Corona Daily 054: How will the Covid Pandemic End? When? Part Final

Today, I come to the most exciting part of the pandemic forecasting exercise – predicting the precise date when the pandemic ends. By ending I mean social ending, with no masks, no social distancing, crowded bazaars and trains, and traffic jams. There will still be a few cases and deaths, but they will not be front page news. Remember, 20,000 people died of respiratory diseases (flu and pneumonia) EVERY DAY in 2019. The official daily covid-19 figure has never surpassed that count.

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WHO says the pandemic won’t end unless 70% of the global population is vaccinated. Considering that 30% of global population (younger than 16) doesn’t yet have a vaccine developed for them, this is a gloomy forecast. WHO is probably thinking of eradicating the disease.

Dr Fauci predicts that 75-80% vaccination would allow America enough herd immunity to exit the pandemic before 2021 ends.

Renowned Indian astrologer Bejan Daruwalla projected the pandemic’s end in May 2021. But one year before verifying it, he died of suspected covid in May 2020.

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From my reading, I can recommend two sources that have done serious work on the subject.

One is an article by McKinsey & company dated 26 March 2021. Based on seven variables, the company predicts the pandemic will end in the UK and USA in the second quarter of this year, EU in the third quarter and the rest of the world in 2022.

The other source is an academic paper by a group of computer engineers from Saudi Arabia, Egypt and Ethiopia. Their “covid-19 pandemic prediction study” is based on machine learning models. The model uses ARIMA and SARIMA, which are not the names of Egyptian queens, but acronyms. ARIMA is AutoRegressive Integrated Moving Average. S in SARIMA is Seasonal.

For some odd reason, if you love reading papers with tables and formulas, you may want to read their two papers, one published in October 2020 and another in April 2021. Their projected pandemic end dates are November 2021 for USA, India, Europe, UK, and September 2021 for Brazil. Unfortunately, after their April paper, severe waves happened in India and Brazil. They made the predictions unrealistic, certainly for those two countries. The Saudi-Egyptian model ignores vaccination levels.  

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My method is a simplified one. I have assumed a bell curve (remember normal distribution?) where the virus after peaking, declines in a symmetrical fashion so that the peak is exactly in the centre of the bell curve. (Since all models can go wrong, simple is better than complex).

I give here the dates of peak cases and peak deaths for nine countries. The last column is the latest vaccination data until yesterday. First figure is the % receiving at least one shot, second % fully vaccinated. (If you are number-immune, you may jump to the next table.)

Source: Worldometer	Peak cases (date)	Peak deaths (date)	Vaccination % (one shot/fully)
World	902,022(23 Apr 21)	17,498(20 Jan 21)	Negligible
USA	305,067(8 Jan 21)	4,463 (12 Jan 21)	53/45
Brazil	98,135 (18 Jun 21)	4,211 (6 Apr 21)	30/11
India	414,433 (6 May 21)	4,930 (15 May 21)	16/3.6
Russia	29,935 (24 Dec 20)	635 (24 Dec 20)	14/11
UK	67,808 (8 Jan 21)	1,823 (20 Jan 21)	65/47
France	58,581 (6 Nov 20)	932 (13 Nov 20)	48/25
Germany	32,546 (14 Apr 21)	1,244 (29 Dec 20)	51/31
Poland	35,246 (1 Apr 21)	954 (8 Apr 21)	43/29

 

(Note: Brazil has reached another peak this week. We don’t yet know when Brazil will peak. Russia’s figures are not trustworthy. Both cases and deaths peaked in December, but the curve was suspiciously flat after that and is now growing. Russians don’t trust vaccines either. Only 14% have opted to take a shot despite plenty of supply. Germany is an anomaly in that the deaths peaked in December, but cases had another surge in April.)

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Taking the peaks from the table above as the mid-point between the first case and the pandemic ending, I get the following pandemic end-dates.

