Covid-19 Diary : Wednesday 13 May, 2020

 

There continues to be a great deal of public “debate” about the rate at which we should be opening up the country.  The quote marks signify there is very little civilized or logical debate, but much hot rhetoric and sadly way too much nonsense.

When you consider the extremely vague, uncertain and error-prone models which people on both sides are using to support their opinions, it is extraordinary that the advocates, both for more and/or less opening, and whether it should be sooner or later, are so adamant in the correctness of their opinions.

One of the consistent themes of my two months of daily diary entries is that the data is all ridden with imprecision and errors, and the analysis layered on top of the data is unavoidably massively worse than the already unsatisfactory data it builds upon.

The truth is no-one knows what is ideal, and we’re all making this up as we go along, and many times changing things dramatically as we do so.  For example, the projections from IHME are, for some reason that escapes me, considered to be among the best available in terms of what the future may hold.  To start with, their projections were based almost entirely on Chinese data, which showed a fundamental and dismaying lack of ability on the part of the statistical modelers to consider the accuracy of the data they were receiving.

Needless to say, the IHME model went through some huge swings up and down, but by now, with several months of “better” US data to use, you’d think it would have settled into a fairly reliable set of projections, changing only to reflect the impacts of states changing their lockdown policies and minor tweaks to their model.  Certainly, they have become more sophisticated in the range of different inputs they’re now feeding in to their models.

But their final data remains widely and wildly variable.  When they issue their projections, they give a “most likely number” and then show a range of numbers, from a “we are 95% certain the number will never go higher than this” to a “we are 95% certain the number will never go lower than this”.

Yesterday IHME updated their models, just two days after their last update.  The headline number was an increase of 10,000 more deaths now predicted will happen in the country, just two days after the last number.  At least that revision was within their “95% confidence interval”.  But some of the states had swings astonishingly outside the confidence interval – New York increased by more than the confidence interval in just two days, and Georgia decreased by more than their confidence interval, also in just two days.

Georgia in particular is really strange.  The state and its governor has attracted a lot of criticism for being slow to close and fast to re-open (for example this CNN article today, which is very fast to gleefully criticize but fails to note the state’s death rate is about half the national average, and ten times lower than New York).  If you look at the IHME data, you’ll see Georgia never broke through their hospitalization capacity.  The Rt site shows that Georgia’s case numbers are steady or declining.

So by the numbers, it seems Georgia was correct not to be “too fast” in closing, and is right again to be opening now.  But you’ll not see any of the mainstream media praising Georgia’s governor for being correct in his non-standard approach to the virus.  I wonder why not – surely the numbers are the ultimate arbiter of correctness here, rather than the governor’s political affiliation?

Current Numbers

Here are the rankings for the eight states of any size with the highest infection rates.  There have been no changes in ranking today.

• San Marino/643 cases/the equivalent of 18,950 cases per million people
• Vatican City/12 cases/14,981 cases per million (unchanged)
• Andorra/760/9,836
• Qatar/26,539/9,212
• Luxembourg/3,904/6,237
• Spain/271,095/5,798
• Iceland/1,802/5,281
• Ireland/23,401/4,739

Here are the top six major countries, showing death rates per million of population in the country  :

• Belgium/8,843 deaths/763 deaths per million
• Spain/27,104 deaths/580 deaths per million
• Italy/31,106 deaths/514
• United Kingdom/33,186/489
• France/27,074/415
• Netherlands/5,562/325

To put those numbers into context, the death rates per million in the US/Canada are 257/140.  The world average (not a very reliable number) is 38.2.

For major countries and/or outbreaks, and in general :

	Same Day Last Week	Yesterday	Today
Total Cases	3,819,891	4,337,625	4,425,657
Total Deaths	264,839	292,561	298,065
US Cases/Deaths/Case rate per million	1,263,092/74,799 3,816	1,408,636/83,425 4,256	1,430,348/85,197 4,321
UK Cases/Deaths/Case rate per million	201,101/30,076 2,962	226,463/32,692 3,336	229,705/33,186 3,384
Canada Cases/Deaths/Case rate per million	63,496/4,232 1,682	71,157/5,169 1,885	72,278/5,302 1,915
Worst affected major country/case rate	Spain/5,426	Spain/5,765	Spain/5,798
Second worst country affected	Ireland/4,506	Ireland/4,707	Ireland/4,739
Third worst	Belgium/4,382	Belgium/4,640	Belgium/4,658
Fourth	USA/3,816	USA/4,256	USA/4,321
Fifth	Italy/3,547	Italy/3,659	Italy/3,673

I Am Not a Doctor, But….

