Politics

GW Johnson · 2020-04-06 08:42:57

What previous experience with epidemics teaches is that the same exponential equation used for peak oil models will model the pulse of deaths that is typical of an epidemic. No one can argue with that, it simply is.

The difficulty with that equation is selecting the constants that go into the two exponential factors in it, early on, before you have seen the real shape of the curve. That is as true for peak oil predictions as it is for peak death rate predictions.

One factor dominates initially, which gives the exponential growth behavior. Late in the model, the exponential decay factor dominates. In the middle, the two battle from growth to decay dominance, leading to the bell shape of the total curve. That's just math, which no sane person can argue with.

As I said, the difficulty is picking the right constants to insert into the model. Predictions with the model are very sensitive to those selections, so predictions vary rather widely, as different people make those selections differently. That really is a severe downside to the prediction of pulse events.

But the form and fundamental behavior of the model does NOT change: growth is exponential upward initially, then bends over in the middle of the event, and decays to an end.

We are still seeing increases in the number of deaths (or infections) from one day to the next, so regardless of the predicted numbers, we know we are still in the exponential growth phase. What that means is the death toll per day some days hence will be far higher than the death toll per day today. Each day's toll adds for the total (accumulated) death toll (integral under the curve).

That behavior is independent of the actual numbers. It is inherent in the math model, one that we already know is appropriate, if difficult to use accurately.

Heart disease and auto accident deaths vary statistically from day to day, but average as a steady trickle all across time. That's a different math model, one which uses the standard statistics bell curve and standard deviation stuff. Not the same model at all.

The difference between the pulse of an epidemic and the steady trickle of heart disease and traffic deaths are why you cannot compare numbers-dead per day directly.

There is another thing about pulsed events modelled with the growth/decay exponential model, and it is behavior that also independent of the actual numbers (being the same no matter how you choose the constants). Things like quarantining affect the choice for the decay model. But the way the math behaves, you have to start early to get the beneficial effect.

That's found by patching together two models with the choice changed earlier or later in time. What you learn from that is that with epidemics, "wait and see" is the wrong strategy. The longer you delay, the less beneficial effect you can have on the height and the integral of the pulse of death.

The US had its first case of COVID-19 documented in January. That's when the quarantining and the distribution of critical supplies should have started. Instead, we screwed around until March to start quarantining, and we are still struggling to distribute critical supplies in April.

We will pay a higher price in deaths for those bad decisions. How many is not predictable reliably, but the math says it will be "high" whatever the number really is. And those bad decisions (in spite of good advice) are what I have been objecting to.

Trump has simply been inexcusably incompetent. His bad decision-making will kill more people than would otherwise have been lost. Simple as that. And just as evil as it sounds.

GW

Last edited by GW Johnson (2020-04-06 08:59:26)

kbd512 · 2020-04-06 12:34:48

GW,

All of the "peak oil" models produced to date have been wrong, quite possibly because they were all based upon belief and assumptions that had little or nothing to do with reality. There's a running inside joke in the industry: "We've always had 30 years of reserves, and we always will." If you can't figure out what that means, then I guess you can't. If you're looking for a "theory" as to why the theory of peak oil has always been proven wrong, decade after decade, you might want to start there. So, once again, you're mistaken, as were all of our supposed "experts" who proved to be anything but, and "wait and see" remains the only correct strategy.

If you're genuinely curious at all, and maybe you are though I suspect not, the actual reserves that we know about will last for around another few centuries, and certainly the next century at a bare minimum unless we decide to quit drilling or demand skyrockets to levels not in line with population-based consumption growth, even with expected increases in demand. Since you've been guessing and assuming about everything else related to this, let's come up with a probable theory about why that is. It could be that they don't actually know where the reserves are located- possible but highly unlikely with the amount of prospecting done in recent decades, it could be that they're trying to drive up the prices- something that hasn't worked very reliably at all or has actually exhibited the opposite of the supposed desired outcome (for the oil companies), or it could be that if you report more than 30 years of reserves that your oil "find" can immediately be nationalized and summarily taken away from you by the various governments of the world- and that specific point turns out to be rather "interesting" if you're in the business of trying to make money off of selling oil. I'll let our learned PhD's in the room figure that one out.

President Trump declared a public health emergency on January 31st and at that point, no American who had not traveled to China had died from COVID-19. President Trump declared a national emergency declaration followed on March 13th, at which point 279 Americans had died.

Former President Obama declared a public health emergency on April 26th, 2009 from H1N1. Former President Obama declared a national emergency on October 24th, 2009, at which point more than a 1,000 Americans had died.

If President Trump is "inexcusably incompetent", then former President Obama was even more inexcusably incompetent and I'm guessing that you voted for him twice. And that's just as evil as it sounds.

