Covid 19 pandemic weekend link fest

1. Glen Weyl and Jaron Lanier highlights the success of Taiwan, a mix of technology and democracy,

Taiwan’s success has rested on a fusion of technology, activism, and civic participation... This culture of civic technology has proved to be the country’s strongest immune response to the new coronavirus... Bottom-up information sharing, public-private partnerships, “hacktivism” (activism through the building of quick-and-dirty but effective proofs of concept for online public services), and participatory collective action have been central to the country’s success in coordinating a consensual and transparent set of responses to the coronavirus. A recent report from the Stanford University School of Medicine documents 124 distinct interventions that Taiwan implemented with remarkable speed. Many of these interventions bubbled into the public sector through community initiatives, hackathons, and digital deliberation on the vTaiwan digital democracy platform, on which almost half the country’s population participates. (The platform enables large-scale hacktivism, civic deliberation, and scaling up of initiatives in an orderly and largely consensual manner.) A decentralized community of participants used tools such as Slack and HackMD to refine successful projects.

Taiwan's is an impressive achievement. One can never say how much these technology innovations contributed, if at all, to Taiwan's success till now. Even if it did, how much of it was built on the foundations of culture and latent conformism of its democracy.

As a comparator, Singapore's success revolved around good old (and super efficient) physical contact tracing involving detective work by police, officials, and even armed forces. 

2. Good FT article on how Singapore managed to control coronavirus,

The city’s success in dealing with the outbreak is attributed to the government’s speed in imposing border controls soon after the disease first erupted in China, meticulous tracing of known carriers, aggressive testing, a clear public communication strategy and a bit of luck... As soon as information about the disease emerged from Wuhan, the city at the centre of China’s outbreak, Singapore began preparing by ramping up laboratory capacity for mass testing and developing its own test kits. This was seen as instrumental to containing infections and not overwhelming hospitals, a problem faced by countries such as Italy... The country’s business community also moved quickly. Soon after Singapore reported its first cases, banks divided their teams between offices, home working and emergency trading floors, many of which were in an outlying industrial area near the city’s Changi airport... It also learnt from its experience of Sars in 2003, which forced it to strengthen its healthcare system.

But several features, apart from its small size, also make it difficult to replicate elsewhere,

Surveillance cameras, police officers and contact-tracing teams have helped the government find 7,957 close contacts of confirmed cases, who have all been quarantined. The government on Friday launched TraceTogether, an app that uses bluetooth to record distance between users and the duration of their encounters. People consent to give the information, which is encrypted and deleted after 21 days, to the health ministry. The department can contact users in case of “probable contact” with an infected individual. “There’s a higher degree of acceptance of being monitored by the state,” said Chong Ja Ian, associate professor of political science at the NUS. “That makes some of the more invasive methods for contact tracing easier.”

3. Underlining this, this article in Wired talks about the privacy and related challenges with using mobile phones for digital tracking and detection of corona affected.

4. NYT has more modelling of different outbreak scenarios based on a study by researchers at Columbia University.

5. Talking of models here is a list. This is a model from researchers at Oxford. Graphics on the value of early quarantine, infection and mortality rates in US modelled for corona compared to other diseases, modelling in WaPo of the spread of corona under various conditions of quarantine or social distancing, another model in NYT of the spread of the virus under different conditions of response. This models Covid 19 based on the classical infectious disease model.

This is a repository of all models and research related to Covid 19. Btw, there are so many models now, with such varying findings, that you can pick your choice to justify your priors on the strategy to be followed. 

I don't know how many of these modellers have even thought of the unknown unknowns - the role of temperature and humidity, genetic or racial characteristics, pre-exisiting immunities, cultural practices and so on. The one thing to remember is that nobody has a clue about the unknown unknowns in this predictions race. 

On models itself, Mark Buchanan has a cautionary note,

Models of this kind depend on parameters for such things as the incubation period of the virus and when people either with or without symptoms can pass it on to others. The values of these parameters are uncertain. The early U.K. policy was based on the belief that one key parameter — the fraction of hospitalized people needing intensive care — was lower than it turned out to be. Indeed, the actual number seems to be roughly twice as large as initially expected, rendering the earlier modeling results irrelevant... It's particularly easy for policy makers to misuse complicated models. “Modeling — especially complex modeling — can promote something of a fairy-tale state of mind,” says Erica Thompson of the London School of Economics and the London Mathematical Laboratory. “People come to believe that optimal outcomes in a simulation invariably reflect desirable pathways in the real world. But things get lost in the move back to reality.” As a result, she says, much simpler models can be more stable and trustworthy for use in policy making, because it is clearer that they are “only models” and don’t invite misplaced confidence in the details. There's little question that most of the other nations that took more aggressive action against coronavirus also had access to complicated computer models to simulate epidemics. But they seem to have fashioned their policies on the basis of a simpler insight: that epidemics grow exponentially, at least in the early stages following an outbreak, and get harder to control as time goes on.

The example of the Imperial College's model is illuminating. This initial model contributed to the UK's herd immunity approach. Its revision contributed to the reversal of the government's policy. But it now emerges that this revision in turn many have erred excessively on the side of alarm.

