Well, that was quick.  Ebola re-emerged this past week in the DRC, as two patients died of disease and were confirmed to have Ebola.  Very likely the Ebola Janes are still circulating, and will make long term control difficult.  Right now, they are trying to sequence the virus from both patients to see if either or both are connected to known transmission chains.  If they are not, we are, once again, in a situation where virus is spreading beyond known chains and more cases are much more likely.  They did vaccinate a bunch more close contacts and healthcare workers (although it is hard to believe there are still healthcare workers in this region of the DRC who had NOT already been vaccinated).

For coronavirus, again, I will try to keep it focused since there is plenty of coverage all over the place.

–First and foremost, there is now pretty good evidence that SARS-CoV-2 was NOT widely circulating in the US prior to February, and California’s odd flu season and the “weak flu A” here in Indiana in January were most likely the actual flu.  In this case, it’s Washington taking advantage of having been hammer timed by SARS-CoV-2 before everyone else in the country to go back to THEIR flu negative cases for the last couple months.  You can find the Twitter publication here: https://mobile.twitter.com/trvrb/status/1249414298444500992 but the long story short is they did not find any SARS-CoV-2 in the flu negatives and could account for most flu negative cases with another form of respiratory virus that can cause flu like symptoms.

–For issues AROUND the virus and quarantine, namely supply chain disruption, I HIGHLY recommend the Hidden Forces podcast episode 132.  This was with the CEO of ISM, who publish the PMI every month. That’s a very acronym laden way of saying this is THE company with a lot of insight into everyone’s supply chain.  On the plus side, as we discussed before, the tariff wars of last year have diversified some of the supply chain issues.  -But- the sneaky challenge is that just in time inventory and production becoming the ONLY way to survive in the global economy over the last 20 years has concentrated supply chains in surprising ways.  Basically, a lot of industries are finding out that their guy making widget A for their product gets part B for widget A from company C, who gets part D for part B to make widget A from company D.  And everyone who makes widget A turns out to have only ONE common supplier of part D–across the whole industry.  Who just had 200 cases of coronavirus on their factory floor, and no business continuity plan.  It’s worth a listen, but the news you can use right now is that this is a FANTASTIC week to stock up on consumer staples.  Think Procter and Gamble’s product line of soaps, shampoos, lotions, detergents etc.  According to the ISM guy, that’s the next supply chain choke point to hit.  You’ve been buying most of the stored inventory, and there are some “Part D” supply chain problems about to pop up.  Again, I don’t know what products, but worth protecting your downside now.

–For what it’s worth, the ISM guy agrees with me that -production- of food for the US will not be a problem (ominously, he says in other places in the world, it might be).  But I’m sure you all saw the major pork wholesaler who had to shutter operations as the ol’ corona got a bunch of their workers.  That’s going to be the choke point–warehousing and distribution, and that is where shortages are likely to crop up.  No pun intended.  I do expect them to be temporary for the US, but again, keep that month supply as your downside protection in case that happens.  Anecdotally, folks I work with here with lots of dairy farmers in the family say the farms are literally pouring off milk.  They are producing at the same rate, but have no one to pick it up or warehouse it.  Why this is not being turned into the greatest expansion of cheese, beyond the wildest of Wisconsin dreams, is not entirely clear to me, but hey, I ain’t a dairy farmer.  Also anecdotally, lines in New York/New Jersey are getting hours long and shelves bare.  That’s a distribution problem.  And it may get worse before it gets better.

–Back to work will be a challenge.  As an illustration, cases in Indiana are starting to plateau and there is plenty of bed space in hospitals and ICUs available.  How to go back to work is now being contemplated.  I expect government officials to be pretty risk averse, and again, expect some fits and starts with re-quarantine orders being issued in some places as cases kick off again and threaten to overwhelm hospitals.  It’s gonna happen.  I don’t know where or when though.  When you do go back, wear your mask, maintain social distancing as much as you can, and if you are a high risk patient category, try to continue working from home as much as possible.  Most US states will be thinking about this within the next couple weeks.  Some of the worst hit in the news (and a few others like Massachusetts and Connecticut, which appear to be the worse for their wear with their high interconnectedness with the New York superregion) are not at that point yet.

–Rumblings that the first antibody tests out of the gate are not performing as well as one would like.  But more are being approved.  Focus now is on finding a diagnostic antibody that not only is specific for SARS-CoV-2, but also identifies a neutralizing antibody (one that would confer resistance, if not immunity). 

–More drugs are entering clinical trials for treatment.  I cannot comment on Gilead’s Phase 3 in China being discontinued (since I work for another company).  Stick to news reports on that.  I also cannot comment on drugs being tested by my employer that announced trials this week, other than (finally) being able to say that happened.  Regulations be regulations.

