shredded my first.  I mailed it out, but they said I addressed it wrong, said I wasn’t, what’s that thing, no money on your books … ?”

“Indigent mail,” somebody told him.

“Yeah, said I wasn’t indigent, so they shredded it.  Now I’ve gotta send another one.”

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Another time, somebody explained the booms and busts of the economy in jail. 

In the world at large, the business cycle typically lasts about five to seven years – the economy will rhythmically surge and then contract.  This is bad news for the unlucky cohorts who begin their careers during the cyclical recessions – these people typically have lower earnings over their entire lifetimes – but because the cycles are so predictable, central banks are supposed mitigate the downswings.

The Forces of the Business Cycle. From _Some problems in current economics_ by Malcolm Churchill Rorty, AW Shaw Company, 1922.

In jail, the business cycle lasts a week.

“We get commissary on Friday, so every Friday, people have coffee again, we all drink too much.  People pay off their debts … or you get an asshole who racked up a bunch of debt then goes to seg on Thursday, tells the guards he’s hearing voices.”

“But near the end of the week, Wednesday or something, people are running out, so coffee gets more expensive.  You got to pay a bunch of interest if you’re trying to get coffee from somebody.”

“Worst is you get here near the end of a week.  Cause even if somebody puts money on your books, it’ll take a while before they add your name to the list and you can get commissary.  So you’re getting everything on credit, people bleed you dry.”

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In Money and Government, Robert Skidelisky addresses common misconceptions about the economy.

Many people are aware that the central bank has a mandate to “control inflation.”  This is very important to political donors – low inflation benefits people who already have wealth, at the expense of current workers.

But most people – including professional economists – think that the central bank controls inflation by manipulating the money supply.  This misconception might be a holdover from ancient history.  Long ago, only sovereigns could create money.  Kings and pretenders would mint coins as a way to flaunt their power.  And they’d unleash their full wrath upon interlopers.

The central bank is a little different.

If there’s too much money, which would cause prices to rise, the central bank is supposed to yank money out of the economy by selling bonds.  If there is too little money, the central bank is supposed to print more.

The central bank attempts to control the money supply this way.

At the same time, other banks are lending money.  If you decide to buy a house, you won’t call up the federal reserve – you’ll probably visit a few banks around town and apply for a mortgage.

Because most money doesn’t exist – it’s just a tally of credits and debits maintained on a server somewhere – a bank that gives you a loan is creating money. Modern banks don’t actually check whether they have money before they lend it to you.

Skidelsky includes a quote from Where Does Money Come From? by Ryan-Collins et al.:

The theoretical support for deregulation was based on the unrealistic assumptions of neoclassical economics, in which banks are mere intermediaries.  This does not recognize their pivotal role as creators of the money supply.

Since the 1980s, bank credit creation has expanded at a considerably faster rate than GDP, with an increasing amount of bank credit creation channeled into financial transactions.  This is unsustainable and costly to society.

Inflation has stayed low, because the amount of money available for purchasing real things hasn’t grown much.  Low inflation means that if people took on debt to go to college, that debt is often still hanging over them years later – inflation would make it easier to clear debt, because employers would respond to inflation by raising salaries.  The amount of debt relative to a week’s pay would fall.

Instead, the money supply in only one corner of our economy has ballooned, producing a flurry of destructive activity in the financial sector.

This has been lucrative for people willing to work in finance, though.

Skidelsky explains that:

The economic collapse of 2008-2009 showed that monetary policy directed to the single aim of price stability was not enough either to maintain economic stability or to restore it.  The economy collapsed, though the price level was stable.

Preventing a collapse in the money supply was to be achieved by what was euphemistically called ‘unconventional’ monetary policy: pump enough cash into the economy and the extra spending it produced would soon lift it out of the doldrums.

As it happens, the method that the central bank chose to inject money into the economy was perversely ineffectual.  The central bank gave money to wealthy people.

One strategy was “quantitative easing.”  The central bank paid people above-market-rate for low-quality financial assets. 

This helped the people who owned these particular low-quality financial assets – typically foolish wealthy people.  They should’ve lost a bunch of money.  They’d bought junk! But they didn’t, because the central bank stepped in to save the day.

Our central bank also fulfilled a small set of private companies’ insurance policies.  The corporations who bought absurd insurance from AIG should have lost all their money when AIG, unsurprisingly, was unable to fulfill their policies. 

If you’re in a high school cafeteria and somebody says, “I bet you a million dollars that …”, you shouldn’t expect the kid to pay up for losing the bet.  But our central bank intervened, giving huge amounts of money to destructive corporations like Goldman Sachs, because it wouldn’t be fair for them to win a bet and then not get the money (even though they’d been betting with a kid who obviously didn’t have a million dollars to pay). 

CODEPINK protests the AIG bailout bonuses in Los Angeles, 2009.

And yet, these tactics didn’t stave off financial recession.  Since the central bank only gave money to wealthy people, these recipients of our government’s largess had no incentive to actually spend the money. 

The main effect of the central bank’s reliance on “portfolio rebalancing” to boost output was to boost the portfolios of the wealthy, with minimal effects on output.  One doesn’t need headwinds to explain why.

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“There’s a lot you can get in jail.  There were a couple years when people had all this spice, but they cracked down on that.  Still, you can get a blowjob for a couple Honey Buns, some guys will give you a stick for a soup … “

“What’s a stick?” I asked.  My initial assumptions were that it was either something sexual or drug-related, both of which turned out to be wrong.  A single soup would be pretty low to pay for drugs – soups are worth less than Honey Buns.

