As of today nearly 318,000 cases of COVID-19 have been diagnosed with nearly 14,000 deaths. China’s reports of both new cases and deaths remain unmatched anywhere else in the world. Germany continues to be anomalous as do Italy and South Korea in opposite directions. I cannot distinguish between differences in what these countries are doing in response to the COVID-19 virus and how they’re reporting their results.
I wanted to draw your attention to a couple of articles. The first is a video from Pro Publica from which I’ve sampled the following infographic:
It illustrates nine different scenarios of how the COVID-19 outbreak may unfold with differing assumptions about the speed with which different percentages of the population become infected. IMO there are two significant revelations in these scenarios. The first is that different parts of the country face different risks. The West Coast and New York City are at increased risk not just because they have a lot of cases but also because the resources available there aren’t great enough to handle the load.
The second revelation is that in order for the course of action that’s being taken here and in other places to make any sense you must assume one of the worst case scenarios. More specifically, the only way in which the “shelter in place” directive Gov. Pritzker has ordered in Illinois makes sense is if a) he is panicking; b) he is making his decisions based on information about a state other than Illinois; or c) he thinks one of the worst case scenarios (the three in the lower right quadrant of the grid) is likely.
The second article is this analysis of the available data, originally posted at Medium but now posted at Zero Hedge along with a refutation of the article. You actually need to click through to read the refutation but it’s well worth the effort. If nothing else the entire discussion is significant evidence that the entire outbreak has been heavily politicized.
Finally, lighten up! Here’s a song parody about our present circumstances which I found through, of all people, Janis Ian.
Bergstrom’s rebuttal was long on invective and short on substance. It really amounted to overly literal and how dare you come on my turf criticism
And now, for something completely different:
A cow runs out onto the road, and a limo driving late at night hits it head on and the car comes to a stop. The woman in the back seat, in her usual abrasive manner, says to the Chauffeur, “You get out and check on that cow. You were driving.”
So the chauffeur gets out, checks, and reports that the animal is dead, but it appeared to be very old. Well, says the woman, “You were driving, so you go and tell the farmer in that lighted farmhouse over there.”
Two hours later the chauffeur returns totally inebriated, a full belly, his hair ruffled, and a big grin on his face. “My God, what happened to you?” asks the nasty woman. The chauffeur replies, “When I got there, the farmer opened his best bottle of single malt scotch, the wife gave me a meal fit for a king, and the daughter made love to me.”
“What on earth did you say?” asks the woman. Well, I just knocked on the door, and when it opened, I said to them, “I’m Nancy Pelosi’s chauffeur, and I’ve just killed the old cow.”
Even within the US there are data anomalies. New York State has 50% of the nation’s cases but a mortality rate that approaches Germany’s.
I’m not comprehending the arguments by comparing death tolls between flu and coronavirus. In Italy from ALL causes has increased 30% due to the viral outbreak.
And I get the arguments that shutting down everything is overly broad. But there is a dilemma, by my reading of data, the only age group not at risk of hospitalization from the disease is 0-30. While the risk of dying between 30-50 is low (0.1%), the risk of hospitalization and requiring ICU is substantial.
I have no idea how to relax restrictions to take advantage that 0-30 are not at risk.
There are no riskless solutions, curious. Never have been and never will. Further, that’s never been the standard wrt the flu or any other of life’s risks. We accept them as part of life, with reasonable precautions or support. Now, we are willing to inflict the most dire set of circumstances on perhaps 250MM Americans rather than focus on 30MM. Its insane.
I have noticed that the view I am voicing is gaining traction in media. Perhaps it is dawning on people that their move heaven and earth and inflict untold hell on people to yield some illusion of benefit is failing. And its only March…………… Wait until the social unrest gets going.
Lost in the discussion and modelling of Italy is that they are much more like NYC than Wyoming. The results are the same.
My own opinion is that “social distancing” will break down quickly.
We have three generations in our home. The adults in their 30’s can’t stay home one day. (We’re not under lock-down). The three year old of course touches every thing and everybody. My wife and I are older and high risk, we hardly ever go anywhere anyway, but you see, all we have to is wait for it to come home.
