Another case where I am reading an author's books backwards. While I read Every Night I Dream of Hell first, and for all intents and purposes, it could be a stand-alone, those who appreciate a continuation of characters might prefer to read this book and the two following in the trilogy first. In the former, Jamieson is running things from jail and we see most things from the POV of his enforcer, aka "security consultant."
In this book, Jamieson is fully in charge but worried that someone is trying to muscle in on his territory. To send a message, it's necessary to eliminate, Lewis Winter, in an effort to smoke out the rival. POVs vary but are primarily those of Calum, his young hitman. We're also introduced to Zora, who plays a prominent role in EIDOH (don't you just love title abbreviations?)
Mackay has a different style of writing, a combination of narrative and stream of consciousness. It took a bit of getting used to, but was appealing in the end. Now, moving on to How a Gunman Says Goodbye the second in the series which follows the same characters, focusing primarily on Frank, the aging hitman.
Thursday, May 28, 2020
Sunday, May 17, 2020
History, and the social and medical impacts of pandemics.
I've collected several readings on the effects of pandemics.
The economic effects are very real and interestingly, dependent on the level of mortality and the groups affected most, often result in upwards pressure on wages. It's simply supply and demand. So many workers died off during the plague years that those remaining could demand higher wages. The short history of each points up the value of those engaged in science and data. John Snow's observations that cholera seemed to be more prevalent around certain wells in London that were contaminated with sewage led to vast improvements in sanitation. (For a terrific book about his work, see Steven Johnson's The Ghost Map: The Story of London's Most Terrifying Epidemic—and How It Changed Science, Cities, and the Modern World.) The Federal Reserve Bank of St. Louis has done studies on the economic impact of recent pandemics. See https://fredblog.stlouisfed.org/2020/03/the-economic-impact-of-a-pandemic/. From an investment standpoint this article is rather bleak. The recent trend of the stock market to go up (its had the best couple of months in many years) while 30 million people are out of work signals the increasing divergence between those who have (and who benefit the most) and those who don't.
https://www.history.com/news/pandemics-end-plague-cholera-black-death-smallpox and also https://www.history.com/topics/middle-ages/pandemics-timeline
Gina Kolata, excellent Times science writer notes that pandemics end socially and medically. Medically, the disease simply runs out of people to kill and goes dormant or disappears as in the plague of Justinian around 541 that killed about half of the world's population, some 50 million people. Socially, pandemics "end" when people just learn to cope and accept a level of death. Trump, inadvertently, may be arguing for a social end. Just get used to risk. Some will take precautions, other won't. So be it. Death is normal, get over it. The interconnectedness of our world is both a curse and a blessing. Generally, it raises the standards around the world but makes the spread of disease more rapid and virulent in its impact. That plagues follow trade routes is indisputable.
A lesson to be drawn from much of the reading is how important science is in learning about and controlling the disease (as opposed to religion and other superstitions) as well as a global approach contrary to unilateral so strengthening of global institutions is paramount. The eradication of smallpox by the World Health Organization is instructive. If we've learned nothing else from the current pandemic, it is that someone has to coordinate on a national or global scale.
Pandemics can affect societies in many different ways. Some research ** has even suggested that the mass die-off of native Americans in South and Latin American (estimated at 90 million) who died by the millions after contracting smallpox and measles from the Spanish explorers resulted in climate cooling called the Little Ice Age. Massive amounts of land that had been under cultivation reducing CO2 capture now was returned to dense vegetation that absorbed large amounts of CO2.