Ideology is a funny thing. It leads people who witness the exact same events to come to remarkably different conclusions. Recall that I stated that I thought former President Obama's response was adequate, despite the delays and higher total number of deaths before a national emergency was declared. Well, guess what. I think President Trump's response is adequate, despite the delays and higher total number of deaths.

Let's come back to this topic in another week to see where we stand.

Sidebar:

Speaking of statistics, one interesting tidbit of knowledge that came from a study in China is that 19% of their fatalities had cardiac damage and 51% of patients with cardiac damage died from complications associated with COVID-19 versus 4.5% for those who had no cardiac damage. In conjunction with the fact that the same receptors present in lung tissue that COVID-19 attaches to are also present in cardiac muscle, that relatively clearly explains why elderly patients are, statistically speaking, more prone to dying of COVID-19.

Experimental AI tool predicts which COVID-19 patients develop respiratory disease

From the article:

The researchers were surprised to find that characteristics considered to be hallmarks of COVID-19, like certain patterns seen in lung images (e.g. ground glass opacities), fever, and strong immune responses, were not useful in predicting which of the many patients with initial, mild symptoms would go to develop severe lung disease. Neither were age and gender helpful in predicting serious disease, although past studies had found men over 60 to be at higher risk.
Instead, the new AI tool found that changes in three features -- levels of the liver enzyme alanine aminotransferase (ALT), reported myalgia, and hemoglobin levels -- were most accurately predictive of subsequent, severe disease. Together with other factors, the team reported being able to predict risk of ARDS with up to 80 percent accuracy.
ALT levels -- which rise dramatically as diseases like hepatitis damage the liver -- were only a bit higher in patients with COVID-19, researchers say, but still featured prominently in prediction of severity. In addition, deep muscle aches (myalgia) were also more commonplace, and have been linked by past research to higher general inflammation in the body.
Lastly, higher levels of hemoglobin, the iron-containing protein that enables blood cells to carry oxygen to bodily tissues, were also linked to later respiratory distress. Could this explained by other factors, like unreported smoking of tobacco, which has long been linked to increased hemoglobin levels? Of the 33 patients at Wenzhou Central Hospital interviewed on smoking status, the two who reported having smoked, also reported that they had quit.
Limitations of the study, say the authors, included the relatively small data set and the limited clinical severity of disease in the population studied. The latter may be due in part to an as yet unexplained dearth of elderly patients admitted into the hospitals during the study period. The average patient age was 43.

SpaceNut · 2020-04-06 13:49:08

False finity model that was based on never finding any more reserves of the fossil fuels, did not account low grade shale plus others and did not look at syngas oils at all. The did not account for the change of coals to nuclear and none saw the hybrid electric at all.

The "inexcusably incompetent" label can be placed on both along with the medical profession that did not change the model of no test and no treatment...if you are not identifying then there is nothing being done.

From what I have seen from the information is the lungs are effected first with which the air in the blood stream drops at which the heart must pump more flow to keep its level up and thats what is causing the snow balling effect as the lungs get worse.

So air inhalation drug for asthma being used to dilalate the lungs to allow them to get more oxygen?
What about a saline rinse with bacterial virus killing content while knocked out to flush them?

Everyone assumes that its just the single virus that a patient has but did they test to see if others are there?

The reduced driving will be effecting the insurance risk and with that allstate has decided to give funds back. In the other view the insurers for health, home ect are all going to want to charge you more....

Allstate to return $600 million in auto premiums as pandemic cuts driving

many Americans stay home and drive less during shelter-in-place orders to curb the coronavirus outbreak.
Most customers will receive a payback of 15% of their monthly premium in April and May, the company said.
The payback, which will apply to 18 million policies issued by Allstate and its Esurance and Encompass units, follows a data analysis by the insurer that showed mileage is down between 35% and 50% in most states,

Every little bit helps.

SpaceNut · 2020-04-06 18:47:20

Grocery workers are beginning to die of coronavirus

There are soon going to be lots of court cases for the deaths of loved ones for casting them into essential roles in all facets of work. These are the first and will not be the last.
Walmart sued over coronavirus death by family of deceased employee

More than 10,500 Americans had died from COVID-19 as of Monday, according to a Johns Hopkins University database and higher once the dead get a final test to prove the virus presence or not.

Making the right call comes hard for some as the Coronavirus hit the Roosevelt as Mr. Trump was seeking to project a confident message of the United States getting through the pandemic with relative ease. How the Theodore Roosevelt's Coronavirus Outbreak Became a Moral Crisis for the Military by reporting to superiors was removed from command and tested positive for the corona virus...

