Friday, April 3, 2020

About that Big-City Marathon You're Planning to Run this Fall...

After things got bad with COVID-19 in early March, lots or big races, from the Boston Marathon to the Bolder Boulder, and even lots of little races, such as my hometown marathon, the Run Through Time in Salida, decided to reschedule for fall. Because it clearly wasn’t safe to move ahead with these races in spring, and, well, surely all this will have blown over by fall. Right?

As we progress further into this pandemic, that last point is starting to look murkier. The reality is that no one really knows what the end game is for COVID-19 in the United States, apart from a vaccine or similarly effective treatment to stop it. And we know that those types of measures invariably take at least 12 to 18 months to implement.

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Which raises the question for runners, what happens to racing after all these shelter in place orders are lifted? What happens this summer and this fall?

This fall, in the United States, we probably (hopefully?) won’t all be on full lock down like we are now, with government orders canceling school and arresting preachers for having services (and rightly so).

But will things be back to normal?

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Most of the smart policy research that’s being done right now is suggesting that it’s probable that we’re in for an extended period with a middle phase of this crisis, where you’re able to get a haircut and grab a hot dog in a restaurant, but where big gatherings and large public events are still not allowed. The paper I linked to above, which was produced by a think-tank with close ties to the current administration, suggests that the limit for public gatherings during this intermediate period should be no more than 50 people.

According to this paper:

Once a robust surveillance sentinel system is in place, coupled with widespread point-of-care testing and a robust ability to implement tracing, isolation, and quarantines—and this is supported by the availability of therapeutics that can help mitigate the risk of spread or reduce serious outcomes in those with infections—or alternatively a vaccine has been developed and tested for safety and efficacy, we can enter Phase III.

According to this paper, Phase I is the lockdown, where most of the country is now. Phase II is the intermediate phase where restaurants and schools open but large gatherings are still prohibited. Phase III is when we can have large public gatherings again.

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As of yesterday, 12 states still didn’t have shelter-in-place orders. For those states, Phase I has not yet even begun. Some well-populated states, such as Arizona and Florida, just started in the last few days. That means that the clock hasn’t even started ticking in much of the country where we can reasonably expect progress toward recovery.

If Phase I hasn’t begun, we can’t begin to move toward Phase II (which is expected to start about 40 days on average after effective implementation of Phase I). And if we can’t begin to move toward Phase II, it’s hard to envision a realistic time frame for a progression to Phase III.

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This paper says that for the US to fully re-open for business, we either need a functional vaccine, or we need an effective system of track and trace, where every person who has the virus can be identified and separated from the rest of the population. But the kind of aggressive track-and-trace measures it proposes, the ones that have proven very effective in Taiwan, Singapore, and South Korea, haven’t even begun to happen in the US (or in Europe)—and now that the crisis is so widespread, it’s hard to imagine how they can happen now.

To give one example of what this might look like, in Taiwan, starting in January, all persons traveling from abroad were isolated and quarantined for 14 days. Those persons were tracked by GPS to ensure that those orders were followed. And if you were caught breaking the rules of those quarantines, as was the case with one Taiwanese man who decided to go clubbing while under quarantine, the penalties were severe—the equivalent of a $30,000 fine for a single offense.

That may seem draconian, but it was also very effective. Taiwan got its first case long before the US did. But Taiwan, a densely populated country immediately adjacent to China, where it all started, now has 339 confirmed cases. Taiwan’s bars and restaurants are open. If you haven’t tested positive of COVID-19 or traveled abroad recently, life is normal there.

The United States, on the other side of the world, now has well over 250,000 confirmed cases (which probably understates the real number of cases by 5x). That number is double from what it was five days ago. It’ll probably double again in another six days. And again in another week. We’ll be in the millions of confirmed cases in April, almost certainly. The only question at this point is how many millions of Americans are going to get COVID-19.

Now, with the sheer number of cases nationwide, a national track-and-trace system along the lines of what worked in Singapore, Taiwan, or South Korea—what’s necessary to move to Phase III of the crisis, to allow us to have public gatherings—may not be feasible.

All that’s to say, unless there is the strongest of strong seasonality to this virus, this isn’t going away any time soon. You don’t go from millions of cases of a virus to zero overnight. It’s going to take months, if not years, to take that number back down to the low numbers of thousands.

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And the problem with that is, even if and when we do manage to get this thing down to the low numbers of thousands, rather than the millions, unless we have a bulletproof track-and-trace system, large public gatherings are still going to be a very bad idea.

Here is a chart with a model of how large public gatherings lead to the spread of the disease.

Reading this chart, it is readily apparent why, even in a situation where there are only a few thousand cases of this virus nationwide, large public gatherings won’t be possible. If there are only 20,000 people with the virus nation-wide and you hold a race with a mere 2,000 people, there’s about a 10% chance that someone will catch the virus at your race. In a situation where 200,000 people nationwide have the virus and you hold a race with 25,000 people, spreading the virus at your race is essentially a mathematical certainty—and there’s a chance that a single race could lead to a new nationwide outbreak. That’s also true of any concert, any stadium event, or any other major gathering.

So yeah, all that’s to say that the odds of your big-city marathon happening this year are becoming vanishingly remote.

The only way these races will happen is if: 1) seasonality eradicates the virus over the summer, and the fall season doesn’t lead to a re-occurrence or 2) if our government develops a totally effective track-and-trace system that is capable of completely removing from the general public all instances of the virus—even those cases that are asymptomatic.

Option 1 isn’t likely, because seasonality in viruses—even if it is a thing for COVID-19—is almost never that strong; Option 2 doesn’t seem likely, because, well, nothing about this government (or the British government, or the French government, or the Spanish government) has shown that it has the vision and administrative capacity to handle such a task (which, at this point, given the sheer breadth and scope of the pandemic, would be a challenge for any administration).

Which means I wouldn’t sweat your training too much for the Fall Boston Marathon. Or Chicago. Or London. They’re probably not going to happen. At least not in the traditional sense with tens of thousands of humans lining up next to each other for a real, in-person race.

In fact, there’s a decent chance that even my hometown Salida’s Run Through Time Marathon, with its mere 350 participants, won’t happen on October 11th. With more than a million people likely to be infected with COVID-19 in this country in a matter of weeks, even that small of a race might prove too ambitious in scope, even five months down the road.

4 comments:

  1. Your science doesn't stand a chance against the money of big sports!

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    Replies
    1. A few bucks to be made in the NCAA tournament, the NBA season, MLB, Champions League soccer, Wimbledon, and the Olympics. How'd things work out for all of them?

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  2. Good point, though those are all chump change compared to the NFL and college football. I'll bet you a slice of pizza that I get to use my Chicago marathon entry this year?

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    Replies
    1. I'll bet you the whole damned pizza you're not lining up at a full-on, traditional, big-city 30,000 person marathon in 2020.

      Virtual races and other shenanigans don't count.

      Delete