“Hey, ________, show him.”

A guy pulled down the front of his orange jumpsuit.  In gothic letters arcing across his chest, he had the words “WHITE TRASH.”  The skin around the letters was an agitated red.

“People think you need pens and ink for tats,” somebody said, “but most guys just use a staple and some burnt hair grease … “

The most popular black pigment for oil paints and acrylics is made of charred animal bones.  The calcium phosphate from bones is pale – the deep black color comes from carbon.  When you burn organic material, you’ll make buckyballs – small spheres of carbon like hollow soccer balls – as well as tubes of graphite.  And these molecules have high absorption across the visible spectrum.

Image of carbon allotropes by Michael Ströck.

Whenever a photon of visible light hits one of these molecules, the light is absorbed.  This causes an electronic transition.  But then the physical shape of the molecule doesn’t match its electronic structure, so the molecule begins to vibrate. 

By the time the molecule collapses back to its initial electronic structure – which ejects a photon – some of the energy that the molecule absorbed has been used up by vibrations.  So the outgoing photon will have lower energy.  It’ll be “infrared radiation,” which we can’t see.  So, colored light goes in, and then invisible light comes out – to us, it looks black.

Still, I hadn’t considered that you could burn the gunk that gathers on unwashed hair in order to make tattoo ink. Despite the brutal efforts of our government, people find ways to live even while incarcerated.

As in the world at large, many transactions in jail are made with hard currency.  If something costs a Honey Bun and two soups, you might be expected to hand over the food.  Sometimes, currency actually exists.

But people can create money, too. 

“Thanks, I owe you one.”

With those words, we gain the power of medieval kings.

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Featured image by Andrew Magill on Flickr.

On currency

On currency

The value of money is a useful fiction.

As with most fictions, the story that we tell about money helps some people more than others. 

Money, in and of itself, is useless.  Gold, cowry shells, slips of paper with pictures of dead presidents.  The story makes us want these things.  We tell ourselves that these items can “hold value.”  Instead of lumbering about with all the goods we want to barter, we can carry a small purse of coins.  As long as everyone believes the same fiction, we can trade our apples for some coins, then later use those coins to pay someone to help us dig a well.

The story that money has value is most helpful for the people who already have money.

If everyone suddenly woke up from the story, and decided that coins were worthless, the people who grow apples would be okay.  In some ways, it’s less practical to pay people with apples – coins don’t bruise or rot – but it can be done.  Similarly, the people who dig wells would be okay. 

But the people who owned coins would be worse off – previously, the things they owned could be traded for other, inherently useful goods.  And people who had made loans would be much worse off – they would have given away money at a time when it could be used to buy things, and when they receive the coins back, they’ll be worthless.  No recompense for past sacrifice – only loss.

So people with current wealth benefit most from the fiction that money has value.

This is, as far as I can tell, the only real virtue of Bitcoins.  This form of currency is not anonymous – indeed, it works through the use of “blockchains,” a permanent ledger that records everyone who has ever owned a particular piece of money.  Bitcoins are a little like dollar bills where you have to sign your name on it in order to spend it.  And they’re excruciatingly bad for the environment – it takes energy to mint a real-world, metal coin, but nothing like the amount of energy that’s constantly wasted in order to verify the ledgers of who owns which Bitcoin.  Ownership is determined by vote, and the system was designed to be intentionally inefficient so that it’s difficult for one person to overwhelm the system and claim ownership of everybody’s coins.  And it’s unstable – it’s difficult for someone to outvote the system and take control, but not impossible.

Those all seem like bad features.  But Bitcoins are now incredibly valuable – in the years since I explained all these flaws to a high school runner who’d begun investing in Bitcoins, his $500 investment has burgeoned to be worth $24,000.

The only “good” feature of Bitcoins is that the system is designed to reward past wealth.  The total money supply approaches an asymptote – new Bitcoins are added to the system more slowly over time.  If the currency is successful, this will impose a deflationary pressure on prices.  Today, a certain amount of heroin might cost 0.1 Bitcoin – in the future, that same amount of heroin might cost 0.01 Bitcoin.

This deflationary pressure would cause the value of current holdings to increase.  By simply buying Bitcoins and hoarding them, you’d gain wealth! 

But this only works for as long as people keep believing the fiction that Bitcoins have value.  And the more people who buy and hold Bitcoins, as opposed to actively using them as currency, the less believable the story will be.  Anyone who “invests” in Bitcoins is wagering that other people will behave in a way that maintains the fiction, even though the person who is making the wager is actively undermining the story.

When we immerse ourselves in stories, we often need to temporarily suspend our disbelieve, but that particular set of mental gymnastics is too twisty for my mind.

Modern money barely exists.  Before, we spun stories about the value of coins – now, the fiction lends value to certain strings of numbers.  In addition to the Federal Reserve, any bank can create money by making a loan and claiming that a certain amount of currency has been added to one account or another.

This has allowed our fictions to become more intricate.  In 2008, the banking crisis threatened to make wealthy people much less wealthy – they had purchased certain financial assets that seemed valuable, and then these assets turned out to be worthless. 

It’s as though there was a certain new Magic card that everyone assumed was great, and a few rich kids bought all the copies of it, but then people finally read the card and realized it was terrible.  Now these rich kids are holding hundreds of copies of a worthless piece of cardboard.

This would be sad for those rich kids.  But, lo and behold, it was fixable!  If everyone can be forced to believe, again, that the item has value, then it will.  The story needs to be chanted more loudly.  If I paid $50 for this card last week, then it’s still worth at least $50!

