Covid-19 Thoughts

It’s been a couple of months that I have been working on a Covid-19 statistics app. At this stage I intend to just do bug fixes and start working on a completely different app. But before I move on, I think it is worthwhile reflecting on where we are with Covid-19 and not where I am with the app. The app was designed to make it easy to see the statistics and to pick up trends which we can learn from. So, what can we learn?

I must first offer a disclaimer, that I am not a doctor, have no medical training, but I do keep up with news outlets from trusted sources (not Facebook shares!) And I have also spent the last couple of months writing this app. I have looked at these statistics for so long and when there is something which I thought would be useful to know, I’ve written some functionality to get that information from the raw data.

Firstly, there are some undeniable facts (although I know that some people like to deny the undeniable).

1. Covid-19 has had a more significant impact on the world than anything else in my lifetime (and I’m no spring chicken anymore). The impact has been in terms of health, with well over 600,000 people currently killed by it and well over 15,000,000 people having caught the virus.
2. Covid-19 does not affect all people in the same way. It goes all the way from not having any symptoms for some people to death for others. In addition, we don’t know what long-term effects the disease has on everyone, including children.
3. Despite some people not taking it too seriously at the beginning and saying it will go away when the warm weather comes, the warm weather came and the virus spread faster. The daily rate of new cases is higher today than it has ever been before. Arizona is very hot and yet there is a steep incline in new cases there.
4. Despite some people claiming that the only reason for the increase in new cases is because of the increase in testing and deaths are still going down, that has proved to be false. Now deaths are increasing at a rapid rate and the daily death toll is now around what it was in April as the lockdown was starting to take effect. (Yesterday was just shy of 10,000 deaths worldwide)
5. This virus is not going away soon.

There are also theories that scientists first believed to be the case which have changed as more knowledge and data have been gathered. This is not to say they got it wrong, but science is about coming up with a theory based on what you believe to be true and finding evidence which either proves or disproves it. At the start of the pandemic assumptions were made that the virus would behave in a particular way, based on how most viruses behave. There is no evidence one way or another at the start, but as more data becomes evident, then the initial hypothesis is either proved or disproved. Here are examples of what I am taking about.

1. Initially it was thought that the virus first infects a person, then symptoms develop and then the person becomes infectious and infects other people. That is the way that H1N1 and SARS behaved. However, it appears that with Covid-19 a person can be infectious before they develop symptoms. Indeed, they may never develop symptoms at all. This is what makes it so much more dangerous as people may be spreading it without knowing that they have the virus. The initial idea of isolating yourself at the first sign of any symptoms is the right thing to do, but it may already be too late by then as you may have infected other people already.
2. Initially most governments were saying that masks were not effective, now they insist that we should wear them. Why did that change? Did the virus change? Not at all. What changed is our view of what a mask is useful for. It is believed that the virus spreads through droplets. We pick those droplets up through touching infected surfaces and then through touching our faces. A mask will not protect us from that and that has not changed. What a mask will do however is stop us from unwittingly spreading the virus if we are infected without knowing it. The virus is also spread by droplets emitting from people’s mouths, as in sneezes or even just talking or breathing. Those droplets are caught in the fabric of the mask and do not spread to others, so the reason why we should all wear masks when in confined spaces outside of our bubble, is not to protect us, but to protect everyone else. That is why wearing of masks has to be compulsory, rather than voluntary, because it is not for our protection; it is to protect everyone else.

Then there are also a number of things that we still do not know.

1. Can people who have had the virus catch it again? In the vast majority of cases, you would have to say, not immediately. As people produce anti-bodies, then those anti-bodies will fight off the virus if it tries to re-infect us. What we don’t know though and it’s impossible to know at the moment, is how long those anti-bodies remain active. With some diseases we get lifetime immunity; with others, such as seasonal flu, we are protected for only a few months. As Covid-19 was not around a year ago, how could we possibly know if our anti-bodies could protect us for more than a few months? They may; they may not. We simply do not know.
2. Will there be a second wave worse than the first? Again, we simply cannot know at this stage. We can look back on other pandemics such as the Spanish Flu of around 100 years ago. The second and third waves of that were much more deadly than the first, before it eventually died out. If this is repeated with Covid-19, we could potentially have several million deaths worldwide.

Where do we go from here? Much of the world is emerging from lockdown, but that doesn’t mean things are going back to how they were before. The virus is still there and will be for a long time. People who have the virus still spread the virus. The only advantage that we have now over this virus that we didn’t have 6 months ago, is more knowledge.

