More interesting data regarding Covid

[BgMstr4u]

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:

 

 

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.

This article is horrifying but, to anyone who has lived in NYC, not exactly surprising.

 

The Governor and the Mayor aside (but really not, because publicly run places like that are ultimately their responsibility), New York, City and State alike, long ago chose the let-the-government-run-it model. Not socialism exactly, but too big to be run well unless you have a managerial genius like Bloomberg watching everything like a hawk all the time. And maybe not even then. There is something about government-run institutions that lends itself to lowest common denominator-ism. Not in every case, of course, but with enough regularity to see patterns. Lax management, over-powerful unions, promotion of the under- or even non-qualified, featherbedding, money for one thing somehow ending up in support of something else. The games are endless, and here you see what it can lead to. When it is discovered, it's always like Claude Rains in Casablanca: Shocked, Shocked to find gambling going on! Negligence? Mismanagement? Here? Who could ever have thought such a thing!

 

New York is the poster child for why the government (or at least our government) should not be trusted to run more than it has to. Just try to fix something in that system. Good people spend their professional lives trying to make it better, but more often than not entropy is the default winner.

Edited May 23, 2020 by BgMstr4u

[+ bigjoey]

This article is horrifying but, to anyone who has lived in NYC, not exactly surprising.

 

The Governor and the Mayor aside (but really not, because publicly run places like that are ultimately their responsibility), New York, City and State alike, long ago chose the let-the-government-run-it model. Not socialism exactly, but too big to be run well unless you have a managerial genius like Bloomberg watching everything like a hawk all the time. And maybe not even then. There is something about government-run institutions that lends itself to lowest common denominator-ism. Not in every case, of course, but with enough regularity to see patterns. Lax management, over-powerful unions, promotion of the under- or even non-qualified, featherbedding, money for one thing somehow ending up in support of something else. The games are endless, and here you see what it can lead to. When it is discovered, it's always like Claude Rains in Casablanca: Shocked, Shocked to find gambling going on! Negligence? Mismanagement? Here? Who could ever have thought such a thing!

 

New York is the poster child for why the government (or at least our government) should not be trusted to run more than it has to. Just try to fix something in that system. Good people spend their professional lives trying to make it better, but more often than not entropy is the default winner.

 

The failure of senior care facilities like the one in the link is only one illustration of NYC run institutional failures. As you note, it runs across the board.

 

The New York City Housing Authority is considered the country’s largest slum lord. Over 400,000 people live in their apartments. The conditions are famous for lead paint harming children, elevators that do not work, lack of heat or hot water, etc.

 

The failures of the school system are legendary: Children who test years behind their grade level. Lack of supplies. Poor physical plants.

 

The subway system that is third world. A national embarrassment. A system that needs billions in upgrades while capital funds are diverted.

 

A mayor who puts his wife in charge of a mental health system. The result is tens of millions of dollars of spending with no receipts!! Her reward is not only a handsome salary but an appointment to a new commission.

 

It is not for lack of money that these things happen. You are correct in listing many of the causes. Starting with bad management that is deeply entrenched and almost impossible to dislodge. When horror stories appear like the nursing home one in my post, there are the denials and the expressions of“shock,” “shock” as you note.

 

As to our current pandemic, there should be no “shock” at the high number of deaths of seniors in NY nursing homes. Not only the terrible conditions that existed before Covid19 in city run places but the stupidity of mandating that nursing homes take people infected with Covid19?. Like throwing lighted matches into a pile of dry kindling.

 

To bring it back to my point in my post, the deaths in NY are not normal when compared to the rest of the country. I have offered the statistics of the county where I live: about 20,000 seniors living in about 150 long term care facilities, 28 deaths in 7 facilities and half those deaths in a single facility that was poorly managed. Yet, a verbose poster extrapolates the NY death rate over time to the entire country. That extrapolation ignores that NY is not the American normal and it assumes that other places are not continually learning what to do and adopting new best practices. That extrapolation ignores that fortunately most of America has better management of senior facilities and government mandates.

 

(It needs to be added that when the verbose poster wants to show that the Swedish model is bad, he forgets about NY and picks places with lower death rates while forgetting to point out that Sweden’s death rate is a mere fraction of NY’s rate. Picking and choosing when and how to use the NY death rate is a hallmark of the verbose ones style.)

 

 

 

Yes, more people will die the more open society becomes as we move away from lockdowns. Each death is its own tragedy. But as Dr Fauci has pointed out, the lockdowns cause “irreparable” harm and those collateral costs need to be balanced with the additional deaths that will occur when the lockdowns are phased out. While those verbose posting praise Dr Fauci when the poster agrees with him, the poster ignores Dr Fauci when the doctor talks about a need for balance.

 

To be clear: I do not know how many more deaths will happen, just that there will be more deaths; bullying me for a specific answer is a strawman argument, a phony argument, an attempt to use emotions to sway readers. Phasing out the lockdowns will lessen the irreparable harm that Dr Fauci mentions but it will come at a cost of more deaths.

 

looking back on this pandemic it is clear what errors happened starting with China, the WHO, our president, governors, mayors, individuals, etc. At this moment, we need to focus on where we are today and how to go forward. Yes, there needs to be test, trace and isolate. Yes, vulnerable people like seniors need to still be sheltered-in-place. Yes, common sense precautions need to be taken. We can not eliminate all risk of more deaths but we can minimize then.

[+ stevenkesslar]

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.

 

Actually, no.

 

If you start with a bad assumption, everything after that initial bad assumption is wrong.

 

Your initial bad assumption is that this process is "inevitable". That is wrong. If you are correct, it does mean maybe 3.3 million Americans will die. So hopefully you are wrong.

 

You said "as I understand it". That is correct. This is as you understand it. Your understanding is flawed.

 

Pretty much every nation in the world, including the US, is operating on the assumption that herd immunity is not "inevitable". There really can't be any confusion about this. All this stuff about "lock downs" and "test, trace, treat" that has been the entire focus of everything happening on the planet for months is all based on the idea that herd immunity is not "inevitable".

 

The most dramatic example is China, which decided it was going to crush the virus. That is 100 % the opposite of herd immunity. Herd immunity would mean China decided, either by choice or by submission, that they had no choice but to let the virus infect over 1 billion people. They would let the virus roll, and see what happened. It is obvious and undeniable that China did exactly the opposite. They crushed the virus. As a result, China has one of the LOWEST rates of death of any large nation on the planet: China has had 3.3 deaths per million citizens, compared to 299.5 deaths per million citizens in the US.

 

You can make a lot of arguments about whether what China did is a good thing or bad thing. Let's save that for the politics section. Here, I think the idea is simply to gain a more helpful understanding of the facts, the facts, and only the facts. So the fact is that China did demonstrate that herd immunity is not "inevitable". I think it is fair to say that had they NOT made that choice, they would have had at least 299.5 deaths per million, like the US did. Spain actually has had 612.7 deaths per million, because the virus silently penetrated so far into the population before they took dramatic action. Like China, they has to act quickly and dramatically. COVID-19 has killed almost 30,000 people in Spain now, and sickened and hospitalized hundreds of thousands more.

 

So whatever you think about "herd immunity" as a goal, there is no question as a matter of objective fact that it involves the idea of sickening, hospitalizing, and killing millions of people through an "organic" process called "disease spread". Spain's rate of death was 200 times greater than that of China. This was objectively based on actions taken in each country to prevent the natural progression of herd immunity.

 

A few more specific examples. When the Bubonic plague was around, your model works. We didn't understand viruses, or have microscopes, or vaccines. So basically you got sick or you didn't, and you died or you didn't. There were forms of "social distancing" back then. But science was not of much help. Same with 1918. We did not understand viruses, or have vaccines. So social distancing had a lot to do with why Philadelphia and Pittsburgh had two or three times the number of fatalities per million from the Spanish flu than other cities. But people were still essentially sitting ducks.

 

News flash. This is not 1918. There are things called microscopes, and vaccines. At some point, somebody said, "Hey, let's get rid of polio, and smallpox." So scientists figured out how to use vaccines to safely induce artificial herd immunity.

 

This is a very important distinction, so it's important to really focus on it. The idea of herd immunity is that you let smallpox and polio roll through a nation and sicken and kill as many people as it can. One might do that because they like mass death. Or one might do that, more likely, because they have no better idea of what to do. But the inevitable outcome of this type of herd immunity is mass disease and mass death. Millions and millions will get sick and die horrible deaths, just like they have all through history.

 

The idea of artificial herd immunity is the exact opposite. Some very smart men and women said, "Geez, what if we try to avoid the mass death of millions and millions of people?" And guess what? It actually worked! That's science for you. They found they could intentionally inject people with "stuff" and prevent mass illness and mass death. So the idea of artificial herd immunity is to use science and medicine to create the same state as what would have happened if millions of people got sick and died. Except now - viola! - we can do it without millions getting sick and dying. Pretty cool idea, huh?

 

So there does seem to be some real confusion about this idea of herd immunity. There are endless articles where doctors and scientists say the whole concept was created to figure out how to safely induce artificial herd immunity through vaccines to prevent mass illness and mass death. If you Google "Dr. Fauci" and "herd immunity" you'll find lots of citations where he talks about all the great work scientrists like him have done to induce herd immunity to prevent mass illness and mass death.

 

One failing so far is that scientists still have not really figured out a vaccine for AIDS, that would completely prevent the transmission of that virus. So this is not easy stuff to do. But that is exactly why scientists like Fauci get paid the big bucks, and you and I don't. We just get to be grateful that these really smart men and women save our lives.

 

One other key point. Since COVID-19 has only been around for months, what most countries are doing is "test, trace, treat." That is not a vaccine. But it does seem to temporarily block the natural progression of herd immunity. In other words, it stops millions of people from getting sick and dying.

 

You can think of it this way: "Buy time to prevent mass death". Some people think that having a swab put up their nose is better than being dead. You can agree or disagree. But it is understandable to me that given the choice between having a swab up my nose, and spending two weeks dying in a hospital, I might choose the swab up my nose.

 

So in South Korea, there have been 5.1 deaths per million citizens. In Hong Kong there have been 0.5 deaths per million. In Australia there have been 4.1 deaths per million citizens. In Taiwan there have been 0.3 deaths per million. In Thailand there have been 0.8 deaths per million citizens. In Japan there have been 6.3 deaths per million citizens. In New Zealand there have been 4.3 deaths per million citizens. Again, in China there have been 3.3 deaths per million. Again, in the US there have been 299.5 deaths per million.

 

Which of these ones is not like the other? Other than the US, all those other nations have been laser focused on one huge project: using "test, trace, treat" to prevent mass illness and mass death. As an objective fact, it appears to be working.

 

Now, some might say, "A swab up my nose? That ideas sucks! I think that whole 'hospital/ventilator/my dead body in a frozen meat truck' thing sounds way more cool." So herd immunity is a perfectly legitimate choice. But just be aware that it means that instead of 1 or 2 or 3 dead per million Americans, it means 4,000 to 10,000 dead per million Americans. Those numbers are based on fatality rates of 0.4 % to 1 % - which is the rate the CDC and JP Morgan both have a ton of very solid research around.

 

To put this in perspective, if China had 300 deaths per million like the US currently has, instead of only 3 per million, it would mean 418,000 more dead Chinese. That's what the merry road to herd immunity would look like in China, right now, if it were just like the US. Instead, they've had 5,000 reported deaths. So I kind of understand why all those countries decided that "test, trace, treat" just sounded better than herd immunity. If Australia had deaths per million like the US, right now, that would be 35,000 dead Aussies. Instead, they've had 102 actual deaths. Go figure.

 

Does it makes sense that herd immunity is not "inevitable"? Because if it were inevitable, we would know that. There would be at least hundreds of thousands more dead people now in all those countries I named.

