Ebola

–Super short. Outbreak has officially been declared over in the Democratic Republic of the Congo. In Guinea, the last confirmed case has been discharged from the hospital after successful treatment. There have been 23 confirmed and probable cases total in Guinea, with about a 52% mortality rate. Suspected cases still pop up on the radar there, and there are known contacts lost to follow up, so not -completely- out of the woods yet. But the countdown officially started this weekend to call an end to the outbreak in Guinea.

Considering that the outbreak seems likely to have been reactivated Ebola Jane (really, Ebola Jim), another Ebola outbreak is probably just a matter of time away. Once travel reopens more consistently status post COVID, again, the chance that Ebola will leap via reactivation to a country with little experience with it and probably gain a solid foothold before anyone knows its moving through that country is not zero, and over a long enough time line, will be probable. Considering the still high mortality rate of even treated Ebola, at least in my humble opinion, more widespread vaccination needs to be on the table. I doubt that will happen though. We seem to genuinely prefer our pound of cure over our pennies of prevention.

Coronavirus

–Yeah, India is getting crushed. Worldwide cases would be down, except for India having so many, so fast. Stories you are reading of hospitals running out of oxygen and getting otherwise overwhelmed over there are true. I have colleagues who have lost family members to COVID there in the last week (in the high risk demographics). Most concerning, some of them had received one of the major vaccines. On the other hand, speaking to friends with family back on the subcontinent, they have family members with 1 of 2 doses of the Indian manufactured vaccine in–one tested positive, but no symptoms as of earlier this week, while the other has not tested positive at all. So I dunno how much, if any, breakthrough of vaccination is going on. Not a whole lot on the reinfection radar, and I don’t think anyone has a good handle yet on the exact predominant variant(s) driving the current outbreak in India, but the “more contagious” variants are undoubtedly leading the charge. The Boston Globe has a list of organization providing needed medical supplies to India if you are at all inclined: https://www.bostonglobe.com/2021/05/04/business/here-are-12-organizations-are-raising-money-covid-19-relief-india/

–While India has dominated the headlines, Japan’s numbers have been quietly creeping up again, even as we get closer to the Summer Olympics there.

–Nepal has also seen a sudden explosion in new cases as well, suggesting the wave from India may be making its way over the Himalayas. Nepal, frankly, is probably less well positioned than India to handle the kind of wave that appears to be starting there. This may also put the Tibet region of China into play geographically, assuming the virus is spreading through the mountains right now although you can expect the Chinese government to keep that on the DL for awhile if and when it happens. In fact, the only news I can find of the Nepal/China border is that the border crossings reopened earlier this year after closing due to COVID late last summer. Nepal had vaccinated 1.9 million people with vaccines from India and China, but efforts stalled as the communist of government of Nepal apparently ran into sourcing difficulties. You have probably read the same rumblings I have that the Chinese vaccines may not be quite as effective either. So China’s vaccination/recovered and immune patient status may be put to the test, because I suspect it is getting close, if not already too late, to close the Nepal checkpoints again.

–On the socioeconomic front then. So remember that Hidden Forces podcast interviewing the supply chain guru last year, where we learned that globalization of the economy has created hidden choke points all over the supply lines of nearly everything? How sometimes 4 or 5 manufacturers down the line for a widget, you find that everyone is basically buying component A for that widget from one and the same source, who may have 90% of the market for that component? How we discussed that the stuff randomly dropping off shelves we saw last year was due to those hidden, but widget-critical suppliers around the world shutting down due to their local COVID situations? How we also said at the very beginning that China is a terrible place to have to quarantine, because many widget-critical component chains can be found there (at least at the start of the pandemic)?

India is -also- a bad place to have to shutdown and quarantine en masse. That is also a GIANT country with many integrations into the global supply chain, and is undoubtedly the land of several widget-critical manufacturers.

So you can again expect pretty random disruption on the store shelves. Probably not to toilet paper, but expect some disruptions. It will also provide absolutely NO relief to the inflation you are undoubtedly seeing too nearly across the board. Yes, I hear you, that reduced production should be deflationary, but I think inventory overall in many if not most things never got completely replenished and this kind of supply disruption will stabilize if not intensify inflationary price pressure. But, I am not an economist, so take that as the totally random damn guess it is.

–Yes, there has been some news about a new antibody designed to crush the “variants of increased concern” heading to the clinic, and some other headlines, all involving a particular pharmaceutical company. I cannot comment on them (especially since I am not involved in the business area for the “other” headlines to even begin to comment on them). Thank you for your understanding.

–In other news, we learned from studies published this week that COVID-recovered patients who get the vaccine neutralize (in petri dishes) variants of increased concern even better than people who never got COVID, but also got the vaccine. This suggests that re-exposure to COVID, either by vaccination, even probably by re-exposure even to a newer variant, triggers memory B-cells which can quickly modify the antibodies to nuke whatever new form of coronavirus comes this way.

This is fantastic replication of how we already know the immune system works. So yea science–and yea immune system, still doing it’s job after all these millions of years.

