How will Covid-19/Coronavirus Affect my Alternative Investment Portfolio? Part 53: March 27th
Micro-edition update; U.S. progress on third death wave drives forward, but then stalls out;Crystal ball: Time to buckle up? Infections surge and imply fourth wave may already be here; The race against time: humanity’s vaccines vs. evolution and the virus; Revenge of the mutants: Europe continues to lose ground against more contagious and deadly variants; Heartbreaking study finds 13-15% of kids who get Covid-19 suffer from debilitating long-haul Covid symptoms weeks or months after “clearing” the virus; Variant watch: French mutation evades detection by coronavirus tests, India detects new, double mutant, California mutation is 20% more transmissible and Oxford vaccine may be ineffective against UK variant;Fatally wrong advice? CDC recommendations that frontline workers don't need N95 masks was based on poor science, and may have contributed to thousands of deaths; Update on my portfolio.
(Usual disclaimer: I'm just an investor expressing my personal opinion and am not an attorney, accountant nor your financial advisor. Consult your own financial professionals before making any financial decisions. Code of Ethics: To remove conflicts of interest that are rife on other sites, I/we do not accept ANY money from outside sponsors or platforms for ANYTHING. This includes but is not limited to: no money for postings, nor reviews, nor advertising, nor affiliate leads etc. Nor do I/we negotiate special terms for ourselves in the club above what we negotiate for the benefit of members. Info may contains errors so use at your own risk. See Code of Ethics for more info.)
This edition is just a micro-version of the usual update, because I’m leaving soon to get my first dose of the vaccine and also have a lot on my plate. So we’ll just look at the latest statistics on viral spread and a some brief items about mutants and about the latest virus research. Next update (in two weeks), we’ll do a full update containing the usual details on state-by-state spread, unemployment, the stimulus package, mutant watch, and latest news.
This article is part of a multi-article series that's been published weekly since the pandemic began, back in March 2020. After this week the series is moving from weekly to a bi-weekly schedule. So the next update will be in 2 weeks (rather than 1) It started with three introductory articles on the virus and its effect on the economy and on alternative investment classes. Then it moved on to weekly updates on the latest and greatest developments (along with weekly updates on my evolving personal portfolio strategy). You can see the links to every article in the series here.
U.S. progress on third death wave drives forward, but then stalls out.
For the 61st week in a row, the United States battled the coronavirus called SARS-CoV-2, which causes the Covid-19 disease. And as of Saturday morning, the official death toll had climbed to 561,142 (versus 546,567 on Saturday morning, two weeks ago).
Here's a quick summary of what's happened so far:
The first U.S. death wave started in early March 2020. It spread overwhelmingly in urban areas (like New York City in the Northeast). It peaked on April 21st and the country fought it down until July 6th.
The second death wave started on July 7th 2020. This ran predominantly through urban areas in the Sun Belt. It peaked on August 1st, before falling until October 8th 2020.
The third death wave began on October 9th, 2020. It was initially led by rural areas and later spread across the entire country. This made it more difficult to contain and fight than earlier waves. By late October 2020, it hadcaused acute shortages of critical drugs and key medical personnel needed to fight the disease and limit deaths. Then in November 2020, it caused hospitals to overload in certain areas of the country. When overload happens, hospitals are forced to deny care to incoming patients (both those infected with the virus and uninfected). And not only do more people die of Covid-19 unnecessarily, but others (via heart attacks and other completely unrelated problems) die unnecessarily, too. This wave peaked in late January of 2021 and began to subside in mid-February 2021. How did things go this week?
Progress had slowed down, two weeks ago, and looked like it might have been poised to reverse. Last week, there was significant progress again, which was good to see. But then, this week’s news was less positive, with progress stalling out again, and even backtracking. It's too soon to say whether this will become a trend or not, so we'll continue to monitor and see.