 

At fatality rates of 0.4 % to 1 %, if we want herd immunity it means the US needs to sort out how to have between 1.3 to 3.3 million dead people. And we have to factor in that your Black bus driver with diabetes and your middle-aged Hispanic Walmart employee and your aging Gay man who has a housekeeper coming in every week are gonna be the ones that get hit hardest. Then again, we could choose to do that whole, "Okay, God damn it. Give me that swab up my nose" thing.

 

One way or the other, these are all choices citizens are making. There is nothing "inevitable" about herd immunity.

Edited May 23, 2020 by stevenkesslar

[+ stevenkesslar]

If done properly, seniors living in senior living facilities can be protected. As Anders Tegnall in Sweden admitted, it is in the execution of actions that Sweden made its mistake concerning senior facilities. Actions taken tells much of the tale in the difference in the statistics. For example, part of the huge difference in deaths in nursing facilities between NY and Florida can be attributed to NY mandating that nursing homes take residents with Covid19 while Florida did not.

 

I understand that you are looking for ways to have herd immunity and avoid the mass death of seniors. That is your goal. Good luck with that. It is going to be extremely difficult.

 

It may be that the rest of the planet is wrong, and herd immunity is "inevitable". So it is definitely worth thinking about how we let 200 million or 300 million Americans get sick, without having a mass death of seniors. But it is going to be a very difficult thing. And since the rest of the world seems to be proving that mass death is not "inevitable", it might be worth considering that, too. Unless you feel that somehow the mass death of seniors fits the "American personality" better. You'll have to explain what "the American personality" has to do with this, because I don't get that.

 

Tegnall is relevant because, to my knowledge, it is the only country in the world that tried what you want to do. Have herd immunity, and somehow offer "special protections" to seniors to prevent their mass death. It did not work. In fact, it had the opposite effect. It unleashed a virus that did what it is very good at: COVID-19 found seniors, and killed them.

 

So it is wonderful in theory to say that "harmonious balance" is a totally cool thing. In theory, a few people get COVID-19, they shake it off like a few sniffles, and seniors get margaritas and free porn. It's awesome. That's what my vision of what "harmonious balance" means.

 

In reality, "harmonious balance" means mass illness and mass death. Thousands of seniors will be unable to breathe or eat, and they will die slow and horrible deaths. That is not what is happening in theory. That is what is happening in reality. So Anders will always have his wonderful theory. But if it doesn't actually work out that way in reality, there is a word for that: FAILURE.

 

Can you please show us where "harmonious balance" has worked? I can't actually name one actual place on the real planet Earth where it has. On the real planet Earth COVID-19 finds seniors and kills them. Brutally. That is what COVID-19 is designed to do. It does it job very well.

 

In Northern California in particular, which led the lock downs nationally, the opposite of Sweden is what actually happened. Leaders that were led by scientists, and in some cases actually are medical professionals, came up with an interesting concept. They decided that if they wanted to keep mass illness and mass death out, they had to keep COVID-19 out. It was pretty much that simple.

 

So the whole idea of lock downs was to suppress the spread of the virus using a very blunt instrument, until more surgical tools like mass testing and contact tracing could be quickly put in place. It is no surprise that California is building an inventory of mass tests and an army of I believe about 10,000 contact tracers.

 

The plan is to suppress the virus, track it down, and kill it. That is the exact opposite of herd immunity. Herd immunity means allowing the virus to track seniors down and kill them - in nursing homes, in their own home, at work, in the grocery store, or wherever they breathe air or touch things.

 

One of the focal points of mass testing will and should be nursing homes and anywhere where there are lots of seniors (for example, many church communities). That way the virus can be tracked down and stopped before it is allowed to run amok and kill indiscriminately, as it would be allowed to under the herd immunity model.

 

Here's an interesting fact about herd immunity. In New York, there have been 18,998 known COVID-19 infections for every 1 million state residents. In California, there have been 2,297 infections per 1 million residents. So that suggests neither state is close to herd immunity. But New York state may be at somewhere around 20 percent, based on the antibody studies. So herd immunity does mean, by design, much more infection.

 

In New York, 1,495 people have died from COVID-19 for every 1 million residents. In California, 94 people have died for every 1 million state residents. In New York, that totals 29,090 deaths. (This does not include at least 5,000 people New York City says died at home, mostly seniors). In California, there have been 3,708 deaths.

 

We do know from the California website that 79 % of those deaths were among people 65 and older. So we know two things: 1) COVID-19 has a huge potential to sicken, hospitalize, and kill workers aged under 65, which creates a massive state work force problem, and 2) that said, about 4 in 5 people who actually die will be seniors. So, again, it seems incredibly clear and factual that wherever it is allowed to run amok, COVID-19 will be brutally effective in findings seniors and killing them. It does that just as effectively in California as it does in New York.

 

To me, this is a very good argument against herd immunity. There are no doubt things that nursing homes can do to protect seniors in the middle of a massive plague. Much as humans can protect themselves in a middle of a massive hurricane or flood. But most people would probably agree that - if possible - it is safer to simple prevent the plague, or the hurricane, or the flood.

 

This is actually what happened in Northern California. The core idea was exactly the opposite of Sweden. Sweden said lets basically let a virus run amok, and see what happens. It did not end well for seniors in nursing homes. Even Anders had to admit that. In Northern California, they did the exact opposite. They said let's not unleash the virus. Let's not just see what happens.

 

I think it is quite logical to argue that the reason they did not have mass deaths in nursing homes in California is simply that they used an entirely different strategy, which worked. It did not allow COVID-19 to do its job, which is finding and killing seniors.

 

If done properly, seniors living in senior living facilities can be protected. As Anders Tegnall in Sweden admitted, it is in the execution of actions that Sweden made its mistake concerning senior facilities. Actions taken tells much of the tale in the difference in the statistics. For example, part of the huge difference in deaths in nursing facilities between NY and Florida can be attributed to NY mandating that nursing homes take residents with Covid19 while Florida did not.

 

To be very specific, it seems like the cirtical action taken in California was that we blocked a plague from being unleashed that was certain to kill many senior citizens - in nursing homes, at home, or at work.

 

Do you disagree? Is there any example anywhere in the world where some community or state or nation tried to do what Sweden has done - let the virus run amok - without having a similarly disastrous outcome for senior citizens?

 

You are citing states that have much lower statewide infection rates than New York - like Florida and California. That's fine. What that actually means is that the best way to prevent seniors from dying of COVID-19 is to prevent them from being infected by it, by blocking the transmission of the virus in the entire state. If that is your argument, we agree.

 

If your argument is that Florida or California could instead sit back while 10 or 20 or 30 million of its residents got sick, but still find a way to keep seniors from getting sick and dying, that simply has not worked. In fact, it failed badly in the one country that tried - Sweden. So, again, please tell us where that strategy has actually worked.

Edited May 23, 2020 by stevenkesslar

[+ WilliamM]

The failure of senior care facilities like the one in the link is only one illustration of NYC run institutional failures. As you note, it runs across the board.

 

The New York City Housing Authority is considered the country’s largest slum lord. Over 400,000 people live in their apartments. The conditions are famous for lead paint harming children, elevators that do not work, lack of heat or hot water, etc.

 

The failures of the school system are legendary: Children who test years behind their grade level. Lack of supplies. Poor physical plants.

 

The subway system that is third world. A national embarrassment. A system that needs billions in upgrades while capital funds are diverted.

 

A mayor who puts his wife in charge of a mental health system. The result is tens of millions of dollars of spending with no receipts!! Her reward is not only a handsome salary but an appointment to a new commission.

 

It is not for lack of money that these things happen. You are correct in listing many of the causes. Starting with bad management that is deeply entrenched and almost impossible to dislodge. When horror stories appear like the nursing home one in my post, there are the denials and the expressions of“shock,” “shock” as you note.

 

As to our current pandemic, there should be no “shock” at the high number of deaths of seniors in NY nursing homes. Not only the terrible conditions that existed before Covid19 in city run places but the stupidity of mandating that nursing homes take people infected with Covid19?. Like throwing lighted matches into a pile of dry kindling.

 

To bring it back to my point in my post, the deaths in NY are not normal when compared to the rest of the country. I have offered the statistics of the county where I live: about 20,000 seniors living in about 150 long term care facilities, 28 deaths in 7 facilities and half those deaths in a single facility that was poorly managed. Yet, a verbose poster extrapolates the NY death rate over time to the entire country. That extrapolation ignores that NY is not the American normal and it assumes that other places are not continually learning what to do and adopting new best practices. That extrapolation ignores that fortunately most of America has better management of senior facilities and government mandates.

 

(It needs to be added that when the verbose poster wants to show that the Swedish model is bad, he forgets about NY and picks places with lower death rates while forgetting to point out that Sweden’s death rate is a mere fraction of NY’s rate. Picking and choosing when and how to use the NY death rate is a hallmark of the verbose ones style.)

 

 

 

Yes, more people will die the more open society becomes as we move away from lockdowns. Each death is its own tragedy. But as Dr Fauci has pointed out, the lockdowns cause “irreparable” harm and those collateral costs need to be balanced with the additional deaths that will occur when the lockdowns are phased out. While those verbose posting praise Dr Fauci when the poster agrees with him, the poster ignores Dr Fauci when the doctor talks about a need for balance.

 

To be clear: I do not know how many more deaths will happen, just that there will be more deaths; bullying me for a specific answer is a strawman argument, a phony argument, an attempt to use emotions to sway readers. Phasing out the lockdowns will lessen the irreparable harm that Dr Fauci mentions but it will come at a cost of more deaths.

 

looking back on this pandemic it is clear what errors happened starting with China, the WHO, our president, governors, mayors, individuals, etc. At this moment, we need to focus on where we are today and how to go forward. Yes, there needs to be test, trace and isolate. Yes, vulnerable people like seniors need to still be sheltered-in-place. Yes, common sense precautions need to be taken. We can not eliminate all risk of more deaths but we can minimize then.

No politics in this forum. You do realize the director of the New York City Housing Authority is likely a politicial appointment, disguised as something else for the masses.

[BgMstr4u]

So the idea of artificial herd immunity is to use science and medicine to create the same state as what would have happened if millions of people got sick and died. Except now - viola! - we can do it without millions getting sick and dying. Pretty cool idea, huh?

Viola! indeed.

 

Nothing you say is in conflict with my post. By inevitable is meant the fact - yes, it is a fact - that the pathogen will continue to be vectored into the population. We can meliorate that process, but it is now and will be a continuing biological fact. Over time more and more of a population is exposed. It just happens. We can slow it down and if/when (hopefully, when) a vaccine is developed we can, as you helpfully point out, speed up the process in a much more controlled and less destructive way. My point is simply that with more knowledge come better strategies to meet this ongoing (and yes - inevitable, though not completely unmanageable) biological process.

Edited May 23, 2020 by BgMstr4u

[+ stevenkesslar]

There's some amazing new stuff that has come out from the CDC and JP Morgan, mostly encouraging, that I think goes further in nailing some things down.

 

To quickly summarize:

 

The CDC has a new guidelines saying that they think the fatality rate is about 0.4 %, but it may be as high as 1 %. I argued above it's probably between 0.5 % and 1 %, depending on the circumstances. Like if hospitals gets crushed, and seniors are dying in droves at home, it's probably going to be more like 1 % of everybody infected. I think there's more and more evidence that these numbers are all in the ballpark.

 

JP Morgan has done a bunch of really cool quantitative analysis. This study (on page 3) summarizes about a dozen antibody studies, and uses them to estimate fatality rates. The range is broad enough (from 0.00 % to 1.06 %) that you could argue there's no point to the exercise. But I think part of the problem is some of these studies are small samples (like 1000 people in Scotland) of populations with low infection rates (like 1 % of the entire population). Minor variations in false positives and false negatives can wreak havoc on those small studies.

