# Covid 4/14/22: China Stays the Course

Will China abandon its zero Covid policy? For now it seems they are determined to stay the course and hope for the best. They continue to claim there have been zero Covid deaths. There are increasing signs the people are not happy about the situation, especially in Shanghai. At some point something has to give, but after one types similar sentences enough times perhaps things can be kept going for quite a while before that happens. Or it could happen on Tuesday.

Outside of China, the news has been extremely quiet on the Covid front other than the numbers themselves. Cases are up substantially, and deaths are up as well, neither of which fits my models of what should be happening here. I am unsure what to make of it all but I do not expect it to be fully sustained in the next week or two.

Executive Summary
-----------------

1.  China continues its Zero Covid policy and lockdowns.
2.  CDC extends travel mask mandate.
3.  Cases rose more than expected.

Let’s run the numbers.

The Numbers
-----------

Predictions
-----------

Prediction from last week: 190k cases (+6%) and 2,950 deaths (-23%)

Results: 222,300 cases (+25%) and 4,304 deaths (+12%)

Prediction for next week: 250,00 cases (+13%) and 3,900 deaths (-10%).

I talk a bit more below but both these movements seem very out of step with previous weeks and I doubt they will be sustained.

Deaths
------

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F9ef8cf7d-3fb0-40d3-8ab3-2222d12774be_611x194.png)

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F3dc4ce30-0884-4f95-8ff2-13aa5e0bc0c5_1200x742.png)

The death number in particular does not make sense to me. There are still a lot of with-Covid deaths rotating out at the top, and three-week-old cases are roughly static. There is no reason to think deaths should be rising here, yet they did. Given the large unexpected rise in cases alongside it, I am going to expect a modest fall again, and chalk this up in part to the previous week being artificially low given there was a very large drop there. We are still far below the rate we were at two weeks ago.

Cases
-----

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F22087313-1f4a-49e4-9003-adb76896e03f_605x194.png)

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fd2ab6de6-0963-4a2d-acc2-971448bffe83_1200x742.png)

Cases jumped substantially more than expected, which is not a good sign, but I still remain not all that worried. My expectations for how high case counts will get has gone up, but I still expect things to stabilize before too long. There is not much more upward pressure to come from increased share of BA.2, so it is about how high cases need to rise and for how long before adjustments and cumulative infections send us going back down again.

Physical World Modeling
-----------------------

Interesting hypothesis from Gottlieb, [that those who are getting BA.2 now are mostly those who did a bunch of prevention during BA.1](https://twitter.com/ScottGottliebMD/status/1512410058218512385), and thus are more likely to be vaccinated, test early and be low risk. In a sane world it would be the opposite, as the people who should do the prevention are the elderly and those with health conditions, _because they are high risk._ Yet here we are.

[Study reports three-fold decline in viral load for those who are boosted (once, so 3 doses total)](https://twitter.com/sailorrooscout/status/1513166796836286464).

[Switzerland vaccine effectiveness data (uncontrolled)](https://twitter.com/redouad/status/1513454323262447617).

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F32c61944-675e-4eee-a89e-31a08d5df0db_2048x1446.jpeg)

[There are now a BA.4 and a BA.5](https://twitter.com/jbloom_lab/status/1513538005545336838). Presumably there was also a BA.3 at some point, although I’ve never heard about it. Looks like the new ones have some potential additional escape properties from the vaccine formulation we are using, but extent of effect is unclear there, and immunity gained via infection from BA.1 or BA.2 should still mostly apply.

The thread linked above also leads back to [a Trevor Bedford thread on the mutations we have seen thus far](https://twitter.com/trvrb/status/1511871593940545536). Takeaway is that we have very poor idea of how often an ‘Omicron-like’ event will take place in the future, where we see the virus get escape and also improve its infectiousness in other ways at the same time. My guess is that such a combination is relatively rare going forward, and these things will usually happen one at a time.

