Sometimes I get a wild idea in my head - actually, I specialize in
that. This week’s wild idea was that I need to learn more about
oscilloscopes. I’ve been working on my electrical
engineering notes and my newly appreciated ignorance about
oscilloscopes was irking me.
Looking online for interesting resources that could educate me about
the topic, I wondered if electrical engineers ever acquire electronics
equipment the most honorable way possible: by making it themselves. I
always found that the best machinists had a lot of tooling that they
had machined themselves.
That sounded awesome. I had to give it a try and I ordered one. My
expectations were reasonable. I figured it had about even chances to
(A) be defective or missing a part, (B) fail because of some ineptitude
on my part, or (C) actually work. At the very least, I expected that I
would get some soldering practice. When it arrived, I set to
practicing!
According to the instructions, a completed unit should look like this.
However what actually showed up was this.
Gulp! Some extreme attention to detail was required to make sure all
the values were thoroughly checked and all components sorted. I
actually used all of the functions on my multimeter for this project,
several for the first time. Just knowing how to test transistors with
my meter was worth $22.
Finally, after a lot meticulous work, I was ready to power it up. I
did the preliminary assembly power checks and they came out good! Wow!
I attached the display and powered it up and it was… iffy. After
playing with it, I had seen it boot properly and sort of work and I
had also seen it act completely rubbish. Hmm.
Carefully studying every connection, I found some dodgy soldering. I
actually did all the resistors and capacitors with my beloved 25 year
old gas powered soldering iron. Unfortunately, its tip was so worn
that it wasn’t doing a great job. After fixing up some of that with a
newer iron I discovered a single lead that I had missed — no solder at
all. Oops. I fixed that and when I subsequently booted it, it came up
fine and worked flawlessly! It was a euphoric feeling to pull off a
correct execution and be so damn lucky.
Ok, cool. I built an oscilloscope. Uh, what now? What do I do with it?
After playing around with it I got the very good idea to hook it up to
a guitar. I just put the probes on one end of a 1/4" patch cable plug — other end on the guitar. Then I was able to see the sound waves.
Amazing! So cool.
In this image you can see I’m holding down the 5th fret (note dot) on
the E string which is an A (E - open, F - 1st fret, F# - 2nd, G - 3rd,
G# - 4th, A - 5th). That A is actually the
A440 pitch
standard described in ISO
16:1975 used to standardize all of music to a certain pitch.
Obviously if my guitar is in tune, the frequency of the sound wave
should be 440. And you can see on the top left that it is reading
Freq: 441.707Hz. You can also get a sense for the amount of voltage
produced by a guitar pickup. Actually I have an unusual
Yamaha
SLG Series and I have no idea how its invisible magic pickups work — with nylon strings no less. But we can see that the voltage while this
note rings goes between 16mV and -20mV, for (presumably) the Vpp (peak
to peak?) of 36mV.
Although this would have been even more fun back when I had enviable
eyesight, I’m still absolutely delighted with this project. I have
learned a lot about a lot of different topics and have added a very
powerful tool to my collection. What a cool little device!
UPDATE 2020-09-20
Having enjoyed that, I looked around for more such fun and found
this signal generator kit.
For only $12, I got to build this thing.
As you can see it does a nice job of giving my oscilloscope something
to do. I think one of the main use cases for a signal generator
(conceptually) is comparing this oscilloscope with a fancier, more
accurate (?) one. But for now I’m just content that it generates
square waves, sine waves, and the triangle waveform shown.
Regular readers may notice a decline in posts about autonomous
vehicles. Rest assured, I’m bringing to light everything interesting
in the field. The problem has been a conspicuous lack of anything
interesting. There are only so many times I can say "They’re doing it
wrong and will fail." But today some PR hype crossed my path that is
actually on the correct trajectory so I wanted to highlight it.
What’s somewhat unnerving to me is that I wonder if any of the people
involved in this project understand why it is the correct approach.
That sounds like a strange and pretentious thing to say, but note how
all the press releases stress the connected aspect of this project;
apparently CAVenue, their marketing name, stands for "connected
autonomous vehicle". Here is their
own
press release saying that.
