Early Trumpist medical treatments

And then I see the disinfectant, where it knocks it out in a minute. One minute! And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that.

When Donald Trump used a Covid-19 press briefing to recommend injecting disinfectants to kill viruses within the human body, people reacted as though this were entirely unprecedented. But it wasn’t, entirely. From Frank Snowden’s Epidemics and Society:

Of all nineteenth-century treatments for epidemic cholera, however, perhaps the most painful was the acid enema, which physicians administered in the 1880s in a burst of excessive optimism after Robert Koch’s discovery of V. cholerae. Optimistic doctors reasoned that since they at last knew what the enemy was and where it was lodged in the body, and since they also understood that bacteria are vulnerable to acid, as Lister had demonstrated, all they needed to destroy the invader and restore patients’ health was to suffuse their bowels with carbolic acid. Even though neither Koch nor Lister ever sanctioned such a procedure, some of their Italian followers nevertheless attempted this treatment during the epidemic of 1884–1885. The acid enema was an experimental intervention that, in their view, followed the logic of Koch’s discoveries and Lister’s practice. The results, however, were maximally discouraging…

Apparently it’s a not uncommon response on someone first learning of the germ theory of disease.

Vaccine probabilities

From an article on the vaccine being developed by Robin Shattock’s group at Imperial College:

The success rate of vaccines at this stage of development is 10%, Shattock says, and there are already probably 10 vaccines in clinical trials, “so that means we will definitely have one”

It could be an exercise for a probability course:

  1. Suppose there are exactly 10 vaccines in this stage of development. What is the probability that one will succeed?
  2. Interpret “probably 10 vaccines” to mean that the number of vaccines in clinical trials is Poisson distributed with parameter 10. What is the probability that one will succeed?

Plagues and statues

I’ve been reading Camus’ La Peste, hoping to obtain some insight into one of the great crises of the present, and finding him commenting on a completely different one. At the height of the epidemic of the novel, the narrator comments on the aspect of the silent, immobilised city, and expresses resentment toward the statues that are permanently in that condition.

La grande cité silencieuse n’était plus alors qu’un assemblage de cubes massifs et inertes, entre lesquels les effigies taciturnes de bienfaiteurs oubliés ou d’anciens grands hommes étouffés à jamais dans le bronze s’essayaient seules, avec leurs faux visages de pierre ou de fer, à évoquer une image dégradée de ce qui avait été l’homme. Ces idoles médiocres trônaient sous un ciel épais, dans les carrefours sans vie, brutes insensibles qui figuraient assez bien le règne immobile où nous étions entrés ou du moins son ordre ultime, celui d’une nécropole où la peste, la pierre et la nuit auraient fait taire enfin toute voix.

The huge, silent city had become nothing more than a collection of solid, inert cubes, where the taciturn effigies of forgotten benefactors or ancient great men were suffocated forever in bronze, evoking a solitary, degraded image of what man had once been. These mediocre idols, enthroned under a thick sky, in the lifeless crossroads, unfeeling beasts that symbolised well the immobilised realm we had entered, or at least its ultimate order, that of a necropolis where plague, stone, and night would have finally silences any voice.

I’ve commented before on how odd it is that, just because some of our ancestors chose to cast their images in heavy bronze or marble and plonk them down at significant sites in our cities, that we should feel obliged to keep them there. But I assumed that the current attacks on statues of racists was unrelated to the pandemic situation, mere coincidence of crises, except perhaps that the lockdown left people with lots of pent-up energy.

But maybe there’s something about coping with an epidemic that inspires iconoclasm?

Adrift on the Covid Sea

Political leaders in many countries — but particularly in the US and UK — are in thrall above all to the myth of progress. Catastrophes may happen, but then they get better. And to superficial characters like Johnson and Trump, the improvements seem automatic. It’s like a law of nature.

So, we find ourselves having temporarily stemmed the flood of Covid infections, with governments laying out fantastic plans for “reopening”. Even though nothing significant has changed. The only thing that could make this work — absent a vaccine — would be an efficient contact tracing system or a highly effective treatment for the disease. None of which we have. But we still have a timeline for opening up pubs and cinemas (though less important facilities like schools are still closed, at least for many year groups).

