My Odds

The Worldometer says California is now over 3K cases. This heat map looks to be lagging them a bit as scanning the hot spot counties gives closer to 2K total. So I uplift Santa Clara County by a fudge factor. Presently showing 459. Call it a thousand today or tomorrow.

Then figure with non-symptomatic spreaders, not testing folks with low symptoms, early stage disease being unsymptomatic: Figure about 10 times that number are actually in the population. So 10,000 likely cases of potential exposure.

Santa Clara County has about a 1.8 million population (per wiki 2010 census – though likely closer to 2M now).

Do the division: 1,800,000/10,000 = 180 (to 200 top end).

So, as of now, any venue with over 200 folks in the day has near certainty of a spreader there or passing through.

That is every grocery store, most bank ATMs, and certainly big box hardware stores. All places currently OK to go and approved without masks or gloves. This guarantees continued spreading of WuFlu / Covid-19.

So, OK, as of now, going there is off limits for me. In an emergency, with my own mask, gloves, alcohol wash, maybe.

My Complaint About Government

The Political Class continues to approach this incrementally, “data driven”, and reactively.

That is guaranteed to fail.

There is a 1 to 2 week lag time between reality of cases and hospital check in / data. If you wait for the data, you will always be too little too late. “A day late and a dollar short” on steroids. You MUST look ahead. Notice that my risk estimate did a “look ahead” to probable spreaders 10 times known symptomatic patients.

Look at Italy. That is where you WILL GO deciding incrementally. We know R0 is incredibly high. So you can easily know you must do everything possible to get that down. It is horribly irresponsible to tell folks not to wear masks. Masks stop the asymptomatic spreaders and newly infected from spreading it around as much.

The responsible thing would be to encourge folks to make masks and wear them. Fold an old T Shirt in half along a line top to bottom, you have 4 layers of cotton cloth. Sew the outline of several masks on it, cut them out, and apply strings, shoelaces, or folded and sewn cloth straps. Tell America to do that, our people will get it done. R0 plummets in a few days. Universal mask wearing is part of how China and S.Korea and others have beat this.

Decide what to do based on the nature of the virus and what if WILL DO, not what it has done. Go to the necessary end state, not incremental ineffective steps for 3 weeks, infect 10x more, and then be screwed.

Enforce the physical distancing and isolation. Saying “We can’t do that here” is defeatist and wrong. We CAN DO what it takes. This also drops R0 a bunch. The longer you do a half assed job of isolation, the longer, exponentially, you will have to keep doing a half assed job of it.

Saying there’s only 4 cases somewhere so you can ignore it and only react to the big problem spots is reactive and stupid. This all started with ONE CASE. Every case is critical. One guy in nowhere West Texas is going to infect the whole county if you ignore it. Instead, build out from zero cases zones and very aggressively eliminate cases in low case areas. That one case? Test everyone in town (as Nowhere Towns are small) and find the 5 asymptomatic folks he’s already infected. Now the town is no longer a spreading zone. Add it to the zero case map and move over to the next spot with few cases. Keep doing this until you only have a few crisis spots to deal with.

Telling us we are stupid so ought to do something stupider, is incredibly stupid. Stop it! Sure, one in 20 will use their mask wrong. Telling the other 19 to not wear a mask and keep spreading is incredibly stupid. Instead, put out a “how to wear, handle, and wash your mask” PSA. The 19 will “get it” and the one can get help from the local social pressure. Trust your citizens.

Similarly, exhorting folks to only buy a little food and every week go back to the Grocery Germ Exchange Store, unprotected by gloves & mask, guarantees spread. Instead, put an enforcer at each store. Limit folks inside. Clean the touch pads and carts after each person. Require a mask to enter (otherwise some of them are breathing virus onto the produce). Deliver a monthly sized food box to anyone in a high risk category, assembled and delivered by staff who are tested every day. That isn’t hoarding, it is limiting exposure to once per month. They still only eat one month of food per month.

TEST EVERYONE! Until you do, the asymptomatic cases are exponentially spreading and you can never beat the exponential. Yes, I know there are not enough test kits right now. But there will be. Stop lying to folks by saying not to test everyone. Be honest and say “We can only test the most necessary now, but eventually we must test everyone.” We’re able to handle that.

Start 100% testing your very low population areas, building out your rural Green Zone. As more kits become available, climb up the population size areas. From the other side, test all hospital staff and cases presenting for treatment. As kits are available, expand out to family, friends, neighbors, regions. Telling folks with low symptoms not to get tested, just go home, is just guaranteeing they will infect bus riders, neighbors, family, kid’s friends as they get it, the grocer as they buy groceries on the way home…

Going for “herd immunity” by telling the “at risk” to hide while everyone else shares the bug is asking for disaster. With about 340 million population, if only 1% of them are surprise bad cases, an order of magnitude below experience, will be 3.4 million and that will break the medical system and be a disaster. Better to be hyper proactive than disastrously reactive.

Think like a farmer who must plan a season ahead, not like a boxer reacting to each new punch. You MUST identify all cases, even the asymptomatic spreaders, and pull them out of the herd into isolation. If boxing, know your opponent is doubling in strength every 3 to 6 days.. Eventually you, as boxer, must lose.

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About E.M.Smith

A technical managerial sort interested in things from Stonehenge to computer science. My present "hot buttons' are the mythology of Climate Change and ancient metrology; but things change...
This entry was posted in Covid, Emergency Preparation and Risks, News Related and tagged , , . Bookmark the permalink.

119 Responses to My Odds

  1. cdquarles says:

    I disagree with testing everyone. Heck, we don’t do that with recurring seasonal epidemics like influenza. Why? The tests are not perfect, nor do we have perfect treatments. They have a false positive rate and a false negative rate. Screening tests are designed to have very few to no false negatives. They err on the side of false positives. You *must* consider the true prevalence rate when using them. Otherwise, you will have a situation where most of your positives are false and make things look worse than they are, at a given here-and-now. If an area is truly virus free, then any positive tests are, by definition, false. Put another way, do you test all of your cattle herd if none are sick or reasonably can be shown to be sick from an illness you are testing for?

    Serological screening helps; but you need to be able to distinguish between varieties, too. Remember cross reactivity. On the plus side, if all you have is IgM, you know you have a relatively fresh infection. If all you have is IgG, you have a late infection or maybe a latent reinfection.

    Coronaviruses are a family of zoonotic viruses. There are lots of them out there. They cause a viral pneumonia in susceptible people. They are not colds nor are they flus. They are influenza like, though; by causing lower respiratory tract infections, being zoonotic, and either direct or secondary pneumonias. There are about a dozen virus families and hundreds/thousands (if not more) of virus strains that cause cold-like and/or flu-like illnesses, too.

    Decisions must be made under uncertainty. That said, if you don’t know what you are dealing with, and it is infectious, hit it hard early. If you can’t, do as much mitigation as you can. There will always be trade-offs and all of us are ultimately mortal.

    Also remember that there is a dose-response relationship for infections, too; and everyone this strain can infect, it will, given enough time. I doubt we will see a 1% surprise rate, when looking back at it. I think it’ll be closer to 0.1% at worst and 0.01% on the better side. Thus, the possible excess deaths, which have to take in account deaths from other causes, won’t be very high given about 0.9% of the population dies each year (not counting abortions). I think we are already doing much of the necessary mitigations, now. So yes, wearing a simple paper/cloth mask does help. Washing hands and cleaning surfaces will help. Minimizing close personal contact will as well. On the other hand, shutting everything down hard is an overreaction, outside of known hotspots such as nursing homes, this far into it.

    In conclusion, I would not be surprised to see, at the end of the year, that the toll is comparable to a bad influenza epidemic or our annual motor vehicle death toll. Dying with a disease is not, necessarily, the same thing as dying from a disease.

    Oh, that reminds me. There are people talking about having the equivalent of the old measles/small pox/polio parties. For those people, what you are doing, in the end, is a semi-controlled vaccination effort ;P.

  2. Foyle says:

    The political classes are sheep. Followers not leaders. Leader types are quickly culled out when one in ten of their decisions goes bad (as is normal/inevitable), because the key to survival in that sphere is having an excuse planned out – and best excuse is that everyone else was doing it.

    So the sheep bunch up in a mob, eyeing the wolf circling and all trying not to stand out, defaulting to inaction even if there is a safe haven close by that they could escape to. All because they lack courage or conviction to act.

