The Iconoclast
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The Iconoclast

The Tyranny of Small Numbers

When Can We Hit Reboot? Pt. 11

by Patrick H. Ruane and Ravi Pamnani, Jul 20, 2020

This is an ongoing series to try to make sense of the Covid-19 pandemic trajectory and try to project its course through various data visualizations. Find the previous post here (Part 10).

Individual and collective decisions made with a myopic, short time perspective often lead to disastrous consequences. It’s really not that difficult to wear a mask, practice good hygiene, and socially distance. We need to find a way to live with our new normal; we as a species are resilient and can figure it out.

It is most assuredly easier to do so in 2020 than it was in 1918 when the Spanish Flu plagued humanity. Johnson and Mueller (2002, Bull Hist. Med.) estimated up to 100 million people died in the 3 waves of the 1918–1920 flu pandemic, with up to 70% of the world’s 1.8 billion infected. Imagine 70% of today’s population infected (5.5 billion), with just a 1% mortality rate that would translate to 55 million deaths.

Today there are less than 1 million worldwide deaths and people are acting like we are nearing the end of Covid-19, we hope they are correct but no one knows.

What we do know is that there is an uptick in many countries, illustrated below for Israel, Spain and France (Figure 1).

Figure 1. 2nd Wave?

There is also worrisome and continued growth in the number of cases in many of the more populous countries as illustrated below (Figure 2).

Figure 2. Notables with consistent growth

We do not think it is a good time for complacency, the battle has not been won, in fact it may barely have started. We would do well to remember the second and third waves of the Spanish Flu were much more severe than the first. One way to illustrate where we are is to consider the prevalence of reported cases to date by country (Figure 3).

Figure 3. Global prevalence by country

Not many places have reported greater than 1% infection rates after 9 months. Here is another way of looking at the same data (Figure 4). As can clearly be seen, the tyranny of small numbers is ripe for generating non-sequiturs, we do not know when this pandemic will end.

Figure 4. Global prevalence, by country, compared to Spanish Flu estimated total global prevalence

Let’s take a cumulative global perspective as the virus has no interest in international or political frontiers. Our model still guesses at Covid-19 topping out at around 55 million global cases mid next year (Figure 5).

Figure 5. Global actual data vs. model (semi-log)

Closer inspection as illustrated in the semi-log plot shows two distinct Waves. The first wave saw a 5 Order-Of-Magnitude (OOM) increase from 1 to 100,000 cases, while the second wave appears destined for a final tally of around 55 million cases (a 2.5 OOM increase). We as humans have evolved to think linearly, but many things in nature don’t grow linearly, they grow exponentially. Our linear thinking often leads to wrong-headed decision making, it’s quite difficult to get out of the evolutionary cognitive cage we call our minds, but that is what is needed. Many policy makers are the worst examples of linear thinkers, they may have good intentions but the road to hell is paved with good intentions.

Have a look at the what the future might entail (Figure 6), let’s just think exponentially for a minute. Imagine a 3rd wave wherein there is a further 1.5 OOM increase, doesn’t sound too bad when compared to the preceding 5 OOM and 2.5 OOM respectively. But alas, this would result in 3 billion infected — now imagine a 4% mortality. And, to quote a good friend and colleague, “Patrick, it’s even worse than that”, imagine if SARS-CoV-2 had an equivalent mortality to another recent coronavirus (MERS-CoV-1) which has a 30% mortality rate; this nightmare situation could happen.

Figure 6. Hypothetical 3rd wave

While a vaccine and better treatments will definitely alter the trajectory of the curve, those technologies need time to be sussed out. A rushed vaccine could potentially be disastrous. In a bad but not worst-case scenario, the rushed vaccine is ineffective and encourages people to drop their guard, thus increasing the rates of infection. In a worst-case scenario, it is both ineffective and unsafe, leading to high rates of complications and then widespread public mistrust in future vaccines (fingers crossed that this is not the case for the Russian vaccine being sped into production now). As described above, we all know (we, the logical ones) that there are very simple measures to help buy scientists, pharmaceutical companies, and government policymakers time to do this right: wash your hands, wear a mask, limit exposure to other people.

We as a species will get through Covid-19 but we need to protect ourselves and our children against the BIG ONE as precedent shows us that it could result in 1–2 billion deaths and decimation of humanity.

Are you a linear thinker? We will leave you with this:

Figure 7. Linear vs exponential growth

This is part of an ongoing series of data visualizations of the Covid-19 pandemic. Part 12 was published on Oct 27, 2020.

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