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Unsanitized: The COVID-19 Report for Sept. 14, 2020

The Building of the Second Wave
Plus, an inaccurate mailer from the Postal Service

 

A band sits in Bustarviejo, on the outskirts of Madrid, which has seen a
resumption of coronavirus cases. (Bernat Armangue/AP Photo)

First Response

Even though in aggregate, the United States appears to be the only
country in the developed world that had a second wave of the coronavirus
in the summer, that's a slightly misleading quirk of this being a
sprawling country. For the most part, the initial wave happened on
different timelines at the state or even the city level. There were
maybe some modest outbreaks initially and then a large one later, or
there was a large outbreak at first that grew mild. The Dakotas, for
example, are experiencing a significant outbreak now
after mostly
avoiding the pandemic previously.

That's not to say that there weren't measures to take to avoid an
outbreak; it wasn't destined for the virus to spread throughout the
country. Just keeping indoor restaurant patronage down would have
significantly reduced spread, according to CDC statistics
.
But for the most part, we've seen the virus rip through states and
regions once, on different timelines.

That's why the presence of a few states on this list where COVID-19
cases are growing

over the past week jumped out. It includes Connecticut, Maine, New
Hampshire, New Jersey, and Rhode Island: states in regions (New England
and the Mid-Atlantic) that have already experienced the worst of the
virus. With Connecticut and New Jersey, this is a rise off a very low
level and could just be a blip. In New Hampshire and Maine, the rise
looks more pronounced but they never had that big an outbreak. Rhode
Island's been stalled at a modest level for a few weeks.

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The reason this provokes concern is what we're starting to learn from
around the world, including places where the spike in cases occurred
earlier than in the U.S. Countries in Europe are seeing a legitimate
second wave, at least at the case level. Spain in particular is back up
to pretty high levels
,
particularly around Madrid .

This should give pause to the louder devotees of "herd immunity,"
the idea that once a certain segment of the population has been
infected, then the virus has nowhere to spread. Successful interventions
against the virus have given rise to the claim that you need lower and
lower levels of immunity to stop the spread. But Madrid in particular
had a high seroprevalence, months of low case counts, and then an
outbreak
.
In England cases are rising as well, in what also looks like a true
second wave.

There's one major positive here: the extra sophistication of the
medical response has led to far lower death rates on the second wave.
That means that suppressing the virus at the outset, rather than letting
it rip through an area with little resistance, makes the most sense,
because saving medical cases for later offers a better chance at
survival. Hospitalizations are also down, which reflects the younger
profile of the average infected individual, but as we saw in the U.S.,
that can filter upward quickly.

This also could mean that the timeframe of immunity might be limited.
More likely, it means that you need a much higher degree of immunity
within a region to give enough protection to let people out in the world
again. If you relax restrictions too soon, the virus will find hosts and
spread around. We don't have a case study of everyone in an isolated
area getting the virus, and there would be too much mortality at risk to
allow that. So the best practice remains suppression until a vaccine.
There's no natural process of letting the virus rip through a
community that will yield enough success.

Maybe if you can lower death rates through treatments and masking to a
small enough level, you can return to normal before vaccinating
everyone. But I doubt you will get there among the immunosuppressed and
the elderly. Israel instituted a second lockdown
,
the first relatively developed country to do so, to get the virus to
stop spreading. That's still a tool for countries, and in the event of
a true second wave you'll see it pulled out.

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Odds and Sods

The idea that there's going to be a partisan split on who uses
absentee ballots in a pandemic has always struck me as fairly odd.
People are going to want to protect themselves and their families
regardless of political party. Sure enough, there are more absentee
ballot requests

in key battleground states like Ohio and Michigan than in any other
election in history. That's not all coming from one political party
(though maybe more Democrats at the margins). Loud and ignorant people
get attention, but large numbers of people will vote by mail.

Which is what makes the postal slowdown so critical. And it's why you
have to view even the most potentially innocuous actions from that
agency with skepticism right now. I got a postcard in the mail,
scheduled to go to everyone in the country, which includes a checklist
to prepare to vote by mail. Because states handle the vote by mail
process in different ways, it's impossible to send a single checklist
to everyone in the country with perfectly accurate information
everywhere. So sure enough, Colorado's Secretary of State has sued to
block the mailing
.

Colorado is an all-mail state, and you don't need to request a mail-in
ballot to get one. But the postal mailer, while it notes that "rules
and dates vary by state" and offers a link
to where to find your local election
boards, advises voters to "request your mail-in ballot (often called
"absentee" ballot) at least 15 days before Election Day." That's
not true in Colorado and eight other states (plus the District of
Columbia), some of which have changed their rules because of the
pandemic. In those states, the mailer will cause plenty of confusion. A
federal district court judge granted a temporary bar

on sending the mailer in Colorado.

In addition, the mailer requests that ballots should be mailed "at
least 7 days before Election Day." Some Secretaries of State were
recommending even longer times in advance, and this now presents a mixed
message.

Confusion is the friend of those who want to suppress the vote, of
course. You can take the Postal Service at their word, and believe they
were issuing this mailer as a public service, to give people a sense of
how far in advance they would need to pre-plan to ensure their vote was
counted. But our elections are local affairs, and it's impossible to
put a one-size fits-all gloss on them. And supplying incorrect
information does interfere with the right to vote.

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Today I Learned

* China has quietly vaccinated over 100,000 people

before its clinical trials have completed. (Vox)

* This is as close as the Federal Reserve gets to flashing red,
screaming for more fiscal spending

to salvage the economy. (Wall Street Journal)

* Trump held an indoor rally

on Sunday in Nevada, for the first time in months. (CNN)

* Brilliant piece about the difference in treatment

between the executives on the top floor of the office tower and the
shopkeepers on the bottom. (ProPublica)

* There is effectively no payroll tax "cut"

or even deferral. No business in their right mind would go along with
it. (New York Times)

* Per its bailout, airlines are allowed to fire workers October 1. You
might not be able to catch a flight to a small airport

after that. (Wall Street Journal)

* Pigs can get coronavirus
.
(South China Morning Post)

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