	First Case	Peak	End date
World	1 Dec 2019	23 April 2021	16 October 2022
USA	22 Jan 2020	8 Jan 2021	25 Dec 2021
Brazil	26 Feb 2020	18 June 2021	10 October 2022
India	30 Jan 2020	6 May 2021	12 August 2022
Russia	31 Jan 2020	24 Dec 2020	17 Nov 2021
UK	31 Jan 2020	8 Jan 2021	16 Dec 2021
France	24 Jan 2020	6 Nov 2020	19 Aug 2021
Germany	27 Jan 2020	14 April 2021	1 July 2022
Poland	4 March 2020	1 April 2021	28 April 2022

 

There you have the joyful dates: Christmas 2021 for the UK and USA. 12 August 2022 for India. I am more confident about dates for these three countries than others. There may be additional waves. As long as they don’t alter the peak; the end date should not change much. This assumes the weakening of the virus severity because of the ‘self-limiting’ nature, natural immunity and vaccination.

If your country is missing from the table here, find the date of the first case (Wikipedia), the peak (worldometer), and calculate the end date taking the peak as the mid-point. The result would be more scientific than an astrologer’s prediction.

Ravi 

Corona Daily 055: How will the Covid Pandemic End? When? Part Two

One way to predict the end of the current pandemic is to analyse how the earlier pandemics ended.

Infectious diseases have threatened humans since the Neolithic revolution 12,000 years ago, when human hunter-gatherers settled in villages to domesticate animals and cultivate crops. Animal domestication was man’s earliest systematic and large scale manipulation of nature. The man-animal interaction was the cause of several pandemics. Justinian plague (541-549 AD) wiped out half the world’s population, Black Death (1346-1353) killed over 50 million. Not enough reliable documentation exists to know how they ended. Probably everyone who was not dead had developed immunity through natural infection.

The current pandemic raised awareness about the Spanish influenza of 1918. Without vaccines and medicines how did the virus disappear? Does Wikipedia offer the end-date of that pandemic the way it mentions the dates of individual deaths?

Readers may be shocked to learn the Spanish flu virus never disappeared. It caused minor pandemics in 1957, in 1968 and in 2009. The H1N1 virus gave rise to swine flu in 2009 killing 284,000. During the Spanish influenza, the same virus was far deadlier killing 50 million people.

The AIDS pandemic continues for forty years, and has killed over 37 million. We are just less afraid of HIV because it doesn’t spread through sneezing and coughing. Chikungunya (2014), Zika (2015), Ebola in Africa (1976-2021) are all around us and can cause outbreaks at opportune times.

If some of these viruses are not widely experienced, take the case of the more familiar malaria. Transmitted via parasite, it is as old as the human race. In 2018, there were 228 million malaria cases and 405,000 deaths worldwide. But malaria didn’t ever shut schools or restaurants.

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No doubt vaccinations help reduce hospitalizations and the death toll, but not a single epidemiologist would think vaccines will eradicate the covid-19 virus.

In human history, the only disease eradicated through vaccination was smallpox. The last person to naturally contract it was Ali Maow Maalin, a hospital cook in Somalia. (In 1977, he recovered from small pox, but eventually died of Malaria in 2013). Smallpox was exceptional in many respects. Its vaccine offered lifelong protection. More importantly, its virus, Variola major, had no animal host. Eliminating it in humans really meant its end. Smallpox symptoms were so unusual, it was easier to trace and isolate patients.

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That is also probably the reason why SARS-I (2002) ended so quickly, claiming only 813 lives. The symptoms appeared together with infection. The infected person could immediately isolate. SARS-2, better known as Covid-19, has a gap of a couple of days between infection and symptoms. Worse, it is possible to attract and spread infection without having any symptoms. The strategies that worked with SARS can’t work with covid-19.

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In short, the end of the pandemic can’t be associated with the disappearance of the covid-19 virus. It will stay with us for many decades, perhaps for ever, just like influenza. Of course, it is expected to turn into a seasonal flu virus, emerging every year in a mild form probably in winter months. Winter because children are at school, and everybody spends more time indoors.

It will be a sort of truce agreement between humans and the corona virus.

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Historians talk of two types of pandemic endings, the medical ending (like for smallpox) and the social ending, when fear recedes, panic disappears, life returns to normal. When people ask: ‘when will the pandemic end?’, they are asking about the social ending, says Dr Greene, a historian at Johns Hopkins.

Tomorrow, I will share the latest thinking about when this social ending may happen. It means in-person classes at schools and universities, opening of businesses, offices, restaurants, theatres, malls, large gatherings and inter-regional and international travel as it was pre-pandemic.