It’s like we had been adrift for days in a lifeboat on the open ocean, carefully conserving our supplies. And there’s still no rescue in sight, but Captain Johnson announces that since we’re all hungry from limiting our food rations, and the situation has now stabilised, we will now be transitioning toward full rations.

Capitalist omelettes

Communists are routinely stigmatised by association with the adage “You can’t make an omelette without breaking a few eggs”, which is taken to summarise their willingness to excuse present cruelty in the name of never-realised lofty future goals.. In the 1930s it was sufficiently widespread that the hero of Sinclair Lewis’s It Can’t Happen Here exclaimed

If I ever hear that ‘can’t make an omelet’ phrase again, I’ll start doing a little murder myself! It’s used to justify every atrocity under every despotism, Fascist or Nazi, or Communist or American labor war. Omelet! Eggs! By God, sir, men’s souls and blood are not eggshells for tyrants to break!

Sick of hearing this justification on a tour of the Soviet Union in the early days of Stalin’s rule, Panait Istrati famously retorted, “All right, I can see the broken eggs. Where’s this omelet of yours?”

Anyway, these days the true radical utopians are the capitalists, and so we have seen the right wing in the US — and elsewhere — following Donald Trump in obsessing over stock market declines in a pandemic. “Don’t let the cure be worse than the disease.” The deadly cure being a reduction in economic activity, and the disease being… an actual often fatal disease. The epitome of this tendency was the Lieutenant Governor of Texas proclaiming that the older generation — in which he includes himself, to be fair — needs to be ready to die in the current pandemic to avert destruction from the American economy: “keeping the America that all America loves for your children and grandchildren”. In other words, we need to break some elderly (and young immune-compromised) so our grandchildren can have the omelettes.

Except they’ll still have to eat their omelettes indoors, because the same people insist on boiling the planet. More eggs, more omelettes.

The bourgeoisie will not only sell the rope for their own hanging. On the scaffold they will try to underbid the hangman to take on the hanging themselves, and sell off part of the rope as really more than is strictly needed to carry out the task.

Capitalist utopianism, it might be mentioned, was beautifully summarised by Joe Hill in his song The Preacher and the Slave:

You will eat by and by
In that glorious land above the sky
Work and pray, live on hay
You’ll get pie in the sky when you die.

O tempora, o mores!

I was watching a 15-year-old comedy yesterday — The Terminal (okay, not great) — set in an airport. And the whole time I was feeling viscerally uncomfortable at seeing people in public standing close to each other, touching each other, touching their faces, sharing food.

This pandemic is going to have very serious long-term social and cultural reverberations. I hope someone is documenting these.

Covid-19 and climate change

I’m wondering whether the pandemic disaster might in some way mitigate our climate-change disaster. I don’t mean in the trivial short-term sense that the collapse of travel and general economic activity reduces CO2 output. I mean that the experience of the pandemic undermines the intellectual foundations of climate-change denialism. Again, not in a trivial, debating-point sort of way, but a visceral “I refute it thus“.

Climate-change denial rests, it seems to me, on two intellectual — or perhaps it might be better to call them “mental” — pillars. I refer here not to the occasionally valid but always irrelevant sand-in-the-eyes technical quibbles that are used to convey the impression of scientific disagreement. I mean the actual intellectual motivations for the position that drives the search for these quibbles, to the extent that the motivation is not simply pelf or partisanship. These are

  1. The world is too big for humans to change meaningfully. Often they say it is “arrogant” to imagine that insignificant humans could do something as grand as to change the Earth’s climate.
  2. Action against climate change is woolly feel-good sort of stuff. Maybe it would be a good thing in principle, but hard-head thinkers care about people’s jobs and the here-and-now.

In a sense these are opposites: The first says human activity is trivial compared to the whole planet. The second says human activity is autonomous, and far more significant than the whole planet.