They seem utterly fixated on the wrong thing. They claim they are
trying to "develop the world’s most sophisticated roadway" but that
can not be true. What they hope to build will ideally be less
sophisticated than any random road. No, I don’t care about the V2V
distractions and great network coverage so people can adore their
phones better. I’m talking about the brains here. Do you think their
roads will match the sophistication of the sum total of human minds
currently required to function on normal roadways? No. They will most
certainly not do that.
But that’s just it. What we need isn’t a more sophisticated road. We
need a less sophisticated road. Look at any of the PR shots of this
thing. What is really going on that is profound and useful is what I
call "idiot driver insulation".
That is the necessary and sufficient requirement to end human driving
completely. We are not waiting on technology. We are waiting to do the
simple things necessary to make the real problem not a problem.
I suspect that this move is shrouded in "connectedness" to distract
the Silicon Valley people while real progress is made.
The
connectedness of vehicles is utterly irrelevant. Weather sensors, a
perfectly good idea, are not essential. Platooning (as shown in the
image) may one day be helpful for many reasons but so might
teleportation. No, the real breakthrough here is simply clearing the
road of idiot drivers.
If you’re following my logic here, then one question should come up:
why not just build a light rail (like the kind my neighbors rightly
complain
about for the wrong reasons)? It is a good question and I think that
the value proposition works today because the physics benefits of
commuter rail are not as heavily leveraged as freight rail where steel
on steel is important to energy budgeting.
I believe that autonomous cars running on a closed single corrider
would still have some advantages. First is better on demand
scheduling; with rail the granularity is an entire passenger car.
Starting and stopping disadvantages rail but is easier for smaller
shuttles and even very small transportation pods. It is also easier to
integrate small freight shipments into the closed corridor. For
example, how would Amazon send a couple of delivery vans down a light
rail corridor? They can’t.
But the huge advantage and why I very much hope this project doesn’t
hype-fizzle away is that this arrangement provides the launch pad for
mixed mode cars. The reason you can’t sleep (alone) in your moving
Tesla (or Cadillac for that matter) is because it is not on one of
these roads. There are no other impediments. When people can choose
a road where they can stop driving completely, I believe they will.
Sure, 99.999% of all other roads require the dangerous and tedious
chore of driving, but if there’s one shining example of how it could
be, maybe people will start to think differently about how every road
might be organized. I certainly hope this will spark some discussion
and thinking about the correct way forward.
If you really want to understand this news you can go back and revisit
my 2016 post where I predict
this exact development. Indeed, although we have finally managed to
claw our way back to exactly where
we
were in 1997, in the world of autonomous vehicles, that is immense
progress. Let us hope we don’t retrogress again.
The bad news is obvious, right? It’s everywhere. Plague! House arrest
for everybody! Great Depression or Greatest Depression Ever?! Riots! A
president who once savagely beat a puppy to death with a golf club.
(Actually, I just made that last one up — but what is worse, that
false "fact" or a president who doesn’t mind citing such flagrantly
false facts? Feel free to make up your own "facts" about the president — he doesn’t care!)
Enough has been said about the bad news. I want to focus on the good
news. Before that can make sense, however, we need to consider the
ugly news — the news that makes no sense and is a muddled mess.
Unfortunately, that has been literally all news about the details of
this pandemic.
The current coronavirus disease, Covid-19, has been called a
once-in-a-century pandemic. But it may also be a once-in-a-century
evidence fiasco.
At a time when everyone needs better information, from disease
modelers and governments to people quarantined or just social
distancing, we lack reliable evidence on how many people have been
infected with SARS-CoV-2 or who continue to become infected. Better
information is needed to guide decisions and actions of monumental
significance and to monitor their impact.
That was back in March. Plenty of time for everybody to start to
figure out what sensible data looks like. And yet, it never came!
Every day there would be some fatuous headlines like these:
Another grand example of terrible data is the CDC. Check out their
CDC COVID Data Tracker.
The default that comes up is "Total Cases". What is so stupid about
this? Imagine a prolific creator of false facts using this "data" to
"manage" the pandemic. First of all one can have fewer "total cases"
by
simply
nerfing testing. But a really accomplished false fact artiste would
say something like, "COVID-19 cures most natural causes of death! Just
look at how the population is thriving under the therapeutic influence
of this wonderful virus. Which was my idea by the way." Go on, look at
that "data" in the CDC chart and tell me how that claim can be
refuted. It can’t.