  3. Another Ian says:

    “Never Let a Crisis Go to Waste”

    “Radical Leftists the world over are buzzing with joy at the thought of their wildest dreams coming true as a result of this crisis:”

    http://www.smalldeadanimals.com/index.php/2020/03/26/never-let-a-crisis-go-to-waste-4/

    And

    “China just sold €4,320,000,000. worth of medical supplies came from nationalized US supply chains to Spain, the country with the 2nd highest deaths caused by the Chinese virus:”

    http://www.smalldeadanimals.com/index.php/2020/03/26/chinese-virus-2/

  4. E.M.Smith says:

    @CDQuarles:

    I’ve had a false positive for a very important disease. The answer was not treating me, but retesting. I assert a test regime can be created that catches the false positives. (At least enough of them).

    Yes, IF you can show a county or city has no cases, put it in quarantine for rwo weeks, if no cases pop, add it to the green zone untested. But be prepared to yank it out and test aggressively if a case shows up. But this late in the game, very few counties fit that description.

    For any population with known cases, you must test everyone or you will not find the asymptomatic spreaders. The false positives can be filtered out with repeated and different tests.

  5. Ed Forbes says:

    My significant other says I am heartless for asking the $ amount we as a nation should be willing to pay due to the new virus to postpone death in the elderly with chronic conditions and excess deaths among those younger.
    .
    Currently, as a WAG, I think the nation has spent in the neighborhood of $80M per death, and much more if one only considers excess deaths of those elderly with chronic conditions, from both direct and indirect costs to our economy. This $ amount cost per death is increasing at a much higher rate than the virus death rate.
    .
    Insanity, leading to national destruction.
    .
    As one who is approaching 70, I am at risk of death from many illnesses that younger people shrug off. But destruction of the US economy to lower that risk somewhat is insane for national policy.

  6. Serioso says:

    The severity of a viral infection probably depends on the number of viral particles in the initial dose. If small enough your body can attack the virus and develop antibodies in a timely manner, If the initial dose is large, your defenses may be overwhelmed and take a long time to mount a successful counterattack — if they can. I can’t say, following cdquarles, that a contagion party is a good idea, but I am not much worried about cardboard boxes and doorknobs (although I do wear nitrile gloves when going out).

  7. Bill In Oz says:

    EM Thanks That’s great post !
    It’s fact based and clear !
    Excellent !
    Can I repost it here in Oz on my Facebook group page ?
    Of course with attribution
    Bill

  8. Saighdear says:

    Aye munn, you’re listening to me at last ! Think ( and Act ) like a Farmer. That’s what the World needs to hear. Sadly there are a lot of Duff Farmers around too. – We are NOT ALL Grass -chewing Wursels – even tho’ some grass stems are quite Sappy for refreshment, much same as way as soorucks -Sour Leaves of ( name escapes me this now) – but they make an excellent salad.
    I just weep when I hear all this Tripe from Governments and Modern -Day Health experts, quoting what Models predict. – where did we hear all this from before? Nothing changed -just the packaging. I really wonder What n Why we taught and which is so out of step with this stuff.
    What I cannot understand is WHY our Teachers have not come out to lay down the Riot Act to those modern day ‘Perts ( ex).

  9. YMMV says:

    Serioso: “The severity of a viral infection probably depends on the number of viral particles in the initial dose. If small enough your body can attack the virus and develop antibodies in a timely manner, If the initial dose is large, your defenses may be overwhelmed and take a long time to mount a successful counterattack — if they can.”

    My gut feeling is that this is true. Otherwise, everybody in the airplane along with the carrier would get it, everybody in the mass transit care, everybody in the grocery store. That does not seem to be the case, far from it. Despite that, it is very highly contagious and the simple epidemiology models say that if R0 is greater than 1, everybody will get it eventually.

    We do not know for sure whether having it gives immunity. Going for herd immunity is gambling, going all-in. E.M. has it right.

    Serioso’s comment also applies to society’s ability to fight off the virus. With small numbers of infections, you can still do aggressive tracking of contacts and you do not overwhelm the health system. The more you let it grow (exponentially), the less resources you have to track and fight the individual cases.

  10. H.R. says:

    @Serioso – Yup. I’ve been wearing the nitrile gloves, too. I wore gloves and a mask to my semi-annual visit to the Dr. There’s a bunch of sick people there!

    The Dr. mentioned what you brought up just now and has been discussed a bit; viral load. The masks reduce that so there should be a better outcome. I am suspecting that aerosol transmission is happening (sure bet), but is not happening as much as people handling stuff and then touching their eyes and nose. That seems to put a big load into most people.

    Keep up with the gloves. I can’t believe how few people I am seeing wearing them. I’m not noticing any funny looks when I use them. I guess people just take it a sign that I’m more worried about exposure than they are.

    Oh, if everyone starts wearing masks, how will we catch the bank robbers? What… put seven guys in masks in a lineup? “That’s him! The one wearing a mask!” ;o)

  11. Bill S says:

    Well heck. I’m starting to wonder if I should be commenting on this blog. Other people bought food and TP. (I married a Filipino so have enough rice to get through one world war or three family get togethers.)
    EM is calculating odds and reviewing his dry storage. cdquarels is reminding me about Bayes.
    Meanwhile, I jumped on Trump’s bandwagon an invested in anti malaria stuff. Limes, Gin, and Tonic water. I don’t know about any prophylactic probabilities but I can tell you all that I am a lot less nervous after starting my quinine regimen.
    ——————–
    On a serious note. Living in southern California – I am up to snuff for earthquake preparedness except for water and electricity. Water is just plain stupid on my part but I only need electricity to protect my wine cellar in the summer.

  12. E.M.Smith says:

    @Bill In Oz: Feel free to repost.

    @Serioso:

    Take note, as you won’t hear this often from me:

    Under Trump, IMHO, the CDC & FDA and the whole Federal response has blown it. From a great start with an early block of incoming cases from China, they went down hill fast. Broken tests arriving late. Not blocking EU flights soon enough. Stupidly not isolating low symptom cases. Ignoring asymptomatic spreading. Very late talking about social distancing. Now pushing for a restart / “opening” when we still have stupid policies and exponential growth. The chest beating by Trump about how great they have done is wearing thin in that context…

    Handling well the current logistics issues and flushing $ Trillions at a financial crisis that did not need to happen, being reactive well, does not excuse poor to crap action on the proactive front.

    Yes, there is a dose effect on severity. Given the broad range of outcomes, I’d not risk an exposure party. Then your kid with sniffles can kill their grandparents. Not good.

    @Ed Forbes:

    There is no way to know the cost per death avoided. Doing too little, you enter hospital melt down (see Italy still in early stage collapse). Fatality rate skyrockets. The number of asymptomatic / low symptom cases is unknown, so true CFR might be anywhere from 1% to 10%. For the USA the low end is about 2 MILLION dead at the end of the event. 2 $ Trillion / 2 Million is $1 Million per life. At the other end, $200k / life.

    Then you need to figure the cost of the ambulance runs and an average of about 20 days of ICU for those dead, and the hospitalization cost for the 30 Million who “recover” (many now lacking a sense of smell, some men sterile, many out of breath after a short walk on dissability payments for life). Oh, and $10k per funeral as typical costs, so $20 billion, and more. (Legal cost settling estates, for starters.) Death is expensive.

    Also, kids as young as 14 WITHOUT COMORBIDITY have died. Many in the 30 to 50 age range die, so their lifetime earnings must be figured in too. The notion that it is only the old sick who die is wrong. Higher odds, yes. But many middle aged parents will die too. Add in costs of orphanage, foster care, damaged lives…

    You have a long ways to go in fixing your cost / benefit analysis and avoided costs. As it stands, your number is “not even wrong”. (That is not a compliment…)

    Now, it is possible you are right IF:

    We have transmission properties very wrong. Or
    We have huge unseen symptom free cases of giant proportion.

    Neither one known. So until we do know, being overly proactive and avoiding the catastrophic case is warranted. We need to pick a population and antibody test 100% of it to answer those unknowns. Then we will know if the catastrophic case is real, or we were stupid.

  13. cdquarles says:

    I will bring this into the discussion: https://wattsupwiththat.com/2020/03/25/covid-19-updated-data-implies-that-uk-modelling-hugely-overestimates-the-expected-death-rates-from-infection/, noting that Nic does not address false positives.

    Locally, the number of confirmed cases follow the total tested number (between an eighth and a tenth) right now. Only one confirmed death, but more detail is needed to judge the possible future projections.

    We also need to consider the true prevalence much more seriously, as well as how much overlap this strain has with previous ones. Numbers I have seen suggest that if you have 100 folk exposed, somewhere between 10 and 20 ultimately get an infection, depending on the dose they were exposed to. So yes, antibody testing will definitely help, especially considering cross reactivity. All IgM, relatively fresh infection (takes about a week for IgM to show). All IgG, relatively late infection or a latent reinfection. Somewhere in between, an idea where that particular person lies in the timeline. Projecting from the one to the many or from the many to the one isn’t easy. Decisions have to be made under uncertainty. My guess is that we are further along than we think and the true contagiousness and case fatality rate are not known and any guesses have large error bars. I think Trump’s instincts here, colored by the advice he is being given, are not nearly as far off the mark in either direction, as some are saying.