SpaceNut · 2020-04-07 17:59:45

https://en.wikipedia.org/wiki/List_of_a … s_Congress

Just adding in the laws that have been passed for the corona virus pandemic:

1. Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020
https://en.wikipedia.org/wiki/Coronavir … _Act,_2020
https://www.congress.gov/bill/116th-con … -bill/6074

2. Families First Coronavirus Response Act
https://en.wikipedia.org/wiki/Families_ … sponse_Act
https://www.congress.gov/bill/116th-con … -bill/6201

3. Coronavirus Aid, Relief, and Economic Security Act
https://en.wikipedia.org/wiki/Coronavir … curity_Act
https://www.congress.gov/bill/116th-con … e-bill/748

SpaceNut · 2020-04-07 19:54:53

The states with stay at home social distancing sure can get it screwed up Colorado man handcuffed for playing T-ball with daughter in empty park sign specifically allowing gatherings of fewer than five people.

A doctor got angry that teen girls weren’t practicing social distancing. Then he attacked them, police say.

The incident highlights how “quarantine shaming” — calling out people who are perceived as not doing their part to stop the spread of the novel coronavirus — can escalate quickly and even turn outright dangerous.
The growing emphasis on regulating individual behavior has also raised concerns about police overreach.
The New York Police Department has been criticized for arresting people who allegedly fail to maintain social distancing, and then throwing them in jail, where they have an increased likelihood of being exposed to the virus.
Similarly, a Pennsylvania woman who went for a drive just to get out of the house was pulled over and given a $200 citation for violating the state’s stay-at-home order, raising a slew of civil liberties concerns.

Not having all the facts....

President Trump after invoking the Defense Production Act was to make things better and that was to take control and then he walks it back to the states to do what they want its not the federal governments job...

In the absence of a national testing strategy, states go their own way

States battle each other for equipment in supply chain crunch

Companies Offer FEMA Critical Supplies the Government Can't Buy

Kushner’s team seeks national coronavirus surveillance system

SpaceNut · 2020-04-08 08:04:48

The national stock system has dispensed items not in working order and even items that have past there expiration as well to which even Hospitals to can store items which can go bad.

Baptist Memorial Hospital-Memphis recently found dozens of cases of the masks in storage but couldn't use them because the elastic straps had dry-rotted and needed to be replaced.

Volunteers fixed 20,000 N95 masks for Memphis hospital in a weekend

SpaceNut · 2020-04-08 19:23:34

Scared enough to run after the last vote Senate Minority Whip Dick Durbin is warning that the Senate coming back in two weeks as scheduled would be “dangerous and risky” amid the coronavirus pandemic. return on April 20 to try and have Mnuchin, Schumer in talks to strike short-term relief deal to approve of an additional $250 billion for the popular Paycheck Protection Program under which small businesses can get federally backed loans that will be forgiven if they keep workers on payroll during the coronavirus downturn. Americans now may have to worry that our President and his cronies could turn a relief package into a vehicle for self-dealing and a sweetheart deal for the rich, but here we are. Nobody expects error-free governance, but good leaders are able to deal with mistakes, swiftly correct them, and accept independent oversight.

GW Johnson · 2020-04-10 17:54:48

Kbd512:

Your distrust of predictive models led me to formulate one for the pandemic. I posted this today as an update to the Covid-19 article on "exrocketman" a couple of days ago. I played with it enough to see the strengths and the weaknesses of the technique, which I put into that update. All the math is there. I would encourage you to take a look at what I did.

GW

kbd512 · 2020-04-11 07:22:05

GW,

In Data We Trust, Models Not So Much

What I distrust about models is all of the assumptions baked into overly-simplistic models, the dearth of accumulated data, and the lack of information regarding which factors dramatically influence the death rate. I think you're already aware of the fact that I get paid to use predictive models for forecasting demand for various products. They're often quite useful for making predictions when we use appropriate modeling algorithms, have access to pertinent accumulated data, and make use appropriate causal factors or parameters that govern how the data is interpreted by the modeling software. The corollary to that statement is that if we don't, the predictions made often aren't worth the paper they're printed on.

Blindly Following Trend Lines

If there were no limitations placed upon exponential spread of the virus, then your assertion from Post #1624 that 10,000 deaths could become 100,000 in just a few days would be true. However, there are obviously some other factors at play that prevented that from occurring. In point of fact, that didn't happen. We're nearing the end of this week, so unless something truly apocalyptic happens over the next two days, we're unlikely to see 100,000 American deaths from COVID-19 by the end of this week.

The Grim Truth

I think CDC listed COVID-19's R0 value as 5.7, so essentially everyone needs to become immune by contracting the disease or by being vaccinated to achieve herd immunity. The containment strategy failed catastrophically in China due to the lack of forethought of their communist "leadership" (and I use that term in the loosest possible manner). Vaccines typically take a year or more to develop and if we wanted to beat that average, then an all-out "Manhattan Project" level effort was mandatory from the word "go". We're still behind the power curve, yet also making rapid progress.