That’s the ugly news. I feel like I have been watching an endless game
of Numberwang.
But I have seen a glimmer of hope! Let’s turn now to the good news.
Back in March, some rando on the internet — who also happens to be a
faculty member of the University of Cambridge’s Risk and Evidence
Communications unit — wrote a sensible article about
How
much normal risk does Covid represent?
The answer, summarized, was that your risk of dying pretty much
doubled.
The way I would explain that is to imagine playing Russian roulette
with a six-shooter that had two bullets instead of one. If your gun
had 800 chambers (equivalent odds for a normal person in their 30s),
going from 1 bullet to 2 wouldn’t be quite so problematic. Note that
everybody’s gun gets smaller as they age.
My real point there was that article way back in March was the last
example of good data considered sensibly that I have seen during this
entire mess — until today.
I feel too financially insecure to afford The Economist, but I do get
their email newsletter and sometimes their content is not paywalled.
Today they tipped me off to this unusually clear and cogent resource.
Stare at this and soak it in and you’ll understand what is wrong with
all other sources.
The first thing to notice is they’ve cut through the bullshit of
bullshit testing. The last time I saw such a muddled testing situation
was either standardized academic testing or maybe even IQ. Testing
sensibly for Covid pathologies and dangers is even worse than normal
CYA medical diagnostics. This data from The Economist understands that
and moves on to what can be sensibly inferred about the situation.
If we stop and ask ourselves what we care about, number one on the
list is not getting killed. So The Economist asks the simple question,
are we getting killed more than normal? Don’t worry about why. It
could be people dying of asbestosis because masks are hard to acquire
for construction work. Doesn’t matter. Step one is to answer the
question - is there a problem? And The Economist’s methodology is so
simple that it’s actually plausible. They simply look at how many
people used to die and how many people are dying now and see how/if
that has changed.
That’s so simple, but really it is a relief to me that someone is
looking at this in a way that is not deeply flawed to the point of
being meaningless. They even have a
nice
Github repo with all their data and scripts if you’d like to quibble
with their methodological details. (For example, I would make minor
adjustments based on
natural
changes of population, but really, not strictly necessary to
appreciate these numbers as better than anything we’ve seen thus far.)
It is "good" news in the sense that it is of good quality. It is also
good in the sense that it looks pretty good. I am not terrified by
this data.
At first I misunderstood the "Absolute" setting on the graphs to mean
they were like the fatuous CDC data. But really this data is much
more useful. It is not showing absolute deaths - which no one really
cares about. It is highlighting the validity of testing statistics.
The difference in Covid-19 attributed deaths and real deaths is
directly measuring the effectiveness of the testing programs. They are
frankly not as abysmal as I thought — though I live in NY where, like
NJ, Spain, Holland, Italy, and non-WEIRD nations, it is pretty
abysmal.
It’s interesting to note the negative rates after the spike. The
article cautions that some of this more recent data may just reflect
reporting lag. My intuition is that many victims were probably close
to death anyway and there were less people to die in June if they had
their exit schedule moved up to May.
Reports
of a "second wave" seem pretty overblown. Again, could be reporting
lag, but this data isn’t terrifying me. It’s looking like people got
sick, like they do when something is going around. All the vulnerable
and unlucky people got it, and it doesn’t really have much more room
to cause trouble. That could be a very wrong guess, but this data,
real actual data that is not meaningless, is in no way contradicting
that assessment.
I’m actually pretty impressed that a lot of states really are not
seeing anything like what New York and New Jersey saw. Look at
Wisconsin or Idaho or Missouri.
I would actually say that the danger for them is
greater. It’s greater because to my thinking they have not had the
full force of the pandemic come and hit their vulnerable populations
yet.
One could make the case that this shows that protective measures,
lockdowns, and hygiene theater are working. I’m not sure if there is
enough data for that by, say, comparing Sweden with Switzerland. But
this kind of data could tell us exactly what works. It’s not testing
as I had previously imagined. Testing is almost as elusive as a
vaccine; let’s just rule sensible tests out and focus on real and
obvious effects.
What really works is simply tracking deaths promptly and accurately
like any 21st century society should be doing anyway. With sensibly
tracked deaths, accurate studies to gauge the efficacy of various
measures are actually plausible, even using "natural" experiments with
different sides of the state line doing different things. It would be
really helpful to see these plots with the same plots superimposed
from other flu seasons and outbreaks.