  14. Jradig says:

    EM,

    I think about everything you say in the post makes sense. But I have a question about this one:
    “We know R0 is incredibly high.”

    If that is the case, what are we to make of the Diamond Princess cruise ship, where some 80-85 % of the total passengers and crew did not get infected? Willis had a post on this at WattsUpWithThat a while ago. Any ideas for an explanation?

  15. Ed Forbes says:

    Still looks like an overreaction in the US to me.
    https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/

    The US deaths for the virus is very low at 3.1 deaths per M, vs Italy at 124.16 per M.
    As both became infected at about the same time, it is obvious that the factors pushing the scope of the pandemic are different between these two nations and the rate in Italy cannot be used to project the path in the US.
    .
    As the true infected rate is unknown, and has not even been attempted to be estimated, death rate per infection cannot be reliably computed. Currently, deaths per capita is the only reliable measure.
    .
    Deaths of 3.1/M is no reason to destroy the economy. For that matter, I think Italy is over reacting.

  16. YMMV says:

    Watch out for pink-eye. People with conjunctivitis may be infected with infected with SARS-CoV-2.
    https://www.aao.org/headline/alert-important-coronavirus-context
    “Alert: Important coronavirus updates for ophthalmologists”

    “Li Wenliang, MD, the whistleblower ophthalmologist who sounded the initial alarms on the coronavirus, believed he was infected by an asymptomatic glaucoma patient.”

  17. ossqss says:

    I think we need some Bacon Humor. Just sayin, a distraction once in a while is a good thing. :-)

    Now I am hungry again, dangit!

  18. Another Ian says:

    More government helping

    “BUREAUCRATS IN THE USSA CREATE HAND SANITIZER SHORTAGE”

    https://richardsonpost.com/danielg/16869/hand-sanitiser-shortage/

  19. E.M.Smith says:

    @Jradig:

    The passengers were isolated in their rooms to reduce R0 after the first cases. So we don’t know the mode of infection and what effective R0 was under those circumstances.

    So was infection limited to one part of the ventilation system with the first infected? The set of cabins where food was delivered by a particular asymptomatic infected crew member? Compare to the Korean church of thousands in shared space and air.

    @YMMV:

    Also lost ability to smell. Some Wuhan Virus patients present with only loss of ability to smell. Both pink-eye and smeller fisfunction may help spot otherwise asymptomatic spreaders.

    @Ed Forbes:

    The hype is over the economic “crisis”.

    All the capital stock is still there. Almost all the labor still exists. Only thing really “lost” is some rent payments and bank debt IF someone declares bankruptcy. Nothing real is being broken, mostly just numbers in a computer and legal filings. The Government Is even shoving other computer account entries at it to stop those. (“Money” stimulus…)

    Restarting consists almost entirely of saying “Go to work now”. Even those that go bankrupt can chose a chapter other than liquidation.

    Hard on those without a paycheck? Yes, but no worse than a big layoff. Hit the unemployment insurance line and polish the resume. Done it a dozen times.

    @Another Ian:

    I’d be more inclined to think on it with some idea what it was… A blind “look here” is the signature of phishing attempts. A bit impolite and some sites will tend to toss that kind of comment. So it rsises my “check for SPAM” reflex until I read your name. But probsbly not the effect you wanted.

  20. jonova1 says:

    Chiefio. Spot on. All the way. Agree. Agree. Exactly what I have been saying too. The fatalism and out-dated use of the old influenza pandemic plan is killing people every day.

    Jradig — re The Diamond Princess, not so! The cruise ship shows exactly the opposite — one carrier ended up infecting 706 people on that ship with four weeks exposure and half of that was during “quarantine” when everyone was confined to cabins and trying not to catch it. That is one highly virulent strain.

    The good thing about the ship is that we know the mortality rate (when there are enough ICU beds) is as low as 1% even in a moderately older demographic. We know the rate of asymptomatic infections because nearly everyone was tested. But one fifth of that ship caught the disease in only a couple of weeks of normal cruise ship exposure. Ouch!

  21. E.M.Smith says:

    @Jonova:

    Thanks for the props… and nice to hear from you again!

  22. Another Ian says:

    “Michigan Democrat Governor Threatens Licenses of Doctors and Pharmacists Who Prescribe Hydroxychloroquine to Treat Coronavirus…”

    https://theconservativetreehouse.com/2020/03/27/michigan-democrat-governor-threatens-licenses-of-doctors-and-pharmacists-who-prescribe-hydroxychloroquine-to-treat-coronavirus/

    In comments

    “I’ll make a deal with her … until she provides double blind testing … and repeatable experimentation … to PROVE Global Warming … I’ll go ahead and use chloroquine medications if I need it”

    https://theconservativetreehouse.com/2020/03/27/michigan-democrat-governor-threatens-licenses-of-doctors-and-pharmacists-who-prescribe-hydroxychloroquine-to-treat-coronavirus/#comment-7987171

    And FWIW first comment there

    ” If you have seen the Governor of Michigan on TV lately and wonder where she came from? Wonder no more. She used to work for George Soros. All you need to know.

    — Chuck Woolery (@chuckwoolery) March 24, 2020″

  23. Another Ian says:
  24. M Simon says:

    In my neck of the woods (northern Illinois) anti-Trump commercials have started running. The election is quite a ways off in political time.

  25. Another Ian says:

    And further down on hand sanitiser

    “Why there is a shortage of hand sanitizer. I bet you aren’t shocked. https://www.frontpagemag.com/fpm/2020/03/you-cant-get-hand-sanitizer-because-government-daniel-greenfield/?fbclid=IwAR1PluEu4A0v9jf9fOPLttofPQztGncOK3Ez0OnRMrkk1t1E-ffbcdZftU8

    Certain powers that be do not want a cheap effective established medication, they want billions spent on research and vaccines. ”

    https://theconservativetreehouse.com/2020/03/27/michigan-democrat-governor-threatens-licenses-of-doctors-and-pharmacists-who-prescribe-hydroxychloroquine-to-treat-coronavirus/#comment-7987193

    And following

  26. Saighdear says:

    Watch out for pink-eye? Thought that ONLY affected Cattle? ….. Powder puff treatment for that years ago was common enough to know about it, but nothing else at the time. What have I missed?

  27. Tony Hansen says:

    Jradig,
    I think we need to be cautious accepting the figures given.
    The first(?) death in Australia was a man quarantined in Darwin who was flown to Perth for specialist treatment. The John Hopkins page registered him as a Perth (Australia) fatality. I think the Worldometers site also registered him as an Australian fatality but I cannot load their page to double-check.
    He was a Diamond Princess passenger. Maybe not all the cases from that ship have been attributed to it.

  28. Tony Hansen says:

    Jradig,
    https://www.abc.net.au/news/2020-03-02/coronavirus-victim-james-kwan-described-as-pioneer-of-wa-tourism/12015842
    James Kwan became the first Australian to die from the virus when he passed away at Sir Charles Gairdner Hospital in Perth on Sunday morning.

    He contracted the disease on board the quarantined Diamond Princess cruise ship in Japan, before his health deteriorated rapidly while he was in isolation in hospital.

  29. phil salmon says:

    Here’s a home-made face mask my wife made for me (she makes one each time I go out for shopping). Three paper tissues and two rubber bands. A little sore on the ears but OK.

  30. Bill In Oz says:

    Well I did the post on the Facebook group I admin about wearing face masks. And I copped such flack as I have never copped before..Just from a small group of 3-4 women members with a para medical background…They did not like me taking the WHO apart or for dissing the regular advice here designed to save face masks for the medical people treating infected persons….

    Very very weird…
    I replied and gave as good as was given..But it all settled down when I said that ” I wear face masks as a courtesy to prevent any germs infecting you”…

  31. Simon Derricutt says:

    EM – there you go, applying engineering principles to a medical problem and producing a logical way forward…. It seems the politicians don’t get the problems with exponential growths or the problems with asymptomatic spreading.

    Stopping the problems isn’t easy using the quarantine method, since although it works if correctly applied there are so many needs for exceptions (and continued trade, delivery of food, etc.) that unless you can be sure that all the people moving around are not taking the virus with them it’s going to get through. Much the same as with the internet – when you allow some communication, you also allow others.