 

Three of these studies either sampled a lot of people, or happened in areas with high infection rates, or both. So I think they are more accurate, and reinforce the idea of a 0.4 % to 1 % range.

 

The biggest study was of 60,897 people in Spain - one of the hardest hit countries. They estimated an overall mortality rate of 1.06 %.

 

New York State tested 15,000 people for antibodies and determined a fatality rate of 1.00 %, according to JP Morgan. Some news accounts I read said the estimated NY fatality rate was lower - like 0.5 %. But if you include the deaths of seniors at home, which perhaps JP Morgan did, it works out to be about 1 % of everyone infected.

 

Germany tested 500 people in Gangelt and found a 0.4 % fatality rate. Of all the studies, that one found the highest overall population infection rate: 14 % of the entire local population. The next highest was NY State, where 12.3 % of state residents are estimated to have been infected.

 

I keep thinking we ought to be thinking of this as both a senior citizen death machine, and a work force disease. In order to avoid future lock downs, if we can, we really have to be thinking about how we prevent workers from getting sick, being hospitalized, and dying in droves. You just can't have Apple stores and grocery stores where 5 % of workers end up in hospital beds, and customers therefore - especially seniors - are afraid to go inside them. Even if it works out that very few of those workers actually die in the end, many of the seniors will. It is something to be avoided, not encouraged.

 

That is why I think the German study is interesting. Gangelt is a small town where they had a Carnival celebration, which ended up being a huge vector for COVID-19 transmission. One thing that helps prove, which New Orleans reinforced, is that mass gatherings are very good transmission vectors. But I also think, given the nature of the gathering, that the people infected tended to be younger. So it is probably consistent to say that only 0.4 % of those people died, whereas in Spain and New York - where the virus ran amok among older people - that fatality rate was 1 %, which is of course two and a half times higher.

 

I know part of the reason Germany has had fewer deaths than many of its neighbors from COVID-19 is that it started as a "ski diseaase" that Germans and Austrians brought back home from Italian ski lodges. Overall, the average age of patients in Germany was much lower than Italy or Spain, hence a lower fatality rate. Again, I think something like 0.4 % to 1 % is the correct range, depending on the circumstances.

 

JP Morgan COVID-19 infection tracking and the search for second waves of infection

 

How did Asia do it, and can we trust the Chinese data?

 

Differences in infection rates reflect in part the degree of government policy, testing, quarantine, and voluntary social distancing by individuals and companies. While there are questions about China data (see page 9), they appear to rhyme with the rest of Developed Asia (S. Korea, Japan, Singapore, Taiwan and Hong Kong).

 

I can't find a postable JPG of the chart, but on Page 8 of that JP Morgan study there is a fascinating image that explains why America is maybe fucked, and maybe not fucked.

 

As a caveat, since the goal here is the facts, the facts, and only the facts, I am going to use the word "individualism" the way JP Morgan does - as a behavioral concept that may help us to understand viral transmission and death rates. This may get at some of what @bigjoey means when he talks about "the American personality". The reason I say America (and the UK) may be fucked is that it may be, according to JP Morgan's research, that more individualism simply means a lot more death from COVID-19.

 

That chart on Page 3 compares red dots ("collectivist" nations) to blue dots ("individualist" nations). It's hard to see the abbreviations on the dots. But the red dots include China, Hong Kong, Japan, South Korea, and Taiwan. As I indicated above, their death rates per million citizens have been low single digit numbers - like 3 or 2 or 1 or even less than 1 per million dead. I think it goes without saying that Americans would rather not have 100,000 or 1 million more deaths.

 

On the opposite end of the chart, the US and the UK are two of the most individualist nations, and they have two of the highest death rates per million in the world. As I said above, it is 300 dead per million in the US right now. In the UK it's now up to 550 dead per 1 million. Implicit in that is that the number of dead in the US could double quickly, just to catch up to where the UK is at. And if the ultimate fatality rate is 1 %, it means the fun won't stop until both the US and the UK gets to about 10,000 dead per 1 million. Buckle your seat belts. If herd immunity is the only option, we may be fucked.

 

What I find encouraging is that some of those blue dots also have very little death. So if the question is: "Can we have an individualistic society, and still NOT have mass death?", the evidence suggests the answer is YES. We just have to be thoughtful about it.

 

So Australia and New Zealand are two of the countries that are both as individualistic as the US, and have also essentially stopped the virus. There are others as well. JP Morgan summarizes the actions of the Asian countries. But what Australia and New Zealand and some of those other low death countries did is basically the same. It is "collectivist" mostly in the sense that it takes steps - masks, tests, tracing, cell phone apps - that prioritize public health, and the common good. Those are hardly radical ideas.

 

While it stems from a specific religion, I think every religion and therefore every nation in the world believes in and practices some version of this behavioral concept: "I am my brother's keeper." That is essentially what this "collectivist" action that has prevented mass death boils down to. People in the US and the UK understand "I am my brother's keeper." Just like people in Australia and New Zealand have proven they do, too.

[+ sync]

The facts coming down about C19 appear to be mutating faster than C19 itself. My understanding from previous briefings was that we here in the Northeast U.S. would be experiencing a brief respite from C19 by the onset of warmer weather. Now there are reports that C19 is raging in Brazil, Ecuador, and California. What's different about the warmer weather in South America and California than the warmer weather in the Northeast U.S?

[+ stevenkesslar]

Viola! indeed.

 

Nothing you say is in conflict with my post. By inevitable is meant the fact - yes, it is a fact - that the pathogen will continue to be vectored into the population. We can meliorate that process, but it is now and will be a continuing biological fact. Over time more and more of a population is exposed. It just happens.

 

Sorry, but no. We don't agree about herd immunity.

 

Maybe there is a semantics issue here. I respect your intelligence, and I do not want to get into a semantic debate.

 

But when I read what you wrote, it sounds like an argument for herd immunity. If I am reading it right, my point is exactly the opposite. There is nothing inevitable about this. There is no particular reason why "more and more of a population is exposed".

 

So let's look at polio:

 

 

I think we both agree that the key action that changed the game is the introduction of a vaccine. To use the magic words, the vaccine created artificial herd immunity.

 

Your point may be that until we have a vaccine, the only kind of herd immunity we have available to us is organic herd immunity, aka disease, sickness, and either recovery or death. But it's also important to point out one minor scientific fact: nobody knows what COVID-19 antibodies actually do. They may confer some immunity for six months, or for six years, or for six decades. or they may not. We just don't know. For that matter, we don't know how effective a vaccine will be, or when it will be available.

 

So we also agree that one strategy is to delay until we get to the red line above - the introduction of a vaccine.

 

It's at that point that I think you and I part company. Anyone who believes in herd immunity as a concept, which @bigjoey clearly does, essentially believes that inducing infection is a good thing. Why? Because absent infection, recovery can not occur, and antibodies can not develop. (Nor, of course, can sickness and death occur. But that's just a minor point. Not really anything to worry much about.)

 

To quote the screed he posted that set me off, our "virgin" bodies are stuck at home, free of infection, pining for the outside and growing increasingly resentful of the assholes who took our very lives away. (Did I mention @bigjoey likes drama?)

 

In fact, in places like South Korea or Iceland or Hong Kong or Australia, there are not virgin bodies stuck inside. All along, they've been going to restaurants, malls, and the beach. If you believe the Kiwis, there are actually tooth fairies and Easter bunnies prancing about. Egads! Clearly that sounds better than The Grim Reaper!

 

Those countries either NEVER had a full lock down, or have had ones that were quicker and more effective than our sort of shit show. The main difference is that, for whatever reason, they really did embrace the idea "I am my brother's keeper." That said, if they didn't, they got fined, or bitched at by the cops. At the end of the day, it worked. And the infections pretty much went away.

 

It's not quite right to say this is all or nothing, or completely black or completely white. But to make the scientific and medical point as clearly as I can, it really is all or nothing. At least with this virus, if 1 % or even 0.01 % of the population is infected, it will spread. So the whole idea behind "test, trace, treat" is that you have to beat it back constantly, and universally.

 

It does therefore make sense that this could be marginally easier in societies where what an individual feels is their right is less important than what is good for the society as a whole. So maybe America is fucked. Maybe 1 million of us just need to die, to protect our individual right to get infected and die. If that makes any sense.

 

That said, it's not like people in the US don't understand the words, "I am my brother's keeper." It's not like Dr Birx isn't being perfectly clear when she says that her grandmother didn't really want her own mother to die, which she did of the Spanish flu. So whether it's the idea of "don't kill Grandma" or "I don't want my Mommy to have to die," these are concepts people in America can easily understand.

 

Dr. Birx's point, which is simply science, medicine, and fact, is that if you get enough of the herd saying, "it is my right to get and spread this virus without knowing it," you are fucked. That has nothing to do with politics. She is simply speaking as a medical professional, about medical facts.

 

I've been following @mike carey's very informative posts, both in terms of anecdotal stories, and studies and research he has posted. My strong impression is that in Australia, which is as individualistic as the US, people just decided that the virus was going to be fucked, not the people. (Mike didn't quite say it that way, of course. I'm just the crude asshole around here.)

 

So, semantics aside, if we want herd immunity, we really do want the virus to spread, albeit it in a way we at least try to control - which is kind of like controlling a wild fire. If we want to do "test, trace, treat", Birx and Fauci and the rest of the world are right. We really do have to use testing and tracing to push the virus back, constantly and universally. The evidence so far is that you can actually stop the spread of the virus in very large populations of people. Presumably while everybody hopes the vaccine is soon to arrive.

 

That is the other reason I posted that polio chart. Note that, with polio, the disease took several years to completely kill, even after the introduction of the vaccine. In fact, there was a final spike of transmission in the late 1950's. So it's not like this vaccine was just sprayed in the air, or everybody drank it in the water. My point is that the things we have to do to buy time are actually very similar to the things we have to do the day a vaccine arrives. Both before and after V Day (the day the vaccine becomes available to everyone), there is a set of collective behaviors that matter. As we know with other vaccines, for example, if 5 % of the population refuses to be vaccinated, others may be placed at risk as well. So the entire set of behaviors that prevent illness and death both before and after a vaccine all do very broadly boil down to, "I am my brother's keeper."

 

The final point that I think really matters to me is that everything I said above is what is good for the economy, not people's health. I just don't get the idea that the best plan for the economy is to have middle-aged Black women and Hispanic men with diabetes working at Walmart who will get sick and go to a hospital and die. While they are also infecting some customers. To me, this is a good plan for terrorizing seniors and workers. And for keeping customers out of Walmart. What am I missing?

 

The better plan, if possible, is to do what China and Australia and Germany are doing. Just keep the virus out of Walmart completely, by keeping it out of the county and state Walmart are in. That also keeps it out of restaurants, and gyms, and hair salons. I think that is what Dr. Birx wants to do. I think she's right. That way seniors don't have to be terrified about shopping in Walmart with a mask on.

[+ bigjoey]

Responses to Covid19 are not black and white; it is not lockdown or completely open. Sweden’s response was guidelines to the general public like ours: hand washing, avoid non-essential travel, distancing, etc. They banned gathering of more than 50. Schools for children over 16 were closed. Bars, cafes, gyms and restaurants were open with distancing rules in place.

 

Where Sweden has admittedly fucked up was in not having greater protections for seniors. Like NY, proper protections for seniors were an afterthought. Sweden’s death rate is a fraction of NY’s death rate even though NY has a much tighter lockdown. Sweden’s deaths were over 80% seniors, especially the elderly-elderly. If Sweden had taken better steps and protected seniors more, their goal of keeping life as “normal” as possible would have been better served.

