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Coronavirus: the revenge of the old gods!

I’ve been waiting for the pandemic to reach India. And not just me. Every day for the last week I see headlines which shout: “India the next hotspot!” In fact, Bloomberg put up a video interview, Is India the Next Coronavirus Hotspot?, predicting 300 to 500 million infections, just before I wrote this post.

But, it hasn’t happened yet. Yet. I’m not holding my breath. But until India explodes, we can still make jokes about caste, untouchability, and social distancing.

I just got off a podcast with Phillip “the Frog” Lemoine, where we discussed our coronablogging, and one thing we’re both struck by is the heterogeneity of the pandemic. The death rate is very high in Italy, rather low in Germany. And this difference persists. Spain is on an Italian trajectory, France is somewhat different. South Korea, Japan, Taiwan, and Singapore have contained the pandemic, all in somewhat different ways.

Coronavirus has been tardy to come to the tropics, and we’ve discussed why. Or possibilities for why.

But Phillip, and others, have marveled at the success of the Asian societies. Some peculiar internet Hindus claim that it illustrates the genius of the Sanatana Dharma. More generally, Hong Kong, Singapore, Japan, South Korea, Thailand, Cambodia, and India, are all are kingdoms of unreprentent heathenry.  They do not bow before the God of Abraham, the God of Isaac, the God of Jacob. In contrast, Shia Iran was struck early, and the pandemic burns quite close to the seat of the Roman Catholic Church. The kami take their revenge against those who have given themselves to the new gods.

I jest. But I think differences will persist, and in a year we’ll know why. It looks now that New York City will be the “American Wuhan.” This is appropriate in light of the fact that New York City and Wuhan have the same population, and only New York City of the great American metropolises resembles those of the Old World in its density.

In two weeks China will lift its lockdown on Wuhan. Today we are arguing about nationwide lockdown in the United States. But it seems eminently plausible that conditions for the coronavirus pandemic will be attenuated in some regions in comparison to New York City. Our problems could be more regional than we’d expect, and our solutions might have to be too.

Anyway, listen to my conversation with Phillip.

16 thoughts on “Coronavirus: the revenge of the old gods!

  1. I’ll be happy if its the American Wuhan.

    But I think we’re gonna be the American Lombardy.

    Do you agree/disagree?

  2. We touristed India last November. I was taken with the greeting custom of “namaste”.

    When the virus epidemic began to hit I suggest to friends that we should adopt the practice here instead of handshakes and hugs.

    No one laughed.

    I have wondered if the practice has arisen out of a cultural evolution that selected it a survival tactic in a land where there are many diseases floating around.

    I understand that the practice probably originated in religious purity rules that limited or forbade physical contact between certain classes of people. But, the process of evolution is blind to motivation. The only issue is whether persons who follow the practice survive and reproduce in greater numbers than those who do not.

  3. Incidentally. I never figured out what you were supposed to do when you were carrying a heavy object that could not be easily set down.

  4. India already is in lock down. So, I am not sure if there is any validity to predictions when actions were so swift and persistent.

    For comparison, India school closures occurred at about 500 cases which Canada did for the same number of cases at much much lower population. Per capita basis, density basis, India’s reaction was quite quick and tracing is quite diligent. So, extrapolating the rates to total number of cases may not turn out to have much predictive value.

    Good to see Allu Arjun making it to Razib Khan’s site. Long live AA!

    @Walter,
    People slightly bend their heads and bring hands towards chest when both hands are full. Happens quite often in temples when hands are full of worship articles (coconuts etc).

  5. The cOld Gods?

    (Re; India it of course probably doesn’t matter, but arguments have been made that levels of general social distance and closed off social groups in society reflect long term adaptation to pathogen presence).

  6. Although seems more appropriate for an Open Thread:

    Re; pinboard- “Swedes Try Laissez-Faire Model in Controversial Virus Response” – Indeed, Sweden being part of “mysterious low case:death rate” Nordic+Germany group (though there are others with low rates beyond this). Seems like the small Nordic countries will be the world’s true “natural experiments” in this. I hope this will not be a disaster for them.

