Pandemic diary 2020-05-05: Segregation cannot set you free

A few days ago, David Frum offered this extraordinary conjecture:

I don’t think the President and people like Governor Kemp are consciously planning this, but they’re removing all the alternatives to the only policy that is going to remain this time six weeks from now or eight weeks from now. Which is they’re moving toward the policy of what’s — “let’s take the punch.” He’ll reopen and see what happens. Let’s accept that there may be hundreds of thousands, or some double hundreds of thousands, of Americans killed. They’re going to be mostly poor and minorities, mostly not going to be Trump voters. Let’s take that punch and push through and try to get to herd immunity as fast as possible.

I don’t think the President quite processes it quite that rationally, but maybe Governor Kemp does. I suspect Governor DeSantis probably does. But that’s where with they’re going.

There’s lots to say about this. In the short-term, the strategy Frum describes is self-defeating. If affluent people don’t emerge from isolation, “reopening” won’t do much to revive the (dollar-weighted) service economy. We’ll still be saddled with the same ugly economy, but with a higher prevalence of the disease, rendering it even harder to sustain the supply chains of essential goods even Trump’s base relies upon. If the red-state affluent do emerge, the “punch” will be taken in significant part by Republicans’ base after all, and they may not like it.

But also, there’s an error in this thinking that transcends the heavily memed frontier between red and blue. It afflicts affluent Americans broadly. It’s hidden in that phrase “herd immunity”.

We have all heard that “herd immunity” may set in once, say, 60-70% of the population have been exposed to the virus and so (hopefully) immunized. The logic is simple: If R0 is 3, then once two-thirds of the public have been infected, two of the three people a new case would have infected will now be immune. So they’ll infect only one to take their place as they recover, stabilizing rather than increasing the infected population. Once more than two-thirds are immune, on average they’ll infect less than one person, causing the infected population to decrease over time rather than stabilize. Cool.

Affluent Americans of all stripes I think are quietly mulling something like this: It’s a terrible time, and tremendous death and suffering may be inevitable. For all kinds of reasons, we as a country may not be able to “crush the curve” and adopt South-Korea-style social distancing. Maybe it’s just impossible, given the extent the disease has spread and Americans’ general unruliness. Maybe it’s not worth the cost, in dollars and liberty, of living several years in a kind of quiet stage-managed by public health bureaucrats. So maybe acquiescing to “herd immunity” before a vaccine will have to be the way forward. We could get lucky! Maybe asymptomatic spread is much more than experts estimate, so the infection fatality rate is low. Maybe much of the population is immune already, genetically or due to cross-reactive antibodies from common-cold coronaviruses. But we have to be prepared for not getting lucky, in which case more than 200M Americans would become infected, and (under current estimates of an infection fatality rate of ~0.7%) more than 1.4M would die.

But even in that case, some significant fraction the country — say 25% to 33% — need never become exposed, need never risk this game of Russian Roulette where even “winning” may involve suffering and disability. If my family can isolate, comfortably and so diligently, if we can place in the top 25% of isolation diligence, then we can hold out until enough other people have risked and suffered and died that we can emerge safely. If, sadly, herd immunity before a vaccine is inevitable, then why delay acquiring it? Shouldn’t we race there as fast as we can, subject maybe to the constraint that ICU capacity should not be outstripped? The people who are going to be exposed will be exposed anyway, but at least they’ll not be unemployed as long. And the people capable of isolating most diligently would like to be (safely) free of their diligent isolation as soon as possible, thank you. So, as Frum describes it, let’s (let them) “take the punch”.

Segregation is affluent America’s go to coping mechanism. There are always horrible things going on “over there”, whether over there is a famine in Africa, a war we are prosecuting in the Middle East, or poverty and violence in West Baltimore. The first amenity Americans seek as they grow affluent is a “nice neighborhood”. As a nation, we describe ourselves as blessed by the protection of our two wide oceans. As families &mdash if we are affluent, especially if we are white — we understand that we are protected by more subtle boundaries. Maybe that’s a sad injustice, maybe it’s because we’ve earned it, choose your poison and your political party. But whatever it is, we are used to it. It’s not surprising, when we read that COVID-19 has hit poorer communities, black communities, immigrant communities disproportionately. It may not be right, but it’s the way of the world, and whatever our political or ethical attitude, affluent Americans tacitly rely upon it. Manhattan, denser but whiter and richer, has less than half the COVID infection rate as the Bronx.

But the segregation that so often protects affluent America this time cannot free it. Remember how herd immunity works? If R0 is 3 and more two-thirds of the population is immune, then an infected infects less than one replacement and the virus dies out. But that assumes a uniform draw: the three people a new case would have infected are randomly chosen from the population, and at least two of them turn up immune (on average). But if the population is segmented, segregated, stratified, that won’t be true at all. Herd immunity might be achieved in the Bronx, but over in Manhattan, most of the privileged will remain immunologically naive. If you want to ride out the epidemic without exposure, it’s not enough to be in the top 25% to 33% of the most diligent isolators in the United States, or even in New York City. You have to be one of the top 25% to 33% of diligent isolators in your own community, among the people you interact with. If you are an affluent person who lives in a desirable neighborhood, who if liberated would work in a tony office, your implicit competitors in the coronavirus virginity game are not meatpackers or transit workers, but your neighbors and coworkers. And that’s a much tougher league. They have resources comparable to your own, or maybe better. The game of mortal attrition could last a long time. Months or years after the transit workers have taken their punch, your little world could still be ripe for an outbreak, if you all come out to play. So you won’t, not until there’s a vaccine or you are compelled by circumstance. Segregation will have helped to protect you, as it usually does. But this time, it will also imprison you.

