More interesting data regarding Covid

[+ stevenkesslar]

An interesting study I missed when it came out a few weeks ago:

The Stanford study, however, does not include the largest antibody study to date: that involving a randomized sample of 70,000 Spanish residents, whose preliminary results were published by the Carlos III Institute of Health two weeks ago. That suggested that five percent of the Spanish population had been infected with the virus. With 27,000 deaths in the country, that would convert to an IFR of 1.1 percent.

 

The article that paragraph comes from is mostly a Stanford study that provides "evidence" that perhaps COVID-19 is no more dangerous than the flu. At this point, I really don't think it's possible to take that argument seriously. New York and New Jersey have now both had about 10 times as many deaths, in a few months, as they normally have from the flu every year. And that is after an unprecedented lock down to suppress the spread of the disease. So after that, and Spain, and Italy, and France, and pretty much the entire world's experience, the idea that this is no more dangerous than the flu is both laughable and tragic. It just invites death, by keeping people off guard to a lethal menace.

 

It's not clear what is going on with some of these studies that come up with seemingly absurd results, like maybe the death rate is 0.02 % or something like that. My guess is they are doing antibody testing on very small segments of populations. And when you are testing a small group to reach conclusions about large populations, a few false positives or false negatives can screw the numbers up.

 

For that reason, I think that Spain study is much more noteworthy, as the article I cited is honest enough to point out - even though it undercuts some of the absurd arguments the article makes. The Spain antibody study tested a whole bunch of people in a country that was really hit hard. So whatever testing errors they might have had would have less impact on the final outcome.

 

The Spain study squares with the fairly large New York antibody testing study that was done last month. For the same reasons, the New York study is likely to be the most accurate of the antibody studies done in the US to date. That study estimated that 14 % of state residents and 21 % of city residents had been infected. Based on those estimates, they extrapolated a 0.5 % statewide fatality rate of all those infected.

 

At the time the study came out, I checked the number of deaths in New York. If 21 % of New York City residents were infected, that would be about 1.7 million people. There's about 20,000 COVID-19 deaths in NYC now. But if I recall at the time the study came out, it worked out to about a 0.6 % fatality rate in NYC based on the number of state-reported hospital deaths at that time. NYC was also reporting that another 5,000 probable COVID-19 deaths had occurred at home. If you included those, the fatality rate was just about 1 % of all 1.7 million people estimated to have been infected.

 

The best abstract studies, like in the Lancet, have used numbers like 0.67 % for a few months. Fauci keeps saying about 1 %.

 

So I think we now know enough to say somewhere in the ballpark of 0.5 % to 1 % makes sense as a range. The 1 % figure - or a bit higher - particularly makes sense if you factor in pandemic conditions. Meaning mass illness, ICUs filled to capacity, people dying at home. Those things actually occurred in New York City and Spain. That is, in fact, what lock downs were intended to avoid, or end. So it would make sense that the fatality rate would end up higher in NYC or Spain than in a place like Germany, or California, or Australia, where hospitals were not under similar extreme stress or overcapacity.

 

Add @Unicorn's point about unrelated and potentially fatal outcomes- like heart attacks or gunshot wounds - and it only aggravates the state of emergency more. If you count people who unnecessarily died of other causes because they could not got adequate care, either, then the death rate just goes higher.

 

I think the worst case scenario now is "flatten the curve". Meaning most of us will get sick of COVID-19, and whoever is going to die will die. And the very best we can hope for is to manage it so it is the minimum amount of hell it has to be for hospitals, doctors, nurses, and patients. For whatever reason, it is clear to me that some minority of people are going to be pessimists. They believe that the only way out of this is what worked in 1918. Meaning people will have to get sick, and in some cases die, until the virus just can't find enough people to sicken or kill anymore.

 

I'm increasingly optimistic based on the experience of most of the rest of the world that 2020 is not 1918. We actually know what viruses and vaccines are now. So Europe and Asia and most other places clearly have decided that they think they are smart enough to take shelter and wait out the storm. Yeah, it sucks for the economy. But it's actually probably less sucky for the economy than a full blown pandemic, with 2 million or so dead Americans. The real winners in this game of Russian roulette are the countries that have either avoided lock down for the most part, or had short but intense lock downs that crushed the virus quickly. All the winners have become masters of the protocols of test, trace, treat.

 

I think California, Ohio, Texas, and Florida are the states to watch. Nothing against the other 46. But they are not states that were already crushed, like New York or New Jersey. They are large, and diverse. And they all have managed this crisis about as well as Germany, which for whatever reason did one of the best jobs of the larger European nations. So my guess is that a lot of what we are going to learn about dealing with COVID-19 is going to be learned by the best practices in those states.

Edited May 21, 2020 by stevenkesslar

[Guest]

You know @stevenkesslar, why don’t you just start a blog.

You sooooo want to be heard...

It would allow up you to type and type and type

And no worries for time outs...

[+ Pensant]

You know @stevenkesslar, why don’t you just start a blog.

You sooooo want to be heard...

It would allow up you to type and type and type

And no worries for time outs...

I agree. He writes clearly and backs up his posts with research.

i recently read that a possible reason for some of the deaths of younger people may be related to their inability to produce interferon. Something like 1 in 10,000 have this genetic condition. I’m about to read a book on virology. This crisis has piqued my interest in this area. I also have a lot of time on my hands. Perhaps I can be a guest contributor to SK’s blog.

[+ bigjoey]

Focusing on the macro numbers for the United States or a city like NYC obscure what is happening on a micro level. For example, in a post above, one senior living home out of about 150 in my county accounts for half the fatalities from Covid19; the others managed to have no or minimal deaths because of better management and use of best practices.

 

The Wall Street Journal had a story on one university that did not send its students home after Spring break:

The Education of Jerry Falwell Jr.

The story is behind a firewall but for non-subscribers a summary:

 

1-when Jerry Falwell announced that students could return to campus after Spring break or continue the semester on line, 1,200 students returned to campus.