https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html?searchResultPosition=1
Another book, that I just started, discusses the history and implications of microbial ecology. The title is a bit deceptive as Yellow Fever is barely mentioned. Cholera, the Black Goddess, is. Yellow Fever, Black Goddess: The Co-evolution Of People And Plagues by Christopher Wills (selection here)
Yale has several books as part of its Open Course Series and one by Frank Snowden who developed a course for Yale on epidemics and their consequences highlights pandemics: Epidemics and Society: From the Black Death to the Present (The Open Yale Courses Series) Some twenty years ago, the US Department of Defense warned: “Historians in the next millennium may find that the 20th century’s greatest fallacy [they had no idea how crappy things would get in the 21st] was the belief that infectious diseases were nearing elimination. The resultant complacency has actually increased the threat.” Snowden argues that pandemics have influenced the course of history as much or more than wars. The emphasis has been on more visible threats like heart disease to the exclusion of preparedness for pandemics. In spite of years of warnings from WHO concerned with the increased mobility and a global economy, countries were woefully unprepared for COVID-19. As early as 1996, Michael Osterholm, the Minnesota state epidemiologist, informed Congress: “I am here to bring you the sobering and unfortunate news that our ability to detect and monitor infectious disease threats to health in this country is in serious jeopardy. . . . For 12 of the states or territories, there is no one who is responsible for food or water-borne disease surveillance. You could sink the Titanic in their back yard and they would not know they had water.” 335 new human diseases have emerged since the development of the polio vaccine in the late 1950s, most of them originating in animals (many in bats). “Their names now run the gamut from A to Z – from avian flu to Zika,” Snowden notes, “and scientists caution that far more potentially dangerous pathogens exist than have so far been discovered.” Yet still, when he finally acknowledged the destructive presence of Covid-19 in his nation’s population, the primary response of the president of the US was one of genuine surprise: “Who would have thought?”
** "Earth system impacts of the European arrival and Great Dying in the Americas after 1492" by Alexander Koch. Quaternary Science Reviews Volume 207, 1 March 2019, Pages 13-36
The economic effects are very real and interestingly, dependent on the level of mortality and the groups affected most, often result in upwards pressure on wages. It's simply supply and demand. So many workers died off during the plague years that those remaining could demand higher wages. The short history of each points up the value of those engaged in science and data. John Snow's observations that cholera seemed to be more prevalent around certain wells in London that were contaminated with sewage led to vast improvements in sanitation. (For a terrific book about his work, see Steven Johnson's The Ghost Map: The Story of London's Most Terrifying Epidemic—and How It Changed Science, Cities, and the Modern World.) The Federal Reserve Bank of St. Louis has done studies on the economic impact of recent pandemics. See https://fredblog.stlouisfed.org/2020/03/the-economic-impact-of-a-pandemic/. From an investment standpoint this article is rather bleak. The recent trend of the stock market to go up (its had the best couple of months in many years) while 30 million people are out of work signals the increasing divergence between those who have (and who benefit the most) and those who don't.
https://www.history.com/news/pandemics-end-plague-cholera-black-death-smallpox and also https://www.history.com/topics/middle-ages/pandemics-timeline
Gina Kolata, excellent Times science writer notes that pandemics end socially and medically. Medically, the disease simply runs out of people to kill and goes dormant or disappears as in the plague of Justinian around 541 that killed about half of the world's population, some 50 million people. Socially, pandemics "end" when people just learn to cope and accept a level of death. Trump, inadvertently, may be arguing for a social end. Just get used to risk. Some will take precautions, other won't. So be it. Death is normal, get over it. The interconnectedness of our world is both a curse and a blessing. Generally, it raises the standards around the world but makes the spread of disease more rapid and virulent in its impact. That plagues follow trade routes is indisputable.
A lesson to be drawn from much of the reading is how important science is in learning about and controlling the disease (as opposed to religion and other superstitions) as well as a global approach contrary to unilateral so strengthening of global institutions is paramount. The eradication of smallpox by the World Health Organization is instructive. If we've learned nothing else from the current pandemic, it is that someone has to coordinate on a national or global scale.
