The orderly control of pandemics always starts with quick and reliable testing as well as proactive and selective prevention (neither of which are being practiced with the current response to COVID). It appears that the current state of medical uncertainty (i.e., what is the true rate of transmission, rate of mortality, etc.) along with the global visibility (i.e., worldwide access to internet news, Twitter, etc.) continue to be the drivers for behavior around the world.
This posting will be updated frequently to share insights and perspectives on the progress with the coronavirus response.
Reference the update on April 16 below about the crazy mortality statistics and causes of death that we are likely to see. You can now see what’s happening based on this headline today in the Sacramento Bee: “California hospitals saw sharp drop in heart attacks during COVID-19 shutdown“:
The results, published as a research letter in the New England Journal of Medicine, show that although California avoided the kind of dire outbreaks seen in Italy and New York, the specter of infection may have kept people away from the hospital.
The rate of hospitalization for heart attacks was nearly cut in half, falling by 48% from the beginning of January until mid-April. The study used data from Kaiser Permanente’s 21 medical centers in Northern California and the Central Valley and measured the rate weekly.
“There’s no intervention that we’re aware of that could drop the true incidence of heart attacks by this much,” Solomon said. “In other national emergencies like earthquakes or terrorist attacks, heart attack rates go up due to fear and anxiety. And there’s a ton of fear and anxiety about the COVID-19 pandemic.”
May 20, 2020
A deadly virus in not a new phenomenon on our planet. Societies, without our modern technologies and much less equipped to deal with epidemics, have been managing the outbreaks for centuries. The most fundamental approach is by identifying those that have contracted the illness, quarantining those that have become infected, and sequestering those with the highest risk of mortality. For some reason, here in the 21st century we are doing everything tushy-backwards by locking down 99% of the healthy people and introducing financial calamity. Of course, States such as New York are the worst at handling the situation:
The sad news from the Land of 10,000 Lakes (and nearly 50,000 state employees) is that Minnesota has been implementing the disastrous Covid-19 strategy made famous by New York’s Gov. Andrew Cuomo. The essence of the plan is to forcefully reduce the income of people at low risk, while simultaneously increasing the chances of virus exposure for those at high risk.
It’s almost beyond belief that governors like Minnesota’s Tim Walz and New York’s Mr. Cuomo would impose impoverishing lockdowns that restrict so much of everyday life—while systematically endangering the elderly who bear by far the greatest risk.
May 17, 2020
It is interesting that COVID now appears to be the preferred explanation for most illnesses and deaths. In fact, it seems to becoming a universal diagnosis of what ails the entire human race.
While it should be emphasized that most, if not nearly all doctors are genuinely concerned about the health of their patients and about COVID-19 — which is a real disease caused by a real virus — it should be remembered that much harm has been done to human beings by fake science and by extending science beyond its capacities to observe and to analyze more than material realities. Scientific formulas and projections can cause great harm when extended beyond the scientific method into metaphysics.
May 11, 2020
Using the data of the relatively controlled settings of the Diamond Princess cruise ship (see earlier data in this posting) and the USS Theodore Roosevelt war ship (neither of which are representative of a typical civilian population), we’re starting to an infection rate pattern in selected samples of approximately 25% and a fatality rate of roughly 0.1% :
The USS Theodore Roosevelt had a crew of 4,800. Given the acute sample, testing was holistic. This yields an actual infection rate of roughly 23 percent, and among those infected, the fatality rate is 0.09 percent. Among the Roosevelt’s entire crew of assumedly healthy and able-bodied sailors, on a floating Petri dish, during the thick of viral outbreak that shut down all schools and placed healthy citizens across America under house-arrest, the fatality rate was .002 percent.
May 10, 2020
The public policy lunacy continues with the VAJINO governor of Illinois stating that his rules will remain in place until the coronavirus is eradicated… Eradicated? How do you like that one? It’s tantamount to: “I am the dictator of this bankrupt State until further notice”. And how about the largest head fake in history being played on the population of this planet: “social distancing”. Who made up this cockamamie phrase and concept?
Very likely, you already instinctively know that the guidelines suggesting that it’s somehow helpful to keep a six-foot space between healthy people, even outdoors, is not based on science, but just an arbitrary suggestion we’ve been conditioned to accept without evidence.
And your gut feeling would be right. There’s a reason that “social distancing” wasn’t a buzzword common to the American lexicon prior to 2020. There’s very little science behind “social distancing” at all.
