Cypherpunk Bitstream 0x07: Pandemic I

   |   18 minute read   |   Using 3626 words

Frank Braun talks with Arto Bendiken about the ongoing Coronavirus pandemic (COVID-19). How did we get here and what convinced us to prep. Paranoia, case fatality rates, and vaccines. Secondary and tertiary effects. Normalcy, authority, and confirmation bias.

Show Notes

Introduction

  • 00:01:40 What set this whole thing in motion?
    • Both Frank and Arto are already in lockdown mode, and prepared.
    • It’s ~6 weeks since both of them started “buying some insurance”.
    • Arto prepared for 11 people.
  • 00:05:25 What made you think it’s going to be a big deal? (Risk assessment)
    • Observations from Wuhan.
    • Lessons from Spanish Influenza 1918-1920.
    • High infectiousness, showing no symptoms while being infectious.
    • People suddenly dropping in the streets.
  • 00:08:00 Book: “The Great Influenza”
    • Few media coverage on strange cases, like the woman dropping on the vegetable market.

2020, A strange year

  • 00:09:10 First week of February: cancelling all travel plans (Arto Bendiken).
  • 00:10:00 “An earthquake happened in Wuhan, and the tsunami will follow. It is hard to see the tsunami until it comes close to the shore, but it will follow.” (Arto citing Steve)
  • 00:11:05 Analytical preparation, emotional process (fear) comes later.
  • 00:11:40 Reactions by others: accusations of panicking.
  • 00:12:03 Convincing others to prepare?
  • 00:12:28 People buy insurance for things that are less likely to happen.
  • 00:14:43 NN Taleb’s Tweet on Paranoia: “When paranoid, you can be wrong 1000 times & you will survive. If non-paranoid; wrong once, and you, your genes, & the rest of your group are done.” - Not everyone takes action on something so far away.
  • 00:15:40 Balaji S. Srinivasan’s Three categories of people: “1) Post-headline people: only believe things that are already in print 2) No filter people: forget it, they’ll believe anything :) 3) Pre-headline people: will listen to a rational argument and look at primary data”.
  • 00:17:05 Authority bias: Credentials, degrees, other people’s opinion.
  • 00:18:10 Talking to family and friends about situation when there was still time to prepare.
  • 00:18:40 Cassandra Myth (Iliad)
  • 00:19:15 Uniform set of responses: you’re panicking and making it worse, dismissal
  • 00:19:53 Bill Gates warned about pandemics long ago, but was dismissed as a college dropout and IT guy. (Confirmation bias, ad hominem attack)
  • 00:21:09 Bill Gates: “The most predictable disaster in the history of the human race”.
  • 00:21:20 Albert Camus: These things have a way of reocurring out of the blue sky.
  • 00:21:50 Increased risk factors: base risk plus big cities, international travel.
  • 00:22:03 On average, three pandemics a century.
  • 00:22:21 Ebola outbreak was a close call. Hongkong Flu (1 million dead), late 1960s.

Economic cost

  • 00:23:14 Many animal to human transmissions were contained early by slaughtering millions of animals at the slightest sign of sickness. (Economical cost!)
  • 00:23:53 Vaccines and public health system. (Smallpox)
  • 00:25:47 We are still in the beginning of the economic impact.

Common thinking errors and biases

  • 00:26:45 Bias to focus on things that are caused by humans. Helplessness when confronted with pandemics.
  • 00:27:37 Man-made virus from Wuhan lab?
  • 00:28:19 Illegaly sold lab test animal at wet market? (野味 yewei, bush meat; 街市 jieshi, wet market)
  • 00:30:08 Cognitive bias: systematic error of thinking. Man is the rationalizing animal. (Example: seeing faces in clouds)
  • 00:31:31 Examples of observed biases: authority bias, confirmation bias, combinations of these.
  • 00:32:25 Normalcy bias (nobody wants to be bothered to change routines).

The Virus: An Abstract Threat, vs. Zombies

  • 00:33:05 Max Brooks (World War Z): Fear of pandemics is so deep, cannot be discussed rationally. Zombies = Pandemic.
  • 00:34:50 Virus is an abstract threat, there will be 1 trillion copies of it by infection.
  • 00:35:14 Plague: people did not even know what caused infection. (Germ theory)
  • 00:36:45 Are Zombie enthusiasts better prepared for a virus pandemic?
  • 00:37:55 Trying to find out what’s going on fundamentally vs. latching onto experts.
  • 00:38:48 Engaging brain about status vs. primary data.
  • 00:39:30 People starting with the premise that they are not smart enough to understand what’s actually going on, not making any effort of their own.
  • 00:40:40 Trying to understand incoming data, for example the first papers coming out of Wuhan.
  • 00:42:05 Impossible to keep up with current findings, research, and papers.
  • 00:42:40 More data globally, in the beginning filtering was easier.