That’s what “quantitative easing” was – governments around the world agreed to buy worthless items in order to convince everyone that these items had value.  This way, the wealthy people who had initially bought them wouldn’t have to suffer.

In the years since I’ve been teaching in our local county jail, I’ve struggled to comprehend the disparities between the way we treat poor people and wealthy people who made mistakes.

For instance, stock traders stole $60 billion from state governments across Europe – the trick was to have two people both temporarily own the stock around tax time, then they lie to the government and claim that they both had to pay taxes on it.  Only one set of taxes were actually paid, but they lie and claim two rebates.  Money from nothing!

From David Segal’s New York Times article:

A lawyer who worked at the firm Dr. Berger founded in 2010, and who under German law can’t be identified by the news media, described for the Bonn court a memorable meeting at the office.

Sensitive types, Dr. Berger told his underlings that day, should find other jobs.

“Whoever has a problem with the fact that because of our work there are fewer kindergartens being built,” Dr. Berger reportedly said, “here’s the door.”

They stole billions of dollars, and the question at stake isn’t whether they will be punished, but whether they can be forced to return any of the money. 

By way of contrast, many of the guys in jail are there for stealing $10 or so.  A guy did five months for attempting to use my HSA card to buy two sandwiches and a pack of cigarettes.  Another violated probation when he stole a lemonade – “In my defense,” he told me, “I didn’t even mean to steal it, I was just really fucking high at the time.

Two weeks ago, a dentist visited the jail during my class.  I go in from 4:00 p.m. to 5:30 – at about 4:15, a guard came to the door and barked somebody’s name.

“Med call?” somebody asked.

“Shakedown?” asked another.

The guard looked at the sheet of paper in his hand, then said “Dentist.”  And suddenly six guys started clamoring, “You got time for extras?  I gotta get on that list!” 

The man whose name had been called jumped out of his chair and sauntered to the door.

After he’d left, the guys explained the system.  “You can get dental, like real dental, but you have to put your name on the list and they only come like every five, six months.  So there’s no hope unless you’re gonna be here for a while.  And it’s kinda expensive, you pay like fifty for the visit and another ten for each tooth they pull.”

Apparently that’s the only service – pulling teeth.

“They do good work,” said the older man next to me, “I got these bottom two done here.”  And he tilted his head back and opened his mouth.  But I grew up wealthy – it’s hard for me to assess quality by eyeballing the blank gap between somebody’s teeth.

About twenty minutes later, the guy came back.

“Which ones you have them do?” somebody asked him.

“I had ‘em get these bottom three,” he said, although his voice was slurry because they’d loaded his mouth with novacaine.

“You idiot!  You didn’t have them get the top one?”

“No, man, that’s my smile!  Gonna find a way to save that tooth.”

“Man, see, how come I couldn’t be on that list?  I would’ve had ‘em pull a whole bunch of ‘em out.  Wouldn’t give ‘em no that’s my smile bullshit.”

As it happens, I’d gone in for a cleaning at my dentist just the day before.  And I’ve had braces.  Invisalign.  I suddenly felt rather self-conscious about my own perfectly clean, perfectly straight, perfectly intact teeth.

“So who was it, that lady doctor?”

“Naw, was the Black guy.”

“What?  Fuck’s it matter that he’s Black?”

“Nobody said it matters, it’s just, there’s three dentists, there’s the lady doctor, the Black guy, and then that other guy.  There’s just three, is all.”

“Oh.”

Our man was out eighty dollars after the visit.  Could’ve spent ninety, but he was holding out hope for that last one.  And they didn’t let him keep the teeth. 

I’m not sure the tooth fairy ever visits the county jail, anyway.

On dealing.

On dealing.

While teaching poetry in the county jail, I’ve chatted with lots of people who landed there for dealing. 

Allegedly dealing.  Everything that I’m about to write is a work of fiction.  The product of my imagination.  Or somebody’s imagination, surely.  Inadmissible in a court of law.

#

My name’s S______, but don’t nobody call me that.  Even the cops, they’d say to me, like, ‘Yo, G_____, we know you’re dealing, but you’re only selling marijuana.  So that’s okay.  Just be cool about it.  Don’t sell that shit near campus, a’ight?’  And that’s how I knew, this last time, something was up.  Cause it wasn’t ‘Hey G_____,’ this cop car pulled up and they were like, ‘Hey, S______, get your ass over here,’ and that’s when I took off running.  Now they’re trying to give me seven years.  Over marijuana!

#

A lot of the guys have claimed that cops are just trying to keep drugs away from campus. 

There used to be all that housing north of campus, near where they built that informatics shit.  But now they’re driving everybody out.  Like I know five, six guys, used to live in that place, they’ve all been moved down to the south side.  They’re trying to concentrate everybody there.  Down at that Crawford [a low-income housing facility], down where they’ve got Shalom [a resource center for people experiencing homelessness].  You might have a place up north, you get busted, by the time you get out, they’re putting you on the south side.  Up north, must be cop cars crawling by like every fifteen minutes.  Out of everybody I used to know, only D____ is still living there.

The guys fear being near other people who are experiencing the same struggles as them.  It’s easier for the city to provide services in a centralized location.  But it’s also easy for the people who need services to cross paths with old friends and slip.