 

2-media response was hysterical. Daily Beast quoting a doctor “If Liberty University reopens, people will die.” The NY Times headlined “Liberty University Brings Back Its Students, and Coronavirus, too.” Paul Krugman wrote that Mr Falwell “seems to have created his own personal viral hot spot.” Washington Post headlined “An authoritarianism power structure brought coronavirus to Liberty University.”

 

3-false facts of reports of infections were in the media such as The NY Times and Financial Times which had to be retracted.

 

4-results at the end of the school year: no infections of students or employees on campus. For students who were online and employees working remotely off campus none had their infections traced back to campus.

 

5-critics of Falwell’s political and religious convictions allowed bias that to distract them from the question whether Liberty University behaved responsibly.

 

6-the story tells of what the University did to protect students and that two surprise visits from state health inspectors found no violations. The story details those best practices.

 

As other universities decide what to do, they should look at what was successful, understand why and copy the things that worked. This is not about Falwell’s beliefs on evolution, politics or religion but about what was successful in protecting students and employees.

 

Last I read, the California University system was not going to allow students to resume campus classes in the Fall. This will only add to the collateral damage of the pandemic by harming the education of tens of thousands of young people. This is the result of the pandemic of fear the media is spreading.

 

People can have a “normal” life but like Falwell’s campus, it needs to be done smartly. Like the well managed senior facilities, there do not have to be fatalities. Unfortunately, people do stupid things and some will not follow best practices; their lives will be shorter and tragically they will kill others; think: drunk drivers who kill thousands of people besides themselves. Society often cleans up the messes made by people making bad choices.

 

By the way, the Falwell story’s happy ending has so far not produced any mea culpas from The NY Times, Paul Krugman and the other wrong prophets of death and doom. There were retractions of wrong facts like reports of infected students but no stories from those sources of being wrong in their predictions. The story about how Liberty University was treated in the media is an illustration of media hysteria generating a pandemic of fear rather than focusing on best practices that need to be adopted.

 

The Wall Street Journal story ends:

“In a part of his early statements on Liberty’s reopening that received almost no attention, Mr. Falwell said in its handling of coronavirus Liberty would prove a ‘model’ for others. Would it kill the critics so quick to paint Mr. Falwell as the Grim Reaper to acknowledge, if only in the name of science, Liberty’s experience might have something to teach them?”

[xyz48B]

Politics now reign supreme in the US response to this crisis. Pandora’s box on that one has been opened. Lines have been drawn and sides taken. Now it’s about defending your team. Facts be damned.

[+ Charlie]

I think there is much to that: the Boomer’s fear of death is driving their responses. After thinking about that, another factor may be that Boomers (and younger people) are more secular than previous generations. Just my general observation (but I welcome someone posting research) is that deeply religious people are more accepting of death and human mortality than non-believers.

This should be true in theory, but whether it is in reality is not so clear. Certainly in a society in which everyone has the same religious convictions it is probably true: death was accepted much more easily in pre-modern societies which were culturally homogeneous, in which one was taught that death served an accepted purpose. However, in modern societies which are predominantly secular, religion is often a superficial identity badge rather than an absolute conviction for most people. It is very difficult to genuinely believe that death is the portal to "a better place" when you have spent a lifetime being exposed to overwhelming evidence that it isn't. A society that places the highest value on the right of the individual to "life, liberty and the pursuit of happiness" is hard to reconcile with death, which negates it all.

[xyz48B]

@Charlie, part of the problem is *merely* perceiving death as a portal to a better place. If death is no longer viewed as the worst thing that can happen to you, it allows you to more fully embrace the current life as well. When religion (in this case likely Christianity) is reduced to “escape bad life for a better next life,” it does lose a lot of value. That’s not to say many, supporters and detractors, of religion haven’t been reductionistic about it in precisely that way, but it does offer a possible explanation for why for so many it’s lost its value and need something else to cling to for hope etc.

[Guest]

....

 

I'm not completely sure I understand your point. Are you saying instead of a lock down in NYC, it would have been better if 50,000 or 100,000 New Yorkers fell ill and died? Would it have have made it easier for people with gun shot wounds or car crash injuries to get treatment if the hospitals were so crowded that people were dying in hospital hallways? Is that your point?

 

If it's not, what is your point? ...

For someone who writes such lengthy posts, you sure don't seem willing to read the shorter posts to which you respond. Since we have population data from NYC, that's the one place we do have case fatality rates (at least for March and early April), and, as previously mentioned it's at 0.5% there (or was in the late Winter/early Spring). NYC has a population of 8.4M, so even assuming a worst-case scenario, the most that would die would be 42,000 total, so your arithmetic is off from the get-go. And that assumes (1) 100% infection rate, every single person in the city, (2) the remaining population is just as vulnerable as those who've already died, (3) unlike any other known corona virus, no decrease in virulence in warmer weather, and (4) no improvement in mortality from remdesivir.

That being said, of course I wouldn't be OK with 42,000 dying. I never said we didn't need to start the lockdown in March, and it's preposterous for you to suggest that I did. Of course, when one looks at the graphs, the efficacy of the lockdowns is clearly not as dramatic as we were led to believe. Some states have been open for a good 4 weeks now, and not one has seen a spike. We have the data of 50 states to peruse. Some have gone up a bit, some down, but mostly it's been rather flat. And, bear in mind, that we have greatly increased testing capacity, so that accounts for a large number of diagnoses. Where I live, one originally had to have pretty significant symptoms to be tested, and now even people with no symptoms who are just curious can be tested. I don't think one can look at this data and conclude either that the lockdowns were extremely efficacious, or that opening things up slowly leads to disaster:

https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html

 

So I'll repeat my points one more time, and won't do it again, since there's no point in repeating myself if you won't read my responses. (1) Those vulnerable to severe infection and death should receive special protection (nursing home residents, assisted living facilities, and so on), as I've described previously, and (2) At this point, it's clear, at least to me, that maintaining the lockdown at the level that it's been is doing more harm than good. This doesn't mean we need to hold rock concerts or mass spectator sports, but businesses should be able to re-open with certain precautions.

