Tag: Coronavirus Data

Saturday Soother – October 31, 2020

The Daily Escape:

Mohawk Trail, just off Route 2, near Williamstown, MA – October 2020 photo by Alahomora

Three days to go.

Happy Halloween, although at the Mansion of Wrong, All Hallows Eve is just another day. We’ve never had a human come to the door looking for treats. Let’s hope that tonight’s not the night.

The reality show that is 2020 really sucks. On Monday in NYC, a man fell about 15 feet into a pit of rats when a sidewalk sinkhole opened under him. He was injured and while he will recover, nobody will ever want his nightmares.

And early on Sunday morning, we turn the clocks back one hour when daylight saving time ends in most of the US. This year, more than 30 states considered legislation to make daylight saving time permanent, something that Wrongo endorses.

Roll Call has this about Trump’s closing argument:

“By arguing that the country is ‘rounding the corner’ on COVID-19 in the face of irrefutable data that the coronavirus is surging, Donald Trump risks appearing more and more out of touch with reality.”

But we know cases are way up. This is the NYT’s chart from Friday:

From the NYT:

“As of Friday morning, more than 9,024,100 people in the United States have been infected with the coronavirus and at least 228,700 have died…”

That’s roughly a 2.5% death rate since the virus came to our shores. It seems serious that cases are rising in most states, while deaths are rising in 24. The NYT reports that the top ten states with the highest death rates are: (in order) North Dakota, South Dakota, Wisconsin, Montana, Wyoming, Alaska, Nebraska, Idaho, Iowa and Utah.

Most of these states have significant populations that refuse to wear masks or practice physical distancing. Now, there clearly are people in America who won’t work for the common good, because their backs have never really been against the wall. We’ve become a soft, cartoonish version of what our parents and grandparents had to be in order to survive.

Americans play at being tough. Some of us strap on side arms or long guns to go to the supermarket. We complain when the internet is down because we can’t play Netflix or our favorite video game. We melt down on Facebook when someone objects to our little thoughts.

What this moment should have given all of us was a sense of common purpose that united us against an invisible enemy. Instead, it’s simply too hard for us to delay even a moment’s gratification in the face of the second wave of the pandemic.

Notice too that of those ten states, only one (Wisconsin) is a good bet to vote Blue next week. That’s not necessarily a problem, since the path to 270 for Biden looks like this:

If you look at voters in generational terms, Trump has turned into an electoral cul-de-sac. He’s simultaneously losing younger voters by a 2-to-1 margin, while also losing seniors by nearly 10 percent.

If you’re voting Blue this year regardless of your Party affiliation, you are indeed serving a common purpose, one that you will remember forever: When our democracy was on the brink of collapse, when our fellow Americans needed us, we came together to fire Donald Trump.

There are still a few days left to obsess about the election, but its Saturday, and we need our weekly break from the monster that sucks all of the happiness out of our lives. It’s time for our Saturday Soother.

We had snow on the fields of Wrong on Friday, and the weekend is bringing overnight temperatures in the 20’s, so few outdoor plants will survive that hard frost. We’ve still got a tree to plant that is supposed to arrive today, but Wrongo will wait for next week’s warmer weather to get it in the ground.

No coffee today, but a very relaxing video. The music is by Franz Schubert, his No. 4 Standchen from Schwanengesang, which means “swan song” in German. It’s from a collection of songs written by Schubert at the very end of his life. The Schwanengesangs were composed in 1828, and published in 1829, just a few months after the composer’s death. Franz Liszt later transcribed them for solo piano.

So a hopeful swan song for Trump, and a relaxing moment for all of us who listen today. Here the solo piano is played by Vadim Chaimovich.

The video combines Schubert with images of a Van Gogh painting. Pretty relaxing:

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Our COVID Data Is Inaccurate, And It’s Going to be Spun

The Daily Escape:

Sand Harbor State Park, Lake Tahoe, CA – 2020 photo by debarnec

Happy belated tax day! Two disturbing articles about both the accuracy and reliability of COVID-19 data were in the NYT yesterday.

