Post-infection cardiac damage found in 78% of recovering COVID19 patients

That's 78% of a cohort, average age 49, of whom 67% had recovered at home (ie. disease was not categorized as severe enough to need hospitalization). Cohort was normalized with respect to other risk factors relative to uninfected patients. Diagnosis by MRI. Looks reasonably solid, at first glance, publication in JAMA Cardiol. (Journal of the American Medical Association, cardiology). Study coordinated via a German hospital.

Reason for "no comment necessary" is that this suggests most COVID19 survivors—including mild disease survivors—suffer cardiac damage.

You don't want to get this virus.

On April 16—gosh, it feels like an entire year ago—I made some predictions about where we were going. How do they hold up?

  1. Vaccine development will take a flat minimum of 12 months.

Too soon to tell; it's only been two and a half months. A few people have signed up for testing, but we won't know if the prototype vaccines have provided any protection for months yet. (I haven't seen any reports of them killing the guinea pigs though, so there's that.)

Manufacturing of vaccine adjuvants and the little extras required to turn a raw product into a deliverable medical treatment are in progress, though.

  1. Lockdown can't be sustained more than 1-2 weeks after peak ICU occupancy passes, so it will be lifted in mid-May in the UK and possibly as early as May 1st in the USA.

I am really glad I got this wrong. Lockdown lasted until the end of May in the USA; it began being relaxed in England in mid-June, and here in Scotland non-essential shops are due to lift in July. The English government (that is, the Westminster parliament governing England: Scotland is run by the Holyrood parliament in respect of domestic affairs such as public health and education) tried to convince schools to re-open, but that mostly flopped; Scottish schools are, I believe, staying shut until the next academic year (the Scottish school year ends earlier than the English one by a couple of weeks).

Incidentally, Scotland is broadly coping better than England per this dashboard: there have been no new COVID19 cases confirmed in the past 4-5 days. However, Westminster's desire to dink with the statistics in order to justify a premature re-opening is making it hard to tell just WTF is going on.

  1. Trump is shooting for May 1st because he's been told the economy will take 6 months to recover ... 1-4 weeks later there will be a secondary surge in infections and it'll follow the same exponential growth

Because the US lockdown didn't really begin to lift until June, the USA is hitting this secondary surge right now, and some states are trying to lock down again. Red states with Republican governors who are in complete denial are getting hit badly, though—notably Texas and Florida.

  1. Extra Lulz in the UK

Boris clung on to power and is now visible again, busy pulling levers and waffling in public, Cthulhu help us. His main approach to COVID19 is to treat it as a public relations project, so he's going with patriotic rah-rah rhetoric rather than coolly rational choices. Because he's not a planner he delegates everything to Dominic Cummings, who is in the process of purging the top ranks of the civil service and replacing the current leadership with those willing to swear a loyalty oath to Brexit.

It'd be hilarious if I wasn't trapped in the back of the bus these clowns are driving towards a cliff.

  1. Wildcards: we might conceivably find a simple and effective medical treatment.

Hydroxychloroquine is a bust (snake oil is about what you can expect from a snake oil salesman). Dexamethasone improving the prognosis for ICU patients is a welcome finding, but it's not a magic bullet—it just reduces the death toll by up to 30% among people who require mechanical ventillation. Trump buying up the global supply of remdesivir (even though it's not very effective) is exactly the kind of Milo Minderbinder act you'd expect of the guy. Prediction: it won't work, but it'll make Trump lots of enemies and a little bit of money.




What did I miss?

I missed: the rest of the world, where populist authoritarian leaders everywhere are trying to make Trump and Johnson's handling of COVID19 look magisterial and professional, from Brazil's Bolsonaro to Russia's Putin.

I totally didn't see Black Lives Matter turning into a global protest movement. To be fair, George Floyd was brutally murdered by the Minneapolis police department on May 25th, and the predictive blog entry I'm referring back to was posted more than a month earlier. (I've only posted once since then, prior to this, and that last blog entry was about brainstorming a fiction idea, not current affairs.) In retrospect I should have anticipated that heavy-handed racist policing of lockdown would lead to numerous flashpoints worldwide. There have been other side-effects: illegal raves and parties in the UK, for example. Widespread flouting of social distancing and/or masking guidelines, and the emergence of anti-mask rhetoric among Trump loyalists as a very disturbing kind of political statement.