[+ bigjoey]

Great article on “lockdowns” and “herd immunity”:

https://www.tabletmag.com/sections/science/articles/plague-journal-herd-immunity-doidge

 

It explains why we will get a second and third wave of infection. It exposes the dangers of “group think” which seems to be where we are as a society.

[xyz48B]

@bigjoey – That article was a good read. Of course, even pondering alternatives to the narrative presented us is crimethink. That’s doubleplusbad.

[+ stevenkesslar]

Great article on “lockdowns” and “herd immunity”:

https://www.tabletmag.com/sections/science/articles/plague-journal-herd-immunity-doidge

 

It explains why we will get a second and third wave of infection. It exposes the dangers of “group think” which seems to be where we are as a society.

 

So what is an acceptable number of dead Americans to you? 500,000? 1 million? 2 million?

 

You seem to like articles that have almost nothing to do with reality, and that never talk about actual dead people. So if we are focused on data, here's the data: we have 100,000 dead Americans, mostly seniors. Oh, by the way, the article you posted seems to overlook that minor fact.

 

How much bigger do you think that number should be? 500,000 dead American seniors? 1 million dead American seniors?

 

You are speaking out against "group think". Good for you. I'm with you on that. Group think is bad.

 

So please be clear. Don't be an intellectual wimp. Tell us the truth. How many dead Americans is herd immunity worth?

 

I think herd immunity means 2 million dead Americans, mostly seniors. Is that worth it to you? Should our goal be to promote herd immunity, at the cost of 2 million dead Americans? Is that your idea?

 

Again, you don't want group think. You want clarity, and reason, and fact, and honesty. So give us clarity, and reason, and fact, and honesty.

 

The articles you post are pretty much devoid of honest, factual presentations. Nowhere does the author bother with the tiny little fact that at least 100,000 Americans, mostly seniors, died in two months from COVID-19 - despite an unprecedented lock down.

 

Nowhere does the author deal with an honest discussion of the alternative - test, trace, treat - that has been used everywhere in the world. The author bad mouths China, but doesn't mention that they actually did stop the virus, and have a fraction of the deaths in the US. The author praises Sweden's herd immunity plan, but fails to mention they have actually had a rate of death double or triple that of their neighbors, Norway and Finland. Oh, and the economy of Finland and Norway did better than Sweden's economy, too. My simplistic theory about that is that dead people and sick people just don't go shopping.

 

So what exactly is the thing Sweden did that we are saying is good? Killed more seniors? Had a shittier economy than Finland and Sweden? Spell it out, since the article you posted doesn't spell it out at all. It just posits theories about how much herd immunity Sweden may have achieved, without bothering to mention the pesky little details of dead older Swedes.

 

And since we are being honest and factual and not engaging in group think, what is the death toll in Sweden that you think makes herd immunity worthwhile?

 

My own view is that you are the group think guy. Just about every country in the world that has tried has shown that some combination of lock downs, suppression, targeted closings, and especially testing, tracing, and treating have gotten the virus under control. The countries that did it best actually never had to lock down their economies, because they were way ahead of the global curve on getting the virus under control.

 

Again, key point. Countries like Taiwan and South Korea and Iceland that avoided lock downs and focused like a laser on testing, tracing, and treating did not do it to promote herd immunity. They did it for exactly the opposite reason. Their goal was to prevent death and illness, which it works out is bad for the economy. That is why the economies of countries like Taiwan or South Korea or Iceland -and, importantly, China - are doing better than most others, including the US and Sweden. Herd immunity turns out to be bad for the economy, not good.

 

Lots of medicals professionals and scientists actually object to the use of the term "herd immunity" in the context you keep using it. Their point, which is valid, is that scientists came up with the notion of artificial herd immunity through the use of safe vaccines. And the word safe is critically important, because nobody likes the idea that the cure is worse than the disease.

 

This idea that it is somehow a good thing to let a lethal disease sweep through a society is actually a pretty rare idea. To the degree it was even speculated about, like in the UK, it went down very, very badly. Thee seems to be an emerging global consensus (aka "group think") that "test, trace, treat" - also known as prevention - is better than the mass illness and death that natural herd immunity requires. The author fails to mention how the idea of letting a disease sweep through a society and kill some unknown (500,000? 1 million? 2 million?) number of people is a real intellectual outlier. Most doctors I don't know don't set out to see people get infected, or hospitalized, or end up dead.

 

Your author is honest enough to mention that there might be one little problem with herd immunity. Which is that it doesn't exist. Like most of the stuff you post, it is comic book in nature. Great theory. Nice stories. Fun to read. But pretty much devoid of facts. If it turns out that in the real world there are 100,000 dead Americans while we speculate about whether antibodies actually will protect people, or for how long, you wouldn't know that by reading your comic book fantasy.

 

If you have any actual data about actual deaths, actual GDP, that suggests that herd immunity is a good thing, or anything other than make believe and abstract theory, please share it with us. I am 100 % with you that group think is bad. I am 100 % with you that we should be objective data seekers.

 

But when you keep posting vague articles that fail to mention that 100,000 Americans actually died, and it also don't honestly say that 2 million more Americans will die, it's not being very factual or honest. The author does mention 2 million dead Americans, but only by way of trashing honest people who did put forth estimates of how NOT mitigating the virus wouldkill millions of Americans. So I don't buy it, @bigjoey. You have a tremendous capacity to just overlook actual mass death, as if it is some small thing that doesn't matter on the way to exploring some wonderful comic book theory.

 

I posted the data from The Netherlands on actual deaths by age cohort. I said that if you played those death rates out in the US, 2 million Americans are going to die to achieve herd immunity. Almost all of them are seniors. And that's a death rate of about 0.6 %, which is actually on the low side of what most people, including Dr. Fauci say. So I am being honest, and taking an honest non group think position. Herd immunity means 2 million dead Americans.

 

Herd immunity also means a work force of younger adults that is sick, hospitalized, and in some cases dead. None of these comic book herd immunity fantasies come within a mile of explaining how a crippled and sick work force is good for an economy.