Problems with “Confirmed cases”

  • 00:42:42 Mon, March 16th: currently 170.000 confirmed cases, 5000-6000 dead.
  • 00:42:49 Confirmed cases != infections
  • 00:43:17 Impossible to keep up with new cases.
  • 00:44:00 “Confirmed case count"= comes with limitations (manpower, test kits).
  • 00:44:55 Again, not enough test kits (USA, Berlin). Wuhan could test only 3000/day in the beginning.
  • 00:45:20 “Confirmed cases"= lag in data.
  • 00:46:35 “When people focus on these official measures… that are limited by staffing, test kits, by political considerations, then that’s not a good way… of understanding what’s going on.”
  • 00:46:55 “That’s why it was so good to get this leaked information, leaked videos, from Wuhan. That way we got a sense of what was actually going on.”
  • 00:47:30 The plural of anecdote is data.
  • 00:47:41 Investigative Reporting.
  • 00:48:00 Actions speak louder than data: Measures against the virus were severe. 1 Mio people in lockdown, 10% of global population.

Mathematical Modelling

  • 00:48:42 Mathematical Modelling… common problems:
    • people cannot understand exponential function.
    • people compare to flu last year.
    • countermeasure lag: it takes time to show effect, politics make new changes 2 days apart, makes no sense.
  • 00:51:12 Case fatality rate.

World Health Organization (WHO)

  • 00:51:22 Role of WHO: gives recommendations for guidelines, funding by member countries (China among them), driven by political considerations.
  • 00:52:15 Public health emergencies of international concern (PHEIC).
  • 00:52:25 WHO got rid of the term “pandemic”.

Case Fatality Rate (CFR)

  • 00:53:25 “Naïve” Case Fatality Rate (CFR), released by WHO. First, 2.1% (mostly China); revised 3.5%, and going up.
  • 00:55:20 SARS initial outbreak CRF ~2%, but by the end of the outbreak, it was ~6% (resolved CFR).
  • 00:56:49 Makes no sense to compare past cases to current cases (open cases vs. resolved).
  • 00:57:45 CFR for age groups: not taking into consideration system overload (needed care might not be provided).
  • 00:59:22 CFR only says so much, 20% require hospitalization, many of those need ICU.
  • 01:00:00 Hospitals in Italy are already overwhelmed, will worsen until end of the week.
  • 01:00:40 Italy’s CFR is already higher than China’s.

Secondary and Teritiary Effects

  • 01:00:50 Cases overload the medical system, secondary effect: death rates go up.
    • Patients with other diseases might not get medical help.
    • Empty hospitals beds waiting for the next pandemic are unlikely.
    • Economic impossibility, health care system already occupies significant percentage from GDP.
    • Makeshift hospitals.
  • 01:03:20 Investment options.
    • Stock-market implosions.
    • Crypto-market implosions.
    • Flight to cash.
  • 01:04:28 Supply chain problems.
    • Goods coming from China.
    • Food also comes from China.
    • Just-in-time economy (supermarket have no more backrooms, but once or twice a day a truck delivery).
    • Tesco is already limiting purchases like toilet paper.
    • Respirators (EU: FFP2 & USA: N95, or FFP3 & N99): China restricted exports.

Overreacting

  • 01:08:15 “It’s always about efficieny, never about risk of failure.”
  • 01:08:28 Pandemic response bears a similar problem like IT security.
    • Overreaction with swine-flu might had been the reason it never got that bad, that’s why it was called an overreaction later.
  • 01:09:23 “It’s a bit like prepping: no matter how bad it gets, you want to be overreacting in retrospect, otherwise, you didn’t prep enough. And, you’re not gonna hit exactly on target, so you wanna err on the side of overreaction.”
  • 01:10:01 Control theory (robotics): accuracy vs. speed.