Essentially, that means nearly everyone will contract the disease before a vaccine becomes available and you'll either live or die. Therefore, the only correct mitigation strategy was identification of the vulnerable people to quarantine them, rather than the rest of us. I think I already stated as much elsewhere in the forum or in this thread. That's what President Trump actually meant when he said the cure shouldn't be worse than the disease and that we needed to consider everything in its totality when making such decisions. I don't think the entire world can afford to sit at home and wait this thing out. Since there was never any practical containment strategy in place for our modern interconnected world, the majority of us are going to contract COVID-19 and live or die. There was never any such thing as stopping it, merely slowing the rate of transmission to something our medical system can handle and accepting the inevitable deaths. At this point, I'm ready to let nature take its course before starvation kills whomever the virus didn't.

The Ultimate Goal

The real question is whether or not we can predict where the worst outbreaks will occur and how can we protect the vulnerable populations in those epicenters, since the total number of infected is driving the death rate through transmission to those vulnerable people. A useful and skillful model would predict those things with a reasonable degree of accuracy. Provided a sufficient number of data points are available in the data series, forecasting tends to be more accurate using a more granular level of data. Taking a national level data set as a starting point is not how I'd go about analyzing this problem, unless that's the only data available. I don't believe our scientists are limited to using such coarse data sets.

Curious Data Points

I don't doubt for a second that there will inevitably be more American deaths from COVID-19, yet I fail to see the utility of guessing at the magnitude of the problem. The plain truth is that even now, we just don't know. Making predictions about death rates without first using better data and modeling techniques is little different than preying upon the fears of the ignorant.

To put that 100,000 number in perspective, over the past 2 years there were about as many influenza deaths. Nobody compared those deaths to the last world war or 9/11, though. Between 2010 and 2020, our influenza death toll is only around 100,000 shy of our WWII death toll. Every two years, influenza produces a death toll that's very similar to the Viet Nam War's death toll, but there's very little fanfare over that. Come to think of it, traffic deaths over the past 2 years amount to about 75,000 and yet I still see people talking on their cell phones, watching movies, doing their makeup, and nearly every other thing conceivable besides driving their car.

Each and every year, our death toll associated with heart disease and diabetes exceeds the death toll associated with all wars America fought in since this country was founded. The utter lack of 24/7 media coverage over that isn't the least bit curious, though, is it? Every year our medical professionals "sound the alarm" over obesity and diabetes, and every year that alarm is ignored by nearly everyone, irrespective of their politics or personal beliefs, and every year we quietly lose more Americans than we lost in WWII by a good wide margin. For whatever reason, there's no media panic over the sheer numbers involved, nor talk of valuing lives over money.

If the hoopla over this new but not-that-novel corona virus seems a bit mystifying to me, then maybe those numbers explain my thought process about what COVID-19 actually means in the grand scheme of things. Once again, please note that an average of over 100,000 people were dying in WWII per day, whereas this new virus hasn't managed to kill that many people after several months of global spread.

My admonition that the death toll associated with this viral outbreak is nothing remotely like WWII remains as true today as it ever was. America's good fortune in WWII was its geographical isolation from the actual fighting. However, diseases are far less limited by means of practical available transportation and sustainment than human soldiers are.

Better Modeling Approaches

"Modeling Infectious Diseases in Humans and Animals by Matt Keeling and Pejman Rohani" is a good primer on the subject. There's an admonition about not paying attention to stochastic dynamics on Page 12, as it relates to early stage epidemics, which is what we're in with COVID-19. The e-book version is around $70. I've spent way more than that on individual pieces of software and individual college textbooks. It's worth the asking price if you actually want to understand how we model infectious diseases. Most people aren't that curious, nor are they interested in modeling infectious diseases.

I found this approach to be of interest:

Modeling stochastic processes in disease spread across a heterogeneous social system

Parting Thoughts

If I was trying to predict which people were most likely to become serious ill and die, I'd be working on a Bayesian-Markov model of the vulnerable population. Your parameters would be the age / health / wealth characteristics of the vulnerable population, given the marked difference in death rates between age groups and men vs women, your causal factors would be the prevalence of specific genetic traits or other preexisting medical conditions common to so many of those who have actually died within that population, and their proximity to other people / disease vectors. Your stochastic process is, naturally, the spread of the virus.

Simple models are good teaching tools for conveying basic concepts to students, but they're typically poor at modeling complex natural phenomenon such as death rates associated with the early stage spread of infectious diseases. Even if your model was 100% accurate, which it's clearly not if that's where your "100,000 Americans could be dead in a few days" statement came from, it still doesn't tell me anything beyond what I already knew from looking at similar graphs of data from historical infectious diseases. I haven't found any research papers published by statisticians using your model that were used to predict the death rates associated with infectious diseases at a point in time before the utility of knowing such information has already passed. That's generally a clue that people who study the spread of infectious diseases don't find that sort of model very useful (for predicting death rates associated with early stage spread of infectious diseases). Your pulse function is what they'd refer, with respect to what you did, as something akin to the "simple model" for pandemics.