As one of the early adopters of Covid-19 I can tell you that if you
get it, it’s no picnic. (I am feeling a bit better than last month,
thanks.) But this data is not only good in the sense of not being
stupid; it’s good because it doesn’t show an impending apocalypse.
It’s exactly data like this that we need.
UPDATE 2020-08-10
A perceptive reader sent me this NYT article from late May:
Putting
The Risk Of Covid-19 In Perspective. It tries to focus on the
comparative risk side of things. That would be valuable and correct if
there was sufficient data to support such aspirations. Note what this
article uses for data.
Using data from the [CDC], New York City experienced approximately
24,000 excess deaths from March 15 to May 9, when the pandemic was
peaking.
…
…using the C.D.C. data, Michigan had approximately 6,200 excess
deaths during this same time period.
Note he’s not comparing those directly but using excess deaths — the
only metric we really have right now — to go on to put the risks into
perspective. Excess deaths is finally some data that makes sense.
Although bad haircuts are a widespread side effect of the current
pandemic, it is not hard to recognize this guy even with a mask on.
That of course is a guy who is famous for three things (besides his
hair). The third is being prime minister of the UK and the second is
being a famous Brexit wanker. But his most famous fame is being one of
the most notorious victims of COVID-19. Whatever your feelings about
him, I think we can all agree that Boris Johnson was hospitalized in
mid-April because of a severe case of COVID-19. So here’s what I want
to know.
Besides privacy/anonymity, masks can have two functional objectives.
The first one, the normal and obvious one, is to keep bad stuff away
from you, like when you’re sanding fiberglass. Interestingly, in
pandemic times, this is not why masks are encouraged. For airborne
disease control the idea of masks is a second objective, keeping
the wearer from expelling and spreading infectious particles.
Are we worried that The Right Honourable Mr Johnson is a threat to our
health? Are we worried that he will spread some infectious agent that
will inflame the pandemic? Do we think that two months after suffering
the most unambiguous case of COVID-19 possible that he is still an
infectious threat?
Or, is Mr. Johnson looking to the first function of protective masks
and trying to keep himself from getting infected again with C19?
Either way, I would suggest that if this strategic thinking is valid,
we are into some serious zombie apocalypse scenario.
Of course I bring this famous case up to highlight one of the most
obscure cases of COVID-19 — mine.
It turns out that I’m not too fond of wearing masks even when sanding
fiberglass (though I do my best to do so). But having to wear a mask
in the limited public outings I’ve had in the last 4 months has been
especially tiresome. Why? Because it impedes breathing. Not a problem
for a high volume athletic oxygen furnace like me, right? Not so much
these days.
I’m still cycling about 100km a week but I can feel the damage. I had
mentioned reduced circulation in my
shins but that was really just the most noticeable problem. I’ve done
a lot of work to strengthen my shins and they feel ok today but still
not full strength. But as in December there has been a wave of
problems targeting many different subsystems, just much more mild.
Right now my thighs are covered in bruises, both left and right — I
have no idea why. Last week I had unnatural leg muscle pain for no
explainable reason. When I wake up in the morning my arms tingle with
paresthesia (aka limbs
"falling asleep"). I also have an ear infection, just like I did at
the end of my illness previously, but other ear now; the second ear
infection of my life. And my breathing is not at full strength. I can
become winded just climbing the stairs. When riding I can feel the
loss of capacity. I’ve been saying that it feels like I’m living at
2000m or 3000m, depending on the day — about the altitude of
HAPE, a
mountaineering sickness, which has some very similar symptoms to C19.
It’s all pretty tiring.
Is this weakness half a year later scarring of some kind? Nerve
damage? Vasculature damage? Immune system weakened? More live C19
virus attack? Reinfection? Hard to say.
That’s my current situation — there are indeed long term effects.
What can we do about it? Probably nothing for me personally, but for
humans in general there are many different strategic approaches to
defeating this disease. Let’s review my tiny opinions about each of
them.
The first is a vaccine. To which I say good fucking luck. You can have
no more than two of the following: developed soon; works; safe.
This
sensible article from a former CDC epidemiologist calls out all kinds
of problems with the hope for a magic cure any time soon.