[Vaccination combined with infection _by beta_ seems to have increased antibody response by 69 fold](https://twitter.com/sigallab/status/1513515490718760962). Nice. Not sure what else to make of it. More tests, I suppose.

[We could be working on new vaccines that would prevent transmission, and could extend this effort to all disease families that infect humans for remarkably little money](https://www.washingtonpost.com/health/2022/04/10/nasal-covid-vaccine/). Except there is no funding.

![Image](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fa974b535-d30a-479c-acd6-be8e06c1ee8e_1358x832.jpeg "Image")

[What could we do, and what would it cost](https://twitter.com/HandNF/status/1512989818057379841)?

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F3703bfb5-1b3a-4f00-9717-296c9c7df304_642x384.png)

I will admit I have not done a dive into the science here. Before actively saying this should get the money I would want to confirm that this works the way I think it does. Yet I see a lot of people I respect echoing this, and the claim we could with funding be close to a nasal vaccine for Covid that would much better prevent transmission, and I see essentially zero pushback.

[Instead, we seem to be skimping even on vaccination effort spending](https://twitter.com/rajpanjabi/status/1512818080120029195). There are bigger mistakes one can make, but there aren’t more _obvious_ ones.

[Thread from 9 April on situation in the Northeast](https://twitter.com/Craig_A_Spencer/status/1512946223946346501). Cases rising, potentially far more than is being measured, but this is not resulting in hospitalizations.

Some highlights:

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fa978b666-6caf-4dab-b5d9-9e1930ddd773_662x144.png)

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Ff5c9ca54-69c1-484a-b1a4-166fe6d46d8e_655x179.png)

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fd96421c9-e853-4307-819a-7ba1a9e6be60_647x217.png)

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F2ba12fef-4fcf-4e56-a59a-3d6d6a3c1192_658x160.png)

Despite the rising case count, [report that hospital conditions are actually the best they have been the whole pandemic](https://twitter.com/WHCOS/status/1514585037185896449).

Prevention and Prevention Prevention Prevention
-----------------------------------------------

[CDC extends transportation mask mandate an additional two weeks](https://twitter.com/thenewsoncnbc/status/1514390551554146307). They should lift it. However, the case for lifting it is weaker than it was when they last extended it, rather than stronger.

[This thread goes over some of the considerations on the mandate](https://twitter.com/Bob_Wachter/status/1514324778030559232), with support for the extension but for probably ending things without another extension if we don’t see a major surge. That seems right to me given the CDC’s preferences.

[Noting that a lot of people are getting Covid at conferences, a future attendee lays out her planed precautions](https://twitter.com/angie_rasmussen/status/1514603895049269252). This is what I would describe as ‘sane paranoia’ protocol. One personally chooses to do relatively good-cost-benefit things to moderate risk, and everyone picks how far they want to take that. Good.

Think of the Children
---------------------

[Emory blocks social media access for students who fail submit proof of a booster](https://twitter.com/kerpen/status/1512097936448053253). This seems great on two fronts. One, it is probably good for the students. Two, it makes clear that this is pure vindictiveness and punishment, and does not pretend to be something else. Good policy.

China
-----

[The Shanghai timeline](https://twitter.com/QinchenCQ/status/1513845959200976897).

[In a great surprise to everyone, WHO has no comment on China’s policies](https://twitter.com/ScottGottliebMD/status/1514282104825298949).

Every day like clockwork, [the BNO headline comes out](https://twitter.com/medriva/status/1514407113551978506).

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Ffe3f233e-afb2-4907-b671-902cec628e95_659x90.png)

OurWorldInData does have the total Chinese average declining slightly for the first time today, but I’m assuming this is some combination of data lag and ‘yeah, right.’

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fdb0f70fd-f0fe-4ba2-81a2-293b2498558e_957x709.png)

[Some short videos and descriptions of things going on in Shanghai](https://twitter.com/DonnaWongHK/status/1512471545213440000). Presumably cherry-picked to look bad, but still.

