Data Comparisons

All Covid-19, All the time!!

1,025 Comments

One of Jim’s borthers is something of a hypochondriac. The other is the opposite. Jim talked to his hypo-ish brother for a little while yesterday and successfully calmed him. (This will be temporary.)

One of the things the brother lamented is that it’s hard to calm himself down when the news and everyone’s discussions are “All Covid-19, all the time.”

Well yes. But what else is there to talk about? There are no sports, no dining eating out, I can’t go out dancing. My tutoring continues, but that’s not really a big conversation starter.

Even climate blogs are discussing Covid-19. James Annan has some posts on modeling Covid-19 transmission, death etc. I’d been sort of mulling over, “Given the factors people talk about…. how would I create a cheesy toy models to help me better understand the evolution of something like this?” Just thinking about it I realized there are lots of parameters that matter. Their possible size ranges from (pretty small, to really big). James is discussing how to estimate some of those and the possible consequences based on the sizes. Plus, he’s launching from some know epidemiological matters rather than just reinventing the wheel.

Willis has posted a nice graphic showing some death rates by state and added a bit to show “estimated date to equal # of cases of flu” based on the curve fits. (All his readers always bring up flu).

He’s written more, but I was interested in Death v time by State on semi-log paper, and he did it. He’s done a similar thing for the world, but I always find it hard to link usefully to specific posts in Facebook.

I know many people have posted their musings on how to stop this rise in deaths and infections. Mine are… dunno. Social distancing could help. I can certainly reduce my chance of getting sick by staying home, so I am. I could say other things, but I’ll limit that to comments.

So feel free to continue with the only topic anyone is really talking about these days. (Yes. Going off topic is also allowed.)

1,025 thoughts on “All Covid-19, All the time!!”

  3. Italy has now had four straight days with new cases and deaths below the high set on March 21.

    I was wondering why the quarantine period for asymptomatic people was 14 days, but then I remembered that a lack of symptoms does not prove a lack of infection. OTOH, it's not at all clear whether an asymptomatic person is an active carrier.

  4. Another data point on how impotent the media is. Trump approval rate at all time high of 49%, 60% approve of his handling of the coronavirus. Perhaps this is just the normal rally to the flag effect in a time of crisis. I don't think he has handled this particularly well, it's his typical performance, but I also admit I haven't paid any attention to him either. Why would I?
    .
    Case in point is the current "Aaaaaggghh, Trump wants to reopen the US economy by Easter, experts say he can't do that!!!!!" meme. I'd like to see some actual predictions/estimates from these experts that call into question everything Orange Man says, but as we know they are all very good at avoiding accountability as they just generalize, find anyone who supports them, and label those people as the "experts" pretending there is a consensus position.
    .
    One credentialed person with an actual estimate:
    University of Florida epidemiologist: COVID-19 pandemic deaths to peak in U.S. in 2-3 weeks
    https://www.thecentersquare.com/florida/university-of-florida-epidemiologist-covid–pandemic-deaths-to-peak/article_b8c4f2d8-6ec0-11ea-9b31-1fd74e7f7bbd.html

  5. Tom,

    I see no sign of a bending of the new case curve from a pure exponential yet. That could mean over 3 million total cases and 11,000 new deaths per day in two weeks. But maybe the curve will start bending soon. It did in Italy. OTOH, some other state may turn into New York.

    From your link:

    "Dr. William Schaffner, a Vanderbilt University infectious disease specialist, told CNN the patchwork of city and state shelter-in-place shutdowns will not be effective unless uniformly applied nationwide in containing the virus, which he said will peak nationwide over a six-week span beginning in about three weeks.

    "Asking a subset to remain sheltered in place, to remain in home” while others are returning to normal, he said, “that's more difficult to do.”"

    That completely ignores the economic disaster that a nationwide shelter-in-place shutdown for six weeks would cause. Cure worse than disease.

  7. Right, I don't think anyone really knows for sure. Everyone wants to be the heroic Cassandra and there is little benefit to being "heroically optimistic". We might be Italy, we might be South Korea, we are probably somewhere in between. It's going to get worse before it gets better and the media will pretend to be surprised when the counts keep going up without a nuanced view of the point on the curve we are at. "Total death counts up!", as if the reverse could be true.

  9. Today's new cases and new deaths in the US are still too close to a pure exponential model to say the curve is bending.

    Seasonally adjusted initial unemployment claims were 3,283,000 for the week ending March 21. The previous high was 695,000 in October 1982.

  10. I am wondering if we are going about this all wrong.

    Does anybody know if people can be *forced* to take the test for the Wuhan virus?

    I ask because last week an elderly man in New Mexico went to his doctor with the Wuhan virus, refused the test, and was sent home. Died on Monday. Tested positive yesterday.

    When I saw that, I asked myself: You can refuse the test? The government can shut down businesses, close churches, make people stay in their homes, but they can't make people take a simple non-invasive test even when there is good cause? Real question.

    If that is so, then we may be screwing our economy for no good reason. It seems that democratic countries that have gotten control of this have done so without shutting things down. Instead, they aggressively trace and test contacts.

    The reason R0 is large for Wuhan is that people remain infectious for a long time. Look at this graph for South Korea: recoveries lag identification by almost three weeks.
    https://en.wikipedia.org/api/rest_v1/page/graph/png/2020_coronavirus_pandemic_in_South_Korea/0/c221da076f6ea78d725880556fde94e23e92badc.png
    From: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_South_Korea#Statistics

    So even if there is a lag between becoming infectious and a positive test, most opportunities for transmission can be avoided.

  11. You have about 5 days before symptoms, so one would expect that lag at a minimum after social distancing efforts start to gauge the effectiveness of these things. The US certainly looks to be in the breakout stage still. The good news is that once the slowdown is detected it means that it has already been in place for a week or so.

  12. Mike M.
    My guess is a state government COULD force people to take the test for COVID-19. Also, they could say that you will be quarantined UNLESS you take the test. My understanding from law blogs (Volokh) is government has draconian powers in quarantine. This is long standing from pre-colonial times. It is a power states retain.
    .
    Not sure if the FEDS can… dunno.
    .
    BUT, obviously, this legal power is moot if we *do not have enough tests* to test people for the virus and to repeat testing from time to time.
    .
    Until such time as enough testing kits are available and distributed, stay at home orders are the only thing WE can do. Other countries can do other things because they have testing kits.
    .
    ***If that is so, then we may be screwing our economy for no good reason.**
    You are assuming we have enough testing kits. It appears we do NOT. So…
    .
    I would suggest that instead of clamoring to stop lockdowns, it would make more sense to clamor to get more testing kits out there. Then AFTER they are available, you can clamor for stopping lockdowns.
    .
    No strategy for what we could do IF we had testing kits is worth much while we LACK test kits. Right now we are locked down because we don't have them.

  13. It is an item of faith in the media that we will endure any economic pain to flatten the curve and save lives. This is clearly not the case. We will certainly endure some temporary economic pain but I doubt that will last longer than 1-2 months. The professional class can likely ride this thing out for 6+ months and everything in the media is from this viewpoint. These heroic warriors can carry the heavy burden working from home and getting sushi takeout. If things get really tough they will need to use paper towels for toilet paper. Oh the humanity.
    .
    The lower 50% paycheck to paycheck service industry workers cannot endure a long downtime. They have to buy food and pay rent, and eventually social unrest will force the professional class to ease restrictions regardless of their moral supremacy on saving lives. The dynamics at play will be interesting to watch, but I detect yet more culture bubble isolation so far in all the anecdotal stories.

  14. lucia (Comment #181603): "You are assuming we have enough testing kits. It appears we do NOT".
    .
    But South Korea did it, with less testing than we are now doing. They peaked at about 14K/day; the U.S. equivalent would be 92K/day. There were 74K reported tests yesterday, the actual number is much higher since many negative tests are not reported. Capacity has been rising rapidly. So we did not have the needed capacity last week, but it would that we now do have the capacity.

    ————
    Addition: The lockdowns were a reasonable initial response as a temporary measure. But we should be looking to move on after the end of the month.

  15. Tom,
    That's right: People are NOT going to endure economic pain forever. They won't because they can't. Most in retail are out of jobs right now. They soon won't be able to pay rent. They landlords can just forgive everyone's rent forever. They have mortgages and taxes to pay. The banks can't just forgive the mortgages; the creditors would then be out money. Some of those are the elderly who need the money to buy food, pay rent and medicine. The states need the taxes for uhm…. services. Well… yes services (and to pay state reps! 🙂 ) Teachers, police and firemen (not to mention other public employees) want to be paid so they can eat and pay rent or mortages.
    .
    Kids need to get back in school. Water needs to be treated (brother in law Robert is at the sewage treatment plant. Yes, he wants to be paid.) Pharmaceutal companies employees will want to be paid. All of this takes a working economy.

    So yeah, we need to get the economy going.
    .
    But all the attractive solutions involve *having available tests*.

  16. Mike M.
    **But South Korea did it, with less testing than we are now doing**
    They did it when they didn't have a full blown outbreak. We didn't. We now have the virus spread across the entire country. We have too many people exposed to track. For us, that toothpaste is out of the tube.
    .
    My question to you is how do we do that NOW. Avoid proposals that involve going back in history and implementing testing last February. Or even last week.

  17. MikeM
    **But we should be looking to move on after the end of the month.**
    We should be getting test kits in production and deploying them. That should be doable. But saying "move on" without also saying "get test kits out" is basically saying "let the virus rip through". That is NOT a good solution and will almost certainly ALSO slam the economy.

  18. What is the situation for test availability in the U.S.? I tried searching for it, but all I find are stories from three weeks ago.

    I do know that New Mexico has done over 7200 tests in the last 10 days. Per capita, that is a little more than South Korea managed at their peak.

  19. "At this time, in the U.S., the virus is not spreading in the community," she added. "For that reason we continue to believe that the immediate health risk from the new virus to the general public is low at this time.”

    This was Jan 27 from CDC.

    Not sure where the 'Trump wasted 3 months' timeline comes from.

  21. Mike N,
    Right now, I'm not concerned whose fault things are. What I would like to see is a plan to have testing in place with a provision to allow people who have been tested to be able to show that to employers and get back to work.
    .
    Ideally, we have people have provision to show it so they can do things like go to parks malls and so on.
    .
    Companies have started to have apps that people can track. The israeli tracker that snitched on the exposed who went out… if the creepy factor was gone, would work.
    .

  22. Re Earle (Comment #181618)
    March 26th, 2020 at 1:46 pm
    If the numbers at this web site are accurate it has been jumping by about 70k tests per day nationwide.

    https://covidtracking.com/us-daily/
    _____

    Earle, thanks for the link. I was surprised by State differences in positives and negatives as percentages of total tests. Don't know to what extent the differences result from lack of uniformity in reporting.

  25. Fed aid: The $2 trillion package approved by the Senate and now headed for the House limits aid to U.S.-incorporated companies with a majority of workers based in the U.S.
    .
    Guess what cruise industry? Bypassing all those US regulations, US corporate taxes, and using low wage international labor isn't always a plus I guess. They may be up a creek without a paddle. I don't think a lot of people will be booking cruises for a while, even after things calm down. They are full of seniors typically to make things even worse. As it turns out travel insurance had an exemption for pandemics.

  26. Lucia wrote: "But saying "move on" without also saying "get test kits out" is basically saying "let the virus rip through". That is NOT a good solution and will almost certainly ALSO slam the economy."
    .
    I agree with the sentiment, but I'm not sure how much of an answer testing would be. As a worst case scenario, a person who tested negative could be infected right after but now he, and those around him have got a piece of paper telling everyone there's nothing to worry about.

  27. lucia (Comment #181610)

    **"That's right: People are NOT going to endure economic pain forever."**

    True, and probably not much more than already, unless the situation worsens. It is possible, however, for people to endure a lot more.

    **But all the attractive solutions involve *having available tests*.**

    You can say that again.

  28. Oh the question of could the government force people to get testing: The force typhoid Mary.

    https://www.spectator.co.uk/article/the-curious-age-discrimination-of-coronavirus/amp?__twitter_impression=true&fbclid=IwAR1Nv_HoU419PcnoClxC459vQVZkrrUJlQ09dWoOV7ixYHPI54m1nis9M6E

    *********
    Typhoid Mary was a cook who moved from one rich employer to another in New York and Long Island, infecting seven households with typhoid between 1900 and 1907 before doctors traced her as the common cause of the infections. The key point is that she was in good health herself throughout. When confronted, she indignantly refused to submit stool samples for analysis, until eventually imprisoned for this refusal.
    **********
    Isolating her pretty much forever ended up being allowed.

  29. Earle (Comment #181624)
    March 26th, 2020 at 2:23 pm
    @ OK_Max

    If you read the summary for each state you see that many do not report negative test results. So the actual number of tests per day is greater by some unknown factor.

    https://covidtracking.com/data/
    _______

    Too bad. Obviously, would be good to know actual total number tested so we could see trend in percent who tested positive.

  30. OK_Max
    **It is possible, however, for people to endure a lot more. **
    Sure. Especially if it is involuntary. But we are asking people to endure a lot voluntarily. So we are asking people to *chose* to endure a lot. Which is different from them merely being *able* to endure something.

  31. The value of testing is to trace contacts so as to identify the infected before they have a chance to infect many others. So how much test availability is needed to accomplish that?

    At peak, South Korea had 4-7% positive tests. So it seems that is sufficient to gain control. Lately they have been running about 1% positive.

    So with 10K new daily identified cases in the U.S., it would seem that 150-250K daily tests would be sufficient. We might not be there yet, but we are probably close. Sadly, the required data do not seem to be available.

    But are we even trying to aggressively trace contacts? I have not seen anything to convince me that is so.

    Do some states have a problem with available tests? If so, why? Is the press reporting on that?

  32. Tom Scharf (Comment #181625)
    March 26th, 2020 at 2:35 pm
    OK_Max,
    Investing genius, ha ha.
    ______

    Not genius, my success, just dumb luck.

  33. Better info on face masks:
    https://slatestarcodex.com/2020/03/23/face-masks-much-more-than-you-wanted-to-know/
    .
    Obviously if they work for healthcare workers they can work for normal people. N95 are better than surgical. Improperly worn N95 masks are effectively a surgical mask, and almost everyone wears them wrong including healthcare personnel. Normal people are rarely disciplined enough to wear masks even when told to do so by doctors when someone in their family has the flu.
    .
    CDC was against normal people wearing face masks before the coronavirus. The author surmises the CDC recommendation against normal people wearing a mask may be because of the usual "hasn't been proven definitively medical standard", such as we get with off label drug use.

  34. Being able to test yourself at home for the coronavirus will be a huge breakthrough. It might take a while but solves a lot of problems.
    .
    Someone at the WSJ suggested giving all first responders the coronavirus intentionally while they stay for two weeks at empty resorts. Out of the box thinking there.

  35. MikeM, I think the number of tests needed is much higher. What portion of people getting tested are aymptomatic?

  36. 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 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.

  37. Police in China have RoboCop/Terminator style helmets that can identify potential cases based on heat signature.

  38. Miken. (MikeN?),
    The Terminator movies do remind one of China, with CCP in the role of the machines. 😉

  39. Ed Forbes,
    Of course, no nation can assign infinite value to each life, and any that do so will destroy their economies. But touchy-feely-types will never have a serious conversation about costs and benefits when it comes to expenditures to save lives. Hopefully, cooler heads will ultimately prevail.
    .
    Extra Federal expenditures are already looking well over $2 trillion, and who knows the State expenditures. I will be shocked if the pandemic ends up costing the economy less than $10 trillion. If all that saves 5 million lives (which seems unlikely) then the cost is $2 million per life saved….. it is bonkers.

  40. Tom Scharf (Comment #181637): "Being able to test yourself at home for the coronavirus will be a huge breakthrough. It might take a while but solves a lot of problems."
    .
    I don't see how it would help. Perhaps that is because I don't actually know what such a test might consist of.

    It seems to me that a home test would likely have a very high rate of false negatives, thus giving people encouragement to spread the virus. Would the authorities know about positive tests? If not, it would defeat the main value of testing.

  41. Ed Forbes (Comment #181639)

    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.
    ______

    Presuming you are retired, you and other retirees lowering your own risk shouldn't be much of a detriment to the economy. It could even be good for the economy in some ways.

  42. Max
    I have a much higher risk to my wellbeing due to rampant inflation due to runaway printing of money than I do to this virus.
    .
    Rampant Inflation for those on a fixed income is just another form of death.
    .

  43. From March 22-25, Washington state averaged 236 new cases per day, with no real trend. Today they reported 111. So maybe there is reason for hope.
    ——-
    While I am at it: What Ed Forbes said.

  44. Ed Forbes (Comment #181648)
    March 26th, 2020 at 4:38 pm
    Max
    "I have a much higher risk to my wellbeing due to rampant inflation due to runaway printing of money than I do to this virus.

    Rampant Inflation for those on a fixed income is just another form of death."
    ___________

    Good point, Ed. Inflation seems likely, rampant inflation is a possibility. Do you have a plan for protection?

  47. What part is the scarecrow? That we have more infections than China or that Trump the Chump frittered away the lead time we had to prepare?

  48. MikeM
    **The value of testing is to trace contacts so as to identify the infected before they have a chance to infect many others. So how much test availability is needed to accomplish that?**
    A freakin' lot if you already have 100,000 infected, everyone has just been mingling normally and they 100,000 are no spread over the entire country.
    .
    With a 1% infection rate. If testing is random, you need to test 10,000,000 to find 100,000 infected. If the infected. With mingling, most of the infected will have a HUGE number of contacts..
    .
    The cashier at my grocery store probably has 200 contacts a day. If she's infected, you have to test all 200.
    .
    Korea started when their cases were localized. We didn't. You can't point to the "ease" in Korea and just wave away that our situation is already different in ways that make it harder.

  49. Thomas Fuller,
    I don’t recall anyone on this blog suggesting the Wuhan coronavirus is a hoax. Unless you can prepare a list of commenters who said that, you’re invoking a strawman. Your TDS is confusing you. I hope you will be OK if Trump is re-elected…. a real possibility.

  50. SteveF (Comment #181643).
    **I will be shocked if the pandemic ends up costing the economy less than $10 trillion. If all that saves 5 million lives (which seems unlikely) then the cost is $2 million per life saved….. it is bonkers.**
    _______

    I feel fortunate to live in a country that would spend $2 million to save a life. And if it were my life, I hope the country would be willing to spend a little more.

  51. OK_Max,
    You certainly are fortunate that you live in a very wealthy country. But really, I think you are nuts.

  52. Max “ Good point, Ed. Inflation seems likely, rampant inflation is a possibility. Do you have a plan for protection?”
    .
    Protection from inflation? Limited…
    I have refinanced my house at long term low interest to pay off credit card debt. Sold off extra cars such as my Mustang and classic Vet (😩) to generate cash to reduce expenses and debt. Working to get my monthly and annual expenses as low as I can get them. Will hold onto cash savings until (if) the wheels come off the economy with high inflation, then decide based on current condition.
    .
    None of the above hurts me any direction the economy goes and gives me breathing room if inflation starts to cut my purchasing power from my fixed pensions.
    .

  53. Thomas Fuller,

    The frittering away was done at the CDC with their slow rollout of too few and dud test kits and the FDA. That technically makes Trump responsible, but there's plenty of blame to go around. I'm sure that if Trump had raised hell about the CDC at the time, you and the press would have tried to crucify him over that too.

  54. lucia (Comment #181654): "A freakin' lot if you already have 100,000 infected, everyone has just been mingling normally and they 100,000 are no spread over the entire country."
    .
    It is not clear to me why the number matters. Why is 100K different from 10K or 1K if they have been mingling normally and spread all over the country.
    .
    lucia: "With a 1% infection rate. If testing is random, you need to test 10,000,000 to find 100,000 infected."
    .
    No, with 1% infection rate you have to test 330 million to find 3.3 million infected. With a 0.03% infection rate have to test 330 million to find 100 thousand infected. Etc.
    .
    lucia: "If the infected. With mingling, most of the infected will have a HUGE number of contacts."
    .
    Indeed. But that is true with 1000 infected or 100K infected.

  55. MikeM,
    If it's not clear to you that numbers matter in a pandemic, then I don't think it's possible to clarify anything for you. Whether 1billion die is different from whether 1 dies. Whether we need to test 100 million to prevent lots of people dying is different from whether we only need to test 10 people. We need more testing kits to trace 100 million people than 10 people. It costs more to trace the contacts of 100 million people than 10 people.
    .
    If you don't see this, than no. I can't explain to you why the number of already infected and the extent of dispersal matters.

  56. Mike M

    **10,000,000 to find 100,000 infected**

    10^5 is 1% of 10^7. Your example of 330 x 10^6 / 3.3 * 10^6 is also correct. Both are correct. Not sure why you think your example makes mine wrong.

  57. 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.

  58. Thomas Fuller,
    Back here: ( http://rankexploits.com/musings/2020/cost-of-quarantine/#comment-181228 ) you said Wuhan Woo-Woo. Now again ( http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-181651 ) it's the Woohan WooHoo.
    .
    I'm sure you think you mean something with these baby sounds. All you are conveying to me is the impression that you are losing your faculties. I don't delight in saying this actually, instead I find I am faintly embarrassed on your behalf.
    .
    Pull yourself together and speak English man. Like an adult.

  60. Yeah, much more fun to rag on me than face the disaster that is the Trump maladministration. How many will die unnecessarily because of their sheer incompetence?

  61. Are you drunk or possessed? We'd like to speak with THOMAS now. Is Thomas in there?
    .
    [Edit: Christ Thomas, I'm not ragging on you. I don't have the first effing clue what you are talking about when you say 'the WooHan WooHoo'. Dead earnest. I don't understand if you are referring to the virus, the pandemic, the whole phenomenon.. What the heck are you trying to say there? ]

  62. This is why you don't let your thirteen-year-old nephew get access to your blog identity.

  63. My 10-year-old nephew would actually do a better job than Trump, let alone blogging for me.

  66. Thomas Fuller (Comment #181651)
    "Hey, we're Numbah One! Izzat worth a Woohan WooHoo?
    Not bad for a hoax."
    "My 10-year-old nephew would actually do a better job than Trump, let alone blogging for me."
    "Yeah, much more fun to rag on me than face the disaster that is the Trump maladministration. How many will die unnecessarily because of their sheer incompetence?"
    –
    The disaster, Tom [or nephew as the case may be] is the Chinese originated Wuhan virus.
    –
    Trump did try to slow it's passage to USA but you deliberately forget.
    –
    Blogging over at ATTP I commented that herd immunity is the natural way we cope with most epidemics.
    Look after the old folks and hope the rest of us get infected and immune without too many health issues in a slightly slowed down time frame. Helps to cope. Does not wreck the economy much.
    –
    I think my initial TDS was due to the dishonest picture pushed by the Democrats and the media. Certainly noone here was complementary 3 years ago.
    _
    No big tax detail leaks means nothing much there.
    No massive me too movement, so his past relationships were consensual.
    –
    He looks Presidential, sounds Presidential and acts that way. He tweets too much.
    –
    So is it the person the Press or your own innate view of the way things should be that triumph over all the good he has done and tried to do?
    –
    I could do a list but if you cannot see them already you will not be able to see them.
    Obama did a great job for decency, compassion and race relationships in being elected and acting as President.
    Trump does a great job for his stated purpose, making Americans proud of being Americans.
    He pushes the Confucius principle, make sure things are good around you then try to improve others lots.
    Give him a break.
    –
    Of course this is really for your nephew to read so he can take up blogging and hopefully and make the blogosphere great again.

  67. Re Ed Forbes (Comment #181659)

    "Protection from inflation? Limited…
    I have refinanced my house at long term low interest to pay off credit card debt. Sold off extra cars such as my Mustang and classic Vet (😩) to generate cash to reduce expenses and debt. Working to get my monthly and annual expenses as low as I can get them. Will hold onto cash savings until (if) the wheels come off the economy with high inflation, then decide based on current condition."
    ______

    Seems like a good plan, Ed. I would have kept the Vet.

  68. SteveF (Comment #181658)
    March 26th, 2020 at 6:18 pm
    OK_Max,
    You certainly are fortunate that you live in a very wealthy country. But really, I think you are nuts.
    _____

    That's because you are too old fashion to appreciate Modern Monetary Theory.

  69. What happens if you test positive for the Wuhan virus? If you are really sick, you get hospitalized. But otherwise, I *think* you are sent home and told to self-isolate. Is that right? But surely, anyone you live with must also self-isolate.

    Does anyone know how that works? You need food and other supplies. Do the authorities bring that to you? Or are you left to cope on your own? If the latter, then for most people there would seem to be little choice but to break isolation.

    All real questions.

  70. MikeM,

    Jim and I just got a card in the mail. It says it's from the CDC. The front says "President Trump's Coronavirus Guidelines for America".

    On the back it says "If someone in your household tested positive, keep the entire household at home."

  71. MikeM.

    The Guidelines I was sent by the Trump administration. They don't say how you are going to get food.
    .
    Many people have food in the house. Many people have friends or neighbors. Many people can call their village or state rep to ask how to get food. If you have money, you can get some local grocery stores to deliver, likely for a fee. You can probably get Amazon to bring you stuff. So it's not like everyone *must* leave to maintain self-isolation.
    .
    Of course, the ability to bring those who test positive provisions is contingent on the fraction of the population that is currently infected being low. If it gets high… well… you better have a lot of food at home. (In fact, if more than 5% are currently positive for virus, you really shouldn't want to go out and circulate for your own sake.)
    .
    This is clearly something those who are in charge of actually implementing and carrying out quarantines or isolation of contageon need to work out. That's GOVERNORS. You might want to drop a line to your Governor and ask him what the plan for dealing with people who test positive is in your state. Ask if food will be delivered and so on.
    .
    Obviously, if people who test positive don't self isolate voluntarily, the it will need to be enforced somehow. And if not, full lockdowns are going to need to continue (which will be worse for the economy.)

  72. OK_Max,
    Looks to me like MMT is mainly supported by Marxists and lightweight lunatics like Occasional Cortex. Even someone as lefty as Paul Krugman thinks MMT is wrong. From Wikipedia:

    “… economist and Nobel laureate Paul Krugman argues that MMT goes too far in its support for government budget deficits and ignores the inflationary implications of maintaining budget deficits when the economy is growing.[67] Krugman described MMT devotees as engaging in "calvinball" — a game from the comic strip Calvin and Hobbes in which the players change the rules at whim.”
    .
    So I guess most everyone must be too old fashioned to appreciate MMT. But not the Marxists who want to do away with capitalism.
    Good thing.

  73. Lucia,
    In my small city, lots of stores and restaurants are offering to deliver to your home. But not toilet paper. Amazon will deliver almost anything.

  74. lucia (Comment #181685): "If someone in your household tested positive, keep the entire household at home."
    .
    Thanks, lucia. I also got that card, read it, and forgot it. The text you quoted and that I repeated above is perfectly clear in isolation, but not so clear in context. The rest of the card is largely "stay at home as much as you can".

    Presumably, anyone who tests positive gets instructions that are both clearer and firmer. I would hope such instructions deal with things like getting food. But I would also think that information should be publicly available, so as to put people's minds at ease.

    I am thinking specifically of someone who is thinking that maybe they should get tested and is worried about the consequences of a positive test. Many people can not afford to lay in a 2+ week supply of food, or to pay for delivery. The FAQ's at my states DoH site do not address the issue.

    Sadly, I can easily imagine that the People in Charge have not thought that through.
    ———–
    Addition – The official UK web site says "ask your employer, friends and family to help you to get the things you need to stay at home".

  75. Mike M.
    They are guidelines, not laws.
    .
    If they actually identify you and quarantine you, they send a letter to you specifically.
    .
    Can you afford to buy 20 lbs of dried beans, a jar of beef broth paste so you can reconstitute, a 20 lb bag rice and a huge bag of onions? At least you'll have calories. The beans alone will give you enough calories for a person to get through 10 days.
    .
    Have a jar of multi vitamines on the shelf. If you are feeling flush, get four BIG jars of peanut butter, a 10 lb bag of bread flour and a jar of dried yeast. Or buy a big thing of oatmeal. Have some sugar around.
    .
    Prices are up. I bought lots of these 4 weeks ago precisely for the contingency that we'd have a hard lockdown.

  76. On ventilators from Cuomo's press briefing yesterday:

    "- COVID-19 patients average time on ventilator: 11 – 21 days (vs. 3 – 4 days for non-COVID-19 patients). "We have patients that have been 20 days 30 days on a ventilator. The longer you are on a ventilator, the more likely you are not going get off a ventilator"

    Now that I think about it, this is sounding somewhat more like polio than the flu. I think a lot of us are old enough to remember the pictures of wards full of patients in iron lungs.

    And still no sign of bending away from an exponential model in the US. Italy has now had five days without exceeding its high on new deaths or new cases.

  77. I know exactly how it works in FL. You can't get tested unless you are showing very clear symptoms * plus * have had known contact with someone who tested positive or has traveled to a hot spot recently. A large unknown number of people are at home with symptoms, can't be tested, and riding it out with mild symptoms. According to the CDC you put these people in isolation in your house.
    https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/index.html
    .
    Fever, cough, and a red flag shortness of breath are the main symptoms. You stay in isolation and ride it out unless you have trouble breathing, chest pain, become unresponsive, or a couple other things. They don't even really want you to go to doctor at all, but contact them as necessary when things change. You wait until they have had 3 days with no symptoms before they can leave isolation.
    .
    If you are caring for someone who is sick (and they are isolated in the home with their own bathroom, etc.) and you have no symptoms then it's a bit of a gray area. I would stay as isolated as possible but still go to the grocery store, etc.

  78. Here's what I think is a good article on calculation of mortality rate:

    https://www.worldometers.info/coronavirus/coronavirus-death-rate/

    Scroll down to the section: How to calculate the mortality rate during an outbreak

    "At present, it is tempting to estimate the case fatality rate by dividing the number of known deaths by the number of confirmed cases. The resulting number, however, does not represent the true case fatality rate and might be off by orders of magnitude […]

    A precise estimate of the case fatality rate is therefore impossible at present. "

  79. I can't emphasize enough that most people with mild symptoms can't get tested now (80% of cases?). If you just have a cough, that's not enough. This will change as more tests become available but it's a very strange situation.
    .
    You can't even really go to the doctor for a flu test to isolate the problem because they don't want potentially infected people in their waiting rooms. Stay at home, take two aspirin, call me in the morning.
    .
    The only way a lot of people will ever even know if they had coronavirus is a future antibody test.

  80. Tom Scharf
    **I can't emphasize enough that most people with mild symptoms can't get tested now (80% of cases?). **
    That was my impression. Which is why the people clamoring for us to somehow "do what Korea" did without also discussing lack of tests strikes me as a big blind to reality.
    .
    We can't do what Korea did unless we have enough tests. Based on reports of who can and who cannot get tested, we don't have enough.

  81. Right, there's no reason we need teams of healthcare workers doing contact tracing when so many people have the virus. The people themselves will do that work if you give them the tools to do so. Easy testing. If you knew someone who had it you would run to the store to get a test for you and your family. As it sits now you basically tell people who you have been in contact with you might have the virus, can't test for it, and neither can they even if they wanted to. Sub-optimal.
    .
    People are having a stress fit when they cough once or twice a day like they always have for the past year, they have become hyper-sensitive to their body, they convince themselves they are having chest pain. It's pollen season in FL and lots of people have various symptoms. Do you quarantine yourself for 14 days because of allergies? Is it really allergies? The irrational part of the brain is screaming "you're gonna die!". There is probably going to be a coronavirus stress syndrome. The happiest people around are going to be the recovered. You can't get it, you can't give it.

  82. SteveF (Comment #181687)

    **So I guess most everyone must be too old fashioned to appreciate MMT. But not the Marxists who want to do away with capitalism**
    ________

    Government spending to help us through the pandemic will be sort of an experiment with Modern Monetary Theory. We will see how it works out. I doubt business leaders and politicians who are for the spending see it as Marxist, but if they do they obviously don't care.

    Of course MMT is not the way of pure capitalism (laissez-faire) which would just let the pandemic resolve its self without the government stepping in. But we haven't had that kind of capitalism in a long time anyway.

  83. "Government spending to help us through the pandemic will be sort of an experiment with Modern Monetary Theory."
    —–
    Max,
    I don't think so. My admittedly poor understanding of MMT is that it is similar to generally accepted economics in most ways. If you want to assert that government spending to help us through a pandemic would *validate* MMT, I think you ought to explicitly make the case for why that is; why MMT predicts that this would be economically viable whereas more traditional economic thinking does not.
    [Edit: I should add, I don't think that traditional economic thinking finds that government spending to help us through a pandemic is not economically a good idea.]

  84. Put another way, would Paul Krugman agree with your premise that government spending to mitigate the economic impacts (recession / depression) of a pandemic would be an experiment that might validate MMT? I doubt it. I think Krugman would say absolutely government spending is necessary to mitigate the economic impacts, but that this has essentially nothing to do with MMT.

  85. Tom..
    I am now hypersensitive to my nose itching. I was especially so while shopping for groceries. I cough every day when I drink my first coffee… I'm pretty darn sure I have NOT had corona virus. If I had the case has been so mild it's less than a cold. I do wish there was an easy to get test because I know rhino-virus colds happen, and I'll definitely be stressed if I get that.

  86. lucia (Comment #181700): "We can't do what Korea did unless we have enough tests. Based on reports of who can and who cannot get tested, we don't have enough."
    .
    Perhaps it is a matter of priorities. We might well have enough tests to trace contacts *if* we make that the priority. But we don't have enough tests to test everyone with a cough, let alone do that and trace contacts. So we might be doing neither.

  87. Mike,
    Making something a "priority" does not make the impossible possible. We can't trace contacts of all the infected if we don't have enough tests to identify who is infected. Saying it's a "priority" wouldn't not change this.
    .
    Getting tests kits made and deployed has to happen before we can do what Korea did. The CDC and FDA appear to have f***ed up and operated in ways that made us have insufficient number of tests.
    .
    At this point we need testing capacity for any and every possible scenario.

  88. How many tests are sufficient?

    Edit: Does anybody know where I can find a good description of what South Korea did?

  89. It is encouraging that the government has the ability to drop the BS for ten minutes and get something done together. I imagine the a-hole house member from KY just sealed his fate in the next election. Now back to the original programming…

  90. The short answer on tests is how ever many people want. People in high exposure jobs would want tested daily or weekly, etc. I guess the answer is millions of tests until the outbreak stops.

  91. Tom Scharf,
    I agree with you. While there is a geographically disperse distribution of infected, people in high exposure jobs should want to be tested frequently. And we should want them tested even if asymptomatic. To slow transmission, the test needs to be for the virus not antibodies.
    .
    The group that needs testing now probably includes medical– which everyone things of– but also people like cashiers at the grocery store. ( I need to get cash to tip my cashier!!! I don't have any around the house though. I wonder if she has paypal? Or Stripe?)
    .
    I think we need more than 10 times the number of tests *per capita* than Korea used because *they acted quickly before it spread*. We didn't. It's spread. That makes a huge difference to the number we need.
    .

  92. Tom Scharf (Comment #181712): "The short answer on tests is how ever many people want."
    .
    That does not seem to be what South Korea did. So far, the best info I can find says about the drive through centers:
    "Doctors in full protective suits and goggles take the driver's temperature with an infrared thermometer and hand out a questionnaire to fill out. If you're running a fever and, in the doctor's opinion, may be at risk based on where you've been or whom you've contacted, you're eligible for a test."
    https://www.npr.org/sections/goatsandsoda/2020/03/13/815441078/south-koreas-drive-through-testing-for-coronavirus-is-fast-and-free
    From March 13, which was after the peak there.

    I think that is not much different than has been the case in New Mexico for the last week and a half.

  93. I don't think we can do South Korea testing at this point, it is too late. Now we will need far more tests because of the size of the current outbreak and the backlog of people who want tested. NYC will be a feeder for the virus to other areas for a long time. This seems like a genie out of the bottle thing. I wouldn't be surprised to see 100M+ tests having been done in the US a year from now.
    .
    Failure to identify the infected early will be the biggest lesson learned here. It's not like people didn't know that was the goal, they just screwed it up.

  94. Where I live, the great state of Alaska, we might be able to approximate SK effectiveness. It's purely guessing on my part, but it appears that we have a goodly number of tests.

    https://covidtracking.com/data/state/alaska/#history

    At present we have a ~3% positive rate. That may be due to really low transmission of the virus or it may be due to really poor screening of test candidates.

  95. An Italian doctor tested his entire village of a few thousand people and found a 3% positive rate. Half of them were asymptomatic.

  96. It is clear that I have failed to make myself clear.

    Testing is limited. It will be limited next week, next month, and next year. The available testing must be used to maximum effectiveness.

    There are two components to effectiveness:
    (1) The number of tests required to uncover each new case of the Wuhan virus.
    (2) The fraction of infected individuals that are uncovered.

    Those two components are in opposition to each other. The trick is to find the optimal balance.

    Objective (1) can be maximized by using the tests only under highly restrictive conditions. CDC tried that. It was an epic fail on (2).

    Trace and test can produce an excellent result on (1) while also doing well on (2). The odds of an infected person transmitting to the clerk at the supermarket or someone he passed on the street since they are extremely unlikely to receive the minimum infective dose. Transmission is only likely to/from people you are close bodily contact with or who spend significant time in the same room as you. Under the current social distancing rules, how many people would that be? 10? If you gave the bug to two of them, then 20% of tests would produce a hit. Very efficient. And that would probably be 90% of the people you infected. Very efficient.

    At the opposite extreme, we have random testing. If you test 10% of the population (not likely) and 0.1% have the bug, then only 0.1% of the tests produce a hit and 90% of cases are missed. (Epic fail)^2

    Priority should be on trace and test. Where you draw the boundary for who should be tested would depend on test availability. That should be supplemented by testing sick people. Where you draw the boundary for eligibility would depend on test availability. The balance between them could be determined initially by modeling then refined by experience.

    Testing everyone is not an option because it is impossible.

  97. Tom Fuller,

    If Trump has not done a good job at managing the problem, then what about Cuomo and de Blasio? In this country, mayors and particularly state governors have primary responsibility for their citizens safety, not the President. IMO, the responsibility for why the US is leading the world in coronavirus cases rests with Cuomo and de Blasio, not Trump.

    I haven't seen much sense coming from Biden, who is obviously blowing a major opportunity to look good, or other leading Democrats either. Some of the worst governed cities in the US have progressive Democrat mayors, Baltimore, e.g. Buttigieg, by all that I have seen, was not a particularly good mayor of South Bend.

  98. Ed, there is an unknown variable. What would the death rate have been if the shutdowns had not happened? It is very easy to look at the models and then claim all reduction is because of the shutdown.

  99. Thomas Fuller, where is this three month dallying by Trump?
    On Jan 27, CDC issued a notice that it is not spreading in the community.
    Should Trump have ignored this?

  100. Regarding contact tracing, the first person who died in the US came from Wuhan. They tested everyone he was in the airport shuttle with, about 60 people. All came back negative. Nevertheless, it is thought that one of them spread to the nursing home, which then spread to other nursing homes as staff and priests went from one facility to another.
    The first case in North Carolina was traced to having visited a nursing home in Washington.

  101. Italy had a new record number of deaths today, 919. Also, 46 doctors in Italy have died and 6,414 health care workers have tested positive out of 86,948 total cases. However, the exponential model that was a reasonable fit on daily deaths through 3/21 would predict over twice as many deaths at 1946. So the curve still seems to have bent. It just hasn't peaked yet.

    Btw, Johns Hopkins and a number of major media outlets around the world use worldometers.inf, where I get the numbers I use, as a source.

    https://www.worldometers.info/coronavirus/italy-numbers/

  103. Besides beans and rice, corn and beans will also give you all the essential amino acids you need. Wheat and beans probably also works, i.e. a bean burrito or bean nachos (just use real grated cheese, not that nasty liquid cheese that most places use). Or you could use a corn tortilla, although corn tortillas are a bit harder to roll up than a wheat flour tortilla. For a change, dried split peas also have all the essential amino acids and shouldn't cost all that much.

  104. I don't think it's impossible for China to have eradicated the epidemic.
    China's lockdowns, and use of other medical treatments, with more authoritarian enforcement, could have stopped spreading.

    India with about the same population has total cases under a thousand, though still increasing.

  106. OMG. Bill De Blasio sees a silver lining in the epidemic. It is reducing the prison population in New York. Because they have told the police to stop arresting people and are releasing inmates.

    The man is a public menace.

  108. DeWitt, using a time lag as they suggest would produce a mortality rate around 15%. I think it is the case that the early case total is too low and the denominator will catch up.

  109. MikeN,

    "I think it is the case that the early case total is too low and the denominator will catch up."

    I'm sure it will. But using current cases, which includes lots of people who were just diagnosed, for the denominator is pointless. We don't know and won't know for a while. You may have noticed the example where they thought the death rate for SARS was only about 4% until the final numbers came in and it turned out to be nearly 10%.

    The death rate is going to depend on whether the medical facilities are overwhelmed or not. It will also depend on the percentage of asymptomatic cases which haven't been counted. We won't know that until there has been widespread antibody testing after the new infection rate has dropped to negligible levels. China could give us that information if we could believe what they tell us. But I don't see how we can at this point. Perhaps the data from South Korea can tell us.

  111. mark bofill (Comment #181705)
    March 27th, 2020 at 11:45 am

    *Put another way, would Paul Krugman agree with your premise that government spending to mitigate the economic impacts (recession / depression) of a pandemic would be an experiment that might validate MMT? I doubt it. I think Krugman would say absolutely government spending is necessary to mitigate the economic impacts, but that this has essentially nothing to do with MMT.*
    _________

    Seems to me that huge amount of government spending on the coronavirus crises is right from the MMT playbook. I wonder whether you and I have the same opinion on what MMT means

    I will present quotes on Modern Monetary Theory (MMT), which give some explanation of the theory's meaning as I understand it, and then give my opinion on this theory.

    “Its (MMT’s) main message is that in principle there are no financing restrictions for large countries. A historical example is the financing of wars.”

    https://www.socialeurope.eu/coronavirus-crisis-now-is-the-hour-of-modern-monetary-theory

    “MMT has met with severe criticism, with detractors saying excessive government expenditure leads to high inflation. MMTers response is that the high inflation in some of these economies is because of governance (think Germany in 1920s, Zimbabwe today). If one sees some of the most highly indebted countries of today, such as Japan, US and so on, the problem there is of low inflation. In fact, MMTers turn the entire debate of public investment upside down. They argue that economists should not focus on an economy’s debt levels but instead focus on using the money to achieve economic objectives such as full employment, eradicate poverty and so on.”

    “Going by MMT, what could be a better government programme than a solution against Covid19 and easing the sharp economic crisis? Households are cutting down on consumption and businesses on investments. If the government worries about its budget constraint and does not spend, we are headed for a severe recession. And a recession will lead to higher deficits eventually, due to a slowdown in economic activity and lower tax revenues.”

    https://www.moneycontrol.com/news/business/markets/could-modern-monetary-theory-rescue-us-from-the-covid-19-economic-crisis-5061071.html

    IMO, MMT is not a cure-all for every economic problem (eradicate poverty?), but I believe there is a time and place for MMT, and our current crises with the coronavirus in the U.S. is one. Hopefully, the government spending will not lead to high inflation.

    I don’t know what Paul Krugman thinks about MMT as it relates to the coronavirus. I’m too cheap to pay for a NYTimes subscription to find out.

  112. Thanks Max.
    .
    "Seems to me that huge amount of government spending on the coronavirus crises is right from the MMT playbook. "
    .
    It is. My point is simply that huge government spending on the coronavirus crisis is not *uniquely* from the MMT playbook. It is also from the classic Keynesian playbook. Therefore, the success or failure of huge government spending on the coronavirus crisis with respect to the econom[y] does not validate MMT over traditional economics. You'd need to look at the ways in which MMT are specifically different from Keynesian economics. Wikipedia lists five (5) main tenets that are different, and none of those five would appear to be put to the test by the current situation.

  113. To support my claim that government expenditures as a solution to the coronavirus is also out of the Keynesian playbook:
    https://www.investopedia.com/terms/k/keynesianeconomics.asp
    "What Is Keynesian Economics?
    Keynesian economics is an economic theory of total spending in the economy and its effects on output and inflation. Keynesian economics was developed by the British economist John Maynard Keynes during the 1930s in an attempt to understand the Great Depression. Keynes advocated for increased government expenditures and lower taxes to stimulate demand and pull the global economy out of the depression."
    [Edit: My day starts bright and early before 5 AM tomorrow. Nite all, Max.]

  114. The total case curve may be starting to bend. I'm seeing increasing differences between the exponential model and the actual numbers for the last three days. But it will take a few more days to be sure.

    If we are seeing bending, then when the time the new deaths curve starts to bend will give us more information on the actual death rate. We still won't know the true number of infections though.

  115. Re mark bofill (Comment #181746)

    **Keynes advocated for increased government expenditures and lower taxes to stimulate demand and pull the global economy out of the depression."**
    ______

    Well, that does seem consistent with Modern Monetary Theory (MMT) in that it's fiscal policy, but mainstream Keynesian today puts more emphasis on monetary policy according to the linked wiki piece.

    Mainstream Keynesian’s main strategy for achieving full employment is through monetary policy ( lowering interest rates and increasing money supply) whereas MMT uses fiscal policy (government deficit spending). I believe the $2T aid package for the Covid-19 crises would come under fiscal policy though I don’t know all the details.

    On the monetary side the Fed is helping by funneling cash into the economy and assuring availability of credit, but has little room left to lower interest rates.

    I may sound like I know more than I do (unless you are an economist). There’s a lot I don’t know about this.

    https://en.wikipedia.org/wiki/Modern_Monetary_Theory

  116. Max,
    "I believe the $2T aid package for the Covid-19 crises would come under fiscal policy though I don’t know all the details."
    .
    Good point. I think you are correct in that. Viewed in that light, every government stimulus is an MMT exercise. I still suspect we are missing some crucial distinction; like you, I'm not an economist and I certainly am not an MMT expert.
    .
    [Edit: I withdraw my initial objection. It looks like you can say with perfect utility that the response to the pandemic is an experiment in MMT.]

  118. mark bofill (Comment #181759): "every government stimulus is an MMT exercise. I still suspect we are missing some crucial distinction; like you, I'm not an economist and I certainly am not an MMT expert."
    .
    I don't think that is true. What distinguishes MMT from more traditional economics is that there is essentially no limit to how much the government can borrow. Also, it seems to me that the MMT advocates think that wealth can be created just by printing money, but maybe that comes from people who don't really understand the theory.

  119. lucia (Comment #181762): "That should mean it detects the infection, not your reaction. THIS is what we need a lot of to start an effective method of isolating people at our current point of infection."
    .
    But it must be doing that without amplifying the genetic material, so it is probably not all that sensitive. That would imply a high rate of false negatives. In that case the proper interpretation of the test might be that the result is either 'positive' or 'inconclusive'.

    False negatives have the potential to do real damage since many would treat a negative test as a license to spread their infection.

    Catching, say, 70% of the people with the virus *now* rather than in 2-3 days is really valuable since you can then isolate the person *now* and start tracing contacts *now*. If the negative results are sent for a RT-PCR test, then all the cases caught by the more sensitive test would still be caught.

  120. People who test positive should not be sent home. If they live alone, they will be at risk if the illness takes a turn for the worse, which can happen very suddenly. If they live with others, then it places all the others at high risk of infection and possibly an enhanced risk of severe illness due to a high initial dose of the virus.
    .
    There are huge numbers of empty hotel rooms that could be used to isolate those who are infected but not seriously ill.

  122. Heck I don't know.
    https://www.investopedia.com/terms/e/economic-stimulus.asp
    It sounds to me like traditional economics / keynesian economics supports government stimulus including fiscal policy actions. Maybe that's where we're foundering, on the notion that monetary policy is the … what, primary or only tool in the keynesian toolbox.
    So yeah, no. One could argue that government stimulus isn't a good test of MMT specifically.
    What do you think Max?

  123. Mike M,
    “… seems to me that the MMT advocates think that wealth can be created just by printing money, but maybe that comes from people who don't really understand the theory.”
    .
    I suspect there is a great deal of misunderstanding, but among supporters are many who understand debasing currency via expanding government expenditures and simultaneous “borrowing” (ultimately by increasing money supply) will lead to inflation. The expenditure by government then effectively transfers wealth from people with fixed value financial instruments to those who benefit from government expenditure. It is just warmed over 1960’s thinking with a new name. Inflation is economically destructive…. and some people want that.
    .
    I worked with a fellow in 1973 who purchased a house that was absolutely the most he and his wife together could afford. He was “house poor” for a little while, but within a few years inflation had nearly doubled his dollar income. He used to joke that the federal government had paid for most of his (very nice) house.
    .
    It can, and likely will, happen again.

  124. MikeM,
    I think you are speculating about a false negative rate. It appears to be a two step test– some positives come in the 5 minute tests, more in a little longer.
    .
    But at that, quantifying would be nice. what do YOU call a high false negative rate? 1%, 10%, 50%, 70%?
    .
    **False negatives have the potential to do real damage since many would treat a negative test as a license to spread their infection.**
    .
    Even a test with a 50% false negative rate is better than letting 100% of the infected circulate, which appears to be what those wanting to end stay at home w/o testing seem to be suggesting.
    .
    And nothing prevents us from having a protocol where people with negatives go through a second test. We 'd still be catching some people FAST, which is better than not catching them.
    .
    You seem to be making conclusions about the impact of this test that
    *assumes* some particular protocol for using it. The protocol for using the test can certainly depend on both its estimated false positive and false negative rates.

  125. Sorry… Mike… I was waitig for a student and responded based on the beginning. Looks like you are thinking of protocols! 🙂

  126. lucia,

    With respect to false negatives, I was thinking of rapid influenza tests (RIDT): https://www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm

    But now I see that is a very different type of test. The new Wuhan virus test is of the type that CDC calls a Rapid Molecular Assay. I could not find any numbers on the influenza version of that at the CDC site except that is says it is better than RIDT but not as good as PCR. But it sounds closer to the latter than the former.

  127. The NYT has repeated at least 50 times in my reading that normal people should not wear masks, and shamed anyone who suggested differently.
    .
    NYT, today:
    More Americans Should Probably Wear Masks for Protection
    https://www.nytimes.com/2020/03/27/health/us-coronavirus-face-masks.html
    .
    "As the coronavirus pandemic rages on, experts have started to question official guidance about whether ordinary, healthy people should protect themselves with a regular surgical mask, or even a scarf."
    .
    Experts question official guidance! Ha ha. I was strangely under the impression official guidance came from experts. A whole new logical fallacy should be created called "appeal to unidentified expertise".

  128. If you were wondering why Italy and Iran are epicenters of covid-19 infection, the answer is One Belt, One Road. Italy was the only European country to sign on with China and, as a result, there were a lot of Chinese traveling back and forth. The same goes for Iran. Italy was warned not to sign on, but didn't take the advice. The way OBOR works, the Chinese will end up owning any country that signs on.

    Information on OBOR: https://thefederalist.com/2017/06/12/chinas-project-century-aims-unseat-u-s-worlds-dominant-power/

    OBOR and covid-19: https://thefederalist.com/2020/03/17/iran-and-italy-are-paying-a-hefty-price-for-close-ties-with-communist-china/

    Also, there is considerable circumstantial evidence that China has been less than honest about the consequences of the epidemic there, particularly the death rate. Here's one: http://www.asianews.it/news-en/Wuhan,-endless-queues-for-ashes-of-coronavirus-dead-cast-doubts-on-numbers-49673.html

    "During the epidemic, the dead were cremated immediately, without ceremonies and without specifying the cause of death. Now family members are waiting to bury the urns containing the ashes of their loved ones. About 45,000 urnes will be distributed in Wuhan alone. The number of coronavirus deaths in China is deliberately underestimated. In the days of the peak of the epidemic, the crematory ovens worked for 19 hours a day. Journalists Li Zehua, Fang Bin, Chen Qiushi have disappeared. Photos and videos of queues at Funeral Parlors and cemeteries are blocked on social media."

  129. You can call the $2T stimulus bill whatever you want, I call it the "you better give business and people the means to survive or they will never respect your lock down order" stimulus.
    .
    Just for scale $2.2T/330M = $6,667 per citizen.

  130. Tom Scharf (Comment #181776): "You can call the $2T stimulus bill whatever you want, I call it the "you better give business and people the means to survive or they will never respect your lock down order" stimulus."
    .
    Indeed. It is not really an economic stimulus act, it is an economic survival act.

    No doubt, it also has lots of pork, having been drafted by Congress Critters.

  131. Tom
    **The NYT has repeated at least 50 times in my reading….**

    And, of course, the probably make no comment this is an UTTER reversal of what 'experts' have been saying.
    .
    "We have always been at war with Eastasia…"

  133. Depends on the test. It is technically possible to amplify a signal without doing rt-PCR. One example I can think of which could be useful is the use of self priming primers which resulted in a coil of DNA of repeating sequences. A fluorophore or enzyme could then be attached to a complimentary primer which would then be used for amplification. Then there are chemical means of enhancement using reconstitution of functional enzymes. Unfortunately, it's been a few years and the state of tbe art has no doubt moved on and streamlined such methods.

  134. More refutation of Tom Fuller's Trump has been incompetent meme:

    https://pjmedia.com/trending/the-top-10-lies-about-president-trumps-response-to-the-coronavirus/

    For example: Trump didn't dissolve the White House pandemic office as claimed in the media.

    Biden accused Trump of "fearmongering" and "xenophobia" when Trump imposed the ban on US entry for foreign nationals traveling from China on January 31. Whether that actually helped is, needless to say, controversial, but it was Presidential action aimed to prevent spread of the virus that may well not have happened with a Democrat as President.

    On a per-capita basis, the death rate from covid-19 in the US is about the same as Germany and far below Italy, Spain, Iran and France. New York, OTOH at 38.7/million is above France and Iran on a per-capita basis.

    https://pjmedia.com/trending/what-the-media-isnt-telling-you-about-the-united-states-coronavirus-case-numbers/

  135. Ed,
    Yes, I noted the media was switching between absolute counts and per capita counts in a repeatable and very predictable way. A better comparison for absolute counts is Europe vs. the US, not individual countries as the populations are closer. Italy has 6x less people. Best are infection rates / death rates per capita, etc. Perhaps it's best to just concentrate on regions and breakout centers.
    .
    The media intent is both a desire to cause alarm to propel change and to cause alarm to sell their product. They do seem to go out of their way to not even try to show the full story. The US per state and county bubble charts are pretty good, but a bubble chart with infection rate / death rate is the best. Infection and death rates per square mile also would be useful.
    .
    Lists of who has the most cases mostly just follow population size since the virus has spread everywhere so these convey less information than most people think.
    .
    I want to know "If a hundred random people cough on me, where is the worst place to be?" and "Where are the places where I am most likely to encounter infected people?". This is infection rate and population density.

  136. I just sorted the US data based on deaths per million residents.

    The order for the top ten is:
    state population total deaths deaths/million
    New York 19,440,469 728 37.45
    Louisiana 4,645,184 119 25.62
    Washington 7,797,095 175 22.44
    Vermont 628,061 12 19.11
    New Jersey 8,936,574 108 12.09
    Michigan 10,045,029 92 9.16
    Connecticut 3,563,077 27 7.58
    Georgia 10,736,059 65 6.05
    District of Columbia 720,687 4 5.55
    Colorado 5,845,526 31 5.30
    Massachusetts 6,976,597 35 5.02

    So avoid anyone from New York, Louisiana, Washington and Vermont especially.

    I can do cases next.

  137. It is also a bit rich for the NYC media to be Trump bashing as they sit in the world's worst hot spot with both a progressive mayor, high taxes, and bluest of blue states. According to their counts they have the highest density of experts, science worshipers, and "more government solves everything" adherents on the planet. And yet they never saw this coming, apparently only The Wise And Powerful Orange Man could have saved them, but he has forsaken them.
    .
    New York City will survive, as they always do. They do seem to attract a lot of disasters. I wish them the best, it's going to be rough for a while.

  138. By identified active cases per current resident:

    state per million
    New York 2,514
    New Jersey 975
    Louisiana 566
    Massachusetts 459
    Washington 439
    Connecticut 355
    Michigan 354
    District of Columbia 346
    Vermont 317
    Colorado 291

    New York is by far the worst. I'm guessing that New York City is higher than the state total. Wearing a mask outdoors in NYC definitely makes sense.