    Currently, the shortage of test kits and the time it takes to process a test means that only symptomatic people are being tested. The Diamond Princess data shows that around 50% of infected (and presumably infectious) people will be asymptomatic.

    I’d figure a good way forward would be to dose everyone (unless their medical history counter-indicates it) with Hydroxy-chloroquinone so that they become effectively immune for a period of maybe 4-6 weeks. Probably around 95% of people would be able to take the prophylactic dose. A few with heart problems or other medical problem would not be able to. Given the dearth of new bodies to infect, the virus would die out over a period of a few weeks. Again, that’s an engineering solution, since we’ve found that the anti-malarial drugs also stop replication of the virus and that allows us to produce a large cohort of effectively immune people without needing them to get ill first and recover. Mass use of prophylaxis would allow business to resume as usual, without needing to test whether people have the virus or not. When I last took Chloroquine in 1986, I needed to start a week before travelling and take one pill per week. No problems. Seems that a nationwide application of prophylaxis would enable restarting everything in a week, therefore.

    Though here in France the Chloroquinone (and Hydroxy-chloroquinone) cure has been mentioned on the news, seems the BBC in the UK is ignoring it altogether apart from a reference to Trump having mentioned it. It’s hard to believe that no-one in the UK is doing anything about it, but it’s not in the news. Instead, there are exhortations to “stay home”. Strangely, people walking on the moors maybe a mile from anyone else are being held up as an example of something they shouldn’t do, but instead they should stay at home. Go figure….

    Breaking news is that in the UK Boris Johnson has caught the virus. I wonder if they’ll give him HQ?

  32. p.g.sharrow says:

    I can not believe the heated opposition to the use of Hydroxy-chloroquinone. It is if someone with power wants to prevent this solution to the “pandemic”. Chloroquinone is a long proven pharmaceutical, cheap, ready available and relatively safe even for unsupervised use. It is known to reduce the effects of all virus including this one and would greatly flatten the load curve on the ICUs while “Herd” immunity builds. and only cost a few billions for everyone rather then a few Trillions under the present direction. Why do we seem to be stampeded in the direction of the worst solution…pg

  33. A C Osborn says:

    Simon, I have heard that all the Chloroquinone type medicines have been sequestered by the Government, whether true or not I can’t say.
    Matt Hancock also has been tested positive.

    The UK (and most of the western world) has forgotten how Quarantine and Isolation works, when we used to have very infectous & dangerous deseases like Small Pox, TB, Polio etc we had lots of Isolation Hospitals, there is one 3 miles from me which is no longer used for that purpose.
    Vaccination seems to have replaced Isolation, but that is useless for new deseases.

  34. A C Osborn says:

    P G, one word, cash.
    The company(s) that produce Vaccines at $400 a pop are set to make a “killing”, pun intended.

  35. Saighdear says:

    Don’t know much about the Chloroquinone, but I wholeheartedly agree with you Quarantine and Isolation works,I’d forgotten about the List of infectous & dangerous deseases like Small Pox, TB, Polio etc
    You telling us that the World of Medics was never taught all this – and that we’ve retired out of the system – all those Parental generation of Experts who know all this? Of course nobody listens to their Parents or Grandparents, do they? They all know so much better nowadays – being “Smart”Asses. Unfortunately I was born in a Mixed generation – Old Parents and young children so hence can “Bridge” the gap of knowledge – but “what do I know”

  36. A C Osborn says:

    EM, in your answer to CD & Ed you forgot one more critical cost in both cash & human lives.
    I keep repeating this on other forums where people advocate herd immunity.
    Once the health service is overwhelmed the following happens.
    The Medics treating the victims get it and die or are very ill, they can no longer treat anybody other than COVID patients even if they only have mild symptoms.
    All the non COVID patients are no longer able to get critical care, everything stops.
    All the following Patients and any others that you can think of
    Stroke
    Heart
    Renal failure
    Cancer
    Accident victims
    COPD
    Emphysema
    Cystic Fibrosis
    It all stops, no more operations, no dialysis, no chemo etc because the stupid health organisers put the isolation units inside the General Hospitals instead of keeping Isolation Hospitals.
    So the first requirement is create Isolation hospitals with ICUs and move the patients to them
    Otherwise there will be many non COVID deaths.
    ps my brother is waiting for a very urgent Heart Valve op.

  37. jim2 says:

    Some people in NYC should be charged, tried, and hanged!!! They killed hundreds of people. Democrats elect such YUGE idiots!!!

    From the article:

    Carlson criticized New York City health commissioner Dr. Oxiris Barbot, among others, who dismissed the incoming threat of the coronavirus in February.

    “The risk to New Yorkers from coronavirus is low and … our preparedness as a city is very high,” Barbot said at a Feb. 2 press conference supporting the Chinatown Lunar New Year Parade and Festival. “There is no reason not to take the subway, not to take a bus, not to go out to your favorite restaurant and certainly not to miss the parade next Sunday [Feb. 9].”

    “Future generations are gonna watch that video with their jaws open in disbelief,” Carlson said in response to Barbot. “How could someone charged with protecting public health so recklessly endanger it?”

    The host also criticized State senators John Liu and Brian Kavanaugh, who also advocated for the parade and downplayed the threat of the virus.

    Carlson also highlighted New York City Mayor Bill de Blasio encouraged New Yorkers in early March to “get out on the town despite Coronavirus.”

    “Soon after that, people in New York inevitably started to get sick, in some cases very sick. In some cases, they died,” Carlson said. “And then suddenly de Blasio was on ‘Meet the Press’ shrieking that Donald Trump had abandoned the city.”

    https://www.foxnews.com/media/tucker-carlson-nyc-leaders-endangering-public-coronavirus

  38. A C Osborn says:

    One other point about using the Diamond Princess for any analysis is that it is not complete, ie there are still many patients in ICU.
    Surprisingly Nic Lewis made that mistake using February report. Which showed 9 deaths, there are now 10.
    The other thing I would like to point out is the overall World values on the Worldometer site.
    Look at the over cases, still active cases, closed cases, cured vs dead. The percentages are horrific.

  39. Saighdear says:

    Yes makes sense to me, why not to THEM? £$$£p perhaps and from the neck down or whatever silly comment some of them make

  40. cdquarles says:

    Note well, I am not advocating herd immunity. What I am saying is that’s where we will end up, almost regardless of measures taken, other than the standard universal precautions.

    I was able to find out that at the largest teaching hospital in the state, they have 60 cases, as of yesterday. Of those, 30 are on ventilators. What I have not seen is how many were truly local and how many were sent in from other areas, which would be typical since many of the outlying hospitals would be less able to handle the worst cases.

    Take the worldometer site numbers with a grain of salt. They are, by their nature, skewed. By how much and which direction, we don’t know. Again, the symptoms, if any, from a viral illness are rather non-specific. We are likely not doing sputum cultures or tissue biopsies and electron microscopy on each and every one to confirm them. To the extent we know a case has this coronavirus, how many also have some other respiratory virus along for the ride (RSV, parainfluenza & more)?

  41. A C Osborn says:

    cdquarles says: 27 March 2020 at 3:03 pm
    The still Active Cases and Closed Cases are very well known
    of 558,416 identified 404,400 are still active and of those 21,071 (5% of active) are still serious/critical.
    Of the 154,016 Closed cases 25,262 (16% of closed cases) are dead.
    That is the burden on the health systems.

    It doesn’t matter what eventually kills them, once their body is severely compromised by COVID19 that is all it takes.
    Like I keep saying, nobody is counting all those that are unnecessarily dying because they can’t get the help they need because health systems can’t cope.
    In the UK a young man died of Malaria because they wouldn’t give him medical aid, a 34 healthy young woman died of COVID 24 hours after being told by a visiting medic to stay at home and self isolate. She gets counted and the guy doesn’t.
    My 84 year old brother was due to have an urgent heart replacement op,we expect it will cancelled, how many thousands are in his situation?

  42. p.g.sharrow says:

    Enloe here in Chico has a tent receiving area outside the hospital for walkins. You had better be dying to get into the hospital and tests are ONLY for those that are dying and NOT for those that are merely sick. “If you are sick, go home and take Tylenol ” So no one knows the level of infection here

  43. ossqss says:

    Seems WOM clicked up to a CFR of 17% on closed cases today.

    One wonders how Germany continues to have such an incredibly low serious/critical rate in active cases.

    https://www.worldometers.info/coronavirus/country/germany/

  44. E.M.Smith says:

    @Another Ian:

    Soros and his ilk believe they can dump Trump via this event and don’t mind deaths in the process at all. Like all good authoritarians and aristocrats. Last thing they want is effective control or, horrors!, a cure.

