I want to take note of a recent post from Nate Silver. In the post Nate does a pretty fair job of assessing the present state of America’s struggle with COVID-19. It is blessedly free from political posturing. Here’s his one sentence assessment:
While the situation in many states is improving, in nearly half of all states in the U.S., there are as many COVID-19 cases as ever, and in some cases, even more.
but he has a reasonable humility about the limitations of the approach he’s using in his analysis:
As I’ve written before, the number of new confirmed cases can be a deceptive indicator of how much the coronavirus is spreading unless you also account for how many tests are conducted. But the stubborn persistence of the novel coronavirus in many parts of the country isn’t just an artifact of rising testing volume.
I think it’s it’s a weak indicator even if you account for the number of tests conducted and that will be the case as long as who is tested is basically self-selecting. That’s the reason I’m skeptical of his announcement of victory in New York:
Last week, I wrote about how New York has successfully bent the coronavirus curve after an extended period of social distancing. The evidence this week is even stronger. As of Wednesday, just 27.6 percent of newly reported COVID-19 tests in New York City were positive, still a fairly high rate — but substantially down from a peak of 59.4 percent on March 29. Other states are also seeing a decline in new cases — Louisiana, in particular, has seen a highly encouraging turnaround.
It may be a sign of victory or it may be a sign that lots of panicky New Yorkers with coughs who don’t have COVID-19 are having themselves tested and the tests are available to them. Until we have a better handle on how many people have contracted the virus but don’t show the symptoms of COVID-19 there’s really no way of telling. You’ve got to have some idea of what both the numerator and the denominator are.
I also want a better explanation of what’s happening in Illinois. Illinois was the second state in which the governor issued a statewide “stay at home” directive but at least to my eye it shows few if any signs of having “bent the curve”. I, for example, have basically been at home since the middle of March. I think the rational explanations are limited and contribute evidence to the notion that what we’re seeing, not just in Illinois but everywhere, is just the disease running its course rather than any measures that have been taken being effective in slowing its spread.
At any rate, read Nate’s post. It’s interesting and well-informed.
The performance of our federal and state governments has been appalling in the extreme, easily the worst in the entire world.
China, with 18% of the world’s population has only 3% of its cases and 2% of its deaths. It is well out of the worst. China was taken by surprise.
We, with only 4% of the world’s population, have 33% of its cases and 27% of its deaths. We are stll approaching peak. Our leadership had two full months warning.
This is an indictment of our politicians and medical system. They know it, and they are running a racist vilification campaign against China to deflect attention away from their failures and crimes.
The US is failed state with a corrupt, incompetent elite. Think Nero, Caligula, et al. Nearly every politician and senior civil servant is focused on stealing, bribery, power seizures. It’s been this way since at least JFK’s assassination.
China’s authoritarian regime performed flawlessly. But then, China’s leaders are patriots, care for their people, and are highly intelligent, competent and experienced. Everything our elite is not.
I cannot express how much I hate our elite. Truly the equal of the French nobility and royals on the eve of the revolution.
The number of people and the percentage testing positive if affected by too many things to be a reliable measure right now. Hospitalizations, ICU admissions and deaths are more reliable but deaths in particular have a real lag issue.
Steve
Bob, you cannot, you must not, trust any numbers coming out of China. Everything I’ve read that I even half trust indicate that the number of cases and deaths are at least an order of magnitude greater than what Tyrant Xi has reported, and perhaps a good deal more.
It’s starting to look like much of the public response to Kung Flu was in many ways similar to what happened in 1918; well-meaning but ineffective. In which case the only effective response would have been to nuke or MOAB the Wuhan lab last fall. No one in the world has that level of prescience and even if POTUS did even he’s not nuts enough to have started WW III over it.
Steve: From all your posts you and your hospitals seem to have done everything you can to fight the thing, and done as well as you can, but I suspect we’ll learn how to combat it effectively and figure out exactly what happened when it’s long dead and buried. And by the time the next superbug comes along the lesson will have been forgotten and the reaction will be as equally over the top rabid. The way the reporting of so many other kinds of fatal outcomes have fallen off a cliff make me suspect the COVID-19 death numbers have been exaggerated, I would trust ICU admissions a bit more (but not much considering the remuneration reporting problem).
Coronavirus: A Report From The Front Lines.
By which goals are we measuring against?
If the goal was to keep hospitals from being overwhelmed — by and large that has succeeded; except for maybe New York City no one is reporting someone didn’t get a ventilator when they needed one.
If the goal is suppressing the outbreak — it does not look that impressive.
What you want is called a “nowcast†in weather forecasting terms. It would require a rethinking of who we test; and more innovative ways to gather “real time†data.
It also require decision makers to do something with the data if they get it. I haven’t seen much on this end since end of March. Here is an example; are the current policies at nursing homes making a difference; if they are not; what further steps should be tried? If public transit is an issue; why not run public transit more frequently to make social distancing easier?
I don’t know why policy makers are not trying more things…. instead it is mostly an argument over retaining or dropping the existing “lockdownâ€.
Here is a coronavirus story coming out of a NY hospital that, if true, is horrific. It kind of takes some of the shine off of the care being delivered there, with a skeptical look at the use/abuse of ventilation practices.
Sorry, but the above link is already gone. Strange…..
5 minutes into your video your ED doctor is lying. Also, ED doctors dont study any more microbiology than I have. There is a good case for opening things back up, ut if you have to lie to make your point I am not interested in listening.
Steve
Curious, and Dave in his next to the last paragraph, basically make the observations I have been making for a month. This thing is largely just running its course.
It may, perhaps would, have made sense to not have the disease overwealm the health care system. But that was another gloom and doom scenario that never came to pass.
When the dust settles it will become clear that although a nasty bug, the cure, as they say, was worse than the disease. If only people could put risks and mortality/morbidity in context rather that get hysterical for, ahem, political and economic gain. IL pension bailout anyone?
I would assume that the goal was to accomplish something resembling all the infographics that have been published—to reduce the maximum number of active cases. I think that has been a flop. If the goal were to minimize ICU and ventilator use that has largely succeeded but as I have intimated that is probably more related to changes in practices by physicians that to the “stay at home” directive. Not that the “stay at home” directives are completely irrelevant. I just don’t think they’re the main factor.
“If the goal were to minimize ICU and ventilator use that has largely succeeded but as I have intimated that is probably more related to changes in practices by physicians that to the “stay at home†directive. ”
Based upon what?
Steve
So one week after locking down; Singapore is now trying centralized quarantine.
https://www.straitstimes.com/singapore/health/coronavirus-singapore-airshow-grounds-converted-to-isolation-facility
— Maybe now that Singapore is doing it; will experts in the West pay attention?
No one trusts the Chinese; but they said it was not the lockdown that turned around Wuhan; but centralized quarantine.
I personally would feel better if governments were trying lots of things and none of them were the magic bullet; at least I know they are not satisfied with how things are.
Just telling people to stay the course and not really try anything new is going to depress people — especially when progress is so slow.
Because of its federal structure, the U. S. is practically the perfect place for diverse experimentation. I guess the question is why the longing for a single, nationwide strategy?
Bob, I agree 100%.
Everyone with power and connections is grabbing for small business loans like a shark feeding frenzy. I’d only like to add that this is not new. This country has always been a criminal enterprise. That’s how free people act. In their own self interest. You can behave better but the financial winners will always consider you a chump. The good image of our leaders is created in myth after their deaths. Sorry.