  139. The NYT's does its job and examines what went wrong with early testing. A scathing review.
    https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html
    .
    "…large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels".
    "The C.D.C. also tightly restricted who could get tested and was slow to conduct “community-based surveillance,” a standard screening practice"
    "Dr. Stephen Hahn, 60, the commissioner of the Food and Drug Administration, enforced regulations that paradoxically made it tougher for hospitals, private clinics and companies to deploy diagnostic tests in an emergency."

  140. By the way, at 2,514 active cases per million residents, New York has more than twice as many as Italy at 1,157. Although I'm sure that there are areas in Italy with higher rates of active cases.

  141. Tom Scharf,

    It's a little hard to blame all of that on Trump, but I'm sure they'll try. Also, I doubt that this lurid example of government incompetence will have any effect on the party of more, and more centralized government.

  143. Re mark bofill (Comment #181769)

    " One could argue that government stimulus isn't a good test of MMT specifically.

    "What do you think Max?"
    ______________________

    Yes, not a good test of MMT specifically, not a test of MMT for "all seasons," not a test as a solution for every economic problem that exists or could come along in the future. The pandemic is not only a unique problem, but is only one kind of economic problem.

    I may (or may not) try to address this subject later when I have had time to give it more thought. In the meantime, in the interest of further clarification (or confusion) regarding the different schools of economics, I will quote selected statements from the linked source on descriptions of (1) New Keynesian Economics (the mainstream), (2) Post-Keynesian Economics (not many proponents), and (3) Modern Monetary Theory.

    https://www.pragcap.com/a-cheat-sheet-for-understanding-the-different-schools-of-economics/

    **New Keynesian Economics**

    Overview – The New Keynesians are the adaptation of the Old Keynesians who responded to the criticism of the New Classicals in the 1970s and 80’s by creating an updated model of the economy to help explain some of the Keynesian failures of the 70’s.  Most of the “economics” one learns today is closely related to or directly related to New Keynesian economics.  It has become, by a wide margin, the dominant model used by policymakers.

    Mission Statement – Although economic agents are rational we believe policymakers can improve economic stability and help attain full employment through various stabilization policies designed to combat a variety of market failures.

    General view of the economy – Economic agents are rational, but markets are imperfect due to phenomena such as “sticky prices”.  This can result in broad market failures leading to recession.
    How to fix the economy – New Keynesians will generally deviate towards the use of Monetary Policy, but will at times also recommend fiscal policy to help stablilize the economy.

    ** Post-Keynesian Economics**

    Overview – A branch of Keynesian economics that portends to get back to what the “true Keynes” thought about the economy and how to improve it.

    Mission Statement – JM Keynes had it all right all along.  Involuntary unemployment is the result of aggregate demand shortages resulting primarily from failures by firms to maximize investment.

    General view of the economy – Capitalism exists on an inherently unstable foundation and will at times require some forms of government intervention to achieve prosperity.

    How to fix the economy – Counter-cyclical policies with a focus on fiscal policy.

    **Modern Monetary Theory (MMT or Chartalism)**

    Overview – A heterodox school associated with a branch of the Post-Keynesian school of economics that has become very popular on the internet in the last 10 years.

    Mission Statement – There is no economic problem that fiscal policy can’t solve.

    General view of the economy – Capitalism is naturally flawed and can only operate at full capacity if the government is used to permanently fill any demand shortages that exist.

    How to fix the economy – Fiscal policy in the form of tax cuts and spending increases in addition to the implementation of a government Job Guarantee to employ anyone who wants a job.
    ____________

    This source goes on to say “Most of the “economics” one learns today is closely related to or directly related to New Keynesian economics.  It has become, by a wide margin, the dominant model used by policymakers.  Although it adopted the term “Keynesian” in its name the school actually pitches a fairly broad tent using some neoclassical foundations as well as Monetarist perspectives.” Notable Pundits – On the liberal side: Paul Krugman, Brad Delong & Joe Stiglitz. On the conservative side:   Greg Mankiw, David Romer & Olivier Blanchard.

    Other schools of economics also are described: Austrian, Behavorial, Classical, Market Monetarism, Marxism, and New Classical. The descriptions are brief and not highly technical, making for easier reading. Again the link is https://www.pragcap.com/a-cheat-sheet-for-understanding-the-different-schools-of-economics/

  145. Mike M. (Comment #181765)
    "What distinguishes MMT from more traditional economics is that there is essentially no limit to how much the government can borrow."
    ________

    Mike, I think MMT people believe there is a limit. If they didn't, I see no reason why they wouldn't propose a Covid-19 rescue package giving 90% of Americans $100,000 each or even more, rather than a measly thousand or two. None are making such a proposal that I know about.

    Perhaps I misunderstand your statement.

  146. Previously in (Comment #181791) i said:

    "The pandemic is not only a unique problem, but is only one kind of economic problem."

    I shouldn't have said the pandemic "is only one kind of economic problem."

    Indeed, the pandemic has resulted (or will) in all kinds of economic problems.

  147. Lucia, you have misused Eastasia.
    The key line is not
    'We have always been at war with Eastasia.',
    but
    'Have we always been at war with Eastasia?'.
    The point is forcing people to say what they know is not true.

  148. Golfing tidbit:
    The course I frequently play here in Florida yesterday set a new record for number of players for one day…. today was not far behind. I don’t think people are terribly frightened by the illness….. probably half the players were over 65. The course management did ask you to not shake hands.

  149. Tom Scharf,
    “Just for scale $2.2T/330M = $6,667 per citizen.”
    .
    Indeed the scale is huge. It is more than huge…. it is explicit wealth transfer. I will not get a dime that can be documented; one son (relatively low income) who was already laid off, will benefit hugely. Another son, (relatively high income) will get nothing. Never let a crisis not justify more wealth transfer.

  151. SteveF (Comment #181797)
    March 28th, 2020 at 5:37 pm
    Tom Scharf,
    “Just for scale $2.2T/330M = $6,667 per citizen.”
    .
    Indeed the scale is huge. It is more than huge…. it is explicit wealth transfer. I will not get a dime that can be documented; one son (relatively low income) who was already laid off, will benefit hugely. Another son, (relatively high income) will get nothing. Never let a crisis not justify more wealth transfer.
    ________

    Yes, it is huge. Like you, I won't be getting any free cash. I would like some, but I can't always get what I want. I do take comfort in knowing I don't really need any.

  154. mark bofill (Comment #181798)
    March 28th, 2020 at 5:57 pm
    Re "On the lighter side of the MMT discussion"

    Good one! I don't agree with the Bee's politics, but it has some talented writers.

  155. DeWitt,
    "This legislation may prove the biggest one-day expansion of government power ever."
    .
    I am shocked, *shocked* I say by this!

  156. OK_Max,
    "……I can't always get what I want."
    .
    You missed your calling as a writer of rock music lyrics.

  161. OK_Max (Comment #181791)
    The link below gives a reasonably good explanation of MMT from an Austrian economist perspective.

    https://mises.org/wire/mmt-even-more-dubious-aocs-green-new-deal

    Both Keynesian economics and MMT present no new ideas but simply attempt (but fail under scrutiny) to rationalize bigger government and government spending. Politicians and there big government friends from the intelligentsia like these so-called theories because they give their crude actions that governments have used over long periods in history a luster of being justified with valid theories.

    I suspect that Krugman's apprehension with MMT comes from the same line of thought that economists use to justify minimum wages. The theory that says minimum wages lower employment can be obscured in empirical economic studies that ignore or mishandle confounding factors. This is more readily done when the minimum wage is relatively lower, but would become apparent if the counter argument were taken up by the proponents of a minimum wage when they are presented with the challenge that if $15 dollars an hour is beneficial than why not $50 an hour.

    My twin granddaughters in MN are taking an advanced economics course in high school and when I asked who authored the text book they said Paul Krugman. I told them that Krugman was a partisan and while his economic school of thought might be popular currently there were other schools. They are independent thinkers and skeptical so they have that on their side and I hope use their grandfather's strategy of giving the teacher/professor what they wanted to hear without actually endorsing that point of view.

  162. DeWitt Payne,

    "Amid warnings from public health officials that a 2020 outbreak of a new coronavirus could soon become a pandemic involving the U.S., alarmed readers asked Snopes to verify a rumor that U.S. President Donald Trump had “fired the entire pandemic response team two years ago and then didn’t replace them.”

    The claim came from a series of tweets posted by Judd Legum, who runs Popular Information, a newsletter he describes as being about “politics and power.” Legum’s commentary was representative of sharp criticism from Democratic legislators (and some Republicans) that the Trump administration had ill-prepared the country for a pandemic even as one was looming on the horizon.

    Legum outlined a series of cost-cutting decisions made by the Trump administration in preceding years that had gutted the nation’s infectious disease defense infrastructure. The “pandemic response team” firing claim referred to news accounts from Spring 2018 reporting that White House officials tasked with directing a national response to a pandemic had been ousted.

    Rear Adm. Timothy Ziemer abruptly departed from his post leading the global health security team on the National Security Council in May 2018 amid a reorganization of the council by then-National Security Advisor John Bolton, and Ziemer’s team was disbanded. Tom Bossert, whom the Washington Post reported “had called for a comprehensive biodefense strategy against pandemics and biological attacks,” had been fired one month prior.

    It’s thus true that the Trump administration axed the executive branch team responsible for coordinating a response to a pandemic and did not replace it, eliminating Ziemer’s position and reassigning others, although Bolton was the executive at the top of the National Security Council chain of command at the time."

    https://www.snopes.com/fact-check/trump-fire-pandemic-team/

  163. Thomas Fuller,

    When politics are involved, I don't believe that Snopes is a reliable source. My source may not have been reliable either, though.

    Given how poorly the supposed experts at the CDC and FDA performed early on, I seriously doubt that a White House team would have changed things.

  164. Thomas
    ** Tom Bossert, whom the Washington Post reported “had called for a comprehensive biodefense strategy against pandemics and biological attacks,” had been fired one month prior.**
    He was calling for something that did not exist. So, this is actually evidence that program was not "disbanded". Programs can only be disbanded if they already exist.
    .
    Bear in mind: Some of what people were working on was response to biological attacks. As in: terrorists releasing anthrax in subways or the Superbowl and so on. The response for that has some similarities to a pandemic, but also has huge differences.

  165. TDS on full display today:
    .
    Pelosi: “His denial at the beginning was deadly,” Ms. Pelosi, a California Democrat, said on CNN’s “State of the Union.” “Now I think the best thing would be to do is to prevent more loss of life.”
    .
    NY Gov Cuomo: Mr. Trump, when he said he was considering a quarantine for the region, offered no details about how his administration would enforce it. Speaking to CNN, Gov. Andrew Cuomo of New York criticized the idea, calling it “a declaration of war on states.”
    .
    Trump is definitely doing way too little and way too much simultaneously. I don't give much credence to Trump the genius, but one could argue he setup that trap and they walked right into it.

  166. Lucia: Those fired would have been invaluable in shaping our early response.

    Tom Scharf, if one argues that Trump is setting up political traps at this particular time it speaks less well of him than what many Democrats are saying.

    I wonder how many friends he made in Michigan with his spat with the state's governor? Did he set a trap for her? Did she fall into it?

    Who is in a better position to appreciate the nuances of the political trap Trump set–the 4,650 in Michigan with the virus or the 111 who have succumbed to it?

  167. Tom Scharf,
    "TDS on full display today"
    .
    TDS is on full display *EVERY* day, just turn on any MSM outlet and watch for half an hour. Doesn't matter the problem, Trump will be blamed, if not for causing the problem, then for making it worse. I stipulate that Trump often acts like a jerk, and often presents his policies poorly. But his policies are unrelated to his poor presentation of them, and unrelated to him acting like a jerk.
    .
    Trump appears to have driven the MSM absolutely bonkers. Really, they seem to me unable to think rationally about anything even remotely related to Trump. Maybe it stems from having policies put in place they very much disagree with, by someone they think is a jerk.

  168. Fuller, you are rather obsessed with blame here. It is truly magical thinking that had some government bureaucrat in an invented job outside of the CDC, NIH, and FDA been present that the outcome would have changed measurably. Feel free to live in your alternate history universe where Clinton prevented everyone from dying, it's not falsifiable. Throw in some unicorns and rainbows while you are at it.
    .
    This is not a single point of failure crisis, it is a pandemic that all governments are struggling with, even favored ideologies. Every city, county, and state government had many options available to it and months of warning for this crisis. They didn't even bother buying more masks, think about that. There isn't a single person in the entire medical response hierarchy who didn't think testing was vitally important, and yet it was still flubbed.
    .
    This is exactly how I would expect bureaucratic sclerotic government agencies to react to an unprecedented event. Sluggish and inept followed by slowly getting their act together and becoming effective. Some people apparently expect that government will handle this type of thing well, I harbor no such illusion regardless of who is in charge.

  169. Thomas
    **Lucia: Those fired would have been invaluable in shaping our early response.**
    Oh? I think you are assuming that. Jim worked with DHS on the response to military threats. I'm not convinced your claim is true.
    .
    In fact, lots of experienced people were changing jobs when administrations changed as priorities changed. This often happens with administration changes. (One guy working in projects involving bio-agents left because…. uhmm… he left some sort of secret materials in a pouch on an airplane. These were found by a reporter who informed the Feds. This was not publicized much.)
    .
    But beyond that: that's a subject change relative to evaluating whether Trump "disbanded" something. Even though Snopes "interpretation" is that he did, their interpretation is based a person who suggested something be CREATED being fired. But if that thing had not previously existed, it couldn't be disbanded. So Snopes evidence is that it was not "disbanded". It is merely that Trump failed to *create* something that had also not existed in the previous administration.
    .

    **I wonder how many friends he made in Michigan with his spat with the state's governor? Did he set a trap for her? Did she fall into it?**
    Well… I don't know the answer to those. But they appear rhetorical. 🙂

  171. I think those who favor ever bigger government like to personalize it when the government fails. "If my guy or my party were in power the outcome would have been much better". Unfortunately it seems to work and distract the voting public from looking at the real problem: the inefficiencies of government.

  172. Re Kenneth Fritsch (Comment #181809)

    Kenneth, thank you for your link to the explanation of MMT from an Austrian economist's perspective.

    Given the Austrian School of Economic’s aversion to government involvement in the economy, I thought this School would disapprove of what governments have been doing in response to the coronavirus pandemic. But then I saw the following Mises quote in your link:

    Ludwig von Mises, speaking in 1951 on wartime finance:
    “What is needed in wartime is to divert production and consumption from peacetime channels toward military goals. In order to achieve this, it is necessary for the government to tax the citizens…”

    I haven’t found what Mises or other founders of the Austrian School said about pandemics specifically (maybe you know), but I see a parallel between fighting a war and fighting a pandemic. If Mises were alive today, I wonder if he would say governments are doing the right thing about coronavirus providing their actions are financed through taxation.

  173. lucia,

    "…Snopes "interpretation"…"

    That's a classic example of why I don't trust Snopes when politics are involved. They will always "interpret" things to favor the progressive view. And the idea that yet another government group duplicating other agencies would have improved the response is indeed magical thinking.

    Speaking of magical thinking, the first M in MMT should stand for Magical not Modern.

  174. If we are serious about the problems caused by our reactions or lack of reactions to a COVID-19-like pandemic, I would think there would be a model that looked at the following (at least from my perspective):

    1. The much higher death rate of the elderly and higher rate of the younger population already weakened health-wise from the virus and non-virus causes.

    2. Expected outcomes based on concentrating mitigation efforts on the most susceptible groups and not shutting down the economy based on a non-selective strategy.

    3. Consideration that the elderly and a higher than normal percentage of the younger compromised health-wise do not hold jobs and thus are not critical to keeping the economy up and running.

    4. A breakdown from both an economic and health standpoint of the costs of shutting the economy down and including the federal, state and local government dollars spent in reaction to shutting down the economy.

    5. Were attempts to broaden the curve of the number of cases over time – in order to avoid overwhelming the healthcare system -successful in significantly reducing the number of cases and deaths or did it merely avoid a worst case healthcare capacity crises?

    6. How much did regulations and adherence to those regulations get in the way of responding in timely fashion to the crises in general and especially in hospitals attempts to avoid being overwhelmed?

    7. Could a more selective process in handling hospital cases been administered and could it have had a significant effect in avoiding an overwhelming of the system?

    8. How much did save-lives-from-COVID-19-at-any-cost thinking get in the way of a more reasonable and less extreme reaction?

    I believe that the reactions to the COVID-19 crises have set a precedent for reaction to a crises of unknown extent and would thus motivate a study/model of these reactions. If the thinking that we should attempt to save lives at any cost prevails such a study will not be made or if made ignored since the reactions are not limited.

    It would appear that overwhelming the healthcare system has been the primary concern with this pandemic and a prime target for study – and a study that looks for efficient ways to accomplish a favorable outcome and not one that merely opens the spigots for near unlimited government spending.

  175. OK_Max (Comment #181820)

    I suspect the thread of Mises' message from which that comment was excerpted involved a common libertarian message which is that if the populace of a nation going to or at war would see in direct fashion the cost of that war by way of real time taxation ii would require much more convincing by the government to go to war. Thus most governments have historically used borrowed and printed money to fight wars.

    A number of libertarians do not see a limitation on what private agencies can do versus governments and further would be required to be more efficient without the power of coercion that governments possess. Mises and Rothbard had somewhat differing views about these matters with regard to extent.

  176. Kenneth,

    I doubt that the Austrian school or any other school of economics would say that a country should effectively commit suicide by not doing everything possible to survive an existential crisis, specifically a war, even if that included printing money. Note that you don't always have a choice about going to war. Countries have been invaded. The question that needs to be answered is whether COVID-19 is an existential crisis. If it isn't, then shutting down the economy for an indefinite time may be a serious and perhaps dangerous overreaction. A cure shouldn't be worse than the disease. "It became necessary to destroy the village to save it." [Peter Arnett quoting an unidentified US Major, 2/7/1968]

    That brings up the subject of ventilators. I would like to know the survival rate for COVID-19 patients on ventilators. I suspect it's low, especially for patients who had a low life expectancy before infection. Whether to use or how long to use artificial ventilation is usually covered in Advanced Directives and DNRs. I doubt most people would want to live on a ventilator for an indefinite time. At least an iron lung allowed you to talk and eat. That's hard to do with a tube down your throat.

    I found one article that said the survival rate was 50% if you needed a ventilator and that about 50% of those initially admitted to intensive care would need ventilators. An article in The Lancet reporting on cases in China said that of 32 patients that required invasive mechanical ventilation, 31 died. That's not very good odds.

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30633-4/fulltext

  177. Through March 28, the total case curve in the US still seems to be bending. An exponential model gives 176,379 cases. The actual number was 123,578. I don't have a model for New York, but I don't think all the bending can be explained by New York alone.

  178. If you want to know why New York is a hot spot for COVID-19, read the timeline here: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_New_York_(state)

    Cuomo and de Blasio had the same information as everyone else and had primary responsibility for the safety of the people of New York and New York City.

    "On March 5, Mayor de Blasio says that coronavirus fears should not keep New Yorkers off the subway, riding from Fulton Street to High Street in a public press attempt to demonstrate the safety of the transportation method."

    "Also on March 6, an article appeared in the New York Post stating that while Mayor de Blasio assigned responsibility for the lack of N95 masks and other PPE supplies to the federal government, the city never ordered the supplies until that date."

    Too little, too late.

    I plotted the New York case data. It looks like New York could explain more than 100% of the bending of the US curve. That probably means that other hot spots are picking up the slack.

  179. DeWitt,
    "The question that needs to be answered is whether COVID-19 is an existential crisis."
    .
    Perhaps a lot more existential for you and me than for the country.
    .
    We have about 3 million deaths per year in the USA from all causes (but most all associated with old age). If you take a typical "worst case" scenario, with 25 million symptomatic cases (who knows how many asymptomatic cases!), and 1% deaths among symptomatic cases, then we can expect about 250,000 excess deaths. The USA has about 2.9 million deaths per year, so a typical worst case represents something like 9% extra deaths in the short term. That increase in death rate is distorted by the health profile of people who the coronavirus typically kills: people over 75, in very poor health, who are at risk of dying in the next year, even if there were *no* coronavirus around. This virus is most certainly *NOT* an existential threat to the country. It is a threat to the very old and the very unwell.

  180. DeWitt,
    DeBlasio should, by any reasonable analysis, be tarred, feathered, and ridden out of town on a rail…… but only because burning at the stake offends too many sensibilities.
    .
    He is a nutcake socialist who should be flipping burgers at McDonald's or tending bar someplace in Brooklyn, with Occasional Cortex as a co-worker. He should not be holding public office. Not even dog catcher or local school board.

  181. Here is a very helpful video from a doctor at the Cornell hospital in NYC. https://vimeo.com/399733860

    Around the 26 to 27 min point he gives a qualitative answer to DeWitt’s question about the success of ventilators

  182. Re Kenneth Fritsch (Comment #181823)

    Kenneth, in looking for what Austrian School Economist are saying about the government response to the pandemic, I did find the linked article "What Would Murray Say About the Coronavirus?" by Llewellyn H. Rockwell, Jr. The "Murray" of course is the late Murray N. Rothbard, a famous Austrian School economist and Rockwell is the founder of the Mises Institute which promotes the Austrian School.

    I know too little about Rothbard's writings to comment much on the opinion piece. I doubt, however, if alive today he would be laughing at the coronavirus pandemic as Rockwell's closing paragraph (quoted below) seems to suggest.

    “Why has a panic developed over this disease? Here we can again learn from Murray. He taught us to follow the money, and in this case, drug manufacturers and developers of vaccines stand to profit if they can frighten enough people. We all remember the “swine flu” panic of several years ago. Doctors developed a vaccine to prevent people from getting the alleged disease, and this vaccine killed many people. When Gerald Ford was president, there was also a “swine flu” panic, and you can watch Murray laughing at the panic here. If he were with us today, he would be laughing at the fearmongers, warning us about the dangers of vaccines, drugs, and quarantines, and reminding us that the main danger we face is the tyrannical and predatory state.”

    In fairness to Rockwell it should be noted that he wrote the article a few weeks ago ( March 5 release), when the coronavirus threat seemed less serious. I recall going out to dinner with a group of friends on March 8, and the virus wasn't a topic of discussion. Things sure have changed fast.

    https://mises.org/wire/what-would-murray-say-about-coronavirus

  183. Unless people can identify that a team not disbanded or official not fired or office not created would have led to a travel ban on China three weeks earlier, you can't make the case that Trump's actions caused significant harm. Possibly an earlier travel ban on Europe would have prevented New York's cases, but that's not clearly established.
    As it was, testing was done on all contacts with patient zero in the US.

  184. RE: Dewitt Payne NY Responsibility for Covid Cases

    ….
    Here is wisdom from NY Health Commissioner Dr. Oxiris Barbot on 1/28/20

    …

    "I'm interested in insuring all of our measures are in place," Barbot explained. "We have a fairly tight network that goes in different levels to make sure that we are vigilant."

    Barbot took the opportunity to dispel what she called "misinformation" circulating on social media: that Chinatown should be avoided and that there was scientific evidence proving the virus could be contracted from a person not exhibiting symptoms.

    "There is no reason to avoid subways or restaurants or to change your daily routine," Barbot said. https://patch.com/new-york/new-york-city/coronavirus-no-match-nyc-health-commissioner-says

  185. It is easy in hindsight to criticize people like Barbot for not being sufficiently concerned sufficiently early. I don't think that is very fair since it seems that few, if any, experts were saying much different. On the other hand, it is extremely hypocritical to attack Trump while not criticizing Barbot and other lefties. Trump may have been overly optimistic, but he was more proactive than any of his critics on the left.

  186. Mike,
    "On the other hand, it is extremely hypocritical to attack Trump while not criticizing Barbot and other lefties."
    —-
    To a extent yes, except that the buck stops with Trump. I don't think it's nuts to hold the President to a higher standard than bureaucrats in general.

  188. mark bofill (Comment #181844): "To a extent yes, except that the buck stops with Trump. I don't think it's nuts to hold the President to a higher standard than bureaucrats in general."
    .
    But we are not talking about "bureaucrats in general". We are talking about experts with a specific responsibility. Trump is not responsible for the errors of technical experts any more than Ronald Reagan was responsible for the Challenger explosion.

  189. I just came across the details for the free money. I am annoyed to learn that I will be a recipient. Oddly enough, I am even more annoyed to learn that my payment will be reduced by a $500 penalty for filing my taxes early.

  190. Dewitt
    **And the idea that yet another government group duplicating other agencies would have improved the response is indeed magical thinking. **
    More to the point: As they are purporting to determine whether the claim X was "disbanded", the interpretation that something that *never existed* WAS disbanded is just hopelessly befuddled.
    .
    This "X" did not exist under Clinton. It did not exist under Bush. It did not exist under Obama. And it continued to not exist under Trump.
    .
    Trump did not "disband" it.
    .
    Trump may very well have cocked lots of things up. It may well be that the guy who called for it was a swell guy and might have managed to create something that would have been spectacular. Or maybe it would have been another agency that would have just gotten in the way of yet other agencies.

    .
    We don't know because IT EVER EXISTED. Hence, it was not and could not be "disbanded".

  191. Mike M.
    **Oddly enough, I am even more annoyed to learn that my payment will be reduced by a $500 penalty for filing my taxes early.**
    There's a penalty for filing taxes early?!

  192. Mike,
    Yes. At the end of the day though, Trump is the guy on top. The President isn't going be an expert on everything anymore than the CEO of a company is going to be expert on every function every employee of his company does. Still, he's got more power than anybody else does to select the experts, or select the people who select and manage the experts.

  193. I do agree that there's no reason to believe that yet another team of bureaucrats would have changed anything. I seriously doubt that.

  194. lucia (Comment #181849): "There's a penalty for filing taxes early?!"
    .
    Yes, if your income in 2019 was both greater than in 2018 and greater than level where the phase out begins.

    My use of the word "penalty" was sarcastic.

  195. mark bofill (Comment #181851): "At the end of the day though, Trump is the guy on top."
    .
    How often is a President held even a little responsible in that manner? Real question.

    The closest I can come up with was that some people tried, but failed, to lay Deepwater Horizon at Obama's feet. He got away scot-free on Swine flu. Bush did not get blamed for 9/11 and the people who tried to blame him got labelled as kooks. USS Cole, Challenger, Discovery, Lebanon barracks mombing, Lockerbie. Carter was criticized for his handing of the Iran Hostage crisis and for his handing of events leading up to the embassy takeover; but as I recall that criticism was highly partisan and he was not blamed for the takeover itself.

  196. Mike, I don't think the media holds Trump to the same standards they've held other Presidents in the past, I don't even think that's controversial. They don't even really make any bones about it anymore. Still, that's a separate issue in my book. Whether or not the President is ultimately responsible is one thing. Whether or not the media applies a consistent standard is another, it doesn't change the idea in my view that the President is ultimately responsible.

  197. Mike M,
    Yes, my memory says that the criticism of Carter was for how he responded to the taking of embassy hostages; he was not ever blamed for the hostages being taken. Except for Obama's failure to enforce his "red line" about Syria gassing its own people, Cater's response to the taking of the hostages was the weakest and most foolish I can remember by a US president.

  198. OK_Max (Comment #181830)
    March 29th, 2020 at 9:11 pm

    "If he were with us today, he would be laughing at the fearmongers, warning us about the dangers of vaccines, drugs, and quarantines, and reminding us that the main danger we face is the tyrannical and predatory state.”

    Rockwell tends to hyperventilate and go into a bit too much of a conspiratorial state of mind with issues such as these. This is something from which individual libertarians, like those in other groups of political theorist, are not immune.

    I do agree that inventing crises and over reacting to crisis is something that those wanting more power for government tend to do. Those emergency powers do not all go away once the emergency is over.

    Even so-called small government conservatives can fall prey to acceding government more power in the case of military actions and wars where the government and its supporters have worked up a frenzied emergency. Those war powers do not completely disappear with the ending of the conflict.

    Rothbard was at his best when analyzing governments and politicians motivations as being less magnanimous and high-minded than is taught in Civics 101 and believed by a significant number of the current intelligentsia.

  199. mark bofill (Comment #181857): "Whether or not the President is ultimately responsible is one thing. Whether or not the media applies a consistent standard is another, it doesn't change the idea in my view that the President is ultimately responsible."
    .
    In an abstract, ivory-tower sense, I agree with all of that. But in the real world, they are not at all separate.

  200. mark bofill,

    There have been endless unheeded warnings about the potential for a viral pandemic since well *before* the SARS coronavirus disease in 2003. (https://justthenews.com/politics-policy/coronavirus/pandemic-neglect-how-us-health-care-failed-heed-warnings-supply)
    All the presidents (and Congresses) between then and now were in a better position to act on those warnings than Trump. So if we are going to assign blame for lack of being prepared, I think Trump should be well down the list of those responsible.

  201. Steve,
    Fair enough, to an extent. Everything within reason I guess; I mean, we cut Obama some slack for inheriting the housing economic mess from Bush, but eventually it became his (Obama's) economy.
    Maybe by second term, Presidents should be cut less slack. I don't know.

  202. @ mark bofill,

    The problem as I see it is that you are being reasonable mark, while those who criticize Trump either refuse to or are incapable of reason.

    It's probably too early to be hopeful, but the deaths attributed to COVID-19 in the US appears to be slowing. the daily deaths dropped for March 29.

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

  203. The entire government saw this coming. Wuhan, Italy, Europe. They were simply not prepared because they have only thought about it theoretically. It's like a army that has never fought before, the first battle isn't likely to be a glorious success. Contrast that to an army that has been through many battles. The US and the rest of the world will be much better in the next battle, which is inevitable. It seems that rolling lock downs based on regional breakouts and better surveillance will improve results next time if the initial containment fails. We are currently using very blunt instruments.
    .
    Trump is in charge of the government so owns its failings. The people most critical of Trump tend to be those who believe the government can solve anything it puts its mind to. Government response is like a huge oil tanker, it just can't be steered quickly.

  204. Mike M. (Comment #181847)
    March 30th, 2020 at 7:25 am
    I just came across the details for the free money. I am annoyed to learn that I will be a recipient. Oddly enough, I am even more annoyed to learn that my payment will be reduced by a $500 penalty for filing my taxes early.
    _______

    That's crazy and it's probably happening to a lot of people.

  205. My understanding is that the "free money" will initially be sent based on your last year's tax return, but your qualification for this money is really based on this year's tax return. If there is discrepancy here (for example you received too much money) then you will have to pay the government back the difference. So you aren't really penalized by filing early.

  206. Tom Scharf,
    Ha ha! I'll probably qualify. Jim retired after working a few months in 2019. Our official income "plunged".

    Seriously, if I get money, I'm finding some deserving service to spend on!! I know small businesses that are likely to go out of business.

  208. Carter was also blamed for the failed rescue attempt.
    The election happened one year after the hostages were taken.
    His campaign manager said they should have taken the $30 million spent on the election and used it to buy a helicopter.
    The rescue mission was aborted because they were short one helicopter after a mechanical problem. On return, another helicopter crashed and 8 people died.

  209. lucia (Comment #181871): "if I get money, I'm finding some deserving service to spend on!! I know small businesses that are likely to go out of business."
    .
    My plan also. But before I do that, it would be nice to know if the money will be taxable or if there might be a claw back as Tom claims.

  210. Based on the latest data, Italy may soon see active cases decreasing. That's because new cases may have peaked and recoveries are increasing. When recoveries plus new deaths exceed new cases, active cases will decline.

    For where you would want to be to avoid infection, the bottom seven in terms of active cases per million residents are Texas 93, Kentucky 81, South Dakota 73, West Virginia 69, Minnesota 63, Nebraska 60 and Puerto Rico 54.

  211. If one does not understand how the Federal Reserve affects the business cycle and to the degree it can, I would suppose it would be easier to blame or give credit to a President or his party in Congress for the state of the economy. How many times has the business cycle hit the bottom during a President's tenure only to rise in the tenure of the next President since that is how Federal Reserve caused cycles occur. The deeper the bottom of the cycle the more likely it is to rise further from that bottom. Our Presidents are mostly ignorant of how the Federal Reserve operates and thus have little influence over the business cycle other than knowing that lowering interest rates by the Feds might increase economic activity on their watch. Voters are mostly totally ignorant of how the Federal Reserve controls the business cycle and will thus be influenced by whose watch the cycle either goes down or up and attribute it to the current President.

    I also suspect that voters are more influenced by what a President says he will do than by how that turns out. Crises are great for Presidents as they tend to make a President appear more presidential than they actually are and allows them to take credit for ending the crises where in fact all crises end.

    My best President given the current political process would be one who did the least harm and actually talked about possible/probable unintended consequences of government actions.

  212. The checks from the Feds will really not help almost all people. Only an upturn in the economy as soon as possible will do that. What I lost (on paper, since I do not have to sell any assets to live on) on stocks and bonds was much larger than any payment I might receive. I will not be receiving any payments nor will anybody in my immediate family. The lower and middle income working family will have to make do with unemployment insurance. Those Federal checks would appear very small compared to the unemployment insurance. For some that insurance will be worth more to them than going back to work and might well prolong the unemployment problem. That makes those checks for most people more of a symbolic than helpful gesture.

  213. Mike M: "It is easy in hindsight to criticize people like Barbot for not being sufficiently concerned sufficiently early. I don't think that is very fair since it seems that few, if any, experts were saying much different. "

    No, on January 20, China announced that the virus was transmissible from human to human. See https://en.wikipedia.org/wiki/Timeline_of_the_2019%E2%80%9320_coronavirus_pandemic_in_November_2019_%E2%80%93_January_2020 [look to January 20 date]

    Would also add that no matter what various authorities say, she as a doc, with specialized knowledge and responsibilities, is required to exercise her own independent judgment. I as a lawyer quite often hear lawyers and officials with fancy titles spouting garbage. Just because it comes from what appears to be a high-level source doesn't mean it is correct. For instance, just look at the FISA and Mueller "investigation" clown shows.

    She bears a very large responsibility for her statement and incompetence.

  214. Although Trump as head of state bears some responsibility for the late roll out of testing, he made the mistake of relying on the professionals, who screwed up the testing procedure. It is not like he intervened and asked them to do something stupid. So, I would say, he has roughly 20% responsibility for the delay in testing. From NYTs article describing problems at CDC and FDA.

    . . .

    "Dr. Robert R. Redfield, 68, a former military doctor and prominent AIDS researcher who directs the C.D.C., trusted his veteran scientists to create the world’s most precise test for the coronavirus and share it with state laboratories. When flaws in the test became apparent in February, he promised a quick fix, though it took weeks to settle on a solution."

    ********
    "Dr. Stephen Hahn, 60, the commissioner of the Food and Drug Administration, enforced regulations that paradoxically made it tougher for hospitals, private clinics and companies to deploy diagnostic tests in an emergency"
    *********

    *********
    "At the start of that crucial lost month, when his government could have rallied, the president was distracted by impeachment"
    ********
    "On Jan. 7, the C.D.C. created an “incident management system” for the coronavirus and advised travelers to Wuhan to take precautions. By Jan. 20, just two weeks after Chinese scientists shared the genetic sequence of the virus, the C.D.C. had developed its own test, as usual, and deployed it to detect the country’s first coronavirus case."
    ***********
    "Assessing the virus would prove challenging. It was so new that scientists had little information to work with. China provided limited data, and rebuffed an early attempt by Mr. Azar and Dr. Redfield to send C.D.C. experts there to learn more. That the virus could cause no symptoms and still spread — something not initially known — made it all the more difficult to understand."

    **********

    But soon after the F.D.A. cleared the C.D.C. to share its test kits with state health department labs, some discovered a problem. The third sequence, or “probe,” gave inconclusive results. While the C.D.C. explored the cause — contamination or a design issue — it told those state labs to stop testing.

    The startling setback stalled the C.D.C.’s efforts to track the virus when it mattered most. By mid-February, the nation was testing only about 100 samples per day, according to the C.D.C.’s website.

    Dr. Redfield played down the problem in task force meetings and conversations with Mr. Azar, assuring him it would be fixed quickly, several administration officials said."

    https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html

  216. JD Ohio, what makes the CDC's delay even more galling is that their test had 3 parts. 2 of them were the standard ones used by others but they added a third which caused the problem. They stopped testing for weeks to resolve this when they could have simply just continued using the 2 working parts. I suppose the proper forms needed filling out. Or something.

  217. It's too late for the U.S. to contain this virus… that opportunity has been lost. The only way to stop it now is to quarantine the healthy and deprive the virus of new hosts. Not an easy task when you also have to try to keep society fed and functioning.

    New York City will soon be completely overwhelmed with the sick and dying. It's a horrible situation which has no immediate solution.

    My personal opinion is that acquiring testing kits is far less important right now than acquiring sufficient quantities of protective equipment for those treating the sick.

  218. skeptical,
    I think both are equally important. We don't know how many people are infected. But the more people who get infected, the more protective equipment we need.

  220. Lucia,

    Sorry I never located that article about Dr Zelenko in NY state successfully treating more than 300 people with Hydroxychloroquine. Just found another one from the 28th saying he has now treated 699 successfully with only 4 hospitalizations. Haven't watched the embedded video(41 min.) but the treatment sounds pretty good to me.

    https://techstartups.com/2020/03/28/dr-vladimir-zelenko-now-treated-699-coronavirus-patients-100-success-using-hydroxychloroquine-sulfate-zinc-z-pak-update/

    Ordered my Hydroxy… renewal on the 25th and received it today. The VA hospital pharmacy in Connecticut also sent a letter saying they would be reducing all Hydroxy… scripts to a 30 day supply for the foreseeable future to ensure not running out for those already taking it.

  221. Using MikeN's logic for calculating mortality, the recovery rate is only 3.27%, 5220 recoveries divided by 159689 cases.

    skeptikal,

    It was too late to contain the virus at least a month ago, probably more like two months. de Blasio and Cuomo are largely responsible for this, IMO. Another example of people getting the government they deserve. Remember that Trump was ridiculed for his policy to prohibit entrance of non-citizens from most of Europe as late as March 12. Admittedly, most of the horses were already out of the barn, but every little bit helps when you're talking about exponential functions.

  222. Another interesting golf tidbit: I played today with a radiologist who splits his time between Palm Beach and southern Connecticut. He was playing a public access course because his private club closed do to fear of coronavirus….
    .
    I asked if he had prescribed himself and his family hydroxy chloroquine. He said he had. Said he “You would have to be crazy to not take the drug based on all the available studies… people saying otherwise are uninformed or motivated to either make Trump look bad or to keep supplies of the drug in hospitals.”.

  223. SteveF (Comment #181891)

    I asked if he had prescribed himself and his family hydroxy chloroquine. He said he had. Said he “You would have to be crazy to not take the drug based on all the available studies… people saying otherwise are uninformed or motivated to either make Trump look bad or to keep supplies of the drug in hospitals.”.
    _______

    I'll pass on taking the drug for the time being. My decision has nothing to do with Trump or hospital supplies. This proves I'm crazy.

    Nah !

  225. OK_Max,
    “ This proves I'm crazy.”
    .
    Well, it’s either you or the radiologist.
    .
    But I suspect the “you” in his statement was referring to a medical doctor who can write prescriptions, not “you” in the general public.
    .
    The good news is fourfold: 1) The FDA has formally endorsed treatment with hydroxychloroquine plus azithromycin for victims in hospitals. 2) On-the-ground experience continues to show good results… no, not placebo controlled double blind studies, but an awful lot of practicing MD’s will have to be very wrong if hydroxy chloroquine is finally shown to not be effective. 3) Preliminary results from placebo controlled studies will be available within a few weeks. 4) Manufacturers keep upping the number of promised doses; today an additional 30 million doses for the USA was announced.

  226. Maryland Man Arrested for Hosting Party of 60

    "A Maryland man was arrested on Friday night for violating a state coronavirus order when he hosted a massive bonfire party, authorities said.

    Shawn Marshall Myers, 41, was busted after refusing multiple orders to disperse the crowd of 60 people at his Hughesville home, according to the Charles County Sheriff’s Office.

    Myers was charged with failure to comply with an emergency order implemented by Gov. Larry Hogan barring gatherings of 10 or more people to help curb the spread of coronavirus, the sheriff’s office said.

    Last Sunday, Myers also attracted the authorities for holding a similar large gathering, the sheriff’s office said. But when officers arrived that time, he agreed to kick out his company, authorities said."

    https://nypost.com/2020/03/29/maryland-man-arrested-for-breaking-coronvirus-order-hosting-bonfire-party/
    _________

    I don't understand why only the host was arrested. The guests also are responsible. But putting 60 in jail would make matters even worse.

  227. I'm pretty sure a placebo controlled trial is not necessary if the disease outcome is understood. For example, the clinical trial for Keytruda did not have to use a placebo or the standard treatment because in stage four melanoma, the outcome with the standard treatment was well known, i.e. you die in fairly short order.

    The other thing is that a quantitative measure, like viral load in an infected patient, is not, I'm pretty sure, subject to a placebo effect. So if the treatment reduces the viral load to undetectable in a much shorter time and reduces the percentage of patients who develop pneumonia, both of which are more or less knows at this point, the drug works. The question that then needs to be answered is the optimum dose.

    I will be pleasantly surprised if any drug regimen has much effect on late stage patients. Anti-viral drugs for regular influenza need to be started early, like within 48 hours of developing symptoms.

    Now if you're testing whether the drug prevents infection, then you would need a control group taking a placebo. That would have to be at least single blind, i.e. the patient couldn't know, but it's not clear that it needs to be double blind. But I don't think there's enough available to do that sort of trial yet.

  228. SteveF (Comment #181897)

    OK_Max,
    “ This proves I'm crazy.”
    .
    Well, it’s either you or the radiologist.
    .
    But I suspect the “you” in his statement was referring to a medical doctor who can write prescriptions, not “you” in the general public.
    _____________

    For new prescriptions my doctor requires an office visit. I'm not exposing myself to a waiting room full of patients to get pills that just MIGHT make me feel less sick if I get coronavirus from one of those patients.

    Now, if I already have the virus, sure I'll take those pills. Probably nothing to lose, and the pills just MIGHT work.

  229. OK_Max
    **I don't understand why only the host was arrested. The guests also are responsible. But putting 60 in jail would make matters even worse.**
    There could be a number of reasons. I can think of at least 2.
    1) Perhaps the guest ran while the host stuck around or was identifiable.

    2) The Host is a repeat offender who would probably organize again. The guests probably won't end up going to another gathering unless ahost organizes. So they are less dangerous going forward.

  230. OK_Max
    **For new prescriptions my doctor requires an office visit. I**

    Well.. yeah. 'Cuz you aren't his wife or child and he doesn't love you the way he loves them.

  231. Lucia,
    “ Well.. yeah. 'Cuz you aren't his wife or child and he doesn't love you the way he loves them.”
    .
    Helps too that you have to pay the doctor $100 or so for the visit. It’s the MDIIR: Medical doctor income insurance rule. The drug may only cost $10, but 5 minutes of the gatekeeper’s time costs 10 times that. Of course, *you* have to waste an hour or more in a crowded waiting room for the privilege of that 5 minutes. A bit like a mafia protection money scam, but completely legal.

  232. DeWitt,
    I am pretty sure at least one placebo controlled study of prophylaxis for health care workers was formally proposed (maybe 2 or 3 studies). But I think not yet approved by the FDA; perhaps for fear of not having enough doses….. or fear it might save too many lives. It’s not clear to me which it is. Of course, that won’t stop golfing radiologists.
    .
    There is a perfect retrospective study that could be done right now: lots of people, and mostly past 55 years old, take hydroxy chloroquine twice a day (about 300 mg active drug in total) for arthritis and lupus. I am betting that a fair number of those people live in regions with high coronavirus case rates. It would be simple and cheap to see how many people already taking the drug got the illness versus a comparable cohort not taking the drug.

  233. SteveF,

    The retrospective study sounds too easy and relatively inexpensive for the FDA. Also, selecting a comparable cohort would not, I think, be trivial. Then there's HIPAA to deal with…

    As far as office visits for a prescription, I think I've already mentioned this, but in Canada, the last I heard (which was a while ago), you could only get a prescription for thirty days of doses with no refill and you had to make an office visit to renew it. Needless to say, this is one of the ways Canadian physicians game the system to make up for their relatively low compensation.

  234. Media framing bias. The models the WH is using are going to be released today. Media outlets operating off the same information:
    http://www.healthdata.org/sites/default/files/files/research_articles/2020/COVID-forecasting-03252020_4.pdf
    .
    WSJ: "That group last week estimated 81,114 deaths over the next four months, with 95% confidence that the number would be between 38,242 and 162,106."
    .
    NYT: "Even if all of the social distancing guidelines are followed “perfectly,” Dr. Birx said, the death toll in the nation could reach 100,000 to 200,000."
    .
    NBC: "The White House coronavirus response coordinator said Monday that she is "very worried about every city in the United States" and projects 100,000 to 200,000 American deaths as a best case scenario."
    .
    CNN: "And assuming social distancing will continue through May, it finds that, by August, around 82,000 people in the US could die from Covid-19."
    .
    "up to", "could reach", etc. are the same BS language they use for climate estimates. What's the range, what's the timeline? The WSJ is the only one to state the data accurately. NBC is a complete failure.

  235. CDC considering recommending general public wear face coverings in public
    https://www.washingtonpost.com/health/cdc-considering-recommending-general-public-wear-face-coverings-in-public/2020/03/30/6a3e495c-7280-11ea-87da-77a8136c1a6d_story.html
    .
    "Officials at the Centers for Disease Control and Prevention are considering altering the official guidance to encourage people to take measures to cover their faces amid the coronavirus pandemic, according to a federal official who spoke on the condition of anonymity because it is an ongoing matter of internal discussion and nothing has been finalized."
    .
    "Face coverings", ha ha. Don't wear a mask! Should make Antifa happy. Everyone in Beijing is required to wear a mask in public now.

  236. DeWitt,
    "Also, selecting a comparable cohort would not, I think, be trivial. Then there's HIPAA to deal with."
    .
    Actually, there already exists a perfect comparable cohort: people who tested negative. That population directly gives you an estimate of the expected number of cases of people who take hydroxy chloroquine but test positive for corona virus (assuming hydroxy chloroquine doesn't work as a prophylactic). That much larger population of test negatives also minimizes potentially confounding factors.
    .
    Heck, the FDA could tomorrow issue a dictate: any and all tests for coronavirus 19 must include a question about taking hydroxy chloroquine, with the results sent to the FDA. There are so many tests being done now that we would have a statistically valid result in a few days.
    .
    Don't worry, they won't do it: too fast, too cheap and too definitive.

  238. Ed Forbes (Comment #181940),

    If I understood the article you linked, then it seems that high blood pressure is not a risk factor, or at least not much of one.

    The article says that 50% of those who die have high blood pressure and that 30% of Americans have high blood pressure. And both death from the Wuhan virus and high blood pressure correlate with age.

  239. Ed Forbes,

    I found the phrasing of the article to be tendentious and unconvincing. Blaming Big Pharma is almost as prevalent as blaming the Bad Orange Man. I seriously doubt that the data on zinc deficiency in coronavirus patients is actually available. I won't say that the article was fabricated from whole cloth, but I wouldn't be surprised if that were the case.

  240. Ed Forbes,

    Look at all the other articles the author (Mike Adams) has written. He appears to me to be many sigma toward the lunatic-fringe end of both the political and intellectual spectra. IOW, I highly doubt what he writes.

  243. DaveJR,

    Thanks for the link. That article makes much more sense than the Mike Adams rant. We don't, in fact, know whether ACE inhibitors are good or bad for COVID-19. But we do know that there are negative consequences for stopping the use of ACE inhibitors.

    One of the, as Kenneth puts it, bad smells of the Mike Adams rant was the comment that blood pressure drugs only treat symptoms, not the possible underlying disease. Hypertension is a symptom, but in many cases, we don't have a clue as to why the hypertension exists. Treating symptoms has been a part of medical practice since long before the existence Big Pharma. Also, we know that high blood pressure damages a lot of organs, so there is good reason to treat the symptom. Adams' claimed alternatives for reducing blood pressure, other than losing weight, have not, in fact, been demonstrated in proper clinical studies to be effective.

  245. Lucia,
    “ I had to laugh…. at my last physical my blood pressure was 100/60. That was AFTER drinking at least 3 cups of coffee.”
    .
    Then it is clear you can strut the streets of Chicago with no fear of coronavirus illness! 😉
    .
    One of the good things about insane and often conspiratorial thinking is its humor value. But don’t strut the streets of Chicago, in spite of your low blood pressure.

  248. This morning after 3 cups of very strong coffee my BP was 90/58. I take only one Entresto pill currently. You do not want to know what my BP was with 2 pills. Even with very low BP with 2 pills I would get only slightly light headed and with a little physical exercise I would be fine. My doctor was more concerned with the upper reading dropping below 90 than the lower one which could go to 50.

    I continue to shop my own groceries, but will probably not be strutting the streets of Chi Town.

  249. One of the perks of not living in a major city is reduced mass transit. Mass transit in cities such as New York is one of the main reasons the virus is spiking so high there.
    .
    If most all own and use personal transportation, the odds of their being infected is greatly reduced.
    .
    Nothing like stuffing large numbers of people into a subway car to spread plagues.
    .
    Our local bus system is operating at very reduced ridership due to schools being closed. Very low percentage here rides the bus to get to their job. In New York, mass transit ridership is almost required due to the low rates of both car ownership and parking spaces.

  250. People who can afford it in NYC take a taxi rather than use mass transit. It will be interesting to see the income distribution of the infected.

  253. Ed Forbes,
    The rate of doubling seems to be the same in NY and MOST other states. Washington state is the outlier.

  254. Ed Forbes,

    "Toss out New York as an outlier and the US death total curve flattens out considerably."

    Most of the rest of the country is behind New York but they'll probably get there. The question is when the curve bends down from a pure exponential. And just because the curve is flattened or the exponential slope is lower doesn't mean that the area under the curve isn't the same or larger on a per capita basis. The argument for flattening the curve is that the mortality rate goes up if the local health care system is overwhelmed.

    There's too much we still don't know.

    Just saw an AARP ad calling for government control of drug prices, although not in so many words. There's reasons why I refuse to join that organization. If we get an effective treatment or vaccine for COVID-19 it will be in spite of the government, not because of it. And it's likely to be done by the evil Big Pharma.

  255. DeWitt Payne (Comment #181965): "The question is when the curve bends down from a pure exponential."
    .
    One of the fundamental rules of data analysis is don't process the data before doing the analysis. Integrating data is processing data. The more fundamental number is the daily new cases.

    Daily new cases have been increasing linearly, not exponentially, since March 16 or 17, when it crossed 1000 cases a day.

  256. Mike M.,

    And how is looking at total daily cases in the US not processing? Of course, it is. Different areas in the US are at different stages of the outbreak. Adding them all together is probably making it look like the infection is proceeding more slowly than it really is. In New York, new cases are not increasing as fast as they were. But elsewhere they're beginning to increase more rapidly. New York likely won't be dominating the numbers much longer. We'll see what the rate of increase looks like then. I expect it won't be pretty.

  257. California is not seeing exponential growth. I don’t see it in most of the other states either. New York is an outlier.

    “ Kaiser is treating 350 COVID-19 patients, which accounts for about 6-7% of available beds at its 36 hospitals in the state. The figure has remained relatively stable, Parodi said.

    “What we’ve seen with hospitalization in both Northern California and Southern California is essentially a leveling off over the past week and a half,” Parodi said. "Which is in contrast to other systems in the United States where they’re seeing significant increases or even exponential increases and we’re not seeing that in California.””
    .
    https://www.usnews.com/news/best-states/california/articles/2020-03-31/governor-california-bought-time-to-prepare-virus-peak

  258. DeWitt,

    Fair enough. Adding cases from different areas is a form of processing. Still it is less processing than summing up all the resulting numbers.

  259. Ed,
    Do you mean deaths? Which is what Willis is posting and looks exponential?
    Or cases? Which can be affected by lack of testing equipment growing exponentially with cases.

  261. What are people's opinion of the effectiveness of wearing masks to top coronavirus?
    Surgeon General advised people not to buy them, because they would be lacking for medical personnel, and suggested wearing the masks could make things worse.

  262. Looking at hospital beds, California is stable per Kaiser over the last 1-1/2 weeks.
    .
    As the whole shut down the economy issue is based on not running out of hospital beds and/or equipment, that is the metric that matters.
    .
    I have never liked the death rate metric as many deaths are counted against the virus if they test positive, regardless the actual cause of death. With, not particularly from.

  263. MikeN (Comment #181978)

    **What are people's opinion of the effectiveness of wearing masks to top coronavirus?**
    ___________

    MikeN, I think that would depend on the kind of mask. That may seem obvious, but I have observed people wearing all kinds of masks during the past couple of weeks.

    I found that common dust masks fit to loose around my face to give me sufficient protection from very small particles when sanding some materials. I don't see why these mask would be any better at protecting against the coronavirus. However, they may be better than nothing at all ( or maybe not).

    My wife and I use the 3M N95 masks I bought at a hardware store before the coronavirus began. I bought them for protection when sanding, and they are much better than common dust masks. I don't know whether these N95's are the same as those used in medical settings, but I hope they give us some protection against the coronavirus when we go out. Our main defense, however, will be to keep a safe distance from others.

  264. It's hard to believe the U.S. has more than twice as many coronavirus cases as China. I doubt their draconian measures to prevent spread of the virus can completely explain that difference.

    I read China is now going to add an estimate of the silent infected (40,000 ?) to their total number of cases, but that will not close the U.S/China case gap. And then there's our silent infected to estimate.

  266. Ed Forbes (Comment #181959)

    "One of the perks of not living in a major city is reduced mass transit. Mass transit in cities such as New York is one of the main reasons the virus is spiking so high there.

    If most all own and use personal transportation, the odds of their being infected is greatly reduced.

    Nothing like stuffing large numbers of people into a subway car to spread plagues."
    _______________

    Yes, which makes Japan's 2,900 cases remarkably low. If you think New York City leads in dependence on public transportation, try Tokyo or any other large Japanese city.

  267. Ed Forbes (Comment #181988)
    https://i2.wp.com/www.drroyspencer.com/wp-content/uploads/EU-MOMO-2020-wk12.jpg

    **EU excess deaths are Down this season, regardless of the C-virus.**
    _____

    I thought they were speculating deaths could be down because of the C-virus (well, indirectly), as people taking precautions against the C-virus resulted in fewer deaths from other kinds of flu and contagious diseases.

    I don't know whether traffic fatalities are included in "excess deaths," but with people going out less, that too could contribute to the decline. Also, maybe fewer industrial deaths if fewer people were at work.

  268. Ed,
    The death metric is the only useful one we have. Sure, maybe a person who got C-virus, ended up in the hospital, has clogged lungs and so on ultimately dies because their heart failed. I would not call attributing that to C-virus incorrect.

    You didn't actually answer my question which is whether you are saying the death rate is NOT increasing exponentially. I get that you might not like the death metric. But do you deny it has been increasing exponentially?

    (It may be slowing– the case metric is a useful metric for predicting that happens there. But the deaths HAVE been increasing exponentially.)

  269. OK_Max (Comment #181986):
    "It's hard to believe the U.S. has more than twice as many coronavirus cases as China."

    There's two ways of looking at this;
    1/ China started putting cities into lock down at a time when they had around one thousand confirmed cases and only a handful of deaths… so it's plausible that they did limit the spread by taking drastic action so early.
    2/ China is a secretive communist regime and we just have to take the numbers they give us… there's no way to verify the numbers so it's up to you if you want to believe them or not. I lot of people seem to hold the opinion that their numbers are too low.

    Personally, I think it's a bit of both… China has probably been doing a bit of under-reporting, but they also did go in hard and fast which would have made a big difference to how many people eventually got infected.

  271. DaveJR,

    That's not surprising at all. The city has been locked down for a couple of months and everything would be in short supply… including urns. People will still die from causes other than coronavirus so the need for urns won't stop.

  272. Reports from Wuhan are that crematoria have been working 24/7 to clear the backlog of dead bodies. Estimates of the number of cremations over the last two months are 45,000. About 6,000 deaths per month are normally expected and China claims about 2-3 K from the Wuhan virus.

  273. They don't really understand yet why some * regions * explode and some don't. Country and state boundaries don't make a lot of sense here, but obviously that's how the numbers are reported.
    It may simply be luck and hitting a certain threshold in places that put you into explosive growth. This outbreak will be studied heavily for decades and let's hope we learn something.
    .
    Italy's curve is definitely bending, they have been in isolation for about 3 weeks now. The US looks to have a tough few weeks ahead given the "momentum" of the virus.
    https://coronavirus.jhu.edu/map.html

  274. Tom Scharf (Comment #182003): "They don't really understand yet why some * regions * explode and some don't. Country and state boundaries don't make a lot of sense here, but obviously that's how the numbers are reported."
    .
    I am not convinced that epidemic models have ant predictive value. It is my impression that every year there are models predicting what will happen during the flu season and that they usually get surprised by what actually happens.

