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PANDEMECONOMICS

The Great Pause.  The Great Realisation.  Amidst the rising case counts, fatalities, isolation and eye-popping economic collapse, there are some who are finding as much future salvation as present desolation in our pandemic-induced trauma.

And some available metadata might agree with them.  I am not a creature of social media of any sort, so I never expect to see much of the data gathered from it let alone be among those whose data has been mined for fun or profit.  Except for one thing.  I do wear a Fitbit religiously, and it tracks my steps, my activity, my heart rate and the quality of my sleep.

Like all unwitting providers of personal data in the surveillance economy, I have never thought about what use Fitbit might make of this peculiar but undeniably intensely personal data.  On May 3rd, they let me in on just some of their analytical skullduggery.  An otherwise innocuous Fitbit Weekly Boost appeared in my e-mail that day and reported some interesting data that they had recently aggregated.  It seems that since mid-March, average resting heart rates of North American Fitbit wearers have been trending downward, with a reported reduction of 1.26 beats per minute among 18 to 29-year olds.  They didn’t report the numbers for seniors like myself, but I can anecdotally report that my own average resting heart rate is down by just a titch less than that amount since mid-March.

This despite lockdown conditions that have lowered average steps per day among all age groups (true here as well), countered ably among 42% of wearers by a corresponding increase in their active minutes in that period and a further 31% who have at least maintained their level of active minutes.  Furthermore, 45% of wearers have increased their average sleep duration, with another 30% at least maintaining their prior sleep duration.  They also note that wearers of all ages are going to bed earlier on weekends and later on weekdays, thereby reducing bedtime variability, another known contributor to more healthy sleep.

So, I thought, perhaps there is some merit to the idea that this pandemic disruption will be the catalyst to the development of personal habits that contribute to healthier living.  Maybe we will indeed emerge from our mandatory isolation with a new appreciation for and corresponding commitment to lives in better balance, with unthinking and unblinking consumerism nudged away just a touch in favour of a healthy dose of introspection and downtime.

Certainly that is what the equity markets think.  No more than a pause in corporate earnings has to date been priced into the markets.  Oh sure, the market is pricing in lingering shifts away from travel and hospitality, some medium-term retrenchment in office and retail real estate, but the market otherwise assumes a quick recovery with just a reorienting of a few consumer priorities.

From the relatively benign performance of global markets to date, one must assume that most equity market participants wear Fitbits, or at least get Fitbit’s Weekly Boosts.  And that would not be surprising if true, because I would suspect that the typical Fitbit wearer, like me, lands on the right side of the income distribution curve, as do most of those making decisions with respect to funds invested in equity markets.

Unfortunately, the reality is a little different for those who can’t afford the cost of self-actualizing support tools like the Fitbit, and/or could not be bothered with such self-indulgence even if they could.  They are the people working low-paying part-time jobs in long term care homes, facing even higher incidences of infection than their higher paid counterparts in hospitals with poorer working conditions and less effective and plentiful protective equipment.  They are also the people who are among the 38 million people in North America who have to date lost jobs since the onset of the pandemic, whose already precarious income is reflected in the fact that the loss of their jobs has resulted in a remarkable rise in the average income of employed people in both Canada and the US over that same period.  They are the people whose lower paying jobs in hotels, airports, casinos and retail stores are the least likely to bounce back as we enlightened Fitbit wearer retool our priorities.  They are the people facing the reality that the relentless daily reporting of negative macroeconomic data is signalling the onset of another Depression that has somehow been blithely discounted by equity markets.

Maybe we need to get those people Fitbits, so we can see where their heart rates, fitness practices and sleep patterns are at.  Maybe that is the Even Greater Realisation that we need to pause to reflect on.

But not for too long.  Don’t want to get our heart rates too high.