It highlights a
phenomenon known as antibody-dependent enhancement which…
…causes some vaccine recipients, who nevertheless become infected by
exposure to a pathogen, paradoxically to have more severe illness than
if they had not been vaccinated at all. ADE has been observed for
coronavirus vaccines in monkeys, pigs, cats, and in cultured human
cells. It was also observed in children after a trial of a respiratory
syncytial virus vaccine and after a mass campaign of a licensed dengue
virus vaccine given to 830,000 children in the Philippines, resulting
in withdrawal of the vaccine."
I just can’t help but think that the vaccine hope is a form of wishful
thinking similar to "pharma is not predatory and these magic beans will
magically cure my lifetime of poor lifestyle choices".
At this point C19 is a real pain in the ass, but so is HIV and ebola
(actually now has a
brand
new vaccine after only 44 years!) and a lot of other diseases; why
not come up with cures for them too? Because it is very hard to do and
considerable luck is required.
What about "contact tracing"? Good idea, right? I side with Bruce
Schneier
who says correctly it is "just plain dumb". And he’s not even
introducing any privacy concerns to the discussion. I like this barb
at gormless Silicon Valley tech bros for their typical banality when
solving any problem (Ans: a telephone app?). "To me, it’s just techies
doing techie things because they don’t know what else to do."
Australia’s experience is what I would expect:
How
did the Covidsafe app go from being vital to almost irrelevant?
What’s sad to me is that contact tracing is close to the right answer.
This pandemic is not really a medical problem any more. It is
an industrial
engineering problem. Unfortunately the world’s industrial engineers
are restrained in obscurity thanks to a terrible name for their
profession. It has been extremely frustrating to see the terrible ad
hoc industrial engineering popping up everywhere in response to The
Virus. Suffering the virus itself was only slightly more demoralizing
than the constant stream of fatuous reports featuring numbers of new
cases lacking base rates! But a sensible application of some serious
industrial engineering could cure this pandemic in a few weeks.
Because very few people understand this, it will not happen. (I am
delighted with the I.E. consolation prize — that this virus forced
major grocery store chains to use single feeder lines. Yay! Should
have done that decades ago!)
One problem that severely impacts the aforementioned industrial
engineering cure is testing. Testing, if quick, accurate, and
effective enough would itself essentially be a cure without fancy
industrial engineering heroics. But it’s neither fast nor accurate,
and thus not effective. People keep asking me, "Don’t you want to know
if you have it?" Well, my symptoms were enough of a red flag
positive test for me, but of course I’d love for some simplistic magic
test to tell me something useful about this disease. But I have no
faith in such things. I’ve seen all kinds of health security theater
going on and these tests seem fraught with complexity.
This
resource is very expansive and hints at the diverse problems someone
taking "testing" seriously will encounter. Tack onto that living in
the medical third world and I’m not too keen to try my luck — you
only need to read the title of this article to appreciate my
misgivings:
Two
Friends in Texas Were Tested for Coronavirus. One Bill Was $199. The
Other? $6,408.
Earlier some people were thinking that the warmer weather would tamp
down the virus. That’s obviously not actually happening. People are
out more, the dumb ones at political rallies even. Even if hot weather
was helpful, it’s looking pretty strongly like air conditioning is not
great for controlling the virus. When the AC industry lobby
is
worried about that we probably all should be.
How will this pandemic end? Consider the difference between these two
scenarios:
A. The disease is running amok and no one realizes there’s a problem.
B. People are aware there is a virulent disease that is quite deadly
to a certain demographic.
It is possible that all the reduction we’re seeing is because we once
had A and now we have B. I think that has been the single biggest
factor in controlling things. My money is still on luck mysteriously
causing this to simply go away for reasons that medical research will
be too underfunded to understand. Like previous pandemics! At some
point we will run out of susceptible potential victims.
One final interesting therapeutic approach is transfusions of
antibody-rich blood plasma from COVID-19 survivors to inoculate
against the disease.
This
article claims it is promising but mired in regulatory friction. I
can’t say if that’s a sensible idea or not. But it does make me
wonder… Who knows, maybe it might be smart for uninfected people to
inhale deeply in the unmasked presence of strong antiviral producers
like Boris Johnson. And me.