(Continued tomorrow)

Ravi 

Corona Daily 056: How will the Covid Pandemic End? When?

Predicting the future is dangerous business. We live in a misinformation age, where accurately knowing the past is challenging. The pandemic end-date is something everyone is desperate to know about, and few would dare to foretell. India’s PM Modi declared victory in January, and was proved wrong. UK’s PM Johnson had announced 21 June as UK’s Freedom Day (from the virus), now the threat of the Delta variant has postponed British freedom by four weeks.

Over today and tomorrow, I will risk foretelling the end date of the pandemic. I will use logic, available research, analysis of history, opinions of various epidemiologists, and statistics. Of course, the prediction can go wrong. But then, unless you have a railway timetable, how will you know how late the train is?

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In my research, I came across two interesting concepts. One is a concept in biology called “self-limiting”. It particularly relates to parasites. A parasite can enter your tummy; start multiplying in millions, billions to cause serious gastrointestinal diseases. Nature is a master designer. Parasites, like viruses, have no brains and certainly no souls. By occupying the host’s guts, the parasite colony will harass the host, make his life miserable. However, it will not grow beyond a certain number, for fear of killing the host. If the patient dies, the parasites’ life would end as well.

To give an analogy: Imagine a corporate husband working hard, earning a decent package. His non-working wife is fond of spending. There is an ongoing race between his earnings and her spending. The innate wisdom of the wife makes sure she will not spend so much as to cause divorce, lose the husband, and her credit cards. (Sorry for the sexist analogy, but it is a historical stereotype that is easier to relate to).  

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In medical science, this beautiful concept of Nature results in Self-Limited diseases that resolve spontaneously. We are familiar with mild ones like the common cold, flu, conjunctivitis, or simply headache or back pain. They can all be self-limiting in that they will go away on their own, without any treatment. There is a long list of diseases that neither I nor my spell check recognize: Epiploic appendagitis, mesenteric adenitis, pericardial fat necrosis, omental infarct and so on. Maybe we don’t hear about them because they are self-limiting.

My key take-away from the concept is that lots of things in nature are self limiting, so are pandemics. Every single major pandemic in history came to an end, so will the current pandemic.

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Error Catastrophe is an expression I had never heard before the pandemic.

By now we all know viruses mutate. Earlier I had mentioned that the covid virus uses our living body as a photocopier, and keeps making copies of itself. This replication process is not perfect, the virus keeps on making mistakes, its copies differ or in other words mutate. We know that the mutations (now a lesson in re-learning the Greek alphabet) help the virus escape recognition by the immune system. A certain mutation can be more transmissible, faster spreading, or deadlier. Some mutations can even escape or reduce vaccine effectiveness. This has given us great cause for concern. What if the number of mutations keeps growing and goes beyond the Greek and all other alphabets?

Well, it is unlikely. The principle of Error Catastrophe explains why. If the virus makes too many mutations, it usually loses some of its biological features which have evolved to its advantage, including the ability to reproduce at all.

The Darwinian principle of ‘survival of the fittest’ applies to the virus as well. In the first few mutations, the virus is fit. After reaching a certain number, it loses its potency. Mathematicians are always working with hideous-looking formulas to arrive at that number.

In fact, some scientists are trying to use this concept to create a new antiviral medicine. Any replication system has a maximum error rate beyond which the original genetic information is gone. The antiviral medicine tries to use this rate to disrupt the virus’s replication ability.  

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(Continued tomorrow)

Ravi    

Corona Daily 057: Internet’s Dad

Rob Kenney, who will turn 57 this year, is essentially an introvert. Happily married, his two grown up children are well settled. When the pandemic started, Rob thought of posting a few simple YouTube videos giving his kids some practical lessons based on his lifetime experience. Maybe another 30-40 people would view the clips.

On 3 April 2020, he posted a two minute video called “how to tie a tie?” It’s a simple visual demonstration of how any male can tie a tie. Even geniuses and male Noble laureates had to learn this skill from someone else. Rob’s video went viral. Instead of the 30-40 viewers he had expected, it was viewed 1.3 million times. Some viewers wrote to him that they sobbed watching the video because of the “dad vibes”.