THE LIMITS OF COMPASSION

On Monday March 16th, just after 4 am, I received a call from the high-care seniors’ residence where my 91 year old father was living letting me know that he had died.  I had last seen him on the previous Friday.  He had been struggling with physical and cognitive challenges that had been tentatively diagnosed two years earlier as Lewy Body Dementia, and during my visit he was very tired and at a low level of awareness of me and his surroundings.  He had his teeth cleaned by the visiting hygienist, and I gave him a shave with his electric razor, both of which he enjoyed.  But he was too tired to go for even a short walk with his walker, and was quickly asleep after the flurry of attention.  We exchanged few words, but it was not without meaning for either of us.

As it turned out, the timing of my visit was very fortuitous.  The next day, the facility was put into full lockdown in the face of the pandemic threat, and no visitors have been permitted since.  I spoke to him briefly on the phone the next day, but he remained very tired and not very communicative.  The next morning I was advised that he was running a fever and further down in terms of his level of consciousness.  Despite the fever, he was not tested for Covid-19, because the predominant secondary symptom was more gastrointestinal than respiratory, and at that time that was not considered to be indicative of Covid-19, even with fever.

By early afternoon, his fever was down somewhat with Tylenol and ice packs, but his level of consciousness and breathing were continuing to decline.  He was then at the point that the protocol would have been to transfer to hospital unless the Power of Attorney, who was me, indicated otherwise. I did indicate otherwise, and they quickly forwarded an updated direction for me to sign to confirm that, which I did.

They then transferred my father to a hospital bed (until then he and his wife still shared a normal Queen-size bed) to make it easier to provide him with the care he needed.  The last view I had of my father alive was a 10 second video showing him resting comfortably and peacefully in that bed with supplementary oxygen flowing to his nose.  He died less than 12 hours later.

Shortly after his death, the residence reported positive diagnoses of Covid-19 among staff, and later among a number of residents, including my father’s widow.  Since that time, two residents have died, but Irene is hanging in, although the shock of losing her spouse of 35 years and the ravages of the illness have exacerbated her Alzheimer’s to bring her own level of consciousness and communication very low.  More than two weeks into the infection, she is by no means out of the woods.

The level of care that can be offered in the facility is demonstrably less attentive than was available to my father earlier in the crisis.  Not only are there many more sick residents, the others are restricted to their rooms, and meals and other care has to be delivered in compliance with strict infection control protocols.  And the staff available to provide the care has been decimated by those that have become infected themselves, including those mildly ill but precluded from coming to work by their positive infection status.

It is a tragic and difficult scenario for everyone, and especially so for families.  I know what they are feeling.  My own father died without me being there, and although I comfort myself with the certainty that his level of consciousness was at a point that my absence did not register with him, I know that I would have felt better to have seen him off.  I begrudge the virus for that, but not for taking my father.  He was in his final days, and something was going to take him.  We carefully chose the facility that we last moved him to (there had been two prior moves as his dementia progressed) not because we had any thought that they would forestall his last breath as long as possible.  We chose it because we felt it was a place that would offer him the opportunity to continue to interact with people at the level that he was capable and continue to do so as that capability continued to decline.  And that he could stay there until the end and be spared the confusion, futility and fear of dying in a stretcher in the hallway of an overburdened hospital.

And that is what happened.  I am not sure that the system, the care home, my family or I could promise and deliver anything more than that.

Rest in peace, Stu.

KNOWLEDGE, PRUDENCE, AND COMPASSION IN A TIME OF FEAR

Whenever you find yourself in a crowd running for your life, it is always a good idea to take a moment to sneak a peak over your shoulder and take stock of exactly what you are running from.  Now, there can be some risk to that.  Someone might get the drop on you on that last jumbo pack of toilet paper or case of Purell, but you might gain some perspective that keeps you from running yourself into a wall or a heart attack.