Crystal ball: Time to buckle up? Infections surge and imply fourth wave may already be here
If we're unable to make clear progress and deaths remain high, then the overwhelming consensus of economists is that this would sabotage hopes of a quick, V-shaped recovery. Instead, the recovery would assume a different shape (W-shaped, U-shaped, etc.). This would be slower, involve more long-term damage to both health and economy, and potentially cause problems for some or many consumers, businesses and investments. (See part 14 for more information on the possible "recovery shapes" and their ramifications).
Since this is potentially so important, let's take a look at one of the leading indicators of upcoming deaths: virus infections. Virus infections tend to lead deaths by anywhere from 2 to 8 weeks (depending on how long it takes someone to die and how long it takes their particular location to report the information). These case numbers are not completely reliable due to testing labs' difficulties, in many parts of the country, with getting results back on time. And some states are not reporting all of the positive tests (specifically, the antigen tests). But they can still provide a clue of what might lie ahead with deaths.
How did virus infections look this week?
This isn’t a great graph. Two weeks ago, infections had ominously plateaued. Last week, that continued. And then this week, there was an unmistakable bump up. It's too soon to declare this a trend, and the situation could change. But if it continues, then then will mean that this week marked the beginning of the fourth wave.
The race against time: humanity’s vaccines vs. evolution and the virus
In the meantime, many health experts say that the U.S. continues to be in a race against time. On one hand, vaccinations are moving forward and hold the promise of establishing "herd immunity" and ending the pandemic. This happens when a virus can no longer find enough susceptible people to infect and then it peters out.
On the other hand, there isn't enough vaccine supply to vaccinate everyone immediately. And, for example, children under 12 aren’t expected to receive vaccinations in the U.S. until next year (2022). So this slow roll-out, along with people relaxing their guard on health measures, increases the evolutionary pressure on the virus to mutate in potentially dangerous ways.
"I'm worried. If you wanted to put all the viral ingredients in one big mixing bowl to cause them to transmit in ways that would be very damaging to us, do what we're doing right now."
Why does this matter? Even prior to widespread vaccine usage, the virus had already defied many early predictions and mutated numerous times across the world. And several of these variants are already more contagious, are more antibody/vaccine resistant and/or more deadly. The scenario that keeps some epidemiologists up at night is one where these pressures cause a mutation to evolve that’s highly resistant to vaccines. Some call this “achieving escape velocity.” If that happens, it would most likely mean the start of a brand-new phase of the pandemic. And this would be expected to bring on a new wave of health challenges, death and economic pain. So it’s a race against time. And surveys have shown that many in the U.S. are unintentionally helping the virus. Data and surveys have shown that about one third of health workers (30%), about a third of the military (30-40%) and almost one third of the general population (30%) are unwilling to get vaccinated. We don't yet know the threshold needed to achieve herd immunity for the virus. But it's currently believed to be between 60 to 80% (either vaccinated or previously infected). If that's true, and if attitudes don’t change, then herd immunity may be unlikely to ever occur.
And, the longer the virus is only "semi-crushed" (with partial vaccinations and half-hearted health precautions), the more evolutionary pressure is put on it to achieve escape velocity and start a new wave. And preventing escape velocity in the U.S. alone will not likely be sufficient. The problem is much bigger: it’s global.
"If we don't get rid of this thing everywhere, it's going to just come back and get us again. The virus will continue to mutate. This is really a worldwide problem."
As a result of all these factors, a growing number of scientists and health experts have begun to change their tune on the possibility of herd immunity against the virus.
Data scientist Youyang Gu publishes a popular forecasting model that he has always called "Path to Herd Immunity." This month, he actually changed the name to "Path to Normality." Gu said the reason why is because:
"Reaching a herd-immunity threshold is looking unlikely because of factors such as vaccine hesitancy, the emergence of new variants and the delayed arrival of vaccinations for children."
Lauren Ancel Meyers, executive director of the University of Texas at Austin’s COVID-19 Modeling Consortium (a popular model that’s been used by the White House and others), agrees:
“We’re moving away from the idea that we’ll hit the herd-immunity threshold and then the pandemic will go away for good. The vaccine will mean that the virus will start to dissipate on its own. But as new variants arise and immunity from infections potentially wanes, we may find ourselves months or a year down the road still battling the threat, and having to deal with future surges.”
