Month: August 2020

I am still not seeing as much as I would like about ventilation.  One of main things we have learned about the virus is that indoor air exchange is the A-1 vector for transmission.  I think of this at work when I go down to the cafeteria and a young woman with gloves has to pick up a sugar packet, a coffee stirrer, and a coffee cover and hand it to me.  Then I go back to an isolated office for phone and online meetings while all the air in the building is pumped directly onto me.

This is significant for nursing homes.  No everyone is there for the comorbidities we are so attentive to these days.  For some, it is dementia, or mobility and balance issues, or Parkinson’s symptoms that prevent independent living. But there they are, now stuck in close quarters with a lot of people with C-Pap machines aerosolising everything. I have an ugly suspicion that it goes less-noticed because it is not easily weaponised by either camp in the national debate. If a governor had said early on that businesses like restaurants could stay open with a few restrictions, so long as they had ventilation systems that met a certain standard – particularly in areas outside of the Northeast cities that were so heavily affected – it would be hard to gin up anger either way.  Dan from Madison raised the caution flag that a lot of these systems are now so far back-ordered that no one is getting delivery in months.  I’m betting that stuff is harder to switch production to than individual ventilators.  So who can capitalise on that one at the Conventions?

I have also not heard much about viral load, which I suggested early on would be important.  Next-most-affected after older people are those taking care of them. It can’t be a non-factor, but whether it large or merely worth noting as a possibility would seem of some interest. If I were to guess, the importance of superspreader events would suggest that crowds indoors are an enormous risk.

Bsking just mentioned in the Apples to Apples comments (at Assistant Village Idiot) that America’s high obesity rate as a factor is also neglected. That matters at a couple of levels. Median age has also been mentioned WRT Laos in specific and SE Asia in general.  It likely matters. 

The advance notice for the Apples to Apples II post is that the regional approach within countries does look like the best way to look at this, and whatever lessons we might extract across countries are often going to come from this.

Yes, there will be a followup. I’m just trying to get a grip on what comparisons are valid – and getting you thinking about the same thing.

In trying to find proper comps for America WRT C19, I have to conclude that there are none which are excellent, perhaps not even very good. It is fair to have industrialised nations as our starting point, and places so small that a single one-off event (or lack of them) can change the picture too quickly.  Andorra, San Marino, and Liechtenstein are not comps, whether for good or for ill.  There are Latin American countries – our own hemisphere – which have recently seen many cases, but I can’t see Peru as a serious comp.  We share a border with Mexico, and parts of that country have similarity to parts of this country in more than one way, but “industrialised” seems out of reach.  Ditto Brazil. We are narrowing to Europe and the Anglosphere pretty quickly, I think. Japan clearly qualifies as a first-world nation, though it is very much an island, and was culturally willing to isolate long before any of this. They remain solidly racist and homogeneous, resenting the Chinese and looking down on Koreans and especially Filipinos, so their degree of international contact has never been at European or American levels. Russia, China, and India are powerful economies and have industries but can’t really be regarded as industrialised.

Which leads to the next criterion, degree of international contact. Europeans have both contact with each other, often at places of great population density, and contact with the rest of the world.  America has two long borders, mixed between population dense and sparse population areas.  We have a great deal of international contact, much of it coming in by air. Canada less so, but still considerable. Australia has a great deal of regional contact, New Zealand and South Africa not so much. Even a lot of Europe isn’t in the same league, here. Because many come in by air, the international contact is in many places, well into the heartland.  Somewhat true of Canada as well, though Toronto, Montreal, and Vancouver are the main contact points. Not nearly so many as America or in Europe.  By population it’s a comp, but by area – that is, how much international contact per square kilometer, even if only measuring the southernmost parts – not quite so much.  As both population and area seem to be mattering with CoVid, that’s worth noting.

Because the NYC metro area has so dominated the American statistics, over a third of the deaths, and other major metros have had similar problems, I think the presence or absence of such areas is an important comp. A lot of people have criticised what New York has done, but what would they have done differently?  Not sending infected persons to nursing homes is a biggie, and worth mentioning, but what else?  Close the subways?  Then Ubers upon Ubers. What about elevators?  How do NYC apartments function without elevators?  This is going to weaken a lot of possible comparisons.  France has Paris.  The UK has London, and bonus points for the Midlands cities.  Argentina may work it’s way onto the list simply because of Buenos Aires.  Japan might work it’s way back on as well.  Mexico City is huge, but I think it is usually described as “sprawling.” Amsterdam, Brussels, Stockholm, Berlin, Rome, etc – not so much high-rise, not so much density. Canada has Toronto, not quite a megacity, but plenty of skyline. Montreal a little less. Vancouver probably not.  We are into places that are populous, have skyscrapers and some density, but just not Manhattan or downtown Chicago. Half-credit?

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Laos has had 22 cases of C19, 3 currently active, 0 deaths. Cambodia, Vietnam, Thailand, Nepal, Myanmar, are not quite so low, but very low. These are not South Korea or Taiwan, where we can point to cultural support for masks and distancing and good medical care and awareness. It is fair to note that there is little testing and there might be deaths out in the boonies that are just “Eh.  Death.  Who knows why?” that leave actual CoVid unreported, but these national numbers are ridiculously low. If there were a CoVid holocaust in these areas word would be leaking out.  Even though no one, left or right, pays much attention to what is happening in these places, if there were some serious bump in the data, someone would be twisting it around to make some political hay out of it on NPR, The Nation, or some fringe right-wing sites.  It is, of course, very cool to be walking around knowing stuff about some country that everyone has heard of but no one has been paying attention to, so some news would get out.

If you go to Worldometers.info and look at the lower reaches of the list you see patterns.  You see islands, whether in Oceania, Indian Ocean, or the Caribbean, or essential islands like Gibraltar, Vatican City, Liechtenstein. Yes, they can keep others out, and are in fact used to keeping others out. There are also a lot of African countries, with similar poor medical care, low social cohesion for masks and distancing, but likely also poor reporting.  Yet I will note again, not that poor reporting. When there are lots of deaths, word leaks out.  The outside world may not believe those reports of death because they are uncomfortable, as the Gulag deaths, 6M Jews, or 25M Great Leap Forward deaths in China leaked out in the 20th C were ignored, but the reports were there.

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