I strongly support re-opening our economy, restaurants, and stores. I'm going to outline why here, but also comment on how this issue is being handled.
The evidence in favor of re-opening is strong. Initial calculations of death rate were based on hospitalized patients only. With population testing the breadth of the epidemic is clear, as is the population at risk. Complete population testing was done on the crew of the Theodore Roosevelt, and 840/4809 were positive, for a prevalence of 17.5% in a close-quarters, closed environment. All the crew are young and healthy. No one died, only 17 hospitalized, for a hospitalization rate of 2% in this population. LA County did a representative sample of healthy, asymptomatic adults, and found 4.1% positive, a rate of infection 28-55 times higher than the total reported positive cases. Stanford's population sample found an infection rate of 15%.
Hospitalizations have been a tiny fraction of the dire predictions. Cuomo called for 110,000 hospital beds. Total utilization at the time of my review was 26,000 beds, less than what was expected for ICU use. Deaths are concentrated overwhelmingly in those over 65, especially those over 75 or with cardio-pulmonary disease.
WHO continues to muddy the water by claiming there is no evidence infection confers immunity. Well, no, except that infection by anything confers immunity to it for an extended period if not for life. Governmental policy continues to be rooted in deep caution not justified by data and is using models that are flawed.
The initial models used what data was available- proven cases and fatalities. The data was 'unstable', meaning the confidence intervals were quite large. The initial model predicted 30,000-2,200,000 deaths! Even though the 50th percentile prediction was 60,000 deaths, governmental agencies used the 95th percentile number, which is never done in prediction of any kind. It is invalid statistically and practically, but that is what has been done. To add to the distortion, deaths from uncertain causes are being added to proven covid 19 deaths, distorting data as it is being collected.
Complications from viral illness can occur. Measles, for example, can produce pulmonary fibrosis and SSPE, a progressive, degenerative neurological disorder leading to paralysis, dementation, and death. Many viral illnesses can produce a post-viral cardiomyopathy, or Guillain-Barre syndrome. Complications from covid 19 have been reported in such a way to produce further panic when death rates fail to justify the existing anxiety.
Further supporting opening the economy is the economic fragility of many Americans who live from paycheck to paycheck. Multiple articles have been written about the grossly differential effects of lockdown on lower income, hourly workers. Restaurant workers, singers and actors, factory workers in 'non-essential industries', all are out of work and out of money while white collar and tech employees work from home, drawing a paycheck while depending on grocery clerks, utility workers and healthcare workers to do what they refuse to do- go out and 'brave the virus' to take care of themselves. There is a gross differential not only in economic impact but in casually allowing some to take risks others claim are too dangerous to let them go out.
Surrounding all this are the saddest and most surprising beliefs. Like many viruses, covid 19 can survive on surfaces up to four days, but it doesn't mean the surviving virus is terribly infective. One person seemed to think covid 19 is in the air, kind of like ozone, waiting like radiation to kill anyone who was foolish enough to go outside. We have had deaths from people driving while wearing a mask, and the ludicrous image of people stripping down after coming in from outside and rinsing their hands in clorox.
The accumulation of data clearly justifies re-opening our economy, but beyond that it is unrealistic in the face of any calamity to simply shut down a nation for an extended period of time. St. Louis' response to the 1918 flu pandemic has been cited as a model, and that is instructive. Their shutdown was targeted (more children were dying, and the schools were closed), lasted 2 months, and was rescinded in the middle of shutdown. It also occurred in the midst of a disease with a mortality rate of 6500 per million, not 156 per million as covid 19 currently is.
Despite rationality and necessity, there has been surprising resistance to reopening America. Republican governors have re-opened or are re-opening their states while Democratic mayors object and refuse to be bound by arbitrary timetables. Both sides accuse the other of playing politics, but it sure doesn't look that way to me. Except for political points, obstructing what must be done has no purpose, and there has been plenty written about the political benefits each party claims it is accruing.
