Thoughts on coronavirus

There wasn’t enough blockchain and healthcare content this week to make a good newsletter, and all anyone is thinking and talking about is coronavirus, so I thought I’d send out some of my thoughts on the situation, and I’ll try to not rehash stuff you would have read elsewhere.

To start I don’t think we have come to terms with the fact that this coronavirus will be in our societies until we develop a vaccine and everyday life will be altered in some way until then, perhaps forever. In the short term cities will lock down. In the medium to long term we’ll see a much greater degree of bio-surveillance as we try to stop this virus and the next one from taking hold ever again. Regardless of the particular policy measures taken this affair will continue to shape our lives for much longer than a two week quarantine.

In the meantime, I wouldn’t focus much on the number of confirmed cases. As testing ramps up we will inevitably start to pick up false positives (and false negatives!) and likely more asymptomatic / mild cases. The more important data points are those that point to the limitations of our healthcare system like the number of people hospitalized, needing ICUs, and that have died. Moreover, the locus of the crisis is quickly shifting from our inability to test people at scale to the woeful state of protective gear for healthcare workers on the frontlines. I suspect that how we handle this next stage will be defined by our ability to produce resources on a short notice.

So far that prospect is not looking good. In an exponentially increasing crisis each action taken, especially in the early stages, can have a massive impact. America’s sclerotic institutions actively made the situation worse by making faulty tests, keeping labs from developing their own, and shutting down researchers. Folks on the right cite regulation as the cause of these failures, folks on the left cite the hollowing of the administrative state. I think both are misplaced given that there was also misinformation spread by the President and various media outlets, self dealing by members of Congress, a general lack of seriousness across society, and similar failures across Europe. The systematic nature of the failure to respond appropriately suggests that there is an underlying malaise afflicting society and our ability to get things done, what some thinkers label as stagnation or decadence. My hope is that when this is all over we take a long and hard look at what went wrong and why, reckon with our failures, and as a result we enter a much needed period of reform and revitalization.

Looking towards the future I expect a shift from the physical to the remote. As one tech entrepreneur put it: remote work, remote education, remote everything (and I would add remote healthcare). The biopharma industry will see a surge in interest and funding as governments seek to mitigate this pandemic and the next. Some sort of government intervention in healthcare is inevitable, but my guess is that the US stops short of universal healthcare. We’ll see new levels of surveillance with mass deployment of wearables and testing to try and catch sick people before they get others sick. Ensuring data is used, but in a way that respects the rights and dignity of people, is one place where blockchain and privacy preserving technologies can be very impactful in the coming years. Lastly on this note the economic fall out and ensuing battles over bailouts and the coming stimulus are going to be very, very painful.

I’ll close with a personal note on my experience in this saga. In January I closely followed developments in China and was disconcerted by how the Chinese deployed the full power of their state to fight the outbreak in Wuhan. That, and some early data, was enough to put me on edge and get me to stock up on food and move out of NYC. At the same time, few others seemed to care and several institutions openly dismissed concerns, so I was left feeling a bit crazy for the dire conclusions I was reaching. This cognitive dissonance led me to decline to publish warnings that I had written instead of doing the work of thinking hard, coming to independent conclusions, and taking responsibility for those conclusions.

To be absolutely clear this isn’t meant to be a reflection about how I was “early,” but instead on how I was in the right position to be early and sound the alarm, but ultimately didn’t in the face of complacent institutions and massively conflicting information in general. That experience has reinforced in me the dire need for critical and independent thinking and a sense that I shouldn’t worry too much about credentialism. I hope that next time around I get it right.

Anyway, this went a bit longer than what I intended it to. Thanks for reading. As always if you have any comments, feedback, or thoughts I’d love to hear them. My guess is that blockchain related news will slow down for some time and I’ve been thinking about what to do with this newsletter if that is the case. Any input is much appreciated!

Stay safe everyone.

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