“Are we there yet?”
The question asked by every kid on every family trip ever is now the one we’re all asking. Except this time instead of asking whether we’re at grandma’s house or the beach, we’re all wondering: Are we at the peak of the pandemic yet?
The answer to that takes us down a rabbit hole that includes lots of math and science. For all those who suffered through those two subject in school, these are not happy times — or, perhaps, a time to turn to your favorite television commentator who offers easier answers.
There are lots of models out there that attempt to project when and how the pandemic will peak. The most popular has been the one developed by the Institute for Health Metrics and Evaluation at the University of Washington. It’s also turned out to be way wrong so far. A study by researchers at three other universities — the University of Sydney in Australia, along with Northwestern University and the University of Texas — found that the IHME’s state-by-state model so far has been outside the margin of error 70% of the time. In general, the IHME model has overstated the number of deaths from COVID-19 but perhaps understated how quickly all this will end. For instance, it currently projects no deaths in the United States after June 21. Is that really realistic? Other scientists are skeptical, to say the least. Dr. Ashish Jha, director of the Harvard Global Health Institute, told CNN: “We know that’s not true. We know that the number of cases will continue. The virus is not going away.”
How are policy-makers — by which we mean politicians — supposed to make sense of all this? Not a single politician in the country was elected on the basis of how they’d handle a pandemic. Economics, these are things politicians know, or at least think they do. Epidemiology is not in their skill set. This is terra incognito for every governor in the country except one — Ralph Northam is the only governor who is also a doctor. You need not approve of Northam’s politics, but we probably should trust his medical judgment. So far, Virginians seem to agree. A survey by Virginia Commonwealth University found that 76% of Virginians approve of how Northam has handled the crisis. That’s a far cry from the late unpleasantness that Northam found himself in a year ago this time.
Here’s an instructive compare-and-contrast: On the same day that President Trump was grandly making wild and unconstitutional claims about the extent of his presidential powers, Northam was more quietly turning to math and science.
Back in January — before there was a single case of coronavirus in Virginia – the Northam administration asked the Biocomplexity Institute at the University of Virginia to put together models for how the disease might unfold in the state. Sharp-eyed readers might recognize the name of this institute; its executive director and 37 researchers had been at Virginia Tech until they decamped to UVA in 2018 in what was seen in Blacksburg as an impolite “raid” by their colleagues in Charlottesville. UVA also offered a lot more money, although there’s still the question of whether state universities should be competing like that. In any case, if you wondered then what “biocomplexity” was, here’s a good example. Those researchers have pumped lots of data into computers and come up with a Virginia-specific model for the virus. Northam should get credit for trying to find better ways to understand what might happen. “We wanted something that could take more of our Virginia-specific actions into account,” Northam said Monday.
The good news from the UVA model: The social-distancing implemented in Virginia has slowed the spread of the virus in some pretty dramatic ways. This can’t be stressed enough.
The not-so-good news: Instead of a sharp spike in cases in the spring, Virginia will see a slow growth in the number of infections that won’t peak at a much lower level until late summer.
This seems to be the trade-off: We’ll have a lot fewer deaths, but will have to endure this virus a lot longer than we thought.
Now back to some better news: “We really think the way we show the peaks are never going to happen,” says researcher Madhav Marathe. “People always adapt to the ground reality, so the peak should be just viewed as a mathematical possibility. I believe this is used to guide how the interventions are going to be put in place — constantly controlling the trajectory of this epidemic [so] that we never reach that peak.”
Put another way: Social distancing really is working, so we better keep at it, as painful as it is. We thought things might be back to normal come summer, but we can see now that’s not going to be the case. Summer concerts are getting cancelled; some in the industry wonder if they should just write off 2020 altogether. The NCAA is modeling what a shortened or delayed football season might look like. College also have to look at what it would mean not to have any football season at all. The mayor of Los Angeles says large gatherings such as concerts and sports may not return until 2021. Researchers at Harvard School of Public Health published in the journal Science that social distancing might have to stay in place until 2022 if no vaccine is developed by then. Trump claims he alone has the power to reopen the country. Governors point out they’re the ones with the authority to issue quarantine orders — and lift them. Actually, it’s people themselves who will decide —and people are unlikely to risk going to big events until they feel safe again.
If you favor war analogies — and Northam himself has called this “a biological war” — then here’s one: If the stay-at-home orders were our equivalent of D-Day, the moment when we were fully engaged in the war, then right now we’re in the summer of 1944 when the allies were bogged down in the hedgerows of France. We were beating the Nazis, but slowly — and there was a lot of war left to be fought. There was also the fierce German counter-attack known as the Battle of the Bulge where they tried their best to break the Allied lines. The great danger is that the virus spikes again in the fall. We know that in the 1918 flu pandemic many cities lifted their restrictions too soon, and saw the virus spike again. Trump is understandably eager for the country to return to normal, but the worst thing politically for him would be if the virus roared back just before the election. So are we there yet? Not yet, but we’re getting there, so just be patient.