A Reasonable Approach to COVID in 2022

A pandemic is a confusing event, as we have discovered.  It is science in real time.  Much has been said about the sometimes puzzling and occasionally even contradictory messages coming from governments and scientists.  But our understanding of COVID-19 and its ramifications is constantly evolving, and it is extremely difficult to chart a perfect course of action and recommendations.  We should all be extremely grateful to the scientists and medical professionals who have worked tirelessly to confront this crisis.

Europe now appears to be entering its fourth wave of infection.  If the past two years are any guide, the USA will follow in a month or two.  Vaccinations have reduced the relative number of hospitalizations and deaths, but there are still large numbers of unvaccinated people and there is almost zero probability of achieving true ‘herd immunity’.

Should we view COVID-19 as an endemic disease now?  Should life go on as normal with a few basic restrictions?  These are difficult questions, but I believe there are a few basic guidelines that make sense.

First, vaccinations should be strongly encouraged for everyone and even mandated in certain areas (healthcare and retirement communities for example).  There is enough data available now to prove that the risks of any vaccine side effects are vastly lower than the risk of COVID in an unvaccinated adult.  Any responsible leader should emphatically endorse vaccination.

It is reasonable to raise the question as to whether instituting or continuing draconian shutdown measures may have more negative impact than the virus itself at this stage in the pandemic.  It was, however, unreasonable and highly unethical to argue against those measures at the outset of the pandemic.  The ultimate metric for those decisions is clearly the burden on the healthcare system.

When hospitals and healthcare workers are overwhelmed by serious COVID cases, as they were at the onset of the pandemic and several other times in the past two years, society must do everything in its power to reduce that burden.  A full breakdown of the healthcare system - doctors and nurses dying or abandoning their practices from fatigue or discouragement – is a catastrophic event with very long-term consequences.  Moreover, such an event will precipitate higher death counts because of the saturation of available ICU’s and ventilators. 

The UK data from before and after the vaccine gives us some encouragement for hoping that we can treat the pandemic with more moderate measures.  It is a good test case because the country is highly vaccinated (over 90% in adults over 40 - see the chart below) and has essentially eliminated all protective measures in the general population.

The UK CFR (case fatality rate) for the period from late November2020 to late February 2021 was about 2.5%.  For the post-vaccine period from late June to today, the CFR was about 0.3%, or about one eighth as much.  That is a dramatic decrease in the death rate.  This is especially interesting because the average daily number of new cases in the latter period was significantly higher (35k/day) than during the earlier period (29k/day). 

The USA will have a more difficult time unless vaccination rates improve dramatically.  During the same time that the UK had a CFR of 0.2, the USA had a CFR of 1.1, more than five times that of the UK.  This can only really be interpreted as an emphatic endorsement of the vaccine.  Sadly, our political polarization has made the vaccine a tribal litmus test for many in this country.

Whether the UK healthcare system is still under tremendous pressure is difficult for me to discern in a quick look online.  My guess is that there are pockets of distress and that the future will be a whack-a-mole game of employing vaccines, surgical shutdowns or protective measures and new treatment regimens to minimize the hospitalizations and deaths while allowing life to go on as close to normal as possible.

In my opinion, the reasonable way to proceed is to recognize that our healthcare systems must be protected at all costs.  Life can go back to semi-normal, but the minute we see a region where the healthcare system is in grave danger we must act decisively and initiate whatever measures are necessary.

The Evolution of the Nerd – from Zero to Hero to Megalomaniacal Villain

I don’t perceive myself as a classic nerd, though I have some nerdy characteristics – highly analytical, a tendency to be very precise with numbers, a strong interest in nerd topics such as science, technology and math. 

The truth is that I blundered into the technology field without really having an intense desire to become a techie or an engineer.  And I very nearly abandoned the technology path in the middle of my freshman year of college after a quarter focused on Chinese politics and French existentialism.  However, an intriguing physics course and a romance with a physics major provided enough inertia to keep me headed down the science path and then into engineering and computers.