First, the collection and reporting of data is increasingly reliant on outdated technology to deliver test results:

“Health departments track the virus’s spread with a distinctly American patchwork: a reporting system in which some test results arrive via smooth data feeds but others come by phone, email, physical mail or fax, a technology retained because it complies with digital privacy standards for health information.”

The problems are compounded by human error:

“These reports often come in duplicate, go to the wrong health department, or are missing crucial information such as a patient’s phone number or address.”

Before the pandemic, nearly 90% of laboratory test results for diseases tracked by public health departments were transmitted digitally. But the need for substantially greater Coronavirus testing has brought many more players into the public health arena, including companies that usually run employment screening tests, and small clinics that usually test for diseases like the flu and strep throat.

This has increased the share of lab tests coming to public health departments via fax and phone.

The result is unreliable information. The Times quotes Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists: (emphasis by Wrongo)

“Nationally, about 80% percent of coronavirus test results are missing demographic information, and half do not have addresses…”

Hard to trace an infected person without an address. America’s health system is a jumble of old and new technology that make it difficult to track what’s really going on with the COVID pandemic.

Also, the Trump administration’s guidelines on demographic data haven’t taken effect yet. In June, they required laboratories to report a patients’ age, race and ethnicity, so public health officials could better understand the demographics of the Coronavirus pandemic. But, those rules won’t take effect until August, and they only state that laboratories “should” provide patients’ addresses and phone numbers. They do not mandate it.

Dr. Frieden, former CDC director says:

 “You’ve got hundreds of laboratories and thousands of tests. Nothing is interoperable because they haven’t been mandated to do that.”

Other countries have a unique number identifier for each patient, something that Congress refuses to provide in the US. Instead, data often come to public health authorities using only the information that laboratories need to track the record, not the details that public health officials need to help manage the disease.

Anyone who has healthcare knows that patients routinely fill out the same information on multiple forms in multiple offices. The need for doctors and testing services to use fax machines betrays the fundamental lack of modern technology in some health care settings.

And remember, it’s not for lack of money: There’s plenty of money in the US health care system.

The second item regarding COVID data is more troubling. The NYT reports that: (emphasis by Wrongo)

“The Trump administration has ordered hospitals to bypass the Centers for Disease Control and Prevention and, beginning on Wednesday, send all coronavirus patient information to a central database in Washington — a move that has alarmed public health experts who fear the data will be distorted for political gain.”

From now on, HHS, and not the CDC, will collect daily reports about the patients that each hospital is treating, how many beds and ventilators are available, and other information vital to tracking the pandemic.

This is seen as an inherently political move by outside public health experts. The NYT quotes Nicole Lurie, who served as assistant secretary for preparedness and response under former President Obama:

“Centralizing control of all data under the umbrella of an inherently political apparatus is dangerous and breeds distrust….It appears to cut off the ability of agencies like C.D.C. to do its basic job.”

This is more disturbing than finding out that the data are terrible. Alex Azar, who runs HHS, is a Trump crony and has clearly used his position to be helpful to Trump’s re-election campaign.

If there ever was any hope for a dispassionate, reasoned, and scientific FEDERAL response from Trump, it is certain that these two problems, one with the quality of the data, and the second with how it will be spun as it is reported, show we’re doomed.

How many health care workers will have to die? How many people living in states run by Trump’s personal bootlickers will get the treatment that they need?

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Who Should Fight America’s Pandemics?

The Daily Escape:

Lightning strikes with rainbow, Dickinson, ND – photo by Lightcrafterartistry

COVID-19? Nobody thought anything like this would ever happen. Wrong. Lots of people did. From VOX:

“Per capita, the United States is currently seeing about twice as many confirmed coronavirus cases as Canada and about 30 percent more deaths.”

