Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here.
Last week, the NYT reported on a private conference that tried very hard to be Covid-safe but failed.
A technology executive in California has apologized for hosting a conference in Culver City after which two dozen attendees and staff members at the event tested positive for the coronavirus.
The executive, Peter H. Diamandis, was among those who contracted the coronavirus. He hosted the conference — an annual summit for a paid-membership group called Abundance 360 — indoors in late January, with a total of about 80 attendees, panelists and members of the support staff.
The gathering flouted guidance from public health officials in Los Angeles County, who had repeatedly urged people to avoid excess travel or public mingling. At the time of the conference, Southern California was just coming down from a surge in coronavirus cases, and many hospitals were still overwhelmed.
The virus got in and spread. Because this was a gathering that appeared to violate various guidelines and laws, this outcome is certainly not pretty. But I am conscious that we are hearing about it only because things went wrong. As someone who is interested in knowing whether measures to hold safe events can work, laws and guidelines often prevent those things from occurring so we can actually find out. Given that we know about this, what can we learn from it?
Any information regarding the practices put in place has to be taken with a grain of salt due to the law-skirting nature of all of this. However, in a blog post, Diamandis does provide details and it is instructive to note them. I am also interested in Diamandis’ conclusion:
The bottom line is that I am sincerely and deeply sorry for the consequences of the choices we made. As a scientist, engineer and medical person, I believed we were using the very best that science had to offer. And I trusted that an immunity bubble was a “real thing”.
I no longer believe that.
In other words, if asked, Diamandis believes that such events should not be held even when considerable precautions are taken. Let’s be clear. This is a financially lucrative event with hosting people who you want to please. From an economics standpoint, I don’t believe that Diamandis was poorly motivated to protect participants. Exactly the opposite. That he failed given those incentives is also instructive.
What precautions did Diamandis take?
Pre-arrival Tests: everyone had to be tested negative according to a PCR test, within 3 days before the event. (It is not clear if support staff had this requirement).
Arrival Tests: everyone (attendees and staff) were all tested again on arrival with two swabs for additional confirmation.
During Tests: everyone was tested again every morning of the four-day event.
Masks were asked for but not required. It seems that support staff adhered to this more than others.
Doctors: 4(!) licensed doctors were on premises at all time. I am not sure what that means exactly as that seems a lot for 80 people.
Drugs: they provided various things to boost immunity.
Step 1 actually caught one person prior to arrival. Steps 2 and 3 meant that everyone was tested 5 times over 4 days. But these were PCR tests not rapid antigen tests. That, I believe, may have mattered.
In the end, half of the attendees, the ‘faculty’ and the support staff contracted Covid-19. The AV team was spared which Diamandis concludes was because they wore masks but it could easily have been that they were always in the larger, potentially better-ventilated space, and behind barriers as often AV staff are.
Let’s face it, that was a decent amount of precautions taken. So how did the virus get in? There were 80 people all told at the event. One person was picked up by the testing before it and then another one got in. It seems that person may have been a staff member. In all likelihood, that person had just contracted the virus but became infectious during the event. But, interestingly, was not picked up by subsequent tests. Diamandis thinks the tests were to blame:
In fact, further investigation into testing has revealed even more curious and concerning data. Once it was clear that I personally had contracted COVID-19 (which sucks as much as everyone says it does), I tested myself with Rapid PCR and Rapid Antigen every day, twice per day, for several consecutive days. I was flabbergasted that NONE of the tests turned up positive. I was consistently negative. Four days into my quarantine, I finally tested positive on a PCR “Spit Test” that measures viral load. I was told I was “highly infectious."
It could be that the rapid PCR tests were flawed in some way. But they seem to be very flawed which makes me suspicious that something wasn’t being done properly in a systematic way. Basically, the false-negative rate would have been unprecedented for any testing. Had antigen screening also been used that would have added diversity and also self-assessment to the mix. It would have picked up people immediately rather than sometime later. Diamandis says he tested himself. But what does that mean? On a plain reading, it means he wasn’t doing it properly. It is very rare to have false negatives at all when you are symptomatic.
There is another reading of all of this. That, in fact, the event was exceptionally unlucky. There is no such thing as a perfect bubble. It is always the case that an infected person could get through. It is just that you want to be in a position to move them and their contacts from harm’s way quickly. That is why these methods are good for on-going work environments rather than once-off events.
But, overall 2 out of 80 people were infected or 2.5%. In late January, Santa Monica (where the event was held) had about 4,000 cases per 100,000 people or 4%. But most of those were in the latter half of their infection. Thus, the overall prevalence of infectious people would be more like 1%. In other words, having 2 in 80 was a higher than expected rate especially conditional on testing. It could easily have been the case that no one infected got through their system.
Importantly, and it is hard to assess this, it may well have been that the system worked in an important sense — the 30 people who were infected with Covid-19 knew about it relatively quickly and, therefore, could well have prevented those infections being transmitted to others. That is the point of testing — to break chains in transmission. We don’t know if this is the case because, again, the whole under-ground nature of this precludes good information being collected. But this may have been a potential super-spreading event that didn’t become one.
I don’t think the take-a-way necessarily is that, if the cause is important enough, it is impossible to have a relatively safe event. Instead, it is that there is no such thing as a perfectly safe event and so even when things look good, caution is required. It seems that this whole matter was taken as a license to pretend the virus didn’t exist. And there was a probably a strong desire to do that. But there will be risk. The real question is what risks are worth taking.