So we'll continue to monitor and see what happens.
Revenge of the mutants: Europe continues to lose ground against more contagious and deadly variants
Due to the brevity of this week’s edition, we're not going to look at European countries individually. Instead, we'll just look at all of Europe as an average.
Here’s what’s happened so far:
In its first death wave, Europe was hit earlier and harder. But, due to more aggressive strategies, it continued to push down their first wave, while the U.S. suffered a second.
But, that all changed in late 2020, as new mutations took hold (first in the U.K. and then elsewhere). This caused a second wave of infections and deaths to sweep the continent. And countries were forced to re-implement many of the painful, strict lockdowns from the early pandemic. By late February, this strictness had worked well enough to bring down the second wave a bit.
But the progress was short-lived. By March, mutated strains fought back and caused most progress to stall out.
How did things go this week?
This is a concerning graph. Europe is no longer just stalling out, but is now moving in the wrong direction, as deaths are increasing. If this continues, then this week would mark the beginning of their third wave.
As mentioned above, infections can be a leading indicator of deaths. How do they look?
This is an alarming graph. Not only are infections clearly accelerating into a third wave, but they are almost to the point of eclipsing the highs of Europe’s second wave.
Heartbreaking study funds 13-15% of kids who get Covid-19 suffer from debilitating Long-Haul Covid symptoms weeks or months after “clearing” the virus.
Most people believe that, if they get Covid-19, it'll last only for a short time (10 days) and then they'll be back to normal. However, as we talked about in depth in past articles, a significant percentage of the infected actually suffer for months with debilitating symptoms.
Many former high achievers find themselves unable to work or to perform even basic self-maintenance routines. They suffer from chronic fatigue, muscle and joint pain, respiratory problems and heart palpitations, brain fog, headaches and insomnia. For a long time, many people didn't believe that this was really occurring. But studies have shown that victims of other coronaviruses have suffered similar problems for as long as years later. And now the scientific community acknowledges that an overwhelming body of evidence shows that "Long-Covid" does exist and affects a significant number of people.
This week, another false narrative about Covid-19 was shattered. Many people still believe that children cannot be significantly affected by the virus. However, this week, the U.K. Office of National Statistics released a heart-breaking study which found that 13 to 15% of children with Covid-19 suffer from long-haul covid-19 symptoms for more than five weeks.
Also, Italian scientists put out their own study. It is not yet been peer-reviewed. But if accurate, more than half of children with Covid-19 have at least one persisting symptom 17 weeks after being diagnosed. And, 43% of the kids reported being impaired by their symptoms during daily activities.
A third study (performed in the U.S. and U.K.) was also put out. It also has not yet been peer-reviewed. If accurate, it found that the most common symptom among children is tiredness and weakness (87%), headaches (79%), abdominal pain (76%), and muscle and joint pain (61%). Additionally, there were frequent gastrointestinal problems as well as rashes.
Like adults, the effect of Long Covid on children can be debilitating: 61% of children had trouble concentrating, 46% had difficulty remembering information, 33% difficulty processing information and 32% had trouble finding the right words when speaking. Many suffered from unexplained irritability.
Variant watch: French mutation evades detection by coronavirus tests, India detects new, double mutant, California mutation is 20% more transmissible and Oxford vaccine may be ineffective against UK variant
This is an abridged version of the usual variant watch, due to the shortened edition.
In the last two weeks:
A new variant was discovered in France that can’t be detected by standard coronavirus tests.
Conclusive proof came out that the California variant is 20% more transmissible than the original.
A study found that two doses of the AstraZeneca Oxford Covid-19 vaccine were ineffective in treating mild to moderate infections of the U.K. variant (B1351).