There's a growing, seemingly global, sense that we can't or shouldn't go back to the status quo ante—in many ways, this sentiment ehoes earlier occasions when pressure for major social change emerged during and after world wars. The long term global economic effects, and possibly the death toll, are clearly in the same order of magnitude as a 20th century global war: it may be that such wars (or in this case a frightening pandemic) provide the trigger for the sort of societal change more normally associated with revolutions. (This certainly happened in 1917-19, and again in 1945-49.)

A new world is being born. I just hope I live to see it, and that there's room in it for someone like me to exist.

From one who has not played AD&D since (checks) 1983 or so (and is ignorant of anything TTRPG since they stuck "1st edition" on its name) ...

Posit a D&D campaign being run in the Laundry Universe, during/after CASE NIGHTMARE GREEN (so circa 2015-20, in a world where magic has been out of the closet and rattling its fingerbones under everyones' nose since 2014).

What strange character classes and odd tropes might a sufficiently creative GM come up with? What existing mechanisms and monsters would have gone abruptly out of fashion, and what might be the new hotness in a campaign where some of the players might be accountants by day, and others might be capable of setting their hair on fire?

(Yes this is a "do my homework" question, and I have zero intention of explaining why. Suck it up!)

You better watch out
You better not spy
Don't go out
I'm telling you why
Dominic Cummings is coming to town

He's taken a test
And ignored it twice;
COVID19'll take him in a trice
Dominic Cummings is coming to town

Doesn't care where he's sleeping
He just knows he's exempt
He doesn't care if he's being bad
Pandemic lockdown can go and get bent
So stay in for goodness sake!
O! You better mask up!
You better not cry
Better not cough
I'm telling you why
Dominic Cummings is coughing
Dominic Cummings is coughing
Dominic Cummings is coughing on you

(To the tune of Santa Claus is comin' to Town)

... I'm not even ill.

However, I'm unproductive because I'm mildly depressed, and mildly depressed in part because I'm unproductive. Also the world is a flaming dumpster in a toxic waste site next to a reactor meltdown and I want to get off.

I think I wrote almost a thousand words last week. (About 15-20% of my normal output.) But that may be optimistic.

On the productive side: I suddenly realized my public profile had dropped to zero these past couple of years so I've done a couple of podcast/interviews and have a couple more lined up over the next week or so.

And who knows—maybe tomorrow I'll mop the kitchen floor then write another thousand words.

(This blog entry exists to serve notice that I'm not dead, and because the comments on the previous blog entry have become way too cumbersome and slow to load. So feel free to chat among yourselves in the comments on this entry instead!)

Let me make some predictions, starting with:

No it won't.

Vaccine development will take a flat minimum of 12 months. Then another 1-3 months to ramp up (on a Manhattan Project management basis) and a to-some-extent-overlapping 1-3 months to roll out around the various nations that are involved. (I predict the USA will merrily go its own way and faceplant, unless y'all elect a competent next POTUS. Or VPOTUS, insofar as Biden appears to be past it and Pence is incompetent at anything but arse-licking.)

Meanwhile.

Lockdown can't be sustained more than 1-2 weeks after peak ICU occupancy passes, so it will be lifted in mid-May in the UK and possibly as early as May 1st in the USA. (I know the Eastern Coalition are kicking back against Trump's deranged demand for an early restart: I expect other states may also join in if their estimates of the long-term damage track reality.)

Trump is shooting for May 1st because he's been told the economy will take 6 months to recover, minimum, and he's shooting for the November election deadline. This is laughably optimistic, even if the pandemic had burned out by May 1st: we're in Greatest Depression territory already, the hospitality sector has crashed 75%, airlines have crashed 90%, etcetera. It's not going to be back to normal by November, even if the Fairy Godmother shows up and banishes the horrid virus with a wave of her wand. Period.

So. The immediate peak hospital occupancy will pass, lockdown will be lifted sector by sector (or all at once) and region by region ... and the 50% of COVID19 cases who are asymptomatic will go back to work, mingling with the uninfected.

1-4 weeks later there will be a secondary surge in infections and it'll follow the same exponential growth as the first spike in Feb/March. And lockdown will resume, probably in mid-June. (It may be mitigated by summer heat, in which case things will look good for a month or two longer, but I'm not holding my breath: even if heat prevents spread, the prevalence of air conditioning in public spaces in the US provides a transmission-friendly environment.)

