A Sunday reflection

The BSing of the Red Death: and a K.I.S.S. model for the coronavirus pandemic

Reuters/Ipsos poll this past week found that only 2 in 10 Republicans, vs. 4 in 10 Democrats, say the coronavirus poses an imminent threat to the United States. In keeping with that lack of concern, fewer republicans are taking any steps to prepare, such as washing their hands more frequently.

Anecdotally, from several GOPers in my neighborhood as well as from the proverbial table of old white men at the coffeeshop in the morning, I have overheard conversations all but trumpeting that “coronavirus is a hoax.” I think it was Chris Hayes who has said that Trump is trying to “BS his way through a pandemic.”

This derisive lack of concern reminded me Edgar Allen Poe’s story “The Masque of the Red Death.” In case you’ve forgotten your high school reading, in the story, during a plague known as the Red Death, a masquerade ball is thrown by Prince Prospero for numerous wealthy nobles, as they all hide in an abbey.  Despite this, during the revelry, a mysterious figure – presumably a personification of the Red Death itself – enters and all of the revelers die.

So, how many people might die as a result of Trump’s treating the coronavirus outbreak as a PR and re-election campaign issue, rather than a public health emergency, and when will it likely happen?  Just to give myself some markers, I did what I normally do: try to game this out.

So far, it seems that serious coronavirus cases have been increasing 10-fold every three or four weeks. Put another way, doubling about once a week. If there are currently 10,000 such cases worldwide, including 200 in the US right now (the latter being Pence’s most recent number), how quickly does this spread?

Further, let me use 3 possible scenarios: one where warm or hot weather does not drive the virus into hibernation, and two where it does, using April 1 and Memorial Day weekend as bookends. Here are the dates of 10-fold increases:

March 6: 200 serious US cases
March 28: 2,000
April 17: 20,000
May 7: 200,000
May 27: 2,000,000
June 16: 20,000,000
July 6: 200,000,000

Under the no-hibernation model, if we figure that there are 4 non-serious infections for every serious infection, that would mean that by the 4th of July, virtually everyone in the US will have been infected. I won’t even tally how ghastly a 2% fatality rate would be.

Under the Memorial Day hot hibernation model, about 1 in 30 in the US population will have been infected, two million seriously so, and there will be about 200,000 deaths at a 2% mortality rate. That’s twice the normal seasonal flu fatality count.

Under the April Fools Day warm hibernation model, there will only be about 3,000 serious US infections of 15,000 total infections, with 300 deaths.

Given the extreme difference in outcomes from the three different hirbernation models, tracking the outbreak in tropical regions and also the global south – where it has been summer – will give us important information.

I am cautiously encouraged by the fact that two developing countries in the tropics close to China – Vietnam and the Philippines, respectively – have only reported 18 and 2 cases, respectively. Neither has recorded any deaths. Neither have any local community clusters. The majority in the Philippines have been travelers from China. On the other side of the globe, Brazil has eight cases, with one case with local transmission. The rest are travelers who returned from China or Europe.

Meanwhile in the global south, where summer is just ending, Australia has 53 cases, most of which were travelers from overseas. South Africa has only two cases, both of which are travelers who returned from Italy. Chile has three cases, all of whom recently returned from Europe. Argentina has eight cases, all of whom also recently returned from Europe.

In fact the only tropical or southern country that has reported over 100 cases is Singapore, according to the latest Johns Hopkins interactive chart.

I don’t mean to give false hope, and assume that hotter weather will help. But it’s a possibility worth exploring. All of these could simply represent the immediate onset of a pandemic and/or underreporting. Within two to three weeks, we ought to have enough information to make a better guess which of the three hibernation models is closer to the truth.

And keep in mind, even in the most benign warm hibernation model, coronavirus returns next winter. This is what happened with the Spanish Flu a century ago. It took three years for the disease to infect virtually every person on the globe, ultimately killing 2% of the entire world population.