All this is to say that I once understandably celebrated the transformation of the lowly Nerd from a caricature cog in the technology business to the hero of the computer and information revolution.  But sadly, the evolution of the Nerd has exceeded all expectations and become yet another cautionary tale of human temptation.

The space race and the subsequent computer revolution signaled the first subtle ascendancy of the Nerd engineer and programmer in society.  Cultural catalysts like Star Trek and Star Wars accelerated the pace. 

At first, the Nerd was a curious oddity – the necessary but somewhat comical sidekick of the heroic adventurers.  The caricature image of an unattractive guy with thick glasses, a pocket protector, a belt several inches too long and high-water pants was the stereotype.  He was a whiz at all things technical, but hardly an object of veneration, and often one of ridicule.  His technology skills were impressive, but no one really wanted to be him!

Solid evidence that the Nerd was gaining new respect came in the form of a movie franchise called ‘The Revenge of the Nerds’, which first appeared in 1984.  By this time Apple computers had been out for several years and the iconic Macintosh was launched in January 1984.

In Revenge of the Nerds, not only do the Nerd heroes exact revenge on their frat boy tormentors, but the lead Nerd even gets the pretty girl!  This transition from a valuable but slightly peculiar supporting role to star status heralded the creation of the new tech mythology.

The rapid assimilation of computer technology into our everyday lives and the recognition that computer entrepreneurs were becoming fabulously rich burnished the legend considerably.  Suddenly computer geeks were cool, especially if they had prospects of cashing in on their expertise.

Several movies followed that developed the trope of the former high school class dweeb showing up at a reunion as a millionaire tech entrepreneur with new confidence and flair.  The Nerd became a figure of respect and even envy, maybe a little dorky around the edges but with enough money and prestige to compensate.

As the 90’s came and went, bringing us the Internet, and the 2000’s accelerated the pace of technology with ipods, smartphones, Teslas, google and social media (ugh!), the billionaire tech wizards (perhaps questionable how much true wizardry there was behind much of what made billions – but that is another story) became our cultural icons with a position not far beneath movie stars, rock stars and British royalty – Steve Jobs, Bill Gates, Jeff Bezos, Elon Musk, Mark Zuckerberg and a host of lesser heroic Nerds.

Then suddenly, the hero myth began to turn Greek.  The tragic flaws of the tech titans and their technologies became all-too-apparent:  the monopolies, the uber-wealth, the ironically fratboy-like workplaces, the incestuous manipulation of the marketplace, the appalling menace of social media, the arrogance and narcissistic expressions of massive egos.

The Nerd had become Frankensteinian.  With more money and power than anyone should ever have at their disposal, today the tech masters of the world are no longer the sought-after destroyers of the old empire as pictured in the renowned Apple super bowl ad, but rather the new plutocrats of an increasingly polarized and authoritarian society.

I am reminded of the last scene of Orwell’s Animal Farm, when the pigs and the humans are sitting together at a banquet and the once revolutionary pigs have taken on all the characteristics of their former persecutors.  But instead of pigs and humans, it is Nerds and the industrial robber barons.  And we are the creatures gazing with incredulity at the scene.  “The creatures outside looked from pig to man, and from man to pig, and from pig to man again; but already it was impossible to say which was which.”

Numbers, Statistics and Misconceptions

Numbers are confusing to most people.  Few of us are comfortable with statistics and really understand how to interpret them.  Any lingering numerical skills from the painful years of high school math are gleefully jettisoned, and we are easily led astray when confronted with any sort of statistical analysis.

Numbers can also be cynically manipulated or naively misused.  Numbers and statistics are ultimately representations of events, and the meaning behind the numbers must be clear in order to ensure the correct interpretation.

A powerful example of this occurred about six months into the pandemic, when the CDC reported that 94% of COVID deaths had other morbidities associated with the death.  Very quickly large numbers of social media posts and talking heads interpreted that to mean that only 6% of the reported COVID deaths were actually caused by COVID.  This misinterpretation persists even today and there are many Americans who believe the number of COVID deaths is radically overcounted.