My policy approach is to get people to accept the deaths as part of life, because there's nothing else we can realistically do and many of those people who did die were also likely to die shortly thereafter anyway from their underlying medical conditions, and move on with the rest of life for those who remain who have to pay the medical bills. It's either that, or you do away with the concept of money in favor of some other system that underpins society's valuation of work, but you can't have it both ways. Them's the breaks, as they say. Read 'em and weep.

GW Johnson · 2020-04-11 11:01:29

Kbd512:

Actually, I think we are closer to being in agreement than would seem at first glance. You probably have more experience with prediction of future stochastic events than I do. My usual predictive models are along the lines of engineering design analysis. What breaks, what overheats, what will fly, that sort of thing.

I just know what I've read about the stochastic crystal balls, and my small efforts using them identify very well the sensitivities to underlying assumptions, and the extreme difficulties defining the model parameters from ill-behaved real-world data without having seen the peak yet in pulse models. I'm not afraid of the math, obviously.

My model of the US epidemic is crude, with limits to its utility, but since it would appear the actual peak of the pulse is happening now, or within the last several days, it's converging toward reality. As posted on "exrocketman", it predicts an accumulated total number of infections of around 660,000 by mid-may to early June. At about the observed 2.5-3% death rate (deaths divided by known infections), that's a predicted 20,000 U.S. deaths. That's out of some 325 million of us.

Where we differ is whether we should fight the infection spread with quarantining or not. If we already had a treatment, or better yet a vaccine, I'd agree with you and say no quarantine, let it try to infect all of us. But we don't, and we won't have a treatment or a vaccine for another year or so yet.

If we were to let it run its course without any treatment or vaccine, with all 325 million of us infected at a 3% death rate, the upper bound on the death toll would be 9 or 10 million. How is that better than trying to limit infections with quarantine, and holding the upper-bound toll under 100,000? Besides, with our quarantining, it looks to be well under that upper bound: my model indicates only 20,000. Only a model, but there you go.

So, as with epidemics since the Black Death 600 years ago, the only tool we actually have is quarantine to stop the spread. That reduces the death toll by dropping the peak, at the cost of spreading out the pulse over time. We're better at it than they were 600 years ago, simply because we know more about science and medicine now, than we did then (so our quarantines work better).

So what happens this summer is that this thing is over, but the vast majority of us are left vulnerable with zero immunity. It will come around again, so we need the treatments and the vaccine to fight this off next time without resorting to quarantine.

This thing was a problem in China back around November. They tried to cover it up to avoid bad publicity for the communist government. Info was leaking out anyway, during December, when the disease got out despite the harsh Chinese quarantine. Murphy's Law says it would, but officials in all sorts of governments around the world always self-deceive about that.

They (the Chinese) came clean about it by January, and have offered good information since, as the disease has swept around the planet. Better late than never, I suppose. But their delay has killed a lot of people. Very evil, that.

Our U.S. quarantine and supply logistics got delayed by about 2 months because of the same idiotic deny-any-bad-publicity attitude in the White House. That's why the early U.S. hot spots (New York, New Jersey, Washington state, Florida, etc.) have been as bad as they have been. We here in Texas saw a later epidemic start, and had the quarantine in place from the get-go, so we aren't suffering the way those hot spots are. But we have yet to peak in Texas, looking at the published daily infections data. Even so, it'll probably be over by about early June, if our infections peak in the next several days. The area beneath our pulse will be smaller.

That's less about modeling, and more about just watching the data, with the pulse and S-curve concept behaviors in mind. Not so focused on creating a model, more focused on just understanding why the data is doing what it does. Which is a pulse in daily rates, and an S-curve-shaped increase in accumulated totals. Simple as that.

GW

elderflower · 2020-04-12 09:42:46

I wouldn't be so quick to believe what comes and doesn't come out of China. It seems that University and Hospital research results are still subject to political scrutiny before publication. Take your data from places with a better degree of intellectual freedom!

kbd512 · 2020-04-12 19:41:41

GW,

If I was making the decisions, which I'm obviously not, priority number one would have been identification of the vulnerable population. It's a hell of a lot easier to pay to support 3% of a country's population than 80%+ of the population, and we were already doing that if we consider the poor. There would most likely have been a statistically insignificant death toll, had we quarantined them instead of everyone. If it wasn't possible to quarantine 3% of the population reasonably well, then quarantining 80% or more was, and is, a pipe dream. That was my underlying message about quarantining- i.e., it's a heck of a lot easier to do with a much smaller group of people and trying to do it with everyone is inordinately difficult, ineffective unless everyone maintains strict personal discipline- something most civilians are not renowned for, and very destructive to the economy. Unless we do away with the concept of money, people starving to death from economic destruction is always a consideration, no matter anyone's feelings about saving lives. No matter how you die, there are not different categories of dead. Dying of starvation is no better than dying from a virus. The final resultant outcome is precisely equivalent.