This was followed by regular uploads of short clips: how to fix running toilets? How to polish your shoes? Get a close shave? Install a ceiling fan? Change the car tires? Make a pizza? Plant grass seeds? Fry an egg? Get a driver’s license? Replace a refrigerator filter? How to read a bible? And many others.

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Rob Kenney became an internet sensation. His YouTube channel which was named “Dad, how do I?” got 3.5 million subscribers with no soliciting. There were requests for TV interviews, thousands of daily comments from viewers, corporate job offers, invitations to host TV shows.

A British girl commented on a YouTube video: “I lost my dad when I was 3 years old and I don’t know how it feels to have a dad over my head. Can I call you my father please?”

Each of his videos starts with the words: hey kids. “Hey kids, today I am going to show you how to replace a car battery.” And ends with “I love you. I am proud of you. God bless you.”

Followers flooded Rob with personal stories about their parents, broken relationships, and traumatic experiences. They looked at the ‘Internet’s dad’ for comfort.

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Rob’s parents had divorced early. His dad gained custody of the children, as the mother was manic-depressive and alcoholic. His father found another woman, and left the eight children on their own. Rob was the seventh child, 14 at the time. He moved in with his 23 year old married brother, three of them living in a 280 sq foot trailer. Rob’s teenage life was full of anger, sorrow and mental trauma. He resolved he would never allow anything similar to happen to his own children. As he grew up, he learnt he was not the only fatherless kid. There were thousands without a dad; they needed a father figure in their life.

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YouTube is full of “how to….” Videos. Why did Rob Kenney stand out and became a father figure for millions? Primarily because of his warmth and simplicity. An unassuming fellow, he didn’t even ask anyone to subscribe to his channel. His videos are shot on his Samsung Galaxy phone, using the phone’s basic free editing software. After his becoming a sensation, his daughter handles his social media, including FB and Instagram pages.

When asked what distinguished his videos from other DIY videos, he gave a one-word answer: “heart”. There is more to being a dad or mom than just fixing things, parents must share their heart with the kids, he says. And that is evident in his videos. His tone is never patronizing, or paternal. It is more about ‘let us do this thing together’.

Rob reads passages from the Bible every morning. It adds calmness and clarity to his life. In the mornings, he stays off his phone and computers.

Last month, he has published his first book called: “Dad, How do I?” In a way it is an extension of his YouTube channel, the book offering ‘dadvice’ for everyday tasks and successful living. It has many more how to chapters than the YouTube channel.

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The surreal year for the Internet’s dad continues. Tomorrow, on Father’s day, Rob is likely to get thousands of emotional letters and emails again.

Ravi 

Corona Daily 058: Quest for a Magic Pill

Yesterday’s announcement by the White House may take the world closer to the pandemic finish line. The Biden administration will invest more than $3 billion for the discovery, development and manufacturing of a medicine, ideally an oral pill, against Covid-19. America’s $18 billion investment in vaccines produced five vaccines at miraculous speed. Reliable covid tests and effective vaccines were great scientific and political achievements. An oral pill is missing in the portfolio. AIDS, once considered a death sentence, can now be managed with pills. Flu and hepatitis C also have pills.

The plan is to have a rapid test kit at home. If you test positive, you buy a strip of covid pills, and complete the 5-10 day course. As easy as measuring temperature and swallowing a paracetamol. It is hoped this investment will produce pills by the end of this year. In the next few months, you will likely keep hearing three names of pill makers: Pfizer, Merck and Roche.

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Why is this investment by the US government so important? Because private investors are absolutely not interested in drugs that cure anything quickly. The commercial angel investors prefer chronic ailments such as high cholesterol, diabetes or rheumatoid arthritis. Only lifelong drugs attract private investors.

The $3.2 billion are invested for scientists to develop pills not only against covid-19, but against any viruses with pandemic potential. Compared to vaccines, pills can have wider applications, they are easier to repurpose. Vaccines are incredibly disease specific, medicines less so. Remdesivir, initially approved to treat covid, was originally developed for hepatitis C, and tested during the 2018 Ebola epidemic in Congo.

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Scientists have found that the best way to defend against the covid virus is to control it right when the infection starts. This is the time when the virus is multiplying rapidly in the infected body. The pills will disable this process of copying. Once the patient is taken to the hospital, it is generally too late. The virus has already made millions of copies that are eroding the organs. Remdesivir failed because it can be applied only intravenously, in a hospital setting, by which time the virus has already penetrated the body.