Dave, you may be ok if you can stand 18 months of this, but I wonder if anyone has any idea what prolonged isolation is really like.
To repeat, I’m not saying social distancing should break down, I’m just saying that it will, and fairly quickly.
The response to the pandemic is being controlled by medical people, and they have no knowledge of nor interest in anything economic. Our current economic statistics (stock market, economic activity, employment) are those of a great depression. The longer the lock down goes on, more businesses will close due to bankruptcy, and the longer the economic recovery will take. If even businesses shut down, the recovery will take years. The Great Depression lasted a decade, and that could very well be our fate.
On a somber note, the Great Depression in the US only ended with our entry into WW II. The Fascists and Nazis in Italy and Germany actually did better in generating a recovery, but then they plunged the world into war.
“Now, we are willing to inflict the most dire set of circumstances on perhaps 250MM Americans rather than focus on 30MM. Its insane.”
Sure would be nice to have better data from a wide-ranging and comprehensive testing program, wouldn’t it? Data that could better inform policy responses.
On one hand, we have a set of people running worst-case scenarios that haven’t been eliminated by the available evidence – so they are supporting draconian policies that seek to avoid those outcomes. On the other hand, we have people, like Ginn, claiming it’s all overblown. The problem is, there isn’t sufficient data to determine who is right. Given that ambiguity, politicians are always going to play it safe so they can avoid blame if the bad scenario turns out to be the correct one. And their default response is always to “do something” even when the evidence indicates that doing nothing is the most prudent move. And in this case, we don’t have that evidence.
@Andy
Just like weather reporting.
And now we learn that China may have stopped testing for the virus and are letting people out of quarantine early. So now their numbers are hosed as well as being suspect.
https://twitter.com/lokinhei/status/1241220936906338304?ref_src=twsrc%5Etfw%7Ctwcamp%5Eembeddedtimeline%7Ctwterm%5Eprofile%3ABookwormroom%7Ctwcon%5Etimelinechrome&ref_url=http%3A%2F%2Fwww.bookwormroom.com%2F
I just think testing is overblown. It’s always nice to know more, but what are you, or would you, going to do with it. As I noted earlier, you need testing to tell you NYC is dense packed, a hot spot, and going to get hit? Or Italy?
I think politicians listened to public health people – no casualties at any cost. They will not achieve that goal and do tremendous damage while they try.
“you need testing to tell you NYC is dense packed, a hot spot, and going to get hit? ”
You want testing to avoid getting to that point. If you are heading that way you want to know so you can prepare.
Steve
“I just think testing is overblown. It’s always nice to know more, but what are you, or would you, going to do with it.”
I don’t understand this argument. Testing is the foundation of epidemiology. If testing isn’t important then neither is epidemiology. And health care for that matter, since testing is foundational for that as well.
As for what are you “going to do with it” you’re going to inform your decisionmaking.
As I have been saying for some time, I think a lot depends on your assumptions. I think we passed the time when containment was a workable strategy back in January. Testing makes the most sense while containment is still possible.
The problem is that everyone is operating off of assumptions because we lack sufficient data. The way you get data is through testing. It’s not merely or even mostly about containment. Since this is a novel virus, testing is required to simply characterize the disease, much less all the other things that testing enables or facilitates.
JOHN P.A. IOANNIDIS has joined the team of experts on Trump’s task force. It is thought he will represent a counterbalance to Dr. Fauci and some of the others on the team by his statistical evaluations and POV that are not necessarily based on the worst case scenario position.
A recent article written by him March 17, 2020 illuminates his take on this virus:
A fiasco in the making?  As the Coronavirus Pandemic takes hold we are decisions without reliable data.Â
“I think we passed the time when containment was a workable strategy back in January.”
Maybe if we had testing we would know. Maybe it was some time in February. If we had testing we might have known. Maybe it was confined to just a few areas early on. With testing we might have known.
Plus, you seem to place no value on testing now. It would be a great aid in using PPE gear appropriately and knowing how to treat patients. Not every pt with fever and pneumonia has Covid.