The key difference between the US and Canada says David Fisman an epidemiologist at the University of Toronto:

“We have a federal government that is supporting provinces’ responses….You have a chief executive who is directly undermining the public health response.”

Politics and politicians by definition, are always in the loop in a national emergency. Yesterday, we talked about how civic-minded politicians stand aside, letting the experts decide strategy. Then they help the experts by making the government work to support the strategy. And they then help with communicating priorities to citizens.

Our national response to the pandemic has been mostly incompetent. The wealthiest, most scientifically advanced country in history has been brought to its knees by a virus it knew was coming. As late as 2016, we had a coordinated national strategy to combat pandemics.

What can we do to insure we do a better job in the future?

This has been a hot topic in pundit land for the past few weeks. There are two threads of discussion: First, make the US military the leader in fighting pandemics. Alternatively, an “empowered” civilian agency or possibly, an empowered public-private partnership should direct the fight.

Let’s start by talking about how civilian government agencies might do a better job, if they were “empowered” and also funded. In 2005, GW Bush said: (emphasis by Wrongo)

“If we wait for a pandemic to appear, it will be too late to prepare….we need medical personnel and adequate supplies of equipment…In a pandemic, everything from syringes to hospital beds, respirators masks and protective equipment would be in short supply….If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine on line quickly and manufacture enough to immunize every American against the pandemic strain…”

Bush thought it would take $7 billion to build out his plan, plus annual appropriations thereafter. But that wasn’t supported by Congress. Obama built on Bush’s plan, but his efforts also were not sustained by a Tea Party Congress. Trump’s FY 2021 budget proposal reduces CDC funding by 16%. It was submitted just 11 days after the WHO declared the Coronavirus a public health emergency.

What should we be doing? First, we need to invest in ourselves, to break our reliance on offshore sources of PPE and pharmaceuticals. We saw that China stopped exporting PPE to the US, husbanding it for their own needs, and subsequently, showing a preference for shipping these goods to nations they perceived as friendlier.

Second, we need to empower an elite governmental team to combat a pandemic. The 2014 Ebola outbreak told us we needed a health security infrastructure. By 2016, America had coordinated an “all-government response” to the next pandemic. Laurie Garrett, a science journalist summed up the infrastructure created by Obama as a:

 “…special elite corps inside of the National Security Council, the Department of Homeland Security, Health and Human Services and CDC…an emergency capacity for surge drug approval at FDA… a lot of co-ordination with the states… a division that was doing nothing but training hospitals in infection control and appropriate epidemic responses… and…Study on how to surge hospital beds, how to surge physicians out of retirement…”

Sounds great, no? It needs to be rebuilt if we are to have effective control of our pandemic response.

The story of using the military also begins with Garrett. In September 2014, she briefed the Joint Chiefs of Staff on how the US military could help the countries affected by Ebola. She says that this was:

“…unprecedented in US history; we’d never mobilized US military for a medical response like that before”.

But today, the military wants the job. From Roll Call:

“To many lawmakers, the Defense Department is an attractive place to fund medical programs, partly because the defense budget is so large and enjoys support from both political parties, especially Republicans.”

Congress not only funds the NIH, it also provides $1 billion a year for DOD research labs looking into cures and treatments for cancers and other diseases.

Going forward, the military would like to see an increased focus on health as a part of national security. The debate is not a matter of either health security, or military security, it has to be both.

With a new administration, we need to think beyond stimulus packages, to fundamentally rethink what national security means. In the next pandemic, we can’t be scrambling for enough face masks to protect our medical professionals and hoping that the military can save us.

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Saturday Soother, Covid Plateau Edition – May 2, 2020

The Daily Escape:

Spring flower bloom at Keukenhof Garden in Holland. (Hat tip to Ottho H.)

Remember when we had fifteen COVID-19 cases, and they were just going to be gone, like a miracle?

If you ask Trump, that’s where we are, plus a few orders of magnitude. All of the recent happy talk about reaching or being past the peak have omitted the detail that so far, “flattening the curve” isn’t substantially reducing the number of cases, or deaths.

