Seeing the big picture: how to think about the pandemic and predict what’s next

Those readers who have followed us since our early coverage of the SARS-CoV-2 outbreak in Wuhan, China, know that The Prepared has consistently predicted the twists and turns of this pandemic. Our blog has been ahead of many stories, and our detailed COVID-19 scenario guide has accurately outlined how various aspects of the pandemic would unfold.

As the editor responsible for anticipating what comes next with the pandemic, I want to share the mental model I’ve developed—and continue to refine—to understand where we are and where we might be heading.

There’s no secret formula here. Anyone can do what I’m doing if they’re willing to invest time and effort. It’s a simple set of guidelines, attitudes, and assumptions, combined with constant reading, discussion, debate, and reflection.

Attitudes and Methods

My guiding principle is to pay close attention to experts so I can update my basic assumptions about the virus and its spread. I follow these experts on Twitter and check their updates regularly. Many of them also contribute to The Prepared, and I often consult them when new information emerges.

The second most important thing I do is stick to my mental models, regardless of what any particular group or crowd says at any given moment.

I see too many smart people get sidetracked by political bias when thinking about the pandemic. If their ideological opponents (the media, the left, the right, etc.) say something about the virus, they feel compelled to say the opposite. Even experts fall into this trap. So I factor political bias into my thinking in two ways:

  1. I actively monitor my own thinking for this tendency. I must be comfortable agreeing with facts from people whose views I otherwise find repulsive, even if it costs me socially. Likewise, I must be ready to tell people I usually agree with, “You're all wrong, and these others are right.”
  2. I do due diligence on the experts I follow, so I can gauge whether they are prone to bias. If they are, I adjust my evaluation of their work accordingly. I don’t dismiss what they say, but I take their biases into account.

I take it as a given that mathematical models are largely useless for predicting the future of the pandemic. I've spent a lot of time tracking these models, and I've learned they’re best ignored. Here's why:

  • Like weather forecasts, the further out you go, the less accurate they become. The best models are only useful a few days ahead. By two weeks, the error margins are too large to be meaningful.
  • The virus spreads based on human behavior, which is inherently unpredictable.

Models have done more harm than good. They’ve convinced the public that experts are clueless and institutions untrustworthy. These models should have been downplayed from the start.

Finally, I always keep in mind that random chance plays a big role in how and when outbreaks occur, and how severe they become. There's a lot of randomness in the timing of outbreaks—when they start, when they accelerate, and how badly different places are hit. Not every city is affected at the same time, and some are hit much harder than others. So you can't look at a population and say, “These people will definitely be hit hard in the next six months.” Maybe they will, maybe they won’t.

How to Think About the Pandemic

My evolving mental model of the pandemic has three parts:

The virus (SARS-CoV-2) and disease (COVID-19): Factors like fatality rate, transmission methods, incubation period, asymptomatic spread, hospitalization duration, and symptoms.

The population: Characteristics of a specific population in a given area that make it more or less vulnerable. This includes age distribution and prevalence of chronic conditions.

The society: Social factors such as government policies, mask mandates, compliance with distancing rules, and other institutional and behavioral elements that affect the pandemic.

The pandemic isn’t just a biological event—it’s the interaction of these three elements in different ways.

I have my own internal understanding of each of these aspects, and I don’t change it without strong, persuasive evidence. Again, I don’t let what others I agree with say influence me. I stick to my understanding and adjust it carefully.

Now I’ll go into each part in detail.

The Virus and Disease

Here’s what I currently believe about the virus.

SARS-CoV-2 is a novel coronavirus. It may seem obvious, but this virus is new to humans, so we have no natural immunity. Before a vaccine, the only way to gain immunity is to catch it and recover.

It spreads mainly through shared air pockets. Transmission occurs mostly when someone is indoors with others. Surfaces and lingering aerosols also play a role, but the main route is indoor exposure.

Outdoors is mostly safe, unless you’re crowded and shouting or singing. This is the flip side of the primary mode of transmission.

We are far from herd immunity, which is estimated at around 60% attack rate. People argue about T-cell cross-immunity and other factors. While there's some evidence, I still think claims of herd immunity at 20% are wishful thinking.

The virus spreads unless we intervene. It doesn’t "get tired" or stop on its own. Some theories suggest it peaks at 40 days, but I don’t believe that. Without intervention, it will keep spreading.

The virus stops spreading when we change our behavior. Lockdowns and masks do matter. Some people deny this, but behavior has a huge impact.

Most spread happens asymptomatically or presymptomatically. People transmit the virus before showing symptoms or without ever showing any.

The virus has a low dispersion factor. Most people who get infected don’t spread it. Only about 20% do. This means transmission chains are fragile and easy to break with social distancing.

For example: Imagine a church with 1,000 members. If 100 catch the virus, and only 20 are contagious, then only 20 need to stay home to prevent further spread.

Masks help, but they’re not a silver bullet. I’ve supported masks from the start, but they aren’t enough on their own. Masking and distancing together are needed.

COVID-19 is far deadlier than seasonal flu. We’ve consistently reported a 1% fatality rate in representative populations. Flu fatality rates are lower, but they’re not measured the same way.

Death rates are heavily age-dependent. What matters is the average age of the infected population, not the overall fatality rate.

COVID-19 causes long-term damage. Unlike the flu, it can leave lasting effects, including lung damage and other complications.

The Population

Some regions have younger, healthier populations, while others are older with higher comorbidities. I expect fewer deaths in areas with younger demographics and better health profiles. In contrast, places with older populations will likely face graver outcomes.

I try to consider local demographics when assessing how the pandemic might evolve in different regions.

The Society

People tend to gather in enclosed spaces unless prevented. Unless we actively enforce distancing, people will return to crowded environments and risk transmission.

Many people ignore the threat until it affects them directly. Until they know someone who gets sick or dies, they often dismiss the danger.

People eventually change behavior when they see the real impact. Once they experience the virus firsthand, they take precautions.

Government actions matter, but they’re not the only factor. Policies can influence behavior, but people ultimately decide how to act based on their own experiences and fears.

Data is unreliable. Case counts, death tolls, and hospitalizations are often misleading. Numbers are delayed, manipulated, or inconsistent. I remain skeptical but watch closely.

Unpredictable consequences will arise. Protests, economic shifts, and social unrest are already linked to the pandemic. More surprises are on the way.

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