    I like that “medicine w/o a license” idea ;-)

    Once the government regulates anything, it slowly strangles the thing with the “advice” of the industry leaders who want to exclude everyone else. So common there is econ jargon for it: “Industry Capture”.

    @Saighdear:

    Pink-eye is a very common human disease and lots of viruses can cause it if they land on the eye.

    @Phil Salmon:

    Nice idea. Might try shoe strings for more comfort.

    @Bill In Oz:

    That’s what gets me. To “save masks” for medics we increase people spreading disease to them at the grocery store… Attack the exponential growth first, you reduce the PPE demand by huge amounts later.

    @Chloroquine & Isolation topic:

    We are getting political decisions instead of practical. It’s all about butt cover, asigning blame, money, and maybe after that, a good show. If anything works, well, fine, take credit for it.

    Yes, I’m having an unhappy morning given the news.

    But really: We have effing existance proofs for what works. Singapore. S. Korea. China. Taiwan. And more. How many do we need?

    1) STRICT lock down quarantine in active case areas.
    2) UNIVERSAL mask wearing (to stop the spread to others, get R0 down).
    3) Frequent disinfection of public places
    4) Educate on hand washing, mask and gloves use.
    5) Effective and big public health response with new hospitals and treatment / isolation.
    6) TESTING TESTING TESTING.

    Of those, the west is doing, maybe, 5, half of 4, and a piss poor 6.

  45. jim2 says:

    Trump’s approval rating for his handling of the virus problem is still going up – people are loving the daily update! Hope Soros gets CV. He deserves it more than anyone else on the planet.

  46. Saighdear says:

    Thanks E.M. -but, huh, I thought you knew ALL about Pink Eye from https://www.nadis.org.uk/disease-a-z/cattle/eye-conditions-in-cattle/
    Infectious Bovine Keratoconjunctivitis (IBK, “Pink eye”, “New Forest Disease”) – IBK is a highly contagious disease caused by a bacterium Moraxella bovis that can spread rapidly during the summer months. It is more commonly seen in young stock than adults. THIS is what I knew about from my Student days. No one ever said it was transferable or whatever to us – had me worried /Angry at same time – Can sleep better now having refreshed the memory. – don’t deal with Calves every day now. Human Pink Eye I understand as Conjunctivitis …. as you say.
    This is a wonderful Blogsite for learning other things.

  47. cdquarles says:

    @ACO,
    Identified number of cases does not equal true numbers of cases, and one of the reasons is simple reporting delay.

    Again, no one is telling us what the true and false positive rates are for the screening tests. They are not telling us all of the kinds of screening tests that are being used. The reverse transcriptase + polymerase chain reaction type tests are extremely sensitive; but if not done correctly have a horrible true and false rate for both positives and negatives. They are not telling us what confirmatory tests are being used. Likewise with them, we are not being told what the true and false rates are for either positives or negatives.

    There is way too much over certainty here, mostly on the pessimistic side, and not nearly enough error analysis such that the proper uncertainty bounds are being applied to either side. China’s numbers can’t be fully trusted. Neither can ours, though I think ours are more transparent.

    There will be papers and books written about this, about both over and under reaction, regionally, in hindsight.

  48. cdquarles says:

    @Saighdear,
    I will add not only viruses cause human pink-eye. Allergies, bacteria, chlamydia and fungi, too, are causes. Pink-eye, in humans is the colloquial term for the medical term, conjunctivitis = inflammation of the eye’s epithelium.

  49. A C Osborn says:

    ossqss says: 27 March 2020 at 4:58 pm
    There have been questions about both Germany’s and Japans methods of reporting, people from Germany say that testing is not carried out after death.

  50. E.M.Smith says:

    @A C Osborn:

    Yeah, can’t list everything.

    I also didn’t include the cost of “lost human capital”. How much does it cost to raise a child, put them through 20 years of education, and produce a doctor or nurse? Then they work for about 40 years to replace that value. But that sunk cost is lost when 10% of your medical staff die after the hospitals are over run.

    Then do a similar calculation for all other still working who die (NOT a small number).

    And yes! The number infected who take 20 to 30 days in hospital to recover is startling. After 20 to 30 days on a ventilator, few survive (whatever the disease). There’s a huge human suffering even in those that do recover. I’m not so bothered by the risk of death, as by the potential of spending a month on my stomach on a ventilator in misery, then dying.

    @Jim2:

    Also note that Cuomo regularly put in his daily complaint, a “blame the Feds” for not absorbing State responsibilities / costs. Lots of emotion about the bailout package not replacing lost State tax revenue. No State “rainy day” fund, Gov.? Spent it all on PC BS and feather bedding for Friends Of Democrats?

    @CDQuarles:
    Good points.

    @P.G.:

    Chico, eh? I suppose I ought not be surprised. Liberal junkets around the world for the college professors and vacations in Italy for the well paid leftists…

    Still, somehow I’d figured farm country might dodge it.

    Then again, Spring Break… Wonder how strong the correlation is with college towns.?

    @Ossqss:

    Tis a mystery. Different treatments? Genetics? History of NSAID use? Age profile? Far fewer smokers? Different testing? Does need explaining.

  51. cdquarles says:

    The governor here gave a streamed statement: https://yellowhammernews.com/ivey-orders-non-essential-businesses-shuttered-statewide/. There are locals who want the whole state locked down, mostly democrats. It is too late for that, mostly. NB that the governor said that localities can take more extreme measures as they deem necessary by the facts on the ground, locally.

  52. cdquarles says:

    Hmm, about college towns. Counties here that have colleges: Jefferson, Madison, Limestone, Lauderdale, Macon, Talladega, Calhoun, Etowah, Sumter, Montgomery, Pike, Lee, and Mobile all come to mind. I may be missing some. Of those, I want to say only Sumter has had no confirmed cases, as I write this.

    The University of Alabama is in Tuscaloosa. The University of West Alabama is in Sumter county. Also in Tuscaloosa county is a small, historical black one.

    Here is the list from wiki: https://en.wikipedia.org/wiki/List_of_colleges_and_universities_in_Alabama.

  53. A C Osborn says:

    EM, I had pnuemonia 18 years ago, temps of 104F, Hallucinations and on oxygen unable to get a breath.
    The description of being like drowning is not bad.
    It tooks me 7 weeks to be able to walk up our hilly road to the shops and get back to work.
    Not recommended.

  54. YMMV says:

    An unfortunate aspect of the MSM is that they can only handle one headline at a time (well, two: whatever the current Big Thing is and Trump). Which leaves most of us in the dark about what is happening elsewhere and whatever happened to that older Big Thing?

    We want to stop the spread, but we only get news about how many are dying in Italy or now NY.
    What about news about what is being done to track down the contacts of each new victim? They could hire a lot of people to do that job. Or else they could just use the staff they already have who aren’t doing anything else at the moment. Or maybe not bother at all. It’s important. Why don’t we know?

    What about news of how the virus spreads. We are in the Cancel Economy lockdown because we don’t know a less brutal way to avoid the spread. Maybe if everybody had worn masks and gloves since the start, none of this would have been necessary. Maybe Japan is better off (even with a less strict lockdown) because of their custom of greeting by bowing instead of by handshake. Maybe the politicos are worse off because their job is to shake hands with everybody. Why don’t we know better exactly how it spreads? So we can focus on what counts most and not panic about every little possibility.

  55. YMMV says:

    https://www.theguardian.com/commentisfree/2020/mar/20/south-korea-rapid-intrusive-measures-covid-19

    “A team at Mount Sinai has developed a test that could quickly determine who doesn’t have to fear the coronavirus.”

    “The test itself is a variation of a standard one called an enzyme-linked immunosorbent assay, or ELISA. The concept goes back to Rosalyn Yallow, who was at the Bronx Veterans Hospital in 1977 when she became the second woman ever to win a Nobel Prize for medicine. Yallow’s test involved radiation, while the ELISA involves enzymes. Other elements include a plastic plate, 1 percent milk, and horseradish root, which contains an enzyme called horseradish peroxidase that turns purple if the targeted antibody is present in a blood sample. The depth of the color can be precisely measured with a spectrometer as an indicator of the concentration of the antibody.”

  56. A C Osborn says:

    YMVV, we know exactly how it spreads, but the so called experts advising governments think they know better than those countries that have been through previous epidemics.
    They tell us not to wear a mask, but do not tell us to wash the Virus, that the mask would have helped stop, from our faces, just our hands.
    So you go home wash your hands and then touch your face re-infecting your hands, kiss the wife/girlfried/kids voila infection passed on.
    Clueless

  57. jim2 says:

    It has come to light recently that Cuomo is sitting on top of thousands of warehoused ventilators. He is just trying to suck up more based on what models say may be the future of NYC. I understand that, but lying is lying. He has enough at the moment.