 

Meanwhile, I don't need to theorize about how crushing a virus through testing, tracing, and treating is good for an economy. All I need to do is point to China, or Germany, or Austria, or Iceland, or Australia, or South Korea. Those are not comic book theories. Those are real nations, with almost no real COVID-19 deaths. So please, explain to us how the reality of those 1 billion + real living people fits into your pro-death comic book herd immunity theory.

 

Spell it out. How many people do you think need to die in the US to achieve herd immunity?

Edited May 22, 2020 by stevenkesslar

[+ stevenkesslar]

I'll take your use of the little emoji as a statement of your lack of real intellectual curiosity, or intellectual honesty.

 

If you want to have a serious discussion about herd immunity, go for it. One very good reason to have such a discussion is that I will be the first to admit that I have ZERO proof that China or Germany or Australia or Austria or Iceland or South Korea or Taiwan or New Zealand know what they are doing. Maybe it is really just bullshit, easter bunnies, and tooth fairies. Maybe, like in 1918, it is going to work out that it it is simply impossible to avoid a horrific level of mass death and illness. Maybe this Fall we'll be burying people in our backyards, like families did in 1918.

 

Or maybe we could stop the virus, but it would be at a cost so high that it isn't worth it. The idea that 100,000 dead seniors is acceptable is implicit in all these arguments about how the lock downs were a mistake. I think it's pretty factual to say that if we had no lock downs, we would have had many more dead. But then when you say we could have had 2 million dead, the critics say, "Oh, that's just bullshit. Who elected these scientists? Who elected Dr. Birx or Dr. Fauci?"

 

So if you don't want group think, fine. But then you have to be honest. Fauci spelled it out. Birx spelled it out. That number 2 million comes from a lot of people, including them. It is simply not intellectually honest of you to say that herd immunity is a good thing, and we should seriously think about it, without spelling out what it actually means.

 

How many dead? How do we know herd immunity even exists? When do we find out how long antibodies give us immunity? And how many people will be dead by that point?

 

You keep saying you want an honest discussion. So let's have it. Spell it out. These are very fair questions.

[+ bigjoey]

@stevenkesslar: If you had bothered to actually read and comprehend what I have posted and articles that I have linked, your questions have been answered. I have quoted statistics. You only see things through the lens of your bias and distortions of reality.

 

No matter what the subject, you only see your side of the argument and the virtue signaling of your self-righteousness has grown tiresome. Your distortions of facts, strawman arguments, cherry-picked statistics, bullying, repetitive postings, lies, etc. do not lend themselves to an honest discussion. You ignore what does not fit your world view. When you are challenged, you simply ignore the challenge when you can not justify your stance.

 

Sorry, I will not engage with you until you change your behavior. My posts are clear. They are fact supported.

[+ stevenkesslar]

How many dead? How do we know herd immunity even exists? When do we find out how long antibodies give us immunity? And how many people will be dead by that point?

 

@stevenkesslar: If you had bothered to actually read and comprehend what I have posted and articles that I have linked, your questions have been answered. I have quoted statistics. You only see things through the lens of your bias and distortions of reality.

 

I did read the entire article, multiple times. I've read all the articles you've posted on herd immunity, as well as many others.

 

Like the author, you won't spell out what herd immunity actually means. So, like him, you seem to want to lob bombs at respected people like Dr. Birx and Dr. Fauci. The author trashed the idea that we might have had 2.2 million dead Americans, had we done nothing. Which is, of course, what Fauci and Birx said. He has every right to trash them. So do you. And I agree with you that questioning "group think" is always a good thing. But if you are going to do that, you actually have to spell your alternative out.

 

Now what you are doing is mirroring the intellectual dishonesty of the author. "Oh me, oh my. I'm being censored. The media won't let me speak."

 

Nobody is censoring you, @bigjoey. If you won't spell out what herd immunity means to you, and why you think it is worthy of consideration, you are only censoring yourself.

 

But since you won't spell it out, I will. The author speculates about certain outcomes, which he still fails to spell out numerically - perhaps because he actually understands how bad they sound. So let's actually look at what he says.

 

Lockdown has always posed a serious problem that even its exponents, who are skeptical of herd immunity, can’t deny. After the virus has initially spread through a country, the more the lockdown succeeds—and keeps indoor bodies virgin pure and free of the virus—the more likely it is, when the lockdown is lifted, that the virus will rage and kill again, in second, third and fourth waves—as long it has not been completely obliterated from planet Earth. It’s inevitable by lockdown’s own logic. The very purity of the lockdown guarantees danger going forward, and undermines hope for anyone who takes the logic seriously. The pain is deepened and prolonged; with each passing day, the population exhausted, depleted, and of course financially ruined, until, ultimately, it becomes rebellious, which happens recurrently in the history of plagues.

 

Around this time the most comprehensive testing undertaken in New York to determine the infection rate showed that 21% of people in New York City had COVID antibodies as of mid-April (and presumably many more now). This suggested that many more New Yorkers had been exposed to the virus than previously believed, and that the death rate from exposure was much lower than had been believed. These death rates were much more in line with the rates Ioannidis was finding in other data sets. Since the overwhelming majority of these New Yorkers who showed antibodies seemed healthy, the testing appeared to suggest they indeed had resistance, and that herd immunity was probably building.

He reported on similar suggestions emerging from the cramped Diamond Princess Cruise, and from the fact that most young people seemed spared, and from findings in Iceland, which tested 5% of its population. All this testing suggested that there were more mild cases than the WHO data suggested, and that herd immunity might be building, though he was at pains to say we still needed more data.

 

There's a lot in that article, but I think those paragraphs spell out the core of the author's case for herd immunity. And I'll repeat what I said above. One very good reason to think about this is that a second, or third, or fourth wave might be inevitable. Maybe Jacinda Arden is really only good at talking about easter bunnies and tooth fairies. We just don't know. As optimistic as the lessons from many countries look, they are hardly proven science. So, again, I'm 100 % with you on the idea that group think is bad.