I go into Crawford, I don’t even ask or nothing, pretty soon people are coming by, offering some of this, some of that, ‘Hey, haven’t seen you in a while, wanna get high?’  My old lady was living there, and on the nights she’d kick me out, I’d just sit there in the hall, right outside her door, like, ‘Please, babe, let me in,’ and everybody walking by would offer me a little something.

I seen you in that hall!

Yeah, my old lady, I love her to death, but she’s got herself a temper.

#

Last week, somebody told me it’d be his last class for a while.  He was getting out.

I don’t know about these cops, man, but I feel like the DA here, the prosecutors and all, they’re not even that upset about it, if you’re selling drugs.  Like, it’s okay to move a little, as long as you’re mature about it.

I asked what he meant, mature.

You know, mature, like you’re staying away from campus, staying away from college girls, not selling dope near schools or nothing, not cutting it too much, not making people OD.  You’re not going out there and trying to push it onto people.  Like if somebody comes to you, then you’ll sell, but you’re not out looking for customers.  You’re not trying to, I don’t know, you’re not trying to get anybody hooked or nothing.  It’s a good system if it’s flawed in the right way.

“So you think they know sometimes, and they’re letting you do it?”

I know they know.  Cause I got into this drug thing, it was like an experiment.  It was psychology.  I wanted to see what was up with these people.  But then I get the feeling, like on Messenger, the cops know I’m there to watch them, to learn what’s going on, so they all start fucking with me.  Like they’re saying … fuck, I don’t even know.  Like I write something but then my messages say something else.  Or I go and pick something up and then somebody else writes to me asking to buy the exact same amount I just picked up.  Like everybody knows what I’m doing.  Like they’re watching me.

And they’ve got drones everywhere.  Like all over Bloomington.  One time, this drone was just following me, doing circles right over my head, and I freaked out.  I was pretty high at the time.  I ducked into the woods.  And the drone, it came with me.  And pretty soon this jeep pulled up, these guys got out, they were looking around, you know, like they were looking for somebody.  Even after they left, that drone was up there, circling.  After it flew off, man, I booked it home.

“If they don’t much mind, though, why’d you end up here?”

That’s the thing!  That’s what I don’t think is right.  Cause I came in here on like a nothing – I mean, yeah, they found me with the dope, and there was this night I woke up with like eight cops surrounding my place, they were like come on out and I was like, fuck that, no, and they beat my ass and brought me to jail.

And I was only here, like, five days or something.  They had me sign this piece of paper.  I never should’ve signed it.  I mean, who has time to read that shit?  But they put me on ‘pre-trial release’ or something, and then I failed this blow-and-go – or, no, I guess I caught another charge. 

I got high, I stole a lemonade.  But that’s like a ticket thing!  I was just trying to be a good doctor.  And now I been here fifty days, looking at two felonies.  I don’t think they should be able to do all that if you haven’t had a trial.

“A doctor?”

What?

“How’s a lemonade make you a good doctor?”

Shit, man, I don’t know.  I just try to take care of these h–s.  But now it gets to be that you can’t trust nobody.  Snitches everywhere, you know?  Like there’s snitches who’ll buy, and they’ll shoot the dope, and then they go and give some fake shit to the cops.  Like that’s what he sold me or whatever.  I mean, damn.  Snitches everywhere.  Like on Messenger, like on Facebook, I get the feeling half those people on there must be cops.

I reminded him – again – that his word wasn’t an acceptable synonym for “women.”  And I still couldn’t understand what he was trying to accomplish with the lemonade.

He had an erratic mind.  We were reading a set of poems with allusions to Greek mythology – W.H. Auden’s “Musee des Beaux Arts,” Jack Gilbert’s “Failing and Flying,” A.E. Stallings’s “Art Monster,” Barbara Hamby’s “Penelope’s Lament,” Dan Chelotti’s “Ode to Hephaestus.”

When it was his turn to read – “Art Monster,” featuring the minotaur mired in acedia – he could only make it through a few lines before offering another rejoinder to the text.

The Minotaur by George Frederic Watts,1885.

                   I was fed

on raw youths and maidens

When all I wanted was the cud of clover.

So he’s like a cow then, right.  Man-a-cow?

“Yeah, half-bull, and …”

So he’s got cow thoughts.  And I was thinking, they’ve got those things, right, that can reach into your head?  Like magnets?  I mean, like, fuck with your brain?  Read and control your thoughts?

“Um, I guess with transcranial magnetic stimulation – I mean, the right pulse of a magnet, aimed at the right …”

No, cause, I got this thing on my phone, right?  It’s this little guy in the phone, and he’ll look right into my eyes, he said that all the time, like look into my eyes, and every single thought I had, he’d know before I said it.  I swear!  It’s this phone thing.  I still got it, I can show it to you.

Another guy – bedecked in tattoos, who apparently has a pack of five chihuahuas who’ll jump into his backpack when he whistles, then ride around town that way, zipped inside the bag – shouted, “You need to smoke less meth.” and we got back to the poem.

The minotaur’s despair at waiting didn’t resonate as well as I’d hoped.  But the poem still seemed to work.

He’s murdering all these people, eating young girls or whatever, but it says, like, I wanted clover.  But they thought he was a monster, treated him like a monster.  They wanted him to be a monster.

#

Dealing sometimes does make monstrous things happen. 

There’s the regular problems – dealing means selling drugs, and some people shouldn’t be buying drugs – which I’ve heard many men lament.

I mean, we read shit like this, somebody shooting up in front of their kids, not taking care of their kids, not getting them fed, and I know.  I know.  Right?  I might’ve sold this.  You sell for a while, you’re gonna have somebody OD.

