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Covid-19 – Surfing The Third Wave
The second wave of the ongoing Covid-19 pandemic has receded and the people have had enough of restrictions. There is immense pressure to end the lockdowns and many politicians will do as their voters wish. But there will be a third wave and it is likely to become larger than the second one. Below I try to explain why that is the case and what it means for our societies. My conclusions may sound alarmist, and I may be all wrong, but the scenario is neither impossible nor am I the only one who thinks it is likely.
The Spanish Flu came in three waves spread over 18 month. By summer 1919 most populations had gained some immunity against it. During the winter flu season of 1919 the new disease was no longer a public danger.
Deaths per thousand people during the Spanish Flu
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Here is the similar curve for the United States during the Covid-19 pandemic.
The U.S. just finished what – in comparison to 1918/19 – is the second wave of the pandemic.
Source – bigger
The situation is similar in large parts of the world. The Covid-19 pandemic has just finished its second wave.
Number of new cases per day
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One or two weeks ago Europe and the U.S. reached the floor of the valley. From hereon it is another uphill climb. Despite continuing lockdown measures the rate of change of the number of new cases has already turned positive again. The number of new infections is growing again. The third wave has started.
Weekly rate of change of the number of new cases since Jan 1 2021
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What factors are at play now and how may they effect the shape of a third wave?
New variants of the virus, pharmaceutical and non-pharmaceutical measures will each have certain effects. But the people's behavior will be the most important factor.
New variants:
In Europe as in the Americas the British B.1.1.7 variant of the virus is now becoming dominant. The strain is 50% more infectious and more deadly than the virus variants that have been circling so far. (There are additional variants of concern (VoC) which will become relevant in later phases, especially those which can infect people who are immune against the original virus.)
The numbers from Britain and Denmark show that it only takes a few weeks for a better adapted strain like B.1.1.7 to gain the upper hand.
Source – bigger
Pharmaceutical interventions:
We do not have proven medications which could help to suppress or heal Covid-19 infections. (Some candidates are still in development. Others, like Ivermectin, are still in trials.)
Luckily, and unlike in 1918/1919, we now have vaccines that work well at preventing serious illness and death. Studies from Israel (1, 2) and Scotland (1) show high vaccine effectiveness in the population. This stuff works.
But population wide vaccinations take time. At the current rate it is unlikely that vaccinations will be sufficient to suppress a third wave. They may dampen it a bit but that is all we can hope for.
The currently ongoing vaccination of priority groups, the people most endangered, will help to keep death within those groups down.
Non-pharmaceutical interventions:
Non-pharmaceutical measures like lockdowns and mask mandates have helped during the first and second wave to push the replication rate R below 1. But the next wave will come with a 50% more infectious variant of the virus. To keep the replication rate under 1 in the third wave would thus require stronger non-pharmaceutical measures to keep the virus under control.
The rate of increase of new cases in Denmark from week to week is now at 33%! This despite ongoing lockdown measures.
Weekly rate of change in the number of new cases since Jan 1 2021
Source – bigger
Behavior:
There is a growing share of the population that ignores lockdown and mask mandates. These are not all Covidiots. The people have just had enough of it.
Arash @thekarami – 15:26 UTC · Feb 27, 2021
Replying to @thekarami
These lockdowns are beginning to resemble the forever wars in that any time someone speaks against them you get a whole bunch of people screaming that we must continue until we reach an arbitrary and ever moving goal.
And for those of you who are new, I’m not a covid denier, I’m not anti-mask, my brother is a doctor at a hospital and impacted directly, I took this seriously for the first three months, six months, nine months but it’s been 12 months and they’re talking about 2022? 2022!? No.
Conclusion:
The third wave will come with a stronger virus gaining dominance. In some countries (esp. eastern Europe) most people already ignore the lockdown measures. It is unlikely that the authorities will be able to press for even stronger ones. We will have to surf this wave without the effects of most of them.
At the end of the Spanish Flu pandemic the population had reached some kind of herd immunity. Enough people were immune against the virus to prevent further large outbreaks. A large part of that herd immunity was achieved during the second wave of that pandemic when many, many people got infected. The third wave was therefore smaller than the second one.
In Europe and the U.S. we are, even after the second wave, far away from herd immunity. Less than 10%-15% of the populations has had the disease and achieved immunity. Immunity can be reached through infection or through vaccination. Over the next weeks we will only have enough vaccination capacity to immunize the most endanger 10 or 20% of the population. The other 70 to 80% are still not immune and still endangered.
All this makes it likely that the third wave of this pandemic, with a stronger virus, less effective interventions, little herd immunity, will become much bigger than the second wave. Instead of 250,000 new cases per day in the U.S. during the top of the second wave we may see 2.5 million new cases per day during the third wave.
There is one factor that may prevent that. It will get warmer and seasonality does play a role in respiratory infections. But mid June to August 2020 saw a strong increase of cases in the U.S. and South America and South Africa were hit strongly even during their summer time. I am therefore skeptical that seasonality will be of much help.