The theory was that once we “flattened the curve”, we could ease up on social isolation, mask-wearing and get back to work. When we think about the downside of the curve, we think bell curves, with a sharp rise and fall from a high peak. As Wrongo said on April 20, that was unlikely to be the outcome, because it didn’t happen like that in countries that started fighting the virus long before us. And that’s how it seems to be working out. Here is where we are:

Source: Washington Post

The chart tracks a 3-day average of cases, since that smooths out some of the big day-to-day variances. As of April 29, it seemed clear that we have reached a peak, but we’re not showing any real signs of a rapid decline. This means the COVID-19 curve could remain elevated for a long time.

And we should remember that 878,839 cases are still active.

Politicians are obsessed with “the peak.” Are we at it? Are we past it? When will it come? Has it come? Now they’ve turned to communicating their plans for reopening the economy. That makes sense. Re-opening is becoming urgent, with more than 30 million Americans out of work, but it’s dismissive for politicians to say we’re past the worst of it “medically” while more people go to the ICU every day.

Massachusetts governor Charlie Baker (R), sees the plateau, and wonders when the curve will start to decline:

“Baker focused on hospitalizations and ICU admissions, saying, we’ve basically been flat for 12 days. We’re flat at a high level. But 12 days, 13 days counting today — you’re not going to find a lot of other places that just sit like this for 13 days.”

Former FDA Commissioner Scott Gottlieb MD, an advisor to Baker, tweeted:

IHME (mentioned in the tweet) is a closely watched model from the University of Washington Institute for Health Metrics and Evaluation.

What we do over the next few weeks will determine whether we get this right, or whether COVID remains a large ongoing threat. We need to understand the potential risks that come with a decision to reopen, and make plans to mitigate these risks as best we can. Some states, like Connecticut, are planning carefully.

If we look state by state, in about half of the country, the numbers of cases are still rising. In about another third of the country, there is a leveling off. Only in a minority of states are the numbers actually coming down on a daily basis. New York, Washington, Louisiana and Idaho have had reductions of more than 50% from their peaks in new infections.

According to STAT, there are several possible outcomes: Recurring small outbreaks, a monster wave of cases, or a persistent crisis. And no one knows which outcome is most likely. We should expect new infections to start rising again in states without much testing, but with large populations that opened early like Texas, Florida and Georgia.

We should also realize that in some states, cooking the books about new cases and deaths will happen. Newsweek reported data compiled by Florida medical examiners was no longer being reported by the state government. The official state data has not been updated in over a week.

Acting like we’re flattening the curve when we really don’t know if we are, is likely to create a San Andreas-sized political earthquake if cases spike again.

But let’s try to get past all this, because it’s time for another Saturday Soother, when we stop checking Twitter, and think about spring.

Here on the fields of Wrong, the pear, plum and cherry trees have flowered, while the crab apples are soon to bloom. We have bluebirds nesting in both bluebird houses. Our weather remains cold and wet, so stay indoors and brew up a hot mug of Bengal Spice tea.

Now grab a socially distant chair and have a few minutes of fun with a song parody by the Opera Guy, Matthew Ciuffitelli. Here’s his parody of “Phantom of the Opera”, called “Phantom of the Quarantine”. Wrongo promises you won’t be disappointed:

Those who read the Wrongologist in email can view the video here.

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Monday Wake Up Call – April 27, 2020

The Daily Escape:

Harvest Moon over Bisti Badlands, south of Farmington, NM – 2019 photo by navidj.

Question: How many Americans have died from COVID-19? A: 54,024 as of Sunday.

Question: How many Americans died in the Vietnam War? A: 58,220.

Barring a miracle, we will pass that Vietnam milestone this week. By then, there will be more than one million confirmed cases, and 60,000 deaths in the US. Can we take a minute, and try to place the Coronavirus in the context of the dead and broken bodies from Vietnam?

