Our Covid Memory
Thoughts After a Year Tracking Covid-19 Data
Everyone reading this sentence is likely more capable of parsing Covid-19 data than the vast majority of politicians and media/Twitter pundits. The reason is simple: you choose to be informed and seek out the data behind the headlines. It’s unlikely you arrived at this article otherwise. The bad news? You are dwarfed by so many with massive reach who play fast and loose with facts and data in order to map a preconceived narrative neatly onto reality. And there are enough data levers to pull that a clever wordsmith or talking head can provide a technically “truthful” presentation to achieve whatever end he or she so desires.
Much of the skewed presentation isn’t scheming or malevolence—it’s sales. People prefer to watch a dramatic movie, complete with good and bad guys, death-defying behavior, failure, and ultimately triumph. The media know this. Many Covid post-mortem stories have already been written, I’m sure. The arc is clear: the dark days of 2020 gave way to the halcyon days of fall 2021. Kids in schools. Packed sports stadiums. Buzzing restaurants and bars. It’s all coming, and soon. But how will we (the collective “we”) remember what took place in between? Inaccurately, I suspect.
The Collective Wisdom
I’ll begin with what has become the collective wisdom across most of the pundit class regarding the percentage allocation of Covid-driving factors (until the vaccine’s arrival on the scene):
The (intentionally absurd) chart above captures the zeitgeist of 2020 (and even 2021, simply add variants into the mix). Numbers improving in your region, state, or city? Proof that people are “behaving” appropriately. All implemented mandates and restrictions are working.
Numbers turning for the worse? Well, you’re just not masking hard enough (just look at [random picture] of largely unmasked crowd at the beach…see!?). Too many schools are open (here’s an anecdotal story about 4 people with a connection to [bad in-person school X] who tested positive for Covid…see!?). Too many people are dining indoors. Only one answer makes sense—scale it back or shut it down:
Am I suggesting that groups of people in close contact, especially indoors, have no effect on Covid transmission. Of course not. I’m simply asking two important questions: (1) Is there another factor more predictive than the blunt tools in our arsenal?; and (2) Is the juice worth the squeeze when it comes to restrictions? Too few people care about the answers to those two questions.
Seasonality
Seasonality seems to me the most predictive—and most ignored—factor in determining a region’s Covid trendline (outside of immunity through either prior infection or vaccination). By the term “seasonality,” I mean more than weather or the month of the year. There are likely several factors that come into play. Many on Twitter were far out ahead of me on this issue. I generally just posted and interpreted the metrics, often correcting those who didn’t seem to understand the concepts of per capita, reporting lags, reporting dumps, positive testing percentage, etc. It wasn’t until fall 2020 when I couldn’t help but notice what happened with the rise of Covid in the United States.
It was as if someone dropped a pebble into the the nation’s coldest states (the Upper Midwest) in October, and then we watched as the Covid rise ripple outward from region to region, ending in the southernmost states. I followed along as very serious national media types attributed the rise to various other factors, from a motorcycle rally to the holidays to the restrictions in place—anything but a phenomenon in which climatological factors have natural peak and trough conditions for Covid transmission. This despite the fact that states within a certain geographic area peaked at remarkably similar times, many long before Christmas (or even Thanksgiving).
By spring, I was pretty consistent on Twitter in showing our most recent rise (in March 2021) following a similar regional trend:
But why did so many ignore this factor? And why continue to ignore it? I suspect it’s because there is nothing that the politicians or media can do to change it. There are no good or bad guys. You can’t lay blame on temperature, humidity, and sun azimuth as easily as a governor or mayor on the bad team (and in turn get more clicks for your stories). So where did the blame fall by the spring? Well, misbehavior again (of course), and variants as well.
Even as variants increased as a share of Covid cases, their spread varied at least in part based on region:
Why This Matters
Barring some horrible unforeseen wild card that changes our trajectory this spring and summer, the Covid-19 pandemic in the United States is on the way out. Yes, it will likely become endemic and resurface (seasonally, one might expect?) in levels lower than those that changed our world these past several months. No doubt vaccinations will end up the champion that dealt the fatal blow, and the speed with which they became viable will always amaze me.
But the pre-vaccine pandemic ebbs and flows are important as well, and so are the measures to which we attribute success in blunting Covid’s effect. Consider that pie chart I included above for a moment. I don’t want to hazard a guess as to what the real pie chart might actually look like in terms of the relative influence of factors that drive Covid (though I suspect seasonality and immunity would be major portions), but one would hope that professionals dedicated to the study of epidemiology, public health, risk assessment, and a host of other disciplines would be at least as curious and dogged as a few dozen randos on Twitter (like me).
Instead, politics crept in, as it so often does. Covid hit us hard right smack in the middle of the election season—an election many people considered the most consequential of their lifetime. I have little doubt that this affected our objectivity and inquisitive nature, and unfortunately I saw many professionals simply line up behind their team and parrot catchy soundbites and talking points. Now, as Covid wanes, I hope we begin to reconstruct and analyze the data so that we may better understand the spread and treatment of deadly respiratory viruses. I only hope we proceed with a clear memory of what actually happened and not what our favorite politicians, media members, Twitter personalities, and influencers—our team—tell us happened.
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I think you bring up some interesting points, but I would add a few points of additional nuance.
My personal beliefs: individual measures like masks, business and school closures, and social distancing are likely helpful, although none of them are foolproof- and we don’t have the science to know how much they help or what the most effective dose of each is. Additionally, practice is more important than policy. My son was watching a YouTube video in which Minecraft programmers in Sweden were talking about working from home since the start of the pandemic. And a half hour spent on Twitter will reveal plenty of people in states or countries with more restrictive measures that have completely ignored them.
The truth about the effectiveness of any intervention is likely to be about differences in degree, not differences in kind. For example, both of the Dakotas have seen over 200 covid deaths per 100,000 of population, while their neighbors Minnesota, Colorado, and Nebraska are at 129, 112, and 122 respectively - despite each of those states having many more cases and deaths in the early days of the pandemic. The pandemic has been terrible in all three states, but it has been meaningfully worse in the Dakotas. There is no climate difference or demographics that explain those discrepancies. Luck? It could certainly be a factor. Every time someone has thought they know something about the virus with certainty, it turns out not to be true (widespread cross-immunization from other coronaviruses? hotter, moister climate of Southeast Asia providing protection? Prior immunization against malaria or smallpox? Huge numbers of asymptomatic infections driving herd immunity after last summer’s surge? Nope, nope, nope, and nope).
We are trying to write history as we live it. That’s hard enough with political history, where history has a degree of art to it. It’s a tougher task altogether in the sphere of public health. Humility and a dedication to facts would benefit us all. Your dedication to identifying the facts and making them understandable has helped the discourse.
“I only hope we proceed with a clear memory of what actually happened and not what our favorite politicians, media members, Twitter personalities, and influencers—our team—tell us happened.“ Thank for you this piece. So many Instagram consumers such as myself that follow a mix “health and well-being” and “doctors” often forget about agendas. I’m enjoying anchoring my thoughts in a different space.