But here is the highly probable truth:

First of all, no one really dies solely from COVID.  The virus manifests itself in other pathologies such as pneumonia, respiratory distress or cardiac arrest.  The attending physician will add those pathologies to the death certificate, along with any known factors that may have made them more susceptible – diabetes, obesity, cancer, weakened immunity, etc. – to provide as much information as possible for later analysis.

But how can one know for sure that these people didn’t die from those other problems?  Perhaps the COVID virus was just present, not a contributing factor.  Here is where additional statistical (not anecdotal!) data plays a decisive role – the number of EXCESS DEATHS.

The total number of deaths in the USA is tracked and is predictable to within a small margin of error each year based on historical data.  Thus, the number of excess deaths in 2020 over what would have been expected is a very good estimate for the true number of COVID deaths and is probably more accurate than the confirmed number.  There were 3.38 million deaths in 2020 versus 2.85 million in 2019 (see the graph below and the dramatic step between 2019 and 2020). This would mean that the 2020 COVID deaths are closer to 500k!  The death rate (number of deaths per one thousand people) had an 18% increase in one year, from 8.7 to 10.3.

 Over eight hundred thousand people will have officially died from COVID in the USA by the end of 2021. There were about 380k confirmed COVID deaths in 2020 and there will be at least 450k in 2021.  But when one analyzes the excess death data it is extremely likely that the total number of COVID deaths for the two years will exceed one million!

 

 

 

They Were Expendable

In an earlier blog post I wrote about the unconscionable use of anti-vaccine policies to bolster the Trumpian credentials of Republican governors such as Abbott and DeSantis, and how their incredibly selfish and narcissistic acts were resulting in increased sickness and death in their states. 

It is now mid-October 2021, and what should have been a summer of relief from COVID and a resumption of somewhat normal life has been torpedoed by an anti-vax movement that has been promoted and led by Trump’s sycophants and the craven politicians who see their future in his wake.

I have examined the deaths that have occurred in ten states that represent a cross-section of blue and red states – states that strongly encouraged or even mandated vaccinations for their citizens and those that squandered their opportunity to protect their citizens by attacking vaccine mandates and making idiotic speeches about freedom.

I have calculated the number of deaths per million people (thus normalizing the numbers so that there is an apple to apple comparison) that have occurred from April 1 to Oct 13.  I chose April 1 because vaccines were really starting to have an impact at that point in states that embraced them.  It was also the time when the delta variant began to play a significant role.

It is also important to note that less than 2% of COVID deaths in this time period were vaccinated people.

These statistics dramatically illustrate the difference in deaths between states that embraced the vaccine and those who made it a political issue.  

There have been over 165,000 deaths since April 1.  The excess deaths in red states where governors and republican legislators have fought the vaccine, as well as the collateral damage in all states of conservatives who died embracing the so-called ‘freedom’ that the death cult has espoused, easily exceed 1/3 of those deaths, or about 55,000. 

I guess if you have Trumpian presidential aspirations or are a brainwashed right-winger who somehow cannot acknowledge any societal obligations, then those 55,000 deaths don’t mean much to you.  Either your own grotesque ambition or some toxic mixture of demented myths and lies has hijacked your humanity.  The dead won’t haunt you, because you have no conscience.  The people who died were just a necessary sacrifice. They were expendable.

To Die, To Sleep, No More

I have always loved the famous Hamlet soliloquy ‘To Be or Not to Be’. At some point I memorized it, though I must refresh it periodically or it slips away.  I have even written a song that addresses the same question.

The question ‘To Be or Not To Be’ postulates the possibility of suicide in the face of the myriad ‘slings and arrows of outrageous fortune’.  The same theme and question come up in the Goethe classic The Sufferings of Young Werther (Die Leiden des Jungen Werther).  The question of whether suicide is justified when a person is tortured by mental anguish, physical infirmities or sickness of the soul is one many poets and scholars have wrestled with over the centuries.