The socio-political divide on this issue has, like so many other issues, produced the most stunningly ugly and vitriolic commentary, all of it from liberals I am sorry to say. I have been called a MAGA motherfucker, a tin foil hat wearing MAGA idiot, condemned for being a conspiracy theorist, ignorant, uncaring about the health of the elderly, been preached to sanctimoniously about how I should volunteer to help in hospitals. All this when I haven't said one word about Trump in my comments!
The most recent kerfuffle involves comments Trump made wondering if there was a way to cleanse the blood the way disinfectants cleanse surfaces. The actual 'offending phrase' was-
"So, supposing we hit the body with a tremendous -- whether it's ultraviolet or just very powerful light -- and I think you said that that hasn't been checked, but you're going to test it. And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way, and I think you said you're going to test that too. It sounds interesting...
"...Right. And then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that. So, that, you're going to have to use medical doctors with. But it sounds -- it sounds interesting to me."
Somehow these comments, which seem prima facie as wondering whether we could find a way to clean blood as quickly and effectively as we clean surfaces, have been interpreted by a chunk of the media as a call to inject disinfectants. This was followed right away by claims, without data, there would be a rash of disinfectant injections and ingestions. In fact there has been no such upsurge, suggesting Americans are a lot smarter than our media, which doesn't seem to understand the difference between the phrases 'time flies like an arrow' and 'fruit flies like a banana'.
All the interpersonal and political nastiness does nothing to address the practical problem. We cannot leave an entire nation shut down in fear, nor is it reasonable to arbitrarily designate some work as essential while others lounge or cower at home. It is reasonable to resume cautious normal life, it is essential to millions of Americans to do so, and insulting each other and the president and yelling won't solve anything.
Ted
The evidence in favor of re-opening is strong. Initial calculations of death rate were based on hospitalized patients only. With population testing the breadth of the epidemic is clear, as is the population at risk. Complete population testing was done on the crew of the Theodore Roosevelt, and 840/4809 were positive, for a prevalence of 17.5% in a close-quarters, closed environment. All the crew are young and healthy. No one died, only 17 hospitalized, for a hospitalization rate of 2% in this population. LA County did a representative sample of healthy, asymptomatic adults, and found 4.1% positive, a rate of infection 28-55 times higher than the total reported positive cases. Stanford's population sample found an infection rate of 15%.
Hospitalizations have been a tiny fraction of the dire predictions. Cuomo called for 110,000 hospital beds. Total utilization at the time of my review was 26,000 beds, less than what was expected for ICU use. Deaths are concentrated overwhelmingly in those over 65, especially those over 75 or with cardio-pulmonary disease.
WHO continues to muddy the water by claiming there is no evidence infection confers immunity. Well, no, except that infection by anything confers immunity to it for an extended period if not for life. Governmental policy continues to be rooted in deep caution not justified by data and is using models that are flawed.
The initial models used what data was available- proven cases and fatalities. The data was 'unstable', meaning the confidence intervals were quite large. The initial model predicted 30,000-2,200,000 deaths! Even though the 50th percentile prediction was 60,000 deaths, governmental agencies used the 95th percentile number, which is never done in prediction of any kind. It is invalid statistically and practically, but that is what has been done. To add to the distortion, deaths from uncertain causes are being added to proven covid 19 deaths, distorting data as it is being collected.
Complications from viral illness can occur. Measles, for example, can produce pulmonary fibrosis and SSPE, a progressive, degenerative neurological disorder leading to paralysis, dementation, and death. Many viral illnesses can produce a post-viral cardiomyopathy, or Guillain-Barre syndrome. Complications from covid 19 have been reported in such a way to produce further panic when death rates fail to justify the existing anxiety.
Further supporting opening the economy is the economic fragility of many Americans who live from paycheck to paycheck. Multiple articles have been written about the grossly differential effects of lockdown on lower income, hourly workers. Restaurant workers, singers and actors, factory workers in 'non-essential industries', all are out of work and out of money while white collar and tech employees work from home, drawing a paycheck while depending on grocery clerks, utility workers and healthcare workers to do what they refuse to do- go out and 'brave the virus' to take care of themselves. There is a gross differential not only in economic impact but in casually allowing some to take risks others claim are too dangerous to let them go out.