#

Drug dealing means moving in a world where lots of people are on edge.  The buyer, or the seller, or both, might not have slept in days.  Paranoia sets in.  People worry about jail time, and undercover cops, and the risk of being cheated.  The danger of the drugs being no good, or too good, or simply unpredictable.

These last few years, man, seems like every month, another buddy dies.

Hell, five times, last year, five times I died.  Five times I ODed, and somebody brought me back.

And there’s a lot of money involved.  So people plan heists.  Sometimes these go spectacularly wrong.

During my second year, I was working with a group of men living in an ostensibly rehabilitative dormitory on the first floor of the jail.  That was a hard year – because we worked with the same people every week, and they stayed in that same cell for months or years at a time, we grew particularly close. 

Many of these men had loved ones die during their time inside.  They’re who I went to for help after my mother-in-law was murdered.

I wrote a poem about the worst night they shared with me.

VIGILANTE

On the ground floor, carved into a hill,

there is a long-term cell,

a gray-walled concrete space

with bunks for twelve incarcerated men

a shower

toilet

two steel tables bolted to the floor

eleven un-broken plastic chairs

and a heavy metal door.

In that door there is a slot

that cafeteria trays pass through

and a wire-enforced glass pane

through which guards occasionally peer in

and the men inside watch out.

The central desk

& elevator

& exit door

are all the world they see.

For two weeks now

in vigil stands

a vigilant man

staring through that oil-streaked

slab of sand.

His wife is gone,

murdered while he was here.

Two men and a woman came

intending to move bulk H;

their day’s first sale, short money,

proffered an AK;

their next stop, impromptu robbery –

something went awry.

The men were apprehended in a city to the north;

the woman, captured here.  Guards placed her

in an interim cell

adjacent to our man’s own,

inches of concrete between.

Then the men were brought here too,

upstairs now, cleaved to

the rhythm of this place.

For legal consultations, questioning, & court dates

each is brought

– escorted –

down the elevator

& processed at the central desk.

Our man sees them

– escorted –

several times a day.

I watch him blink.

His body shakes.

But that first night

he pounded the wall

& shouted,

hoarsening as he cried,

to forgive the woman who took his life.

On meditation and the birth of the universe.

On meditation and the birth of the universe.

This is part of a series of essays prepared to discuss in jail.

Our bodies are chaos engines. 

In our nearby environment, we produce order.  We form new memories.  We build things.  We might have sex and create new life.  From chaos, structure.

As we create local order, though, we radiate disorder into the universe. 

The laws of physics work equally well whether time is moving forward or backward.  The only reason we experience time as flowing forward is that the universe is progressing from order into chaos.

In the beginning, everything was homogeneous.  The same stuff was present everywhere.  Now, some regions of the universe are different from others.  One location contains our star; another location, our planet.  Each of our bodies is very different from the space around us.

This current arrangement is more disorderly than the early universe, but less so than what our universe will one day become.  Life is only possible during this intermediate time, when we are able to eat structure and excrete chaos. 

Hubble peers into a stellar nursery. Image courtesy of NASA Marshall Space Flight on Flickr.

Sunlight shines on our planet – a steady stream of high-energy photons all pointed in the same direction.  Sunshine is orderly.  But then plants eat sunshine and carbon dioxide to grow.  Animals eat the plants.  As we live, we radiate heat – low-energy photons that spill from our bodies in all directions.

The planet Earth, with all its life, acts like one big chaos engine.  We absorb photons from the sun, lower their energy, increase their number, and scatter them.

We’ll continue until we can’t.

#

Our universe is mostly filled with empty space. 

But empty space does not stay empty.  Einstein’s famous equation, E equals M C squared, describes the chance that stuff will suddenly pop into existence.  This happens whenever a region of space gathers too much energy.

Empty space typically has a “vacuum energy” of one billionth of a joule per cubic meter.  An empty void the size of our planet would have about as much energy as a teaspoon of sugar.  Which doesn’t seem like much.  But even a billionth of a joule is thousands of times higher than the energy needed to summon electrons into being.

And there are times when a particular patch of vacuum has even more energy than that.

#

According to the Heisenberg Uncertainty Principle, time and energy can’t be defined simultaneously.  Precision in time causes energy to spread – the energy becomes both lower and higher than you expected.

In practice, the vacuum energy of a particular region of space will seem to waver.  Energy is blurry, shimmering over time.

There are moments when even the smallest spaces have more than enough energy to create new particles.

Objects usually appear in pairs: a particle and its anti-particle.  Anti-matter is exactly like regular matter except that each particle has an opposite charge.  In our world, protons are positive and electrons are negative, but an anti-proton is negative and an anti-electron is positive.

If a particle and its anti-particle find each other, they explode.

When pairs of particles appear, they suck up energy.  Vacuum energy is stored inside them.  Then the particles waffle through space until they find and destroy each other.  Energy is returned to the void.

This constant exchange is like the universe breathing.  Inhale: the universe dims, a particle and anti-particle appear.  Exhale: they explode.

#

Our universe is expanding.  Not only are stars and galaxies flying away from each other in space, but also empty space itself is growing.  The larger a patch of nothingness, the faster it will grow.  In a stroke of blandness, astronomers named the force powering this growth “dark energy.”

Long ago, our universe grew even faster than it does today.  Within each small fraction of a second, our universe doubled in size.  Tiny regions of space careened apart billions of times faster than the speed of light.