  275. Because of uneven responses by governors to the corona virus, the success of some states will be vitiated, perhaps negated, by the lack of an effective response by others. I would be really annoyed if I were the governor of a state bordering Florida or Mississippi.

  276. Mike M. (Comment #182001)

    The Wuhan metropolitan area has a population of about 19 M people.

    Using the CIA's worldwide estimate of a crude mortality rate of 7.7/1000 and assuming by Math is right, I get about 12000/Mo estimated deaths for that size population.

    Where do your estimates come from?

  277. Maybe some of you skilled in statistics out there can parse this better than me. If there were only roughly 67,000 confirmed cases of Covid in Hubei (population 20 million–I would assume actual cases, including those not tested would be roughly 10 times higher) and 3,300 deaths, why would doctors be surprised that out of 80 lupus cases, none had Covid? Wall Street Journal article explained that chloroquinine is used to treat lupus and Wuhan Docs noticed that there was no Covid among lupus patients. See https://www.wsj.com/articles/an-update-on-the-coronavirus-treatment-11585509827?mod=searchresults&page=1&pos=3

    Seems to me that if Covid is anywhere near the levels that China is reporting that Docs wouldn't be that suspicious that lupus treatment might prevent Covid based on a sample of only 80 patients. This might be an indication that China is under reporting Covid cases.

  278. Thomas Fuller (Comment #182005)

    As resident of PA, where we are approaching two weeks of a "textbook" government shutdown, as of yesterday we had 4843 cases growing at 18%/day.

    Florida had 6741 cases growing at 18%/day.

    Florida has 1.7 times the population of PA.

    It will indeed be an interesting comparison going forward.

  279. Licia “ Ed, Do you mean deaths?”….” You didn't actually answer my question which is whether you are saying the death rate is NOT increasing exponentially. ”
    .
    You asked, I answered. I understand that you prefer using deaths, but I prefer hospital beds.
    .
    The entire rationale of shutting down the economy is based on availability of beds and ventilators being restricted. So if these are used as the rationale, it makes sense to quantify it.
    .
    As to the death rate, I posted a graph showing EU overall death going DOWN, not up. Listed causes of death are too amorphous in my mind due to in many cases of being with, not particularly from, the virus.
    .
    If the overall death rate in the EU, which is taking a major hit with the virus is going down, and is NOT rising exponentially, I really doubt that the US death rate is rising exponentially.
    .
    Deaths related to the virus are going up, but many in the high risk group that are dying would have died of other causes shortly anyway of something else. As such, the virus is not having much of an affect on the overall death rate.

  281. MikeM
    **"They don't really understand yet why some * regions * explode and some don't. Country and state boundaries don't make a lot of sense here, but obviously that's how the numbers are reported."**
    .
    Often no. For example: Both Oregon and Washington State have an East of the Cascade side (Seattle, Tacoma, Portland, Eugene), a dry, fairly low population center and at least in the case of WA, a west side with some cities (Spokane.) Use of public transportation, space between houses and towns differs a lot between these regions.
    There's also a fair amount of north-south traffic and access on the east-of-the Cascades side. So in some ways, the natural "region" for transmission is north-south east of the Cascades.
    .
    At that, that region is still very different in population density and so on relative to the east coast NY-DC corridor.
    .
    But as state and country data are what is collected, it is still interesting to see state and country data. I'm sure we'll eventually see some analyses that are more nuanced.

  282. JD Ohio
    ** If there were only roughly 67,000 confirmed cases of Covid in Hubei (population 20 million–I would assume actual cases, including those not tested would be roughly 10 times higher) and 3,300 deaths, why would doctors be surprised that out of 80 lupus cases, none had Covid? **
    The shouldn't be toooo surprised that none of the 80 had the disease.
    > prob=67e3/20e6; # probability an individual is infected.
    > pbinom(0,80,prob) # probability 0 or fewer will be infected.
    [1] 0.7645637

    .
    But maybe the doctors do think the number of cases is greater than the number of *confirmed* cases. That's not mis-representing. Our number of confirmed cases is certainly less than the number of actual cases.
    .
    I think the real reasons doctors started looking at chloroquinine is in-vitro studies and animal models. I think quite a while ago i read it was used to treat some porcine corona virus illnesses.
    .
    I'm agnostic on whether China is concealing or not. Lying is something they have a history of doing, and often in amazing situations.. They may or may not be in this case.

  283. EdForbes
    **f the overall death rate in the EU, which is taking a major hit with the virus is going down, and is NOT rising exponentially, I really doubt that the US death rate is rising exponentially.**
    .
    Willis's simple plots show death rate is rising exponentially in BOTH most of the EU and in the US. The places in EU where it is not rising exponentially are places it rose exponentially in the past and is *finally* bending. Given the evidence of this happening currently or just ending in BOTH places, I cannot fathom my you think it is not happening here.

  284. Lucia: "But maybe the doctors do think the number of cases is greater than the number of *confirmed* cases. That's not mis-representing. Our number of confirmed cases is certainly less than the number of actual cases."

    I am sure the Chinese Docs, as do everybody, think the number of cases is much higher than the confirmed cases. Not in any way accusing the docs of lying. (Chinese Govt — different story) My question, is using the tool of statistical analysis, roughly how many [more] unconfirmed cases would have to out there, for the absence of Covid in 80 lupus cases to "hit the doctors in the face" and give them a sense that 80 people with lupus should have maybe 3 or 5 cases of Covid. My instinct is that even 1 million cases of Covid out of 20 million population in Hubei should not statistically trigger the notion that there should be some cases of Covid in 80 patients. Obviously, I not being skilled in statistics, am making a wild guess and speculation.

  285. Ed
    ** I understand that you prefer using deaths, but I prefer hospital beds.**
    I prefer to use deaths to measure the rate of contagion…. yes.
    Hospital beds don't measure this. They can measure how ready we are to deal with the contagion, but not the reate of cotagion.
    .
    The problem I see with your preference is that you at least seem to want to use hospital beds to measure *rate of contagion* which makes absolutely no sense whatsoever.
    .
    But I guess you mostly just want to avoid discussing the rate of growth of contagion and want to discuss hospital bed availability. In many places, we are on the brink of exhausting available beds. That's why Chicago is constructing hospital facilities in McCormick place. So by your argument, Chicago should be shut down.
    .
    We've got Navy ships moving in the supply beds in New York. They are putting up beds in Central Park.
    .
    And even if you don't want to consider the how the *growth rate* in contagion affects this, the fact that the growthrate is currently exponential in many places means the bed shortage is getting more acute.

    **I posted a graph showing EU overall death going DOWN, not up. **
    So… If I am not mistake, you posted a link to a DIFFERENT subject, which is not deaths do to Corona, but rather a link to overall deaths to all sources. (And which when visited appeared to actualy be for flu deaths.) Or if you mean something else, please supply the link again to clarify which point you are trying to make.

  286. Thomas Fuller,
    "I would be really annoyed if I were the governor of a state bordering Florida or Mississippi."
    .
    As is altogether too common for you, this comment is factually wrong on multiple levels, and shows only your political preferences, not reasoned analysis.
    .
    First, Mississippi and Florida rank respectively 18th and 21st in the rate of corona virus cases per million population (360 and 316 respectively, versus the champion, New York, with almost 4,000 cases per million population). Georgia has about 40% more cases per million population than Florida. The governors who should be unhappy about their neighboring governor are in New Jersey and Connecticut, where the very high infection rate in New York City has spilled over and caused big problems. Cuomo and de Blazio refused to act until the New York City area was already an inevitable catastrophe. As I noted up thread, de Blazio should be tarred, feathered and ridden out of town on a rail…. but only because burning at the stake offends too many sensibilities. His willful refusal to accept reality cost many New Yorkers their lives.
    .
    Second, the vast majority of cases in Florida are located in the high density areas of Dade county (Miami) and Broward county (Fort Lauderdale), with lesser concentrations in Palm Beach, Orlando, and Tampa. Florida counties outside these heavily populated regions have extremely low case rates, and many of the counties abutting Georgia and Alabama have virtually *no* cases.
    .
    Third, the single biggest factor in the rapid spread of the virus is population density, with only a secondary effect, negative or positive from the policies of politicians. I will stipulate that while de Blazio and Cuomo made the situation in New York City worse than it could have been, even if they had shown a bit of competence, New York City was always going to be hard hit.
    .
    It seems you hate all Republican governors (and maybe all Republicans?), but it might be more constructive if you stick with reasoned analysis and lot let your political inclinations take over and run with your keyboard.

  287. John M (Comment #182006): "Where do your estimates come from?"
    .
    I used the conurbation population of, I think, 11 M without being at all sure if that is the appropriate number and the China death rate of 7.1/1000, if memory serves.
    .
    Independent of any estimates, if the crematoria have indeed been running 24/7, then the number of deaths has been far higher than normal.

  288. JD
    **My question, is using the tool of statistical analysis, roughly how many [more] unconfirmed cases would have to out there, for the absence of Covid in 80 lupus cases to "hit the doctors in the face" and give them a sense that 80 people with lupus should have maybe 3 or 5 cases of Covid.**
    Hit in the face? Well, 3 times the number of confirmed cases means there would be a 45% chance of no Covid in the lupus patients.

    > pbinom(0,80,3*prob)
    [1] 0.4457186

    About 11 times more cases before you hit the magic this happens "with probability less than 5% …"

    > pbinom(0,80,11*prob)
    [1] 0.04960373

  289. Strangely I live in FL and have been under a stay at home order for about a week now, but I expect Fuller couldn't possibly know that given where he likely gets his information. As well as Hillsborough, Miami-Dade, Broward, etc. and all other breakout areas in FL all have "safer at home" orders.
    .
    This just in, DeSantis issued a statewide stay at home order.

  290. Lucia. Thanks for your response. Obviously, my knowledge of statistics is very poor.

  291. JD,
    I just used a built in function from R. I did assume each Lupus persons infection was uncorrelated from other infections. So it's like a coinflip model — just not 50/50 chance of heads/tails.

  292. JD Ohio: "My instinct is that even 1 million cases of Covid out of 20 million population in Hubei should not statistically trigger the notion that there should be some cases of Covid in 80 patients."

    With a 5% random chance (1 million out of 20 million), and assuming independence, the chances of having "n" cases are:
    n=0 1.7%
    n=1 7.0%
    n=2 14.5%
    n=3 19.8%
    n=4 20.0%
    n=5 16.0%
    n=6 10.5%
    n=7 5.9%
    n=8 2.8%
    n=9 1.2%
    n>=10 0.7%

    So your guess that 3-5 is the likely number, is correct. Tails are wider than you thought, though.

    [I think Lucia used reported cases, not your hypothetical 1 million.]

  293. This comment from the James Freeman opinion piece in today's WSJ encapsulates my concerns about who the policy makers are listening to when making policy concerning mitigation of Covid-19. How would your typical climate scientist advise policy makers on climate change mitigation?

    "The President might consider providing financial briefings for the people whose decisions now have enormous financial implications. For example, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases,Fauci said at a White House briefing on Tuesday:

    "If you look at our history, we’ve been through some terrible ordeals. This is tough. People are suffering. People are dying. It’s inconvenient from a societal standpoint, from an economic standpoint to go through this, but this is going to be the answer to our problems."

    Dr. Fauci has spent a laudable career leading the federal effort against infectious diseases. His belief that the current economic impact is merely “inconvenient” illustrates that he cannot reasonably be expected to also serve as an expert on the costs of virus countermeasures."

    I do see more model estimates with confidence ranges for the number of Covid-19 caused deaths. The estimates ranges vary considerable from model to model. The ones I have seen have an overall low estimate of around 40,000 and a high estimate over 200,000. That gives some comfort, but in thinking about the bases for these models and the many factors involved and not currently well understood there has to be myriad of assumptions going into these models.

    Now let us see a model on the counter measure damages to the economy and all its effects.

  294. The thing about the economic impacts is they have barely begun to show while deaths are here and now. When lots of companies "furlough" lots of their employees and start cutting off their medical insurance then the sh** will hit the fan. The economy has to hit a measurable crisis mode for workers and then the trade offs will be made. The federal piggy bank isn't large enough to keep the US economy running very long.

  296. JD, this particular question can be done with a basic calculator for the 'no infected' case.

    1 million out of 20 million = 1/20 chance of infection.
    To not be infected, chance is 1- 1/20 = .95
    For 80 people, it would then be .95^80 that all 80 are not infected, and 1-.95^80 that at least one is infected.

  297. Starting to bend the curve?
    https://imgur.com/f6xM0Ai
    Unless there is an increase in new cases over the next couple of days, then 'social distancing' seems to have had an effect.

    Data from CDC website…. I can't comment on its accuracy.

  299. SteveF,
    That's hopeful.
    Death rates lag infection rates. But the flattening of detected infections is hopeful. That seems to have flatted about the time IL had it's "stay at home" in place.

  300. As I said above, the U.S. daily new cases have been rising linearly. Same is true for New Mexico, New York (but it might be leveling off), New Jersey, U.S. other than NY and NJ (with a gradual onset), Washington state up until the last week (when the reported data start to act crazy). The linear period seems to start whenever state testing started to get serious; as early as March 9 (Washington) and as late as March 20 (NJ).

  301. Mike M,
    Do you mean recently? Because they *were* rising exponentially as can be seen by simple graphs. The rise appears to have changed *after all the 'stay at home' orders.

    **e linear period seems to start whenever state testing started to get serious**
    uhmm… after "stay at home" orders seems more like it.

  302. lucia,

    The linear periods start in mid-March. But the stay at home orders did not start until mid-March or later and so are much too late to be the cause. Remember that the test results relate to infection rates from a week or two before the results are recorded.

  303. MikeM
    **The linear periods start in mid-March.**
    Uhmm… our "stay at home" started mid-March. Which states are doing "test results" at any significant rate? (Real question. Because WE certainly aren't.)

    Also: do you have a link to a graph showing your "linear period" and also the previous exponential period? Because the death rates Willis is showing are still exponential. (Those are a lagging indicator, but they still look exponential.)

  304. And note: Even WA states rate of rise of deaths is exponential. It's just a slower exponetial. (This may be spring from the fact that Seattle is a much smaller city that others affected AND the geographic lay out of the state makes east west travel relatively light across the state.)

  306. Hi Lucia,
    I plotted up the per day new cases from that site… same story as the CDC site: pretty clearly NOT exponential growth. The curve is flattening when plotted with a log y-axis scale. Only time will tell, but it really looks to me like people staying away from each other has had some effect.

  307. lucia (Comment #182060): "Eyeballing, the graph here looks exponential until March 23 when IL governor did a lock down."
    .
    I don't see a graph at the link.

    A lockdown on March 23 can not have much effect on the data since it affects infection. Five days average from infection to symptoms. Probably at least a few days from symptoms to testing. Then a couple of days, maybe more in some places, to get results.
    .
    lucia: "I'd need to extract the data and plot it on log paper to show better. If you have a flat file of data, I'll do it."

    If you want to see if something is consistent with linear, you can't use a log scale.

    Here are daily new cases for New Jersey, first point is March 18, last is April 1:
    160
    315
    148
    437
    587
    930
    831
    727
    2474
    1949
    2299
    2262
    3250
    2060
    3559

    New York, March 16 through April 1:
    221
    750
    682
    1770
    2950
    3254
    4812
    5707
    4790
    5146
    6447
    7377
    7683
    7195
    6984
    9298
    7917

    ——-
    Edit: Deaths are a result of infections weeks ago, they are not deaths from, they are deaths with, they are exceptional cases, and the numbers are small. They may or may not be indicative of the broader infection.

  308. Illinois, starting on March 16. On that date, they reported 512 tests, compared to 708 total for all prior dates.
    29
    66
    129
    134
    163
    168
    296
    224
    262
    330
    673
    488
    465
    1105
    461
    937
    986

    Pretty near linear, but eyeballing is confusing due to 1105 positives reported on March 29, a day with a little over half as many tests reported as on most of the surrounding days. It looks to me like there is a data synchronization problem. For eyeballing purposes, I think it makes sense to apply a first order binomial smooth. That gives:

    35.5
    72.5
    114.5
    140.0
    157.0
    198.8
    246.0
    251.5
    269.5
    398.8
    541.0
    528.5
    630.8
    784.0
    741.0
    830.2
    961.5

    Note that the last point may not be reliable due to the end of the data set.

  310. The WSJ did an analysis comparing the death counts from Italy in March 2015-2019, versus March 2020, and concluded Italy is under counting all their coronavirus deaths by almost 2x.
    https://www.wsj.com/articles/italys-coronavirus-death-toll-is-far-higher-than-reported-11585767179
    .
    The point here being that deaths can be both over counted (death with coronavirus) and under counted (not ever tested for). Italy is likely an exceptional case.
    .
    In other news, the CDC will not release gender information for infections and deaths. Another case of rigid idiocy at our agencies.

  311. From a financial newsletter I received today:

    "I struggle to see how economic policy would be fundamentally different with Bernie Sanders as president, except for higher taxes."

    "Don’t get me started on the pathetic levels of assistance we are offering American citizens in favor of financially irresponsible corporations."

    "Tough time to be a libertarian or a hard assets investor, though that may be changing soon."

  312. A quote from the WSJ article linked by Tom Scharf above:

    "The health-care system in the region is so overstretched that doctors can’t treat all the sick. Those who die outside the hospital usually aren’t tested for the coronavirus.

    “They are not receiving postmortem tests,” Eleonora Colombi, a family doctor based near Brescia, says of people who die outside hospitals, such as in nursing homes. “Many of those who die and aren’t tested are old, but you normally don’t have so many people all dying at the same time. It’s corona.”"

    Note that this almost certainly happened in China too. If you don't test post-mortem, you don't have to report it as a COVID-19 death.

    Reported COVID-19 deaths in Italy appear to have peaked, but we'll never know the true number.

  313. About that Imperial College model that changed policy in the UK:
    https://www.wsj.com/articles/coronavirus-lessons-from-the-asteroid-that-didnt-hit-earth-11585780465
    .
    "Several researchers have apparently asked to see Imperial’s calculations, but Prof. Neil Ferguson, the man leading the team, has said that the computer code is 13 years old and thousands of lines of it “undocumented,” making it hard for anyone to work with, let alone take it apart to identify potential errors. He has promised that it will be published in a week or so"
    "The authors of the Imperial model have argued that they don’t have time to explain to people how to get their 13-year-old computer code running."
    .
    I cannot believe that there isn't a model bought and paid for by taxpayers that was ready for this.

  314. Mike:
    Could you add dates to those? Or column headings? Or titles?
    You say something about tests being 512, but there is NO 512 in the list. I don't know what that data means because you don't tell me.

  316. Beyond that "the state" is not testing. Tests are becoming available. Tests are not becoming available at an exponential rate…. so of course, the numbers coming out of tests would not appear to increase exponentially EVEN IF the underlying infections were increasing exponentially.

    Deaths are the only rate that is not strongly biased by:
    1) Limitations of testing availibility.
    2) Self selection of people deciding to test or not.
    3) Changes in testing availaibilty or locations where testing is available.

    I know you want to look at cases instead of deaths. But if deaths are still exponential, the claim that *underlying cases* is linear is suspect. The *measured number of cases* is limited by a non-exponential growth in test kits. As long as the number of test kits does not exceed the number of tests one might wish to take, the number of cases data is potentially HORRIBLY flawed for the purpose of estimating contagion rate.
    .
    The death rate is NOT flawed in this way.

  317. lucia,

    The data are the numbers of new positive tests recorded on each day. I gave the start date at the top of each list, I was inconsistent about end date, all are April 1.

    Data source is here:
    https://covidtracking.com/api
    "States Historical Data" I used the CSV file to get the Illinois numbers. The others were cut and paste from the screen, with new values added manually each day.

    Yes, the case data is flawed. The death data is also flawed, just in very different ways.
    ———

    Addition: Something seems to have gone wrong with the above site.

  318. Mike
    **The data are the numbers of new positive tests recorded on each day. I gave the start date at the top of each list, I was inconsistent about end date, all are April 1**
    Honestly, that doesn't.

    Your first list begins with this preface.

    "Illinois, starting on March 16. On that date, they reported 512 tests, compared to 708 total for all prior dates.
    29"

    Do you mean there were 29 tests on the 16th? Or that the first date is the 29… ? Or the 16th? (Impossible given the rest of the dates.)
    There is no 512 in that list. Is that first list a list of tests?

    If yes: it indicates tests ARE NOT being rapidly deployed.

  319. Willis agrees with me that we are destroying the US economy with lock downs to no good purpose.

    .
    “As you can see, there is very little difference in the death rates between the various countries, despite the fact that they all have differing levels of health interventions to try to prevent the spread. They’re all following the same trajectory.”
    .
    https://wattsupwiththat.com/2020/04/01/do-lockdowns-work/

  320. Mike M,
    Very good data site. Sorting the state data by state gives a complete history by state. Very interesting. There are places where 40 tests are administered to find a single positive, and others where 2.5 tests are administered (NY) to find a single positive. Makes me think all the cases in NY are not being identified. Impossible to say how many positives are not being caught, but I would bet a lot. Dead people are easier to count.
    .
    The fatalities in Illinois and Florida remain on a perfectly exponential curve, but in NY, the fatality curve appears to be bending.

  321. lucia,

    Oh. Sorry about that.

    "Illinois, starting on March 16. On that date, they reported 512 tests, compared to 708 total for all prior dates.
    29"

    I was explaining why I picked March 16 as the start date. On that date, they reported nearly as many tests as on all prior dates, so it represents a change in the testing regime.

    On March 16, there were 29 positive tests. Then on March 17 the number of positive tests were whatever the next number in the list is, and so on.

  322. Total U.S. daily deaths are almost perfectly linear from March 20-30, but the last two days lie quite a bit above that line. Yes, pretty much everything is linear over a small enough range, but daily deaths increased ten-fold from March 20 to 30.

    I do not claim that linear is right. I am challenging the blind assumption of exponential. If it is really exponential, then both cumulative and daily numbers, whether new positives or deaths, would be exponential. But the daily numbers do not appear to be exponential.

    If you have a linear increase and you integrate it, you get a quadratic. Plot the quadratic on a log scale and it will look exponential for a time, but then will begin to bend over. So maybe the bend is because it was never exponential in the first place.

  323. Real questions.

    There are over 200 viruses that cause the common cold. Have we identified every one of them? If so, how can we be sure of that? If not, then how can we be sure that we have sequenced the RNA of every coronavirus that infects humans? If we haven't, then how can we be sure that the small snippet of RNA used to identify the Wuhan virus is unique?

    I expect that we have sequenced all the coronaviri that are *known* to affect humans and that we can say that the bit of RNA used to identify Wuhan is not present in any of those. But I don't see how we can be sure that the test for Wuhan does not also identify an unknown coronavirus.

  324. Mike M,
    I'm pretty sure the entire genome of the coronavirus 19 collected in Wuhan was sequenced in February, and more recent samples (not from China) have been fully sequenced and verified to have mutated "very little". Some virologists suggest a rate of mutation that is about 25% that of influenza virus. Of course, it is not yet possible to say if the coronavirus 19 mutations will lead to an ever changing vaccine target…. let's hope not.
    .
    The SARS coronavirus and the MERS coronavirus are very different in genetic sequence, with estimates ranging from 30% to 50% different.

  325. Mike M
    There is no change in "testing regime". We are getting more testing out there. But the Illinois page says this:

    https://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/coronavirus/personal-guidance-and-testing
    * Don't call the health department about getting testing.
    * Your healt care providor will determine if you should be tested and if necessary contact the health department.
    * The health departments do not collect specimens.

    You still can't just get a test in Illinois. You might not even be able to get one if you are sick. So testing, while increasing is limited. That means the number of tests is capped– and by something other than the number of potentially infected people.

    I don't know what's happening in other states, but "the state" is not testing in Illinois. There certainly wasn't any on March 16!

    **I do not claim that linear is right. I am challenging the blind assumption of exponential.**
    IT's not a blind assumption. It's based on the graphs of deaths vs. time on log paper Willis is posting. Those still look linear on log(death) vs time paper.

    **But the daily numbers do not appear to be exponential.**
    Can you make a graph of deaths, on log paper **without* trimming the early data and snow this? Or has someone? (Real Q. ) And don't trim the early data. Trimming the extent of the time axis is a known technique that is bound to hide the true functional form.

    **If you have a linear increase and you integrate it, you get a quadratic. Plot the quadratic on a log scale and it will look exponential for a time,**
    It would look linear on a Log(death) vs log( t) graph. Not on a Log(death) vs time graph.

    y=exp(cx) > log(y) = log c + x. Linear on semi log, which is what Willis shows.

    y=x^2 > log(y) = 2 log (x). Lienar on log-log which is NOT what willis shows.

    Of course if you truncate the data into a small time, it's hard to distinguish. You seem to want to do this. Willis is not. He's doing it the proper way.
    .

  326. Beyond that: We know it won't stay exponential forever. The issue is whether it looks like that now– without someone "trimming" the data into a small time range to make it hard to see the shape of the curve.

  327. Lucia,

    Are you and I looking at the same graph from Willis? I am looking at his Figure 1, and I see every country with high case loads showing some bending of the curve, not linear with a semi-log graph (Italy, Spain, Netherlands, etc).

  328. What you may have is a series of exponentials that start at different times. They also likely have different R0 depending on population density and so forth. Some people normalize by 100th case, 10th death, etc. I think it is best to only look at one region at a time than a bunch of loosely correlated regions which is probably a big mess.

  329. Ed Forbes (Comment #182079)
    April 2nd, 2020 at 11:21 am
    **Willis agrees with me that we are destroying the US economy with lock downs to no good purpose.**
    _________

    "Destroy" means to damage beyond repair. I don't see how lock downs can destroy the economy, and I don't understand what you mean by "to no good purpose."

  331. It's clear lock downs should work, and it's a good question of how well different methods actually work. A binary question of work/not work doesn't make any sense to me.
    .
    Questions such as "Is reducing the overall US population death rate in one year from 2% (no intervention) to 1% (massive recession) make sense?". You cannot have this debate currently because of the moralizing.

  332. Had a Telehealth appointment with my doctor today for prescription refills. It sure beat having to go to her office (no exposure to anyone, and a time and transportation saver). Telehealth has obvious limitations, but it is efficient.

  333. Tom, it sure looks like a binary question to me.
    .
    Sweden has not locked down and their rate of infection/death does not look that different than most others on lock down.
    .
    But I agree with you on the moralizing

  334. Tom Scharf (Comment #182093)

    Questions such as "Is reducing the overall US population death rate in one year from 2% (no intervention) to 1% (massive recession) make sense?". You cannot have this debate currently because of the moralizing.
    ________

    As Yogi Berra might say "Morality gets in the way of discussing what's right and what's wrong."

  336. Ed
    **April 2nd, 2020 at 11:21 am
    **Willis agrees with me that we are destroying the US economy with lock downs to no good purpose.**
    Perhaps we are. Or perhaps we aren't. We could debate that. But it has no bearing on whether the lines in this graph are "bending" or not

    https://i1.wp.com/wattsupwiththat.com/wp-content/uploads/2020/03/corona-deaths-states-20200331.png?w=713&ssl=1

    Uhhmmm reports from brother-in-law who is "essential personell"….. there is a supplemental refrigerated trailer on county grounds. It's a supplemental morgue for anticipated overflow.

  337. Covid-19 is thinning out the frail elderly, arguably to the economic benefit of everyone else. But money can’t buy love.

  338. First world problems. They didn't include "lawn service" personnel in essential businesses for Florida. That lasted about 24 hours before it was reversed.

  339. OK_Max,
    "arguably to the economic benefit of everyone else. Money can't buy love."
    .
    I am waiting to hear that argument.
    .
    But yes, MD's are going to let you catch Covid 19, and perhaps die, rather than issue the off-label prophylactic prescriptions for hydroxy chloroquine they already wrote for themselves and their families. You may have the money, but you don't have the love.

  340. Tom Scharf,
    "That lasted about 24 hours before it was reversed."
    .
    Well, I don't even have a lawn mower there in Florida, so lack of service would be a sort of emergency.

  341. Lucia,
    " It's a supplemental morgue for anticipated overflow."
    .
    At least the dead don't care much about how warm they are. If people know the trailer is there awaiting the arrival of the dead, then it sort of sends a negative message.
    .
    What was the old Saturday Night Live skit "Bring out your dead, bring out your dead"? I doubt it will reach that point.

  343. DeWitt,
    I realized that after I posted. Old comedy tends to blur in one’s memory (at least mine).

  344. Tom Scharf (Comment #182090)
    April 2nd, 2020 at 1:39 pm

    I agree that it does seem good statistical practice to lump all the state data together because of the factors you noted and several others that come to mind. In IL the data are broken down by counties and cities. Obtaining useful information from analysis of the data would be better to look at it by classification – like by large urban centers, suburban and rural areas and then further group it by age and other factors if the data size did not go below what would be needed for significance. Obviously start times of the outbreak would be an important classification factor. Even an analysis such as I have described would require a number of assumptions for modeling. I am not sure that the start times for lock downs and social distancing by edict are good measures since that would depend on how well the edicts were followed in practice. Unless policy makers are satisfied with one size fits all I would think they would seek out classified and grouped data analysis.

  345. There are massive layoffs. Wasn't the two trillion spending bill supposed to stop that by providing funds to firms to keep people on payroll? What am I missing?

  346. Mike M,
    Ummm… IMHO, the Federal response is orthogonal to any meaningful response. It will not significantly impact layoffs. All the Federal funds may keep some small companies from folding permanently… they may not. The blanket lockdown/closure approach being implemented by most states is horribly destructive and almost guaranteed to maximize economic damage. Almost any other approach would be less damaging. Nothing will stop the nightmare except seeing the infection and death rates turn over.

  347. In California Central Valley I notice more cars on the road this week over last week. I think the locals are getting a bit of cabin fervor.
    .
    One amusing point was on a trip to the nursery for plantings for my garden today, I noticed a road side t-shirt vender. Cars were hitting the brakes hard to stop and buy.
    .
    “F**k the Coronavirus” was the only shirt displayed for sale.

  348. Ed Forbes,
    “ I think the locals are getting a bit of cabin fervor.”
    .
    If so, they wouldn’t be driving, they would be chasing their significant other. 😉

  350. Tom Scharf (Comment #182105)
    April 2nd, 2020 at 4:39 pm

    "First world problems. They didn't include "lawn service" personnel in essential businesses for Florida. That lasted about 24 hours before it was reversed."

    And I see liquor stores in FL are considered "critical businesses".

    Here in PA, the state-run liquor stores are closed. Fortunately, a couple of years ago, they at least started allowing wine sales in grocery stores (yes, I said a couple of years ago).

    Proving once and for all, no state has any business running a retail sales operation, of any kind.

    More seriously, Florida is allowing road construction to continue. PA I guess thinks road construction crews are too stupid to practice social distancing.

  351. MikeM: "If you want to see if something is consistent with linear, you can't use a log scale."

    Has it occurred to you that maybe you can't but she can?

  352. SteveF (Comment #182110)

    OK_Max,
    "arguably to the economic benefit of everyone else. Money can't buy love."

    **I am waiting to hear that argument.**
    ___________

    SteveF, that argument is frail elderly people aren't worth the cost of saving from the coronavirus because they aren't productive and don't have long to live anyway.

    It's not an argument I'm making. I love old people more than I love money.

    Psalm 71:9 Do not cast me away when I am old; do not forsake me when my strength is gone.

  353. Saw the following at
    https://www.usatoday.com/story/news/nation/2020/04/02/states-without-stay-home-orders-residents-celebrate-freedoms

    I’m looking out the window of my dealership, and people are everywhere, it’s unbelievable,” says Chris Mayes, who owns Big Red Kia and Oklahoma Motorcars along the Mile of Cars commercial strip in Norman. “We’re not on lockdown here.”

    “At his Big Red Kia, which remains open, Mayes makes sure salespeople stay six feet away from customers.”
    ________

    Mayes should do that all the time.

  354. SteveF,
    On Twitter…. I have definitely heard people trying to claim that old people who died from covid-19 are just "inflating" the count and should be deemed to have died from something else, but only died "with" covid-19.
    .
    The argument is odd. After all, it's not like these old people were hit by cars while they just happened to be walking around "with" covid-19. And of course, if they had gotten flu and died, we'd call that a flu death. But somehow, some people want to say covid-isn't that bad because, for example, the person who died of covid also had diabetes… so we shouldn't count their death as "from covid" but "with covid"…..

  355. Ed Forbes (Comment #182122)

    One amusing point was on a trip to the nursery for plantings for my garden today, I noticed a road side t-shirt vender. Cars were hitting the brakes hard to stop and buy.
    .
    “F**k the Coronavirus” was the only shirt displayed for sale.
    ____________

    You can’t copulate with coronavirus, but you can get coronavirus from copulating.

    **Legal sex workers in Nevada struggling during coronavirus closures**

    “On March 18, Nevada Gov. Steve Sisolak announced the closure of all non-essential businesses, including bars and strip clubs, and the directive was expanded the following day to include the state’s brothels.” 

    https://www.recordnet.com/zz/news/20200402/legal-sex-workers-in-nevada-struggling-during-coronavirus-closures

    The one day delay suggests the governor needed additional time to think about whether brothels were essential businesses.

  356. OK_Max,
    When stores and bars are closed, they are closed. Not so easy to do with the oldest profession. The Governor’s order will be, shall we say, difficult to enforce. You can close the buildings, but it’s not easy to stop the workers.

  357. Lucia,
    You are right, that is a silly argument. The cause of death on the death certificate should be CoVid19.
    .
    I guess it is made because people are unwilling to face an uncomfortable reality: no society can afford unlimited expenditures to keep people alive as long as possible. Is extending a person’s life by one minute worth a million dollars spent by the public? How about an hour, a day, a week or a month? A year? (not rhetorical) Clearly, we as a society make this kind of decision all the time, it is just not usually explicitly discussed, and not usually one where only a small cohort (in this case, the very elderly, and especially the very infirm elderly) is at greatest risk. The huge cost for the current lockdown is a societal cost, is almost unimaginably damaging, and in the long run will be born only by younger people…. including many who are as yet unborn.
    .
    I have read the breathless news reports of Sweden refusing to close down their economy. None of these reports seem to “get it”: the Swedes have decided the cost of closing down their economy, and the reduction in quality of life during an extended “lockdown”, are not worth the benefit of slightly reduced risks.

  358. For those of us that have been following the numbers desperately seeking a bending in various curves, this news out of France is disturbing.

    “On April 2, France reported 884 additional deaths that have occurred in nursing homes over the past days and weeks [source]. The French Government did not include these deaths in their official count, as their count only takes into consideration deaths of hospitalized patients. Following international standards of correct inclusion, our statistics will include these deaths, and will add them to the April 2, 2020 count following the attribution criteria of date of report.

    If and when the French government determines and communicates the correct distribution of these additional deaths over time, we will adjust the historical data accordingly. A similar issue took place on February 12, when China reported an additional 13,332 new cases in a single day due to a change in how cases were diagnosed and reported in Hubei.”
    France now has one scary looking death curve.

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

  359. The problem is a "scary looking death curve" hides important context. This is good for media horror stories, but useless for proper risk assessment. I want to see a breakdown of deaths by age and health. I want to see how many require intubation by age and health. I want to see how many have a few miserable days in bed etc etc.
    .
    These gross statistics hide the gritty details required to make proper decisions and this needs correcting.

  361. Here's a question about the daily Gov. Cuomo briefing:
    The other day he said (figures approximate) 1200 hospitalizations, 1100 releases from hospital, 400 deaths. Does that imply a reduction in patient count? (+1200-1100-400= -300) Or did he mean a net increase of hospitalized patients? There was no chart about hospital population that I recall.
    TIA

  362. The silver lining: A break from all the climate change "biggest challenge of our time", "existential crisis", blah blah blah. The budget priority will be early pandemic detection and control for a while I suspect.

  363. lucia (Comment #182131): "And of course, if they had gotten flu and died, we'd call that a flu death."
    .
    It is actually not even close to being that simple.
    https://sciencebasedmedicine.org/influenza-deaths/
    and
    https://aspe.hhs.gov/cdc-%E2%80%94-influenza-deaths-request-correction-rfc
    "according to the CDC's National Center for Health Statistics (NCHS), "influenza and pneumonia" took 62 034 lives in 2001—61 777 of which were attributed to pneumonia and 257 to flu, and in only 18 cases was flu virus positively identified".
    .
    I think that might suggest that the Wuhan virus is worse, relative to the flu, than the numbers imply.

  364. "Infectious outbreaks, like the novel coronavirus, could become more common as climate change forces animals and humans to live in closer proximity, according to an infectious disease specialist." – Christine Johnson, director at the One Health Institute at UC Davis
    .
    Over the past decade, Johnson studied emerging infectious diseases as the director of PREDICT, a project funded by the United States Agency for Public Development.
    .
    "We discovered well over 1,000 viruses that had not been known to man," said Johnson. "It was a big effort to focus on viruses that we think could be a potential pandemic."
    .
    "Johnson believes mitigating climate change is crucial to prevent disease transmission."
    .
    …..

  365. Yes, the "all roads lead to and from climate change" argument. People make the argument about pandemics getting worse with climate change with a straight face ignoring the actual history over the past 150 years. Healthcare innovation has far exceeded any climate effects. The flu gets worse with cold weather, but whatever, let's not bring that up. I'm sure the climate activists are searching for an angle here, just getting drowned out by an actual emergency.

  366. Just to clarify, pneumonia is a pathology. It's an inflammation of the lungs which leads to things like a build up of fluid. There are many causes of pneumonia, of which bacteria and viruses are the most common, but it is also caused by fungi and inhaling noxious stuff.
    .
    So, a comment like "influenza and pneumonia" took 62 034 lives in 2001—61 777 of which were attributed to pneumonia and 257 to flu" suggests to me that the people who died of "flu" died of something other than pneumonia while the pneumonia cases include those who had "flu".
    .
    Using the same criteria, most people don't die from CV19, they die from pneumonia.

  367. SteveF
    **Is extending a person’s life by one minute worth a million dollars spent by the public? How about an hour, a day, a week or a month? A year? (not rhetorical) **
    Those are all important questions that need to be discussed. I think people wanting coroners to NOT mark COVID-19 as the cause of death want to avoid that discussion. There's really no good reason to somehow have a DIFFERENT method of attributing death than we had when old people died of flu, pneumonia, urinary tract infections and so on.
    .
    My mother in law ultimately died of a urinary tract infection. She was 97. If she'd been 60 yo, without Alzheimers yada, yada… she probably would have lived. But that's no reason to write died "with" a UTI but "of" old age and her death certificate lists UTI as her cause of death. Anyone who wants to later process the data can figure out she was old!!

  368. DaveJR
    **The problem is a "scary looking death curve" hides important context. **
    The curves don't hide anything. You can still look at additional data. Many people are looking at additional data. They can also make other curves. One curve doesn't preclude any other whether that curve is scary or not.

  369. MikeM
    I'm not sure what point you are trying to make. The quote says those deaths WERE atrributed to flu

    **"according to the CDC's National Center for Health Statistics (NCHS), "influenza and pneumonia" took 62 034 lives in 2001—61 777 of which were attributed to pneumonia and 257 to flu, and in only 18 cases was flu virus positively identified".**
    .
    Is your objection that these flu deaths should have been attributed to something else? Like diabetes? Or old age? If whatever your objects, why is that something you object to? Real question?

  371. Ed Forbes,

    I recommend reading the comments on your link. To put it mildly, they aren't very favorable. For example, the idea that only 1% of the population would be infected in the absence of lockdowns and social distancing is patently ridiculous. In his example of the cruise ship, 25% of the passengers were infected. He's correct that we don't have enough data, but that's almost always the case until long after the situation is resolved.

  372. Ed Forbes (Comment #182151) quoting John Ioannidis: “The current coronavirus disease, Covid-19, has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco.”
    .
    Indeed. The panic has been due to concern that the Wuhan virus might overwhelm the health care system. Independent of what the statistics are, it would appear that those concerns are being borne out by events. But is some of the strain in the system being caused by the panic? Hard to say.

    It seems to me that a greater concern is that there is no evidence that the extreme measures being taken will help. Indeed, it is not clear if they are having any effect.

    There are about 8-9K deaths a day in the U.S. There are 1K reported deaths a day from Wuhan. So it ought to be visible in the total death rate. That is the number that matters. That is also how they get the death rate for the flu. Anybody know where to find those numbers?

  373. Willis updates. He uses the $2T fed bailout #, where the # is MUCH higher taking in the costs borne by the public
    .
    https://wattsupwiththat.com/2020/04/01/do-lockdowns-work/

    “ Suppose the “flattening the curve” saves 10% of them. By all indications, it won’t, but let’s use that number.
    .
    That means that we have spent two trillion dollars to save maybe 8,000 people.
    .
    And that, in turn, means that we’ve spent a QUARTER BILLION DOLLARS PER PERSON, most of them over 70 like me but unlike me with other diseases, and put our economy in the crapper in the bargain. I may be wrong, but somehow I don’t think my life is worth a quarter billion dollars.”

  374. Anybody want to start a pool on when Sweden imposes a lockdown? If you look at the numbers, the percentage of severe cases in Sweden is high. That indicates to me that the number of cases reported is low. Considering that cases and deaths are increasing exponentially, I give them no more than two weeks before they are overwhelmed or realize that they are going to be overwhelmed.

  376. DeWitt Payne
    **Anybody want to start a pool on when Sweden imposes a lockdown? **
    Yeah. There are "cause vs effect" issues at play in interpreting the effect of lockdowns from the various graphs. Plus there is debating what "lockdown" means. Officially, we in Illinois are on "stay at home" but not really "locked down". We've been this way since 5 pm March 21, so not quite 14 days. That's just enough time to potentially start seeing changes in "new cases", but probably not quite enough to see the effect on "deaths". (And, I remind people, I think "new cases" is to difficult to interpret because it's testing limited.)

    Some other States are only just starting "stay at home"– or have it in some places but not others. Given how recent any 'stay at home' is in most parts of the country, I don't think comparing our death rates to those in Sweden tells us anything about the effectiveness of lockdowns (or stay at home) YET. It might in about 2-3 weeks IF Sweden persists in not instituting stay at home AND our curve bends while theirs does not.
    .
    That said: we probably should be wearing washable homemade masks when we do go to the grocery store or on other important errands. (And of course washing them after each use!) I think I'm going to finally break down and make some after I tutor from 2:30-3:30. One of my students said he and his buddies were going to make them. And that's an "immortal teenager" speaking!
    .

  377. DeWitt Payne (Comment #182155): "Anybody want to start a pool on when Sweden imposes a lockdown? … I give them no more than two weeks before they are overwhelmed or realize that they are going to be overwhelmed."
    .
    Those are two different things. Places with lockdowns have been or will be overwhelmed. The question is whether lockdowns help. So far, there is no evidence they do. Sweden is smack in the middle of various EU countries, following a parallel path.
    https://en.wikipedia.org/wiki/File:COVID-19-Europe-selection-relative-deaths-log.svg

    ———-
    Addition: Do we know why epidemics stop? Real question. They don't just run out of victims. There were three waves to the Spanish flu and two waves to the 2009 swine flu.

  378. DeWitt,
    This interesting site (https://covid19.healthdata.org/projections) projects total US deaths at ~93,000 through the end of the pandemic. Since we have about 2.9 million deaths a year from all causes, the entire pandemic looks to add 3.2% to total deaths for 2020. Suppose all the efforts so far expended and all efforts to come cuts the total deaths by a factor of 3…. IOW, if all we did was bid granny goodbye, maybe there would have been another 186,000 deaths (I very much doubt this, but suggest it as a worst case). The economic cost will likely total $5 trillion or more…. so each life saved costs ~$27 million. This is madness.
    .
    The Swedes have a slightly older population than the States, so their death rate might be slightly higher, but not that much higher. I suspect the Swedes may try to reduce contacts with the highest risk population, but I doubt they are going to shut down a large part of their economy.

  380. Luica,
    "I think I'm going to finally break down and make some after I tutor from 2:30-3:30."
    .
    My wife has been turning out 4 or 5 an hour when she is not caring for our 18 month old granddaughter, and selling most of them for $5 each to raise money for her sewing school in Haiti.

  381. DeWitt Payne (Comment #182155)

    "Anybody want to start a pool on when Sweden imposes a lockdown? … I give them no more than two weeks before they are overwhelmed or realize that they are going to be overwhelmed."
    ______

    "No more than 2 weeks" sounds about right.

    The result of Sweden's "no lockdown" policy may be beginning to show up in the case data. Cases reported the first two days in April represent 18% of Sweden's Covid-19 cumulative total, compared to 15% and 9% of the totals for Denmark and Norway, respectively.

    Covid-19 data for Sweden and other Nordic countries are available at

    https://www.statista.com/topics/6123/coronavirus-covid-19-in-the-nordics/#dossierSummary__chapter3

  382. OK_Max,
    Sweden's population is double Norway's and double Denmark's. The progression of the spread is unlikely to be the same in these countries. With no "lockdown, the peak rate is likely to be higher and the overall duration less. FWIW, Norway, Denmark, and Sweden all have about the same number of cases….. that won't continue, Sweden will eventually catch up on a per million population basis.

  384. SteveF (Comment #182164)

    *Sweden's population is double Norway's and double Denmark's.*

    Yes, I know. But I wasn't comparing absolute numbers.

    *With no "lockdown, the peak rate is likely to be higher and the overall duration less.*

    I'm not sure what you mean by "duration less."

    *Denmark, and Sweden all have about the same number of cases….. that won't continue, Sweden will eventually catch up on a per million population basis.*

    I expect it to catch up and pass.

    BTW, estimates of costs to fight coronavirus should be related not only to number of lives saved, but also to number of infections prevented. While some of the infected suffer very little others can suffer a lot before recovering.

  385. OK_Max,
    By shorter duration, I mean, the time until the rate of new deaths falls to near zero. For example, go to this site: (https://covid19.healthdata.org/projections) and compare the projected rates of death for New York and Florida. They are very different in duration.
    .
    We will have to wait and see what happens in the end to these countries with very different policies. I do think that prudent sheltering (protect those at great risk) can make a big difference in total deaths per million population. Economically destructive lock downs? Not likely much different for total deaths, but very different for total costs.

  386. You can't compare different regions for whether a lock down works. You need to compare how the curve bends a couple weeks after the lock down is in effect and being complied with.
    .
    The cost per life must be compared against the number of deaths without a lock down. In theory this is letting the exponential keep going until it reaches herd immunity and factoring in extra deaths due to lack of resources in hospitals. This is the upper bound, it's very unclear whether a lower bound should reasonably be used.
    .
    I wore my first face mask to the grocery store today. Felt like an idiot until I saw a bunch of others in there with them. About 5% to 10% of the people, I bet next week it will be 50%. R0(mask).

  387. Tom Scharf,
    "You need to compare how the curve bends a couple weeks after the lock down is in effect and being complied with."
    .
    It is the "complied with" part that is doubtful. I think the comparison has to be places where a lock-down is attempted (no matter how successful) and places where it is not attempted. Sweden may well give us that comparison.
    .
    WRT masks: I saw some people here in Martin County wearing them in the store today…. but not many. Maybe because the county has only 37 positive tests (out of several hundred tested).

  388. Tom Scharf (Comment #182168): "You can't compare different regions for whether a lock down works. You need to compare how the curve bends a couple weeks after the lock down is in effect and being complied with."
    .
    New Mexico was faster than some states in shutting down and slower than others.

    It is now 3 weeks of a public health emergency in NM with all large gatherings banned, schools closed, people encouraged to work from home, and to practice social distancing. Hasn't worked.

    It is more than two weeks since those rules were tightened. No effect.

    It is two weeks since gatherings were limited to 10 or fewer; bars, restaurants, theaters, malls etc closed. No effect yet.

    10 days of a virtual lockdown. No sign of any effect.

    I supported pretty much all of the above. I was wrong.

  389. You can compare NYC(lock down) to rural Kansas (no lock down) and assert lock downs make things much worse. A comparison between "all things being equal" regions could work but I doubt all things are going to be equal. Compliance is definitely an issue, I suspect compliance will increase as death tolls mount.
    .
    I think two weeks is the minimum to start seeing the effect.
    5 days for symptoms to appear.
    2 days to get bad enough for a test to be authorized
    7 days for test results.
    .
    So approximately a two week lag time. But I'm on board for not doing it if it doesn't work. I think the jury is still out and I think it will reduce things, but not nearly as much as some people expect. Reducing the doubling time from 3 days to 6 days should be significant.

  390. Here is probably the most unlikely map I have ever seen:
    https://google.com/covid19-map/?hl=en
    .
    Most every developed country with good health care is suffering high case rates and deaths, while every country that has poorer health care seems to have very few cases. What the heck?!?
    .
    Is this an illness being spread by the health care system? Or are there just vast numbers of cases not being reported? Or some other explanation? I have no idea.

  391. Tom Scharf (Comment #182171): "I think two weeks is the minimum to start seeing the effect.
    5 days for symptoms to appear.
    2 days to get bad enough for a test to be authorized
    7 days for test results."
    .
    7 days for results? Then what is the point of the #!*@ test? It should take no more than 2-3 days, positives in no more than 1-2 days.

  393. SteveF (Comment #182172): "Most every developed country with good health care is suffering high case rates and deaths, while every country that has poorer health care seems to have very few cases."

    You can't count cases if you don't test people. People without access to doctors won't get tested.

    Also, I am guessing that most of the countries with low rates are in the tropics or subtropics. Lots of people taking malaria drugs. And warmer weather means less transmission.

    Guessing since Google is persona non grata on my computer.

  395. Tom Scharf
    **You can compare NYC(lock down) to rural Kansas (no lock down) and assert lock downs make things much worse. **
    Haha! Yeah. Mostly, people in rural areas don't take subways. 🙂

  396. SteveF,
    If you read the early cases, you can see why things popped up in wealthy countries first. Those populations fly to other places for work and recreation. Early reports would be people who'd gone on vacation in Asia, people who went skiing in Europe, kids back from their year abroad at school, people at business conferences and so on.
    .
    It's going to transition to hitting lower income workers who are manning grocery stores, warehouses and so on. But the first start is wealthier people who "got around".

  397. Mike M,
    Here is the weird thing: in countries like Brazil or India, there are pockets of almost unimaginable crowding, poverty, and lack of sanitary conditions. Yet even though these countries can count deaths, there is no explosion of coronavirus deaths. I had multiple Brazilians say they were terrified what would happen when the illness reached the favelas…. nothing happened.
    .
    Maybe we are seeing a version of the polio effect: polio was a non-illness so long as everyone contracted the illness as an infant. When wealth and hygiene improved, kids began getting polio much later, and it started killing them. Real question: Is the squalor in poor countries exposing people to other strains of coronavirus so frequently that they have better resistance to coronavirus 19?
    .
    I think it might be worthwhile examining the frequency of contracting the illness and individual wealth (which brings with it a very different environment).

  399. Lucia,
    “It's going to transition to hitting lower income workers who are manning grocery stores, warehouses and so on. But the first start is wealthier people who "got around".”
    .
    I have to say I am a bit skeptical about that. The places I am talking about appear perfect for transmission, but it isn’t happening. We’ll see if that changes.

  400. SteveF,

    Based on number of cases, Brazil is at least three weeks behind Italy. If you correct for the difference in population, more like four weeks behind. Deaths have doubled in the last three days. I wouldn't be quite so sanguine about Brazil as you seem to be.

    Some interesting information about Italy from worldometers:

    "Italy: the real number of COVID-19 cases in the country could be 5,000,0000 (compared to the 119,827 confirmed ones) according to a study which polled people with symptoms who have not been tested, and up to 10,000,000 or even 20,0000,000 after taking into account asymptomatic cases, according to Carlo La Vecchia, a Professor of Medical Statistics and Epidemiology at the Statale di Milano University.

    This number would still be insufficient to reach herd immunity, which would require 2/3 of the population (about 40,000,000 people in Italy) having contracted the virus [source].

    The number of deaths could also be underestimated by 3/4 (in Italy as well as in other countries) [source], meaning that the real number of deaths in Italy could be around 60,000.

    If these estimates were true, the mortality rate from COVID-19 would be much lower (around 25 times less) than the case fatality rate based solely on laboratory-confirmed cases and deaths, since it would be underestimating cases (the denominator) by a factor of about 1/100 and deaths by a factor of 1/4."

    Apply that to New York and you get about half the population already having been infected. Note 60,000 deaths and 20 million cases would mean the CFR is 0.3%. But we probably haven't seen all the deaths yet.

    However, if the number of infected really is 20,000,000 then the new case curve would be bending anyway. That rather calls into question whether social distancing or whatever is accomplishing anything in Italy.

  401. DeWitt,
    WRT Brazil: we will see what happens over the next few weeks. As of now the number of cases is not growing exponentially, thought there is always uncertainty about the accuracy of that count.
    .
    One thing I am puzzled about is the apparent assumption that everyone is susceptible to being infected. I don’t know how anyone can possibly know this. It matters because the number of people needed to reach herd immunity depends on the number who are susceptible in the first place. The apparent transmission frequency (about 2 infected for each person who gets the disease) could be the result of a higher transmission rate among a susceptible population combined with near zero transmission to a non-susceptible population. For example, the transmission frequency could be 4 among the susceptible, but appear to be 2 if half the population is resistant to infection. In such a hypothetical population, the total number of cases to reach herd immunity would be about 1/4 of the total population, not half.

  402. I am beginning to think that John Ioannidis is right. This is turning into a once-in-a-century evidence fiasco.

    We have no idea how many people have had the virus.

    We have no idea what brings an epidemic in any region to an end.

    We have no idea how many people are susceptible.

    We don't know how it is transmitted.

    We have no idea how to control it.

    We don't know why it behaves differently in different places.

    We don't know what similar coronaviri might be circulating, whether they might confer some immunity, or whether they might give a positive test for the Wuhan virus.

    But hey, let's burn a few trillion dollars based on guesses.

    Maybe we should try curing it by blood letting.

  403. Mike M,
    Dramatic actions based on little evidence are the most frightening things of all. I have seen beheaded chickens act more rationally than what I see happening right now.
    .
    It seems "first do no harm" ends at the doctor's office door. When it's the economy, the rule is "first, do all the harm you want". It's worse than unintended bad consequences; major decisions are being made with known *intended* very bad consequences, and the unintended ones will come on top of those… all based on an almost complete lack of accurate information.

  404. This paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095096/ reports that a suspected outbreak of SARS in a nursing home, which infected 1/3 of the staff and 2/3 of the residents (and killed several residents), was in fact just the run-of-the-mill corona virus which causes many common colds. Yet initial tests for SARS were positive….. the SARS test was detecting the “common” human corona virus, not the SARS virus. Makes one wonder about the specificity of the current tests for corona virus 19.
    .
    Mike M,
    John Ioannidis is in danger of being broadly attacked by the MSM for trying to be rational…. something which is simply verboten at this time.

  405. Make no mistake, the science worshipers, the academy, and "experts" are on trial here. Everyone who has been tut-tutted and shamed as being under-educated are now looking to the experts to do their magical science thing and fix this.
    .
    As Mike M has pointed out above, the results are not entirely convincing so far. Don't even get me started on the mask reversal and the pathetic excuse that it's because of "new evidence". The usual suspects in the media go immediately from shaming people who want to wear a mask to shaming those who won't.
    .
    My guess is they will come through with improved treatment and a fast(er) vaccine. A lot of work done over the past decades with genetic sequencing has been helpful here.
    .
    The front line medical establishment is obviously doing their job and deserve their praise. Beyond the front line I'm not so sure I see a real sense of urgency. This is the furthest thing from business as usual. Service industry workers sitting home unemployed without health insurance are unlikely to have much patience with the situation as they protect the professional set working at home from the virus. Math-splaining to the unemployed is not likely to go over well 6 weeks in without toilet paper and sick people in their household. Shaming people who need a job to survive is going to get Trump re-elected.

  406. On the lighter side…
    .
    Welcome Back, Plastic Bags
    https://www.nationalreview.com/2020/04/welcome-back-plastic-bags/
    .
    "Cue up a head-spinning headline: San Francisco has just banned the use of reusable tote bags and switched back to single-use plastic bags to help fight the spread of the coronavirus. In New Hampshire, on March 21, Governor Chris Sununu signed an executive order to the same effect. Massachusetts governor Charlie Baker followed suit on March 25. A Maine ban on plastic bags was due to take effect on April 22 but has just been pushed back until next year."

  407. Some of the good folks here seem to be forgetting the policy goal of the lockdown. It is not meant to reduce the number of cases, with the exception of the very old who need to be isolated for a long period of time.