Pandemics can affect societies in many different ways. Some research ** has even suggested that the mass die-off of native Americans in South and Latin American (estimated at 90 million) who died by the millions after contracting smallpox and measles from the Spanish explorers resulted in climate cooling called the Little Ice Age. Massive amounts of land that had been under cultivation reducing CO2 capture now was returned to dense vegetation that absorbed large amounts of CO2.
https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html?searchResultPosition=1
Another book, that I just started, discusses the history and implications of microbial ecology. The title is a bit deceptive as Yellow Fever is barely mentioned. Cholera, the Black Goddess, is. Yellow Fever, Black Goddess: The Co-evolution Of People And Plagues by Christopher Wills (selection here)
Yale has several books as part of its Open Course Series and one by Frank Snowden who developed a course for Yale on epidemics and their consequences highlights pandemics: Epidemics and Society: From the Black Death to the Present (The Open Yale Courses Series) Some twenty years ago, the US Department of Defense warned: “Historians in the next millennium may find that the 20th century’s greatest fallacy [they had no idea how crappy things would get in the 21st] was the belief that infectious diseases were nearing elimination. The resultant complacency has actually increased the threat.” Snowden argues that pandemics have influenced the course of history as much or more than wars. The emphasis has been on more visible threats like heart disease to the exclusion of preparedness for pandemics. In spite of years of warnings from WHO concerned with the increased mobility and a global economy, countries were woefully unprepared for COVID-19. As early as 1996, Michael Osterholm, the Minnesota state epidemiologist, informed Congress: “I am here to bring you the sobering and unfortunate news that our ability to detect and monitor infectious disease threats to health in this country is in serious jeopardy. . . . For 12 of the states or territories, there is no one who is responsible for food or water-borne disease surveillance. You could sink the Titanic in their back yard and they would not know they had water.” 335 new human diseases have emerged since the development of the polio vaccine in the late 1950s, most of them originating in animals (many in bats). “Their names now run the gamut from A to Z – from avian flu to Zika,” Snowden notes, “and scientists caution that far more potentially dangerous pathogens exist than have so far been discovered.” Yet still, when he finally acknowledged the destructive presence of Covid-19 in his nation’s population, the primary response of the president of the US was one of genuine surprise: “Who would have thought?”
** "Earth system impacts of the European arrival and Great Dying in the Americas after 1492" by Alexander Koch. Quaternary Science Reviews Volume 207, 1 March 2019, Pages 13-36
Sunday, May 10, 2020
Economic Inequality and Revolution
I have been engaged in an interesting conversation with a cousin as the rising inequality of wealth in the world and its effect on social unrest. What prompted the discussion was a graphic that showed how about eight wealthy individuals "earned" more than $6 billion in one *day* while 33 million are unemployed because of the virus.
This kind of wealth achieved really while doing nothing (it's all interest, stock, or business income, I doubt any of these guys made specific decisions that would have resulted in such enormous returns.) The result has been an increasing disparity between those at the top and those at the bottom. eight hyper-rich Americans today own as much as the entire bottom half of the nation’s households – but it is not an anomaly. Such massive inequalities are a global phenomenon.
I remembered reading several years ago an article by a futurist (not one of the silly types but someone who examines the past for trends in the future.) His comment was stark: increasingly wide disparity between the rich and the poor was the greatest predictor of revolution. Then again, one of my old professors noted that "welfare was democracy's alternative to revolution."
Walter Scheidel wrote a book entitled The Great Leveller,* which examined the relationship between economic disparity and social unrest, particularly violent. The U.S. is now beyond the disparity that existed in 1929 (leveled eventually by the Depression) and close to that of Rome in AD 400. Scheidel observes that, left to their own devices, most societies – including ancient Rome – seem to reach a demographic and technological limit of inequality. What reverses this is violence – and not just ordinary violence.
“Only specific types of violence have consistently forced down inequality,” Scheidel writes. War has to be total; revolution has to be ultraviolent and socially pervasive; state failure has to lead to violence so intense that “it wipes the slate clean”. Ditto the social effects of pandemics. The Black Death killed some 30% of Europe's poopulation. That leveled the disparity by making labor so much more scarce leading to higher wages.