    E.g. Iceland reports about a 1% prevalence in general population from their random sample of asymptomatic individuals – 48/5571 (courtesy of good old deCode genetics with which we’re well familiar; deCode apparently also found some interesting mutational fingerprints in their samples suggesting regional diversification, a cool genomic way of contact tracing samples from different origins and perhaps tracking population growth rate, see https://www.information.dk/indland/2020/03/forskere-sporet-40-mutationer-coronavirus-alene-paa-island, plus Google Translate).

    From the OurWorldInData stuff, reported of deaths and cases, Iceland’s raw CFR (case fatality ratio) is about 1/50 to 1/30 of Italy, and even allowing for the valid complaint of lag in deaths to case reports (allowing 7-14 days for identified cases to die, so thus comparing fatalities to cases 7-14 days ago), still about 1/35 to 1/20 of Italy (lag in death rates doesn’t smooth out the difference). That whole population CFR seems almost certainly an overestimate of the CFR from random sampled cases as it’s mostly gathered from people who reported symptoms, then were tested.

    Comparison of the discrepancies in deaths:population would then seem to suggest that prevalence in Northern Italy must be quite a bit higher than Iceland, perhaps an order of magnitude? There’s a lot of layered assumptions here though I must admit.

    This event may end up being proof that either relatively small, developed polities are absolutely vastly, vastly superior in making health policy decisions (compared to huge, coordinated entities who are shaken by risks), and that the high trust liberal social democrats did better than Singapore to boot. Or, assuming this is a testing error by deCode (about the only other way I can see to square the circle), I really hope they figure it out before it could go very badly wrong for them indeed. We’ll know in a month or a little more as more data roll in. Possibly this will age terribad in a week’s time.

    (I’d also have hoped China would’ve done a large random anti-body test sample in Wuhan… unless they have and for reasons of their own, just aren’t telling).

    Germany’s a larger country that seems somewhat of a check on this. CFR (again, allowing for lag) is closer to Iceland than it is to Italy (about on the same order of magnitude at least, a little higher by a factor of 2 perhaps).

    One point about Germany is that the median age of their cases is 46 (per “Germany’s health institute”) which closely mirrors the median age of the country at 47.1, while in Italy it is 63, against a country median age of 45.5. (Ages from an article in the Daily Mail, which also notes UK’s case age at 64, even further out from country median at 40.5). Note Germany and Italy are the 3rd and 5th oldest median age countries at the mo.

    Suggests that Germany’s sample of cases is at least pretty representative age wise (if not in terms of underlying health conditions etc), while Italy is skewed almost 20 years older than its general population… Unless there’s a reason to think infection rates, rather than just symptoms, really would skew older, that seems to hew to Germany’s sample being more likely to be true cross section.

    (The commentary on Germany’s cases seems odd to me in that commentators often seem to be under the impression there is something “wrong” with Germany’s sample being young, and that this is evidence that their testing is going wrong… when it matches the age dynamics of the country and what you’d expect for a virus that doesn’t care about age.)

  7. The virus may not care about age but age cares about the virus. Old people who have it are more likely to be symptomatic and the symptomatic old are more likely to die from it. If the young also come out of it more quickly, testing is also more likely to miss some of them who no longer have it.

  8. Re “Social Distancing for 3,000 years”

    See “Plagues and Peoples” p110-111 (per Amazon Preview, don’t have the book on me)

  9. The Thirteenth Century Jewish philosopher, legist, and physician, Moses ben Maimon, known in the West as Maimonides and often referred to by Jews as Rambam, posited that many Jewish dietary and other rules were intended by their legislator to protect the health of the Jewish people.

    Like the Indian customs, many of them are rooted in religious purity rules, some of them may have survived because of their actual utility, such as hand washing before eating.

  10. @Matt;

    was that iceland study a PCR or antibody? I suspect PCR.

    The exclusion of antibody tests in the public discourse is staggering. There was a researcher at Columbia, but she had to stop her efforts because it is “non-essential”. Singapore did antibody tests but did find only 2-3 of population exposed.

    Oxford group models 50% of UK population exposed.

    https://www.dropbox.com/s/oxmu2rwsnhi9j9c/Draft-COVID-19-Model%20%2813%29.pdf?dl=0

    Again this is what is missing from the temperature studies. Healthy throats and nasal passages. If you’re not showing symptoms, that is a low viral load, and if you are not coughing much harder to spread a virus.