India announced it has detected samples of a new "double mutant." The Health Ministry said: "Such [double] mutations confer immune escape and increased infectivity." However, this is only theoretical at this point, based on the detection of the mutations and what they have individually done in other studies. The double mutant itself has not yet been tested in the same way. And it's not known if there are enough of these mutations yet to explain the current surge in India.
Fatally wrong advice? CDC recommendations that frontline workers don't need N95 masks was based on poor science, and may have contributed to thousands of deaths.
Due to continuing shortages of N95 masks, many hospitals have been forced to prioritize their use. And through most of the pandemic, it's been believed that the highest risk to health workers was from "aerosol generating" procedures. That's when a breathing tube has to be placed down the trachea of a critically ill, Covid-infected patient. And virtually everyone believed that this was the highest risk activity in which a health worker could engage. One doctor in the early pandemic compared the danger he believed he was taking on during the intubation process to "being right next to a nuclear reactor."
And so the ICU workers doing intubations received the best protective gear and the precious N-95 masks. And nurses and others "merely" taking care of patients and in "less dangerous" roles were deemed by the CDC (and a widespread group of experts) as sufficiently protected by a mere surgical mask.
As we've discussed in previous articles, nurses’ unions and others have howled in protest and demanded that they also get the highest level protection with N-95 masks and other gear. But, until last month, that complaint has mostly fallen on deaf ears.
But a growing surge of scientists has emerged to challenge this status quo. And the tidal wave of evidence strongly suggests the previous strategy was fatally misguided. If so, it may have contributed to the deaths of thousands of front-line workers.
Dr. Tim Cook, an anesthetist with the Royal United Hospitals Bath, was one of the earliest to raise the alarm. His data was showing that frontline workers were dying at significantly higher rates than would be expected. This led to a flurry of research challenging the assumption. And his published study concluded that a mere cough produces 20 times more particles than the much feared intubation.
"The guidelines singling out those [aerosol generating] procedures was based on research from the first SARS outbreak in 2003. That framework includes a widely cited 2012 study which warned that those earlier studies were “very low” quality and said there was a “significant research gap” that needed to be filled."
Yet despite that, the guidance was pushed ahead anyway, and then relied upon as if it was rock solid. But Cook says:
“It was all a big house of cards. The foundation was shaky and in my mind it’s all fallen down.”
Many others agree. Dr. Michael Klompas, a Harvard Medical School associate professor said, in a recent paper published in the Journal of the American Medical Association:
"[Even the name] "aerosol-generating procedures" is a misnomer. The whole thing is upside down the way it is currently framed. It’s a huge mistake."
And, if coughing is more dangerous than aerosol generating procedures, that's not the end of the risk to front-line health workers. Studies have shown that about 20% of the population spreads about 80% of the particles. These are typically people who are older or obese and are called "super spreaders." And a super spreader who is merely breathing in the vicinity can be equally as dangerous (or more so) than a coughing patient.
David Edwards, a Harvard faculty associate in bioengineering, explained:
"When highly infectious, such patients emit three times more tiny aerosol particles (about a billion a day) than younger people. A sick super-spreader who is simply breathing can pose as much or more risk to health workers as a coughing patient."
Dr. Donald Milton, a professor at the University of Maryland School of Public Health, reviewed the studies and offered a scathing review of the CDC guidance that claimed N-95 masks weren’t necessary for front line workers:
“The upshot is that it’s inhalation of tiny airborne particles that leads to infection. That means loose-fitting surgical masks are not sufficient.”
Meanwhile the "Lost on the Front Line" project has documented that at least 3,500 U.S. health workers have already died from Covid-19.
In contrast, the CDC official data shows 50% fewer deaths (only 1391 healthcare worker deaths). However, critics point out that the CDC guidelines didn't (and still don't) consider wearing a surgical mask while caring for a Covid patient to be a source of “exposure." So, those cases (and deaths) aren't being properly documented as work-related.
On Feb. 10, 2021, the CDC belatedly updated its healthcare worker guidance. It deleted the previous suggestion that wearing a surgical mask while caring for Covid-19 patients was acceptable. And it now urges workers to wear an N95 or a “well-fitting face mask,” which could include a snug cloth mask over a looser surgical mask.