  58. Saighdear says:

    Jings, E.M. this reads like a Sci-Fi fantasy – I’m getting worried now. Not by any means am I saying that YOU are writing comic scripts – just that some of the TV Films now playing in the background – (‘cos a’thing else is repeats or other trash) seem to go along some of those lines – and I am wondering whether Modern day Politicians and Scientists ( incl. Medics??) have seen too much of this kinda stuff and gotten queer ideas about People management etc….
    Finding the latch that protects the Swamp /Sump Plug is the problem

  59. Another Ian says:

    “Prime Minister Boris Johnson Tests Positive for Coronavirus, Is Self-Isolating”

    https://www.breitbart.com/europe/2020/03/27/boris-johnson-tests-positive-for-coronavirus-self-isolating/

    AND further down

    “Delingpole: Fear of the Coronavirus Is Worse Than the Disease”

    UK Health Secretary infected as well

  60. Another Ian says:

    A look at Govenor Cuomo’s spending priorities

    “How Many Ventilators Would That Have Bought?”

    https://realclimatescience.com/2020/03/how-many-ventilators-would-that-have-bought/

  61. Bill In Oz says:

    Here is an interesting explanation of what went wrong in Italy : https://www.spiked-online.com/2020/03/27/italys-lockdown-has-been-a-recipe-for-disaster/

  62. M Simon says:

    Hillary Klug in case the video doesn’t show up.She plays a mean fiddle.

  63. Another Ian says:

    ”This is GAME CHANGER. Abbott to market, starting next week, a fast point-of-care #coronavirus test, delivering positive results in 5min and negative results in 13min. Will deliver 50K tests/day to start. Kudos to Abbott and FDA’s Jeff Shuren and team at CDRH who are in the fight.

    — Scott Gottlieb, MD (@ScottGottliebMD) March 28, 2020″

    http://www.smalldeadanimals.com/index.php/2020/03/27/wuhan-flu-14/

  64. David A says:

    Concerning economic damage, Cov19 gives every indication that if it was treated like the common flu, the exponential would run up to two months longer then otherwise from strong defensive protocols. And it would be steeper. Likely about four magnitudes more then the current case numbers before the flattening curve. So, in that case all the economic damage attributed to the defensive protocols would happen regardless, only worse with far greater panic and inconceivable hospital overload and a death horror show, along with increased risk of gain of function mutation. There is already evidence of increased harm to younger people.

    Currently the CFR, cured vs dead, is 17 percent and rising. Despite disparate degrees of defensive protocols implemented far earlier in the disease progression then what China did (nothing for two months) It is a steeper and longer rise then what China lies show, and the CFR will be far higher then China claims.

    As to US death rates, look at the cured. ( very low).

    The Diamond Princess after at least 6 weeks of illness now has 10 dead, 105 still I’ll, and 15 still in critical. I have estimated all along that their CFR will be three to 5 percent with an early half baked quarrantine and then a perfect quarrantine. ( In other words left to run like the flu 80 plus percent would have become infected), and sans perfect medical care of 3 to 5 percent CFR, the CFR would skyrocket with triage and ventilator shortages.

    This ain’t the flu, and the dollars cost will happen with or without defensive protocols.

  65. Another Ian says:

    Seems to fit here about odds

    “COVID-19 And Some Thoughts on Data Analysis”

    http://coyoteblog.com/coyote_blog/2020/03/covid-19-and-some-thoughts-on-data-analysis.html

  66. Ed Forbes says:

    Very good look at the actual data on the effect of the virus and the media hype.
    .
    https://pjmedia.com/trending/what-the-media-isnt-telling-you-about-the-united-states-coronavirus-case-numbers/
    .
    The US is in a panic that will (has) caused more damage to the nation than the virus will (has).

  67. cdquarles says:

    @Ian,
    I agree with that particular blog post. Did I not bring some, if not all, of those points up here? I am getting old and my memory isn’t quite what it used to be ;).

    Locally, the numbers of tested people and the number of confirmed cases has exploded. The total number of deaths: 3 people out of nearly 5 million. Will that number change? I’d be surprised at this point if it didn’t. The number of confirmed cases is still following the number of cases tested number (I wrote a paper and published it via a personal communication about this kind of thing for a different condition almost 40 years ago). I’d still like to know what kinds of tests are being done and what the false positive and negative rates are. We still have to guess at the true prevalence before we could put a range number on the positive predictive values.

    I’d like more info about the UA hospital (yeah, it is UAB hospital now; but it wasn’t when I was there) admissions, isolation unit admissions, ICU admissions, numbers on ventilators and where the admissions came from data.

  68. Another Ian says:

    “Doubts Cast on Story About ‘Britain’s Youngest Coronavirus Victim’ ”

    https://www.breitbart.com/europe/2020/03/28/doubts-cast-on-tragic-tale-of-britains-youngest-coronavirus-victim/

    So, a sophisticated summary of COVID19 fatality in both symptomatic & asymptomatic patients (via https://t.co/F4CIJU22kU ) is:
    Age 0-9: 0.0094%
    Age 10-19: 0.022%
    Age 20-29: 0.091%
    Age 30-39: 0.18%
    Age 40-49: 0.4%
    Age 50-59: 1.3%
    Age 60-69: 4.6%
    Age 70-79: 9.8%
    Age 80+: 18%
    16/ pic.twitter.com/CeH8RyS8o2

    — Nicholas A. Christakis (@NAChristakis) March 28, 2020″

  69. Another Ian says:

    How things change – trading toilet paper

    https://realclimatescience.com/2020/03/printing-rolls-of-money/

  70. David A says:

    Ed Forbes, all appear to have a bias, including the article you linked, which conviently ignores where on the curve exponential each nation is.
    For sometime new cases rip upwards and cured and fatal lag. US is fully in the early stage with cured a very low number. He US fatal to cured is very high.

    Oh, and China’s number are FUBAR of course. For several days Germany’s new dead was twice or greater then the total serious/critical.
    Suddenly German serious/critical jumped from the low 20s to 1,500 plus.

    Without knowing testing numbers and policy, it I all fairly opaque.

  71. E.M.Smith says:

    Korean head Covid MD in the place with the best testing and data says fatality rate is 3.x% (I don’t remember the fractional part). They are using chloroquine and kaletra to reduce fatalities…

    Details here:
    https://chiefio.wordpress.com/2020/03/23/23-march-2020-wuhan-china-covid-19-restarting-economy/#comment-127529

    3% of 80% of 320 million = 7,680, 000 dead in the USA under present conditions.

  72. jim2 says:

    I’m thinking that if CV had been allowed to run its course “naturally” the impact to the economy would have been comparable to the isolation orders. There would have been a lot more panic and ensuing chaos.

  73. Another Ian says:

    Numbers just got much bigger!

    “Founder of US Judicial Watch launches 20 TRILLION U$D lawsuit against Communist China over its Virus”

    https://www.michaelsmithnews.com/2020/03/founder-of-us-judicial-watch-launches-20-trillion-ud-lawsuit-against-communist-china-over-its-virus.html#comments

  74. YMMV says:

    Ed Forbes: “The US is in a panic that will (has) caused more damage to the nation than the virus will (has).”
    jim2: “I’m thinking that if CV had been allowed to run its course “naturally” the impact to the economy would have been comparable to the isolation orders.”
    New York Gov. Andrew M. Cuomo: “the coronavirus outbreak in New York state will reach its apex in “14 to 21 days”

    My question to all politicians (and anybody) is “how do we know?”

    Ed linked to a pjmedia story saying that although the US has the most cases, it’s not so bad because per capita it’s doing better than the other countries in the headlines. There is a problem with that. The growth rate of the infections is proportional to the number of active cases; it does not have any relationship with the size of the population, so doing ‘per-capita’ is whistling through the graveyard.

    The size of the population does tell us one thing — that is the maximum possible number of cases, which is everybody, unless somebody finds an effective way to stop it. Left unchecked, the growth in cases will slow down when the virus has a hard time finding new victims. That can be when almost everybody has it or it can be when almost all of the active cases are isolated — which is turning out to be too high a price for too many people. What to do? Move to South Korea?

    Worldometers does not have a column for new cases over active cases. That is the one to watch, and especially its trend over time.

  75. E.M.Smith says:

    @YMMV:

    FWIW, I’m in one of the counties with the large case counts. The assertion that the nation is in a panic is not born out by observations here.

    There was a grocery stocking up run at the first announcement of the shelter in place order. Between not being clear stores would stay open, and folks wanting to not venture back out during the plague, some products sold out. Big whoop. They were restocked in days.