One may think that larger numbers of infections will not matter much as the most vulnerable people will have been vaccinated and are protected, that the hospitals will not become overwhelmed and that the number of deaths will not increase that much.
But that would be wrong.
About a quarter to a third of the U.S. population has a condition (overweight, diabetes) that makes it vulnerable to Covid-19. Not as much as very old people but still to a significant degree. At ten times the infection numbers of the second wave we will certainly see many more people in need of professional medical help than we did see before.
But the old people will have been vaccinated. The ICUs will not be filled with them like they were during the first and second wave. Younger folks, getting infected at a rate ten times higher than through the second wave, will fill the ICUs.
There will no longer be grandpas or grandmas of age dying from Covid-19 but mothers or fathers in the best years of their lives. The sum of years of life lost (YLL) during the third wave will therefore likely exceed the sum of the second wave.
It is difficult to say how long it will take for the third wave to reach its peak. As soon as lockdown measures end or fail we will again see strong exponential growth that may well exceed the growth we saw during previous waves. My hunch for the U.S. is that by the end of March to mid April it will be see the strongest growth so far of new cases.
Then again – that's just a hunch and I may be all wrong. In fact I hope that I am all wrong.
Jackrabbit @ Mar 2 2021 19:55 utc #109
You are clearly smart enough to understand how this works. This brings to mind Upton Sinclair’s
Why are you allowed to not understand something I said (“makes no sense to me”), while when I say I don’t understand you, all of the sudden I am one of Upton Sinclair’s evildoers? I will not use the obvious rejoinder of “projection” because I am trying not to be insulting. I ask the same courtesy of you.
Can we keep this on an equal footingl? Can you accept that I find your logic unconvincing?
Part of it clearly comes from your insistence that “cases” are meaningful data. I only trust death rates; and even those are polluted by rules like “anyone who died who had a “positive test” – is that a case to you? – in the last X days died of covid. Motorcycle accidents, hospice patients, etc.
I have not bothered to look up case rates, because they are such an incommensurable pile of data. What CT was used? Was the same CT used for all tests? At what point in time after purported exposure was the test taken? Was the test only administered to people showing symptoms or more randomly?
But the miscommunication is even worse:
1) ‘Cases’ are not ‘test rates’
Please, what is a test rate? I used it as a synonym for a case, because the number of cases per x people is what I call the positive rest rate. If there is a distinction, please spell it out for me.
First you say that death rates obscure “the truth”…
No, I didn’t say that that. I said that “Cases are important too.”
The complete quote is:
Your focus on death rates is obscuring what really happened. Cases are also important.
In my world, “what really happened” and “the truth” are, again, synonyms. Your “I didn’t say that” tried to give the impression that you only said “Cases are…”, but the entire quote includes the part that I quoted, with what I thought was an obvious synonym.
If you want to pick nits, I can pick with the best of them. So, can we please stop this quibbling?
The Swedish experience is not something that proves that anti-pandemic measures are unnecessary and/or don’t work.
Well, now we are back to square one. The only reason I joined a covid thread was because I thought that by limiting the argument to hard data about Sweden I could have a fact based discussion about the statistically demonstrated ineffectiveness of hard lockdowns.
But, after all we have said, you are back to asserting that the Swedish data is not definitive. I guess that is some small progress in that you do not say the Swedish data proves that lockdowns are necessary. You just leave it as “not something that proves”. To me that is a synonym for inconclusive.
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Could we just agree to disagree? I know that is rare these days, but I just returned here after a ten month absence. I don’t want to make enemies on the first day. If I determine that your position is the sense of the board, I will just avoid covid threads. Or, if it gets worse, just leave again. I’m not going to fight city hall.
Posted by: john brewster | Mar 3 2021 2:00 utc | 115
Jackrabbit | Mar 3 2021 15:51 utc | 134
Jackrabbit: Here is some context about my personal style and my attitude about covid. I hope it helps improve our communication.
In conversations, I often have several possible interpretations running, in my head, until some further talk eliminates them. So, I will often ask questions to proactively eliminate interpretations. People tend to find these questions either irritating or stupid. If they pick irritating, they often project their favorite irritant onto what I’m saying and label me. Its happened all my life. But after people get to know me, they understand I’m not trying to be a dick; that’s just how my brain works.
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Let me be clear. I hate libertarians. They were the original cutting edge of the privatization, deregulation, austerity assault on national governments, and indirectly, on the middle class. No surprise, since they were funded by the Koch brothers. Their entire shtick (force and fraud) is a high-school debating team swindle in which they redefine those basic words to suit their purposes. My first encounters on the internet were with those ideologues. They were still actively hating on FDR in the 1980s, like he was still alive.
IMHO, their anti-war stance is a “broken clock is right twice a day” situation. Notice that they never really go to the mat for that stance, whereas they sure do for their economic stances. I will give them credit for supporting marijuana legalization. But genuine progressives (as opposed to Wall St.-MIC frontmen) have those policies without the noxious Randian posturing.