–Common questions on the inbox this week:  Did this start in a China biolab in Wuhan?  I dunno.  Maybe?  Again, genetically, this looks like a bat coronavirus that crossed over.  Was it being studied in the Wuhan BSL 4 lab?  That would be a good place to do it, if you were going to study that particular virus–even though you only need BSL-2 containment for SARS-CoV-2.  Did it get out of that lab?  Good a guess as any.  Was it weaponized?  Probably not, if only because a ton of Chinese people also got it, lots of them died too, and it shut their economy down causing the worst public venting against the CCP in a looooong time.  If you’re going to make a bioweapon, you’d better have the cure.  And since bioweapons can mutate around your cure anyways, bioweapons are always, and will always, be an -incredibly- dumb idea.  Nukes are much cleaner.  They tend not to turn around and hit YOUR cities too.  But this was a Chinese government BSL-4 lab–it had to be a weapon, right?  Again, maybe, but doubt it.  Remember, the two main BSL-4 labs in the US are at CDC and USAMRIID.  The latter is Fort Detrick, Maryland, which, as you can guess, is a US Army facility.  The US does not do offensive bioweapons research (we don’t need to–we have a lot of nukes.  Like, a lot), but they will study things like Ebola at USAMRIID.  That said, the US has absolutely done some offensive bioweapons research in the past; China might be doing it now.  Again, there is nothing in the genome of this coronavirus to suggest it was weaponized, and more importantly, it’s REALLY dumb to create a bioweapon that gets YOU sick too.  The most parsimonious explanation, assuming the BSL-4 lab in Wuhan release is correct, is still that they were looking at a bunch of coronaviruses there in general (not even to weaponize, but to protect against things like SARS, which hit China not too long ago), in a lab that had containment, and just screwed up and released the damn thing on accident.  Regardless, doesn’t end quarantines here or anywhere else.  Finding -the- specific box Pandora opened does nothing to put the virus back in the box.  But it -does- keep you entertained if you are not on Netflix, and might even cause you to look away from the colossal failures of many, many governments and national and international health agencies in the response to this virus.

–Trump defunded the WHO!  Oh noes!  Should Trump be doing this?  Look, those of you on this list since the West Africa outbreak of Ebola in like, what, 2014, recall me heavily criticizing the WHO response.  I was not the only one.  Even the WHO admitted in their after action report that they were too slow to respond, were too political in their response, and did not have rapid action capability to contain an outbreak.

Here’s a little secret– they still don’t.  They nearly lost contain on the DRC outbreak by sticking with ring vaccination LONG after it was clear they could not trace contacts successfully enough for ring vaccination to work.  They believed Chinese numbers and what the Chinese authorities were telling them LONG after it was apparent the CCP had a narrative and was trying to stick to it.

What the WHO is best at is technical guidance.  They have some great doctors and great people who work with them.  Their technical papers on who to test and how, both in hospitals and in the community, are better than the CDC’s in my humble opinion. 

But here’s what screws the WHO.  They can’t get in unless the host country lets them.  They have no authority to set quarantines and travel restrictions.  They can only make recommendations.  MOST IMPORTANTLY, the WHO has NO MEANS to raise money independently.  None.  They are entirely beholden to the donations of the countries of the world.  If the CCP, a major donor (in addition to being a government not afraid of gathering blackmail and using it, and very aggressive in defending its narrative no matter who you are–see the NBA kerfluffle just recently), wants things put a certain way, the WHO is -always- going to have a hard time saying no.  I guarantee you if Trump got on the phone and chewed Dr. Tedros’ ear off, the WHO spokesman would be out on podium -the next day- talking about how the US response was the best response ever, most beautiful response, saving the most lives, and possibly, -possibly-, even resurrecting the COVID-19 dead.  Have to look into that though.

The WHO cannot do otherwise.  They have no money to do anything unless they defer (okay, cower) to whomever is writing the check.  This is why major NGOs run into virtually identical problems and always will.  As much as we -want- a WHO that can come in and competently run things and speak truth to whatever power, you will -nevvvvvvvvvvvver- get that in the real world.  As Taleb puts it, you are free only in proportion to -whom- you can tell to fuck off, and not self-censor for fear of some kind of meaningful retribution.  That’s a surprisingly short list for Dr. Tedros and the political/fundraising arm of the WHO.

And it always will be.

Odds are good you think the World Health Organization now is an altogether different organization than it ever can be.
Once the temper tantrum is over, fund what works in the WHO, and get rid of the rest. 

–In fact, going back to it, one of the best lessons of life in the time of the coronavirus is which institutions are what they say they are, and which are demonstrably not.  And we all have the same information on how they are doing in the real world, in real time now.  This is the best summary you will read on that, and is a MUST READ:

https://www.epsilontheory.com/first-the-people/

–I’ll wait until you’re done reading that, because you should. 

–Seriously.

–Done?

–Good.

–Because I am going to go off the science a bit now.

–The government is handing back $1200 of your own money (the government must tax it from you to have it, after all)–with Trump’s signature on it.  They have billions for Boeing–in fact, just enough to replace what Boeing’s management cashed in on in stock buybacks over the last several years.  Meanwhile, the small business program ran out of money today.  And hey, here’s your $1200 back though.  Are they not benevolent?  Do they not have your best interests at heart?

–Jeffrey Epstein did not kill himself.  

–Keep the President.  Change the President.  Won’t matter.  That’s not how all of this gets fixed.  We are going to have to start from the ground up.  The solution to Varys’ riddle is that it’s the sellsword who holds the power.  What the sellsword values, and who he gives attention and authority to, he chooses. That is the source of political power.  In other words…

–“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.  That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed,  That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.”

–Which institutions on the list in that must read article above still have your consent?

–Takes time to overcome inertia.  But an unusual year could very well change what is “usual” going forward.

–Your chances of catching Ebola are higher than last week, but still really low.  Your chances of catching coronavirus remain high.

Love in the time of Coronavirus:

<Paladin>