    Since then, no signs of anything much. Folks cheerfully walking dogs. Neighbors having conversations while walking, from12 feet away. People politely taking turns at crossing paths to avoid overlap. Folks at the grocery store a week back looking at most a little worried. Those at Home Depot mostly oblivious to any risk and clearly working on things around the house. Planting gardens.

    A few days ago, a drive around about a 10 mile loop showed things a quiet peaceful state. Folks driving slower, less rushed. Restaurants doing s good take-out business. Drug stores too. Overall, less drama that the typical work day, and even the grocer had sbout 1/2 the usual parking lot load.

    Maybe somewhere else is worked up about it, but not here.

    The physical capital is all intact. Labor is ready. There just isn’t any damage to be seen. No out of business signs either. Maybe that changes in a few months, but not in a few weeks.

    What IS a worry is that cases are still doubling. The exponential has slowed, but not much. We are still on track for about 32,000 deaths in this county alone, using a 60% eventual infection rate and S. Korea’s best case 3% fatality rate (per their head medical guy). THAT will eventually cause panic, but not about the economy.

  76. A C Osborn says:

    EM, an interesting statistic, of the top 50 countries (including the diamond princess) the percentage of Critical Cases of Active Cases varies from 0% to 27%, the world average is 5%.
    China is the 27%, the diamond princess is 14%.
    In Europe there is also quite a large variation, not only do Germany have a lower death rate than most of the other EU countries but also less critical care cases as well ie
    Germany 3.2%
    Italy 5.5%
    Spain 7.2%
    France 14.4%
    Swiss 2.2%
    Netherlands 9.1%
    Belgium 9.6%
    I know not all countries are on the same point of the curve, but why is there such a variation?
    Is it that some countries are not reporting Critical cases or is it that those countries are dealing with a slightly less virulent strain of the virus.
    It doesn’t seem to be related to what percentage of active cases there still are for those countries.

  77. p.g.sharrow says:

    ACO; your question is interesting to me and leads me to posit that the “experiment” of the Diamond Princess points Me to think that a percentage of the population is naturally resistant and a percentage is susceptible to this infection. This is also indicated by the fast rolling curve in the national infection rate. We do have the problem of the speed and quality of various national responses. Testing is still spotty and restricted in America and the medical profession very resistant to learning from the mistakes and successes of others in combating this virus. Insisting on using techniques and medications that don’t really work and at times make things worse.
    Just like Generals that always plan on fighting the next war with the techniques learned from the last one, our medical profession is very resistant to change.
    Populations and their political processes vary from nation to nation so results vary, I should think that the only thing that is fairly constant is the virus…pg

  78. E.M.Smith says:

    @AC Osborn:

    IMHO an “all of the above” style answer applies. Several variables combining to make the result.

    We know there are two major strains with different virulence.
    Smoking prevalence matters.
    Average age of population.
    General nutritional status (and I’d speculate degree of sun exposure)
    Environmental insults (smog and the low sun low vit-D that goes with it)
    Medical practices (video of Italian medical staff with surgical masks, no goggles, vs others in bunny suits changing % staff infected and then infecting folks going to doctors)
    Population genetics (we know plague selected for genes improving immunity response)
    Diet (how much citrus / vit C & E, etc.)
    Family practices – Italians like extended family living, so grandparents have high exposure to younger asymptomatic carriers so more elders hit.

    And undoubtedly a lot more.

  79. rhoda klapp says:

    I’d add what medications they are on. Are all the pre-exisitng condition folks who are most susceptible to this on ACE-inhibitors? A lot of people over 70 are being treated for hypertension.and I wonder if anyone is looking at that as a factor, or even a cause.

  80. E.M.Smith says:

    @Rhoda:

    Yes, it is a factor. As is the National Preference for Ibuprofen and NSAIDS vs acetaminophen. Italians like their Ibuprofen and that looks like a virus promoter. Have the Italian M.D.s learned not to give that yet?…

    There’s several other medications with probable issues. It is possible some big fraction of the age distribution of issues stems ftom the tendency to be on more drugs with age.

  81. YMMV says:

    What is a good source of data? I can copy the table from http://www.worldometers.info/coronavirus/ and paste it into a spreadsheet, but they only give today (incomplete) and yesterday. Is the data from past days and weeks available somewhere?

    Sweden has no lockdown and is growing 11% per day; Denmark has a strict lockdown and it is at 7%. What’s going on in New Zealand? It’s at 32% — it could just be a one day bump, so I would like to see it over a longer period. Or they bumped up their testing. (S. Korea is a 3%)

  82. A C Osborn says:

    YMVV, Wikipedia has stats on every country, but you have to ask for them individually.

    Sweden was using a leave everything open policy, but that has been changing recently.
    New Zealand didn’t have their first case until February 27th, so only been on the curve for a month.

  83. A C Osborn says:

    YMVV.
    ps if the country has a blue link as it’s name then it will show you more stats if you click it.

  84. cdquarles says:

    @Rhoda,
    Even the ACE inhibitor/receptor blocker thing is up in the air. For some these seem to make them more susceptible. For others, it seems these may inhibit infectivity. At this point, we just don’t know. Many interactions from medicines, nutrition and genetics is simply not known. For some, will acetaminphen”s glutathione actions make them more susceptible to kidney trouble? For some, what would prednisone do? Same with aspirin, ibuprofen (and other NSAIDS, which have similarities in actions and adverse effects as well as differences between patients) and then there are many more.

  85. A C Osborn says:

    Something of interest found, 27.4% of susceptable italians live with their youngsters, 33.5% in Spain and only 7% in Germany.
    Another factor.

  86. YMMV says:

    @A C Osborn, thanks. I see I can pick off data values for older dates from the graphs by hovering over the points. But for New Zealand, it turns out I can download Excel files with all the data they make public, and that is way more than any other place I’ve seen so far. For each person, the region they live in, sex, age group, international travel yes/no, last country before return (ummm, that might not be the right one), flight number and flight dates. They have tables for both confirmed and probables. The nzherald says most were associated with international travel and the other cases were a private wedding, a rest home, a specific workplace, a conference, and one unknown. Most were in the 20 – 29 age group. Over 500 cases, 56 recovered, one death. All since 26 February. The reported day by day growth is very erratic since the numbers are still small. I couldn’t say if they have a worse problem than anywhere else, but it is clear they are taking it very seriously. How is this for an emergency alert (25 March)?

    This message is for all of New Zealand.
    We are depending on you.

    Follow the rules and STAY HOME. Act as if you have Covid-19. This will save lives.

    Remember:
    • Where you stay tonight is where YOU MUST stay from now on
    • You must only be in physical contact with those you are living with
    It is likely level 4 measures will stay in place for a number of weeks.
    Let’s all do our bit to unite against Covid-19. Kia Kaha.

  87. E.M.Smith says:

    Painfully slow to listen to as Giuliani learns biochemistry and pharmacology… but he is interviewing Dr. Vladimir Zalenko who has successfully treated over 500 patients with a 3-way of hydroxy chloroquine, azithromycin, and zinc (that he keeps calling vitamin zinc… ) Claims it is most important to give it early before virus load is high and lungs are already compromised (that makes a lot of sense since you are trying to prevent replication and doing that after replication is a bit dumb). He also doesn’t know the effect on interferon and other antiviral modes of azithromycin so speculates if is preventing secondary bacterial infection. Still, words right from the front…

  88. E.M.Smith says:

    The Indian accent is a bother, but this doctor has some useful information. He uses chloroquine to treat autoimmune diseases so knows a lot about side effects.

    The eye issues usually only shows up after years of use. Not an issue for covid.
    Heart rhythm issues easily monitored and mostly only matters if you are on some other dtugs with additive effects.

    Oh, and that Chinese study saying no benefit over “standard of care”? The standard of care was other antiviral drugs. So it is as good as some other antivirals.

  89. YMMV says:

    The Johns Hopkins University daily dataset is archived here, for those who like to crunch numbers:
    https://github.com/CSSEGISandData/COVID-19

    BTW, The WHO has downgraded the aerosol transmission of the virus.

    My opinion is that masks and gloves are important (and washing hands, face, and not touching your face). Distance from people while all wear masks, not so much. It’s the difference between big doses (droplets) and little doses (aerosols). Little doses give the body time to build defenses, big doses are overwhelming. That’s the theory anyway. But no touching!

  90. A C Osborn says:

    The WHO are totally irresponsible putting out that data, when other actual studies show that it is airosol, they really don’t want people wearing masks.
    I wonder why?
    The Czech republic go along with us EM, they are using home made cloth masks and it appears it may be starting to work.