 

My issue with where we are today is those of us who are in vulnerable groups, with “Covid19 virgin bodies” have no choice but to be extremely careful and mostly shelter-in-place. Countries that have “beat” the virus keep having flare ups like China and Singapore. I have stated that until there is a vaccine which brings “artificial herd immunity” or “ natural herd immunity” our “Covid19 virgin bodies” are in danger. Unless there is a good medical therapy, for those of us who are in vulnerable groups face a high risk of death if infected. If I took my “Covid19 virgin body” to a country that beat the virus like South Korea and went to a gay club, guess what? I would find myself in the middle of a Covid19 flare-up?. (For those who do not follow the news, South Korea just a flare up centered in gay clubs; tracing is hard as many people gave false names to hide their identity).

 

Until there is a safe and effective vaccine, Covid19 is going to be with us for some time like the regular flu’s that come around which kill 30,000-40,000 a year with no hysteria. As I noted, 380,000 seniors die each year from infections in nursing homes with no hysteria.

 

I have cited the Covid19 nursing home statistics for the county where I live. Best practices can keep deaths down. Is it easy? No. But it can be done. Seniors living in long term care communities can be protected. The Johnson County, Kansas statistics show that. Keeping seniors safe from Covid19 and regular infections is very hard work and requires good management and good staff. Just because the task is hard does not mean it shouldn’t be tried.

 

As I have previously stated, this is not either/or. We can do multiple things at once. In previous posts, I have stated that test, trace and isolate should be done. Interestingly enough, for some reason Sweden has not adopted much testing; not sure why. Just because I think a looser lockdown is possible, that does not mean there is not test, trace and isolate program.

[+ stevenkesslar]

The facts coming down about C19 appear to be mutating faster than C19 itself. My understanding from previous briefings was that we here in the Northeast U.S. would be experiencing a brief respite from C19 by the onset of warmer weather. Now there are reports that C19 is raging in Brazil, Ecuador, and California. What's different about the warmer weather in South America and California than the warmer weather in the Northeast U.S?

 

Nothing.

 

I've never heard the idea that this is seasonal presented as a fact. Like a lot of other things, it's a theory that, like the flu, there may be seasonal differences.

 

I think the best scientific group think is that this is NOT seasonal. Brazil and Australia were not excluded from the party, just because it was warmer there

 

I personally run counter to "group think" on this one. I've wondered whether (in order) Florida, California, and especially Texas have lower infections and deaths because of warmer or more moderate weather than in New York or New Jersey. Some people who think the lock downs are stupid are arguing right now that things may be going better than expected in Georgia because the weather is getting warmer there. (Cases in Georgia are increasing, albeit slowly. So it's not clear yet how well things are going there.)

 

The theory I've read that makes sense to me is that weather matters, but indirectly. In nicer weather, people can go outside more. The virus does way more poorly on airy beaches than in crowded bars or cramped restaurants or subways with poor air flow.

 

But, again, if it were that simple the weather, everybody would be flocking to Rio. Rio is quickly becoming a global death hot spot.

 

I think Australia and Brazil are excellent examples of the difference between using "test, trace, treat" as a "buy time and contain" strategy on the one hand, and herd immunity on the other hand. Although what I hear from Brazil actually sounds less like any kind of plan, and more like an impulse. The impulse being, "You think I give a flying fuck?" So I would put Brazil's dance with death down to that, much more than the weather.

 

Brazil has 200 million people, compared to 25 million in Australia. So here's the difference between two large Southern hemisphere countries

 

Brazil is now runner up to the US as the country with the most confirmed cases. They have 341,048 cases, which works out to be 1,628 per million citizens. Australia has 7,111 cases, which works out to 284 cases per million. Since the adjustment for population is built in, this is infecting about six times as many people in Brazil as in Australia.

 

Brazil has a total of 21,682 deaths, which is 103.5 deaths per million citizens. Australia has 102 deaths, which works out to 4.1 deaths per 1 million citizens.

 

Which leads to an obvious question: why would Brazil have six times as many infections as Australia, factoring in population, but about 25 times as many COVID-19 deaths?

 

My guess is that having a good public health system like Australia does, where everybody who gets really sick from COVID-19 can get the best quality care, might make a big difference. It seems like the death rate might be quite variable, like from 0.4 to 1 % if not even more, based on how hard a country gets hit, and what their health care system is like.

 

And it gets worse:

 

74,000 Missing Deaths: Tracking the True Toll of the Coronavirus Outbreak

 

There's now another clear global reason to be against herd immunity. In every country where there are huge COVID-19 spikes, there are also thousands of "missing deaths". Meaning that there is a huge spike in overall deaths. But even when you subtract out all the additional deaths that are diagnosed from COVID-19, there are still a huge number of deaths left over the long term averages. So in that story, about 6,000 of those 74,000 "missing" deaths comes from five large cities in Brazil. If you add those deaths to the total, that's now about 28,000 deaths in Brazil, or 30 times as many deaths as Australia relative to their populations.

 

I've read some pro-herd immunity arguments that point out that people who have had heart attacks or strokes can't get adequate medical care and die, because hospitals are overwhelmed. Or simply because everything is all about COVID-19. It's a strange argument, and an illogical one. It's very likely that people died of strokes when they didn't have to. It's also possible, we know now, that the stroke could have been caused by COVID-19. Either way, you still end up dead. So whether those 6,000 "missing deaths" in Brazil were because of undiagnosed COVID-19, or because the hospitals were so overwhelmed that people died for other reasons, is kind of irrelevant.

 

These are all arguments against herd immunity. Because allowing a lot of people to get infected to achieve herd immunity requires conditions - mass illness and mass death - that lead to hospitals being overwhelmed. And to "missing" or "unnecessary deaths". That is exactly what appears to be happening in Brazil, but not Australia.

 

I think the theory in Brazil is that we should just man up and let the virus run its course, so it won't fuck up the economy. That way people can go to the beach, or go shopping at the mall. What that means in practice is that more and more people are ending up in hospitals and cemeteries.

 

Meanwhile, in Australia, people are headed back to the shopping malls and beaches, in much safer conditions.

 

Conditions are never the same in two countries, so comparisons always fall short. But Australia and Brazil are examples of two more or less polar opposite strategies for managing COVID-19. I don't think it is mostly about the weather. I think it's mostly about whether you have the will and the way to actually contain the virus and stop it from infecting and killing people.

[+ Charlie]

The problem with depending exclusively on "test, trace, treat" is that the first two are extremely expensive and labor-intensive, all for the purpose of gathering information for the third, but what does "treat" mean? If every Californian could be tested today, and everyone who tests positive could provide all contact information for those to be traced, we would be drowning in information, much of it useless except for future statistical analysis, because by the time the contacts could be found, most would be ill, dead, or no longer infectious. It may be done effectively in a small country, or one with an authoritarian government that can ruthlessly control its citizens and outsiders, but not in a democratic state with 39 million people and porous borders. What "treatment" do we have to offer those we find through the tracing? We have no cure, so the only logical option would be isolation for those we find who are infected, especially those with no symptoms. It's a catchy mantra, and it might be effective early in an epidemic, but it is a little too late as an all-purpose solution in places where the virus is already widely established in a large population.

[+ stevenkesslar]

Responses to Covid19 are not black and white; it is not lockdown or completely open

 

You're completely misrepresenting one side of this debate. So please stop doing that.

 

I'm tired of the argument that I am against a Black bus driver or a Hispanic grocery store clerk going to work. I am not for lock downs. Please stop using this language that suggests anybody is for lock downs.

 

I can post videos of the actual Black bus driver and Hispanic grocery store clerk that died of COVID-19 is you wish. They were not seniors citizens. They were working age people, who wanted to work. They did not want to die. And yet they did die.

 

So that is the actual problem to be solved.

 

I did not wake up one morning and say, "Geez, I think I'd like a depression today. I think it would be great to destroy the economy."

 

I woke up one morning and said, "Geez, why are Black bus drivers and Hispanic grocery clerks dying? They don't want to die. How might we stop them from dying?"

 

I use those examples because both involve people going to work and doing "essential services". Like driving buses, and making it possible for me to buy food. So this bullshit "health v. wealth" debate is just that, bullshit. Millions of Americans have been working through this, in the public, at risk. They want to work. But they don't want to die. So this has nothing to do with "pro-lock down" or "anti-lock down".

 

If you want to characterize my position, do it this way. I am "pro-work" and "anti-death".

 

The countries that have been best at "test, trace, treat" have actually avoided lock downs, either entirely or partially. I don't think South Korea or Hong Kong or Taiwan or Iceland ever closed all the restaurants or stores. China did, but mostly in the areas that were the hot spots. So in none of these places was the goal to lock things down to fuck up the economy. In many of the places I just named, including huge chunks of China, they were far enough ahead of the curve to avoid the blunt instrument of a lock down completely.

 

Had we done what South Korea did in January, when the first cases appeared, things in the US might have been very different. But that's a moot point. We are where we are.

 

The question now is how do we reopen or stay open in a way that does not simply lead to another lock down in one month?

 

If the answer is herd immunity, the best models of where that gets us is Sweden, or Brazil, or New York City at the height of the crisis. I for one am NOT for that.

 

If the answer is "test, trace, treat", I am FOR that. While we have a very tricky and lethal virus to fight, the world appears to be learning how to fight it. South Korea at one point was the poster child of what NOT to do, because they missed a big sect that caused close to 5000 infections. So trial and error worked. Now they are a global poster child. Singapore was a poster child, but they forgot about the fact that they have all these immigrant workers living in cramped dorm rooms. Again, trial and error worked. They went back into lock down, and are now cleaning it up.

 

So it is trial and error. But the overwhelming lesson, so far, is that the virus can be contained. And the economy can be made "safer".

 

Until there is a vaccine and everybody gets its, we can't have an economy as safe as what we had a year ago. But if we want a safer economy, we have to contain COVID-19.

 

Responses to Covid19 are not black and white; it is not lockdown or completely open

 

With infection, its is black and white.

 

Gay men know this about AIDS. There is no such thing as more HIV infection being a good thing. Less HIV infection is the only good thing.

 

I think COVID-19 is just as black and white. That is the difference between "herd immunity" and "test, trace, treat".

 

The goal of herd immunity is to promote infection. The more infected people, the better. Why? Because that is the only way to create antibodies, which creates immunity, which IN THEORY protects people like seniors. They can't afford to become ill, or they will die. That is why I keeping asking, appropriately: how many people have to die? 200,000? 2 million? What "special protections" actually keep seniors safe in the mean time?

 

I don't think there are any good answers. The good answer is the exact opposite. You do not promote infection. You promote testing and tracing, to crush the virus completely.

 

Either you are promoting infection. Or you are promoting the complete suppression of infection. You can't have it both ways. Former FDA head Gottlieb is one voice of science on this. Obviously we can't go from 25,000 new infections a day to zero in one day or one week. But we now know that Spain and France and Italy did go from around 5,000 to 10,000 new daily infections to about 90 % less pretty quickly. So either we are working to completely contain the virus, or we are not. And if we are not, we are pretty much in a position where a huge wildfire can break out anywhere.

 

Again, Sioux Falls learned the hard way that what Dr. Birx keeps saying is correct. New York had only 10 cases at one point. You can easily have 1,000 cases before long. That has been her consistent message. Sioux Falls went from one diagnosed case to over 3,000 in about one month. It wreaked havoc on their local economy and workers.

 

Here are two examples of why I think it is fair to call herd immunity advocates "anti-work" and "pro-death".

 

Daily New Cases in New York

 

Daily New Cases in Texas

 

So let's talk about the logic of herd immunity in New York. Everybody knows that NYC hospitals were turned into a morgue.

 

So you could say to New Yorkers, "Hey, you folks have 20 % herd immunity built up. Congratulations! Why not go for 60 % or 80 %, so you don't have to worry about COVID-19 anymore?"

