True's beaked whale.jpg

Western spotted skunk

Hooded skunk

Yellow-throated Marten


Archive for May, 2020

Links for May 2020

Friday, May 8th, 2020

Adrian Bott—’I never thought leopards would eat MY face,’ sobs woman who voted for the Leopards Eating People’s Faces Party. LeopardsAteMyFace subreddit

Judy Mikovits is a pseudo-scientific anti-vax, conspiracy theory pushing nutter.

Universities are run by corporate style boards, and this is a failure. Time to go back to faculty-run universities.
Free puzzle books in Project Gutenberg
The Conspiracy Theories A Conservative Must Believe Today by David Atkins
New York Times’ Style Guide Substitutions for “The President Lied” by Mickey McCauley
The Nonprofit Grifters Who Want a Cut of the Coronavirus Bailout: After years of undermining health policy to aid their Big Pharma patrons, patient advocacy groups are making claims to federal pandemic relief. by Audrey Farley
The workout drug: As researchers learn more about how exercise fights chronic ills like heart disease and diabetes, doctors may soon be able to treat physical activity as the powerful medicine it is. by Bob Holmes

Maybe COVID-19 isn’t that dangerous? (and the country should mostly ignore it)

Friday, May 8th, 2020

JP Sears is an irreverent comedian. He made a video poking holes in the mainstream story of COVID-19. He claims:

1. You should do what you think is best based on your own assessment and accept the consequences of your decision.

2. Original estimate of death rate of 4.5%. LA County study shows incidence is 25X-40X higher, so the actual death rate is lower. New estimate of death rate is between 0.1% - 0.2%.

3. Anyone who tests positive for COVID-19 and dies is labeled a COVID-19 death, so the death count is over estimated. The treating physician doesn't determine the cause of death.

4. Mandatory vaccination is offensive. If a vaccine is developed, it will be approved for use without long term safety testing.

5. Pharmaceutical companies have a track record of recklessly pushing dangerous drugs.

6. Be afraid of any tracking--RFID, phone apps.

7. Rant about Bill Gates not having medical training. He controls the WHO, which is setting US COVID-19 policy. He is using his non-profit foundation to gather power.

I’ll address claims out of order, because “YOU CANT TELL ME WHAT TO DO, I’M A REBEL!”.

2. 26,000, or 1 in 700 (0.14%), of New Yorkers have already died of COVID-19, which provides a floor to estimates of the death rate. Estimates of incidence in New York range from 21% (New York city) to 3.6% upstate to 13% expectant mothers in New York, to 13.9% statewide incidence from antibody testing. Estimate that 20% of people in the state have had COVID-19, gives a death rate of 0.14% x 5 = 0.7%. But the confirmed death count is known to be an under count. The true death rate can be estimated by looking at how many people have died in NY this year and comparing it to a typical year. This gives an estimate that the COVID-19 mortality that is ~50% higher in NY than the confirmed death toll. So 0.7% x 2 = 1.4% mortality rate. A death rate of ~1% +/- 50% (0.5-1.5%) with good hospital care seems like a reasonable estimate.

In Iceland, testing a random sample of people gave an estimate that 2100 – 2800 people in the country had COVID-19, with 10 deaths, giving an estimated mortality rate of 0.36% – 0.48%.

So the incidence of COVID-19 is higher than reported with many people having mild disease. The US isn’t testing all symptomatic people, population surveys are only starting to report results.

Illinois reports 3,111 deaths and 70,873 cases, a death rate of 4.4%. But no one thinks that 4.4% is the death rate. A more reasonable estimate would be 50% more deaths, 4666 and 10X more cases, 710k, giving a mortality rate of 0.66%. The number of undiagnosed cases is where most of the uncertainty lies.

No one was reporting a mortality rate of 4.5%, that is bullshit. The early March results were all over the map, but no one took them seriously, they were early reports. And everyone knows the number of cases is higher, a lot of people with mild or asymptomatic disease, though there still is a lot of uncertainty as to how many people have had COVID-19.

It is still possible that the best estimates today are off, and that the mortality rate is lower. Let’s say it is 0.25%. Given that there is no vaccine, no one had any immunity to the virus a few months ago, and how easily it spreads, it would infect 2/3 of the country in a few months if it wasn’t slowed down. 2/3 of the US is 200 million people, 0.25% mortality would be 500,000 people. 2.5 million people would require hospitalization, but the US only has hospital beds for a small fraction of that number, so mortality rate under conditions of uncontrolled spread would be much higher.

Here are graphs of excess mortality, NY, UK, US state estimates, and CDC (NCHS) reporting:

3. This is a conspiracy theory that grew out of an interview Minnesota State Sen. Scott Jensen, a family physician, did with Fox News host Laura Ingraham on April 8. This turned into a meme, “hospitals get an extra $13,000 if they diagnose a death as COVID-19!”. There is no evidence for this, and Jensen now says his statements were misconstrued.

COVID-19 deaths are being reported by doctors using the existing practices. That there are *lots* of COVID-19 deaths can be seen from the rise in overall mortality this year. The CDC estimates disease prevalence and mortality using multiple lines of evidence–death certificates, testing of hospital samples, etc. This is how the yearly flu mortality figures are assembled by the CDC. It takes 1-2 years for these estimates to get finalized.

4. It will be interesting to see whether this blows up if a vaccine is developed. I could see the anti-vax movement colliding with the ‘taking COVID-19 seriously is a Democratic attack on freedom’ being pushed already by the President.

If a vaccine is developed, every sensible person will go out of their way to get it. Middle aged people who get COVID-19 end up in the hospital 2-3% of the time. Who wants to risk that? Also, widespread vaccination would allow us to open up the country again without triggering a new wave of cases. Will vaccination be mandatory for school children, or for people visiting nursing home or attending concerts? Maybe.