Dr. Claire Rezba, is an anesthesiologist who has scoured the web for almost a year, and tweets out stories of healthcare workers who have died. She said:
“I think it’s pretty obvious that we did a very poor job of recommending adequate PPE standards for all health care workers. I think we missed the boat.”
“What plays out there, is there is this disparity in whose exposures get taken seriously. A phlebotomist or environmental services worker or nursing assistant who had patient contact — just wearing a surgical mask and not an N95 — weren’t being treated as having been exposed. They had to keep coming to work.”
Update on My Investment Strategy
Since this is an incomplete week, I am not updating this section like I normally would. The vaccine rollout is accelerating a bit quicker than originally expected. At the same time, the spread of the variants, the continued resistance of sizable percentages of the public to taking the vaccine, and unwillingness of continue to take health precautions remain troubling X-factors that could allow the virus to evolve and jump the vaccine firewall.
But for now, here is a rehash of my portfolio update from several weeks ago.
Every week, I take a look at the latest developments and data and reevaluate my personal outlook on the possible economic scenarios and my personal investment strategy. This week, I've made minor changes and my overall strategy is essentially the same as last week.
Treatment: Back in May many health experts said we wouldn't get a vaccine for at least two years. But, after I saw unprecedented amounts of resources being thrown against the virus week after week (and their successes), I felt this was overly pessimistic. And on May 21st, I said I thought the chances were good that we would have one vaccine by winter (and with luck we might get two). It turns out the world has been very lucky and we ended up with two right before the end of the year. And in early 2021 more are potentially set to come online. Unfortunately, as I also predicted in late May: these can't be manufactured and distributed in large enough quantities to immediately treat everyone. Most in the U.S. will have to wait well into 2021). So this will not be enough to super-charge the economy right away. And, there may potentially be a huge quality-of-life difference between the treatment-haves and treatment have-nots. This will be divisive and will exacerbate existing tensions and conflicts between rich and poor countries. And it's likely to cause considerable instability in "have-not" countries that could easily cause unexpected global consequences, not just for themselves but also for the U.S. and the world.
Recession: When the U.S. was first hit by the virus, many pundits claimed the U.S. economy was so strong, it would have little to no effect (or if it did, then it would rebound quickly and things would be back to normal in a jiffy). But, after looking at all of the micro data week after week, I said I couldn't see any way the country could avoid plunging into a technical recession (two consecutive quarters of negative GDP growth). Ultimately that happened (-5% in Q1 and -32.9% in Q2). Then as the Q3 data unfolded week after week I predicted we would see strong double-digit growth but also disappointingly short of the amount needed to break even to where things were before the pandemic. Ultimately both happened: 33.1% increase from rock-bottom but still well short. For Q4, it looked to me like easy gains were gone and the rest would be a long, tough slog. So I predicated it would be up modestly but it would still come up short of the amount needed to "break even" to where we would have been in Q4 without the pandemic (and thus well short of a true V-shaped recovery). Ultimately both were correct (Q4 was up 4% but year to date was -3.5% and the worst yearly performance since 1946) What about 2021 Q1? Thankfully we have now gotten more stimulus and some brief extensions on eviction/foreclosure moratoriums. So I am not as afraid of immediate double-dip recession as I was just a couple weeks ago. On the other hand, the stimulus itself falls short in many important areas such as restaurants and bars, rental assistance, transit, student loans etc.. And I'm very concerned about the mutated variation making the partial lockdowns we have now ineffective and causing significant economic damage. So, without further stimulus (and a little bit of luck), I'm still concerned we could still have a double-dip recession.