World War I also resulted in a great levelling, at least until Thatcherism through the development of welfare states, communist revolutions, and confiscatory taxes required by the war. Scheidel didn't foresee any form of levelling given the technological and economic success of society. Then again, he couldn't foresee the enormous economic impact of the current pandemic.
One optimistic reviewer doesn't foresee any violent unpheaval from the disparity arguing that social democracy has stifled the distinctions.
Social democracy wishes to suppress inequality in a controlled, consensual way, using the very state the elite has fashioned to entrench it; heading off pestilence, state failure and violent revolution. The vast wealth being generated in the highly technologically efficient society of the 21st century must, contrary to Scheidel, offer the possibility of an even greater redistributional space in which social democracy can operate.
I would argue that until the most recent election cycle social democracy trends were being stifled by those in power, mostly the 1% and has lost the will to redistribute. Instead we have tax cut after tax cut that uniformly favor the top having very little benefit on the lower 90%. Hence the popularity of Sanders and the erstwhile popularity of Trump who was elected on the basis of his antipathy to the status quo until shortly after the election he joined it.
The current pandemic may lead to a levelling through the application of universal health care and changes to the welfare social net, perhaps a reinvigoration of social democracy. That would preserve the vast health of the 1%, but it would eliminate many of the current tensions. Perhaps.
*Scheidel, Walter. The Great Leveler: Violence and the History of Inequality from the Stone Age to the Twenty-First Century. Princeton UP, 2018. Scheidel writes that across recorded history, the periodic compressions of inequality brought about by mass mobilisation warfare, transformative revolution, state failure and pandemics have invariably dwarfed any known instances of equalisation by entirely peaceful means.’ Scheidel means to insist on the massiveness and violence of these disruptions; nothing less will do. A dark vision, indeed.
**Note that Thomas Piketty has an explanation in his book that I have not read but quote from a review:
That the rich have grown both absolutely and comparatively richer in recent decades has been evidenced in great statistical detail by Thomas Piketty in Capital in the 21st Century. While the two world wars and the world depression of the first half of the 20th century entailed a massive destruction of accumulated wealth which, however catastrophic, did reduce inequality, the postwar peace has restored the advantage of the very wealthy. The perverse price of peace, Piketty finds, is that in peacetime the return to capital (interest, dividends and profits) routinely exceeds the rate of economic growth (and therefore of income growth). Year by year, as long as this apparently invariable relationship holds, mounting inequalities in income distribution are inevitable.
I found one pertinent quote in a review that may have implications for how we react to COVID:
Scheidel’s statistics do not take into account the incalculable blood tax of conscription. A democratic ethos requires that when it comes – perhaps before all else – to the chance of dying on the battlefield, every citizen should be treated equally. By extension, it is intolerable that some should profit directly or indirectly from the deaths of their fellow citizens. Total warfare requires an exceptional measure of patriotism, the maintenance of which depends on the mass conviction that everyone is being treated fairly. In other words, the levelling effects of total warfare aren’t simply the result of the state’s squeezing the whole of society for every last drop of work, cash and blood; they are also a consequence of the equalising passions that moments of great sacrifice arouse in the population.
James C. Scott. "James C. Scott · Take Your Pick: Cataclysm V. Capitalism · LRB 18 October 2017." London Review of Books, 6 Nov. 2019, www.lrb.co.uk/the-paper/v39/n20/james-c.-scott/take-your-pick.
This kind of wealth achieved really while doing nothing (it's all interest, stock, or business income, I doubt any of these guys made specific decisions that would have resulted in such enormous returns.) The result has been an increasing disparity between those at the top and those at the bottom. eight hyper-rich Americans today own as much as the entire bottom half of the nation’s households – but it is not an anomaly. Such massive inequalities are a global phenomenon.