So let’s look at what we are all running from today: the Covid-19 virus.  It’s a nasty new bug that is as easily transmittable as everyday influenza and considerably more lethal.  In fact, so far it seems to be about 20x more lethal than the flu, but even that is a little misleading because it seems that only a small number of individuals under the age of 30 even exhibit symptoms, likely skewing the denominator by assuming virtually zero infections among that demographic.  Even as stated, though, the fatality rate is still about 1/15 that of even the recently improved death rate associated with Ebola.  And in the case of Covid-19, 80% of those positively diagnosed experience symptoms that do not require medical attention.  Not so for Ebola; nobody rides that out with a few days of Netflix and some soup.

So we have something that is considerably closer to a regular flu in its impact upon the health of infected persons than it is to Ebola.  But a whole region of China, much of South Korea and Iran and most of Italy is in lockdown.  SportsNet is facing a spring filled with nothing but darts and poker as the NBA, NHL MLB, MLS and NLS have all shut down their operations.  Mass gatherings all over Europe and North America are cancelled, and we are confined to our homes except as necessary to keep essentials in stock.  Borders are closed to foreign travelers, and air travel has ground to a halt.  Public school are even one-upping the private schools by extending their March Breaks out to at least three weeks, and the reality is that the school year might well be over.  Financial markets and oil prices have plummeted, economic activity has ceased, and businesses are busily planning the implementation of their heretofore theoretical business continuity plans.  How do we square that circle?  Are we finally coming face to face with the prophesied End Times?

Nope.  We are just a knowledgeable, prudent and compassionate people.  Knowledgeable enough to understand in detail the math and manner of pandemic contagion.  Prudent enough to try to slow the inevitable spread of infection to ensure that those few who do require hospital treatment to manage the symptoms of Covid-19 can be accommodated within the stretched capacity of our health care systems.  Compassionate enough to try to keep the infection out of the communities of medically vulnerable people, including the elderly, for whom the risk of severe complication and death are materially higher than for regular flu.  And we have knowledgeably decided that some short-term disruption to the global economy and our everyday life is a price worth paying for our prudence and compassion.

We have not always been so prudent and compassionate.  Through much of modern human history, knowledge of pandemic control strategies has been spotty, and even when available, expedience has trumped (pun, as always, intended) prudence and compassion.  The Spanish Flu of 1918 infected 500 million people, 25% of the world’s population.  Global statistics on the fatality rate are much disputed ranging from as few as 17 million to as many as 100 million, meaning somewhere between 3% and 20% of those that were infected.  The fatality rates are far greater than even the worst projections for Covid-19.

What made the Spanish Flu particularly nasty was that the fatalities skewed not toward the usual vulnerable populations of the very young and the very old, but to the strongest and healthiest.  It seems that its worst effects were the stimulation of the healthiest immune systems into a lethal overreaction.  99% of Spanish Flu fatalities were younger than 65, and more than 50% were between the ages of 20 and 40.  Covid-19 appears to instead be most dangerous for our oldest citizens, who are more inclined and thus far easier to keep out of circulation in the broad population, and leaves the youngest almost unaffected.

But these are facts that were unknown to even the most learned of Western societies in 1918.  Europe was in the midst of its Great War, and a flu was not going disrupt the critical war effort.  In many soldiers, the infection was mild enough to weather it out in the trenches, where they did so in relative isolation to protect the remaining healthy troops.  The sickest were not more carefully quarantined, but were instead shipped off in crowded transports back to civilian hospitals in Britain and France.  The application of even the limited knowledge of viral transmission of the day and a smattering of prudence and compassion could have saved millions.  But there was a war to be won, and individual lives were far less precious than they are today.

Stop running.  Take a breath.  No one is telling us to run for our lives.  We are being asked to be just sufficiently knowledgeable, prudent and compassionate to allow even those few for whom this viral illness presents a serious risk to have the best chance of the same good outcome that the vast majority of us will have if we do indeed become infected.  We are not cowering in the face of Divine Retribution; we are engineering a triumph of Enlightenment.

Wash your hands.  Stay home.  Be knowledgeable, prudent, compassionate, and calm.