 

I do find it interesting that the author cites only one other nation - Iceland. It's easy to dismiss Iceland, since they are tiny. What the author does not mention is WHY Iceland was so good at testing. They actually ended up testing 18 % of their population so far - not 5 %, as the author cites.

 

The goal in Iceland is NOT herd immunity. It is the exact opposite. They tested and traced in order to stop the virus, not to let it continue on its course and kill more people. And they have beat the virus. Check out the numbers. These are facts, not theories. That have had a total of 10 deaths. They are now down to one reported case a week. That's not promoting herd immunity. That's the exact opposite. Relative to population, Iceland has had 29 dead per million. Sweden has 384 dead per million - which is about 13 times more death. Oh, and Iceland's economy is actually doing better than Sweden's. They never had a lock down, because they got ahead of the curve.

 

So if your point is we should have honest intellectual debate, I'm 100 % with you. Let's debate facts. But these are all the relevant facts. How many died? What impact did it have on the economy? Was a lock down necessary? If you want honest debate, these are the facts we need to debate. What Iceland has done is one example of a national success that suggests mass death and illness is simply not necessary. The author is entitled to his own biases. But why would he fail to mention Iceland's success?

 

And let's spell out the very dark picture he paints of New York and the US, without really telling us the details. Because, again, he might be right. Maybe we will have a second and third and fourth wave.

 

So his point is that New York City achieved 20 % herd immunity. Let's go with that. That came at a cost of 20,000 deaths, if I use the NYC data - including people they say died at home. I am going to assume that herd immunity means 60 % infection, which is probably low ball. The author should spell that out, but he doesn't. So, assuming he is right, a second and third and fourth wave of infection that finally achieves herd immunity would mean 60,000 dead in New York City - again, assuming herd immunity is achieved at 60 % infection. If we assume 80 %, it's of course 80,000 dead.

 

Extrapolating to the entire US is easy. The population of the US is about 40 times the population of the NYC. So if it takes 60,000 dead in New York City to achieve herd immunity, that would mean 2.4 million Americans. Which is in the ballpark of what Fauci and Birx said (2.2 million). What happened in New York City - in the real world, not theory - actually confirms that the horrific numbers Fauci and Birx used could actually happen.

 

Now let's do the same thing with Iceland. They had 10 deaths in a country of 364,000 people. I'm going to use very simple math and say there are about 1000 Americans (330 million) for every Icelander. So the equivalent number of deaths in the US would be 10,000. Meaning that if we had the option of doing what Iceland did, and used very aggressive testing and tracing to contain the virus and avoid the herd immunity route, it might have meant 10,000 Americans died, rather than 100,000 and growing. And, critically, Iceland has NEVER HAD A LOCK DOWN. Again, the lock down is of course NOT the goal. The goal is to stop the virus from sickening, hospitalizing, and killing an unacceptably high number of people. Lock downs are blunt instruments. Testing and tracing are more refined surgical tools.

 

So you can tell me if you think I am being unfair. But I am using real numbers based on real deaths in real places. I think what this means is that had we done what Iceland did, we might have had 10,000 dead Americans before we stopped the virus. If we instead assume we need to play out NYC all over America, and add a second and third and fourth wave until we finally achieve herd immunity, it could mean something like 2.4 million dead Americans.

 

If you think I am not being honest or fair, please let me know how. But if you are going to promote herd immunity - either as a choice, or as an unfortunate inevitability - you ought to be willing to actually spell out what it means to you. I just did. You simply won't.

Edited May 22, 2020 by stevenkesslar

[BgMstr4u]

Thank you, @bigjoey, for the Tablet article.

 

As I read it, the article does not so much argue the case for herd immunity per se, but for seeing through a taboo- (in the anthropological sense) driven response which isolates and ostracizes those who discuss it. In other words, the creation of a group-think mob mentality in the analysis of this event. The truth is that the science of this event, both of the virus itself and its associated epidemiology, is not fixed. This section spoke volumes to me:

 

“What is especially hard to accept at the moment, is that science has not yet answered all our questions so that we can know with a comforting level of certainty, what policy is best. We must live, for the moment, with some ambiguity. Those who can’t handle this ambiguity are promoting false certainty, the product of some fictional settled science, and anyone who deviates from that must become YouTaboo, unclean, impure.”

 

I think this is an important insight.

Edited May 22, 2020 by BgMstr4u

[+ bigjoey]

Dr Fauci newest remarks today:

https://www.cnbc.com/2020/05/22/dr-anthony-fauci-says-staying-closed-for-too-long-could-cause-irreparable-damage.html

 

Dr Fauci seems to understand that there is a “balance” between staying closed down to protect lives, especially seniors, and staying closed down too long which can cause collateral damage. I understand him saying we can open smartly and do things right (like Falwell did at Liberty University in my post above) that will minimize (but certainly not eliminate) risk.

 

As things reopen, we will all need to take personal responsibility for both ourselves and each other. We have the freedom to chose how to respond to this crisis. The results in the months to come as things open up will be our legacy.

 

We know what to do to minimize risk and the demands are not hard: wash your hands, do not touch your face, keep physical distance, etc. Certainly, we are capable of the task. Do we have the will to do so?

[+ stevenkesslar]

“What is especially hard to accept at the moment, is that science has not yet answered all our questions so that we can know with a comforting level of certainty, what policy is best. We must live, for the moment, with some ambiguity. Those who can’t handle this ambiguity are promoting false certainty, the product of some fictional settled science, and anyone who deviates from that must become YouTaboo, unclean, impure.”

 

I think this is an important insight.

 

I completely agree with that point, as well. Which is why I agree with the idea that "group think" is inherently bad, and should always be challenged.

 

Let’s Remember That the Coronavirus Is Still a Mystery

 

That article by Nicholas Kristof is a nice reminder about humility. His main point is that the real experts are the ones who are being very clear about how ignorant they are right now. Because this is a brand new virus.