Respirators and Masks

  • 01:12:30 “You don’t have them [the respirators] until you have them in your hand” … “It’s like cash”.
  • 01:13:10 Only stock up on masks if you intend to not avoid people.
  • 01:14:23 Ukrainian border confiscated protective gear when trying to cross border to Poland (export is forbidden).
  • 01:15:21 Idea that you don’t need respirators:
    • “You don’t know how to properly use them!”
    • “Doctors need them.”
  • 01:15:50 Why didn’t hospitals stock up in January?
    • True: Doctors need respirators more.
  • 01:16:30 How can wearing a mask not help?
    • If everyone wears a mask, that means every infected person wears a mask, and this decreases chances of transmission. (Hongkong)
  • 01:17:25 “Wearing a respirator makes it less likely you’re getting infected yourself, … and wearing a surgical mask … helps not infecting other people, so it makes total sense that everyone wears at least surgical masks”.
  • 01:18:40 Men’s issue: shaving gel and razors (beards and masks don’t go well together).

Prepping

  • 01:20:40 People tend to be dismissive of people with health problems, who might need medication or health care, and the elderly (“It kills only old people!").
  • 01:22:02 Ukrainian health care system is monopolized by state (surgeries, child birth, vaccine). “A public hospital is the last place I want to go [in the Ukraine]".
  • 01:22:22 Contingency planning differs on country.
  • 01:23:25 “The real carnage is going to be in third-world countries, just like it was in 1918”. (USA: 675.000 vs. India: 2 Million, Spanish Flu)
  • 01:24:20 Lviv Infecitous Diseases Hospital messaged it would be well-prepared with 20 isolation beds (and plans to expand to 300), 4 ventilators, 0 ECMO, 10.000 surgical masks and respirators.

Medical supplies

  • 01:25:40 No difficulty to buy antibiotics in Ukraine, whereas in other countries it’s highly regulated (prescription vs. over the counter).
  • 01:26:37 Chloroquine is promising in treatment of COVID-19 (malaria drug).
  • 01:27:39 Paracetamol is not easy to buy in bulk. India also has restricted export (Indians source precursors from China, too).

Location

  • 01:28:40 Arto’s housing situation: countryside Western Ukraine, foothills of Carpathians. Frank: Berlin suburbs.
    • Location cannot be changed later.
    • Time is a constraint.
    • Economy is going down.
    • “If you wanna prep now, and you don’t already have a place to go… I don’t see why you should go there now”.
    • Consider threat model: main risk for both is electricity going down.

Social Distancing

  • 01:32:51 Where do you stay put, and with whom?
    • Acquire resources to stay put: food and drinking water, some personal protection for supply runs.
    • Nitrile gloves
    • Any mask will be useful, at least you won’t touch your face.
    • Disinfectant: WHO guide how to make your own, primers might still be available.
    • Goggles: Construction glasses or swim goggles.

Scenario

  • 01:36:30 Think about your scenario: staying inside apartment for a long time.
    • food, water, protective gear
    • what could go wrong- how do I deal with it?
    • If electricty goes down: gasoline cooker, cheap carbohydrates (no freezer/ storage), pressure canning (no freezer, conserving meat).
  • 01:40:30 Most likely scenario: you stay indoors, everything works (electricity, water, internet)
    • first, get prepared for this scenario.
  • 01:41:00 If electricity goes down for extended periods, water goes down. The big problem is not drinking water, but sanitation.
    • Off-the-grid bucket loo with trash bags and wood shavings as absorbant, and wet wipes to clean. (BranQ portable toilet)
  • 01:43:00 Water filter
    • Micropur Forte
    • Katadyn Filter
    • Foodgrade Canisters for tap water and disinfect with Micropur Forte.
  • 01:44:06 “I tried to focus on stuff that I normally eat anyway, … I just got a lot more, so it doesn’t go to waste. Other things like rice bags, I got as an insurance, but the rest I would eat anyway.”

Threat model: Electricity, Water, Internet going down

  • 01:44:50 Threat model and scenario.
  • 01:47:10 “… if the situation gets particulary bad, which it might over here [in Ukraine] at least, I would expect some more outages, for the internet connectivity, there’s multiple options for that, so I expect at least one of them working.”
  • 01:47:44 A lot of people getting sick means a lot of people not working, especially in grid systems workers might not be able to fix things in time.
  • 01:48:24 “For the internet, we will see how well that works if everybody’s sitting at home watching netflix, or porn in full HD.”
  • 01:48:59 Mobile internet.
  • 01:49:17 Mitigate risk for short downtimes.
  • 01:50:40 Wuhan pictures from people queuing for water.
  • 01:51:11 Mitigate risk of having to go to the store a lot.
    • not because of food shortages, but it’s a risk for virus exposure.
  • 01:51:48 Going out for walks, just don’t meet anybody (countryside).
    • avoid contact, don’t touch anything
    • droplets in common areas that you pass on the way out (hallway, elevator).