I remembered reading several years ago an article by a futurist (not one of the silly types but someone who examines the past for trends in the future.) His comment was stark: increasingly wide disparity between the rich and the poor was the greatest predictor of revolution. Then again, one of my old professors noted that "welfare was democracy's alternative to revolution."
Walter Scheidel wrote a book entitled The Great Leveller,* which examined the relationship between economic disparity and social unrest, particularly violent. The U.S. is now beyond the disparity that existed in 1929 (leveled eventually by the Depression) and close to that of Rome in AD 400. Scheidel observes that, left to their own devices, most societies – including ancient Rome – seem to reach a demographic and technological limit of inequality. What reverses this is violence – and not just ordinary violence.
“Only specific types of violence have consistently forced down inequality,” Scheidel writes. War has to be total; revolution has to be ultraviolent and socially pervasive; state failure has to lead to violence so intense that “it wipes the slate clean”. Ditto the social effects of pandemics. The Black Death killed some 30% of Europe's poopulation. That leveled the disparity by making labor so much more scarce leading to higher wages.
World War I also resulted in a great levelling, at least until Thatcherism through the development of welfare states, communist revolutions, and confiscatory taxes required by the war. Scheidel didn't foresee any form of levelling given the technological and economic success of society. Then again, he couldn't foresee the enormous economic impact of the current pandemic.
One optimistic reviewer doesn't foresee any violent unpheaval from the disparity arguing that social democracy has stifled the distinctions.
Social democracy wishes to suppress inequality in a controlled, consensual way, using the very state the elite has fashioned to entrench it; heading off pestilence, state failure and violent revolution. The vast wealth being generated in the highly technologically efficient society of the 21st century must, contrary to Scheidel, offer the possibility of an even greater redistributional space in which social democracy can operate.
I would argue that until the most recent election cycle social democracy trends were being stifled by those in power, mostly the 1% and has lost the will to redistribute. Instead we have tax cut after tax cut that uniformly favor the top having very little benefit on the lower 90%. Hence the popularity of Sanders and the erstwhile popularity of Trump who was elected on the basis of his antipathy to the status quo until shortly after the election he joined it.
The current pandemic may lead to a levelling through the application of universal health care and changes to the welfare social net, perhaps a reinvigoration of social democracy. That would preserve the vast health of the 1%, but it would eliminate many of the current tensions. Perhaps.
*Scheidel, Walter. The Great Leveler: Violence and the History of Inequality from the Stone Age to the Twenty-First Century. Princeton UP, 2018. Scheidel writes that across recorded history, the periodic compressions of inequality brought about by mass mobilisation warfare, transformative revolution, state failure and pandemics have invariably dwarfed any known instances of equalisation by entirely peaceful means.’ Scheidel means to insist on the massiveness and violence of these disruptions; nothing less will do. A dark vision, indeed.
**Note that Thomas Piketty has an explanation in his book that I have not read but quote from a review:
That the rich have grown both absolutely and comparatively richer in recent decades has been evidenced in great statistical detail by Thomas Piketty in Capital in the 21st Century. While the two world wars and the world depression of the first half of the 20th century entailed a massive destruction of accumulated wealth which, however catastrophic, did reduce inequality, the postwar peace has restored the advantage of the very wealthy. The perverse price of peace, Piketty finds, is that in peacetime the return to capital (interest, dividends and profits) routinely exceeds the rate of economic growth (and therefore of income growth). Year by year, as long as this apparently invariable relationship holds, mounting inequalities in income distribution are inevitable.
I found one pertinent quote in a review that may have implications for how we react to COVID:
Scheidel’s statistics do not take into account the incalculable blood tax of conscription. A democratic ethos requires that when it comes – perhaps before all else – to the chance of dying on the battlefield, every citizen should be treated equally. By extension, it is intolerable that some should profit directly or indirectly from the deaths of their fellow citizens. Total warfare requires an exceptional measure of patriotism, the maintenance of which depends on the mass conviction that everyone is being treated fairly. In other words, the levelling effects of total warfare aren’t simply the result of the state’s squeezing the whole of society for every last drop of work, cash and blood; they are also a consequence of the equalising passions that moments of great sacrifice arouse in the population.