Vietnam took ten years to reach that horrible number, while COVID-19 has met it in less than three months. Wrongo served during the Vietnam War. It was a trying time for all Americans. We were disunited at home, at much at war with each other, as with the Viet Cong. It scarred at least a generation, and there are still victims of both the domestic and foreign fights among us.

Today’s fight against the Coronavirus may become the current generation of 20-something’s Vietnam. Jobs won’t come back quickly, friends and family are dying, and the lack of testing and a vaccine will make life scarier for young people than for any other group.

Like Vietnam did to the boomers, Coronavirus could scar young people for years to come.

As we head into month four of the outbreak, we know that we are undercounting deaths. The Economist reported on one aspect of the undercount early in April, comparing cardiac arrest deaths in NYC to the historical average:

Are the increased rate of cardiac arrest deaths really COVID-19 deaths? A strong case can be made that they are. Back to the Economist, who says that the outbreak will be worse in the South: (emphasis and parenthesis by Wrongo)

“Places with older residents and more diabetes, heart disease and smoking have higher CFRs (case-to-fatality rates)…..Counties with lots of poor or black people tend to have more health problems, less social distancing and fewer ICU beds. Yet CFRs in such areas are even higher than you would expect from these factors alone.

Together, these variables leave a geographic footprint….the highest death rates will probably…be…in poor, rural parts of the South and Appalachia with high rates of heart disease and diabetes. Worryingly, the three states that announced plans this week to relax their lockdowns (Georgia, Tennessee and South Carolina) are all in this region.”

It didn’t have to be like this. There’s plenty of blame to go around, but in the end, the single most important factor in America’s disaster of a response was the lack of early testing. That will be a greater disaster if we fail to keep growing testing as the lockdowns end.

One thing that’s difficult to comprehend is the lack of empathy for the dead and their families and friends by some Americans. Most can rouse themselves to celebrate the first responders, health care workers, and “essential” workers, but not all can.

The WaPo has analyzed all of Trump’s Coronavirus briefings, and found this:

“The president has spoken for more than 28 hours in the 35 briefings held since March 16, eating up 60% of the time that officials spoke….Over the past three weeks, the tally comes to more than 13 hours of Trump — including two hours spent on attacks and 45 minutes praising himself and his administration, but just 4½ minutes expressing condolences for coronavirus victims.”

Trump has not even ordered American flags lowered in tribute to the dead, while some governors have. New Jersey’s Governor Phil Murphy and New York’s Governor Andrew Cuomo both did in April. As Susan B. Glasser said in the New Yorker:

“Trump, who has in the past personally asked for the flags to be lowered after a shooting or a politician’s death, can’t even bring himself to do this much for victims of the coronavirus.”

Time to wake up, America! We must tread carefully for the next few months, because we truly know very little about the virus. For example, there’s no evidence that Coronavirus antibodies prevent reinfection.

To help you wake up, listen to “Road to Nowhere” written by David Byrne for the 1985 Talking Heads album “Little Creatures”. Here, it’s performed in 2012 by David Byrne and St. Vincent, live in Paris with a brass band:

Sample Lyric:

Well, we know where we’re going
But we don’t know where we’ve been
And we know what we’re knowing
But we can’t say what we’ve seen

Those who read the Wrongologist in email can view the video here.

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Flattening the Curve May Take Time

The Daily Escape:

Dying Tornado, KS – photo by mattgphoto

When it comes to ending the lockdown, the theory is that once we’ve “flattened the curve” we can ease up on social isolation, mask-wearing and get back to work. The problem is that when we think about the downside of the curve, we think parabolas. This chart demonstrates that even with the “flattening”, we’ve been told to expect a sharp drop-off in cases:

But as Cathy O’Neil says: (brackets by Wrongo)

“The dying won’t be over nearly as soon as it [a curve like that] suggests.”