Prepping and timing

  • 01:53:25 “Although I’m now pretty well prepared compared to most people, it kinda caught me cold-handed… because I was always interested in prepping, and I was always planning on prepping more for when SHTF, but I never really executed that much. But when I started six weeks ago, I realized how much harder… it was than I imagined, and also how much harder it was because… of such a short notice, and it was getting harder to get things, for example the respirators. It would have been so easy to stock up on all of this stuff. For example, the ridiculous situation that you had to ship me antibiotics from Ukraine although I was in Ukraine in January, I should have just bought all the prescription medicine a prepper needs.”
  • 01:55:37 Early Infections in Italy, Seattle, etc. happened in January/Feburary. COVID-19 death in Spain 2 weeks before the first confirmed case there. (Lack of indicator)

Food and Cans

  • 01:56:56 Cheap carbohydrates, easy to store. (“Insurance”)
    • Potatoes, rice, buckwheat.
  • 01:57:10 Newly acquired freezer to stock up on meat.
    • Canned meat as backup.
    • Pressure Canning, if you have time, or already own a pressure canner.
  • 01:58:15 Add variety, if you switch to carbohydrates.
    • Canned veggies and canned fruit.
    • Salt, Pepper, Spices.

Deliveries

  • 01:59:18 Deliveries still working.
    • Disinfecting parcels.
    • All delayed (surge of deliveries, momentarily overwhelmed).

Fat

  • 02:01:05 Freeze butter, or make Ghee.
    • Olive oil might be adulterated with industry/ vegetable oils.

Timescale

  • 02:02:55 “Right now, people in the last week or two stopped laughing… and stopped repeating this mindless It’s Just The Flu, Bro… in any case, they’re still expecting this will be over soon. … And authorities are still telling them it will be over soon, prepare for a few weeks.”
    • even emergency measures expire in about a month (bars and club are closed only until April, etc.)
    • People stay at home close to 50 days. (Wuhan)
    • China is looked upon as having “beaten the virus”.
  • 02:04:57 “It’s always better if you’re dealing with a foreign virus, than with a domestic virus”.
    • In Iran: Zionist conspiracy.
    • “Virus doesn’t care!”
  • 02:05:40 Once China resumes work, and life, there will be another wave.
    • re-imports to China (from Italy for example)
    • fully stopping virus is not so easy.
    • virus will become endemic.
    • multiple waves.

Dystopian future vs. helpful tracking and tracing

  • 02:07:26 Countries which deal well with it: outbreak, containment measures, a lot of testing, tracking, and contact tracing -> situation under control, problem: reintroduction from other countries.
    • China is currently trying to automate contact tracing.
    • Location tracking.
    • Surveillance cameras with face recognition.
    • Helpful scaling of tracking vs. dystopian nightmare.
  • 02:10:10 The Virus can travel up to 4,5m, passenger infected others through a long-distance bus ride.
    • video camera in bus.
    • position of citizens is known at all times.
    • re-engineering passenger’s travel was possible.
  • 02:12:20 Controlling coming waves, keeping the country in lockdown is not a solution unless we transition to a permanentely remote economy.
  • 02:12:30 Appeal from engineer perspective.
    • Social Scoring system is already established.
    • put people on specific quarantines if they were in contact with an infected person.
    • government AI tells you if you should leave your apartment today, or get a test.
    • scaling without the disruptions from now would be possible.
  • 02:14:04 Germany outruled events with more than 50 people, but if you do an event with less people, you need to create a list of all attendees. (old school approach)
    • pressure into direction of more surveillance.
    • pushing ban on cash forward as well.
    • China destroyed cash on basis of contamination questions.
    • some chains in Germany went cashless because of the virus.

Acceptance pipeline

  • 02:16:39 “Acceptance pipeline”, dealing with grief: it won’t be over soon.
  • 02:17:10 Pipe dream: Many place hope on vaccine development.
    • vaccines are for healthy populations.
    • vaccine is far away: more than 12 months, at least.
    • might not be easy to develop (7 different coronaviruses, 15 years of development but currently no vaccine for either).
    • not so effective: 20-60% for common flu vaccine.
    • high mutation rate.
  • 02:20:30 Accepting that there’s no easy fix.
    • what are you going to do to plan for it?
    • avoid infection as long as possible (6 months).
    • look at vaccine development like a lottery win.
    • by the time the vaccine is developed (18 months), whatever will happen has already happened.
  • 02:23:12 It’s hard to plan to stay in apartment for 18 months.
    • instead, plan for a world with Coronavirus, and a lot of lockdowns, and a lot of infections.