 

My read is that most people would say, "Buddy, you have a mental health issue. We had 20,000 deaths. We don't need 60,000 or 80,000 more." You might also want to check with the hospitals, and doctors and nurses, too - some of whom died. And, again, it's not just seniors. When 20 % of NYC was getting infected, about 20 % of the NYPD was out sick. Dozens of cops died. So are we saying we want 60 to 80 % of the NYPD out sick, and hundreds of cops to die?

 

New York is now like Italy or Spain or France. They have driven the number of cases down close to 90 percent. That's from over 10,000 a day, to between 1,000 and 2,000 a day. Meanwhile, Texas is also between 1,000 and 2,000 cases a day. But for Texas, that is MORE cases than ever before, not less.

 

Why not just have 2,000 cases a day? That won't crush the hospitals, right?

 

The only problem is this. There were 1,342 cases in New York on March 18th. By April 4th, two weeks later, there were 11,506 cases. THAT is why New York has to shut down. There was a sudden and massive wall of illness and death.

 

So the danger for Texas and New York right now is this: what's to stop that from happening again by June? Because we know - from every poll in America today - that if that happens in Texas or New York, it will lead to another shut down. 75 to 80 % of Americans say they will want a return to shelter-in-place if the the number of cases and deaths skyrockets.

 

Think about that, @bigjoey. Promoting herd immunity promotes the exact conditions that 4 out of 5 Americans say will lead them to demand more lock downs, Which will of course fuck up the economy even more. I view herd immunity as "pro-death" and "anti-work".

 

What's the alternative?

 

First, the public is now educated. Public education is always the first goal of public health. Every Gay man knows this. How do you stop AIDS? Wear rubbers. That is how public education saves lives. Now it's not wear a rubber. It's wear a mask.

 

Second, there's test, trace, treat.

 

Daily New Cases in Austria

 

Austria is a good apples to apples with Texas and New York. On it's worst day, March 26, Austria had 1,321 cases. Now it is between 25 and 100 new cases a day. Their economy is open again. Probably the single most important thing is public education. But some people are going to get sick. So if we don't have testing and tracing, we're simply asking for trouble.

 

It is encouraging to me that Texas has "SWAT teams" of testers and contact tracers that they send out to met packing plants. Or any hot spot where the virus appears - as soon as the virus appears. Other countries have learned they can actually do that pro-actively. They are able to find the virus through testing before anyone even knows it's there.

 

Again, this is black and white. You can't try to stop the virus before it infects meat packers, and also say we'll just let meat packers get sick so we can all develop herd immunity. You have to pick one.

 

I think it's clear already that letting meat packers experiment with herd immunity is bad for the human herd. It promotes sickness, hospitalization, and death. It fucks up the economy.

 

The goal of those meat packing plants is to slaughters animals. Not humans and jobs, right?

[+ bigjoey]

You're completely misrepresenting one side of this debate. So please stop doing that.

 

I'm tired of the argument that I am against a Black bus driver or a Hispanic grocery store clerk going to work. I am not for lock downs. Please stop using this language that suggests anybody is for lock downs.

 

I can post videos of the actual Black bus driver and Hispanic grocery store clerk that died of COVID-19 is you wish. They were not seniors citizens. They were working age people, who wanted to work. They did not want to die. And yet they did die.

 

So that is the actual problem to be solved.

 

I did not wake up one morning and say, "Geez, I think I'd like a depression today. I think it would be great to destroy the economy."

 

I woke up one morning and said, "Geez, why are Black bus drivers and Hispanic grocery clerks dying? They don't want to die. How might we stop them from dying?"

 

I use those examples because both involve people going to work and doing "essential services". Like driving buses, and making it possible for me to buy food. So this bullshit "health v. wealth" debate is just that, bullshit. Millions of Americans have been working through this, in the public, at risk. They want to work. But they don't want to die. So this has nothing to do with "pro-lock down" or "anti-lock down".

 

If you want to characterize my position, do it this way. I am "pro-work" and "anti-death".

 

The countries that have been best at "test, trace, treat" have actually avoided lock downs, either entirely or partially. I don't think South Korea or Hong Kong or Taiwan or Iceland ever closed all the restaurants or stores. China did, but mostly in the areas that were the hot spots. So in none of these places was the goal to lock things down to fuck up the economy. In many of the places I just named, including huge chunks of China, they were far enough ahead of the curve to avoid the blunt instrument of a lock down completely.

 

Had we done what South Korea did in January, when the first cases appeared, things in the US might have been very different. But that's a moot point. We are where we are.

 

The question now is how do we reopen or stay open in a way that does not simply lead to another lock down in one month?

 

If the answer is herd immunity, the best models of where that gets us is Sweden, or Brazil, or New York City at the height of the crisis. I for one am NOT for that.

 

If the answer is "test, trace, treat", I am FOR that. While we have a very tricky and lethal virus to fight, the world appears to be learning how to fight it. South Korea at one point was the poster child of what NOT to do, because they missed a big sect that caused close to 5000 infections. So trial and error worked. Now they are a global poster child. Singapore was a poster child, but they forgot about the fact that they have all these immigrant workers living in cramped dorm rooms. Again, trial and error worked. They went back into lock down, and are now cleaning it up.

 

So it is trial and error. But the overwhelming lesson, so far, is that the virus can be contained. And the economy can be made "safer".

 

Until there is a vaccine and everybody gets its, we can't have an economy as safe as what we had a year ago. But if we want a safer economy, we have to contain COVID-19.

 

 

 

With infection, its is black and white.

 

Gay men know this about AIDS. There is no such thing as more HIV infection being a good thing. Less HIV infection is the only good thing.

 

I think COVID-19 is just as black and white. That is the difference between "herd immunity" and "test, trace, treat".

 

The goal of herd immunity is to promote infection. The more infected people, the better. Why? Because that is the only way to create antibodies, which creates immunity, which IN THEORY protects people like seniors. They can't afford to become ill, or they will die. That is why I keeping asking, appropriately: how many people have to die? 200,000? 2 million? What "special protections" actually keep seniors safe in the mean time?

 

I don't think there are any good answers. The good answer is the exact opposite. You do not promote infection. You promote testing and tracing, to crush the virus completely.

 

Either you are promoting infection. Or you are promoting the complete suppression of infection. You can't have it both ways. Former FDA head Gottlieb is one voice of science on this. Obviously we can't go from 25,000 new infections a day to zero in one day or one week. But we now know that Spain and France and Italy did go from around 5,000 to 10,000 new daily infections to about 90 % less pretty quickly. So either we are working to completely contain the virus, or we are not. And if we are not, we are pretty much in a position where a huge wildfire can break out anywhere.

 

Again, Sioux Falls learned the hard way that what Dr. Birx keeps saying is correct. New York had only 10 cases at one point. You can easily have 1,000 cases before long. That has been her consistent message. Sioux Falls went from one diagnosed case to over 3,000 in about one month. It wreaked havoc on their local economy and workers.

 

Here are two examples of why I think it is fair to call herd immunity advocates "anti-work" and "pro-death".

 

Daily New Cases in New York

 

Daily New Cases in Texas

 

So let's talk about the logic of herd immunity in New York. Everybody knows that NYC hospitals were turned into a morgue.

 

So you could say to New Yorkers, "Hey, you folks have 20 % herd immunity built up. Congratulations! Why not go for 60 % or 80 %, so you don't have to worry about COVID-19 anymore?"

 

My read is that most people would say, "Buddy, you have a mental health issue. We had 20,000 deaths. We don't need 60,000 or 80,000 more." You might also want to check with the hospitals, and doctors and nurses, too - some of whom died. And, again, it's not just seniors. When 20 % of NYC was getting infected, about 20 % of the NYPD was out sick. Dozens of cops died. SoWhat's the alternative?

 

First, the public is now educated. Public education is always the first goal of public health. Every Gay man knows this. How do you stop AIDS? Wear rubbers. That is how public education saves lives. Now it's not wear a rubber. It's wear a mask.

 

Second, there's test, trace, treat.

 

Daily New Cases in Austria

 

Austria is a good apples to apples with Texas and New York. On it's worst day, March 26, Austria had 1,321 cases. Now it is between 25 and 100 new cases a day. Their economy is open again. Probably the single most important thing is public education. But some people are going to get sick. So if we don't have testing and tracing, we're simply asking for trouble.

 

It is encouraging to me that Texas has "SWAT teams" of testers and contact tracers that they send out to met packing plants. Or any hot spot where the virus appears - as soon as the virus appears. Other countries have learned they can actually do that pro-actively. They are able to find the virus through testing before anyone even knows it's there.

 

Again, this is black and white. You can't try to stop the virus before it infects meat packers, and also say we'll just let meat packers get sick so we can all develop herd immunity. You have to pick one.

 

I think it's clear already that letting meat packers experiment with herd immunity is bad for the human herd. It promotes sickness, hospitalization, and death. It fucks up the economy.

 

The goal of those meat packing plants is to slaughters animals. Not humans and jobs, right?

Not sure why you purposely wrongly state my position. Not the first time you have done that. I am not “promoting” Herd Immunity.

 

At this moment in the US, I can only see this pandemic ending with either artificial or natural herd immunity. As I have noted, I am in favor of test, trace and isolate. But like South Korea, China and Singapore, we will continue get flare ups and the professional opinion is there will be more waves coming with the second wave worse than the first.

 

I am not for having “Covid19 parties” like parents had back when I was small for chicken pox to give their immunity.

Yes, I have read of people having “Covid19 parties.” I am not in favor of “promoting” herd immunity as you falsely state.

 

What I am recognizing is the reality of our current situation where the lockdowns can not continue as Dr Fauci has stated because they are causing “irreparable” harm. I am saying there needs to be protection of the vulnerable and common sense rules to slow and/or stop the spread of the infection. At the same time there needs to be test, treat and isolate.

 

We agree with public education. That is a big part of Sweden’s efforts in the pandemic. They are depending on the individuals to act responsibly. Depending on a well behaved public is an interesting concept in a pandemic. Pictures of people failing to social distance are readily available on the internet. While education is necessary in any fight against the pandemic, I would not bet my life on it.

 

As in other subjects, please stop the misrepresentation of my positions. I am “pro-work and anti-death”. We agree on that common goal.

[+ stevenkesslar]

The problem with depending exclusively on "test, trace, treat" is that the first two are extremely expensive and labor-intensive, all for the purpose of gathering information for the third, but what does "treat" mean? If every Californian could be tested today, and everyone who tests positive could provide all contact information for those to be traced, we would be drowning in information, much of it useless except for future statistical analysis, because by the time the contacts could be found, most would be ill, dead, or no longer infectious.

 

Former CDC head on coronavirus testing: What went wrong and how we proceed

Who should seek a test? Should we test everyone? How much will that even help? Let's clear a few things up.

 

There's a good overview article on that by Tom Frieden, former head of the FDA. The part that is probably most relevant right now is this:

 

In the suppression phase, more extensive testing, both for current and past infection, will help identify and stop emerging clusters and facilitate reopening society. We will need to respond rapidly to new clusters as they occur until we have a vaccine.

 

My guess @Charlie is you know more about this than me, thanks to your work on HIV and AIDS. Thankfully, COVID-19 is NOT as lethal as HIV. It is worse than HIV in terms of ease of community spread. And ability to fuck up an economy quickly. But I think a lot of the measures are the same.

 

So "test. trace, treat" is a tool, not a Band Aid or a single solution. HIV testing matters. But it matters less if you just stay HIV-negative. So what matters most is public education. One huge benefit of what just happened is massive public education.

 

No offense to Asians, but they are not inherently smarter. But they did have close encounters with SARS and other viruses that did some really useful public education. So part of the difference between the US and South Korea or Taiwan is that they saw the handwriting on the wall, and sprang into action immediately. The public had a much clearer idea of what to expect and how to prevent it. Including, but not limited to, mass testing and contacting tracing.