6. On an optimistic note, Michael Levitt, the 2013 Nobel laureate and Stanford biophysicist, argues that we may be over-reacting and the toll from the novel coronavirus may not be as large. He bases his assumption on the trends from China where the peaking of the growth rate of the virus happened quickly. He therefore argues that the same could be the case with US and elsewhere.

7. In India, the Kerala government has received much praise for its response with its transparency, constant communication, and painstaking field work. Sample this,

... state's decentralised community-level task force, devised to lend a helping hand for those who are quarantined. Kerala has structured a three-member team in each village, comprising a village's elected representative, a public health worker and a police officer, for monitoring and assisting any need for those in home quarantine.

This is a good description of its economic rescue package. This article highlights how the state has mobilised Kudumbashree women's self help groups to run community kitchens to prepare food for the poor.

This interview of the Kerala Chief Minister is as statesmanly an interview as any. It also clearly indicates the reasons for Kerala's success - being transparent with details, and doing the simple things right. This is another good description of the Kerala response. This describes the state's community kitchens and home delivery which have now been established across all villages and towns.

This is the Kerala government's supply chain and inventory management system which lists over 19000 GST registered traders. This is a very good narrative of the Covid management in Kerala - plain simple and detailed monitoring. This is a summary of the Kerala government's response.

8. This is a good Covid 19 country status monitoring tool. This is the FT's updated corona tracker report. Fascinating graphical illustration here of how the virus spread in South Korea.

9. Politico lists out 34 different ways in which the novel coronavirus outbreak will change the world permanently.

10 Yuval Noah Harari points to two choices faced by the world in the aftermath of the Pandemic,

The first is between totalitarian surveillance and citizen empowerment. The second is between nationalist isolation and global solidarity.

11. Sweden going its own way with herd immunity type approach.

12. China scrambling to recover lost pride with its own corona support diplomacy, "health silk road".

13. Even as countries go the lockdown way, as they perhaps should, Vikram Patel strikes an important cautionary note.

But the one lesson every infectious disease epidemic has taught us is that context matters. Simply put, bugs do not spread the same way everywhere. I vividly recall the hyped pandemic of HIV/AIDS which was predicted to overwhelm India in the late 1990s.

To be fair to governments, especially in countries like India, the possibility of uncontrollable community transmission from not locking down may have been too much to even imagine. And the aggressive public and social media may have forced their hands.

14. Meanwhile the search for Covid 19 drugs goes into top speed.

Scientists are investigating three main types of drugs. The first are antivirals to stop the virus from replicating. Treatment guidelines compiled by the Chinese government during the outbreak include HIV drug combination Kaletra, which US biotech AbbVie recently waived its patents on so it can be made available as a generic; antimalarials such as chloroquine, which generic drugmakers are gearing up to manufacture at scale; and favipiravir, an anti-flu drug from Japan’s Fujifilm... Analysts are eagerly awaiting data from early trials into remdesivir, an antiviral drug that the California-based biotech group developed for Ebola... The second category is anti-inflammatories that treat the lungs after the immune system is overwhelmed. Regeneron and Sanofi have partnered on Kevzara, while Roche has started a trial on Actemra, approved for use on rheumatoid arthritis in 100 countries. The third group are antibody-based treatments, derived either from recovered Covid-19 patients or developed in labs, to be given to the seriously ill or as a temporary prophylactic for healthcare workers. Eli Lilly has paired up with Canadian start-up AbCellera to work on antibodies developed from one of the first US Covid-19 patients, while Japan’s Takeda is developing a new drug derived from the blood plasma of others who have survived the virus.

15. Angela Merkel returns to fight Covid 19.

16. Stanford Medical professors Eran Bendavid and Jay Bhattacharya point to the selection bias introduced by testing and argue that "the true fatality rate is the portion of those infected who die, not the deaths from identified positive cases". Using some available data from China, Italy and Iceland, they argue that the true Covid 19 fatality rate may be lower than 0.1 per cent, that for common flu.

On the same lines, Vikram Patel writes,

the one lesson every infectious disease epidemic has taught us is that context matters. Simply put, bugs do not spread the same way everywhere. I vividly recall the hyped pandemic of HIV/AIDS which was predicted to overwhelm India in the late 1990s.

This interview of Vikram Patel is worth watching.

17. While governments cannot be faulted at all for having resorted to such blanket lockdowns, it is important for the experts and opinion makers to be more careful with their diagnosis and prescriptions.

Right now, we are seeing the application of a narrative generated from the spread of the disease in developed countries to developing countries too. Only time will tell whether this was the right approach or not, not in the idea itself but the degree to which it has been adopted. But for now, given the dominant narrative, governments have no choice. But it is also important for governments in India and elsewhere in developing countries to be ready to revise their priors based on emerging trends from their own contexts.

There is a non-trivial risk that the economic costs from lockdowns can turn out to be higher than the medical costs from business as usual.

18. Finally, this Covid 19 Dashboard of Microsoft is very informative.