So, if you are affluent, in a comfortable isolation but eager to escape it, don’t imagine that “hard men” like Governors Kemp or DeSantis are, however regrettably, accelerating your liberation with a herd-immunity strategy. They may think they are, but all they are in fact doing is risking the supply chains that your comfort and our political order depend upon. And, of course, putting lives of the less affluent, as precious and valuable as your own, needlessly at risk. But, though we fret, those lives seem to weigh little in our political system. Maybe if the affluent understand that “taking the punch” will not protect or liberate us, but may risk food shortages, outrage, and rebellion, maybe that will weigh more.


11 Responses to “Pandemic diary 2020-05-05: Segregation cannot set you free”

  1. Detroit Dan writes:

    So good to have you posting again. Each post is a gem I treasure.

  2. JP writes:

    Really well said. Thank you. I like that you don’t assume all humans are robots; non-uniformity. Your opening logic does assume we are uniform though, when you talk about Rs and immunity percentages. Imagine if only one person were spreading Covid? As a thought experiment only. When would we be immune in that case? Super spreaders get it first and transmission falls faster? Just a thought. As you point out, we aren’t equal in how we respond or receive.

    I really hope we can be more like South Korea next time. Perhaps contain and do even less harm? Your underlying logic seems a bit flawed to me. We should not wreck the supply chain by letting people work? First, we are letting people work. Someone must run those factories. Second, the supply chain is already being ruined. So we should lock-down for years because the supply chain will be ruined if we do or don’t? At some point, wouldn’t you rather take a 10% chance at success than a 100% chance at failure? Even with unfairness baked in, as you point out?

    Singapore has had a recent flare up, but with low deaths. Why? There are natural, if inadvertent, examples out there of intelligent relaxation of the current strategy. Of course, we can’t be anybody but ourselves, but we might be able to adapt some things. It’s a tough situation. How do we do the least damage to society? An inflexible strategy seems to go against everything I know about handling tough and complex situations.

    Thanks again. Just food for thought. I don’t have the right answers either, of course.

  3. Tom O'Keefe writes:

    This is great. Thanks for breaking down the current state of affairs so perfectly.

  4. Unanimous writes:

    @JP Singapore’s low deaths are because the flare up is in temporary foreign worker dormitories, not the general Singapore community. These dorms have only fit young men in them. They are also closely housed and perfect for transmission. I don’t think there’s much to learn from the flare up that isn’t already known.

  5. Unanimous writes:

    Good points as usual.

  6. PQ writes:

    Stunning, but completely sound logic. Based upon Musk’s behavior today I feel certain that at least some of the 1% will not get the point.

  7. Glenn Robert Sills writes:

    One of the stronger analysis I’ve read in a while.

  8. But Prince Prospero was happy and dauntless and sagacious. When his dominions were half depopulated, he summoned to his presence a thousand hale and light-hearted friends from among the knights and dames of his court, and with these retired to the deep seclusion of one of his crenellated abbeys. This was an extensive and magnificent structure, the creation of the prince’s own eccentric yet august taste. A strong and lofty wall girdled it in. This wall had gates of iron. The courtiers, having entered, brought furnaces and massy hammers and welded the bolts.

  9. KV writes:

    We need to remember that “herd immunity” assumes that people infected with covid-19 WILL have effective immunological protection from re-infection for a meaningful duration. We do not know if natural immunity lasts more than a few months. We do not know if it extends to other covid-19 strains.

    Everyone is assuming a vaccine will be developed. We do not know if any vaccine CAN be developed.

    No vaccine has ever been found for any corona virus– not SARS, MERS or the strains associated with the common cold.

    All of this talk of “herd immunity” is simply a pretext for re-opening the economy, letting the little people be the guinea pigs to “see what happens.” You can be assured that rich folks will be watching this real-life medical experiment for the first 3-4 weeks from the places where they think they’ve safely segregated themselves. But as this post points out, this segregation may not confer the safety they hope for. Covid-19 may well be a great leveller. The political implications could be immense and long lasting.

  10. m sam writes:

    Hmm, that the rich won’t be able to save themselves by segregation doesn’t make all this seem any less like we’re entering a concentration camp. Come to work or die (bosses, report your employees to the unemployment offices!), and then only to live a little longer.

    Even if these fascists “hard men” like Kemp end up being right and the coronavirus magically goes away (because, well, that’s what happens when rightwingers really mean it), when are we allowed to say such “natural experiments” go too far? I mean, what is next? I am so tired of simply agreeing to disagree and watching another 1,500 die (as happened today). It really makes me think nobody in this country is up to solving even the most mundane of our problems.

  11. Benign Brodwicz writes:

    Yes, true; but incomplete.

    What you need to add is that the lockdown strategies (especially of the blue states), in combination with the basically blue and probably worthless national level bailouts, are also a means to kill off poor people. We bail out zombie corporations but …

    Consider the miles-long lines at the food banks. What must it feel like to have your livelihood(s) taken away by a guy on TV, suddenly to have no money and no food for your family, and to know that in all likelihood you will soon be homeless? This is going to kill people, regardless of the pathetic checks the government is sending out. Going back to work is a forced move for a lot of people.

    We are at the end state of neo-liberalism or capitalism rampant, collapse, which always seems to involve a contrived depression that benefits the 1% and is intended to decimate the middle and lower classes, and not just by the virus. Read “Anticipations of the Electro-Mechanical Age” (1905) by H.G. Wells, which Wayne Jett considers to be the original blueprint for the New World Order, which Bill Gates et al. now seem hell-bent on imposing ….