Corona Predictions

First, some disclaimers:

I’m definitely not an epidemiologist.  In fact, I’m in that dangerous category where I know just enough about a subject to get me in trouble (if you’d like to read an actual epidemiologist’s take, here’s Lipsitch et al on the topic of what comes next).  I’m also partial to doomerism even in the good times, and the three weeks (years?) of social distancing certainly haven’t ameliorated that tendency.  While I’m in the business of making predictions (literally) that doesn’t necessarily mean that I’m good at it or that the skill in one domain (politics) transfers to others.  But, you know, screw it.  Here are some bleak predictions and let’s hope I’m wrong:

The outbreak in general:

1. The United States will fail to develop a testing/tracing program needed to contain the virus by the end of May.  The curve will bend, but new cases will continue throughout the summer.  Because the virus spread so readily and from asymptomatic or minimally symptomatic people, our testing regime will only catch cases that make it to the doctor’s office.  Even if we implemented extremely widespread testing, it won’t stop the virus. Look at South Korea with their top-line testing program – the outbreak is still trickling along.  Look at Singapore, where the government just announced another lockdown because despite their best-in-the-world contract tracing program they were unable to identify the source of half their new infections.  Look at Hong Kong, with their efficient use of centralized quarantine that will, if ever, only be haphazardly implemented here and would probably raise constitutional issues.  Look at China, where extremely severe measures were needed to contain an outbreak on the scale of New York (that New York is not taking) and where still life has not returned to normal as dozens of cases continue to sporadically emerge (both imported and community spread).  You want to tell me America is going to do better?  Nope.

2. Some cities that are spared in the initial wave in the United States will become hot-spots later.  Rural and small-town communities will see periodic outbreaks that may briefly overwhelm local hospitals (as happened in Albany GA).  Look at the incredibly diffuse spread of the virus in the United States.  It is not going away until half of us have been infected or a vaccine emerges a year from now.

3. By the end of August, there will be estimates based on serological surveys that up to 30 million Americans have been infected.  This is not nearly enough to confer herd immunity and we will still be quite vulnerable to a second wave.

4. There will be a second wave in which peak deaths/day nationwide exceeds 250 or more. It may not be as severe as the first as metro areas institute lockdowns and closures earlier.  Though it’s worth noting the second wave in 1918 hit much harder than the first.

5. In fact, some cities may see multiple waves.

6. The timing of the second wave will depend on the seasonality of the virus and how much restrictions are relaxed and how much better we get at contract tracing, but if it’s anything like 1918, the peak hits literally on election day.  This will cause chaos.

7. Alternatively, it could be barely beginning in late October/November.  Everyone will go to the polls nonetheless, which will accelerate its spread, leading effectively to a nation on lockdown again and a canceled Thanksgiving and Christmas.

8. You will continue to see examples of people violating social distancing norms in various places.  People will begin to turn on each other over this.  Others will get tired of the distancing.  Regardless, our uneven compliance will only be enough to slow the spread but never enough to stop it.  Remember too that many people still need to work and are still using mass transit every day, etc.  The poorest neighborhoods in NYC are the hardest hit so far.  Continued iterations of lockdown and relaxation will persist throughout the year.

9. Sports ain’t happening.  Sorry, sports bettors.  No NBA.  No MLB.  And yes, the NFL is going to see a much shortened season due to the fall wave.  Quite possible there will not be an NFL season at all.

10. People will not want to fly any time soon.  Airlines will require another bailout (and sooner rather than later).  This will be controversial and will collide with the political season.  A major US carrier may go bankrupt.

11. Greenhouse gas emissions will decline.

12. The iterative stop-and-start of social distancing will deepen the severity of the global recession (and prolong it).  Additional stimulus will be required.  At least one more package will be passed.  It too will be inadequate.  Suffering, in the United States, will be far greater than it needs to be as a result.

13. By the end of the pandemic in the second half of 2021, nearly all Americans will know of a friend, co-worker, or family member who was infected, and at least half will know someone who died.

Politics

14. In the short term, Trump will continue to agitate between desperately wanting this to be over quickly and sullenly yielding to the medical professionals who tell him that it will not be.  Expect more of “it would have been a lot worse if I weren’t so amazing” mixed with “we can’t let the cure be worse than the disease” + “hydroxychloroquine will be the miracle drug that saves us all”.  Trump of course will not take action to open things up prematurely – he will instead pass that off to the governors (why take responsibility, ever?).

15. By the end of May, preliminary results from randomized control trials of hydroxychloroquine will show no improvement over standard of care on most measures. Nonetheless, a conservative blog will misleadingly write up this study by saying something like “70% of patients taking hydroxychloroquine showed improvement!” (not mentioning the equal success of standard of care alone).  Trump will happily retweet this.  For him, hydroxychloroquine is a win/neutral play.  Either something comes out of it that he can spin into a giant “I told you so and the media was wrong” or nothing comes out of it and he ignores it and Fox News pretends it never happened.

16. Trump will float the idea of having a big Fourth of July parade / party / celebration (of him) again this year.  It won’t end up happening.

17. The CDC will not relax its guidance saying that gatherings of large crowds are to be avoided by the end of August.  The political conventions, if they take place, will lack all energy and will look very different (normal people will not care).

18. If the conventions happen, expect them to prominently feature doctors, nurses, and EMTs.  I actually think the Trump campaign could be very effective here.

19. There will be no rallies, town halls, or normal campaigning.  What’s happening in the primary race right now (and for campaigns across the country) will not stop because the virus will not stop.

20. Trump and Biden will not shake hands at the debates.

21. Trump will be very upset that the virus is depriving him of that which he’s been looking forward to most as president: Running for re-election and speaking before large crowds.  Don’t think this will be to his detriment however.  His narcissism will not let him avoid the spotlight.  He will call into every TV show every day if he has to get his fix.  He will be better at this than Joe.

22. Don’t make the mistake of assuming that Trump will be blamed for the poor economy – he won’t be.  If he takes on water, it will be because people discover how poorly his administration handled the initial outbreak – or future missteps.

23. It’s possible (but not yet probable) that a member of Congress or candidate for Congressional office dies of COVID.

24. Coronavirus will have both an enormous and a small political impact.  It’s all everyone will talk about during the campaign but at the end of the day it will only act to bring into relief all the pre-existing macro political trends.  City-dwellers rich and poor will hate Trump for messing up the initial response.  Suburban voters will find it another example of why they don’t like Trump.  Rural voters will wonder whether it had to be as big of a deal as it was.  White non-college voters who lose their jobs are an interesting group though I suspect they’ll continue trending Trumpward regardless.

25. Coronavirus will definitely, however, make the race more a referendum on Trump than a contrast election (though it was always going to be that way).  In fact, the small impact it does have in moving the electorate (juicing suburban swing?) could be enough that Joe simply wins a landslide.

How all of this is wrong

The bullish case almost certainly involves the emergence of a truly effective treatment that shortens hospitalizations and dramatically reduces the death rate.  Rapid testing could be deployed such that all health care workers and visitors to nursing homes / prisons / hospitals are tested before entry in order to protect the vulnerable even if the virus continues to spread slowly elsewhere.  There are others that have written big plans about re-opening the economy pre-vaccine and so forth that we can look to, and they all rely on the technological or pharmacological dei ex machina that could certainly happen.  But they haven’t happened yet.

 

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