Wednesday, March 18, 2020

Anticipating the Cull

Now that the US death toll from the Outbreak has passed 100 and all 50 states have reported infection (announced totals close to 6000, but actual totals may be 10-20 times higher) it's time to consider both the immediate future and the mid-term as well as a post COVID-19 future.

As I researched my ancestors, I was struck by how many of them and their relations died between 1918 and 1920. Some were old but most weren't. Hm. Spanish flu victims, probably. As was the case with many families, this loss wasn't discussed much while I was growing up. It must have had an effect, but nobody talked about it, and if I asked questions about it, I don't remember any answers if there were any.

I suspect it will be like that with regard to the aftermath of the COVID-19 pandemic. There was a huge cull of Americans and many, many others around the world on top of the devastation of WWI due to the Spanish Flu, but it seemed to fade from memory fairly quickly. There is every sign there will be a significant cull due to the current pandemic -- how big is yet unknown. The incomplete statistics suggest an overall death rate of about 3%, but estimates of the real death rate vary between 1% or less to 5% or 6%. This is much higher than seasonal flu, and could mean as many as 2-3 million deaths in the US alone before the epidemic burns out (assuming it does). Deaths will be concentrated among the sicker of the old.

"Boomer Doomer" they call it.

This is only partially a joke, and the fact is, the loss of so many oldsters is not an unpleasant thought to some of the younger survivors. Indeed, surviving members of the ruling class might well appreciate the passing of a large percentage of the Boomer generation.

A major cull of humanity has long been seen by nihilists as necessary for the good of themselves or the earth, after all, and if the Outbreak can accomplish it, so much the better. If it's primarily a cull of the olds, how much more beneficial for the younger survivors would that be?

The immediate future is one of isolated anxiety for many millions of Americans. Out here in the wilderness, we've been under semi-lockdown, but most services are still operational, and while Ms. Ché and I stay in most of the time, we aren't limited to home confinement by any means. We go out for groceries, cat food, and supplies in our little town or in the next one, not that there's much on the shelves. We go into town for medical appointments or to socialize with friends. We could go to local and in town restaurants (most are still open) if we wanted. UPDATE: This afternoon, the governor ordered the closure of all bars, restaurants, casinos and so forth due to the enumeration of the first case without an identified source. Community transmission is assumed to have begun.

But we're very conscious of the risks, and we try not to push our luck. Ms. Ché and I are prime targets, not just Boomers, but Boomers with chronic underlying conditions.

In a telephone town hall with our congressmember yesterday, we learned that there is no community spread in New Mexico -- yet. The 23 28 currently identified cases are all in isolation and they are all due to travel-exposure and/or exposure within the household of someone infected. See update above. So far, no one has died, though I seem to recall at least one is hospitalized in critical condition.

Just north in Colorado, it seems the virus is raging, so I'm not at all sanguine about the likelihood of New Mexico escaping eventual widespread infection. It's not just Colorado. Texas and Arizona have cases and because of political ideology I strongly suspect they are underreporting cases and refusing to implement various mitigations. Sadly, we've seen this pattern throughout Trump-country, following the lead of the rightist media and Trump himself until recently. Ah but because there has still been very little testing, no one has any idea what the real infection rate is.

The immediate future is likely to include a good deal more "lockdown" procedures, but how strict it will become is hard to say. In fact, it seems as if Our Rulers, like Boris Johnson in Britain, are toying with the "herd immunity" fantasy by letting the virus infect a substantial percentage of the population and let nature take its course, along with triaging the ill and letting the young and strong survive.  The old and frail? Not so much.

Boris was apparently shamed off that approach as it would be overwhelming to the health care system, and it would mean literally millions dead in Britain alone. Ultimately there may be no choice, as the spread of the disease appears to be out of control in several locations, and so far there's been no real effort to end travel between these locations and the rest of the country.

China's experience, however, indicates that closing off travel between hot locations and elsewhere in the country seems to work, though it takes a while. The Chinese brought their infection rate and death rate down substantially by strictly limiting travel within China, indeed within cities and even apartment blocks. They also put up numerous temporary hospitals to treat those who became infected. It wasn't perfect, it still isn't. But it's been effective.

The Korean experience has been different, but it has also worked to lower the infection rate and death rate.

So far, though, the English-speaking countries and Western Europe have largely been failing, no matter what they try. There are mitigations, but they seem to be too little, too late. How that will translate into infection and death rates remains to be seen. But given the sense of calamity out there, we can expect rates to increase in every area, and substantially increase in some areas. For example, the Seattle area, the San Francisco Bay Area, New York City, and a few other areas are having a very hard time right now and the expectation is they will get much worse before they get better. Many other places may not see a high infection/death rate, or even much of an effect at all. People may get sick but most or all will recover.

There will be a cull, no doubt, and most of the dead will be the old and unwell. How many? Who knows? And what will the world be like afterwards? That's the question.

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