  91. Foyle says:

    French hospital(s?) have treated 1292 with that Hydroxychloraquine+azithromycine combo and only had 1 death:
    https://www.mediterranee-infection.com/covid-19/

  92. Simon Derricutt says:

    ACO – I think the WHO is telling people that masks aren’t necessary in order to try to reserve all the mask production for medical personnel. Otherwise, like toilet paper, some people will stockpile all the supplies available whether they’re needed or not. There must be people with a wall of toilet-paper and cupboards full of hand-sanitiser by now.

    If masks weren’t useful, then doctors wouldn’t be wearing them, so the lie is pretty obvious. Still, there’s suddenly a shortage and the doctors and nurses don’t have enough supply. Since that means that they stand a better chance of being infected, that also means that a lot more people will get infected by their doctor/carer, so I can see the justification for the lie.

  93. jim2 says:

    Simon, as jo nova pointed out, you can make your own mask and it’s way better than nothing. And it has zero impact on medical personnel. So, I don’t buy the lie or approve of it.

    From that post:
    The most useful mask is the one you wear

    Another line we are told is that only the N95 (or P2) masks are good enough, but just about any old mask helps.

    http://joannenova.com.au/2020/03/masks-can-stop-maybe-75-of-influenza-and-you-can-make-them/

  94. Simon Derricutt says:

    Jim2 – yep, I totally agree. Just saying why I think they put the lie out, and the reasoning behind it.

    Trouble these days is that we tend to expect the “people in charge” to lie, and watch out for it. Luckily, sites like this, JoNova, and WUWT are good at telling the truth, but maybe a lot of people won’t read them and prefer to accept the official viewpoint.

    Since it’s looking like a relatively small load of virus can give the body time to respond and develop an immune response, any mask improves your chances of getting through it without getting too ill. Since there are at least some comparative tests, even though not double-blinded and thus not perfectly valid (you can’t double-blind the presence or absence of a mask), it just seems logical to wear one when in public, and I did so myself even though the likelihood of contagion around here is almost-zero. Even a coffee-filter would help, and I have a stock of those….

  95. A C Osborn says:

    Simon, I think the WHO action is dispicable, as you say anything that drastically reduces the number of viruses that get on your face must be a benifit.
    No one is suggesting that the front line medics working with COVID19 patients should use anything other than the best, but for 10 to 15 minutes in a shop any kind of mask that can then be washed, sterilised in the oven, UV light or just thrown away etc has to be better than nothing.
    ps don’t forget glasses for your eyes.

  96. A C Osborn says:

    Another error currently on the worldometer site.
    The new deaths for Spain is showing 537, but their graph shows the real number which is 812.
    I expect it to be updated with the correct data soon.

  97. E.M.Smith says:

    The W.H.O. is lying and killing people.

    They have from the start, as has China.

    The truth is that there is a mask shortage, but even a bandana around your face cuts exposure 50% and that matters. It also strongly reduces asymptomatic spreading.

    Today, the L.A. news reported 4 grocery store workers tested positive. Under current testing rules, that implies a few asymptomatic spreader clerks spitting distance from a few hundred people per day. Which is more costly? A half dozen old Tee shirts and vaccum cleaner bags home sewn into n85 masks , or 100 sick, 20 hospitalized, 5 in ICU on ventilators for 3 weeks and one dead?

    IT IS CRIMINAL TO DISCOURAGE MASKS AS IT KILLS PEOPLE.

    So we’re short and medics ought to get them first. I’m fine with that. Put out PSAs to that effect and show how to DIY masks for yourself.

    DO NOT GO SHOPPING WITHOUT MASK AND EYE COVER. Period.

  98. Saighdear says:

    Jings E.M. you & Jo.N. have had hunnerts of comments about all this.
    Yes when we, in UK, had MadCow disease, the US was kwik to Close borders to UK/Eu Meat products. This literally put a Lid on the Can -have you had any Madcow incidents? think not. Same goes , surely for ANY disease spread through “Any form of contact” Just as we can use our smartphones to pay by swiping, Ppl can contract disease , if not by touch, then being receptor to Air=Borne particles.How to reduce? -Just as you say – wear a mask. All this Talk about assimilating vectors on surface of mask …. Like Dogshit – peel off using hand inside an inverted PLASTIC bag.( OhhH Noses – Plastic is now BANNED) and dispose of safely. Done!
    E.M. it’s not my thing, but shouldn’t there be a CLASS ACTION to recover costs from ……:-) ? – those Politicians, Eco Nut Unis with daft professors of Left wing medicine, etc -what else can I add here?I am suffering from being “HomeBound since 20th Oct until 20th April -the Gritting business Winter season, and the thought of months more to suit political Nutts????

  99. YMMV says:

    Note in the above discussion. Aerosols means particles smaller than 5 nm. Droplets (anything larger) are still a risk.
    https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations

    About the UN… who’s in charge?

    https://www.foxnews.com/world/world-health-organization-coronavirus-what-went-wrong
    “The role of its leader, Ethiopian national Tedros Adhanom Ghebreyesus […] is now also coming into focus. Some are questioning whether he buttered up to governments like China in return for massive donations to the organization.”

    “Furthermore, officials from Taiwan […] claimed that they alerted WHO back in December about “the risk of human-to-human transmission.” However, Taipei leaders this week said that the information was not passed on to other countries and fell on deaf ears.”

    https://www.foxnews.com/world/who-chief-tedros-questionable-past-coronavirus
    “The head of the World Health Organization, in charge of making life or death decisions on a grand scale, has been accused of covering up cholera epidemics, supporting a terrorist organization and inflating his resume to claim he conquered malaria and HIV.”

    Ethiopia and Iran are both in the New Silk Road that China is building.

  100. ossqss says:

    Seems WOM global closed case CFR has ticked up to 19% today. Hopefully we see it reverse soon.

  101. Another Ian says:

    Does WHO approach to Taiwan also include re-naming?

    “World Health Organisation wipes Israel off the map – replaces it with “Palestine” ”

    https://www.michaelsmithnews.com/2020/03/world-health-organisation-wipes-israel-off-the-map-replaces-it-with-palestine.html

  102. cdquarles says:

    Strictly speaking, an aerosol is any sized condensed form that does not readily precipitate. Think water clouds versus drizzle. So the drops can be as large as 100 micron and stay suspended. That said, most masks will help filter the larger drops. The N95 or better ones will stop most of the 10 micron and smaller ones, so nearly all pollens and bacteria but not the smallest viruses, where we are talking nanometers versus micrometers. Still, any mask is better than none.

  103. YMMV says:

    advantages masks:
    it shows you care
    it protects others
    it protects you from other peoples coughs and sneezes and spray while they talk
    (watch in a very strong backlight sometime!)
    it protects you from yourself, it reduces the amount you touch your face (with the germs your hands picked up)

    advantages of gloves:
    they keep the germs off your hands
    they make it even harder to touch your face

    downsides:
    masks and gloves are tools, they help when used properly, but most are not trained in how to use them properly.

    “Still, any mask is better than none.” Even a scarf or a burka.

  104. YMMV says:

    I haven’t seen any motorcycle helmets used … yet.
    Ski goggles and cold weather skiing face mask?

    Masks have been mandatory for anyone going outside in the Czech Republic since March 18th.
    They say they can see the good results already.

    https://www.maskssavelives.org


    (Czech video)

  105. Bill In Oz says:

    That’s an excellent video EM ! Thank you
    I have reposted it elsewhere.
    Bill in Oz

  106. E.M.Smith says:

    Take a hot bath or sauna. Helps the interferon that covid-19 reduces ( and that azithromycin raises…) and may help with cytokine storms.

  107. Another Ian says:

    An article on “following odds” including some interesting links like that Jeffery Lord one

    “The Greater Depression”

    http://catallaxyfiles.com/2020/03/31/the-greater-depression/

  108. M Simon says:

    Ed Forbes says:
    28 March 2020 at 4:48 pm

    The “Hype” is causing more damage than the virus?

    The number of cases in the US is doubling about every 4 days. At what point does “crisis” overtake “media hype”.

  109. E.M.Smith says:

    Oddly, titanium dioxide paint in the sun can break down smog molecules…

  110. David A says:

    M. Simon says, “The number of cases in the US is doubling about every 4 days. At what point does “crisis” overtake “media hype”.”

    Indeed, and that is with VERY large quarantines and increasing travel bans. ( Some of this is testing yet catching up) Remove the travel bans and quarrantines and we get what, a one magnitude increase every 10 days or shorter?

    I saw on the WM site that the UK with 563 deaths today only lists 163 critical/ serious! I guess lots of mild cases are killing people. Or, perhaps, they are told to stay home and by the time the parametics arrive it is to late. ( Or both?)

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