There is a thousand years of history that you control epidemics by identifying and quarantining the infected… not the healthy!
May 7, 2020
This is a good summary statement from Newt Gingrich:
Today, the combination of news media desperation for something about which to be hysterical, the Chinese Communist Party’s role in hiding and then lying about the new virus, and absurdly overstated claims of supposedly scientific modelers has led to the greatest self-inflicted economic disaster in history.
May 7, 2020
Shutting down the economy has wide-ranging consequences that politicians are just starting to discover. One of the most important for state political leaders is the resulting reduction in tax revenue (Somebody needs to tell these economic illiterates that no sales activity means no sales tax collection). Governors who maintain state-wide lock-downs are making a mistake. They think that they are somehow magically safeguarding citizens from COVID. They have forgotten that the lock-downs were intended to only reduce the height of the infection curves to avoid overwhelming hospitals. Unless there is an immediate cure or vaccination, the area under the curve remains the same. Thus, the reality is these lock-down governors are actually exposing us to higher mortality risk from unemployment and poverty.
May 6, 2020
The law of unintended consequences strikes again. With coronavirus, it’s like squeezing a balloon and having the latex distort simultaneously in multiple directions. The latest is the lack of people visiting the hospital emergency rooms when faced with a life-threatening situation:
Across the U.S., doctors call the drop-off staggering, unlike anything they’ve seen. And they worry a new wave of patients is headed their way — people who have delayed care and will be sicker and more injured when they finally arrive in emergency rooms.
May 4, 2020
Well, it appears that the prognostications are becoming reality. As noted in the April 16 posting below, the public will start seeing a gross distortion in the cause of deaths. I have not reviewed the sources of their data, but the chart below is a compilation of absolute numbers from Citizen Free Press:
April 27, 2020
With more human testing and data capturing, we are starting to gain additional insights about infection and mortality rates. However, this knowledge hasn’t really reduced the quantity of spurious claims about the seriousness of this pathogen. At this point, every ailment that somebody contracts leads to the question “Is this a result of COVID?” As a result, you can surmise that most claims about coronavirus that appear in the daily news still begin life based purely on anecdotal observations, which often end up disappearing from the news without any follow-up.
…most criticism of the Stanford study has been aimed at defending the lockdown mandates against the implication that they’re an overreaction. “There’s some sort of mob mentality here operating that they just insist that this has to be the end of the world, and it has to be that the sky is falling…”
Most disagreements among scientists, he notes, reflect differences in perspective, not facts. Some find the Stanford study worrisome because it suggests the virus is more easily transmitted, while others are hopeful because it suggests the virus is far less lethal.
The irrational fears inculcated by the media have led the country to unrealistic expectations — State governments are now behaving as if it’s practical for absolutely every citizen to avoid ever being stricken with COVID.
April 22, 2020
Making large changes in operating policy often results in unintended consequences. I used hyperbole and sarcasm in the April 16 posting about coronavirus and the primary causes of death in the United States (see below). Namely, the fact that people are ignoring the magnitude of deaths from coronary disease and cancer. One tends to lose perspective when there are no daily internet updates on the other 7,000 deaths that occur every day in the US. As a result, we are going to soon be seeing the impact and likely collateral damage from the panic introduced with the total focus on COVID:
Before the coronavirus hit, tens of thousands of people across the state sought emergency help each day. But in the weeks since the virus began its spread throughout the U.S., those numbers have plummeted by a third to a half…
They worry people are dying at home from conditions that could have been treated and others who survive will now suffer from serious, chronic conditions resulting from their failure to seek help… And at the Ronald Reagan UCLA Medical Center, stroke cases also have dropped by half, while people being treated for heart attacks are down 30%.
April 21, 2020
Engineers recognize that most decisions in life involve trade-offs. There are rarely ‘silver bullets’ that solve all your problems without any residual consequences. This is especially true in cases that involve uncertainty and require careful risk management.
Naturally, there are numerous unplanned consequences from the hysteria raised around the COVID pathogen. As indicated in this initial posting on March 18 and the time series presented in the posting on April 16, there are likely going to be other significant impacts on public health. One example is the situation where patients afflicted with the most common causes of death (coronary and cancer diseases) are not seeking or receiving care:
Because of social distancing amid the Covid-19 pandemic, hospitals and doctor’s practices have cancelled routine screenings and non-essential surgeries. The dire predictions of the experts and pronouncements of the elected leaders may be causing some Americans to fear going to seek medical care for life-threatening illnesses.