–Speaking of memory B-cells, long term studies of recovered COVID patients show that even when the antibody response goes undetectable, memory B and T-cells are present for at least a year (the longest they have been able to measure so far) and quickly fire back up to neutralization levels again if re-exposed to SARS-CoV-2. Again, this is wonderful confirmation that immunity to a disease still works the way we teach it in the textbooks, and yes, Virginia, still applies to SARS-CoV-2.

–The upshot of that though is looking to high antibody titers months after vaccination or recovery may underestimate immunity and we may not be able to determine a cut-off where you are “immune.” If similar studies show the years long immunity from memory B and T-cells found in SARS-CoV-1 patients, though, the chances of needing a booster grow slimmer. You would, from a purely medical standpoint, only need one if the virus really started to mutate its way into a high re-infection rate. As we’ve discussed, the probability of that mutation set is small. Not zero, but very, very small.

–Lastly, the zeitgeist. I dunno if it’s just me, or just the pleasantly sunny disposition that every pathologist carries with them and brings to our internet searches getting horribly misinterpreted by the search algorithms–but there has been a lot more chatter out there about the various forms and faces of civilization collapse and apocalypse these past couple weeks. The exact flavor varies. But there seems to be a high degree of confidence among many that some kind of significant reset, with high probability of significantly shifted (and often reduced) standard of living, is coming, possibly as early as this decade. You have everything from the last couple of Hidden Forces episodes (188–Existential risks to humanity, where they even try to assign probability of the various flavors of disaster and 189–Niall Ferguson’s new book on politics of major disaster) to Jamie Wheal’s new book. That one opens with the charming story of a bunch of very wealthy technology and business venture capitalists who hired a futurist to advise them on “how best to keep control of their security forces when they evacuate to their New Zealand bunkers–pros and cons of shock collars” or “how to keep power when money is not as valuable because civilization has collapsed.” Not making up the shock collars, by the way. But the opening is a good rundown of the various expectations for disaster from more directions than you think, and groups that would surprise you. And all as part of Wheal’s larger argument that humanity expects the bleak because the decline in religious belief and participation (no matter the tradition) has left Pascal’s “God-shaped vacuum” in our collective hearts and nihilism has filled it, before some suggestions on how to displace the angst for both the religious and non-religious alike.

So may just be stuff finding me. But maybe you are seeing it too.

Here’s the thing. While I expect this decade to make a century or more, I’m not convinced it will be via collapse yet. Part of that may be optimism bias. Part of it may just be Paladin’s Probability Razor (“when a lot of people expect a thing to happen, with high confidence, the probability of the universe fucking with them by NOT having that thing happen is much higher”). Everyone expects doom? Anticipates apocalypse? Far less likely it will happen, per Paladin’s Razor.

Yet, that is the kind of belief system that can quickly become self-fulfilling, as expectation and apathy kick away the levees our civilization has built against the floods of chaos over these past millennia. We are the ones who can stop that slide, if we find the courage and connection to each other. We are also the ones who can absolutely screw it up for the entire species.

Such is the human condition.

But part of me also wonders if the sudden spike in interest of “what other major calamities are out there that might kill me” that seems to be hitting the collective consciousness goes back to Radigan Carter’s warning we mentioned a few updates ago. A large number of people found out that their world could shift significantly, in ways they would not have thought probable, if not possible, as a result of COVID. The story has always been that humanity, for all its flaws, muddles its way forward, getting progressively better. Again, a lot of people learned that the story doesn’t have to have that ending. It can go a different way. Radigan likened this to the first true brush with mortality that he got in a firefight serving in the military. If I recall correctly, he even quoted Confucius–“We have two lives, and the second begins when we realize we have only one.”

I hope the sudden spike in civilization ending paranoia is just the zeitgeist processing the past year, and the first steps of “realiz[ing] we have only one.” I think it’s only natural to take that first deep breath on the other side and go “holy fuck, what the hell else can come my way?” I hope that’s what is with all the tallying of probability of various ways it could go bad, or even expecting even more worst to come.

If that’s you too, well, I get it.

Just remember one thing though. If the world does end…

…I have dibs on your coolest stuff.

That you should remember first of all. That’s important.

But almost as important is that if the world does end, it will only end in one way.

Which means most of the other predictions and fears floating out there won’t happen.

They won’t. They can’t. Some of them are utterly contradictory.

All hope is not lost. There is no need for nihilism. We do still have choices. If the apocalypse does seem nigh(-er) after COVID, well, now you know it can go wrong. If we let it. And that despite our best intentions, adversity can still come to us.

But remember this lesson of COVID too.

<whispers> We made it through <whispers>.

There is meaning in the struggle against adversity. There is connection in the team, the tribe, that struggles against and overcomes adversity.

So if you’re seeing the same “disaster everywhere and imminent” zeitgeist I am lately, just remember that.

The harder it is, the greater the glory. If the storm does come, it will only add stanzas to the songs of our victories.

–Life in the Time of Coronavirus:

–Your chances of catching coronavirus this week are equivalent to the chances you can now find the right watermelon with this handy guide:

–Your chances of catching Ebola are equivalent to the chances you read that chart closely enough to get the not-really-joking joke.

<Paladin>