Some Unpleasant Outbreak Considerations – and a Hope

Some reasons why this outbreak is probably going to go on for quite some time. And one reason why we might be able to rise to the challenge.  These may sound harsh, but so are the times.

Most people can’t sit still for extended periods (or short periods for that matter). As the weather gets nicer in the US, it will be harder not to scratch cabin fever itches.

Many public officials will keep flip-flopping and making poor decisions, persisting in scientism masquerading as science. 

Major media organizations will keep publishing superficial takes on infection control, while alternative and social media will continue to mislead and misinform. Platform algorithms won’t fully compensate – and may do more damage.

Conspiracy theorizing will continue to infiltrate public discourse. Just as 14th Century superstitions may have worsened plagues, so too will media-propagated apophenia frustrate management efforts. (Although, paradoxically, literacy rates were much lower 500 hundred years, which means fewer people we reading bad information than they are today!)

Supply chains will struggle to link together and support demand for critical equipment and resources. 

An extreme possibility: Massive displacement and surpluses of labor will hammer-down output and consumption. Collapses of equity capital markets will propel debt to historical highs. (Exponential terror isn’t limited to viral spread.) The resulting tension-gap between high debt and low GDP will be precarious enough to snap in an unprecedented way. 

Strategies for fine-grain management to properly lift suppression measures will be malformed or improperly implemented. We have no backup generator for the economy, so the starts and stops will be a nightmare as we try to work through new outbreak cycles.

We will continue to obsess on one feature of a complex problem (e.g. ventilators) at the expense of more comprehensive understanding…until another obsession consumes attention. Masks are the most critical factor in managing this pandemic. They not the only factors, but they are absolutely crucial.

Wearing masks to reduce the spread of an airborne pathogen is not only long-established practice, it’s common sense. And yet as I write this I can already see mixed messages. This failure alone indicates that Coronavirus is likely here to stay – probably for years, even if vaccines are developed (which probably won’t be scalable deployed until at least the first or second half of 2021!)

We may be myopically conceiving Covid as a strictly respiratory illness. Could SARS-CoV-2 material be hammering other systems too? “SARS” might be forcing a *respiratory* pathology assumption on us at the expense of a broader and deeper understanding of Covid’s etiologies. 

Antigenic morphologies might be more complex and multifaceted with this virus than we currently think. After all, there are more ways for a body to suffocate than only from lack of pulmonary ventilation – think sickle cell anemia. We might be dealing with a viral hydra.

We still need more information about immune responses to SARS-CoV-2. If it is the case that re-infections are in fact re-infections and not observations based on false positives, then vaccination development will be more challenging than originally thought, and intervening herd immunity may be more difficult to achieve. By the end of 2020 or early 2021, at least one new variant might evolve with novel conferring of higher transmissibility. That’s just how evolution via natural selection works. Let’s hope luck is on our side.

Will we overlook indirect observations to help guide decisions, such as viral fragments in sewage (if viable)? Indirect observations are crucial when direct observation is partially or fully occluded. 

Are we willing to rethink almost everything we know? Do we have the guts to challenge accepted medical, social, cultural, economic, and political dogmas, without discarding scientific methodology?

These aren’t predictions, but are simply warnings and questions. The difference between warnings and predictions might not be much solace, but it can increase the likelihood of better decisions and outcomes. 

Right now, ingenuity is a vital resource. America is in the worst shape in its history. And yet, there are still slivers of ingenuity left – slender threads. Not much, but perhaps enough to pull us through. Maybe even to a better world than the one that got us here.