 

So Asia is full of countries with citizens that are going to kill the virus, period. Whatever it takes. It obviously helps their project that the virus is out to kill them.

 

I think the "treat" part matters, as well. As far as I can tell, for anyone over 50 or 60, the sooner we learn we have COVID-19 and the earlier we seek really good care - if we need it - the less chance of going what seems like the COVID Cliff, which is still not very well understood. The fatality rate kept going down in China as doctors and hospitals got up to speed, and people got earlier and perhaps better treatment.

 

And, as you say, we need to isolate. It's that, or infect people we work with or live with.

 

Here's a great article that talks about a comprehensive framework that "test, trace, treat" fits into:

 

Coronavirus: The Hammer and the Dance

 

You have to read the whole thing. I posted that once already a month ago. Someone took a pot shot at a chart I posted without bothering to understand what the chart actually said. Pueyo, the author, is based in California. There are links in there to several other articles he wrote, starting in early March. He's been pretty much been dead right on everything so far. In early March he said this is far worse than we think, and shutting down NOW - today - will save thousands of lives and prevent the spread of this lethal virus.

 

We can thank or blame a handful of influential people like him that California started the ball rolling. We now have 95 deaths per million people in California, versus 1500 deaths per million people in New York. That is not to be disrespectful to New York. Like with AIDS, it is to be respectful of the agony and pain they had to go through, because they were the first hit. I hope we can learn from the people that got hit by the first wave, so that everybody else can avoid the same outcome.

 

If you want to really geek out just on testing models, here's a white paper with a title that speaks for itself: Why We Need To Test Millions a Day.

 

Your point about speed being of the essence is right on. China was able to test and contact trace thousands of infected people, and crush the virus. I think they knew that if they had millions of infected people, there was no way you could test and treat your way out of that.

 

In California, Newsom is building an army of 10,000 contract tracers. All these efforts are based on what worked - not in theory, but in the real world. In China, in Australia, in Germany. California now has about 2000 cases a day. So that is fewer than Wuhan had when China threw a similar-sized army of testing and contact tracers at the virus. It worked there. Austria, at its peak, had a roughly similar number of cases - about 1500. Now they are down to 25 to 100 a day. There's now dozens of countries that have shown this works.

 

Your basic point is correct. If you are starting with 100,000 infected people a day, or 1 million, it is just too many. Fauci keeps saying one goal of lock down is to get the total number of infected down to a manageable number.

 

Again, there is a simple alternative. Herd immunity. Tens of millions of Americans will need hospitalization, and millions will need to die. We will be relieved of the cost or complexity of figuring out how to test or trace. We can just let what played out in New York happen in New York again, but 2 to 3 times as deadly. They have maybe 20 % herd immunity for 20,000 dead. So I'm guessing they need at least 60,000 dead in NYC to get 60 % herd immunity. If there actually is such a thing. Multiply that across the US and to get 60 % herd immunity its 2.4 million dead Americans, mostly seniors.

 

I think that would be fuck up the economy way more. As well as cause a lot more death. But it is certainly an alternative. Outside of Sweden (by choice), and Brazil (by default) it is not a very popular option globally.

 

In terms of the cost, check with Bill Gates. His problem 5 years ago is no one wanted to spend tens to hundreds of billions preparing for a big pandemic. Now the question is: how can we afford not to? We just spent $3 trillion on federal Band Aids. The hit to the economy in the US alone is trillions more. So if we could have spent hundreds of billions to avoid losing and spending trillions, that would have been smart. We're being penny wise, pound foolish. The high end range of the most expensive national testing protocols is maybe $250 billion. Compared to .............. ?

 

You can go down the line of Asian countries and they all moved to mass testing and tracing very quickly. It actually saved their economies money. In 3 to 6 months we can compare the GDP hit we took to the one China took. But I'm pretty sure our's will be bigger, and deeper. Like I said, South Korea and Hong Kong and Japan have been able to avoid total lock downs, I think. Testing and tracing are the tools these countries have been using, for months, to keep their economies open. Not to lock them down.

 

I keep coming back to reality, not theory. Like it or not, Smithfield Foods in Sioux Falls had a huge work force and meat production problem. Meat packing probably lends itself to virus spread. But the same basic thing has happened in call centers, churches, and auto factories. So my HIV equivalent is that if you don't have testing, it's like not knowing your HIV status and walking into a bath house and having sex without rubbers. It's just asking for trouble. It doesn't even involve oral or anal sex. All you have to do is breathe or speak near each other.

 

So think that one through as an employer. (Smithfield's main investor is a Chinese billionaire. American cattle men don't like that.) Even the 35 % or so of infected workers that are asymptomatic are freaking out, and contagious. At least half of them are clearly sick. In this case, 7 % of the people who got sick needed hospitalization. Almost all the sick were force force age (20's to 65). Then some seniors got it when workers brought it home. I'm guessing at least 3 to 5 % of those workers ended up in a hospital. At least a handful of them died. So how do you deal with that as employer?

 

There's really only one answer. They tested and traced like crazy. AFTER they shut the factory down. So I'm pretty sure this is something that employers like Ford and GM and Smithfield wat to get on top of. And workers and the American public have now, I think, gotten the memo. This is a disease that you don't want to be caught off guard with. It may not be as bad as AIDS. But it still going to fuck things up real good if you let it.

 

I don't even think we have a choice in the matter. I really don't. The worst thing for the economy is to let a pandemic just run its course. At least so far, everyone else in the world seems to be finding that testing, tracing, and treating is the most cost effective way to contain and control this pandemic.

[+ WilliamM]

You're completely misrepresenting one side of this debate. So please stop doing that.

 

I'm tired of the argument that I am against a Black bus driver or a Hispanic grocery store clerk going to work. I am not for lock downs. Please stop using this language that suggests anybody is for lock downs.

 

I can post videos of the actual Black bus driver and Hispanic grocery store clerk that died of COVID-19 is you wish. They were not seniors citizens. They were working age people, who wanted to work. They did not want to die. And yet they did die.

 

So that is the actual problem to be solved.

 

I did not wake up one morning and say, "Geez, I think I'd like a depression today. I think it would be great to destroy the economy."

 

I woke up one morning and said, "Geez, why are Black bus drivers and Hispanic grocery clerks dying? They don't want to die. How might we stop them from dying?"

 

I use those examples because both involve people going to work and doing "essential services". Like driving buses, and making it possible for me to buy food. So this bullshit "health v. wealth" debate is just that, bullshit. Millions of Americans have been working through this, in the public, at risk. They want to work. But they don't want to die. So this has nothing to do with "pro-lock down" or "anti-lock down".

 

If you want to characterize my position, do it this way. I am "pro-work" and "anti-death".

 

The countries that have been best at "test, trace, treat" have actually avoided lock downs, either entirely or partially. I don't think South Korea or Hong Kong or Taiwan or Iceland ever closed all the restaurants or stores. China did, but mostly in the areas that were the hot spots. So in none of these places was the goal to lock things down to fuck up the economy. In many of the places I just named, including huge chunks of China, they were far enough ahead of the curve to avoid the blunt instrument of a lock down completely.

 

Had we done what South Korea did in January, when the first cases appeared, things in the US might have been very different. But that's a moot point. We are where we are.

 

The question now is how do we reopen or stay open in a way that does not simply lead to another lock down in one month?

 

If the answer is herd immunity, the best models of where that gets us is Sweden, or Brazil, or New York City at the height of the crisis. I for one am NOT for that.

 

If the answer is "test, trace, treat", I am FOR that. While we have a very tricky and lethal virus to fight, the world appears to be learning how to fight it. South Korea at one point was the poster child of what NOT to do, because they missed a big sect that caused close to 5000 infections. So trial and error worked. Now they are a global poster child. Singapore was a poster child, but they forgot about the fact that they have all these immigrant workers living in cramped dorm rooms. Again, trial and error worked. They went back into lock down, and are now cleaning it up.

 

So it is trial and error. But the overwhelming lesson, so far, is that the virus can be contained. And the economy can be made "safer".

 

Until there is a vaccine and everybody gets its, we can't have an economy as safe as what we had a year ago. But if we want a safer economy, we have to contain COVID-19.

 

 

 

With infection, its is black and white.

 

Gay men know this about AIDS. There is no such thing as more HIV infection being a good thing. Less HIV infection is the only good thing.

 

I think COVID-19 is just as black and white. That is the difference between "herd immunity" and "test, trace, treat".

 

The goal of herd immunity is to promote infection. The more infected people, the better. Why? Because that is the only way to create antibodies, which creates immunity, which IN THEORY protects people like seniors. They can't afford to become ill, or they will die. That is why I keeping asking, appropriately: how many people have to die? 200,000? 2 million? What "special protections" actually keep seniors safe in the mean time?

 

I don't think there are any good answers. The good answer is the exact opposite. You do not promote infection. You promote testing and tracing, to crush the virus completely.

 

Either you are promoting infection. Or you are promoting the complete suppression of infection. You can't have it both ways. Former FDA head Gottlieb is one voice of science on this. Obviously we can't go from 25,000 new infections a day to zero in one day or one week. But we now know that Spain and France and Italy did go from around 5,000 to 10,000 new daily infections to about 90 % less pretty quickly. So either we are working to completely contain the virus, or we are not. And if we are not, we are pretty much in a position where a huge wildfire can break out anywhere.

 

Again, Sioux Falls learned the hard way that what Dr. Birx keeps saying is correct. New York had only 10 cases at one point. You can easily have 1,000 cases before long. That has been her consistent message. Sioux Falls went from one diagnosed case to over 3,000 in about one month. It wreaked havoc on their local economy and workers.

 

Here are two examples of why I think it is fair to call herd immunity advocates "anti-work" and "pro-death".

 

Daily New Cases in New York

 

Daily New Cases in Texas

 

So let's talk about the logic of herd immunity in New York. Everybody knows that NYC hospitals were turned into a morgue.

 

So you could say to New Yorkers, "Hey, you folks have 20 % herd immunity built up. Congratulations! Why not go for 60 % or 80 %, so you don't have to worry about COVID-19 anymore?"

 

My read is that most people would say, "Buddy, you have a mental health issue. We had 20,000 deaths. We don't need 60,000 or 80,000 more." You might also want to check with the hospitals, and doctors and nurses, too - some of whom died. And, again, it's not just seniors. When 20 % of NYC was getting infected, about 20 % of the NYPD was out sick. Dozens of cops died. So are we saying we want 60 to 80 % of the NYPD out sick, and hundreds of cops to die?

 

New York is now like Italy or Spain or France. They have driven the number of cases down close to 90 percent. That's from over 10,000 a day, to between 1,000 and 2,000 a day. Meanwhile, Texas is also between 1,000 and 2,000 cases a day. But for Texas, that is MORE cases than ever before, not less.

 

Why not just have 2,000 cases a day? That won't crush the hospitals, right?

 

The only problem is this. There were 1,342 cases in New York on March 18th. By April 4th, two weeks later, there were 11,506 cases. THAT is why New York has to shut down. There was a sudden and massive wall of illness and death.

 

So the danger for Texas and New York right now is this: what's to stop that from happening again by June? Because we know - from every poll in America today - that if that happens in Texas or New York, it will lead to another shut down. 75 to 80 % of Americans say they will want a return to shelter-in-place if the the number of cases and deaths skyrockets.

 

Think about that, @bigjoey. Promoting herd immunity promotes the exact conditions that 4 out of 5 Americans say will lead them to demand more lock downs, Which will of course fuck up the economy even more. I view herd immunity as "pro-death" and "anti-work".

 

What's the alternative?