If the howls of rage at the first lockdown are deafening, the second lockdown will be worse: think of toddlers being sent back to bed with no supper. And that's the lucky work-from-home class: the working poor—with no savings and jobs they need to be physically present for—are going to be increasingly angry and fractious at their exposure. Expect civil disobedience and possibly summer riots unless central banks throw money at the grassroots -- and not $1200 for 10 weeks: more like $1200 per week.

Oh, and then there are the hospitals. Hospital staff will begin to catch their breath in mid-May after two months of running at maximum speed ... then it'll all crash again 4 weeks later. They're getting no respite. About 25% of medical staff are off sick with COVID19 themselves at present, far as I can tell: this cohort will be coming back to work by the second lockdown, but a bunch more will be down and sick.

You can't run doctors and nurses at full pandemic intensity for all that long without them burning out, as well as getting sick. There will be horrifying staff attrition, and although this year's graduate cohort got pressed into service early, next year's cohort will be suspended because teaching ain't happening.

So we're going to see repeated 4-6 week lockdown periods alternating with 2-4 week "business as usual" patches. Somewhere during the second or third lockdown most of the pubs/bars/hotels/restaurants that hibernated during the first lockdown and came back from the dead will give up the ghost: by September-November the damage to about 10-30% of the economy, disproportionately the service sector, will be permanent (FSVO "permanent" that means not coming back until after the pandemic, growing afresh from zero rather than reviving from hibernation).

I do not know what the hell Trump will do when his "get America open again" agenda runs into pandemic spike #2, around the beginning of June. Expect denial and heel-dragging and a much worse death toll, this time reaching the rural heartland (where hospitals may not have any ICU beds at all: there's going to be carnage). By August he may well be in full-on meltdown. I wouldn't even be surprised to see a second round of impeachment hearings as the Senate Republican Party tries to throw him under the bus so they can pivot to President Pence. Assuming it's not too late to save their campaign ...

By September there's going to be social unrest just about everywhere that hasn't nailed down a massive social spending/social security project on a scale that makes the New Deal look restrained and conservative.

And that's going to be the picture until June or July 2022.

Extra lulz in the UK: the Prime Minister is out of hospital but hasn't been seen since Monday—my guess is he's hors de combat for at least another two weeks. A quarter of the senior ministers of state are rabid objectivists who actively hate the poor and want them to die, and a majority of the cabinet are still going full steam ahead for a no-deal Brexit transition on January 31st, at which point the UK economy shrinks another 8% overnight. Boris, in principle, has the credibility to pull them back from the brink (and is a perfectly ideology-free vacuum of naked ambition, so he's personally capable of pivoting) but if they try for a maximalist brexit in the middle of a pandemic there will be pandemonium.

Wildcards: we might conceivably find a simple and effective medical treatment. Or vaccine development is ridiculously easy. Or the 50% of asymptomatic carriers are a sign that the pandemic is more advanced than we realize, that immunity is long-lasting, and that we're much closer to achieving "herd immunity" than anyone in the epidemiology community currently realizes. But I want to emphasize that these are all straw-clutching exercises. In all probability, they're not going to eventuate.

Have I missed anything out? (Aside from the giant meteor, Cthulhu awakening, Krakatoa erupting, and a Dalek invasion. NB: one of those things actually happened last month.)

So, some years ago I blogged a whole bunch of times about books I wasn't going to write for one reason or another.

Now, thanks to COVID-19, I can add another to the list.

Some of you have been waiting years (is it really a decade? Gosh!) for a third book in the would-be trilogy that began with Halting State and Rule 34. The third Scottish near-future police procedural kept getting put back and back because reality wouldn't sit still and behave itself: it's really hard to write something set 10 years in the future (or even 5) if you don't even know what the country it's set in is going to be called. I named the period starting in 2012 "the Scottish political singularity", because it made all near-future fiction set in Scotland problematic: first we had the referendum on independence from the UK, then a general election, then the Brexit referendum. Back in 2012 I thought things would have settled down by 2016 or so: alas, I was sadly disillusioned.

So around 2016 I hatched a Plan B.

(Had, past tense.)

Life comes at you fast.