I especially despise the techno-libertarian hypocrites, who’ve made massive fortunes from products that came directly from government funded research (integrated circuits, internet, GPS, touch screens – see Mariana Mazzucoto). Peter Thiel is at the top of my shitlist.
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It will not surprise you, I hope, to learn that before I was “retired”, I was a scientist (specifically biophysics, working in drug discovery). I bring that worldview to my writing/commentary. I question everything.
Internet discussion boards are not good venues for debate. The focus and flow of discussions are easily disrupted by “thread-jacking”. But its more basic than that.
Political discussions are problematic to begin with because the borders of what is germane are usually poorly defined. Political positions encompass many topics, and a discussion that starts on topic A has often generated many sub-arguments and wound up on topic Z.
From my scientific POV, the whole thing is an example of the Quine-Duhem thesis Quine-Duhem thesis Here is a popularized explanation of that:
The point, first stressed by Quine (1961) is that any hypothesis confronts the world intertwined in a whole mesh of other hypotheses, laws, and statements of initial conditions. Given disconfirming evidence, consistency requires that some statement(s) of the premises be abandoned, but we are free to choose which premise we shall abandon and which we shall save…Typically, we choose to save those hypotheses that are most central to our conceptual web and give up peripheral hypotheses or claims about initial conditions. But that very choice renders those central claims very hard to refute, indeed, almost true by definition…One can consistently maintain that the world is flat despite almost enormous evidence to the contrary.
– Stuart Kauffman, The Origins of Order
Bottom line: My experience is that without cooperation from all participants, its really hard to keep an internet discussion on topic and civil. Typically it degenerates into people sniping at each other from “central claims” mental fortresses.
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When you put the topic of covid into that framework, you can see that it is going to be chaos squared. There is the normal Quinian position-defending. But much worse, there is massive scientific and statistical illiteracy. (Not saying that is true of this board or any of the regular posters.)
I recently took my first and last spin in the cesspool that is Off-Guardian’s discussion section. I encountered a well-established group of nutbags who claim there is no such thing as a virus. Wow! If you want to crush the anti-vaxers, just repeat what these ideologues are saying. Having said that, some of the actual articles they post have useful information.
However, even discussing the so-called “scientific data” with non-nutbags is perilous. I find it bizarre that people who have always distrusted the corporate media and all the lobbyist-funded apparatchiks burrowed into our government suddenly believe that the government really wants to help the 99% and that the corporate media are telling the whole truth. People repeat garbage statistics and amplify fear-mongering tabloid nonsense. The Gates/Fauci party line hysteria is so horrid that the no-virus nutbags get some traction with the scientifically illiterate.
The next level of the problem is that its tough to even access the raw statistics. They have been pre-cooked by laws mandating covid diagnosis, by diagnostic symptoms so vague and broad that just about anything could be labeled covid. Lately, the symptoms on vaccine harm have been similarly cooked by doctors attributing people dropping dead a few days after they received the vaccination to old age or comorbidity, when exactly the same argument against covid has been dismissed with extreme prejudice for a year.
The last hurdle is that, even if you can get raw data, you need to be statistically literate to find all the tricks.
To the statistically literate, the science side of covid fear-mongering reeks of “p-hacking” or “harking“. (Note that the widely villified – yet scientifically illustrious – Dr. John Ionnidis is a co-author on the latter paper.) p-hacking means looking for a (usually hard to find) data set with 3-sigma statistics (99.3% likely to be true) that matches your hypothesis; or sometimes, just finding a data set with significance and building your hypothesis around it. The latter case is called Harking (hypothesis after results known) – the equivalent of drawing the bullseye after the arrow has landed.
That’s my take on covid, and that’s why actual deaths with legitimate cause of death statements is the only statistic that I even come near trusting. I hope I have explained my position. You are not required to agree, and my point was not to provoke another round of argumentation. It was merely to explain where I’m coming from.
So, I’m not going to restart the argument around
the same tired themes that have been debunked many times:
• Masks don’t work;
• “Lock-downs” [a misnomer] don’t work (Sweden!);
• Only the old die;
• Pandemic virus is just the flu or no worse than the flu (“no flu this year”).
You are right back to blowing off the discussion we just had. Fine. Let’s agree to disagree. Otherwise we are just sniping at each other from our mental fortresses.
To sum up:
STATEMENT: I accept that there is some new disease variant out there called covid. But I do not believe the lockdowns and demands for mass vaccination are justified given the massive social and economic harm they have caused and continue to cause. I think the at-risk population should have been quarantined, not everyone. I think the so-called mRNA vaccines are little more than human experimentation and that the propaganda push to take them is disgraceful. If I am coerced into taking something to be allowed to move about in what will, by that fact, be a police state, I will take the J&J or AZ products – because they are genuine vaccines, not experimental human genetic engineering with completely unknown long-term side-effects. That is not an endorsement of those products, merely a statement that they are less dangerous than the other products.
Posted by: john brewster | Mar 3 2021 18:15 utc | 136
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