Little grace in this black swan event
“If we do not follow the rules which are in place now or the rules which may be necessary to implement in the future, the estimation is that over 700 Bermudians can die from this virus.” — David Burt, Premier of Bermuda
The Premier, subsequently, also offered what was termed a “better-case” scenario in contrast to the worst-case scenario above, which asserted that if the country rigorously followed the present guidelines, perhaps we could keep the toll to about the projection of 263 deaths at peak in September.
Either outcome, however, will be not one that any of us find tenable.
The question is, how did we and the rest of the world get here?
The Black Swan
For months there has been a consensus that has emerged globally that this pandemic and the severe economic dislocation that it has left in its wake is a classic black swan event.
A black swan event is one that is extremely rare and devastating in its impact. I tend to agree with that consensus, although some will argue that this pandemic was expected, with individuals such as Bill Gates and the Central Intelligence Agency relatively recently predicting that a pandemic was on the cards.
The term “black swan event” was first conceptualised and latterly popularised by professor Nassim Nicholas Taleb, who is also a statistician and risk analyst, and author of a book about the idea of a black swan event before the Great Recession of 2008.
But let’s be honest here, the 2008 recession despite its economic pain and the financial devastation experienced by millions — many of whom never really fully recovered — is not in the same league with the Covid-19 pandemic at all. In fact, this is in a different universe by way of comparison.
An Economic Pandemic Awaits
Covid-19 is like the fantastical Grim Reaper bringing death to tens of thousands globally, along with economic and financial ruin as the following statistics confirm:
• The first decline occurs in global production since the Second World War
• Twenty-six trillion dollars wiped off the face of equity markets around the world over the course of a few days in March
• Price of crude oil plummets, with a barrel trading below $0 for the first in time in history in late April before rebounding weakly
• In Bermuda since March, more than 11,000 apply for unemployment benefits, representing over 30 per cent of our workforce. The corresponding figure in the United States is 26 million and growing. These are depression-era numbers, and this is not even the half of it. Our gross domestic product is slated to decline by a minimum of 10 per cent, according to the forecasting provided by the Minister of Finance, and, frankly, that is likely to be a conservative number
These bullet points tend to indicate that there will be no immediate economic recovery locally or globally, even with the flattening of so-called curves worldwide.
Has anyone ever seen a black swan? I haven’t. Which tells you how extremely rare it really is. But they do exist. Perhaps your great-great-grandfather saw one or at least a photograph of one. Perhaps after the two billionth hatching, one is brought into the world as a by-product of genetic mutation. That is how rare in the annals of history this existential crisis truly is, and why the black swan metaphor is very useful.
This pandemic, though, does evoke the biblical. Words and imagery such as that of the plague and pestilence come readily to mind. Divine retribution, perhaps, such as depicted in Dante’s inferno. Or the medieval plagues that ravaged Europe and killed tens of millions over the course of centuries.
For those of us over 50, our grandparents lived through the last major global pandemic in 1918 and it was called the Spanish flu. This was a woeful mischaracterisation, as the virus, or influenza, then did not originate in Spain at all. Bermuda was also not spared its impact.
From Animal to Man
One thing that most of these viral events have in common over the centuries, if not millennia — whether the corona variety or of the influenza type — is that initial transmission usually came from animal to human. It does not appear that it was any different in the transmission of this novel coronavirus, subsequently named Covid-19.
There is a scientific consensus that the initial transmission came from bats, very likely through an intermediary species, to humans in the area of Hubei province. What they call a zoonotic transmission. The first major breakout occurring in Hubei’s biggest city, Wuhan, in central China, which is a large manufacturing centre and also a big global transportation hub, moving its products from those factories to the world.
Everyone has an opinion, but not all opinions are equal. This is what the science is saying.
The grim calculus of death and devastation. The pandemic by numbers, as of 3pm yesterday:
• Confirmed cases: 3,173,036
• Confirmed deaths: 225,926
• Countries affected: 213 (including Bermuda)
Scientific opinion such as that found at the World Health Organisation and beyond is still of the view that it will take anywhere from 12 to 18 months before there is a vaccine. And there continues to be evidence of how insidious this virus truly is.