But in this essay, I am not posing the question of whether suicide is an acceptable escape from misery. Fortunately, I am not facing that dilemma.  I am more interested in the corollary questions that Shakespeare introduces in those famous stanzas.  What will one find in that ‘undiscovered country from whose bourn no traveler returns’?  Indeed, ‘what dreams may come when we have shuffled off this mortal coil’?  I am intrigued by death itself and what it will mean for us, if anything.

Most of our religions and spiritual allegiances assure us that we have an immortal soul that continues to exist after physical death.  This is one of the main consolations of being a person of faith.  It is very disconcerting for most people to imagine that they will cease to exist after death.  And I would dare to hypothesize that even the most cavalier atheist is displaying a bit of false bravado when he or she claims to have no fear of the finality of death.

Attempting to visualize or conceptualize an existence of any form after death leads one to a series of questions that border on the absurd.  What form of being will we be?  Will there be a physical form?  If so, what age would we be?  Would we have the same personality and the same history or memory?  Would we meet family and friends?  Will our pets accompany us?  What would we do on a daily basis once the harp playing and singing gets old?  Would we tire of milk and honey? 

The ‘opiate of the masses’ school of thought on death portrays heaven as an idyllic place that will compensate for the pain and suffering that occurred on planet earth.  This is understandably a powerful and compelling story for the heartbroken and miserable. This is the idea that heaven will replace the brutal world with a loving, compassionate place and an eternal life of good things.

Every mother who has lost a child, every husband whose wife has died young of breast cancer, every person whose loved ones have been brutally taken from them by crime, disease or war; every slave, every victim of abuse, every hapless, luckless denizen of this cruelly arbitrary world, deserves such a recompense. 

But the imagery doesn’t hang together well and breaks down under any real scrutiny.  Would the mother who lost an infant child meet that child as an infant or an adult?  Would she have the opportunity to see that child grow up?  What if her own mother had died when she was a teenager? Would she be a teenager again in the eyes of her mother?  What about the billions of children who died in childbirth and never experienced life at all?  How will they be compensated?  Will they meet their parents for the first time and somehow go through a full life with them?  It seems like it would be better to give them another go at life, which brings up the new complication of reincarnation!

Another big question is how the whole eternity thing works. If heaven is an eternal dwelling, would we perceive time?  What purpose would time have?  How does the space-time continuum fit into this? All of these details quickly become self-contradictory and the whole enterprise becomes acutely unimaginable.

Moreover, the idea of a ‘perfect’ place with everything one needs to be happy also has its challenges.  A brief look at the ultra-rich who should be living the ideal life on earth is strong evidence that too much of a good thing is ultimately kind of bad!

Still, there are some indications that a post-death experience awaits us.  Countless near-death episodes have been recounted with tales of passageways leading to luminous, wonderful places, of powerful feelings of peace and contentment, of seeing deceased loved ones and so on.  There are even scientific studies and institutions that have catalogued these experiences and are attempting to understand them more fully.

I want to believe that I will continue to exist after death.  It would make it easier to die, and that certainly appears to be one of the main benefits of a belief in the afterlife.  Dying is a solo gig for the most part.  No one is sharing the experience.  One is all by oneself.  And very few people seem all that eager to let go of life and embark on that journey.  Most of us would ‘rather bear those ills we have than fly to others we know not of’, or perhaps even worse, to nothing at all.

There is enough mystery in the world to make one hesitant to hold fast to either skepticism or unquestioning belief.  I know enough of quantum physics and cosmology to see that all is not what it appears to be.  I may write whimsically about death but in the end, I respect and echo the earnestness with which most human beings approach the end of their days.  My own speculation and hope are that my spirit does somehow continue to exist, and that in some ethereal way we attain new levels of consciousness, love and compassion.  There is no logical or rational way to imagine it, so I will simply hope for the best.

 

 

Texas Heralds America's Own 'Cultural Revolution'

Neighbor spying on neighbor.  Indoctrinated children betraying their own parents.  A cadre of the ideologically unhinged and would-be bounty hunters searching for women, doctors, nurses, social workers and even drivers who they suspect of violating their version of religious law.

Yes, Texas has codified its own version of the Chinese Cultural Revolution.  Bravo! 

