Tomas Pueyo's "hammer and dance" COVID-19 suppression plan — twists evidence — makes epidemiologically baseless jumps of optimism

23 March 2020

Tomas Pueyo's coronavirus suppression plan is . . .

. . . receiving favorable mention from a number of supposedly intelligent people.

So, I read it.

Its downfall are Pueyo's long-winded, arm-waving, magical assumptions that make little epidemiological and medical sense.

That is part of the problem with uncritically taking ideas from biologically and medically ignorant people.

Pueyo's opening summary is a give-away

He starts out:

Strong coronavirus measures today should only last a few weeks, there shouldn’t be a big peak of infections afterwards, and it can all be done for a reasonable cost to society, saving millions of lives along the way.

Say what?

"[A] few weeks . . . shouldn't be a big peak of infections afterwards."

What zoonotic pandemic world are you living in, Tomas?

This is not ebola. This SARS-C0V-2 zoonotic is much more easily acquired. And COVID-19 spreads asymptomatically and massively unseen.

Furthermore, human behavior, being as undisciplined as it generally is, means that social distancing and work-business shut-downs are always going to be surprisingly permeable.

There is not going to be the perfect containment that Pueyo envisions.

Let's jump over Pueyo's numerous errors . . .

. . . in fact and interpretation and go directly to the heart of my objections to his reasoning.

Foremost among these, is his assumption that South Korea presents a workable model for COVID control at this late stage (that — even at the time he wrote his paper) in the virus's global spread.

It isn't.

South Korea was fortunate in that the plurality, if not majority, of its cases came from one church and geographic location.

This is in marked contrast to the United States (for example), which has already slept so long, that COVID is in every state in very probably huge numbers.

Second, Pueyo seems to assume that South Korea's quick access to testing for SARS-CoV-2 — early in that nation's experience with the pandemic — can be imitated by other nations.

Again wrong.

Stupidity kept other countries from emulating South Korea's test kit preparedness. Now, it is too late to get a jump on tracing infected people's contacts and quarantining those in the way that Pueyo recommends.

The virus's exponential spread will now easily outpace even the most motivated governments':

ability to manufacture test kits in the necessarily massive volume

as well as their human capacity to

mobilize the personnel and contract-tracing necessary to keep up with the pandemic.

Pueyo makes a magical leap to help his evidence-lacking argument

Consider this misinterpretation:

With effective suppression, the number of true cases would plummet overnight, as we saw in Hubei last week.

Pueyo's conclusion assumes that:

China is providing the rest of the world with real numbers

and further that

China has near-completely eliminated coronavirus among the rest of its population.

In fact, a few days afterward in Hubei's supposed self-cleansing, China had to clamp back down on reimplementing isolation.

Presumably because letting people go back to work re-fueled the epidemic.

And the idea that China is either (a) free of coronavirus or (b) has it safely controlled is, almost certainly, grossly mistaken.

According reasonably well-understood epidemiological, biological and ecological principles — COVID-19 is endemic in China. Just as it all over the rest of the world now.

Given this endemicity, and absent human herd immunity, COVID cannot be stamped out of the population.

Let's look at Pueyo's erroneous conclusion

He says this:

If you hammer the coronavirus, within a few weeks you’ve controlled it and you’re in much better shape to address it. Now comes the longer-term effort to keep this virus contained until there’s a vaccine.

Some regions will see outbreaks again, others won’t for long periods of time.

Depending on how cases evolve, we will need to tighten up social distancing measures or we will be able to release them.

That is the dance of R: a dance of measures between getting our lives back on track and spreading the disease, one of economy vs. healthcare.

There is no evidence accurately presented in Pueyo's paper that justifies his idea that "you've controlled it".

And his idea about "dance" — after the control plateau is reached — is much more an obscuring metaphor, than it is a well-reasoned prediction.

The epidemiological glitch that Pueyo ignores (in his optimism about control) is that much, if not most of COVID is unseen.

This means that there are re-fueling reservoirs of infection all over the place.

These continue generating new cases, which also spread, because the people who are infected either do not know or do not care that they are.

There is not going to be a magical "control" plateau in which humanity — still lacking herd immunity — is going to be safe enough to resume quasi-normal activity along the lines that Pueyo assumes.

This being so, unless the United States actively investigates the "true" infection rate of the virus, the conditions under which it spreads, and tracks and isolates most of the contacts of the people who newly become sick.

I am pessimistic about these capabilities being accomplished and implemented in the timely fashion that Pueyo's "few weeks" hypothesis requires.

Consider the following factors in support skepticism:

the very high and apparently exponentially increasing numbers of COVID-19 cases already existing in the United States

still grossly inadequate numbers of virus-detection tests

combined with the still too-limited lab capacities necessary to promptly read them

as well as

the still abysmally low numbers of antibody-detection tests

and their similarly low lab interpretation capabilities

plus

almost certainly too few personnel necessary to reliably track contacts, administer tests, and isolate newly discovered patients —

on top of

Americans' customary antipathy to being told what to do.

The moral? — "few weeks"? — my ass

If one has no clue as to the science and mechanics of medicine and epidemiology, the chance that one will correctly analyze and implement pandemic control is near zero.

The problem with accepting Tomas Pueyo's idea — meaning doing just a "few weeks" of economy-bashing control measures — and then skating more casually, as COVID is (according to his flight of fancy) magically somewhat contained — is that it understates the economic damage that is going to result from dealing with the Real World.

Pueyo's faulty facts and reasoning subtly encourage us not to realistically plan for the massively very long-duration economic disaster that is coming.

We can kill and maim just as easily via depressed economic means, as we can via viral ones.

Just ask Iran, with regard to its cloak of US-imposed economic sanctions.

PeteFree.com

Tomas Pueyo's "hammer and dance" COVID-19 suppression plan — twists evidence — makes epidemiologically baseless jumps of optimism