Like Midas, the Rationalist is always in the unfortunate position of not being able to touch anything, without transforming it into an abstraction; he can never get a square meal of experience.
--Michael Oakeshott
Authoritarians talk about protocols, but the only valid ‘protocol’ would be something like ‘perceive, think, act.’ --Ray Peat
Today I read that Anthony Fauci is getting enough death threats that he now has a security detail assigned to him from the Health & Human Services Inspector General’s Office. The fact that there is a deputized law enforcement unit inside HHS is the real news and not that Fauci is getting threatened for presenting epidemiological models to the public. I mean, scientists have been getting death threats from politicians since Socrates peaced out on the orders of the state in 399 BC&E. But I admit, I wasn't expecting HHS to act like a 2A advocate in a big box store. Silly me.
This post is just observing some things that I see about what we are doing at the moment in the middle of a pandemic. In order to perceive, then think, then act it would be good to try just to perceive first. You know, observe things without all the ideological wrapping paper making them seem like something they aren't.
Well, okay, this post does get slightly judgy, but just slightly. I'm not convinced it can't be, but I'm no Werner Heisenberg either, all uncertainty, all the time. You have to put your foot down on reality sometime. And just in the nick of time, too. Events are changing very fast now. Almost as fast as seeing & thinking about what you're seeing getting all mixed together until you get confused: Perceive, think, act? Think, perceive, act? Wat?
Listen, get it together l'hommes! Perceive before you think. That's the whole point of living, to be in it. Otherwise you might end up living inside a reductionist hallucination because you've made up the evaluation even before you've got things to evaluate. More installments to come, since there is still thinking & acting to think about.
In this post I'm just trying to serve up a square meal of experience here. This is dedicated to the eyes.
So, Anthony Fauci is the perfect bureaucrat. He understands that the models don’t make any difference if they aren’t made politically acceptable enough. I mean, they aren’t even his models, they are Chris Murray’s at IHME.
Fauci’s face started to show up this week on cupcakes, socks, and t-shirts as a cultural hero. But you’d want to understand that when expectations are low then it’s easy to outperform. For a man that is committed to the science, but also to political stability, it’s funny that yesterday he said he had to start taking care of himself after the first week or two of the public health crisis because he would go all day without eating. He said, “The adrenaline and hypoglycemia” were getting to him. How can an epidemiologist forget to eat? Easy. We aren't in the habit of thinking about nutrition as literally empirical. Which should be nearly as alarming as a pandemic in the front yard.
He says the models predict big numbers. One day he said 200,000 dead by the time this is all over. But yeah, that isn't really saying anything, is it? Because when would that be exactly?
But he has also drawn attention to the fact that the mortality rate and the infection rate of covid-19 and what those mean depend on testing. And testing availability, seriousness of the threat, and comparisons are political things and are communicated in specific ways for a specific type of public effect. Medical workers report not being able to get access to testing. Low numbers can be a result of lack of exposure, but can also be a result of lack of testing. With widespread testing the mortality rate would initially go up, and then go down closer to its real factual rate. But that would be expensive, though biotech producers would profit.
Even Fauci has said that on the other side of the peak covid-19 may turn out to be more like a bad flu season. If that's true, then that's some seriously hangry flu. Some people have said that “coronavirus is like the flu” and there has been a lot of media alarmism to try to stanch that thought. In the second week in March Fauci said that if he’s being an alarmist then he’s doing his job. That's consistent anyway. The just-like-the-flu-people think they are being calm & cool & not tread-on while other people hear that & think, "And all this time I just thought the flu was like a bad cold with fever." Keep thinking like that & you may end up wanting to re-design society in no time because you realize sick-time & doctors notes have all been a bureaucratic lie to give us bad performance reviews because of "absenteeism." From doctors notes to social revolutionary in 60 seconds. You actually didn't hear that here first. Ivan Illich had already said that in the '70s.
But there is a way to understand the coronavirus-is-flu thing in a way that makes sense: the covid-19 numbers are in fact lower than the flu numbers, in infection rates. Since the mortality rate is an artifact of testing, it can be both true for the data collected, and not true in fact that covid-19 is about 10 times more deadly than influenza. No one knows until more data is collected. And even then the figures will be the product of epidemiological estimation. The CDC uses formulas to estimate how many people might be infected, or had an illness that was never reported and never tested. For flu that can be a 100-fold multiplier. Anyone who says that's nefarious lying is ignorant of how analysis of big numbers of people living in nations work. But if it justifies funding then, yeah, you might slip in an extra zero to keep the helicopter money coming.