The shocking nature of this new move by the anti-abortion zealots is a sign of the extremes to which these people will go to implement their self-righteous crusade.  The fact that five of the supreme court justices refused to immediately reject this radical vigilante-encouraging law is extremely sobering.

There is something about deputized citizens, bounties and vigilante justice that is supremely distasteful.  It is antithetical to a sense of fair play and due process.  It conjures up images of Nazi Germany, the KGB and many other totalitarian regimes where neighbors are encouraged and even paid to turn in their neighbors for perceived infractions or disloyalty.

The religious right may have gone a step too far with this attempt to circumvent our judicial system.  The incredulity, outrage and anger that it has engendered could cause a wave of reaction in independents and middle America and find expression at the polls.

I am not sure what these extremists ultimately hope to accomplish.  The availability of pharmaceutical abortions and the willingness of people to help women find and fund alternative places for ending pregnancies will probably reduce the impact dramatically.  Moreover, there has been a continuous decline in the rate of abortions in the USA since a peak was reached in the 1981.

Here is an extract from the Wikipedia article on abortion in the USA:

In 1973, the Roe v. Wade Supreme Court decision legalized abortion in all 50 states. Thoughout the 1970s, the abortion rate rose almost 80%, peaking at 29.3 abortions per 1,000 women of childbearing age according to the Guttmacher Institute and at 25 abortions per 1,000 women of childbearing age according to the CDC.

From 1981 through 2017, the abortion rate fell approximately in half. It did not fall every single year, but it has not risen two years in a row since 1979 and 1980. The abortion rate fell below the 1973 rate in 2012 and continued to fall through 2017. 

Abortion foes would be so much wiser to encourage these downward trends of abortions by promoting sex education and birth control, especially the newer IUDs that provide highly reliable birth control without the risk of non-compliance that pills, condoms or other means entail.

That presumes that the goal of abortion opponents is truly to reduce abortions and not simply to wage a culture war that projects their own insecurities about a changing and uncertain world.  If they really want to save lives, I would recommend they put their energy towards reversing climate change.  The number of future victims of that onrushing calamity, all of whom will be cognitive, self-aware human beings, will dwarf the number of aborted fetuses.

 

Living in the Moment

I have often heard people say that they are trying harder to ‘live in the moment’.  It seems that we have all become acutely aware that most of the time we are focused on either the past or the future rather than the present.  We suspect that it would be better for us to more fully experience the current moment of our lives rather than be distracted by thoughts of the past or future, or other daydreams.

But what does it really mean to ‘live in the moment’?  Does it imply that we must actually be thinking about or analyzing what we are doing and examining our state of mind and feelings?  Can one be ‘in the moment’ without telling oneself to be ‘in the moment’?  Can we experience something fully without our thoughts conducting a monologue about that experience?

When one is involved in a vigorous activity, such as playing a sport or practicing a musical instrument, background thoughts seem to disappear.  The more the activity requires effort and concentration, the less one is able to conduct the usual soliloquy of conscious thought.  But when one performs less demanding activities, such as listening to music or going on a hike, one often finds that significant periods of time go by without one being at all aware of the activity.  We daydream, fret about a coming event, or analyze something that happened in the past.  Instead of fully experiencing the thoughts, sensations and emotions of that activity, we are distracted and lose whatever benefit those moments might otherwise have brought.

One example is the act of eating.  I have often noticed that I will look forward to eating something but discover after I have finished that I was distracted by other thoughts or social interactions and didn’t fully savor the food.  When I focus my full attention on the act of eating, I get much more enjoyment, especially if the food is something special.  But unfortunately, this is difficult to do when one is in a social setting or watching TV.  Even eating alone, the typical thought distractions that one has may get in the way of that enjoyment.

Distractions - whether daydreams, anticipation, memories or worries - are always waiting impatiently at the doorway of our consciousness.  We have all developed a bad habit of letting them in because much of our time is spent in mundane activity that does not offer any great joy ‘in the moment’.  It requires a certain discipline and training to refocus our mind when we are doing something that merits our full attention.  But life will probably be much more satisfying if we manage to do so.