Surrounding all this are the saddest and most surprising beliefs. Like many viruses, covid 19 can survive on surfaces up to four days, but it doesn't mean the surviving virus is terribly infective. One person seemed to think covid 19 is in the air, kind of like ozone, waiting like radiation to kill anyone who was foolish enough to go outside. We have had deaths from people driving while wearing a mask, and the ludicrous image of people stripping down after coming in from outside and rinsing their hands in clorox.
The accumulation of data clearly justifies re-opening our economy, but beyond that it is unrealistic in the face of any calamity to simply shut down a nation for an extended period of time. St. Louis' response to the 1918 flu pandemic has been cited as a model, and that is instructive. Their shutdown was targeted (more children were dying, and the schools were closed), lasted 2 months, and was rescinded in the middle of shutdown. It also occurred in the midst of a disease with a mortality rate of 6500 per million, not 156 per million as covid 19 currently is.
Despite rationality and necessity, there has been surprising resistance to reopening America. Republican governors have re-opened or are re-opening their states while Democratic mayors object and refuse to be bound by arbitrary timetables. Both sides accuse the other of playing politics, but it sure doesn't look that way to me. Except for political points, obstructing what must be done has no purpose, and there has been plenty written about the political benefits each party claims it is accruing.
The socio-political divide on this issue has, like so many other issues, produced the most stunningly ugly and vitriolic commentary, all of it from liberals I am sorry to say. I have been called a MAGA motherfucker, a tin foil hat wearing MAGA idiot, condemned for being a conspiracy theorist, ignorant, uncaring about the health of the elderly, been preached to sanctimoniously about how I should volunteer to help in hospitals. All this when I haven't said one word about Trump in my comments!
The most recent kerfuffle involves comments Trump made wondering if there was a way to cleanse the blood the way disinfectants cleanse surfaces. The actual 'offending phrase' was-
"So, supposing we hit the body with a tremendous -- whether it's ultraviolet or just very powerful light -- and I think you said that that hasn't been checked, but you're going to test it. And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way, and I think you said you're going to test that too. It sounds interesting...
"...Right. And then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that. So, that, you're going to have to use medical doctors with. But it sounds -- it sounds interesting to me."
Somehow these comments, which seem prima facie as wondering whether we could find a way to clean blood as quickly and effectively as we clean surfaces, have been interpreted by a chunk of the media as a call to inject disinfectants. This was followed right away by claims, without data, there would be a rash of disinfectant injections and ingestions. In fact there has been no such upsurge, suggesting Americans are a lot smarter than our media, which doesn't seem to understand the difference between the phrases 'time flies like an arrow' and 'fruit flies like a banana'.
All the interpersonal and political nastiness does nothing to address the practical problem. We cannot leave an entire nation shut down in fear, nor is it reasonable to arbitrarily designate some work as essential while others lounge or cower at home. It is reasonable to resume cautious normal life, it is essential to millions of Americans to do so, and insulting each other and the president and yelling won't solve anything.
Ted
We're on a ship, 500 miles from shore. There's a small fire on board that is being fought by crew members. Containment is questionable, and then the fire is spreading. As it spreads, some cabins are more immediately affected than others. The Captain is reassuring everyone that more help, and potential rescue, is on the way. Extra measures are taken to assist those closer to the flames. The fire spreads. Other ships are changing course to come to our rescue, but are many hours away. As the flames spread throughout the ship, some people don life jackets and jump overboard. Some folks, cut off by the flames, jump without life jackets. People cling together in the water. Life boats are lowered. Some people, in frail condition, succumb to smoke, exhaustion, and general stress. The life boats are overcrowded and conditions are challenging, at best. Many die on board. Others die, while attempting to save themselves. Most eventually are rescued. Such is our fate today. Some say we need to abandon our positions at home; others say it is too early. Some may die after leaving what has been a refuge. All would eventually die from staying in place. There's a risk in leaving too early; there's a risk in leaving too late. Each must decide.
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