James C. Scott. "James C. Scott · Take Your Pick: Cataclysm V. Capitalism · LRB 18 October 2017." London Review of Books, 6 Nov. 2019, www.lrb.co.uk/the-paper/v39/n20/james-c.-scott/take-your-pick.
Friday, May 08, 2020
Open letter to President Trump
What a shame to let such an opportunity slip through your fingers. You were handed a crisis on a platter, a chance to show the world just how great America could be and how you really could lead. Instead, deaths now exceed 3,000 per day, no one has the materials they need, and your administration is floundering.
It’s as if you had been president at the time of Pearl Harbor and said, “Shame on the Japanese. This is all their fault, but we have it under control, only a few thousand dead. No problem, we are doing a great job, and we’ll be all set in a couple of weeks.”
You appointed a task force run by the best posterior adulator to deal with the virus. Then you became obsessed with concern about the task force leaders taking all the limelight so you focused on the battle between you and the press. Why you would waste your time (and the country’s) by indulging in such childish antics is puzzling unless it reveals how flustered and ignorant you are as to what to do.
Instead of listening to the experts, adopting their advice, and reaping the glory of a job well-done. You fired, shamed, or ignored those who showed any concern. That demoralized those who could have saved you. All the while you preached what a glorious job you were doing, even as the death toll has sky-rocketed.
Blaming governors, other countries, and international organizations, became the order of the day revealing you have no idea what to do. Did you seek advice from countries that had been successful in coping with the virus? No. Have you shown any empathy for the victims, or concern for those who lost their jobs? No. Do you or your subordinates wear masks? No, even though setting an example is key to leadership. Have you shown any evidence of sympathy for the many who are suffering extraordinary deprivation? No. All we hear is constant narcissistic reiteration of what a perfect you have been doing. No attempt to bring the country together, no words of concern, only a daily personal pat on the back, a complete lack of leadership
Your administration will be judged by your own words. Make America Great Again? Keep America Great? Those slogans will become one of history’s greatest jokes. Instead, you will be remembered as the greatest failure and most ridiculous figure this country has ever experienced, assuming we survive this.
It’s as if you had been president at the time of Pearl Harbor and said, “Shame on the Japanese. This is all their fault, but we have it under control, only a few thousand dead. No problem, we are doing a great job, and we’ll be all set in a couple of weeks.”
You appointed a task force run by the best posterior adulator to deal with the virus. Then you became obsessed with concern about the task force leaders taking all the limelight so you focused on the battle between you and the press. Why you would waste your time (and the country’s) by indulging in such childish antics is puzzling unless it reveals how flustered and ignorant you are as to what to do.
Instead of listening to the experts, adopting their advice, and reaping the glory of a job well-done. You fired, shamed, or ignored those who showed any concern. That demoralized those who could have saved you. All the while you preached what a glorious job you were doing, even as the death toll has sky-rocketed.
Blaming governors, other countries, and international organizations, became the order of the day revealing you have no idea what to do. Did you seek advice from countries that had been successful in coping with the virus? No. Have you shown any empathy for the victims, or concern for those who lost their jobs? No. Do you or your subordinates wear masks? No, even though setting an example is key to leadership. Have you shown any evidence of sympathy for the many who are suffering extraordinary deprivation? No. All we hear is constant narcissistic reiteration of what a perfect you have been doing. No attempt to bring the country together, no words of concern, only a daily personal pat on the back, a complete lack of leadership
Your administration will be judged by your own words. Make America Great Again? Keep America Great? Those slogans will become one of history’s greatest jokes. Instead, you will be remembered as the greatest failure and most ridiculous figure this country has ever experienced, assuming we survive this.