 

I think it is now clear that Fauci himself was blindsided by how contagious this virus was in January and February. At the time, he talked about how the few cases that were going on in the US were being tested and contact traced. He specifically said at a few points that it was unlikely that asymptomatic people would be speading the disease widely. I'm not in a position to say Fauci was wrong. Fauci himself was in a position to say he was ignorant, and we all need to have more than a little humility.

 

I think airplane travel is a good analogy for where we are at right now. People won't get on airplanes if they think the plane is going to crash. So, like it or not, poll after poll shows that most people are not going to go out to eat, or out to a mall, or out to a movie - even if they can.

 

This is no surprise to me. In California, business is way down among the carry out restaurants I've gotten food from. It shocked me at first. These are carry-out places that should be thriving in these circumstances. No one is locking them down. No one is telling me I can't go patronize some small business that sells pizzas. And yet, for some strange reason, their business is down 50 % or 75 %. Can anyone guess way? Could it be that people simply don't want to die? Even if it means leaving their house to get a pizza they don't really need?

 

Sorry, but I'm a capitalist. That's the free market speaking. Most economists agree that until we contain this virus, the economy is fucked. Period.

 

If you follow the airplane analogy, that means we do not have two choices, which really sucks. And we do have two choices, neither of which are very appealing.

 

The choice we do not have is normal. Most people get on planes every day and don't think much about whether it will crash. "Normal" actually depends on an almost total absence of fear. And "normal" also actually depends on having a huge army of air traffic controllers and pilots and engineers and a massive government bureaucracy, all of whom are quite disciplined and very good at doing what they need to do: make flying safe. It works great most of the time for flying. But we simply do not have that option now.

 

Nor do we have the option of not flying at all. If you are a Black woman with kids who works at a grocery store, you actually have to go to that grocery store. First, you need work. Second, you need food. In Georgia right now, there are more Blacks than Whites that died of COVID-19. So this stupid elitist "health versus wealth" debate might be interesting for affluent Gay men who don't have to go to work. But it's actually not even a real option for Black women who work in grocery stores. Or Hispanic minimum wage workers. Or, of course, White factory workers who take the subway to work. So they want to go to work in a meat packing plant. They need the job. But they don't want to get sick or be hospitalized or die doing so. That is a very reasonable expectation.

 

And these Black women and Hispanic men and factory workers also probably understand that they are the part of the herd most likely to be "negatively impacted" by "herd immunity" . I use the euphemism "negatively impacted" because part of my point is that these "herd immunity" advocates should cut the bullshit and be clear and honest, like Dr. Fauci and Dr. Birx are being. Fauci and Birx said, honestly, our best guess is a couple million Americans will die. The author of the screed @bigjoey posted is perfectly willing to score points slamming Fauci as an unelected pinhead. Good for him. The author has that right. But he actually won't spell out what "herd immunity" means. Or what impact it might actually have on Black women or Hispanic men or seniors who fear death.

 

So that leave us only two options. We can fly blind, by choice. Or we can try very hard to build the airplane controls while we are flying it. Either way, the polls are telling us reality, and we should believe it. Depending on the economic activity, 60 % or 70 % or 80 % of Americans WILL NOT do it. They just won't. They don't want to be on a plane that is flying blind, or that is under construction as it is flying. They would rather stay home.

 

Meanwhile, you have countries like Iceland and Germany and South Korea that are, in fact, building the plane as it is in the air. And what they are doing is actually very similar to what we know works with airplane safety. They are using similar tools. They are building armies of testers and contact tracers. They are building or expanding links between private for-profit corporations (like drug companies) and government bureaucrats (like contact tracers). And what they are finding is that they can incrementally whittle away at the number of citizens infected by disease. They are using the same kind of daily rigor and discipline that happens every day all over the world so that you and I can safely board an airplane and fly. Except normally we don't think about any of what it takes to make that work. Unless we go see a movie like Sully.

 

Now, it could very well be that everything I just described is a fantasy. It could be that what seems to be working in Germany or South Korea or Iceland - oh, and let's not forget China - is simply doomed to fail. Sorry, but the "test, trace, treat" airplane is going to crash. It is doomed.

 

That is exactly why I keep reading these herd immunity articles. I know enough to believe, like most Americans do, that it is a bad choice. But what if it is our only choice? What if @bigjoey is right, and we are going to have a second and third and fourth wave? (By the way, that is exactly what Fauci and most scientists are saying.)

 

Has anybody ever heard of Tom Friedman? Has anybody ever heard of the New York Times? If Tom Tom Friedman writes something in the New York Times, is that what we call "censorship"?

 

The reason I ask is that the author who wrote @bigjoey's screed is using what I view as a lame and bullshit rhetorical technique. He is whining about how people like him, who are willing to tell the truth about herd immunity, are being censored. Sorry, that is 100 % bullshit. Friedman keeps writing op/eds about the beauty of herd immunity, and I keep reading them. I agree with Freidman 1000 % that we should be having an honest debate about the idea. And we are. When he keeps writing about it in The New York Times, that is not what I call "censorship".

 

It is actually because I read what Friedman writes that I have a very, very, very bad feeling about herd immunity. Friedman likes to use the phrase "harmonious balance" to describe the beauty of herd immunity. On the one hand, younger employees who face no real risk from COVID-19 should be free to go to work. On the other hand, at-risk seniors or people with diabetes or pregnant women should be given "special protections" to keep them safe. Who could be against harmony? Who could be against balance?

 

There's a few big problems. There's a 41 year old NYPD cop with a widow and orphaned kids. There's a Broadway star who is young and healthy in an LA hospital with no leg and ruined lungs. There's a huge meat packing plant in Sioux Falls full of young workers who got sick, or were hospitalized, or in some cases died. And the way they are trying to solve the problem in Sioux Falls is aggressive testing, tracing, and treating - exactly what is working in Iceland, and Germany, and South Korea. So unless Tom Friedman wants to talk about all that, he is really only talking about a comic book reality. Not the real world where 100,000 Americans are actually dead.