In summary, progress since January 2020 has been impressive, but there
is still so much more to learn. Are T cells protective and if so which
are the key antigens and and cytokine effector programs to focus
on? Are all T cell responses beneficial, or are some contributory to
immunopathology and to be avoided? If it is indeed the case that
antibodies are transient and T cell memory is more durable (though,
how durable?), what can we learn about anomalies of T follicular
helper-B cell interactions in germinal centers? In the short to medium
term, we need to ensure that all of this T cell toolkit and knowledge
is brought to bear on robust, comparative evaluation of the different
vaccine platforms, their immunogenicity, efficacy and safety. Entering
the next part of the battle, there are many thousands of people
suffering the chronic aftermath of infection posed by chronic,
so-called long-COVID cases, characterized by diverse symptoms
including fatigue, joint pain and dyspnea. A more detailed
understanding of the T cell immunology will be valuable in deciphering
this pathogenesis.
At the start of the pandemic, a key mantra was that we needed the
game-changer of antibody data to understand who had been infected and
how many were protected. As we have learnt more about this challenging
infection, it’s time to admit that we really need the T cell data too.
I’m citing this paper as a thoughtful excellent contribution to the
topic. It is basically saying that simplistic thinking about the
immune system is wrong. And I believe that sentiment is absolutely
correct. But note the "and and" [sic] in the second sentence. My
writing isn’t grammatical perfection but I’m not published in fancy
scientific journals, i.e. peer reviewed and professionally edited. I
don’t mean to carp but rather point out that we humans are fallible
and even in the field of immunology, mistakes are made. Perhaps
especially in that field? My point is that if we get a miracle cure
it will indeed be a miracle.
UPDATE 2020-07-19
Some industrial engineering heroics finally shambling into action.
It’s been very painful for me to watch this not happen for so long.
Trump
admin allows group Covid-19 testing.
UPDATE 2020-07-28
This short article asks,
Can you get the
coronavirus twice? They seem to conclude that it is possible but
unlikely. They correctly make the logical conclusions echoing my
concerns about the topic.
If [reinfection] can occur, that could undermine the idea of "immunity
passports" for returning back to workplaces. And it would not bode
well for hopes of getting a long-lasting vaccine.
Again, to summarize - either I have nothing to worry about personally
or we’re all screwed.
UPDATE 2020-08-03
Still unclear about what an industrial engineering solution looks like?
Here’s an example of the kind of thing that seems obvious to me but
which has been clumsily avoided throughout this ordeal.
We construct network measures of nursing home connectedness and
estimate that nursing homes have, on average, connections with 15
other facilities. Controlling for demographic and other factors, a
home’s staff-network connections and its centrality within the greater
network strongly predict COVID-19 cases.
This is about as gentle of an introduction to practical immunology as
it gets and clearly addresses things I’ve been wondering about.
In one sentence he hits upon the conundrum I’ve highlighted.
…concerns that people could be infected repeatedly, or even that a
vaccine — many of which work by readying neutralizing antibodies — won’t provide long-term protection.
In other words, either people can’t get reinfected (well, easily
anyway) or vaccines are not as useful as people imagine — one of the
two, pick one. While that simple analysis is simple and not completely
invalid, Yong does rightly spend the majority of the article correctly
emphasizing that when it comes to immunology,
it’s complicated.
"Researchers have yet to find unambiguous evidence that coronavirus
reinfections are occurring…"
My hypothesis here is that this disease affects people for a longer
time than usual and can look like multiple infections as a result.
"This calls for some optimism about herd immunity, and potentially a
vaccine."
It also makes me optimistic about personally avoiding the
mystery preservatives
found in vaccines. Of course the article did not even think to mention
the fate of the zillions of people who have recovered — can we carry
on with life now? Feel free to ask me to help deliver groceries to
vulnerable populations. Etc. But no. That will go uncontemplated.
Some precise number of days (which I know but will redact) before I
turned 18, I know exactly where I was and what I was doing. That is
because I could not quite legally gamble, yet I was in a casino in Las
Vegas. On Christmas Day. I was doing a family thing for family
connections that lived in Las Vegas. Visiting a casino on such a
strange day is just something one can do if you don’t take traditional
holidays too seriously and you happen to be in town coincidentally.
