Asleep at the Switch

The Second Precondition for the Great COVID Panic of 2020

Last week, I talked about how Anthony Fauci must have realized by February of 2020 that COVID19 had almost certainly been created in a Chinese lab with American funding support. Though Fauci did his level best to deep-six that story with a preemptive attack in the prestigious British scientific journal The Lancet, he must have known the truth would come out eventually. (Indeed, just today US Senator Rand Paul has declared that Fauci must be held personally responsible for seven million COVID deaths.)

So Fauci knows he's screwed up big-time; the first precursor to panic.

I would suggest there's a second condition that can make human beings prone to panic: being blindsided by events.

COVID took off in North America because health authorities in both Canada and the United States were asleep at the switch.

Normally, when a new disease emerges, extreme caution and vigilance is advisable for four reasons:

1) Only limited data will exist on how infectious and/or deadly the new pathogen is.

2) Early on it is impossible to know if the disease has serious long-term after-effects.

3) A new disease is much more prone to new -and perhaps deadly- mutations.

4) Far and away the easiest time to rein in a pandemic is at the very beginning.

This last factor is crucial, as can be understood better with a concrete example.

It takes ten doublings to get from one case to 1,000 cases. (If each doubling takes seven days, it would take ten weeks to go from one case to one thousand cases.)

After six weeks, one case will have grown to 32 cases. If you find 16 of those cases and prevent them from spreading the disease to anyone else, it puts the pandemic on hold for that week. Prevent spread in 24 of those cases and the pandemic is set backwards by a week. With case numbers so small, a lot of resources can go to tracking each and every case.

Consider what happens if, instead of intervening at 6 weeks, we wait till 12 weeks to start heavy duty contact tracing. By week 12, there are now 4,096 cases. We have to find and quarantine 2,048 cases just to slow the spread of the disease by one week - a task that is orders of magnitude more difficult. And the task doubles in size each week thereafter that we wait.

The wonders of exponential mathematics mean that once you reach 1,000 cases, the following ten doublings will cause the pandemic to explode into a million cases over the following ten weeks. That rapid growth will quickly overwhelm contact tracing staff, and hospitals, as we saw.

The outbreak of SARS in 2003 was in many ways a dress rehearsal for COVID19. SARS spread to thousands of people across multiple countries in a matter of weeks.

We were lucky with SARS. SARS had signature symptoms which made it reasonably easy to identify those who had it, and only those with symptoms could spread the disease. But those who studied the SARS pandemic realized that if either of those conditions hadn't been true, SARS could have quickly exploded out of control, killing millions.

Southeast Asia was ground zero for the SARS pandemic. Seeing how close they had come to a runaway pandemic, the nations of Southeast Asia developed a meta-strategy of Better Safe Than Sorry for responding to future pandemics.

The United States was incredibly lucky during SARS. Not one American was infected with SARS on American soil. The United States had mobilized an army of 800 medical personnel to deal with an outbreak of SARS in the US. Those 800 people sat around for weeks with nothing to do.

As a result of that experience, the US Government developed a very different meta-strategy for dealing with future pandemics: Wait And See.

Looking at COVID cases, we can see how these two meta-strategies created vastly different outcomes during the first six months of the COVID pandemic:

Southeast Asia moved much faster than North America in imposing travel restrictions, and in quarantining and/or following up on those returning from countries with known COVID outbreaks. They also poured a massive amount of effort into community testing and contact tracing.

Between these two traditional pandemic control strategies, the countries of Southeast Asia were able to keep COVID cases quite low without resorting to draconian lockdowns.

It wasn't even necessary to keep COVID out of a country to keep it under control. See that first little blue bump on the graph above? That's South Korea. They had a significant outbreak of COVID in mid-February, but with copious testing and contact tracing they choked off those initial clusters of infection in a matter of weeks. New Zealand and Australia managed to do the same a few weeks later.

Having attacked COVID hard during the earliest days of the pandemic, Australia, New Zealand, South Korea, Vietnam, Taiwan, Laos, and Cambodia had six months or more with very few cases of COVID. With cases so low, it was possible to keep COVID under control with a combination of testing and contact tracing. Draconian lockdowns were not required. (New Zealand had several months of zero COVID. You may remember pictures from that time of New Zealanders on the beach, or at a baseball game.)

Now look at what happened in the US. Starting about the 15th of March, cases in the US simply exploded. In fact, cases were going up far faster than could be explained by current infections.

In retrospect, it is obvious that COVID had been quietly spreading in North American for many weeks without authorities noticing. (Remember: as recently as the 15th of February, 2020, the United States had only a dozen confirmed cases.)

Belatedly, health authorities realized that COVID had spread much more widely than that. Mass testing confirmed the authorities’ worst fears: thousands of Americans were infected with COVID by the end of March.

Some will argue that the sudden explosion of cases in the US in March was as a result of false positives from overly-sensitive PCR tests, but the corresponding graph for COVID deaths provides confirmatory evidence:

The countries of Southeast Asia had almost no COVID deaths during this entire six month period. (Laos, Vietnam, and Cambodia are on the above graph - you just can't see them because these three countries had had zero COVID deaths before July 21st, 2020.)

In the US, COVID deaths start to take off in the middle of March. COVID generally takes three or four weeks to kill someone - so it stands to reason that the US had thousands of COVID cases by the beginning of March - they just didn't realize it.

Realizing after the fact that COVID was so prevalent in the US that it would soon overwhelm hospitals, and that cases had already grown well past the threshold where they could be reined in by testing and contact tracing, must have caused great deal of consternation at the CDC.

There must also have been a moment of recognition at the CDC that they had screwed up badly. They knew that the proactive approach of the countries of Southeast Asia had been quite successful in reining in COVID. They knew it was America's hands-off-the-wheel negligence that had allowed COVID cases in the US to spin out of control.

With these preconditions, the US Government needed only one more nudge to be stampeded into incredibly stupid behaviour.

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PS: If you remember, there was a significant outbreak of SARS in Toronto over five months in 2003: 44 deaths, and more than 400 probable cases. The Government of Ontario empanelled a SARS Royal Commission which produced an excellent final report. That report was very clear about recommending a Better Safe Than Sorry meta-strategy for responding to any future pandemic.

Canada should have known better. It should have responded to COVID with the a precautionary approach similar to that of New Zealand, Australia and South Korea.

Why didn't the Government of Canada do so? I suspect that Canadian politicians overruled Canada's public health officials. They were afraid to take a different course from the US.

Travel restrictions and quarantines would have cost tens of millions of dollars and inconvenienced thousands of travellers. The Government of Canada wasn't willing to take the political heat for doing those things when the US was not. So instead the Canadian Government did nothing, with the eventual result that 37 million Canadians were massively inconvenienced for two+ years at a cost of hundreds of billions of dollars.