O’Neil looked at the curves for Italy and Spain. Both had uncontrolled outbreaks and climbed the curve about two weeks ahead of the US. They also turned to lockdowns late, leading to overburdened hospitals. So, they offer a decent indication of what to expect in in America:

 “Their curves…are not symmetric curves. They go up fast, flatten out and then descend slowly. How slowly? It’s still hard to tell, but the shape strongly suggests that the bad news won’t go away nearly as quickly as it arrived.”

Here’s Italy for example:

It’s too early in the virus’s growth in the US to know what the right side of our curve will look like, but the evidence from Europe suggests that the descent will be slow. More from O’Neil:

“New York Governor Andrew Cuomo has said ‘the worst is over’ and ‘we’ve reached the peak.’ He should have followed with “now comes the long wait.”

She’s saying that the far side of the curve is likely to be a long, slow slog. This is food for thought for politicians who must decide when to end the lockdown.

It should also be food for thought for all of those protesting the lockdowns. In addition to the shape of the curve, we still have almost no idea what the actual prevalence of the virus is in the general population.

Abbott Labs has developed a 5 minute serology test that it says has 100% sensitivity and 99.6% specificity (Sensitivity means the test detects the presence of antibodies triggered by the COVID-19 virus; specificity means it successfully avoids mistaking that virus for similar coronaviruses).

The test was used in the Boston suburb of Chelsea. It found that of 200 randomly sampled residents who were stopped on the street and asked to give some drops of blood, 64 had antibodies. That’s 32%. The study was conducted by physicians at Massachusetts General Hospital.

John Iafrate, a pathologist at Harvard and the study’s principal investigator, said:

“We don’t know at this point what percent of these antibody-positive individuals are still carrying virus, but a fair estimate is likely 30-50%.”

Soumya, a health reporter for the LA Times, tweeted: (emphasis by Wrongo)

“LA County just released the results of their antibody study. Tests found that 4.1% of the county’s population has antibodies to the coronavirus. That figure is 55 times higher than what is suggested by the official case count.”

This suggests that there are many more infected, but asymptomatic people than are in the official numbers.

So, we need to be more sensible about both the shape of the curve, and about how little we know about who has the disease, and who doesn’t.

We’re still flying almost totally blind, four months after the government found out this was coming.

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Sunday Cartoon Blogging – April 19, 2020

One week ago, the cumulative US COVID-19 death toll was 15,000. Seven days later, the death toll is now 36,000. That means in a week, about 21,000 Americans have died, a growth rate of 140%. In the past two months, here’s how US coronavirus deaths have grown:

  • Feb 17: 0 deaths
  • March 17: 111 deaths
  • April 17: 36,997 deaths

Although deaths are a lagging indicator for how successful we are in our efforts to contain the Coronavirus, and despite all the happy talk about flattening the curve, this looks like a rocket ship leaving the launch pad.

The Navy has now tested about 94% of the crew on the USS Theodore Roosevelt, the aircraft carrier that was sidelined with a Coronavirus outbreak. As of Friday, 660 crew members (of about 4,865) have now tested positive for Coronavirus.

However, of those 660 who were positive, 60% have not shown any symptoms associated with the illness. This should cause us to question the true rate of infections in the US. The proportion of people who are asymptomatic carriers worldwide remains unknown, but at 60%, the Theodore Roosevelt’s figure is higher than the 25%-50% range Dr. Fauci laid out in early April.

Taking these two data points together, America should proceed carefully as it leaves the lockdown.

On to cartoons. Another day, another spin of the big blame wheel:

With big business, some things never change:

If not his signature, then certainly his fingerprints:

The right’s narrative that can kill:

Individual responsibility has consequences:

John Roberts has to live with his Wisconsin voting decision:

 

 

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Should America Be Reopening Now?

The Daily Escape:

Poppies, Antelope Valley, CA – 2020 photo by user_greg. Part of the annual spring “super bloom” in CA.

Given Trump’s decision to open the country to walking around while infected, it’s becoming clear that for the administration, the business of America is strictly business.

