There are a lot of things about the dystopian hellscape that is 2020 I could not have predicted.

The latest trend is people getting arrested for beating people up because their victims weren’t social distancing well enough.

Um…if you’re close enough to hit someone in the face you’re also close enough to get sick from them?

What the fuck is wrong  with people???

In my last post, I talked about how immunity might help us cope by giving us a cohort of immune folks to help society run — and possibly even donate their antibodies — until herd immunity happens.

In this post, I will talk about some other hopeful trends I see on the horizon.

One trend I see is that hacking culture + desperation are attacking the twin shortages of ventilators and PPE.¹ A lot of folks in many walks of life are working on ways to hack, kludge, and gerry-rig our way out of this mess.

Regarding masks, there’s a lot of effort going into “good-enough” solutions. Folks are sharing research showing that any facial covering is better than no facial covering. Folks are sewing masks at home, while others are 3-D printing face shields. People are even doing extremely sophisticated materials and aerosol research on their own dime, and then mass-disseminating information with their findings. For example, just yesterday an article came out that showed that certain shop towels might make very good homemade masks.²

Similarly, there’s other research going on to figure out ways to stretch current supplies of PPE. Commercial ovens may start being used to re-sterilize masks. Others are looking into using things like UV lamps for re-sterilization.

Regarding ventilators, some groups of people are trying to create gerry-rigged low-cost ventilators in various ways, such as re-purposing cpap machines.

Meanwhile, many many MANY medical researchers are working on trying to figure out how this disease operates, and how to fight it.³ While ventilators are necessary, they are also a last resort. By the time a patient gets to the point of needing a ventilator, they have a 50% chance of death. The best thing is to keep a patient from getting sick enough to need one.

Perhaps over the next few months, one treatment or a combination of different treatments will emerge, and these will allow more patients to avoid becoming critical. That would be amazing.

¹ Obviously, the shortages in both areas are nothing less than travesties, brought on by inept, incompetent and often downright malicious government choices. These are horrible and horrifying, and one hopes that in the not-too-distant future, there will be a severe and profound reckoning for everyone who got us into this mess.

² Of course, price gougers are already selling those same shop towels on Ebay for 5 times the usual price.

³ Here is just one article that’s been called “promising.” I can’t claim to understand it myself. But it shows that researchers are leaving no stone unturned to look at different mechanisms by which we can fight this thing.

Hi.

Now that we’re in the thick of things, a lot of folks are wondering, How long does this last? When can we return to normal? etc. etc.

I’m not a soothsayer and I can’t tell you the answer to that — that said, I’m pretty sure that, barring some miracle, the US is going to be on lockdown through the end of the summer at least.

But I can also see some scenarios that will at least allow things to improve.

Factor X: Immunity

The 64 Trillion Dollar Question is: Are you immune once you get the disease? Or can you be reinfected? Most illnesses confer immunity to survivors. However, there are a few that do not. Some survivors of Dengue Fever, for example, are able to get reinfected, and the disease is even worse the second time.

Most medical folks are pretty sure that Covid-19 survivors have immunity. But, there are some questions. There are anecdotal reports coming out of Asia of folks who’ve gotten the illness, left the hospital, and then tested positive again. Why would that be? Is it because the tests are unreliable? Are they testing positive because the test saw virus particles and antibodies? Or are they truly ‘sick’ and truly ‘have it again?’ We don’t know yet.

There are other unanswered questions about immunity. In the worst-case scenario, immunity would only last for a year or two, and would then fade. Or even worse: Covid-19 would mutate to Covid-21 in a year’s time, and just as with the flu, we’d all have to suffer through it all over again.

But I’m going to focus on some rosier scenarios for the time being.

Best-Case Scenario: Survivors are Immune, We Get Reliable Antibody Tests, and Survivor Antibodies are Helpful 

If it turns out that survivors are immune

And we get a shit-ton of reliable, mass-produced antibody tests

Then that will be a game-changer.

Data from Iceland and Vo in Italy are showing that as many as 50% of cases can be asymptomatic. Once we’re able to test the entire population, we could identify all the folks who had it and didn’t know it, plus all the folks who had it but weren’t able to get tested.

All those folks could go back to normal life, and they could help the rest of us, too.

The idea floating around is an “immunity passport.” A QR code, a bracelet, something that identifies you as immune. Once we have a portion of the population that is guaranteed to be immune, we also have folks that are uniquely qualified to do front-line work. They could work in hospitals and medical clinics. They could work with elderly and immune-compromised people. They could work in customer-facing roles or food delivery. They would be the folks who could be guaranteed to be safe, and that is very important thing.

Side note: for some period of time, immune people would also have special bargaining power. We’re already seeing workers at Amazon warehouses and Instacart go on strike. In this desperate time, they are much more at risk than normal, but they also have much more bargaining power and they’re taking advantage of it. Now imagine a bunch of low-income folks who have the immunity superpower. Imagine what kinds of salaries and benefits they could demand if they worked together? This would be a rare time where average folk might have something rich folks can’t buy — immunity. It would be a rare opportunity.

As immunity spreads, I have an image of some limited re-opening of a few bars and restaurants. Almost like speak-easies for the immune. You’d have to show your bracelet to get in, and the immune could party while the rest of us languish inside our homes. It could be a new and different class divide based entirely on luck, albeit a temporary one.

My brother tells me that this image is way too “Philip K. Dick” and is unrealistic. We’ll See.

The second opportunity in identifying immune folks is the possibility that their antibodies can help save patients. There is already research being done on this. If it turns out to be a helpful treatment, our society will by force turn away from an “I’ve got mine” society to one that’s more about working together communally. If rich folks are going to, literally, need the blood of the poor to survive, they’re going to have to start fucking sharing. Medicare for All sounds like a good start. After all, why should someone who’s been denied affordable healthcare for their entire life give away their very life’s blood to a stranger? Something is going to have to give, societally and culturally.

The third opportunity in immunity is of course the old standby, Herd Immunity. At a certain point, slowly or quickly, this disease will work its way through the majority of the population. At that point, the uninfected will be a lot safer, statistically, than they were before.

So these are all things that could make life easier and better while we wait for the Holy Grail, which is a vaccine or highly-effective, safe treatment.

I’ll talk about some other ways thing might improve in Part II.