April will be the cruelest month – mixing, as it will, our memories and desires from spring’s gone by. But we live in the present, and, today, I’m going to take a step back from current events – unfolding as they continue to at breakneck pace – and try to reflect a little bit on the broader context and what we do and do not know about where we are and where we’re headed.
One thing we do know for certain is that the economic and social impact of the COVID-19 pandemic has been – both in its scale and its swiftness – almost unimaginable, and almost unimaginably devastating. Congress has now passed an unprecedented $2 trillion dollar relief bill / bailout / corporate slush fund disguised as aid; here in New York, an already ailing MTA has been hammered; and across the Atlantic, the disease has even reached the British Royals. We must all now worry for the health of the Queen.
But a great deal remains unknown about the disease itself, and to the extent that I’ve been devoting significant time to trying to project the pandemic’s course in NYC, I’ve been engaged with some of those deep uncertainties on a day-to-day basis. Estimates of the disease’s reproduction number, case fatality rate, and the extent of its spread to date all vary quite widely. In fact, we don’t even know, conclusively, whether hot weather will slow the spread of the disease or not. Setting aside the denialists – who speak from places of pure ignorance, hubris, machismo, and self-interest (to get the economy restarted, avoid taking responsibility, etc., etc.) – there has remained room for doubt about the exact nature and expected global course of this disease.
I have a love-hate relationship with Radio Open Source, but I found two recent episodes worth listening to: This one, in which one of the interviewees (Megan Murray, I think) rightly pointed out that this is not “the big one,” and this one, in which John Ioannidis makes a contrarian case regarding our responses to COVID-19 which you can read here for yourself. That same friend in the UK – Frank for our purposes – sent me this New York Magazine piece which references this draft paper out of Oxford University, and while NY Mag, as Frank pointed out, badly mischaracterizes the paper’s conclusions (suggesting that the researchers had found that “half of the population of the United Kingdom may have already been infected with the coronavirus,” when, in fact, the paper simply models a possible outcome in which that would be the case), the researchers do make clear that there are multiple different mathematically sound ways to model the behavior of the virus which would lead to similar outcomes which in turn conform to the empirical data we have so far (or had, at least, at the time of the paper’s writing) about its death tolls in the UK and Italy.
Anyway, let’s not get too lost in the weeds here. Humility demands that we all acknowledge that we all don’t know a lot of things, and there’s nothing to better instill humility than a pandemic. Some things can be figured out relatively easily though – Wuhan is a city of roughly 10 million people; China has a population of roughly 1.4 billion; in Wuhan, where drastic measures were taken to curtail the spread of the disease, between 2,000 and 3,000 people died (I’m going to use 2,500 because I can’t find an exact number for the total, but see a figure putting the Wuhan death toll alone above 2,100, and know that the Hubei province toll has been below 3,200 to date); if we multiply 2,500 by 140 (which means we’re assuming that the whole population of China has the same susceptibility to the disease as do people in Wuhan) we get 350,000. Total global population is around 7.8 billion, so if we further assume that all people on Earth are just as susceptible as people in Wuhan, and multiply 350,000 by 5.5, we get ~2 million. An average seasonal flu kills an estimated ~300,000 to 650,000 people around the world in a year, and the last unusually deadly flu pandemic (in 1968) killed between 1 and 4 million people at a time when the world’s population was less than half of what it is today. Long way of saying that, back-of-the-envelope, if the virus were allowed to spread everywhere evenly but then checked everywhere, in turn, with the strictest of measures once it hit a Wuhan-level of spread, we could expect to see a global death toll on the scale of a serious, but not a catastrophic flu pandemic.
That’s a lot of ifs though, right?
Still, that is why this is not the big one. For the New Yorkers among my readers, it might be instructive to think of the 2009 H1/N1 pandemic-that-wasn’t as akin to Hurricane Irene; there was a lot of sound and fury, but then, at least for those of us in the City (for Irene caused destructive flooding elsewhere), it turned out to be, mostly, a non-event, but also lulled us into complacency. What we’re going through now is like Superstorm Sandy. Seems pretty damn awful, right? What we could see in the future would be a repeat of the 1918 – 1920 flu pandemic that, allowing for uncertainty, infected a double-digit percentage of the world’s population; and killed at least a solid single-digit percentage of the people who became infected (including a large number of healthy, young adults) and, overall, a low single-digit percentage of the total global population. A future pandemic on that scale is like the global climate crisis, except, of course, that the global climate crisis is much much worse.
No pandemic has yet ended human history, but climate disruption certainly could.
People who’ve been following my doings lately know that I’ve been making a lot of graphs. The one which follows is of a different and more quotidian sort – it’s about the weather.
