We Should Be Acting Like the Virus Is Scarier Than Ever Because It Is
The virus is easier to catch than we thought, affects the young more than we thought, and more people have it than ever. So why are we acting like it's the opposite?
We Are Definitely Screwed Maybe is a newsletter about the things that scare me. You should subscribe, so you’ll always know what to be afraid of.
When you talk to friends or family about their plans that involve leaving the house and milling around with strangers, you always hear about how they’re going to use a lot of hand sanitizer, and they’ll wear a mask, and they’ll be mostly outdoors. What you don’t hear is, “I might catch the virus, but I’m going to chance it.” It has sometimes astonished me to hear what kinds of situations my own friends and family were willing to place themselves in over the past few weeks while places like California, Arizona, and Florida have more COVID-positive people in them than ever.
I can’t really judge, because I, Mike Pearl, have taken unnecessary risks as well.
I don’t blame individuals for lacking vigilance; I blame institutions for making it so easy and normal. Obviously I mean institutions like the Georgia state government, under Governor Brian Kemp banning city ordinances that mandate mask use. But there are less dramatic examples, like California’s odd decision to keep allowing people to eat at restaurants as long as people sitting are outdoors. That in turn means waitstaff have to spend their days at work—much of which time is spent indoors—instead of staying home and collecting unemployment.
And places and events that shouldn’t have guests at all love to put our minds at ease with language about compliance with rules and regulations. Here are some unsettling google results I got by searching the phrase “In keeping with social distancing guidelines.”
Slaughterhouses owned by Smithfield Foods are, at this point, famous for hosting super-spreader events. But here’s Ken Sullivan, their president and CEO, talking on March 19 about how wonderfully compliant his company’s slaughterhouses are with the relevant laws and guidelines.
This reassuring video was posted on YouTube less than a week before a Smithfield Foods slaughterhouse COVID outbreak near me in Vernon, California. There have since been more, and more, and some have been fatal. Which is weird when you consider that Smithfield has been “taking the utmost precautions to ensure the health and wellbeing of our employees” according to the video.
What makes this sort of thing insidious is that it taps into associations with risky-looking-but-actually-safe activities such as riding roller coasters, or bungee jumping. When you do things like this, you encounter snooze-inducing sentences like, “All safety procedures covered in training comply with the U.S. Occupational Safety And Health Administration (OSHA), and the National Fire Protection Association (NFPA).” The difference is that scary-looking amusements are almost 100 percent safe, so the safety jargon is justified—it’s good to persuade someone to go on a roller coaster, because roller coasters are both safe and fun. Meanwhile, seemingly harmless activities undertaken during a pandemic can get you infected with a deadly virus, and little statements of reassurance that such undertakings may be perceived as risky, but they are nonetheless sanctioned and tacitly endorsed by local health authorities aren’t reassuring at all; they’re an indictment of the system that sanctions and tacitly endorses them.
Because these activities are absolutely spreading the virus. And just when you were ready to assume the recent horrific spikes in cases were being caused by the super-duper negligent behavior of flip-flop wearing MAGA hat dum-dums that you, a good, smart person who reads newsletters would never be guilty of, we’re finding out that it might be easier to catch this virus than we ever thought. Places like supermarkets and elevators are just as fraught with danger as we suspected they were back in March and April, when we were still on high alert. But we are, perversely, on low alert.
Early on in the pandemic, we all internalized some dumb advice. “Don’t wear a mask,” to cite the dumbest example. I always thought that one was stupid, but I’m far from perfect; one thing I told people back in March was not to be afraid of some kind of miasma or fog of viruses in the air. Sure, measles spreads that way, I said, but in the case of COVID-19, you mostly just need to worry about things like droplets and hand-washing. I have stopped saying this, and I’m sorry to anyone I said it to.
I was basing this on articles like this one from Stat, published on March 16, that acknowledge that COVID-19 had some ability to spread as an aerosol a teeny tiny bit, but that there were “strong reasons to doubt” that COVID-19 has anything close to a measles-like aerosol capacity. “If it could easily exist as an aerosol, we would be seeing much greater levels of transmission,” epidemiologist Michael LeVasseur of Drexel University told Stat. “And we would be seeing a different pattern in who’s getting infected. With droplet spread, it’s mostly to close contacts. But if a virus easily exists as an aerosol, you could get it from people you share an elevator with.”
Droplets are scary enough, but imagine a lingering viral mist that can hang in the air for long periods of time—or worse: drift across large rooms! Why, if that were the case we would have to add a disquieting lack of control over one’s capacity to protect oneself to our existing pile of worries.
And it looks like that’s the reality now.
On July 9, the World Health Organization issued a brief, updating their stance on aerosol transmission: it’s been happening. "[S]ome outbreak reports related to indoor crowded spaces have suggested the possibility of aerosol transmission, combined with droplet transmission, for example, during choir practice, in restaurants or in fitness classes," WHO wrote.
Most likely, that “choir practice” reference stems from a very alarming contact-tracing report from March. The CDC made an infographic about it. Remember?
I remember it, but—speaking only for myself—I didn’t really internalize it. I guess I thought it was a freak incident or something.
This recent WHO brief was a response to an outcry from experts like Dr. Donald Milton, a University of Maryland aerobiologist (meaning he studies the aerosol properties of tiny organisms), who are desperate to get public health agencies to sound the alarm about aerosol spread of COVID-19. Milton told NPR, “I'm glad to see they've moved a little bit. I'm disappointed they didn't move further.”