 

First, the public is now educated. Public education is always the first goal of public health. Every Gay man knows this. How do you stop AIDS? Wear rubbers. That is how public education saves lives. Now it's not wear a rubber. It's wear a mask.

 

Second, there's test, trace, treat.

 

Daily New Cases in Austria

 

Austria is a good apples to apples with Texas and New York. On it's worst day, March 26, Austria had 1,321 cases. Now it is between 25 and 100 new cases a day. Their economy is open again. Probably the single most important thing is public education. But some people are going to get sick. So if we don't have testing and tracing, we're simply asking for trouble.

 

It is encouraging to me that Texas has "SWAT teams" of testers and contact tracers that they send out to met packing plants. Or any hot spot where the virus appears - as soon as the virus appears. Other countries have learned they can actually do that pro-actively. They are able to find the virus through testing before anyone even knows it's there.

 

Again, this is black and white. You can't try to stop the virus before it infects meat packers, and also say we'll just let meat packers get sick so we can all develop herd immunity. You have to pick one.

 

I think it's clear already that letting meat packers experiment with herd immunity is bad for the human herd. It promotes sickness, hospitalization, and death. It fucks up the economy.

 

The goal of those meat packing plants is to slaughters animals. Not humans and jobs, right?

 

 

I mostly agree, but even in Philadelphia the sad deaths are a mix of African-Americans, Whites and Latinos. And some Asians.

 

Simply posting from Palm Springs with journals, newspapers, a book or three is ok, but certainly not optimal.

[+ stevenkesslar]

Yes, I have read of people having “Covid19 parties.” I am not in favor of “promoting” herd immunity as you falsely state.

 

The article you posted did promote herd immunity. There's just no question about it. I cut and pasted the quotes already.

 

Again, I think this is a good debate to have. My biggest problem is that bullshit phrases like "harmonious balance" (Tom Friedman's) mean nothing. Herd immunity means most people get infected, and some die. I think the hit on the economy to achieve herd immunity - if such a thing actually exists - through maybe 200 million infections and recoveries and a few million deaths in the US would be far greater than what we have chosen to do. But if Freidman or others have a better plan, they should spell it out.

 

Absent that, about 4 in 5 Americans are behind lock downs until it is "safe". Unfortunately, we don't have a very clear or common understanding, let alone consensus, around what 'safe" means. Which is why we need to have these debates.

 

I'm an optimist. I think it is becoming increasingly clear we can avoid organic herd immunity by buying time for a vaccine - aka artificial herd immunity. In the mean time, "test, trace, treat" and public education (wear a mask, socially distance, beaches are better than bars) are the tools we can use to reduce and hopefully almost eradicate the spread of the virus. That was not an option in 1918. But COVID-19 is more or less being eradicated in many nations, big and small, island and not island, East and West, right now. So I'm am optimist.

 

I've watched lots of Tegnall interviews. Trevor Noah, to his credit, had him on The Daily Show weeks ago, and treated his ideas with an open mind. That was a particularly good explanation of his views, I thought.

 

 

Tegnall was wrong on one big thing, which is the idea of protecting seniors. His other main theory is one I think you share, which is that herd immunity may be inevitable. This is going to be around for years, we won't have a vaccine in time, testing and treating won't work, etc.

 

He may be right. That Minnesota research piece you posted a few weeks ago suggested that COVID-19 might become an annual event, because antibodies won't protect us for more than a year. That's a theory, not a fact. That research paper didn't address the question of vaccines and their efficacy. But, again, Anders could be right. We certainly need to consider his perspective, if only as the worst case scenario. That is how I view it: the worst case scenario. And that is pretty much where I think 4 in 5 Americans are at. In this case, I believe the herd is right.

 

Tegnall has also said (not in this interview) that this set of options makes sense in part because of a framework of things that are just what everybody accepts in Sweden: a great public health system, sick pay, etc.

 

The part I find naive to the point of delusional is that you could let a virus penetrate deeply and broadly into any society, but somehow keep it away from seniors - in nursing homes, in their own homes, anywhere. I think reality has spoken clearly, without exception: allowed to make its way through any society, COVID-19 will efficiently find seniors and kill them Every time. Everywhere. There is no way to just bubble wrap older people for a year. With both nursing home and in-home care, too many college students and young Moms need to feed them, clean them, dress them, toilet them, and touch them every day. If the virus is spreading among those people, seniors are sitting ducks.

 

When I was looking for some other information, I stumbled on this chart, which is a pretty good comparison of Sweden to the US, and its immediate neighbors. When you factor in that Sweden did its economy no particular favors, I see no advantage in herd immunity.

 

 

In terms of the other 5 to 10 % who are sort of today's version of the anti-vax or "COVID-19 party" crowd, I can't say much without sounding political. But I think I can say this as a totally apolitical three word slogan: let them die. Period. If they want to die, let them die. It's their choice.

 

Arguably it is the same as people who want to do extreme sports, and end up dead at the bottom of a cliff. In that case, if they are a 25 year old extreme sports fanatic, it mostly just kills them. They won't kill anybody else with the risks they take. But if people insist on taking the risk, let them.

 

That said, I won't be inviting them to my house for dinner. And I won't be their friend. And it's not mostly because I am worried about them infecting me, although I am. And it has nothing to do with politics. Because some of these people are on either side, or no side. I just find it offensive when adults can't buy into the basic idea that "I am my brother's keeper." In my eyes, their idea is, "I am my brother's virus spreader." They don't see it that way, but I do. So my view is simple: let them die, if that is the risk they want to take.

 

This is not a new moral category to me. It is not essentially different than escorts I knew who didn't particularly give a shit if they got an STD, or spread an STD. I'm quite aware of the fact that life is not risk free: whether that means a car crash, a plane crash, cancer, or an STD. But part of why I feel grounded about this is I know quite well what it means to manage the risks of things like STDs responsibly, both for myself and those I had sex with.

Edited May 24, 2020 by stevenkesslar

[Guest]

It was interesting to see on the NBC Nightly News tonight, for the first time, reporting that in Georgia, which opened more than almost any other state over 4 weeks ago, there's been no spike (or even overall increase at all) in Covid-19 hospitalizations or deaths.

[+ stevenkesslar]

This post is about really interesting data from JP Morgan's Marko Kolanovic. I think it proves that it is possible to be a top notch quantitative analyst, which Marko is, without being a gifted epidemiologist, which Marko is not.

 

So I am going to post the headline to the story and the two key data charts here. I won't comment on the content of the article itself, other than the data. The charts strongly suggest that the lock downs have worked. Hopefully, they set up individual US states so that they will be able to stay open, without a resurgence of the virus.

 

Lockdowns definitely had the intended effect in many countries around the world. They reduced the number of new infections by something like 80 to 90 % (Germany, France, Italy, Spain) or virtually eliminated them (Australia, New Zealand). Again, there are other countries that NEVER had a full lock down, mostly in Asia, but also places like Iceland. And they have been able to effectively control the virus as well. The lock downs were less effective in the US (other than New York and New Jersey), where they stopped exponential growth, and mostly flattened the number of daily infections without reducing them.

 

So here's the headline:

 

Many US states have seen LOWER infection rates after ending lockdowns that are are now destroying millions of livelihoods worldwide, JP Morgan study claims

 

What's funny about this, and sad, is that the headline only makes sense if you believe that people like Dr. Fauci or Dr. Birx set about to destroy the US economy. I just don't think that was their goal. I think their goal was actually what the headline says: to LOWER infection rates. In fact, I know that was their goal. Fauci and Birx are both excellent communicators. And they both said clearly and relentlessly that their goal was to suppress the virus, and drive down both the number and the rate of infections.

 

If we just go by actual death, as opposed to any projection, we now know that COVID-19 is far more deadly than anything since the Spanish flu. In about two months, we are at 100,00 deaths. That's about triple the average annual death rate for the flu in the last decade. We're in the ballpark of the 100,000 deaths for the Hong Kong flu and Asian flu in the 50's and 60's, although the US population was lower then. And these 100,000 deaths happened AFTER unprecedented steps that have NEVER happened before. So nobody can reasonably argue that if we had just done nothing, we would have had fewer deaths. In fact, if we project out New York City's actual 20,000 dead and presumed 20 % infection rate, Dr. Fauci and Dr. Birx are right. Absent any attempt to stop it, COVID-19 could have killed 2 million people, just like they said. In theory, it still could.

 

So the idea that the lock downs actually killed more people than doing nothing is just absurd. Like I said, Marko is great at data. But he shouldn't be hired to replace Dr. Fauci or Dr. Birx, probably.

 

Fauci and Biirx were also also very clear about another reason why lockdowns made sense. That's because of the testing challenges @Charlie noted. Testing and tracing sounds like challenging work. If you have 1 million sick people, and you have to trace their contacts and self-isolate some of them, it's impossible. 100 people or 1000 people is a whole different story. Fauci has been very clear about that in multiple interviews I've read.

 

As an objective measure, China had about 3,000 diagnosed infections in Wuhan at the time they locked down. They ended up with about 80,000 know infections by the time it was over. That included probably tens of thousands of people who had already been infected, but were undiagnosed and needed to be isolated somehow. If I recall, they actually had more than the 10,000 contact tracers California is hiring and training. It was a small army. So they were able to handle testing and tracing that involved those kinds of numbers.

 

Many other countries all over the world are demonstrating they can do the same thing, without using the same methods, when it involves maybe 500 to 2000 new infections in their country a day. They are showing that, so far, they can incrementally reduce the number of new daily infections. That is the precise goal. So if they are achieving that goal, that is a victory.

 

So here are the two JP Morgan charts that demonstrate that goal appears to be being achieved all over the world, and in the US:

 

 

I've actually read about ten different versions of news reports about this JP Morgan study. Because I've been looking for the study itself. If anyone is curious and can find the original study, please post it. Because the charts leave a lot of questions unanswered. For example, it would be very interesting to learn which countries are identified in that top chart. I can pretty much guess which ones some of them are, anyway.

 

That top chart makes perfect sense to me. When Germany went into lock down, they had a peak of just about 7000 new infections a day. For each day in the last week, they had between 273 and 672 new infections per day. So that works out to a 90 to 95 % reduction in daily infections. However Marko calculated what he calls the "daily infection rate", Germany obviously drove it way down during the lock down. Again, that was the goal. That's victory.

 

The complete victory, if possible, would be to literally get the number of new cases down to zero. Small island countries like Iceland and New Zealand have more or less done that. That's probably not possible in Germany. But we'll see. They are certainly doing their best to track down and eliminate the virus wherever it pops up.

 

So in most of the rest of the world, it seems like these lock downs did what they were supposed to do. That top chart shows that a whole bunch of countries went from infection rates of 4 % or 6 % or 10 % or 14 % down to just about 0 to 1 %. Again, I'd love to know which countries. Because before the lock downs, some of those countries had daily infection rates of 20 % or 30 %. Meaning the number of cases was doubling every three to five days. Which is to say, the virus was completely out of control, and growing exponentially. So if it went from exponential growth BEFORE the lock down to being crushed and almost eradicated AFTER the lock down, that's a victory. A big victory, actually.

 

I think some of the headlines about this JP Morgan study were based on the erroneous idea that the number of infections, or infection rates, were SUPPOSED to go up after lock downs ended. What Fauci in particular has been very clear about is that the idea of lock downs is to get out of control infections under control. After the lock down, Fauci kept saying, you can hopefully track the virus down and kill it, or at least contain it.

 

That was exactly what the CDC in the US was trying to do in January and February. They failed, of course. First and foremost because of the lack of testing kits that actually worked. Now, hopefully, that problem is solved. Fauci has said it's likely that at some point - maybe now, maybe in the Fall - the virus will form a second wave. But the idea is , first, that we have a much more educated public. We are doing things we weren't doing in February or March. Second, we hopefully have adequate tests and tracers - at least in many states, if not all. And if that doesn't work, then we have to go back down the road to partial of total lock downs. Which is obviously what nobody wants to have to do again.