    For the general population, the intent is to space out the infections over a longer period so as to reduce the burden on our healthcare systems.

    That is what we're trying to accomplish. If you believe in the Viscount of Bletchley over at WUWT, it seems to be having the desired effect.

  408. Thomas Fuller (Comment #182190): "For the general population, the intent is to space out the infections over a longer period so as to reduce the burden on our healthcare systems."
    .
    If that is what they think they are doing, then they are idiots.

    The healthcare system in New York City is groaning under the burden of merely 10K new cases a day, 0.1% of the population per day. At that rate, it will take 1000 days for everyone to be infected. The only way it can work is if only a fraction of the population is susceptible and the overwhelming majority of cases are so mild as to be undetected. But if that is true, then the extreme measures are not needed.

  409. SteveF (Comment #182187): "Yet initial tests for SARS were positive….. the SARS test was detecting the “common” human corona virus, not the SARS virus. Makes one wonder about the specificity of the current tests for corona virus 19."
    .
    That is very interesting. I wondered above (Comment #182083) about when false positives might occur because of an unknown human coronavirus; I'd have thought they'd be able to make sure the test did not respond to the known ones.

    And as SteveF pointed out earlier, maybe people who have been infected by a particular human coronavirus have partial or full immunity to the Wuhan virus. We don't know.

    Maybe someone here can answer this question. My immune system has responded to a number of different influenza strains over my lifetime. Does that make it more able to respond to strains that are similar to the ones it has seen before?

  410. The WP's review of the testing debacle:
    https://www.washingtonpost.com/investigations/2020/04/03/coronavirus-cdc-test-kits-public-health-labs/
    .
    It's similar to the NYT's review. Utter bureaucratic disaster by the overly rigid FDA. I found this part particularly entertaining:
    .
    "But when he finally submitted the material, an FDA official told him the agency could not accept it — because he had emailed it."
    .
    "In a statement, an FDA official said information sent by Greninger on Feb. 19 was promptly reviewed, despite not having been submitted properly, and was found to be insufficient to demonstrate that the test would work. The official said that after that interaction, “we immediately addressed how we receive applications.”"
    .
    This is how it works at the FDA from my experience:
    .
    FDA: "insufficient to demonstrate that the test would work"
    You: "what was wrong with it?"
    FDA: "We can't tell you that, it would be unfair to competitors"
    You: "What do we do now?"
    FDA: "Submit a revised report, and we will review it within 90 days"
    .
    They won't tell you their testing requirements or what would convince them. The way you get around this is by hiring people from other companies who know the process and have successfully navigated the system. Large companies lobby the FDA to create very complex review processes as barriers to entry in the market for smaller companies. It is a daunting process, getting FDA approval is a huge step in medical products.

  411. Thomas Fuller,
    My guess is that the size of the susceptible population is far smaller than imagined, and that is in part responsible for the curve bending. Yes, social distancing, lockdowns, etc (AKA economic destruction) slows the spread a bit and so takes some pressure off the hospitals. But the sad truth is: most people who go on a ventilator in the hospital die. There won’t likely be much impact on the death rate for lack of ventilators, should that happen.
    .
    BTW, if you have not already done so, I suggest you read the paper I linked to above. The common coronavirus, which is in constant circulation, can cause very similar outcomes among the old and infirm.

  412. Mike M,
    Almost certainly the more strains of influenza you have seen, the better you will be at fighting other strains. Look what happened to native populations in the Americas with influenza. I got the flu multiple times through age 50…. but not since. (I started taking vaccine this year at age 69, so the lack of flu this year doesn’t count.)

  413. SteveF (Comment #182167)
    April 3rd, 2020 at 3:07 pm
    OK_Max,
    By shorter duration, I mean, the time until the rate of new deaths falls to near zero.
    _________

    Thanks for the clarification.

  414. SteveF (Comment #182160)
    "if all we did was bid granny goodbye, maybe there would have been another 186,000 deaths (I very much doubt this, but suggest it as a worst case). The economic cost will likely total $5 trillion or more…. so each life saved costs ~$27 million. This is madness."

    Bidding granny goodbye?… that's a bit cold, but there's more to this than just telling older people that we want to sacrifice them for the good of the economy. This virus can spread through society like a fire through dry grass on a windy day. You only have to look at what's happening in New York to see that this is no ordinary 'flu'. If left unchecked, this virus would infect so many people in such a short time frame that not only would every hospital in the country be overwhelmed (leading to even more deaths because people would just be sent home to die), but everything would grind to a halt as sick people don't turn up for work. The effects would cascade through society and it would have a really ugly outcome.

    Yeah, the government is spending a lot of money on this, but trying to run the country in a 'business as usual' fashion is not a very good option during this pandemic.

  415. skeptical,
    My “bid granny goodbye” comment was intended as a joke. Of course the most susceptible should be isolated as much as possible to avoid unnecessary deaths.
    .
    Please read my link above to the paper about an assumed SARS flareup at a nursing home. The *normal* coronavirus strains, which cause many “common colds” are fatal to many of the very old and infirm. Yes, it is likely this new strain of corona virus is more deadly than existing strains, but it is unclear exactly how much more. Unfortunately, many hugely expensive decisions are being made based almost 100% on fear rather than data… or even critical reasoning. When the pandemic passes…. and it will pass within 4 or 5 months, if not sooner, data will gradually become available and the many follies of panic driven public policy will be evident. You might also read John Ioannidis’s take on the current handling of the crisis.

  416. According to a major grocery owner in NYC in an article in today's WSJ ( https://www.wsj.com/articles/a-coronavirus-bull-market-for-groceries-11585937507?mod=opinion_lead_pos7 ), 60% of the food dollar in NYC was spent in restaurants. That, rather than mass transport and high population density, may be the most significant factor in the rapid spread of covid-19 in NYC. Note that the two counties north of NYC, Westchester and Rockland, are also highly infected compared to the rest of the state beyond the NYC area.

    Another article I just found says that New Yorkers eat out 130 percent more than other Americans. Or at least they spend 130 percent more. Some of that may be due to the higher cost of living in NYC. Also, in Manhattan at least there is a higher than average percentage of single member households.

    "Moreover, food-and-beverage costs tend to be higher in New York than in other areas of the country."

    https://www.icsc.com/news-and-views/icsc-exchange/new-yorkers-eat-out-130-percent-more-than-other-americans-report

  417. Tom Scharf,

    "Make no mistake, the science worshipers, the academy, and "experts" are on trial here. Everyone who has been tut-tutted and shamed as being under-educated are now looking to the experts to do their magical science thing and fix this."

    Anybody else see a possible application to the climate change situation? If the models for infection rates and deaths don't hold up, I expect lots more people to ignore the climate change hype. The meme 'we know what's coming and how to fix it' won't hold water.

  418. DeWitt,
    Yup. If you stay away from crowds, you're not likely to catch the virus. In cities like New York, it is actually worse than just restaurants: high density public transportation, and even high density walking of the streets, adds to the chance of spread. NYC is the ideal place to spread the disease. Rural upstate NY, not so much.
    .
    My oldest son was commuting every day to Manhattan before he was told to work at home. Fortunately for him, he rode an electric scooter the 1.5 miles between his bus stop at Port Authority and his office. No public transport. He is healthy.

  419. DeWitt,
    "Anybody else see a possible application to the climate change situation? If the models for infection rates and deaths don't hold up, I expect lots more people to ignore the climate change hype. The meme 'we know what's coming and how to fix it' won't hold water."
    .
    Finally, something good which may come from corona virus 19. No, corona virus 19 will not end the world. No, warming 1 C by 2060 will not end the world. Some things that appear obvious to the sane need to be explicitly stated for the rest. Whether they will listen is a different question.

  420. Tom Scharf,
    "Make no mistake, the science worshipers, the academy, and "experts" are on trial here. Everyone who has been tut-tutted and shamed as being under-educated are now looking to the experts to do their magical science thing and fix this."

    I get the view from MSM that many of them think that both the economy and science can be turned on and directed with what to me seem to be magical powers of government and scientists. Put the economy in the dumper because science says that is what you have to do. Recover the economy – when science says it is safe to come out – by the government printing money, fixing very low interests rates and spending trillions of dollars it does not have.

    I am not at all confident that the under-, over- and goldilocks-educated are not believers in this magic. If one magic potion fails there are others yet to be tried. It is simply a matter of keeping the masses believing.

    Atlas was not shrugging this time; he was quarantined.

  421. Thomas Fuller (Comment #182190)
    For the general population, the intent is to space out the infections over a longer period so as to reduce the burden on our healthcare systems.
    __________

    One of my wife's friend's cancer surgery has been put on hold because hospital beds are not available.

  422. Kenneth,
    "I am not at all confident that the under-, over- and goldilocks-educated are not believers in this magic."
    .
    They clearly ARE believers in that magic. It is so weird to me that I often have trouble wrapping my head around it: a bunch of people who know absolutely nothing about science or technology and couldn't understand a model of spread of a disease if it jumped up and bit them in the buttocks, declare that they "believe" a certain analysis, and they have enormous influence over policy. They don't know what they are doing. It is like the clowns are running the circus.

  423. Thomas Fuller (Comment #182190)
    April 4th, 2020 at 10:53 am

    "Some of the good folks here seem to be forgetting the policy goal of the lockdown. It is not meant to reduce the number of cases, with the exception of the very old who need to be isolated for a long period of time.
    For the general population, the intent is to space out the infections over a longer period so as to reduce the burden on our healthcare systems."

    I have brought this matter to the attention of this website previously and I doubt that it is a view held by only a few participants here. That does not, however, imply that the policy decisions have been correct in avoiding the overwhelming of the healthcare system or that policies have been successful or that it was required to shut down the economy in order to keep the healthcare system up and running in one fashion or another.

    It would be most interesting to hear a politician – any politician – state that we are not going to save lives or numbers of cases due to Covid-19 by our mitigation policies, but rather spread out the cases and deaths.

  424. SteveF (Comment #182204)
    No, corona virus 19 will not end the world. No, warming 1 C by 2060 will not end the world. Some things that appear obvious to the sane need to be explicitly stated for the rest. Whether they will listen is a different question.
    _________

    Who thinks Covid-19 will end the world ?

  425. Kenneth Fritsch (Comment #182205): "I am not at all confident that the under-, over- and goldilocks-educated are not believers in this magic. If one magic potion fails there are others yet to be tried. It is simply a matter of keeping the masses believing."
    .
    Indeed. No matter what happens, the magicians will claim to have been right. If the virus suddenly ebbs away, it will be because we did as told. If it is bad, they will have saved us from something much worse. If it ends up being both a viral and economic catastrophe, it will be because we were insufficiently dedicated in taking their advice. And they will continue in their efforts to turn science into a godless religion.

  426. >high density public transportation, and even high density walking of the streets,

    Both of which are high up in the agenda of how to tackle global warming.

  427. OK_Max,
    "Who thinks Covid-19 will end the world ?"
    .
    Based on the policies coming from Washington DC (not to mention many policies from state capitals), that appears to be the consensus: *any* cost is OK to pay to reduce spread of the virus.
    .
    IMO, that is just nuts. Really, just crazy. Any cost is *not* OK to pay to reduce spread of the virus.

  428. SteveF, malaria countries are being hit less, perhaps because of the anti-malarial drugs.
    Countries with more incidence of various strains of flu could be expected to have more resistance.

    Also, countries with worse healthcare systems can be expected to have populations that are genetically more resistant to disease, as wealthier countries kept alive people with weak immunity.

  429. Mike N,
    "Both of which are high up in the agenda of how to tackle global warming."
    .
    Of course!
    .
    You, obviously a stinking CO2 emitting worm, do not deserve even a miserable existence, if that includes emission of CO2… you must crowd into inconvenient and costly public transport, where, it is hoped, you will contract a fatal communicable disease, and end your sorry existence, leaving the world a better place for the whales and polar bears to frolic. Some people love humanity… some do no.

  430. SteveF,

    Deaths (from this virus) in the U.S. have been doubling every 2.75 days…. and it's still doubling at that rate now. Run some numbers if you don't believe me. If this rate continues, you'll be looking at one million (1,000,000) dead people by around the 23rd of THIS month. Sorry granny, I didn't realize is was going to be this bad.

    Even with the hugely expensive shutdown policy the numbers are still going to be bad, but when these policies start to 'bite' we should see that doubling time get longer and hopefully less grannies will have to be fare-welled.

  431. OK_Max,
    "Who thinks Covid-19 will end the world ?"
    .
    Based on the policies coming from Washington DC (not to mention many policies from state capitals), that appears to be the consensus: *any* cost is OK to pay to reduce spread of the virus.
    _______

    I haven't heard Fed or State government officials saying at "any" cost.

    Looks like in dollars the costs will be less than the cost of WWII and less than the cost of the Iraq/afghan war.

  432. skeptical,
    I think you have been reading too many alarmist stories about this. 1 million extra deaths in the USA? As far as I am aware, most projections of US deaths are in the range of (most likely) 100,000 to (worst case) 200,000. You want to bet $1,000 to your favorite charity or mine that deaths go above 300,000? I say they absolutely will not.
    .
    BTW, if extra deaths reached 250,000, that would represent an ~8.5% increase in deaths compared to a typical year. The most likely death rate represents about a 3% to 3.5% increase over the typical death rate for a year.

  433. OK_Max (Comment #182216)

    "I haven't heard Fed or State government officials saying at "any" cost.

    Looks like in dollars the costs will be less than the cost of WWII and less than the cost of the Iraq/afghan war."

    Max, with all due respect where the heck would you get the eventual costs for the shut down of the economy and particularly when the government is stating that they will go back for more money as the needs arise. The eventual costs of wars, including and especially the Iraq war, are always much larger than the government claims on initiation.

    The economy has never been intentionally shut down like currently- it is unprecedented.

  434. skeptikal, things are bad enough, but US deaths are doubling every 4 days, not 2.75.

  435. Kenneth,
    “The economy has never been intentionally shut down like currently- it is unprecedented.”
    .
    Indeed. Sometimes you have to restate the obvious.

  436. Kenneth Fritsch (Comment #182218)

    Max, with all due respect where the heck would you get the eventual costs for the shut down of the economy and particularly when the government is stating that they will go back for more money as the needs arise. The eventual costs of wars, including and especially the Iraq war, are always much larger than the government claims on initiation.

    The economy has never been intentionally shut down like currently- it is unprecedented.
    _________

    Kenneth, the economy has been only partially shut down, but yes the partial shutdown is unprecedented.

    The cost in lost production and government spending is yet to be determined, as is the cost of not having a shutdown (if that alternative had been chosen), so we shall see, or not.

  438. SteveF,

    Most projections of U.S. deaths are based on the policies being implemented…. you know, the policies you so despise. I'm hoping that these policies help to keep deaths low, but I'm not even going to try to guess the final death count. The one million deaths I said was IF the doubling time stayed at 2.75 days, which it won't… the doubling time will get longer because of those expensive policies which you think are a waste of money.

    You don't seem to care how many people die… I find that a little bit disturbing. You also don't seem to accept that these expensive policies are going to save lives. If these policies do keep the final death count low, you'll probably say "see it was just another flu and we wasted all that money for nothing".

  439. Thomas Fuller,

    Day zero (first death) was Feb 28th. A 4 day doubling would give the U.S. a death count of around 500 now. Actual death count is over 8000.

    Run your numbers again.

  440. skeptical,
    The policies, as has been explained multiple time on this thread and elsewhere, are NOT expected to significantly reduce total deaths, but rather to spread them out a bit. I do not for a second doubt they can do that, especially if they are extremely draconian and vigorously enforced.
    .
    But no, I do not think the across-the-board shelter in place policies will reduce total deaths very much. They are extremely costly and economically damaging. But even if we were to accept draconian policies could save 200,000 lives (and I very much doubt that!) the costs already baked in…. likely $5 trillion or more…. mean that each saved life is valued at $25 million. As I noted up thread, this is madness.
    .
    Everyone wants to go to heaven, but nobody wants to die. Our lot is that we, and everyone we know and care about, will die…. as much as we might wish otherwise. I do care that people will die from this virus, and many others, I just recognize the truth in the old prayer my mom used to sometimes say out loud:
    .
    “God, grant me the serenity to accept the things I cannot change,
    courage to change the things I can, and wisdom to know the difference.”
    .
    This is one we can’t change much, but we can do a lot of damage futilely trying to change it.

  441. skeptikal, 2.75 days ago deaths were 5,102. 2.75 days before that they were 3,142. It's 4 days, not 2.75

  442. skeptical and Thomas Fuller,

    The fit I did for daily deaths from 3/14-4/3 gives a doubling time of 3.13 days, not 2.75 or 4. But that's not going to continue for much longer. The new case curve is no longer exponential and hasn't been for at least a week. The new deaths curve should start to bend downward from a pure exponential in a few days.
    Edit: I just checked again and the new and total death curves are already bending down

    The question in the real world is how much it will cost, not just in money, but long term damage. Here are some quotes from an op-ed in today's WSJ ( https://www.wsj.com/articles/was-dr-strangelove-an-epidemiologist-11585952947?mod=hp_opin_pos_2 )

    "“There is no price too high to save a life,” says New Jersey Gov. Phil Murphy.

    “We will not put a dollar figure on human life,” declares New York’s Andrew Cuomo.

    "These statements would be insane if anyone considered them seriously. Or take an icon of high-status wisdom, Bill Gates, who calls for a 10-week national shutdown in the Washington Post. He does not offer any cost-benefit analysis but he knows his audience: “Through my work with the Gates Foundation, I’ve spoken with experts and leaders in Washington and across the country”—i.e., people like himself.

    "The problem here is not an inability to think clearly. It’s an unwillingness to be seen thinking clearly."

    "Many things are worth doing; many risks are worth taking, and many are worth avoiding. It would be great to have more clear thinking about which is which in our present crisis."

    Just to repeat, assigning an infinite value to saving a human life is not just nuts, it's batsh!t crazy. And yes, that includes the governor of New Jersey quoted above. Especially since we don't even know if the damage we're doing to the economy will save lives or just delay deaths by a few months.

  443. skeptikal (Comment #182223)
    April 4th, 2020 at 5:22 pm

    You appear to fall in the trap of the seen versus the unseen. We see the deaths from Covid-19 but the health problems (both physical and emotional), shortened lives and deaths due to a ruined economy are not so obvious. I think that might be an affliction of the self righteous in matters like the current Covid-19 pandemic.

  444. According to the report on Italy at worldometers.info, Italy has turned the corner on new infections and the number of patients hospitalized in intensive care has declined for the first time.

    "An estimated 30,000 lives have been saved as an effect of the lockdown measures, according to Istituto Superiore di Sanità (ISS)"

  445. DeWitt,
    “Just to repeat, assigning an infinite value to saving a human life is not just nuts, it's batsh!t crazy.”
    .
    Absolutely true, but that is not what is actually going on. What the governors are actually saying is getting re-elected by adopting irrational policies does in fact have infinite value and no cost…. when it is the taxpayers funding it all.

  446. There is no doubling time for daily deaths. They have increased linearly from about 100 around March 23 to 1300 today. Each day about 100 more than the day before.

  448. It's late and I apologize for the rant, but come on people (names withheld) quit with the political point scoring and make a serious effort here.

    Math is hard. If you lack the commitment or the sobriety to manage it you just shouldn't comment. Period.

    The doubling rate for U.S. deaths that skeptikal noted earlier is in fact representative of the entire time period in the U.S. from February 28 to April 3. The total deaths went from 1 to 8,452 in that time period, which has a geometric mean growth rate of 1.29 per day.

    If you calculate 1.29 raised to the 2.75 power, you end up with a value of 2.03, which is pretty darn close to the doubling time for an assumed constant exponential growth.

    Change the start and end dates and the values change dramatically.
    Which days do we look at, the ones that support our argument or the ones that weaken it? If you don't qualify your statements with dates and assumptions then you are just wasting time. Please don't lower yourselves to the standard of comments in the twitverse.

  449. Earle,
    Late indeed. The first handful of deaths are too scattered by noise to yield an accurate estimate of doubling time. Another factor which is important to consider is the underlying assumption of starting cases. If a single patient (patient zero) starts the entire pandemic on day zero, then then simple exponential growth is expected. But that is not how it happened; there were surely many “patient zeros” in many different places in the States on many different dates. So you get a far more complicated growth pattern in both cases and deaths. Better to not insult a bunch of people who are quite aware of the underlying math.

  450. Earle,
    Late indeed. The first handful of deaths are too scattered by noise to yield an accurate estimate of doubling time. Another factor which is important to consider is the underlying assumption of starting cases. If a single patient (patient zero) starts the entire pandemic on day zero, then then simple exponential growth is expected. But that is not how it happened; there were surely many “patient zeros” in many different places in the States on many different dates. So you get a far more complicated growth pattern in both cases and deaths. Better to not insult a bunch of people who are quite aware of the underlying math.

  451. Earle, I judge that those rates do not mean that much at this stage of the outbreak. If the data could predict the peak and the slope downward without a lot of assumptions that would be a different story. There is much uncertainty at this point and that leads to many different guesstimates and guessing methods.

    I do judge that a discussion of the costs and benefits is appropriate and the fact that limits exist.

  452. Thomas Fuller (Comment #182234): "March 30: 558 deaths
    Apr. 4: 1,331
    Seems like a bit more than 100/day"
    .
    204 deaths on March 24
    1178 deaths on April 3
    slope of 97 deaths/day/day
    .
    367 deaths on March 27
    1178 deaths on April 3
    slope of 116 deaths/day/day
    .
    There is noise in the data, so you can get all sorts of results by drawing lines through two cherry picked points. If you fit the data from March 23 (73 deaths) through April 4 (1352 deaths) to a straight line the slope is
    (104 +/- 8) deaths/day/day

    March 30 is the extreme point below the trend line, April 4 is the extreme point above the line.
    .
    If a trend covering more than a full order of magnitude can be fit by a straight line, it ain't an exponential.

  453. Earle,
    Sorry, but it's pretty well known you can't just start with "1" and get a fit. In physics involving diffusion problems, you need to wait until something behaves like a "continuum" to do a "continuum" fit. Early on, the thing behaves "stochastically" and you really can't do that.
    .
    The equivalent thing in something like epidemiology is to wait for things to be "diffusive" to use the exponential. At a minimum, you need to wait for at last 10 deaths to do the simple minded math you are trying to do. (Waiting for 100 is better.)
    .
    Fitting to "log(deaths) vs time" isn't quite as subject to the problem you are seeing– though Willis is wise to start things not on the first death, but after a certain number.
    .
    So basically: if your "simple minded" method doesn't match the one from fitting "log(deaths) vs time" , that's because your method is *known to be flawed* comceptually. You aren't starting after the process is "diffusion like".

  454. Earl:
    And no, math is not hard. But people who don't understand the nuances of the math make the sort of mistake you use of applying the "right" equation to the data that equation *does not describe*– in this case to starting from 1 in an epidemilogical setting. (We could monte-carlo this for you and show that the math you are suing works like a charm if you start from a number that is pretty large compared to 1. )

  455. As I always look to lower math for as much information as is available that way, there are factors I do use when analyzing data.

    We know from reports that there are differences in reporting of mortality, most obvious on Fridays and Sundays. Aggregating into weekly batches seems reasonable.

    We fully expect from numerous pronouncements that healthcare systems are under severe stress and may in fact succumb in a manner similar to the patients they are treating. Those interested in the fantasy football league of counting the corpses might want to prepare for that eventuality in advance.

  456. Mike,
    **March 30 is the extreme point below the trend line, April 4 is the extreme point above the line.**
    .
    Presumably, you are aware that's where the "extreme" deviations from linear would be if the data are exponential or non-linear with rate increase with time.
    .
    Thomas isn't cherry picking. The shape of the US data looks exponential IF YOU LOOK AT the full range. Of course if you snip into chunks you can make it look piecewise linear. But that's just perverse data processing.
    .
    The data may be bending– but to see that you need to look at all the data.

  457. The other thing I would mention to those analyzing the corona curves is that if you want to compare the U.S. to anyone you should compare us to a large geographic region such as Europe or North (or South) Asia, rather than an individual country.

    I think our curve will have a much flatter peak than countries like Italy or Spain, with a much longer time at or near the peak, due to inconsistent response choices made in different states.

    Happy to be in Oregon for the moment.

  458. Here is a link from Climate Etc. to an analysis claiming mitigation will only delay the time that the near same number of cases and deaths due to Covid-19 will occur after the mitigation measures are lifted as would have occurred without mitigation. The key factor in this analysis is developing immunity and the claim that mitigation merely delays that from occurring in the absence of a vaccine or effective prophylactics.

    https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-modeling-5c156686a64b

  459. Hi Kenneth

    Yes, that is one side effect of social isolation. But establishing herd immunity is not a straightforward proposition. I would venture to guess that the benefits of having a functioning healthcare system outweigh the negatives of trying to achieve herd immunity. Not sure how either strategy would affect the development of a vaccine…

  460. Kenneth,

    Thanks, great article, and one I wish politicians would read.
    .
    My only critique is that the authors do not address the multiple uncertainties surrounding the pandemic, such as the fraction of the population actually susceptible to the virus (they seem to suggest 100%, which I think is both a wild guess and the worst possible scenario), the uncertainty in the actual number of infections, and the consequent uncertainty in actual fatality rates across all age groups. These uncertainties have large consequences in projections of cases, fatalities, and the development of herd immunity, yet are not even mentioned.
    .
    It is good the authors ask for honesty in modeling. Better if they asked for honesty in modeling and also described the large uncertainties inevitably involved in those models; even with an honest model, the uncertainties remain huge.

  461. "due to inconsistent response choices made in different states."
    .
    I don't think so. It is adding a bunch of exponential curves together that have differing startup times and differing diffusion characteristics. Add a bunch of random exponential curves together with different doubling times and you get a flatter curve. This is hiding the true characteristics of local outbreaks instead of revealing them.
    .
    At some point these outbreaks become basically independent of each other and are locally controlled, not sure where that is, maybe the city or county level. We didn't need to lock down the entire US when there were 100 cases in Wuhan although our nanny state supporters seem to believe "any price is worth it" as they grandstand on their moral pedestals showing everyone their everlasting wonderfulness.
    .
    The question is at what point do you start phasing in a lock down to minimize social disruption? A prerequisite is making sure you have adequate surveillance in place. I'm still rather perplexed that our CDC with 22,000 employees seems to have not ever considered this question as we appear to be making this entire thing up as we go along. I'm fine with everyone using some sort of standard model to make these things predictable in the future. We can then avoid the group shaming hysterics and virtue signalling pile-ons.

  462. Tom Scharf, I saw projections of a possible 2 million deaths in the U.S. as early as February. I think we could have started then.

  463. Kenneth,
    I rolled my eyes at Kristof's graphs when it came out as it was very obviously magical in nature. I have tracked down too many of these type of things with respect to sea level rise estimates to even bother looking at the validity of that model. I'm glad someone did the work to examine it in detail. This is why many people on Team Science simply cannot be trusted and it reduces the credibility of the entire enterprise. Kristof and his modeler intentionally hid this outcome with the typical case of noble cause corruption.

  464. On Jan. 21 an alarming projection of the spread, infectious nature and ultimate international implications of the corona virus was published: https://www.medrxiv.org/content/10.1101/2020.01.23.20018549v1.full.pdf. It predicted cases in the US by Feb. 4.

    The WHO declared a global health emergency on January 30th.

    In the 10 days between Feb. 12 and Feb. 21, Italy, South Korea and Iran experienced explosive outbreaks of the corona virus.

    On March 13 President Trump declared a national emergency. But he still hasn't implemented the provisions of the act that a declared national emergency invokes.

    Imperial College published their bleak projections on March 16th.

    I think different people can look at those dates and pick one that suits them for drastic action and they might differ. But we still do not have a national response to the corona virus.

    That's the tragedy. Not to try and blame anyone (there will be time enough for that over the next decade), but that we're still not there yet.

  465. According to an "expert" talking head on TV this morning, the probability of survival once on a ventilator is only 20%, not "the vast majority" quoted in the video somewhere above. I've also read somewhere that the life expectancy of those who survive after being on a respirator is short. About half will be dead in a year.

  466. Thomas Fuller,

    We don't have a national response because I'm pretty sure that short of declaring martial law, the Federal Government does not have the power to enforce such a response. Given the incompetence demonstrated by the Feds, I don't see why you would want one.

  467. Thomas Fuller,
    " But we still do not have a national response to the corona virus."
    .
    That is the one-size-fits-all fallacy. What is an appropriate response for NYC may not be for Essex county in upstate NY. What is economically suitable for one place may not be suitable for another. The policies that might make sense for New York City definitely do not make sense for Nebraska (363 positives of 5900 symptomatic individuals who were tested, with almost all positives in the Omaha region).

  468. A "national response" is not a magic wand.
    .
    Hindsight bias. Every week for the last ten years someone predicted an imminent market crash, and a few people actually did predict the 2008 financial crisis. They estimated the SARS outbreak would kill millions, it didn't. Climate change will kill millions in just the next 10, 20, 30 years. There are lots of people predicting things like this all the time and it gets lost in the noise. Nobody had even heard of Imperial College before last month. They have no credibility to force a "national US response". We don't depend on random academic hack coders with their 13 year old undocumented code when we have a CDC, NIH, FDA, etc. to allegedly handle this.
    .
    You are going down the road of "Bush notified Al Qaeda might use planes" and thinking things were so obvious that all airlines need to be grounded indefinitely or nets should have been placed around the World Trade Center.

  469. SteveF, as of 3/31 Essex County in NY had recorded 7 cases. They have tested 85 people. I would humbly submit that they really do need to do exactly what New York City has done.

  470. Tom Scharf, I don't think it is exercising hindsight bias to note that the federal administration ignored the WHO declaration of a public health emergency.

    Nor do I think it hindsight bias to note that they have ignored their own declaration of a national emergency.

  471. Thomas Fuller,
    "I would humbly submit that they really do need to do exactly what New York City has done."
    .
    That gave me a chuckle. At least they don't have to abandon the subways in Essex county. Let's see… 7 cases in a population of 40,000… maybe they could track and isolate those people's contacts instead of closing down the county? Nah, not destructive enough.

  472. Thomas Fuller (Comment #182249): "I saw projections of a possible 2 million deaths in the U.S. as early as February. I think we could have started then."
    .
    Started *what* then?

  473. Kenneth Fritsch (Comment #182245)
    April 5th, 2020 at 9:51 am
    Here is a link from Climate Etc. to an analysis claiming mitigation will only delay the time that the near same number of cases and deaths due to Covid-19 will occur after the mitigation measures are lifted as would have occurred without mitigation.
    _______

    I gave up smoking in the hope it would delay my death. I know, not exactly the same thing as the mitigation, but similar in that both are attempts to buy time.

  474. Yes, it is hindsight bias to apply a rigid expectation of behavior and magical outcomes in isolation for one government agency that you do not apply to NY, NYC, Detroit, Chicago, Miami, New Orleans, Italy, Spain, France, UK, etc.
    .
    In your view "Trump alone could have fixed this". Glad to see you are now on board, ha ha.

  476. Tom Scharf, slight correction–Trump alone could screw this up. And he did. That's the last comment I will make on this issue that can be construed as partisan politics.

    Fauci, Adams and pretty much the entire healthcare community are saying there's a fire in the house. Perhaps we should act on the possibility that they know what they're talking about.

  477. SteveF, note that Essex County's report was 3/31 and that the 7 cases reported can be expected to have transmitted the virus to 21 people, who have had ample time to transmit it to 63. They're working now on the 189…

  478. "I would humbly submit that they really do need to do exactly what New York City has done."
    .
    What NYC has done has killed 2,200+ people so far and is the worst outbreak in the US. A very strange example. They are by far the leading example of who has handled this outbreak the worst. Luckily for them they had the best intentions of anyone and a very progressive government that listens to experts, are founding members of Team Science, and decry Trump at every step. This saved the day for NYC.
    .
    An alternate theory is global pandemics are bigger than NYC's ability to handle due to structural issues regardless of the perceived virtue of their government. Let's just say that isolating them as a shining example of government in action here is failing the evidence test.

  479. Thomas Scharf, I think that actually the corona virus killed those New Yorkers, not the government. Conspiracy theories really only go so far.

    As for who has done the worst job, I think we can reserve our 'heckuva job, Brownie' for the feds.

  480. It's very difficult to see through the clever references to feds and national here, ha ha. Perhaps you have been to climate change communication classes? The city and state government killed nobody, the virus did. How could they, they are the good guys. Any errors here were overburdened government officials making good faith judgment errors in a bad situation. As we progress up the chain and get to a level of government that I oppose, then that level of government maliciously ignored clear warnings that cost people their lives due to their greed and ignorance.
    .
    I hope I have that correct now.

  481. OK_Max,
    "I gave up smoking in the hope it would delay my death."
    .
    So far so good. But you never know.

  482. Tom Scharf (Comment #182248)

    **At some point these outbreaks become basically independent of each other and are locally controlled, not sure where that is, maybe the city or county level.**
    _______
    Tom, I may be missing your point. Are you assuming draconian restrictions on travel ? Obviously, when it comes to infections, local areas are independent of each other only if there is no movement of people between them.

  483. Thomas Fuller,
    " Essex County's report was 3/31 and that the 7 cases reported can be expected to have transmitted the virus to 21 people, who have had ample time to transmit it to 63. They're working now on the 189."
    .
    Odd numbers. The infectivity rate really is not known, but I suspect it depends a lot on the environment…. Low population density: lower rate, high population density:higher rate. But in any case, the number I have seen quoted is 2 to 2.5 each 4 days. there have been 6 days since March 31. I don't see how you get to 63-working-on-189 in 6 days. Of course, maybe there is an extra high level of kissing in that county.

  484. SteveF (Comment #182268)
    April 5th, 2020 at 1:19 pm
    OK_Max,
    "I gave up smoking in the hope it would delay my death."
    .
    So far so good. But you never know.
    ______

    Yes, and now would be the time for me to give up drinking, since I'm running out of alcohol. Abstinence probably would be a good thing.

    Other good things resulting from the Covid-19 mitigation measures:

    Fewer traffic fatalities and injuries

    Less crime ( for the time being)

    Cleaner air

    Frequent hand washing becomes a lasting habit

    Higher birth rates (maybe, too early to tell)

  485. Let's try another county, stealing blatantly from Atrios: "cases in Luzerne increased from 484 to 648. The population of Luzerne county is 320,000. Philadelphia has about 5 times the population and about 5 times the cases, meaning the counted infection rate (depends on who/how many are being tested) is about the same. It isn't going to stop at the urban hellhole borders."

    It is ten times the size of Essex County, New York, but it's largest city is Wilkes-Barres, with 41,000 inhabitants.

  486. If Wikipedia can be believed, there are still just 7 confirmed cases in Essex County, NY as of 4/5/2020 4PM EST.

    https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_New_York_(state)

    All the counties with relatively high infection rates are in close proximity to NYC. What Cuomo could do is lock down that area and not allow anyone to enter or leave without specific permission. Wanna bet he'll be brave enough to do that? Of course with a complete lockdown you'd soon have a lot more people starving than would die from SARS-CoV-2.

  487. Thomas Fuller: "note that Essex County's report was 3/31 and that the 7 cases reported can be expected to have transmitted the virus to 21 people, who have had ample time to transmit it to 63. They're working now on the 189…"

    Current count is 14, 9 tested and 5 presumed, per https://www.facebook.com/EssexCountyPublicHealth

  491. Thomas Fuller,

    To add to Harrold's comment, here is the current data from Essex county (1 hour old):
    .
    Essex County, NY Public Health

    Daily COVID-19 Update

    Lab confirmed Positive: 9
    Suspect Positive: 5
    Total Positive: 14
    Total Tests processed: 109
    ______________________________________________
    Suspect Positive means a Provider has clinically determined patient is suspect for COVID-19. Our report of
    Total Positives and Tests reflect the total number since tracking for COVID-19 began.
    ______________________________________________
    Isolation: 9
    Mandatory Quarantine: 23
    Precautionary Quarantine: 10
    ______________________________________________
    Isolation and quarantine numbers reflect the current number of active isolation and quarantine orders on this day.
    They change daily as some people start and others finish isolation/quarantine.
    .
    All I can say is, 9 actual and 5 suspected is damned close (*DAMNED CLOSE!*) to 63 cases going on 189. Most of the 5 suspected cases are probably people with flu or colds… they have tested 109 to find 9 positives. Lots of places (like Nebraska) are testing 10 to 20 or more symptomatic people to find a single Covid19 case. This is not a surprise where the covid19 illness is almost nonexistent.
    .
    The actual situation, like most every situation, calls for calm, rational action, not exaggerations of risk to incite public panic and foolish policies. Looks like the officials in Essex county are doing their jobs (23 quarantined, 10 voluntary quarantined).

  492. SteveF, there is one key datum in your comment, but I don't think it is the one you are emphasizing.

    They have tested 109.

    That's all she wrote.

  493. Thomas Fuller,
    The "keyness" of that datum is lost on me. Perhaps you could be less cryptic…. or even just say what you mean.

  494. What I mean is that Essex County has absolutely no idea of how many people in their county have the corona virus.

  495. Thomas,
    Thanks for that clarification; I really had no idea what you were suggesting.
    .
    I suppose the same can be said of every part of the country. It’s a natural consequence of only testing symptomatic people rather than a random sample of the asymptomatic population. I completely support an immediate program to test randomly selected people to better gauge the true extent of the pandemic nationwide…. a couple of hundred thousand tests of a randomly selected population across the country would answer several critically important epidemiology questions. I am honestly shocked all the available tests are used on symptomatic patients.

  496. I am moved to repeat a line from one of my early lessons in Mandarin: Wo tong yi means I agree.

  497. Thomas
    ** I think our curve will have a much flatter peak than countries like Italy or Spain, with a much longer time at or near the peak, due to inconsistent response choices made in different states.**
    I think it would have been flatter and longer even if this were a pre-industrial pandemic because we are bigger and there are geographic regions with urban areas geographically separated by lots of "middle of nowhere.

  498. OK_MAX,
    Obviously travel is how infections start but they quickly move to being locally spread after that. The rate of spread would appear to be dominated by local conditions. Adjacent counties to NYC having higher rates than would be expected makes them not independent. My point is throwing the entire US into an analysis blender doesn't tell you much about what worked and what didn't when analyzing regions that are effectively independent from each other may give more useful information especially if they had different policies and different cultures.

  499. Hiya Lucia

    You're probably right, but if I remember the spread of the Black Death from Asia to Europe, it was a lot quicker than the spread of cities would have indicated. It traveled about 2.5 miles a day… I think… Kind of an inexorable wave.

  500. Tom Scharf

    Travel can also exacerbate local conditions by reintroduction or reinforcement of infections.

  501. There's no doubt that travel and high density are major factors why NYC lead the way with the biggest initial outbreak and will likely keep having recurring problems in the future. If asymptomatic carriers are effective spreaders of the virus than NYC is in for a long painful year of whack-a-mole. Eventually social isolation fatigue is going to start setting in and who knows what is going to happen.

  502. Based on this site ( https://covid19.healthdata.org/projections ), Trump was correct that New York didn't need 30,000 ventilators. Although the site hasn't been updated since April 1, the deaths per day projection for April 4 was pretty close with 607 projected with a range of 503-684 and 630 actual. The projected maximum number of ventilators needed is 9,995 (6,095-12,748) on April 6.

    Looking at the Tennessee data, admittedly very early on the curve, deaths/day for April 4 was projected at 21 (19-23) actual was 6. Total deaths was projected 82 (77-87) actual was 43. Hospital beds needed projected 4,080 (3,476-4723) actual active cases 2,862, probably not all hospitalized. We now have a stay at home order from the governor, but I don't think much behavior has actually changed, at least in my area.

    A state with relatively few cases and a widely dispersed population, South Dakota, is not expected to even come close to overwhelming its healthcare facilities. Peak need for ICU beds is projected to be about 1/3 of capacity on May 1. North Dakota is similar. There is no need for those states to pursue draconian policies that more properly apply to hot spots like New York.

    IOW, a one-size-fits-all national policy would be a mistake.

  503. The projections for New Jersey, however, are way too low. On April 4, deaths per day were supposed to be 81 (68-92), actual 200. Total deaths, 548 (515-574), actual 846.

  504. Tennessee reported 312 new cases today and 44 deaths to date, for a total number of cases at 3,633. They should be doing what NYC is doing.

  505. DeWitt,
    You know that Trump was right about the maximum number of ventilators will never make it to the MSM reports!
    .
    That same site projects the NY peak death rate at 855 near April 11, but it looks like the peak has already arrived: 630 on April 4. It could change, but new hospitalizations are falling as well. If 630 turns out to be the peak, then that is at the very bottom of their uncertainty range. I am also a little puzzled about the assumptions in their model…. I can’t see how deaths in NY fall to near zero as fast as they project.

  506. Thomas Fuller,
    “ They should be doing what NYC is doing.”
    .
    I’m guessing you would say the same about *every* state and every country. But everyone won’t do what you think they should. Political freedom is a funny thing…. it often demonstrates clear differences in values, priorities, and goals. The response to coronavirus is no different than other important, and often complex, policy questions, like say, global warming.

  507. DeWitt,
    Thanks for those projections…I viewed Cuomo's "We need 40K ventilators" as likely deliberately exaggerated; start from a high number to obtain a better final "compromise" figure. Of course, the models weren't revealed. Also, emergency strategies such as using ventilators on two patients at once, or modifying similar machines such as CPAPs, were kept as backup plans — certainly one wouldn't want to rely immediately on that contingency as that is not medically optimal.

    Thomas,
    Hi! I'm not a fan of one-size-fits-all approaches. Here in Florida there were counties with zero cases, or at least single digits. I could understand the FL governor adding restrictions to the more populous counties where the number of cases was large and growing; but I don't think it's great to impose those economic costs on areas which don't need it. Now, that is — admittedly, the situation may well get worse. [Not as happy with the FL governor finally caving to impose a state-wide stay-at-home order.] But I don't see why one should impose a clear economic penalty based on the mere possibility that things might get worse. That way lies economic paralysis. Limit the economic harm. Yes, there is an implication that the medical effects are not minimized. But medical results aren't the only metric which matters.

  508. my brother is an orthopedic surgeon and he has spent a lot of time on this. April 4 cdc us mortality statistics show us at 86% of historical norms. In Europe they are barely above normal and vastly lower than past flu season peaks. Even for Italy their peak is about equal to 2016-17. Most covid deaths are among those with limited life expectancy which would explain this. Further John Lee argues in the Spectator that covid ‘caused’ deaths are vastly over reported due to covid being classified like smallpox. If you test positive and die from something else you will be counted as a covid death.

    I agree with John Ioannidis that we are taking actions with huge costs based on badly flawed data. If mortality is actually lower than normal why are we causing the worst depression in American history?

    Sweden is not on lockdown and they are not seeing large numbers of deaths or over taxed hospitals. Panic always leads to disfunctional behaviors.

  509. Thomas Fuller,

    "They should be doing what NYC is doing."

    We are. We have a stay at home order from the governor, educational facilities and non-essential services are closed. Travel is not severely limited, but it isn't in New York or the surrounding area either, but probably should have been.

    People are touting Cuomo for President. He looks good on TV, but I haven't been impressed by his whining or his actions.

  510. Re: the IHME model. Looking at FL, the projection for beds today is 3700 (range of 2500-5500) [numbers rounded to 100's]; current count of hospitalizations according to the FL dept. of health website is 1550.

    So, models may not be accurate. [I know, we're all shocked! shocked!]

  511. DeWitt Payne: "People are touting Cuomo for President. He looks good on TV, but I haven't been impressed by his whining or his actions."
    Cuomo is a great explainer at his daily briefings. We need a mind meld — transplant Cuomo's demeanor into Trump's brain.

  512. >most people who go on a ventilator in the hospital die.

    Does that mean most people who go on a ventilator due to COVID-19 die?
    If it does mean that, say 40% of people who go on a ventilator come off the ventilator in a week and are healthy. That would make lack of ventilators significant.

  513. On Jan 21, Fauci said in an interview that we don't need to worry about coronavirus in the US. The timeframe for which Trump 'failed to act and killed millions' has gotten much smaller than three months.

  514. NY hospitalization is coming in well under projections, with some days showing a decline. The military ships sent in to treat overflow non-covid patients are treating 15 people.

  515. Mike N,
    Yes most covid19 patients who go on mechanical ventilation do not make it: https://www.google.com/amp/s/www.physiciansweekly.com/mortality-rate-of-covid-19-patients-on-ventilators/amp/
    .
    In contrast, about 66% of non-covid patients who go on a respirator do recover.
    .
    WRT the hospital ship in NYC harbor: yup, never needed, but a nice gesture on Trump’s part. I expect some way will be found on CNN to claim that sending the ship was a huge mistake by Trump.

  516. SteveF, thanks. Note I think is referring not to respirators but using advanced respiratory care as a synonym for ventilator. I'm surprised by the 63% of non-COVIDs who recover. I was expecting the numbers to be reversed, both because of infection risk from the ventilator, and because you are suffering something serious to go on a ventilator to begin with.

  517. David Young (Comment #182295) maybe using Sweden as an example of how doing nothing is alright is not a good idea compare Sweden to Australia where we have some very strong measures ($1000 fine if you ignore social distancing rules for example. As of the moment using https://www.worldometers.info/coronavirus/ cases/million and deaths per million Sweden 676 and 40, Australia 225 and 1

  518. Sigh… this happened last week as well. Sunday's data did not fully report, which raised hopes. They were counted on Monday which scared everyone. Then Tuesday's data was roughly equal to Monday's–there was a real rise but it looked the same. Things got back to normal on Wednesday.

    Those pesky humans–how dare they?

  519. MikeN,

    If you need a ventilator, you won't be healthy when you come off it. Your lungs will have suffered major damage and will require months to recover, not to mention the general muscular atrophy from staying immobile in a bed that long. If you're on a ventilator for more than ten days, you should seriously consider pulling the plug.

    Here's an abstract of a study in 1993 where they're dealing mostly with normal pneumonia: https://www.ncbi.nlm.nih.gov/pubmed/8404197 The 1 year survival rate was 30%. COVID-19 will be worse until there's some treatment because it does more damage to the lungs.

    Then there's this:

    "All the early research suggests that once coronavirus patients are placed on a ventilator, they will probably need to stay on it for weeks. And the longer patients remain on a breathing machine, the more likely they are to die."

    https://www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients

    Note that when you're on a ventilator, you're unconscious.

  520. DeWitt, perhaps it's different for COVID, but most people on a ventilator are conscious.

  521. David Young,
    Yes, US death rates are down considerably compared to 2018 and 2019, probably in large part due to people trying to avoid catching coronavirus… So, we should obviously just lock down the whole country permanently to continue to reduce the death rate. You can’t place economic value on a life you know. 😉
    .
    Andrew Kennett,
    I would be cautious about comparing rates in two countries of vastly different size, population density, geography, and climate. We will see how things turn out in Sweden, but I suspect they won’t be as bad as Italy, Spain, or Switzerland. Besides, the Swedes are entitled to choose their own course, just as the Aussies are.

  522. MikeN,

    OK, but do they want to be conscious? It's traumatic to be conscious on a ventilator. It's even more traumatic when you can't have visitors and the nursing staff is working hard enough that they can't give you much time.

  523. David Young (Comment #182295): "April 4 cdc us mortality statistics show us at 86% of historical norms."
    .
    Do you have a link to those stats? I was trying to find them and failed.

  524. I'm having a little trouble with the IHME hospital beds required projection. The projection for the US is that on April 5 there will be 179,267 (126,649-225,951) hospital beds required for COVID-19 patients. But there are only 309,080 active cases. That would imply that 58% of confirmed cases are in a hospital. That seems a bit high, to put it mildly. Admittedly, if they require shortness of breath to get tested, which means the lungs are already involved, then you might see a high percentage of hospitalizations of confirmed cases. But my understanding was that at least 80% of cases were not serious.

    Also, the model says that 33,176 ICU beds would be needed and 25,544 ventilators. So 77% of ICU patients need ventilators?

    If those hospital requirements are actually close to reality, then we are wildly undercounting total infections.

  525. DeWitt Payne (Comment #182311): "The projection for the US is that on April 5 there will be 179,267 (126,649-225,951) hospital beds required for COVID-19 patients. But there are only 309,080 active cases."
    .
    Is the latter a projection from that site (if so, I can't find it) or from a different data source? I am guessing the latter. I just went to the IHME site and the projection for Apr. 5 is 90,353 total beds; 17,589 ICU beds; 14,951 ventilators. It looks like they just updated it.

    So the projections were off by nearly a factor of two after just 4 days.

  528. DeWitt, If I were on a ventilator, I think I would want to stay conscious just out of fear of the ventilator disconnecting.

  529. David Young (Comment #182314),

    Thanks. That comes closer to what is needed than anything I managed to find.

    Sadly that link does not tell us much. The latest data is two weeks old and the latest reasonably complete data is a month old.

    Looking at Table 1, the number of deaths from all causes was running at 93% in February. I don't understand how that can be. That would be a shortfall of nearly 4000 deaths a week. The number of pneumonia deaths (largely secondary to the flu) looks roughly normal; 2800-3000 per week compared to a typical annual total around 60,000.

    From Table 2, it looks like the low death rate is spread across all ages, but is especially low for children.

    Oh, heck. Table 3 reveals the national totals to be trash. Nobody has died in Connecticut since January.

  530. If you're in the ICU, then it's probably serious enough to require a ventilator, apart from that, instead of using non-invasive ventilation ie CPAP/BIPAP, people are being put on ventilators to reduce the amount of aerosols produced to reduce worker exposure.

  531. Mike M,
    “Nobody has died in Connecticut since January.”
    .
    Plenty of hand washing, no doubt.

  532. DeWitt Payne (Comment #182306)
    April 5th, 2020 at 8:10 pm

    "MikeN,
    If you need a ventilator, you won't be healthy when you come off it. Your lungs will have suffered major damage and will require months to recover, not to mention the general muscular atrophy from staying immobile in a bed that long. If you're on a ventilator for more than ten days, you should seriously consider pulling the plug."

    DeWitt, you make a good point here. I have been thinking about this a lot in recent times. I have this generally covered and documented with the family for my own case, but have been thinking about giving the family specific instructions in the case of a ventilator. I consider myself in good health – but I am old by anybody's definition.

    If a person on a ventilator was not unconscious it would appear to me to be a form of torture.

  533. Mike M.,

    I'm finally seeing the new numbers now from IHME, ~90,000 beds needed instead of 176,000. But I think they may still be high by a factor of two. IHME now says 17,600 ICU beds needed on April 5, but worldometers.info says that there are 8,702 serious/critical cases in the US on 4/5.

  534. Do the IHME models include baseline usage of respirators & beds, i.e. typical demand for non-covid cases? Seems to me the non-elective base load is a factor that should be included, but I'm not certain that they have. That would help explain part of the discrepancy between the covid case counts and the model outputs.

  535. Andrew P,

    "Do the IHME models include baseline usage of respirators & beds, i.e. typical demand for non-covid cases?"

    Not as far as I can tell. The numbers are all zero until February 21.

    And in other news, did you know that the director of the WHO isn't a doctor? I didn't. His kowtowing to China and the general ineffectiveness of the WHO should be grounds for us to stop contributing to it. The US provides 22% of WHO funding compared to 11% from China, but China has the director by the short hairs.

  536. DeWitt,
    “ China has the director by the short hairs.”
    .
    Maybe, but I think a bigger factor is that the WHO director appears to be a communist as well. Birds of a feather.

  537. Looking like the verified/tested cases in the States will top out well under 1 million, and deaths somewhere under 100,000. The total number of cases (most not tested) will be higher, of course. I am shocked (shocked I say) that it will not be 2 or 3 million deaths. "Submit your self to indeterminate house arrest and lose 25% of your investments, and we will try to save you" seems to be the message. Crap, crap I say.
    .
    I should add that most of the extra deaths will be those over 65, and especially those over 75, most all with pre-existing conditions which compromise their resistance to any infection. Meh.

  538. SteveF (Comment #182325)
    April 6th, 2020 at 3:15 pm
    Looking like the verified/tested cases in the States will top out well under 1 million, and deaths somewhere under 100,000. The total number of cases (most not tested) will be higher, of course. I am shocked (shocked I say) that it will not be 2 or 3 million deaths. "Submit your self to indeterminate house arrest and lose 25% of your investments, and we will try to save you" seems to be the message. Crap, crap I say.
    ________

    1. Instead of worrying about my "on paper" investment loss, I saw the market's nose dive as opportunity to buy stocks at bargain prices, and increased my investments.

    2. I don't submit myself to "indeterminate house arrest," I go for an hour of walking every day.

    3. I'm not going to run out and try to catch Covid-19 to improve the economy. Purposely getting infected would be stupid. Some people are never going to get this virus, and I hope to be one of them.

    4. No offense intended, but you don't seem to have good survival instincts.

  539. Something else in the IHME graphs that has been cut in half is the expected number of deaths. We're back to where we were on March 31 (see this comment above: http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-181935 ) before the infamous press conference that projected 100,000-240,000 deaths best case. Now it's 49,000 to 136,000 with an expected value of 82,000. On March 31, it was an expected value of 81,000 with a range of 38,000-162,000. So the expected value is about the same, but the range has narrowed.

    That press conference caused our Governor to change his safe at home order to stay at home. However, I'm not impressed. An order with no enforcement isn't any different than what we were doing before. And nobody is doing the recommended severe travel limits.

  540. It is starting to look like the number of new cases and deaths might be leveling off, but the noise makes it hard to be sure.

    Over the last 5 days, about 30K/day nationally.

    Over the last 7 days, about 9.2K/day in New York.

    Over the last 6 days, about 3.6K/day in New Jersey.

    Over the last 11 days, about 500/day in Washington. Might even be starting to drop.

    Remarkably, even deaths seem to have leveled off at 1200/day nationally over the last 5 days.

    I sure hope that is real.

    ————-
    Numbers from the COVID tracking project.

  541. OK_Max,

    This may actually be the time to buy some gold. I've seen a recommendation for a 20-20-20-20-20 portfolio. 20% cash, 20% stocks, 20% bonds, 20% REIT's and 20% gold/commodities. But it may be a bit early to buy an REIT ETF.

  542. DeWitt, 20% seems like too much of an allocation to REIT's. Also, 20% seems like a lot to gold, but I haven't been keeping up with these two, so my opinion may be behind the times.

  543. Mike M,
    Virtually every state is showing a flattening of the curves…. with a few exceptions. So I will be very surprised if the trends you note are not real. More likely it is the beginning of the end…. and certainly past Churchill's ‘end of the beginning’.

  544. OK_Max,
    1. How nice.
    2.Good for you. Doesn’t help the 10+ million unemployed or the thousands of small businesses in danger of disappearing.
    3. Nearly all people are not going to get the virus…. or if they do, they will not notice.
    4. Offense taken. You don’t know what you are talking about.

  545. JD, a state legislator in Michigan got better after taking HCQ. She said she was familiar with it after taking it for lupus.

  546. Boris Johnson is in intensive care with the Wuhan virus. Not on ventilator, at least not yet.

  547. Are pneumonia cases down? I would expect them to drop with the reaction to coronavirus, but does the package passed by Congress also encourage hospitals to classify COVID to ensure payment?

  548. **Doesn’t help the 10+ million unemployed or the thousands of small businesses in danger of disappearing.**

    I wish I was important enough to make a difference, but I'm not. I will try to help by not catching Covid-19, so I don't spreading it around.

    **Offense taken. You don’t know what you are talking about.**

    My apologies for thinking you don't have good survival instincts. I can see now that you don't want to get Covid-19.

    Instead, you seem to want others (like me) to get this virus in an attempt to "help the 10+ million unemployed or the thousands of small businesses in danger of disappearing." Once infected, I could change my daily walking route so I run into lots of people. Just call me Covidmax

  549. Mike M,
    I hope Johnson gets better, but the trend looks very bad, and typical of people who do not get better. Maybe he will get the HCQ/antibiotic regime. They don’t have much else to offer him. We will see.

  550. OK_Max,
    “ Instead, you seem to want others (like me) to get this virus in an attempt to "help the 10+ million unemployed or the thousands of small businesses in danger of disappearing."
    .
    You are delusional. I want you to do whatever you think will protect yourself; walk or don’t walk, talk to people or don’t, go to the supermarket or don’t, go to the liquor store or don’t. Get on a sail boat and cruise to the south Pacific…. or don’t. I just don’t want the economy destroyed for no good reason.

  551. SteveF, I thought you favored a laissez faire solution to the Covid-19 pandemic, with governments doing little more than making suggestions and providing limited financial assistance. Now, I’m not sure what your position is.