But this is wrong. In a pandemic, the business of America is not business; it’s public health. Absent public confidence that the virus is at least under control, many businesses and workers won’t be comfortable heading back to work, no matter what politicians say:

“More than eight in 10 voters, 81%, say Americans “should continue to social distance for as long as is needed to curb the spread of coronavirus, even if it means continued damage to the economy…. Democrats (89%) are more likely than Republicans (72%) to say Americans should continue the “social distancing” measures”

Looks like Trump holds a minority view. To see if there was any concrete basis for saying the US was in a position to reopen soon, Wrongo looked at the COVID-19 Tracking Project’s state-level numbers, and subtracted the terrible NY numbers from the rest. Here’s the result:

The conclusion is that NY isn’t all that terrible compared to the rest of the US. It has a decreasing share of America’s total infections and deaths. But the highlighted rate of increase in deaths in the rest of the US since April 12th should concern the White House.

In fact, the seven-day average for growth in new cases shows that cases in the rest of the US are growing faster. NY is growing at 5.27%, while the rest of US is growing at 5.83%.

And the news from the places without lockdowns isn’t good. Politico reports that hot spots have erupted in farm belt states where governors insist lockdowns aren’t needed:

“The only hospital in Grand Island, Neb., is full. The mayor…asked for a statewide stay-at-home order that the GOP governor insists isn’t needed. More than one-third of those tested for coronavirus in the surrounding county are positive — and there aren’t enough tests to go around.

Grand Island is the fourth-biggest city in a state President Donald Trump and his top health officials repeatedly [say is]…keeping the virus at bay without the strict lockdowns 42 other states have imposed.”

New cases in Nebraska and in Iowa, South Dakota and other parts of the heartland are starting to spike. This should be raising concerns about whether we’re controlling the disease. Here’s Nebraska’s Republican Gov. Pete Ricketts saying that voluntary social distancing is working: (emphasis by Wrongo)

“This is a program that depends on people exercising personal responsibility and their civic duty….This is about making that decision, not the heavy hand of government taking away your freedoms.”

All of a sudden, as if they saw the bat signal, Republicans want to do the “Live Free or Die” thing. From the Daily Beast:

“A protest movement is taking hold targeting states that have extended social-distancing rules, closed schools, and restricted access to large religious gatherings. And it’s being fed by loyalists and political allies of President Donald Trump.”

This seems to be “spontaneous” support for Trump’s effort to reopen the economy.

In Michigan, a demonstration called “Operation Gridlock” protested Governor Whitmer’s shelter-at-home orders. Michigan has the third-highest number of COVID-19 cases in America, and the lockdown lowered infections. But Republicans criticize the order. Several thousand cars blocked the Lansing streets to protest what they see as an infringement of their liberty.

A lot of calories are going into the open vs. lockdown debate. It’s all a waste of time. How will we get a healthy economy if we eliminate the lockdown before we have any chance of stopping the mass transmission of this disease?

People aren’t staying at home because governments told them to. They’re doing it because it’s not safe to be out there. They aren’t going to go to work willingly in crowded offices, or travel, or attend concerts unless the danger is visibly lessened. And the economy will not recover until people are willing to do these things.

It’s not about flipping a switch. Businesses reopening will happen in small steps, as public health officials and political leaders, especially mayors and governors (and businesses), work to establish the basic conditions for a return to economic activity.

The bottom line is that the people are in control. We had to be convinced to stay home, and now we’ll have to be convinced to go out.

You go first, should be the people’s mantra. Trump should go back to holding MAGA rallies immediately. He should put his life and those of his supporters, where his mouth is.

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Problems With The COVID-19 Data

The Daily Escape:

Sunrise in Monument Valley, UT – photo by therealmindzeye. Note the sun star!