 

In terms of that second chart, the two big winners are not even on the chart. New York has cut the number of new infections from over 10,000 a day to between 1,000 and 2,000. New Jersey cut them from about 4,000 a day at the peak to about 1,000 a day now. It's a bittersweet victory, because New York and New Jersey had to endure nightmares that @purplekow eloquently documented for us.

 

The idea that Marko could suggest that the lock downs might have killed more people than they saved is a stunning idea. 100,000 dead people, about 40 % of whom lived in New York and New Jersey, is a hell of a lot of people. So I'm pretty sure that the lock downs saved many lives. Especially in places like New York and New Jersey. Again, I think there is some fundamental misunderstanding of what Fauci and Birx were saying all along. The goal was to get caseloads way down, to manageable levels. New York and New Jersey did that.

 

The seeming good news for all the author states listed on that chart is the the reproduction rate of the virus is under 1. As long as that's true - meaning 1 infected person infects 1 or fewer new people - the virus is in decline. That's victory. Again, I'd like to see the numbers. I've been looking at the Georgia and Texas websites. In both cases, the number of cases are going up, not down. Hopefully, that's because they are testing more people, and reducing the spread of the virus incrementally. It's just too early to tell. As Fauci says, it may not be until Fall that we know. But by then the whole idea is to have an educated public, tests, tracers, and a whole toolbox to keep the virus at bay. There is certainly no obvious bad news right now.

Edited May 24, 2020 by stevenkesslar

[+ stevenkesslar]

America’s COVID warning system

 

I'm putting this website up as a counterpoint to Marko's analysis.

 

First, it has a bunch of data that Marko misses. It's data I think Marko actually needed to know and report, to understand why the lockdowns worked. And where we can hopefully go from here.

 

Second, the set of people behind this website are the science and math and medical folks I really trust and respect. They include Tomas Pueyo, who called it exactly right in March, in my view, and said California needs to shut down right now. Pueyo, and the experts around him, were heard. So this website gives you snapshots, by state, of where we are at right now. And where "test, treat, trace" could take us.

 

So, first, what Marko completely misses in his analysis is the nature of the problem Fauci and Birx were actually trying to solve. Which is a virus that was completely out of control, growing exponentially, spreading in all 50 states, and killing indiscriminately.

 

So if you go to that website, and click on New York State, here's what it tells you that Marko doesn't. Back at the peak in mid-March, COVID-19's reproduction rate in New York was 3.0. It was doubling the number of people infected every few days. We now know that 20,000 or so of those people ended up dying in the last few months. We also know that if there has been no lockdown and no other intervention, millions more would have become infected, and tens of thousands more would be dead. So the goal was to stop a virus that was out of control.

 

It was right around this time that Pueyo's crowd was telling leaders in California that every day sooner that they shut down would save thousands of lives. I think Pueyo was right. Had California not shut down, and if we had the exact same rate of infection and death that New York City has actually had, we would have had about 80,000 dead in California alone. Newsom keeps saying if we went for total herd immunity, you could put another "0" on that number. So no, Marko. I don't think the lockdown in California killed more people than not having a lock down. For whatever pain it caused, which was considerable, it saved tens of thousands of lives. Californians did, and still do, strongly support it.

 

New York achieved a low R value of 0.65 in early May. It has been flat lining between that and 0.75 during May. That's all good news. The number of cases has gone down 80 to 90 percent gradually. Way fewer people are dying, and hospitals are no longer being crushed.

 

This website keeps getting better every time I look at it. One new thing they've added for each state is some estimate of contact tracing. In New York's case, it is very low - only three percent of contacts are being traced. The state still has over half their ICU capacity filled. If you look at the whole New York page, that's actually progress - during all of April the ICUs in New York were over 100 % of aggregate capacity. (Meaning NYC was way over 100 % of capacity.) So if the virus were to start reproducing at an R over 1 again, things could look ugly in New York again pretty quickly.

 

Now take a look at Texas, Florida, and Georgia - three of the Southern states that are getting some shit for theoretically opening "too soon". I don't think "too soon" is the right metric. The right metrics are these ones: is the virus growing, or being contained? Do we have the hospital beds we need? Do we have the ability to contact trace to reduce community spread? Those are the variables that will literally determine whether people live or die.

 

So the first and immediate piece of great news, which Marko completely missed, is that these three states had reproductions rates of 2.2 to 2.3 in mid-March, before the lockdowns. So if the goal was to reduce the rapid spread of the virus, that worked. At worst, the virus is now at least not growing exponentially like it was back then. But if the goal was to reduce the number of infections, it did not really work in those states.

 

Texas and Florida both have reproduction rates just above 1. So if people are saying the virus might gradually start to surge back, they are not wrong. Texas in particular seems like it is gradually reporting more new cases, not fewer. Hopefully, that's because they are doing more testing and tracing, so more positive tests ideally means less viral spread. I'm actually surprised that Texas and Florida have more contact tracing than New York. But it's not a complete surprise, since I've read about the virus "SWAT teams" in Texas that swoop in and test and trace. They just targeted some meat packing plant somewhere in Texas. Again, this is exactly what Fauci and Birx were saying SHOULD be happening. So these are signs of success.

 

For the life of me, I really have no clue why some people think herd immunity makes any sense - ESPECIALLY if you want an economic recovery. I just read some story about a Ford plant in Michigan that barely had reopened and then closed after a few days - because a few workers tested positive. By definition, herd immunity means this would be happening all the time. What employer in America would want that?

 

Of course, Ford could implicitly say, "We don't give a shit if you get sick. We just hope too many of you don't have to go to the hospital, or die." My own bias about corporations is they are actually much smarter than that. Even if they are not, it is horrible PR. And even if they don't give a shit about the PR, having workers cycling through illness and hospitalization, and at least in some cases dying, is just a really ineffective way to make cars.

 

I have to imagine corporations would view it as way more cost effective to test and trace the virus into oblivion - or at least as close to oblivion as we can. I have to imagine that workers don't like a constant stop/start work cycle. They'd probably prefer to just come to work using basic precautions, like masks and some distancing, and feel safe, and not catch COVID-19. I also can't imagine that Google, or Apple, or Amazon, or Ford, or Smithfield want to have to go through this shit every single week.

 

My own bias is that Georgia is one of the places more likely to blow it sooner rather than later. The good news for them is that the viral reproduction rate has NOT spiked above 1 since they reopened. The first line of defense is an educated public. So it may actually be a good thing right now that people in Georgia hear the negativity, and are out to prove to the naysayers that they have their shit under control, and will do just fine, thank you. The smart government bureaucrats like Fauci and Birx are always smart enough to say that the most important thing is good citizens doing the right thing. Not government bureaucrats telling citizens what to do.

 

There are two things that worry me. First, there is this single digit set of losers that really do think it is their God-given right to ignore masks, social distancing, or any other simple tool that saves lives. These people probably also make good drunk drivers and wife beaters. They just don't give a shit. And as Dr. Birx keeps saying, their indifference can have lethal consequences, even for the people they love.

 

Second, meat packing plants in South Dakota and auto factories in Michigan shut down for a reason. It is great that most everyone got the memo on masks and social distancing. But the virus is going to spread, anyway. That's what testing and tracing is for.

 

Texas clearly gets it. They have their SWAT teams ready to go. Their infection rate is about half the rate in Ohio, Florida, and California. Those SWAT teams may be part of the reason why. But everything I read about Georgia suggests complete indifference to this point. People in Georgia no doubt feel they are doing the right thing. But these other tools in the toolbox appear to actually be quite helpful to keep the viral shit from hitting the fan. That website above says Georgia's contact tracing rate is only 4 %.

 

As a counterpoint, Oregon has a contact tracing rate of 69 % on that website. That is one of the highest of any state. Perhaps not coincidentally, they have the 4th lowest infection rate in the country. Only Alaska, Hawaii, and Montana have fewer infections per million. Washington has 100 % contract tracing. When this started, Washington had the most deaths, and about the highest death rate per population. Now they are # 21, and at 141 deaths per million are about 50 % lower than the national average.

 

I'm pretty sure my Mom and Dad's generation, and maybe my grandparents' generation, understood this testing and tracing stuff much better than we do. In 1918, of course, we didn't have viruses or vaccines identified. But public health efforts to use new tests and tracing to eradicate diseases like polio or measles, or more recently STDs, are hardly new. Nor are they rocket science.

 

I think partly we are victims of our own success, These are all tools that have worked well for us before. But through our good fortune, we allowed them to grow rusty.

Edited May 24, 2020 by stevenkesslar

[Populist Fury]

 

 

Eternal Kim love for making this righteous anti-fascist vid ?

 

Not many are talking about the irreversible long-term damage the Covid-19 hysteria is inflicting on our civil liberties. The "news" media will certainly never bring it up, they've always been on the side of the Surveillance State & against the constitutional freedoms of the individual.

 

I'm always amazed by how quickly & easily regular people are willing to give up their rights & freedoms do to fear. Willing to live in a police state just so they can feel "safe" from invisible threats like this virus & all those made-up ones that never came.

Edited May 24, 2020 by Corporate Shill

[Populist Fury]

It was interesting to see on the NBC Nightly News tonight, for the first time, reporting that in Georgia, which opened more than almost any other state over 4 weeks ago, there's been no spike (or even overall increase at all) in Covid-19 hospitalizations or deaths.

 

 

Not surprised to hear this. Almost everything our hysterical media & the so-called experts have told us would happen has turned out to be wrong/false, or at least not nearly as dramatic as they claimed. ?

[+ bigjoey]

 

 

Eternal Kim love for making this righteous anti-fascist vid ?

 

Not many are talking about the irreversible long-term damage the Covid-19 hysteria is inflicting on our civil liberties. The "news" media will certainly never bring it up, they've always been on the side of the Surveillance State & against the constitutional freedoms of the individual.

 

I'm always amazed by how quickly & easily regular people are willing to give up their rights & freedoms do to fear. Willing to live in a police state just so they can feel "safe" from invisible threats like this virus & all those made-up ones that never came.

Please keep politics out of this thread. Keep this in the Political Forum.

 

I and others no longer post in that cesspool. It is not worth the time and energy to post in that forum.

 

Sadly, I will not comment.

[+ bigjoey]

Not surprised to hear this. Almost everything our hysterical media & the so-called experts have told us would happen has turned out to be wrong/false, or at least not nearly as dramatic as they claimed. ?

 

Unfortunately, until the history is written, we can only take guesses as to what is happening. The statistics are really just estimates at this point. In different places, the definitions as to “infections” and “deaths” are not only different but change. It will take a historian looking back to sort this all out.

 

This virus is acting in ways not seen before. The large number of asymptotic infections makes true numbers hard to tell and therefore rates of infection and death. Right now, extrapolations are being made to whole populations from limited sample results. Much depends on the accuracy of the sample results, size of the sample, how reflective the sample was of the entire population, etc. To add to the confusion, this data is then fed into models to make predictions and this brings up the whole issue of accuracy of models and how they were constructed.

 

Then layer onto problematic samples and models the changes in the behavior of people from what is learned. For example, NY mandated that people with Covid19 be admitted to nursing home with disastrous results. In Florida, health authorities saw what was happening in Europe and they adopted best practices that kept Covid19 people out of nursing homes and the result was a lower death rate than NY.

 

As they say in show business: “Hold the applause until the end.”

[+ WilliamM]

Please keep politics out of this thread. Keep this in the Political Forum.

 

I and others no longer post in that cesspool. It is not worth the time and energy to post in that forum.

 

Sadly, I will not comment.

 

Politcal issues are part of every day Life. If you believe the political forum is a cellpool, try to make it better rather than just frequently complain in this forum. Jeez