    You did say my way of getting out, the walks, don’t help the unemployed and the small businesses, implying if I wanted to help I should be out buying goods and services, which of course would increase my exposure to the virus.

    I appreciate your concern about the economy. Consider the possibility that I could do far more damage to the economy as a spreader of Covid-19 than I can help the economy through my spending.

    I like your suggestion of a ocean cruise. NOT! Ha ha

  552. OK_Max
    **I should be out buying goods and services, which of course would increase my exposure to the virus**
    .
    You can buy goods and services without going out. We've:
    .
    1) Had our tree trimmed.
    2) Hired someone to spread mulch.
    3) Taken dance lessons
    .
    We've done all communication by email, phone or oneline.
    .
    We didn't do any of these to keep the economy afloat– we wanted to have these things done. But the fact is, you can buy stuff without going out.
    .
    You could buy even more if more stores and services were open. The opinion about whether they should be allowed to operate varies among visitors here. But NO ONE has suggested YOU personally need to go out if you don't like. You personally could do many, many things online, including arranging for grocery delivery.
    .
    Even with the stay at home, some people are either having groceries delivered by the store or asking and getting neighbors to do it for them.
    .

  553. Lots of unfortunate lay-offs due to the coronavirus….. among health care workers. All those thoughtful executive orders prohibiting any medical care except coronavirus treatment and life-threatening emergencies, in states with very few coronavirus patients, have left the hospitals underutilized…. so health care workers are being furloughed. Even family care practices are shutting down. There will be lots of unintended consequences of foolish decisions, made in panic.

  554. SteveF,

    Assuming we don't have a vaccine in a month (and we probably don't) and social distancing seems to work (based on curve bending and deaths going down), the difficult question will be "what now"?
    .
    Given how geographically widespread the virus is, and that we have pretty strong evidence to suggest the pre-symptomatic not only spread it but may be the MAIN group spreading, reopening has the potential of creating a new "burst" which, plausibly, would then grow exponentially again. (Well… unless the bending of the curve was NOT due to social distancing but due to having reached N_infected=1-1/Ro. (Which… is not necessarily impossible as Ro might be 2 or 3 — or not. )
    .
    I don't know if we have tests to "track and trace". AND unless the infected count is smallish, track and trace is not possible anyway.
    .
    So the question of "what next" is a very real one.
    .
    Honestly, even when they lift the quarantine, some people are going to continue to self quarantine , watching and waiting. The elderly — even those who like to think "60 is the new 40"– might seriously want to consider doing so. But… honestly… I am itching to get out!!

  555. I assume we have been handing out HCQ like crazy over the past couple weeks. So far the data says … wait … no information whatsoever. Obviously the people are using it under some protocol that is recording outcomes. This is so typical of "peacetime academic/ FDA operations". No information released until it has been massaged to meet the researcher's preferred result, ha ha.
    .
    They should be releasing this info in real time just like we get breathless death and infection reports every single day.

  556. SteveF (Comment #182345): "Lots of unfortunate lay-offs due to the coronavirus….. among health care workers."
    .
    Indeed. It does not get much more stupid than laying off health care workers during a health care crisis.

  557. They are going to have to open up the economy again with a very large number of uninfected people and a still very measurable presence of the virus worldwide. There will be a lot of pent up consumer demand. They should be putting out an expectation that the economy will be shutdown again if/when local outbreaks occur. One can even imagine duty cycling the economy with a 1 week on / 3 weeks off sequence to keep things alive and keep the infection rate manageable.
    .
    Getting the coronavirus intentionally isn't such a terrible idea once you think about it logically. Going to the free government funded corona-resort for a couple weeks and getting the virus allows you to graduate to full time service sector employment. I don't know about you but I'm more comfortable knowing everyone working at the grocery store and now open restaurants has had it. Outcomes are somewhat predictable with young people without underlying conditions being "low risk". How you define risk here is of course important. This would allow people to effectively volunteer to help themselves and everyone else.

  558. ucia (Comment #182346): "social distancing seems to work (based on curve bending and deaths going down".
    .
    That is the post hoc fallacy. We don't know what is bending the curve. Maybe it is just the epidemic running its course. But since different states have shown different progressions and have adopted different policies, we might someday know what had an effect.

    Deaths this week are probably largely of people infected befoe the crackdown.

  559. Lucia,
    Sure, that is in fact a real dilemma. However, I would note that the likelihood of rapid re-emergence, and a new peak, once the current peak subsides, is based on some assumptions which may in fact not be correct:
    .
    Assumption 1) *Most everyone is susceptible, and will contract the illness (to a greater of lesser degree) if exposed.* There is no good reason to think that is true, and we don't have data to support it. We do know that some people (eg Boris Johnson) in apparent good health, not elderly, and without pre-existing conditions are remarkably susceptible to severe disease and often death, while others with the same profile have either mild or asymptomatic illness. If there is that much range within the population, then it seems plausible, and IMO likely, that many people are simply not susceptible.
    .
    Assumption 2) *Nothing in our immunological experience can protect against COVID-19.* We simply do not know if having been infected multiple times with other families of corona virus infers some resistance to COVID-19. That seems to me a real possibility, and might explain why some people seem much more resistant than others. And why, at least in part, poor countries seem to have consistently lower rates of spread and serious illness than rich countries.
    .
    What is needed right now, and without further delay, is random testing of a few hundred thousand asymptomatic individuals to quantify the size of the population with antibodies to COVID-19. That would at least better define how widespread asymptomatic exposure has been, and so better define the risk of death and the risk of rapid re-emergence.
    .
    A second reasonable step would be easing restrictions in a few states with low rates of infection (on a voluntary basis) and evaluating what happens over several weeks. Answering the "what's next" question has to start somewhere. We can't keep 20+ million unemployed indefinitely.

  560. A widespread finding of lock downs followed two weeks later by the virus being contained is going to be hard to deny. We don't really have a control group here of no lock down as far as I know to compare against. It's possible that no lock down combined with only a compliant social distancing paranoia might also be effective. Because the academy is heavily invested in large government interventions and the technocratic rule of experts their findings will be unanimous and easily predictable (they were right all along and we should have listened to them earlier).

  561. Mike,
    I agree we don't *know*. That's why I say *seems* and *suggest* rather than "know" or "proves".
    .
    I hate to break it to you, but when someone predicts X will happen if we do Y, then they do X with the intention of Y happening, and then Y happens, that does tend to at least *suggest* X did cause Y.
    .
    You can give the fancy name of any "fallacy" you like. But what I wrote was not an example of that fallacy. In the first place, I did not merely notice X happened after Y. I also did not take what happened as proof Y caused X.
    .
    And beyond that: if what I wrote was a "fallacy", then noticing people who took hydroxycloroquinine with the INTENTION of curing them recovered after taking the medicine might *seem to suggest* it works would be committing a "fallacy". It is not a "fallacy" to think this tends to suggest it might work.
    .
    Even people like Fauci who call the evidence "anectdotal" don't go so far as to claim that it's an actual *logical fallacy* to interpret that as a "suggestion" it *might* work.
    .

  562. "President Donald Trump reportedly owns a stake in a company that produces hydroxychloroquine, the anti-malaria drug he has repeatedly touted as a coronavirus treatment even though his experts say there’s no strong evidence it works.

    …"In addition, Sanofi’s largest shareholders include a mutual fund company run by major Republican donor Ken Fisher, the paper said. Trump’s three family trusts, as of last year, each had investments in a mutual fund whose largest holding was Sanofi, according to the Times. Commerce Secretary Wilbur Ross also had ties to the drugmaker, the Times reported."

  563. The infections counts seem to be peaking / starting to decline everywhere at the same time which is a bit strange. It could be seasonality. Cold/flu rates decline by about half during the Feb/Mar time frame.

  564. Tom Scharf,
    "We don't really have a control group here of no lock down as far as I know to compare against."
    .
    Well, there's Sweden, unless they substantially change policies.

  565. SteveF,
    I agree some of those assumptions might be incorrect. That's why it's going to be a hard question! I agree on 1. Also, on (2)
    **and might explain why some people seem much more resistant than others**
    .
    It's not impossible that SARS-covid will turn out to have given some people some protection. Or there may have been other covid strains that circulated and barely infected people. We know so little, that we just don't know. ( Cowpox and vaccinia give immunity to smallpox.)
    .
    On your quote: We are certainly reading a lot of people interpret (a) "we have no evidence that X work" (for this new thing we know almost nothing about and have had practically no time to study) as meaning (b) X does not work. I think the more accurate thing right now is that *we have not yet identified anything that protects against Covid-19". It does mean there is a possibility nothing does protect against it, but that's not quite the same as nothing does protect.
    .
    I also agree random testing (with a fairly reliable test) is required to make good decisions.
    .
    No, we can't keep virtually the entire country on "stay at home" forever.

  566. Tom
    **The infections counts seem to be peaking / starting to decline everywhere at the same time which is a bit strange.**
    .
    If it's the stay at home orders, this is pretty much what we would expect. Many stay at home orders happened during a small window of time.
    .
    I guess if your theory is it's NOT the stay at home orders, you might find it strange. But I don't know why it would seem strange otherwise.

  567. All these evil capitalistic companies with their immoral right wing investors are donating >100 million doses to the effort.
    .
    I have "stakes" in numerous pharmaceutical companies through domestic and international mutual funds. I suppose I should divest immediately less I be shamed by the covid police.
    .
    https://www.marketwatch.com/story/trumps-personal-stake-in-the-malaria-drug-maker-sanofi-could-be-as-small-as-99-2020-04-07
    .
    "Trump’s 2019 financial-disclosure form lists stakes in Family Trusts 1, 2 and 3 valued at between $1,001 and $15,000. So if Trump has the maximum $15,000 in each of the trusts, he holds a stake in Sanofi that’s worth $1,485 — and, at the minimum, just $99."
    .
    Impeachment time!

  568. lucia (Comment #182354): "I hate to break it to you, but when someone predicts X will happen if we do Y, then they do X with the intention of Y happening, and then Y happens, that does tend to at least *suggest* X did cause Y."
    .
    Only a pitifully weak suggestion.

    If I do a rain dance, and a week later it rains, does that suggest that my rain dance worked? Of course not, since it was inevitable that it would eventually rain.

    Trump predicted that when the weather got warmer, the epidemic would abate. The weather is getting warmer and the epidemic is abating. Does that suggest that Trump was right and therefore the shutdowns were not needed? Of course not.

    It would be different if the experts predicted the actual course of events with reasonable accuracy. But they have not done so, not even close. The only thing that was successfully predicted is that something inevitable would eventually happen. The success of such a prediction demonstrates nothing.

  569. It's only strange that the infections seemed to be running at different time lags but now possibly changing simultaneously. I imagine this is your typical situation with many degrees of freedom that will be hard to sort out. I assume social distancing will be a big factor. I'm not sure how you can measure seasonality effect if they barely understand why it happens with the cold/flu.

  570. SteveF (Comment #182357): "Well, there's Sweden, unless they substantially change policies."
    .
    And the Netherlands, Iowa, Arkansas, South Dakota, and probably others.

    I don't think South Korea ever went into a lockdown, but I am not certain of that.

  571. Dave JR ( http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182317 ),

    "people are being put on ventilators to reduce the amount of aerosols produced to reduce worker exposure."

    That's apparently being driven by hospital administrators. It's poor medical practice and likely grounds for a malpractice lawsuit. Putting someone on a ventilator runs a high risk of damaging their lungs.

    "I spoke with Dr Mayo because, as a New York City critical care doctor, he really is in the belly of the beast as far as this pandemic goes in the Anglosphere. (Also, as he is currently home sick with COVID-19, he had plenty of time to talk.) He described increasing pressure from hospital administrators, throughout the city, to put COVID-19 patients on ventilators earlier than would otherwise be recommended. The administrators believe that hooking COVID-19 patients up to a closed-circuit breathing apparatus (i.e. the ventilator) may decrease their infectivity to hospital staff. But does this mean we have the patient’s best interests at heart in hooking them up to a ventilator?"

    https://spectator.us/ventilators-arent-panacea-pandemic-coronavirus/

    More quotes from this link:

    "I am a critical care physician, specializing in the use of such machines. I’m flattered by all the attention our tools are receiving. But I fear the current clamor reminds me of nothing so much as the panic buyers of toilet-paper stampeding over each other in early March. When the history of the COVID-19 pandemic in the Western world is written, I do not believe ‘massive ramp-up of ventilator manufacturing,’ will be credited with our deliverance."
    "It is therefore at least conceivable that putting patients on ventilators for COVID-19 pneumonia could be a bridge to nowhere."
    "There has never been a placebo randomized control trial of putting people on ventilators versus letting them struggle on. We therefore do not, strictly-speaking, know whether those who survive their time on ventilator may have survived anyway, or whether some would-be survivors died because they were committed to a ventilator."

    But don't use CQ or HCQ because they haven't been proven in a clinical trial.

  572. Thomas Fuller,
    ""President Donald Trump reportedly owns a stake in a company that produces hydroxychloroquine, the anti-malaria drug he has repeatedly touted as a coronavirus treatment even though his experts say there’s no strong evidence it works."
    .
    Please. Here is a headline from the Guardian… just minutes ago:
    "India releases hydroxychloroquine stocks amid pressure from Trump

    US president called Modi and threatened ‘retaliation’ if country kept full export ban."
    .
    Surely the action of someone trying to enrich himself, right? If you believe all the paranoid rubbish that comes from the NY Times, then your case of TDS is even worse than I thought.
    .
    Here are the relevant facts (from Forbes):

    "Forbes estimates the value of Trump’s Sanofi holdings to be less than $3,000; for context, Forbes estimates Trump's total net worth at $2.1 billion"

    More garbage from the NY Times:
    "Billionaire Ken Fisher, a major Republican donor (including to Trump), is one of Sanofi’s largest shareholders, while Commerce Secretary Wilbur Ross used to run a fund that invested in Sanofi, the Times reported."
    .
    “Sanofi is neither a material holding of Fisher Investments nor of Ken Fisher personally,” Fisher Investments said in a statement, adding, “The company represents less than 0.8% of Fisher Investments’ portfolio, and the firm’s ownership is less than 0.7% of Sanofi.”
    .
    Hydroxy chloroquine is produced by multiple companies around the world and is long since off patent; it is a low cost/low profit generic drug, with a wholesale price per dose of a few pennies. No company is going to make a lot of money on hydroxy chloroquine. In response to the COVID-19 crisis, several of those producers have donated (at no cost) many millions of doses of hydroxychloroquine to hospitals in the USA and elsewhere. Shameless profiteering capitalist all.
    .
    The Times always accuses first and investigates later. They are a dishonest and evil organization that is harming the public.

  573. The question is whether you can then normalize Sweden to NYC or NY state and do a fair comparison. My guess is two people with different agendas can do a reasonable normalization and somehow get different results, ha ha.

  574. MikeM
    **If I do a rain dance, and a week later it rains, does that suggest that my rain dance worked? Of course not, since it was inevitable that it would eventually rain.**
    Well… if we know it rains on average every three days… no. And if we are constantly doing raindances… no.
    .
    But the problem with your example is, unlike the raindance, (a) we didn't do zillions of lockdowns that failed and the attribute the bend to this, (b) we had no reason to expect the bend *in the time frame that is just about what we would expect if it was due to the lockdown and (c) we actually have a mechanistic reason to expect lockdowns to result in bending.
    .
    I'm not claiming it's *strong* evidence. But it's nowhere near as weak as you are suggesting.
    .
    **It would be different if the experts predicted the actual course of events with reasonable accuracy. **
    .
    Well, of course they didn't claim they could predict with precision. We have a qualitative prediction, and it's panning out. I'd say it seems plausible it's "accurate" but not "precise".

  575. Mike M,
    "I don't think South Korea ever went into a lockdown, but I am not certain of that."
    .
    I believe that is right. They did aggressive contact tracing and isolation of contacts very early, so reduced the rate of spread.

  576. Tom Scharf
    **The question is whether you can then normalize Sweden**
    Or maybe we should normalize Sweden to North Dakota. They are both far north. 🙂

  577. Thomas Fuller,
    One thing you may not know about Sanofi is that they are one of a few pharma houses contracted by the FDA each year to produce egg-based influenza vaccines. The vaccines are tailored to FDA specifications, based on best estimates of the flu strains likely to be circulating each year. Sanofi's production of vaccines in the USA is in northeastern Pennsylvania. They have been doing this since long before Trump took office. You think Sanofi should be barred from this contract because Trump holds $3,000 in Sanofi stock? Real question.

  578. Lucia,
    There is no doubt that if you never come in contact with someone who has COVID-19, you won't get the disease. It is also likely social distancing has had some effect on spread.
    .
    That said, there is a large uncertainty in the magnitude of the effect of social distancing, as well as how that effect is influenced by other factors (like population density, socioeconomic level, etc.). In Florida, the schools and restaurants have been closed and people urged to say away from others, wash hands, etc, etc for three+ weeks. There may be some modest flattening of the case curve, but the fatalities remain very close to exponential, although still relatively low. We continue to have ~8 negative tests of symptomatic people for each positive test, and have for weeks. Florida's case load per million population remains relatively low compared to the worst hit states, so the effects of social distancing could be diminished. But we just don't know.
    .
    IMO, there is no good alternative to relaxing the most economically damaging restrictions, in part to evaluate how much the the current restrictions are actually doing. We can't close every restaurant and many other businesses for 14 months while we wait for a vaccine….. which might not turn out to be very effective.

  579. Putting someone on a ventilator doesnt mean they can't do all their own breathing, so the suggestion that simply putting someone on a ventilator has a "high risk" of lung damage lacks obvious nuance. Of course suggestions like putting more than person on a single ventilator is much more risky. This suggestion is coming from hospital administrators on the basis of advice from medical professionals who work with ventilators etc.

  581. The problem with social distancing is that although it decreases contact with strangers, it increases contact with other people, particularly family members. I have it from an epidemiologist that the result is very little effect unless groups in society are almost entirely isolated from each other. But that is not what is being done.

  582. Dave JR,

    "…on the basis of advice from medical professionals who work with ventilators etc."

    And you know this how? The critical care medical professional, Dr. Mayo, quoted in my link, which was written by a critical care medical professional (Matt Strauss is the former medical director of the critical care unit at Guelph General Hospital, Canada. He is now an assistant professor of medicine at Queen’s University.), was not in favor of prophylactic use of ventilators.

    Here's another quote from my link:
    "Now of course, hope springs eternal. The patient may recover on their own while we keep them alive with our machines. But this is not a risk-free wager. Dr Paul Mayo, perhaps New York City’s most illustrious critical care doctor expressed the risks pithily: ‘putting a person on a ventilator creates a disease known as being on a ventilator.’"

  583. Tom Scharf,
    Yes, I saw that FL site some days ago; it is pretty good, and they now have international information automatically updated as well (by country).
    .
    The removal of racial/ethnic data is no surprise. When It was up, I noted that the hardest hit zip codes were all in high population density areas of Miami, Ft Lauderdale, and several other cities…. no doubt with a large fraction of minorities.

  584. A quick reminder to those who may have forgotten: When counting cases or deaths, beware the weekend effect. Much better to look at rolling 3 day or 7 day averages…

  585. Having just written that, Jeebus–Georgia tripled its case count in one day.

  586. Right, you definitely need to see several days of data to start making an assessment. But the timing is right, it has been about 2 weeks since lock downs started in earnest. I wouldn't be surprised to see it pop back up.
    .
    Wealthier neighborhoods have less prevalence. Not very surprising. The usual recriminations from the usual suspects have already started in the media by broad brushing it. Less healthy people in higher density neighborhoods who can't work from home are going to have worse outcomes. This will all be seen through the normal identity and class lenses.

  588. lucia (Comment #182344)
    April 7th, 2020 at 6:30 am
    OK_Max
    **I should be out buying goods and services, which of course would increase my exposure to the virus**
    .
    You can buy goods and services without going out.
    _________

    Of course, and that's what my wife and I do, except for groceries and liquor.

    In the past four weeks our spending has been about 98% of what it would have been had there been no social distancing, the difference being a postponed haircut and a cancelled luncheon. Wait, thats wrong because we stocked up on some items. Actually, we may have spent a little more than usual.

    All this talk about DESTROYING the economy is gross exaggeration. If you destroy something it's ruined and can't be fixed or just no longer exists. Yes, the imposed social distancing is hurting the economy, particularly the service sector. Voluntary social distancing would be less damaging, but also less effective in slowing the spread
    of Covid-19.

    The worst thing that could happen to the economy would be a depression as deep and long as the Great Depression, with very high unemployment and deflation. I don't believe that's coming. If I did, I would be thinking about moving into cash.

  589. OK_Max,
    "Voluntary social distancing would be less damaging, but also less effective in slowing the spread of Covid-19."
    .
    Please give us the study or the data which shows that is true.

  590. MikeM
    **The problem with social distancing is that although it decreases contact with strangers, it increases contact with other people, particularly family members. **
    I don't see how that's a "problem" with lock down.
    **I have it from an epidemiologist that the result is very little effect unless groups in society are almost entirely isolated from each other. **
    UHmm.. families are "groups" and they are being isolated from each other. So that is PRECISELY what lockdown does.

  591. OK_Max..
    .
    In your statement, which I quoted you claimed "which of course would increase my exposure to the virus". Now it seems you know perfectly well that buying stuff does NOT need to increase your exposure in any way shape or form. .
    .
    If you were trying to rebut the claim about the economy, maybe you should have done that directly rather than tossing out some other claim that you now tell me you know perfectly well was utterly false.

  592. Dave JR,

    I'm not going to watch a three week old 30 minute video from someone who is not a critical care specialist. If you can tell me when in the video he specifically addresses the prophylactic use of a supposedly scarce medical device, i.e. a ventilator, I could watch that.

  593. MikeN ( http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182315 ),

    "If I were on a ventilator, I think I would want to stay conscious just out of fear of the ventilator disconnecting."

    It won't be your choice. While it is possible to be conscious on a ventilator, this is not the case for COVID-19 patients. They are put in a medically induced coma. If I were to be hospitalized for COVID-19, I would have an advanced directive that stated that I should not be put on a ventilator for more than 5 days unless there is substantial progress and no more than ten days in any case.

    See here, for example:

    https://www.nytimes.com/2020/04/04/opinion/coronavirus-ventilators.html

    "Nobody can tolerate being ventilated like this without sedation. Covid-19 patients are put into a medically induced coma before being placed on a ventilator. They do not suffer, but they cannot talk to us and they cannot tell us how much of this care they want."

    "Even before Covid-19, for those lucky enough to leave the hospital alive after suffering acute respiratory distress syndrome, recovery can take months or years. The amount of sedation needed for Covid 19 patients can cause profound complications, damaging muscles and nerves, making it hard for those who survive to walk, move or even think as well as they did before they became ill. Many spend most of their recovery time in a rehabilitation center, and older patients often never go home. They live out their days bed bound, at higher risk of recurrent infections, bed sores and trips back to the hospital."

  594. SteveF (Comment #182382)
    April 7th, 2020 at 12:55 pm
    OK_Max,
    "Voluntary social distancing would be less damaging, but also less effective in slowing the spread of Covid-19."
    .
    Please give us the study or the data which shows that is true.
    _________

    I think you mean the "slowing" part. Don't think you need a study.
    If voluntary, those who don't volunteer are more likely to catch Covid-19 and spread it to other who don't volunteer, thus hastening rather than slowing the spread of the virus.

  595. OK_Max,
    That is what I figured you would say; a thin gruel of personal opinion. If you choose to completely avoid contacts, you won't catch it, right?

  596. lucia (Comment #182384)
    April 7th, 2020 at 1:01 pm
    OK_Max..

    **In your statement, which I quoted you claimed "which of course would increase my exposure to the virus". Now it seems you know perfectly well that buying stuff does NOT need to increase your exposure in any way shape or form."**

    Some purchases would increase my exposure because I can't have them delivered to my home (dining at restaurants, haircuts, air travel, the shooting range, etc). Fortunately, these are things I can do without. When I and millions of others stop buying these things, it does hurt the economy, but it doesn't destroy the economy.

    **If you were trying to rebut the claim about the economy, maybe you should have done that directly rather than tossing out some other claim that you now tell me you know perfectly well was utterly false.**

    lucia, I'm not sure what claim you are talking about. I don't believe I made a claim that I knew was false.

  597. SteveF (Comment #182388)
    April 7th, 2020 at 1:42 pm
    OK_Max,
    That is what I figured you would say; a thin gruel of personal opinion. If you choose to completely avoid contacts, you won't catch it, right?
    _________

    1. If I completely avoid contacts, I won't catch Covid-19.

    2. If I limit my contacts to Covid-19 survivors who no longer shed the virus, I won't catch the virus.

    3. If I limit my number of contacts, I reduce my chances of catching it.

    4. If I keep 6 ft. from my contacts, I reduce my chances of catching it.

    5. If I wear a N95 mask, I reduce my chances of catching it.

    6. If I frequently wash my hands and/or wear rubber gloves, I reduce my chances of catching it.

  598. OK_Max
    You now say this:
    **lucia, I'm not sure what claim you are talking about. I don't believe I made a claim that I knew was false.**
    The claim you made, to which I was referring is the one I quoted and which you requoted. I'll requote it below:
    ** if I wanted to help I should be out buying goods and services, which of course would increase my exposure to the virus. **

    In fat, you now tell us that you know that "which of course would increase my exposure to the virus" is false. You know you could buy goods and services without increasing your exposure, and tell us you've been doing precisely that. Moreover, you tell us you had already adapted your behavior to NOT increase your exposure while buying goods and services. So clearly, you KNEW that buying goods and services did NOT need to "increase [your] exposure to the virus".
    .
    So… of course you knew that the "which of course would increase my exposure to the virus." was false when you wrote it.

  599. OK_Max,

    It certainly destroys the economy for the barbers, waiters and other employees of the companies you and everybody else no longer frequent. If those businesses were operating on borrowed money in any way, the banks or other lenders are going to suffer. That's when you start getting the deflationary spiral of a depression. It doesn't matter how much money the government promises to give out if they can't get it out in a timely fashion. Six weeks to get a $1,000 check?

    People in Italy are getting to the point where they don't know from where there next meal is coming.

    https://www.nytimes.com/2020/04/07/opinion/italy-coronavirus-naples.html?algo=top_conversion&fellback=false&imp_id=504536883&imp_id=705093127&action=click&module=trending&pgtype=Article&region=Footer

  600. OK_Max,
    I'm pretty sure SteveF's point is that if you do 1-2 bulleted list, you won't get the disease no matter what other people do. That's entirely under your control– you could do it without requiring others. If you don't want to do that, you can do 3-6 ad drastically reduce your chances of catching it, no matter what others do. That's also under your control.
    .
    I'm not as against stay at home as SteveF.

    But your posts make it sound like the reason you want quaratine is your concern about yourself and people like yourself. And that your motive for controlling everyone else, and slowing the economy is yourself and people like yourself.

    But the fact is: you and people like you can do a lot to reduce your chance of infection on your own. All you need to do is:
    1) Stay at home. Don't go out. At all.
    2) Have groceries and other goods delivered. This can include prepared meals, tvs and so on.
    These two steps by themselves would protect you about 100% from Covid. (You might die of boredom… but not Covid-19)

    Then, if you go out:

    3) Wash your hands, do your own housekeeping, blah… blah…Everything else on your list.
    4) Since you probably are paranoid about virus coming in on paper packages, leave notes to have your delivers put in a holding area with good ventilation. Be sure you have a good filter on your furnace. Possibly consult with someone to put in some sort of anti-microbial thing in your ducts.

    You're doing everything on your list now anyway. The only difference is whether everyone else is required to do them. But you can prevent yourself from getting sick by doing them even if other people don't. It's an option for you and people like you. (It's an option for me– I think I'm actually in the group you consider people like you.)

    As long as we started "stay at home", I'd like to continue two more weeks to get the number of cases down. After that, perhaps we'll have enough tests to test, track, trace and deal with things individually. But SteveF is right the stay at home can't last FOREVER.
    .
    Beyond that, the mortality rate doesn't seem high enough to warrant that. Yeah… I don't want to die. I don't want Jim, my siblings, my parents or friends to die. But people do die of other things and responses do need to be proportionate.
    .
    I also don't want kids to grow up poorly educated, or enjoyable services to dry up, or employment opportunities to vanish for everyone.
    .
    We have so much uncertainty surrounding lots of things that we just don't know where the balance lies. But really, the argument "I, Lucia, and people like Lucia could die" is not a slam dunk to support the conclusion "and so nearly the whole economy should be shut down." The argument doesn't become more compelling if we change "Lucia" to "OK_Max".

  601. OK_Max,
    OK, so if you do a few things, which are 100% in your control, you will never get the COVID-19 virus. We agree at least on that.
    .
    But what you want is EVERYONE to change their behavior (and in many cases, lose their employment or their businesses) to convenience YOU, and reduce your personal risk of getting the illness whenever YOU choose to venture into that risk-filled, horrid, world of COVID-19.
    .
    Why am I not surprised by this? Because it is the absolutely standard "progressive" take on everything: "You do exactly what I say or I will punish you for doing differently." Pure, self-centered, selfish rubbish, justified by claiming to be morally superior to everyone else. I gag. I suspect you don't and won't ever see this sorry reality…. also quite standard for progressives.
    .
    I am quite happy to let you do whatever you want to protect yourself from COVID-19, *if that is limited to your personal behavior*. Unfortunately, it doesn't work the other way around.

  602. Lucia,
    "I don't want Jim, my siblings, my parents or friends to die."
    .
    Let me state clearly: I don't want you or any of those people to die either. Nor do I want my unemployed son (restaurant business) to remain indefinitely unemployed. He has already called me to advise that unemployment benefits have been "delayed" indefinitely due to the huge rush of new claims, and he is very close to needing money to not go hungry.

  603. DeWitt Payne (Comment #182386)
    April 7th, 2020 at 1:35 pm

    DeWitt, that is information that unfortunately our politicians are evidently fearful of disseminating. I have had the discussion with my two sons and daughter-in-laws about this issue and much in the terms of which you mentioned. I do not know about others but for me it is comforting to know what might happen and to make some plans accordingly.

  604. lucia (Comment #182392)
    OK_Max
    You now say this:
    **lucia, I'm not sure what claim you are talking about. I don't believe I made a claim that I knew was false.**
    The claim you made, to which I was referring is the one I quoted and which you requoted. I'll requote it below:
    ** if I wanted to help I should be out buying goods and services, which of course would increase my exposure to the virus. *
    _______

    lucia, I'm afraid you misunderstood what I meant in the exchange with SteveF. The key word there was "out." I thought he was implying if I wanted to help the unemployed and small businesses, I would be out buying in addition to being out by walking. I never said I didn't go out to buy, so I presumed he was thinking I should be out buying or be out buying more frequently.

    Please read the following comments:

    OK_Max (Comment #182326)s.
    2. I don't submit myself to "indeterminate house arrest," I go for an hour of walking every day.

    SteveF (Comment #182332)
    2.Good for you. Doesn’t help the 10+ million unemployed or the thousands of small businesses in danger of disappearing.

    OK_Max (Comment #182340)
    You did say my way of getting out, the walks, don’t help the unemployed and the small businesses, implying if I wanted to help I should be out buying goods and services, which of course would increase my exposure to the virus.

    lucia, I see how you could have misunderstood my comment. In the paragraph above I should have added a "more" after the "out ."

  605. Kenneth, DeWitt,
    My wife and I long ago set up a living trust and attached wills, with explicit instructions for cases were we can’t choose treatment for ourselves. Sometimes, life is absolutely not worth living. My hard-nosed son the lawyer, named as secondary trustee, will not flinch from making sure we son’t suffer at the end…. the other kids… I would have my doubts.

  606. SteveF,
    I think we see this more-or-less the same way. Government enforced stay at home is definitely hurting many people. I'd say it's hurting the young disproportionately. It's hurting the not-white collar. It's hurting restaurant, retail and so on.
    .
    I don't want them hurt. It's not fair to them.

  607. lucia (Comment #182392)
    April 7th, 2020 at 3:06 pm
    OK_Max
    You now say this:
    **lucia, I'm not sure what claim you are talking about. I don't believe I made a claim that I knew was false.**
    The claim you made, to which I was referring is the one I quoted and which you requoted. I'll requote it below:
    ** if I wanted to help I should be out buying goods and services, which of course would increase my exposure to the virus. **
    _______

    lucia, I can understand why my comment was not clear. I should have added a "more" after the "out" in the above quoted paragraph. Then you would have know I do go out to buy. I did mention going out to buy liquor in an earlier comment, but I don't expect you to read everything I write.

    I thought SteveF was implying I don't go out to buy frequently enough to help the unemployed and small businesses. My guess is I'm helping them as much as he is, maybe more.

  608. Sorry for the last comment. It was just a truncated version of my previous comment, which I thought got lost.

  609. OK_Max,
    Well then you clearly misunderstood SteveF because he certainly never suggested that you personally should be forced to leave your home. If you reread the bit you quoted him as saying, it's difficult to believe YOU could have thought he suggested that. What he said– and you quoted was
    **SteveF (Comment #182332)
    2.Good for you. Doesn’t help the 10+ million unemployed or the thousands of small businesses in danger of disappearing.**
    .
    I have absolutely NO IDEA how you could thinks what he wrote
    **" impl[ies] if I wanted to help I should be out buying goods and services, which of course would increase my exposure to the virus."**
    .
    It really takes some abominable reading skills on your part to read in an implication that you must go OUT into what SteveF actually wrote.
    .
    No one here objects to you self quarantining. No one has suggested or "implied" that YOU need to go out. The issue is whether *everyone* or nearly everyone should be required to shelter-at-home and for many businesses to shut down. That's what's happening now. It has very real consequences for people (who don't happen to be you.)
    .

  610. SteveF (Comment #182395)
    **I am quite happy to let you do whatever you want to protect yourself from COVID-19, *if that is limited to your personal behavior*. Unfortunately, it doesn't work the other way around**
    _______

    Yes, I know, you want the infected to have the freedom to spread the disease around. I don't think that's a good idea for me. So who is being most selfish here, the infected who are irresponsible or me ?

  611. SteveF (Comment #182399)

    My wife (who has since passed away) and I did the same with a revocable trust and a living will some time ago. One of my daughter-in-laws is an estate and divorce lawyer but did not do our trust. I wanted my sons and daughter-in-laws to better understand the ventilator issue. I have already had to make end of life decisions for my daughter and wife and for which I guess one is never prepared.

  612. lucia (Comment #182403)

    OK_Max,
    Well then you clearly misunderstood SteveF because he certainly never suggested that you personally should be forced to leave your home.
    _______

    I don't really know what SteveF was suggesting. You would have to ask him. And while you are at it, ask him what the unemployed has to do with my daily walks. Here again is the exchange:

    OK_Max (Comment #182326)
    2. I don't submit myself to "indeterminate house arrest," I go for an hour of walking every day.

    What follows is SteveF's reply.

    SteveF (Comment #182332)
    2.Good for you. Doesn’t help the 10+ million unemployed or the thousands of small businesses in danger of disappearing.

    Steve's reply is puzzling since my daily walks don't affect the unemployment rate. But I guess he means while out walking, I could help the unemployed by routing my walks past businesses and dropping in to buy stuff.

    lucia, I don't know what else to get out of SteveF's comment. Perhaps you see a meaning there that I don't see.

  613. Lucia,
    Unfortunately there is a sorry mix self-righteous certainty, ignorance, and arrogance among many who are utterly insulated from most of the real-world consequences of the current policies. Yes, when your biggest inconvenience is the need to consider whether to move your investment assets toward cash to minimize financial risk, and to consider buying opportunities in discounted stocks to personally profit from the pandemic, you can comfortably declare that it does not matter how long idiotic policies that put lots of people out of work continue in place. Big hearted progressives. So smart. So self righteous. So amoral. It is enough to make one vomit.

  614. SteveF (Comment #182396)
    I don't want you or any of those people to die either. Nor do I want my unemployed son (restaurant business) to remain indefinitely unemployed. He has already called me to advise that unemployment benefits have been "delayed" indefinitely due to the huge rush of new claims, and he is very close to needing money to not go hungry.
    _______

    SteveF, I'm sorry to hear about your son, and I can understand how what he is going through could affect your point of view on this issue. I have a relative, a travel agent, in a situation similar your son's. Her business is almost down to nothing, despite not having to deal face-to-face with clients as your son has to do. I'm not sure she is even eligible for unemployment benefits, but her husband's job is secure for the time being, and they can live on his income alone.

  615. OK_Max,
    And I am sorry to hear that you are unwilling to address the real issue…. and that is not your walks, as much as you might try to obfuscate about walks. The issue is policies which are very economically destructive, and which you (and virtually all on the left, no surprise) support because changing them “would not be good for me”. Command and control of everyone and everything above all else, right comrade?
    .
    “ and I can understand how what he is going through could affect your point of view on this issue.“
    .
    My position would be unchanged if my son were profiting from stupid public policies. My son is but one example of many millions…. people you clearly don’t give a sh!t about.

  616. OK_Max,
    .
    So you say you are sorry others are being harmed by this. Real question: are you sorry enough to say end THEIR pain by ending the "stay at home"? And if not, why not?

  617. SteveF (Comment #182407)
    **Yes, when your biggest inconvenience is the need to consider whether to move your investment assets toward cash to minimize financial risk, and to consider buying opportunities in discounted stocks to personally profit from the pandemic, you can comfortably declare that it does not matter how long idiotic policies that put lots of people out of work continue in place.**

    I'm sorry if you don't have a lot, but it's not my fault.

    Crises present opportunities. This Covid-19 crises gives me the opportunity to recover what I have lost because of this crises, and possibly even more if I want to take more risks. But I will be satisfied just to get back to where I was.

    I believe it naive to think the economy would be in good shape had governments not took measures to contain and mitigate Covid-19.
    Without theses measures there would be a lot more sick people,
    too ill work or self-quarantining, and far fewer people eating out, going to movies, traveling for business or pleasure, etc. And the health care system would be overwhelmed. Remember this virus is highly contagious and the populations had no immunity.

    **Big hearted progressives. So smart. So self righteous. So amoral.**

    I am glad to take a financial hit rather than throw frail elderly folk under the bus even though they probably don't have more than a few years left anyway. I remember being unemployed and would go through that again if it meant giving thousands of ill elderly more time on this earth. Do you think I am amoral?

  618. OK_Max,
    Based on what you write in #182411 I think you have chosen benefiting yourself an over others. You seem to have little sympathy for others. This is common in older people, especially those with money, which you seem to have plenty of.

  619. lucia (Comment #182410)
    April 7th, 2020 at 7:17 pm
    OK_Max,
    .
    So you say you are sorry others are being harmed by this. Real question: are you sorry enough to say end THEIR pain by ending the "stay at home"? And if not, why not?
    ______

    Not just yet. Too early. Wait until the infection rate (number new cases) has declined as much as can be expected from "stay at home."

    You didn't expand on what you meant by "pain." I take it you meant emotional pain, not physical pain. I will attempt to relate to that. I'm tired of being afraid to go to some places. I don't like my options being limited. I remember not liking being unemployed and broke.

    I also remember how much I disliked diseases I've had, some of which were physically painful, and make some of the above mentioned pains seem like nothing.

  620. vSteveF (Comment #182409)
    **My position would be unchanged if my son were profiting from stupid public policies. My son is but one example of many millions…. people you clearly don’t give a sh!t about.**
    _______

    And you clearly don't give a shit about the millions more vulnerable than your son and the like.

    But don't get the idea that make us moral equals. Being against death is morally superior to being against unemployment. Workers can recover from unemployment.

  621. OK_Max
    **You didn't expand on what you meant by "pain."**
    .
    Pain of unemployment not only for themselves, but during a time when there are no prospects for anyone, losing homes, not being able to pay for groceries etc.
    .
    Honestly, you seem very insensitive to the pain of others. But that's ok. Some people are like that and as I said, often older people are.
    .
    In fact, I've often noticed many in my Mom's generation (just too young to be in WWII, entered the job market during the beginning of a sustained boom) tends to be rather insensitive to the pain of others. I don't know why that is, but they tend to respond to situations by always explaining how bad things were for them and their generation. It's not all of them, but really, it doesn't matter what travails happen to other generations, they always seem to want to explain why they are the ones who had things really hard.

  622. lucia (Comment #182412)
    April 7th, 2020 at 8:43 pm
    OK_Max,
    Based on what you write in #182411 I think you have chosen benefiting yourself an over others. You seem to have little sympathy for others. This is common in older people, especially those with money, which you seem to have plenty of.
    _________

    You got that out of this:

    "I am glad to take a financial hit rather than throw frail elderly folk under the bus even though they probably don't have more than a few years left anyway. I remember being unemployed and would go through that again if it meant giving thousands of ill elderly more time on this earth."

    lucia, I don't know what to say.

  623. Yep. I got that out of that statement. I notice you make NO mention of the suffering of anyone OTHER than yourself. You mention YOUR financial hit (which is, evidently hypothetical, because you previously have revealed you are benefitting by playing the market.)

    You studiously ignore the suffering of OTHERS — that is people who are not you or like you. You studiously avoid that the suffering is not YOU. It's other people, and you are ignoring it.

    While ignoring the sufferig of people not like you, you accuse others of wanting to "throw frail elderly under the bus". This is not what anyone has suggested doing. But I suspect you– an elderly person, identify with the eldery. So you are basically ignoring the suffering of the non-elderly to assuage some emotional angst, which in this case is lack of calm from worrying about getting sick even though you can protect yourself quite well by just self quarantining.

    So: yeah, from that I take it you are insensitive to the suffering of others. You are very sensitive to your own feelings and situation.

  624. OK_Max,

    You are a truly disgusting person.

    You have the good fortune to be able to ride this out with relative ease. You have the financial resources that it does not threaten your financial future, you can afford to have things delivered to you to minimize your risk. And you have a place to go for walks and are allowed to do so. It is quite likely that you have a reasonably spacious home with a yard.

    There is nothing wrong with that, except that if you have stuff delivered then you are reducing your risk but increasing the risk to others. You no doubt worked hard to get those privileges.

    But your selfish refusal to recognize how this impacts others is remarkable. There are people who are faced with losing everything they have worked for: the small business they spent decades building, their entire retirement, even their homes. There are families cooped up in two bedroom apartments with the kids home from school all day, not allowed out other than for an occasional trip to the grocery store and nothing to do except to worry how long they will be able to afford to go to the grocery store and if they will have a job to go back to when this is finally over. There are luckier people who get to go to work every day and get to experience a much higher risk of exposure than you have.

    But what makes you disgusting is that you seem to think that makes you morally superior to the rest of us.

  625. OK_Max

    **Honestly, you seem very insensitive to the pain of others. But that's ok. Some people are like that and as I said, often older people are.**

    Jeez, lucia, you make me sound like a sociopath. Lack of empathy is one of the defining characteristics of ASPD. Would it make a difference if you knew I have trouble holding back tears at funerals.

    **In fact, I've often noticed many in my Mom's generation (just too young to be in WWII, entered the job market during the beginning of a sustained boom) tends to be rather insensitive to the pain of others. I don't know why that is, but they tend to respond to situations by always explaining how bad things were for them and their generation.**

    Those would be people whose parents came of age during the Great Depression. They may have actually had it bad, being kids during the recovery.The economy picked up during WWII, but otherwise the war years weren't a good time (rationing, anxiety about relatives in battle). Some from that generation entered the job market during a recession (late 1950s). Also for women of that generation, the job market wasn't as open as it is for women today.

  626. OK_Max,
    .
    I didn't suggest you were a sociopath.
    **They may have actually had it bad, being kids during the recovery.**
    Sure. And some seem to have grown to not sympathize with others.
    .
    Yeah…there was rationing. I remember my mom telling me she only got one new pair of shoes a year during the war because of rationing. I pointed out she hadn't bought my a new pair in two years and that before that, most of my shoes had been hand-me downs from my older sister. (My mom was the oldest child– so no hand-me downs for her!)
    .
    Mind you:my shoe situation was fine. But I would hardly say rationing made her shoe situation during the war had been worse than mine during my entire childhood!
    .
    There's no doubt somethings were hard for that generation. But other things were harder for others. And my observation is that generation often has difficulty seeing anything was hard for any other generation. It's a trait. Maybe there's a reason for the trait. But the fact is, every generation has some challenges that others don't. .
    Being incapable of seeing the pains, difficulties or challenges of younger generations and thinking your own is the only one that ever had hardhip is not a charming or admirable trait.

  627. Mike M. (Comment #182418)

    **But your selfish refusal to recognize how this impacts others is remarkable. There are people who are faced with losing everything they have worked for: the small business they spent decades building, their entire retirement, even their homes.**

    I recognized the economic impact early on, which is why I was for the government rescue package from the start, while you weren't as I recall.

    What I don't agree with is the notion that no containment would have been better for society than the policy being followed.

    **But what makes you disgusting is that you seem to think that makes you morally superior to the rest of us.**

    Not the rest, just SteveF. And I wouldn't have said I was morally superior to him had he not accused me of being amoral in the first place. I think he was referring to me. If not, SteveF, I take it back.

  628. Even before the shutdown orders, restaurants and other businesses were suffering as people were staying away voluntarily.

  629. How interesting! It's not often that people openly express and argue their moral superiority on blogs in my experience. I'm abruptly interested.

  630. OK_Max (Comment #182422): "I recognized the economic impact early on, which is why I was for the government rescue package from the start, while you weren't as I recall."
    .
    Not so. Not even close.
    ——–
    OK_Max: "What I don't agree with is the notion that no containment would have been better for society than the policy being followed."
    .
    I don't think that anyody here has suggested any such thing.
    ——-
    OK_Max: "Not the rest, just SteveF."
    .
    I don't see how you could make that claim about SteveF without including me and many others.

  631. Max,
    In general, you'd be justified in assuming I was out to attack you. In fact in this particular instance I am not. I do not believe progressives are immoral or evil in general, rather, I believe they are essentially of the same moral character that I am. It's an interest of mine to try to understand how we come to radically different world views and political philosophies given this.
    .
    It looks to me (and I'd be pleased if you'd share your opinion on my thinking) that your position is rooted in response to an attack; Steve asserted that you were amoral and therefore you retaliated by suggesting that you're in fact morally superior to Steve. Maybe then this should be viewed as a dominance hierarchy dispute, rather than a dispute of true beliefs? In plainer terms, are you taking the position that you are morally superior to Steve because a) you believe it? or b) because you're pissed off that somebody is disparaging you and damaging your social standing on a blog by attacking your moral character?
    I tend to believe it's (b), but I am interested in hearing if I'm wrong!
    Thanks,
    Mark

  632. OK_Max,
    **What I don't agree with is the notion that no containment would have been better for society than the policy being followed. **
    Sure. But the only reasons you ever list for why that would not be good is harm to *yourself* and *people like you*. That's why you come off as unsympathetic to the plight of others.
    .
    The government bailout can never be enough if this continues a long time. It will also ever be equitable. (It already isn't. Some groups of people who are heavily harmed are left out. Others who are in harms way risking getting ill get no government benefit and so on.)
    .
    The "stay at home" cannot continue forever– and that's the point most people here are making. You seem to want to want to revert to whether we should have had "no containment at all". Absolutely NO ONE thinks there should have been no containment at all. So changing the subject to that is either you (a) arguing a strawman no one has suggested or (b) you being quite confused about what people are actually discussing or suggesting.

  633. And in other news, Sanders has given up the ghost and suspended his campaign.

  634. Italy could see a reduction in the number of active COVID-19 cases in the next few days.

    Wyoming still hasn't had a COVID-19 death. They've had 221 cases and 52 recoveries.

    Our local hospital system, Ballad Health, has projected a loss of ~$150 million over the next 90 days due to the concentration on COVID-19 cases. That's why you are seeing some health care workers being furloughed. This area is projected to have adequate resources to deal with the expected number of cases.

  635. This is a situation that is controversial because it has conflicting rights. The rights of the elderly to not be recklessly endangered by (lack of) government policy versus the liberty of the people to conduct their normal daily lives without government intervention.
    .
    We should all be able to agree that if this virus was much more lethal and much more contagious then lock downs would be justified, and we should all be able to agree that lock downs are not justified for the common flu.
    .
    Screaming "my side has rights too" is avoiding the meat of the argument which is how to properly balance those rights, and how we could codify those decisions in the future. As it sits we have elected officials making judgments on the advice of medical professionals and the will of the people appear to support these decisions. Unfortunately we are flying blind with blunt instruments and fear/panic are ruling the day. It is also important to note that there can be partial lock downs and social distancing while we work, wearing masks in public etc.
    .
    Public pressure to re-open the economy isn't there yet, but a month from now it probably will be. The WSJ said today 1/3 of people failed to pay the rent the first week of April. My concern is that the decision makers are living in a professional class cultural bubble and that the morality shamers have undue influence. The unemployed and lower classes must have a seat at the table. Do they? I'm not sure.
    .
    I'd like to see measurable infection metrics used to implement and free up lock downs instead of media opinion and left wing Twitter.

  636. Dewitt,

    Hopefully, Wyoming continues to stay on top of things. I've been "benchmarking" my state Pennsylvania against Florida. By the end of today, Pennsylvania may have more total cases than Florida and around the same number of deaths.

    Since you've been following the IMHE site, do you (or anyone else) know what they put into their model? I note they are still projecting a maximum death rate for PA of 40/day in about a week. We've now had two days of around 70. Also, the data they use for "real" data don't seem to match either the Worldometer site or the Wiki summaries for either Florida or Pennsylvania.

    I'm wondering if they're overweighting the social distancing impact.

  637. The NYT's finally discovers their own city and state response wasn't ideal.
    https://www.nytimes.com/2020/04/08/nyregion/new-york-coronavirus-response-delays.html
    .
    "A week later, on March 1, she tested positive for the coronavirus, the first confirmed case in New York City of an outbreak that had already devastated China and parts of Europe. The next day, Gov. Andrew M. Cuomo, appearing with Mayor Bill de Blasio at a news conference, promised that health investigators would track down every person on the woman’s flight. But no one did."
    .
    “Excuse our arrogance as New Yorkers — I speak for the mayor also on this one — we think we have the best health care system on the planet right here in New York,” Mr. Cuomo said on March 2. “So, when you’re saying, what happened in other countries versus what happened here, we don’t even think it’s going to be as bad as it was in other countries.”

  638. Even if they recinded stay at home orders, people will not go to restaurants because they have been ordered shut down as well, or limited to takeout.
    You would have to rescind these shutdown orders as well.
    Then you would need to have people feel they are safe going out before restaurants will recover.
    It's possible that an extreme stay at home order is what is needed to get to the final stage.

  639. When the issue is chloroquine, Dr. Fauci insists on hard data and double blind testing.
    On April 5, Dr. Fauci said he thinks half the population is infected but asymptomatic.

  640. mark bofill,
    "Sanders has given up the ghost.."
    .
    He didn't actually die, but I am sure he knows this was his last presidential rodeo. 😉
    .
    Something to bring cheer in the gloom of bad corona virus policy.

  641. MikeN,
    "On April 5, Dr. Fauci said he thinks half the population is infected but asymptomatic."
    .
    Can you provide a link to that? It seems to me a pretty crazy thing to say…. unless he was talking about northern Italy or NYC.

  642. Steve, I should have checked it.
    He said half the infected population is asymptomatic, but admitted he was guessing.

  643. Virus unlikely to diminish significantly with warm weather, scientific panel reports
    https://www.washingtonpost.com/weather/2020/04/08/coronavirus-unlikely-diminish-with-warm-weather-national-academies-sciences-panel-finds/
    .
    A close reading of this article actually says there is limited evidence that it does diminish, but it is not high quality evidence. Thus, they conclude we should assume it does not diminish. Misleading headline.
    .
    "The report concludes: “…although the experimental studies show a relationship between higher temperatures and humidity levels, and reduced survival of SARS-CoV-2 in the laboratory, there are many other factors besides environmental temperature, humidity, and survival outside of the host, that influence and determine the transmission rates among humans in the ‘real world’.”
    .
    “ … I think it very well might. And the reason I say that is that what we’re starting to see now in the Southern Hemisphere, in southern Africa and in the southern hemisphere countries, is that we’re having cases that are appearing as they go into their winter season,” Fauci said March 26, when asked whether the virus could have a seasonal cycle.

  644. Tom Scharf,

    Governor Cuomo: “So, when you’re saying, what happened in other countries versus what happened here, we don’t even think it’s going to be as bad as it was in other countries.”

    No, it is a lot worse.

    But Trump was supposed to be clairvoyant while those closest to the situation with the power to actually do something were clueless. Does anyone think anybody would have paid any attention to Trump if he had been pessimistic in January or even February? I don't.

  645. MikeN,

    I think Fauci is being extremely conservative about only half the infected population being asymptomatic. Remember I posted above ( http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182182 ) the estimate from Italy that 10% to 30% of the Italian population had been infected. If that's not the case, then the case fatality rate is going to be quite high.

    Also, according to the CDC, 116,000 people died in the US from the 1957 H2N2 flu pandemic. Correcting for population, that would be over 220,000 today. That's on the high end of current estimates, in fact, it's way above the Murray model at IHME which has just been reduced to 60,415 (31,221-126,703).

    John M,

    There's an editorial about the IHME (Murray) model in today's WSJ.

    "The point is that coronavirus models are one guide to the pandemic future, and often imperfect. They should also be one among other factors in determining government pandemic policy such as when to start reopening parts of the country. They’re a tool, not an oracle."

    "As Anthony Fauci of the White House coronavirus task force noted last week, models are only as good as the assumptions fed into them. One problem is there isn’t consensus among public-health experts about how variables other than social distancing affect transmission and fatalities. Nor, by the way, do models account for how treatments could reduce deaths and hospital utilization."

    "The Murray March 26 study noted that its model accounts for population age structure but not the “many other factors that may influence the epidemic trajectory: the prevalence of chronic lung disease, the prevalence of multi-morbidity, population density, use of public transport, and other factors that may influence the immune response.”

    https://www.wsj.com/articles/the-art-of-coronavirus-modeling-11586301975?mod=opinion_lead_pos1

    Note the use of the word 'art' in the title.

  646. Ventilators looking that they do more harm than good treating the c-virus, but one reason it is used over noninvasive devices is :
    .
    https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

    “…The noninvasive devices “can provide some amount of support for breathing and oxygenation, without needing a ventilator,” said ICU physician and pulmonologist Lakshman Swamy of Boston Medical Center.
    .
    One problem, though, is that CPAP and other positive-pressure machines pose a risk to health care workers, he said. The devices push aerosolized virus particles into the air, where anyone entering the patient’s room can inhale them. The intubation required for mechanical ventilators can also aerosolize virus particles, but the machine is a contained system after that.

    “If we had unlimited supply of protective equipment and if we had a better understanding of what this virus actually does in terms of aerosolizing, and if we had more negative pressure rooms, then we would be able to use more” of the noninvasive breathing support devices, Swamy said. ..”
    .
    And here I have always been told that the needs of the patient came first. They are now willfully giving treatment they now KNOW gives harm for expediency.
    .
    If I get sick enough to have to go into the hospital, I think a first stop will be to a tattoo shop for “Do not use intubation” printed on my forehead. The life expectancy for this procedure is so bad that it is not worth the pain and anguish.
    .
    An additional view on this:
    https://thecommonsenseshow.com/conspiracy-economics-education/bombshell-plea-nyc-icu-doctor-covid-19-condition-oxygen-deprivation-not-pneumonia-ventilators-may

  647. Ed Forbes,

    "And here I have always been told that the needs of the patient came first. They are now willfully giving treatment they now KNOW gives harm for expediency."

    See my exchanges with Dave JR above (starting here: http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182372 ). According to him, 'medical professionals who work with ventilators' have recommended prophylactic use of ventilators to prevent the spread of virus aerosols. Of course the increased risk of pneumonia for the patient from the use of a ventilator for more than a day or two isn't important.

  648. Ed, regular breathing also pushes aerosolized virus into the air.
    Is there anything in the noninvasive treatments that makes this worse?
    I think what they are really doing is putting people on ventilators because it reduces the risk from having patients breathing on the workers.
    I am not convinced of the reduced risk of ventilators, as workers would have to be touching the tubes as they are removed and replaced.