Tuesday, May 05, 2020
Mutated COVID-19
We’ve all followed developments of COVID-19 and its associated effects. I daily peruse the numbers and especially the death rates / 100,000 that the New York Times updates frequently on its website ( NYTimes Tracker ) We know that every year we need to get a flu vaccine shot as the strain mutates into a variety of different forms and it’s always somewhat of a guess as to whether the vaccine that’s developed assures immunity to the current strain. Herd immunity is always what is the most favorable goal but the hardest to achieve as you have to have immunity in about 80% of a population to achieve that nirvana. It worked with polio and smallpox, but those were developed during times when people respected science and feared the disease more than the shot.
Something that’s worried me as I examine the numbers is the difference in virulence between the disease in Asia and that of western Europe. Could the virus have mutated? Should we not be talking about the Wuhan Virus but rather the Lombard Virus? Were the differences due to better social vigilance or government enforcement of social distancing?
There could be other reasons as well:
A.Differences in the number of people tested: With more testing, more people with milder cases are identified. This lowers the case-fatality ratio.
B.Demographics: For example, mortality tends to be higher in older populations.
C.Characteristics of the health-care system: For example, mortality may rise as hospitals become overwhelmed and have fewer resources.
D. The number of people tested or better reporting.
E.Other factors, many of which remain unknown.
Or, could it be that the virus mutated after it left Asia and found a haven in Italy and thence to the rest of Europe and the U.S.
There was a disturbing report this morning in the LA Times about a study (1) that reveals a mutation found in Europe that spread to the U.S. which is far more contagious, becoming the dominant form of the virus. As noted in the Abstract, this has real implications for the development of a vaccine and strategies to curb the virus. Opening up without very strict controls may create an environment for even more rapid spread of the virus with concomitant fatalities.
The mutation Spike D614G is of urgent concern; it began spreading in Europe in early February, and when introduced to new regions it rapidly becomes the dominant form. Also, we present evidence of recombination between locally circulating strains, indicative of multiple strain infections. These finding have important implications for SARS-CoV-2 transmission, pathogenesis and immune interventions.
References:
1.https://www.biorxiv.org/content/10.1101/2020.04.29.069054v1.full.pdf
This is the full study cited by The LA Times
Something that’s worried me as I examine the numbers is the difference in virulence between the disease in Asia and that of western Europe. Could the virus have mutated? Should we not be talking about the Wuhan Virus but rather the Lombard Virus? Were the differences due to better social vigilance or government enforcement of social distancing?
There could be other reasons as well:
A.Differences in the number of people tested: With more testing, more people with milder cases are identified. This lowers the case-fatality ratio.
B.Demographics: For example, mortality tends to be higher in older populations.
C.Characteristics of the health-care system: For example, mortality may rise as hospitals become overwhelmed and have fewer resources.
D. The number of people tested or better reporting.
E.Other factors, many of which remain unknown.
Or, could it be that the virus mutated after it left Asia and found a haven in Italy and thence to the rest of Europe and the U.S.
There was a disturbing report this morning in the LA Times about a study (1) that reveals a mutation found in Europe that spread to the U.S. which is far more contagious, becoming the dominant form of the virus. As noted in the Abstract, this has real implications for the development of a vaccine and strategies to curb the virus. Opening up without very strict controls may create an environment for even more rapid spread of the virus with concomitant fatalities.
The mutation Spike D614G is of urgent concern; it began spreading in Europe in early February, and when introduced to new regions it rapidly becomes the dominant form. Also, we present evidence of recombination between locally circulating strains, indicative of multiple strain infections. These finding have important implications for SARS-CoV-2 transmission, pathogenesis and immune interventions.
References:
1.https://www.biorxiv.org/content/10.1101/2020.04.29.069054v1.full.pdf
This is the full study cited by The LA Times
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