If a vaccine is approved, it will have gone through safety and efficacy testing. It will most likely *not* have been tested as thoroughly as a typical vaccine, because this is a crisis, and every day of delay costs lives. And costs people billions in lost income.

6. Until a vaccine is available, the best way to control the spread of COVID-19 is testing and track & trace. Identify and quarantine infected people, and identify and quarantine people that came in contact with them. There have been proposals to use tech–a phone app, or phone location data, to help identify contacts. Other countries are already using this successfully.

The fear that this will be used in the US to set up a permanent regime tracking everyone’s whereabouts all the time for… some sort of bad purpose is crazy.

1., 5., 7. The idea that a person shouldn’t take drugs made by pharmaceutical companies because they are keeping you sick to sell you drugs is, again, nuts. Disease exists, and before effective treatments, people suffered and died. Before modern medicine, people got lots of fresh air and exercise, many people ‘exercised’ all day long, and ate ‘all natural foods’ from the local farms, and they still got sick and died. This point seems unrelated to the COVID-19 rant.

Bill Gates has spent the last ~20 years working on public service projects–education and infectious disease. Not much has come of the education projects, but his funding of infectious disease projects has been very productive and is well-regarded. He knows more about epidemiology than almost everyone without a PhD in the subject. He’s been reading this stuff for years, for ‘fun’. Why are we hearing from him? He knows a fair amount about it, and America loves CEOs and rich guys. The WHO is an organization that coordinates efforts of world governments to fight disease. Like all UN efforts, it has little power and runs on cooperation and donations by member countries.

The idea that you should do what you think is best for yourself and screw everyone else is a very American idea. When it comes to skydiving and shooting heroin, I’m all for it. But this is a case where the behavior spreads disease and puts everyone at risk. A good analogy is drunk driving. Freedom, but never responsibility! Public health measures like quarantine, banning large gatherings, and mask wearing reduce disease and save lives. These are measures taken to fight a disease endangering the country, temporary measures directly aimed at stopping the spread of disease. I think it is reasonable to enact and enforce public health guidelines.


Tuesday, May 5th, 2020

Americans shut down the country for the last 7 weeks to slow the spread of COVID-19 and give the federal government time to get ahead of this–put mass testing in place, ramp up protective gear manufacturing, etc. The Republican administration wasted the time–we don’t have the protective gear or enough testing capacity. They haven’t even tried–Trump gave up, his administration spent the time bullshitting and planning who to blame the disaster on. Now the Republicans are pushing to reopen businesses and attacking states with Democratic governors trying to keep the pandemic under control. They have organized their brown shirts to come out and threaten violence against measures to save lives, measures with broad public support.

This month 1,500 Americans are dying every day of COVID-19. The projections are that this will continue all summer, and may get worse as states reopen businesses without enough testing or protective gear to halt the spread. Work and risk dying or lose your job, no unemployment for you, that’s the Republican plan. The Republican plan is for 100,000 more Americans to be killed this summer, and they are fine with it. Trump gives himself an “A+”, calls his response perfect. He has no plan to change course, to work hard to save these lives. Republicans is Congress and across the country don’t have a word of criticism to offer. They fully support the plan where 100,000 Americans die of COVID-19 this summer. This is an epic failure. With an active, engaged, and competent government, most of these people can be saved.

And this is the second round of failure. When Trump was briefed on the developing COVID-19 pandemic, he sat on his ass for six+ weeks. He didn’t want there to be a disaster while he was President, so he ignored it and hoped it would go away. Most of the 70,000 Americans that have been killed by COVID-19 would have been saved by a proactive response, by a President that listened to scientific advice, took the intelligence reports seriously, and acted–put the government in motion and got the country mobilized.

COVID-19 in the US

Monday, May 4th, 2020

I’m thinking about how the pandemic will play out in the US. I think the experience of Singapore provides an illustrative example. Singapore did a good job of controlling the pandemic early on. The government took steps to put testing in place, identify and quarantine the infected, supply protective equipment so everyone could be masked in public, etc. And it worked, new cases dropped to near zero.

But Singapore isn’t just a prosperous, modern country, it also has a large pool of poor foreign workers, an underclass that doesn’t get government services, by design they get poorly treated and their problems ignored. COVID-19 is spreading among these people in Singapore now. The government wasn’t monitoring them and didn’t know this was happening until the outbreak was extensive. These people weren’t tested, weren’t supplied with protective equipment, and live and work in conditions that are crowded and allow disease to spread freely.

But all these people live in one country, and if the pandemic spreads in one segment of the population, it will spread everywhere, and this is how Singapore’s response failed.

The divide isn’t as stark in the US, but the US has always been a country with a prosperous segment of the population and large patches of underclass–people whose problems are ignored. Basic services are available to those with enough money, everyone else suffers their absence. The US government is organized to ignore the problems of the underclass–they don’t get health care, they are forced to work while sick and into old age. You can see this attitude in the federal government’s response–we have some testing, enough for the people who matter. Not enough protective gear for everyone, so it is distributed commercially–those with money can buy it.

What does this mean for the US response to COVID-19? It means that instead of a national effort, to test, treat, and protect everyone in the country, the US has been focusing on the upper class. Leaving some segments of the population where COVID-19 spreads freely. But the US has one connected population, there are plenty of contacts between people in different classes. The disease doesn’t respect the class boundaries, and so it will spread back to the upper class. A disease can’t be contained by a net with large holes.

So that’s the US response to the pandemic–rather than make a national effort, the US will take its usual approach. This will fail, and the pandemic will continue spreading. Better dead than egalitarian!

I expect the economic response will follow the same outline, and the US will focus on bailing out the ruling class and will choose to have a long and deep depression rather than have the government help everyone out and lift us out of the depression.