It’s important to note that these are not just anecdotal comments from the mainstream media attempting to inflame emotions. A recent article in the New England Journal of Medicine notes:
As the coronavirus pandemic focuses medical attention on treating affected patients and protecting others from infection, how do we best care for people with non–Covid-related disease? … Cancer care, which often involves immunosuppressive therapy, tumor resection, and inpatient treatment, has been disproportionately affected by Covid-19.
This situation emphasizes the importance of maintaining a broader perspective on overall wellness and healthcare.
April 20, 2020
If you’ve been following the still murky but ever evolving COVID story, you are probably aware of the approach that Sweden is taking to manage the virus:
Sweden opted for a different approach to tackling coronavirus: cities, schools and restaurants have remained open. This was judged by critics to be utterly foolish: it would allow the virus to spread much faster than elsewhere, we were told, leading to tens of thousands of deaths…
Sweden hasn’t declared ‘victory’ – far from it. It’s still early days in this pandemic and no one really knows yet how the virus will spread once restrictions are lifted and what excess mortality it will have caused when it’s all over…
…the actual situation isn’t far away from the ballpark suggested by professor Tom Britton in a study that was released this weekend: that between 25 and 40 per cent of the Stockholm population have had the virus and that the region will reach herd immunity in late May.
April 16, 2020
To put the amount of death that occurs on a daily basis into perspective, it’s important to understand that there are more than 200,000 people that die each month in the United States. Approximately 60% of those deaths are from heart disease and cancer.
With the CDC’s latest method of determining the cause of death (as well as State’s making arbitrary decisions), the chart below is my notional projection of what the likely time series chart for 2020 will look like for deaths in the US. Overall, monthly deaths will not change by much even with the presence of the coronavirus. However, one reaction will be, “Wow, look at that big bump for coronavirus deaths in there”. This will be followed by, “Yes, with all of the people driving much less, it makes sense that deaths from accidents decreased.” The most interesting comment will be something like, “Hmm, I wonder why the deaths from heart disease, cancer, and respiratory disease all decreased so much.”
This is a projection of what will be reported based on the ‘incentives’ of declaring all deaths as COVID-related. It’s not at all a reflection of the likely reality. It’s a cynical way of saying that the mainstream media is so distorted that they will draw the conclusion that coronavirus magically reduces deaths related to cancer.
Sources of historical data:
April 16, 2020
It may be a little early, but the analysis from a renowned scientist on the advisory board of the world’s largest pharmaceutical company has his own observations about locking down the world:
Professor Yitzhak Ben Israel has mathematically shown us that coronavirus closures were a mistake. It’s a tough reality. Americans lost their jobs and businesses went under because the United States, along with most first world nations, acted on the chilling predictions of a severely flawed model, a reading of Professor Ferguson’s tarot cards.
April 12, 2020
There are going to be numerous articles and commentaries soon about the abject failures once again of the government organizations that are charged with the mission of managing public health. In particular, the derogatory reviews are going to focus on the lack of anything useful from the WHO, CDC, and FDA. Examples are already emerging:
The Food and Drug Administration’s (FDA) most public failure is its most recent, the blocking of any private production of coronavirus test kits during the initial outbreak. How many Americans will pay the ultimate price for this policy remains to be seen?
The Centers for Disease Control (CDC) mission states as its priority “confronting global disease threats through advanced computing and lab analysis of huge amounts of data to quickly find solutions.”… Apparently not. The most consequential failure involved a breakdown in efforts to develop a diagnostic test that could be mass produced and distributed across the United States, enabling agencies to map early outbreaks of the disease, and impose quarantine measures to contain them.
Rest assured that the New York Times and Washington Post will chime in and claim that it was all Trump’s fault.
April 10, 2020
An update on the more detailed information coming from the controlled setting in Iceland:
Iceland’s randomized tests revealed that between 0.3%-0.8% of Iceland’s population is infected with the respiratory illness, that about 50% of those who test positive for the virus are asymptomatic when they are tested, and that since mid-March the frequency of the virus among Iceland’s general population who are not at the greatest risk – those who do not have underlying health conditions or signs and symptoms of COVID-19 – has either stayed stable or been decreasing.
