GELFAND’S WORLD--I’ve been ruminating over the following question: Since so few people in this giant county have actually come down with the Covid-19 illness, are most of us at least modestly immune to it?
Remember that our bodies throw up all sorts of defenses against bacterial and viral illnesses – everything from having skin to blowing our noses to our propensity to shed the lining of our intestines fairly regularly. On top of that, there are all sorts of cellular-level defenses. So is some undiscovered sort of immunity the reason that there are only about thirty-thousand demonstrated cases in Los Angeles County, and only a little over one million cases in the entire country? Or have we just not yet gotten it so far?
Even if these early numbers are just estimates, (and maybe there are actually twice as many cases) it’s still less than one-percent of the population of the whole country. For Los Angeles county, the proportion is also pretty low.
So if we were to base our guesstimates on these numbers, or the published numbers from Italy, Spain, or China, we would still guess that the disease might skip most of us. Unfortunately, a recent real-world test of this question gives us an unhappy answer.
Suppose you wanted to investigate whether the disease is capable of striking most of us, or just a small fraction of us. One way to do this experiment – thoroughly unethical, but theoretically possible – is to put a group of people together so that they have to interact with each other and cannot voluntarily abandon the experiment. Then you could simply wait for a while and then count all the people who show up positive on the Covid-19 test and likewise count the people who have not (at least yet) shown up positive. You could even count the dead among your sample population.
Like I was saying, it would be unethical for medical researchers to propose such an experiment and to start collecting volunteers. Yes, it would be a way of testing whether social distancing has any practical benefits, but it would endanger those who aren’t social distancing if close encounters actually result in viral transmission.
But there is a way of doing the experiment, and (whether you agree with the methods or not), it is being done. A brief explanation of the logic: A few years ago, a University of Chicago economist and his colleague came up with an intriguing idea. What if we could find real world events that accidentally provided us experiments. The first book (a bestseller) was called Freakonomics, and considered several such accidental experiments.
Perhaps you can see where I’m going with this. The unintended, real-world experiment is called the Terminal Island federal prison (officially, it’s the Federal Correctional Institution, Terminal Island). It contains just over a thousand inmates. They did not volunteer their occupancies, and the government has not been in a rush to move them to less crowded conditions. It would only take one or two cases of Covid-19 in the population to set the experiment off, and after that, we could look to see whether the Covid-19 positive inmates turn out to be ten percent, or maybe 20 percent, or perhaps even more of the total. That result would be a good indication of how susceptible we are as humans to the virus, since you’ve got a population in which pretty much every person is getting exposed. Of all those 1042 exposed people, how many turned up positive?
You can see that we’ve got a pretty decent experiment going on here, whatever the ethics. We’ve got data that answers the above question: Will only a few get it, or will they all get it?
And we have an answer, and it’s not a happy one.
Let’s look at the numbers.
There were, at the last official count, 1042 inmates at Terminal Island.
Out of this 1042, so far 693 of them are reported to have become Covid-19 positive.
That number turns out to be 67 percent, or an even two-thirds.
That may very well be an incomplete count of the sick, because more may convert to Covid-positive over the next few days and weeks.
Whether the final number is closer to 67% or 99%, we already have that Freakonomics type of real-world experiment that tells us something important: Humans don’t seem to have a lot of innate immunity against getting the virus. We might have hoped that half the inmates would show no evidence of illness at all, but that’s not what happened
If we think about how this applies to ourselves, the likely prediction is this: Given enough time and the lack of a new technological marvel such as an effective vaccine, most of us are going to get it. Maybe as many as one-third of us will avoid getting it, but that is the most optimistic estimate.
A note on the limitations of the study: Scientific papers often put in a little section at the end describing the known limitations of the study. In this case, the study is generally limited to adult males who were in reasonably good health prior to their incarceration. There will have been a few with preexisting conditions such as diabetes and congenital heart disease, but that would just make the prison population a little closer to being like the outside population. But women and children are excluded from the study.
The young, the restless, and the stupid
As we speak, there is another Freakonomics sort of real-world experiment going on. The Wisconsin Supreme Court just decided to invalidate the statewide lockdown order. We have a few anecdotal accounts explaining that some establishments have gone back to the old ways, with unmasked people going elbow to elbow. Other establishments in the same state are holding to the social distancing ways that we here in Los Angeles County have gotten used to.
Another state that will be an unwitting Freakonomics experiment is Georgia, what with it opening its doors to all the surrounding states for food sales and commerce.
If the social distancing model is correct – that keeping away from each other is protective – then the prediction is that Covid-19 case counts will start to go up (“spike”) in those places about a week or two after the rules are relaxed. There is a similar prediction regarding the much smaller population of people filling the recently opened bars and restaurants in Orange and Riverside counties. Even in Los Angeles County, we might expect to see a slightly smaller spike in new cases just due to the fact that we’re starting to see a widespread relaxation among people who want to go to the beach or get a haircut.
The Terminal Island death toll
What I’ve heard is that for a lot of people, just having the virus is a terrible experience, even when you don’t die from it. For that reason, I’m not making a big argument about the fact that the death toll is considerably lower than previous epidemics such as smallpox. It’s bad enough just having the thing, as numerous accounts of people being released from hospitals attest.
But the Covid-19 death toll isn’t trivial either. The American population has now lost more than eighty-thousand to Covid-19, and we don’t know how the numbers are going to look next year.
For Terminal Island, the current death toll is 7 out of those 1042. That number is right around one percent of those who tested positive, and a little bit lower for the entire population (including those who have not, so far, tested positive).
The prediction, if the epidemic continues without better treatments or an effective vaccine, is that somewhere on the order of one percent of the American people will succumb. That total is around three million American dead, a number that dwarfs the losses in wars.
The lessons of the Covid-19 epidemic are clear and obvious: We desperately need a vaccine if we are to get back to normality. Without a vaccine, we are left with treating those we can, burying those we can’t, and for the rest of us, enduring whatever set of symptoms comes our way. This is a powerful lesson that will (I hope) convince the vast majority of the American and European people that vaccination is critical.
But there is a vocal subgroup in both places that thinks of vaccines as dangerous, and thinks of those who defend vaccination as evil. It’s all a little bizarre, but there you have it. Anyway, the anti-vaccine freaks are ramping up their anti-vaccine nonsense in response to Covid-19. The result is a host of conspiracy theories that are being passed around. It may be that some of the nonsense that comes out of the president’s mouth comes ultimately from the anti-vaccine noise machine.
(Bob Gelfand writes on science, culture, and politics for CityWatch. He can be reached at firstname.lastname@example.org)