And BTW, where is the testing?? S. Korea can test virtually all of its population but American medical workers can't get tested? We just brought back the astronauts from the space station but that doesn't mean we all the sudden became anti-space & too stupid to figure out logistics. Does it??
The PCR testing has its critics since it's a test that makes its own viral momentum to count as positive. Kary Mullis invented PCR in his car on return from a surfing trip in 1985. And now it just can't get any love. I'd like to know what Kary would have thought about all this. Headline: "Old surfer dude Nobel Prize-winning biochemist says covid-19 not the cause of 'coronavirus' pandemic. " Probably. *Pikachu surprised face.*
What counts as death from one cause or another is the difference between proximate causes--like cardiac arrest, or gunshot trauma--and conditions that make those things possible--like influenza or pneumonia, or poverty, or war. Diagnostics is also political. People die from a coroner's descriptions as well as from physiological decompensation.
MASH units were set up in Central Park, in sports complexes, & refrigerated trucks were backed up to hospitals to warehouse the dead when morgues were full. Meanwhile, in smaller cities & rural areas hospitals were letting some health workers go or they were very quiet.
But there is another point that no one is really talking about with the coronavirus-is-like-flu thing. That is the cultural view that the flu isn’t that serious, and that annual vaccines are developed for that. The CDC estimates that the 2012 vaccines were effective about 67% of the time, more effective for more at-risk groups. Vaccine profits make up only about 2 – 3% of pharmaceutical profits, about 24 billion annually. Which is just to bring attention to the fact that something like the Hepatitis-C biologics bring in about 10 billion. Biologics that cure? Not a good business model, Gilead. Vaccines are like passive income.
No wonder no one wants to talk about the seriousness of influenza and its real social disrupting capacity. If we did we'd have to talk about things like whether flu vaccines make as much difference as improving working conditions & raising standards of living for the working poor. Instead of talking about "Pharma Bro" wanting out of prison to work on a covid-19 vaccine.
But Bill Gates is ready. He's been ready for a pandemic for a long time. And MIT has the funding to prove it. In December they announced they'd developed a vaccine tattoo technology that embeds a record under the skin of having gotten a vaccine, which can be read by removing the infrared filter on a smartphone. It's like crispr on humans, only less stem-cell invasive & more like portable people power with a dystopian undertone.
In fact, the prospect of having coronavirus is frightening because it has at this point settled into a pattern: most people have very mild illnesses, but some people have a rapidly developing acute respiratory distress that ends in death even with mechanical ventilation. As it turns out, especially with ventilation. At first the difference was age, that’s what the media said, older people were more at risk than the young.
By mid-April the peak in NYC seems to have rolled over us. They still have 700 – 800 people a day dying, many in their homes. There is a bottleneck moving the bodies & that makes for dystopian images in the news.
Everyone senses that the numbers aren’t trustworthy. They are estimations, as all large diagnostic & epidemiological numbers are. Diagnostics are evaluations. And today there is no time to calculate the diagnostic algorithms and test & retest them. Gregory House isn't in the house.
Now that the height of panic by the press is subsiding the policy talk has turned to how to open up economies again, and what the next 2 years could look like. The epidemiologists are saying that a vaccine would mark the end of the pandemic. But there are varying reports that that is either just a few weeks away to 2 years away. Some clinical trials have barely begun. Time to stock up on some fashion masks, ya'll. I want people to know I'm happy when I'm trying not to let the environment panic me & everyone looks like they just stopped at the store on the way home from a black bloc action.
The hydroxychloroquine experiments have had worsening results. Lisinopril is out of the news b/c blood pressure instability is part of the illness. The doctors are reported finally to be second-guessing aggressive ventilator use, and it’s dawning on everyone that the threats to the economy must also cause misery & death. Utilitarianism anyone? Even Peter Singer admitted to strange bedfellows thinking that the economic hardship developing today may become a grim scene tomorrow. You don't realize how really suburban first-world you are when you get angry surfing 300k$ homes on realty sites but you still stand in front of the OJ case in the grocery & think you're going to kill your health if you have to drink the pulp. You say you want to eat the rich but you're not even sure you should be eating lamb chops. We're all coronavirus now, baby.
ⒸCelise Schneider 2020