  649. Tom Scharf,
    "My concern is that the decision makers are living in a professional class cultural bubble and that the morality shamers have undue influence. The unemployed and lower classes must have a seat at the table. Do they? I'm not sure."
    .
    I am pretty sure they *do not* have a seat at the table. Yes, the decision makes, unfortunately, are a mixture of incompetent politicians ('each life has infinite value'), 'experts', and lefty shame-mongers with a political agenda… which is control, control, control, for me, me, me. They are often the very same people, of course.
    .
    I agree that there is not yet the political will to lift restrictions, not even in places with extremely low infection rates, but that will probably start changing soon.
    .
    I took a look at the age profile of Dutch covid-19 death rates and compared it to the overall Dutch demographic data (the Dutch keep very good records). As of yesterday, people over 85 years old in the Netherlands have suffered a 0.3% chance of death from coronavirus; to put that in perspective, that 85+ age group has an approximate chance of death from other causes of about 8% per year. The risk of death plummets at all lower ages, as expected, and falls below 0.01% risk for people under 65, and extremely close to zero for all those under 50.
    .
    As economic damage accumulates, I expect more and more people will recognize that the 'cure' is starting to look worse than the illness, and more sensible policies like offering isolation to those at high risk will start looking a lot more attractive. My hope is the madness will start to end sometime soon.

  650. MikeN,

    A CPAP exhausts air into the room continuously. The flow has to be high enough that normal breathing won't cause negative pressure in the mask. So a CPAP will increase the total air flow, but may, or may not increase virus aerosols as one would expect that the concentration of virus in exhaled breath would be higher than in the continuous flow from a CPAP mask.

    The other problem is that unless you have the room under negative pressure compared to the hallway with the exhausted air HEPA filtered, air from the room will flow into the hallway. That then requires the continuous wearing of N95 masks by staff, not just in a patient's room.

  651. There is also the issue of what actually counts as a death from the Wuhan virus.

    Uncle Joe has a bad ticker. He catches a cold, gets tested, and it comes back positive for Wuhan. But it is just a mild case. While still ill, he has a final heart attack. Is that a death from Wuhan virus?

    Grandpa Simpson catches a respiratory infection which develops into pneumonia from which he expires. He was never tested. Is that a death from Wuhan virus?

    From what I understand the answers are "yes" and "maybe"; the latter being the case if the doctor thinks the respiratory infection might have been Wuhan.

    It would be nice to know how many Wuhan deaths are of the two types above. Maybe they are a minor contribution, maybe not.

  652. SteveF,

    Speaking of the Netherlands, IHME projects a total of 5,808 deaths there or 336/million, about twice the rate projected in the US. Of the four social distancing criteria, only educational facilities are closed. There is no stay at home order and no closure of non-essential services or severe travel limitation. However, nobody, with the exception of China, has implemented travel limitation. So only a relatively small number of excess deaths with a whole lot less economic damage.

  653. Another problem with the Murray model (IHME) from the WSJ editorial linked above ( http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182442 ):

    "The Murray team say their projections changed because their early modeling was based largely on data coming from China. “The time from implementation of social distancing to the peak of the epidemic in the Italy and Spain location is shorter than what was observed in Wuhan,” they note. This underlines the limitations of existing models."

    Not to mention that China almost certainly was less than transparent with their data to put it mildly.

  654. MikeM,

    Uncertainty in count is no different for COVID-19 than any other disease. The linked article suggests in your first example (the heart attack) the death would be counted as "heart attack". The second death would either be marked as "pending" (If someone was waiting on a test) or pneumonia.

    So if the article describes the convention for attributing deaths correctly, the tendency seems to be to underount Covid-19 deaths.

    https://www.inquirer.com/health/coronavirus/coronavirus-covid19-cause-death-certificate-pcom-20200401.html

  656. lucia (Comment #182451): "The linked article suggests in your first example (the heart attack) the death would be counted as "heart attack"."
    .
    No, it does not say that at all. From the article:
    "If a person suffers serious head trauma then becomes infected after being put on a ventilator at a hospital, the trauma might be listed as the primary cause, with COVID-19 as contributing factor, he said."

    So that is a Wuhan virus death even though the virus was contracted as a consequence of the original injury, which obviously had nothing to do with the virus.

    "Dr. Deborah Birx said that … in the U.S. you are counted as a victim of the pandemic if you die while testing positive for the virus, even if something else causes your death. "
    https://www.realclearpolitics.com/video/2020/04/08/dr_birx_unlike_some_countries_if_someone_dies_with_covid-19_we_are_counting_that_as_a_covid-19_death.html

    But now that I reread what she actually said, I think that might not be an accurate summary.
    .
    lucia: "The second death would either be marked as "pending" (If someone was waiting on a test) or pneumonia."

    Yes, it would be pneumonia. But it could also be the Wuhan virus if the physician thought that was involved, even if no test was done. I got that from the CDC web site.

    There is not just a single cause of death. Comorbidities are also listed. As I understand it, if the Wuhan virus is listed anywhere, then that goes into the Wuhan total.

  657. SteveF (Comment #182452): "Schools, restaurants, bars, theaters, museums, etc all closed, limitations of number of people who can meet (even in private), distancing (they say 1.5 meters, not 2), and more. How are they different?"
    .
    No actual stay at home order, let alone a lockdown. Higher limits on the number of people who can gather (30 instead of 5). No general closing of "non-essential" businesses unless they involve crowds or close personal contact. It sounds like parks, golf courses, etc. remain open.

  659. MikeM
    **"If a person suffers serious head trauma then becomes infected after being put on a ventilator at a hospital, the trauma might be listed as the primary cause, with COVID-19 as contributing factor, he said."**
    Yes. The trauma is the primary cause.

    **So that is a Wuhan virus death even though the virus was contracted as a consequence of the original injury, which obviously had nothing to do with the virus.**
    Well, that doesn't mean the *death* didn't have anything to do with the virus. The virus, which attackes the body and lungs weakened him further. But the primary cause is STILL listed as head trauma not the virus.

    **But it could also be the Wuhan virus if the physician thought that was involved, even if no test was done. I got that from the CDC web site.**
    Well, that's good then! Otherwise, the undercount of Covid deaths would be amazingly large.

    **There is not just a single cause of death.**
    Which is, as I pointed out, no different with Covid-19 than anything else.
    **Comorbidities are also listed.**
    Which ought to satisfy you. It also allows people to learn what makes one more susceptible to dying.

    **if the Wuhan virus is listed anywhere, then that goes into the Wuhan total.**
    Well, that's not what the article I linked claimed. But even if it did, I'm not under the impression there are many people with Covid getting into head on collisions and having their deaths adding substantially to the count.

  660. I went to my grocery store the other day during the 2 hours for seniors shopping. There were a lot of old people wearing many forms and styles of face mask. I found that to be a damn depressing sight – no matter what the benefits of wearing a mask.

    I ordered masks through Amazon with an expected delivery time of early May. In the meantime I will be ordering groceries online for either delivery or pick up. If I go back to stores with a mask I will be wearing very dark glasses.

    I walk in the forest sometimes so that I do not have to deal with social distancing when walking on sidewalks. I was walking in a forested area the other day in a forest preserve and spotted a young couple walking there with face masks and a baby in a carriage with a face mask. They had a dog but it was without a face mask. I was about to ask, what about the pooch, but I thought this couple was sincere in their beliefs and would not appreciate my attempt at humor. In the forest I will remain without a mask even if the observers say, who was that unmasked man.

  661. SteveF,

    I was going by the list at the top of the page on the IHME site.

    https://covid19.healthdata.org/netherlands

    It's probably behind. But that still sounds like no stay-at-home order.

    In other news, Blacks and Hispanics seem to be more likely to have severe illness and death from SARS-CoV-2. But IIRC, comorbidities like high blood pressure and diabetes may be more common in those communities.

  662. Kenneth,

    I realize that you were joking, but I don't think dogs can get the virus. Cats can, though. See, for example, the tiger at the Bronx zoo. But most people don't walk their cats.

  663. Kenneth,
    Actually…. based on actual tests, it is believed:
    1) Dogs' can't get Covid-19
    2) Cats can.

    I think I read: ferrets can.

  665. Mike M. (Comment #182427)
    April 8th, 2020 at 6:53 am
    OK_Max (Comment #182422): "I recognized the economic impact early on, which is why I was for the government rescue package from the start, while you weren't as I recall."
    .
    **Not so. Not even close.**
    _______

    Mike, my impression you weren't for a Covid-19 rescue package early on comes from your Comment #181272 in " Cost of Quarantine ?,"
    as quoted below:

    “Keynesian stimulus right now is just stupid. There might be a place for it if the economy does not bounce back when the shutdown is over.”

  666. Kenneth,
    That economist seems shocked (*shocked!*) that economists are beaten up when they suggest you put a value on human life. I think he needs to get out a lot more. A large part of humanity, especially in more developed countries, is far too immature to accept that kind of harsh reality, or even willing to contemplate it.

  667. mark bofill (Comment #182428)
    April 8th, 2020 at 7:09 am

    It looks to me (and I'd be pleased if you'd share your opinion on my thinking) that your position is rooted in response to an attack; Steve asserted that you were amoral and therefore you retaliated by suggesting that you're in fact morally superior to Steve. Maybe then this should be viewed as a dominance hierarchy dispute, rather than a dispute of true beliefs? In plainer terms, are you taking the position that you are morally superior to Steve because a) you believe it? or b) because you're pissed off that somebody is disparaging you and damaging your social standing on a blog by attacking your moral character?
    I tend to believe it's (b), but I am interested in hearing if I'm wrong!
    ________

    I was amused by SteveF calling me "amoral," which means like a dog or cat, I am neither moral or immoral, just not concerned with what's right and what's wrong.

    Woof ! Woof!

    I believe both SteveF and I have high moral standards. I went too far in saying mine were even higher than his, as I really don't know. But it felt good saying it.

  668. SteveF,
    I think many of them are used to people being willing to consider a value on human life in climate change.:)

  669. Lucia,
    I don’t know. I think the value of a human life being infinite works to make insanely high expenditures today to save a few people 100 years from now an easier sell.
    .
    In any case, the more common arguments are saving the planet from the cancer that is humanity, and instituting “social justice” by making sure everyone is poor.

  670. lucia (Comment #182429)
    April 8th, 2020 at 8:26 am
    OK_Max,
    **What I don't agree with is the notion that no containment would have been better for society than the policy being followed. **
    Sure. But the only reasons you ever list for why that would not be good is harm to *yourself* and *people like you*. That's why you come off as unsympathetic to the plight of others.
    ____

    lucia, I believe I am both empathetic and sympathetic to the plight of those who have lost their jobs as a result of Covid-19 and the containment measures. Thank you for pointing out that I don't come off that way.

    If I was thinking only of my self, I would be complaining about how much these measures would cost me in taxes, but I haven't complained.
    _________________________________________________________

    **The government bailout can never be enough if this continues a long time.**

    **The "stay at home" cannot continue forever– and that's the point most people here are making.**

    lucia, I believe it can continue a lot longer than most people here think.

    The Great Depression and WWII each lasted as long or longer than the Covid-19 pandemic can be expected to last even under the worst scenarios. The Great Depression had as much as 30% unemployment, a level the pandemic is not expected to reach. At the end of WWII, the national debt was much higher than today ( twice the GDP ?).

    I have much greater faith in the strength and resilience of this country than most here seem to have.

  671. OK_Max
    **If I was thinking only of my self, I would be complaining about how much these measures would cost me in taxes, but I haven't complained. **
    Ehrmmm…. no. That you are willing to pay taxes is NOT an indicator of empathy. Sorry, but no.
    **lucia, I believe it can continue a lot longer than most people here think.**
    How long do you figure it can continue? And with what consequence? Real questions. (You tend to not answer these. You like to stay vague.)

    **The Great Depression and WWII each lasted as long or longer than the Covid-19 pandemic**
    Neither is an entirely voluntary choice. So they are hardly relevant. There is a BIG difference between surviving something that one can do almost nothing about and intentionally choosing it. If you don't see that, I suspect it's not possible for you to see the difference.

    **I have much greater faith in the strength and resilience of this country than most here seem to have.**
    I have A HUGE amount of faith in the strength and resilience of the country. Which is why I suspect that at some point the country will decide to stop "stay at home" rather than continue it.
    .
    I think you are mistaking "strength and resilience" for "willingness to commit ecominic suicide and sacrifice the future of the young and middle aged to save frail old people like OK_MAX"

  672. SteveF,
    Yes. To some extent, that seems to be the rule. Assigning economic value to life/death
    (a) is fine if that makes the cost of "climate change" look high due to death of hypothetical people in the future and so the need to do something now is urgent.

    (b) outrageous, if the final cost/benefit analysis suggests we should let some actual real people die in the current epidemic.

    Basically: the attitude toward using cost/benefit on life/death is diagnosed based on the outcome of the analysis, not before.

  673. For my part, I don't doubt the country will eventually recover. I'd be surprised if anybody here doubts that. I'm concerned with the suffering of our people during the depression.

  674. OK_Max
    **If I was thinking only of my self, I would be complaining about how much these measures would cost me in taxes, but I haven't complained. **
    Ehrmmm…. no. That you are willing to pay taxes is NOT an indicator of empathy.
    _______

    True, but my experience can be. Been unemployed, been broke. Didn't like it. So having felt what it's like, I can imagine how others feel. I could even be over doing the empathy, Maybe I felt worse than they feel.
    ___________________________________________________________

    **The Great Depression and WWII each lasted as long or longer than the Covid-19 pandemic**

    **Neither is an entirely voluntary choice. So they are hardly relevant.**
    _______

    Relevant in terms of the challenges they present. Relevant in terms of the sacrifices that will be made. Relevant in terms of the huge dollar cost.

    The Covid-19 pandemic and Great Depression were not voluntary choices for anyone. Hitler was not our voluntary choice. The U.S. government's response to all three was voluntary. I agree with our governments response on the latter two.

  675. You can get Max there Lucia, but you have to drag him every step of the way. I remember now why I quit doing this.
    Ciao Max.

  676. mark bofill (Comment #182470)
    April 8th, 2020 at 6:25 pm
    For my part, I don't doubt the country will eventually recover. I'd be surprised if anybody here doubts that. I'm concerned with the suffering of our people during the depression.
    __________

    I think recession rather than depression, and hope I'm right. Anyway, we who aren't suffering pay taxes to help the 10% to 30% who are suffering.

  677. Max,
    I think you argue to waste people's time. I'm not interested in doing that anymore. Maybe I'll check in with you later, when I forget again.

  678. mark bofill,
    Yes, the frustration is really not worth it. Pretty much the same thing as I found with commenter Joshua months ago. At some point, you recognize that the other person is simply not an honest counter party in the conversation; they are unable (or perhaps unwilling) to ever step back and entertain even the possibility that a different point of view could be right. So you end up just wasting breath (or perhaps more accurately for this medium, wasting fingers). In any case, life is too short for that.

  679. Ok_Max
    **True, but my experience can be. Been unemployed, been broke**
    Nope. None of that is evidence of empathy.
    **I can imagine how others feel. **
    Doesn't mean you care.
    **Maybe I felt worse than they feel.**
    Yet your statements suggest you don't.
    .
    Honestly, all of the above merely suggests that you don't know what empathy even is.
    .
    **Relevant in terms of the challenges they present. **
    So… not relevant in the meaningful way. Sorry, but involuntarry sacrifices in an oxymoron. An involuntary burden might be a travail. Or a burden. Or something. It is not a "sacrifice". A sacrifice is voluntary.
    .
    I can see why Mark is giving up on you.

  680. Steve,
    It's a shame though. I can't help but think there are insights to be had from examining Max's responses. Take this latest claim:
    "Anyway, we who aren't suffering pay taxes to help the 10% to 30% who are suffering."
    We spent a trillion or two sending out a measly $1200 check to most everybody. Our federal tax receipts for 2018 were only 3.33 [3.46] trillion. Does this remark of Max's illuminate some aspect of the thinking of those who believe socialism can work? I suspect it ties in somehow.
    But yes, it's pretty pointless without some degree of good faith. I don't expect to persuade anybody, but without the good faith I can't really trust that I'm even getting honest responses, so it really does become valueless. I can't learn anything that way.
    As always – I'll disclaim that this hasn't been and continues not to be my experience with Joshua, although I understand your mileage varies and is not consistent with mine.

  681. Kenneth Fritsch (Comment #182457)
    April 8th, 2020 at 4:04 pm
    I went to my grocery store the other day during the 2 hours for seniors shopping. There were a lot of old people wearing many forms and styles of face mask. I found that to be a damn depressing sight – no matter what the benefits of wearing a mask.

    I ordered masks through Amazon with an expected delivery time of early May. In the meantime I will be ordering groceries online for either delivery or pick up. If I go back to stores with a mask I will be wearing very dark glasses.
    __________

    I shopped at a liquor store today, wearing my N95 mask and disposable gloves. Very busy place. I observed that customers who didn't practice social distancing also didn't wear masks. It was hard maintaining distance.

    Didn't stay long. Ordered six cases (72 bottles) of wine, put them in the SUV, and made for home. That amount of wine should last my wife and me about three months. Usually, I buy only one month's supply at a time.

  682. lucia (Comment #182476)
    April 8th, 2020 at 7:21 pm
    Ok_Max
    **True, but my experience can be. Been unemployed, been broke**
    Nope. None of that is evidence of empathy.
    **I can imagine how others feel. **
    Doesn't mean you care.
    **Maybe I felt worse than they feel.**
    Yet your statements suggest you don't.
    .
    Honestly, all of the above merely suggests that you don't know what empathy even is.
    ________

    lucia, your response suggests you are in better touch with my feelings than I myself am. I'm used to that one. My wife uses it.

    _______________________________________________________

    I can see why Mark is giving up on you.
    __________

    I'm worried about mark. He may have ADD or worse. This morning he asked me a question (Comment #182428) which he apparently thought important because he took 15 lines to do it. My answer to the question was then met with silence from mark. I think mark forgot he asked.

  683. Mark,
    As far as I can tell, Joshua doesn't want to discuss anything in good faith with me. That's fine. But I don't see much point in me working very hard to try to get him to change. If he wants to discuss in good faith with you, I have no problem with that.

  684. Max_OK
    I didn't tell you what your feelings are. I told you the think you list aren't evidence of empathy. They aren't.
    .
    I can't give you any advice on the friction you often report with your wife. But it's existence also isn't evidence that you have any empathy.

  685. Based on the ratio of reported tests to cases, New York has only the slightest clue how many people have been have been infected in the city and state. At worldometers.info, it's reported that for the state of NY there have been 365,153 tests and the total cases are 151,171. That's a ratio of 2.4 tests/case. That's way low compared to most of the rest of the country. Subtracting out New York, there have been 1,837,741 tests and 283,756 cases for a ratio of tests to cases of 6.5.

    And then there's the problem that nobody gets tested unless they have symptoms so we can only guess the fraction of asymptomatic infections. Forget the problems with false positives and negatives.

  686. mark bofill,
    “Does this remark of Max's illuminate some aspect of the thinking of those who believe socialism can work?”
    .
    Maybe. I am reminded of an exchange I had once at Ken Rice’s echo chamber, where I tried to point out that massive use of fossil fuels in private jets (and vast material consumption in general!) by many of the rich and famous, who vocally support fossil fuel restrictions for the masses, was inconsistent with their personal behavior. People in the echo chamber simply would not address the issue seriously. The most I can remember getting was “unimportant, it’s just a distraction”. I suspect more accurate is that they want a certain political outcome, and don’t care how they get it. They are intellectually dishonest, and so not worth engaging.

  687. What bothers me some about the actions and reactions to the Covid-19 pandemic is that I have a feeling that a number of politicians calling the shots on mitigation appear to be enjoying the power that they wield in this emergency and further that a number of their constituents are getting used to conforming to these emergency powers. I hope this is not some new normal and that it gets held over as conforming to the power wielding politicians.

    I do not doubt that wearing masks has some benefits, but that does not keep me from not liking the view of many people wearing the same dreary mask that covers their face and depersonalizes them like some gray/black look-alike uniforms worn in the days of Mao in communist China.

  688. DeWitt,
    Yes, and that is why random testing of a very large number of individuals for antibodies against the virus is so terribly important. Right now, both politicians and the various Faucis are declaring the bending of the curves, and the huge discrepancies between actual cases and projections from just two weeks ago, are 100% do to the effectiveness of their policies. That is very far from certain; I would say more aspirational than factual. Show me the antibody data.
    .
    Even more problematic is the possibility that a significant fraction of the population is so resistant that even when exposed they neither get the illness nor develop measurable antibodies to the virus. I am not sure how these individuals, assuming they exist, could be quantified.

  689. Kenneth,
    My mask is yellow. 🙂
    But yes, if I had a manufactured one, I'd probably wear a dreary one.
    The problem is we have limited choices of material. I used an old pillow case. When I do get to the store, I might look for fabric die so I can make a tie-die one.

  690. SteveF,
    Yep. We need random testing for antibodies for that reason and a few others. (Heck, we need them just to better understand epidemiology which would help going forward.)
    .
    We also need a test for someone carrying the virus. That would help a lot with track/test when we get down to small numbers of infected.

  691. My daughter had a mask on the other day. I thought she'd joined Antifa for a second. It was disturbing.

  694. lucia (Comment #182494)
    April 9th, 2020 at 7:04 am
    mark,
    "Well, masks are needed for a health reason now. Just have to get used to it."

    Lucia, I will submit that masks are probably beneficial but that does not mean I will get used to it. In fact my point above was that I hope we do not get used to emergency measures. There are any number of politicians and their supporters who might like to make it the new normal. Of course if individuals want to continue to wear masks and do social distancing after the emergency ends that is certainly their right.

    Do not go gently into that good night.

    An added note mentioned in a WSJ article about masks is that the masks not currently available to the public in the form of N95 and surgical can be effective against the virus but other masks are mostly much less effective and can be counter productive if the wearers lessen their other virus precautions out of over confidence in the effectiveness of wearing those other masks.

  695. A group at a large NYC hospital have examined a number of point mutations in virus collected from different patients at their hospital. They conclude it is likely the virus was spreading for some time in NYC before the first reported symptomatic case on March 1. They suggest that early cases circulating in NYC came from China, but most later cases came via Europe, where the Chinese version of the virus had added a couple of mutations. The work is awaiting publication in Nature.
    .
    Depending on the rate of asymptomatic cases and cases with minor symptoms, the virus could spread for some weeks before a symptomatic person got tested on March 1. If I understood the summary correctly, they estimated introduction to NYC in late January or early February.

  697. Make-shift masks are unlikely to be of any benefit to the wearer; even surgical masks may not help much. The reason we are being told to wear masks is to protect other people from the mask wearer.

  698. Mike M. (Comment #182499)
    April 9th, 2020 at 8:10 am

    Protection for those in the vicinity of the mask wearer and not the wearer was noted in the WSJ article. I hope wearers of masks not N95 are aware of that.

  699. After a review of Florida case numbers and deaths, I make the following projections for Florida:

    Total symptomatic cases (with positive test) end of June: ~30,000
    Total deaths through end of June: ~1,100

    Fatality rate among symptomatic positives: ~3.7%.
    We will see. The population age profile in Florida probably increases the fatality rate significantly. No telling the true fatality rate if you include asymptomatic positives; those people are not being tested.

  700. Kenneth,
    Sure. IF wearers (for some mysterious reason) stop washing their hands, or decided to go to large gatherings then mask would be counterproductive. I don't see that as an even slightly strong argument against wearing masks.
    .
    I'm not under the impression mask wearers as a group are LESS cautious about protecting themselves against virus. Nor do I think the signal by people wearing masks to others communicates "Oh. it's ok to stop washing your hands now."
    .
    In generally, the arguments I've seen against wearing home made masks have been pretty weak. If someone doesn't want to wear one: fine. But my thinking that's fine doesn't mean I accept the claim they don't help. I think the arguments for and against favor them helping reduce spread.
    .
    It's true you can continue to be uncomfortable seeing others wearing mask. I guess my 'get used to it' should have been, "you're going to be seeing this, so get used to it, or recognize you are going to continue to be uncomfortable.".

  701. Florida now has 5 days in a row with lower numbers from the peak.
    https://fdoh.maps.arcgis.com/apps/opsdashboard/index.html#/8d0de33f260d444c852a615dc7837c86
    .
    What I find really odd is that articles in the local paper fail to even mention this rather significant development.
    https://www.tampabay.com/news/health/2020/04/09/florida-reports-two-more-coronavirus-deaths-in-hillsborough-county/
    .
    "That number is more than double what it was a week ago."
    .
    Yes, but they were doubling every 3 days previously.
    .
    And dont.even.get.me.started on how stoopid this oft repeated phrase is in all media outlets:
    "The number of Florida deaths related to the novel coronavirus continues to climb."
    .
    As opposed to corpses reanimating and lowering the death count. Also note that if the infection rate counts are slowing down this should mean the actual infections have been slowing down for over a week now. If only we had experts in the media to point these things out.

  702. Part of the mask thing is psychological. Giving some people perceived personal agency in outcomes lowers their stress. Masks are also a public psychological signal that everyone is working as a team to overcome the problem. Unfortunately this gives the shamer crowd lots of ammo to look down on the non-mask wearing elderly killers. People are calling the cops in our local area to rat out any public groups and neighborhood parties. It's quite an emotional stir up.

  703. Tom,
    Yes. If they are going to discuss the rise, it would be better if they compared number of deaths (per day/week/month). Obviously, total deaths will rise and not fall.

    **should mean the actual infections have been slowing down for over a week now**
    Yes. I do see some articles pointing this out. Death's and identified symptomatic cases are a lagging indicator relative to new infections.

  705. Tom Scharf,
    I would be happy to blame Trump for everything if it could be proven he was eating bats from a wet market in Wuhan back in November 2019. Otherwise? Not so much.
    .
    I think a more reasonable headline would be "MSM makes everything about the Coronavirus pandemic worse….Politicization, Exaggeration, and Inaccuracy." Though much more accurate, I doubt that story would get the Pulitzer.

  706. Tom Scharf (Comment #182503)

    And dont.even.get.me.started on how stoopid this oft repeated phrase is in all media outlets:
    "The number of Florida deaths related to the novel coronavirus continues to climb."

    I consider it a victory when they don't say "SU-U-U-U-R-R-R-GING!", or even better, "EXPL-OH-H-H-H-DING!"

    Edit: Dang, I forgot how to use blockquotes.

  707. I want to know what they are doing in Minnesota. If the numbers are correct, they have had 1,154 cases but now only have 483 active cases and 39 deaths. That means that 632 people have recovered from the disease or ~55%. That's much, much higher than any other state. There are states with no recoveries reported, only deaths. In New York, only 10.6% of total cases have recovered while 4.1% have died. Nationally, only 5.6% have recovered while 3.6% have died.

    Having antibodies to SARS-CoV-2 may not mean you are virus free. At least one case reported on TV no longer had symptoms, had tested positive for antibodies and still had a positive virus test in a nasal swab.

  708. John M,

    "Dang, I forgot how to use blockquotes."

    Doesn't matter. None of that stuff has worked here for a long time. You can't bold or italicize or use special characters. Essentially, no HTML.

  709. I don't think anyone is really tracking recoveries. FL removed this from their counts several days back. For the most part anyone who has a positive test is either recovered or dead in 3 weeks.

  710. DeWitt,
    Part of it may be that they test lots and lots of symptomatic people, so capture more mild cases.
    .
    In the end, I suspect their fatality rate per positive test won't be a whole lot lower than Florida's…. they just have fewer positives per million population. States with lower population densities seem to do better.

  711. Tom Scharf,

    It doesn't matter whether recoveries are reported or not unless they aren't reporting one or more of these: total cases, active cases and deaths. Recoveries equal total cases minus the sum of active cases and deaths. For example Florida yesterday: total cases, 15698; active cases, 15275; deaths, 323; so there have been 100 recoveries. No wonder they aren't reporting them.

  712. SteveF,

    "Part of it may be that they test lots and lots of symptomatic people, so capture more mild cases."

    That could be. They report 30,753 tests and 1,154 total cases. That's close to the highest ratio of tests to cases of any state. OTOH, Alaska reported 7,068 tests and 226 cases with 32 recoveries. But Alaska may be behind on the curve compared to Minnesota.

  713. My new hypothesis is that a high apparent death rate and/or a high percentage of serious cases is due to under testing, not an overwhelmed health care system. Russia has a tests to cases ratio of about 100:1. Eight (yes, single digit) of the 9,357 active cases are listed as serious/critical. Of course they could be lying. But South Korea, with 477,304 tests for 10,423 cases has 204 deaths so far and of the 3,246 still active cases, only 55 are serious/critical.

    If you only test people with severe symptoms (I define shortness of breath as a severe symptom, i.e. the lungs are already involved), you're going to see a high percentage of serious/critical cases

    Spain, OTOH, has 85,043 active cases of which 7,371 (9%) are listed as serious/critical. Spain has done 355,000 tests and reported 152,446 total cases. At a guess, there were probably more like 2 million cases and possibly a lot more.

    Of course, if we are actually killing people by putting them on ventilators, then the US death rate will be higher than South Korea's rate.

    I also agree with SteveF that assuming zero natural immunity is an absolute worst case assumption and unlikely to be true. That means that herd immunity could be achieved at a fraction much lower than 70% infected.

  714. DeWitt,
    "That means that herd immunity could be achieved at a fraction much lower than 70% infected.'
    .
    And defining that fraction is the big tamale. We just *do not know* when the illness would die out on its own. Until extensive antibody (blood) testing of random populations is completed, we have not even a clue about herd immunity. Until there is a way to evaluate the extent of strong natural immunity to the virus (most likely present among people under 65), there will never be a well defined infection level needed to reach herd immunity. If I were a Fauci-critter, that is the *only* thing I would be focused on. Everything else is irrelevant if you care about the long term risk.
    .
    But I'm not a Fauci-critter. And he is certainly not a SteveF-critter!
    .
    That said, the very high infection levels in Italy, Spain, and NYC could provide important information, if there is sufficient random testing for antibodies after the pandemic passes. But I won't hold my breath. They are, after all, politicians and Fauci-critters.

  715. lucia: "In generally, the arguments I've seen against wearing home made masks have been pretty weak."

    That's a point I forgot to make earlier. Both CDC and WHO initially advised against wearing masks. Apparently their reasoning was that persons wearing masks would become careless — treating people like idiots, infantilizing them.

    Somehow over the last two months, CDC has improved its opinion of whether people (as a whole) can follow simple recommendations.

  716. DeWitt,
    I'm not sure I'd go so far as to say zero natural immunity is *unlikely* to be true. It's an assumption. I don't think we have much of a clue as to whether it's more likely to be true than not.
    .
    This lists other corona virus types:
    https://www.cdc.gov/coronavirus/types.html
    Evidently, four are fairly common (229E, NL63, OC43, and HKU1.) Three recent ones tend to make people very sick. We don't know if the other corona viruses tend to give immunity against this one or each other.
    .
    Honestly, I don't know enough about the immune system or these viruses to speculate. So I wouldn't really claim to know if some pre-existing natural immunity was likely or unlikely.

  717. Lucia,
    "So I wouldn't really claim to know if some pre-existing natural immunity was likely or unlikely."
    .
    I think *nobody knows* is the best guess.
    .
    However, we *do* know that one of the four common corona viruses (I think OC43) gave many false positives in an antibody test for SARS, setting off alarm bells for a SARS infection.
    .
    I will be very surprised if multiple exposures to the human corona viruses found in "common colds" does not infer some protection. It is interesting that corona viruses are believed to be responsible for only ~20-25% of common colds. You could have a *lot* of colds and never see a corona virus, or a handful of colds and see a corona virus multiple times; pure chance.
    .
    It ought to be possible to have antibody tests for the common corona virus strains to see if these correlate with lower than expected infection with Covid-19.

  718. Lucia,
    "Honestly, I don't know enough about the immune system or these viruses to speculate. So I wouldn't really claim to know if some pre-existing natural immunity was likely or unlikely."
    —-
    Yes, me too. I sort of naively assumed that most if not all viral immunity was due to antibodies, although when I stopped to think about it I realized I didn't know enough about viruses and how they interface with cells and the immune system and the genetics of all of this to have any idea about it. I've been meaning to read up, but. Essential industry; I'm working slavish hours to build up a buffer in case I get sick and haven't had all that much time to look into it.

  719. More expert analysis from our illustrious fact driven media. The local paper "analyzed" the data trend in FL cases. Their take home message:
    "The number of positive tests for the coronavirus is still increasing exponentially in Florida."
    "Still, the number is climbing by the hour."
    https://www.tampabay.com/news/health/2020/04/09/the-latest-data-how-coronavirus-in-florida-is-trending-right-now/
    .
    The doubling rate has changed from 3.2 days to 6.4 days in the last two weeks, and the number of new cases per day is effectively stable to decreasing over the past 5 days. Perhaps that would be important to mention. This message infers that the rate is maintaining a fixed exponential increase which is misleading. One could say China's cases are still "increasing exponentially", it's just that the doubling time is about 100 years.
    .
    They then do linear extrapolations on a logarithmic curve that is obviously bending. They are attempting to show and explain complicated graphs to non-math nerds so I suppose a little slack is appropriate.
    .
    The media is always quick to report alarming trends and slow to report encouraging trends and then add caveats when they do. It's obvious to everyone and it hurts their credibility, it's one of the reasons nobody paid much attention to them as they were reporting on this virus initially.
    .
    One of the reasons the stock market is continuing to recover is that people who understand math and have to analyze it neutrally believe they can see the limit of how bad this will get. During the true exponential growth period this was not obvious to anyone.

  720. mark bofill,
    " I'm working slavish hours to build up a buffer in case I get sick"
    .
    Unless you are over 55, I think your chances of never becoming very sick are extremely good. If you are obese, diabetic, suffering from heart disease, emphysema, high blood pressure, etc, then you are right to try to save up.

  721. Steve,
    My health is reasonable. Trouble is I can't get into the facility if I'm running a fever, so it needn't even be COVID-19; pretty much anything has the potential to bench me right now. The amount of work we can do remotely here is fairly limited by our practices; lots of hands on with specialized equipment that can't be taken out of the building.
    I shouldn't bitch. Not like I'm worried about what I'm going to eat or having gas for my car or anything of that sort, mostly it'd just inconvenience me to not be able to work for abit.
    [Edit: Oh. I'm 50 this year.]

  722. Tom Scharf.
    "The number of positive tests for the coronavirus is still increasing exponentially in Florida."
    .
    You can't work for these rags unless your are a) stupid, b) dishonest, c) a dedicated lefty, or d) some of each. I prefer to think a) an b), but c) and d) seem not far behind.

  723. This from USAToday:

    “While every American will feel the effects of the economic downturn to some degree, certain industries are expected to bear the brunt of the decline. According to analysis by Moody’s Analytics, these industries include leisure and hospitality, travel services, transportation and warehousing, and oil and gas extraction. In some parts of the country, these industries are economic pillars.”

    “To identify the places a COVID-19 recession will likely hit hardest, 24/7 Wall St. created an index comprising three measures: employment in highly-exposed industries, COVID-19 infection rates, and population density.”

    USAToday ranked 30 of these places in ascending order by percent of workforce in industries at high-risk industries because of Covid-19 and the actions taken to control the virus. The article also gave brief descriptions of each place. I have listed in descending order the 15 places with the highest percents in high risk industries. What struck me most is how widely these areas are geographically dispersed.

    1. Gilpin County, Colorado 82.2%
    2. Twiggs County, Georgia 63.8%
    3. Tunica County, Mississippi 61.6%
    4. Clayton County, Georgia 50.6%
    5. Irion County, Texas  47.5%
    6. Ohio County, Indiana 44.0%
    8. Maui County, Hawaii  40.8%
    9. Bullitt County, Kentucky 40.5%
    10. DeSoto County, Mississippi 38.5%
    11. Worcester County, Maryland   38.2%
    12. Williamsburg, Virginia 37.4%
    13. Clear Creek County, Colorado 37.4%
    14. Hendricks County, Indiana 35.8%
    15. Clark County, Nevada 35.4%

    https://www.usatoday.com/story/money/2020/04/09/coronavirus-30-places-where-recession-could-hit-hardest/2964955001/

  725. OK_Max,
    If you really want to help, stop supporting the idiotic prohibitions on economic activities in all of those local regions which have caused most all the unemployment. I won’t hold my breath waiting.

  726. SteveF, I'm surprised if you doubt the point of the 24/7Wall St. creation, the point being the economic consequences will be geographically pervasive.

    Moving on, there’s talk it will be safe to reopen the economy in May. I sure hope so.

    I don’t expect the economy to come up as fast as it went down. It may be quite a while before the business returns to normal in the restaurant, passenger transportation, and related industries. Many customers will play it safe and wait longer before resuming previous consumption habits. These industries won’t benefit much from pent up demand. People accustomed to eating out 7 times a week aren’t going to eat out 14 times a week to make up for lost time.

    Weak demand will be deflationary, while rising government spending for assistance will be inflationary. On balance, the two tend to cancel out. My guess is deflation at first, maybe for a few years, followed by a gradual return to inflation. But that is just a guess.

  727. OK_Max

    ** if you doubt the point of the 24/7Wall St. creatio**

    Uhmm…. so what's the point YOU want to communicate? Real question.
    Because no one is arguing the economic consequences won't be economically pervasive.

  728. Florida said they dropped recovery counts because there was no accepted definition of what recovery meant.

  729. Pneumonia deaths are listed as WAY down. It looks like many cases of “normal “ pneumonia are being listed wrongly as c-virus.
    .
    https://www.reddit.com/r/conspiracy/comments/fuy72i/pneumonia_deaths_have_fallen_off_a_cliff_this/
    .
    The above site can get a bit strange, but the data posted looks good.
    .
    normalize pneumonia and other deaths to an average year, subtract these additional deaths from listed c-virus deaths and the number of c-virus deaths will go down considerably.
    .
    We are destroying our economy for a very minor issue.

  730. lucia (Comment #182529)
    April 9th, 2020 at 5:38 pm
    OK_Max

    ** if you doubt the point of the 24/7Wall St. creatio**

    Uhmm…. so what's the point YOU want to communicate? Real question.
    Because no one is arguing the economic consequences won't be economically pervasive.
    _____________

    Of course, but I wasn't sure they knew how pervasive and which particular places could be most vulnerable. Plus, I thought some readers might be interested in more info on why a particular place is on the most vulnerable list if you or interested. "I did say "The article also gave brief descriptions of each place" and I provided the link. I thought anyone interested in any of these 15 places or the 15 more would know what to do.

    BTW, your point about my empathy was correct, and I will soon post a comment on the subject.

  731. @ Ed Forbes

    I read somewhere that there is typically some delay in reporting for those pneumonia deaths. It may be that the numbers are there but not yet reported.

    Or not. It wouldn't surprise me to learn that COVID19 poached some souls that otherwise would have been credited to pneumonia, pulmonary disease, etc.

  732. Ed Forbes (Comment #182531): "Pneumonia deaths are listed as WAY down."
    .
    Uh, no. The data appear to come from this source:
    https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
    And they appear to extend through either March 21 or maybe March 28. That is before most Wuhan deaths occurred. If you look at the link I provided, you will see a column headed "percent of expected deaths". That is a crude proxy for completeness of reporting. The last couple weeks are always low, just 47% for the week ending April 4.

  733. Re lucia (Comment #182529)

    lucia, I just responded to your comment, and my reply went into moderation. I have no idea why. Too many posts?

    Several hours ago the same thing happened to my reply to a MikeM. I thought that could have been because I quoted a sentence in which he used a word that might be forbidden, but that seemed like a silly reason.

    I'll now see if this post also goes into moderation.

  735. lucia (Comment #182476)
    April 8th, 2020 at 7:21 pm
    Ok_Max

    **Honestly, all of the above merely suggests that you don't know what empathy even is**
    _________

    Point taken!

    lucia, after looking into what “empathy”means, I must admit I had only a vague understanding of its meaning. I had thought empathy just means imagining how others feel, putting yourself in another's shoes, but I now see there is much more to it than that.

    The American Psychological Association Dictionary defines "empathy” as "understanding a person from his or her frame of reference rather than one’s own, or vicariously experiencing that person’s feelings, perceptions, and thoughts. Empathy does not, of itself, entail motivation to be of assistance, although it may turn into sympathy or personal distress, which may result in action. In psychotherapy, therapist empathy for the client can be a path to comprehension of the client’s cognitions, affects, motivations, or behaviors.”

    I found many sources that expand on the APA definition. An example follows:

    “The social psychologist C. Daniel Batson, who has researched empathy for decades, argues that the term can now refer to eight different concepts: knowing another’s thoughts and feelings; imagining another’s thoughts and feelings; adopting the posture of another; actually feeling as another does; imagining how one would feel or think in another’s place; feeling distress at another’s suffering; feeling for another’s suffering, sometimes called pity or compassion; and projecting oneself into another’s situation.”

    Now that I have some grasp of the meaning of empathy, I believe I can have empathy for unemployed individuals I know. That empathy would vary depending on the particular individual and his or her feelings about being unemployed. But since empathy seems to be a “one on one thing,” I am not sure it would be possible for me to have empathy for an entire group of people (all the unemployed)

    I had always thought I was pretty empathetic, but an online test shows I am only mildly empathetic. My disappointment in the test results, however, was tempered by another finding. Before looking into the subject, I thought empathy was a good thing.

    But no, empathy is not necessarily good. It’s largely amoral. A serial killer who enjoys torturing his victims gets his enjoyment from knowing how they feel. A less extreme example is an automobile salesperson who is able to tailor his pitch because he knows how a customer feels.

    Another thing I learned is empathy can be involuntary or voluntary, and the latter can be taught. Both empathy (how to do it) and how to avoid it (distancing) is covered in medical school.

    lucia, thank you for bringing my lack of understanding about empathy to my attention. I am now less ignorant on the subject.

    https://www.theatlantic.com/health/archive/2015/10/a-short-history-of-empathy/409912/

    https://dictionary.apa.org/empathy

    https://greatergood.berkeley.edu/quizzes/take_quiz/empathy

  738. >My new hypothesis is that a high apparent death rate and/or a high percentage of serious cases is due to under testing, not an overwhelmed health care system.

    DeWitt, my posting of flawed mortality rates was a test of this hypothesis. The numbers went well for awhile, then turned back up as the deaths went up as you predicted, while the testing did not.

  739. lucia,

    "I'm not sure I'd go so far as to say zero natural immunity is *unlikely* to be true. It's an assumption. I don't think we have much of a clue as to whether it's more likely to be true than not."

    SARS-CoV-2 isn't Ebola or rabies. As far as I know, there aren't any asymptomatic cases of those infections. There are asymptomatic SARS-CoV-2 infections, circumstantial evidence says that at least 50% of infections are asymptomatic and possibly a lot more. There are also a lot of mild infections with minimal symptoms and no lung involvement. That says to me that the immune system of asymptomatic individuals is, in fact, dealing with the infection. Even the 1918 flu didn't infect 70% of the population even after all three waves, AFAIK.

  740. DeWitt
    **Even the 1918 flu didn't infect 70% of the population even after all three waves, AFAIK.**
    Do we actually know that? I mean… nowadays, at least hypothetically, we can develop a test to check whether the body made antibodies. I don't think we could do that back them.
    .
    I'm sure we could know the fraction who had visible symptoms.
    .
    But the point about the asymptomatic is well taken. I don't know much about immune response. But it's got to either be that their immune system can respond to completely new agents really quickly in some sort of "blanket" way OR they somehow have a head start due to something else it learned to respond to.

  741. Lucia,
    “I don't think we could do that back them.”
    .
    Nobody knew anything about the immune system, antibodies, or viruses…… heck, they didn’t know what RNA did.
    .
    They knew that if you got certain illnesses once, you didn’t get them again. They also knew that vaccination with cowpox inferred immunity from smallpox, proven in a series of tests in the late 1700’s where individuals were first inoculated with cowpox (vaccinia), and later purposely exposed to smallpox! The FDA would not approve. 😉
    .
    Correction, tobacco mosaic virus had been identified as a pathogen for tobacco plants in 1898. So there may have been at least suspicion that viruses were responsible for animal diseases.

  742. SteveF,
    I agree the FDA would not approve. Also, I'm pretty sure Fauci would call the evidence the cowpox vaccinne worked "anectdotal" because it isn't based on randomized double blind trials. Obviously, there was a time when people considered the outcome of vaccinations to be "data".
    .
    Randomized double blind trials are a wonderful thing and it's a good thing we have them. But something doesn't need to spring from a randomized double blind trial to be "evidence".
    .
    Having said that: the evidence about hydrochloroquine seems to be mixed to date. So it may turn out it doesn't work.

  743. Lucia,
    I read that one small study (40 people?) in China did not show any effect. I have to try to find the original results.

  745. Lucia,
    It was 30 patients (15/15). There were no statistically significant effects in any of the parameters measured. They conclude the drug is safe for clinical use, but a larger study would be needed to evaluate effects. I noted that these patients all presented with mild disease, and all but one had no fever after 2 days. Azithromycin was not part of the study.
    http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.03.03
    This is the only completed study of HCQ on the FDA list. There are many which are awaiting approval from local governments, and several which are either recruiting or in progress.

  746. The Spanish flu killed about 0.6% of the U.S. population. So if it killed even 2% of those infected, most people were never infected.

    Cell membranes have proteins and oligosaccharides on the surface that control the movement of material in and out of the cell and that are used by the immune system to identify the cell as "us" or "them". A virus can not take over a cell unless it can bind to the surface and gain admission. That is why viruses are usually species specific.

    Different people have different oligosaccharides on their cells. Hence, different blood types and the need for transplant recipients to take anti-rejection drugs. So it makes sense that specific virus strains can invade the cells of some people and not others. But I suppose that is not always so. Rabies can infect most, if not all, mammals.

    There are people who have Ebola antibodies but who never had Ebola, or at least were not seriously ill. But I think they are thought to have not been infectious. Ebola is not very infectious unless you come in contact with a victim's blood. But with a serious case, that is very likely.

  747. Jenner's invention of the smallpox vaccine, based on cowpox, was not until the 18th century. Before that, there was inoculation with live smallpox virus obtained from the pustules of people with smallpox. Here is an excellent description of its history:
    https://www.newyorker.com/magazine/2020/04/06/how-does-the-coronavirus-behave-inside-a-patient

    It never caught on in England, but was used in the colonies after Ben Franklin's hero, Cotton Mather, conducted what may have been the first controlled study of a medical intervention. During a smallpox outbreak in Boston he inoculated a substantial number of people, kept careful records of how they fared compared to the general population (of whom something like 10-20% died), and published the results. I am sure that Fauci would have found any number of reasons to criticize the study.

  748. In fairness to Fauci, double blind, placebo controlled studies are able to identify and accurately quantify even small effects…. and that is often what such a study is supposed to evaluate. Things like: “Does this new cholesterol lowering drug have fewer long term neurological side effects than existing drugs that do the same thing?”, when the side effects are found in a very small fraction of people taking the drugs. As experience with illnesses like smallpox and dysentery shows, larger effects can be evaluated, at least approximately, without the need for double-blind placebo controlled studies. You don’t need a hand grenade to kill a mosquito….. even though you know a hand grenade will do the job.

  749. From Matt Murray in the WSJ:

    An immune system gone haywire may be doing more damage than the coronavirus itself in some patients, a growing theory that could point the way to potential treatments.

    Chinese doctors who have for months treated coronavirus patients with chloroquine say there is no clear evidence the anti-malarial drug is effective against the pathogen.

  750. Kenneth,

    A cytokine storm, i.e. an immune system gone haywire, is thought to have been the reason that so many younger people died from the 'Spanish' flu. The vast majority of deaths were people under 65 and the mortality vs age curve had a W shape rather than a U shape with a central peak at age 35 or so. That isn't happening with COVID-19. It's mostly killing people with compromised immune systems. Yes there are young, healthy people dying from COVID-19, but not large numbers of them.

    According to the table from worldometers.info, the highest probability of dying by age is 14.8% for 80+ for all cases and it declines rapidly from there. For confirmed cases for 80+ years of age the probability is 21.9%.

  751. An immune system gone haywire is what's suspected to raise deaths in the young. An immune system that didn't go haywire enough to more elderly deaths.

  752. Kenneth Fritsch,
    "Chinese doctors who have for months treated coronavirus patients with chloroquine say there is no clear evidence the anti-malarial drug is effective against the pathogen."
    .
    Reference/source?

  753. From what I have seen, a cytokine storm, localized in the lungs, is a major cause lung of inflammation and pneumonia in Wuhan virus patients. Even in the elderly. One hypothesis for why hydoxychloroquine helps is that it partially suppresses the immune system (which is why it is used to treat autoimmune diseases) and thus reduces inflammation.

  754. Edit not working.

    So hydoxychloroquine might be helpful in treating Wuhan even if it has no effect on the virus.

  755. Steve, here is a link to the WSJ article. I do not know whether it will work for others. Here are some comments from that article. The evidence is all anecdotal, without any details and with very vague statements about outcomes, but it was reported in the WSJ.

    https://www.wsj.com/articles/chinese-doctors-at-coronavirus-hub-cast-doubt-on-chloroquine-as-cure-11586448660?mod=djem10point

    "Chinese doctors who have for months treated patients on the front lines of China’s fight against the new coronavirus offered a sobering assessment of the potential treatments, saying they hadn’t seen clear evidence that drugs such as chloroquine were effective.

    One doctor, however, said he saw some promise for Kaletra—an antiretroviral drug for HIV…

    In hospital interviews arranged Thursday by government authorities in Wuhan, the central Chinese city of 11 million where the new coronavirus crisis erupted late last year, doctors called for further research into the use of chloroquine, an anti-malarial drug…

    While Dr. Zhang expressed uncertainty about chloroquine, he said Kaletra —a drug made by U.S. pharmaceutical giant AbbVie Inc. that blocks the enzymes some viruses need to replicate—appeared to have been effective with patients and infected colleagues, even though a recent study concluded it didn’t work…

    Zhang Junjian, a doctor who ran a field hospital in Wuhan that treated more than 1,700 coronavirus cases, said in a separate group interview on Thursday that 20 to 30 patients had been treated with chloroquine—with the patients’ permission—but it was unclear if the drug was effective."

  756. Mike M,
    Yeah. I turned a bunch of plugins off in my quest to figure out what is interference with html. I may need to change my theme… or something. Over the next few days, I'll be turning off ALL the plugins until. Then if that doesn't work, I'll change themes.

    It's got to be something. . .

  760. IT’s weird that it would be move comments. But I can turn that on and off as need be. It’s off now. We’ll see if html keeps working. (A test for some time is required incase it’s got something to do with the cache.)

  763. Kenneth,

    Testing HTML

    In hospital interviews arranged Thursday by government authorities in Wuhan, the central Chinese city of 11 million where the new coronavirus crisis erupted late last year, doctors called for further research into the use of chloroquine, an anti-malarial drug…[my emphasis]

    I don’t trust anything from China that was arranged by the government. They lie and then lie about how truthful and transparent they are. Not.

    Edit: Yep, works again.

  764. One would think that an over reactive immune system would be antithetical to an aging one. The comment from the WSJ article does, however, indicate in the first stage the immune system is under reacting before it becomes over reactive in producing cytokines. .Unfortunately the WSJ article does not mention how age related this phenomenon is.

    “In the most severe coronavirus patients, the disease appears to have two stages, doctors and researchers say. First the immune system fails to respond quickly or effectively enough to the virus. Then the immune response becomes too aggressive and floods the body with cytokines.”

    https://www.wsj.com/articles/haywire-immune-response-eyed-in-coronavirus-deaths-treatment-11586430001?mod=djem10point
    “With advancing age, there’s an escalating tendency for our immune system to go haywire. It becomes less capable of protecting us against infections and cancer or responding to vaccinations but, paradoxically, increasingly prone to wallowing in a state of vague, nonspecific irritation that’s called chronic low-grade inflammation.

    Along with this progression — which immunologists have dubbed “inflammaging” — comes a growing vulnerability to disease.”
    https://stanmed.stanford.edu/2016summer/inflammation-implication.html

    “Possibly the most critical change in the ageing innate immune system is the increase in pro-inflammatory cytokines IL-1b, IL-6, IL-18 and TNFa [97]. The resulting low-grade inflammation probably contributes to atherosclerosis, dementia and cancer, inextricably linking inflammation and ageing of other tissues [84,98].”

    https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2014.3085

  767. There’s a chart that says model parameters at 7:30.
    The 80+ yrs entry for needing hospitalization is 27.3%.
    It might be the portion of those needing hospitalization that are over 80, but then the total is under 90%, which can’t be attributed to incomplete data since it is model parameters.

  768. Saw this at RedState. I notice that some sort of chloroquine phosphate is what is being used as the medicine, so the fish tank cleaner was closer than I thought.

    Michigan HHS spokesperson Lynn Sutphin wrote in an email, “Based on the FDA’s Emergency Use Authorization to allow the use of hydroxychloroquine sulfate and chloroquine phosphate products donated to the Strategic National Stockpile (SNS) for certain patients with COVID-19, we are pursuing a request for hydroxychloroquine/chloroquine from SNS.”

  769. Mask doubling rate at the grocery store is every 3 days! It’s exponential! Alert the authorities. About 40% of the customers were wearing masks today.

  770. MikeN,
    I interpreted that to mean that 27% of cases in people over 80 will be require hospitalization and not telling us the rate of infection of people over 80. That is:

    (a) Num_over_80_hospitalized/Num_over_80_infected = 27.

    You seem to interpret it as (b) Num_over_80_infected/Num_over_80 = 27%.

    I listened several times and can’t find words that distinguish. But since this is in “assumptions” (a) makes more sense as an “assumption”. The purpose of the model would presumably be to predict (b) among and other things.

  771. Went to pick up produce at a road-side produce company. You are now not allowed to be out of your car…. order and pay for everything on-line, then they choose what you get and put the box in your trunk (or back seat), after waiting for 20 minutes in a line of cars, then you drive away.
    .
    Not knowing the routine, I approached the establishment on foot…. they were absolutely HORRIFIED, reluctant even to lower their masks long enough to tell me the rules… from 20 feet away. These were 20-30 year olds at effectively zero risk.

    Things are wildly out of control. Really.

  772. Tom Scharf,
    “Mask doubling rate at the grocery store is every 3 days!”
    .
    Next time I go to the grocery store, I am putting a mask on every orifice I can identify. You can’t be too safe you know.

  773. SteveF (Comment #182585)
    April 10th, 2020 at 12:57 pm

    Could not resist. You’ll just have to get used to it.

  774. Kenneth,
    “You’ll just have to get used to it.”
    .
    Until my ashes are in the urn, I will *never* get used to stupidity. These people are at zero effective risk, but too dumb, or brainwashed, to understand that reality.

  776. DeWitt Payne (Comment #182576)

    DeWitt, I posted that WSJ article because I was surprised that without any concrete data or even comments it would have been published.

    I have noted that a number of articles I see in the WSJ lack any new information and tend to have misleading and even biased headlines. I suspect that those writing and contributing to articles for the WSJ have different political views than those writing editorials and reoccurring pieces on the editorial pages.

  777. Kenneth,
    “I suspect that those writing and contributing to articles for the WSJ have different political views than those writing editorials and reoccurring pieces on the editorial pages.”
    .
    This has been apparent for a very long time at the WSJ. A purge of the idiots and lefties (most often the same people!) is badly needed. But PC rules may not allow it.

  779. Is the conservative weekly National Review ambivalent on Swedish policy? Or is this weekly’s view evolving? The following excerpted articles, which appeared only 3 days apart, seem to take opposing views.

    Has Sweden Found the Right Solution to the Coronavirus?
    By JOHN FUND and Joel Hey, National Review, April 6, 2020 6:30 AM
    Sweden is developing herd immunity by refusing to panic. By not requiring social isolation, Sweden’s young people spread the virus, mostly asymptomatically, as is supposed to happen in a normal flu season. They will generate protective antibodies that make it harder and harder for the Wuhan virus to reach and infect the frail and elderly who have serious underlying conditions. For perspective, the current COVID-19 death rate in Sweden (40 deaths per million of population) is substantially lower than the Swedish death rate in a normal flu season (in 2018, for instance, about 80 per million of population).

    More Warning Signs in Sweden
    By THEODORE KUPFER National Review, April 9, 2020 4:55 P
    “There are now alarming reports that the virus has spread to one-third of nursing homes in Stockholm, which has resulted in rising fatalities.”

    “Nor is there much indication that the Swedish economy is weathering the storm better than comparable countries. The drop in the stock market and the rise in unemployment are roughly in line with other advanced economies.” 
    ___________

    As of yesterday, Sweden had 7.79 coronavirus deaths per 100K population, compared to 4.09 in Denmark and 2.03 in Norway.
    The U.S. had 5.04.

    https://coronavirus.jhu.edu/data/mortal

  780. SteveF (Comment #182586)
    Tom Scharf,
    “Mask doubling rate at the grocery store is every 3 days!”
    .
    Next time I go to the grocery store, I am putting a mask on every orifice I can identify. You can’t be too safe you know.
    ________

    Every orifice you can identify? That won’t work if you don’t know your azz from a hole in the ground.

