Thread by @conways_law

The failure of American leadership to effect a *uniform nationwide coronavirus suppression program* will have long-term domestic and international adverse consequences for the US far beyond what we are seeing now.

1/15

To see this, consider that COVID-19 is an infection that can be described at two levels: individual and national. The total absence of the national infection in the public conversation must be remedied. Let’s begin the process here.

2/15

Imagine the national infection as a colored cloud of varying density that covers the US map. This CDC state-by-state map, limited by state reporting, is a too-coarse presentation of the density distribution.

This density distribution is evolving right now.

3/15

We are watching higher-density areas migrate from the coasts toward the interior. As this occurs the overall density distribution is evolving from a heterogeneous collection of acute hotspots embedded in sub-acute regions, into a more uniform distribution of chronic regions

4/15

You can think of this as a “phase transition” analogous to the transition of water from liquid to solid as temperature drops.

A very preliminary assessment of the possible phases produces this list, in evolutionary order.

5/15

1. Total absence of infection.
2. Isolated hotspots, locally suppressible through known isolation tactics.
3. Growing outbreaks in a more uniform but low-density chronic background field. Isolation tactics losing effectiveness.

6/15

4. A more uniform chronic background field of increasing density, with more isolated outbreaks. Widespread morbidity and mortality. Isolation tactics ineffective.
5. “Herd immunity”. We don’t know if the body’s immune response will support this phase.

7/15

The US seems to be at phase 3.

This is a very dangerous stage. We are losing control of the infection because, in the absence of ubiquitous vaccination or effective therapies, we are running out of behavior-based tools.

8/15

Now consider the consequences as we move from phase 3 to phase 4. We can divide them into two groups: domestic and international.

Domestically we can expect increased political instability because we will have to make this choice:

9/15

1. Learn to live with a balance between chronic levels of mortality and economic depression, or
2. Develop strategies of seeding local “green zones” (see @endCOVID19). This will create inter-regional tensions.

10/15

Internationally we can expect the world to partition into two disjoint regions: COVID-19-chronic and COVID-19-suppressed. The division will be stable because the suppressed countries will impose testing, tracking, and quarantine at borders.

11/15

Imagine the consequences for multinational travel and business, especially since the US will be in the chronic region, and the EU, China, and most of the rest of the industrial world will be in the suppressed region.

12/15

I’m thinking about doing some modeling of alternatives, and I’m starting to explore the COVID-19 dashboards supplied by Massachusetts, but I invite others who know more about this than I to take the lead.
mass.gov/doc/covid-19-d…

13/15

Meanwhile, here are some useful statistics from the latest MA cumulative data. (107,061 cases, 7,858 deaths.)
1. Confirmed cases are ~1.6% of the total population (assumed 6.7 million).
2. Deaths from COVID-19 are ~0.12% of the total population.

14/15

3. Total deaths are 7.34% of total confirmed cases.
4. The variation of death rates by age above 50 is striking, roughly x2.7 per decade in this chart.
15/15

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