The antiviral pills we are likely to see this year will aim to stop the virus’s ability to make copies.

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Vaccines are given to healthy people. It is not difficult to find healthy volunteers for trials. Testing antiviral pills is a difficult job. Because you want to catch volunteers immediately after they are infected. Many Covid-19 positive people are asymptomatic, so it is difficult to know if the pill worked on such people. Making safe pills is not the difficult part. Scientists need to have an ongoing disease for carrying on tests. Getting enough covid-19 positive people for trials should not be a problem yet.

Tamiflu, a pill that is taken both to prevent and cure flu, is a role model. Scientists expect covid-19 to become seasonal like flu. Vaccinating the whole world with two doses (16 billion) every year is impractical. Much easier to take pills on first sight of the symptoms. So far, the official number of worldwide cases is 178 million, including asymptomatic cases. Even allowing for under-reporting, these are more manageable numbers.

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This month, on 9 June, USA booked their first pre-order for 1.7 million courses of the pills Molnupiravir. (This is another name you are likely to hear often in the coming months). Developed by Merck, the Biden administration will pay $1.2 billion only if the drug is approved by FDA.

Where private investors are reluctant, such public-private partnership is a viable commercial model to develop treatments against diseases. America’s vaccine gamble paid off; let us hope the antiviral pills one is successful as well.  

Those hesitating to take vaccines will surely run to the chemist to buy pills once they feel the symptoms.

Ravi 

Corona Daily 059: Vacancies without Takers

USA is among the first countries trying to exit from the pandemic – to go back to the old normal. In April, a record 9.3 million jobs were available for workers to grab. By a freak coincidence 9.3 million Americans were unemployed in May. Some industries have a greater worker shortage than others.

Many employers are raising wages to attract workers. If you see lots of vacancies in McDonalds, it is not a real shortage. Hotels and restaurants are receiving more applications than job openings. It is only a matter of recruitment time to fill up those jobs. There are other industries which are not getting workers despite raising salaries. This week, the Washington Post has analysed wage and employment data across hundreds of industries and identified seven sectors where record paychecks for non-managerial jobs have failed to fill up the vacancies.

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The non-managerial staff working with psychologists and other mental health practitioners is now paid 30% more than at the start of the pandemic (reaching $731 a week). Anxiety, depression and stress were on the rise before the pandemic, they peaked during it. Last September, 40% practitioners said they felt burnt out. Like doctors and nurses, psychologists and their staff are experiencing pandemic fatigue. Few new faces want to join the profession.

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Americans want to start wearing new clothes, both formal and casual. But worker shortages at Textile Mills are so acute they are turning down big orders. Workers’ wages went up by 18% (now $880 a week) during the pandemic. This is a more skilled job than a restaurant waiter. Qualified factory workers are in short supply, and different industries are competing for them. Some mill workers might have chosen an alternative career. It appears the USA would need to import textiles from China for a long time, whether they like it or not.

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I wrote earlier about Specialized Long Distance Truck Drivers. Driving long vehicles like refrigerated trailers is a job that requires training and experience. In 2021, their wages have gone up by 10% (now $1060 a week). Bonuses can be double that amount.  Despite a lucrative package, it is a challenging and exhausting job. The pandemic alone is not responsible for the shortage.

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In April 2020, pet adoptions hit a record level. Socially isolated people adopted pets, many becoming dog-owners for the first time. Vet doctors and staff are mentally and physically exhausted trying to manage the number and inexperience of pet owners. Most of them complain they have no personal life left. (Pet owners can call a vet during the night, and sometimes do). Weekly earnings for non-managerial staff rose 16% to $1,352 in 2021. But in most places available staff is reduced by 20%.  

One vet said she lost two receptionists when a client was rude, using profanities, making the receptionists cry. Customers’ emotions ran high during the pandemic, raising stress levels of staff along with them.

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USA has plenty of timber. With nearly interest-free mortgages and the work-from-home revolution, many Americans are thinking of moving to new houses. But to convert the timber to boards, sawmills don’t have enough workers. The weekly paychecks are up by more than 10% to $942. The timber price bubble has already burst, and the mills are not interested in investing in modernization. It is possible some workers prefer to collect the stimulus checks and unemployment allowance rather than resume work.