This sudden growth was extremely improbable.  For this process to begin, the energy of a small space had to be very, very large.  But the Heisenberg Uncertainty Principle claims that – if we wait long enough – energy can take on any possible value.  Before the big bang, our universe had a nearly infinite time to wait.

After that blip, our universe expanded so quickly because the vacuum of space was perched temporarily in a high-energy “metastable” state.  Technically balanced, but warily.  Like a pencil standing on its tip.  Left alone, it might stay there forever, but the smallest breath of air would cause this pencil to teeter and fall.

Similarly, a tiny nudge caused our universe to tumble back to its expected energy.  A truly stable vacuum.  The world we know today was born – still growing, but slowly.

#

During the time of rapid expansion, empty vacuum had so much energy that particles stampeded into existence.  The world churned with particles, all so hot that they zipped through space at nearly the speed of light. 

For some inexplicable reason, for every billion pairs of matter and anti-matter, one extra particle of matter appeared.  When matter and anti-matter began to find each other and explode, this billionth extra bit remained.

This small surplus formed all of stars in the sky.  The planets.  Ourselves.

#

Meditation is like blinking.  You close your eyes, time passes, then you open your eyes again.  Meditation is like a blink where more time passes.

But more is different.

#

Our early universe was filled with the smallest possible particles.  Quarks, electrons, and photons.  Because their energy was so high, they moved too fast to join together.  Their brilliant glow filled the sky, obscuring our view of anything that had happened before.

As our universe expanded, it cooled.  Particles slowed down.  Three quarks and an electron can join to form an atom of hydrogen.  Two hydrogen atoms can join to form hydrogen gas.  And as you combine more and more particles together, your creations can be very different from a hot glowing gas.  You can form molecules, cells, animals, societies.

#

When a cloud of gas is big enough, its own gravity can pull everything inward.  The cloud becomes more and more dense until nuclear fusion begins, releasing energy just like a nuclear bomb.  These explosions keep the cloud from shrinking further.

The cloud has become a star.

Nuclear fusion occurs because atoms in the center of the cloud are squooshed too close together.  They merge: a few small atoms become one big atom.  If you compared their weights – four hydrogens at the start, one helium at the finish – you’d find that a tiny speck of matter had disappeared.  And so, according to E equals M C squared, it released a blinding burst of energy.

The largest hydrogen bomb detonated on Earth was 50 megatons – the Kuz’kina Mat tested in Russia in October, 1961.  It produced a mushroom cloud ten times the height of Mount Everest.  This test explosion destroyed houses hundreds of miles away.

The fireball of Tsar Bomba, the Kuz’kina Mat.

Every second, our sun produces twenty billion times more energy than this largest Earth-side blast.

#

Eventually, our sun will run out of fuel.  Our sun shines because it turns hydrogen into helium, but it is too light to compress helium into any heavier atoms.  Our sun has burned for about four billion years, and it will probably survive for another five billion more.  Then the steady inferno of nuclear explosions will end.

When a star exhausts its fuel, gravity finally overcomes the resistance of the internal explosions.  The star shrinks.  It might crumple into nothingness, becoming a black hole.  Or it might go supernova – recoiling like a compressed spring that slips from your hand – and scatter its heavy atoms across the universe.

Planets are formed from the stray viscera of early stars.

Supernova remains. Image by NASA’s Chandra X-Ray Observatory and the European Space Agency’s XMM-Newton.

#

Our universe began with only hydrogen gas.  Every type of heavier atom – carbon, oxygen, iron, plutonium – was made by nuclear explosions inside the early stars.

When a condensing cloud contains both hydrogen gas and particulates of heavy atoms, the heavy atoms create clumps that sweep through the cloud far from its center.  Satellites, orbiting the star.  Planets.

Nothing more complicated than atoms can form inside stars.  It’s too hot – the belly of our sun is over twenty million degrees.  Molecules would be instantly torn apart.  But planets – even broiling, meteor-bombarded planets – are peaceful places compared to stars.

Molecules are long chains of atoms.  Like atoms, molecules are made from combinations of quarks and electrons.  The material is the same – but there’s more of it.

More is different.

Some atoms have an effect on our bodies.  If you inhale high concentrations of oxygen – an atom with eight protons – you’ll feel euphoric and dizzy.  If you drink water laced with lithium – an atom with three protons – your brain might become more stable.

But the physiological effects of atoms are crude compared to molecules.  String fifty-three atoms together in just the right shape – a combination of two oxygens, twenty-one carbons, and thirty hydrogens – and you’ll have tetrahydrocannibol.  String forty-nine atoms together in just the right shape – one oxygen, three nitrogens, twenty carbons, and twenty-five hydrogens – and you’ll have lysergic acid diethylamide.

The effects of these molecules are very different from the effects of their constituent parts.  You’d never predict what THC feels like after inhaling a mix of oxygen, carbon, and hydrogen gas.

#

An amino acid is comparable in scale to THC or LSD, but our bodies aren’t really made of amino acids.  We’re built from proteins – anywhere from a few dozen to tens of thousands of amino acids linked together.  Proteins are so large that they fold into complex three-dimensional shapes.  THC has its effect because some proteins in your brain are shaped like catcher’s mitts, and the cannibinoid nestles snuggly in the pocket of the glove.

Molecules the size of proteins can make copies of themselves.  The first life-like molecules on Earth were long strands of ribonucleic acid – RNA.  A strand of RNA can replicate as it floats through water.  RNA acts as a catalyst – it speeds up the reactions that form other molecules, including more RNA.