When lockdowns throughout the world initially started, the question was “How long before we can get back to normal?” It is clear that there is no miracle cure or vaccine yet available, although some initial vaccine trials look promising. The reason for the lockdown was to stop people from mixing either socially or at work so that they do not pass on the virus. As a means of stopping the spread it has been successful. It comes though with a cost of destroying the economies and people’s livelihoods. People against the lockdowns have claimed that destroying the economy will kill more people than the virus will. I don’t feel though, that this should be an either/or question. The lockdown was to prevent the spread of the virus, so we have to look at how we can stop the virus spreading using other means and this is where the hard work starts.

With a lockdown, it’s easy to make a hard and fast rule that people have to stay home and some people may object but it’s easy to understand. If I am going to get back to life as normal, then how can I avoid getting infected? To me that is the wrong question. The right question should be “How can I avoid spreading the virus if I have it but don’t know?” If people looked at that question, which is one of selflessness, rather than the former question which is from a more selfish perspective, then we would go a long way to getting back to life as normal. Easing of lockdown has to mean that we have to change the way we behave. With all things, there is an element of risk. What we have to do is try all we can to keep that risk to a minimum. If that means wearing a mask, I’ll wear a mask. If that means avoiding public transport, I’ll avoid public transport. If I can’t avoid public transport, then what’s the least risky way I can travel?

The first thing is that, if I show any signs or even the potential for having the virus, I need to stay isolated and get tested. Until a few years ago, I was always proud of my personal work record in that I had never had a day off sick. Yes, I’ve had plenty of colds and flus over the years. One time (years ago) a day after returning from Zimbabwe, I started with some illness which was never diagnosed, but left me hot and sweaty, with no energy and difficulty breathing. I had never felt so ill before and have never since, but I still went to work as normal and struggled through. Now when I look back on that, I see it as far less heroic and more stupid as I didn’t know what I had, nor did my doctor, and I could have infected other people. It is vital that if we have any symptoms, we don’t struggle on at work, but stay home and not risk infecting others.

From the perspective of the economy, we are going to see a radical shift in how business is done. Some sectors will do well, and some will do less well and may even fail. This actually happens all the time in the economy anyway, and has done since the days of the industrial revolution. What is different now though, is that this shift in the economy is going to happen in a matter of months, whereby it would have normally taken several years, so it will hurt. As an example, most non-essential stores were forced to close during lockdown. People still needed certain goods so would buy them online. Now that stores have reopened, not everybody is going to go back. Over the last few years there has been a gradual shift to shopping online. Covid-19 caused a rapid acceleration in this. The amount we spend on retail overall remains at a similar total value, but the split between online and in store has shifted dramatically to online. The high street stores were already struggling; this has accelerated the decline. The wearing of masks in store may eventually give people more confidence to go back in person. Limiting the number of people in stores helps stop the spread, but isn’t good for sales. Some stores will adapt and survive, others will not.

When it comes to restaurants, masks are not required there. It doesn’t mean that that the restaurant environment is safer, therefore I don’t need to wear a mask. It’s impossible to eat while wearing a mask, so if that restaurant is going to stay in business, then other ways are needed to mitigate the risk. No self-service is one mitigation. I should not be going near the food that someone else could be eating. Keeping tables further apart is another mitigation. Outdoor dining is even better, although very much weather dependent.

The travel industry is one area that has seen a dramatic shift. People flying to infected areas and bringing the virus home certainly had a big impact on the initial spread of the virus. Recirculated air in a thin tube of metal sealed off from fresh air, crammed with people breathing that same air, is the ideal environment for the virus to grow. Masks are therefore essential, although on a 10-hour flight, it’s impossible to last without eating or drinking, and I must remove my mask in order to do so. It’s certainly not easy to come up with solutions.

Education is another controversial area where there is no ideal solution, and we have to get creative. We know that children are much less affected by this virus than older people. They are not immune to it, but the risk of having a serious illness grows a lot with age. I am therefore not too concerned about the health of our children with a return to school. They will be just fine. However, I have serious concerns about the health of our teachers and the health of parents and grandparents. One big unknown is just how infectious a child is if they are not showing any symptoms. If they are infectious, then reopening schools without serious mitigation is not wise.

We have a very difficult balancing act when it comes to the education of our children. To go back to school as it was pre-lockdown risks a large spike in infections when schools return in September. Closing schools risks the long-term future wellbeing of a whole generation. Some schools and some children have done well moving learning to online. For others it has been a disaster. As in most things, the ones who have done best tend to be the wealthiest households.

While adults may find difficulty in social distancing, for children, particularly young children, it is an impossibility. There is going to be an awful lot of work this summer in schools to get them ready to take on the masses of children who will return in September. There are certainly no easy answers and we have to give the teaching community our full support and not get annoyed when things have to be revised at a moment’s notice.

Life will never return to how it was pre Covid-19. What we have to do is adapt and keep others safe.