With respect to modeling of stochastic processes, you're absolutely correct that the assumptions underlying the model are even more significant. However, we shouldn't pretend that we're completely brain dead, as it relates to who is vulnerable. It's the same people who are always at higher risk of serious illness from respiratory infections. Even with these new viruses (SARS / H1N1 / COVID-19), there's a clear pattern regarding who gets seriously ill that doesn't even require modeling, merely maintaining national records about risk factors for death from.

Why haven't we done that already? Medical information privacy laws and antiquated ideas about what privacy means have a lot to do with it. Is privacy more important than doctors knowing what's wrong with you so they can save your bacon? I guess that depends upon who you ask. I can only speak for myself when I say that I want whomever the doctor of the moment happens to be to know exactly what's wrong with me and to not have any delay in getting the information required to save my life.

To your point, at present, following the data trends is probably more useful than having a predictive model. The time when that would've been useful is past.

Back in January and as late as February, people in Congress who do not have those evil "R's" next to their names were telling their constituents to carry on with business as usual and they were, in point of fact, resisting attempts by President Trump to close our borders until it made them look bad. One of those people was named "Pelosi". Your attempt to blame our belated response on one man, quite frankly, has more to do with your ideology than your following "what politicians say and what they do". Without putting too fine a point on it, if you voted for former President Obama twice then you found his belated response acceptable whereas President Trump's belated response was not, which smacks of being more than a little hypocritical. In any event, I think we're all guilty of allowing our personal preferences to override purely logical decision making, from time to time.

clark · 2020-04-15 00:21:32

Sanity check. How many of you want to play these odds: 1 in 5 you require ICU level hospitalization that you can pick up from handling plastic or carboard? How many of you want to play the odds if you are unfortunate enough to get sick, you have a 50% to 80% mortality rate. This is math folks, not politics. Science. Don't be f*cking clowns and pretend otherwise.

You think you would launch a f*cking rocket with these odds? WTF is wrong with you? You are on a Mars board and this is the level of debate?

We just came online with enough capacity to test existing patient populations, barely. We still do not have legitimate antibody testing. We still do not have any other form of treatment other than, "good f*cking luck". Pretty sure economic prosperity is not found when people are f*cking dying in the goddamn streets.

Yeah, we all have to get this disease and hope to god we survive. But the rationale approach in this situation is to have us all get this disease slowly so the goddamn health system has capacity to care for us when it is our turn to play Russian roulette. This isn't politics, this is being goddamn f*cking pragmatic. Chances of survival are pretty bad to begin with, but overwhelming the health system makes collective survival rates approach zero.

And you can't quarantine 3% of the population because the goddamn virus attacks everyone. Completely healthy adults without pre-existing conditions are susceptible. If you want to lock up the hypertension, overweight, pre-diabetic crew, congrats, you've locked up a third of US adults. Congratu-f*cking-lations. What the hell do you think economic recovery looks like in that scenario?

kbd512 · 2020-04-15 15:33:57

clark,

You're "playing the odds" each and every day you're still counted amongst the living. Some people seem to handle that without running around and shrieking "We're all gonna die!", despite the fact that given enough time that's precisely what will happen to all of us. In terms of total numbers, twice as many Americans died from "slightly-less-novel-yet-still-lethal" influenza infections last year than died to date from COVID-19, but no freak-out over that and most of them never bothered with an influenza vaccine, either. That makes me wonder as to whether or not people who choose to freak out over COVID-19 are rational actors.

The level of debate in this thread of this forum has been reduced to unnecessary petty name-calling and vulgarity by people wildly exaggerating actual problems. Most of the responses, at all levels of government and amongst the citizenry, have been gross over-reactions to a serious but otherwise manageable problem. If fewer people were panicking over how to respond effectively to this problem, then I see that as a net benefit to everyone. That said, I'm also a firm believer in freedom of speech, which is why I support your first amendment right to speak your mind, but will then counter whatever I determine to be fallacious assertions with more articulate explanations that don't resort to hyperbole and vulgarity over a difference of opinion. On that note, I think you're confusing merely getting sick with getting sick enough to require both admission to a hospital and the use of a ventilator. Please also note that my following response does require some light reading, basic math, and counting.

CDC - COVIDView

From the article:

Cumulative COVID-19-associated hospitalization rates since March 1, 2020, will be updated weekly. The overall cumulative hospitalization rate is 12.3 per 100,000, with the highest rates in persons 65 years and older (38.7 per 100,000) and 50-64 years (20.7 per 100,000).