Also this week, the CDC issued a case report on a woman in China who used a residential elevator in March while asymptomatic, and set off a chain of events in which 71 people contracted the virus. According to that report, “surfaces” in the elevator are to blame—buttons, I guess? What surfaces do you touch when you’re in an elevator? This seems dubious in my opinion, but who knows? That report may or may not factor in the findings of a separate brand new report from the CDC saying that infectious aerosol COVID clouds can keep their potency for an amazing 16 hours.
Demonstrating conclusively that the virus spreads via aerosol has been tough. “Proof” is a pretty high bar. Experiments have been conducted using ferrets, (because scientists can’t easily conduct experiments in which human beings are directly exposed to a deadly virus) and they’ve demonstrated that ferrets can contract COVID-19 in this way, even if direct contact is a more reliable way to spread the virus.
(Below are some graphics from a paper on one of the ferret experiments, which I am posting here in order to critique them, which officially makes this fair use. The cartoon ferrets aren’t nearly as cute as the real ones, and the light gray bars on the bar graph below are hard to see.)
(Mathilde Richard et al., image via Nature)
Just about everyone in the science world is still being cagey about the extent of aerosol spread, but they seem increasingly worried about it. For instance, Jose-Luis Jimenez, an aerosol chemist at the Univeristy of Colorado-Boulder tweeted on July 11, “I am ready to say publicly that my *guess* is that the majority (>50%) of the spread is through aerosols.” Now I have to say, publicly guessing is kind of a weird thing to do when you’re a scientist. Scientists are supposed to privately guess, and then devise an experiment that may or may not disprove that guess, and then report the experiment’s findings. So by publicly guessing, it’s important to note that he isn’t stating anything conclusively. What it suggests to me is that “COVID is mostly being transmitted as an aerosol” is a hypothesis Jiminez urgently wants other scientists to disprove.
So getting back to my original point, I can still remember a time—May, roughly—when I mistakenly felt like I had a pretty firm grip on my own ability to prevent myself from getting infected without the need to shelter at home: don’t hang around nursing homes; be outdoors if I’m around people; wear a mask; wash my hands. And I was totally off base. The part about being outdoors was probably on the right track, but we’re still ignorant about how this virus spreads. It was just last week when New York City bus drivers were directed to keep their windows open. Looking back, it seems insane that bus windows were ever closed, but honestly it wouldn’t have occurred to me to make a fuss about closed windows before I learned about the prevalence of aerosol spread.
Worse, while the very elderly are still the group likeliest to die from the disease, the latest hump in our nation’s dromedary COVID surge is largely being driven by infections in young adults. Still worse than that, a University of California San Francisco study published this week culled from 8,400 people between 18 and 25 found that about a third were “medically vulnerable” to the serious form of COVID-19, particularly if they smoke.
At the start of the crisis, California Governor Gavin Newsom said at a press conference that more than half of the people in my state could get the virus if we didn’t take steps to mitigate the spread. A few weeks later, a Harvard study projected a scenario in which social distancing lasts until 2022. Newsom later explained that he was just trying to scare some caution into Californians, and the day after he said half of us might get infected, he issued the first stay at home order in the country. Similarly, when CNN wrote about the Harvard study warning about social distancing until 2022, they added, “That is, unless a vaccine or better therapeutics becomes available, or we increase our critical care capacity. In other words, 2022 is one scenario of many.”
To say that the US has fucked up since those early warnings were issued is putting it mildly. Ed Yong, a science writer usually published in The Atlantic—in other words someone not usually prone to the sort of blackpilled, VICE-inflected nihilism you might expect from, say, me—had this to say when he was asked on CNN about the eventual rollout of a vaccine:
Can a country that is doing so badly as we are right now at controlling Covid-19 roll out a vaccine in a way that is equitable? Efficient? [I'm] not sure I have faith in that process. Let me give you three predictions for a vaccine: Firstly, that a lot of people are going to resist the very idea of getting it, because they've been told for months, years now, not to trust experts. That the people who have been most marginalized during this pandemic, who've been disproportionally hit—black, brown, poor, indigenous, disabled, elderly people will be last in line to get a medical countermeasure that's developed, and that the deployment of such a vaccine is just going to be a logistical nightmare. A country that, seven months into a pandemic still cannot ensure that its healthcare workers have enough gowns and gloves and protective equipment is not going to be able to distribute a vaccine in an efficient way. It simply isn't.
It really seems like the worst case scenarios are the reality. We are at the peak of this outbreak, and the next peak will be tomorrow, and yet I know and love people who are —despite some recent rhetoric about a need to close back up and get back into lockdown mode—nonetheless gathering in people’s homes, climbing into boats with one another, and going to restaurants in large groups. Hell, even I will let myself be pressured into gatherings I’m not comfortable with because I’m not immune to social pressure. Again: I don’t blame individuals; I blame institutions. I will whitewash my own description of my risky behaviors with a nice coat of safety jargon, but the fact remains that quarantining means staying in your house.
And I haven’t even mentioned the nationwide plan to send tens of millions of kids back to school without substantially changing anything about how our schools function.
Something about all this has to change or the US could see over a million deaths—or multiple million. People who want to avoid infection might be stuck inside until well after 2022. In fact, the whole idea that this could be over by 2022 might, when we look back on this, be nothing but a cruel joke.
Note for people who read all the way to the bottom: Hi. If you’re enjoying this newsletter, please subscribe and spread the word. I’m hoping to post these more often, with a paid tier, and more in-depth reporting, etc. Earning more subscribers is the only way to make that possible. —Mike
Loving this newsletter, Mike (this is Ben from the old days of Red Lion Trivia).