Happy tax day! Here are the updated COVID-19 seven-day results as of 4/13:

  • The number of new cases has plateaued. The average rate of increase for the past seven days is 6.88% vs. 5.00% on 4/13. But, this is a function of how many tests are conducted.
  • The number of deaths is increasing more slowly, averaging 11.94% for the past seven days vs. 7.35% on 4/13.
  • More people were tested on 4/13 than on any day in the past seven days, but we still lag April 4th, which was the country’s high point in tests at 229,268.

We all hear the daily recitation of new cases, deaths and tests, but as Wrongo said last week, there are multiple issues with the data that politicians and public health officials are relying on for decision-making.

Cathy O’Neil, who writes at Bloomberg and blogs as the Mathbabe, has a column addressing reasons to doubt the COVID-19 data. Here are a few of her points: (emphasis and brackets by Wrongo)

“1. The number of infected is close to meaningless. Only people who get tested can be counted, and there still aren’t enough tests…anecdotal evidence suggests that people need to be ill enough to be hospitalized [to get tested]. About 10% of cases merit hospitalization, so the actual number of infected might be about ten times larger than what’s reported.

2. The tests aren’t accurate and the inaccuracies aren’t symmetric. In particular, they produce many more false negatives than false positives….Some research suggests that the false negative rate could exceed 30%.

3. The number of tests doesn’t equal the number of people tested. Because the tests are so inaccurate, some people get tested twice….This means that the share of the population tested compared to the number of people found to be infected paints a rosier picture than reality…another reason to believe that the actual number of infected is higher.

4. The numbers aren’t in sync. People sometimes die weeks after being hospitalized, and they get hospitalized a week or more after testing positive for the virus. So we shouldn’t expect the “number of deaths” curve to flatten until pretty long after the “number of cases” curve does.

5. The meaning of hospitalization is changing. Officials have recently presented flattening hospital admissions as a positive sign. But it takes a lot more to get somebody to the hospital these days. Hotlines are jammed, ambulances are scarce, standards for who gets hospitalized have drastically changed, and people are avoiding overwhelmed emergency rooms. So fewer hospitalizations doesn’t necessarily mean that the situation is getting better.

6. Deaths aren’t reported immediately or consistently. Various operational issues, such as paper filing and notifying next of kin, determine when a death actually gets registered. This might help explain why the most deaths tend to get reported on Tuesdays.

7. Deaths outside hospitals aren’t being reported. When people die at home or in nursing facilities, veteran homes, or prisons, they’re not always counted…..When France started reporting fatalities in nursing homes, their death count increased by 40%. Belgium reports nursing home deaths pretty well, and they’re finding 40% of deaths occur there.

8. The policy for attributing deaths isn’t consistent. Once somebody is gone, why waste a valuable test? So doctors might not mention Covid-19 as a contributing cause. It’s a judgment call, especially when someone was sick already. This might have a very large effect on the data in certain environments like rehab facilities and nursing homes.

9. Officials may have incentives to hide coronavirus cases. China, Indonesia and Iran have all come under scrutiny for their statistics…..So don’t assume that officials are above…manipulation.

10. What happens in one place, or on average, might not be applicable everywhere. Some small studies suggest that the Covid-19 mortality rate is about 1% of the infected population. But that doesn’t mean it will be the same in the US, or in New York City….As we’ve seen in recent days, such disparities are disproportionately affecting people of color.”

You should follow the Mathbabe. We all rely on the count, but as Cathy says, we may not know the true numbers for some time. Testing needs to be done systematically, particularly on asymptomatic people, once we decide to end the lockdowns.

For deaths, accurate numbers may never be available. It’s possible to estimate using the number of unexpected deaths compared to a year earlier. But even that’s not ideal, because lockdowns might suppress other kinds of deaths — traffic accidents, for example — since people are forced to stay at home.

Despite flaws in the data reporting, we’re all obsessed with learning how America is responding to the pandemic. And the daily updates on tests, cases, and deaths gives us a reasonable clue about what to expect, when things might get better, or how our leaders are doing with the response to the virus.

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