On March 12th, this was my provisional plan for public appearances.

Here's the update: ConPulsion is/was cancelled. Eastercon is cancelled. Satellite VII is not cancelled but is being postponed at least 8 months and might yet be cancelled). ConZealand, the world science fiction convention in New Zealand, is switching to a virtual/online-only format: as a face-to-face gathering, it's cancelled.

(Novacon isn't until November so they don't need to make a decision yet, but if this isn't resolved by August—widespread test kits deployed in the community, initial infection spike smoothed, and treatments coming online—my money's on "cancelled".)

Given the news none of this is surprising (they postponed the Olympics—that normally only happens during a world war). Whether SF conventions will ever get restarted is an open question at this point: the hospitality industry and public transport (including airlines) are taking it in the neck, and even after COVID-19 ebbs away people are going to be very nervous about mingling in large public gatherings with people who've come from far away. Certainly, with the exception of a trickle of events postponed from before the pandemic, I don't see much happening in 2021 or 2022. And it's kind of hard to pitch for/organize a future world science fiction convention when your venue is a plague hospital and half your committee members are in lockdown overseas.

2020 may be remembered as the year convention-going SF fandom died. I hope not, but there it is.

We interrupt the apocalypse to give you a shiny new cover reveal! Because the UK edition of Dead Lies Dreaming now has a cover and a release date (October 29th), even though Big River Co can't let you pre-order it just yet.

Dead Lies Dreaming UK cover

Obligatory disclaimer: this is being announced as Laundry Files book 10, because Marketing. But it's not actually part of the same story line at all — rather, it's the start of a spin-off series, set in the world of the New Management, after the end of the main Laundry Files story about Bob et al. No, you don't get to find out what happened to Bob, Mo, and the gang in this story: that'll have to wait for another book. (And not the next one: the next one in this setting will be a sequel to "Dead Lies Dreaming".)

As far as Bob goes—I believe I'm now allowed to say that I've sold an interstitial novella about Bob to Tor.com. So keep your eyes out for "Escape from Puroland", coming some time in the second half of the year.

PS: I haven't forgotten "Invisible Sun". In fact, I've been really busy rewriting it for the fourth time! It's now with my editors and scheduled for publication next March, assuming that no zombie plagues, dino-killer asteroids, or other disasters come along to derail it.

If that sounds like a weird disclaimer, it's because this has been the cursed project from hell. My first draft didn't quite gel at a plot level, then every time I tried to rewrite it—for three consecutive attempts—someone close to me died. This time round, no single person died—but we got the global COVID19 pandemic instead. I think I stuck the landing this time round, but it's almost as if the multiverse is trying to send me a message ...

This probably doesn't need saying, but I'm cancelling/avoiding public gatherings and/or public appearances for the indefinite, but hopefully short-term, future.

As of an hour ago the Scottish government announced that we're moving from "contain" to "delay" wrt. Covid-19—community transmission unrelated to travel or contact has been confirmed—and banning all assemblies of >500 people from Monday.

I'm personally in the high-risk category, being over 50 and with both type II diabetes and hypertension, so I'm self-isolating as of today.

Anyway. I won't be attending ConPulsion (local gaming convention in Edinburgh) in two weeks' time. I also expect the Eastercon in Birmingham to be cancelled, if today's COBR committee meeting in Whitehall announces a ban on public assemblies.

Looking more than two months ahead is pointless right now, but it's not looking good for this year's World Science Fiction Convention in Christchurch, New Zealand, either.

I'll update this if anything changes.

Stay safe.

Not much to say here: by now you've all heard of Coronavirus Disease 2019, and it's probable that there are cases in your country. (Another 13 cases just got added to the UK score this morning.)

Remember: Coronaviruses have a lipid membrane, which is vulnerable to disruption by detergents (including soap and water). It can persist for up to 24 hours on some surfaces (especially polished metal). Wash your hands! You're probably safe from droplet inhalation unless an infected person coughs in your face—droplets settle fast.