 

The even bigger problem is that senior experts say that COVID-19 is a brutally effective senior killing machine. If Friedman has spent time in nursing homes, it was a drive by. He has no clue. He does not articulate what "special protections" he would offer seniors, or how they would work in practice. He does not articulate how the army of college students who serve food or clean floors, or the army of young Moms who change senior diapers or dress Mom and Dad, would somehow be tested so that we knew they were not the weak link in the chain. Meanwhile, the reality in every nation on Earth that Friedman simply ignores is that wherever there is a community where the virus has spread broadly, it is always effective at finding seniors and killing them. It finds and kills seniors in nursing homes, at home, at work, or wherever they are. Friedman just won't deal with that reality.

 

If we are going to debate herd immunity, this is the real debate should have. Sorry, but Tom Friedman spouting about "harmonious balance" in The New York Times, when reality is 100,000 dead seniors, is my definition of out-of-touch elitism. He is not being censored. But he is also not being honest, in my opinion.

Edited May 22, 2020 by stevenkesslar

[+ stevenkesslar]

Anybody who wants to have a reality-based discussion about the relative merits of herd immunity versus "test, trace, treat" as a way to contain the virus might also want to consider where the American people are at in a new poll on this question.

And in the event of a second wave of cases of COVID-19 (coronavirus) in the United States in the next year, would you support or oppose the following measures? Stay-at-home orders that restrict travel except for essential reasons such as getting groceries or seeking medical attention

 

Strongly support: 57 %

Somewhat support: 21 %

Somewhat oppose: 9 %

Strongly oppose: 7 %

In a way, this makes @bigjoey's argument about "group think". You can make a reasonable argument that if 78 % of Americans will quickly support another mandatory lock down if there is a second wave of infection, that is "group think".

 

That said, it is also reality. Maybe 78 % of Americans are wrong. But if you believe that, and you want to change their minds, you better have pretty solid arguments, driven by lots of facts.

 

I think it's fair to say that herd immunity advocates are not only saying that a second wave is inevitable. They are actually arguing it is desirable. The point of herd immunity, in their mind, is to be done with it. So they tend to go a little bit, but not very far, down the road of talking about how we can offer "special protections" to certain vulnerable people during a second or third or fourth wave. Meanwhile, everybody else just shakes COVID-19 off without really breaking a sweat.

 

It's a perfectly fine argument to make. But it isn't based in reality.

 

First, most Americans just don't see COVID-19 as a "shake it off" disease. Second, if and when the virus comes back in full fury, Americans are already saying loud and clear that they are not going to vote for herd immunity. At least not right now.

 

I think this is a very important part of the discussion. I have come to deeply resent being told that I am somehow against a Black grocery store clerk or a Polish American factory worker or a Hispanic bus driver being able to go to work. I'm not. It's actually the grocery store clerks and the factory workers and the bus drivers that are saying - very loudly, and very clearly - that they want to be able to go to work. But without getting sick, or being hospitalized, or dying.

 

The only way in the world we know how to do that is test, trace, treat. Sweden is trying a somewhat different route. But so far what they have to show for it is more death than their neighbors, but no better an economy. One of their main ideas - keeping seniors in nursing homes safe - has been a spectacular and lethal failure. They admit that.

 

To me, reality is telling us what we need to know, and do. Whether meat packers even are aware of the dangers of COVID-19, what happens in reality is that when a bunch of them start to get really sick, and end up cramming ICU units, somebody actually does need to do something.

 

So what does somebody do? Get on a platform and tell everybody, "Hey, folks. We're gonna do herd immunity now. It'll be great."?

 

No. That does not happen in the real world. In the real world, they shut down the factory and cart out the test, trace, and treat protocols that are working everywhere else in the world. That is not a theory. That is what happens in the real world. In Sioux Falls, South Dakota. Now they have figured out that it is better to do it pro-actively. That way they can hopefully avoid having to shut the factory down, or have an ICU full of sick people.

 

We have no clue whether this idea of testing and contact tracing and marginally improved treatments will work for six months, or a year, or two years, or however long it will take. But we do know it is working now. Meanwhile, we have absolutely no clue whether anyone who got sick from COVID-19 in the last few months could get sick again next Fall or next Spring. All these herd immunity theories are completely untested. The 100,000 deaths are real, and happening right now. The theoretical herd immunity pay off is simply a theory. And if it happens, it happens somewhere down the line. No one can really tell us when, or how.

 

So when I read that 78 % of Americans will respond to a second wave by demanding another lock down, it makes perfect sense to me. Maybe if the herd immunity folks had better and clearer arguments, Americans would feel differently. But based on what they know now, it is incredibly clear that they simply don't want to take the risk of letting the pandemic play out however it happens to play out, like in 1918.

 

Given all that, for people who DO NOT want another lock down, like me, there is really only one practical choice. We have to do everything we can to make testing, tracing, and treating work. It is the best practical hope we have in the real world we actually all live in to avoid a second lock down, when the virus tries to come back in a fury. Fortunately, this approach is actually working relatively well, at least for now, in the real world we actually live in.

 

And when it fails, it is not hard to figure out why. Singapore was doing a great job. They had the best somewhat invasive phone app ever. Oh, but geez. They simply forget they have all these crammed dorm rooms with low-wage immigrant workers that might spread the disease. Oops. And when you have low-wage workers, letting them all get sick and having a lot of them filling up hospitals beds and ICUs is not viewed as a good outcome. So Singapore screwed up and learned from their ignorance, as did the rest of the world. That is how trial and error works.

 

If the herd immunity folks can come up with a better plan than this, go for it. Let me say it yet again. We have ZERO guarantee that what Iceland or Germany or South Korea or Singapore - or Sioux Falls, South Dakota, for that matter - is trying to do is going to work in the long haul. Maybe there is a better way to do it, by letting hundreds of millions of Americans experience what Tom Friedman calls "harmonious balance".

 

Here's a news flash. Americans are not stupid. So if you want them to buy into "harmonious balance", Tom, you really do need to spell out what it means.