    If you do spread it to your partner in bed, again they will get a low viral load.

    The key is keeping it out of the hospitals.

  11. I am completely mystified by Japan’s low coronavirus case numbers and death rate. The government controls to prevent the virus spread have for the most part been lax and voluntary. Japan’s leaders have been criticized for their indifference and slowness to react to the crisis, yet today Japan has only 1193 cases and 43 deaths. This is in a country the size of California with 126,000,000 people and where travel by mass transit is the rule. The first coronavirus infection was confirmed almost two months ago, January 28th.

    Could some kind of medical cover-up be in place? For example, if a old person with an underlying condition dies of pneumonia they simply aren’t tested and their death is attributed to preexisting condition or pneumonia?

    These numbers are so odd compared to what is happening in the rest of the world that even Japanese journalists wonder why they are such an outliner.

    https://www.japantimes.co.jp/opinion/2020/03/21/commentary/japan-commentary/japan-still-coronavirus-outlier/#.XnuYHXVKg3F

  12. @charlie, yeah, seralogical testing has been raised a lot in the last day or so (Oxford Epidemio. paper).

    It does seem to me though, that it shouldn’t change too much, assuming we are right that this thing is exponentially growing and cases take some time to recover, then there shouldn’t be too much of an issue with recoveries.

    Iceland have recorded about 10% recoveries of cases – https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Iceland. Though of course that sample may be somewhat biased for a slow to recover population, and it may be that no-one is really keeping any accurate information about “recoveries” in a non-hospitalized and asymptomatic population, and if the majority of cases are very quick to recover then I suppose it may be more of an issue.

    Unless we’re *really* wrong and it’s not growing exponentially, in which case the data are worse than worthless, exponentiality a data artifact, not even as a representative count that is off by an order of magnitude or something like this. In which case “Once in a century evidence fiasco” would be a once in a century understatement and confident predictions on the data a once in a century act of being wrong! But that seems impossible to believe.

    (Their 50% upper bound seems far too high to be consistent with the data from other parts of the world – death rates, levels of hospitalization etc- but still seems there’s a lot of room for cases to be higher than we know, while deaths less so).

  13. Listening to your voice at .5x speed on google podcasts is the funniest thing i’ve heard in a while. i needed a good laugh. reminds me of fear and Loathing in Las Vegas when Flea is licking the LSD off of Johnny Depp’s arm:)

  14. Wuhan residents estimate region’s coronavirus death toll much higher than reported
    by John Gage | March 29, 2020 | https://www.washingtonexaminer.com/news/wuhan-residents-estimate-regions-coronavirus-death-toll-much-higher-than-reported

    * * *

    Officially, there have been around 3,000 deaths in the Hubei province where Wuhan is located, but residents think the total is more likely 42,000-47,000.

    They have estimated that the seven funeral homes in the Wuhan area are giving out 3,500 urns each day. Another calculation estimated the capacity for each funeral home in cremating people. Both estimates have led them to conclude that likely over 40,000 people have died in the area.

    * * *

    Stacks of Urns in Wuhan Prompt New Questions of Virus’s Toll
    https://www.bloomberg.com/news/articles/2020-03-27/stacks-of-urns-in-wuhan-prompt-new-questions-of-virus-s-toll
    March 27, 2020

    The long lines and stacks of ash urns greeting family members of the dead at funeral homes in Wuhan are spurring questions about the true scale of coronavirus casualties at the epicenter of the outbreak, renewing pressure on a Chinese government struggling to control its containment narrative.

    The families of those who succumbed to the virus in the central Chinese city, where the disease first emerged in December, were allowed to pick up their cremated ashes at eight local funeral homes starting this week. As they did, photos circulated on Chinese social media of thousands of urns being ferried in.

    Outside one funeral home, trucks shipped in about 2,500 urns on both Wednesday and Thursday, according to Chinese media outlet Caixin. Another picture published by Caixin showed 3,500 urns stacked on the ground inside. It’s unclear how many of the urns had been filled.
    * * *

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