The headline mortality rate for COVID-19, 2%, is comparable to the 1918-20 Spanish Flu (an order of magnitude higher than a regular winter flu). However, it rises to around 15% in over-70s. This is therefore going to cause a crisis in the nursing home sector, where homes will either have to run on a skeleton staff by sending home sick care workers, or risk killing their residents in large numbers. (This is why we need statutory sick pay!) It has the potential for major demographic, political, and age/wealth redistribution as side-effects. Also for exposing butt-headed political moves like Boris Johnson demanding the UK leaves the EU's pandemic response early warning system (apparently viruses will give the UK a free pass because Brexit), or Iranian clergy in the holy city of Qom staying open to pilgrims because their shrines are places of healing. And I'm fairly certain that as soon as there's a vaccine, the Anti-Vaxxers will crawl out of the woodwork.

Anyway, feel free to discuss COVID-19 related matters in the comments below.

(Because I am still elbow-deep in the guts of "Invisible Sun", blogging is sparse right now ...)

I just asked a couple of questions on twitter, and I thought you might like to share the misery.

SERIOUS QUESTION for space geeks:

  1. The flight of Apollo 11. Postulate that Mike Collins is a werewolf. At what point during trans-Lunar injection does he go furry? And how many times during the mission profile is he forced to shapeshift by the light of the full Moon?

ANOTHER SERIOUS SPACE QUESTION:

  1. A full Moon must subtend an angle of at least 0.5 degrees to trigger shapeshifting in werewolves. A werewolf is aboard a spaceship bound for Ganymede, largest moon of Jupiter. In low Ganymede orbit, how many Jovian moons trigger shapeshifting?

Assumptions:

  1. Werewolves are real.

  2. Shapeshifting is not triggered by direct exposure to the light of the full Moon, but by the existence of a full, uneclipsed Moon in the sky (otherwise werewolves could just hole up indoors to avoid furry hijinks).

  3. Werewolves shapeshift involuntarily in an arbitrary short period of time (WARNING: any discussion of relativitic effects or the use of werewolves as an FTL signaling mechanism will be firmly discouraged).

  4. A Moon other than Earth's moon suffices, but it must be a primary Moon (by IAU definition) and not a Moon of a Moon, and also it must subtend an angle of no less than 0.5 degrees to be effective. Earthrise, from Lunar orbit, is not a lycanthropy trigger.

  5. The first rule of Vampires is: Vampires do not exist. (See also "The Rhesus Chart").

Have at it!

I watch as little television as I can, and most of it by accident.

Whenever I do catch an eyeful, it usually consists of one of three things: a talking heads news channel, organized sportsball, or a Reality TV show. The first I try to ignore (they're usually triangulated on the tabloid newspapers with added eye candy, then dumbed down: as information sources this century, TV news channels are useless). The sportsball I leave to my spouse (who is prone to lecturing me interminably about Manchester City). But the latter phenomenon—Reality TV—has all the grisly attention-grabbing potential of a flaming school bus careening out of control into a public execution: I basically have to leave the room in a hurry to avoid having my eyeballs sucked right out of my head by the visual media equivalent of internet clickbait. (Luckily, my glimpses into this surreal hell-world are usually transient, a side-effect of my spouse channel-hopping between football matches.)

What makes Reality TV shows so addictive?

In one of my previous guest stints on Charlie's blog, I wrote a post about low thrillers and high thrillers. If you don't want to click through and read the whole thing, here's the Twitter version: high thrillers deal with seats of power and show the inner workings of government agencies/other powerful organizations as they deal with large scale dangers like coups d'etat or bio-terrorism, while low thrillers deal with ordinary citizens facing smaller threats, like professional criminals or a serial killer.

Those distinctions were at the front of my mind when I sat down to write One Man: a City of Fallen Gods Novel. I wanted to try an experiment, to create a fantasy that felt huge, but had very small stakes. No Dark Lord. No invading demon army. No impending magical cataclysm.

I wanted to write a story about a nine-year-old girl who gets kidnapped by gangsters because of something stupid her mother did, and about her neighbor--a man bearing many old scars, not all of them visible--who tries to rescue her. That was it. The stakes are one life, an orphaned little girl in a city full of them. A girl with only one person left in the world who cares what happens to her. But, with magic. A fantasy version of a low thriller.

I've got a new book coming out next October 27th. And it's one I haven't said very much about, because it wasn't actually supposed to happen.

So here's a discursive history of events leading up to "Dead Lies Dreaming", and then an explanation of my train-wreck of a schedule (and how I got mugged by an entirely unplanned book).

Specials

Merchandise

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