April 9, 2020
This is a story about the observations from a phlebotomist taking hundreds of blood samples for coronavirus. While the data is more anecdotal/informal than scientific/controlled, it nevertheless illustrates the problem when not testing a reasonable cross-section of the population:
The number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease…
Of those who contract the coronavirus, around 25 percent may be asymptomatic… A recent study of 1,000 people in the Heinsberg District of Bonn, Germany found that 15% of the population had contracted the virus, many unknowingly and without symptoms.
This would appear to provide support for the previous observations about the Diamond Princess, South Korea, and Iceland where wider testing provided much greater insight. When fighting an epidemic, the most important first step is understanding the nature of the pathogen to enable the rapid introduction of wide-scale testing among a representative sample of the population. It’s important to note that a representative sample is not just those coming to the hospital with manifest symptoms.
When the Government is trying to quarantine the 99% of the population that doesn’t have the virus instead of the 1% who do, that’s the first sign that the people employed full-time to watch for these problems (CDC) have majorly failed. As you would probably expect, the CDC — the Center for Disease Control — was too busy focused on racism and obesity.
April 8, 2020
And here you go! As indicated in this posting back on March 18, the politicians will exclaim “It would have been even worse if I wasn’t in charge”. Here is the first:
Dr. Robert Redfield, the Director of the Centers for Disease Control (CDC), predicted that the death toll from the Chinese coronavirus will be “much, much, much lower” than the models have projected due to Americans following social distancing recommendations.
Medical uncertainty and global visibility led all the politicians to take the extreme route of attempting to lock-down the world, without any regard for a rational approach to risk management.
April 6, 2020
An editorial in the Wall Street Journal uses a variation of the phrase made famous by Charlton Heston — “Let Our People Go”. The focus is clearly on the notion that locking everyone in their homes is not the path to success:
We’re seeing the economic destruction wrought by blunt government instruments of prohibition. It’s time to let free people show how they can both fight infection and produce the wealth that is essential to good health.
While market-based indicators suggest that the financial markets may be stabilizing, economic activity, especially in the U.S. is still in freefall.
I realize that most people don’t like to bother themselves to understand the intricacies involved in a ‘supply chain’, but it’s essential as part of realizing that you can’t lock everyone in their homes and expect to have food items available for sustenance.
The simple supply chain illustration that I use for my wife is refilling the shelves at the grocery store. I explain: to get the 1 gallon jug of milk at the local Kroger store, you need someone working to milk the cow; another person to pasteurize the milk; another to package the milk into containers; another person to load the pallet of milk containers onto the truck; somebody to drive the truck to the Kroger distribution center; another person to unload the delivery truck; yet another person to stock the shelves; and finally someone at the grocery store to take your money when you purchase the milk… then multiply that by the 5,000 or so items available at the grocery store.
April 5, 2020
It’s about 3 weeks since my initial observations (noted in the intro at the top of this posting) and little has changed… This editorial provides a very good summary of the current lack of perspective being practiced by the political class:
The “experts” are people of genuine theoretical scientific knowledge but no real-world experience and no capability of risk assessment beyond the specific risks in their chosen field. They are focused on the virus and only the virus, because it is not their job to worry about anything but the virus. They could, without blinking an eye, recommend a six-month in-home lockdown. You could scream, “But people will starve by the millions!” That is not their concern. If they starve to death in their homes, they did not die of coronavirus and thus the “experts” have done their jobs. It doesn’t help that almost all of them are government employees for life guaranteed to receive full pay and benefits until the end of the known universe. They are not capable of grasping the concept that no work equals no pay, no insurance, no food, and finally nowhere to live.
April 4, 2020
Another case study on coronavirus response is South Korea (home of Samsung, Hyundai, and 23,000 US troops). This geographically small country adjacent to China, started turning the tables in the middle of March:
So how is it that the South Koreans got a handle on this virus without stopping the economy or shutting down the country? South Korea has a crowded population of some 52 million people crammed into a geographical location about the size of Indiana, a perfect situation for a pandemic to spread – but it didn’t.
They were also very proactive, in testing and separating anyone who tested positive for the virus, whether they were showing symptoms or not. Because as you are correct, the majority of the cases are quite mild. It’s just very contagious… We had our scary moment too, when we had 5000 cases in one city and it really made people nervous and afraid. But the government and the medical staff just keep handling it very matter-of-factly, and because they didn’t quarantine everyone — it didn’t make us panic.”