Steve
Did y’all see the bit where they asked 18 epidemiologists what there predictions were for total US cases by March 29th? They gave their answers as a range.
So far 15 of them are clearly wrong. All low. Of the three that can still be correct, one of them gave a range that clearly indicates he is saying, “Who the fuck can tell?”
The kicker is when they made there predictions: pretty much the middle of last week! Most of them couldn’t even get it right less than a week out! LOL at experts, but I guess the topic is hard.
Overall deaths in the USA look to be up over 50% in the last 14 hours or so. I don’t think that low death rate is going to hold up for NYC.
I’m coming to believe that the testing the US is doing and currently focused on will not provide the data Andy wants.
The current testing regime is designed for containing a few cases (like where the US was in Jan), and now it is being repurposed for point of care diagnostics (should the patient be put in the Coronavirus ward or be given allergy medicine).
But for epidemiology, you have to take a different approach.
`1). with an outbreak this big, to know how many people are sick, a random sampling is required. The current test method (test people who think they are sick) is like guessing Trump’s support based on who voted in the Democratic primary.
2) We have no data on how many were infected and are asymptomatic or already recovered.
3) Given a significant amount of transmission is now believed to occur through touching objects that infected people have touched (virus can stay on surfaces for 72+ hours_ — we need data on these objects (how many, how often are they touched).
Point 3 makes me think there should be guidelines about glove-wearing, and disinfection practices for high touch areas.
“’m coming to believe that the testing the US is doing and currently focused on will not provide the data Andy wants.”
Then what will provide the data? Please be specific.
I guess I don’t know why so many think the importance of testing is controversial or not very important. You can’t know if someone has Covid until you test them. Just like you can’t know if someone has strep or an STD or heart disease until you run tests. Testing isn’t just important for measuring the macro epidemiological problem, it’s also important for the treatment and care of individuals as well as those individuals who have come into contact with the infected person.
Our entire medical system is based on observing symptoms and testing for specific conditions to determine how to treat a patient and make judgments about what is wrong with a patient. But suddenly with Covid, testing is not important anymore? It won’t give us the data we need? Ok, then what will?
The fact is that we currently have no idea how many people in this country are infected. What is the solution to discovering that number? If it’s not comprehensive and timely testing, then what is it?
Seriously, what is your alternative? If testing doesn’t matter, then how can you measure the scope and depths of this pandemic? How can you know if someone died from Covid vs pneumonia vs the flu vs something else? How can you know who has the virus and who doesn’t without testing?
Testing is fundamental IMO. If you have some alternative then please be specific as to what will give us the information we need to make informed decisions on an individual and collective level. The entire reason politicians and authority figures are shutting the country down is because we have no farking idea who is and isn’t infected and we are unable to track the spread of this disease in anything remotely close to real-time. Well, the solution to that seems pretty damn obvious to me.
Curious,
On a second reading, I think I may have misinterpreted your comments. I agree the current testing regime is inadequate, which is why I’ve been beating that drum since the beginning. A nation of 330 million and we’ve tested far less than a million (~100k last time I checked). People who should be tested are turned away because they don’t meet some criteria that became irrelevant a week ago. Many test results are taking so long they are overtaken by events.
Yet somehow other, poorer, smaller countries have been able to scale testing while we flounder around.
CuriousOnlooker:
Your comment above is very closely aligned with what I am thinking.
Yet we rely on polls with sample size of 1K from a population of 100 million every day to predict election results.
I agree the US is lacking in the amount of tests for clinical diagnosis.
But for decision making at government levels, e.g. should there be a mandatory lockdown vs voluntary social distancing, how much to restrict travel — counting clinical diagnosis is inefficient and won’t scale. Given its spread to 100+ countries, we need data on scale of outbreak for poor countries as well, unless the US plans to close its borders forever.
So here is my suggestions
1). Get statisticians to create a sampling program that can provide the data on how widespread it is
2). Develop a test can detect past infection
3). For detection of infected objects, it is asking for star trek technology, but we can check with physicists / chemists to see if a moonshot can be attempted.