[BgMstr4u]

As I understand it, “herd immunity” is something that happens, whether we like it or not. A pathogen makes its way through a biological community and those who come out the other end are resistant and comprise its continuity. The question is not whether or not we will develop herd immunity, but how we manage that inevitable process. So the debate is really about how to meet this infection most usefully. As we become more knowledgeable about the virus, who it affects most and how, we can make better-informed choices. We can move from sledge hammers to scalpels, from total lockdowns to sensible precautions altering previously "normal" behavior. I see this as a continuum from initial necessary, total defense to instructed containment. The goal, it seems to me, is to achieve “herd immunity” to the extent we can with as little death and destruction as possible along the way, protecting as best we can those most vulnerable, so that our economic and social lives can go on. If an effective vaccine can be found, á la smallpox, Hooray! If it becomes a condition to be managed, so be it. But the main thing is to pay attention all along the way, and be ready to adjust our understandings and behaviors to shifting states of knowledge, to minimize harm and maximize the biological future of our community, since we will have to live with this thing as part of our environment from now on. As some wise prophet once said, Shit Happens. This is our shit, happening now. It’s not ever going to go away.

Edited May 23, 2020 by BgMstr4u

[+ WilliamM]

Dr Fauci newest remarks today:

https://www.cnbc.com/2020/05/22/dr-anthony-fauci-says-staying-closed-for-too-long-could-cause-irreparable-damage.html

 

Dr Fauci seems to understand that there is a “balance” between staying closed down to protect lives, especially seniors, and staying closed down too long which can cause collateral damage. I understand him saying we can open smartly and do things right (like Falwell did at Liberty University in my post above) that will minimize (but certainly not eliminate) risk.

 

 

 

Didn't Falwell keep Liberty University open, when most universities closed including the University of Pennsylvania?

[Islesguy]

While this was already posted in another thread, it is an important read: how do pandemics end.

https://www.nytimes.com/2020/05/10/us/coronavirus-deaths-cases.amp.html

 

It seems pandemics end when people decide they end. The opening up of the lockdowns is being forced on the various governments. People wanting to go to the beaches or out to bars or casinos.

 

Watch for changes in a few different indexes such as the University of Michigan Consumer Sentiment Index (which has started rising) and different economic indexes. These changes will give numbers reflecting people deciding the pandemic is over.

 

Ending lockdowns does not mean no longer protecting the vulnerable and elderly. It does not mean that you can not make personal decisions on your own behavior.

 

This does not mean that people will stop dying. It means that people will decide to live with the risk of something that will be part of our lives like the annual flu which kills tens of thousands of people per year or high speeds on our interstate highways that kills tens of thousands of people. People acting jointly will balance the risk of dying with the collateral lockdown damage to physical health, emotional well being and the economy.

 

Every life is important and every death is tragic but living involves risk balancing. For better or worse, people are voting with their feet for the risk balance they want and how they want to live.

A pandemic ends when a virus is no longer spreading in such a way that a person is not infecting more than 1 other person. It has zero to do with whether or not people are locked down.

 

People aren't voting with their feet on how they want to live; they are voting for how many people potentially will die because they don't give a damn especially the ones that refuse to wear a mask and socially distance when possible.

[+ bigjoey]

Didn't Falwell keep Liberty University open, when most universities closed including the University of Pennsylvania?

Yes. In my post #54 above I linked to a story about Falwell opening Liberty University. Because it is behind a firewall, for those who do not subscribe to The Wall Street Journal, I have a summary of the key points.

 

The “group think media” has buried the story of how best practices can be used. Despite the freak out that Falwell was having students and staff on campus and claims that students were going to die, the results: no infections amoung the students or staff were on campus??. Read my post #54 for more information.

 

Despite massive word dumps to the contrary, we can open up with lowered risk of infection and death. IF best practices are followed in schools, nursing homes, beaches, parks, restaurants, etc., there can be a return to a new normal. I have linked to Dr Fauci saying today that the lockdowns continuing will cause “irreparable”harm. Dr Fauci is endorsing a “balance” between the fact there will be some deaths and that the lockdowns if continued will cause harm as well. While those word dumps continue to praise Dr Fauci, nothing is said that notes his position on “balancing.”

Edited May 23, 2020 by bigjoey

[+ bigjoey]

In my post number 34 in this thread, I note the nursing home results where I live as to Covid19 deaths. It should be clear that they are a tiny fraction of the rate in NYC. Why? Because better practices are followed and we have learned from places like NYC. Unfortunately, NY nursing homes have been poorly served by the governor and the mayor and their traditional way of doing business. An idea of why NY nursing homes are death traps:

https://nypost.com/2020/05/17/nurses-give-inside-look-at-nightmare-nyc-run-adult-care-center/

 

This is important because in the massive word dumps that predict that millions could die, the assumptions are faulty. For example, those predictions assume that as the pandemic progresses, nothing will be learned that lowers deaths and makes a straight line progression; those predictions take NYC’s experience and extend it to places that are better run; those predictions ignore that best practices are known and just need to be followed.

 

 

While those massive word dumps unfavorably compare Sweden to the writer’s carefully selected countries, he does not compare Sweden to the sovereign state of NY which had a lockdown. Guess why? Sweden with its modified open policy has a death rate that is a mere fraction of NYC’s death rate. The writer uses NY’s death rate to promote fear of what could happen but does not use that death rate when writing how bad Sweden’s policy has been. Careful manipulation of facts to confirm his bias.

[+ WilliamM]

I was able to read a little of the Journal article on the University's site. To be honest, I was surprised that most of the students are online long before the novel coronavirus. Disappointing.

[+ bigjoey]

I was able to read a little of the Journal article on the University's site. To be honest, I was surprised that most of the students are online long before the novel coronavirus. Disappointing.

I was surprised as well that their online classes were so large. Apparently, they have been way ahead of larger universities in moving online. I did not realize their size and influence was so large.

 

I guess that just because you do not believe in evolution that does not mean that you can not use advanced technology.