We are all desperate for as much data as possible so as to better understand the present nature and possible future of this pandemic.  One of the points of huge concern at present is the spread of the virus in midwest meat plants and the implications for our food supply.  There are also valuable lessons to be obtained from studying this data, because there are many other currently closed down industries that involve similar close-working environments.

So, what do the public health officials in Nebraska do?  They stop reporting data on virus numbers in their meat plants!

As I’ve bemoaned before, one of the greatest inefficiencies and handicaps we struggle with in this country is political correctness.  How many tens of thousands of lives have been needlessly lost already in our struggle against Covid-19 due to people preferring not to brutally and honestly confront the ugly realities of the virus and what needs to be done to control it?

Another example of where political correctness is costing us – both in terms of lives and dollars – is our unwillingness to accept any sort of realtime monitoring of where we are and the possibility of us interacting with an infected person.  If China is to be believed, realtime monitoring is the secret of their success.  I’ve described how realtime monitoring could work for us in the past.

But to do that would be un-American, we’re told.  I agree, it is a massive intrusion on our freedom and privacy.  But we’ll soon have counted 100,000 deaths from the virus, and we have the eighth worst death rate per head of population of any major county in the entire world.  Being among the eight worst countries is also un-American, and our right to life is cited before our right to liberty and the pursuit of happiness.  It is un-American to watch 100,000+ of our fellow citizens die, many of them unnecessarily, because of our unwillingness to accept unpleasant short term remedies.

To put it another way, if we accepted some type of monitoring system, we could also release our country from most of the other un-American restrictions on movement and social grouping.  This isn’t a case of “good vs bad”, it is a case of “less bad vs more bad” and our choices are measured in the deaths we allow to happen as a result.

It is way past time for people to man-up and start making the hard choices that will save our lives and our economy.

One more thing that is un-American – accepting bad unreliable equipment and making life-changing decisions based on it.  We certainly used to be proud manufacturers of highest quality equipment.  But somehow that concept seems to have been tossed out the window when it comes to making virus tests.  Even now, some of the “best” of the “does a person currently have a Covid-19 infection” test kits are proving to be dangerously unreliable.

You may have wondered how it is there are so many virus cases being discovered in the White House, even among people immediately associated with both the President and Vice President.  It isn’t because these people aren’t being tested (we understand everyone who comes in contact with them is tested, every day), it is because the tests are unreliable.

What is the massive malfunction that is infecting every part of our nation when it comes to responding to this virus threat?

Timings And Numbers

I wrote in the opening about the latest IHME data projections as they applied to the US.  The researchers are also projecting numbers for a growing number of other countries too.  The biggest surprise this time was to see the projected deaths in Sweden – the “naughty child” of Europe because it has obstinately insisted on not locking itself down – drop from a projected 10,196 total deaths and now the projection is 5,760 deaths.

Might Sweden yet end up having the last laugh on the rest of the world?

Here also is a fascinating interactive tool.  You can use it to make your own determinations about which countries are winning and losing their virus battles.

One of the points made about the count of virus deaths is there are many other people dying, not of the virus, but because of the virus.  That is probably true and a full accounting should consider every type of death that is reasonably directly related to the virus.

But there are also lives being saved because of the virus.  Fewer road deaths, for example, including this interesting data snippet – it is now 58 days in a row, a record, that there have been no pedestrian deaths in New York city.

The media loves to imagine a rift between President Trump and Dr Fauci; nothing would make them happier than to see Trump fire Fauci, and they’ve regularly predicted its imminent occurrence.

In the latest such story of “a deepening rift” they point to Trump and Fauci having different opinions about re-opening schools.  Trump is pro, Fauci is anti.

The thing about Dr Fauci, and the point that Senator Paul was making yesterday, is that he is a public health official.  His job is to zero out diseases.  In a quest to zero out a disease, keeping public schools closed makes sense.  But the thing about President Trump is that his job is to do the least harm to the country as a whole.  He has to balance the economic and social costs as well as the medical benefits.  I’m not saying he is finding the ideal compromise points – that brings us back to my opening comments again.  We all have different positions on the relative importance and appropriate trade-off between education, the economy, and lives/deaths.

But sometimes I feel Dr Fauci slightly over-eggs his “I am a doctor” pronouncements that the rest of us mere mortals have to accept on blind faith and never question.  For example, I’d love him to explain this statement (from the link immediately above)

There is a real risk that you will trigger an outbreak that you may not be able to control

As a non-doctor, I don’t understand what that means.  Surely any level of outbreak escalates rather than appears without warning, especially now that we are testing at ever increasing rates, so we have warnings about what is occurring, just as was the case back in March; and surely any level of outbreak, no matter how severe, can be stopped in its tracks if we get serious about a socially distanced lockdown for a couple of weeks.