    I hope you know viruses can enter through your eyes. Blindfold yourself, wear rubber gloves, and feel your way around. Don’t worry about being arrested for sexual assault. You have a good excuse.

    But seriously, if you wear contact lenses, switch to glasses. People who wear contacts tend to touch their faces more

  782. “ Not sure what you could use for your ears“

    Boy am I glad that I wear hearing aides!

  783. As someone (believe it was MikeM) pointed out earlier, the mask is more for protection of people around you if you have Covid-19 and don’t know it. If you know you are infected, you shouldn’t be in public.

    A good friend who is a molecular biologist has been advising me on how to stay safe. He says without a mask an infected person can spew droplets a few feet just by talking and as much as 10 ft to 15 ft by sneezing and coughing. Masks can prevent or minimize the droplets reaching other people directly or being deposited on surfaces we later contact.

  784. >As someone (believe it was MikeM) pointed out earlier, the mask is more for protection of people around you if you have Covid-19 and don’t know it. If you know you are infected, you shouldn’t be in public.

    If my wearing a mask protects other people from getting infected by me if I have it but don’t know I have it, then why wouldn’t it protect me from getting infected by others who have it but don’t know they have it?

  785. MikeN (Comment #182599): “If my wearing a mask protects other people from getting infected by me if I have it but don’t know I have it, then why wouldn’t it protect me from getting infected by others who have it but don’t know they have it?”
    .
    The droplets are bigger coming out of your mouth (high humidity, lots of moisture) than after floating around a bit. Bigger drops are easier to filter. Even a surgical mask does not provide a lot of help when inhaling. A surgeon wears a mask to protect the patient, not himself.

    If you cough or sneeze, air is ejected at rather high speed. A mask, even an old west outlaw style bandana, will slow it down and keep it from reaching others.

  786. MikeN,

    Description of model that predicted 74000 deaths in Minnesota.

    Proving again that when you choose the right parameters, you can construct a model that predicts whatever you want. The IHME Murray model, btw, predicts 442 (107-1560) deaths in Minnesota by August 4. If we than scale to the whole US, using the Murray model ratio of 442:61,545, then we’ll get 103 million deaths in the US. OTOH, if it just scaled by population, there would be 4.3 million deaths in the US or 1.3%. Even that would be much worse than the Spanish flu.

  787. MikeN

    If my wearing a mask protects other people from getting infected by me if I have it but don’t know I have it, then why wouldn’t it protect me from getting infected by others who have it but don’t know they have it?

    A few weeks back I sort of poked around reading papers and found one that discussed a bunch of different findings. Many were what we now know is merely “anecdotal”. (Not randomized. Not double blind. Often samples of opportunity.)

    At least one paper involving passengers in an airplane found in this anectdoctal case the mask did protect the wearer.

    There were lots of types of experiments. Results were mixed.

    I think people who say the mask doesn’t ever protect the wearer are going overboard in that claim. Once again, it’s more like there isn’t convincing evidence– some experiments find a protective effect. Other’s don’t. Blah…. blah….

    I can’t help but think that the mask *could* protect you from someone directly coughing onto your nose and mouth. Also, if you do fail to not touch your face, you’ve now touched the mask. While all the warnings then point out that the virus or bacteria is no on your mask (The Horror!!) and could eventually be touched by someone to transfer the virus there, the fact is that at least in this first touch, the virus that would have gone on your face went on the mask, which is NOT YOU (or someone else.)
    .
    Obviously, you need to wash these regularly. Perhaps have one to wear on the bus to work, put it in a ziplock and another to wear home… then wash. But it seems to me most the “horrible” things one supposedly *might* do when wearning a mask are the exact things one might do when NOT wearing a mask. So, perhaps the mask protects the wearer too.
    .
    But, a poor sealing home made mask isn’t going to protect like a well sealing mask with optimal filtration properties. That doesn’t mean the protection must be zero.

  788. Lucia,
    We teach children to cover their mouth when coughing or sneezing. If most people do this (a mask helps), they will protect others and will be protected in turn. 100% is not needed to make a difference.

  789. DeWitt,
    “Proving again that when you choose the right parameters, you can construct a model that predicts whatever you want.”
    .
    For sure. The IHME model has been adjusted downward (by huge amounts) over just the last 8 days, and will probably be adjusted downward again in the next few days. This long after all the school and restaurant and other closings, shelter at home orders, stay 6 feet way, etc. were in place. What changed? Only the assumptions going into the model, nothing else. The projections were pure garbage from the beginning. Current model projected deaths are near 60,000. It is perfectly reasonable to expect them to go lower again…. probably lower than deaths in a bad flu year, like 2018. Fear and uncertainty lead to bad models, and bad models lead to bad policy decisions.
    .
    Where have we seen this before? Oh yes, climate models.

  790. It can’t go that much lower, as total deaths is still over 1000/day and we are over 16,000.

  791. MikeN,
    We will see, but I will be very surprised if it ends up greater than 45,000 total by July 1.
    .
    One thing is very clear though: population density is key. Nebraska has not closed schools, not closed restaurants or other businesses, not done anything at all beyond warning the most vulnerable to avoid exposure. Yet they have a very low rate of infection, and the model projection (which is almost certainly too high) is 273 deaths for 2 million population, for a 0.01365% chance of death. Uniform policies nationwide are not sensible.

  792. SteveF,
    We can see more rural areas in North East trying to cordon OUT others. Many know keeping out fleeing people fleeing from more concentrated NY city and environs or forcig them to quarantine would be helpful. (RI, Long Island, Maine, some towns and so on are trying. As you know FL’s governor took steps. The problem is it’s difficult.)

  793. Lucia,
    There has been a long term rush of New York City region residents migrating to Florida…. mainly to avoid high state income taxes. But I expect that trend to increase in the near future. Fear is a strong motivator.
    .
    My younger brother, who lives on Cape Cod year round (where winter population is very low), told me that the locals were horrified by a big flux of New Yorkers arriving in the off-season to avoid the virus …… some bringing it with them, of course.

  794. SteveF,

    You really can’t see how nasty this virus is or how fast it can spread. New York went in late with their shelter-at-home order and have a look at what’s happening there now. They’re burying rows of bodies in trenches on Hart Island. It’s been about three weeks since they ordered people to shelter at home and they’re just hitting their peak deaths now. Compare that to San Francisco, which took action earlier… they have ten deaths (last time I looked). That’s ten deaths TOTAL. While Frisco only has about a tenth of the total population of New York City, it is still a fairly densely populated area… yet, by taking action earlier, they managed to control the spread of the virus much better.

    As Lucia pointed out, people are fleeing New York. They’re fleeing because it’s a death zone. Most people don’t want to die and, while the elderly are most at risk, you can die from this virus at any age. Not many people are complaining as much as you are about the economic damage, and there’s a reason for that…. the economy will recover, dead people won’t.

    Obviously you can’t have a perpetual shelter-at-home, but it’s needed now to limit the deaths and it gives the leaders time to devise an acceptable exit strategy.

  795. Skeptikal,

    Not many people are complaining as much as you are about the economic damage

    I’m not sure this is true. Seventeen million people have filed for unemployment since the shutdowns. I suspect they’re complaining and we’re just not hearing them.

  797. “They’re burying rows of bodies in trenches on Hart Island.”
    .
    1. They’re always burying rows of dead bodies in trenches on Hart Island.
    2. It’s where they put the bodies of the unclaimed from the morgues and have been doing so for decades.
    3. They’ve recently reduced the time limit of morgue holding from 30 days to 14 days to free up space.

  798. One can make a case that we have overreacted. I’m not sure it actually stands up, but it can be argued.
    If 17 million people have filed for unemployment since the shutdowns and usually around 158 million are employed, that’s around 10% of our workforce that has become unemployed.
    Weigh this against COVID-19 which has so far killed about 18,000 people in the U.S. The numbers are comparable to those who die of the flu every year, according to the CDC.
    I know, the dying isn’t done yet. But then again the economic damage isn’t done yet either.

  799. SteveF (Comment #182607): “One thing is very clear though: population density is key. Nebraska …”
    .
    Nebraska is hardly a good example of low population density since half the population lives in a single metropolitan area.

    One the other hand:
    San Juan County, New Mexico; population 125K, 142 confirmed cases, 24 people per square mile.
    McKinley County, New Mexico; population 72K, 113 confirmed cases, 13 people per square mile.

    Compare to:
    Bernalillo County, New Mexico; population 679K, 407 confirmed cases, 571 people per square mile.

  800. mark bofill (Comment #182614): “I know, the dying isn’t done yet. But then again the economic damage isn’t done yet either.”
    .
    Also not done yet: all the extra suicides, drug overdoses, and domestic abuse.

  801. mark bofill,

    Another thing which shouldn’t be overlooked is that this is a Pandemic…. it’s global. With pretty much the whole world shutting its borders, it means you’ve lost all your tourism related jobs no matter what policies are enacted within the U.S. You’ve also lost all your international flights and booking agencies… and hotels would have to try to survive on interstate travelers… which would be really tough on hotels in virus hotspots. People would not eat out as much because of the fear of becoming infected, so restaurants would struggle too.

    Also remember that the 18,000 deaths is what it is now because of the shelter at home orders. That number would be a lot higher if no action had been taken.

  802. Skeptikal,
    Yes. Both good points. A certain amount of economic damage was inevitable, and a case can be made that the economic damage might have been in fact been worse without the shelter at home orders. [Edit: sorry, not what you said. A certain amount of economic damage was inevitable and the number of deaths might have been higher. True.] Others have made these points elsewhere and they’re certainly not points that can be ignored.

    That number would be a lot higher if no action had been taken.

    That’s gets to the heart of the trouble, we don’t really know. Almost certainly it would have been higher. How much higher?
    I don’t think we know how to answer this, although I’m open to being corrected if somebody thinks otherwise.

  803. skeptical

    They’re burying rows of bodies in trenches on Hart Island

    Really? That’s horrifying.
    I know DuPage county brought in a refrigerated truck or something quitely placed near the morgue. . . Hope we won’t need it. (But glad they are planning.)

  804. Skeptical

    You’ve also lost all your international flights and booking agencies… and hotels would have to try to survive on interstate travelers

    Perhaps this will be a revival for vacationing in the Wisconsin Dells. 🙂

  805. Maybe our response was near to optimal, and maybe both the economic damage and mortality was limited in a near optimal way. It just naively seems that almost 900 people unemployed for everyone who died is draconian. But again, maybe the alternatives were all far worse. … Or not.

  807. Mark,
    I agree with you that we don’t know how high the damage would be without the stay at home. We know it’s not zero.

    I know that dance studios were feeling the effects before the lockdown. My dance teacher reported some students cancelling lessons, the number of people at group lessons was thinning. I would expect restaurants were finding fewer patrons coming.

    The lockdown may have helped some restaurants *relative to no lockdown*, because they quickly went to carry out without the slow drain of trying to stay open and watching the dining areas not fill.

    It definitely has NOT helped dance studios. But I am taking lessons online.

    Grocery stores are probably doing well. Even with takeout people are cooking more. Evidently easy to cook egg meals are popular. 🙂

  808. lucia,
    When this is done, will we be able to evaluate our response against say Sweden’s response do you think, or are the countries fundamentally too different for any meaningful comparison?

  809. Lucia,
    Sorry. Maybe Max is correct and maybe I do have ADD. I’ve actually thought this before.

    It definitely has NOT helped dance studios. But I am taking lessons online.

    Sometimes there’s opportunity to be found in adversity. My karate school has been trying to adapt by going virtual. I’m sure they’ve taken a hit, but they appear to be staying afloat. I think they may ultimately expand their business if they continue to devote some resources to developing online methods of teaching after the crisis is over.
    It makes it hard to determine what’s really going on in net. But the massive increase in unemployment claims can’t be a good sign.

  810. The trouble is that I’m not sure the lockdowns were instrumental to these changes. Restaurants could have (actually I believe they did in Alabama) switched to carryout only without the lockdown orders. Karate school change the same. Maybe it was just good business sense.

  811. The issue is not lockdown versus doing nothing. It is lockdown vs something less drastic.

    I have no doubt that it was a good idea to restrict or ban situations where substantial numbers of people are crowded together, especially indoors. But banning people from walking in the park or playing golf seems like overkill. So does the prohibition of drive-in church services and the closing of businesses arbitrarily deemed non-essential (which never seem to include liquor stores and pot shops). And banning “elective” medical procedures, even if needed for the patient’s health and well being; excepting abortion, of course.

  813. Thanks Thomas. From the link:

    What accounts for the big drop between Sweden and Greece? Why does the United States have one-third the CFR of Great Britain? It’s not because of our low testing rate: if we tested more and therefore uncovered more cases, our CFR would be even lower. Does it have something to do with demographics? National health profiles? The quality of medical care?
    .
    I don’t know.

    Me neither.

  814. mark bofill (Comment #182614)
    April 11th, 2020 at 8:16 am
    “One can make a case that we have overreacted. I’m not sure it actually stands up, but it can be argued.
    If 17 million people have filed for unemployment since the shutdowns and usually around 158 million are employed, that’s around 10% of our workforce that has become unemployed.”

    There a lot more than 17 million who are either not working but still officially employed or who are unemployed and not eligible for unemployment insurance or have not yet filed.

  815. Thanks Thomas, very interesting inter-country comparison. (And for the record, I’m with mark — I don’t know either.)

    I’m puzzled by the article’s lines following mark bofill’s excerpt (after “I don’t know”):

    But a 7x spread from 1.7 percent to 13.0 percent seems pretty remarkable. Whatever the answer is, it goes a long way toward explaining why our death rate from COVID-19 is pretty low (so far).

    The author suggests that whatever causes the large variation in CFR “goes a long way toward explaining why” the US’s CFR is pretty low. Sounds like a tautology to me. Perhaps I’m missing something.

    P.S. Thanks Lucia, for restoring HTML in comments!

  816. Kenneth,
    Yes. Thanks. Do you think the coronavirus death figures are reasonable or are they similarly low? I’d imagine they’re likely to be low as well.. although I’d expect the error is proportionally smaller than the error in my unemployment estimate.

  817. No, I think that was wrong. I doubt we are underreporting covid19 deaths. Its what’s consuming everyone’s attention right now.

  818. With social distancing rules and shutdown orders, why aren’t airports shut down?
    Are the flights obeying a six foot minimum rule? With the reduced seat pitch, this would require one person on each side of the plane, and two people every three rows.
    Given the closed space, the flights should be considered a large gathering and be canceled as well.

  819. It is very strange the differing responses in different countries, and it is very clear nobody understands it. They probably will but it will take a year or so. This thing is going to be a virus research bonanza. Tons of data, and tons of money.
    .
    One of the best parts of this modeling exercise is that all the doomsayers actually have to be accountable for a change. I don’t think anyone got this thing close to right so far. What has struck me is that when you have doubling times of 3 days it is important to react quickly, and lethargic governments are never ready for something like that. The other thing is when you fail on containment, the sh** really hits the fan, don’t fail. We don’t really want governments on a hair trigger to lock down the economy. There needs to be acceptable losses.
    .
    On the humorous side, it is fun to watch all the Trump is an authoritarian and dictator people complaining loudly that he hasn’t been authoritarian enough.

  820. Mark bofil

    lucia,
    When this is done, will we be able to evaluate our response against say Sweden’s response do you think, or are the countries fundamentally too different for any meaningful comparison?

    I’m sure we will be able to do comparisons. It’s just that we can’t necessarily do them extremely quickly, and we will need to consider factors that matter. New York isn’t, for example Seattle, or Bismark North Dakota. Exactly how to do a fair comparison today… dunno.

    I’m pretty sure that if everyone just let the virus play out, the infection rate would be higher in New York than in North Dakota. ND’s main danger is New Yorkers might flee to ND. ButNew Yorkers don’t tend to flee to ND where they won’t find posh digs with hot tubs. They feel to Long Island and Connecticut..

  821. Mark bofil,
    I should add wrt to comparing Sweden to other countries. It seems to me that lots of people want to compare and draw conclusions *prematurely*. Based on what little we know about incubation, diagnosis and death, there is going to be a lag of at least three weeks, and possibly 6 weeks between an intervention like a “stay at home” , seen hints of it’s effect and being able to know for sure something has changed in the rate of new cases and deaths.

    What we know about Sweden: It’s growth doesn’t look like South Korea (none of Europe does.) But if I eyeball Willis graph, Sweden looks “noisy”; (possibly small denominator in normalization.) But I’d say it’s premature to conclude they’ve started bending. Meanwhile, Germany looks like it has. We’ll have to wait to see. But…

    Honestly, if I were in Sweden, I’d be worried.

  822. MORE ON MASKS

    MikeN (Comment #182599)
    “If my wearing a mask protects other people from getting infected by me if I have it but don’t know I have it, then why wouldn’t it protect me from getting infected by others who have it but don’t know they have it?”
    _________

    The other Mike, MikeM, gave a good answer to your question and it’s worth repeating here. I will quote his comment and give some additional thoughts on the subject of self-protection.

    Mike M (Comment #182600): ”The droplets are bigger coming out of your mouth (high humidity, lots of moisture) than after floating around a bit. Bigger drops are easier to filter. Even a surgical mask does not provide a lot of help when inhaling. A surgeon wears a mask to protect the patient, not himself.

    If you cough or sneeze, air is ejected at rather high speed. A mask, even an old west outlaw style bandana, will slow it down and keep it from reaching others.”
    _____________

    Think of your nose or mouth being like the muzzle of a shotgun. When the shotgun is fired, the pellets cover an area not much larger than the circumference of the muzzle (barrel) as they leave the gun, but then spread out to cover a progressively larger area the farther they travel. Similarly, when we cough and sneeze, the droplets spread out. A mask catches the droplets before they can spread out.

    In my previous post, I did not intend to imply masks only protect other people from the person wearing the mask. In fact N95 masks are supposed to protect the wearer by filtering out 95% of small particles. The surgical masks and home-made masks are not that effective, but may be better at protecting the wearer than nothing at all. Again, however, the primary purpose of wearing a mask is to protect those around you.

    NO mask gives as much protection to you and those around you as social distancing gives. I believe more than the usual recommended 6 ft is needed for full protection. I prefer twice that distance. Unfortunately, I have found that maintaining even 6 ft. is difficult when shopping in stores, since I don’t have eyes in the back of my head.

    The most difficult or hard-to-follow safety practice for me has been avoiding exposure by touching objects. I use disposable gloves, but sometimes forget about cross contamination. For example, I have opened a door with a contaminated glove after returning from shopping, minutes later touched the same door knob with my bare hands, then touched my face before washing my hands. It’s so easy to forget.

  823. mark bofill (Comment #182633)
    April 11th, 2020 at 11:02 am

    No, I think that was wrong. I doubt we are underreporting covid19 deaths. Its what’s consuming everyone’s attention right now.

    There was a WSJ report this morning about nursing homes not reporting Covid-19 deaths. The reporters evidently diligently attempted to get these data and mostly to no avail. It would have to be assumed that some deaths are not counted just like a death that was due to a prior medical problem is attributed to Covid-19.

    Interesting that in MN the reported nursing home deaths due to Covid-19 accounted for over 50% of all Covid-19 deaths in that state. That proportion varied greatly from state to state.

  824. mark bofill (Comment #182625)
    April 11th, 2020 at 9:03 am
    Lucia,
    Sorry. Maybe Max is correct and maybe I do have ADD.
    _____

    mark, I hope you know I wasn’t serious about ADD. It’s unusual for an adult to have ADD. You may be just a very busy multitasker.

  825. When they were doing contact tracing they found the prevalent source of infection was being in close proximity to an infected person for 15 minutes or more. There were unknown links like you might imagine “walked by someone in a grocery store for 10 seconds” but from what I read that was not common.
    .
    All the paranoia is useful in reducing risk, forming automatic behavior, and not getting sloppy. They still don’t really understand the relative prevalence of infections being transferred via directly breathing droplets versus touching a contaminated surface. There is surprisingly very little information here.
    .
    It is really hard to maintain discipline and never touch a possibly contaminated surface and then touch your face. Things like credit card machines, ATM’s, gas pumps, door handles, etc. are everywhere.

  826. Tom

    When they were doing contact tracing they found the prevalent source of infection was being in close proximity to an infected person for 15 minutes or more.

    Believe it or not…. on a dance forum, there is/was a dancer who kept INSISTING that dance competitions and parties would somehow not be bad. In contrast he thought professional society meeting and professional sports like audiences packed to watch the NBA would be bad. But somehow Dance wouldn’t. His theory had to do with lost of things– among them less hand shaking.
    .
    This was a while ago. My main thought was he just doesn’t want Dance to be cancelled and so wants to believe things that happen at dance competitions just can’t be a problem.
    .
    Let me tell you: At dance competitions I’ve been to people are close. (Waltze, Foxtrot, Tango stances are ‘body contact’.)

    Ladies HUG. Competitors breathe heavily. The ladies dresses are SOOOOO complicated everyone helps each other zip up and do hooks in the bathrooms. At parties, everyone dances with everyone. People share snacks….
    .
    Much as I wish it were not so, these needed to be cancelled.

  827. Mike M. (Comment #182616)
    April 11th, 2020 at 8:23 am
    mark bofill (Comment #182614): “I know, the dying isn’t done yet. But then again the economic damage isn’t done yet either.”
    .
    Also not done yet: all the extra suicides, drug overdoses, and domestic abuse.
    ____

    Don’t forget the offset. Fewer traffic fatalities; lower crime rate (for now), maybe a higher birth rate.

    Also the effect on personal habits could be a positive thing if lasting. The public may improve their hygiene, giving them more protection against other contagious diseases. A greater appreciation of the need for financial reserves (saving for a rainy day) could result in a higher personal savings rate and discourage running up big credit card debt.

    I’m not sure it’s a positive, but some illegal immigrants may be returning home because they lost their restaurant jobs.

  828. Lucia “ Honestly, if I were in Sweden, I’d be worried.”

    Why?
    .
    I look at the graph and see not much different than normal. The purple line at the top of the graph is its main point. No country looks like they are going to break past this line.
    .
    If respiratory deaths fall inside normal variation, why are we not restarting the economy now? It makes no sense to me that we continue down the path leading to such economic hardship when the data clearly shows otherwise.
    .
    This entire situation can be laid at the feet of the “experts” that released the model the US government based its reaction on and that generated the panic now seen. The model that had NO relation to reality.
    .
    The same “experts” who told the public NOT to wear masks as they did no good for the general public.

  829. Ed Forbes,
    Because try as I might, I can’t see the slightest hint of concave downward bend for Sweden. And I’m trying and trying to see it. Although it might be wishful thinking I think see a hint of concave down for US, UK and France.

    (Italy, Spain, Netherlands, German definitely going concave down.)

    I’m not going to say everyone should see what I do because there is no doubt I’m just trying to see downward bends. But with Sweden… I definitely can’t. So if I were in Sweden, I’d be worried.

  830. Ed,
    By the way, I disagree that the purple line at the top is the “main point”. It might be what someone cares about; it may be what Willis is emphasizing. But to my mind on that sort of graph, the main things I look at are:

    1) The apparent shape: Linear means increasing exponentially. Concave up: faster than exponentially. Concave down: lower than exponentially.

    2) The current apparent slope. That gives the “time constant” for growth. If two curves both look linear, the one with the larger slope has the faster doubling rate.

    Sure, it’s interesting to see how the compare the purple line to get a handle on size. But other than COVID, the causes for the purple line don’t have the potential to grow exponentially, hit that line while still growing and keep on going and going. If other countries did something that made their curves bend, and my country is just going up straight… I’d be scared.

    It might just be that the “jitters” in Swedens rate mask it, but I don’t see concave downish in the past 10 days and other countries do show a hint. It’s a hint… but well, in 10 days we’ll see. Beyond that, I think it is premature for the people claiming that Sweden shows lockdown doesn’t make any difference to make that claim. Because we’ve only had time for lockdown to make a HINT of a difference, but I think– eyeballing that graph– that I see a hint it might be happening.

  831. OK_Max

    but some illegal immigrants may be returning home because they lost their restaurant jobs.

    UHhmmm… unlikely. Covid’s going to be hitting Latin America. Plus, let’s hope the jobless don’t decided to start moving around and carrying the virus willy-nilly!

  832. Lucia,
    “Covid’s going to be hitting Latin America”
    .
    Maybe, but so far, the rates are low compared to the USA and Europe. If I had to guess, I would bet that Latin American countries (say everything south of the US southern border), will have much lower deaths per million population.

  833. I played golf today with (yet another) medical doctor… this time family practice. I didn’t ask if he was self prescribing hydroxychloroquine, but I did ask if he had any patients who had tested positive. He said that he had sent more than a dozen for testing after they had URI symptoms and fever….. but all were negative. He said he had a friend (late 50’s) who had just died two days ago from COVID-19, but he was a terminal cancer patient already in the hospital… where he apparently picked up the COVID-19 infection.

  834. skeptical,
    “Obviously you can’t have a perpetual shelter-at-home, but it’s needed now to limit the deaths and it gives the leaders time to devise an acceptable exit strategy.”
    .
    No, it really is not needed in many, if not most, places now. Not sure what “acceptable” means to you, but I expect it has great deal to do with valuing a single life at infinite dollars. There are significant differences between regions in the rate of fatalities, but that seems mainly the result of population density, not government policies. Maybe NYC needs to be more restrictive than New Mexico, but in many places (if not most) the whole “you can’t do (fill in the blank)” has gotten way out of hand. WRT to NYC being a “death zone”: please calm down. The death rate for NY is projected to be 13,000 total (for 19 million residents), and I will not be surprised if it is considerably lower. Yes, all deaths are terrible, but the sad reality is that we all will die, and nearly all of those now succumbing to the COVID-19 illness are of advanced age and/or with serious pre-existing conditions. Sure there are a handful of victims who do not fit that profile, but the overwhelming majority do. There are also a handful of people who fall off ladders and have fatal car crashes who don’t fit that profile.
    .
    I have a son who was commuting every day from North Jersey to Manhattan until he was instructed to work from home. He is not worried at all, and not worried about returning to work in Manhattan. Maybe you could be less worried as well.

  835. Well that narrows it down.
    “ researchers estimated that the number of people actually infected with coronavirus is between 2,300 and 115,000”
    .
    https://www.miamiherald.com/news/coronavirus/article241908771.html
    .
    “.. Biobot Analytics, along with researchers from MIT, Harvard and Brigham and Women’s Hospital, tested samples of wastewater from an urban treatment plant in March, according to a report posted to the preprint server medRvix. Researchers found the amount of coronavirus particles in the samples was far higher than expected, indicating there are likely a lot more people infected with the virus than the official count, Newsweek reported…”

  836. Ed Forbes,
    I am utterly shocked (shocked!) that the rate of infection is higher than expected. What I suspect we will ultimately find is:

    a) many people are resistant and will never generate antibodies, even if exposed to the virus
    b) those who do generate antibodies upon exposure represent something less than 40% of the population, but most are either asymptomatic or have mild symptoms
    c) a very small fraction of people are truly at risk
    d) reaching effective herd immunity requires only ~half the people who generate antibodies upon exposure to actually be exposed

  837. ~half the people

    Well… maybe half. It depends on on Ro, right? ( Ro which is a function of virus properties, unexposed population properties and some social interaction factors. But we want the number for our normal social interaction behaviors and population genetics.)

  838. Thomas Fuller, ( http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182628 , it’s been so long, I’ve forgotten how to hide links)

    The Mother Jones article you link does not give the actual CFR, probably not even close. As I pointed out to MikeN, you cannot calculate a meaningful CFR from current total deaths and current total cases. Deaths are related to the new cases from weeks before, and we don’t know the value of that delay. And then you don’t know the actual number of cases and the error could be quite large. In Italy, the estimate of the total number of infected ranges from 5 to 20 million people compared to the 152,271 confirmed cases.

    There were almost certainly at least 1,000 infected people in New York before the first case was detected. I would think about betting real money that the number now is well into the millions. The actual CFR is likely less than 0.3% pretty much regardless of the state of the local health care system. So the apparent differences between countries are almost certainly artefacts of differences in testing.

  839. Lucia,
    Yes, we want the numbers for normal social interaction. But finding that will not be easy, outside a few places like Sweden, and Sweden’s normal social interactions may not be the same as for the States. In any case, it is inevitable that the worst case scenarios will turn out to be way wrong.

  840. lucia,

    It depends on on Ro, right?

    But we don’t know Ro any better than we know the CFR for the same reasons.

  841. SteveF (Comment #182651)
    April 11th, 2020 at 2:42 pm
    skeptical,
    “Obviously you can’t have a perpetual shelter-at-home, but it’s needed now to limit the deaths and it gives the leaders time to devise an acceptable exit strategy.”
    .
    No, it really is not needed in many, if not most, places now. Not sure what “acceptable” means to you, but I expect it has great deal to do with valuing a single life at infinite dollars.
    __________

    StefeF, we probably could agree on extremes ( eg. that it wouldn’t be worth saving one life if it meant putting 100,000 workers out of jobs for a few months, or it would be worth saving 100,000 lives if it meant putting one worker out of a job. And we probably could continue to agree as these tradeoffs are narrowed.

    I doubt we could agree, however, on exactly or even approximately what a human life is worth in job losses or dollars. We might also disagree on whether the worth depends on age, health, dependents, expected remaining earnings , and other characteristics of the deceased, factors that are considered in civil law but carry little weight in criminal law. A robber who murders a sick old person may not get a reduced sentence because of his victims advanced age and poor health.

    I struggle to estimate how much I think the life of an elderly victim of Covid-19 is worth. I have thought about this for several days, and I just can’t give you a number or even a range. You may have an opinion on what lives are worth by age and health condition. If so, I would be interested in hearing about it.

  842. Tom Scharf (Comment #182641)
    April 11th, 2020 at 12:27 pm

    All the paranoia is useful in reducing risk, forming automatic behavior, and not getting sloppy. They still don’t really understand the relative prevalence of infections being transferred via directly breathing droplets versus touching a contaminated surface. There is surprisingly very little information here.
    .
    It is really hard to maintain discipline and never touch a possibly contaminated surface and then touch your face. Things like credit card machines, ATM’s, gas pumps, door handles, etc. are everywhere.

    I agree that there is much that has not been previously studied, identified and prioritized with regards to day-to-day transference of viruses in general. That is somewhat surprising. I would think that touching objects could be a greater transfer source than breathing and spending short periods of time within breathing range of an infected person. I heard a doctor opine the other day that Covid-19 is transferred in droplets and that exhaled tobacco smoke was not a source. He immediately followed with a do not smoke warning. I do not know the residence time of the virus on an object under given conditions, but if it is reasonably lengthy like longer than the time between reasonable disinfecting periods I would suspect that would make it a most likely source. The other unknown, for me at least, is how the virus would get from the infected person to an object that is frequently touched by others or rather from the virus source to the infected person’s fingers. I see most people use the hand wipes going into a grocery store but none on the way out. I see many fewer gloves than masks.

    This all adds up to the best way of avoiding contamination is to keep the likely infected person out of areas of close contact. I have not seen a coughing or sneezing person in the stores I frequent for quite a while now. An asymptomatic person would, I think, be less likely to spread the virus by coughing or sneezing but more likely through touching objects.

    Would some kind of more or less automatic temperature taking device be a good first line indicator for the symptomatic? I believe that was being used for admitting people to their work stations before all that was shutdown. I would also think that a mass testing is in order.

  844. Here’s where I commented on the estimate of 5-20 million infected in Italy: http://rankexploits.com/musings/2020/all-covid-19-all-the-time/#comment-182182

    It’s not on the worldometers Italy page any more.

    Edit: It’s still there if you click on the ‘more news’ button. It’s in the April 3 update.

    Kenneth,

    I found an article about using non-contact IR thermometers for screening a while back. They’re not very effective. My forehead, for example, reads about 91 degrees where the usual estimate is that forehead temperature is only a degree or two lower than oral temperature. My guess would be that false positives would be low, but false negatives would be high.

  845. “Obviously you can’t have a perpetual shelter-at-home, but it’s needed now to limit the deaths and it gives the leaders time to devise an acceptable exit strategy.”

    If you don’t do shelter-at-home, then leaders do not need to devise an exit strategy from shelter-at-home.

  846. Lucia link
    Abstract:

    “..It is a highly contagious positive strand RNA virus and its clinical presentation includes severe to critical respiratory disease that appears to be fatal in ~3-5% of the cases..”
    .
    With hidden infections now looking to be in the millions, this number is almost certainly BS, especially with the death with, not from, issue in reporting.

  847. Lucia,
    Thanks. The process has started to understand the illness more than beheaded chickens do. That is a good thing. Unfortunately, the beheaded chickens are still mostly in charge of policy. This will gradually change, of course, but I suspect much more slowly than makes sense.

  848. lucia,

    “Human ACE2 receptor polymorphisms predict SARS-CoV-2 susceptibility”

    Not so much:

    Overall, ACE2 variants are rare….

  849. DeWitt..
    On the one hand, the predict. On the other hand, the number of people with the variants that might make them LESS suscpetible are rare…. I think? 🙂

  850. lucia,

    The way I read it was that some variants resulted in higher susceptibility and others were likely to result in lower susceptibility, but that all these variants were rare so they wouldn’t have much effect on the overall susceptibility. Maybe. As the song lyric (Man Piaba, Harry Belafonte) goes:
    …It was clear as mud but it covered the ground
    And the confusion made the brain go ’round.

  851. States are restricting Easter gatherings amid COVID-19. Churches and lawmakers are pushing back.

    “Republican Senate President Susan Wagle (Kansas) painted the executive order as an attack on Christians.”

    https://www.usatoday.com/story/news/nation/2020/04/11/coronavirus-easter-kansas-kentucky-restrict-religious-gatherings-church/2975593001/

    I don’t believe Christians are being singled out. The restrictions apply to all religious gatherings as well as non-religious gatherings.

    Matthew 6:1 “Beware of practicing your righteousness before other people in order to be seen by them, for then you will have no reward from your Father who is in heaven.”

    Matthew couldn’t have know that today’s churches have pretty big bills to pay

  852. Lucia, DeWitt,
    I read it the same way as DeWitt, but it is very poorly worded. (EASL issues?) The full article might clarify, but I was not interested in getting past the paywall. Two questions come to my mind: if these variants are so rare, why are there so damned many of them? If these variants infer no advantage, why do they exist at all? Usually an abstract at least hints at the important questions…. not so here.

  853. Amino acid mutations are largely to amino acids in structurally unimportant parts of the protein or to amino acids that carry out a similar role. A mutation doesn’t need an advantage to be passed on, it need only not confer a disadvantage. Important amino acids are highly conserved, even between species.

  855. He Could Have Seen What Was Coming: Behind Trump’s Failure on the Virus
    https://www.nytimes.com/2020/04/11/us/politics/coronavirus-trump-response.html
    .
    “An examination reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response.”
    .
    This is the NYT’s best effort to blame Trump. The magical framing here is that Trump alone was given smoking gun memos and advice that there was a top secret pandemic about and he failed to act in time. Never mind that everyone had access to the same information which was all very much public and blindingly obvious in hindsight, and the entire world failed to act even though their leader’s names wasn’t Trump. Even the national headquarters of Team Science and global center of Experts-R-Us in NYC was not immune. This framing gets so tiring, but it is just reflexive at this point, they could write these articles in their sleep. It’s not an indictment of government, it’s an indictment of government run by the perceived opposition.
    .
    How do we prepare for the next pandemic? Is it get rid of Trump or get better global, national, and state healthcare preparedness?

  856. Tom Scharf,
    As I noted somewhere up thread, the NY Times is a dishonest and evil organization. I stopped reading their tripe long ago; it’s just not worth the time spent.

  857. Experts-R-Us. 538 asked a bunch of experts to forecast the number of US infections two weeks in advance of 3/29.
    https://twitter.com/katy_milkman/status/1244668082062348291
    .
    Expert average estimate: 20,000 cases.
    Actual: 122,653 cases
    .
    Only 3 out of 19 had the correct number in their confidence interval, ha ha. The experts did worse than just continuing the exponential curve on the graph would have.

  858. Tom Scharf (Comment #182676): “538 asked a bunch of experts to forecast the number of US infections two weeks in advance of 3/29.
    Expert average estimate: 20,000 cases.”
    .
    No, they estimated 19,000 *reported* cases by March 29. The same experts also estimated that “there were actually about 29,000 infections in the U.S. as of March 15, more than eight times the known tally”.
    https://fivethirtyeight.com/features/infectious-disease-experts-dont-know-how-bad-the-coronavirus-is-going-to-get-either/
    So it seems that what they missed was the rapid ramp up in testing that was about to begin.
    ———–

    Addition: Another factor is the question the experts were asked. From one week later:
    “In past surveys, the experts have been asked to forecast numbers published by the Centers for Disease Control and Prevention, which tend to be lower than those from other sources. (Also, the CDC data updates only on weekdays, so Sunday’s numbers are the same as Friday’s.) This week, the survey asks experts to forecast numbers published by The COVID Tracking Project, which aggregates data collected from state or other local public health authorities.”
    https://fivethirtyeight.com/features/experts-say-the-coronavirus-outlook-has-worsened-but-the-trajectory-is-still-unclear/

  859. The experts were asked a basic *falsifiable* question “How many total COVID-19 cases in the U.S. will the CDC report on March 29?” so they were free to expert-ness their way all around the testing issues and the doubling rates. They could have just added a large uncertainty which very few surprisingly did. This is their overconfidence in their own numbers bias. The few who put a huge range in there are the only winners.
    .
    There appeared to be lot more unknown unknowns (or known and ignored) than these experts were willing to admit to. Anyone who has ever done a real error analysis knows how quickly error estimates can balloon if done properly. These experts appeared to be using a lot of gut instinct instead of math.
    .
    Overstating the certainty of an estimate is the plague of our experts lately, everything from climate science to economics. The point of this original comment was the isolated demand that Trump should have known of the oncoming storm when other actual credentialed experts were also in the dark. The partisan game is then to go backwards in time and find someone who made an accurate estimate, declare that person the “experts” that should have been listened to and dismiss everyone else who had sent mixed signals.

  860. It was Peter Navarro that got Trump’s attention, advising for a travel ban based on even a small chance of a pandemic.

  861. Denmark, one of first european countries to impose Covid-19 restrictions, will begin gradually easing restrictions next week, starting with re-opening elementary schools. Denmarks borders will remain shut.
    https://www.bbc.com/news/world-europe-52226763

    Hopefully, this bodes well for the U.S. and other countries that got a later start on restrictions. Compared to Denmark, however, the U.S had a less uniform approach because different states had different policies.

  862. Denmark is effectively a state in this comparison. Europe/Countries is comparable to US/States.

  863. Tom Scharf (Comment #182688): “Denmark is effectively a state in this comparison.”
    .
    One very large difference: They could, and did, close their borders.

  864. Tom Scharf (Comment #182688)

    Denmark is effectively a state in this comparison. Europe/Countries is comparable to US/States.
    ___________

    Good point, Tom. The only state with the same population size as Denmark is Minnesota, each having about 6.5 million. It’s hard to compare Covid-19 for these two places because Denmark’s greater population density makes it easier for Covid-19 to spread. I couldn’t find a state similar to Denmark in both population size and density.

  865. Mike M. (Comment #182691)
    April 12th, 2020 at 4:17 pm
    Tom Scharf (Comment #182688): “Denmark is effectively a state in this comparison.”
    .
    One very large difference: They could, and did, close their borders.
    ______

    I didn’t see MikeM’s comment before replying to Tom.

    Yes, Denmark closing it’s borders makes a very big difference.

  866. I thought that in Italy the new cases curve would drop below the rising recovery curve by now. But it hasn’t happened. The new cases curve isn’t dropping very fast anymore and recoveries aren’t increasing much. The closed case fraction of total recovered curve is continuing to separate from the fraction of total deaths.

    Note to the Florida health department, Italy doesn’t seem to have a problem with defining recoveries. In fact, most countries and states don’t have a problem either.

  867. Looks like Florida may have turned the corner on new cases….
    https://www.google.com/search?sxsrf=ALeKk00BZ1eboPuB-bfHYuxKr7MxA6I80w%3A1586788951824&ei=V3qUXry2Mc7N_Ab4nr_ADg&q=covid+19+deaths+florida&oq=covid+19+deaths+florida&gs_lcp=CgZwc3ktYWIQAzoECCMQJzoKCAAQgwEQFBCHAjoFCAAQzQI6BQgAEIMBOgIIAEoRCBcSDTktODlnOTdnODhnNzZKDQgYEgk5LTFnN2c1ZzVQ9CtYk1VgglZoAXAAeACAAXSIAfQLkgEEMTUuM5gBAKABAaoBB2d3cy13aXo&sclient=psy-ab&ved=0ahUKEwj8vbm-0eXoAhXOJt8KHXjPD-gQ4dUDCAw&uact=5
    If the peak of new cases has in fact passed, then that is about two weeks earlier than expected.

  869. I think Florida has separation between the most vulnerable population and the spring breakers responsible for most of the spread. Include that they had better knowledge of care to be taken in nursing homes compared to Washington, and a lower impact is likely.

  870. Tom Scharf,
    That web page is visually impressive, but is not up to date, and has been really wrong for a long time before that. None of the model projections or actual data has been changed since April 10. I think they know they are going to have to revise their projections down yet again, and want enough current data that they won’t have to continue revising downward after that.
    .
    The Florida State department of health says their numbers are accurate through the 12th. It really does look like the peak for new cases was in the first few days of April. That puts the peak death count likely within a few days. Time will tell.
    .
    BTW, the normal average rate of deaths in Florida is about 500 per day. I think people need to have some perspective about the COVID19 deaths, but I doubt most will.

  871. I have been waiting for them to update this page, but they haven’t. I don’t think they need to do it every day, but they obviously need to do it frequently or it is useless.
    .
    http://www.healthdata.org/covid/updates
    .
    “Our next set of results will be published on Monday, April 13.”
    .
    I wish people wouldn’t use line graphs where bar graphs are much more appropriate.
    .
    There should be at least a week lag between confirmed test and death. Last data I saw was a 17 day average from onset of symptoms to death, but you also now need to estimate test result delay. I agree that maximum danger to exposure was likely a few days ago but is now still near peak. Perhaps maximum number of contagious individuals also has a lag? Not sure.

  873. The IHME projections fall into three groups.

    One group (15 states) has peak deaths in the date range April 4 to 10. The predicted peak per 100K population ranges from 0.17/day for Idaho to 4.1/day for New York. The projected total per 100K ranges from 3.4 for Idaho to 69 for New York.

    The second group (13 states) has peak deaths in the date range April 13-21. The predicted peak per 100K population ranges from 0.15/day for Maine to 0.50/day for Maryland and Mississippi. The projected total per 100K ranges from 4.0 for North Carolina to 14 for Mississippi.

    The third group (23 states) has peak deaths in the date range April 25 through May 2. The predicted peak per 100K population ranges from 0.12/day for Oregon to 4.1/day for Connecticut. The projected total per 100K ranges from 4.8 for Oregon to 129 for Connecticut.
    ——

    Within each group, there is a good correlation between peak deaths and total deaths, but the correlation is different for each group. The slope gives widths of 16 days for the early peak group, 23 days for the middle group, and 32 days for the late peaking group.

  874. Here are the states that, according to the IHME model, have done a bad job of flattening the curve in the sense of having a high ratio of predicted peak deaths to predicted total deaths:

     Alaska
     District of Columbia
     Vermont
     Wisconsin
     Washington
     Michigan
     Nevada
     Illinois
     Louisiana
     New Jersey
     Ohio
     Delaware
     Idaho
     New York
     Colorado

    ————-
    The middle group:
     Indiana
     West Virginia
     California
     Maryland
     New Hampshire
     Hawaii
     Maine
     North Carolina
     Pennsylvania
     Mississippi
     Alabama
     Tennessee
     Montana

    ————-
    And the states that have flattened the curve the most:
     Kentucky
     New Mexico
     Connecticut
     Missouri
     Oregon
     Arizona
     Florida
     Georgia
     Kansas
     Massachusetts
     Minnesota
     Rhode Island
     Virginia
     Oklahoma
     Texas
     South Carolina
     Utah
     Arkansas
     North Dakota
     South Dakota
     Iowa
     Nebraska
     Wyoming

    ————
    Does that make sense? Real question.

  875. Is #1 Wyoming?
    I don’t know that flattening the curve is a desirable goal.
    Worst case, you have 1000 deaths per day forever, yet curve is very flat.
    Instead, you could get higher peak but deaths stop, hopefully at a low total number.

  876. Mike M.

    Rather than “states that have flattened the curve the most”, I think it would be better to say ‘states that have a flatter curve.’ IIRC, several states in that category have done very little in terms of social distancing orders.

    I also think that once the most recent data are added, then Virginia will move out of the flattest curve category. VA was behind TN a week ago in total cases, deaths and active cases per million, but now they are ahead and pulling away. Now some of that may be due to a difference in reporting active cases. OTOH, perhaps they really have fewer recoveries than TN. They certainly have more deaths.

  877. Mike M,
    “Does that make sense?”
    .
    No, makes no sense at all.
    .
    There are multiple variables, including (at a minimum) proximity to a “bad” state like NY, population density (and not just average density, but density normalized for non-uniform density distribution), the frequency of international travelers to/from the state in question… bringing the infection with them, the age profile of the population, and more. Nebraska did absolutely NOTHING recommended to reduce spread, yet is one of the “good” states.
    .
    IMO, it is all rubbish, designed to assuage the hurt feelings of incompetents.

  878. NY’s * reported * infection rate is now >1% of the state population. Actual number 10%? I don’t see how this virus can be suppressed with NY feeding the rest of the US unless a large percentage of the population is basically immune already. It’s going to be hard to put that forest fire out. Cuomo is in a really hard spot, but I’m not sure why they think he is a hero for this outcome.

  879. Tom Scharf,

    Cuomo is in a really hard spot, but I’m not sure why they think he is a hero for this outcome.

    There was on op-ed in today’s WSJ that recommended that Biden pick Cuomo as his VP.

    *shudder*

  880. Tom Scharf,
    “unless a large percentage of the population is basically immune already.”
    .
    Not at all an unreasonable guess. The progress of the infection is consistent with that.
    .
    “Cuomo is in a really hard spot, but I’m not sure why they think he is a hero for this outcome.”
    .
    Cuomo is a big part of the problem, not the solution. He resisted reducing economic activity in the NYC metropolitan area until the spread was already out of control. As to why ‘they’ think such an incompetent nincompoop is a “hero”: you need only look at 1) his party affiliation and 2) his willingness to trample constitutionally guaranteed liberties, with minimal justification. The totalitarian inclined left, for which the NY Times is the publication of record, knows what they like, and Cuomo is it.

  881. MikeN
    **What is the proper definition of herd immunity and can the level change for the same virus in an area?**
    .
    I think it’s when the effective reproduction rate R of the virus in the population is less than 1. When this happens, outbreaks peter out naturally. Defined this way, it can’t really change since it’s the same for all viruses at all time. The effective reproduction rate is affected by many things including the number of available victims.
    .
    I think the rule is that if we know the based reproduction rate for a population where no one is immune is Ro (given behavior and condition of that population) then herd immunity is reached when the fraction of population that becomes immune is equal to f=1-1/Ro.
    .
    The value of Ro, and so F IS affected both by the virus, it’s victims AND the social organization of the victims. So, for example, a virus that can be transmitted by material landing on hands and then transfering to the face enters a society where everyone already washed their hands, always did and always will, the Ro will be lower for that population. If everyone ALWAYS self isolated for whatever reason, Ro would be lower.

  882. MikeN,
    **Instead, you could get higher peak but deaths stop, hopefully at a low total number.**
    I don’t see how having a high peak could result with a low total number of deaths. It might result in the same number of deaths in less time, but I don’t understand how it could be lower.

  883. DeWitt Payne (Comment #182724): “Rather than “states that have flattened the curve the most”, I think it would be better to say ‘states that have a flatter curve.’ IIRC, several states in that category have done very little in terms of social distancing orders.”
    .
    I agree. I just took the model projections and stuck them into the “frame” being pushed: That aggressive restrictions are flattening the curve. But it looks to me like there is either little correlation or a negative correlation between restrictions and flatter curves.

  884. MikeM,
    The problem, of course, is that in most cases, the cause (or motivations) of restrictions seems to be the high rate of deaths.

  885. Tom Scharf,

    Also, infections aren’t distributed uniformly across the state. If you look at the individual county statistics, it’s even worse. In Rockland and Westchester counties, north of NYC, the infection rate is 2.6% and 2.1% based on the numbers in the Wikipedia page. In the city, it’s ‘only’ 1.3%. But having looked at the map on the page over time, the infection is diffusing from Long Island and the suburban counties into the rest of the state.

  886. Lucia,
    “The value of Ro, and so F IS affected both by the virus, it’s victims AND the social organization of the victims.”
    .
    One of the many problems for the models. Ro is not at all a constant, but depends on a host of factors, none of which is well known… if known at all. The Ro value would only be a constant if people behaved like gas molecules under random motion. As such, it is a useless construct, because people don’t behave that way, they respond to information…. no matter how egregiously incorrect that information might be.
    .
    The flip side of the Ro nonsense is the trailing edge behavior. My eyes roll when I see the projections for cases in NY (or anywhere!) to fall to essentially zero within a few weeks. That is not going to happen, because the value of Ro is variable, not constant. The COVID 19 death rate will not fall to zero in a few weeks, nor will people suddenly stop dying from other causes. It is all so very naive and misleading. The only thing that matters, and the question our cowardly politicians should answer, is what residual death rate from COVID 19 is acceptable when balanced against the (huge) economic damage current policies have brought on. I am guessing they will resist suggesting an answer for as long as possible.
    .
    Some politician somewhere should be smart enough and brave enough to lay out the harsh reality: we can’t save everyone from COVID19 if we want a functioning economy. Haven’t seen such a politician so far.

  887. lucia (Comment #182733): “The problem, of course, is that in most cases, the cause (or motivations) of restrictions seems to be the high rate of deaths.”
    .
    Hardly. The restrictions almost always led deaths by a significant margin. For instance, New Mexico has had a stay-at-home order since March 24; the first death was reported on March 25.

  888. What is the purpose of the shutdowns? Is it to reduce the eventual number of deaths? Or to spread them out to keep the system from being overwhelmed? If it is the latter, why is there almost a factor of 40 range in predicted per capita deaths by state?

    And why don’t we *know* what the objective is? Shouldn’t that be made perfectly clear when forcing people to make huge sacrifices? Why has there been no real public debate on that?

    I don’t actually *know* the answers to any of those questions. Maybe somebody can provide them. I have my suspicions as to the answers, which have a implications as to what should be done about it.

  889. Lucia, what I meant is you could have a peak of 5,000 deaths in one day, 30,000 in a week, or reach a peak of 100,000,000 total deaths.

  890. Mike M,
    “Why has there been no real public debate on that?”
    .
    Because it is a political hot potato no politician wants to hold. The rational answer, is we (as a society) have to make hard choices about the better good, and that inevitably means we assign (implicitly or explicitly) an economic value to the lives which will inevitably be lost when normal economic activity resumes. The problem is politicians like Cuomo and Phil Murphy of NJ who refuse to accept reality. If that is because they really believe a life has infinite value to society, then they are infantile fools, and should not hold public office. If that is because they are too cowardly to explain a hard reality to the voters, for fear they will not gain re-election, then they should not be holding public office.

  891. Is there any correlation between states that flattened the curve of COVID, and states that flattened the curve in their weather?
    When in Texas, I frequently saw heavy rainstorms that lasted 5-10 minutes.

  892. Why is Cuomo the target? He doesn’t seem to be doing anything more than other governors, like Kent, Mich, Minn, Ill.

  894. MikeN,
    Cuomo explictly stated that he refuses to place a value on a single human life. That makes him the best known advocate for the idiot crowd. I do not doubt there are many other politicians who are just as idiotic.

  896. It appears to me the unofficial answer is that it is to spread out the total number of cases in order to avoid overwhelming the health care system and thus the term flattening the curve. What is not publicized is that the total cases and deaths with or without the flattening could well be near the same -without an intervening effective vaccine and/or prophylactic. Total deaths might change with interventions that do not alter the number of cases but alleviate the symptoms.

    I suspect the political entities in this matter do not like to explain this to the public in their attempts to rationalize the shutting down of the economy. Covid-19 appears to be very readily spread and very infectious and thus avoiding the natural numbers of cases and deaths could be between shutting down the economy for 12 to 18 months until a vaccine is ready or letting the virus take its natural course. I am not at all confident that social distancing and other precautions would hold down the total numbers over the longer haul.

    An important number in all this and one that should be relevant to the policy makers is an estimate of the portion of the public that has already been infected.

  898. Kenneth Fritsch (Comment #182746): “It appears to me the unofficial answer is that it is to spread out the total number of cases in order to avoid overwhelming the health care system and thus the term flattening the curve. What is not publicized is that the total cases and deaths with or without the flattening could well be near the same”.
    .
    But the IHME model, which is supposedly very influential in policy circles, seems to contradict that claim since it has a huge variation in predicted deaths from state to state.

  899. Kenneth,

    It appears to me the unofficial answer is that it is to spread out the total number of cases in order to avoid overwhelming the health care system and thus the term flattening the curve. What is not publicized is that the total cases and deaths with or without the flattening could well be near the same -without an intervening effective vaccine and/or prophylactic.

    You might think with all the questions Trump’s task force gets, they would have received and answered that one…. but not so far as I know. Even if they got that question, I doubt they would ever give a straight answer, if only because the answer would be too politically uncomfortable. It may actually be possible to reduce total deaths by very aggressively isolating people known to be at greatest risk for long enough to develop effective treatments or vaccines. But a vaccine in a reasonable time is a long shot…. the Fauci man keeps saying 12 to 18 months.
    .
    I think the best we can hope for is that the fraction of the population susceptible to infection (that is, susceptible to become carriers of the virus, even if asymptomatic) is well below 100%, so that getting Ro below 1 without destroying the economy is possible.

  900. The Covid 19 projections for U of Washington have been updated. They are doubling down: they have increased projected deaths…. even in States where the data are clearly saying otherwise (like Florida). All I can say is… Wow. Maybe these folks should go into climate modeling.

  901. MikeN,

    Why is Cuomo the target?

    Because there are far more cases and deaths in New York then in any other state. Even scaled by population, New York stands out.

  902. SteveF,

    I looked at the IHME projections for Italy. IMO, they are underestimating the total deaths. They have the daily deaths dropping exponentially over a fairly short time, i.e. to effectively zero by May 1. Not going to happen. Their estimate for New York seems similarly flawed.

  903. DeWitt,
    ” Not going to happen. Their estimate for New York seems similarly flawed.”
    .
    I completely agree. That was what I was trying to say in comment 182735…. the disease is not going to drop to nothing because the Ro value is NOT constant across the entire population, and the entire population has NOT acquired herd immunity. Resuming more normal economic activity will lead to more cases due to more effective transmission.

  904. I think it’s fair to say the Twitter shaming conglomerate is just waiting for anyone to name a number for a COVID life. Every politician is making the same judgment to not name that number but proceed with an effective hidden number anyway. Let the Twitter crowd do the calculation. The politicians are all waiting for someone else to open their economy first so they will not receive all the incoming artillery.

  905. I have no problem with the model updates, they are public, falsifiable, and real time. They are also very difficult in that they are modeling something with very little prior experience and making estimates not knowing future political decisions that affect the outcome.

  906. Too bad Biden already declared he would nominate a woman, ha ha. I suppose Cuomo can simply declare himself a woman.

  907. MikeM

    Hardly. The restrictions almost always led deaths by a significant margin.

    Huh? Where. Not in the US. There were plenty of deaths in Illinois, NY etc before we had restrictions.

    Restrictions came before deaths in Korea. They kept deaths down.

  908. MikeM

    What is the purpose of the shutdowns? Is it to reduce the eventual number of deaths? Or to spread them out to keep the system from being overwhelmed? If it is the latter, why is there almost a factor of 40 range in predicted per capita deaths by state?

    Both. If the number of people who need beds in ICU to stay alive exceeds the number of beds, those people will die. So, a goal is to flatten the curve in order to lower the total number who die.

  909. MikeN

    Lucia, what I meant is you could have a peak of 5,000 deaths in one day, 30,000 in a week, or reach a peak of 100,000,000 total deaths.

    I still don’t understand how we could have fewer deaths with a bigger peak. There is nothing about the fast tall peak that is expected to results in fewer total getting infected. ( I would expect it would, if anything result in more infected due to the lag times associated with infection.)
    .
    If the peak is high and the number of ill exceed the rate that allows us to treat them and prevent them from dying, then the overwhelming majority severely ill die. If the peak is low, then a decent fraction of those people live.
    .

  910. lucia (Comment #182759): “There were plenty of deaths in Illinois, NY etc before we had restrictions.”