[Resident of Beijing makes sure her stores of food are ready. Wise decision](https://twitter.com/EmilyZFeng/status/1513362787061448706). Especially if she likes any ‘western’ food since it seems that is [sometimes deemed ‘inessential’ and not delivered](https://twitter.com/billbirtles/status/1514260112789020673)?

[Inside a Chinese quarantine facility in Beijing](https://unherd.com/thepost/inside-shanghais-zero-covid-camp/).

> For the past 11 days, Jane has been known as resident HI-17 118 at the central Shanghai Covid quarantine centre — one of 4,000 individuals held in a single vast room with no walls, without showers and without information as to when they will be released. Jane points out that, as well as there being no separation or ventilation, they are living at such close quarters that if they didn’t have Covid on arrival they very likely will catch it at the facility.
> 
> She has been tested five times, and has received the results of four: negative, positive, negative, negative. “Today we were told that apparently if you have four negative tests in a row you can be released from the hospital — but I still don’t know if we can really trust this information, so until I actually see people leaving I can’t believe it.” To date, she hasn’t seen anyone leave.
> 
> “Yesterday there was a list circulating with names of people who might be leaving today. But nobody left.”

I have a suspicion that keeping four thousand people in a single room may have _something_ to do with how the virus keeps spreading, no matter how many tests they run.

Chinese lockdowns in Jilin [threaten to leave 10% of China’s corn supply unplanted](https://www.scmp.com/economy/china-economy/article/3173149/china-food-security-farmers-jilin-leave-fields-fallow), as farmers are not able to plow their fields and plant their crops. This is the kind of thing that can end up as pretty serious trouble.

Can’t yet verify, but still worth a read: Chinese take to Weibo, decide government’s suggested propaganda hashtags are a bit on the nose, [and for a brief moment run over the censors](https://twitter.com/CameronWEF/status/1514413029936414720).

There was also [a Shanghai cooking contest](https://twitter.com/polijunkie_aus/status/1513840457050365954), won with 94% of the vote by a half-eaten steamed bun.

A commenter complained that some of the quoted translations from the Chinese were bad, but with photos it is difficult to check. So are [these](https://twitter.com/TGTM_Official/status/1513110794606727170) accurate?

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fc543c339-90a9-4721-8b58-61896344eecb_643x381.png)

In Other News
-------------

[Important safety tip](https://twitter.com/SBF_FTX/status/1514377790300336135).

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F2f2d6718-ef79-4e27-8472-f3f652887ff1_652x239.png)

[Our solution to a shortage of Paxlovid is that many doctors don’t know it exists](https://twitter.com/michaelmina_lab/status/1513165317496791042).

[Things are mostly back to mostly normal, _except_ no one wants to come into the office](https://twitter.com/jameshohmann/status/1513832412144451589).

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F937415fe-8353-4bc9-90c7-854ae14b33fa_653x707.png)

I agree this has very little to do with ‘scared of Covid’ and is mostly about ‘I don’t have to and you can’t make me.’ Not going into the office is potentially a lot less _productive_ per minute time spent in production, but the lived experience of not being there so often is far better for most people, and you save the commute. Having an office where you _can_ go in when it is useful, but where you are not obligated to go every day, should be the best long-term solution for many people. I very much want an office space where I can go _when I need it,_ but if they told me to be there 40 hours a week I’d quit or demand a _much_ better pay package.

[From Reason, 2.5 minute video: In a world… where CDC Delenda Est](https://www.youtube.com/watch?v=MQRuOs4pMdw&t=121s&ab_channel=ReasonTV).

[WHO Delenda Est thread](https://twitter.com/robinhanson/status/1512973736365940746), Robin Hanson does not understand why they make deliberately inaccurate predictions and some of us try to explain edition. Resulted in [this post](https://www.overcomingbias.com/2022/04/the-accuracy-of-authorities.html).