Shape of the recovery: In part 14, we talked about how the shape of the recovery (V-shaped, U-shaped, swoosh-shaped, W-shaped, L-shaped, combo-shaped etc.) will have a huge effect on the ultimate outcome of many different investments. So far, pretty much everything that's happened has been much worse than the consensus expected. Pretty much no one saw the virus spreading in the U.S. in any meaningful way. Virtually no one came close to imagining that lock-downs would occur in May. Hundreds of thousands more people have been killed than originally projected. And now, even the later May projections, which maxed out at 200,000 dead, have proven to be too optimistic. Tens of millions more people than expected have lost jobs. The stimulus and unemployment aid was enormous, but had too many unexpected holes and didn't get into the hands of millions who needed it the most. States reopened, but were forced to backtrack. Many businesses have reopened, but customers are staying away. And now we have faster spreading mutations that could cause significant economic harm. So unfortunately, I still don't think a quick, V-shaped recovery is going to happen. I would love to be wrong. I'm getting more and more concerned about a very damaging "W", which could come from the second and/or third waves of the virus (including by mutated strains). Unfortunately, this is looking more and more likely. My slim hope is that the 3rd wave can be controlled and kept small. If this happens... and if the US government also passes additional stimulus law... then the worst effects of the additional waves could be mitigated. That's a lot of "if's"... so we'll see. And I'll continue to monitor the data very closely. Currently, I still believe we will have a three-stage combo-shaped recovery that starts off (1) quickly as the first "easy" industries and companies come back online (i.e. v-shaped). But (2) this will peter out as the more difficult ones are unable to return, and a slow swoosh will become apparent. [2/7/2021 update: That is exactly what happened:]
If we get a second (or third) lockdown, then this step (2) will become W-shaped and more painful. So it's a race between vaccines vs. new mutant strains. Effective vaccines will eventually trigger the third stage and an accelerated recovery. But this most likely won't be a straight-V recovery, because it will take time to ramp up production and delivery to enough Americans to push towards herd immunity (not until well into 2021). So the boost will be slower and smaller at first. And there are obstacles to this that could slow it down more including bungles with distribution, reluctance of people to take the vaccine, no evidence so far that the approved vaccines will actually stop spread to others ("sterilizing immunity") etc. But, we also could get a little lucky (for example, if we get a successful vaccine treatment that is a newer type that can be scaled up more quickly or is proven to works bette). If so, then the third-stage boost would be faster.
Investments: If the above is roughly correct, then it will unfortunately be painful for many individuals and some investors. And some sub-sectors of alternative investing (like certain real estate classes) could come under heavy stress. Some may fold in the coming months. At the same time, I think there will also be an opportunity to purchase dislocated and distressed assets at very favorable pricing and significant discounts. And I believe that patient, discerning investors may be able to take advantage of once-in-a-decade or once-in-a-generation opportunities.
No new investments in real estate or any asset classes that are correlated with the unemployment or the business cycle until there is more clarity about the unknowns concerning the virus and the upcoming financial cliff.
Invest in assets that are coronavirus resistant (and uncorrelated with the business cycle). That includes:
Music royalties (which can actually do better in lockdowns due to increased streaming).
Life settlements (which actually perform better when people are dying faster and in any event aren't directly tied to the business cycle).
Litigation finance (which performs based on winning or losing cases, and also isn't directly tied to the business cycle).
Invest in coronavirus "portfolio insurance" (i.e. an investment that would be expected to do better the longer coronavirus continues or if it gets worse).
N95 Mask Manufacturing Company. If the pandemic should disappear tomorrow (which I personally am not counting on), I would be happy to take a small loss here given that the rest of my portfolio would be doing extremely well. On other hand, if Covid-19 doesn't disappear and things go as I expect (or worse), then this investment could provide a welcome profit boost and improve my diversification.
Continue to hold cash and be patient for dislocated and distressed opportunities. The worse the economic damage, the more chance there will be for those once-in-a-generation or once-in-a-lifetime opportunities.
My opinions and strategy will change if we get some better or worse news on the science side or in some of the other X factors. For example, a new stimulus law could shift things in a more positive direction. And, as I mentioned above, the virus getting out of control again in large areas and forcing large lock-downs a second or third time, could easily make things worse.
In the meantime, that's the review for this week. And I hope you and your loved ones are staying safe and healthy.