We'll assume a base population for the US of 400,000,000.

400,000,000 / 100,000 = 4,000

4,000 * 12.3 = 49,200 <- total number of people requiring admission to a hospital from COVID-19

49,200 / 2 = 24,600 <- expected death toll if 50% of those admitted to a hospital subsequently died from COVID-19 (note that this is vastly different from the rate of infection or the incident mortality rate, which appears to hover around 3% of those infected)

26,601 <- cumulative actual observed number of COVID-19 deaths reported by hospitals to CDC or estimated / presumed to be COVID-19 related deaths by CDC to date

For COVID-19 cases with a known outcome, 19% of COVID-19 patients were hospitalized and 6% were admitted to the ICU.

Source (read the section entitled "illness severity"): Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)

Therefore, 50% to 80% of the people who contract COVID-19 are NOT dying, NOT requiring a trip to the hospital, and NOT requiring a trip to the hospital's ICU with mechanical ventilation! If 50% of those infected required hospitalization, then every hospital system in the entire world would be completely overwhelmed in very short order.

I can't speak to how other countries are doing, but I'm pretty sure that a vanishingly small number of Americans are actually "dying in the streets", unless it's from motor vehicle accidents, which kills around 38,000 Americans annually. Since the death toll associated with operating motor vehicles hasn't prevented any country from achieving economic prosperity, I'm also pretty sure that bit of "dying in the streets" hyperbole is bogus. Worldwide, more than 1,100,000 people die each year in motor vehicle accidents, or about 10 times what COVID-19 has achieved to date. In the same period of time that COVID-19 has been most active, 283,750 people would be expected to die in motor vehicle accidents, a death rate roughly 3 times higher than COVID-19. Even so, prior to this COVID-19 nonsense I drove to work every single day and so did hundreds of millions of people around the world. In fact, sometimes we even took family trips by car for "fun".

I don't think "hoping to a god" is a particularly good survival strategy, though not being morbidly obese is probably a reasonable precaution. Contrary to your objectively false assertion, chances of surviving COVID-19, without hospitalization, are truly excellent- even with pre-existing medical conditions. 96%+ of those who contract the disease will survive.

If you can't "effectively", and that's the key word here, quarantine 3% of the population, then effectively quarantining 80%+ of the population is pure fantasy. That was my point. Nearly everyone is susceptible to illness from influenza-like viruses, yet the numbers show that very few people become seriously ill or die from contracting them. As far as 1/3rd of the people eating themselves to death is concerned, there's not much we can do about that.

Sooner or later, fantasyland comes to an end and nature takes over. It always does. Speaking of pragmatism, the pragmatic would learn to accept that death is a part of life and to stop being so self-centered that they demand that everyone else bring their lives to a stand-still merely to delay the inevitable for around 3% of the population. Alternatively, we could've identified our vulnerable population and protected them instead.

clark · 2020-04-16 00:16:28

Using math based on stats generated through policy outcomes designed to drive down the very numbers you are using to prove your misguided point is ironic.

Hospitalization rates are down for precisely the reason you rail against. No coordinated mitigation effort results in Italy level death tolls, or like NY, which become inundated and the system overwhelmed causing a higher death rate as the health system could not respond.

Regarding where Covid sits in the pantheon of causes of human death, if we land around 60K, which is the current projection, it will end up being the third or 4th leading cause of death.

But hey KB, you got this. Get out there, enjoy yourself. Maybe go to that rally and shake those hands. Live it up and hit that concert; that stadium game with 50K all pressed against you, cheering the same sane mantra you outline here. There is a poetic fatalism in saying "f*ck it".

I'm sure math will be on your side. Let your convictions be the light in the darkness that science fails to be.

See you in the obits brother.

elderflower · 2020-04-16 06:45:23

Clark. If you look at the causes of death on your graphic you will see that most of them are chronic in nature. Covid19 is observed to be picking off the weakened individuals, the aged and those with chronic conditions, so the virus will increase in its importance as a cause of death at the expense of the figures for other conditions.

Terraformer · 2020-04-16 07:32:05

Which will, of course, be reflected in a lower death rate for a few months/years after this has passed.

This is certainly no Spanish Flu. Though I still wouldn't go to crowded worship/prayer services, which is a likely cause of why Asians in the UK are getting it at a disproportionate rate. I wonder if they'll provide the statistics broken down by origin? If that's the cause, we should see it being heavily waited towards those of Pakistani and Bangladeshi origin.

On the other hand, there's also biological factors to consider. Carriers for sickle cell disease will be harder hit than non-carriers, and well, see the distribution...

sickle-cell-distribution

kbd512 · 2020-04-16 09:45:41

clark,

Accepting your own mortality can be a very difficult thing to do, yet whether or not you accept it there's a singular end state for all of our lives.