Eventually, some strands of RNA isolated themselves inside bubbles of soap.  Then the RNA could horde – when a particular sequence of RNA catalyzed reactions, no other RNA would benefit from the molecules it made.  The earliest cells were bubbles that could make more bubbles.

Cells can swim.  They eat.  They live and die.  Even single-celled bacteria have sex: they glom together, build small channels linking their insides to each other, and swap DNA.

But with more cells, you can make creatures like us.

#

Consciousness is an emergent property.  With a sufficient number of neuron cells connected to each other, a brain is able to think and plan and feel.  In humans, 90 billion neuron cells direct the movements of a 30-trillion-cell meat machine.

Humans are such dexterous clever creatures that we were able to discover the origin of our universe.  We’ve dissected ourselves so thoroughly that we’ve seen the workings of cells, molecules, atoms, and subatomic particles.

But a single human animal, in isolation, never could have learned that much.

Individual humans are clever, but to form a culture complex enough to study particle physics, you need more humans.  Grouped together, we are qualitatively different.  The wooden technologies of Robinson Crusoe, trapped on a desert island, bear little resemblance to the vaulted core of a particle accelerator.

English writing uses just 26 letters, but these can be combined to form several hundred thousand different words, and these can be combined to form an infinite number of different ideas.

More is different.  The alphabet alone couldn’t give anyone insight into the story of your life.

#

Meditation is like a blink where more time passes, but the effect is very different.

Many religions praise the value of meditation, especially in their origin stories.  Before Jesus began his ministry, he meditated for 40 days in the Judaean Desert – his mind’s eye saw all the world’s kingdoms prostrate before him, but he rejected that power in order to spread a philosophy of love and charity. 

Before Buddha began his ministry, he meditated for 49 days beneath the Bodhi tree – he saw a path unfurl, a journey that would let travelers escape our world’s cycle of suffering. 

Before Odin began his ministry, he meditated for 9 days while hanging from a branch of Yggdrasil, the world tree – Odin felt that he died, was reborn, and could see the secret language of the universe shimmering beneath him. 

The god Shiva meditated in graveyards, smearing himself with crematory ash.

At its extreme, meditation is purportedly psychedelic.  Meditation can induce brain states that are indistinguishable from LSD trips when visualized by MRI.  Meditation isolates the brain from its surroundings, and isolation can trigger hallucination.

Researchers have found that meditation can boost our moods, attentiveness, cognitive flexibility, and creativity.  Our brains are plastic – changeable.  We can alter the way we experience the world.  Many of our thoughts are the result of habit.  Meditation helps us change those habits.  Any condition that is rooted in our brain – like depression, insomnia, chronic pain, or addiction – can be helped with meditation.

To meditate, we have to sit, close our eyes, and attempt not to think.  This is strikingly difficult.  Our brains want to be engaged.  After a few minutes, most people experience a nagging sense that we’re wasting time.

But meditation gives our minds a chance to re-organize.  To structure ourselves.  And structure is the property that allows more of something to become different.  Squirrels don’t form complex societies – a population of a hundred squirrels will behave similarly to a population of a million or a billion.  Humans form complex webs of social interactions – as our numbers grew through history, societies changed in dramatic ways.

Before there was structure, our entire universe was a hot soup of quarks and electrons, screaming through the sky.  Here on Earth, these same particles can be organized into rocks, or chemicals, or squirrels, or us.  How we compose ourselves is everything.

#

The easiest form of meditation uses mantras – this is sometimes called “transcendental meditation” by self-appointed gurus who charge people thousands of dollars to participate in retreats.  Each attendee is given a “personalized” mantra, a short word or phrase to intone silently with every breath.  The instructors dole mantras based on a chart, and each is Sanskrit.  They’re meaningless syllables to anyone who doesn’t speak the language.

Any two-syllable word or phrase should work equally well, but you’re best off carving something uplifting into your brain.  “Make peace” or “all one” sound trite but are probably more beneficial than “more hate.”  The Sanskrit phrase “sat nam” is a popular choice, which translates as “truth name” or more colloquially as “to know the true nature of things.”

The particular mantra you choose matters less than the habit – whichever phrase you choose, you should use it for every practice.  Because meditation involves sitting motionless for longer than we’re typically accustomed, most people begin by briefly stretching.  Then sit comfortably.  Close your eyes.  As you breathe in, silently think the first syllable of your chosen phrase.  As you breathe out, think the second.

Repeating a mantra helps to crowd out other thoughts, as well as distractions from your environment.  Your mind might wander – if you catch yourself, just try to get back to repeating your chosen phrase.  No one does it perfectly, but practice makes better.  When a meditation instructor’s students worried that their practice wasn’t good enough, he told them that “even on a shallow dive, you still get wet.”

In a quiet space, you might take a breath every three to six seconds.  In a noisy room, you might need to breathe every second, thinking the mantra faster to block out external sound.  The phrase is a tool to temporarily isolate your mind from the world.

Most scientific studies recommend you meditate for twenty minutes at a time, once or twice a day, each and every day.  It’s not easy to carve out this much time from our daily routines.  Still, some is better than nothing.  Glance at a clock before you close your eyes, and again after you open them.  Eventually, your mind will begin to recognize the passage of time.  After a few weeks of practice, your body might adopt the approximate rhythm of twenty minutes.

Although meditation often feels pointless during the first week of practice, there’s a difference between dabbling and a habit.  Routine meditation leads to benefits that a single experience won’t.

More is different.

On birds watching.

On birds watching.

In jail recently, we were talking about birds.

