Thoughts on a virus

I’ve been studying digital media “viruses” for more than 20 years, and much of what we have discovered about them comes from the analogy to epidemiology and the behavior of real viruses.

Here are some ideas that might be relevant as we come to grips with a slowly unfolding tragedy, and help us with our fears and plans each day.

Viruses act like they are digital. A loud concert gets quieter as you move away from it. A chemical dumped in a lake gets diluted as it moves further from where it landed. But a virus starts fresh every time it infects someone else. Often, we act as if that’s not true. Even though it’s organic and living in our body, it’s a code, one that replicates fairly completely as it spreads. It evolves as it goes, but it also recharges with each new host.

Viruses are contagious. Epidemiologists measure R0, pronounced R-nought. It’s the measure of how many people a virus in one person will reach. An R0 of 3, for example, means that every person who gets it will infect three more people. Obviously, if the R0 stays above 1, it means that eventually, it will infect every single person. That never happens. What does happen is that the number shifts. When the measles is in an elementary school, it can have an R0 of 20. But, over time, as environmental and other factors come into play, it goes down. Right now, the R0 of Covid-19 is estimated to be between 2 and 3, though it might be higher than measured if there are a lot of mild or unreported cases. As you can see below, more than 2 is very high.

Viruses can spread when we don’t know we have the disease. (And of course, there’s an analogy here to malicious computer viruses). Of course, that’s not how memes and YouTube hits work, but it’s very relevant here. The virus has no intent, no goals, no desires, but viruses that spread tend to be viruses that are contagious when we don’t know it and that last a while. It increases their R0 because apparently healthy people walk around spreading the disease. Freaking out around someone who is coughing isn’t helpful, since there are plenty of people who aren’t coughing who may be almost as contagious.

There’s a difference between the impact of a virus and its virality. The measles are one of the most contagious viruses we know, and fortunately, they only seriously impact (or kill) a small percentage of the people they infect. Because they infect so many, though, it’s urgent to be vaccinated for measles… to prevent you, or the person you’ll infect next, from being a victim. Here’s a chart from a really helpful article in the Times: (click to enlarge)

It’s very difficult to buy your way out of this. We’ve been trained that a good way to deal with emotional stress is to buy something, but there’s not much to buy. So far, it seems as though most healthy people will have an unpleasant time if they contract the virus, but with fluids and rest, will recover completely. It’s possible you’ll need medical help for pneumonia or perhaps access to oxygen supplements or a respirator, but there’s not very much you can have in your home that will help. However, if you meet the CDC’s definition of warranting medical evaluation—such as the presence of a new cough—it is best to call your doctor or local department of health. You may need to be tested, examined or treated.

Big numbers conceal the tragedy of the small ones. If 98% of the people who get a disease end up okay, that can still mean that hundreds of thousands or millions of people don’t do so well. The odds are definitely in your favor, but they’re still odds. There’s a slow-moving tragedy happening, and it’s going to impact people we care about.

The ideavirus in the media is preceding the actual virus’s arrival. That means we are experiencing the effects of this twice. Once, when we’re filled with fear of the unknown (with various entities fanning panic) and again when it actually arrives.

The R0 varies because of superconnectors and the places in which they hang out. They closed the Louvre for this reason—some people and some places dramatically amplify the average rate of spread of the virus.

A mask is not a good luck charm. Medical professionals know how to wear masks and use gloves and proper sanitation to prevent themselves from communicable diseases. Commercially available N95 masks don’t block particles as small as COVID viruses. Watching people walking through airports with their facemasks misadjusted, or touching a surface (the germs can last for days) makes it clear that this is talisman thinking, not actual prevention. Handwashing can work, particularly if it’s done often and well.

The thing is, if every person on Earth was isolated for three weeks, we could be pretty confident that we could move on, but the world is a lot more connected than that. We’ve built a worldwide culture of connection, both digital and physical, and while we can slow down the spread of a virus, we can’t stop it.

There are so many things we can do to radically improve public health. Everyone can get fully vaccinated for childhood diseases and seasonal risks as well. That alone will save hundreds of thousands of lives a year. We can aggressively campaign against drunk driving and get people to stop smoking. We can clean up the environment and invest in clean water and adequate sanitation. That’s millions and millions of lives saved annually. Each of these problems will kill more people than this virus. It doesn’t pay to panic ever, and in a case like this, getting smart and making appropriate decisions is far more effective than going into a frenzy.

Wishing you and yours good health, peace of mind and a quick end to this.

 

Thanks to Dr. Jonathan Sackner Bernstein for his contributions, all errors are mine.

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