The pandemic response in the USA and what might be coming

Along with public health interventions,  policy makers and the general public might consider the reshaping of American society and re-balancing of global societies that this single pandemic is causing.  I wanted to reflect on that a bit,  and encourage your to make comments below!

We know from past experience that interest in pandemics has a clear panic-then-forget cycle,  typically moving on to new topics before many lessons-learned can even be defined, let alone be implemented.   So, a question: Aside from inside the government, where are lessons-learned actually being incorporated into social infrastructure during this pandemic that will improve our odds of surviving the next global crisis?

One thing that bears watching is how we manage "risk communication" on both the sending and receiving ends, since they are intimately linked. This regards improving the sensing process by which important things are noted and sent "upwards", the sense-making process at "the top", the process of sharing "the big picture" with the wider public of what is going on, the formulation and issuing of guidance and/or orders to various levels about what to be doing today and next week ( on a moving basis ), and the fabric of compliance with those orders.

In short, these are really the component of the most fundamental cybernetic control loop that defines "living": sense your environment, decide what it means, decide what to do, try to do it, watch how well that works and what new stuff breaks loose, rinse and repeat.


The 2020 elections in the USA may reflect people’s conclusions, by then, regarding how well our country’s “cybernetic loop” has served us in this pandemic, who offers what ideas on how it can be improved, and how high a priority that is among voters among other issues and values.


Some countries, most notably authoritative China, are very strong on connecting what is ordered to happen and what actually happens. With strong surveillance state technology China also keeps tabs on what is actually happening on a daily basis.

The USA probably is at the far opposite end of the spectrum from China, since between distrust of the government, the perceived meaning of “freedom and liberty” and "rugged individualism", many people will do whatever they feel like regardless what they are told to do by the government, public health, or anyone else.    

As a consequence,  if we believe the published numbers,  the fact that China seems to have managed to get the pandemic under control with under 100,000 cases provides very little reassurance that such a strategy would work in the USA.

One huge reason for concern is that, with an epidemic,  “almost contained” is a world apart from “contained.”   Epidemics can and do start with a single case - one solitary human being.   That’s enough.    So for containment to work,  not one single human being can escape quarantine.

The Washington Post just ran some very nice animated graphic illustrations of how the infection might "leak out" of a small hole and continue to spread.  See Why outbreaks like corona virus spread exponentially, and how to “flatten the curve” By Harry Stevens March 14, 2020 

Image from that article showing a snapshot of the animation as the infection starts to leak out.

So, in my mind, the odds of containment working inside the USA seem close to zero.  Clearly other people's opinions vary, and how likely you are to believe this analysis may be related to the costs you will incur if your judgment is wrong in that direction.   In fact, even with draconian measures,  one suspects the government will be continually playing “whack-a-mole”,   stopping the outbreak in one place only to have it reappear in another place.  Already counties that take strong measures are frustrated by neighboring counties that take weaker measures, but that's how things operate inside the US.

Photo: TPapi under Creative Commons license (https://creativecommons.org/licenses/by-nc-sa/2.0/)

The fact that Covid-19 has a long period where it is infectious but not contagious really does not help design strategies that stop it without overkill blocking everyone regardless of symptoms.

Following that logic, it seems to me, at least today, that the most likely coming scenario is that the epidemic will grow,  authorities will squeeze tighter,  the epidemic will slow, then break out anew in different places,  those will get squeezed,  the epidemic will slow, then break out anew in yet new different places, etc.

So I suspect that, at some point,  just as “containment” has been abandoned as hopeless,  even “mitigation” will be recognized to be enormously expensive in both dollars and social costs,  and failing to work well enough to justify the costs,  and so some new strategy will be sought.  One can imagine the case where mitigation will be applied for at least a month,  when it might be declared successful, or when social pressure declares it too expensive and disruptive,  causing it to be removed, at which point the infection may start again, followed by a renewed imposition of measures, etc., a dance lasting many months.

What can we expect? What can we do?

Well,  trying our best to make mitigation work despite doubts is a good start. We should at least try.  I believe I will request an absentee ballot for the November elections, just in case.

One thing that comes to mind is that there will be a growing body of people who will be immune to the virus or no longer carriers if they are recovered victims.   These will heavily be young people, apparently, as the virus strikes most heavily at the older population and mostly spares children.

So, there is no reason if they are recovered and no longer contagious for such people to be subject to quarantine measures.   They can come out of quarantine and run vital services,  shop for others or themselves,   and for that matter go to concerts or sports events of their own kind.

Meanwhile, the older population seeking safety will continue to self-quarantine even if they are not ordered to quarantine,  erring on the side of caution because their risks are higher. Besides, if you get hospitalized and end up in a nursing home, no one may be allowed to visit you.

Visible society will become substantially younger.  The people working behind the counters and the customers will be mostly younger, at least for a while.  Generation Z will dominate the visible world.  One suspects they will take delight in that and possibly be reluctant to give it back.

Greta Thunberg, outside the Swedish parliament. 

Creative commons,  https://commons.wikimedia.org/wiki/File:Greta_Thunberg_01.jpg

After a year or two most people will have ended up getting the virus, the population at large that has survived will be mostly immune to it,  and it will join the other annual flu viruses as something we are warned about but most people ignore.  Perhaps there will be a vaccine, but efforts to develop one for SARS and MERS have been unsuccessful so it seems illogical to count on it.

Meanwhile — working from home, telecommuting, classrooms from home will all be permanently ramped up and, to a large extent, having been funded, stay ramped up. Commuting will be substantially reduced,  carbon emissions reduced,  central urban populations reduced, etc.  These changes will delight many young people and advocates of action on climate change.

In any case, a renewed interest might be paid, then, to the question of how to make remotely attended meetings at least as good as, or not better than, face-to-face meetings.

See my blog post from February 10 on that: We need serious R&D on how to improve meetings!

Meanwhile,  let’s not forget that this pandemic is taking place on a world stage,  and has substantial social, economic, and military consequences, which are not evenly distributed, and in fact may substantially change the balance of power.

In the weeks and possibly months ahead, if other countries bring the pandemic under control, and the USA does not,  we may well expect to find the travel bans reversed, either totally banning incoming passengers from the US,  or at least demanding, as New Zealand has just done, that all inbound passengers be quarantined for 14 days.    This will be a rather huge change in the global dynamic as well as a blow to how the US is regarded as a global role-model.

[ I no sooner posted this than someone brought this to my attention-- it's begun:

Norwegian university tells students in US to return home due to ‘poorly developed health services’: report

]


Therefore, in business, I hope to see a strong emphasis on Research and Development on making remote conferencing software at least as good as “actually being there” to lessen the disadvantage the US would suffer from being late to the game on dealing with its own population’s health and well being.    The large number of companies in the Virtual Meeting space is encouraging, as reviewed in the Gartner Group's Magic Quadrant diagram for 2019 for "meeting solutions".