This graph would seem to substantiate that we’re having some pretty peculiar weather this March, though not entirely in the ways we might expect; and, of course, it’s unreasonable of me to compare the data for one year (always more likely to be erratic, and less likely to show discernible patterns) with long-term trends. But, interestingly, I’d say the peculiarity of this early spring has mostly been lost on a panicked New York population being subjected to harsh “non-pharmaceutical interventions” which – like the measles – we thought until quite recently were a thing of the past.
What if, in Wuhan, as (this is purely speculative) now in Italy and New York City, the entire population was actually infected before any significant measures were taken to combat the pandemic? Sort of like taking antibiotics once you’re body is already in the process of overcoming an infection; you take the drugs at the peak only to think it was they, and not your immune system, that made you better. This would be the herd immunity argument, and for now, we have no way of knowing if it has any value whatsoever. In Lombardy, a region of Italy with a population roughly equivalent to that of Wuhan, people continue to die in large numbers from COVID-19 (hundreds a day; remember from the infographic above, tuberculosis, the most deadly disease in the world, kills roughly 3,000 people worldwide daily), and the death toll in Lombardy – as of this writing, around 4,500 – is already at least 50% higher than that in Wuhan (though Lombardy’s population is, I’m told, on average, older, but then again, the air pollution is much worse in Wuhan). In my view, this hypothetical – in which our interventions are actually useless because they come too late; everyone is already infected; the vast majority of people show no signs whatsoever of having been exposed to the virus; and the death rate is actually a small fraction of what most people currently think it is – seems unlikely, but – given the radically different approaches to the disease being enacted, or not enacted, as the case may be, at present by countries around the world – we should soon have the results of a natural experiment to guide us out of our current confusion.
In the meantime, let me, finally, just steer the conversation once again back to climate. Commentators are prone to metaphors – which I generally find dehumanizing, though have likely myself been guilty of employing at times – that liken epidemics to floods and wildfire. But as relates to wildfires, at least, I think there’s more than a metaphorical connection to be made. In recent years, in California, in the Amazon, and in Australia, among other places, we’ve witnessed catastrophic fires of staggering proportions. It’s not that they’re entirely unprecedented in history, but their occurrence one after another all around the world certainly feels anomalous (on top of record fire year after record fire year in many different widely-distributed locations). But haven’t we created the conditions for these blazes? Through misguided land-use and forest management policies; encroachment; carelessness; infrastructural design; and, above all, through anthropogenic climate disruption and its chief signal, global heating?
Zoonoses have no doubt manifested across human history, but circumstances such as our present one have never before existed, in which human encroachment on non-human animal habitat – itself likely driven by food scarcity, urbanization, and a host of other factors – creates conditions that make zoonosis far more likely to occur at the same time that global air travel and circulation of goods create perfect conditions for the spread of contagious disease, while simultaneously, human settlement patterns (read: the way we live together cheek-by-jowl in large cities), air pollution, diseases of diet and lifestyle, etc. all make us more susceptible to this current pandemic which is, of course, dangerous not only to elders, but to those with respiratory ailments related to smoking and air pollution, as to individuals with co-morbidities like diabetes and heart disease, suffering from which is largely a function of sedentary contemporary ways of being and industrial food production. Even the way we cluster our elders in soul-sucking “homes” (as the way we travel in air-tight metal tubes through the sky or “recreate” on giant floating amusement parks with recirculated air) creates conditions very much conducive to the spread of disease.
Capitalism and climate crisis converge in our vulnerabilities, and what once would’ve generally been localized (if shattering) phenomena – a fire triggered by a lightening strike or a controlled burn gone out of control; an outbreak of a disease in a particular population that remained largely regionally confined, or took years and decades to spread widely – now become instantaneous / simultaneous global crises.
That’s probably enough for today, but if you’re looking to do something worthwhile after all this reading, please consider donating to the National Domestic Workers Alliance Coronavirus Care Fund; at least have a look at One Million Masks (I’m a little skeptical of their focus on exclusively private hospitals, as I think the need is greater elsewhere, but there’s no question that all of our healthcare workers – and healthcare support staff – should have adequate PPE); consider playing with Folding@Home’s crowd-sourced COVID-19 protein simulation (which I came to through Manhattan Borough President Gale Brewer’s daily COVID-19 newsletter); complete the 2020 US Census if you haven’t yet and it is relevant for you (like our democracy itself, it is problematic, but it takes maybe five minutes and may give you a little additional hope for the future); sign this letter in support of the New York State Nurses Association’s COVID-19 Surge Action Plan; and read this short, powerful piece by my partner – Birth Centers NOW – on the urgent need for alternative birthing sites in New York City as we accelerate into the worst of this crisis.
(For my convenience, all influenza numbers above were sourced from Wikipedia.)