Learning from past pandemics

  • 02:23:35 Learn from past pandemics (1918 Spanish flu, 3 waves).
  • 02:24:04 Spanish flu: passed through ships, first cases (first wave) very mild, less than influenza, less than COVID-19. Second wave, 5 months of carnage. Worse than COVID-19, at least currently. Third wave, somewhere in between.
    • future waves might be more lethal.
    • or become endemic, less lethal.
    • it would be prudent to plan on a worst-case scenario where it takes a couple of years.
    • “something worth paying attention to is going on.”

Economic changes

  • 02:27:50 Practical preparations for 6 months is difficult (economically).
    • savings rates in Western countries are shit.
    • people are out of jobs already (events cancelled, tourism breaks down).
    • bankruptcy.
    • no more fundraising tours.
    • airlines discharge employees.
  • 02:29:29 Good thing: remote work will be more accepted.

Prepping List

  • 02:30:00 Supply run gear for securing supplies
    • goggles (and anti-fog spray), respirator (or surgical mask), rain poncho (or whole body protection suit), gloves (most important).
  • 02:32:20 Surfaces: virus can be contangious on surfaces a few days (up to 9 days).
    • Buttons, handrails, etc. (disposable gloves).
  • 02:33:38 Coming from outside to inside.
    • Shoes (rain boots can be easily disinfected).
  • 02:34:10 Sourcing is already hard, will become more difficult.
    • switching to local production.
    • repurposing existing production facilities.
  • 02:34:50 Power issues.
    • solar panels, butane, propane, camping stove, space heaters on butane.
    • fuel: gasoline, diesel, firewood.
    • prepare for next winter.
  • 02:36:00 Sanitation
    • TP!!!
    • plumber might not be available: be prepared to unplug it on your own.
  • 02:37:05 Disinfectant
    • Alcohol-based wet wipes
    • since disinfectant is nearly everywhere sold out, switch to local production and DIY.
  • 02:37:45 Medical
    • The Prepared List/ Medical
    • Broad-band Antibiotics: prevent secondary infections (pneumonia, 50-60% CFR). Doxycycline, Bactrim, Zithromax.
    • India is restricting 26 medicines& pharmaceuticals, including paracetamol.
    • China is restricting personal protective equipment (PPE) export since a month, maybe also medicine.
    • If you take any prescription medicine, stock up for a few months at least.
    • Stock up on painkillers (Ibuprofen and other non-steroids like aspirin, might be a risk factor for COVID-19).
    • Prepare to treat yourself.
  • 02:43:13 Pregnancies.
    • Prepare for home birth.
    • Access to healthcare resources will be restricted (Check-ups).
    • Sourcing books.
    • Remote consultation with midwives.
    • Might be a common situation this year.
  • 02:44:45 Chronic diseases and cancer patients.
    • Might be unable to receive treatment.
  • 02:46:34 Hygiene and Sanitary Items.
    • Condoms.
    • Tampons, Pads.
    • can also be tradeables
  • 02:47:05 Tradeables.
    • see above, and:
    • Alcohol.
    • Cigarettes.
    • Lighters.

Wrap-up

  • 02:48:05 Send us your questions!
  • 02:48:32 Expert: Jon Stokes, ThePrepared.com. Founder of Ars Technica.
  • 02:49:20 Book Recommendation: Barry, John M. (2004): The Great Influenza. The Story of the Deadliest Pandemic in History.
  • 02:51:15 Book Recommendation: Hatfill, Steven; Coullahan, Robert; Walsh, John (2019): Three Seconds To Midnight.
    • US-specific, but general sections are great.
  • 02:51:50 “Bottom line here is: People underestimated this systematically. … Systemic error of thinking, they underestimated it, and they continue to underestimate it, even though they are no longer laughing, they continue to underestimate it. … This is something that has not happened in any of our lifetimes, there’s no listener who has seen anything that has been on the order of this, and it would be very good to get out of our normalcy bias.”
    • recognizing a lethal situation as a lethal situation.
    • go through the acceptance pipeline.
    • err on the side of overreaction.
    • it’s not about calculating the odds, we have no way to know which scenario will play out, so prepare for a few.
    • it’s not just about us, it’s also about other people (keep granny around!), that also depends on your actions.

Donation Report

  • 02:55:11 Donation Report and Minimum Wage Calculation.

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