What single adjective would I use to describe the Las Vegas casinos on
Christmas Day? Answer: Chinese. That was a while back, but I doubt
things are too much different today. Think about it. Normal
Christmas-celebrating Americans wouldn’t usually think to go to Vegas
on such an incompatible major holiday. But it would be reasonable for
normal Chinese people to happily take up the slack and cheap rates.
In 2019, exactly 8 days after flying and spending the day in airports
(SAN, PHX, BUF — LAS on the way out!), I record my first written
description of the illness that dominated my life this past winter.
What day did I travel? November 28 - Thanksgiving Day. A day I chose
because the rates (and I) were cheap — Americans do not like to
travel the entirety of Thanksgiving Day. I have no idea if this is
truly relevant, but it is certainly interesting to think about.
You know how my blog posts often maddeningly change topics a few
paragraphs in? The change often looks like a radical departure, but I
do actually try to keep a thematic strand connecting them. So here we
go.
The immune response to a virus starts with infected cells producing a
suite of signalling molecules called cytokines. Some of these tell
other cells nearby to be on their guard against attack, thus stymying
the virus’s ability to replicate itself. Others tell the immune system
to come and put some stick about. Thus called to arms, the immune
system launches both a prompt all-purpose response—inflammation—and
a subsequent targeted counter-attack using antibodies and cells
specifically programmed to attack both virus particles and the cells
they have infected. Unfortunately SARS-CoV-2 seems able to interfere
with the early steps of the immune response. It can apparently
counteract the part that dampens replication in nearby cells. It may
also enhance inflammation.
…
When inflammation gets completely out of control the body enters what
is called a cytokine storm. Such storms drive the most severe
outcomes for covid-19, including multi-organ failure.
Now take a look at this birthday greeting I wrote to a friend and
former colleague who is a computational biophysics researcher and
professor of pharmacology.
2019-12-29
I’m still struggling to get to my next birthday, still under attack by
some kind of pathogen. … I’ve never had an illness like this as an
adult. My guess is that it is a flu virus but it could be bacterial. I
feel like it went from my lungs to my major meat muscles. Each day I’d
get a new thing. For example, one day my tibialis anterior was hit
with what runners call "shin splints". I’m very familiar with muscle
pain from muscle wear and tear but it’s unnerving when there is no
sensible cause. I set up a bike inside and riding that helped my leg
muscles a lot. I think the main infection is mostly defeated and
controlling secondary infections is indeed the important thing. I lost
a lot of weight so I’m trying to eat as much as possible. That’s not
easy since I have very little appetite. I’m also wondering if maybe my
body is doing some silly overreacting, something like a cytokine
storm. Of course, as you know, at that level it all becomes
overwhelmingly complex.
Reviewing these emails has helped
me put together some other pieces of the puzzle. All spring long I’ve
been cold. Especially my shins. I moved a down sleeping bag to my
office to put on my shins thinking I was blocking a draft or
something. I crawled around to see if a fan from a computer on the
floor was blowing on my legs. I changed things around with my seating
arrangements thinking maybe my circulation was being constrained by my
chair making me cold (circulation problems are synonymous to me with
being cold — and, yes, I
am an expert). Then a few weeks ago the weather went from cool to
insanely hot (90F/32C) overnight. My shins were still cold.
That was an "oh shit" moment for sure. My illness has really messed
up my shins apparently. I am now aggressively rebuilding my shin
muscles. Now that I’m focusing on them it’s clear, they’re not right
at all. I’m a little nervous about other lasting damage. I’m sleeping
about 30 minutes to an hour longer each day than I did at the same
time last year (I always sleep the maximum amount my body will let
me).
But I feel mostly ok. I have a near comically healthy lifestyle — if
anyone is going to shake off problems that can be shaken off, it will
be me. The excellent Ed Yong (whose book
I reviewed) has
a
very interesting article in the Atlantic; it is the first I have seen
which has been properly sympathetic to the brutal hardships of
symptomatic survivors. The article is very scary because of this and
strong hints of long term effects. You can see why I’m taking this all
kind of seriously. And even though the
infallible
apolitical CDC has assured me — by fiat — that I did not suffer
covid 19 because they did not notice the infection, I’m going to pay
attention to covid 19 data and assume it is relevant for the
functionally identical illness I did have.