Locking down, in some form or another, has been dramatically proven to work in other countries, and without exception.  No country, anywhere, has yet suffered an outbreak they can not control, not even un-locked down Sweden.

Why is Dr Fauci hinting that opening schools may bring about an apocalyptic epidemic we couldn’t control?  We deserve more than a bare statement when making decisions effecting almost one hundred million children and costing trillions of dollars.

Closings and Openings

The problem with poorly managed lessenings of social controls is that you end up back where you started before the lockdown, at square one, and have to repeat the lockdown.  As is being feared may be the case in some countries already.

Would you wait an hour in a drive-through line for fast food? Is it still fast food when you wait an hour to order?  Apparently this is okay if you’re in Southern California.  Here are some fascinating pictures of long lines at drive-throughs.

Who Should Pay

Here is a classic example of how our economic stumble can become a full-blown depression.  We’re starting to see the flow-on effects; as people cut back on spending, companies that are not at all directly affected by the virus now start to be secondarily impacted by the shrinking economy.

Logic?  What Logic?

We noted on Monday how Elon Musk was opening defying the order requiring him to keep his Fremont, CA car plant closed, and daring officials to come and arrest him.

Exactly as we expected, the officials retreated and have now “reached a deal” – which is a face-saving way of saying “totally capitulated to bully-boy Musk and his refusal to comply with the law”.

What sort of a message does that send to those of us who accept personal hardship for the greater good of the country?  What sort of a message does that send to people not named Musk who do not accept such hardships, but are arrested and fined/imprisoned for their non-compliance?

The answer can be seen in another capitulation to bullies.  This time, it is on airplanes.  The airlines have told their flight crews that while wearing masks is “mandatory”, they should not enforce the requirement for passengers to wear masks on planes.

This is so so very wrong.  Masks don’t only protect us from virus particles coming from other people – they also protect other people from the virus particles we in turn are breathing out.  We are forced to rely on the airlines making their airplane cabins as safe as practical, and now the airlines are abdicating their responsibility to do so.

They’ve already tried to persuade us that it doesn’t matter if the middle seat is filled or not, are they now telling us that actually masks don’t matter, either.  Why is it that wearing a seat belt is mandatory, and flight attendants will eagerly enforce that requirement, but wearing a mask, while also mandatory, is too much for flight attendants to enforce?  What is this strange death-wish we have?

A nurse who spoke about how a colleague would possibly have lived if there was sufficient PPE available is now being investigated by her hospital employer for having breached the HIPAA standards of patient confidentiality.

That would seem a marginal claim to start with, but it is massively more marginal in light of the fact that the colleague’s death had already been featured in national news items.  Even more bizarrely the hospital management praised other staff members who did speak to the media on the matter.

This article tells a complicated story of inconsistent double-standards and what seems like an embarrassed hospital administration trying to penalize nurses for revealing the truth.

Virus?  What Virus?

Here’s an interesting way to spend five hours of your time – take a free online course being offered by Johns Hopkins in how to become a contact tracer; maybe even subsequently take a job helping to trace contacts of infected people.  Details here.

Is that a bit like becoming a skip tracer, ie, a bounty hunter?  Do you get to have handcuffs and a badge?

Medical

Here’s an interesting but depressing list of promising vaccines and cures.  We can’t comment on the possible vaccines on the list, but we do see a very dismaying and disappointing lack of entries in the list of promising drugs that might help cure infections.

Money

The Dow decline accelerated today, dropping a further 517 points (2.2%) to close at 23,248.

Rumors

Yesterday had bad news for men, today has slightly better news for “manly” men.

Here’s a very strange story that includes that phrase I love to hate, “out of an abundance of caution” – in this case describing a decision to return ventilators that may or may not have been a gift from Russia in the first place.

Other

American bathrooms have always been a bit strange to me.  I remember the first time I ever entered one, in the airport in Honolulu back in the days where there was no such thing as nonstop flights between New Zealand and the US west coast.  Stalls with doors and dividers that were only half there, and strange individual urinal things; both quite unlike the norm in NZ.

Here’s an interesting article that considers how it may be necessary to rethink some of these US design concepts in light of such concepts as “viral plumes” from toilet flushing.

This is a truly distinctive approach to introducing social distancing in a restaurant.  Instead of merely removing tables or chairs, a VA restaurant has adopted a different solution.  We know how not many people like dining in an otherwise empty restaurant, but we’re not sure if their solution is slightly spooky or reassuring.

Lastly for today, if you wear glasses, you may have noticed how sometimes wearing a mask can redirect your exhaled breath upwards to fog your glasses.  This article suggests how to stop your glasses fogging.

 

Please stay happy and healthy; all going well, I’ll be back again tomorrow

 

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