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Connected to the heated housing market are the two industries: Movers and Specialty Finishing Contractors. Moving companies pay 14% more in 2021 (now $745 a week), but not enough workers are turning up. Across the USA, frustrated customers are waiting for weeks for their belongings to arrive.  

Specialized contractors deal with new construction, re-modeling, interior decorators for residences and commercial property. The 17% raise this year has elevated their wages to $1,075 a week. But they are losing rather than gaining skilled workers.

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By August or September, the unemployment allowances will likely disappear. Schools may re-open allowing parents to go back to work. Some of those vacancies may get filled. If not, a no-brainer solution is to import the goods or bring in migrant workers.  

Ravi                                                                                      

Corona Daily 060: Hygiene Theatre

Last year, the first time my family went to a restaurant, our temperatures were checked. When I asked the waiter for the menu, he said it would be on my smartphone. Please click on the QR code and you will see the menu.

The ice cream shops stopped serving cones. McDonalds ketchup pumps disappeared. In Bombay, a roadside vegetable vendor asked me to pay him through Google Pay.

Cleaning of handles and knobs, metal surfaces, Amazon parcels; washing of vegetables and fruits became an obsession. A friend of mine carries a special stick to press the lift knobs. For the first time in 116 years, New York City shut down its subway system in the night to disinfect seats, compartment walls, and poles with antiseptic weapons. “They are power washing the outside of cars as if New Yorkers were going around licking the exteriors of subway cars. It’s hygiene theatre, and it has no place in the public discussion about covid now.” Said someone.

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This obsession is similar to the safety theatre triggered by the terrorist attacks. Before entering Bombay’s shopping malls and luxury hotels, a guard checks under your car with a mirror. The same car can carry a rocket launcher or Kalashnikovs inside, not under. At the airport, toothpastes and perfume bottles get confiscated. In 2006, a British not-such-a-gentleman was planning to carry a powdered drink Tang, and with a set of batteries wished to detonate the drink on a flight. He was arrested before boarding. Not sure if anybody has checked whether 100ml+ Tang can cause an explosion. But that single speculative case has prevented millions of air passengers from carrying ordinary water bottles on flights. Would the “hygiene theatre” continue like the “security theatre”?

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Last July, Emanuel Goldman, a microbiology professor, published a paper in the Lancet called “Exaggerated Risk of Transmission of Covid-19 by Fomites”. In medical lingo, Fomites are objects and surfaces that can transmit an infectious pathogen.

It is believed that if you touch a surface that a sick person has touched, and then touch your eyes or mouth, you will infect yourself. Goldman says this is true of some diseases, particularly bacterial diseases. However, most respiratory viruses spread primarily through air. RSV (respiratory syncytial virus) is the only one where there is evidence fomite transmission can happen. Rhinovirus that causes the common cold, and flu overwhelmingly spread via aerosols.

Ventilation, therefore, is more important than surfaces. Open windows may be safer than the strongest disinfectants. Washing hands, though, is a good habit, before preparing food, and after going to the bathroom. This has nothing to do with the pandemic.

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A well known case study in Seoul, South Korea talks about cases in a skyscraper. On its eleventh floor was a call center. This is where people were talking loudly as part of their job. More than half the members of the call center became sick. More than 1000 employees and residents shared elevators in the same building, and touched the same buttons as the call center employees. However, less than one percent was infected in the rest of the building. This case is cited as an example that transmission happened mainly through aerosols and was airborne, rather than by touching the surfaces.

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Two months ago, America’s CDC finally acknowledged that the risk of getting infected through contact with contaminated surfaces or objects (fomites) was low. The CDC director said disinfection is recommended in indoor settings such as schools or homes only if there has been a suspected or confirmed case in the last 24 hours.

Aggressive cleaning of surfaces creates a false sense of security. It is also a waste of money and time. The current consensus is that outdoor activities are much safer. Indoors, ventilation is critical. Masks and handwashing are more useful than obsessive cleaning of surfaces.

One hopes the hygiene theatre doesn’t become a constant the way security theatre has.

Ravi