In Iceland some weeks ago after testing 9,000 self-selected persons, a private laboratory named Decode, which tested in conjunction with Iceland’s National University Hospital, found that 50 per cent of those who were tested by them and who had contracted the virus were deemed to be asymptomatic.
These are those who show no obvious symptoms, yet they can pass on the virus to the unsuspecting. Although there is some scientific opinion that asserts that what we may be characterising as asymptomatic may indeed be pre-symptomatic.
Jeffrey Shaman, an infectious-diseases expert at Columbia University, urges that we should resist the temptation to get in a debate over the two, which he asserts would result in us wasting time on semantics. In a recent interview in The New York Times, Dr Shaman stated: “The bottom line is that there are people out there shedding the virus who don’t know that they’re infected.”
In total, Iceland tested 17,900 persons representing 5 per cent of their population, with the National University Hospital testing the 8,900 persons. America’s National Institute of Allergy and Infectious Diseases director Anthony Fauci has estimated that 25 per cent to 50 per cent of cases may indeed be asymptomatic.
While it is difficult to place a hard percentage figure on the asymptomatic globally, it is clear that significant transmission by those in this category is occurring and we now know that by way of our health authorities this trend is present in Bermuda.
Pre-existing Conditions, Anyone?
Additionally, in the Bermuda context and with its ageing population now at a median of 44 years (2016 population and housing census) and its extensive number of rest homes per population, the research coming out of the London School of Economics indicates that the European Union experience should give us pause.
According to that study, the research appears to show that half of all deaths emanated out of care homes. The Guardian newspaper in Britain recently reported that 521 coronavirus deaths had occurred in two of the largest private-sector care home providers in the country.
These so-called care homes are residences that overwhelmingly comprise the elderly and disabled. We, too, have growing numbers of elderly that are being cared for in their homes, along with — by Bermuda standards — an extensive network of rest homes.
Think about that.
We also have a higher rate of diabetes then both Britain and the United States, believe it or not. The incidences of cancer, kidney and liver disease and those on dialysis, not to mention our obesity levels, do not make for a pretty picture. If the virus had the magical power to create a perfect or ideal host population, it would look a lot like us, I fear, or the US.
The Italian experience, which was horrific, was illustrative of the threat to those countries with aged populations. Italy, with one of the most aged populations in the world, is only slightly ahead of us with a median of 46 years.
Test, Test, Test and then Test Some More …
The above clearly confirms why this virus is so dangerous. It is also why the Premier and the Government were not indulging in scaremongering or even exaggeration to warn that in terms of a worst and even a better-case scenario as outlined, Bermuda is at risk of losing hundreds of lives if we fail to take the threat risk seriously.
It is also why we must address a key deficit through no fault of our own, which has hobbled our ability to fight this viral threat effectively. There are two key weapons that any government must have in its arsenal to fight this battle. One, social-distancing. And two, community-wide testing. Having the ability to test, test, test and then test some more is invaluable.
However, because of extreme shortages and the early recalcitrance on the part of Britain, which refused initially to assist with the provision of test kits, placing us at a significant disadvantage. We were in effect partially driving blind in our public health response.
It appears that deficit has been addressed now through a combination of government leadership, philanthropic efforts of a leading private-sector donor, and that of Bermudian geneticist Carika Weldon, whose efforts on our behalf have been impressive.
We have also succeeded in obtaining enough of the critically vital swabs and diagnostic chemicals to complement the increasing number of test kits now available. It appears that we are beginning to build the testing capacity that our government and the healthcare professionals sorely need.
The opening of another lab through the good work of the team under the leadership of the aforementioned researcher Dr Weldon also has been no small feat.
The key here is to test, contact trace, and then isolate and contain, with some precision — starting first with our frontline essential workers. We should then over the interim period be able to test increasing numbers of our general population, which is absolutely critical.
With the type of robust testing and diagnostic capacity now emerging, we will have the ability to liberalise our shelter-in-place regime, which is beginning to happen — and open our economy again in phases.
• Rolfe Commissiong is a government backbencher and the MP for Pembroke South East (Constituency 21)
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