April 3, 2020
Here is another relatively controlled setting for the establishment of more reliable statistics… As epidemiologists around the world try to get a handle on the actual prevalence of coronavirus and its true mortality rate, Iceland has been doing the testing that is necessary to determine an objective set of parameters. Of course, while Iceland is a controlled setting similar to the Diamond Princess, it may not be representative of more populous nations.
About half of the people who tested positive reported no symptoms, underlining the importance of general testing in estimating the prevalence of infection…
Iceland’s response to COVID-19—which features aggressive testing, contact tracing, and quarantines of infected people but no general lockdown—is also strikingly different from the response in the United States, where the federal government squandered the opportunity to take a more proactive and targeted approach. Iceland began testing people in early February, weeks before its first confirmed case.
April 2, 2020
It’s appears that the Diamond Princess ship is lifting its quarantine after a detailed disinfection process:
The restoration group completed a Level-3 deep cleaning (highest level) of the entire ship. The Japanese Ministry of Health and CTEHLLC both monitored and approved this process,” the tweet read. The ship has been held in a shipyard in Yokohama Harbor in Japan…. Some passengers said on Twitter they received health check forms asking if they had symptoms such as a headache, fever or coughing. Passengers who tested negative and had no symptoms still had to get their body temperature checked before leaving.
The ship’s operator, Princess Cruises, said in a statement Tuesday that 169 people who tested positive recently were still on the ship as they waited for transportation to hospitals.
As you can see in the data from the March 30 posting below, some of the numbers in this recent story don’t seem to jibe with the numbers in these statistics (169 “who tested positive” versus 109 [712 – 603] still infected). Perhaps the 169 includes passengers that “recovered” but did not pass the exit criteria?
March 30, 2020
At this point, the most reliable statistics about the virulence of the coronavirus would appear to come from the relatively controlled situation about the Diamond Princess cruise ship. There was a well-publicized outbreak among its 3,711 passengers and crew in January and February 2020. The passengers were held aboard the ship in constricted quarters with 3,068 of the ‘guests’ tested for the virus. The latest statistics from that situation indicate the following:
- Total tested: 3,068
- Total infected: 712
- Total recovered: 603
- Total deaths: 10
- Approximate days to recovery: 14 to 30
This results in these epidemiological metrics:
- Infection rate: 23%
- Mortality rate: 1.4%
It’s important to note that many of those that tested positive for the virus did not manifest the typical symptoms.
March 18, 2020
I don’t know about the rest of you, but I am weary from the overwhelming focus on the coronavirus… Frankly, people are behaving as if it’s the black plague with everyone catching skin lesions and a 50% fatality rate.
My executive summary of the situation: the combination of medical uncertainty (what is the true rate of transmission, rate of mortality, etc.) and unprecedented global visibility (worldwide access to internet news, Twitter, etc.) has resulted in the reaction that we have now. That is, this combination has resulted in politicians taking the path most logical for them — being extremely risk averse without regard to cost/benefit. The political “cover your rear” position is one of demonstrating to constituents that you are doing everything possible to save every life. This enables the politician to exclaim “It would have been even worse if I wasn’t in charge”.
Now, for a little more detail (Please note that I’m an engineer acting as an amateur epidemiologist in describing the nature of potential viral epidemics). It appears that the quantitative factors listed below are the best predictors of the virulence of coronavirus (or any pathogen for that matter). You’ll note that I made ease of transmission (airborne versus contact) and level of mutability (virus changes structure as it multiplies) as sub-factors of the rate of transmission.
1. The rate of transmission
1a. The ease of transmission
1b. The level of mutability
2. The mortality rate
From reading recent papers in the New England Journal of Medicine (NEJM), the few takeaways that I have are:
- The most common manifestation or correlation from a biological test is leukopenia (low white blood cells).
- The costly CT exam has been the second most useful predictor of the presence of coronavirus (presence of glassy areas in the lungs).
- It appears that there has been the lack of any reliable and quick diagnostic methods
I haven’t seen any reliable or statistically significant quantitative data about these set of factors that I listed above. Based on the NEJM articles, I am assuming that most of the data is just now being generated and analyzed, and the greatest fears are the unknowns around 1a and 1b above, along with the absence of any reliable diagnostic testing.
Thus, here we are… “sheltering in place”, and waiting for the 21st century version of the black plague to come and get us… the mob mentality survives.