    NY: restrictions started on March 18, when there were 7 deaths total. Stay at home went into effect on March 22; prior to that date there were 44 deaths, but it jumped to 114 on that day. Currently 10,056.

    IL: Restrictions started on March 17, the day of the first death. It was up to 6 total deaths on March 21, when the stay-at-home started.

    I am getting the dates on restrictions from the IHME site and deaths from the COVID tracking project.

  911. In terms of valuing human life, insurance companies do it all the time. There is a sliding scale depending on number of Quality Adjusted Life Years lost, but a common figure these days is between $8 and $10 million.

  912. lucia (Comment #182760): “Both. If the number of people who need beds in ICU to stay alive exceeds the number of beds, those people will die. So, a goal is to flatten the curve in order to lower the total number who die.”
    .
    If that is the case, then the IHME projections say that we are badly missing the mark and better start letting up. Not nearly enough people are dying for that strategy to work.

  913. Tom Scharf,
    I have no problem with the U of Washington model… save for it appearing wrong. It is absolutely falsifiable…. as we see in real time. I do wonder how long they are going to look at falling new cases in Florida while the model says rapid future increases in deaths before someone says “wait a minute, this can’t be right”.
    .
    “ I suppose Cuomo can simply declare himself a woman.”
    LOL, sounds like the Babylon Bee.

  914. MikeM

    I am not sure whether those model predictions are referring to a first wave or all possible waves. Certainly their could be large differences in case and death numbers for first wave for states and locales.

    Theoretically I would suppose that a locale could somehow through total isolation get a handle on all active cases and asymptomatic ones and then in addition remain isolated. That could also lead to fewer cases and deaths without a vaccine intervention, but in my view not very likely at this point in time of occurring.

  915. MikeM

    NY: restrictions started on March 18, when there were 7 deaths total. Stay at home went into effect on March 22; prior to that date there were 44 deaths, but it jumped to 114 on that day. Currently 10,056.

    IL: Restrictions started on March 17, the day of the first death. It was up to 6 total deaths on March 21, when the stay-at-home started.

    IOTW: There were lots of deaths in NY. There was a death in Illinois even with your claim the stay at home started on March 17.

    Illinois’s stay at home started the 20th, not the 17th. One small community announced a stay at home earlier. (Oak Park.)

  916. Thomas Fuller,
    Can you give any link or supporting information?
    .
    The 9-11 compensation fund was $7.2 billion, which was paid out to the the families of all victims. I believe the average compensation was about $2 million, although individual payments varied over a considerable range, depending on age and expected earnings.
    .
    Based on that, $8 to $10 million seems very high.

  917. MikeM

    If that is the case, then the IHME projections say that we are badly missing the mark and better start letting up. Not nearly enough people are dying for that strategy to work.

    Could you elaborate. Because i have no idea (a) How you conclude that if that’s the goal then IHME projects say aything about hitting or missing the mark nor (b) How it means not nearly enough people are dying for the strategy of flattening to curve so we have resources to treat the ill and keep them from dying.
    .
    More words would help here. Because it just looks like two claims.

  918. How often in this Covid-19 pandemic has there been a shortage of ICU in the US? I have been in ICU as a patient and visiting. The difference between that and a regular room appeared to be the ratio of staff ( mainly nursing) to patients. I am wondering what the relative outcomes would be for Covid-19 in ICU and a regular room.

  919. “As of 2011, the Environmental Protection Agency set the value of a human life at $9.1 million. Meanwhile, the Food and Drug Administration put it at $7.9 million — and the Department of Transportation figure was around $6 million. Are any of these the right answer?”

    https://www.theglobalist.com/the-cost-of-a-human-life-statistically-speaking/

    Inflation takes it to $10 million.

    “…the Environmental Protection Agency pegs the value of one life at about $10 million, one of the highest among federal agencies.”

    https://www.bloomberg.com/graphics/2017-value-of-life/

    But… “Richard Thaler, winner of the 2017 Nobel Prize in Economics, similarly calculated a much lower estimate for human life. His wage studies, which are used by federal agencies as the most common way of estimating VSL, calculated how much more a worker would expect to be paid to assume a risk. The size of the worker pool at risk for one annual death multiplied by the amount of extra wages equals the VSL. In 1976, Thaler calculated the value of life at approximately $200,000 in 1967 dollars, or $1.5 million in today’s dollars.” (Ibid)

  920. Hmm. At around 1k jobs lost per COVID19 death in the US, assuming a 40k average annual income loss, that was 40 millionish per life. Pretty steep. Maybe a year is too much, but even at 3 months unemployment we are up around 10 million per life.

  922. IHME Italy deaths projected for 4/13: 261 (137-461)

    Actual deaths (so far) 4/13: 566

    IHME Spain 4/12 projected: 267 (84-719)

    Actual: 603

    Spain 4/13 projected: 215 (61-593)
    Spain 4/13 actual (so far): 547

    We’re seeing a long tail on deaths/day

  923. Thomas Fuller,
    I don’t know the basis for each of the values you noted. I did find quite a few references to QALY. It is used by several different national health care programs to evaluate if a treatment makes economic sense. The upper end value I have seen used is US$150,000 per QALY. If you say a typical life is valued at $10 million, that implies a much higher assigned value per QALY…. probably in the range of $500,000 or more. That seems out of line with how QALYs are valued in health care systems. Considering the age profile of COVID 19 victims, $10 million seems wildly too high.

  925. I’m sorry Thomas, sure I can explain more fully.
    About 17 million unemployment claims have been filed since COVID-19. About 17,000 people have died of COVID-19. Therefore, about a thousand jobs have been lost per death.
    Assuming an average annual wage of $40,000/yr, we’ve lost 40K*1K or 40 million per COVID death. But this assumes a full year of unemployment. At average 6 months unemployment its 20 million, at 3 months average unemployment its 10 million.

  927. Yeah, deaths are at 23,555 as I write. Unemployment will surely climb in tandem with deaths. But I fail to see how the two are related. The unemployment is meant to reduce deaths…

  928. lucia,

    Perhaps I don’t understand what you and Kenneth claim the strategy to be. As I understand it, the idea is to spread out the epidemic so that herd immunity is eventually reached without overwhelming the health care system. Is that right?

    If not, feel free to correct me.

    If that is right, then how long should the process take? How many new cases a day can the system handle?

    I think if you give rough estimates for those numbers, either you will see my point or I will see yours.

  929. There’s some assumptions involved to be sure. If one believes the unemployment is primarily fueled by the shutdowns, then the unemployment loss approximates the cost of the measures taken to save lives.
    Perhaps the unemployment would have been essentially as bad regardless; this may be the case.

  930. Thomas Fuller,

    The unemployment is meant to reduce deaths…

    Tell that to the unemployed coal miners in W. VA addicted to opioids.

  931. I’m sorry Thomas, I’m still not being clear maybe. If 1000 people lose their jobs per death, we have effectively decided a life is worth 1000 jobs. More stringent measures would presumably save more lives and cost more jobs, less stringent vice versa.

  933. Mark, I thought the large scale shutdown of our economy was not predicated on the existing (now) 26,000 deaths, but to prevent anywhere from 240,000 to 2 million deaths. Shouldn’t an estimate of costs/benefits be based on that?

  934. Thomas,

    Shouldn’t an estimate of costs/benefits be based on that?

    I’m not making any statement about what an estimate of cost/benefit should be based on. I’m observing the price we are currently effectively paying, based on certain questionable assumptions. IF more stringent shutdown measures would save more lives at a cost of more jobs, and IF less stringent shutdown measures would save fewer lives at a cost of fewer jobs, then we have effectively put a price in jobs on each life at the equilibrium point we’re executing.
    It’s true that the numbers are in flux and that there’s no reason to assume a linear relationship. We’d need more data points to figure that out.

  935. It seems that your equations are a bit forced. I think the costs of the shutdown should be apportioned to the number of illnesses/hospitalizations/deaths avoided. Not exactly an easy task.

  936. DeWitt, isn’t it the new case plot that should look like a bell curve. In the case of South Korea its a bell shaped curve with a long lumpy tail. I wonder what stage of lockdown/mitigation that South Korea is in.

  937. shrug I don’t see how we can possibly know how many illnesses/hospitalizations/deaths we are avoiding. It’d be a field day of speculation and I think it’d not be unlikely any numbers we came up with would be controversial.

  938. Darn Thomas, now you have me questioning my reasoning.
    What do y’all others think? Am I making a mistake someplace besides the assumptions that 1. the lockdown measures we’re taking are a dominant factor in determining how many lives are saved and 2. the lockdown measures are the dominant factor in determining how many jobs are lost? I get that these assumptions may well be wrong, but if they are not — am I making some other error?
    [Edit: probably. It’s probably pretty bone headed too.]

  939. Kenneth,

    The daily new case curve tail is lumpy because the numbers are small and the date each case is added is only loosely related to the date of infection. If the numbers were larger, the lumps would be relatively smaller. The number of infected curve, because it’s integrated, is going to appear less noisy. It’s probably also a predictor of the future death rate.

  940. Perhaps I don’t understand what you and Kenneth claim the strategy to be. As I understand it, the idea is to spread out the epidemic so that herd immunity is eventually reached without overwhelming the health care system. Is that right?

    If not, feel free to correct me.

    If that is right, then how long should the process take? How many new cases a day can the system handle?

    The more efficient the mitigation and the longer it is in place the longer it would take to obtain herd immunity. Do we know how long that will be?

    If we await vaccine immunity we are talking as long as it takes to find an effective one. Most quoted estimates are 18 months. I heard a doctor on TV the other say he thought it would be three years. Again do we know when the vaccine will be available?

    If the mitigation practices are at least partially removed in order to start up the economy do we know how big the second surge will be. If that surge is like the current one will the politicians reimpose mitigation?

  941. mark bofill,
    You are arguing against wild speculation. Nobody knows how many lives are saved by depressing economic activity. The models of virus spread and projections of death were obviously very influential…. remember the early projections were several hundred thousand deaths. If you stipulate that all of the disruption/business closings/school closures etc saved 500,000 lives (yes, that seems pretty high to me too), and estimate the damage to the economy (not to mention damage to peoples lives through unemployment) comes to at least $5 trillion (and yes, it will probably be much more), then the cost per life saved is $10+ million. Those saved are mostly elderly, people with serious pre-existing health conditions, or most often, both.
    .
    That seems to me a very bad economic trade-off, and one that we, as a society, will one day regret. To put it all in perspective, keep in mind that ~2.9 million people die each year in the states.

  942. Steve,
    Thanks, but the logic I’m using – is it wrong?
    I’m claiming that 17K deaths == 17 million jobs [lost] if we assume that we could make changes that would increase one at cost of the other but we do not. I guess this is the part of my argument I’m questioning.
    So 1 death == 1K jobs lost, so 1 life == 1K jobs?
    The more I try to explain it the weirder it sounds to me…
    [Edit: Oh, nevermind. It’s not important.]

  943. Kenneth,
    The answers to your questions are: no, no, no, and no.
    .
    Until widespread random testing has been completed and we better understand 1) why there is a huge range in severity among those who contract the illness, and 2) what fraction, if any, of the population is effectively immune to infection, we are flying blind. I just wish someone working with Pence would focus immediately on random testing of asymptomatic people; that would be a useful start.

  944. Alright, in for a penny in for a pound, let me finish the dying horse off.

    17K deaths == 17 million jobs [lost] if we assume that we could make changes that would increase one at cost of the other but we do not.

    In other words, we could tighten our lockdowns and have maybe 15K deaths and lose maybe 25 million jobs. We don’t do this; it’s not worth it. Jobs are worth more than that,. We could loosen our lockdowns and have maybe 20K deaths are lose maybe 10 million jobs. We don’t do this; lives are worth more than that.
    We’ve chosen a trade off point where a certain number of jobs lost equals a certain number of lives lost. That’s the center of my argument I think.
    Then I go on to say a death is the loss of a life, so – the cost in jobs of preventing one death is the cost in jobs of a life.

  945. Kenneth Fritsch (Comment #182795): “The more efficient the mitigation and the longer it is in place the longer it would take to obtain herd immunity. Do we know how long that will be? …
    Again do we know when the vaccine will be available? … do we know how big the second surge will be”
    .
    I think we don ‘t know any of those answers. It seems to me that implies that what we are doing is extremely ill-considered.

  946. mark bofill,

    You’re only looking at jobs. What about businesses lost? That represents a cost too. Given how inefficient the government is in starting up new programs, it’s very likely that a lot of small businesses will not be able to obtain the loans they need to avoid closing. Then there are the property owners, since I suspect most small businesses lease the property they use. Yet more wealth lost. I think just using jobs seriously underestimates the cost imposed on the economy.

  948. mark bofill,

    I agree with your overall concept on the impact of lost jobs being a cost that we have incurred to reduce the overall deaths of COVID-19.

    I also agree with Steve F that trying to put a number on that at this stage looks to be a fool’s errand. Probably a fool’s errand even when this shutdown is far in our rear-view mirror. We will probably be able to come up with a price tag for the shutdown but I doubt we can ever know how many deaths were averted.

  949. Thomas,
    The more I think about it the more I think our methods ought to yield the same results — if we could actually know the real numbers using your method.
    I think what you propose is determining the slope of a line via (y2-y1)/(x2-x1) where Y is lives saved and X is jobs cost, and one of the points is ‘policy not implemented’ and the other point is ‘policy implemented’.
    I estimate the slope by looking directly at the situation; Y lives vrs X jobs. SX = Y; S approximately 1K. But I think if we had ‘correct’ numbers for deaths avoided and jobs cost we’d arrive at the same answer.
    I’m not wasting anymore of anybody’s time on this, thanks for the indulgence.

  951. Mark, the issue of the worth/cost of a life in the case of the Covid-19 pandemic is only relevant because the government is involved. As private citizens we would decide how much we could afford to allocate of our limited resources to our various needs and we would directly face the consequences of those decisions. In the case of the politicians and their advisors they do not directly have to face the consequences of their decisions. It is the taxpayers, future taxpayers, those unemployed, those seeking medical help, those who are sickened, those who are isolated and those with close associations with the sick and dying that are affected and without direct control of the situation. In fact the politicians and their advisors often gain in these crises as the polls readily show – and with little accounting for performance and especially when trade-offs are considered.

    If you ask any number of people who depend on government funds for their work or benefit they will easily see the importance of their work or needs and too often as though the world was not bounded by and subjected to limited resources. They will be much less inclined to see other needs where those funds (resources) could be applied. You cannot as a reasonable person declare that I will spend an unlimited amount of other people’s money on a given cause and means to an end because that leads quickly to a tragic end. You cannot even spend a limited amount without looking at what other needs most suffer. Human lives are involved in these decisions, but unfortunately for the public and fortunately for the political spender the only lives and potential good that are usually publicized are the entities that are obtaining the money or benefits from it being spent. Therein lies the problem.

  952. MikeM

    I think if you give rough estimates for those numbers, either you will see my point or I will see yours.

    The answers to those questions have anything to do with my “point”. I didn’t make a point. I had answered your question about the general purpose of flattening the curve. Answering those questions doesn’t affect what the intended purpose is.
    .
    What I was trying to tell you is based on what you wrote, I have no idea what point you are trying to make. I’m not saying it is right, wrong, sideways, pointless etc. I am saying: I have absolutely no idea what it is.
    .
    If you want to make a point, why don’t you just make it? Then perhaps support with some degree of clarity. Just posting something mysterious… That only results in me not having the slightest clue what you are trying to say.

  953. Mike M.
    I have a graphic that will perhaps clarify the intention of flattening the curve. It’s a cartoon–no actual numbers.

    I the graph above, the red curve indicates the daily number of cases (and likely ill people) without something like quarantine (and no vaccine.) The blue is the number with something like quarantine.
    The dashed line is some measure of hospital capacity– so perhaps ICU beds etc.

    The area under each curve is the total number of cases– and about the same in both cases. But the area under the curve but above the dashed is ill people who can’t get treated. The rate of death for this group is presumably higher.
    .
    I think this is the answer to your query about the purpose. The general idea is qualitative.

    Questions like how many people die, what happens and so on are important. But they don’t really affect what the purpose of flattening the curve is. It’s what I just described.
    .
    I should add: Saying both that you don’t understand the purpose and seeming to be trying to explain that the purpose has not been achieved doesn’t make any sense. If you say you actually don’t understand the purpose, obviously, you can’t explain how that purpose has not been achieved.

  954. Thomas Fuller (Comment #182790)
    April 13th, 2020 at 6:24 pm
    It seems that your equations are a bit forced. I think the costs of the shutdown should be apportioned to the number of illnesses/hospitalizations/deaths avoided. Not exactly an easy task.
    __________

    Yes, all three. Deaths aren’t the only bad thing about catching Covid-19. Those who leave hospitals alive may continue to suffer from the effects of the disease. Even those not sick enough to be hospitalized may be too ill to work for many days. The costs of the virus to the recovered is difficult to put in dollar terms, but is both an economic loss and quality of life loss.

    IMO, relating job loses to lives saved isn’t very meaningful. Death is permanent, unemployment can be temporary and vary in duration.

    The dollar cost of the lockdown in lost GDP and government expenditures for aid and recovery can be measured at some time in the the future. Then we may be able to see whether the lockdown was a good idea. Then again, it may never be clear.

  955. lucia,

    The cartoon is a lie. I don’t see how it can work that way, at least not given the claims about how bad this could get. Qualitatively yes, but the numbers make no sense. A cartoon should not be the basis for a multi-trillion dollar expenditure and ruining peoples’ lives

    The current IHME projection shows a shortage of both hospital beds and ICU beds. That is with just 2-3% of the original projected numbers of deaths and no more than a few percent of the projected number of cases. So the cartoon should have the capacity line right down against zero. Or the “without measures” line up through the ceiling.

    The area under the two curves is about the same. The IHME projected curve has an average width of about 4 weeks for the country as a whole, quite a bit less for individual states. I am doubtful that it could have been much narrower. So either there never really was that much of a problem or most of the problem is still there and is not being dealt with; it is only being put off. Either way, we are being lied to.

    Maybe 90% of the population has natural immunity and 90% of cases are undetected, so that we are already well on the way to herd immunity. In that case we might be fine, but we would have been fine without the massive economic and human damage. Otherwise we have just kicked the can down the road a bit, at massive cost in both lives and treasure. It is insane.

  956. Mark, are you familiar with VAR (Value at Risk) as a concept? It might inform your thinking on this.

  957. MikeM,
    There are no numbers on the cartoon. So it doesn’t make sense for you to claim numbers that don’t exist don’t make sense!
    .
    The cartoon is just an explanation of a qualitative idea. I don’t know in what sense you think it is “a lie”.
    .
    The cartoon shows a shortage of resources in both cases. That doesn’t conflict with what IHME showing a shortage. Qualitatively it matches it. (Numbers might not– but then you’ve given no numbers.)
    .

    The area under the two curves is about the same.

    The total area is about the same.

    The area between the dashed line and the top of the curves is dramatically different. The areas that are different would represent sick people who can’t be treated

    FWIW: It looks like so far, we’ve managed to avoid overwhelming hospital capacities, so what what’s happened so far looks more like the blue curve than the red one. Whether the red one would have happened, and whether the cost of saving the lives that might have ended if we’d followed the red curve is, to some extent a value judgement.

    But I don’t see how you can say anything about that cartoon is a “lie”.

    The IHME projected curve has an average width of about 4 weeks for the country as a whole, quite a bit less for individual states.

    Is this projected curve you are discussing with or without “stay at home”? Can you provide a link to the curve which might include a title, axis labels and a figure caption? (I’ll be happy to screen shot so we can discuss it.)
    .

    Either way, we are being lied to.

    I have no idea what you think is “a lie”.
    .

    Maybe 90% of the population has natural immunity and 90% of cases are undetected,

    Sure. Maybe. I think it’s rather unlikely given that this is a new virus and we know the reproduction rate initially was probably at least 2. That would be a rather amazing feat if the natural immunity was 90%. But who knows– maybe it could turn out to be the case.

    That’s a subject change from all the previous.
    .
    Look: it’s fine look at numbers and suggest that maybe the economic cost was too high. But you are trying to say something about projections, beds and so on and not being remotely clear about how those fit the idea of “flatten the curve”.

  958. lucia (Comment #182810

    lucia, thanks for posting and commenting on that graph. Your explanation was concise and very easy to understand. I followed up by finding and watching the video.

  959. Lucia, Mike M,
    The cartoon curves are exactly the justification that was used initially to start forcing businesses to close, schools to close, people to stay at home, etc.
    .
    That has completely changed. Politicians are now talking about many lives their policies are “saving”. Thomas (up thread) appears to be parroting that same notion. The switch from “flatten the curve” to “saving lives” is the part that is dubious…. not the obvious concept that it is advantageous to avoid overwhelming the health care system. I suspect an argument could be made that aggressive isolation, testing, tracking, and putting infective people in quarantine can actually save lives (reducing the area under the flatter curve), especially if that buys enough time to develop treatments that save lives or an effective vaccine. But as far as I can tell, nobody has actually been making that argument, or if they have, it is not being clearly stated. Certainly Fauci and Birx have NOT been making that argument, probably because they know it is rubbish. Right now, most of what we hear on TV about the objectives of Federal and state policies is the purest form of BS.
    .
    This scene from Ghostbusters says it all: https://m.youtube.com/watch?v=uo2aVSqh9Mk

  960. SteveF,
    Flattening the curve may be saving lives since the death rate would likely be higher if people couldn’t be treated. But we really don’t know how many. Eventually, someone will have better parameter estimates and they’ll hindcast it. We’ll get a big range of hindcasts. We’ll never know the number.
    .
    It is obvious we can’t be shut down forever or even much, much longer. We still don’t have track/trace. I haven’t heard any plans to isolate after we hit a low enough level of infections to be able to do that.
    .
    I think people aren’t announcing plans because they don’t know have specific plan.

  961. I could draw a cartoon curve of how we can transition easily to 100% solar energy in 10 years. And then we’ll all be drinking that free Bubble Up and eating that Rainbow Stew.
    .
    Not only that, but my cartoon would be irrefutable. If anyone tries to argue that the numbers don’t work, I could just follow lucia’s example and say “Irrelevant. There are no numbers on the cartoon”.
    .
    The ‘do nothing’ curve eventually declines because of herd immunity. The flattened curve eventually declines because of herd immunity, it just takes longer to get there. But we have apparently gotten there *sooner* than anyone predicted without taking action. Not possible.
    ————

    SteveF (Comment #182817): ” The switch from “flatten the curve” to “saving lives” is the part that is dubious”.
    .
    Indeed. But I would use stronger language: The switch reveals the lie.
    ——-

    Edit: The Imperial College projection that drove the current policy had the death rate peaking in late June. That was the basis of the no intervention curve.
    https://theintercept.com/2020/03/17/coronavirus-air-pollution/

  962. Lucia,
    “ I think people aren’t announcing plans because they don’t know have specific plan.”
    .
    In many cases, if not most, that is certainly true. Beheaded chickens don’t have plans. Just remember to buy your tomato seedlings before you go to Michigan. And forget about re-painting the spare bedroom if you live in Michigan…..not allowed. Petty tyrants run wild when rational thinking is overrun by fear.

  963. Here is an alternative, data-driven view of how the epidemic evolves:
    “This is how it is all over the world. Both in countries where they have taken closure steps, like Italy, and in countries that have not had closures, like Taiwan or Singapore. In such and such countries, there is an increase until the fourth to sixth week, and immediately thereafter, moderation until during the eighth week, it disappears.”
    https://jewishjournal.com/israel/314118/israeli-space-agency-chair-says-israel-is-in-final-stages-of-coronavirus-pandemic/
    .
    I am guessing that will end up being closer to the truth than anything the experts have been saying.

  964. MikeM,
    It’s perfectly legitimate to draw cartoon curves to communicate ideas that are also discussed in a narrative. There are no numbers on the cartoon. If you want to “refute” the ideas that
    (1) Stay at home lowers the rate of transmission,
    (2) Consequently lowers the total number of infected on a day without changing the total infected over time and
    (3) Consequently reduces the instantaneous need for treatments (like ICU beds etc.) and
    (4) Has the potential for saving lives by reducing the number of ill who get no treatment at all.
    .
    Have at it.
    .
    There may be good reasons not to adopt the policy of “flattiening the curve”. But you absolutely haven’t advanced them all. Complaining the curve is a cartoon, is pretty lame.
    .
    As for the switch revealing the lie: I actually don’t think so. Either the those saying int think (4) (which is not implausible) OR they don’t actually understand what flattening the curve really does (also not implausible.)
    .
    If you think flattening the curve saves zero lives, you should ask yourself if your really think Boris Johnson would have lived if he hadn’t been treated in ICU. I, for one, seriously doubt it.
    .
    Flattening the curve probably does save at least some lives. We don’t know how many. And one can ask at what cost to the economy. But I’m pretty darn sure at least some lives are saved, so claiming so is not a “lie”.

  965. Mike M,
    “The flattened curve eventually declines because of herd immunity, it just takes longer to get there. But we have apparently gotten there *sooner* than anyone predicted without taking action. Not possible.”
    .
    I think it is a bit more complicated than that. The simplistic gaussian curves with equal areas assume constant infectivity, and only herd immunity leads to the illness dying out. But that is not really the case. The illness declines on its own whenever the net rate of new infection per infected person drops below one. The shape of that declining curve depends on the duration of individual infectivity and how far below the value of 1 the net rate of transmission has been driven. Driving the net rate of transmission below 1 would be only due to herd immunity (perhaps combined with natural immunity for a fraction of the population) in the absence of any changes in social behavior. But it can also be due to widespread social isolation, effective tracking and isolation of infective carriers, or a combination of those along with growing herd immunity.
    .
    It seems to me that individual isolation, closing restaurants, quarantines of infective individuals, etc are likely to have reduced the rate of transmission below 1 in all the places where new case rates are already falling (eg in Florida). How fast those new case rates fall in the coming weeks will show us how far below 1 the net transmission rate has dropped.
    .
    The problem is that current policies are enormously damaging to the economy. We can’t afford to shut down the economy for many months, and the number of lives “saved” will never justify the long term costs. I believe we could implement different policies which would be more effective at “saving lives” by keeping the net transmission rate well below 1, but far less economically damaging. That is the conversation I think people should be having, not shrill arguments and accusations about ventilators, N95 masks, border closings, etc. That is all beside the point.

  966. lucia (Comment #182823): “If you want to “refute” the ideas that”
    .
    Challenge accepted. I predict that the number of daily deaths will soon peak (if it has not already) and will drop to near zero with 60K +/- 20K deaths. As opposed to the curve flattening prediction of te death rate remaining high until there are a few hundred thousand deaths.
    ———-

    SteveF (Comment #182824): “I think it is a bit more complicated than that. ”
    .
    Indeed. That is my claim.

    We *might* be truncating the curve, but we are most certainly not flattening it. But if that is so, then we are just kicking the can down the road, not actually solving any problem. Without a plan for actually solving the problem, it is a waste of lives and treasure.
    .
    SteveF: ” I believe we could implement different policies which would be more effective at “saving lives” by keeping the net transmission rate well below 1, but far less economically damaging. That is the conversation I think people should be having”.
    .
    I wholeheartedly support that. Lacking a vaccine, the only potentially effective societal immune system that I know of consists of tracing and isolating those who are sick. There is some of that going on, but many states don’t even seem to be trying. That is a disgrace.

    A large number of cases is not an excuse to not trace and isolate. It might be that at first it can’t keep up, but even so it slows the growth. But as the immune system ramps up it can eventually overwhelm the infection.

    Ramping up a trace and isolate system really doesn’t cost much more than not doing so. There are hundreds of thousands of unemployed healthcare workers available to do the work. And millions of empty hotel rooms available for isolation.

  967. SteveF,
    I also think we need to come up with new policies that are more along the lines of isolate, track, trace. I also think three weeks ago we were not in a position to do that. But we may be now, and certainly, good leadership should be trying to propose methods to do that.
    .
    We are also going to need travel restrictions which will include enforcing quarantine for people who travel into some regions where mixing is currently fairly save.
    .
    Given current situations, people living in New York City and adjacent area should not be allowed to just fly to Montana, Wyoming, Iowa or what have you without being forced to quarantine for 14 days after they arrive. Same for people in Chicago or its collar counties.
    .
    People in Galena? Probably fine to move around but they also probably aren’t flying to spend time on some dude-ranch/bed-breakfast in Montana.
    .
    Inside states, different levels of “stay at home” could be applied (also with similar travel restrictions.) Tolono, Illinois can probably keep its sit down restaurants open provided they can keep students from Urbana from driving out there just because. Chicago probably needs to continue requiring take-out-only. But at the same time, we would need someway to reign in those in the more heavily locked down communities from deciding to just drive out and back to have outings.
    .
    I have no idea how we implement and enforce something like this. But we do need some guidelines for how it is going to be done.

  968. MikeM

    Challenge accepted. I predict that the number of daily deaths will soon peak (if it has not already)

    So…. you are predicting stay at home works as intended. I’m not seeing how that would refute what those advising it claim.

  970. And then there are these models or perhaps incomplete models.

    “Two months of mitigations have not improved the outcome of the epidemic in this model, it has just delayed its terrible effects. In fact, because of the role of weather in the model presented in the Kristof article, two months of mitigations actually results in 50% more infections and deaths than two weeks of mitigations, since it pushes the peak of the epidemic to the winter instead of the summer, whose warmer months this model assumes causes lower transmission rates…

    The same thing plays out in other papers modeling a low number of infections or deaths from short-term suppression efforts. For example, Murray’s paper models 4 months of mitigations, but only models the epidemic over a 4 month period, ending in July. He concludes that less than 100,000 people will die in his model. But what happens in August? He obtains improvement in death rates in his model precisely because a small minority of the population becomes infected in his mitigation window. (In fact, because his approach is based on fitting a model to current data, it is unable to model a world in which transmission levels have returned to normal.) In fact, as soon as transmission levels increase, a large epidemic will follow, which he would detect if he did model the epidemic past 4 months. Similarly, in the Lancet study modeling mitigations in Wuhan, the only effect of delaying the end of mitigations is to delay the epidemic; infections are “reduced” in “mid-2020” and “end-2020”, but increased at later time-points…

    For two months of containment to be better than two weeks of containment, the situation on the ground has to change”

    https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-modeling-5c156686a64b

  972. Uhnmm. No mike. The argument for “flatten the curve” predicts:

    1) If you DON’T do something like stay at home, the deaths will will continue to rise
    2) If you DO do something like “stay at home” the effective reproduction rate will drop. If
    (a) Reff remains above 1, the graph looks like the blue graph.
    (b) Reff falls below 1, the death rate will peak and drop.

    So: what you are taking as evidence that stay at home does NOT work is *precisely* what the argument for stay at home predicts IF we stay at home, in the event (b) occurs. So it means “stay at home” worked BETTER than the people making the blue graph suggested.

  973. I think the actual curve will probably be as DeWitt indicates, a “bell curve” with a steep rise (no social distancing) and a slow decline (with social distancing). A hybrid of the red/blue curves. The rate of the decline will be controlled by parameters such as population density and the effectiveness of the social distancing policies. Had the social distancing been in place from the beginning (which doesn’t make much sense) then it might be closer to a true bell curve.
    .
    I doubt they know what any particular region’s rate of decline will be very accurately.

  974. It appear the politicians are banding together in groups so none of them will be first out to open their economies and be thrown to the liberal media “blood on your hands” wolves.

  975. I would suggest (cost to implement policies) / (lives saved) is the overall calculation to make. This has so much uncertainty that it might be an academic exercise and have no useful value in the real world. The costs are the loss of economic activity, the debt burden, opportunity costs, etc.
    .
    The real challenge is the find a useful and directly measurable real time proxy for this number to gauge when to lock down and reopen economic activity. Good luck with that.

  976. lucia (Comment #182831),

    You need to read and understand Kenneth Fritsch’s excellent Comment #182829. The models that form the basis of your argument are basically the same models he is referring to.
    .
    lucia: “So: what you are taking as evidence that stay at home does NOT work is *precisely* what the argument for stay at home predicts IF we stay at home, in the event (b) occurs. So it means “stay at home” worked BETTER than the people making the blue graph suggested.”
    .
    Stay at home is irrelevant to what I am saying. My claim is that we are *not* on the “flatten the curve” trajectory. Not even close.
    .
    Maybe we have been following a very different strategy of the sort that worked with SARS: contain until it goes away for good. But given the assumptions being made, that has only three ways to resolve:

    (1) Drive the virus into virtual extinction, as was done with SARS. It looks like there is no real chance of that.

    (2) Knock the epidemic down, then adopt a different strategy for when it comes back. I see no indication that is being done.

    (3) Catastrophe, as in the models described above by Kenneth Fritsch (Comment #182829).
    ————

    On the other hand, maybe the experts have absolutely no idea what has been going on and have spectacularly overestimated the problem. I am hoping for that one.

  977. DeWitt, Dr. Deborah Birx early in the crisis showed a graph shape without numbers of predicted Covid-19 cases (maybe deaths) with a steep climb to a peak and then a slower receding rate after the peak. I believe she said that was the more typical shape of the curve for this type of virus. The models show a decline to zero new deaths and thus I assume zero new cases. Is that merely an artifact of drawing the model curve and not a realistic outcome? Are those models indicating that zero new cases can be obtained without a vaccine or herd immunity and merely by a few months of strict mitigation?

    My questions I guess boils down to the issue of what happens when the mitigations are relaxed or lifted. If we as a nation are not completely isolated from infected outsiders or if not all potential infections can be eliminated in the nation by mitigations how many unidentified infected individuals are required to start a new surge of infections? Do we have any clues or estimates from the beginnings of the infections in this country?

  978. It is quite unclear how social distancing gets us to a virtual elimination of the virus in a region as it allegedly has done in China. It would seem more likely to put us on a slow burn for a long time.

  979. Lucia,
    “Given current situations, people living in New York City and adjacent area should not be allowed to just fly to Montana, Wyoming, Iowa or what have you without being forced to quarantine for 14 days after they arrive. Same for people in Chicago or its collar counties.”
    .
    That would be really hard to enforce, even if it stood up to constitutional challenges…. which I doubt it would, except maybe as a very short term emergency rule.
    .
    I think a smart approach is to 1) focus on very widespread testing (especially of asymptomatic people), 2) track and quarantine carriers, 3) work to keep people who are at greatest risk as isolated as possible (Florida nursing homes are trying to do just that), and 4) being more flexible about where forced closings (schools, restaurants, businesses) make sense. Aggressive reduction in personal contacts is more suitable in high population density areas, where you might cross paths with hundreds of people a day versus someplace where you might cross paths with 10 a day. Forcing Mama Leone’s in NYC to close may be perfectly reasonable. Forcing Maria’s Mexican in Great Falls, Montana to close may not be at all reasonable.
    .
    Ultimately, only effective treatments for those who get the virus, or an effective vaccine, will eliminate the problem. The economic damage we suffer before achieving those needs to be minimized.

  980. Tom Scharf,

    You can’t believe anything the Chinese government says. A report cited in an op-ed in today’s WSJ estimates that the total cases in China are more like 2.9 million instead of the 80,000 reported. If you think that China couldn’t possibly hide that many cases and the associated deaths, you’re not paying attention. The possible survival of the current regime is at stake.

    What worries Beijing most is public opinion at home. The two sources of the Chinese Communist Party’s legitimacy—its technocratic skill and its ability to increase China’s prestige abroad—are challenged both by the epidemic and the government’s flailing response to it.

    After seven decades in power, the party still depends on a governance system that combines arbitrary rule, brutal repression, eye-popping corruption and massive levels of deception, fraud and abuse. The coronavirus outbreak, concealed as long as possible from the higher-ups by the usual self-dealing cliques of local officials, cruelly exposed the gap between the imposing image Beijing seeks to project and the gritty, unsavory realities of one-party rule.

  981. Updating Italy, worldometers.info reports 602 new deaths for a total of 21,067 deaths today while IHME projects a total of 21,130 deaths by August 4 and 192 (85-385) deaths for today. Eyeballing, I would guess Italy will get to 30,000 deaths by August 4 and the daily deaths and new cases will still not be zero.

  982. I ginned up a simple model in R. The result is: Flattening the curve should save lives even without considering the issue about whether the hospitals are overwhelmed.

  983. DeWitt,
    The new case rate in Florida looks like is is dropping only very slowly…. no surprise if the effective rate of transmission is just slightly under 1.0.
    .
    Italy has 60 million people. If they lose 40,000 total, that would be 0.067% of the population. It will be interesting to see how ‘bad boy’ Sweden, that has done essentially nothing (the horror!) compares to Italy later this year. U of Washington’s model predicts Sweden at 18,000 deaths by August, or 0.18% of the population….. I doubt it.

  985. MikeM

    Stay at home is irrelevant to what I am saying. My claim is that we are *not* on the “flatten the curve” trajectory. Not even close.

    We are in the trajectory one would expect if
    * Stay at home reduced the effective transmission, Reff and
    * It did so BETTER than the “flatten” suggest. (We are on a “kill it” curve.)

    Mind you: we probably can’t stay on a “kill it” curve for economic reasons. But what we are seeing is consistent with: Stay at home doing BETTER than mere flattening, but other wise doing just what we hoped.

    I don’t know what you other point you are trying to advance. But if it’s taht stay at home is NOT reducing the infection rate, obviously, you can’t demonstrating that the infection rate dropped after stay at home was put in place.

    Anyway,I’ve ginned up a toy model to show a few things. It will be oversimplified, but I’ll show some stuff tomorrow.

  986. lucia (Comment #182845): “Anyway,I’ve ginned up a toy model to show a few things. It will be oversimplified, but I’ll show some stuff tomorrow.”
    .
    I suggest you try:

    (1) Let it run with R = 3, say.

    (2) Reduce R to say, 1.5. That should give you something like the flattened curve in the cartoon with a peak much lower and later than in (1), and much broader.

    (3) Let it run a bit with R = 3, then reduce R to 0.5 or so. That should give a peak that is much lower and earlier than (1) but with a width more like (1) than (2). That is somewhat like what has been done *if* what we are doing fits into the claimed framework.

    (4) Like (3) but let R go back up to 3 before the cases drop to zero. Uh-oh. That is the issue I am raising.

    If we are on the “kill it” curve, then there is a huge problem: IT WON’T STAY DEAD.

  987. SteveF (Comment #182839): “I think a smart approach is to 1) focus on very widespread testing (especially of asymptomatic people), 2) track and quarantine carriers, 3) work to keep people who are at greatest risk as isolated as possible (Florida nursing homes are trying to do just that), and 4) being more flexible about where forced closings (schools, restaurants, businesses) make sense.”
    .
    Yes, that would be smart. Although I am not sure of the value of testing asymptomatic people unless there is reason to believe they have been infected. But a random sample of asymptomatic people would be useful for understanding.

  988. My wife’s company just announced mandatory temperature screening upon work entry. They are also mandating social distancing at work, whatever that means. This looks like initial prep for leaving stay at home order by government.
    .
    If companies could pay for weekly testing of the entire workforce that would go a long way to defeating this. If they could get the cost down to say $5/test and ramp up kits then maybe it’s possible.

  989. In order to save our health system it was necessary to destroy it.
    .

    “ Mayo Clinic Forced To Cut $1.4 Billion In Pay After Walz Order Guts Business….. Mayo Clinic has unveiled a plan to cut $1.6 billion in pay, withdraw nearly $1 billion from its financial reserves and save another $700 million through a hiring freeze to counteract a $3 billion loss inflicted by the coronavirus….
    A large portion of this loss was the result of Governor Tim Walz’s ban on non-essential procedures that has cost Mayo up to 75% of its business in some areas…”
    .
    https://alphanewsmn.com/mayo-cut-pay-walz/

  990. Ed Forbes,

    I would say that the State of MN owes the Mayo Clinic $1.4 billion, at least. Considering that MN has almost the lowest number of active cases per million people, the restriction on ‘non-essential’ procedures is completely unwarranted. Ask someone with a bad knee or hip if replacing the joint is not essential. Delay a joint replacement long enough and the patient becomes an invalid due to muscle atrophy. That’s the sort of thing that happens in the UK.

    Speaking of national health services, I wonder what Canadians are doing now that they don’t have the US to rely on when the waiting time in Canada is too long? Real question.

  991. Thomas Fuller (Comment #182813)
April 13th, 2020 at 9:58 pm
    Mark, are you familiar with VAR (Value at Risk) as a concept? It might inform your thinking on this.
    ___________

    Thomas, I don’t know if mark is going to reply, so I would like to see if I understand what you mean.

    For an investment, Value at Risk (VAR) is a formula for estimating the maximum that can be lost over a given time period. I believe “maximum” here means worst scenario.

    I don’t know whether the VAR formula could be adapted to estimating the maximum lives that could be lost as a result of Covid-19, but the idea of maximum at risk applies.

    The worst scenario for total number of Americans infected with Covid-19 is everyone exposed since no one had immunity to this virus. Actually some exposed people may successfully resist infection, but that number is unknown.

    The worst scenario for total number of Americans becoming seriously infected could be 105 million (see following paragraph).

    “More than a third of American adults — or 105 million people — are at higher risk of serious illness if they get infected with the coronavirus, according to a Kaiser Family Foundation analysis of CDC data. For most of them, their age puts them in danger: More than 76 million Americans are 60 or older. The remaining 29 million people are younger but have underlying health issues.”
    https://publicintegrity.org/health/coronavirus-and-inequality/pre-existing-inequality-could-make-coronavirus-hit-some-harder/

    The worst scenario for total number of Americans killed by Covid-19 would be estimated using the mortality rate for the above 105 million.

    Thomas, this was simplistic attempt to get at what you mean by Value at Risk. Please correct me if I have the wrong idea.

  992. Ed Forbes (Comment #182850): “In order to save our health system it was necessary to destroy it.”
    .
    Indeed. It is pure madness. It would be one thing if that were so that health care workers could be transferred to treating the sick, looking after the quarantined, and tracing contacts. But no, they are just left to twiddle their thumbs.
    .
    DeWitt Payne (Comment #182851): “Ask someone with a bad knee or hip if replacing the joint is not essential. Delay a joint replacement long enough and the patient becomes an invalid due to muscle atrophy. That’s the sort of thing that happens in the UK.”
    .
    It happens in Canada also. Some give up on the wait and decide to pay out of their own pocket. If they have enough money, they go to the U.S., otherwise to some medical tourism country like India or Costa Rica. I guess they are now stuck.

  993. Walz is a dedicated socialist; he appears quite in love with the CCP. Destroying wealth is what socialists do. It is also what they want to do….. because they believe it is always the right thing to do.

  994. DeWitt Payne (Comment #182851)
    Speaking of national health services, I wonder what Canadians are doing now that they don’t have the US to rely on when the waiting time in Canada is too long? Real question.
    ___________

    It works both ways. Canada doesn’t put high priority on hip and knee replacement and some other non life-threatening surgeries, and waits are long, so rather than wait some Canadians go to other countries for these surgeries despite the cost, the U.S. being one. Conversely, some Americans (though a smaller number) go to Canada in cases where there’s a cost savings or treatments are more advanced or not available in the U.S.( remember Rand Paul).

    Canada has a much lower Covid-19 death rate than the U.S., 2.5 per 100K pop. compared to 7.19 per 100K pop., and only slightly less hospital bed capacity. This suggest Canadians who need hospital beds for non Covid-19 reasons may get surgeries sooner than we in the U.S.

    On the other hand, the difference in death rates may mean something else. Perhaps older Canadians are hospitalized for Covid-19 at the same rate as older Americans, but are healthier and less likely to die from the virus.

  995. OK_Max,

    Canada has a much lower Covid-19 death rate than the U.S., 2.5 per 100K pop. compared to 7.19 per 100K pop.,

    Canada doesn’t have New York and New Jersey. Take those two states out and you account for more than half the deaths in the US. Then the death rate in the rest of the US is about 4/100k, not all that different from Canada. The death rate in New York is 52/100k and 27/100k in New Jersey. If you look by county in New York, you have New York City with 90/100k, Nassau county with 68/100k, Rockland county with 64/100k, Westchester county with 59/100k, Suffolk county with 38/100k and Orange county with 34/100k. All these counties are in close proximity to NYC.

    It’s likely that the death rate in NYC is a lower limit. A large number of people who died at home were never tested.

    There’s also circumstantial evidence that Canada is catching a higher percentage of infected. Canada has a high ratio of recoveries to deaths.

  996. DeWitt Payne (Comment #182858)
    OK_Max,

    Canada has a much lower Covid-19 death rate than the U.S., 2.5 per 100K pop. compared to 7.19 per 100K pop.,

    Canada doesn’t have New York and New Jersey. Take those two states out and you account for more than half the deaths in the US.
    ______

    Then also take Toronto and Montreal out of Canada.

  998. OK_Max,

    Then also take Toronto and Montreal out of Canada.

    Why? Do you have the data for Toronto and Montreal that makes them hotspots on the order of New York and New Jersey? Notice that I didn’t take out a lot of other large cities in the US like Los Angeles, Chicago, Houston, Phoenix and Philadelphia or states like California, Texas and Florida, all of which have a higher population than New York. New Jersey is eleventh by population. Toronto also has half the population density of NYC.

    MikeN,

    dunno. I don’t have that data. However, I seriously doubt that any hot spot in Canada is anywhere close to the New York City area.

  999. OK_Max (Comment #182859): “Then also take Toronto and Montreal out of Canada.”
    .
    Nonsense. Toronto and Montreal are nothing like New York. More like Boston, Chicago, Seattle, etc.
    ———–
    DeWitt Payne (Comment #182858): “It’s likely that the death rate in NYC is a lower limit. A large number of people who died at home were never tested.”
    .
    A lot who died in hospitals were never tested. But they are now being added to the count anyway:
    https://www.dailywire.com/news/nyc-officials-start-adding-people-who-never-tested-positive-to-total-deaths-from-virus

    “On Tuesday, New York City added a huge number of deaths to the total number of deaths caused by the coronavirus after deciding to include over 3,700 victims who had not tested positive for the virus but were presumed to have the virus because of their symptoms and medical history.”

    “New York City is not alone; Connecticut, Delaware, Maryland and Ohio have started reporting probable cases of coronavirus-affected death”.
    ——
    Hey, they have to do something. New cases are dropping. Deaths have leveled off and will likely soon start dropping. The pot must be kept at a boil.

    Never let a crisis go to waste.

  1000. Mike M.,

    “On Tuesday, New York City added a huge number of deaths to the total number of deaths caused by the coronavirus after deciding to include over 3,700 victims who had not tested positive for the virus but were presumed to have the virus because of their symptoms and medical history.”

    worldometers.info doesn’t show this spike. It’s already in their data and in the Wikipedia New York pandemic page. Perhaps the lower count was what de Blasio was reporting. worldometers.info had NY with 10,056 deaths yesterday before this story broke and 10,834 today.

  1001. The counties in New Jersey with the highest number of cases are right across the Hudson river from New York City. The number of cases diffuses outward across the state from those counties. That’s why I included New Jersey.

  1003. Mike M. (Comment #182863)
    April 14th, 2020 at 4:30 pm
    OK_Max (Comment #182859): “Then also take Toronto and Montreal out of Canada.”
    .
    Nonsense. Toronto and Montreal are nothing like New York. More like Boston, Chicago, Seattle, etc
    ______

    I don’t get your point. I didn’t say Toronto was like N.Y. I didn’t even say Toronto was like Montreal.

    My point was if comparing statistics for the U.S. and Canada, removing N.Y and N.J. doesn’t leave you with a comparison of the two countries.

  1004. DaveJR,
    That is very interesting. Six asymptomatic women with Covid 19 per symptomatic woman. That’s a lot. If that is typical, then there are a lot of asymptomatic people who are never going to be found without extensive random antibody screening.

  1005. DeWitt Payne (Comment #182864): “”worldometers.info doesn’t show this spike. It’s already in their data and in the Wikipedia New York pandemic page. Perhaps the lower count was what de Blasio was reporting. worldometers.info had NY with 10,056 deaths yesterday before this story broke and 10,834 today.”
    .
    You are confusing New York with New York City. Wikipedia shows 6,589 deaths for the latter, that does not include the new additions. Perhaps they will keep it that way. It will be interesting to see what various sources do.

  1007. OK_Max,

    My point was if comparing statistics for the U.S. and Canada, removing N.Y and N.J. doesn’t leave you with a comparison of the two countries.

    Sure it does. Canada doesn’t have a metropolitan area with the population density of the New York City area that includes the adjacent parts of New Jersey. Remove that and population densities compare better. OTOH, remove Toronto and Montreal and you hardly have any high population density centers left in Canada

  1008. DeWitt Payne (Comment #182862)
    April 14th, 2020 at 4:29 pm
    OK_Max,

    Then also take Toronto and Montreal out of Canada.

    Why?
    _________

    My point is a comparison between Canada and the United States (excluding N.Y. and N.J.) is not a comparison of the two countries.

    If you are interested in comparing population density keep in mind that a large proportion of Canada’s area is almost or totally uninhabited, which results in a misleadingly low persons per square mile statistic. For a meaningful comparison of population density, we need to fill the blanks in the sentence that follows or something similar:

    Ninety-percent of Canada’s population resides in areas totaling _____ square miles, while 90 percent of the United State’s population resides in areas totaling ______ square miles.

    These statistics may be available somewhere, but I haven’t found them.

  1009. SteveF,

    …there are a lot of asymptomatic people who are never going to be found without extensive random antibody screening.

    And this surprises you why? It would only surprise me if there were about the same number of asymptomatic as symptomatic. I’ve been expecting at least an order of magnitude difference. Given the small number tested, I don’t believe a factor of ten difference can be ruled out.

  1010. OK_Max,

    I assume you’ve never driven through West Texas, New Mexico and Arizona on the way to California, not to mention North and South Dakota and Montana or Alaska. Sure Canada has the Great North Woods, but the US has large areas of low population density too. But I say again, there’s nothing in Canada that compares with the New York City area.

  1011. DeWitt,
    It doesn’t surprise me; it is a confirmation of what many people have suspected. It especially confirms that the actual fatality rate per infection is quite low…. certainly below 1% and probably much lower than that.

    Two interesting questions remain: 1) why does the illness vary so widely in symptoms, even among people who belong to groups that are on average at very low risk, and 2) is there a population that is refractory, and don’t ever get even asymptomatic disease, despite exposure….. and if so, why. Many papers to come.

  1012. Steve McIntyre posted on Twitter about a week ago that Toronto was doing better than Ontario.

  1013. Any antibody testing would have to first show that they are not creating false positives for the other types of coronaviruses, particularly SARS. This is a critique of a study that concluded 15% infected rate for a town in Germany where they tested a majority of the population. 2% infected, 14% positive for antibodies, 1% overlap.

  1014. DeWitt Payne (Comment #182874)
    April 14th, 2020 at 6:32 pm
    OK_Max,

    **I assume you’ve never driven through West Texas, New Mexico and Arizona on the way to California, not to mention North and South Dakota and Montana or Alaska.”**

    DeWitt, I’ve driven from Oklahoma to California and back many times. But never on old Route 66 where you can get your kicks.

    **Sure Canada has the Great North Woods, but the US has large areas of low population density too.**

    Not as much as Canada. It’s the world’s second largest country in land area.

    **But I say again, there’s nothing in Canada that compares with the New York City area.**

    Sure, no Canadian metro area has as much population as the New York metro area and probably none has as much population per square mile. But Canada’s population is concentrated near the U.S. border, whereas the U.S. population is more scattered across the country.

  1016. David Young (Comment #182907)

    Quoted from David Young’s link:
    “So, roughly speaking, we might say that getting COVID-19 is like packing a year’s worth of risk into a week or two. Which is why it’s important to spread out the infections to avoid the NHS being overwhelmed.”
    _________

    Another way of looking at it.

  1017. OK_Max,

    But Canada’s population is concentrated near the U.S. border, whereas the U.S. population is more scattered across the country.

    And this argues against the subtraction of New York and New Jersey before comparing the US death rate to Canada how? If you just look at the parts of Canada where people actually live, it looks a lot like the rest of the US outside of the New York City area where the population density can be twice that of Toronto.

  1018. DeWitt Payne (Comment #182919)
    April 15th, 2020 at 11:35 am
    OK_Max,

    ** If you just look at the parts of Canada where people actually live, it looks a lot like the rest of the US outside of the New York City area where the population density can be twice that of Toronto.**
    ______________

    No, DeWitt, it does not look like that at all. Canada’s population is concentrated mostly in a line near the U.S. border. U.S population isn’t concentrated in a line.

    Please look at the third cartogram for Canada at
    http://metrocosm.com/canada-population-map/

    Also see the Canada maps at
    https://matadornetwork.com/read/mapped-canadas-incredible-population-density/

    BTW, the single largest concentration of Canadian population (more than 9 million) is in what’s called the Greater Golden Horseshoe, a stretch running across the north shore of Lake Erie, which includes the Greater Toronto Area, Hamilton, St. Catharines-Niagara, Oshawa, Kitchener-Waterloo, Barrie, Guelph, Brantford, Peterborough and places in between. My wife and I drove across it in the autumn of 2017 after attending a tattoo festival in Kingston, Ont. No, we didn’t get tattoos.

  1020. OK_Max,

    The fact that large parts of Canada are effectively uninhabited is irrelevant. If you just look at the populated areas in Canada, the population density distribution looks to me much like the US.

    The true comparison would be, as you wrote somewhere above, the population density for 90% or so of the population of both countries. But I haven’t been able to find that either.

    Also, you have never really effectively argued against the exclusion of the New York City area. Do you or do you not agree that the population density of the New York City area is higher by a factor of two or so than anywhere in Canada? The overall population densities of the two countries is a red herring.

    the single largest concentration of Canadian population (more than 9 million) is in what’s called the Greater Golden Horseshoe, a stretch running across the north shore of Lake Erie, which includes the Greater Toronto Area, Hamilton, St. Catharines-Niagara, Oshawa, Kitchener-Waterloo, Barrie, Guelph, Brantford, Peterborough and places in between.

    So? What’s the total area of that region? I’m betting that it’s a lot larger than the New York City area including Long Island, Westchester and Rockland County and the two or three counties in New Jersey across the Hudson River from NYC.

  1022. Re DeWitt Payne (Comment #182949)

    DeWitt, worldmeters says the populations of Canada and the U.S. have about the same degree of urbanization. About 82.8% of America’s 331 million residents live in urban areas, a slightly larger percentage than the 81.3% of Canada’s 37.7 million residents.

    Dewitt, the U.S. excluding New York would be less urbanized than Canada, which could distort comparisons of anything affected by population density, which I believe is what you are trying avoid in the first place by excluding New York’s Covid-19 cases.

    We know the two countries are different in some ways and similar in others, and we can keep that in mind when making comparisons.

    https://www.worldometers.info/world-population/canada-population/

    https://www.worldometers.info/world-population/us-population/

  1023. DeWitt got me interested in population density as a Covid-19 driver, so I looked into how many cities are real crowded, and now I’m feeling even worse about this disease. Thanks DeWitt.

    The 10 most densely populated cities in the world are listed below. The numbers are from a 2019 USAToday article that listed the 50 most densely populated foreign cities. The first number is total population and the second number is population per square mile.

    1. Mumbai, India 14,350,000 76,790
    2. Kolkata, India 12,700,000 61,945
    3. Karachi, Pakistan 9,800,000 49,000
    4. Lagos, Nigeria 3,400,000 47,027
    5. Shenzhen, China 8,000,000 44,464
    6. Seoul/Incheon, S. Korea 17,500,000 43,208
    7. Taipei, Taiwan 5,700,000 39,263
    8. Chennai, India 5,950,000 37,223
    9. Bogota, Colombia 7,000,000 35,000
    10. Shanghai, China 10,000,000 34,718
    https://www.usatoday.com/story/news/world/2019/07/11/the-50-most-densely-populated-cities-in-the-world/39664259/

    Had the list included American cities, New York City with a population of 8,550,405 and 27,000 residents per square mile would have been at about 17th or 18th place in the density ranking

    Considering how population density contributed to the Covid-19 toll in New York, it is scary to contemplate the potential for damage from the virus in so many even more crowded cities.

  1024. India has been on lockdown, with police forcing cart sellers off the streets. There is limited time for grocery purchases(which should then become more dense). Overall, the numbers have been low so far, with only citizens(not dual citizens) allowed to fly in. Muslims have been blamed after a large gathering in Delhi caused spread to other states.

  1025. Max_OK,

    I wouldn’t be too quick with a comparison of the US and Canada. Eyeballing the latest data at worldometers.info, Canada may well still be in the early stages of their COVID-19 epidemic. The last two days had the highest numbers of new cases per day and current active cases are bending up again, not down.

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