The experience of the pandemic is likely, it seems to me, to make people much less receptive to these arguments. Seeing how small the planet is, that a virus originating in one market in Wuhan can infiltrate the whole world within a few months is liable to leave people feeling that the Earth is quite a fragile thing.

And then, the economic cost of this pandemic is likely to be far higher than even the upper end of estimates of the cost of achieving carbon neutrality. Faced with the pandemic, we are thrown back on the material reality of the economy: Not jobs but work, not production but material goods such as food and shelter. We pay the cost because the alternative is clearly more expensive, in lives and social disruption. And this time, people have been willing, mostly, to pay the cost in advance, believing that the disaster would be vastly greater if we waited. The timeline for the climate-change apocalypse is much longer, but it is not implausible to suppose that the same frame of mind might then allow people to see that global catastrophe is a real thing, and worth making some effort to avert.

(Of course, the opposite might be true. People might say, the apocalypse-averting cupboard is now bare. Come back to us in a decade.)

A problematic false Italian friend

For some reason I’ve been reading a lot of Italian epidemiology reports lately, and my Italian isn’t very good. So I found myself at first assuming that counts of “ricoverati” cases were those who had recovered. And that made it really confusing that this document estimates the median time from “ricovero in ospedale” to death (4 days). I had to look it up to discover that ricovero actually means hospitalised (and more generally, sheltered).

The unexpected epidemic: A political paradox

An epidemiologist says, “A new pandemic will definitely sweep the world some time this century. But you won’t know until the day it starts when it will be. So you’d better start preparing now.”

The president is downcast. He doesn’t like preparing, but he also doesn’t like when the stock-market falls and people on TV blame him for millions of deaths and blah blah blah. What can he do?

His son-in-law comes to him and says, “I read a book on this. This prediction of an unexpected epidemic can’t happen. Imagine it’s 2099 and there hasn’t been a pandemic yet. Then people would know it has to happen in 2099. So it has to happen earlier. But now, suppose we get to 2098 without a pandemic. We know it can’t happen in 2099, so we would know for sure it must be 2098, which would contradict what the so-called expert told us.” And so, step by step, he shows that the unexpected pandemic can never happen.

You know the rest: The president disbands the National Security Council pandemic preparedness team and writes a celebratory tweet. And then in 2020 a pandemic arrives, and the president announces that “this is something that you can never really think is going to happen.”

(For the original version see Quine’s “On a so-called paradox“. For an account of some of the many times experts warned that a pandemic was coming and would be disastrous, see here.)

COVID-19 and the Dunkirk spirit

My recent post suggesting that the government may have some reasonable thinking behind their go-slow-but-not-too-slow strategy had two underlying errors:

  1. I assumed they knew what the NHS capacity is, and were trying not to linger too long in the period where there is plenty of spare capacity. In fact, resources already appear to be overstretched, particularly protective equipment (PPE), even though the epidemic has barely started, and there are just a few thousand cases in total so far.
  2. I neglected to reckon with — what was otherwise obvious to me — Johnson’s Churchill complex. Johnson doesn’t have all that much in common with Churchill, but one thing the two do share is a mania for all manner of harebrained wheezes rather than careful dependable planning. Keynes famously said “Worldly wisdom teaches that it is better to fail with the crowd than to succeed unconventionally”. Johnson is one of those rare individuals who would rather fail unconventionally — or, at least, is willing to hazard a strong risk of failure for the compensation of being seen as brilliantly unconventional.

Now the government says they miscalculated, after a paper from Imperial College’s Covid-19 Response Team found that the previous strategy would exceed available ICU capacity by a factor of 8! Did they misplace a decimal point? So suddenly the schools, gyms, and everything else that was announcing plans to cope with staying open through the epidemic is shutting down.

I find it genuinely shocking that the UK does not have a strategic reserve of PPE and ventilators, particularly the latter, as the shortage of ventilators was widely discussed in the press in 2009, in the context of the H1N1 pandemic.

Anyway, I’m glad I’m not in the US…

Californians panic-buying guns