[Florida passes law giving patients right to have visitors in the hospital](https://twitter.com/politicalmath/status/1512281053997711360). This proved necessary as some hospitals were not letting anyone see Covid patients even very late into the pandemic. Now do prisoners.

[I left my mask in San Francisco](https://twitter.com/pmarca/status/1512874224741806081).

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fb612ad22-5be1-4173-b7bb-8869fad1e984_657x544.png)

[FDA requires ‘race and ethnicity diversity plan’ be filed for trials](https://twitter.com/PamelaKunzMD/status/1514406121624244224). I do see the scientific case here. It is still piling _more_ requirements on trying to get approval rather than working to make approvals not cost eleventy billion dollars and several years too many.

Not Covid
---------

[Elon Musk makes hostile bid for Twitter](https://twitter.com/Reuters/status/1514598178326294531). I kept telling _other_ people to buy Twitter. What a waste of time, when I could have instead waited for Elon Musk.

[This](https://twitter.com/matt_levine/status/1514549976910770182) is now my all-time favorite tweet, should definitely be sold as an NFT.

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fb1c3c893-3db3-4584-aa3e-0969330f9ec4_421x232.png)

[RIP Gilbert Gottfried](https://twitter.com/mannyfidel/status/1513966261469863939).

So there was a mass shooting on a New York Subway platform in Brooklyn, which caused a bunch of very expensive train delays and a lot of emotional damage from people who did not know anyone who was anywhere near that Subway platform because we’ve trained a generation that such things are traumatic.

We have a mayor, who used to be police, who has somehow _twice_ failed to say no to, and wow this is something actual people are suggesting, ‘[putting metal detectors at the entrance to the subway.](https://twitter.com/SallyGold/status/1513998291356299272)’

What they also did not do at first was catch the gunman, partly because [the camera in question didn’t work](https://twitter.com/jpmeyer/status/1514247353120792579).

Which is such a coincidence, that almost never happens.

![Image](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fac8ae04d-c0bf-44f6-8d42-ffddecf5e1ac_1080x1443.jpeg "Image")

Which puts this in a light that may or may not be better than before, since we can be reasonably confident the subway camera wasn’t singled out for sabotage:

![Image](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Ffa21843a-a4c0-4399-bbc3-222a49ad61cb_1080x835.png "Image")

However, good news everyone. The suspect wore a mask and over that wore a gas mask and used a smoke bomb to get away, but it’s fine, every crook makes one mistake, which was presented this way.

![Image](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fea3bf16f-ce94-4738-acfe-73a1589c730a_749x971.jpeg "Image")

Except no, that’s Encyclopedia Brown. In the real world, everyone who isn’t simply not doing anything is _constantly_ making _tons_ of stupid mistakes, most of which are never caught. That’s the model. And also a lot of why a lot of people never do anything.

[They have now indeed caught their suspect](https://twitter.com/KlasfeldReports/status/1514319515584286729). And yes, the credit card was a minor part of the issue. Operational security was, shall we say, not ideal from a ‘get away with it’ perspective. From the indictment:

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F00b56db8-602e-4b51-9f81-0c6e6828e95a_1180x1082.jpeg)

![](https://cdn.substack.com/image/fetch/w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fb9a7a807-e4f2-4c88-a32e-921562775f8e_1216x830.jpeg)

Everyone is innocent until proven guilty, but also there’s a lot of silver that went into the making of that platter.

Heretic [points out that heresy is increasingly enforced](http://paulgraham.com/heresy.html), declines to name any heresies or to fund companies of known heretics or anyone who does not [conform to the proper recursive principles](https://thezvi.wordpress.com/2015/05/15/in-a-world-of-venture-capital/). Does he [support the current thing](https://twitter.com/pmarca)?

[New York State allows nurse practitioners to practice without a doctor’s supervision](https://twitter.com/AlecStapp/status/1513617454739636234). This seems like a pure win, hopefully other states follow.