Italy's death toll was a direct result of introducing the virus to a massive concentration of a vulnerable population. Many of those who died were already in their 80's and had at least one if not several underlying medical conditions. At that age, nearly anything can kill you without extraordinary effort.

List of known underlying illnesses that COVID-19 greatly exacerbates:

Diabetes
Lung Disease
Cancer
Immunodeficiency
Heart Disease
Hypertension
Asthma
Kidney Disease
GI/Liver Disease

NYC COVID-19 Mortality Stats by Age Group:

0-17: 3
18-44: 309
45-64: 1,581
65-74: 1,683
75+: 3,263

Males: 4,095
Females: 2,530

Older people, especially old men with underlying illnesses, are the ones that COVID-19 is killing. It doesn't matter whether you go to Italy or New York City, advanced age and severe underlying medical conditions show up in 9 out of 10 deaths. In all probability, the other person not included in that mortality statistic did have an underlying medical condition that went undiagnosed.

Hospitalization rates are down because they've quit trying to hospitalize absolutely everyone they've tested who became infected with the virus, as doing that turned out to be a counter-productive strategy. I view talk of containing airborne viruses or viruses spread through human interaction as having roughly the same level of credulity as talk of containing hurricanes and earthquakes. It's a quaint idea, yet still grossly unrealistic.

Eventually, you will see my name in the obits and someone else will see your name in the obits. Even if the virus we call COVID-19 never existed, such would still be the case. You can choose to work yourself up into a tizzy over that fact, or learn to enjoy whatever time you do have. I quite prefer the latter. Do you prefer the former?

clark · 2020-04-17 00:53:55

Again, I entreat you, go forth and make merry. Spin the wheel. Play the odds. You’ve clearly dissected the numbers in a way that makes you comfortable.

Hospitalization rates are down because of mitigation efforts. We don’t hospitalize because you have covid. We hospitalize because you can’t breathe. Rates are down because overall infection rates are lowering. Because of mitigation.

Again, do what you want. Self select out you and your social circle. Because that’s what you are going to do. Cheers.

kbd512 · 2020-04-17 12:20:32

clark,

My desire to "go forth and make merry", as you put it, is directly related to my desire to obtain another brain surgery for my wife. I can't do that right now because of what I judge to be an over-reaction to this virus. As I've yet to identify different categories of dead with meaningful differences, I don't judge death by brain tumor to be any better or worse than death by virus. Oddly enough, her neurosurgeon agrees with my own estimation that this entire thing is a tad bit over-blown. However, he's beholden to state-wide decree like everyone else. Maybe he doesn't believe in math and science and is "self-selecting out", as you put it. I'm sure that's why the college he teaches at has him as a member of their neuroscience faculty.

Terraformer · 2020-04-17 15:41:08

What? They won't allow tumours to be removed whilst this is going on? Or is it because they're saving the beds and equipment for potential COVID patients?

kbd512 · 2020-04-17 16:57:30

Terraformer,

If I had to guess, it's some combination of fear of running out of hospital beds and fear of spreading the virus. We're not running out of hospital beds at the moment, which would be what our neurosurgeon pointed out to the hospital administrators, not that they have much say at this point since that's now controlled by the state, and that the COVID-19 patients are presently as isolated as they can make them. I guess we'll wait until the tumor kills her or they decide it's important enough to remove. At present, there's sufficient excess capacity to perform the surgery and she'd most likely be out of the hospital in a week.

As a function of the present size, rate of growth, and location of this tumor, it has produced another midline shift in the brain. That cuts off one of the ventricles where the spinal fluid is produced. Right now, the only adverse effect is a severe persistent migraine. She can take enough meds at night to sleep for a few hours. The side effects from the tumor won't remain that mild forever, though. The ultimate result is unconsciousness and death. This has happened twice before, so it's not conjecture on my part.

GW Johnson · 2020-04-17 17:54:33

Kbd512:

The governor today removed the restriction holding in abeyance the surgery for your wife. We here on the McGregor farm are "rooting" for a quick resolution and cure for her.

Terraformer:

To answer your question, the fear was running out of hospital capacity due to coronavirus problems. That didn't materialize in Texas the way it did in New York, so today the governor of Texas released that restriction.

We can argue as to why it didn't materialize here the way it did in NY, but I think timing played the largest role. NY started getting cases by Feb, Texas not until March, same time as the start of quarantines. Texas had effectively an earlier start (in the disease-spread process) with its quarantine, something well known (for centuries) to help.

GW

kbd512 · 2020-04-17 18:44:51

GW,

I'll happily take whatever good news I can get. I was told she has her spot reserved in line for surgery in about 2 to 3 weeks after the restrictions are lifted. This time the surgeon intends to start radiation treatment after the surgery, which will hopefully ensure that the tumor doesn't come back again.

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