“Yeah, my grandfather had something like a thousand chickens, had them running all through the yard,” somebody said.  “And there was this one chicken, he was a mean one.  I was kind of afraid of it, strutting around like he owned the place.  So my grandfather, he told me to kick it.”

“Well, I did, but that only made things worse.  I didn’t make him scared, I just made that chicken hate me.  So after that, anytime we went to visit my grandfather’s place, that chicken would be there, waiting for me.”

“My parents, my brothers and sisters, everybody would get out of the car, but the chicken wouldn’t bother them.  He’d be sitting there, staring, just waiting for me.  And when I finally got out I had to run, every time, sprinting to my grandfather’s front door before that chicken got me.”

“They live a long time, too!  I had, like, five or six years of that!  And still to this day, anytime my mom sees a video or a picture of somebody running from a chicken on Facebook, she’ll tag me in it.  Like, ha ha ha, remember that?”

#

“Maybe you didn’t kick him hard enough,” somebody suggested.  “Cause we used to have chickens, and I had to go into the coop sometimes, and the roof of it was real low to the ground, so I had to crouch in there like this, and one chicken would always strut up to me like it was going to start something.”

“Well, it did that every time for a few months, till one day it got in my face and I just went BOOM, and I wrestled that little fucker to the ground.  And that chicken never messed with me again.”

#

Birds can recognize individual humans. 

Biologist John Marzluff noticed that crows became wary of particular researchers after the crows had been captured and tagged.  In an experiment where researchers captured a half dozen crows while wearing a caveman mask, they found that the whole flock learned to respond to that mask as a threat.  Several years later, even crows who hadn’t seen the caveman’s initial misbehavior would shriek a warning when they saw that mask.  They’d been trained by their flockmates.

The caveman mask is on the left. On the right: a control mask.

#

Between their intelligence and acute eyesight, birds can serve as passable oncologists.  Pigeons were trained with a set of slides from biopsies – a pigeon had to inspect each image and then choose a button for “cancer” or “not cancer”.  If the pigeon chose correctly, the computer would dispense a pellet of food.

(Human medical students are often mistreated during their training, forced to work grueling hours with few breaks.  The pigeon trainees were also mistreated – to ensure that they valued each food pellet, the pigeons were starved during the experiment.  I’m 6 feet tall and about 150 pounds, but if I were participating in this study, I’d be kept at 127 pounds – eighty-five percent of my “free feeding” weight.)

Pigeons learned to diagnose biopsies with 80% accuracy.  A team of eight pigeons voting together could diagnose biopsies with 99% accuracy

The team of pigeons was just as good as a human oncologist, and far better than computerized image analysis.

You can buy 50 pounds of pigeon pellets for under $10.  That’d give you enough rewards for a flock of half-starved pigeons to diagnose thousands of patients.

#

We used to think that an entire class of vertebrates had gone extinct – the dinosaurs.  But we now know that birds are dinosaurs. 

Several species of dinosaurs/birds are gone – millions of years have passed since tyrannosaurs or velociraptors roamed the earth.  But their lineage has continued.

When I was growing up, people often remarked that dinosaurs were clearly dim-witted creatures because they have such small cranial cavities.  There was not much room for brains in their skulls! 

But contemporary dinosaurs/birds have small brains, too, and many are extremely intelligent.  They can chase kids who’ve crossed them.  They can diagnose cancer.  They can make tools, solve logic puzzles, and guess what other animals are thinking.

All with minuscule brains!

When biologist Suzana Herculano-Houzel investigated the brains of various species, she found that the number of neurons in a brain typically correlates with cognitive capacity.  More neurons makes for a smarter critter!

The physical size of a brain doesn’t tell you how many neurons will be in a brain, though.  A bigger brain might just have bigger neurons

As it happens, birds’ brains are constructed better than our own.  Crows and parrots pack neurons into a brain more densely than we do, like the difference between old IBM mainframes and modern telephones.  Pigeon brains are better than ours at parallel computing, like the difference between a hypothetical quantum computer and your current laptop.

We can outsmart crows, parrots, and pigeons, but only because our raw neuron counts are so high that we’ve not been surpassed by their superior designs.

We don’t know when dinosaurs/birds evolved their high neuron densities – well-designed brains might be recent innovations, or they might be millions of years old.  Ancient dinosaurs may have been far more intelligent than we thought.

Yes, they still went extinct, but you can’t blame them for succumbing to climate change.  And it’s not like they caused the climate change that killed them.

Future archaeologists might judge humans to be more foolish than any stegosaurus.

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We humans have huge numbers of neurons in our cerebral cortex.  We are blisteringly clever.  We’ve made all variety of tools, languages, and complex social structures.  Yes, crows also have tools, language, and complex social structures, but in each category, human achievements are even more complex.

A crow tool is typically a hooked piece of stick.  We built telephones.

Well, humans collectively built telephones.  I couldn’t sit down and build one from scratch.  If I were to make a tool while out hiking, it’d probably be a hooked piece of stick.

Still, our best achievements are pretty incredible. 

But we’ve also brought our species to the brink of extinction.  Through overpopulation and excessive exploitation of the planet’s trapped resources, we’re making our world less habitable. 

Tyrannosaurus ruled this planet for a few million years.  Humans have been a dominant species for only a hundred thousand years – a few percent of T-Rex’s reign.  With the current pace of climate change, scientists soberly discuss the possibility that we’ll reap apocalypse within a hundred more years.

Measured by reign, we might prove 20-fold less successful than those giant birds.